Relationship between ruminative style and adolescent depression

BACKGROUND

The role of rumination in depression remains controversial. We aimed to establish the ruminative tendency style theory (RTST), discuss the occurrence of depression in adolescents with rumination as the core, and explore the different associations between adolescent ruminative tendency, ruminative style, and depression.

METHODS

This study employed an online questionnaire survey of 1110 Chinese adolescents aged 12-17 years, assessing ruminative tendency, ruminative style, stressful life events, depressive state, depressive trait, the Big Five personality traits, and social support. Conditional process analysis was used to test the chain mediation effect with Ruminative Style as a moderator. After screening for the predictor variables, a logistic regression risk prediction model was established and validated internally.

RESULTS

The chain mediation effect of ruminative tendency and depressive trait between stressful life events and depressive state was significant, with the indirect effect accounting for 63.4%. Ruminative Style negatively moderated the relationship between Ruminative Tendency and Depressive Trait (β=-0.053，P＜0.001). The risk prediction model for depressive state showed good calibration and clinical utility. Area under the curve values for the validation and training sets were 0.926 and 0.927, respectively.

CONCLUSION

Different associations may exist between adolescent ruminative tendency, ruminative style, and depression, and the proposal of ruminative style is of great significance for intervention in adolescent depression.

Association of sleep status with depressive state in centenarians: Evidence from Hainan centenarian cohort

OBJECTIVE

The objective of this study is to analyze the association between sleep quality, sleep duration, sleep patterns, and depressive states among centenarians due to the crucial impact of depression on the well-being of elderly individuals, particularly the oldest. Recognizing easily identifiable manifestations and risk factors is essential since the onset of depressive states tends to be insidious.

METHODS

The baseline data from the China Hainan Centenarians Cohort Study (CHCCS) served as the basis for this study. Questionnaire surveys were conducted to obtain research indicators, with depressive states evaluated using the GDS-15 scale and sleep quality evaluated using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was employed to describe the association between sleep status and depressive states.

RESULTS

A total of 994 centenarians, with an age range of 100-116 years and a mean age of 102.77 ± 2.75 years, were included in this study. Among these participants, 815 were female, accounting for 82.0 %. After adjustment, the odds ratio (OR) for the association between poor sleep quality and depressive states was 2.07 (95 % CI: 1.54-2.77) compared to those with normal sleep quality. Additionally, there were associations between depressive states and both nighttime sleep duration and total sleep duration. After adjustment, the strongest association between depressive state and sleep patterns was found for those who had >9 h of nighttime sleep and ≥2 h of daytime sleep (OR = 1.80, 95%CI: 1.02-3.16). Moreover, compared to centenarians with 7-9 h of sleep duration and good sleep quality, the highest odds ratio (OR = 3.44, 95%CI: 2.18-5.43) for the association between depressive states and sleep duration ≤7 h and poor sleep quality was observed.

CONCLUSION

The findings of this study indicate that there is an association between poor sleep quality and depressive states in centenarians. Furthermore, both sleep quality and long/short total sleep duration are associated with depressive states in this population. Therefore, special attention should be given to the psychological state of elderly individuals with short sleep duration and poor sleep quality in order to prevent depression and minimize its negative impact on their overall health.

Factors Associated with Caregiver Burden and Depressive States among Family Caregivers of Patients Admitted due to Behavioral and Psychological Symptoms of Dementia

INTRODUCTION

Among those caring for people with dementia (PwD) at home, more than 60% feel a caregiver burden (CB), and one in three are depressed. Reducing feelings of burden and depressive states in caregiving families will improve the living environment for PwD. However, very few studies have focused on effective methods and reducing feelings of burden and depressive states of caregivers. Thus, using data from a previous study, we aimed to determine the factors associated with perceived CB and depressive states experienced by caregivers for PwD with behavioral and psychological symptoms of dementia (BPSD) at home.

METHODS

We performed single regression analysis on 285 participants' data to determine the association between each item and the Zarit Caregiver Burden Interview and Center for Epidemiologic Studies-Depression Scale scores. We performed multiple regression analysis with variables considered in the single regression analysis as independent variables.

RESULTS

Severity of BPSD, caregivers' subjective health status (SHS), time of caregiving, and depressive states were related to CB, and caregivers' SHS and CB were related to depressive states.

CONCLUSIONS

Similar to previous studies, we identified an association between family caregivers' perceived CB and BPSD in PwD. Additionally, we found that caregivers' SHS is commonly associated with both perceived CB and depressive states. This is a new finding. Our results suggest that interventions focusing on family caregivers' health status can help not only to reduce family caregivers' CB and depressive states but also stabilize patients' symptoms and provide home-based care for a longer time.

