Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults

Background: Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety, and stress with delays in getting a contraceptive method or prescription. Materials and Methods: Data from a supplementary study (May 15, 2020-March 20, 2023) to a cluster randomized trial in 29 sites in Texas and California were used. The diverse study sample included community college students assigned female at birth of ages 18-29 years (n = 1,665 with 7,023 observations over time). We measured the association of depression (CES-D [Center for Epidemiologic Studies Depression Scale]) or anxiety and stress (DASS-21 [Depression Anxiety Stress Scales]) symptoms with delayed contraceptive care-seeking with mixed-effects multivariable regression with random effects for individual and site. We controlled for age and sociodemographic factors important for access to care. Results: Over one-third of participants (35%) reported they delayed getting the contraceptive method they needed. Multivariable regression results showed increased odds of delayed contraceptive care among participants with symptoms of depression (adjusted odds ratio [aOR] 1.58, 95% confidence interval [CI] 1.27-1.96). Likewise, delays were associated with anxiety and stress symptoms (aOR 1.46, 95% CI 1.17-1.82). Adolescents were more likely to delay seeking contraception than young adults (aOR 1.32, 95% CI 1.07-1.63). Conclusions: Results showed a strong association between mental distress and delayed contraception. Interventions are needed to increase contraceptive access for young people delaying care, along with supportive mental health care services, including for adolescents who face elevated odds of delay. ClinicalTrials.gov Identifier: NCT03519685.

Level of basic hope and symptoms of anxiety and depression in women after miscarriage

Introduction

The study aimed to determine the level of basic hope and symptoms of anxiety and depression in women after miscarriage.Methods: To evaluate the symptoms of anxiety and depression, and basic hope, the standardized questionnaires the Hospital Anxiety and Depression Scale (HADS) and the Basic Hope Inventory (BHI-12), respectively, were used. Patients hospitalized at the Department of Obstetrics and Gynaecology of the Provincial Combined Hospital in Kielce due to miscarriage in the period from September 2019 to August 2021 were included in the study.

Results

The sense of basic hope increased after 3 months (p < 0.001). The intensity of symptoms of anxiety and depression decreased (p < 0.001). The BHI-12 correlated significantly and negatively with the level of anxiety (r = -0.438, p < 0.001) and depression symptoms (r = -0.456, p < 0.001) during and after hospitalization (anxiety r = -0.649, p < 0.001; depression r = -0.643, p < 0.001).

Conclusions

It was found that the level of hope significantly increased after 3 months compared to this level during hospitalization. Hope was associated with lower levels of anxiety and depression symptoms.

Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil

BACKGROUND

This study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health-related quality of life (HR-QOL) outcomes 3 months after initiating treatment.

METHODS

This is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient-centered outcomes (HR-QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage.

RESULTS

Fifty-six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy - General FACT-G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, -0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found.

CONCLUSION

Remote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR-QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient-reported outcomes in low-resource environments.

Organizational Resources and Social Support Influences on Stress and Depression: A Comparison among Cooperative and Non-Cooperative Farmers

BACKGROUND

Farmers are disproportionally affected by depression and suicide. Social connectedness has been shown to reduce depression and suicide among the general population but its impact on farmers is less well-known. Our previous research indicated that farmers who had cooperative resources and social support reported decreased symptoms of depression. However, it was unclear whether farmers who were not cooperative members or utilized resources from non-cooperative organizations differed from cooperative farmers in mental health.

METHODS

A survey consisted of online self-completion and phone interviews was conducted among 307 participants (197 co-op, 110 non-co-op) to examine whether Midwest (north central United States) cooperative and non-cooperative farmers differ in perceived stress and symptoms of depression and whether potential differences were impacted by program use, program satisfaction, and social support.

RESULTS

Cooperative farmers reported lower perceived stress and symptoms of depression than non-cooperative farmers and the difference was statistically significant for perceived stress. Use of educational programs, such as training and mentorship, was associated with decreased perceived stress but not symptoms of depression. Satisfaction with programs and social support were associated with decreased perceived stress and symptoms of depression. Program satisfaction was observed to have more associations with decreased perceived stress and symptoms of depression than program use.

CONCLUSIONS

Results reveal that organizational resources and social support can mitigate mental health risks among farmers. This study highlighted an opportunity for future investigation of social connectedness in addressing farmers' mental health.

Longitudinal associations between alcohol use, smoking, genetic risk scoring and symptoms of depression in the general population: a prospective 6-year cohort study

BACKGROUND

Alcohol consumption, smoking and mood disorders are leading contributors to the global burden of disease and are highly comorbid. Yet, their interrelationships have remained elusive. The aim of this study was to examine the multi-cross-sectional and longitudinal associations between (change in) smoking and alcohol use and (change in) number of depressive symptoms.

METHODS

In this prospective, longitudinal study, 6646 adults from the general population were included with follow-up measurements after 3 and 6 years. Linear mixed-effects models were used to test multi-cross-sectional and longitudinal associations, with smoking behaviour, alcohol use and genetic risk scores for smoking and alcohol use as independent variables and depressive symptoms as dependent variables.

