How Income and Income Inequality Drive Depressive Symptoms in U.S. Adults, Does Sex Matter: 2005-2016

Effects of Receiving Pain-Related Support on Psychological Well-Being: The Moderating Roles of Emotional Responses to Support

OBJECTIVES

We investigated whether receiving greater pain-related instrumental support is associated with poorer psychological well-being among chronic pain patients who report less positive (e.g., grateful) or more negative (e.g., angry) emotional responses to support.

METHODS

We conducted regression analyses, utilizing data from two waves of interviews with 152 knee osteoarthritis patients. Three indicators of psychological well-being were examined: depressive symptoms, positive affect, and negative affect.

RESULTS

Receiving greater support was associated with poorer psychological well-being at baseline, as well as higher depressive symptoms and negative affect at the 18-month follow-up, only among patients with low positive emotional responses to support. Furthermore, receiving greater support was related to poorer psychological well-being at baseline only among patients with high negative emotional responses to support.

DISCUSSION

Care recipients' less positive emotional responses to support may be a risk factor for poorer psychological well-being in both the short- and long-term, when receiving greater support.

Assessment of Depressive Symptoms and Sociodemographic Correlates of Adult Patients Attending a National Health Insurance Clinic at a Tertiary Hospital, Southwest Nigeria

Background

Depression affects individuals across all age groups, genders, and socio-economic backgrounds. Socio-demographic correlates of depression may include factors such as age, gender, education level, income, and marital status. These factors, including the presence of chronic diseases, have been shown to impact the prevalence and severity of depression. This study assessed the prevalence of depressive symptoms and its association with socio-demographic correlates and co-morbid chronic medical conditions among adult patients attending a National Health Insurance Clinic of a tertiary health facility in Southwest Nigeria.

Methodology

A hospital-based descriptive cross-sectional study was conducted between April - May 2023 in which 250 consenting adult patients were recruited using a systematic random sampling technique. Respondents' information on socio-demographic profiles and awareness of co-morbid medical conditions were assessed using semi-structured interviewer-administered questionnaires. Depressive symptoms were determined using the Patient Health Questionnaire. Data were analyzed using SPSS version 20. The strength of the association between independent and dependent variables was measured using chi-square and the p-value was set as <0.05.

Results

The mean age of respondents was 38.96±13.096 years (range: 18-80 years). There were 159 (63.6%) females. The prevalence of depressive symptoms was 44.8%. There was a statistically significant association between age, gender, marital status, monthly income, presence of chronic diseases, and depressive symptoms.

Conclusion

The prevalence of depressive symptoms among adult patients attending the National health insurance clinic was 44.8%. These findings call for health policies to integrate and strengthen mental health in NHIA primary care.

Iron Deficiency is Related to Depressive Symptoms in United States Nonpregnant Women of Reproductive Age: A Cross-Sectional Analysis of NHANES 2005-2010

BACKGROUND

Findings of the association between iron status and depressive symptoms in nonpregnant women of reproductive age (WRA) are equivocal, limited by a small sample size, or did not consistently control for confounders.

OBJECTIVE

We tested the association between iron status and depressive symptoms in WRA with the NHANES data (2005-2010).

METHODS

Nonpregnant WRA (20-44 y) with complete data on iron (ferritin and transferrin receptor (TfR)) and anemia (hemoglobin) biomarkers, depressive symptoms (Patient Health Questionnaire-9), and sociodemographic variables were included. Logistic and negative binomial regressions were used to estimate presence (odds ratios) and magnitude (prevalence ratios), respectively, for depressive symptoms by iron deficiency (ID)/anemia/ID anemia in the total sample and stratified by poverty:income ratio (≤ 1.85 or >1.85).

RESULTS

Among 2516 females, the prevalence of ID was 8 to 16% (depending on the iron biomarker used), of anemia 8%, of which 52 to 65% were also ID. The prevalence of depressive symptoms was 10%. Crude logistic models showed that females with ID (TfR ≥ 8.3 mg/L or body iron <0 mg/kg) from the total sample had 1.82 (95% confidence interval [CI]: 1.24, 2.68) and 1.62 (95% CI: 1.05, 2.48), respectively, higher odds of depressive symptoms than females with iron sufficiency; these associations were attenuated after adjustments for confounders. Adjusted negative binomial models showed that females with ID (TfR ≥ 8.3 mg/L) from the total and low-income samples showed 1.19 (95% CI: 1:00, 1.40) and 1.27 (95% CI: 1.03, 1.58), respectively, higher prevalence ratios of depressive symptoms scores than females with iron sufficiency.

CONCLUSIONS

These nationally representative data indicate that nonpregnant WRA with ID (based on high TfR) in the United States have higher prevalence of somatic depressive symptoms scores than those with iron sufficiency, especially if they are of low income.

Prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in living arrangements: a cross-sectional study

BACKGROUND

Older adults with different living arrangements may have different mental health statuses and different factors that influence their mental health. The aim of the present study is to investigate the prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in their living arrangements.

