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1.
BMC Psychiatry ; 24(1): 419, 2024 Jun 04.
Article En | MEDLINE | ID: mdl-38834943

BACKGROUND: Few studies have simultaneously focused on the associations of vegetable and fruit intake, physical activity, school bullying, and Internet addiction (IA) with depressive symptoms. This study aimed to explore the direct and indirect effects of the above factors on depressive symptoms in adolescents by constructing a structural equation model (SEM). METHODS: This study was conducted in Qingdao from September to November 2021. A total of 6195 secondary school students aged 10-19 years were included in the analysis. Information on all variables was assessed using a self-administered questionnaire. An SEM was constructed with depressive symptoms as the endogenous latent variable, IA as the mediating variable, and vegetable and fruit intake, physical activity, and school bullying as the exogenous latent variables. The standardized path coefficients (ß) were the direct effects between the latent variables, and the indirect effects were obtained by the product of direct effects between relevant latent variables. RESULTS: The median value with the interquartile range of depressive symptom scores was 7 (3,12). Vegetable and fruit intake (ß=-0.100, P<0.001) and physical activity (ß=-0.140, P<0.001) were directly negatively related to depressive symptoms. While school bullying (ß=0.138, P<0.001) and IA (ß=0.452, P<0.001) were directly positively related to depressive symptoms. IA had the greatest impact on depressive symptoms. Vegetable and fruit intake, physical activity, and school bullying could not only directly affect depressive symptoms, but also indirectly affect depressive symptoms through the mediating effect of IA, the indirect effects and 95% confidence intervals (CIs) were -0.028 (-0.051, -0.007), -0.114 (-0.148, -0.089) and 0.095 (0.060, 0.157), respectively. The results of the multi-group analysis showed that the SEM we constructed still fit in boy and girl groups. CONCLUSIONS: The results indicated that vegetable and fruit intake, physical activity, school bullying, and IA had a significant direct impact on depressive symptoms, among which IA had the greatest impact. In addition, both vegetable and fruit intake, school bullying, and physical activity indirectly affected depressive symptoms through the mediating effect of IA. The impact of IA on depressive symptoms should be given extra attention by schools and parents. This study provides a scientific and effective basis for the prevention and control of adolescent depressive symptoms.


Bullying , Depression , Exercise , Fruit , Internet Addiction Disorder , Students , Vegetables , Humans , Adolescent , Male , Bullying/psychology , Bullying/statistics & numerical data , Female , Depression/psychology , Depression/epidemiology , Exercise/psychology , Child , Students/psychology , Students/statistics & numerical data , Internet Addiction Disorder/psychology , Internet Addiction Disorder/epidemiology , Schools , Young Adult , China/epidemiology
2.
Nutr J ; 23(1): 59, 2024 Jun 04.
Article En | MEDLINE | ID: mdl-38834985

BACKGROUND: Given the benefits of gardening for physical and psychological health, we explored whether gardening was associated with lower risks of subjective cognitive decline (SCD), a precursor of dementia, and SCD-related functional limitations. METHODS: Included in this cross-sectional study were 136,748 participants aged 45 + years old from the Behavioral Risk Factor Surveillance System 2019 survey, who were then categorized into three groups according to self-reported exercise status: non-exercisers, gardeners, and other exercisers. SCD was assessed via a questionnaire, and SCD-related functional limitations were referred to as having difficulties in engaging in household or social activities due to SCD. The odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the associations of gardening with SCD and SCD-related functional limitations, adjusted for age, sex, socioeconomic status, lifestyle factors, and health status. Mediation analyses were conducted to examine whether the observed association between gardening and SCD was mediated by energy expenditure (MET-hours/week), depression status, and consumption of fruits and vegetables. RESULTS: Overall, 11.1% and 5.4% of participants self-reported experiencing SCD and SCD-related functional limitations, respectively. The adjusted OR for gardeners vs. non-exercisers, was 0.72 (95% CI 0.62-0.83) for SCD and 0.57 (95% CI 0.44-0.73) for SCD-related functional limitations. The observed association between gardening and SCD was explained by higher energy expenditure (39.0%), lower likelihood of having depression (21.5%), and higher consumption of fruits and vegetables (3.4%) (P<0.05 for all). Similar patterns were observed for SCD-related functional limitations. CONCLUSION: In this nationally representative sample, gardening was associated with better cognitive status, which may be mainly attributed to better depression status and energy expenditure.


