The prevalence and risk factors of depression in engineering college students: A cross-sectional study

Background

Engineering students like any other students face several stressors in their lives, which make them vulnerable to depression. Depression may affect students' academic performance.

Aim

The present study aims to estimate the prevalence and associated risk factors of depression among engineering students.

Material and Methods

A cross-sectional study was conducted in December 2016 among 110 randomly selected students from an engineering college in a rural area of Pune district, India. PHQ-9 questionnaire was used. Univariate and multivariable ordinal logistic regression was used to quantify association.

Results

Of a total of 110 students, 71.8% were males, while 28.2% were females. The mean age was 20.7 years. 29.1% had no depression, 48.2% had mild depression, and 22.7% had moderate depression. Univariate analysis found four variables significantly associated with a greater risk of depression: parental stress, sibling stress, economic stress, and interpersonal conflict. In the adjusted (multivariable) ordinal logistic regression analysis controlling for all independent variables, only lack of economic support and interpersonal conflicts retained their statistical significance.

Conclusion

The prevalence of depression in engineering students is high and strongly associated with the presence of economic and personal stress. Screening for depression and giving them care and support is of paramount importance.

Prevalence and influencing factors of suicide in first-episode and drug-naive young major depressive disorder patients with impaired fasting glucose: a cross-sectional study

Background

An association exists between major depression disorder (MDD), suicide attempts, and glucose metabolism, but suicide attempts in young MDD patients with comorbid impaired fasting glucose (IFG) have been less well studied. The purpose of this study was to examine the prevalence and risk factors for suicide attempts in young, first-episode, drug-naive (FEDN) MDD patients with comorbid IFG.

Methods

We recruited 917 young patients with FEDN MDD, 116 of whom were judged to have combined IFG because their blood glucose was >6.0. We collected anthropological and clinical data on all of them. The Hamilton Depression Scale (HAMD) score, the Hamilton Anxiety Scale (HAMA) score and the Positive and Negative Syndrome Scale (PANSS) positive subscale score were used to assess their clinical symptoms. Blood glucose, plasma thyroid function and lipid indicators were measured.

Results

The prevalence of suicide attempts in young MDD patients with IFG was 32.8% (38/116). Furthermore, among young MDD patients with comorbid IFG, suicide attempters had more severe depression and anxiety symptoms, more comorbid psychotic symptom, higher levels of antibody of thyroid stimulating hormone and thyroid peroxidases (TPOAb), and more severe lipid metabolism disorders than those without suicide attempts. In addition, HAMA scores and TPOAb were independently associated with suicide attempts in young patients with FEDN MDD.

Conclusion

Our study suggests that young MDD patients with IFG have a high rate of suicide attempts. Some clinical symptoms and thyroid function parameters may be the risk factor for suicide attempts in young MDD patients with impaired glucose metabolism.

Correlation of systemic immune-inflammation index and moderate/major depression in patients with depressive disorders: a large sample cross-sectional study

Objective

To evaluate the clinical value of systemic immune-inflammation index (SII) based on peripheral blood neutrophil, lymphocyte, and platelet count in evaluating the subtype and severity of depression in patients with depressive disorder.

Methods

This retrospective cohort study was conducted in the Third People's Hospital of Fuyang City from January 1, 2020 to December 31, 2022. The data included sociodemographic information at admission, clinical data, discharge diagnosis and inflammatory markers. Patients were divided into low SII group and high SII group according to the optimal threshold of SII determined by receiver operating characteristic curve (ROC curve). Binary logistic regression was used to analyze the correlation between moderate/major depression and SII level.

Results

Compared to the low SII group, the high SII group had a higher age level (χ² = 7.663, p = 0.006), more smokers (χ² = 9.458, p = 0.002), more moderate/major depression patients (χ² = 45.645, p < 0.001), and a higher proportion of patients with accompanying somatic symptoms (χ² = 14.867, p < 0.001). In the final logistic regression model, after controlling for confounding factors, SII at admission was significantly associated with moderate/major depression [β =1.285, p < 0.001; odds ratio (95% confidence intervals) = 3.614 (2.693-4.850)]. Patients with high SII scores were 3.614 times more likely to have moderate/severe depression than those with low SII scores. We propose a cut-off value of SII =540.78 (sensitivity = 36.4% and specificity = 80.3%) according to the maximum Youden index.