METHODS

Participants were 6,055 older adults from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms and their determinants were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale and multivariate logistic regression analysis, respectively.

RESULTS

The prevalence of depressive symptoms among older adults living alone, as a couple, and with children was 47.8%, 33.2%, and 39.5%, respectively. The common risk factors for depressive symptoms were shorter sleep duration, poorer activities of daily living, and poorer self-rated health. Women, those with lower educational levels, and those suffering from chronic diseases had a higher risk of depressive symptoms among older adults living as a couple and those living with children. Smoking and participation in economic activities were also risk factors of depressive symptoms among older adults living with children and those living alone, respectively.

CONCLUSIONS

The findings suggest that older adults living as couples had the lowest prevalence of depressive symptoms, while those living alone had the highest prevalence of depressive symptoms. The determinants of depressive symptoms differed by living arrangement; hence, they should be considered in future interventions.

Impact of COVID-19, cancer survivorship and patient-provider communication on mental health in the US Difference-In-Difference

Poor mental health has been found to be more prevalent among those with cancer and is considered a public health crisis since COVID-19. This study assessed the impact of COVID-19 and cancer survivorship on mental health and investigated factors, including online patient-provider communications (OPPC; email/internet/tablet/smartphone), associated with poor mental health prior to and during the early COVID-19. Nationally representative Health Information National Trends Survey data during 2017-2020 (n = 15,871) was used. While the prevalence of poor mental health was high (40-42%), Difference-In-Difference analyses revealed that cancer survivorship and COVID-19 were not associated with poor mental health. However, individuals that used OPPC had 40% higher odds of poor mental health. Low socioeconomic status (low education/income), younger age (18-64 years), and female birth gender were also associated with poor mental health. Findings highlight the persistence of long-standing mental health inequities and identify that OPPC users might be those who need mental health support.

Evaluating Correlations Between Premium Cigar Smoking and Mental Health and Substance Use Dependence Conditions Among U.S. Adults, 2010-2019

INTRODUCTION

Improved understanding of health conditions associated with premium cigar smoking can inform efforts to reduce cigar use. This paper extends findings commissioned for the National Academies of Science, Engineering, and Medicine report on premium cigars.

AIMS AND METHODS

We pooled 2010-2019 National Survey on Drug Use and Health data to evaluate cross-sectional associations between premium cigar smoking and mental health and substance use conditions among U.S. adults. A series of logistic regression models adjusted for age, sex, race and ethnicity, cigarette smoking, and alcohol consumption compared odds of each condition associated with past-month premium cigar smoking relative to past-month nonpremium cigar smoking, never tobacco use, and current established cigarette smoking.

RESULTS

Premium cigar smoking was associated with lower adjusted odds of past month serious psychological distress, past year major depressive episode, and cannabis and illicit drug dependence relative to nonpremium cigar and cigarette smoking; however, higher odds of alcohol and cannabis dependence were observed relative to never tobacco use, and lower odds of alcohol dependence were observed relative to current cigarette smoking but not current nonpremium cigar smoking.

CONCLUSIONS

We observed considerable variation in both magnitude and direction of associations between premium cigar smoking and mental health and substance use indicators depending on the condition and reference group to which premium cigar smoking was compared.

IMPLICATIONS

Premium cigar smoking frequently cooccurs with cigarette smoking and alcohol consumption, thus potential health correlates must be considered in appropriate context. We observed considerable variation in direction and magnitude of association depending on the health condition and reference population, as well as potential for reverse causality and residual confounding in this cross-sectional analysis. As the tobacco landscape continues to evolve, rigorous scientific studies that incorporate clear differentiation of cigar type, measures of cumulative use, and temporal data collection are necessary to fully evaluate the health effects of premium cigar smoking and effectively inform Food and Drug Administration regulation.

Mental Health of the Russian Federation Population versus Regional Living Conditions and Individual Income

The objective of our study was to assess the impact of regional living conditions on the Russian population's mental health. For the analysis, we used data from the cross-sectional stage of a 2013-2014 study, "Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation (ESSE-RF)". The final sample included 18,021 men and women 25-64 years of age from 11 regions of Russia. Using principal component analysis, we performed an integral simultaneous assessment of stress, anxiety, and depression. To describe the regional living conditions, we utilized five regional indices, which were computed from publicly available data of the Federal State Statistics Service of Russia. Overall, mental health indicators were improved, on the one hand, with the deterioration of social conditions and an aggravation of the demographic depression in the region, but on the other hand, they were improved with an increase in economic and industrial development, along with economic inequality among the population. In addition, the impact of regional living conditions on mental health increased with a higher individual wealth. The obtained results provided new fundamental knowledge on the impact of the living environment on health, using the case study of the Russian population, which has been little studied in this regard.

