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Peltzer K, Pengpid S. Impact of Somatic Conditions and Lifestyle Behaviours on Depressive Symptoms and Low Life Satisfaction among Middle-Aged and Older Adult Men in South Africa. J Mens Health 2023; 18:194. [PMID: 38107592 PMCID: PMC10723043 DOI: 10.31083/j.jomh1809194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Objective The purpose of this study was to assess the association between somatic disorders, lifestyle factors, incident and persistent depressive symptoms, and low life satisfaction in a longitudinal study in South Africa. Methods We analyzed longitudinal data from two consecutive waves, 2346 men aged 40 years or older in 2014/2015 in wave 1 and 1864 men of wave 1 in 2018/2019 in wave 2 of the "Health and Ageing in Africa: A Longitudinal Study of an International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) Community in South Africa (HAALSI)". Results In total, 360 of 1932 male participants without depressive symptoms in wave 1 (24.3%) had incident depressive symptoms in wave 2 and 77 of 349 men had depressive symptoms in both waves 1 and 2 (persistent depressive symptoms). In all, 457 of 1258 male participants without low life satisfaction in Wave 1 (47.6%) had incident low life satisfaction in Wave 2, and 360 of 998 men had low life satisfaction at both Wave 1 and 2 (persistent low life satisfaction). In the unadjusted logistic regression analysis, having kidney disease and living with HIV had greater odds of incident depressive symptoms. In adjusted analysis, alcohol dependence (Adjusted Odds Ratio-AOR: 4.54, 95% Confidence Interval-CI: 1.05-19.66) was positively correlated and 1-7 and 8-11 years of education (AOR: 0.45, 95% CI: 0.27-0.74, and AOR: 0.20, 95% CI: 0.07-0.54, respectively) were negatively associated with persistent depressive symptoms. Increasing age increased the odds (AOR: 1.03, 95% CI: 1.01-1.04), while higher education (≥12 years) (AOR: 0.50, 95% CI: 0.33-0.76), and high physical activity (AOR: 0.68, 95% CI: 0.52-0.89) decreased the odds of incident low life satisfaction. Increasing age (AOR: 1.03, 95% CI: 1.02-1.04) and tobacco use (AOR: 1.64, 95% CI: 1.23-2.19) increased the odds and high physical activity (AOR: 0.73, 95% CI: 0.56-0.96) decreased the odds of persistent low life satisfaction. Conclusions Of the seven chronic conditions and five lifestyle factors evaluated, alcohol dependence increased the odds of persistent depressive symptoms and low physical activity, and tobacco use increased the odds of incident and/or persistent low life satisfaction among men in rural South Africa.
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Affiliation(s)
- Karl Peltzer
- Department of Psychology, University of the Free State, 9300 Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Wufeng, 41354 Taichung, Taiwan
| | - Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health Mahidol University, 10400 Bangkok, Thailand
- Department of Research Administration and Development, University of Limpopo, 0727 Polokwane, South Africa
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Hannah LA, Walsh CM, Jopling L, Perez J, Cardinal RN, Cameron RA. Economic evaluation of interventions for treatment-resistant depression: A systematic review. Front Psychiatry 2023; 14:1056210. [PMID: 36873195 PMCID: PMC9979220 DOI: 10.3389/fpsyt.2023.1056210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Background The extraordinarily high prevalence of treatment-resistant depression (TRD), coupled with its high economic burden to both healthcare systems and society, underscore how critical it is that resources are managed optimally to address the significant challenge it presents. Objective To review the literature on economic evaluation in TRD systematically, with the aim of informing future studies by identifying key challenges specific to the area, and highlighting good practices. Methods A systematic literature search across seven electronic databases was conducted to identify both within-trial and model-based economic evaluations in TRD. Quality of reporting and study design was assessed using the Consensus Health Economic Criteria (CHEC). A narrative synthesis was conducted. Results We identified 31 evaluations, including 11 conducted alongside a clinical trial and 20 model-based evaluations. There was considerable heterogeneity