Conclusion

Our research indicates that SII may be a useful, repeatable, convenient, and affordable index to identify moderate/major depression in depressive disorder.

Sociodemographic and clinical characteristics related with hyperprolactinaemia in psychiatric clinical population

BACKGROUND

Hyperprolactinaemia (HyperPRL) induced by psychotropic drugs is a high-prevalence consequence which has repercussions in psychical and mental health in the psychiatric population, so this research had the objective to expand which sociodemographic and clinical features are associated with prolactin (PRL) elevation in patients treated with antidepressant and/or antipsychotic drugs.

METHODS

An observational, cross-sectional, comparative and retrolective study was conducted on 300 patients who received clinical attention in a third level of psychiatric care unit in Mexico during 2017. These patients have been reported to show PRL levels greater than 25 ng/mL among women and greater than 20 ng/mL among men. In the same way, sociodemographic and clinical variables were collected, as well as psychiatric diagnosis and type of psychopharmacological treatment used by the patients.

RESULTS

HyperPRL was more frequent in women (80.7%) than men (19.3%). The mean levels of PRL were 68.94 ± 62.28 ng/mL with higher levels in women (71.9 ± 67.3, p=.02). Regarding the treatment, 78.3%, 71.3% and 49.7% consumed antipsychotics, antidepressants, and both drugs, respectively. The relationship between hyperPRL (>100 n/mL) and typical antipsychotics was dose-dependent (33.23 ± 13.24 mg, p=.01). In the multivariate regression models according to the type of treatment, as well as the demographic and clinical features, hyperPRL was associated independently with the use of antipsychotic treatment, pituitary adenoma and hypertension (R²=0.05).

CONCLUSIONS

HyperPRL is a complex clinical syndrome frequent in the psychiatric population with detrimental long-term consequences, as well as its relationship with the use of psychotropic drugs as in the case of antipsychotics. Effective actions should be implemented in the prevention, approach and treatment of this condition paying special attention to the accompanying medical comorbidities.

Transcranial ultrasound stimulation relieves depression in mice with chronic restraint stress

OBJECTIVE

Exhaustion of Serotonin (5-hydroxytryptamine, 5-HT) is a typical cause of the depression disorder's development and progression, including depression-like behaviors. Transcranial ultrasound stimulation (TUS) is an emerging non-invasive neuromodulation technique treating various neurodegenerative diseases. This study aims to investigate whether TUS ameliorates depression-like behaviors by restoring 5-HT levels.

METHODS

The depression model mice are established by chronic restraint stress (CRS). Ultrasound waves (FF = 1.1MHz, PRF = 1000 Hz, TBD = 0.5 ms, SD = 1 s, ISI = 1 s, and DC = 50%) were delivered into the dorsal raphe nucleus (DRN) for 30 min per day for two weeks. Depression-like behavior changes are evaluated with the sucrose preference and tail suspension tests. Liquid chromatography-mass spectrometry is performed to quantitatively detect the concentration of 5-HT in the DRN to explore its potential mechanism. The effectiveness and safety of TUS assessed by c-Fos immunofluorescence and hematoxylin and eosin (HE) staining, respectively.

RESULTS

Three weeks after CRS, 22 depressive mice models were screened by sucrose preference index (SPI). After two weeks of ultrasound stimulation of the DRN (DRN-TUS) in depressive mice, the SPI was increased (p = 0.1527) and the tail suspension immobility duration was significantly decreased (p = 0.0038) compared with the non-stimulated group. In addition, TUS significantly enhances the c-Fos (p = 0.05) positive cells' expression and the 5-HT level (p = 0.0079) in the DRN. Importantly, HE staining shows no brain tissue damage.

CONCLUSION

These results indicate that DRN-TUS has safely and effectively improved depression-like behaviors including anhedonia and hopelessness, potentially by reversing the depletion of 5-TH.

