Depressive Symptom and Related Factors: A Cross-Sectional Study of Korean Female Workers Working at Traditional Markets

Clinical predictors of depressive symptom remission and response after racemic ketamine and esketamine infusion in treatment-resistant depression

BACKGROUND

Major depressive disorder (MDD) is a leading cause of disability worldwide and most people do not achieve symptom remission. Treatment-resistant depression (TRD) is characterized by the failure of at least one adequate trial of a major class of antidepressant, with adequate time and dosage. We aimed to identify clinical predictors of depressive symptom remission and response 24 h and 7 days after racemic ketamine and esketamine infusions.

METHODS

A randomized, double-blind, active-controlled, non-inferiority trial using ketamine and esketamine in TRD. Individuals diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders version IV and fulfilling TRD criteria were recruited from March 2017 to June 2018. Participants received a single subanesthetic dose of ketamine (0.5 mg/kg) or esketamine (0.25 mg/kg) for 40 min. Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and symptom remission was defined as a MADRS score ≤7 and response defined as ≥50% reduction in depressive symptom severity, 24 h and 7 days after the infusion. Clinical variables were selected based on previous clinical trials. Stepwise backward logistic regression was used, considering a confidence level of 95%.

RESULTS

61 subjects were included: 39 (63.9%) were females with a mean age of 47.2 ± 14.9. Higher number of therapeutic failures (Odds Ratio (OR) = 0.677; 95% confidence interval (CI): 0.47-0.97) and higher severity of illness (OR = 0.912; 95% CI: 0.83-0.99) were associated with fewer remissions of depressive symptoms 7 days after intervention, and with fewer response in 24 h (OR = 0.583; 95% CI: 0,40; 0,84 and OR = 0.909; 95% CI: 0,83; 0,99, respectively).

CONCLUSION

Number of treatment failures and severity of illness were predictors of fewer remissions and responses of depressive symptoms in this TRD population. Study of predictors of remission may contribute to better selection patients that may benefit from receiving ketamine.

The Burnout Syndrome among Women Working in the Retail Network in Associations with Psychosocial Work Environment Factors

The burnout syndrome is a significant occupational health problem in various employees’ populations. The aim of this study was to evaluate burnout level among retail network workers and its associations with psychosocial work environment. The cross-sectional epidemiological study was conducted on workers of one Lithuanian retail network (n = 254), where all respondents were women. In order to assess their occupational stress and burnout, two instruments were used: HSE management standards work-related stress indicator tool and Copenhagen burnout inventory (CBI). The statistical analysis showed high prevalence of burnout—the frequency of personal, work-related and client-related burnout was 53.5%, 66.5% and 55.5% respectively. The Spearman’s correlation analysis revealed that job demands, control manager’s support, coworkers’ support and relationships significantly associated with all burnout subscales. The multivariable logistic regression analysis was performed to determine the independent associations between HSE indicators and burnout subscales. The multivariate logistic regression model revealed that job demands and manager’s support were significant factors for all burnout dimensions. In conclusion, in order to reduce occupational burnout among employees working in retail companies, it would be useful for occupational interventions to focus on workload reduction and optimization, and for the human resources management strategy to focus on maintaining this.

Agility Testing in Youth Football (Soccer)Players; Evaluating Reliability, Validity, and Correlates of Newly Developed Testing Protocols

