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Kiaris H. Nontraditional models as research tools: the road not taken. Trends Mol Med 2024:S1471-4914(24)00191-6. [PMID: 39069395 DOI: 10.1016/j.molmed.2024.07.005] [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: 05/31/2024] [Revised: 07/07/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
Historical reasons resulted in the almost exclusive use of a few species, most prominently Mus musculus, as the mainstream models in biomedical research. This selection was not based on Mus's distinctive relevance to human disease but rather to the pre-existing availability of resources and tools for the species that were used as models, which has enabled their adoption for research in health sciences. Unless the utilization and range of nontraditional research models expand considerably, progress in biomedical research will remain restricted within the trajectory that has been set by the existing models and their ability to provide clinically relevant information.
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Affiliation(s)
- Hippokratis Kiaris
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy and Peromyscus Genetic Stock Center, University of South Carolina, Columbia, SC, USA.
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Cecchini V, Agahi N. Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years. Aging Ment Health 2024:1-9. [PMID: 38644675 DOI: 10.1080/13607863.2024.2341877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. METHOD Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. RESULTS Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. CONCLUSION Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.
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Affiliation(s)
- Valeria Cecchini
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Strand BH, Håberg AK, Eyjólfsdóttir HS, Kok A, Skirbekk V, Huxhold O, Løset GK, Lennartsson C, Schirmer H, Herlofson K, Veenstra M. Spousal bereavement and its effects on later life physical and cognitive capability: the Tromsø study. GeroScience 2024:10.1007/s11357-024-01150-y. [PMID: 38594472 DOI: 10.1007/s11357-024-01150-y] [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: 10/30/2023] [Accepted: 03/31/2024] [Indexed: 04/11/2024] Open
Abstract
Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants (N=5739) aged 50-70 years with baseline self-reported overall health and health-related factors and measured capability (grip strength, finger tapping, digit symbol coding, and short-term recall) at follow-up. Participants had data from Tromsø4 (1994-1995) and Tromsø5 (2001), or Tromsø6 (2007-2008) and Tromsø7 (2015-2016). Propensity score matching, adjusted for baseline confounders (and baseline capability in a subset), was used to investigate whether spousal bereavement was associated with poorer subsequent capability. Spousal bereavement occurred for 6.2% on average 3.7 years (SD 2.0) before the capability assessment. There were no significant bereavement effects on subsequent grip strength, immediate recall, or finger-tapping speed. Without adjustment for baseline digit symbol coding test performance, there was a negative significant effect on the digit symbol coding test (ATT -1.33; 95% confidence interval -2.57, -0.10), but when baseline digit symbol coding test performance was taken into account in a smaller subsample, using the same set of matching confounders, there was no longer any association (in the subsample ATT changed from -1.29 (95% CI -3.38, 0.80) to -0.04 (95% CI -1.83, 1.75). The results in our study suggest that spousal bereavement does not have long-term effects on the intrinsic capacity components physical or cognition capability to a notable degree.
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Affiliation(s)
- Bjørn Heine Strand
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway.
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
| | - Asta K Håberg
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Harpa Sif Eyjólfsdóttir
- Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Stockholm University, Stockholm, Sweden
| | - Almar Kok
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life Programme, Amsterdam, The Netherlands
| | - Vegard Skirbekk
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Gøril Kvamme Løset
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Carin Lennartsson
- Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden
- Swedish Institute for Social Research (SOFI), Stockholm University, Stockholm, Sweden
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Cardiology, Akershus, University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Katharina Herlofson
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
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Xu DD, Zhang GX, Ding XB, Ma J, Suo YX, Peng YY, Zeng JL, Liu M, Hou RT, Li J, Hu F. Bereaved parents' perceptions of memory making: a qualitative meta-synthesis. BMC Palliat Care 2024; 23:24. [PMID: 38273273 PMCID: PMC10809512 DOI: 10.1186/s12904-024-01339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/01/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE This study aims to investigate the experiences of parents who have experienced bereavement in their efforts to preserve memories of their deceased child. METHODS Employing a qualitative meta-synthesis approach, this study systematically sought relevant qualitative literature by conducting searches across various electronic databases, including PubMed, Embase, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Wiley, up until July 2023. RESULTS Nine studies are eligible for inclusion and included in the meta-synthesis. Three overarching categories are identified: (1) Affirming the Significance of Memory Making. (2) Best Practices in Memory Making. (3) Barriers to Effective Memory Making. CONCLUSION Bereaved parents highly value the act of creating lasting memories, emphasizing its profound significance. While forming these memories, it is imperative to offer family-centered care and honor diverse preferences and needs. It is essential to offer effective support to parents, offering them a range of choices. Furthermore, a more comprehensive examination of memory-making practices is required to better understand their influence on parents' recollections of their deceased child.