Cognitive Dysfunction , Gardening , Humans , Cross-Sectional Studies , Gardening/methods , Male , Female , Cognitive Dysfunction/epidemiology , Middle Aged , Aged , Mediation Analysis , Exercise , Vegetables , Fruit , Behavioral Risk Factor Surveillance System , Depression/epidemiology , Surveys and Questionnaires
3.
J Manag Care Spec Pharm ; 30(6): 588-598, 2024 Jun.
Article En | MEDLINE | ID: mdl-38824634

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous condition with extensive psychiatric comorbidities. ADHD has been associated with substantial clinical and economic burden; however, little is known about the incremental burden specifically attributable to psychiatric comorbidities of ADHD in adults. OBJECTIVE: To assess the impact of psychiatric comorbidities, specifically anxiety and depression, on health care resource utilization (HRU) and costs in treated adults with ADHD in the United States. METHODS: A retrospective case-cohort study was conducted. Adults with ADHD were identified in the IQVIA PharMetrics Plus database (10/01/2015-09/30/2021). The index date was defined as the date of initiation of a randomly selected ADHD treatment. The baseline period was defined as the 6 months prior to the index date, and the study period as the 12 months following the index date. Patients with at least 1 diagnosis for anxiety and/or depression during both the baseline and study periods were classified in the ADHD+anxiety/depression cohort, whereas those without diagnoses for anxiety or depression at any time were classified in the ADHD-only cohort. Entropy balancing was used to create reweighted cohorts with similar baseline characteristics. All-cause HRU and health care costs were assessed during the study period and compared between cohorts using regression analyses. Cost analyses were also conducted in subgroups stratified by comorbid conditions. RESULTS: After reweighting, patients in the ADHD-only cohort (N = 276,906) and ADHD+anxiety/depression cohort (N = 217,944) had similar characteristics (mean age 34.1 years; 54.8% male). All-cause HRU was higher in the ADHD+anxiety/depression cohort than the ADHD-only cohort (incidence rate ratios for inpatient admissions: 4.5, emergency department visits: 1.8, outpatient visits: 2.0, and psychotherapy visits: 6.4; all P < 0.01). All-cause health care costs were more than 2 times higher in the ADHD+anxiety/depression cohort than the ADHD-only cohort (mean per-patient per-year [PPPY] costs in ADHD-only vs ADHD+anxiety/depression cohort: $5,335 vs $11,315; P < 0.01). Among the ADHD+anxiety/depression cohort, average all-cause health care costs were $9,233, $10,651, and $15,610 PPPY among subgroup of patients with ADHD and only anxiety, only depression, and both anxiety and depression, respectively. CONCLUSIONS: Comorbid anxiety and depression is associated with additional HRU and costs burden in patients with ADHD. Comanagement of these conditions is important and has the potential to alleviate the burden experienced by patients and the health care system.


Attention Deficit Disorder with Hyperactivity , Comorbidity , Health Care Costs , Patient Acceptance of Health Care , Humans , Attention Deficit Disorder with Hyperactivity/economics , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit Disorder with Hyperactivity/therapy , Male , Female , Retrospective Studies , Adult , Health Care Costs/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , United States/epidemiology , Middle Aged , Health Resources/economics , Health Resources/statistics & numerical data , Anxiety/epidemiology , Anxiety/economics , Young Adult , Depression/epidemiology , Depression/economics , Cohort Studies , Adolescent
4.
Sultan Qaboos Univ Med J ; 24(2): 161-176, 2024 May.
Article En | MEDLINE | ID: mdl-38828247

This study aimed to assess the prevalence of neuropsychiatric sequelae following traumatic brain injury (TBI) among the Western Asian, South Asian and African regions of the global south. All studies on psychiatric disturbances or cognitive impairment following TBI conducted (until August 2021) in the 83 countries that constitute the aforementioned regions were reviewed; 6 databases were selected for the literature search. After evaluating the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, post-traumatic stress disorder (PTSD), TBI-related sleep disturbance (TBI-SD), obsessive-compulsive disorder (OCD) and cognitive impairment. Of 56 non-duplicated studies identified in the initial search, 27 were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in 1,882 samples was 35.35%, that of anxiety in 1,211 samples was 28.64%, that of PTSD in 426 samples was 19.94%, that of OCD in 313 samples was 19.48%, that of TBI-SD in 562 samples was 26.67% and that of cognitive impairment in 941 samples was 49.10%. To date, this is the first critical review to examine the spectrum of post-TBI neuropsychiatric sequelae in the specified regions. Although existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north.


Brain Injuries, Traumatic , Humans , Brain Injuries, Traumatic/epidemiology , Brain Injuries, Traumatic/complications , Brain Injuries, Traumatic/psychology , Prevalence , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/etiology , Depression/epidemiology , Depression/etiology , Cognitive Dysfunction/etiology , Cognitive Dysfunction/epidemiology , Anxiety/epidemiology , Anxiety/etiology , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Africa/epidemiology , Mental Disorders/epidemiology , Mental Disorders/etiology
5.
BMC Public Health ; 24(1): 1502, 2024 Jun 05.
Article En | MEDLINE | ID: mdl-38840150

BACKGROUND: A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC). METHOD: A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety. RESULTS: SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001). CONCLUSION: Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.


