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Khawagi WY, Al-Kuraishy HM, Hussein NR, Al-Gareeb AI, Atef E, Elhussieny O, Alexiou A, Papadakis M, Jabir MS, Alshehri AA, Saad HM, Batiha GES. Depression and type 2 diabetes: A causal relationship and mechanistic pathway. Diabetes Obes Metab 2024; 26:3031-3044. [PMID: 38802993 DOI: 10.1111/dom.15630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024]
Abstract
Depression is a mood disorder that may increase risk for the development of insulin resistance (IR) and type 2 diabetes (T2D), and vice versa. However, the mechanistic pathway linking depression and T2D is not fully elucidated. The aim of this narrative review, therefore, was to discuss the possible link between depression and T2D. The coexistence of T2D and depression is twice as great compared to the occurrence of either condition independently. Hyperglycaemia and dyslipidaemia promote the incidence of depression by enhancing inflammation and reducing brain serotonin (5-hydroxytryptamine [5HT]). Dysregulation of insulin signalling in T2D impairs brain 5HT signalling, leading to the development of depression. Furthermore, depression is associated with the development of hyperglycaemia and poor glycaemic control. Psychological stress and depression promote the development of T2D. In conclusion, T2D could be a potential risk factor for the development of depression through the induction of inflammatory reactions and oxidative stress that affect brain neurotransmission. In addition, chronic stress in depression may induce the development of T2D through dysregulation of the hypothalamic-pituitary-adrenal axis and increase circulating cortisol levels, which triggers IR and T2D.
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Affiliation(s)
- Wael Y Khawagi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Nawar R Hussein
- College of Pharmacy, Pharmacology Department, Al-Farahidi University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Esraa Atef
- Respiratory Therapy Department, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Omnya Elhussieny
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, Egypt
| | - Athanasios Alexiou
- University Centre for Research & Development, Chandigarh University Chandigarh-Ludhiana Highway, Mohali, India
- Department of Research and Development, Funogen, Athens, Greece
- Department of Research and Development, AFNP Med, Wien, Austria
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
| | - Majid S Jabir
- Applied Science Department, University of Technology, Baghdad, Iraq
| | - Abdullah A Alshehri
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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Gouveri E, Gkouveri A, Popovic DS, Papazoglou D, Papanas N. Intentional Insulin Overdose and Depression in Subjects with and Without Diabetes Mellitus: A Commentary. Diabetes Ther 2024:10.1007/s13300-024-01623-5. [PMID: 39046697 DOI: 10.1007/s13300-024-01623-5] [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: 05/09/2024] [Accepted: 07/09/2024] [Indexed: 07/25/2024] Open
Abstract
Insulin is an essential medication for people with type 1 diabetes mellitus and for some people with type 2 diabetes. Interestingly, insulin abuse has been reported as a mode of suicide, not only among people with diabetes, but also among their relatives, and among medical and paramedical personnel who have access to insulin. The aim of the present commentary was to raise awareness of potential depression-related intentional insulin overdose and its complications, as well as of the diagnosis and treatment of this entity. Insulin overdose may lead to severe and prolonged hypoglycemia, hypoglycemic coma, and death. Moreover, hypokalemia, hypomagnesemia, hypophosphatemia, and elevated liver enzymes are common. Insulin overdose should be suspected among people with diabetes in case of unexplained prolonged hypoglycemia and among people without diabetes who exhibit hypoglycemia and may have access to diabetic medications. The ratio of insulin to C-peptide helps distinguish exogenous insulin administration from endogenous secretion. The cornerstone of therapy is prompt administration of concentrated glucose infusions for days with simultaneous oral intake, when possible, and intense glucose monitoring to prevent hypoglycemia. Moreover, monitoring of serum electrolyte levels is recommended. Finally, psychiatric evaluation aiming at early identification of depression and suicidality is of paramount importance.
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Affiliation(s)
- Evanthia Gouveri
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece
| | | | - Djordje S Popovic
- Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Vojvodina, Novi Sad, Serbia
- Medical Faculty, University of Novi Sad, Novi Sad, Serbia
| | - Dimitrios Papazoglou
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece
| | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece.
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Ni MH, Yang YS, Huang JY, Lo SC, Huang CN, Kornelius E. The association of depression and sleep disorders in patients with type 1 diabetes in Taiwan. Medicine (Baltimore) 2024; 103:e38969. [PMID: 39029051 DOI: 10.1097/md.0000000000038969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
The association between depression and sleep disorders in patients with type 1 diabetes mellitus (T1DM) in Taiwan is underexplored. We used a nationwide population-based dataset to evaluate the association of T1DM with these conditions in Taiwan from 2001 to 2019. Patients with T1DM were identified as cases, and 2 control groups were used for comparison: patients with type 2 diabetes mellitus (T2DM) and nondiabetic patients. Age, sex, date of diagnosis, and multiple comorbidities were included and matched using propensity score matching between cases and controls. The primary outcome of this study was to identify new occurrences of the first diagnosis of depression or sleep disorders. After matching, this study included 27,029 T1DM cases, 54,058 T2DM controls, and 108,116 nondiabetic controls. Patients with T1DM exhibited a 1.55-fold higher risk of developing depression (hazard ratio [HR] 1.55, 95% confidence intervals [CI] 1.48-1.61) and a 1.41-fold higher risk of experiencing sleep disorders (HR 1.41, 95% CI 1.37-1.46) compared to nondiabetic controls. Similarly, patients with T2DM displayed elevated risks of both depression (HR 1.39, 95% CI 1.34-1.43) and sleep disorders (HR 1.40, 95% CI 1.37-1.44) relative to non-diabetic controls. When comparing the T1DM and T2DM groups, T1DM patients demonstrated a slightly higher risk of depression (HR 1.11, 95% CI 1.07-1.16) but no significant difference in the risk of sleep disorders compared to T2DM patients. These results were consistent regardless of different ages or sexes. This study demonstrates a significant association between diabetes mellitus and the risk of depression and sleep disorders in a large cohort of Taiwanese patients.
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Affiliation(s)
- Meng-Han Ni
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Sun Yang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shih-Chang Lo
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chien-Ning Huang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Edy Kornelius
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital, Taichung, Taiwan
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4
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Al-Jabi SW. Emerging global interest: Unraveling the link between diabetes mellitus and depression. World J Psychiatry 2024; 14:1127-1139. [PMID: 39050204 PMCID: PMC11262933 DOI: 10.5498/wjp.v14.i7.1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/03/2024] [Accepted: 06/19/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Studies have shown a strong bidirectional association between diabetes and depression, with diabetes increasing the risk of developing depression and vice versa. Depression among patients with diabetes is associated with poor glycemic control, complications, and poor self-care. AIM To explore the present state of research globally concerning diabetes and depression, to aid understanding the current research landscape and identify potential future areas of research. METHODS A bibliometric approach was used, utilizing the Scopus database to gather pertinent research articles released from 2004 to 2023. Analyses encompassed publication patterns, significant contributors, research focal points, prevalent themes, and the most influential articles, aimed at discerning emerging research subjects. RESULTS A total of 3229 publications that met the search criteria were identified. A significant increase in the number of publications related to diabetes and depression has been observed in the past two decades. The most productive nation was the USA (n = 1015; 31.43%), followed by China (n = 325; 10.07%), the UK (n = 236; 7.31%), and Germany (n = 218; 6.75%). Three principal themes in research on depression and diabetes were delineated by the analysis. First, the exploration of the elevated prevalence and etiology of this comorbidity; second, the focus on interventions, particularly randomized controlled trials, aimed at enhancing diabetes management among individuals with depression; and finally, the investigation of the involved risk factors and biological mechanisms underlying this bidirectional relationship. CONCLUSION There has been a recent surge of interest in the relationship between diabetes and depression. This could aid researchers to identify areas lacking in the literature and shape future research.
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Affiliation(s)
- Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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5
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Wu Y, Su B, Zhong P, Zhao Y, Chen C, Zheng X. Association between chronic disease status and transitions in depressive symptoms among middle-aged and older Chinese population: Insights from a Markov model-based cohort study. J Affect Disord 2024:S0165-0327(24)01177-7. [PMID: 39032710 DOI: 10.1016/j.jad.2024.07.116] [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: 08/20/2023] [Revised: 06/27/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND The relationship between chronic disease status (CDS) and transitions in depressive symptoms (DS) remains unclear. This study explores the association between CDS and DS transitions. METHODS This cohort study analyzed data from 8175 participants aged 45+, sourced from China Family Panel Studies (2016, 2018, 2020). DS were assessed using a brief version of Center for Epidemiologic Studies Depression Scale (CES-D). CDS was categorized into healthy, single disease, and multimorbidity. Markov models were used to estimate state transition intensities, mean sojourn times and hazard ratios (HRs). RESULTS DS transitions occurred between adjacent and non-adjacent states, but transition intensity between adjacent states was higher than among non-adjacent states. Self-transition intensities of severe-DS, mild-DS, and non-DS progressively increased, with average durations of 1.365, 1.482, and 7.854 years, respectively. Both single disease and multimorbidity were significantly associated with an increased risk of transitioning from non-DS to mild-DS, with multimorbidity showing a stronger association. In contrast, HRs for single diseases transitioning from mild-DS to severe-DS were significantly lower than 1. Furthermore, their HRs were almost <1 in recovery transitions but not statistically significant. LIMITATIONS Specific chronic diseases and their combinations were not analyzed. CONCLUSIONS The progression of DS exhibits various pathways. CDS is associated with DS transitions, but the roles of single disease and multimorbidity may differ across different DS progression stages. Both conditions were significantly linked to the risk of new-onset DS, with multimorbidity posing a greater association. However, this relationship is not observed in other progression stages. These findings could provide insights for early prevention and intervention for DS.
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Affiliation(s)
- Yu Wu
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Binbin Su
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Panliang Zhong
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Yihao Zhao
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Chen Chen
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Xiaoying Zheng
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China; APEC Health Science Academy (HeSAY), Peking University, Beijing, China.
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6
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Shetty S, Duesman SJ, Patel S, Huynh P, Toh P, Shroff S, Das A, Chowhan D, Keller B, Alvarez J, Fisher-Foye R, Sebra R, Beaumont K, McAlpine CS, Rajbhandari P, Rajbhandari AK. Sex-specific role of high-fat diet and stress on behavior, energy metabolism, and the ventromedial hypothalamus. Biol Sex Differ 2024; 15:55. [PMID: 39010139 PMCID: PMC11247790 DOI: 10.1186/s13293-024-00628-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/11/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Scientific evidence highlights the influence of biological sex on the relationship between stress and metabolic dysfunctions. However, there is limited understanding of how diet and stress concurrently contribute to metabolic dysregulation in both males and females. Our study aimed to investigate the combined effects of high-fat diet (HFD) induced obesity and repeated stress on fear-related behaviors, metabolic, immune, and hypothalamic outcomes in male and female mice. METHODS To investigate this, we used a highly reliable rodent behavioral model that faithfully recapitulates key aspects of post-traumatic stress disorder (PTSD)-like fear. We subjected mice to footshock stressor followed by a weekly singular footshock stressor or no stressor for 14 weeks while on either an HFD or chow diet. At weeks 10 and 14 we conducted glucose tolerance and insulin sensitivity measurements. Additionally, we placed the mice in metabolic chambers to perform indirect calorimetric measurements. Finally, we collected brain and peripheral tissues for cellular analysis. RESULTS We observed that HFD-induced obesity disrupted fear memory extinction, increased glucose intolerance, and affected energy expenditure specifically in male mice. Conversely, female mice on HFD exhibited reduced respiratory exchange ratio (RER), and a significant defect in glucose tolerance only when subjected to repeated stress. Furthermore, the combination of repeated stress and HFD led to sex-specific alterations in proinflammatory markers and hematopoietic stem cells across various peripheral metabolic tissues. Single-nuclei RNA sequencing (snRNAseq) analysis of the ventromedial hypothalamus (VMH) revealed microglial activation in female mice on HFD, while male mice on HFD exhibited astrocytic activation under repeated stress. CONCLUSIONS Overall, our findings provide insights into complex interplay between repeated stress, high-fat diet regimen, and their cumulative effects on health, including their potential contribution to the development of PTSD-like stress and metabolic dysfunctions, emphasizing the need for further research to fully understand these interconnected pathways and their implications for health.
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Affiliation(s)
- Sanutha Shetty
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Samuel J Duesman
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sanil Patel
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Pacific Huynh
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Pamela Toh
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sanjana Shroff
- Center for Advanced Genomic Technology, Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anika Das
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Center for Excellence in Youth Education, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Disha Chowhan
- Center for Advanced Genomic Technology, Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin Keller
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Johana Alvarez
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Rachel Fisher-Foye
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Robert Sebra
- Center for Advanced Genomic Technology, Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristin Beaumont
- Center for Advanced Genomic Technology, Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cameron S McAlpine
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Prashant Rajbhandari
- Diabetes, Obesity and Metabolism Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Disease Mechanism and Therapeutics Program, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Abha K Rajbhandari
- Department of Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
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7
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Greene CRL, Blackbourn LAK, McGurnaghan SJ, Mercer SW, Smith DJ, Wild SH, Wu H, Jackson CA. Antidepressant and antipsychotic prescribing in patients with type 2 diabetes in Scotland: A time-trend analysis from 2004 to 2021. Br J Clin Pharmacol 2024. [PMID: 38981672 DOI: 10.1111/bcp.16171] [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: 02/15/2024] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 07/11/2024] Open
Abstract
AIMS Prescribing of antidepressant and antipsychotic drugs in general populations has increased in the United Kingdom, but prescribing trends in people with type 2 diabetes (T2D) have not previously been investigated. The aim of this study was to describe time trends in annual prevalence of antidepressant and antipsychotic drug prescribing in adult patients with T2D. METHODS We conducted repeated annual cross-sectional analysesof a population-based diabetes registry with 99% coverage, derived from primary and secondary care data in Scotland, from 2004 to 2021. For each cross-sectional calendar year time period, we calculated the prevalence of antidepressant and antipsychotic drug prescribing, overall and by sociodemographic characteristics and drug subtype. RESULTS The number of patients with a T2D diagnosis in Scotland increased from 161 915 in 2004 to 309 288 in 2021. Prevalence of antidepressant and antipsychotic prescribing in patients with T2D increased markedly between 2004 and 2021 (from 20.0 per 100 person-years to 33.3 per 100 person-years and from 2.8 per 100 person-years to 4.7 per 100 person-years, respectively). We observed this pattern for all drug subtypes except for first-generation antipsychotics, prescribing of which remained largely stable. The degree of increase, as well as the overall prevalence of prescribing, differed by age, sex, socioeconomic status and subtype of drug class. CONCLUSIONS There has been a marked increase in the prevalence of antidepressant and antipsychotic prescribing in patients with T2D in Scotland. Further research should identify the reasons for this increase, including indication for use and the extent to which this reflects increases in incident prescribing rather than increased duration.