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Affiliation(s)
- Dan-Dan Xu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China
| | - Guang-Xiong Zhang
- Department of Anesthesiology, Hubei Province Corps Hospital of The Chinese Armed Police Force (CAPF), Wuhan, China
| | - Xin-Bo Ding
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China
| | - Jing Ma
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China
| | - Ya-Xi Suo
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China
| | - Yang-Yao Peng
- Department of Neurosurgical Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ji-Li Zeng
- Department of Otorhinolaryngology, General Hospital of Central Theater Command, Wuhan, China
| | - Miao Liu
- Department of Pulmonary Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Rui-Tong Hou
- Department of Pulmonary Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jin Li
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China.
| | - Fen Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China.
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Schwartz GL, Leifheit KM, Arcaya MC, Keene D. Eviction as a community health exposure. Soc Sci Med 2024; 340:116496. [PMID: 38091853 PMCID: PMC11249083 DOI: 10.1016/j.socscimed.2023.116496] [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: 06/14/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/23/2024]
Abstract
Evidence suggests that being evicted harms health. Largely ignored in the existing literature is the possibility that evictions exert community-level health effects, affecting evicted individuals' social networks and shaping broader community conditions. In this narrative review, we summarize evidence and lay out a theoretical model for eviction as a community health exposure, mediated through four paths: 1) shifting ecologies of infectious disease and health behaviors, 2) disruption of neighborhood social cohesion, 3) strain on social networks, and 4) increasing salience of eviction risk. We describe methods for parsing eviction's individual and contextual effects and discuss implications for causal inference. We conclude by addressing eviction's potentially multilevel consequences for policy advocacy and cost-benefit analyses.
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Affiliation(s)
- Gabriel L Schwartz
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA; Urban Health Collaborative & Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Kathryn M Leifheit
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Mariana C Arcaya
- Department of Urban Studies & Planning, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Danya Keene
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Elgendy H, Shalaby R, Owusu E, Nkire N, Agyapong VIO, Wei Y. A Scoping Review of Adult Inpatient Satisfaction with Mental Health Services. Healthcare (Basel) 2023; 11:3130. [PMID: 38132021 PMCID: PMC10743343 DOI: 10.3390/healthcare11243130] [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: 10/15/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Patient satisfaction with hospital services has been increasingly discussed as an important indicator of healthcare quality. It has been demonstrated that improving patient satisfaction is associated with better compliance with treatment plans and a decrease in patient complaints regarding doctors' and nurses' misconduct. This scoping review's objective is to investigate the pertinent literature on the experiences and satisfaction of patients with mental disorders receiving inpatient psychiatric care. Our goals are to highlight important ideas and explore the data that might serve as a guide to enhance the standard of treatment and patient satisfaction in acute mental health environments. This study is a scoping review that was designed in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) statement. A systematic search was conducted in the following databases: PubMed, MEDLINE, PsycINFO, CINAHL, and EMBASE. A comprehensive review was completed, including articles from January 2012 to June 2022. Qualitative and quantitative studies were included in this review based on our eligibility criteria, such as patient satisfaction as a primary outcome, adult psychiatric inpatients, and non-review studies published in the English language. Studies were considered ineligible if they included nonpsychiatric patients or patients with neurocognitive disorders, review studies, or study measure outcomes other than inpatient satisfaction. For the eligible studies, data extraction was conducted, information was summarized, and the findings were reported. A total of 31 studies representing almost all the world's continents were eligible for inclusion in this scoping review. Different assessment tools and instruments were used in the included studies to measure the level of patients' satisfaction. The majority of the studies either utilized a pre-existing or newly created inpatient satisfaction questionnaire that appeared to be reliable and of acceptable quality. This review has identified a variety of possible factors that affect patients' satisfaction and can be used as a guide for service improvement. More than half of the included studies revealed that the following factors were strongly recommended to enhance inpatient satisfaction with care: a clear discharge plan, less coercive treatment during the hospital stay, more individualized, higher quality information and teaching about the mental disorder to patients by staff, better therapeutic relationships with staff, and specific treatment components that patients enjoy, such as physical exercise sessions and music therapy. Patients also value staff who spend more time with them. The scope of patient satisfaction with inpatient mental health services is a growing source of concern. Patient satisfaction is associated with better adherence to treatment regimens and fewer complaints against health care professionals. This scoping review has identified several patient satisfaction research gaps as well as important determinants of satisfaction and how to measure and utilize patient satisfaction as a guide for service quality improvement. It would be useful for future research and reviews to consider broadening their scope to include the satisfaction of psychiatric patients with innovative services, like peer support groups and other technologically based interventions like text for support. Future research also could benefit from utilizing additional technological tools, such as electronic questionnaires.