A Young Japanese Patient with Spinocerebellar Ataxia Type 3 Presenting Depressive State with Cenesthopathy and Delusion: a Case Report

Depressive state is a common complication of spinocerebellar ataxia type 3 (SCA3). To the best of our knowledge, cases of SCA3 presenting with cenesthopathy have not been described. Here, we present a case of a severe depressive state with cenesthopathy and delusion in a young Japanese man with SCA3. A 43-year-old Japanese man with SCA3 developed a severe depressive state with associated cenesthopathy and delusion. He was treated with escitalopram (10 mg/day) and olanzapine (2.5 mg/day). Computed tomography showed atrophy of the cerebellum, bilateral superior cerebellar peduncle, and tegmentum of the pons. Single-photon emission computed tomography demonstrated reduced blood flow in the cerebellum, vermis, and brainstem. After 8 weeks, his depressive state and delusion improved; however, his cenesthopathy persisted. We encountered a case of a severe depressive state with cenesthopathy and delusion in a young Japanese man with SCA3. This case supports previous studies that the cerebellum could have a role beyond motor functions.

Relationship between depression and movement quality in normal young adults

[Purpose] Somatic symptoms, such as hyposomnia and anorexia, can affect depression and result in decreased movement quality; however, the relationship between movement quality and somatic symptoms is unclear. The present study investigated the characteristics of this relationship using observable posture and movements. [Participants and Methods] Twenty healthy young adults (mean age 20.9 ± 0.4 years) participated in the study. First, we administered the Self-rating Depression Scale questionnaire to the participants. Second, a qualified physical therapist assessed the movement quality of the volunteers using the Body Awareness Rating Scale-Movement Quality and Experience. We classified the participants into high- and low-score groups based on their Self-rating Depression Scale scores and then analyzed the Body Awareness Rating Scale-Movement Quality and Experience scores in both groups. [Results] There was a significant difference in the movement quality between the Self-rating Depression Scale high- and low-score groups. The Self-rating Depression Scale total score ranged from 20 to 80, with higher scores indicating a greater severity of depression. The low-score group had higher scores for the Body Awareness Rating Scale-Movement Quality and Experience than the high-score group in all items. [Conclusion] The present study showed that movement quality was related to symptoms of depression, thereby suggesting that early detection and treatment interventions for depression are possible by an assessment of movement quality.

Nightmare experience and family relationships in healthy volunteers and nightmare disorder patients

BACKGROUND

Nightmares are associated with parental bonding styles and various psychiatric disorders, but the exact connections between different nightmare experience features and family relationships in healthy volunteers and nightmare disorder patients are still unclear.

METHODS

We therefore invited 62 nightmare disorder patients and 135 healthy volunteers to undergo tests of the Nightmare Experience Questionnaire (NEQ), the Family Relationship Questionnaire (FRQ), and the Plutchik - van Praag Depression Inventory (PVP).

RESULTS

Besides the higher nightmare frequency and the higher PVP and four NEQ scale scores, the nightmare disorder patients had higher scores of FRQ Paternal Abuse, and lower ones of General Attachment, Maternal Encouragement, Maternal Freedom Release, and Paternal Freedom Release. The PVP was correlated with some NEQ and FRQ scales in both healthy volunteers and patients, and it functioned as a mediator between Physical Effect and Maternal Dominance in patients. Regarding predicting NEQ by FRQ, Paternal Abuse predicted Physical Effect, Maternal Dominance predicted Physical Effect and Horrible Stimulation, General Attachment predicted Horrible Stimulation (-) in healthy volunteers; Maternal Dominance predicted Physical Effect, Meaning Interpretation, and Horrible Stimulation, Paternal Freedom Release predicted Physical Effect (-), and Paternal Dominance predicted Meaning Interpretation and nightmare frequency in patients.

CONCLUSIONS

Our study has demonstrated that the inappropriate family relationships were linked with different aspects of nightmare experience, especially in nightmare disorder patients.

Association between long work hours and depressive state: a pilot study of propensity score matched Japanese white-collar workers

Although long work hours have been associated with various physical health problems, studies of their association with mental health have yielded inconsistent results, due to differences in study settings, study outcome and/or unmeasured background factors. In this study, we used a propensity score method to evaluate the association between work hours and depressive state. A total of 467 Japanese white-collar workers were surveyed and divided into long and regular work hour groups according to overtime work records. Propensity score matching was performed based on 32 individual background and workplace factors, yielding 74 pairs of propensity-matched subjects. CES-D score, an indicator of depressive state, did not differ significantly among the two groups (p=0.203). However, work motivation, work control, social support and emotional stability correlated with CES-D score. These findings suggest that work control and social support factors are more associated with depressive state than control of work hours. These results also suggest that it is possible to use propensity score matching to evaluate the association between work hours and mental health in occupational study settings. Further studies, in larger populations, are required to determine the association between work hours and mental health parameters.