SIGNIFICANCE

TUS may provide a new perspective on depression therapy, possibly through restoring monoamine levels.

Depression, anxiety, and post-traumatic stress disorder symptoms after hyperemesis gravidarum: a prospective cohort study

OBJECTIVE

To determine the prevalence of depression, anxiety, and posttraumatic stress disorder (PTSD) years after hyperemesis gravidarum (HG) and its association with HG severity.

MATERIAL AND METHODS

This prospective cohort study consisted of a follow-up of 215 women admitted for HG, who were eligible to participate in a randomized controlled trial and either declined or agreed to be randomized between 2013 and 2016 in 19 hospitals in the Netherlands. Participants completed the Hospital Anxiety and Depression Scale (HADS) six weeks postpartum and during follow-up and the PTSD checklist for DSM-5 (PCL-5) during follow-up. An anxiety or depression score ≥8 is indicative of an anxiety or depression disorder and a PCL-5 ≥ 31 indicative of PTSD. Measures of HG severity were symptom severity (PUQE-24: Pregnancy Unique Quantification of Emesis), weight change, duration of admissions, readmissions, and admissions after the first trimester.

RESULTS

About 54/215 participants completed the HADS six weeks postpartum and 73/215 participants completed the follow-up questionnaire, on average 4.5 years later. Six weeks postpartum, 13 participants (24.1%) had an anxiety score ≥8 and 11 participants (20.4%) a depression score ≥8. During follow-up, 29 participants (39.7%) had an anxiety score ≥8, 20 participants (27.4%) a depression score ≥8, and 16 participants (21.9%) a PCL-5 ≥ 31.Multivariable logistic regression analysis showed that for every additional point of the mean PUQE-24 three weeks after inclusion, the likelihood of having an anxiety score ≥8 and PCL-5 ≥ 31 at follow-up increased with OR 1.41 (95% CI: 1.10;1.79) and OR 1.49 (95% CI: 1.06;2.10) respectively.

CONCLUSION

Depression, anxiety, and PTSD symptoms are common years after HG occurred.

Prevalence of Mental Disorders in Patients With Chronic Thromboembolic Pulmonary Hypertension

OBJECTIVE

Pulmonary hypertension (PH) is a chronic and progressive pulmonary vascular disease resulting in symptoms such as shortness of breath and fatigue and leading to death from right heart failure if not adequately treated. Chronic thromboembolic pulmonary hypertension (CTEPH) is a subgroup of PH characterized by obstruction or occlusion of pulmonary arteries by post-embolic fibrotic material. To date, few studies examined symptoms of depression and anxiety in patients with CTEPH, showing depression levels as high as 37.5%. However, none of the former studies used structured expert interviews.

METHODS

Mental disorders were diagnosed using the Structured Clinical Interview for DSM-5 (SCID). The prevalence of mental disorders in patients with CTEPH were compared to the prevalence in patients with pulmonary arterial hypertension (PAH) and the general German population. Quality of life (QoL) was measured with World Health Organization (WHO) Quality of Life questionnaire (short form). Factors associated with QoL were analyzed with linear regression and the diagnostic value of the Hospital Anxiety and Depression Scale (HADS) was evaluated using receiver operating characteristics (ROC) curve analysis.

RESULTS

Hundred and seven patients with CTEPH were included. Almost one-third of the patients (31.8%) had current psychological disorders. Panic disorder (8.4%), specific phobia (8.4%), and major depressive disorder (6.5%) were the most prevalent mental illnesses. The prevalence of panic disorders was higher in CTEPH compared to the German population while major depressive disorder was fewer in CTEPH compared to PAH. The presence of mental disorders had a major impact on QoL. Hospital Anxiety and Depression Scale discriminated depression and panic disorder reliably.

CONCLUSION

Mental disorders are common in patients with CTEPH and associated with an impaired QoL. The HADS may be a useful screening tool for panic and depression disorders in patients with CTEPH. Further research on therapeutic strategies targeting mental disorders in patients with CTEPH is needed.