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Affiliation(s)
- Hossam Elgendy
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (E.O.); (N.N.); (V.I.O.A.); (Y.W.)
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (E.O.); (N.N.); (V.I.O.A.); (Y.W.)
| | - Ernest Owusu
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (E.O.); (N.N.); (V.I.O.A.); (Y.W.)
| | - Nnamdi Nkire
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (E.O.); (N.N.); (V.I.O.A.); (Y.W.)
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB T5J E34, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (E.O.); (N.N.); (V.I.O.A.); (Y.W.)
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Yifeng Wei
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (E.O.); (N.N.); (V.I.O.A.); (Y.W.)
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Lee KH, Jun JS. Grief, Social Support, Spirituality, and Depressive Symptoms Among Older Adults in Assisted Living in Kansas. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023; 20:765-779. [PMID: 37843264 DOI: 10.1080/26408066.2023.2211970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
PURPOSE The purpose of this study was to explore the roles of grief, social support, as well as spirituality on the depressive symptoms of older adults in assisted living in Kansas. This study tested three hypotheses: a high level of grief will be related to a high level of depressive symptoms; high levels of social support (family, friends, and significant persons) will be associated with a low level of depressive symptoms; and high levels of spiritual experience and coping will be associated with a low level of depressive symptoms. METHODS This study recruited 316 older adult residents aged 65 or over from seven assisted living facilities in Kansas. This cross-sectional survey was done by face-to-face interviews using the purposive sampling method. Hierarchical multiple regression was used to test the three sets of variables in relation to depressive symptoms: socio-demographics, social support factors, and spiritual factors. RESULTS Participants' mean age was 82.6 years, ranging from 65 to 102; 70.9% were female. Married participants consisted of 18.7%, and over 64% were widowed. Hierarchical multivariate regression results indicated that a high level of grief was significantly related to a high level of depressive symptoms. On the other hand, high levels of social support from friends and spiritual coping were significantly associated with a low level of depressive symptoms. DISCUSSION AND CONCLUSION Assisted living facilities may consider developing appropriate bereavement, social support, and spiritual intervention programs, which will alleviate the depression issues of older adult residents after the COVID-19 pandemic.