COVID-19 , Hair , Hydrocortisone , Mental Health , Sense of Coherence , Humans , COVID-19/psychology , COVID-19/epidemiology , Cross-Sectional Studies , Male , Aged , Hair/chemistry , Female , Hydrocortisone/analysis , Hydrocortisone/metabolism , Aged, 80 and over , Sweden/epidemiology , Anxiety/epidemiology , Depression/epidemiology , Depression/psychology
6.
J Clin Psychiatry ; 85(2)2024 Jun 03.
Article En | MEDLINE | ID: mdl-38836859

Objective: We explored depressive symptom trajectories and their associations with underweight and obesity in Korean women.Methods: This prospective cohort study involved 7,691 women enrolled in the Korean Longitudinal Survey of Women and Families, with a follow-up period spanning from 2014 to 2020. Depressive symptoms were evaluated through the 10-item version of the Center of Epidemiologic Studies Depression Scale. Growth mixture modeling was employed to identify trajectories of depressive symptoms. Multinomial logistic regressions were conducted to investigate the correlation between depression trajectories and the evolving risks of underweight and obesity over the study period.Results: Five distinct trajectory classes were observed ("persistent low symptoms": N = 5,236, 68.1%; "decreasing symptoms": N = 930, 12.1%; "transient high symptoms": N = 421, 5.5%; "increasing symptoms" N = 825, 10.7%; and "persistent high symptoms": N = 279, 3.6%). Those with a low socioeconomic status, comorbidity, and who were divorced or widowed were more likely to follow the persistent high symptom trajectory. Among the 5 trajectories, the risks of underweight and obesity steadily increased in women following the trajectory with persistent high symptoms. For these women, the odds ratio (OR) of underweight increased from 2.27 (95% CI, 1.32-3.92) in 2014 to 3.39 (1.91-6.05) in 2020. They were not associated with obesity in 2014 (OR [95% CI]: 1.38 [0.61-3.11]) but exhibited an elevated risk of obesity in 2020 (3.76 [1.97-7.17]).Conclusion: We observed considerable heterogeneity in the trajectories of depressive symptoms among women, and individuals with persistent high depressive symptoms face an escalating risk of both underweight and obesity.


Depression , Obesity , Thinness , Humans , Female , Thinness/epidemiology , Republic of Korea/epidemiology , Obesity/epidemiology , Adult , Longitudinal Studies , Depression/epidemiology , Middle Aged , Prospective Studies , Risk Factors , Comorbidity
7.
Front Public Health ; 12: 1381273, 2024.
Article En | MEDLINE | ID: mdl-38841667

Introduction: It remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases. Methods: Data were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan-Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality. Results: Out of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09-1.33]). An increased rate was observed for 55-64 years old (HR = 1.23 [95% CI, 1.03-1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18-1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30-1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61-2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00-1.40]), diabetes (HR = 1.41[95% CI, 1.02-1.95]), and arthritis (HR = 1.29 [95% CI, 1.09-1.51]). Conclusion: Depressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.


Depression , Humans , Male , Female , China/epidemiology , Depression/epidemiology , Depression/mortality , Middle Aged , Chronic Disease/mortality , Longitudinal Studies , Aged , Cause of Death , Risk Factors , Mortality/trends , Proportional Hazards Models
8.
Front Public Health ; 12: 1356988, 2024.
Article En | MEDLINE | ID: mdl-38841675

Background: As the most commonly used illicit substance, cannabis is gaining global acceptance through increasing legalization efforts. This shift intensifies the need for research to guide policymakers and healthcare providers in harm reduction and treatment strategies. Nonetheless, the relationship between psychopathological symptoms and cannabis use remains inadequately understood. Methods: A sample of regular cannabis consumers completed self-reported assessments for depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), Attention-Deficit/Hyperactivity Disorder (ADHD; Adult ADHD Self-Report Scale V1.1), and psychosis (Early Recognition Inventory based on IRAOS) as well as previous black-market cannabis use patterns. Cannabis Use Disorder Identification Test Revised (CUDIT-R) was used to identify cannabis use disorder (CUD). To understand psychopathological symptom load related to cannabis consumption as well as cannabis use motives, multiple regression models were performed to identify psychopathological variables predicting cannabis use frequency and quantity. Linear regression and correlation analyses were conducted, adjusting for relevant covariates (age, gender, education, alcohol, other substance use). Results: Three-hundred-sixty regular cannabis users interested in a study on regulated cannabis access in Basel, Switzerland were examined. In bivariate analysis, cannabis use frequency correlated with depressive (r(358) = 0.16, p = 0.003) and anxiety symptom load (r(358) = 0.11, p = 0.034). Cannabis quantity correlated with depressive (r(358) = 0.15, p = 0.005), ADHD (r(358) = 0.14, p = 0.008), and psychosis symptom load (r(358) = 0.16, p = 0.002). However, in the adjusted regression models only depressive and ADHD symptom loads were significantly associated with cannabis use frequency (p = 0.006 and p = 0.034, respectively) and quantity (p = 0.037 and p = 0.019, respectively). No significant correlations between cannabis consumption and anxiety or psychosis remained after adjustment. Conclusion: ADHD and depressive symptoms correlate with increased cannabis use in a cohort of regular users, suggesting potential self-medication in nonclinical populations. With the rising availability of cannabis worldwide, these results highlight the necessity for longitudinal studies to disentangle the complex dynamics between cannabis consumption and mental health symptoms.