Prevalence of depression disorder in industrial workers: a meta-analysis

Objectives. Depression is known to be associated with a variety of occupational factors. The aim of this study was to meta-analyze the prevalence of depressive disorder in industrial workers. Methods. Three databases indexing abstracts of articles were selected and searched until August 2020: PubMed, Web of Science and Scopus. For each study, the sample size and number of depression events were extracted, and after extracting these data, the random effects method was used to assess the prevalence. I² and χ² values were used to investigate the heterogeneity. Results. The prevalence of depressive disorder in industrial workers is 21%. The prevalence of depressive disorder in men and women industrial workers is 23 and 28%, respectively. The prevalence of depressive disorder in Asia, Europe and America is equal to 22, 18 and 20%, respectively. The result of the heterogeneity test showed that the heterogeneity is high. Conclusion. The prevalence of depression in industrial workers is higher than in the general population. These differences can be due to the working conditions of industrial workers. Therefore, the work environment and the promotion of occupational health can play an important role in preventing depression.

Effect of daily social media exposure on anxiety and depression disorders among cargo seafarers: a cross-sectional study

BACKGROUND

Several studies have linked social media use to increased risks for anxiety and depression. Cargo seafaring is one occupation prone to constant mental health instability due to workload, social isolation, and harsh working conditions. We examined the effect of daily social media exposure, occupational experience, and socioeconomic factors on anxiety and depression disorders among cargo seafarers.

MATERIALS AND METHODS

We assessed the anxiety and depression disorders of 153 cargo seafarers using Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9 scales. We fitted generalised linear models to estimate associations between depression and anxiety disorders and daily social media exposure, occupational experience, and socioeconomic factors.

RESULTS

Approximately 30% and 37% of the seafarers had mild, moderate, or severe anxiety and depression disorders. The prevalence of anxiety was 2.68 times higher (adjusted prevalence ratio [aPR] 2.68, 95% confidence interval [95% CI] 1.30-5.50) and 2.27 times higher (aPR 2.27; 95% CI 1.12-4.62) among seafarers who spend > 2 to 4 hours and > 4 hours each day, respectively, on social media compared to seafarers who spend only up to 2 hours. In addition, seafarers who were on social media daily for > 2 to 4 hours (aPR 1.49; 95% CI 0.86-2.60) and > 4 hours (aPR 1.34; 95% CI 0.75-2.40) had a higher prevalence of depression compared to seafarers who were on social media daily for only up to 2 hours. Non-Catholics or seafarers with ≤ 10 years of occupational experience had a higher prevalence for anxiety and depression disorders than Catholics or seafarers with > 10 years of occupational experience.

CONCLUSIONS

Daily social media exposure for > 2 hours, working for ≤ 10 years, or being a non-Catholic may contribute to the increase in the seafarers' susceptibility to depression and anxiety disorders. The establishment of support groups for cargo seafarers is warranted to promote mental health awareness and well-being.

Anxiety and Depression in Patients With Pulmonary Arterial Hypertension in Northwest China: A Cross-Sectional Study

OBJECTIVE

Pulmonary arterial hypertension (PAH) is a rare life-threatening and incurable disease. Although symptoms of depression and anxiety have been widely reported, these traits and associated factors have not been systematically assessed in Northwest China.

METHODS

A cross-sectional study was conducted between March 2020 and February 2021. 106 PAH patients in Northwest China were evaluated by Self-rating Anxiety Scale (SAS) and the Self Rating Depression Scale (SDS) questionnaire.

RESULTS

Overall, the included patients had particularly high depressive symptoms (70.09%), while anxiety among them was 17.55%. Multivariate linear regression revealed that patients with lower age (p = 0.04), female (p < 0.01), smoking (p < 0.01), WHO functional class III/IV (p < 0.01), higher mean pulmonary hypertension (p < 0.01), lower left ventricular ejection fraction (p < 0.01), and lower 6-min walking distance (p < 0.01) had higher anxiety scores. Patients who lived in rural areas (p = 0.01), smoking (p < 0.01), WHO functional class III/IV (p < 0.01), higher mean pulmonary hypertension (p = 0.04), lower 6-min walking distance (p < 0.01), and college degree or above had higher depression scores (p = 0.02).