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Affiliation(s)
| | - Luke A K Blackbourn
- MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | | | | | - Daniel J Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Honghan Wu
- Institute of Health Informatics, University College London, London, UK
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Tsukamoto‐Kawashima S, Ikeda K, Sone M, Ogura M, Okamura E, Kondo A, Ueba Y, Inagaki N. An exploratory study of factors in disordered eating behavior in diabetes self-management in Japan. J Diabetes Investig 2024; 15:874-881. [PMID: 38426367 PMCID: PMC11215692 DOI: 10.1111/jdi.14176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024] Open
Abstract
AIMS/INTRODUCTION Diet directly affects glucose metabolism, and eating behavior is influenced by various daily life stressors. This study was conducted to investigate the relationship between common psychosomatic stressors on endocrine hormones and eating behavior in patients with type 2 diabetes. MATERIALS AND METHODS This cross-sectional study was performed in 40 patients with type 2 diabetes. Resting hormone blood sampling and four self-reported questionnaires were employed. RESULTS Patients who scored higher on the 'anger/hostility' (AH) subcategory of the profile of mood state (POMS) questionnaire had significantly higher serum cortisol (β = 0.40, P = 0.01 by least squares adjusted for age and sex). In the eating behavior questionnaire, the subcategories of 'feeling of hunger/satiation' (β = 0.49, P < 0.01) and 'eating as diversion' (β = 0.39, P = 0.03) were associated with higher serum cortisol. Resting morning cortisol levels were higher in participants who rated high on the POMS-AH and in those who reported 'irritated when hungry' and 'tend to eat when irritated or anxious'. Sleep quality showed no association with eating behavior. CONCLUSIONS Mood state is associated with eating behavior. Anger increases cortisol levels and may lead to compulsive eating. Various forms of hostility are important factors in appetite control and increased cortisol secretion, and can be an impediment to successful dietary self-management in patients with type 2 diabetes. Thus, assessment of mood state and control of negative mood are important therapeutic targets in diabetes management.
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Affiliation(s)
- Sachiko Tsukamoto‐Kawashima
- Preemptive Medicine and Lifestyle Related Disease Research CenterKyoto University HospitalKyotoJapan
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
| | - Kaori Ikeda
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
- Department of Clinical Research Facilitation, Institute for Advancement of Clinical and Translational ScienceKyoto University HospitalKyotoJapan
| | - Masakatsu Sone
- Department of Metabolism and EndocrinologySt. Marianna University School of MedicineKawasakiKanagawaJapan
| | - Masahito Ogura
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
- Department of DiabetesNational Hospital Organization Kyoto Medical CenterKyotoJapan
| | - Emi Okamura
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
| | - Aki Kondo
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
| | - Yoko Ueba
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
- Medical Research Institute KITANO HOSPITAL, PIIF Tazuke‐kofukaiOsakaJapan
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9
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Li S, Pan S, Jiang S, Shin JI, Liu GG, Lyu B. Prescription medication use among patients with type 2 diabetes in the United States: 1999-2020. Diabetes Obes Metab 2024; 26:2933-2944. [PMID: 38695210 DOI: 10.1111/dom.15619] [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: 01/26/2024] [Revised: 03/31/2024] [Accepted: 04/10/2024] [Indexed: 06/05/2024]
Abstract
AIMS We aimed to examine trends in overall prescription medication use among patients with type 2 diabetes in the United States to provide insights for patient care. MATERIALS AND METHODS We used nationally representative data from the National Health and Nutrition Examination Survey from 1999 to 2020 and included adult patients with type 2 diabetes. We examined the use of prescription drugs, overall and by drug class, polypharmacy (use of ≥5 medications), and number of medications attributed to specific classes. RESULTS In the period 2015-2020, the mean patient age was 59.6 (51.0-70.0) years, with 46.8% (43.6-49.9) being female and 57.8% (52.8-62.8) being non-Hispanic White. Among 9489 adults with type 2 diabetes, the prevalence of polypharmacy was high and increased from 35.1% (31.6-38.6) in 1999-2002 to 47.2% (43.7-50.7) in 2003-2006, and further to 51.1% (48.3-53.9) in 2015-2020 (p for trend <0.001). Increasing trends of polypharmacy were found across all population subgroups and across the majority of therapeutic classes. Use of non-cardiometabolic medications was common. Among them, the most common were antidepressants (19.8%), proton pump inhibitors (19.0%) and analgesics (16.2%). Among patients with polypharmacy, approximately 40% of medication use was attributed to non-cardiometabolic medications. CONCLUSIONS Prescription medication burden and complexity increased substantially among patients with type 2 diabetes, with more than 50% of patients with polypharmacy. Attention should be paid to this escalating medication use and regimen complexity, which requires multidisciplinary and coordinated care.
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Affiliation(s)
- Shanshan Li
- Institute for Global Health and Development, Peking University, Beijing, China
- China Center for Health Economic Research, Peking university, Beijing, China
| | - Shaoxi Pan
- Institute for Global Health and Development, Peking University, Beijing, China
- China Center for Health Economic Research, Peking university, Beijing, China
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Shaoxiang Jiang
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Jung-Im Shin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gordon G Liu
- Institute for Global Health and Development, Peking University, Beijing, China
- China Center for Health Economic Research, Peking university, Beijing, China
- National School of Development, Peking University, Beijing, China
| | - Beini Lyu
- Institute for Global Health and Development, Peking University, Beijing, China
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Hu Z, Tang L, Xu X, Zhan Y. Association between physical activity and psychosocial status in adults with epilepsy: Results from the 2022 National health Interview survey. Epilepsy Behav 2024; 156:109836. [PMID: 38761448 DOI: 10.1016/j.yebeh.2024.109836] [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: 01/21/2024] [Revised: 05/11/2024] [Accepted: 05/11/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE The study aimed to investigate the association between physical activity and the four dimensions of psychosocial status in adults with epilepsy. METHODS The data of individuals with epilepsy utilized in this cross-sectional study were derived from the 2022 National Health Interview Survey(NHIS). Physical activity was analyzed based on walking, moderate or vigorous intensity physical activity and the 2018 Physical Activity Guidelines (PAG) for Americans. The psychosocial status of the participants was assessed using self-report questionnaires that evaluated life satisfaction, symptoms of depression and anxiety, and social functioning. A multivariate ordinal regression model was employed to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) following adjustment for potential confounding factors. RESULTS In total of 424 individuals with epilepsy(mean age:48.0 years; male: 40.6 %) were included in this study. About 39.9 % of the participants met the 2018 PAG for aerobic activity. After controlling for potential confounding factors, individuals who adhered to the 2018 PAG for aerobic activity were found to have a higher likelihood of reporting increased life satisfaction (OR, 0.39; 95 % CI: 0.21, 0.71), decreased symptoms of depression (OR, 0.53; 95 % CI: 0.30, 0.94), and improved social functioning (OR, 0.42; 95 % CI: 0.24, 0.74). However, no significant association was observed between physical activity and anxiety symptoms among individuals with epilepsy. CONCLUSIONS This study emphasizes that moderate to vigorous physical activity enhances psychosocial health in individuals with epilepsy. Nevertheless, it is important to note that a causal relationship cannot be inferred from these findings, and further verification through randomized controlled trials is necessary.
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Affiliation(s)
- Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Lu Tang
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Xiaowei Xu
- Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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11
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Akif A, Qusar MMAS, Islam MR. The Impact of Chronic Diseases on Mental Health: An Overview and Recommendations for Care Programs. Curr Psychiatry Rep 2024; 26:394-404. [PMID: 38767815 DOI: 10.1007/s11920-024-01510-7] [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] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE OF REVIEW The current achievement of medical advancement is noteworthy; however, the occurrence of chronic diseases is increasing day by day, with a significant percentage of affected people are suffering from a mental health crisis. This article aims to present a thorough yet brief review of methods that can be employed to build the emotional wellness of chronic patients. RECENT FINDINGS The mental health care strategies include resilience-building, coping skills training, professional counseling, and lifestyle adaptations. Additionally, the article highlights the efficacy of several modern interventions, such as mindfulness-based therapies, cognitive behavioral therapy, eye movement desensitization, and recovery from stress therapy. The global burden of chronic illness emphasizes the pressing need to mitigate mental health problems among chronic patients. By providing actionable insights, our study clears the path for targeted interventions and holistic approaches for chronic disease patients. Moreover, the article suggests to policymakers and clinicians the need for collaboration and multifaceted interventions.
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Affiliation(s)
- Adnan Akif
- University of Houston College of Pharmacy, 4349 Martin Luther King Boulevard, Houston, TX, 77204-5000, USA
| | - M M A Shalahuddin Qusar
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Shahabagh, 1000, Dhaka, Bangladesh
| | - Md Rabiul Islam
- School of Pharmacy, BRAC University, Kha 224 Bir Uttam Rafiqul Islam Avenue, Merul Badda, Dhaka, 1212, Bangladesh.
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Merwass NA, Alkhader YK, Alharthi SA, Al Fardan RM, Alqahtani AM, Mahnashi FA, Salam NM, Al Najim MM, Alenezi AA, Binobaid AO. The Role of Screening, Risk Factors, and Early Intervention in Preventing Diabetes in the Obese Population: A Systematic Review. Cureus 2024; 16:e63952. [PMID: 39104999 PMCID: PMC11299129 DOI: 10.7759/cureus.63952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2024] [Indexed: 08/07/2024] Open
Abstract
With its rising global prevalence, diabetes has become one of the most significant and challenging health problems afflicting the world's population today. The increasing burden of diabetes and its associated complications calls for immediate action for prevention which primarily includes addressing the risk factors. The most significant risk factor for the onset of diabetes is obesity. Obesity and diabetes rates have been rising simultaneously, posing a threat to patient mortality and driving up community healthcare costs. A weight loss of five percent or more of total body weight has been shown to improve the quality of life, reduce the need for pharmacological therapy for diabetes, and enhance glycemic control. This level of weight loss can have significant health benefits, particularly for individuals with diabetes or at risk for developing diabetes. We aim to conduct this systematic review to assess diverse risk factors contributing to the incidence of diabetes among the obese population and determine various preventive strategies and recommendations in practice for the prevention of diabetes in this cohort. As a result, we included original studies that recruited the obese and diabetic populations and defined preventive measures for early intervention. Additionally, we included studies published in the last 10 years (2014-2024) only for the latest evidence. Studies including obese populations with cardiovascular diseases and neurological disorders were excluded. The Newcastle-Ottoman Castle assessment tool was utilized to assess the quality of the studies. We included nine studies that recruited 60,645 patients and were published between 2015 and 2022. Findings suggest that obesity alone is a significant contributor to the occurrence or onset of diabetes. At the same time, the presence of other risk factors, including hypertension, dyslipidemia, elevated triglycerides, or HDL and LDL levels, may further increase the risk of diabetes and its associated complications among the obese population. Preventive strategies emphasize early intervention through increasing awareness and educating communities about risk factors and lifestyle interventions, including the limitations of fast food diets for the prevention of diabetes and weight control. Since obesity is considered to be an independent risk factor for the development of diabetes, addressing and managing it is of critical importance clinically. Targeted early interventions, including screening for risk factors, health promotion, and education activities, can aid in the adaptation of healthier lifestyles, which can reduce the burden of these diseases significantly.
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Affiliation(s)
- Noor A Merwass
- Department of Internal Medicine, Al Thager Hospital, Jeddah, SAU
| | - Yazed K Alkhader
- Family Medicine, Riyadh Second Health Cluster, King Fahad Medical City, Riyadh, SAU
| | - Salma A Alharthi
- Department of Internal Medicine, King Abdulaziz Specialist Hospital, Taif, SAU
| | | | | | - Fahad A Mahnashi
- Department of Family Medicine, Medical Administration at Presidency of State Security, Riyadh, SAU
| | - Nora M Salam
- Nursing Department, King Salman Hospital, Riyadh, SAU
| | - Mustafa M Al Najim
- Department of General Medicine, Locumlimk Healthcare Agency, Mullingar, IRL
| | - Ahmad A Alenezi
- Department of Primary Care, Al-Jahra Health Region, Al Jahra, KWT
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13
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Kołodziej-Sobczak D, Sobczak Ł, Łączkowski KZ. Protein Tyrosine Phosphatase 1B (PTP1B): A Comprehensive Review of Its Role in Pathogenesis of Human Diseases. Int J Mol Sci 2024; 25:7033. [PMID: 39000142 PMCID: PMC11241624 DOI: 10.3390/ijms25137033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024] Open
Abstract
Overexpression of protein tyrosine phosphatase 1B (PTP1B) disrupts signaling pathways and results in numerous human diseases. In particular, its involvement has been well documented in the pathogenesis of metabolic disorders (diabetes mellitus type I and type II, fatty liver disease, and obesity); neurodegenerative diseases (Alzheimer's disease, Parkinson's disease); major depressive disorder; calcific aortic valve disease; as well as several cancer types. Given this multitude of therapeutic applications, shortly after identification of PTP1B and its role, the pursuit to introduce safe and selective enzyme inhibitors began. Regrettably, efforts undertaken so far have proved unsuccessful, since all proposed PTP1B inhibitors failed, or are yet to complete, clinical trials. Intending to aid introduction of the new generation of PTP1B inhibitors, this work collects and organizes the current state of the art. In particular, this review intends to elucidate intricate relations between numerous diseases associated with the overexpression of PTP1B, as we believe that it is of the utmost significance to establish and follow a brand-new holistic approach in the treatment of interconnected conditions. With this in mind, this comprehensive review aims to validate the PTP1B enzyme as a promising molecular target, and to reinforce future research in this direction.