Burnout in Japanese residents and its associations with temperament and character

AIM

High risk of burnout in healthcare workers has long been recognized. However, there are no methods to predict vulnerability to burnout.

METHODS

We examined whether temperament and character are associated with burnout and depressive state in residents by using the Temperament and Character Inventory (TCI). The TCI was used for residents at the beginning of clinical training and then the Maslach Burnout Inventory-General Survey (MBI-GS) and the Self-Rating Depression Scale (SDS) were administered at the beginning of clinical training and after four and ten months. Participants were 85 residents who started clinical training after graduating from the University of Miyazaki Hospital in April 2012 and 2013.

RESULTS

After ten months, 23.5% of participants were newly identified with burnout using the MBI-GS and 15.3% of participants were newly diagnosed with depressive state using the SDS. We found that residents with high Cooperativeness were significantly more prone to burnout and that residents with high Harm Avoidance and low Self-Directedness were significantly more prone to depressive states.

CONCLUSIONS

Our results suggest that the TCI can predict not only the risk for future depressive state but also the risk for future burnout. We feel it is important for the resident education system to identify residents with these temperament and character traits and to help high-risk residents avoid burnout and depressive state.

Longitudinal assessment of pain management with the pain management index in cancer outpatients receiving chemotherapy

PURPOSE

The adequacy of pain management for individuals with cancer who receive outpatient chemotherapy is unclear. The primary objective of this study was to assess pain prevalence and intensity in such patients. The secondary objectives included assessment of pain management with the pain management index (PMI) and exploration of predictors of inadequate pain management.

METHODS

Cancer patients who received outpatient chemotherapy were enrolled. Patients were required to complete questionnaires covering demographic data and including the Brief Pain Inventory and the Distress Thermometer and Impact Thermometer. The PMI score was determined twice with an interval of at least 3 weeks.

RESULTS

Of the 740 patients enrolled in the study, 524 individuals (70.8%) completed all questionnaires. Totals of 282 patients (53.8%) and 264 patients (50.4%) reported pain at baseline and follow-up, respectively, with ∼14% of patients having moderate or severe pain at each assessment. Totals of 365 patients (69.7%) at baseline and 320 patients (61.1%) at follow-up reported pain or were prescribed analgesics, with the rate of inadequate pain management for these patients being 39.7 and 51.6%, respectively. Multivariable analysis for 418 patients (79.8%) who had pain or required analgesics at baseline or follow-up (or both) revealed that the most significant predictor of inadequate pain management was depressive state.

CONCLUSIONS

Pain in cancer patients receiving outpatient chemotherapy is prevalent and at risk for undertreatment. Pain management should be assessed on a regular basis and is likely to be improved by screening for depression.

Housing under abnormal light-dark cycles attenuates day/night expression rhythms of the clock genes Per1, Per2, and Bmal1 in the amygdala and hippocampus of mice

Although the results of previous studies have suggested that disruptions in circadian rhythms are involved in the pathogenesis of depression, no studies have examined the interaction of clock gene expression deficit and depression state. In this study, we examined clock gene expression levels and depressive-like behavior in mice housed under 3.5h light, 3.5h dark (T = 7) conditions to investigate the association between clock gene expression and depressive state. C57BL/6J mice were housed under a T = 24 cycle (12h light, 12h dark) or a T = 7 cycle and clock gene expression levels in the hippocampus and the amygdala were measured by real-time RT-PCR. Depressive state was evaluated by the forced swim test (FST). Although circadian rhythms of Per1 and Per2 clock gene expression in the hippocampus and amygdala were still detected under T = 7 conditions, rhythmicity and expression levels of both significantly decreased. Mice housed with a T = 7 cycle showed increased immobile time in the FST than those with a T = 24 cycle. The present results suggest that the presence of a depressive state around the early active phase of activity may be related to impairment of rhythmicity and expression levels of Per1 and Per2 genes under abnormal light-dark conditions.

Relationship between depressive state, job stress, and sense of coherence among female nurses

Background:

People with a strong sense of coherence (SOC) have a high ability to cope with stress and maintain good physical and mental health.

Aims:

The aim of this study was to investigate the relationship between depressive state, job stress, and SOC among nurses in a Japanese general hospital.

Materials and Methods:

A self-reporting survey was conducted among 348 female nurses in a general hospital. Job stress was measured using the Japanese version of the effort-reward imbalance (ERI) scale. Depressive state was assessed by the K6 scale. SOC was assessed with the SOC scale, which includes 29 items. Stepwise multiple regression analysis was conducted to examine factors that significantly affect depressive state.

Results:

SOC, over-commitment, effort-esteem ratio, and age were significantly correlated with the depressive state (β = −0.46, P < 0.001; β = 0.27, P < 0.001; β = 0.16, P < 0.001; β = −0.10, P < 0.001, respectively).