RESULTS

In the multi-cross-sectional analysis, smoking status and number of cigarettes per day were positively associated with depressive symptoms (p < 0.001). Moderate drinking was associated with less symptoms of depression compared to non-use (p = 0.011). Longitudinally, decreases in the numbers of cigarettes per day and alcoholic drinks per week as well as alcohol cessation were associated with a reduction of depressive symptoms (p = 0.001-0.028). Results of genetic risk score analyses aligned with these findings.

CONCLUSIONS

While cross-sectionally smoking and moderate alcohol use show opposing associations with depressive symptoms, decreases in smoking behaviour as well as alcohol consumption are associated with improvements in depressive symptoms over time. Although we cannot infer causality, these results open avenues to further investigate interventions targeting smoking and alcohol behaviours in people suffering from depressive symptoms.

Mental Health Among People Presenting for Care of Physical Symptoms: The Factors Associated with Suicidality and Symptoms of Depression and Anxiety are Similar Across Specialties

Background

To identify differences in thoughts of suicide and symptoms of depression and anxiety by specialty among people presenting for care of physical symptoms, we analyzed data from routine mental health measurement in a small multispecialty practice and asked: 1. Are there any differences in suicidality (analyzed as an answer of 1 or greater or 2 or greater on the Patient Health Questionnaire [PHQ] question 9) in non-specialty and various types of specialty care? 2. Are there any factors-including specialty-associated with symptoms of depression (mean PHQ score), PHQ thresholds (greater than 0, 3 or greater, 10 or greater), Generalized Anxiety Disorder instrument [GAD] score of 3 or greater, and either GAD score 3 or greater or PHQ score 3 or greater? and 3. What factors are associated with referral to a social worker?

Methods

As part of routine specialty and non-specialty care, 13,211 adult patients completed a measure of symptoms of depression (PHQ) that included a question about suicidality and a measure of symptoms of anxiety (GAD). Factors associated with suicidality and symptoms of depression and anxiety at various thresholds, and visit with a social worker, were sought in multivariable models.

Results

Accounting for potential confounding in multivariable analyses, a score higher than 0 on the suicidality question (present in 18% of people) was associated with men, younger age, English-speakers, and neurodegenerative specialty care. Symptoms of depression on their continuum and using various thresholds (28% of people had a PHQ score greater than 2) were associated with non-Spanish-speakers, younger age, women, and county insurance or Medicaid insurance. Care from the social worker was associated with PHQ score of 3 or greater and having any suicidal thoughts (score of 1 or greater on question 9) but was less common with Medicare or Commercial Insurance and less common in the unit treating cognitive decline.

Conclusion

The notable prevalence of symptoms of depression and suicidality among people presenting for care of physical symptoms across specialties and the relatively similar factors associated with suicidality, symptoms of depression, and symptoms of anxiety at various thresholds suggests that both non-specialty and specialty clinicians can be vigilant for opportunities for improved mental health. Increased recognition that people seeking care for physical symptoms often have mental health priorities has the potential to improve comprehensive care strategies, alleviate distress, and reduce suicide.

The Impact of Distance Education during the COVID-19 Pandemic on Physical Activity and Well-Being of Czech and Polish Adolescents

BACKGROUND

The aim of this study was to identify the changes in the structure of weekly physical activity (PA) and well-being among adolescent boys and girls between habitual education (HE) and distance education (DE) during the pandemic in secondary schools.

METHODS

The research was carried out in 12 Czech and 18 Polish schools during 2019 to 2020 academic session for HE and 2020 to 2021 academic session for DE. The research involved 723 girls and 626 boys aged 15 to 18 years. The structure of the weekly PA was assessed using the International Physical Activity Questionnaire-Long Form, while well-being was assessed using the World Health Organization-5 Well-Being Index.

RESULTS

There was a statistically significant decrease of PA among boys in school PA, transportation PA, recreation PA, vigorous PA, moderate PA, walking, and overall weekly PA during the DE resulting from the pandemic. In girls, during DE, a decrease was observed in school PA, vigorous PA, and overall PA. During DE, a high level of well-being was reported by only 34.9% of girls (43.8% during HE) and 50% of boys (65.6% during HE).

CONCLUSIONS

The observed low PA and high incidence of depressive symptoms in adolescents in distance education during pandemic constraints are a challenge for schools to change in supporting physical activity, eliminating similar negative impacts on school life in the future.

Association between Sleep Duration and Symptoms of Depression Aged between 18 and 49: The Korea National Health and Nutrition Examination Survey (KNHANES Ⅶ) from 2016 to 2018

This study aimed to determine the association between symptoms of depression and sleep duration in a representative sample of the Korean population. Using national cross-sectional data from the seventh Korea National Health and Nutrition Examination Surveys (KNHANES-VII), 5461 adults aged 18−49 years were analyzed using logistic regression models. The proportions of participants with total daily sleep durations (24 h) of <6 h, 6−8 h, and ≥9 h were 26.2%, 60.6%, and 13.3%, respectively. The proportions of individuals with symptoms of depression in the <6 h, 6−8 h, and ≥9 h sleep duration groups were 37.4%, 46.3%, and 16.3%, respectively. The odds ratios (ORs) were significantly higher in the <6 h and ≥9 h sleep groups than in the 6−8 h sleep group. There was a significant association between short (<6 h/day) and long (≥9 h/day) sleep duration and symptoms of depression among the general Korean population. In particular, our findings suggest that short sleep (<6 h/day) is more associated with symptoms of depression than long sleep (≥9 h/day).