Reactive agility (RAG) and change of direction speed (CODS) are important determinants of success in football (soccer), but there is an evident lack of information on reliable and valid football-specific testing procedures which will be applicable in defining sport-specific RAG and CODS in youth players. This study evaluated reliability and construct validity of newly developed tests of football-specific RAG (FS_RAG) and CODS (FS_CODS), which involved the ball kicking football technique. Additionally, factors associated with FS_RAG and FS_CODS were evaluated. The participants were youth football players (n = 59; age: 13.40 ± 1.25 years) divided according to their age into U13 (11–12 years of age; n = 29), and U15 (13–14 years of age; n = 30) categories. Additionally, performance levels (starters [first-team] vs. non-starters [substitutes]) were observed in each age category. The dependent variables were newly developed FS_RAG and FS_CODS tests. The independent variables were sprinting capacities over 10 and 20 meters (S10M, S20M), countermovement jump (CMJ), the reactive strength index (RSI), and a generic CODS test of 20 yards (20Y). The newly developed FS_CODS and FS_RAG were observed as dependent variables. Results showed appropriate intra-testing and inter-testing reliability of the FS_RAG and FS_CODS, with somewhat better reliability of the FS_CODS (ICC=0.82 and 0.79, respectively). Additionally, better reliability was evidenced in U15 than in U13 (ICC: 0.82–0.85, and 0.78-0.80 for U15 and U13, respectively). Independent samples t-test indicated significant differences between U13 and U15 in S10 (t-test: 3.57, p < 0.001), S20M (t-test: 3.13, p < 0.001), 20Y (t-test: 4.89, p < 0.001), FS_RAG (t-test: 3.96, p < 0.001), and FS_CODS (t-test: 6.42, p < 0.001), with better performance in U15. Starters outperformed non-starters in most capacities among U13, but only in FS_RAG among U15 (t-test: 1.56, p < 0.05). Multiple regression calculations indicated nonsignificant association between independent and dependent variables in U13 (FS_CODS: 19%, FS_RAG: 21% of the explained variance, both p > 0.05), but independent variables explained significant proportion of both dependent variables in U15 (FS_CODS: 35%, FS_RAG: 33% explained variance, both p < 0.05). The study confirmed the applicability of newly developed tests in distinguishing studied age categories of players. Results indicate that superiority in all studied fitness capacities is translated into performance level in U13. Meanwhile, FS_RAG seems to be important determinant of quality in U15.

Evaluation of the Effectiveness of Mobile App-Based Stress-Management Program: A Randomized Controlled Trial

Improving mental healthcare using mobile apps might be an effective way to increase interest in mental health and respond to the demand for better psychological health. However, few studies have investigated the effectiveness of app-based stress-management programs. This study aimed to assess the efficacy of an app-based stress-management program. A non-equivalent comparison group pretest-posttest design was used. Participants were randomized into the experimental (n = 26) and control (n = 30) groups. The experimental group used an application developed for workers for four weeks. The results indicated that stress, emotional labor, self-efficacy, and well-being were significantly different in the experimental group, but the control group’s average scores did not change significantly. On average, the Perceived Stress Scale scores decreased by 1.5 points (p = 0.035) and the Korean Occupational Stress Scale scores decreased by 0.87 points (p = 0.4). However, depression and anxiety were not significantly different. Emotional labor decreased by 0.16 points (p = 0.027), and well-being and self-efficacy mean scores increased by 0.492 (p = 0.005) and 0.162 (p = 0.025), respectively. These findings support the developed application’s value for promoting mental health and healthy lifestyles. Further research and supplementation are needed for the application’s sustainability.

The Role of Occupational Stress in the Association between Emotional Labor and Mental Health: A Moderated Mediation Model

This study investigated whether occupational stress factors moderate the effect of emotional labor on psychological distress in call center employees. A cross-sectional and descriptive study using anonymous paper-based survey methods was conducted in a sample of 283 call center employees in South Korea. Participants completed the Emotional Labor Scale, the Depression Anxiety Stress Scale, and the Korean Occupational Stress Scale. Moderated mediation analyses were conducted using the PROCESS macro in order to investigate the relationship among variables. The results showed that the association between surface acting while having emotional labor and psychological distress was mediated by emotional dissonance. The mediated effect of emotional dissonance was moderated by discomfort in occupational climate, suggesting that improving the occupational environment can lessen the level of psychological distress among emotional workers, and that more attention should be devoted to the development of an intervention at the organizational level in order to prevent mental health problems in this population.

