Absence Of Depression Research Articles

Pain Remission Following Delayed Targeted Muscle Reinnervation in Amputees.

Targeted muscle reinnervation (TMR) has demonstrated efficacy for treatment of neuropathic pain. This study aims to identify patients for whom delayed TMR may be most effective and to identify associated factors for favorable pain outcomes in this patient population. An analysis was conducted on prospectively enrolled amputee patients who underwent delayed TMR at a tertiary care center from 2017 to 2024. Data on demographics, comorbidities, surgical details, and pain outcomes were collected. Patient reported pain severity on a 0-10 scale was prospectively collected. The main pain outcome was pain remission (achieving the minimally clinically important difference (MCID)). Additionally, sustained mild pain (pain score ≤ 3/10 for ≥ 3 months), and pain disappearance (pain score 0/10 for ≥ 3 months) were assessed. Multivariable regression analyses identified factors influencing pain outcomes. Out of 101 patients included in this study, 64 patients (63.4%) achieved pain remission within a two-year post-operative period, and 37 patients (36.6%) did not. Sustained mild pain, which could be achieved in addition to pain remission, was achieved by 45.8% of patients, with 17.8% of these achieving complete pain disappearance. Patients achieving pain remission demonstrated lower pain over the entire post-operative trajectory (p < 0.001). Lower pre-operative pain scores, absence of depression, no pre-operative opioid use, lower Elixhauser Comorbidity Index, and distal amputation levels were correlated with favorable outcomes following delayed TMR (p < 0.05). Pre-operative pain severity, psychiatric comorbidities, and opioid use significantly influenced pain outcomes, emphasizing the need for comprehensive patient assessment. These findings will help with patient stratification and pre-operative counseling to support patients who are best suitable for delayed TMR surgery.

Staying Happy During COVID-19: Analyzing Happiness Indicators Among Poultry Farmers in Malang Regency

This study aims to examine the contribution of each happiness indicator, assess the overall happiness levels among laying hen and broiler chicken farmers, and analyze variations in happiness based on farm scale during the COVID-19 pandemic in Malang Regency. The research site was chosen through purposive sampling, as Malang Regency is a key center for poultry farming in East Java. Accidental sampling yielded 75 respondents, comprising 36 farmers with less than 5,000 livestock and 39 with more than 5,000. Results identified 16 valid indicators out of the 21 used in the study. The roles of each happiness indicator were as follows: education and skills (0.782), employment (0.780), health (0.632), family harmony (0.735), leisure availability (0.757), social relations (0.754), security conditions (0.584), happiness (0.716), absence of depression (0.793), optimism (0.867), empathy (0.570), independence (0.828), environmental mastery (0.815), self-development (0.598), positive relationships (0.615), and life goals (0.605). The overall happiness score for poultry farmers was 4.37, with laying hen farmers at 4.33 and broiler chicken farmers at 4.39, placing them in the "happy" category. No significant difference was observed in happiness levels between farmers with business scales below and above 5,000 livestock.

The depressant-free flotation separation of Cu/Zn sulfide minerals with an environmentally friendly triazine-thiol collector

The depressant-free flotation separation of chalcopyrite from sphalerite in the lower alkaline (pH<10) environment will contribute to reduce carbon emission and benefit the recovery of precious metal minerals. However, it is almost impossible for traditional collectors such as xanthates due to their weak selectivity for chalcopyrite against sphalerite. In this paper, a novel triazine-thiol collector, 2-diethylamine-4-hydroxy-1,3,5-triazine-6-thiol (DEHTT), was first introduced in flotation separation of chalcopyrite from sphalerite. The micro-flotation results elucidated that in the absence of depressants, the recoveries of chalcopyrite and sphalerite from their mixture with 2.0 × 10−6 mol/L DEHTT at pH 9.45 (Na2CO3 as regulator) were 91.83 % and 28.84 %, respectively, while those with sodium isobutyl xanthate (SIBX) were 96.11 % and 78.00 % under the same conditions. In situ AFM and contact angle exhibited that DEHTT assembled on chalcopyrite surface to form lots of aggregates which increased its hydrophobicity, while an insignificant change of sphalerite surface was observed. FTIR, zeta-potential and XPS explored that DEHTT chemisorbed the Cu sites of chalcopyrite surface through its S or O atoms. The specific flotation affinity of DEHTT to chalcopyrite might contribute the cleaner recovery of copper sulfide ores with the lower carbon emission.