Psychosocial correlates of symptoms of depression among patients with endometriosis in the United Kingdom

A recent study found high levels (43%) of moderate to severe symptoms of depression among patients diagnosed with endometriosis in South Africa (SA) and identified several psychosocial predictors of these symptoms of depression. However, there is limited research on predictors of symptoms of depression in other settings. Considering the contextual differences between SA and the United Kingdom (UK) and their vastly different healthcare settings, we conducted a replication study in the UK and improved on the methodology by adding an established measure of sexual dysfunction to the model and obtaining a larger sample. The study comprised of a secondary analysis of cross-sectional data collected among patients with endometriosis. Study particulars were advertised by a national endometriosis association and data were collected online using Qualtrics. The sample consisted of 598 adults with self-reported endometriosis who completed measures assessing symptoms of depression, physical functioning, menstrual characteristics, sexual functioning, feelings about the medical profession, feelings about infertility, and sexual relationships. Seventy-one percent of participants reported moderate to severe levels of symptoms of depression. In addition, physical functioning, concerns about menstrual characteristics, sexual dysfunction, feelings about infertility and feelings about the medical profession were identified as significant predictors of symptoms of depression. It is important that healthcare professionals recognize that patients with endometriosis may be at risk of depression and that psychological referral should be considered.

Trajectories and Predictors of Symptoms of Depression in Chinese Women From Early Pregnancy to the Early Postpartum Period

OBJECTIVE

To explore the trajectories and predictors of symptoms of depression in Chinese women from early pregnancy to 3 months after birth.

DESIGN

Prospective cohort study.

SETTING

Several maternal and child health care institutions and obstetric departments of general hospitals in Beijing, Jiangsu, Hunan, Sichuan, Shandong, Guangdong, and Shanxi provinces in China.

PARTICIPANTS

Chinese women (N = 667) during pregnancy and the postpartum period.

METHODS

From August 2019 to June 2020, participants from several tertiary hospitals in China who completed at least three measurements during early pregnancy to 3 months after birth (from time point 1 to time point 5) were included for data analysis. We used the self-administered basic information questionnaire and the Edinburgh Postnatal Depression Scale for follow-up. We used Mplus version 8.3 to construct the growth mixture modeling and SPSS version 25.0 to carry out logistic regression analysis.

RESULTS

We found three potential trajectories of symptoms of depression during pregnancy and the postpartum period: the down-then-up healthy group (Class 1, 68.5%), steady-growth moderate-risk group (Class 2, 27.5%), and up-then-down high-risk group (Class 3, 4.0%). Multinomial logistic regression analysis showed that being pregnant for the first time, being a company employee, being less satisfied with the living environment, and the occurrence of negative life events were significant predictors of the Class 2 trajectory, whereas younger age, being less satisfied with food, and the occurrence of negative life events were predictors of the Class 3 trajectory.

CONCLUSION

The trajectories of symptoms of depression during pregnancy and the postpartum period among Chinese women showed significant group heterogeneity. The trajectory categories were influenced not only by demographics and pregnancy-related factors but also by maternal subjective feelings.

Does Training Motivation Influence Resilience Training Outcome on Chronic Stress? Results from an Interventional Study

Resilience is understood as an acquired skill which aids in coping with acute and chronic stress. Accordingly, the present study aimed to determine the effect of resilience training on mental health problems during chronic stress. To this end, we conducted a quasi-experimental study with 127 male cadets (mean age: 21 years) of the Swiss Armed Forces officers' school. Whereas the intervention group (IG) received resilience training in addition to the standard officer's education program, the control group (CG) completed the officers' school as usual. Data assessment included pre- and post- measurement of chronic stress, symptoms of depression, and vital exhaustion in both groups. Motivation for training was collected before the first training session. Those who received the resilience training reported no change in chronic stress, whereas participants in the CG showed a significant increase in chronic stress over time (η_p² = 0.025). Furthermore, significant differences between IG and CG were only found for symptoms of depression: Participants in the IG reported significantly decreased symptoms of depression, while this was not the case for participants in the CG. Within the IG, participants' training motivation strongly influenced the effectiveness of the resilience training. More specifically, motivated individuals were more likely to benefit from the resilience training than unmotivated ones. Outcome data suggest that resilience training appeared to favorably affect chronic stress and related mental health symptoms; however, the motivation for the training seemed to be an essential prerequisite.

Weight perception and symptoms of depression in rural Australian adolescents

OBJECTIVE

To investigate associations between measured and perceived weight, and symptoms of depression in rural Australian adolescents.

METHOD

At baseline a prospective rural adolescent cohort study collected demographic data, measured weight and height, weight self-perception, and presence of depression (Short Mood and Feelings Questionnaire). Using World Health Organisation's (WHO) age and gender body mass index (BMI) standardisations, participants were classified into four perceptual groups: PG1 healthy/perceived healthy; PG2 overweight/perceived overweight; PG3 healthy/perceived overweight; and PG4 overweight/perceived healthy. Logistic regression analyses explored relationships between these groups and symptoms of depression.