CONCLUSIONS

Mental health problems such as depression are common among patients with PAH in Northwest China. Patients' characteristics such as smoking status, WHO functional class, and 6-min walking distance were related to anxiety and depression scores. Thus, early detection of mental health problems such as depression and anxiety should be detected in PAH patients. Meanwhile, interventions against these problems should be used to improve such patients' mental status.

Prevalence of Mental Disorders and Impact on Quality of Life in Patients With Pulmonary Arterial Hypertension

Objective: Mental health may affect the quality of life (QoL) in patients with pulmonary arterial hypertension (PAH). However, mental disorders have not been systematically assessed in these patients. We examined the prevalence of mental disorders using structured interviews and determined their impact on QoL in patients with PAH. Methods: This study included 217 patients with PAH from two German referral centers. Psychiatric disorders were assessed using the structured clinical interview for DSM-V. QoL was assessed using the WHO Quality of Life questionnaire (short form). The diagnostic value of the Hospital Anxiety and Depression Scale was evaluated by receiver operating characteristic curve analysis. Results: More than one third of the patients had psychological disorders with current or past adjustment disorder (38.2%), current major depressive disorder (23.0%), and panic disorder (15.2%) being the most prevalent mental illnesses. About half of the patients with a history of adjustment disorder developed at least one other mental illness. The presence of mental disorders had a profound impact on QoL. The Hospital Anxiety and Depression Scale ruled out panic disorder and depression disorder with negative predictive values of almost 90%. Conclusion: Mental disorders, in particular adjustment disorder, major depression, and panic disorder, are common in patients with PAH and contribute to impaired QoL in these patients. The Hospital Anxiety and Depression Scale may be used as a screening tool for the most common mental health disorders. Future studies need to address interventional strategies targeting mental disorders in patients with PAH.

Berberine Suppresses Mice Depression Behaviors and Promotes Hippocampal Neurons Growth Through Regulating the miR-34b-5p/miR-470-5p/BDNF Axis

BACKGROUND

Berberine has been found to inhibit the progression of depression disorder, but its specific mechanism is still unclear. MicroRNA (miRNA) is considered to play an important role in the progression of depression. However, it is unclear whether Berberine is involved in the regulation of depression progression through miRNA.

METHODS

The chronic unpredictable mild stress (CUMS) mice model was constructed. Mice depression behaviors were evaluated by sucrose preference test (SPT) and forced swim test (FST). Quantitative real-time PCR was employed to assess the expression of miR-34b-5p, miR-470-5p and brain-derived neurotrophic factor (BDNF). The protein expression of BDNF was examined using Western blot analysis. In addition, the viability and apoptosis of hippocampal neurons were determined using cell counting kit 8 assay, flow cytometry and TUNEL assay. The interaction between BDNF and miR-34b-5p or miR-470-5p was verified by dual-luciferase reporter assay and RNA immunoprecipitation assay.

RESULTS

Our data indicated that Berberine could inhibit CUMS mice depression behaviors and enhance hippocampal neurons growth by targeting miR-34b-5p and miR-470-5p. In addition, we found that BDNF was a target of miR-34b-5p and miR-470-5p. Overexpressed BDNF could reverse the regulation of miR-34b-5p and miR-470-5p on CUMS mice depression behaviors and hippocampal neurons growth. Furthermore, Berberine could promote BDNF expression to regulate CUMS mice depression behaviors and hippocampal neurons growth.

CONCLUSION

Berberine might inhibit the progression of depression disorder by regulating the miR-34b-5p/miR-470-5p/BDNF axis.

Association between gastroesophageal reflux disease and depression disorder: A protocol for systematic review and meta-analysis

BACKGROUND

This study will systematically synthesize the evidence on the potential association between gastroesophageal reflux disease (GERD) and depression disorder (DD).