Conclusions:

SOC may have a major influence on the depressive state among female nurses in a Japanese general hospital. From a practical perspective, health care professionals should try to enhance the SOC of nurses.

The effects of mental state on assessment of bipolar temperament

BACKGROUND

Although the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A) was designed to identify temperaments which derive from traits but not states, there is a possibility that TEMPS-A scores might be affected by mental state in non-clinical populations. For the purpose of clarifying the effects of mental state on TEMPS-A scores, it is worthwhile to examine associations of the full version of the TEMPS-A with various depressive scales and, if possible, mania rating scales.

METHODS

TEMPS-A data acquired from 314 medical students and staff was used to investigate the association of temperament scores with mental assessment scores such as the Beck Depression Inventory (BDI), the Quick Inventory of Depressive Symptomatology Self-Report Japanese version (QIDS-SR-J), the Patient Health Questionnaire-9 (PHQ-9), the Hamilton Depression rating scale (HAM-D) and the Young Mania Rating Scale (YMRS).

RESULTS

Depressive state scores were significantly and positively associated with depressive, anxious, cyclothymic, and irritable temperament scores of TEMPS-A whereas sub-threshold hypomanic state scores were significantly and positively associated with irritable temperament of TEMPS-A. There was no association between depressive state or sub-threshold hypomanic state and hyperthymic temperament scores.

LIMITATIONS

The nature of the present study is cross-sectional, and it is unknown whether depressive and/or sub-threshold hypomanic states may have affected temperament scores or whether temperament scores might have affected depressive and/or sub-threshold hypomanic scores. Other limitations are that the sample may not represent the entire population and that there is no evidence that Japanese findings can be applicable outside Japan.

CONCLUSIONS

It is worthwhile to consider the effects of mental state on temperament scores of TEMPS-A even in non-clinical population.

Association of salivary cortisol levels and later depressive state in elderly people living in a rural community: a 3-year follow-up study

BACKGROUND

Late-life depressive disorder is becoming an important issue in health economics in the world, as it has been reported to be one of major risk factors for incidence of dementia. Identification of predictive markers associated with depression in later life is therefore of high priority in public health. The aim of the study was to examine the association of salivary cortisol levels with a later depressive state in elderly healthy people living in a rural Japan community.

METHODS

Salivary cortisol levels were measured in 68 elderly healthy people (24 men; 44 women) followed by completion of the BDI, MMSE, and FAB from 2004 to 2006. The same cohort underwent BDI again from 2007 to 2009.

RESULTS

In healthy elderly women subject, a significant positive correlation was found between salivary cortisol levels at baseline and BDI scores at follow-up, but not at baseline. Salivary cortisol levels at baseline were not correlated with the score of either MMSE or FAB. When the cut-off point of BDI scores were set at 20/21, logistic regression analyses revealed that salivary cortisol levels at baseline had a significant positive relationship with a later depressive state. Age and gender were also significantly related with a later depressive state.

LIMITATIONS

The present study involves small number of participants.

CONCLUSIONS

Higher salivary cortisol levels were associated with a later depressive state in elderly healthy women living in rural community. Salivary cortisol might be a predictive marker for a later depressive state in elderly women.

Prevalence of insomnia and its relationship to the health habits or status of women living along a city road part 1. epidemiologie study

The prevalence rate of insomnia among 424 married women and its associated factors were surveyed. Insomnia is defined as having one of the following symptoms one or more times per week: difficulty inducing sleep (Fl), difficulty maintaining sleep (F2), early morning awakening (F3), light sleep (F4), or worry about poor sleep quality (F5). Poor sleep as a whole in the past one month (F6) was also inquired about. Percentages of Fl, F2, F3 and F5 among the subjects in their sixties were 21.3%, 13.3%, 6.7% and 10.7%, respectively, relatively higher than those of subjects in their thirties or forties. There was a significant difference in the percentage of F6 among four age categories (p < 0.05), and the percentage of F6 was highest (23.3%) in those in their thirties. Depressive state correlated with six insomnia items, Fl to F6 (rs.=-0.195, -0.161, -0.117,-0.221, -0.176, 0.284, respectively). Perceived health status correlated with Fl (-0.237), F4 (-0.213), F5 (-0.259), and F6 (0.373). Present medical condition correlated with Fl (-0.195), F3 (-0.146), and F5 (-0.220). The prevalence rates of insomnia for subjects in their thirties, forties, fifties and sixties were 16.7%, 17.7%, 25.7%, and 24.0%, respectively. Increases in the percentages of difficulty in inducting and maintaining sleep, early morning awakening and worry about poor sleep quality in the subjects in their sixties, and sleep dissatisfaction of those in their thirties were recognized.