RESULTS

Data on adolescents (n = 339) aged 9-14. PG1 contained 63% of participants, PG2 18%, PG3 4% and PG4 14%. Across the cohort, 32% were overweight and 13% had symptoms of depression. PG2 (overweight/perceived overweight) were more likely to experience symptoms of depression than PG1 (healthy/perceived healthy; Adjusted Odds Ratio [AOR] 3.1, 95% CI 1.5-6.7). Females in PG3 (healthy/perceived overweight) were more likely to experience symptoms of depression (38%) than males (14%) and females in PG1 (10%, AOR 5.4, 95% CI 1.1-28.2).

CONCLUSIONS

Results suggest that perceptions of being overweight may be a greater predictor for symptoms of depression than actual weight. This has public health implications for youth mental health screening and illness prevention.

Association between First Sexual Intercourse and Sexual Violence Victimization, Symptoms of Depression, and Suicidal Behaviors among Adolescents in the United States: Findings from 2017 and 2019 National Youth Risk Behavior Survey

The objective of this study was to investigate the association between first sexual intercourse and sexual violence victimization, symptoms of depression, and suicidal ideation among sexually active adolescents in the United States. Data for this study came from the U.S. 2017 and 2019 iterations of the National Youth Risk Behavior Survey. An analytic sample of 6252 adolescents aged 14–18 years old (49.5% female) who reported ever having sexual intercourse was analyzed using Poisson regression. The outcome variables investigated in this study were sexual violence victimization, symptoms of depression, suicidal ideation, a suicide plan, and suicide attempts, and the main explanatory variables were age at first sexual intercourse and forced sexual intercourse. We also analyzed differences by gender and race. Of the 6252 adolescents who reported ever having sexual intercourse, 7.1% had their first sexual intercourse before age 13, and 14.8% experienced forced sexual intercourse. About 16% of adolescents experienced sexual violence during the past year, 42.6% reported symptoms of depression, 23.9% experienced suicidal ideation, 19.3% made a suicide plan, and 11.1% attempted suicide during the past year. In the regression analysis, early sexual intercourse was significantly and positively associated with suicidal ideation (relative risk (RR) = 1.15, 95% Confidence Interval (CI) = 1.02–1.30), suicide plan (RR = 1.18, 95% CI = 1.00–1.38), and suicide attempts (RR = 1.36, 95% CI = 1.15–1.61). Controlling for the effects of covariates, history of forced sexual intercourse was positively associated with the five outcomes examined with the relative risk ranging between 1.59 and 6.01. Findings of this study suggest that history of early or forced sexual intercourse is associated with poor mental health outcomes among adolescents and underscores the importance of developing interventions that offer psychological support in reducing the adverse impact of early sexual intercourse and forced sexual intercourse on adolescent health.

Associations of Symptoms of Depression, Social Support, and Quality of Life Among Korean Women Who Experience Infertility

OBJECTIVE

To describe the quality of life (QOL) of Korean women experiencing infertility based on sociodemographic and infertility characteristics and to examine the associations among symptoms of depression, social support, and QOL.

DESIGN

Cross-sectional, descriptive study.

SETTING

Participants were recruited from July to August 2019 on one of the largest South Korean websites where individuals share pregnancy and parenthood experiences.

PARTICIPANTS

Adult women (N = 186) who received infertility treatment.

METHODS

Participants completed an online survey using the Korean version of the Patient Health Questionnaire 9 to measure symptoms of depression, the Multidimensional Scale of Perceived Support, and the Fertility Quality of Life (FertiQOL) scale. Data were analyzed using descriptive statistics, correlation, analysis of variance, and multiple regression.

RESULTS

There was a significant negative relationship between scores on the Patient Health Questionnaire 9 and FertiQOL (r = -0.557) and a significant positive relationship between scores on the Multidimensional Scale of Perceived Support and FertiQOL (r = 0.404). The length of time from diagnosis of infertility to data collection, past and current treatments, cost burden, and degree of inhibition of daily life due to infertility also significantly affected participants' FertiQOL scores. Symptoms of depression, the burden of treatment, and inhibition of daily life activities explained 46% of the variance in QOL.

CONCLUSION

Women experiencing infertility and symptoms of depression had lower FertiQOL scores. Health care providers, who are most familiar with and attentive to patients, could provide a first line of defense against poor QOL in this population. By continuously assessing the levels of psychosocial stress in women with infertility, nurses could provide timely resources and design interventions to improve women's QOL.

Examination of Symptoms of Depression among Cooperative Dairy Farmers

Farmers experience a high risk of stress, depression, and suicide. Risk factors are well documented but protective factors are seldom examined. Social support has been reported to reduce psychological distress among the general population but its effect on farmers is inconclusive. Agricultural cooperatives are typically created and owned by farmers to secure markets, access supplies and services, and participate in decision-making. It is unknown whether having cooperative resources impacts symptoms of depression. A survey was used to examine whether having access to cooperative programs and social support impacted symptoms of depression among dairy farmers. Farm bankruptcies, stress, depression, and suicide were identified as ongoing concerns. Having social support and cooperative educational opportunities and mentorship programs were associated with decreased symptoms of depression. Conversely, having cooperative policy discussions was associated with increased symptoms of depression. Results suggest that social support can potentially reduce symptoms of depression among farmers and having access to cooperative resources can reduce or increase it, depending on the type of program. Our findings identified an opportunity to further examine how programs provided by farmer-led organizations such as cooperatives can impact stress, depression, and suicide among farmers.