METHODS

We will search the following electronic bibliographic databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, the Chinese Bio Medical Literature Database, China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal database (VIP) and Wanfang Data. In addition, ongoing trials will be retrieved from the WHO ICTRP Search Portal, the Chinese Clinical Trial Register and The Clinical Trials Register. Articles related to gastroesophageal reflux disease and depression will be searched. And language and time will be unlimited.

RESULTS

The study will afford additional insight into the investigation the association between GERD and DD.

CONCLUSIONS

The results of this study will provide helpful evidence to explore the association between GERD and DD.

REGISTRATION NUMBER

INPLASY202090026.

Esketamine Nasal Spray for Treatment-Resistant Depression

Major depression affects millions of adults in the United States, and women are affected at twice the rate of men. Approximately 30% of individuals may continue to experience depression symptoms despite treatment with oral antidepressants. In March 2019, the U.S. Food and Drug Administration approved esketamine (Spravato), which is specifically indicated for treatment-resistant depression. Available as a nasal spray in a health care office or facility, esketamine has the potential to fill an unmet need for individuals who continue to experience depression with conventional treatment. Symptom improvement may be seen as rapidly as 1 week after treatment initiation. This article provides an overview of esketamine, including administration, adverse effects, and practice implications for women's health nurses.

Research Progress on Classical Traditional Chinese Medicine Jieyu Pills in the Treatment of Depression

Depression is a common clinical psychological disease, which is called "yu zheng" in traditional Chinese medicine (TCM). TCM has a long history in the treatment of depression (yu zheng), which has unique advantages. Jieyu pill (JYP), a classical TCM formula, has been widely used for treating depression because of its clear clinical efficacy, low side effects, and high compliance. In this review, we systematically introduce recent clinical and animal experimental studies on JYP and depression, and review the pharmacological mechanism and active ingredients of JYP, as well as its clinical application in depression therapy. This systematic review provides a deep understanding of TCM prescriptions, pharmacological mechanisms, and disease-medicine interactions, and lays the foundation for developing new treatments for depression.

Validation of the Chinese version General Causality Orientation Scale-Clinical Population and causality orientations assessing in major depressions

INTRODUCTION

This study examined the psychometric properties of the Chinese version General Causality Orientation Scale-Clinical Population (GCOS-CP) and assessed the causality orientations in patients with major depression disorders (MDDs).

METHOD

The psychometric properties of the Chinese GCOS-CP were tested in an adults group (study 1). And then, the Chinese GCOS-CP was given to individuals with and without MDD (study 2).

RESULTS

The Chinese GCOS-CP provided good reliability and validity. MDD showed lower autonomy but higher impersonal orientations relative to healthy controls.

DISCUSSION

The GCOS-CP is suitable for the assessment of motivation in patients with mental disorders in Chinese setting.

Examining the impacts of 12 weeks of low to moderate-intensity aerobic exercise on depression status in patients with systolic congestive heart failure - A randomized controlled study

OBJECTIVES

Psychiatric depression disorder is common in patients with systolic congestive heart failure (HF), and both conditions share underlying pathophysiological mechanisms. The incidence rate of depression disorder has clearly increased with the increase in HF manifestations in recent decades. Depression disorder is considered an independent predisposing factor for hospitalization, disturbed functional performance, and high rates of morbidity and mortality in HF patients. This randomized controlled study was designed to examine the impacts of low- to moderate-intensity aerobic exercise training on depression status in patients with systolic congestive HF.

METHODS

A total of 46 systolic congestive HF patients with depression (40-60 years of age) were randomized to receive twelve weeks of mild- to moderate-intensity aerobic exercise plus standard medical treatment (exercise group) or standard medical treatment without any exercise intervention (control group). Depression status was examined using the validated Patient Health Questionnaire-9 (PHQ9) pre- and post-intervention at the end of the study program.

RESULTS

No significant differences were observed between the exercise and control groups in demographic data or clinical characteristics (p>0.05). Both study groups showed a significant reduction in depression status at the end of the 12-week intervention (p<0.05). The comparison between the mean values of the depression scores showed significant differences between the two groups after 6 and 12 weeks of the intervention, indicating a greater reduction in depression scores in the exercise group than in the control group (p<0.05).