Depression , Humans , Male , Female , Adult , Cross-Sectional Studies , Switzerland/epidemiology , Depression/epidemiology , Marijuana Abuse/epidemiology , Marijuana Abuse/psychology , Anxiety/epidemiology , Marijuana Use/epidemiology , Marijuana Use/psychology , Attention Deficit Disorder with Hyperactivity/epidemiology , Self Report , Surveys and Questionnaires , Young Adult , Cannabis , Middle Aged
9.
PLoS One ; 19(6): e0303345, 2024.
Article En | MEDLINE | ID: mdl-38843208

OBJECTIVE: We aim to evaluate the association of depressive symptoms, depressive symptoms severity and symptom cluster scores (i.e., cognitive-affective and somatic) with food security (FS). We will also evaluate the interaction effect of sex, income and ethnicity on these associations. METHODS: Data from the 2005-2018 National Health and Nutrition Examination Survey cycles were used in this study. Participants included survey respondents 20+ years who had completed Depression and Food Security questionnaires. Multivariable logistic regression was used to estimate the associations between depressive symptoms and FS. RESULTS: A total of 34,128 participants, including 3,021 (7.73%) with depressive symptoms, were included in this study. In both unadjusted and adjusted models, participants with depressive symptoms had lower odds of FS (aOR = 0.347, 95% CI: 0.307,0.391, p<0.001). Moreover, in both unadjusted and adjusted models, for each 1-point increase in cognitive-affective (aOR = 0.850, 95% CI = 0.836,0.864, p <0.001) and somatic symptoms (aOR = 0.847, 95% CI = 0.831,0.863, p <0.001), odds of high FS decreased correspondingly. Our study found no significant interaction effects of sex on depressive symptoms-FS association. Statistically significant interactions of ethnicity and poverty-to-income ratio on depressive symptoms-FS association were observed, revealing higher odds of FS among Non-Hispanic Black and Mexican American groups, and lower odds of FS in Non-Hispanic White and high-income subgroups. CONCLUSION: Our study demonstrated an association between depressive symptoms and decreased FS. Further research is required to deepen our understanding of the underlying mechanisms and to develop focused interventions.


Depression , Food Security , Nutrition Surveys , Humans , Male , Female , Depression/epidemiology , Adult , Middle Aged , Young Adult , Aged , United States/epidemiology
10.
PLoS One ; 19(6): e0302939, 2024.
Article En | MEDLINE | ID: mdl-38843237

OBJECTIVE: To explore the relationship among nap time, night sleep time, and depression among the elderly and to determine the recommended sleep time to provide a scientific and reasonable basis for the prevention and control of depression in residents. METHODS: Based on the 2020 China Health and Elderly Care Longitudinal Survey (CHARLS) database, the demographic data and the health and lifestyle information of the study subjects were obtained. A total of 2,959 valid samples were included, and the relationship between sleep and depression was explored by logistic regression, restricted cubic spline, and isotemporal substitution model. RESULTS: In the cross-sectional analysis, no statistical relationship was observed between napping time and depression in the elderly. The optimal sleep interval for the elderly at night is 6-7.5 hours, and the health benefits are the largest. A sleep duration of < 6 hours at night (OR = 2.25, 95% CI: 1.90 to 2.65) was associated with a high likelihood of depression. The probability of depression in the elderly continues to decrease with the increase of time after the nighttime sleep duration reaches 6 hours and is at the lowest level of about 7.5 hours. Moreover, the probability of depression will increase after the sleep duration exceeds 9.5 hours. In the range of 6-7.5 hours of recommended sleep duration, the likelihood of depression in the elderly will be reduced by 0.311 for every 30-minute increase in nighttime sleep time instead of noon sleep time. CONCLUSION: The duration of nighttime sleep and the probability of depression have a U-shaped relationship. The likelihood of depression was lowest in the elderly who slept for 6-8 hours at night, and the likelihood of depression could be reduced by increasing the nighttime sleep time instead of napping time within the optimal nighttime sleep range.