Analysis of the Degree of Acceptance of Illness Among Patients After a Stroke: An Observational Study

Introduction

The aim of this study was to analyse the level of illness and disability acceptance in stroke patients undergoing regular rehabilitation at two time points, before rehabilitation and after 3 weeks, and to answer the following questions: What is the functional and emotional status of stroke patients, characterized by a lower and higher level of illness acceptance before and after the 3-week rehabilitation period? What factors, including clinical, sociodemographic, functional and emotional, are associated with the degree of illness acceptance in patients who have suffered a first stroke?

Sample and Methods

The study included 64 patients after first stroke, aged 50–87 years. The following tests were used: Acceptance of Illness Scale, Geriatric Depression Scale, Rivermead Mobility Index and Barthel Index. Tests were conducted at two time points, the first before rehabilitation and the second after 3 weeks of regular rehabilitation.

Results

The study group had an average level of acceptance of their illness and disability, both before and after 3 weeks of rehabilitation. After rehabilitation process, statistically significant improvements were achieved in acceptance of illness, mood disorders, functional status, mobility and locomotion. Low levels of illness acceptance were observed in stroke patients with a poorer functional condition, with mood disorders, with primary and vocational education.

Conclusion

The results suggest that the level of illness acceptance may be an important factor in the rehabilitation of stroke patients; however, further studies are necessary.

Depressive symptoms and adherence to prophylaxis in patients with haemophilia from Croatia and Slovenia

INTRODUCTION

Adherence to a prophylactic therapy is obligatory to prevent bleeding in patients with haemophilia. It has already been recognized that depression is associated with treatment adherence.

AIM

The aim of this study was to examine the prevalence of depressive symptoms in adults with haemophilia using an instrument designed or validated for diagnosing or screening for depression and to investigate the association of symptoms of depression with nonadherence to prophylactic therapy in patients from two East European countries.

METHODS

Adult patients with severe or moderate haemophilia receiving prophylaxis were eligible for the study. Depressive symptoms were assessed with BDI-II, adherence with VERITAS-Pro, demographic and socioeconomic data were collected using a questionnaire, and clinical data were obtained from medical records.

RESULTS

Final sample included 81 participants (median age was 45 years, range 18-73 years). There were 9 (11%) participants with scores on BDI-II above 14 points, the cut-off score for depressive symptomatology. In general, participants were adherent. However, there were 14 (17%) participants who had scores above 57 points, the cut-off score for nonadherence. There was an association between having depressive symptoms and being nonadherent, and depressive symptoms explained additional variance in adherence after controlling for sociodemographic, psychosocial and clinical characteristics.

CONCLUSION

Since there is an association between depressive symptoms and nonadherence, it would be beneficial for both patients and the public health system for screening for depressive symptoms to be included as a part of the treatment protocol.

Role of Perceived Social Support on the Association between Physical Disability and Symptoms of Depression in Senior Citizens of Pakistan

An emerging body of literature has implied that perceived social support is known as an upstream element of cognitive health. Various dimensions of perceived social support may have divergent influence on physical and cognitive health in later life. The present study aimed to investigate the mediating role of perceived social support on the relationship between physical disability and symptoms of depression in senior citizens of Pakistan. The data were collected from three metropolitan cities (Lahore, Faisalabad, Multan) in the Punjab province of Pakistan and 100 participants were approached from each city with a total sample size of 300. The results demonstrated that family support, friends' support, and significant others' support mediated the association between physical disability and symptoms of depression, with an indirect effect of 0.024, 0.058, and 0.034, respectively. The total direct and indirect effect was 0.493. Physical disability was directly associated with symptoms of depression and greater physical disability predicted a higher level of symptoms of depression. Perceived social support, including family support, friends' support, and significant others' support, showed an indirect association with symptoms of depression. Furthermore, family support and friends' support were more significantly associated with symptoms of depression as compared to significant others' support. The research discoveries have better implications for health care professionals, hospice care workers, and policy makers. A holistic approach is required to prevent senior citizens from late-life mental disorders.

Stressful Life Events, Cognitive Biases, and Symptoms of Depression in Young Adults

Although the link between stressful experiences and depression has been supported in numerous studies, the specific mechanisms of this relationship are still unclear. Cognitive theories of depression postulate that the influence of stress on depression may be modified by cognitive factors. The aim of the present study was to examine the interplay between negative life events, cognitive vulnerability factors, and depressive symptoms. It was hypothesized that the relationship between negative life events and symptoms of depression is shaped by rumination and cognitive biases. The study sample consisted of 108 young adults (19 men and 89 women; M = 20.31; SD = 1.84). Memory bias and attentional bias were assessed using the Attentional Blink Task and the Memory Task, respectively. Rumination and depressive symptoms were assessed via self-report questionnaires. Logistic regression and moderation analyses were conducted to examine the relationship between the study variables. Stressful life events, rumination and memory bias were found to be significantly related to depressive symptoms. Moderation analyses revealed that there is a positive relationship between negative life events and depressive symptoms but only among individuals characterized by an elevated level of rumination and among participants exhibiting negative attentional bias. The results provide further evidence for cognitive models of depression.