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Affiliation(s)
- Kyoung Hag Lee
- School of Social Work, Wichita State University, Wichita, Kansas, USA
| | - Jung Sim Jun
- Department of Sociology, Anthropology, and Social Work, Kansas State University, Manhattan, Kansas, USA
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Wen FH, Prigerson HG, Chou WC, Huang CC, Hu TH, Chiang MC, Chuang LP, Tang ST. Comorbid Prolonged Grief, PTSD, and Depression Trajectories for Bereaved Family Surrogates. JAMA Netw Open 2023; 6:e2342675. [PMID: 37948078 PMCID: PMC10638651 DOI: 10.1001/jamanetworkopen.2023.42675] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/30/2023] [Indexed: 11/12/2023] Open
Abstract
Importance Family surrogates of patients who die in an intensive care unit (ICU) are at risk of cooccurring prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depressive disorder during bereavement, but symptom trajectories are often explored individually. Objectives To simultaneously examine and determine co-occurrence of PGD, PTSD, and depressive symptom trajectories. Design, Setting, and Participants This cohort study was conducted in ICUs of 2 Taiwanese medical centers from January 2018 to March 2020, with follow-up through July 2022. Participants included surrogates responsible for decision-making who provided data 6 to 24 months after the death of their loved one. Data were analyzed from August to December 2022. Main Outcomes and Measures PGD was assessed with the 11 grief symptom items of the PG-13; PTSD, the Impact of Event Scale-Revised; and depressive symptoms, the depression subscale of the Hospital Anxiety and Depression Scale at 6, 13, 18, and 24 months after the death. Latent growth mixture modeling was conducted to identify distinct trajectories, and joint latent class analysis was used to assess joint patterns of trajectories. Results A total of 303 participants were included, with most younger than 56 years (207 participants [68.3%]), female (177 participants [58.4%]), and married (228 participants [75.2%]), and their relationship with the patient was mostly spouse (88 participants [29.0%]) or adult child (166 participants [54.8%]). Three trajectories were identified each for PGD, PTSD, and depressive symptoms. A resilience trajectory was predominant across PGD (253 participants [83.5%]), PTSD (250 participants [82.5%]), and depressive (200 participants [66.0%]) symptoms. Second most common was a recovery trajectory identified for PGD (36 participants [11.9%]) and PTSD (41 participants [13.5%]) symptoms, while for depressive symptoms, a moderate trajectory (72 participants [23.8%]) signified persistent moderate distress. A chronic trajectory characterized by persistently high distress was identified for PGD (14 participants [4.6%]) and depressive (31 participants [10.2%]) symptoms, whereas a unique delayed-onset trajectory (12 participants [4.0%]) was identified for PTSD symptoms. Most family surrogates (228 participants [75.2%]) experienced cooccurring PGD, PTSD, and depressive symptom trajectories, but multiple patterns were discordant. Symptom trajectories cooccurred in joint patterns: resilient (247 participants [81.5%]), recovered (43 participants [14.1%]), and distressed (14 participants [4.5%]). These patterns were characterized by high conditional probabilities for the resilience (PGD, 0.999; PTSD, 0.999; depressive, 0.804), recovery (PGD, 0.854; PTSD, 0.890; depressive, 0.588), and chronic (PGD, 0.921; PTSD, 0.789; depressive, 0.980) symptom trajectories. Conclusions and Relevance In this cohort study, grief-related psychological symptoms evolved in complex ways during ICU bereavement, as characterized by heterogeneous trajectories. Some ICU bereaved surrogates experienced persistent elevated PGD, PTSD, and depressive symptoms individually or conjointly, underscoring the importance of early screening to identify this population at high risk of comorbid psychological distress trajectories.
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Affiliation(s)
- Fur-Hsing Wen
- Department of International Business, Soochow University, Taipei, Taiwan
| | | | - Wen-Chi Chou
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Chung-Chi Huang
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
- Department of Respiratory Therapy, Chang Gung University, Tao-Yuan, Taiwan
| | - Tsung-Hui Hu
- Department of Internal Medicine, Division of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan
| | - Ming Chu Chiang
- Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan
| | - Li-Pang Chuang
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Siew Tzuh Tang
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan
- School of Nursing, Medical College, Chang Gung University, Tao-Yuan, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
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Katsiferis A, Bhatt S, Mortensen LH, Mishra S, Jensen MK, Westendorp RGJ. Machine learning models of healthcare expenditures predicting mortality: A cohort study of spousal bereaved Danish individuals. PLoS One 2023; 18:e0289632. [PMID: 37549164 PMCID: PMC10406307 DOI: 10.1371/journal.pone.0289632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 07/21/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The ability to accurately predict survival in older adults is crucial as it guides clinical decision making. The added value of using health care usage for predicting mortality remains unexplored. The aim of this study was to investigate if temporal patterns of healthcare expenditures, can improve the predictive performance for mortality, in spousal bereaved older adults, next to other widely used sociodemographic variables. METHODS This is a population-based cohort study of 48,944 Danish citizens 65 years of age and older suffering bereavement within 2013-2016. Individuals were followed from date of spousal loss until death from all causes or 31st of December 2016, whichever came first. Healthcare expenditures were available on weekly basis for each person during the follow-up and used as predictors for mortality risk in Extreme Gradient Boosting models. The extent to which medical spending trajectories improved mortality predictions compared to models with sociodemographics, was assessed with respect to discrimination (AUC), overall prediction error (Brier score), calibration, and clinical benefit (decision curve analysis). RESULTS The AUC of age and sex for mortality the year after spousal loss was 70.8% [95% CI 68.8, 72.8]. The addition of sociodemographic variables led to an increase of AUC ranging from 0.9% to 3.1% but did not significantly reduce the overall prediction error. The AUC of the model combining the variables above plus medical spending usage was 80.8% [79.3, 82.4] also exhibiting smaller Brier score and better calibration. Overall, patterns of healthcare expenditures improved mortality predictions the most, also exhibiting the highest clinical benefit among the rest of the models. CONCLUSION Temporal patterns of medical spending have the potential to significantly improve our assessment on who is at high risk of dying after suffering spousal loss. The proposed methodology can assist in a more efficient risk profiling and prognosis of bereaved individuals.