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Affiliation(s)
- Dominika Kołodziej-Sobczak
- Department of Chemical Technology and Pharmaceuticals, Faculty of Pharmacy, Collegium Medicum, Nicolaus Copernicus University, Jurasza 2, 85-089 Bydgoszcz, Poland;
| | - Łukasz Sobczak
- Hospital Pharmacy, Multidisciplinary Municipal Hospital in Bydgoszcz, Szpitalna 19, 85-826 Bydgoszcz, Poland
| | - Krzysztof Z. Łączkowski
- Department of Chemical Technology and Pharmaceuticals, Faculty of Pharmacy, Collegium Medicum, Nicolaus Copernicus University, Jurasza 2, 85-089 Bydgoszcz, Poland;
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14
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Ye ML, Wang JK. Association of total bilirubin with depression risk in adults with diabetes: A cross-sectional study. World J Clin Cases 2024; 12:3428-3437. [PMID: 38983435 PMCID: PMC11229937 DOI: 10.12998/wjcc.v12.i18.3428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/30/2024] [Accepted: 05/17/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Individuals with diabetes mellitus are more likely to experience depression, although most patients remain undiagnosed. The relation between total bilirubin and depression has been increasingly discussed, but limited studies have examined the association of total bilirubin with depression risk in adults with diabetes, which warrants attention. AIM To investigate the association between total bilirubin levels and the risk of depression in adults with diabetes. METHODS The study included adults with diabetes from the National Health and Nutrition Examination Survey 2007-2018. Depression was determined using the Patient Health Questionnaire-9. Multivariable logistic regression, propensity score-matched analysis and restricted cubic spline models were utilized to investigate the association between total bilirubin levels and depression risk in adults with diabetes. RESULTS The study included 4758 adults with diabetes, of whom 602 (12.7%) were diagnosed with depression. After adjusting for covariates, we found that diabetic adults with lower total bilirubin levels had a higher risk of depression (OR = 1.230, 95%CI: 1.006-1.503, P = 0.043). This association was further confirmed after propensity score matching (OR = 1.303, 95%CI: 1.034-1.641, P = 0.025). Subgroup analyses showed no significant dependence of age, body mass index, sex, race or hypertension on this association. Restricted cubic spline models displayed an inverted U-shaped association of total bilirubin levels with depression risk within the lower range of total bilirubin levels. The depression risk heightened with the increasing levels of total bilirubin, reaching the highest risk at 6.81 μmol/L and decreasing thereafter. CONCLUSION In adults with diabetes, those with lower levels of total bilirubin were more likely to have depressive symptoms. Serum total bilirubin levels may be used as an additional indicator to assess depression risk in adults with diabetes.
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Affiliation(s)
- Man-Li Ye
- Department of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Jie-Ke Wang
- Department of Hand and Plastic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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15
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Shimoda T, Tomida K, Nakajima C, Kawakami A, Shimada H. Combined effects of loneliness and diabetes mellitus on disability incidence among older Japanese adults. Arch Gerontol Geriatr 2024; 126:105544. [PMID: 38909439 DOI: 10.1016/j.archger.2024.105544] [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: 05/05/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Developed countries worldwide face the challenge of aging populations in which loneliness is problematic, leading to mental and physical health issues. Diabetes mellitus (DM) can cause decreased physical activity, reduced functioning, and depressive symptoms. However, how interactions between loneliness and DM influence health outcomes remains unclear. We aimed to determine the effects of loneliness and DM-related complications on the incidence of disability among older individuals. METHODS We analyzed data from the Japanese National Center for Geriatrics and Gerontology Study of Geriatric Syndromes for community-dwelling adults aged ≥65 years without initial long-term care needs. Loneliness was assessed using the University of California Los Angeles Loneliness Scale, and DM status was determined based on medical history obtained through face-to-face interviews. Disability incidence was identified by monthly tracking of certifications under the Japanese long-term care insurance system. The combined effect of DM and loneliness on care needs was examined using Cox proportional hazard regression models. RESULTS Among 5,160 participants, 298 (5.8 %) developed incident disabilities within 24 months. Cox models adjusted for potential confounders revealed a significantly increased disability risk among persons with DM and loneliness. Having DM without loneliness and vice versa were not significant risk factors for disability incidence compared with having neither. CONCLUSIONS The combination of loneliness with DM was a risk factor for disability development among community-dwelling older adults. Loneliness and DM might be interrelated and associated with disability development, suggesting that support along with assessments of mental health and illness might help to avoid disability in this population.
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Affiliation(s)
- Takahiro Shimoda
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
| | - Kouki Tomida
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Chika Nakajima
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ayuka Kawakami
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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16
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Li Y, Wang D, Fang J, Zu S, Hu Y. Association between depressive symptoms and prediabetes: NHANES 2007-2016 findings. J Affect Disord 2024; 355:426-431. [PMID: 38537755 DOI: 10.1016/j.jad.2024.03.122] [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: 05/27/2023] [Revised: 02/04/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION The association between diabetes and depressive symptoms is well recognized. However, the impact of depressive symptoms on prediabetes remains unclear. This study aims to explore the specific correlation between depressive symptoms and prediabetes. METHODS A total of 7467 participants from the National Health and Nutrition Examination Survey (NHANES) were included in this study, spanning five rounds of surveys conducted between 2007 and 2016. Weighted logistic regression was utilized to assess the relationship between depressive symptoms and prediabetes. RESULTS Compared with the normoglycemic population, individuals with prediabetes had a significantly higher probability of experiencing trouble sleeping (P = 0.020). After adjusting for non-glucose factors, there was no significant correlation between PHQ-9 and prediabetes; however, severe depressive symptoms were positively associated with abnormal fasting plasma glucose (FPG) levels (OR = 1.093 [95 % CI 1.002, 1.192]). There was a positive correlation between trouble concentrating and FPG abnormalities (OR = 1.065 [95 % CI 1.004, 1.129]). LIMITATIONS The cross-sectional design limits causal inference. CONCLUSION Individuals with depressive symptoms, especially severe cases, should be targeted for prediabetes prevention and management efforts. The diverse symptom presentations may have distinct impacts on glucose, necessitating personalized prevention and management strategies.
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Affiliation(s)
- Yuwei Li
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiexin Fang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Si Zu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yongdong Hu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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17
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Peinado Molina RA, Martínez Vázquez S, Martínez Galiano JM, Rivera Izquierdo M, Khan KS, Cano-Ibáñez N. Prevalence of depression and anxiety in women with pelvic floor dysfunctions: A systematic review and meta-analysis. Int J Gynaecol Obstet 2024. [PMID: 38859723 DOI: 10.1002/ijgo.15719] [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: 02/05/2024] [Accepted: 05/23/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Female pelvic floor dysfunction (PFD) is a common condition affecting the emotional well-being of women. OBJECTIVE To estimate the prevalence of depressive and anxiety symptoms in women with PFD. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION AND ANALYSIS: Following prospective registration (PROSPERO CRD42022362095) we conducted a search of three electronic databases (PubMed, Web of Science and Scopus) from inception to April 2023 without language restriction to capture studies reporting the prevalence of depression/anxiety among women with PFD (chronic pelvic pain [CPP], urinary incontinence [UI], pelvic organ prolapse [POP], and/or fecal incontinence [FI]). Only studies with validated tools were included. Data extraction and study quality assessment were performed by two independent reviewers. Stratifying by type of PFD, rates of depression and anxiety were pooled using random effects model computing 95% confidence interval (CI) and assessing heterogeneity using the I2 statistic. Funnel plots were used to detect potential reporting biases and small-study effects. MAIN RESULTS The search yielded 767 articles, from which 54 studies containing 632 605 women were included. All the studies were high quality. The prevalence of depression was: CPP 26.8% (95% CI: 19.2-34.4, I2 = 98.7%; 12 studies, 4798 participants with 491 cases; Egger's P value = 0.009); UI 26.3% (95% CI: 19.4-33.2, I2 = 99.9%; 26 studies, a total of 346 114 participants with 25 050 cases; Egger's P value = 0.944); POP 34.9% (95% CI: 24.3-45.6, I2 = 68%; three studies, 297 participants with 104 cases; Egger's P value = 0.973); and FI 25.3% (95% CI: 0.68-49.9, I2 = 99.7%; six studies, 14 663 participants with 1773 cases; Egger's P value = 0.780). The prevalence of anxiety was: CPP 29.5% (95% CI: 16.3-42.7, I2 = 97.7%; nine studies, 2483 participants with 349 cases; Egger's P value = 0.001); UI 46.91% (95% CI: 39.1-54.6, I2 = 99.6%; 11 studies, 198 491 participants with 40 058 cases; Egger's P value = 0.337); and POP 28% (95% CI: 13.6-42.4, I2 = 89%; three studies with 355 participants with 90 cases; Egger's P value = 0.306). CONCLUSION The prevalence of mental health illness was variable in the different types of PFDs. This meta-analysis helps quantify the burden of depression and anxiety in PFD and will help inform the policies regarding screening of emotional well-being by healthcare professionals engaged in care of women with PFD.
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Affiliation(s)
| | | | - Juan Miguel Martínez Galiano
- Department of Nursing, University of Jaen, Jaén, Spain
- Consortium for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Mario Rivera Izquierdo
- Consortium for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs. Granada), Granada, Spain
| | - Khalid Saeed Khan
- Consortium for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Naomi Cano-Ibáñez
- Consortium for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs. Granada), Granada, Spain
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18
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O'Sullivan DJ, Bearne LM, Harrington JM, Cardoso JR, McVeigh JG. The effectiveness of social prescribing in the management of long-term conditions in community-based adults: A systematic review and meta-analysis. Clin Rehabil 2024:2692155241258903. [PMID: 38863236 DOI: 10.1177/02692155241258903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the effectiveness of social prescribing interventions in the management of long-term conditions in adults. DATA SOURCES Eleven electronic databases were searched for randomised and quasi-randomised controlled trials. REVIEW METHODS Outcomes of interest were quality of life, physical activity, psychological well-being and disease-specific measures. Bias was assessed with the Cochrane Risk of Bias 2 tool. A narrative synthesis and meta-analysis were performed. RESULTS Twelve studies (n = 3566) were included in this review. Social prescribing interventions were heterogeneous and the most common risks of bias were poor blinding and high attrition. Social prescribing interventions designed to target specific long-term conditions i.e., cancer and diabetes demonstrated significant improvements in quality of life (n = 2 studies) and disease-specific psychological outcomes respectively (n = 3 studies). There was some evidence for improvement in physical activity (n = 2 studies) but most changes were within group only (n = 4 studies). Social prescribing interventions did not demonstrate any significant changes in general psychological well-being. CONCLUSION Social prescribing interventions demonstrated some improvements across a range of outcomes although the quality of evidence remains poor.
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Affiliation(s)
- Declan J O'Sullivan
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Lindsay M Bearne
- Population Health Research Institute, St George's, University of London, London, UK
| | - Janas M Harrington
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Jefferson R Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Brazil
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
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Weinberg M, Shorer S, Marom D, Cohen L, Cohen M. Combat military service and male depression: The relationship between social support, PTSD, and male depression following combat military service. Int J Soc Psychiatry 2024; 70:801-807. [PMID: 38351685 PMCID: PMC11144356 DOI: 10.1177/00207640241231216] [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] [Indexed: 06/02/2024]
Abstract
BACKGROUND Soldiers in military service are at risk of exposure to traumatic and stressful experiences, which can lead to symptoms of posttraumatic stress disorder (PTSD) and symptoms of depression. In the context of veterans' PTSD and depression, social support has been shown to be a very significant resource. However, while general depression has been examined among veterans and although combat soldiers are often men, male depression has been rarely examined. Therefore, the present study aimed to examine the relationships between social support, PTSD symptoms, and male depression among veterans. METHODS Five hundred and ninety-five male combat veterans completed a demographic questionnaire and measures of social support, PTSD, and male depression, including the specific symptoms of anger, substance use, social withdrawal, and restricted emotions. RESULTS Structural-equation-model analyses showed that social support was negatively associated with both PTSD symptoms and depression symptoms. Specifically, social support showed lower trends of associations with substance use and anger; whereas there were higher associations with social withdrawal and restricted emotions. PTSD showed the strongest association with anger. Thus, we can see that social support is a key resource for coping with PTSD and different symptoms of male depression. CONCLUSION Greater attention to social support, PTSD, and aspects of male depression could assist the development of intervention and therapeutic programs and also help to prevent the misdiagnosis of depression among military veterans.
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Affiliation(s)
- Michael Weinberg
- School of Social Work, Faculty of Welfare and Health Sciences, University of Haifa, Israel
| | - Shai Shorer
- School of Social Work, Faculty of Welfare and Health Sciences, University of Haifa, Israel
- B’Shvil Hamachar Organization, Yahud, Israel
| | - Doron Marom
- B’Shvil Hamachar Organization, Yahud, Israel
| | - Lihi Cohen
- Department of Psychology, University of Haifa, Israel
| | - Miri Cohen
- School of Social Work, Faculty of Welfare and Health Sciences, University of Haifa, Israel
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Huang CJ, Lin CH, Liu TL, Lin PC, Chu CC, Wang JJ, Wei CW, Weng SF. Healthcare Utilization and Its Correlates in Comorbid Type 2 Diabetes Mellitus and Generalized Anxiety Disorder. Psychiatr Q 2024; 95:233-252. [PMID: 38639873 DOI: 10.1007/s11126-024-10072-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
This study investigated the healthcare utilization and medical expenditure of type 2 diabetes mellitus (T2DM) patients with generalized anxiety disorder (GAD) and identified the associated factors. The healthcare utilization and expenditure of T2DM patients with (case group) and without (control group) GAD between 2002 and 2013 were examined using the population-based Taiwan National Health Insurance Research Database. Healthcare utilization included outpatient visits and hospitalization; health expenditure included outpatient, inpatient, and total medical expenditure. Moreover, nonpsychiatric healthcare utilization and medical expenditure were distinguished from total healthcare utilization and medical expenditure. The average healthcare utilization, including outpatient visits and hospitalization, was significantly higher for the case group than for the control group (total and nonpsychiatric). The results regarding differences in average outpatient expenditure (total and nonpsychiatric), inpatient expenditure (total and nonpsychiatric), and total expenditure (total and nonpsychiatric) between the case and control groups are inconsistent. Sex, age, income, comorbidities/complications, and the diabetes mellitus complication severity index were significantly associated with outpatient visits, medical expenditure, and hospitalization in the case group (total and nonpsychiatric). Greater knowledge of factors affecting healthcare utilization and expenditure in comorbid individuals may help healthcare providers intervene to improve patient management and possibly reduce the healthcare burden in the future.