Association Between Maternal Feeding Practices and Symptoms of Anxiety and Depression Among 6-Year-Old Children

Background:

Maternal feeding practices (MFPs) have been linked to childhood obesity and other eating disorders. However, population-based research examining the association between MFPs and children’s emotional well-being is currently lacking.

Methods:

We examined 1241 participants from Year 6 Follow-Up of the Infant Feeding Practices Study II, conducted from March to June 2012 in the United States.

Results:

Approximately 57.5% and 47.8% of participants reported at least one symptom of childhood anxiety and depression, respectively. After adjusting for potential confounders, mothers who responded “yes” to “If I did not guide or regulate my child’s eating, he or she would eat too much of his or her favorite food” had higher odds of having a child who has symptoms of depression and anxiety compared with mothers who responded “no” (odds ratio [OR], 95% confidence interval [CI]) (2.02; 1.47-2.78, P < .001) and (1.41, 1.05-1.91, P = .024), respectively. The odds of having a child who has symptoms of depression were lower among mothers who responded “yes” to “I make sure that my child does not eat too many sweets or junk foods” compared with mothers who responded “no” (0.49; 0.26-0.91, P = .020). Mothers who responded “yes” to “I encourage my 6 year-old to eat all of the food on his or her plate” had higher odds of having a child who has symptoms of anxiety compared with mothers who responded “no” (1.43; 1.01-2.05, P = .049).

Conclusions:

Controlling MFPs may influence a child’s emotional well-being. Further research is needed to address the complex relationships between MFPs and psychosocial well-being in children.

Are There Gender Differences in the Psychological Effects of Ethnic Identity and Discrimination in Hawai'i?

The purpose of this study is to investigate whether there are gender differences in the psychological effects of ethnic identity and discrimination in Hawai'i. Using data from an anonymous survey of undergraduate students (N = 1,033) at a university in Hawai'i, regression results revealed that higher levels of ethnic identification were associated with significantly lower levels of depressive symptoms. This association was statistically significant (P < .001), adjusting for gender, age, socioeconomic status, racial/ethnic group, mixed racial/ethnic status, years living in Hawai'i, immigrant status, and discrimination. Interaction effects (b = 2.55; P < .05) further indicated that the inverse relationship between ethnic identity and symptoms of depression was stronger for men than women. Also, everyday discrimination was significantly more psychologically distressing for women (b = 0.19; P < .05) than men. Overall, these findings suggest that a strong ethnic identity, which encompasses ethnic pride and knowledge, involvement in ethnic practices, and a cultural commitment or feeling of belonging to one's ethnic group, significantly benefits mental health, and to a greater extent among men. Although the chronic stress of discrimination (not necessarily due to race/ethnicity) was linked with increased levels of distress among both men and women, it was significantly more intense among women. Future research is needed to uncover why the mental health consequences of everyday discrimination and a salient ethnic identity would be different for young men and women in this cultural context and whether this holds true in other locations in the United States.

Stress and Symptoms of Depression in Fathers of Infants Admitted to the NICU

OBJECTIVE

To describe perceived stress and symptoms of depression in fathers of infants admitted to the NICU through 2 months after discharge and to explore associations between fathers' childhood and current relationships with their own parents and their stress and symptoms of depression.

DESIGN

Observational, longitudinal.

SETTING

Tertiary care center in northeastern United States.

PARTICIPANTS

English-speaking fathers of newborns admitted to the NICU.

METHODS

Fathers completed the Parental Stress Scale and the Edinburgh Postnatal Depression Scale (EPDS) at infants' NICU admissions (Time [T] 1), 3 weeks (T2), discharge (T3), and 2 months after discharge (T4).

RESULTS

A total of 146 fathers were enrolled between March 2013 and February 2016. Infants' mean gestational age at birth was 31.9 weeks, and 88% remained in the NICU for 3 weeks or longer. We found that 12% of fathers reported high stress levels at T1, 8% at T3, and 13% at T4. Overall EPDS scores improved over time (p < .001). From T1 to T4, the proportion of fathers with distress/minor symptoms of depression decreased from 41% to 10% and with symptoms of major depression from 16% to 2%. Statistically significant positive associations were found between fathers' EPDS scores and the quality of relationships with their fathers (at T1, T2, and T3) and with their mothers (across all time points).

CONCLUSION

From admission to 2 months after discharge, stress and symptoms of depression persisted for some fathers of infants admitted to the NICU. Evidence-based strategies to support fathers during and after their infants' NICU hospitalizations need to be further developed, implemented, and evaluated.

Change of appetite in patients with functional digestive disorder. Association with psychological disorders: A cross-sectional study

BACKGROUND AND AIMS

Changes in appetite are a frequent complaint in patients with functional gastrointestinal disorders (FGIDs). The aims of this study are to evaluate whether the changes in appetite are associated with specific FGIDs and to explore associations of these changes with symptoms of anxiety or depression.

METHODS

This study included 1009 consecutive FGID patients (71% female), aged 48.9 years who all filled out a Rome III questionnaire for the evaluation of FGIDs, submitted to a psychological evaluation of symptoms of anxiety, and completed the Beck Depression Inventory questionnaire. The patients were classified according to their appetite change using a 7-point grading scale and split into three groups: those with appetite loss, those with no change in appetite, and those with increased appetite.