Relationship between subjective well-being and depressive disorders: Novel findings of cohort variations and demographic heterogeneities

This paper uses a large-scale nationally representative dataset, the Chinese General Social Survey, to examine the relationship between subjective well-being and depressive disorders. Statistical results indicate that higher levels of subjective well-being help decrease perceived depression. Robustness checks are carried out using different types of explanatory and dependent variables, various regression models, penalized machine learning methods, instrumental variable approaches, and placebo tests, all of which lend further credence to the above findings. Based on it, heterogeneities in the relationship between subjective well-being and self-rated mental disorders are explored. In respect of variations in age cohorts, it is found that the absolute values of happiness's estimated coefficients are smaller in the 20-30 and 30-40 age groups, while that in the 40-50 age group increase substantially. In older cohorts, the estimates remain at higher levels while fluctuating to some degree. Furthermore, the significantly negative interaction between happiness and age proves that age amplifies subjective well-being's effect on perceived depressive disorders. With age increasing, the impact of happiness on reducing perceived depression tends to be stronger. Therefore, for older people, subjective well-being plays a more important role in suppressing self-rated depression. Heterogeneities of the relationship between happiness and perceived depressive disorders in subgroups with different demographic characteristics are also investigated. It is found that the negative correlation between subjective well-being and self-rated depression is stronger among those with higher educational levels, living in urban areas, being members of the Communist Party of China, having pensions, and owning more housing assets. However, gender, ethnic identity, religious belief, and marital status exert no significant moderating effects.

Integrating maternal depression care at primary private clinics in low-income settings in Pakistan: A secondary analysis

Introduction

The prevalence of depression among women in Pakistan ranges from 28% to 66%. There is a lack of structured mental healthcare provision at private primary care clinics in low-income urban settings in Pakistan. This study investigated the effectiveness and processes of a facility-based maternal depression intervention at private primary care clinics in low-income settings.

Materials and methods

A mixed-methods study was conducted using secondary data from the intervention. Mothers were assessed for depression using the Patient Health Questionnaire-9 (PHQ-9). A total of 1,957 mothers (1,037 and 920 in the intervention and control arms, respectively) were retrieved for outcome measurements after 1 year of being registered. This study estimated the effectiveness of the depression intervention through cluster adjusted differences in the change in PHQ-9 scores between the baseline and the endpoint measurements for the intervention and control arms. Implementation was evaluated through emerging themes and codes from the framework analysis of 18 in-depth interview transcriptions of intervention participants.

Results

Intervention mothers had a 3.06-point (95% CI: -3.46 to -2.67) reduction in their PHQ-9 score at the endpoint compared with their control counterparts. The process evaluation revealed that the integration of structured depression care was feasible at primary clinics in poor urban settings. It also revealed gaps in the public-private care linkage system and the need to improve referral systems.

Conclusions

Intervening for depression care at primary care clinics can be effective in reducing maternal depression. Clinic assistants can be trained to identify and deliver key depression counseling messages. The study invites policymakers to seize an opportunity to implement a monitoring mechanism toward standard mental health care.

Use of Telehealth to Address Depression and Anxiety in Low-income US Populations: A Narrative Review

Symptoms of anxiety and depressive disorders have been increasing substantially among adults in the United States (US) during the COVID-19 pandemic, particularly for low-income populations. Under-resourced communities have difficulties accessing optimal treatment for anxiety and depression due to costs as well as the result of limited access to health care providers. Telehealth has been growing as a digital strategy to treat anxiety and depression across the country but it is unclear how best to implement telehealth interventions to serve low-income populations. A narrative review was conducted to evaluate the role of telehealth in addressing anxiety and depression in low-income groups in the US. A PubMed database search identified a total of 14 studies published from 2012 to 2022 on telehealth interventions that focused on strengthening access to therapy, coordination of care, and medication and treatment adherence. Our findings suggest that telehealth increases patient engagement through virtual therapy and the use of primarily telephone communication to treat and monitor anxiety and depression. Telehealth seems to be a promising approach to improving anxiety and depressive symptoms but socioeconomic and technological barriers to accessing mental health services are substantial for low-income US populations.

Social Determinants of Mental, Physical, and Oral Health of Middle-Aged and Older African Americans in South Los Angeles

BACKGROUND

A growing body of research suggests that financial difficulties could weaken the protective effects of socioeconomic status (SES) indicators, including education and income, on the health status of marginalized communities, such as African Americans.

AIM

We investigated the separate and joint effects of education, income, and financial difficulties on mental, physical, and oral self-rated health (SRH) outcomes in African American middle-aged and older adults.

METHODS

This cross-sectional study enrolled 150 middle-aged and older African Americans residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics (education, income, and financial difficulties), and self-rated health (mental, physical, and oral health) were collected. Three linear regression models were used to analyze the data.

RESULTS

Higher education and income were associated with a lower level of financial strain in a bivariate analysis. However, according to multivariable models, only financial difficulties were associated with poor mental, physical, and oral health. As similar patterns emerged for all three health outcomes, the risk associated with financial difficulties seems robust.

CONCLUSIONS

According to our multivariable models, financial strain is a more salient social determinant of health within African American communities than education and income in economically constrained urban environments such as South Los Angeles. While education and income lose some protective effects, financial strain continues to deteriorate the health of African American communities across domains.