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Affiliation(s)
- Chun-Jen Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Hua Lin
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Chen Chu
- Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Chun-Wang Wei
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center for Medical Informatics and Statistics, Office of R&D, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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21
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Cai J, Zhang S, Wu R, Huang J. Association between depression and diabetes mellitus and the impact of their comorbidity on mortality: Evidence from a nationally representative study. J Affect Disord 2024; 354:11-18. [PMID: 38447915 DOI: 10.1016/j.jad.2024.03.003] [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: 08/17/2023] [Revised: 01/16/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Depression and diabetes mellitus (DM) are major chronic noncommunicable diseases that impair one's mental and physical well-being and impose substantial burdens on the health system. Depressed individuals have an increased risk of impaired blood glucose, weight gain and dyslipidemia which could induce poorer long-term survival. METHODS 37,040 individuals from the National Health and Nutrition Examination Survey (NHANES) were included. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and classified by the total scores as no (0-4), mild (5-9), moderate (10-14), and severe (15-27). DM was determined based on self-reported medical history, clinical test results, and medication use. Logistic and Cox regression were the main statistical models. All analyses were based on weighted data from complex sampling. RESULTS The prevalence of DM was higher in depressed than non-depressed individuals (21.26 % vs. 13.75 %). The adjusted odds ratio (OR) (95 % CI) of comorbid DM increased with depression severity, from 1.00 (reference) for no depression, to 1.22 (1.09,1.36) for mild, 1.62 (1.37,1.92) for moderate, and 1.52(1.28,1.82) for severe depression. Comorbidity of DM and depression significantly associated with a higher risk of all-cause mortality, with a hazard ratio (HR) (95 % CI) = 2.09 (1.64,2.66). LIMITATIONS Dynamic demographic and metabolic data were not available. CONCLUSION Depression is associated with a higher risk of DM, which may be related to biological, socioeconomic, and medication-related factors. Comorbidity of the two worsens long-term survival. Therefore, blood glucose management and prevention of DM should be emphasized in depressed patients.
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Affiliation(s)
- Jingda Cai
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Songyan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Renrong Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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22
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Jain A, Sunder S, Jain N, Yadav N, Saini A, Yadav KS. Study of cognitive functions and their association with depression in type II diabetes mellitus. J Family Med Prim Care 2024; 13:2323-2328. [PMID: 39027822 PMCID: PMC11254044 DOI: 10.4103/jfmpc.jfmpc_1150_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 07/20/2024] Open
Abstract
Introduction Individuals with diabetes have higher risk of developing depression, cognitive impairment, and dementia compared to those who do not have diabetes. The present study aims to assess the level of cognitive functions and the presence of depression in diabetes patients and healthy controls. The study also explores the level of cognition among the normal control, diabetes without depression, and diabetes with depression. Methods In the present study, the presence of depression and the level of cognitive functions of 59 cases of diabetes mellitus type-2 were compared with an age- and gender-matched control group of 40 individuals. Clinical and demographic details were recorded on a semi-structured performa. Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9) were applied to both diabetes patients and healthy controls to assess the level of cognitive functions and the presence of depression, respectively. Results On applying odds ratio (OR), it was observed in the present study that there were 93.50% more chances [OR 1.935 with 95% confidence interval (CI) being 0.481-7.789] of depression among diabetic cases as compared to the control group. Similarly, the chance of MoCA score being less than 26 was twice among the diabetic group as compared to the control group (OR 2.208 with 95% CI being 0.702-6.946). On application of the Chi-square test, the association of depression was significant with HBA1C level, level of education, and presence of complications. Conclusions Patients with diabetes had almost double the risk of developing depression and poor cognitive functions as compared to the healthy control. High HbA1C level, level of education, and presence of complication in diabetes had a positive statistical association with depression. Thus, it is advisable to investigate patients with diabetes for the presence of depression and cognitive dysfunction by applying simple tools.
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Affiliation(s)
- Akhilesh Jain
- Department of Psychiatry, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Shyam Sunder
- Department of Medicine, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Nitesh Jain
- Department of Medicine, ESIC Model Hospital, Jaipur, Rajasthan, India
| | | | - Ashok Saini
- Department of Psychiatry, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Kuldeep S. Yadav
- Speciality Doctor, Adult CMHT, Somerest NHS Foundation Trust, United Kingdom
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23
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Dandamrongrak C, Rechenberg K, Granger J, Johnson A, Yan K, Kue J. The association between depressive symptoms and executive function in type 1 diabetes population: A scoping review. Prim Care Diabetes 2024; 18:299-307. [PMID: 38653620 DOI: 10.1016/j.pcd.2024.04.001] [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: 10/18/2023] [Revised: 02/13/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The purpose of this study was to explore the existing literature on the relationship between depressive symptoms and executive function in patients with type 1 diabetes (T1DM) across the lifespan. METHODS The scoping review followed the PRISMA protocol by using three databases: PubMed, CINAHL, and PsycINFO on May 14, 2023. Primary research that included reported executive function and the association with depressive symptoms was included in the review. RESULTS Of 1470 de-duplicated publications identified, nine articles were included in the review. Five studies evaluated the T1DM population, while four studies evaluated T1DM and type 2 diabetes (T2DM) as an aggregate result. Three studies indicated an association between depressive symptoms and executive function in adults with T1DM, and four studies indicated an association between depressive symptoms and executive function in adults with either T1DM or T2DM. In general, participants who reported depressive symptoms also exhibited poor executive function. However, two studies did not find an association between depressive symptoms and executive function. CONCLUSION In summary, the seven studies in this review suggest that individuals with T1DM who report depressive symptoms are at a higher risk of poor executive function; a clear association between depressive symptoms and executive function in individuals with T1DM remains inconclusive. There is a need to explore this relationship in the future.
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Affiliation(s)
- Chawisa Dandamrongrak
- College of Nursing, University of South Florida, USA; Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
| | | | - Jumpee Granger
- Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
| | | | - Kailei Yan
- College of Nursing, University of South Florida, USA
| | - Jennifer Kue
- College of Nursing, University of South Florida, USA
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24
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Herhaus B, Kruse J, Hinz A, Brähler E, Petrowski K. Depression, anxiety, and health-related quality of life in normal weight, overweight and obese individuals with diabetes: a representative study in Germany. Acta Diabetol 2024; 61:725-734. [PMID: 38430257 PMCID: PMC11101582 DOI: 10.1007/s00592-024-02248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Diabetes in the course of lifetime is related to a higher risk for mental disorders. The present study addresses the comparison of individuals with diabetes and non-diabetic individuals in depressive symptoms, generalized anxiety symptoms, and health-related quality of life. Furthermore, mediator effect of BMI and health-related quality of life (HRQOL) on the association between diabetes, depression, and generalized anxiety was analyzed. METHODS In this cross-sectional study, the three questionnaires PHQ-9, GAD-7, EQ-5D-5L were measured in a representative sample of the German population (N = 2386). In addition, the presence of diabetes and BMI were assessed via self-report. RESULTS There were higher values in depressive and anxiety symptoms as well as lower score in HRQOL in individuals with diabetes compared to non-diabetic individuals. Obese individuals with diabetes showed the highest rates in depressive symptoms and generalized anxiety as well as lowest score in HRQOL. With regard to the mediator analyses, association between diabetes, depressive symptoms, and anxiety symptoms is partially mediated by the BMI and fully mediated by the HRQOL. CONCLUSIONS In conclusion, individuals with diabetes have an increased risk in the development of depressive and anxiety symptoms as well as lower health-related quality of life. Future research and strategies in the public health policies among individuals with diabetes should take into account that the association between diabetes, depression, and anxiety is mediated by BMI and HRQOL.
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Affiliation(s)
- Benedict Herhaus
- Medical Psychology and Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Duesbergweg 6, 55128, Mainz, Germany.
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Philipps University Marburg, Marburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Duesbergweg 6, 55128, Mainz, Germany
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Kolars B, Minakovic I, Grabovac B, Zivanovic D, Mijatovic Jovin V. Treatment adherence and the contemporary approach to treating type 2 diabetes mellitus. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:97-104. [PMID: 38511473 DOI: 10.5507/bp.2024.009] [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: 12/25/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
The rising burden of type 2 diabetes mellitus (T2D) poses a significant healthcare challenge on a global scale. The economic impact is also substantial and continually increasing. In Serbia, even though the prevalence is officially around 12 percent, nearly 40 percent of the adult population is estimated to be living with undiagnosed diabetes and more than half the population is obese or overweight. This review comprehensively addresses the present approach to treating T2D, emphasizing the critical role of treatment adherence. We review the various components of T2D treatment, underlining the significance of lifestyle modifications. The pros and cons of medications used in treatment are discussed and factors influencing adherence are analysed. A healthy lifestyle remains the foundation of the treatment, and if not sufficient, early pharmacotherapy is initiated. Medications have been developed to lower blood sugar levels with cardiorenal protection, however, due to their still high cost, metformin remains the drug of first choice for most patients. Adherence to the treatment regimen is often poor. Factors associated with this are diverse and often multiple in a particular patient. Poor adherence is associated with poor glycaemic control, increased risk of disease complications, higher cardiovascular risk, increased mortality, hospitalizations, and healthcare costs. In addition to reducing the complexity of drug therapy and better informing the patient, improved education and motivation could lead to greater adherence. Enhanced communication between the patient and the physician and reduced treatment costs could also have a positive impact. The review concludes that addressing factors affecting adherence can significantly improve T2D outcomes and reduce costs. Further research is needed to identify region-specific risk factors for poor adherence.
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Affiliation(s)
- Bela Kolars
- Department of General Medicine and Geriatrics, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Health Center "Novi Sad", Novi Sad, Serbia
| | - Ivana Minakovic
- Department of General Medicine and Geriatrics, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Health Center "Novi Sad", Novi Sad, Serbia
| | - Beata Grabovac
- Department of Social Sciences and Humanities, Hungarian Language Teacher Training Faculty in Subotica, University of Novi Sad, Subotica, Serbia
| | - Dejan Zivanovic
- Department of Psychology, College of Human Development, Belgrade, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vesna Mijatovic Jovin
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Alshaikh AA, Al-Qahtani FS, Alqahtani SAM, AlFarhan AA, Al Nuwayhidh AM, Madkhali AM, AlQahtani RS, AlAsmari AF, Alserhani AS, Alqubaisi HA, Saeed Aldawh ZS, Al Bin Ahmad AK, Ghazy RM. Exploring the self-efficacy of patients with diabetes: its role as a predictor of diabetes management and well-being. Front Endocrinol (Lausanne) 2024; 15:1347396. [PMID: 38841304 PMCID: PMC11151748 DOI: 10.3389/fendo.2024.1347396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Background Self-efficacy is a popular psychological concept that refers to an individual's perception or belief in his ability to perform specific actions. This study aimed to assess the predictive value of self-efficacy, measured using the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEM6S) questionnaire, for diabetes management and overall well-being in patients with diabetes. Subject and methods An anonymous online cross-sectional study was conducted to evaluate the self-efficacy of diabetic patients in the Asser region of Saudi Arabia. The participants were requested to upload their most recent glycated hemoglobin A1C (HbA1C) measurements taken in the last three months, which helped in the accurate categorization of their diabetes as either controlled or uncontrolled. We used the valid Arabic version of the SEM6S and WHO-5 well-being questionnaires to assess patient self-efficacy and well-being. Results A cohort of 342 patients was enrolled in the study, 67.25% were married, their mean age was 43.17 ± 17.61 years, and 52.69% had university-level or higher education. Among the participants, 46.0% exhibited well-being, while 24.9% reported poor well-being, including 9.4% who were identified as experiencing depression. The mean scores of self-efficacy and well-being were significantly higher among those with controlled diabetes versus uncontrolled diabetes (40.86 ± 13.26 vs. 36.48 ± 13.26) and (67.35 ± 21.22 vs. 60.93 ± 25.05), respectively. The predictors of glycemic control were self-efficacy [Odds ratio (OR)=1.03 (95%CI, 1.01-1.06, P=0.002], having other chronic diseases [OR=3.25 (95%CI), P<0.001], having type 1 diabetes [OR=7.16, 95%CI, P=0.005], being Saudi [OR=7.67, (95%CI, P=0.027], working in a public sector [OR=0.15, (95%CI, 0.05-0.44), P=0.005], being unemployed [OR=0.19, (95%CI, 0.06-0.59), P=0.005], being a smoker [OR=0.44, 95%CI, 0.19-0.98, P=0.048], and duration of diabetes between 6-10 years [OR= 0.33, 95%CI, 0.11-0.95), P=0.043] or more than 10 years OR=0.32, 95%CI, 0.12-0.86), P=0.026]. The main determinants of well-being were having self-efficacy [OR=1.07 (95%CI, 1.04-1.09), P = 0.0001], having public health insurance [OR=4.36 (95%CI, P=0.015], and education level (read and write) [OR=0.13 (95%CI,.02-.70), P=0.021]. Conclusions The study reveals that non-modifiable and modifiable factors, including self-efficacy, play a crucial role in diabetes control. The study recommends providing targeted educational interventions, using different social media platforms, psychosocial support programs, and inclusive healthcare policies to improve diabetes control and mental well-being among diabetic patients.