Regional differences in the Association of Healthy Aging with the incidence of falls: an analysis based on the China Health and Retirement Longitudinal Study from 2011 to 2020.

Falls frequently occur among the older adult population. In this study, we examined the variations in fall incidence across different regions over time, focusing on the disparities between urban and rural areas among older adult Chinese individuals, Healthy aging is comprised of five dimensions: (1) absence of chronic diseases, (2) good physical functioning, (3) normal cognitive function, (4) active social participation, and (5) absence of depression. Additionally, we explored the relationship between healthy aging and the occurrence of falls in middle-aged and older adults. Falls are defined as events that occurred within the past two years. Among 9,918 participants, 33.8% lived in urban areas and 23.0% achieved healthy aging. In contrast, 66.2% resided in rural areas with 16.5% achieving healthy aging. In 2011, rural residents had a higher fall incidence rate (17% in rural vs. 13.5% in urban); by 2020, the fall rate remained higher in rural areas (19.5% in rural vs. 17.3% in urban). Unhealthy aging (HR = 1.08, 95%CI: 1.00-1.16) were risk factors for falls. Subgroup analysis revealed that in rural areas, unhealthy aging increased the risk of falls. In urban areas, the increased risk of falls associated with unhealthy aging was not significant (Rural HR = 1.11, 95%CI:1.01-1.22; Urban HR = 1.05, 95%CI: 0.93-1.18). Healthy aging may be more strongly associated with a lower risk of falls in rural areas, while this association might be less pronounced in urban areas due to different environmental and social factors. This highlights the need for environment-specific fall prevention strategies and targeted measures for the older adult.

Redefining migraine prevention: early treatment with anti-CGRP monoclonal antibodies enhances response in the real world

BackgroundAnti-CGRP monoclonal antibodies (anti-CGRP MAbs) are approved and available treatments for migraine prevention. Patients do not respond alike and many countries have reimbursement policies, which hinder treatments to those who...

Suicide attempts in the absence of depression: Differences between broad cultural groups

Suicide is one of the leading causes of death worldwide (WHO, 2021). Depression is a common precursor to suicide and suicidality; however, individuals' experience of depression and the meaning of suicide differs depending on one's cultural background (Colucci, 2013; Goodmann et al., 2021; Kleinman, 2004). The current study explores the relationship between suicide and depression among six broad cultural groups in a large sample (N = 17,015) of adults representing six broad cultural groups (Latin America, South Asia, former Soviet Bloc, Western English-speakers, Chinese, and Arab World). Participants were recruited to a multilingual depression and suicide screening study via Google Ads (Leykin et al., 2012; Gross et al., 2014). As expected, the presence of depression was associated with suicide attempts. However, cultural group moderated this association, with Chinese participants being most likely to report suicide attempts while screening negative for depression. Although depression remains an important predictor of suicidality, it appears that certain cultural groups may be at higher risk even when depression is not present. Clinicians should consider using culturally adapted assessments for depression and suicidality.

Psycho-emotional state during pregnancy and one year after childbirth in mothers of children with functional gastrointestinal disorders

Aim. To determine the relationship between the incidence of functional gastrointestinal disorders in children up to 1 year of age and the psycho-emotional state of their mothers during pregnancy and after childbirth.&#x0D; Materials and methods. A survey of 1203 mothers of children under 4 years of age was conducted using a questionnaire of functional gastrointestinal disorders according to the Rome IV criteria (2016). The questionnaire contained domains on general issues (the age of the mother at the time of the child's birth, the data of obstetric and gynecological anamnesis, the type of child's nutrition at the time of the survey), psycho-emotional state (retrospectively, the psychological component of the gestational dominant – PСGD – during pregnancy, Beck's anxiety and Beck's depression questionnaires) and questions on functional disorders in infants and young children.&#x0D; Results. Questionnaires of 487 mothers of children of the 1st year of life were analyzed. Only in 34.4% of cases, mothers' responses lacked anxious and depressive PCGD. In mothers with anxious PСGD, the risk of regurgitation in their children was statistically significantly 2-fold higher compared to mothers with depressive PСGD. In mothers with optimal PСGD, the rate of colic in their children was statistically significantly 2-fold lower compared to mothers with anxious and depressive PСGD. After childbirth, anxiety was noted in 17% mothers and signs of depression in 59% mothers. Significant and severe depression was diagnosed in 10% mothers; the children of these mothers had persistent regurgitation.. In the absence of depression in mothers, the probability of no regurgitation and colic in their children was statistically significantly 2-fold higher compared to the children of mothers with depression.&#x0D; Conclusion. The incidence of functional gastrointestinal disorders in a child up to 1 year of age is associated with maternal anxiety during pregnancy and maternal depression after childbirth.