RESULTS

Among the 1009, 496 patients (49%) reported a change in appetite, of which 332 (33%) patients reported a decrease in appetite and 164 (16%) patients reported an increase in appetite. Appetite was not affected in 51% of patients. Changes in appetite depended on gender, body mass index and psychometric evaluation scores. Increased appetite did not have specific FGIDs associations, while decreased appetite was associated with esophageal, gastroduodenal, bowel, and anorectal symptoms. The presence of depressive symptoms was also a predictor for the majority of FGIDs in decreased appetite, while anxiety trait was significant for globus and dysphagia.

CONCLUSIONS

Decreased appetite was associated with FGIDs, especially in the presence of depressive symptoms. A reduced appetite would help to predict psychological disorders associated with FGIDs.

FINANCIAL DISCLOSURE

None declared.

LEGAL REGISTRATION

This study was a registered study in the French National Drug Agency (ANSM, Agence Nationale de Securité du Medicamentet des produits de santé, Study Number 2016-A01120-51).

COMPETING INTERESTS

Michel Bouchoucha, Marinos Fysekidis, Florence Mary, Gheorghe Airinei, Cyriaque Bon, and Robert Benamouzig have no competitive interests.

Does job promotion affect men's and women's health differently? Dynamic panel models with fixed effects

Background

Higher occupational status has consistently been shown to be associated with better health, but few studies have to date examined if an upward change in occupational status is associated with a positive change in health. Furthermore, very little is known about whether this association differs by sex.

Methods

Data were derived from four waves (2008-14) of the Swedish Longitudinal Occupational Survey of Health (SLOSH), a follow-up study of a nationally representative sample of the Swedish working population. The present study comprises 1410 men and 1926 women. A dynamic panel model with fixed effects was used to analyse the lagged association between job promotion on the one hand and self-rated health (SRH) and symptoms of depression on the other. This method allowed controlling for unobserved time-invariant confounders and determining the direction of causality between the variables. Multigroup comparisons were performed to investigate differences between the sexes.

Results

The results showed that job promotion was associated with decreased subsequent SRH and increased symptoms of depression among both men and women. Women reported a larger relative worsening of self-rated health following a job promotion than men and men reported a larger relative worsening of depression symptoms. There was limited evidence that SRH and symptoms of depression were associated with subsequent job promotion.

Conclusions

The present study indicates that a job promotion could lead to decreased SRH and increased symptoms of depression in a 2-4-year perspective. Associations appear to differ for women and men.

The Impact of Symptoms of Depression and Walking on Gestational Age at Birth in African American Women

BACKGROUND

Symptoms of depression have been related to lower gestational age and preterm birth (<37 completed weeks gestation). Leisure time physical activity may have protective effects on preterm birth; however, less has been published with regard to other domains of physical activity such as walking for a purpose (e.g., for transportation) or the pathways by which symptoms of depression impact gestational age at birth.

METHODS

This was a secondary analysis of available data of African American women. Women were interviewed within 3 days after birth. We proposed a model in which walking for a purpose during pregnancy mediated the effects of symptoms of depression (measured by the 20-item Center for Epidemiologic Studies-Depression [CES-D] scale) on gestational age at birth in a sample of 1,382 African American women.

RESULTS

Using structural equation modeling, we found that the direct effect of CES-D scores of 23 or greater, which have been correlated with major depression diagnosis, on gestational age at birth was -4.23 (p < .001). These results indicate that symptoms of depression were associated with a decrease in gestational age at birth of 4.23 days. Walking for a purpose mediated the effect of CES-D scores of 23 or greater on gestational age at birth.

CONCLUSIONS

Compared with African American women without symptoms of depression, African American women who had symptoms of depression walked less for a purpose during their pregnancy and delivered infants with lower gestational age at birth. If not medically contraindicated, clinicians should incorporate walking as part of prenatal care recommendations and reassure women about safety of walking during pregnancy.

Stuck in Limbo: Motivational Antecedents and Consequences of Experiencing Action Crises in Personal Goal Pursuit

OBJECTIVE

Action crises describe the intrapsychic conflicts individuals experience when they feel torn between further goal pursuit and goal disengagement. The present investigation introduces autonomous and controlled motivation as independent predictors of action crisis severity, beyond known personality-level predictors (action orientation) and novel personality-level predictors (Neuroticism and Conscientiousness).

METHOD

Using a multi-wave prospective longitudinal design and multilevel modeling (MLM), we followed students pursuing three personal goals across an academic semester (N = 425 undergraduates; 76% female; 57% Caucasian; M_age  = 20.2, SD = 2.3). In two follow-up surveys, participants reported on the severity of their action crises, goal progress, and symptoms of depression.

RESULTS

Results suggest that autonomous motivation shields individuals from experiencing action crises, whereas controlled motivation represents a risk factor for developing action crises beyond personality-level predictors. Furthermore, MLM revealed that autonomous motivation is a significant predictor of action crisis severity at both the within- and between-person levels of analysis. Action crises mediate both the relationship between autonomous motivation and goal progress, and the relationship between controlled motivation and symptoms of depression.

CONCLUSIONS

The implications of these findings for the prevention of action crises and motivation research are discussed.