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Affiliation(s)
- Ayoub Ali Alshaikh
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Faisal Saeed Al-Qahtani
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Saif Aboud M. Alqahtani
- Internal Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmad Ali AlFarhan
- Medical Colleague, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | | | - Ali Fayez AlAsmari
- Medical Colleague, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Hatim Ahmed Alqubaisi
- Clinical pharmacist Intern, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | | | | | - Ramy Mohamed Ghazy
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Varela-Moreno E, Anarte-Ortiz MT, Jodar-Sanchez F, Garcia-Palacios A, Monreal-Bartolomé A, Gili M, García-Campayo J, Mayoral-Cleries F. Economic Evaluation of a Web Application Implemented in Primary Care for the Treatment of Depression in Patients With Type 2 Diabetes Mellitus: Multicenter Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e55483. [PMID: 38754101 PMCID: PMC11140277 DOI: 10.2196/55483] [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: 12/14/2023] [Revised: 03/04/2024] [Accepted: 03/14/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Depressive disorder and type 2 diabetes mellitus (T2DM) are prevalent in primary care (PC). Pharmacological treatment, despite controversy, is commonly chosen due to resource limitations and difficulties in accessing face-to-face interventions. Depression significantly impacts various aspects of a person's life, affecting adherence to medical prescriptions and glycemic control and leading to future complications and increased health care costs. To address these challenges, information and communication technologies (eg, eHealth) have been introduced, showing promise in improving treatment continuity and accessibility. However, while eHealth programs have demonstrated effectiveness in alleviating depressive symptoms, evidence regarding glycemic control remains inconclusive. This randomized controlled trial aimed to test the efficacy of a low-intensity psychological intervention via a web app for mild-moderate depressive symptoms in individuals with T2DM compared with treatment as usual (TAU) in PC. OBJECTIVE This study aimed to analyze the cost-effectiveness and cost-utility of a web-based psychological intervention to treat depressive symptomatology in people with T2DM compared with TAU in a PC setting. METHODS A multicenter randomized controlled trial was conducted with 49 patients with T2DM, depressive symptoms of moderate severity, and glycosylated hemoglobin (HbA1c) of 7.47% in PC settings. Patients were randomized to TAU (n=27) or a web-based psychological treatment group (n=22). This web-based treatment consisted of cognitive behavioral therapy, improvement of diabetes self-care behaviors, and mindfulness. Cost-effectiveness analysis for the improvement of depressive symptomatology was conducted based on reductions in 3, 5, or 50 points on the Patient Health Questionnaire-9 (PHQ-9). The efficacy of diabetes control was estimated based on a 0.5% reduction in HbA1c levels. Follow-up was performed at 3 and 6 months. The cost-utility analysis was performed based on quality-adjusted life years. RESULTS Efficacy analysis showed that the web-based treatment program was more effective in improving depressive symptoms than TAU but showed only a slight improvement in HbA1c. Incremental cost-effectiveness ratios of 186.76 for a 3-point reduction in PHQ-9 and 206.31 for reductions of 5 and 50 percentage points were obtained. In contrast, the incremental cost-effectiveness ratio for improving HbA1c levels amounted to €1510.90 (€1=US $1.18 in 2018) per participant. The incremental cost-utility ratio resulted in €4119.33 per quality-adjusted life year gained. CONCLUSIONS The intervention, using web-based modules incorporating cognitive behavioral therapy tools, diabetes self-care promotion, and mindfulness, effectively reduced depressive symptoms and enhanced glycemic control in patients with T2DM. Notably, it demonstrated clinical efficacy and economic efficiency. This supports the idea that eHealth interventions not only benefit patients clinically but also offer cost-effectiveness for health care systems. The study emphasizes the importance of including specific modules to enhance diabetes self-care behaviors in future web-based psychological interventions, emphasizing personalization and adaptation for this population. TRIAL REGISTRATION ClinicalTrials.gov NCT03426709; https://clinicaltrials.gov/study/NCT03426709. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/S12888-019-2037-3.
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Affiliation(s)
- Esperanza Varela-Moreno
- Research and Innovation Unit, Costa del Sol University Hospital, Marbella, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Málaga, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Malaga, Malaga, Spain
| | - Maria Teresa Anarte-Ortiz
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Malaga, Malaga, Spain
| | - Francisco Jodar-Sanchez
- Department of Applied Economics, Faculty of Economics and Business Administration, University of Malaga, Malaga, Spain
- Pharmacoeconomics: Clinical and Economic Evaluation of Medications and Palliative Care, Malaga, Spain
| | - Azucena Garcia-Palacios
- Network Biomedical Research Center. Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, Castellon, Spain
| | - Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Margalida Gili
- Research Network on Preventive Activities and Health Promotion in Primary Health Care (RedIAPP), Madrid, Spain
- Institut Universitari d'Investigació en Ciències de la Salut, University Institute for Research in Health Sciences (IUNICS)- Palma Health Research Institute (IDISPA), University of the Balearic Islands, Palma, Spain
| | - Javier García-Campayo
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Málaga, Spain
- Institute of Health Research of Aragon, Zaragoza, Spain
| | - Fermin Mayoral-Cleries
- Biomedical Research Institute of Malaga, Malaga, Spain
- Mental Health Clinical Management Unit, University Regional Hospital of Malaga, Malaga, Spain
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Zhou X, Qin JJ, Li H, Chen J, Zhang Q, Ye X. The effect of multimorbidity patterns on physical and cognitive function in diabetes patients: a longitudinal cohort of middle-aged and older adults in China. Front Aging Neurosci 2024; 16:1388656. [PMID: 38808035 PMCID: PMC11130586 DOI: 10.3389/fnagi.2024.1388656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/22/2024] [Indexed: 05/30/2024] Open
Abstract
Background The prevalence of diabetes has increased rapidly, and comorbid chronic conditions are common among diabetes patients. However, little is known about the pattern of multimorbidity in diabetes patients and the effect on physical and cognitive function. This study aimed to assess the disease clusters and patterns of multimorbidity in diabetes patients using a novel latent class analysis (LCA) approach in middle-aged and older adults and explore the association between different clusters of multimorbidity in diabetes and the effect on physical and cognitive function. Methods This national observational study included 1,985 diabetes patients from the four waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2011 to 2018. Thirteen chronic diseases were used in latent class analysis to identify the patterns of multimorbidity in diabetes, which span the cardiovascular, physical, psychological, and metabolic systems. Cognitive function is assessed via a structured questionnaire in three domains: memory, executive function, and orientation. We combined activities of daily living (ADL) with instrumental activities of daily living (IADL) to measure physical function. Linear mixed models and negative binomial regression models were used to analyze the association between patterns of multimorbidity in diabetes and the effect on cognitive function and disability, respectively. Results A sample of 1,985 diabetic patients was identified, of which 1,889 (95.2%) had multimorbidity; their average age was 60.6 years (standard deviation (SD) = 9.5), and 53.1% were women. Three clusters were identified: "cardio-metabolic" (n = 972, 51.5%), "mental-dyslipidemia-arthritis" (n = 584, 30.9%), and "multisystem morbidity" (n = 333, 17.6%). Compared with diabetes alone, the "multisystem morbidity" class had an increased association with global cognitive decline. All patterns of multimorbidity were associated with an increased risk of memory decline and disability; however, the "multisystem morbidity" group also had the strongest association and presented a higher ADL-IADL disability (ratio = 4.22, 95% CI = 2.52, 7.08) and decline in memory Z scores (β = -0.322, 95% CI = -0.550, -0.095, p = 0.0058). Conclusion Significant longitudinal associations between different patterns of multimorbidity in diabetes patients and memory decline and disability were observed in this study. Future studies are needed to understand the underlying mechanisms and common risk factors for multimorbidity in diabetes patients and to propose treatments that are more effective.
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Affiliation(s)
| | | | | | | | - Qing Zhang
- School of Nursing, Department of Geriatric, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xujun Ye
- School of Nursing, Department of Geriatric, Zhongnan Hospital of Wuhan University, Wuhan, China
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29
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Vázquez-de Sebastián J, Ortiz-Zuñiga AM, Ciudin A, Ars J, Inzitari M, Simó R, Hernández C, Ariño-Blasco S, Barahona MJ, Franco M, Gironès X, Crespo-Maraver MC, Rovira JC, Castellano-Tejedor C. Cognitive Profile and Cardiovascular Risk Factors in Older Adults with Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:500. [PMID: 38673411 PMCID: PMC11050679 DOI: 10.3390/ijerph21040500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
The prevalence of cardiovascular risk factors (CVRFs) in the older adults population and their specific impact on their cognitive profiles still requires further research. For this purpose, a cross-sectional study was carried out to describe the presence of CVRFs and their association with cognitive performance in a sample of older adults (65-85 years old) with Mild Cognitive Impairment (MCI). Participants (n = 185) were divided into three groups concerning their cardiovascular risk level determined by the presence of different CVRFs, including Type 2 Diabetes (T2D), dyslipidemia, hypertension, and obesity. The primary outcome measures were the participant's scores in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Sociodemographic, clinical, and psychosocial data were collected. Non-parametrical statistical analyses and effect sizes were calculated. Findings revealed that a greater presence of CVRFs was not associated with a worse overall cognitive performance. High-risk patients were more likely to have significantly worse performance in the attentional domain compared to medium-risk (p = 0.029, r = 0.42) and compared to low-risk (p = 0.041, r = 0.35), specifically in the digits repetition subtest (p = 0.042). T2D alone was the CVRF associated with cognitive differences (p = 0.037, r = 0.32), possibly mediated by the duration of the condition. Consequently, a higher presence of CVRFs did not lead to a worse overall cognitive performance. However, high-risk individuals were more likely to experience cognitive impairment, particularly in the attentional domain. T2D played a significant role in these cognitive profile differences, possibly influenced by its duration.
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Affiliation(s)
- Julia Vázquez-de Sebastián
- Facultat de Psicologia, Universitat Autònoma de Barcelona (UAB), 08192 Barcelona, Spain
- RE-FiT Barcelona Research Group, Vall d’Hebron Institute of Research & Parc Sanitari Pere Virgili (VHIR-PSPV), 08023 Barcelona, Spain (C.C.-T.)
- Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), 08035 Barcelona, Spain
| | - Angel M. Ortiz-Zuñiga
- Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), 08035 Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III Spain & Endocrinology Department, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Andreea Ciudin
- Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), 08035 Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III Spain & Endocrinology Department, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Joan Ars
- RE-FiT Barcelona Research Group, Vall d’Hebron Institute of Research & Parc Sanitari Pere Virgili (VHIR-PSPV), 08023 Barcelona, Spain (C.C.-T.)
- Medicine Department, Universitat Autònoma de Barcelona (UAB), 08192 Bellaterra, Spain
| | - Marco Inzitari
- RE-FiT Barcelona Research Group, Vall d’Hebron Institute of Research & Parc Sanitari Pere Virgili (VHIR-PSPV), 08023 Barcelona, Spain (C.C.-T.)
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain
| | - Rafael Simó
- Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), 08035 Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III Spain & Endocrinology Department, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Cristina Hernández
- Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), 08035 Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III Spain & Endocrinology Department, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Sergio Ariño-Blasco
- Geriatric Service, Fundació Privada Hospital Asil de Granollers (FPHAG), 08402 Barcelona, Spain
| | - María José Barahona
- Endocrinology Service, Hospital Universitari Mutua Terrassa (HUMT), 08221 Terrassa, Spain
| | - Maite Franco
- Consorci Sanitari de Terrassa (CST), 08227 Terrassa, Spain
| | - Xavier Gironès
- Faculty of Health Sciences (UM-FUB), University of Vic-Central University of Catalonia, 08500 Vic, Spain
| | | | - Joan Carles Rovira
- Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain
| | - Carmina Castellano-Tejedor
- RE-FiT Barcelona Research Group, Vall d’Hebron Institute of Research & Parc Sanitari Pere Virgili (VHIR-PSPV), 08023 Barcelona, Spain (C.C.-T.)
- GIES Research Group, Basic Psychology Department, Universitat Autònoma de Barcelona (UAB), 08192 Bellaterra, Spain
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Busili A, Kumar K, Kudrna L, Busaily I. The risk factors for mental health disorders in patients with type 2 diabetes: An umbrella review of systematic reviews with and without meta-analysis. Heliyon 2024; 10:e28782. [PMID: 38617916 PMCID: PMC11015102 DOI: 10.1016/j.heliyon.2024.e28782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
Background Patients with type 2 diabetes have a nearly twofold higher rate of diagnosed mental disorders than those without diabetes. The association between type 2 diabetes and mental disorders is well established in the literature and recognized as a bidirectional relationship. This study aims to conduct an umbrella review of risk and protective factors for mental health disorders in patients with type 2 diabetes and assess the credibility of the evidence for the association between each factor and mental health disorders. Methods A comprehensive search was conducted of Medline via PubMed, Web of Science, EMBASE, CINHAL, and PsycINFO from inception to November 17, 2022, to identify systematic reviews with and without meta-analyses examining associations of factors with mental health disorders in patients with type 2 diabetes. For each association, we recalculated the summary effect size and 95% confidence intervals using random-effects models. We also reported the 95% prediction interval and between-group heterogeneity. Results The study included 11 systematic reviews that met the inclusion criteria, comprising eight meta-analyses and three without meta-analyses. This involved approximately 489,930 participants and encompassed 26 unique factors. Six factors were rated as having suggestive evidence at the Class III level. These factors were obesity (n = 18,456, OR 1.75 [1.2 to 2.59], I2 97.7%), neuropathy (n = 3898, OR 2.01 [1.60 to 2.54], I2 44.5%), diabetes complications (n = 1769, OR 1.90 [1.53 to 2.36], I2 39.3%), peripheral blood concentrations of CRP (n = 1742, SMD 0.31 [0.16 to 0.45], I2 84.1%), female sex (n = 35,162, OR 1.36 [1.19 to 1.54], I2 64.5%), and social support (n = 3151, OR 2.02 [1.51 to 2.70], I2 87.2%). Conclusions Several factors associated with mental health disorders in patients with type 2 diabetes were identified with varying degrees of supporting evidence. Significantly, obesity, neuropathy, complications, peripheral blood CRP concentrations, female sex, and social support emerged with suggestive evidence. An investigation of these factors should be conducted to target interventions accordingly. It may be helpful to prioritize patients who have these risk factors as high-risk groups and to implement plans and policies to enhance support before mental health disorders occur.