Factors Associated with the Risk of Developing Coronary Artery Disease in Medicated Patients with Major Depressive Disorder

Background: The aim of this study was to identify factors associated with high Framingham Risk Score (FRS) in medicated patients with major depressive disorder (MDD). Methods: We examined 61 medicated patients with MDD (mean age 37.77 ± 7.67, 90.2% women) and 43 non-depressed controls (mean age 38.26 ± 9.20, 90.7% women). We administered the Hamilton Depression Rating Scale (HAM-D) and measured systolic blood pressure (SBP), diastolic BP (DBP), mean arterial BP (MAP), pulse wave velocity (PWV), intima-media thickness (IMT), interleukin-6 (IL-6) and triglycerides. Results: We found that medicated patients with MDD had significantly higher levels of HAM-D score (p < 0.01), SBP (p = 0.015), MAP (p = 0.037), IL−6 level (p = 0.007), as compared with controls. Medicated patients who remained moderately to severely depressed showed significantly higher SBP (p = 0.049), DBP (p = 0.009), MAP (p = 0.024), IL−6 level (p = 0.019), left PWV (p = 0.004) and average PWV (p = 0.026) than those with mild depression. Multivariate regression showed that the interaction effect between HAM-D score and triglyceride level (p = 0.018) was significantly associated with FRS in medicated patients with MDD. Conclusions: This study highlights that the interaction effect of the severity of depression and the triglyceride level, was a modifiable factor positively associated with high FRS.

Effects of changes in occupational stress on the depressive symptoms of Korean workers in a large company: a longitudinal survey

Background

Prospective studies on occupational stress and depression among Korean workers are scarce. This study aimed to investigate the causal relationship between changes in occupational stress and the presence of depression.

Methods

This study analyzed data from a survey conducted with workers in a large Korean company (2015–2016). Occupational stress was measured using the Korean Occupational Stress Scale, and depression was screened using the WHO-5 Well-being Index. The levels of occupational stress were grouped in quartiles based on subjects’ occupational stress scores in 2015, and changes in occupational stress were measured using the score changes between the 2015 and 2016 surveys. Subjects were divided into four groups according to the presence or absence of depression in 2015 and 2016: a non-depressed group whose mental health did not change, a non-depressed group whose mental health deteriorated, a depressed group that continued to be depressed, and a depressed group whose symptoms of depression were alleviated. Logistic regression analysis was used to calculate the odds ratios (ORs) and confidence intervals (CIs) of the subjects’ deterioration in mood or alleviation of depression by occupational stress levels and changes.

Results

The OR for developing depressive symptoms was 2.51 (95% CI 1.46–4.33) and 2.73 (95% CI 1.39–5.36) in the third and the fourth quartiles of occupational stress, respectively, compared to the first quartile. When the occupational stress score increased by 1 point, the OR for increasing depressive symptoms was 1.07 (95% CI 1.04–1.10). There was no significant difference in the alleviation of depressive symptoms between the groups by level of occupational stress. However, when the occupational stress score decreased by 1 point, the OR for alleviating depressive symptoms was 1.08 (95% CI 1.05–1.11).

Conclusion

The results showed that increased occupational stress increased the presence of depressive symptoms, and that reduced occupational stress suppressed the development of depressive symptoms. More attention should be paid to stress management among workers.

Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

Objectives: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to identify the pretreatment predictors of response to ketamine in TRD as part of MDD and BD. Method: Electronic search engines PubMed/MEDLINE, ClinicalTrials.gov, and Scopus were searched for relevant articles from inception to January 2018. The search term ketamine was cross-referenced with the terms depression, major depressive disorder, bipolar disorder, predictors, and response and/or remission. Results: Multiple baseline pretreatment predictors of response were identified, including clinical (i.e., Body Mass Index (BMI), history of suicide, family history of alcohol use disorder), peripheral biochemistry (i.e., adiponectin levels, vitamin B12 levels), polysomnography (abnormalities in delta sleep ratio), neurochemistry (i.e., glutamine/glutamate ratio), neuroimaging (i.e., anterior cingulate cortex activity), genetic variation (i.e., Val66Met BDNF allele), and cognitive functioning (i.e., processing speed). High BMI and a positive family history of alcohol use disorder were the most replicated predictors. Conclusions: A pheno-biotype of depression more, or less likely, to benefit with ketamine treatment is far from complete. Notwithstanding, metabolic-inflammatory alterations are emerging as possible pretreatment response predictors of depressive symptom improvement, most notably being cognitive impairment. Sophisticated data-driven computational methods that are iterative and agnostic are more likely to provide actionable baseline pretreatment predictive information.