Co-existence of depression and post-concussion syndrome one month after mild traumatic brain injury

ABSTRACT Background Previous studies suggest an association between Post-concussion syndrome (PCS) and depression, both highly prevalent after mTBI. Objective To assess the prevalence and risk-factors of depression among patients with PCS 1 month after mTBI. Methods We prospectively screened 372 mTBI patients admitted in two academic Emergency Departments between 2017 and 2019. One month after mTBI, we administered the Rivermead Post-concussion symptoms Questionnaire (RPQ) and the Patient Health Questionnaire (PHQ-9) questionnaires over the telephone. PCS and depression were defined by RPQ ≥ 12 and PHQ-9 ≥ 10. Multivariate multinomial regression identified baseline factors associated with PCS and depression. Results Two hundred and eight completed RPQ and PHQ-9. Forty-seven patients (22.5%) met criteria for PCS, among which 22 (46.8%) met criteria for depression (PCS+D+). Patients with PCS but without depression were less likely to present with an associated injury (Coefficient = −1.6, p = 0.047) and to report initial sadness (Coefficient = −2.5, p = 0.03). Initial sadness (Coefficient = −1.3, p = 0.047), associated injury (Coefficient = −1.9, p = 0.008), as well as initial nausea (Coefficient = −1.8, p = 0.002), and male sex (Coefficient = 1.8, p = 0.002), were associated with the absence of depression and PCS in comparison with PCS+D+ patients. Conclusion Among patients with PCS 1 month after mTBI, those with depression are more likely to present with initial sadness and with an associated injury.

Management of chronic pain in a rural Australian setting: Findings from the Crossroads-II mixed-methods study.

A cross-sectional survey (2016-18) involving quantitativeand text-based data was completed by adultsfrom randomly selected households in the Goulburn Valley, Victoria. Among the 2680 respondents, 594 (22%) reported chronic pain. Few (6%) respondents with chronic pain were accessing specialist pain clinics. Logistic regression analysis suggested that the strongest predictors of well‑managed chronic pain were older age, the absence of depression or disability and a longer duration of chronicpain. This study found a similar prevalence of chronic pain to other, predominantly metropolitan Australian studies, withlow participation in specialist pain clinics. The results suggest that improved access to multidisciplinary pain management approaches in rural areas is warranted.

S18: Newcomers to euthanasia and assisted suicide: challenges for Psychogeriatrics with a focus on Spain and Portugal

Euthanasia or assisted suicide are now legal in several European countries. Spain has approved related legislation in 2022, and in Portugal the subject is currently under debate after preliminary ratification. This remains a controversial topic, raising passionate discussions that sometimes hamper the need to consider, in depth, the ethical, clinical, and operational difficulties of processes of this type. Older age people do not necessarily lose their autonomy with age, nor should they lose their right to decide on euthanasia or assisted suicide whenever the jurisdiction allows it. However, there is a growing concern of older people being coerced into decisions about ending their lives, not least due to their own fears of becoming a burden both for their families and the society. Manuel Martín-Carrasco will analyze how ageism can influence or model a wish to die in elderly people, especially those living with greater physical and/or mental disability. The so-called rational suicide focuses on the possibility that a healthy subject eventually decides to end his own life as a reflex of a free decision, and not within the context of a mental illness. Manuel Sánchez-Perez will discuss how difficulties in assessing the rationality of suicidal ideation include its dimensional character, together with the evidence that rationality is not always absent in depression and that the absence of depression does not imply rationality. Next, Lia Fernandes will provide an overview of years of public and parliamentary debates on euthanasia and physician-assisted suicide in Portugal. She will focus on issues regarding the exact role of psychiatrists (old age psychiatrists in particular) in the decision process, as proposed by the recently approved legislation. Finally, Javier Olivera will provide a brief overview of the recent implementation of legal access to euthanasia in Spain. A discussion of several controversial aspects of the operationalization of such a complex process will follow, including those related with conscientious objection.