Coping With Strain (CWS) course - its effects on depressive symptoms: A four-year longitudinal randomized controlled trial

The Coping With Strain (CWS) course is a modification of the Coping With Depression (CWD) course. CWD is by far the most studied psycho-educational intervention to reduce and prevent depression, but CWD has never been tested in a randomized controlled trial in the workplace. This study seeks to examine the extent to which CWS, on a short-term and a long-term basis, reduces depressive symptoms in employees. After advertising at workplaces, 119 employees were randomized into Intervention Group I (IG1), which immediately participated in CWS, or Intervention Group II (IG2), which functioned as a control group for six months until its participation in CWS. The follow up period lasted for four years in both IG1 and IG2. Linear mixed models were fitted to the data. Depressive symptoms were significantly reduced during the course. The reduction of depressive symptoms was maintained over a period of four years in both IG1 and IG2, although there is a slight increase towards the end of the follow-up period. CWS is effective in reducing depressive symptoms among employees. The effects are long lasting and may be maintained over a period of four years.

Pleasure Now, Pain Later: Positive Fantasies About the Future Predict Symptoms of Depression

Though common sense suggests that positive thinking shelters people from depression, the four studies reported here showed that this intuition needs to be qualified: Positive thinking in the form of fantasies about the future did indeed relate to decreased symptoms of depression when measured concurrently; however, positive fantasies predicted more depressive symptoms when measured longitudinally. The pattern of results was observed for different indicators of fantasies and depression, in adults and in schoolchildren, and for periods of up to 7 months (Studies 1-4). In college students, low academic success partially mediated the predictive relation between positive fantasies and symptoms of depression (Study 4). Results add to existing research on the problematic effects of positive fantasies on performance by suggesting that indulging in positive fantasies predicts problems in mental health.

The Paradox of Discrimination, the "Aloha Spirit," and Symptoms of Depression in Hawai'i

It remains to be determined whether the "aloha spirit" is a cultural resource that influences psychological well-being in Hawai'i. Thus, the purpose of this study is to investigate whether the aloha spirit is associated with levels of psychological distress and the risk of depression, while taking into account various risk factors. Data for this study were drawn from an anonymous survey of undergraduate students (N = 1,028) at the University of Hawai'i. Regression results revealed that having learned the aloha spirit was associated with significantly lower levels (b = -1.76; P < .01) of psychological distress and a reduced odds of depression (OR = .69; P < .01) over and above the effects of perceived discrimination, local identity, levels of ethnic identification, race/ethnicity, immigrant status, duration of residence in Hawai'i, and other sociodemographic factors. In contrast, everyday discrimination was associated with significantly higher levels (b = 0.41; P < .001) of psychological distress and a greater odds of depression (OR = 1.08; P < .001). Together, these findings highlight the paradox of discrimination and the aloha spirit in Hawai'i by documenting their distinct relationships with mental health. Overall, this study contributes to medical and public health research on mental health disparities during the transition to adulthood by delving into the social context of daily life in the understudied, multicultural location of Hawai'i.

Disadvantaged family background and depression among young adults in the United States: the roles of chronic stress and self-esteem

Although several longitudinal studies have demonstrated that having a disadvantaged family background is a risk factor for subsequent symptoms of depression, few studies have examined the mediating mechanisms that explain this long-term relationship. Thus, this study uses US national longitudinal data and integrates social stress theory with the life course perspective by focusing on two mediating mechanisms-the chronic stress of poverty and self-esteem during the transition to adulthood. Results reveal that self-esteem largely mediates the inverse relationship between parental education and levels of depressive symptoms in young adulthood. However, the inverse relationship between parental occupational prestige and depressive symptoms among young adults is not mediated by self-esteem, but rather long durations of poverty across 16 years. Overall, these findings suggest that different components of family socioeconomic status can leave a lasting imprint on mental health via the self-concept and the chronic stress of poverty throughout the journey to adulthood.

Trajectories of individual depressive symptoms in adolescents: gender and family relationships as predictors

Depressive syndrome and disorders increase substantially during adolescence. Little is known, however, about how individual symptoms of depression change over the course of this developmental period. The present study examined within-person changes in symptom severity of each individual symptom of depression, utilizing longitudinal data collected across 6 years of adolescence. Adolescent gender and family relationship variables were tested as predictors of the symptom trajectories (i.e., intercept and slope). Adolescents and their mothers (N = 240) were first evaluated when youth were in Grade 6 (M = 11.86 years old, SD = 0.56, 54% female) and then annually through Grade 12. Individual symptoms of depression were assessed by a clinical interviewer using the Children's Depression Rating Scale-Revised (CDRS-R). Mothers and youth also completed measures about their relationship on the Children's Report of Parent Behavior Inventory and the Family Environment Scale. Results showed that all depressive symptoms increased linearly over time except psychomotor disturbances and problems with concentration and decision making, which were best represented by a quadratic growth model. Sex differences were found such that significantly more rapid increases in worthlessness/guilt were found for girls than boys, and concentration/decision making problems significantly changed for boys, but not girls. Poor family relationship quality (mother-reported) predicted a significantly faster rate of increase in adolescents' symptoms of anhedonia, appetite/weight changes, and fatigue. High maternal psychological control (youth-reported) also predicted a faster rate of increase in anhedonia. Study limitations, future research directions, and clinical implications of the findings are discussed.