in the definition of treatment-resistant depression, although with a trend for more recent studies to use a definition of inadequate response to two or more antidepressive treatments. A broad range of interventions were considered, including non-pharmacological neuromodulation, pharmacological, psychological, and service-level interventions. Study quality as assessed by CHEC was generally high. Frequently poorly reported items related to discussion of ethical and distributional issues, and model validation. Most evaluations considered comparable core clinical outcomes - encompassing remission, response, and relapse. There was good agreement on the definitions and thresholds for these outcomes, and a relatively small pool of outcome measures were used. Resource criteria used to inform the estimation of direct costs, were reasonably uniform. Predominantly, however, there was a high level of heterogeneity in terms of evaluation design and sophistication, quality of evidence used (particularly health state utility data), time horizon, population considered, and cost perspective. Conclusion Economic evidence for interventions in TRD is underdeveloped, particularly so for service-level interventions. Where evidence does exist, it is hampered by inconsistency in study design, methodological quality, and availability of high quality long-term outcomes evidence. This review identifies a number of key considerations and challenges for the design of future economic evaluations. Recommendations for research and suggestions for good practice are made. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259848&VersionID=1542096, identifier CRD42021259848.
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Affiliation(s)
- Laura A. Hannah
- Applied Research Collaboration East of England, National Institute for Health and Care Research, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Cathy M. Walsh
- Applied Research Collaboration East of England, National Institute for Health and Care Research, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Louise Jopling
- Eastern Academic Health Science Network, Cambridge, United Kingdom
| | - Jesus Perez
- Applied Research Collaboration East of England, National Institute for Health and Care Research, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Psychiatry Unit, Department of Medicine, Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain
| | - Rudolf N. Cardinal
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Rory A. Cameron
- Applied Research Collaboration East of England, National Institute for Health and Care Research, Cambridge, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Serrander M, Bremander A, Jarbin H, Larsson I. Joy of living through exercise - a qualitative study of clinically referred adolescents' experiences of moderate to vigorous exercise as treatment for depression. Nord J Psychiatry 2021; 75:574-581. [PMID: 33884944 DOI: 10.1080/08039488.2021.1909128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIM Depression is common and rising in adolescents. Recent meta-analyses indicate a moderate effect of exercise on depression symptoms. Clinically referred adolescents and their experiences of an exercise intervention have rarely been studied. The aim of this study was to describe clinically referred adolescents' experience of moderate to vigorous exercise as a treatment for depression. METHODS A total of 16 clinically referred adolescents with persistent major depression, who had taken part in a 14-week aerobic exercise intervention of moderate to vigorous intensity, were interviewed. Data was analysed by latent qualitative content analysis. RESULTS After taking part in the exercise intervention the adolescents expressed enhanced participation in daily life and joy of living by demonstrating commitment and a sense of empowerment. The categories contained both improved vitality and structure of everyday life as well as improved self-esteem and self-control. Participation in the exercise intervention changed their self-image, relationships, school performance, and family life. The adolescents highlighted that exercising in a group was beneficial, giving security and structure. CONCLUSIONS Adolescents with persistent depression experienced several beneficial aspects of participating in an aerobic group exercise of moderate to vigorous intensity.