Suicide and rationality

The so-called rational suicide focuses on the possibility that a healthy subject can make the determination to end his life in the absence of conditions on his freedom of decision, as in the context of a mental illness. Difficulties in assessing the rationality of suicidal ideation include its dimensional character and the evidence that rationality is not always absent in depression and the absence of depression does not always implies rationality.

Attitude to the disease and quality of life in elderly patients with mild vascular dementia after the novel coronavirus infection

In order to study the types of attitude towards the disease and quality of life (QoL) in elderly patients with mild vascular dementia (MVD) living in the conditions of the psychoneurological institution Social Service House “Severnoye Izmailovo” in Moscow, there were 2 study groups: the patients with the clinical debut of the novel coronavirus infection (NCVI) of 6 months +/– 1 month with the recovery outcome (n=65; 33 men, 32 women) and those who did not have COVID-19 (hospital control group; n=67; 34 men, 33 women). The mean age of the studied patients was 73.05±3.48 years. The age and sex composition of the two groups was homogeneous (p&gt;0.05). Emotional disorders were investigated using the Cornell Scale for Depression in Dementia (CSDD); cognitive disorders – by means of the Montreal Cognitive Assessment (MoCA); QoL – by the Quality of Life in Alzheimer's Disease scale (QoL-AD): QoL self-assessment (QoL-AD-SR (self-rating)) and proxy QoL rating (QoL-AD-PR (proxy rating)); the type of attitude towards the disease – by the TATD scale (Wasserman L.I. et al., 2005). It was found that COVID-19 aggravates cognitive deficits in patients with MVD (according to MoCA 20.80±0.59 /21.40±0.78 points; p&lt;0.05) in the absence of depression (according to CSDD 1.52±0.50 / 1.52±0.84 points in the group of the patients after NCVI / hospital control group, respectively; p&gt;0.05). In the patients after COVID-19, a correlation was found between the proxy QoL rating and the severity of cognitive dysfunction according to the MoCA (R= – 0.28), while in the hospital control group – between the proxy QoL rating and the severity of depressive manifestations (R= – 0.33). The first group of the patients was characterized by a mixed type of attitude to the disease and intrapsychic maladaptation (the neurasthenic type ranked first at 16.03±8.29 / 9.34±5.03 points), while the second group had a diffuse type of attitude to the disease and interpsychic maladaptation (the sensitive type ranked first at 10.31±5.71 / 14.90±7.62 points by the TATD scale among the elderly patients with MVD who have / have not undergone NCVI; p&lt;0.05). The revealed patterns can contribute to the optimization of personalized models of medical and psychological rehabilitation of elderly patients with MVD living in closed-type care facilities.

Family support in adults with epilepsy.

The perception of family support in chronic disease can be relevant. To assess the perception of family support in adult patients with epilepsy (PWEs) and relate it to quality of life (QoL) and clinical aspects. Data from the Perceived Family Support Inventory (IPFS) of 130 PWEs were related to the clinical variables, QOLIE-31 scores, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with statistical tests, with p < 0.05. The mean age was 49.9 ± 17.2 years, and the duration of epilepsy was 20.8 ± 15.4 years. The presence of depression (scores ≥ 15) was associated with lower family support. Being married and non-occurrence of depression were the variables associated with a higher IPFS score (R = 0.2112), in the multiple linear regression. The perception of greater family support was associated with demographic aspects, the absence of depression, and better QoL. Family relationships may play an essential role in health adjustment behaviors and QoL in epilepsy.

The Possible Role of NLRP3 Inflammasome in Depression and Myocardial Infarction Comorbidity.