CONCLUSIONS

Twelve weeks of a low- to moderate-intensity aerobic exercise program was safe and effective for reducing depression severity in patients with systolic congestive HF. Low- to moderate-intensity aerobic training should be recommended for cardiac patients, particularly those with HF-related depression.

Major depression disorder trajectories and HIV disease progression: results from a 6-year outpatient clinic cohort

Contradictory evidence exists on the role of Major depression disorder (MDD) as a predictor of human immunodeficiency virus (HIV) disease progression, particularly regarding the effect of MDD presence versus pattern of illness. The objective of this study was to examine whether MDD status and pattern of illness differentially predict HIV disease progression. Retrospective cohort data from a six-year follow-up of HIV patients at an outpatient clinic were analyzed. MDD trajectories were identified by latent class growth analysis and generalized linear mixed models were used to examine their relation to low CD4+ T-lymphocyte counts (<200 cells/μL) during follow-up. Among 1,494 HIV patients, four MDD trajectory groups were identified: Low-Chronic, Moderate-Ascending, High-Episodic, and High-Chronic. Trajectory group membership was predicted by male sex (P = .04), minority race (P < .01), older age (P < .01) and low baseline CD4 count (P = .04). The High-Chronic group had lower odds of having a low CD4 count than the Low-Chronic group (adjusted Odds Ratio [aOR]: 0.63; 95%CI: 0.49-0.81) while the Moderate-Ascending group had higher odds (aOR: 1.53; 95%CI: 1.08-2.19). The odds of having a low CD4 count were higher among male (aOR: 1.25; 95%CI: 1.03-1.52), minority races (American Indian [aOR: 1.85; 95%CI: 1.38-2.49] and African Americans [aOR: 1.58; 95%CI: 1.33-1.87]), Hispanic (aOR: 1.52; 95%CI: 1.06-2.18), and divorced/separated patients (aOR: 1.62; 95%CI: 1.16-2.28) but decreased over time (P < .01) across trajectory groups. In this study, because MDD trajectories and CD4 counts were determined based on secondary data abstracted from electronic medical records, the results should be interpreted cautiously due to the potential for selection and misclassification bias. Overall, study findings suggest the pattern of MDD illness among HIV patients can be classified into clinically meaningful trajectory groups that appear to be programmed by known risk factors, and are useful for predicting HIV disease progression. Targeted interventions among at-risk patients may be critical to altering MDD illness patterns and curtailing HIV disease progression.

Psychological Predictors of Sexual Intimate Partner Violence against Black and Hispanic Women

Background: Although various types of intimate partner violence (IPV) tend to co-occur, risk factors of each type of IPV may differ. At the same time, most of the existing literature on risk factors of IPV among minorities has used a cross-sectional design and has focused on physical rather than sexual IPV. We conducted the current study to compare Black and Hispanic women for psychological predators of change in sexual IPV over time. Methods: Using data from the Fragile Families and Child Wellbeing Study (FFCWS), this study followed 561 Black and 475 Hispanic women with their male partners for four years. Independent variables included male partners' depression, anxiety, problem alcohol use, and male-to-female physical and psychological IPV perpetration. The dependent variable was sexual IPV reported by female partners, measured at baseline, two years, and four years later. Covariates included age, income, marital status and educational level. We used a multi-group latent growth curve model (LGCM) to explain intercept, linear, and quadratic slopes, which represent the baseline, and linear and curvilinear trajectories of male-to-female sexual IPV, where groups were defined based on ethnicity. Results: Psychological IPV was associated with sexual IPV at baseline among both ethnic groups. The male partner's depression was a risk factor for an increase in sexual IPV over time among Black but not Hispanic women. Anxiety, problem alcohol use and physical IPV did not have an effect on the baseline or change in sexual IPV over time. Psychological IPV was not associated with an increase in sexual IPV over time in either ethnic groups. Conclusions: There is a need for screening of sexual IPV in the presence of psychological IPV among minority women. There is also a need for screening and treatment of male partners' depression as a strategy to reduce sexual IPV among Black women.