Depression , Sleep , Humans , Male , Depression/epidemiology , Cross-Sectional Studies , Female , Aged , Sleep/physiology , China/epidemiology , Time Factors , Aged, 80 and over , Middle Aged , East Asian People
11.
PLoS One ; 19(6): e0304168, 2024.
Article En | MEDLINE | ID: mdl-38843241

To examine the association between recent experiences of discrimination and depressive symptom presentation and severity among a U.S. sample of older Black and African American adults. A cross-sectional survey of 124 Black and African American adults aged 50 and older in the United States was conducted assessing interpersonal discrimination and depressive symptoms. The Perceived Ethnic Discrimination Questionnaire assessed four forms of interpersonal discrimination. A measure of heightened vigilance to bias assessed anticipatory coping with discrimination experiences. Past-month affective and somatic symptoms of depression were assessed using the Depressive and Somatic Symptoms Scale. All forms of interpersonal racial discrimination were positively associated with greater affective symptom severity. Being avoided, devalued, and threatened or actively physically harmed were associated with greater somatic symptom severity. Vigilant coping was positively associated with affective symptom severity but not somatic symptom severity. Racial discrimination is linked to depression severity among older Black and African American and varies by symptom. This study helps inform work on processes linking discrimination with poorer psychological outcomes and will allow for more effective interventions and prevention efforts that are tailored to older minority populations.


Black or African American , Depression , Racism , Humans , Black or African American/psychology , Male , Female , Depression/psychology , Depression/ethnology , Depression/epidemiology , Middle Aged , Aged , Racism/psychology , Cross-Sectional Studies , United States/epidemiology , Adaptation, Psychological , Surveys and Questionnaires , Aged, 80 and over
12.
BMJ Open ; 14(6): e083121, 2024 Jun 06.
Article En | MEDLINE | ID: mdl-38844393

OBJECTIVES: To evaluate the external validity of the FINDRISC, DESIR and ADA risk scores for the prediction of diabetes in a Spanish population aged >45 years and to test the possible improvement of FINDRISC by adding a new variable of high risk of depression when Patient Health Questionnaire-9 (PHQ-9) questionnaire score ≥10 (FINDRISC-MOOD). DESIGN: Prospective population-based cohort study. SETTING: 10 primary healthcare centres in the north of the city of Madrid (Spain). PARTICIPANTS: A total of 1242 participants without a history of diabetes and with 2-hour oral glucose tolerance test (OGTT) plasma glucose <200 mg/dL (<11.1 mmol/L) were followed up for 7.3 years (median) using their electronic health records (EHRs) and telephone contact. PRIMARY AND SECONDARY OUTCOME MEASURES: Diabetes risk scores (FINDRISC, DESIR, ADA), PHQ-9 questionnaire and 2-hour-OGTT were measured at baseline. Incident diabetes was defined as treatment for diabetes, fasting plasma glucose ≥126 mg/dL (≥7.0 mmol/L), new EHR diagnosis or self-reported diagnosis. External validation was performed according to optimal cut-off, sensitivity, specificity and Youden Index. Comparison between diabetes risk scores, including FINDRISC-MOOD (original FINDRISC score plus five points if PHQ-9 ≥10), was measured by area under the receiver operating characteristic curve (AUROC). RESULTS: During follow-up, 104 (8.4%; 95% CI, 6.8 to 9.9) participants developed diabetes and 185 had a PHQ-9 score ≥10. The AUROC values were 0.70 (95% CI, 0.67 to 0.72) for FINDRISC-MOOD and 0.68 (95% CI, 0.65 to 0.71) for the original FINDRISC. The AUROCs for DESIR and ADA were 0.66 (95% CI, 0.63 to 0.68) and 0.66 (95% CI, 0.63 to 0.69), respectively. There were no significant differences in AUROC between FINDRISC-MOOD and the other scores. CONCLUSIONS: The results of FINDRISC-MOOD were like those of the other risk scores and do not allow it to be recommended for clinical use.


Depression , Glucose Tolerance Test , Humans , Female , Spain , Male , Middle Aged , Prospective Studies , Aged , Depression/diagnosis , Depression/epidemiology , Risk Assessment/methods , Risk Factors , Blood Glucose/analysis , Blood Glucose/metabolism , Diabetes Mellitus/epidemiology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/epidemiology , Surveys and Questionnaires , ROC Curve , Patient Health Questionnaire
13.
AIDS Res Ther ; 21(1): 38, 2024 Jun 07.
Article En | MEDLINE | ID: mdl-38844952

BACKGROUND: People with HIV/AIDS (PWHA) have 7-36 times greater risk for completed suicide associated with depression symptoms compared to general population. However, no study has sufficiently analyzed the mediating or moderating variables of the relationship between depression and suicidal ideation in Rwanda. OBJECTIVES: This study aimed to examine how complicated grief mediates and substance abuse moderates the effects of depression symptoms on suicidal ideation. METHODS: Data were collected from a convenient sample of 140 participants (M-age = 38.79 years, SD = 10.218) receiving antiretroviral therapy (ART) at Remera Health Center in a cross-sectional study. Multiple linear regression and Sobel test were used to examine the relationships between depression symptoms, complicated grief, suicidal ideation, and substance abuse. RESULTS: The results indicated that 29% of the sample had clinically significant symptoms of depression and 18% had suicidal ideation. The interaction between substance abuse and depression symptoms (ß = .468, t = 8.02, p = 0.000) was a significant predictor, explaining the 55.7% of variance in suicidal ideation. Furthermore, the Sobel test demonstrated that complicated grief mediated the effects of depression symptoms (t = 4.67, SE = 0.0101, p ≤ 0.001) on suicidal ideation. CONCLUSION: The results suggest that depression symptoms are associated with an increased risk of suicidal ideation, and this risk significantly amplified in the presence of complicated grief and substance abuse. These findings highlight the importance of integrating mental health services, particularly those addressing depression, complicated grief, and substance abuse, into HIV care programs to mitigate the risk of suicidal ideation among PWHA.