It is well-established that cardiovascular disease and depression are highly comorbid. This study aimed to assess the possible role of the NOD-like receptor protein 3 (NLRP3) inflammasome pathway and the high-sensitivity C-reactive protein (hsCRP) in patients with incident myocardial infarction in the presence or absence of depression. Sixty-eight consecutive patients with incident ST-elevation myocardial infarction and twenty healthy subjects were included. The patients were assessed using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version during their 1-4-day-long hospitalization and were divided into two groups: with and without comorbid depression. Blood samples for the determination of NLRP3, interleukin-18 (IL-18), interleukin-1β (IL-1β), and hsCRP levels were analyzed using ELISA. NLRP3, IL-1β, IL-18, and hsCRP levels were significantly higher in myocardial infarction patients compared to the healthy group (p = 0.02, p < 0.001, p < 0.001, and p < 0.001, respectively). No significant difference was found between the myocardial groups with and without depression. However, in the logistic regression analysis, the NLRP3 variable in myocardial infarction patients was found to have a significant contribution to the likelihood of depression (p = 0.015, OR = 1.72, and CI = 1.11-2.66). The likelihood of depression is associated with increasing NLRP3 levels in myocardial infarction patients. However, this potential role should be further explored in a larger sample.

The Diagnostic Concept of Unipolar Mania: The Missing Entity of the Affective Spectrum.

Although the traditional nosological view interprets mania as strictly connected with depression in the context of manic-depressive illness, unipolar mania (UM), that is, the lifetime occurrence of mania or hypomania in the absence of depression, has been proposed as a necessary diagnostic entity. Epidemiological data estimate that at least 5% of people with type I bipolar disorder never experienced depression. These subjects are more often males with a hyperthymic temperament, a younger age at onset, and more psychotic features. Current classification systems do not formally recognize UM, but different definitions of mania without depression have been proposed. UM should be assessed according to the number of mood episodes, the predominance of manic or hypomanic episodes, and its clinical course. More generally, UM should be considered in the context of an affective spectrum including different clinical phenotypes based on the predominance of depressive or manic symptoms. Additional clinical and epidemiological research in this field is needed.

Characteristics of Korean Employees Without Depression but Having Suicidal Ideation.

The aim of this study was to identify the factors related to suicidal ideation targeting the risk group showing suicidal ideation despite the absence of depression in Korean workers. The data of 14,425 participants who were employees aged of 18 to 75 years who attended a mental health checkup program at the Workplace Mental Health Institute, Kangbuk Samsung Hospital from June 2015 to October 2019 were analyzed. A self-report questionnaire consisting of sociodemographic factors, suicidal ideation, job stress, levels of depression and anxiety, and resilience was administered. A Hierarchical logistic regression model was used with suicidal ideation as dependent variable. Separate analyses were conducted according to depressive symptoms using the 20-item Center for Epidemiological Studies Depression (CES-D) scale. Being women, older, and having low resilience, more perceived stress, more severe anxiety and less sleeping hours were associated with suicidal ideation in no-depression group (CES-D <16). In the subcategories of job stress, lack of reward was significantly associated with suicidal ideation in no-depression group. This study identified the characteristics of a group that has no depression but has suicidal ideation in Korean workers. Among job stress items, lack of reward is a clear characteristic to be considered with caution in this group.

The usefulness of machine learning analysis for predicting the presence of depression with the results of the Korea National Health and Nutrition Examination Survey.