Collaborative care for the treatment of comorbid depression and coronary heart disease: a systematic review and meta-analysis protocol

BACKGROUND

Depression and coronary heart disease (CHD) are frequently comorbid and portend higher morbidity, mortality and poorer quality of life. Prior systematic reviews of depression treatment randomized controlled trials (RCTs) in the population with CHD have not assessed the efficacy of collaborative care. This systematic review aims to bring together the contemporary research on the effectiveness of collaborative care interventions for depression in comorbid CHD populations.

METHODS/DESIGN

Electronic databases (Cochrane Central Register of Controlled Trials MEDLINE, EMBASE, PsycINFO and CINAHL) will be searched using a sensitive search strategy exploding the topics CHD, depression and RCT. Full text inspection and bibliography searching will be conducted, and authors of included studies will be contacted to identify unpublished studies. Eligibility criteria are: population, depression comorbid with CHD; intervention, RCT of collaborative care defined as a coordinated model of care involving multidisciplinary health care providers, including: (a) primary physician and at least one other health professional (e.g. nurse, psychiatrist, psychologist), (b) a structured patient management plan that delivers either pharmacological or non-pharmacological intervention, (c) scheduled patient follow-up and (d) enhanced inter-professional communication between the multiprofessional team; comparison, either usual care, enhanced usual care, wait-list control group or no further treatment; and outcome, major adverse cardiac events (MACE), standardized measure of depression, anxiety, quality of life, cost-effectiveness. Screening, data extraction and risk of bias assessment will be undertaken by two reviewers with disagreements resolved through discussion. Meta-analytic methods will be used to synthesize the data collected relating to the outcomes.

DISCUSSION

This review will evaluate the effectiveness and cost-effectiveness of collaborative care for depression in populations primarily with CHD. The results will facilitate integration of evidence-based practice for this precarious population.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42014013653.

The impact of emergency room utilization by depression patients on medical treatment expense in Korea

Objectives

To investigate the determinants of total medical expense for depression patients admitted through the emergency room (ER).

Methods

Data were selected from the Korean National Health Insurance sample data for 2009. SPSS version 18 was used for the statistical analysis such as descriptive analysis, correlation analysis, and multiple regression analysis. Data included 1203 cases admitted through the ER with ICD-10 codes (F31–F39).

Results

In the multiple regression analysis, significant variables affecting total payment were gender (p < 0.001), age (p < 0.001), main illness (p < 0.001), course of admission to the ER (p < 0.05), and length of stay (p < 0.001).

Conclusion

It is necessary to build a long-term program and system for high-risk depression groups.

Stroke lesion in cortical neural circuits and post-stroke incidence of major depressive episode: a 4-month prospective study

OBJECTIVE

Little is known about the relevance of lesion in neural circuits reported to be associated with major depressive disorder. We investigated the association between lesion stroke size in the limbic-cortical-striatal-pallidal-thalamic (LCSPT) circuit and incidence of major depressive episode (MDE).

METHODS

We enrolled 68 patients with first-ever ischemic stroke and no history of major depressive disorder. Neurological and psychiatric examinations were performed at three time-points. We diagnosed major depressive episode, following DSM-IV criteria. Lesion location and volume were determined with magnetic resonance imaging, using a semi-automated method based on the Brodmann Cytoarchitectonic Atlas.

RESULTS

Twenty-one patients (31%) experienced major depressive episode. Larger lesions in the left cortical regions of the LCSPT circuit (3,760 vs. 660 mm3; P = 0.004) were associated with higher incidence of MDE. Secondary analyses revealed that major depressive episode was associated with larger lesions in areas of the medial prefrontal cortex including the ventral (BA24) and dorsal anterior cingulate cortex (BA32) and subgenual cortex (BA25); and also the subiculum (BA28/36) and amygdala (BA34).

CONCLUSIONS

Our findings indicate that depression due to stroke is aetiologically related to the disruption of the left LCSPT circuit and support the relevance of the medial prefrontal cortex dysfunction in the pathophysiology of depression.