Depression , Grief , HIV Infections , Substance-Related Disorders , Suicidal Ideation , Humans , Male , Adult , Female , Substance-Related Disorders/psychology , Substance-Related Disorders/epidemiology , Substance-Related Disorders/complications , HIV Infections/psychology , HIV Infections/drug therapy , HIV Infections/complications , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Middle Aged , Rwanda/epidemiology , Risk Factors
14.
BMC Psychol ; 12(1): 333, 2024 Jun 06.
Article En | MEDLINE | ID: mdl-38845034

BACKGROUND: According to previous studies, unpredictability in childhood could significantly increase the risk of depression in adulthood. Only a few studies have explored the relationship between these two variables in China. This paper aims to explore the relationship between unpredictability in childhood and depression and examine the mediating roles of coping styles and resilience. METHODS: We investigated 601 college students, who had an average age of 19.09 (SD = 2.78) years. Participants completed questionnaires regarding unpredictability in childhood, coping style, resilience, and depression. We analyzed survey data using the bias-corrected bootstrap method. RESULTS: The findings revealed a significant positive association between unpredictability in childhood and depression among college students. Mature coping style, immature coping style, and resilience were found to mediate this relationship independently. Furthermore, the study unveiled a serial mediation process, wherein both mature and immature coping styles, followed by resilience, sequentially mediate the relationship between unpredictability in childhood and depression, underscoring the complex interplay between these variables. CONCLUSIONS: The results indicated that the risk of depression among college students who have experienced unpredictable childhood should be valued. Attention to coping styles and resilience should be paid to decrease depression among college students who have experienced unpredictable childhood.


Adaptation, Psychological , Depression , Resilience, Psychological , Students , Humans , Female , Male , Students/psychology , Students/statistics & numerical data , Young Adult , Depression/psychology , Depression/epidemiology , Universities , Adolescent , China/epidemiology , Adult , Uncertainty , Surveys and Questionnaires
15.
BMC Psychol ; 12(1): 332, 2024 Jun 06.
Article En | MEDLINE | ID: mdl-38845048

Much research has focused on how emotional and spiritual intelligences promote well-being and help combat mental health issues. This comparative study, which was conducted in Israel and India with emerging adults enrolled in higher education, explored the relationship of emotional intelligence, spiritual intelligence, anxiety and depression, and satisfaction with life. The results in Israel showed a positive correlation of emotional intelligence with satisfaction with life, but in India, only spiritual intelligence correlated positively with satisfaction with life. In both groups, female participants scored higher on all variables than male participants. We offer initial explanations for these results.


Anxiety , Depression , Emotional Intelligence , Personal Satisfaction , Spirituality , Humans , India , Male , Female , Israel , Anxiety/psychology , Depression/psychology , Depression/epidemiology , Young Adult , Adult , Sex Factors , Adolescent
16.
J Health Popul Nutr ; 43(1): 79, 2024 Jun 06.
Article En | MEDLINE | ID: mdl-38845053

AIM: Facebook has become a part of daily life for its users and therefore become a very significant factor of mental health. As the number of Facebook users increases exponentially, the problems related to immense use have become more evident and more frequent. Therefore, the study aimed to explore the impact of Facebook addiction on depression among its users. METHODS: An online-based questionnaire was used to collect data from 269 Facebook users of Bangladesh using convenient sampling technique. Bergen Facebook Addiction Scale (BFAS) and Patient Health Questionnaire (PHQ-9) scale was used to assess Facebook addiction and its impact on depression.Ordinal logistic was used to extract the significant variables associated with Facebook addiction and depression. RESULTS: The result categorized the Facebook users into three categories as : normal (17%), problematic user (52%) and addicted (30.5%). Facebook users were suffering from mild (13.4%), minimal (15.6%), moderate (59.5%), and severe (11.5%) level of depression. Both Facebook addiction and depression were moderately correlated (0.701). Ordinal regression showed, gender [Formula: see text] (95% CI) = 0.859 (0.223,1.495)), age (ß (95% CI) = -2.051(-3.789, -0.313)), residential area (ß (95% CI) = -0.858(-1.626, -0.09)), occupation ([Formula: see text]), time length of Facebook use ([Formula: see text]are the significant predictors of Facebook addiction. Wheras, relationship types and occupation are also responsible for depression. CONCLUSION: The study showed large portion of facebook users of Bangladesh are suffering from depression. Authors suggest to arrange mental health campaign to promote bounded and legitimate use of facebook and therefore will accelerate the attaining rate of sustainable development goal related to the Bangladesh's health status.