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Affiliation(s)
- Alexandros Katsiferis
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Denmark
| | - Samir Bhatt
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Laust Hvas Mortensen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Denmark
| | - Swapnil Mishra
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Majken Karoline Jensen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Denmark
| | - Rudi G. J. Westendorp
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Kustanti CY, Jen HJ, Chu H, Liu D, Chen R, Lin HC, Chang CY, Pien LC, Chiang KJ, Chou KR. Prevalence of grief symptoms and disorders in the time of COVID-19 pandemic: A meta-analysis. Int J Ment Health Nurs 2023; 32:904-916. [PMID: 36880520 DOI: 10.1111/inm.13136] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/30/2023] [Accepted: 02/19/2023] [Indexed: 03/08/2023]
Abstract
Millions of people worldwide are mourning the loss of loved ones due to the COVID-19 epidemic, which may adversely impact their mental health. This meta-analysis aimed to investigate pandemic grief symptoms and disorders for developing policy, practice, and research priorities. The databases of Cochrane, Embase, Ovid-MEDLINE, WHO COVID-19, NCBI SARS-CoV-2, Scopus, Web of Science, CINAHL, and Science Direct were comprehensively searched until July 31, 2022. The Joanna Briggs Institute's and Hoy's criteria were used to evaluate the studies. A pooled prevalence was presented in a forest plot figure with a corresponding 95% confidence interval (CI) and prediction interval. Between-study heterogeneity was measured using the I2 and Q statistics. Variations in the prevalence estimates in different subgroups were examined by moderator meta-analysis. The search identified 3677 citations, of which 15 studies involving 9289 participants were included in the meta-analysis. The pooled prevalence rate of grief symptoms was 45.1% (95%CI: 32.6%-57.5%), and grief disorder was 46.4% (95%CI: 37.4%-55.5%). Grief symptoms were significantly higher in <6 months (45.8%; 95%CI: 26.3%-65.3%) compared to the period of more than 6 months. Unfortunately, moderator analyses for grief disorders could not be performed due to limited studies. The prevalence of grief problems during the pandemic was substantially higher than in non-pandemic conditions; therefore, it is crucial to strengthen bereavement support to reduce psychological distress. The results provide a foundation for nurses and healthcare workers to anticipate a heightened need for support and provision of bereavement care in the post-pandemic era.