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Affiliation(s)
- Amani Busili
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Kanta Kumar
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Laura Kudrna
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Idris Busaily
- Lecture, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
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Subramanian P, Prabhu V, Nehru M, Palanirasu R, Janardhanan R. Association of indoleamine 2,3 dioxygenase, brain derived neurotrophic factor and cellular senescence in type 2 diabetes mellitus with depression: a clinical approach. Mol Biol Rep 2024; 51:481. [PMID: 38578530 DOI: 10.1007/s11033-024-09435-3] [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: 12/04/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND AIM Type 2 diabetes mellitus (T2DM) and depression are often linked. Several studies have reported the role of molecular markers either in diabetes or depression. The present study aimed at molecular level profiling of Indoleamine-2,3-dioxygenase (IDO), brain-derived neurotrophic factor (BDNF) and cellular senescence in patients with type 2 diabetes with and without depression compared to individuals with healthy controls. METHODS A total of 120 individuals diagnosed with T2DM were enlisted for the study, with a subset of participants with and without exhibiting depression. The gene expression analysis was done using quantitative real-time PCR. RESULTS Indoleamine 2,3 dioxygenase (p < 0.001) and senescence genes (p < 0.001) were significantly upregulated, while brain derived neurotrophic factor (p < 0.01) was significantly downregulated in T2DM patients comorbid with and without depression when compared to healthy controls. CONCLUSION Indoleamine 2,3 dioxygenase, Brain derived neurotrophic factor and cellular senescence may play a role in the progression of the disease. The aforementioned discoveries offer significant contributions to our understanding of the molecular mechanisms that underlie T2DM with depression, potentially aiding in the advancement of prediction and diagnostic methods for this particular ailment.
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Affiliation(s)
- Prasanth Subramanian
- Department of Medical Research, SRM Medical College Hospital & Research Centre, SRMIST, Kattankulathur, Chennai, Tamil Nadu, India
| | - Venkataraman Prabhu
- Department of Medical Research, SRM Medical College Hospital & Research Centre, SRMIST, Kattankulathur, Chennai, Tamil Nadu, India.
| | - Mohanraj Nehru
- Department of Medical Research, SRM Medical College Hospital & Research Centre, SRMIST, Kattankulathur, Chennai, Tamil Nadu, India
| | - Rajapriya Palanirasu
- Department of Transfusion Medicine, HLA and Transport Immunology, Dr Rela Institute and Medical Centre, Chromepet, Chennai, Tamil Nadu, India
| | - Rajiv Janardhanan
- Department of Medical Research, SRM Medical College Hospital & Research Centre, SRMIST, Kattankulathur, Chennai, Tamil Nadu, India
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Vafopoulou E, Christodoulou N, Papathanasiou IV. Treatment Adherence and Quality of Life Among Elderly Patients With Diabetes Mellitus Registered in the Community. Cureus 2024; 16:e58986. [PMID: 38800199 PMCID: PMC11127614 DOI: 10.7759/cureus.58986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Background This study investigates the association between medication adherence and health-related quality of life among adults with type 2 diabetes mellitus at the Health Center of Tyrnavos community level. Materials and methods This cross-sectional study involved 125 patients with type 2 diabetes mellitus, aged 60 years and older, who were visiting community healthcare facilities. The research was conducted with a structured questionnaire that included 34 questions related to socio-demographic data, self-reported compliance, and stress. The DQOL-BCI (Diabetes Quality of Life - Brief Clinical Inventory) scale was used to measure health-related quality of life. Results A total of 125 patients with a mean (SD) age of 69.2 (8.1) years were included in the study (64 women and 61 men). Based on the results of the descriptive analysis, 88.0% reported high medication adherence. However, 66% of the participants reported having high anxiety levels, with 33.6% having difficulty controlling their anxiety. Quality of life was negatively correlated with lower medication adherence (P < 0.05). Conclusions Older age and low medication adherence are associated with lower quality of life among diabetic patients. Interventions to improve the quality of life in elderly diabetic patients should consider the effect of age and medication adherence.
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Cherrington AL, Bebu I, Krause-Steinrauf H, Hoogendoorn CJ, Crespo-Ramos G, Presley C, Naik AD, Balasubramanyam A, Gramzinski MR, Killean T, Arends VL, Gonzalez JS. Does Emotional Distress Predict Worse Glycemic Control Over Time? Results From the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care 2024; 47:620-628. [PMID: 38252848 PMCID: PMC10973910 DOI: 10.2337/dc23-0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/09/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVE To evaluate whether baseline levels of depressive symptoms and diabetes-specific distress are associated with glycemic control in Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE), a large randomized controlled trial comparing the metabolic effects of four common glucose-lowering medications when combined with metformin in individuals with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS The primary and secondary outcomes were defined as an HbA1c value ≥7%, subsequently confirmed, and an HbA1c value >7.5%, subsequently confirmed, respectively. Separate Cox proportional hazards models assessed the association between baseline levels of each exposure of interest (depressive symptoms measured with the eight-item Patient Health Questionnaire and diabetes distress measured with the Diabetes Distress Scale) and the subsequent risk of metabolic outcomes. RESULTS This substudy included 1,739 participants (56% of whom were non-Hispanic White, 18% non-Hispanic Black, 17% Hispanic, and 68% male; mean [SD] age 58.0 [10.2] years, diabetes duration 4.2 [2.8] years, and HbA1c 7.5% [0.48%]). A total of 1,157 participants reached the primary outcome, with time to event of 2.1 years on average, while 738 participants reached the secondary outcome at 3 years on average. With adjustment for sex, race/ethnicity, treatment group, baseline age, duration of T2DM, BMI, and HbA1c, there were no significant associations between the depressive symptoms or diabetes distress and the subsequent risk of the primary or secondary outcomes. CONCLUSIONS The current findings suggest that, at least for individuals with diabetes of relatively short duration, baseline levels of emotional distress are not associated with glycemic control over time.
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Affiliation(s)
- Andrea L. Cherrington
- General Internal and Preventive Medicine, Department of Medicine, University of Alabama, Birmingham, Birmingham, AL
| | - Ionut Bebu
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Heidi Krause-Steinrauf
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Claire J. Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Gladys Crespo-Ramos
- Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Caroline Presley
- Division of Preventative Medicine, University of Alabama, Birmingham, AL
| | - Aanand D. Naik
- University of Texas Health Science Center (UTHealth) School of Public Health, Houston, TX
| | - Ashok Balasubramanyam
- University of Texas Health Science Center (UTHealth) School of Public Health, Houston, TX
| | - Michaela R. Gramzinski
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Tina Killean
- Obesity and Diabetes Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Valerie L. Arends
- Advanced Research and Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Jeffrey S. Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY
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Fernández-Rodríguez R, Zhao L, Bizzozero-Peroni B, Martínez-Vizcaíno V, Mesas AE, Wittert G, Heilbronn LK. Are e-Health Interventions Effective in Reducing Diabetes-Related Distress and Depression in Patients with Type 2 Diabetes? A Systematic Review with Meta-Analysis. Telemed J E Health 2024; 30:919-939. [PMID: 38010739 DOI: 10.1089/tmj.2023.0374] [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] [Indexed: 11/29/2023] Open
Abstract
Background: e-Health refers to any health care service delivered through the internet or related technologies, to improve quality of life. Despite the increasing use of e-health interventions to manage type 2 diabetes (T2D), there is a lack of evidence about the effectiveness on diabetes distress and depression, which are common issues in those living with T2D. Purpose: To synthesize and determine the effects of e-health interventions on diabetes distress and depression among patients with T2D. Methods: We systematically searched PubMed, Scopus, Cochrane CENTRAL, and Web of Science for randomized controlled trials (RCTs), non-RCTs and observational cohort studies for the effects of e-health interventions on diabetes distress and depression in patients with T2D up to September 14, 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 recommendations were followed. The risk of bias was assessed according to the Risk-of-Bias 2 tool (RCTs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) (non-RCTs) and the National Institute of Health tool (observational). The standardized mean difference (SMD) and its related 95% confidence intervals (CIs) were estimated with the DerSimonian-Laird method through random-effect models. A pooled raw mean difference (MD) meta-analysis was conducted for RCTs comparing the effects of e-health versus control on diabetes distress screening to display the clinical impact. Results: A total of 41 studies (24 RCTs, 14 non-RCTs, and 3 observational) involving 8,667 individuals were included. The pooled SMD for the effect of e-health versus the control group on diabetes distress was -0.14 (95% CI = -0.24 to -0.04; I2 = 23.9%; n = 10 studies), being -0.06 (95% CI = -0.15 to 0.02; I2 = 7.8%; n = 16 studies) for depression. The pooled raw MD on diabetes distress screening showed a reduction of -0.54 points (95% CI = -0.81 to -0.27; I2 = 85.1%; n = 7 studies). Conclusion: e-Health interventions are effective in diminishing diabetes distress among adults with T2D, inducing clinically meaningful reductions.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Lijun Zhao
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Bruno Bizzozero-Peroni
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autonoma de Chile, Talca, Chile
| | - Arthur Eumann Mesas
- Universidad de Castilla La-Mancha, Health and Social Research Center, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Gary Wittert
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Leonie K Heilbronn
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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Yeung YL, Lee KL, Lau ESH, Yung TF, Yang A, Wu H, Wong KTC, Kong APS, Chow EYK, Ma RCW, Yeung T, Loo KM, Ozaki R, Luk AOY, Lui JNM, Chan JCN. Associations of comorbid depression with cardiovascular-renal events and all-cause mortality accounting for patient reported outcomes in individuals with type 2 diabetes: a 6-year prospective analysis of the Hong Kong Diabetes Register. Front Endocrinol (Lausanne) 2024; 15:1284799. [PMID: 38586459 PMCID: PMC10999250 DOI: 10.3389/fendo.2024.1284799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/29/2024] [Indexed: 04/09/2024] Open
Abstract
Background Psychosocial status and patient reported outcomes (PRO) [depression and health-related quality-of-life (HRQoL)] are major health determinants. We investigated the association between depression and clinical outcomes in Chinese patients with type 2 diabetes (T2D), adjusted for PRO. Methods Using prospective data from Hong Kong Diabetes Register (2013-2019), we estimated the hazard-ratio (HR, 95%CI) of depression (validated Patient Health Questionnaire 9 (PHQ-9) score≥7) with incident cardiovascular disease (CVD), ischemic heart disease (IHD), chronic kidney disease (CKD: eGFR<60 ml/min/1.73m2) and all-cause mortality in 4525 Chinese patients with T2D adjusted for patient characteristics, renal function, medications, self-care and HRQoL domains (mobility, self-care, usual activities, pain/discomfort, anxiety/depression measured by EQ-5D-3L) in linear-regression models. Results In this cohort without prior events [mean ± SD age:55.7 ± 10.6, 43.7% women, median (IQR) disease duration of 7.0 (2.0-13.0) years, HbA1c, 7.2% (6.6%-8.20%), 26.4% insulin-treated], 537(11.9%) patients had depressive symptoms and 1923 (42.5%) patients had some problems with HRQoL at baseline. After 5.6(IQR: 4.4-6.2) years, 141 patients (3.1%) died, 533(11.8%) developed CKD and 164(3.6%) developed CVD. In a fully-adjusted model (model 4) including self-care and HRQoL, the aHR of depression was 1.99 (95% confidence interval CI):1.25-3.18) for CVD, 2.29 (1.25-4.21) for IHD. Depression was associated with all-cause mortality in models 1-3 adjusted for demographics, clinical characteristics and self-care, but was attenuated after adjusting for HRQoL (model 4- 1.54; 95%CI: 0.91-2.60), though HR still indicated same direction with important magnitude. Patients who reported having regular exercise (3-4 times per week) had reduced aHR of CKD [0.61 (0.41-0.89)]. Item 4 of PHQ-9 (feeling tired, little energy) was independently associated with all-cause mortality with aHR of 1.66 (1.30-2.12). Conclusion Depression exhibits significant association with CVD, IHD, and all-cause mortality in patients with diabetes, adjusting for their HRQoL and health behaviors. Despite the association between depression and all-cause mortality attenuated after adjusting for HRQoL, the effect size remains substantial. The feeling of tiredness or having little energy, as assessed by item Q4 of the PHQ-9 questionnaire, was found to be significantly associated with an increased risk of all-cause mortality after covariate adjustments. Our findings emphasize the importance of incorporating psychiatric evaluations into holistic diabetes management.
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Affiliation(s)
- Yiu-Lam Yeung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Ka-Long Lee
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Eric SH. Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Tsun-Fung Yung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Kelly TC. Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Alice PS. Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Elaine YK. Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Ronald CW. Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Theresa Yeung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Kit-man Loo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Risa Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Andrea OY. Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Juliana NM. Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Juliana CN. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
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Song A, Koh EJ, Lee WY, Chang S, Lim J, Choi M, Ki M. Suicide risk of chronic diseases and comorbidities: A Korean case-control study. J Affect Disord 2024; 349:431-437. [PMID: 38190857 DOI: 10.1016/j.jad.2024.01.037] [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: 09/28/2023] [Revised: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Chronic diseases including mental disorders have been associated with suicide. This study broadens the approach by incorporating a comprehensive list of chronic diseases and a context of comorbidities and explored their associations with suicide. METHODS Data-linkage between death registry and Korean National Health Insurance data was conducted. Suicide cases (n = 64,099) between 2009 and 2013 were 1:4 matched for gender and age to an alive control (n = 256,396). A total of 92 individual diseases of 9 broad categories were identified from insurance claims data. Conditional logistic regression was applied to assess the associations, adjusting for mental and behavioral disorders and socioeconomic status. RESULTS Suicide cases frequently experienced chronic diseases (90.0 %) and comorbidities (74.6 %). Chronic diseases greatly increased suicide risk and, among these, mental and behavioral disorders showed the highest suicide risk (OR = 7.53, 95 % CI = 7.32-7.74) followed by cardiovascular (OR = 3.36, 95 % CI = 3.26-3.47). For individual diseases, gastritis and duodenitis were most prevalent (68.1 %) among suicide cases but depressive disorder showed the highest risk (OR = 4.95, 95 % CI = 4.79-5.12). Suicide risk was strong in comorbid status sometimes comparable to odds for mental and behavioral disorder alone (e.g., OR for cardiovascular and eye vision-related diseases = 4.01, 95 % CI = 3.86-4.17). LIMITATIONS Differentiation of comorbidity was limited to pairs between major disease categories, neglecting the heterogeneity within categories. CONCLUSION Chronic diseases, in particular comorbidity, showed strong associations with suicide. This suggests that those with comorbidities feel that they are pushed to the extreme line, supporting comprehensive interventions for them to address wider reasons including psychological and social problems, besides medical problems.