Behavior, Addictive , Depression , Social Media , Humans , Female , Cross-Sectional Studies , Male , Bangladesh/epidemiology , Adult , Depression/epidemiology , Young Adult , Behavior, Addictive/psychology , Surveys and Questionnaires , Adolescent , Internet Addiction Disorder/psychology , Internet Addiction Disorder/epidemiology , Middle Aged
17.
Cancer Med ; 13(11): e7330, 2024 Jun.
Article En | MEDLINE | ID: mdl-38845478

OBJECTIVES: Patients with advanced colorectal cancer (CRC) have multiple concurrent physical and psychological symptoms. This study aimed to explore the relationship between anxiety, depression, and symptom burden in advanced CRC. METHODS: A multicenter cross-sectional study was conducted in 10 cancer centers from geographically and economically diverse sites in China. A total of 454 patients with advanced CRC completed the Hospital Anxiety and Depression Scale and the MD Anderson Symptom Inventory. Multiple regression analysis was applied to explore the relationship between anxiety, depression and symptom burden. RESULTS: About one-third of the patients showed symptoms of anxiety or depression. Patients with anxiety or depression reported significantly higher symptom burden than those without (p < 0.001). Patients with anxiety or depression reported a higher proportion of moderate-to-severe (MS) symptom number than those without (p < 0.001). About 52% of the patients with anxiety or depression reported at least three MS symptoms. The prevalence of MS symptoms was ranging from 7.3% (shortness of breath) to 22% (disturbed sleep), and in patients with anxiety or depression was 2-10 times higher than in those without (p < 0.001). Disease stage (ß = -2.55, p = 0.003), anxiety (ß = 15.33, p < 0.001), and depression (ß = 13.63, p < 0.001) were associated with higher symptom burden. CONCLUSIONS: Anxiety and depression in patients with advanced cancer correlated with higher symptom burden. Findings may lead oncology professionals to pay more attention to unrecognized and untreated psychological symptoms in symptom management for advanced cancer patients.


Anxiety , Colorectal Neoplasms , Depression , Humans , Colorectal Neoplasms/psychology , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/complications , Male , Female , Cross-Sectional Studies , Middle Aged , Depression/epidemiology , Depression/etiology , Depression/psychology , Anxiety/epidemiology , Anxiety/psychology , Aged , China/epidemiology , Prevalence , Adult , Aged, 80 and over , Quality of Life , Symptom Burden
18.
BMC Med Educ ; 24(1): 617, 2024 Jun 04.
Article En | MEDLINE | ID: mdl-38834998

BACKGROUND: Medical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of stressful life events on medical students' academic adjustment, focusing on the mediating roles of depression and anxiety. It also differentiated the impacts between at-risk students (those with academic failures) and their peers respectively. METHODS: This case-control study involved 320 at-risk medical students and 800 other students from a university in western China. Participants anonymously completed the scales of stressful life events, depression, anxiety, and academic adjustment. T-tests, ANOVA, Pearson correlation, and structural equation modeling were employed for statistical analysis. RESULTS: Depression and anxiety were significantly more prevalent in at-risk students (46.8% and 46.1%, respectively) than in controls (34.0% and 40.3%, respectively). Notably, at-risk students had poorer academic adjustment (t = 5.43, p < 0.001). The structural equation modeling had good fit indices and the results indicated that depression and anxiety fully mediated the effects of stressful life events on academic adjustment. For at-risk students, stressful life events significantly decreased academic adjustment through increased depression and anxiety (p < 0.001). Conversely, anxiety had a positive effect on academic adjustment in other students. CONCLUSION: Targeted interventions focusing on depression and anxiety could reduce the negative impact of stressful life events on medical students' academic adjustment. However, educators have to distinguish the differences between at-risk students and others.


Anxiety , Depression , Stress, Psychological , Students, Medical , Humans , Students, Medical/psychology , Female , Male , China/epidemiology , Depression/epidemiology , Case-Control Studies , Anxiety/epidemiology , Stress, Psychological/epidemiology , Young Adult , Life Change Events , Adaptation, Psychological , Adult
19.
BMC Public Health ; 24(1): 1498, 2024 Jun 04.
Article En | MEDLINE | ID: mdl-38835005