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Affiliation(s)
- Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Hsiu-Ju Jen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan.,Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ching-Yi Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Li-Chung Pien
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kai-Jo Chiang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
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11
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Becker CB. Utilizing the spirituality of funeral rituals for post-pandemic grief recovery. Front Psychol 2023; 13:1040482. [PMID: 36687981 PMCID: PMC9851600 DOI: 10.3389/fpsyg.2022.1040482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
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12
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Katsiferis A, Bhatt S, Mortensen LH, Mishra S, Westendorp RGJ. Sex differences in health care expenditures and mortality after spousal bereavement: A register-based Danish cohort study. PLoS One 2023; 18:e0282892. [PMID: 36947502 PMCID: PMC10032540 DOI: 10.1371/journal.pone.0282892] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/26/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Spousal bereavement is a life event that affects older people differently. We investigated the impact of spousal bereavement on medical expenditures and mortality in the general population, emphasizing on age and sex. METHODS Data are from a population-based, retrospective cohort study following 924,958 Danish citizens over the age of 65 years, within 2011-2016. Changes in health care expenditures in those who suffer bereavement were compared with time matched changes among those who did not. Mortality hazards were analysed with time to event analysis. RESULTS A total of 77,722 (~8.4%) individuals experienced bereavement, 65.8% being females. Among males, bereavement was associated with increase of expenditures the year after, that was 42 Euros per week (95% CI, 36 to 48) larger than the non-bereaved group. The corresponding increase for females was 35 Euros per week (95% CI, 30 to 40). The increase of mortality hazards was highest in the first year after bereavement, higher in males than females, in young old and almost absent in the oldest old. Compared with the reference, mortality the year after spousal loss was 70% higher (HR 1.70 [95% CI 1.40 to 2.08]) for males aged 65-69 years and remained elevated for a period of six years. Mortality for females aged 65-69 years was 27% higher in the first year (HR 1.27, [1.07 to 1.52]), normalizing thereafter. CONCLUSION Bereavement affects older people differently with younger males being most frail with limited recovery potential.
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Affiliation(s)
- Alexandros Katsiferis
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Copenhagen, Denmark
| | - Samir Bhatt
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Laust Hvas Mortensen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Copenhagen, Denmark
| | - Swapnil Mishra
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rudi G J Westendorp
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Copenhagen, Denmark
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13
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Folayan MO, Zuniga RAA, Ezechi OC, Brown B, Nguyen AL, Aly NM, Ellakany P, Idigbe IE, Khan ATA, Lawal FB, Jafer M, Gaffar B, Popoola BO, Quadri MFA, Virtanen JI, Lusher J, El Tantawi M. Associations between Emotional Distress, Sleep Changes, Decreased Tooth Brushing Frequency, Self-Reported Oral Ulcers and SARS-Cov-2 Infection during the First Wave of the COVID-19 Pandemic: A Global Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811550. [PMID: 36141821 PMCID: PMC9516999 DOI: 10.3390/ijerph191811550] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/10/2022] [Accepted: 09/10/2022] [Indexed: 06/12/2023]
Abstract
This study assessed the association between emotional distress, sleep changes, decreased frequency of tooth brushing, and self-reported oral ulcers, and the association between COVID-19 status and decreased frequency of tooth brushing. Using a cross-sectional online survey, data were collected from adults in 152 countries between July and December 2020. Binary logistic regression analyses were conducted to determine the associations between dependent (decreased frequency of tooth brushing, oral ulcers, change in sleep pattern) and independent (tested positive for COVID-19, depression, anxiety, frustration/boredom, loneliness, anger, and grief/feeling of loss) variables after adjusting for confounders (age, sex, level of education, employment status). Of the 14,970 participants data analyzed, 1856 (12.4%) tested positive for COVID-19. Respondents who reported feeling depressed (AoR: 1.375), lonely (AoR: 1.185), angry (AoR: 1.299), and experienced sleep changes (AoR:1.466) had significantly higher odds of decreased tooth brushing frequency. Respondents who felt anxious (AoR: 1.255), angry (AoR: 1.510), grief/sense of loss (AoR: 1.236), and sleep changes (AoR: 1.262) had significantly higher odds of oral ulcers. Respondents who tested positive for COVID-19 had significantly higher odds of decreased tooth brushing frequency (AoR: 1.237) and oral ulcers (AoR: 2.780). These findings highlight that the relationship between emotional distress and oral health may intensify during a pandemic.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
| | - Roberto Ariel Abeldaño Zuniga
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Post Graduate School, University of Sierra Sur, Oaxaca 70805, Mexico
| | - Oliver C. Ezechi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos 100001, Nigeria
| | - Brandon Brown