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Affiliation(s)
- Maria Serrander
- Child and Adolescent Habilitation, Skåne University Hospital, Malmö, Sweden
| | - Ann Bremander
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark.,The Rydberg Laboratory for Applied Sciences, Halmstad University, Halmstad, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden
| | - Håkan Jarbin
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Sweden.,Child and Adolescent Psychiatry, Region Halland, Sweden
| | - Ingrid Larsson
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden.,Center of Research on Welfare, Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Silver J, Olino TM, Carlson GA, Klein DN. Offspring of Mothers With Histories of Chronic and Non-chronic Depression: Symptom Trajectories From Ages 6 to 15. Front Psychiatry 2020; 11:601779. [PMID: 33329155 PMCID: PMC7710605 DOI: 10.3389/fpsyt.2020.601779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Several studies have reported that individuals with chronic depression have higher rates of depressive disorders, and particularly chronic depression, in their first-degree relatives, compared to those with non-chronic (episodic) major depression. In addition, a few studies have suggested that offspring of parents with chronic depression have elevated rates of depression and other psychopathology. Most of this work uses the Diagnostic and Statistical Manual of Mental Disorders (DSM), which defines chronicity as persistence for at least 2 years. An alternative is a life-course, approach, which evaluates overall course since first onset. We examined the trajectories of depressive, anxiety, and externalizing symptoms in a community sample of 577 offspring of mothers with histories of chronic depression, non-chronic (or episodic) major depression, and no depression using prospective, multi-informant assessments from age 6 to age 15. Offspring of mothers with a history of depression exhibited higher levels of depression, anxiety, and externalizing symptoms than offspring of mothers who were never depressed. Moreover, the effects of maternal depression on offspring depression, anxiety, and externalizing symptoms were more pronounced for mothers with histories of chronic than non-chronic depression, particularly when the life-course approach to classifying chronicity was used. These data suggest that research that combines chronic and non-chronic depressions includes significant heterogeneity that may hinder understanding of etiology and reduce the likelihood of developing a cumulative and replicable literature. In addition, these findings have significant implications for prevention and treatment.
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Affiliation(s)
- Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Thomas M. Olino
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Gabrielle A. Carlson
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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Abstract
Objectives Research has shown that yoga may be an effective adjunctive treatment for persistent depression, the benefits of which may accumulate over time. The objectives of this study were to evaluate the following in a sample of persistently depressed individuals: whether yoga increases mindfulness and whether yoga attenuates rumination. Rumination and mindfulness both represent attentional processes relevant for onset and maintenance of depressive episodes. Methods One-hundred-ten individuals who were persistently depressed despite ongoing use of pharmacological treatment were recruited into an RCT comparing yoga with a health education class. Mindfulness and rumination were assessed at baseline and across 3 time points during the ten-week intervention. Results Findings demonstrate that, compared to health education, yoga was associated with higher mean levels of the observe facet of mindfulness relative to the control group during the intervention period (p =.004, d =0.38), and that yoga was associated with a faster rate of increase in levels of acting with awareness over the intervention period (p= .03, f2 =0.027). There were no differences between intervention groups with respect to rumination. Conclusions Results suggest a small effect of yoga on components of mindfulness during a 10-week intervention period. Previous research suggests that continued assessment after the initial 10 weeks may reveal continued improvement. Future research may also examine moderators of the impact of yoga on mindfulness and rumination, including clinical factors such as depression severity or depression chronicity, or demographic factors such as age.
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Affiliation(s)
| | - Geoffrey Tremont
- Alpert Medical School of Brown University, Providence, RI.,Rhode Island Hospital, Providence, RI
| | - Ivan W Miller
- Alpert Medical School of Brown University, Providence, RI.,Butler Hospital, Providence, RI
| | - Lisa A Uebelacker
- Alpert Medical School of Brown University, Providence, RI.,Butler Hospital, Providence, RI
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Abstract
Depression in old age deserves special attention in view of the fact of progressive population ageing, because of the way in which depression and risk factors interact in this period of life and the particularly negative impact of late-life depression on health and quality of life. This editorial aims to provide some insight into longitudinal aspects of depression in old age. Depression may follow varying trajectories (e.g. episode emergence, recurrence) across the lifespan. Late-life depression is not an exception. A symptom-based approach is presented as an appropriate research method to study the predictors and course of affective syndromes in old age. Findings from our studies on depressive symptom trajectories in old age revealed that participants with a course of unremitting elevated symptoms showed the highest levels of loneliness across the trajectory groups and that participants with subclinical symptoms also showed higher levels of loneliness than their counterparts with a minimal-symptom course trajectory. This highlights the need to address loneliness as a way of dealing with depression in old age.
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