BACKGROUND: In the context of persistent wars and conflicts worldwide, the impact of acute, excessive and constant exposure to media coverage of such events on mental health outcomes becomes a serious problem for public health, and requires therefore urgent investigation to inform an effective prevention and management response. The objective of the present study was to test the hypothesis that war-related media exposure is directly and indirectly associated with insomnia through depression and perceived stress among adults from the general population of different Arab countries. METHODS: A cross-sectional study was carried-out two weeks after the beginning of Israel-Gaza war on the 7th of October 2023. An anonymous online survey and a snowball sampling method were adopted to collect data. A sample of 2635 general population adults (mean age of 23.98 ± 7.55 years, 73.1% females) took part of this study. RESULTS: The results of the mediation analysis showed that, after adjusting over potential confounders, depression and perceived stress fully mediated the association between war media exposure and insomnia; higher war media exposure was significantly associated with higher depression (Beta = 0.13; p < .001) and perceived stress (Beta = 0.07; p < .001), whereas higher depression (Beta = 0.43; p < .001) and perceived stress (Beta = 0.31; p < .001) were significantly associated with higher insomnia. It is of note that war media exposure was not significantly and directly associated with insomnia (Beta = - 0.01; p = .178 and Beta = 0.02; p = .098 respectively). CONCLUSION: The present study is the first to provide evidence that more time spent viewing the horrors of war is significantly associated with insomnia. In addition, symptoms of stress and depression were present as early as two weeks following the beginning of the war, and played a significant role in mediating the association between war media coverage and insomnia. These findings suggest that timely screening for, and management of depression and stress symptoms in clinical and preventive programs might be beneficial for community adults who have been heavily and indirectly exposed to war through media, and present with insomnia.


Depression , Sleep Initiation and Maintenance Disorders , Stress, Psychological , Humans , Female , Male , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Cross-Sectional Studies , Adult , Israel/epidemiology , Depression/epidemiology , Stress, Psychological/epidemiology , Young Adult , Middle East/epidemiology , Mass Media/statistics & numerical data , Adolescent , Surveys and Questionnaires , Middle Aged , Warfare
20.
BMC Med ; 22(1): 225, 2024 Jun 05.
Article En | MEDLINE | ID: mdl-38835034

BACKGROUND: Depression and sleep disturbances are associated with increased risks of various diseases and mortality, but their impacts on mortality in cancer survivors remain unclear. The objective of this study was to characterize the independent and joint associations of depressive symptoms and sleep disturbances with mortality outcomes in cancer survivors. METHODS: This population-based prospective cohort study included cancer survivors aged ≥ 20 years (n = 2947; weighted population, 21,003,811) from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Depressive symptoms and sleep disturbances were self-reported. Depressive symptoms were assessed using the Patient Health Questionnaire 9 (PHQ-9). Death outcomes were determined by correlation with National Death Index records through December 31, 2019. Primary outcomes included all-cause, cancer-specific, and noncancer mortality. RESULTS: During the median follow-up of 69 months (interquartile range, 37-109 months), 686 deaths occurred: 240 participants died from cancer, 146 from heart disease, and 300 from other causes. Separate analyses revealed that compared with a PHQ-9 score (0-4), a PHQ-9 score (5-9) was associated with a greater risk of all-cause mortality (hazard ratio [HR], 1.28; 95% CI, 1.03-1.59), and a PHQ-9 score (≥ 10) was associated with greater risk of all-cause mortality (HR, 1.37; 95% CI, 1.04-1.80) and noncancer mortality (HR, 1.45; 95% CI, 1.01-2.10). Single sleep disturbances were not associated with mortality risk. In joint analyses, the combination of a PHQ-9 score ≥ 5 and no sleep disturbances, but not sleep disturbances, was associated with increased risks of all-cause mortality, cancer-specific mortality, and noncancer mortality. Specifically, compared with individuals with a PHQ-9 score of 0-4 and no sleep disturbances, HRs for all-cause mortality and noncancer mortality in individuals with a PHQ-9 score of 5-9 and no sleep disturbances were 1.72 (1.21-2.44) and 1.69 (1.10-2.61), respectively, and 2.61 (1.43-4.78) and 2.77 (1.27-6.07), respectively, in individuals with a PHQ-9 score ≥ 10 and no sleep disturbances; HRs for cancer-specific mortality in individuals with a PHQ-9 score ≥ 5 and no sleep disturbances were 1.95 (1.16-3.27). CONCLUSIONS: Depressive symptoms were linked to a high risk of mortality in cancer survivors. The combination of a PHQ-9 score (≥ 5) and an absence of self-perceived sleep disturbances was associated with greater all-cause mortality, cancer-specific mortality, and noncancer mortality risks, particularly in individuals with a PHQ-9 score (≥ 10).


Cancer Survivors , Depression , Sleep Wake Disorders , Humans , Male , Female , Cancer Survivors/psychology , Middle Aged , Sleep Wake Disorders/mortality , Sleep Wake Disorders/epidemiology , Depression/mortality , Depression/epidemiology , Prospective Studies , Adult , United States/epidemiology , Aged , Neoplasms/mortality , Neoplasms/complications , Neoplasms/psychology , Nutrition Surveys , Young Adult
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