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Social Medicine, Population and Public Health, Riverside School of Medicine, University of California, Riverside, CA 92501, USA
| | - Annie L. Nguyen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Nourhan M. Aly
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21544, Egypt
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Ifeoma E. Idigbe
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos 100001, Nigeria
| | - Abeedha Tu-Allah Khan
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Biological Sciences, Faculty of Science, Superior University Lahore, Main Raiwind Road Punjab, Lahore 54590, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan 200132, Nigeria
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Preventive Dental Sciences Department, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam 31441, Saudi Arabia
| | - Bamidele Olubukola Popoola
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Child Oral Health, University of Ibadan, Ibadan 200132, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA 98105, USA
| | - Jorma I. Virtanen
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Faculty of Medicine, University of Turku, 20014 Turku, Finland
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Provost’s Group, Regent’s University London, London NW1 4NS, UK
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21544, Egypt
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14
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Naito R, Kasai T. Bereavement of a child as a risk of heart failure. Eur J Heart Fail 2021; 24:190-191. [PMID: 34816534 DOI: 10.1002/ejhf.2388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ryo Naito
- Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
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15
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Jopp DS, Lampraki C, Meystre C, Znoj H, Brodbeck J. Professional Support After Partner Loss: Likelihood and Correlates of Help-Seeking Behavior. Front Psychol 2021; 12:767794. [PMID: 34887814 PMCID: PMC8649630 DOI: 10.3389/fpsyg.2021.767794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Intimate partner loss in later life can be one of the most stressful events in adulthood. Individuals who struggle to adapt to the new life conditions may need support from a mental health professional. However, less is known about the likelihood to seek professional help after separation, divorce, or bereavement in later life and associated factors. This study investigated professional help-seeking (PHS) for partner loss after a long-term marriage in separated, divorced, and bereaved individuals and examined the extent to which specific person and event-related variables, as well as depressive symptoms, increase its likelihood. The data were derived from the LIVES "Intimate Partner Loss Study." The self-administered questionnaires were completed by 388 adults. PHS was higher after separation (57%) and divorce (49%), compared to widowhood (18%). Higher likelihood of PHS was associated with separation and divorce, female gender, having someone to count on, loss unexpectedness, needing more time to overcome the loss, and more depressive symptoms. Informing individuals unlikely to seek help (e.g., males, bereaved, and individuals with no confidant) about PHS benefits may facilitate adaptation to partner loss.
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Affiliation(s)
- Daniela S. Jopp
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
| | - Charikleia Lampraki
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
| | - Claudia Meystre
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
| | - Hansjörg Znoj
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
- Institute of Psychology University of Bern, Bern, Switzerland
| | - Jeannette Brodbeck
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
- Institute of Psychology University of Bern, Bern, Switzerland
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16
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Sichko S, Bui TQ, Vinograd M, Shields GS, Saha K, Devkota S, Olvera-Alvarez HA, Carroll JE, Cole SW, Irwin MR, Slavich GM. Psychobiology of Stress and Adolescent Depression (PSY SAD) Study: Protocol overview for an fMRI-based multi-method investigation. Brain Behav Immun Health 2021; 17:100334. [PMID: 34595481 PMCID: PMC8478351 DOI: 10.1016/j.bbih.2021.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/22/2022] Open
Abstract
Depression is a common, often recurrent disorder that causes substantial disease burden worldwide, and this is especially true for women following the pubertal transition. According to the Social Signal Transduction Theory of Depression, stressors involving social stress and rejection, which frequently precipitate major depressive episodes, induce depressive symptoms in vulnerable individuals in part by altering the activity and connectivity of stress-related neural pathways, and by upregulating components of the immune system involved in inflammation. To test this theory, we recruited adolescent females at high and low risk for depression and assessed their psychological, neural, inflammatory, and genomic responses to a brief (10 minute) social stress task, in addition to trait psychological and microbial factors affecting these responses. We then followed these adolescents longitudinally to investigate how their multi-level stress responses at baseline were related to their biological aging at baseline, and psychosocial and clinical functioning over one year. In this protocol paper, we describe the theoretical motivations for conducting this study as well as the sample, study design, procedures, and measures. Ultimately, our aim is to elucidate how social adversity influences the brain and immune system to cause depression, one of the most common and costly of all disorders.