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Affiliation(s)
- Areum Song
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Emily Jiali Koh
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, 84 Heukseok-Ro, Dongjak-Gu, Seoul 156-756, Republic of Korea
| | - Shusen Chang
- Department of Public Health, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Zhongzheng Dist., Taipei, Taiwan
| | - Jiseun Lim
- Department of Preventive Medicine, Eulji University, 77 Gyeryong-ro 771beon-gil, Yongdu-dong, Jung-gu, Daejeon, Republic of Korea
| | - Minjae Choi
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Myung Ki
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; BK21FOUR R&E Center for Learning Health Systems, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, Republic of Korea.
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Kim EY, Lee YB, Lee GN, Han K, Jeong SM. Associations between body weight change and incidence of major depressive disorder in patients with type 2 diabetes mellitus: a nationwide longitudinal follow-up cohort study of 1.1 million. Psychol Med 2024:1-9. [PMID: 38469866 DOI: 10.1017/s0033291724000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND Comorbid depression substantially affects the management of glycemia and diabetes-related complications among patients with type 2 diabetes mellitus. In this study, we sought to determine the association between weight change over 4 years and depression risk among patients with type 2 diabetes mellitus. METHODS This population-based retrospective cohort study from the National Health Insurance Services of Korea included 1 111 345 patients with type 2 diabetes who were divided into groups according to body weight change over 4 years. Body weight changes were compared with the preceding 4-year period (2005-2008). Depression was defined according to the International Classification of Diseases 10th revision code for depression (F32 and F33) on one or more inpatient or outpatient claims. RESULTS During a median follow-up of 7.4 years, 244 081 cases of depression were identified. We observed a U-shaped association between body weight change and depression risk with a higher risk among both groups of weight loss (hazard ratio (HR) 1.17, 95% CI 1.15-1.19 for ⩾ -10%; HR 1.07, 95% CI 1.06-1.08 for -10 to -5%) and weight gain (HR 1.06, 95% CI 1.04-1.08 for ⩾10%; HR 1.02, 95% CI 1.01-1.04 for 5-10%) compared with the stable weight group (-5 to 5%). CONCLUSIONS A U-shaped association between body weight change and depression risk was observed in this large nationwide cohort study. Our study suggests that patients with type 2 diabetes and weight change, either gain or loss, could be considered a high-risk group for depression.
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Affiliation(s)
- Eun Young Kim
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Mental Health Center, Seoul National University Health Care Center, Seoul, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gyu-Na Lee
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Su-Min Jeong
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University Health Service Center, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Teo V, Weinman J, Yap KZ. Systematic Review Examining the Behavior Change Techniques in Medication Adherence Intervention Studies Among People With Type 2 Diabetes. Ann Behav Med 2024; 58:229-241. [PMID: 38334280 PMCID: PMC10928844 DOI: 10.1093/abm/kaae001] [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] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Although previous systematic reviews have studied medication adherence interventions among people with Type 2 diabetes (PwT2D), no intervention has been found to improve medication adherence consistently. Furthermore, inconsistent and poor reporting of intervention description has made understanding, replication, and evaluation of intervention challenging. PURPOSE We aimed to identify the behavior change techniques (BCTs) and characteristics of successful medication adherence interventions among PwT2D. METHODS A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. Studies were included if they were randomized controlled trials with BCT-codable interventions designed to influence adherence to anti-diabetic medication for PwT2D aged 18 years old and above and have medication adherence measure as an outcome. RESULTS Fifty-five studies were included. Successful interventions tend to target medication adherence only, involve pharmacists as the interventionist, contain "Credible source" (BCT 9.1), "Instruction on how to perform the behaviour" (BCT 4.1), "Social support (practical)" (BCT 3.2), "Action planning" (BCT 1.4), and/ or "Information about health consequences" (BCT 5.1). Very few interventions described its context, used theory, examined adherence outcomes during the follow-up period after an intervention has ended, or were tailored to address specific barriers of medication adherence. CONCLUSION We identified specific BCTs and characteristics that are commonly reported in successful medication adherence interventions, which can facilitate the development of future interventions. Our review highlighted the need to consider and clearly describe different dimensions of context, theory, fidelity, and tailoring in an intervention.
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Affiliation(s)
- Vivien Teo
- Institute of Pharmaceutical Sciences, King’s College London (KCL), London, UK
- Department of Pharmacy, National University of Singapore (NUS), Singapore
| | - John Weinman
- Institute of Pharmaceutical Sciences, King’s College London (KCL), London, UK
| | - Kai Zhen Yap
- Department of Pharmacy, National University of Singapore (NUS), Singapore
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Lin YK, Hepworth E, de Zoysa N, McCurley J, Vajravelu ME, Ye W, Piatt GA, Amiel SA, Fisher SJ, Pop-Busui R, Aikens JE. Relationships of hypoglycemia awareness, hypoglycemia beliefs, and continuous glucose monitoring glycemic profiles with anxiety and depression symptoms in adults with type 1 diabetes using continuous glucose monitoring systems. Diabetes Res Clin Pract 2024; 209:111596. [PMID: 38428746 PMCID: PMC10960959 DOI: 10.1016/j.diabres.2024.111596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
AIMS To evaluate relationships of hypoglycemia awareness, hypoglycemia beliefs, and continuous glucose monitoring (CGM) glycemic profiles with anxiety and depression symptoms in adults with type 1 diabetes (T1D) who use CGM. METHODS A cross-sectional survey and data collections were completed with 196 T1D adults who used CGM (59% also used automated insulin delivery devices (AIDs)). We assessed hypoglycemia awareness (Gold instrument), hypoglycemia beliefs (Attitudes to Awareness of Hypoglycemia instrument), CGM glycemic profiles, demographics, and anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Analysis included simple and multiple linear regression analyses. RESULTS Lower hypoglycemia awareness, weaker "hypoglycemia concerns minimized" beliefs, stronger "hyperglycemia avoidance prioritized" beliefs were independently associated with higher anxiety symptoms (P < 0.05), with similar trends in both subgroups using and not using AIDs. Lower hypoglycemia awareness were independently associated with greater depression symptoms (P < 0.05). In participants not using AIDs, more time in hypoglycemia was related to less anxiety and depression symptoms (P < 0.05). Being female and younger were independently associated with higher anxiety symptoms, while being younger was also independently associated with greater depression symptoms (P < 0.05). CONCLUSION Our findings revealed relationships of impaired hypoglycemia awareness, hypoglycemia beliefs, CGM-detected hypoglycemia with anxiety and depression symptoms in T1D adults who use CGMs.
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Affiliation(s)
- Yu Kuei Lin
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
| | - Emily Hepworth
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48105, USA
| | - Nicole de Zoysa
- Department of Diabetes, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | - Jessica McCurley
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Mary Ellen Vajravelu
- Center for Pediatric Research in Obesity and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA
| | - Wen Ye
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48105, USA
| | - Gretchen A Piatt
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI 48105, USA
| | - Stephanie A Amiel
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Kings College London, London SE5 9RJ, UK
| | - Simon J Fisher
- Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 40508, USA
| | - Rodica Pop-Busui
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48105, USA
| | - James E Aikens
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI 48105, USA
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Kim J, Hurh K, Han S, Kim H, Park EC, Jang SY. Association between antidepressants and the risk of diabetic foot ulcers and amputation in antidepressant-naïve type 2 diabetes mellitus patients: A nested case-control study. Diabetes Res Clin Pract 2024; 209:111591. [PMID: 38403177 DOI: 10.1016/j.diabres.2024.111591] [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: 09/20/2023] [Revised: 12/15/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
AIMS Antidepressants are widely used by individuals with type 2 diabetes mellitus (T2DM). This study aimed to explore the correlation between antidepressant use, considering specific antidepressant subclasses or cumulative doses, and diabetic foot ulcer (DFU) risk. METHODS This nested case-control study was conducted using a representative population-based Korean cohort database from 2002 to 2019. Participants with DFUs were matched with participants without DFUs based on age, sex, date of T2DM diagnosis, and follow-up duration. In total, 791 DFUs and 3900 controls were included. The association between antidepressant use or cumulative dose of each antidepressant subclass, DFU risk and amputation risk was examined using a conditional logistic regression model. RESULTS Antidepressant ever-use was associated with an increased incidence of DFUs compared with non-use. Furthermore, an increase in DFU risk was evident with increasing cumulative antidepressant dosage, particularly among tricyclic antidepressant (TCA) ever-users and selective serotonin reuptake inhibitors (SSRIs) ever-users. Additionally, antidepressant ever-users displayed a higher risk of DFUs requiring amputation, which was consistently observed when the cumulative dosages of overall antidepressants and TCAs were considered. CONCLUSION Caution is advised when administering TCAs and SSRIs in antidepressant-naïve T2DM patients to reduce DFU and the consequent amputation risk.
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Affiliation(s)
- Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seokmoon Han
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
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Ghafori SS, Yousefi Z, Bakhtiari E, mohammadi mahdiabadi hasani MH, Hassanzadeh G. Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review. Brain Behav Immun Health 2024; 36:100734. [PMID: 38362135 PMCID: PMC10867583 DOI: 10.1016/j.bbih.2024.100734] [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: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, loss of interest, and decreased energy. Early diagnosis of depression can improve its negative impacts and be effective in its treatment. Previous studies have indicated that inflammation plays an important role in the initiation and development of depression, hence, various inflammatory biomarkers have been investigated for early diagnosis of depression, the most popular of which are blood biomarkers. The Neutrophil to lymphocyte ratio (NLR) may be more informative in the early diagnosis of depression than other widely used markers, such as other leukocyte characteristics or interleukins. Considering the importance of early diagnosis of depression and the role of NLR in early diagnosis of depression, our paper reviews the literature on NLR as a diagnostic biomarker of depression, which may be effective in its treatment. Various studies have shown that elevated NLR is associated with depression, suggesting that NLR may be a valuable, reproducible, easily accessible, and cost-effective method for the evaluation of depression and it may be used in outpatient clinic settings. Closer follow-up can be performed for these patients who have higher NLR levels. However, it seems that further studies on larger samples, taking into account important confounding factors, and assessing them together with other inflammatory markers are necessary to draw some conclusive statements.
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Affiliation(s)
- Sayed Soran Ghafori
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Bakhtiari
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Zhang Z, Sun L, Guo Y, Zhao J, Li J, Pan X, Li Z. Bavachin ameliorates neuroinflammation and depressive-like behaviors in streptozotocin-induced diabetic mice through the inhibition of PKCδ. Free Radic Biol Med 2024; 213:52-64. [PMID: 38215890 DOI: 10.1016/j.freeradbiomed.2024.01.010] [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: 12/10/2023] [Revised: 12/31/2023] [Accepted: 01/08/2024] [Indexed: 01/14/2024]
Abstract
Depression and diabetes are closely linked; however, the pathogenesis of depression associated with diabetes is unclear, and there are no clinically effective antidepressant drugs for diabetic patients with depression. Bavachin is an important active ingredient in Fructus Psoraleae. In this study, we evaluated the anti-neuroinflammatory and antidepressant effects associated with diabetes and the molecular mechanisms of bavachin in a streptozotocin-induced diabetes mouse model. We found that bavachin clearly decreased streptozotocin (STZ)-induced depressive-like behaviors in mice. It was further found that bavachin significantly inhibited microglia activation and the phosphorylation level of PKCδ and inhibited the activation of the NF-κB pathway in vivo and in vitro. Knockdown of PKCδ with siRNA-PKCδ partially reversed the inhibitory effect of bavachin on the NF-κB pathway and the level of pro-inflammatory factors. We further found that PKCδ directly bound to bavachin based on molecular docking and pull-down assays. We also found that bavachin improved neuroinflammation-induced neuronal survival and functional impairment and that this effect may be related to activation of the ERK and Akt pathways mediated by the BDNF pathway. Taken together, these data suggested that bavachin, by targeting inhibition PKCδ to inhibit the NF-κB pathway, further reduced the inflammatory response and oxidative stress and subsequently improved diabetic neuronal survival and function and finally ameliorated diabetes-induced depressive-like behaviors in mice. For the first time, we found that bavachin is a potential agent for the treatment of diabetes-associated neuroinflammation and depression and that PKCδ is a potential target for the treatment of diabetes-associated neuroinflammation, including depression.
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Affiliation(s)
- Zhonghong Zhang
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, China
| | - Liyan Sun
- Department of Pharmacy, Yantaishan Hospital, Yantai, Shandong, China
| | - Yaping Guo
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, China
| | - Jie Zhao
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, China
| | - Jiaqi Li
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaohong Pan
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, China
| | - Zhipeng Li
- School of Pharmacy, Binzhou Medical University, Yantai, Shandong, China.
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Soejbjerg A, Rasmussen SE, Christensen KS, Christensen B, Pedersen AF, Maindal HT, Mygind A. Managing mental health in chronic care in general practice: a feasibility study of the Healthy Mind intervention. Scand J Prim Health Care 2024; 42:72-81. [PMID: 38095546 PMCID: PMC10851809 DOI: 10.1080/02813432.2023.2289525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/26/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Mental health issues are common among patients with chronic physical conditions. This study aims to evaluate the feasibility of the Healthy Mind intervention, a general practice-based programme that provides problem-solving therapy (PST) to patients with poor mental well-being and type 2 diabetes (T2D) and/or ischaemic heart disease (IHD). DESIGN AND SETTING A one-arm feasibility study was conducted in three general practices in the Central Denmark Region. INTERVENTION Eight healthcare providers from the included general practices underwent a two-day course to acquire PST skills. Screening for poor mental health was carried out at the annual chronic care consultation for T2D or IHD, and PST sessions were offered to patients on indication of poor mental health. Nine patients received PST. METHODS Semi-structured interviews with eight healthcare providers and six patients were conducted. Data were analysed deductively focusing on appropriateness, acceptability and fidelity of the intervention. RESULTS The intervention was considered appropriate for the patient group and the general practice setting. The providers acknowledged PST as a valuable tool for managing psychological issues in general practice, and the patients perceived PST as an effective and tangible treatment. Since practice nurses' schedules were generally better suited for longer consultations, they were often the preferred intervention providers. The intervention was largely delivered as intended. However, the GPs generally expected patients to prefer a more directive approach, which sometimes challenged their role as facilitator and guide. CONCLUSION The Healthy Mind intervention was found to be feasible, and the results support proceeding to a full-scale evaluation trial.