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Affiliation(s)
- Stassja Sichko
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Theresa Q. Bui
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Meghan Vinograd
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, and Department of Psychiatry, University of California, San Diego, CA, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Krishanu Saha
- Wisconsin Institute for Discovery and Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Suzanne Devkota
- Department of Medicine, F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Judith E. Carroll
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Steven W. Cole
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Michael R. Irwin
- Department of Psychology, University of California, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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17
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Peña-Vargas C, Armaiz-Peña G, Castro-Figueroa E. A Biopsychosocial Approach to Grief, Depression, and the Role of Emotional Regulation. Behav Sci (Basel) 2021; 11:110. [PMID: 34436100 PMCID: PMC8389251 DOI: 10.3390/bs11080110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/27/2022] Open
Abstract
According to the field of affective neuroscience, grief has been identified as one of the seven primary emotions necessary for human survival. However, maladaptive grief could cause significant impairment in an individual's life, leading to psychopathologies such as major depressive disorder. Research on grief has shifted to a biopsychosocial approach, leaving behind outdated models-such as the Kübler-Ross theory-that have shown poor consistency. The field of psychoneuroimmunology has identified adverse life events such as social loss as being associated with major depressive disorder, and inflammatory processes in chronic health conditions. Likewise, scientists in the field of affective neuroscience have theorized that prolonged and sustained activation of the grief neurological pathway can cause a cascade of neurotransmitters that inhibits the reward-seeking system, causing symptoms of depression. The objective of this review is to highlight findings on the grief process using a biopsychosocial approach to explore grief's impact on psychopathophysiology.
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Affiliation(s)
- Cristina Peña-Vargas
- Ponce’s Research Institute, Ponce Health Sciences University, Ponce, PR 00716, USA
| | | | - Eida Castro-Figueroa
- School of behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA;
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18
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Mental health during the COVID-19 pandemic and beyond: The importance of the vagus nerve for biopsychosocial resilience. Neurosci Biobehav Rev 2021; 125:1-10. [PMID: 33582230 PMCID: PMC8106638 DOI: 10.1016/j.neubiorev.2021.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 pandemic has led to widespread increases in mental health problems, including anxiety and depression. The development of these and other psychiatric disorders may be related to changes in immune, endocrine, autonomic, cognitive, and affective processes induced by a SARS-CoV-2 infection. Interestingly, many of these same changes can be triggered by psychosocial stressors such as social isolation and rejection, which have become increasingly common due to public policies aimed at reducing the spread of SARS-CoV-2. The present review aims to shed light on these issues by describing how viral infections and stress affect mental health. First, we describe the multi-level mechanisms linking viral infection and life stress exposure with risk for psychopathology. Then, we summarize how resilience can be enhanced by targeting vagus nerve function by, for example, applying transcutaneous vagus nerve stimulation and targeting lifestyle factors, such as exercise. With these biopsychosocial insights in mind, researchers and healthcare professionals will be better equipped to reduce risk for psychopathology and increase resilience during this challenging pandemic period and beyond.
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19
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Foubert L, Noël Y, Spahr CM, Slavich GM. Beyond WEIRD: Associations between socioeconomic status, gender, lifetime stress exposure, and depression in Madagascar. J Clin Psychol 2021; 77:1644-1665. [PMID: 33825203 DOI: 10.1002/jclp.23131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/05/2021] [Accepted: 03/03/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although research has examined associations between socioeconomic status (SES), gender, and acute and chronic life stressors in depression, most studies have been conducted in Western, educated, industrialized, rich, democratic (WEIRD) populations. METHOD We addressed this issue by interviewing 65 adults (55 women, M age = 37) living in Madagascar, a typical low- and middle-income country. RESULTS As hypothesized, women experienced more life stressors and depressive symptoms, on average, than men, as did those from lower (vs. higher) SES backgrounds. Additionally, lifetime stress exposure was associated with greater symptoms of depression, accounting for 19% of the variability in depressive symptom levels. These effects differed for acute versus chronic and distal versus recent stressors. Finally, stress exposure significantly mediated the relation between SES and gender on depressive symptoms, accounting for 24.0%-70.8% of the SES/gender-depression association depending on stressor type. CONCLUSION These data extend prior research by describing how social stratification and gender relate to lifetime stress exposure and depressive symptoms in a non-WEIRD population.
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Affiliation(s)
- Laurent Foubert
- Department of Psychology, Rennes 2 University, Rennes, France
| | - Yvonnick Noël
- Department of Psychology, Rennes 2 University, Rennes, France
| | - Chandler M Spahr
- Department of Psychology, University of California, Riverside, California, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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