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Affiliation(s)
- Anne Soejbjerg
- Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Stinne Eika Rasmussen
- Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Kaj Sparle Christensen
- Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Bo Christensen
- Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Anette Fischer Pedersen
- Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | | | - Anna Mygind
- Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
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Sy S, Sinclair A, Munshi M, Kahkoska AR, Weinstock R, Cukierman-Yaffe T. Use of Technologies at the Advanced Age. Diabetes Technol Ther 2024; 26:S172-S186. [PMID: 38441458 DOI: 10.1089/dia.2024.2511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Affiliation(s)
- Sarah Sy
- Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Alan Sinclair
- Foundation of Diabetes Research in Older People (fDROP), London, UK
- King's College, London, UK
| | - Medha Munshi
- Joslin Diabetes Center, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Anna R Kahkoska
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- UNC Center for Aging and Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruth Weinstock
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Tali Cukierman-Yaffe
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Zuniga-Kennedy M, Wang OH, Fonseca LM, Cleveland MJ, Bulger JD, Grinspoon E, Hansen D, Hawks ZW, Jung L, Singh S, Sliwinski M, Verdejo A, Miller KM, Weinstock RS, Germine L, Chaytor N. Nocturnal hypoglycemia is associated with next day cognitive performance in adults with type 1 diabetes: Pilot data from the GluCog study. Clin Neuropsychol 2024:1-20. [PMID: 38380810 DOI: 10.1080/13854046.2024.2315749] [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: 06/11/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Individuals with type 1 diabetes (T1D) have increased risk for cognitive dysfunction and high rates of sleep disturbance. Despite associations between glycemia and cognitive performance using cross-sectional and experimental methods few studies have evaluated this relationship in a naturalistic setting, or the impact of nocturnal versus daytime hypoglycemia. Ecological Momentary Assessment (EMA) may provide insight into the dynamic associations between cognition, affective, and physiological states. The current study couples EMA data with continuous glucose monitoring (CGM) to examine the within-person impact of nocturnal glycemia on next day cognitive performance in adults with T1D. Due to high rates of sleep disturbance and emotional distress in people with T1D, the potential impacts of sleep characteristics and negative affect were also evaluated. METHODS This pilot study utilized EMA in 18 adults with T1D to examine the impact of glycemic excursions, measured using CGM, on cognitive performance, measured via mobile cognitive assessment using the TestMyBrain platform. Multilevel modeling was used to test the within-person effects of nocturnal hypoglycemia and hyperglycemia on next day cognition. RESULTS Results indicated that increases in nocturnal hypoglycemia were associated with slower next day processing speed. This association was not significantly attenuated by negative affect, sleepiness, or sleep quality. CONCLUSIONS These results, while preliminary due to small sample size, showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive fluctuation in real world settings, an approach that may be utilized in other populations. Findings suggest reducing nocturnal hypoglycemia may improve cognition in adults with T1D.
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Affiliation(s)
| | - Olivia H Wang
- Elson S, Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Luciana M Fonseca
- Elson S, Floyd College of Medicine, Washington State University, Spokane, WA, USA
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Jane D Bulger
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Devon Hansen
- Elson S, Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | | | | | - Shifali Singh
- Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - Martin Sliwinski
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | | | | | - Ruth S Weinstock
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Naomi Chaytor
- Elson S, Floyd College of Medicine, Washington State University, Spokane, WA, USA
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Lu Y, Li Z, Qin K, Chen J, Zeng N, Yan B, Liu D. Association between perceived neighborhood environment and depression among residents living in mega-communities in Guiyang, China: a cross-sectional study. BMC Public Health 2024; 24:343. [PMID: 38302930 PMCID: PMC10836001 DOI: 10.1186/s12889-024-17844-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Little was known about the relationship between perceived neighborhood environment and depression among residents living in mega-communities. Furthermore, the mediating effects of physical activity (PA) and anxiety in this relationship have not been investigated. Thus, this study aimed to comprehensively examine the association between perceived neighborhood environment and depression among residents living in mega-communities, and test whether PA and anxiety mediated the association. METHODS A cross-sectional study on perceived neighborhood environment and depression was conducted among individuals who lived in mega-communities (n = 665) in Guiyang, China from July to August 2022. Perceived neighborhood environment was assessed from the following six aspects: traffic, building quality, accessibility, neighborhood, indoor, and pollution. Depression was measured by the Patients Health Questionnaire-9. Structural equation model was used to evaluate the association between perceived neighborhood environment and depression, and test the mediating effect of PA and anxiety in this association. RESULTS We found that neighborhood (β = -0.144, p = 0.002) and PA (β = -0.074, p < 0.001) were both negatively associated with depression, while anxiety was positively associated with depression (β = 0.447, p < 0.001). Married residents were less likely to experience depression than residents of other marital status. PA played a mediator role in the relationship between accessibility and depression (β = 0.014, p = 0.033). PA mediated the relationship between neighborhood and depression (β = -0.032, p = 0.015). The mediating effect of anxiety in the relationship between perceived neighborhood environment and depression was not significant. CONCLUSIONS This study demonstrated that neighborhood, which was assessed by satisfaction with safety, hygiene, parking, greening, lighting, and building shape, was negatively associated with depression, and PA mediated the relationship.
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Affiliation(s)
- Yong Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zenglin Li
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Kai Qin
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jiao Chen
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Nana Zeng
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Bo Yan
- Guangzhou Medical University Library, Guangzhou, China.
| | - Di Liu
- School of Public Health, Guangzhou Medical University, Guangzhou, China.
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Ajayi T, Thomas A, Nikolic M, Henderson L, Zaheri A, Dwyer DS. Evolutionary conservation of putative suicidality-related risk genes that produce diminished motivation corrected by clozapine, lithium and antidepressants. Front Psychiatry 2024; 15:1341735. [PMID: 38362034 PMCID: PMC10867104 DOI: 10.3389/fpsyt.2024.1341735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Background Genome wide association studies (GWAS) and candidate gene analyses have identified genetic variants and genes that may increase the risk for suicidal thoughts and behaviors (STBs). Important unresolved issues surround these tentative risk variants such as the characteristics of the associated genes and how they might elicit STBs. Methods Putative suicidality-related risk genes (PSRGs) were identified by comprehensive literature search and were characterized with respect to evolutionary conservation, participation in gene interaction networks and associated phenotypes. Evolutionary conservation was established with database searches and BLASTP queries, whereas gene-gene interactions were ascertained with GeneMANIA. We then examined whether mutations in risk-gene counterparts in C. elegans produced a diminished motivation phenotype previously connected to suicide risk factors. Results and conclusions From the analysis, 105 risk-gene candidates were identified and found to be: 1) highly conserved during evolution, 2) enriched for essential genes, 3) involved in significant gene-gene interactions, and 4) associated with psychiatric disorders, metabolic disturbances and asthma/allergy. Evaluation of 17 mutant strains with loss-of-function/deletion mutations in PSRG orthologs revealed that 11 mutants showed significant evidence of diminished motivation that manifested as immobility in a foraging assay. Immobility was corrected in some or all of the mutants with clozapine, lithium and tricyclic antidepressant drugs. In addition, 5-HT2 receptor and muscarinic receptor antagonists restored goal-directed behavior in most or all of the mutants. These studies increase confidence in the validity of the PSRGs and provide initial clues about possible mechanisms that mediate STBs.
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Affiliation(s)
- Titilade Ajayi
- Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
| | - Alicia Thomas
- Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
| | - Marko Nikolic
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| | - Lauryn Henderson
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| | - Alexa Zaheri
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
| | - Donard S. Dwyer
- Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
- Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, Shreveport, LA, United States
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Saha CK, Shubrook JH, Guyton Hornsby W, Yang Z, Pillay Y, Mather KJ, de Groot M. Program ACTIVE II: 6- and 12-month outcomes of a treatment approach for major depressive disorder in adults with type 2 diabetes. J Diabetes Complications 2024; 38:108666. [PMID: 38266570 PMCID: PMC10922820 DOI: 10.1016/j.jdiacomp.2023.108666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/12/2023] [Accepted: 12/17/2023] [Indexed: 01/26/2024]
Abstract
AIMS To evaluate the long-term effects of behavioral treatments on glycemic and psychological outcomes for patients with major depressive disorder (MDD) and type 2 diabetes (T2D). METHODS Program ACTIVE II was a multicenter randomized controlled comparative effectiveness trial of cognitive behavioral therapy (CBT), exercise (EXER), combination treatment (CBT + EXER) and usual care (UC) for adults with MDD and T2D. RESULTS Primary outcomes: change in A1c and depressive symptoms at 6- (N = 87) and 12-months (N = 75) from baseline. In those with a baseline A1c ≥7.0 %, CBT + EXER showed lasting A1c benefit at 6- (-1.2 %; SE: 0.6; p = 0.032) and 12-months (-1.4 %; SE: 0.6; p = 0.025) compared to UC. All groups had clinically significant improvements in depressive symptoms. At 6 months, CBT + EXER had significant improvements in diabetes-related distress regimen burden (p = 0.005); and social support (CIRS, p = 0.043) compared to UC. CONCLUSIONS The Program ACTIVE II CBT + EXER intervention demonstrated a sustained improvement in A1c for a subgroup of study participants with a baseline A1c ≥7.0 %. However, this finding should be considered preliminary because of small sample size. All 3 behavioral intervention groups demonstrated improvements in psychosocial outcomes one-year post-intervention. These findings point to the enduring benefits of community-based interventions to extend the availability of depression treatment for T2D patients.
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Affiliation(s)
- Chandan K Saha
- Indiana University School of Medicine, United States of America
| | | | - W Guyton Hornsby
- West Virginia University School of Medicine, United States of America
| | - Ziyi Yang
- Indiana University School of Medicine, United States of America
| | | | - Kieren J Mather
- Indiana University School of Medicine, United States of America
| | - Mary de Groot
- Indiana University School of Medicine, United States of America.
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Hristov M, Nankova A, Andreeva-Gateva P. Alterations of the glutamatergic system in diabetes mellitus. Metab Brain Dis 2024; 39:321-333. [PMID: 37747631 DOI: 10.1007/s11011-023-01299-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/17/2023] [Indexed: 09/26/2023]
Abstract
Diabetes mellitus (DM) is a chronic disease characterized by elevated blood glucose levels caused by a lack of insulin production (type 1 diabetes) or insulin resistance (type 2 diabetes). It is well known that DM is associated with cognitive deficits and metabolic and neurophysiological changes in the brain. Glutamate is the main excitatory neurotransmitter in the central nervous system that plays a key role in synaptic plasticity, learning, and memory processes. An increasing number of studies have suggested that abnormal activity of the glutamatergic system is implicated in the pathophysiology of DM. Dysfunction of glutamatergic neurotransmission in the central nervous system can provide an important neurobiological substrate for many disorders. Magnetic resonance spectroscopy (MRS) is a non-invasive technique that allows a better understanding of the central nervous system factors by measuring in vivo the concentrations of brain metabolites within the area of interest. Here, we briefly review the MRS studies that have examined glutamate levels in the brain of patients with DM. The present article also summarizes the available data on abnormalities in glutamatergic neurotransmission observed in different animal models of DM. In addition, the role of gut microbiota in the development of glutamatergic alterations in DM is addressed. We speculate that therapeutic strategies targeting the glutamatergic system may be beneficial in the treatment of central nervous system-related changes in diabetic patients.
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Affiliation(s)
- Milen Hristov
- Department of Pharmacology and Toxicology, Faculty of Medicine, Medical University of Sofia, 2 "Zdrave" St, Sofia, 1431, Bulgaria.
| | - Anelia Nankova
- Department of Endocrinology, Faculty of Medicine, Medical University of Sofia, Sofia, 1431, Bulgaria
| | - Pavlina Andreeva-Gateva
- Department of Pharmacology and Toxicology, Faculty of Medicine, Medical University of Sofia, 2 "Zdrave" St, Sofia, 1431, Bulgaria
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AlQashqri H, Hariri N, Jadkarim RJ, Falemban AH, Alfalogy E. Screening of Geriatric Depression in Makkah, Saudi Arabia: A Pilot Study. Cureus 2024; 16:e53313. [PMID: 38435946 PMCID: PMC10906780 DOI: 10.7759/cureus.53313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE There is currently limited evidence about the prevalence of depression among elderly people residing in Makkah, Saudi Arabia. This study aims to report the magnitude of depression among the older population in Makkah, Saudi Arabia, and the related risk factors. METHODS An online cross-sectional pilot survey was carried out in Makkah City, Saudi Arabia. Data were collected using an online self-administered questionnaire. RESULTS The study questionnaire was completed by 191 older people. The participants' ages varied from 60 to 88 years. 55.5% were women, 47.9% were married, and 21.5% were divorced/widowed. 46.6% had hypertension, 42.4% had diabetes, 17.3% had hypothyroidism, 7.9% had cardiovascular diseases (CVDs), and 6.3% reported psychiatric problems. 44.5% of the subjects had no depression, 23.5% had mild, 15.2% had moderate, and 16.8% had severe depression. The sample included 32% who had been classified as having major depression. Elderly participants with insomnia, cognitive diseases, and chronic diseases showed a high risk for experiencing severe depression (OR=2.74; 95% CI: 1.42-5.28),(OR=2.63; 95% CI: 1.29-5.40), and (OR=2.62; 95% CI: 1.11-6.14) respectively. CONCLUSION Depression was common among the elderly population in Makkah, particularly among those with a documented history of insomnia, cognitive diseases, and chronic diseases. Depression screening and treatment for old people in medical settings is recommended.
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Affiliation(s)
- Hamsa AlQashqri
- Community and Family Medicine, Umm Al-Qura University, Makkah, SAU
| | - Nahla Hariri
- Community Medicine, Umm Al-Qura University, Makkah, SAU
| | - Renad J Jadkarim
- Epidemiology and Public Health, Umm Al-Qura University, Makkah, SAU
| | - Alaa H Falemban
- Pharmacology and Toxicology, Umm Al-Qura University, Makkah, SAU
| | - Enas Alfalogy
- Family Medicine, Suez Canal University, Ismailia, EGY
- Family Medicine, Umm Al-Qura University, Makkah, SAU
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