Depression is a major public health concern, with an estimated 10.8% of adults experiencing depression. Depression can have a significant impact on an individual's quality of life, social function, and productivity. Early diagnosis of depression is important in preventing its progression. Several tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Beck Depression Inventory, are used to screen patients for depression. We investigated the potential of machine learning in predicting the presence of depression using the results of a national survey. We collected the data of 5,420 patients from the 2020 Korea National Health and Nutrition Examination. The presence of depression was defined as ≥5 PHQ-9. We categorized output variables into the presence of depression (PHQ-9, ≥5) and absence of depression (PHQ-9, <5). We used 20 variables related to sociodemographic characteristics, health behavior, and presence of chronic disease for the development of three machine learning algorithms [random forest, logistic regression, and deep neural network (DNN)]. Eighty-seven decision trees were used for the random forest model. Linear regression algorithm shows a linear relationship between various input and output variables. For the DNN model, three layers with 16-32-64 neurons, Adam optimizer, and rectified linear unit (ReLU) activation were used. Of the included samples, 70% and 30% were randomly divided into the training and test sets, respectively. The area under the curve (AUC) of the test dataset for the random forest model was 0.803 [95% confidence interval (CI), 0.776-0.829], 0.812 (95% CI, 0.787-0.837) for the logistic regression model, and 0.805 (95% CI, 0.780-0.831) for the DNN model. Our study demonstrated the potential of machine learning for the development of models for predicting the presence of depression based of various health-related data. Machine learning models can potentially overcome the limitations of traditional diagnostic methods for depression by incorporating a wide range of objective variables to accurately identify patients with depression, thus avoiding the subjectivity and potential diagnostic errors associated with the subjective interpretation of symptoms observed by a clinician. Further efforts to increase the accuracy of machine learning models by utilizing more variables and data needed to detect depression.

An adapted version of the Three Words Three Shapes Test (3W3S) to old Brazilian adults

AbstractBackgroundAn adapted version of the Three Words Three Shapes Test (3W3S) is conducted for old Brazilian adults. This study describes the translation, back‐translation, and pilot study of 3W3S‐Br senior Brazilian adults' adaptation process.MethodThe 3W3S administration and scoring procedures were translated to Brazilian Portuguese by three independent translators. Concomitantly, a panel of specialists selected 18 abstract, regular nouns with the same amount of letters of the original format. The selected words must have had medium to high frequency in Brazilian Portuguese. They should also relate semantically and phonetically to the original ones. A final version was established and back‐translated. The 3W3S‐Br was then applied to 24 participants, divided into two groups, according to forms, of 12 members each (Form A (FA) and Form B (FB)). Inclusion criteria were age between 60‐80 years in the absence of depression, cognitive and functional impairment. The 3W3S‐Br has 5 conditions: 1) Copy (C); 2) Incidental Recall (IR); 3) Learning Trials total (LT), presented in three attempts; 4) Delayed Recall (DR); 5) Recognition (R). Correlations were verified by Pearson coefficient and differences between groups were compared by the Mann‐Whitney test. The analysis was performed by SPSS 28.0 or Windows.ResultThere were no significant associations between age (mean: 67±5), education (11±5), and sex(42%female) in all conditions of this instrument (p&lt;0,05). Significant positive associations were demonstrated between MMSE and 3W3S‐Br in C (r = 0,481), LT (r = 0,455), DR (r = 0,407), R (r = 0,773). The comparison between alternate forms did not reveal differences in the 5 conditions of the test (p &lt; 0,05). The groups also did not show significant differences between age, education, gender, and occurence of COVID‐19 infection.ConclusionAge, education, and sex did not correlate with 3W3S‐Br, whereas MEEM demonstrated correlations in most of its conditions. Alternate forms did not differ in this group of old Brazilian adults. The first steps of the adaptation process were completed and led to evidence of its clinical utility, granting further investigations. Further studies will be conducted to test psychometric properties and finalize the adaptation process.

Joint Contributions of Depression and Insufficient Sleep to Self-Harm Behaviors in Chinese College Students: A Population-Based Study in Jiangsu, China.

Self-harm in young people is common, and previous studies have shown that insufficient sleep or depression was associated with self-harm. However, the joint association of insufficient sleep and depression with self-harm is unknown. We employed representative population-based data from the "Surveillance for Common Disease and Health Risk Factors Among Students in Jiangsu Province 2019" project. College students reported their self-harm behavior over the past year. Rate ratios (RRs) and corresponding 95% confidence intervals (CIs) for self-harm in relation to sleep and depression were modeled using negative binomial regression with a sample population as an offset, adjusting for age, gender, and region. The instrumental variable approach was used for the sensitivity analyses. Of the study population, approximately 3.8% reported self-harm behaviors. Students with sufficient sleep experienced a lower risk of self-harm than those with insufficient sleep. Compared with students with sufficient sleep and the absence of depression, the adjusted risk of self-harm was elevated 3-fold (1.46-4.51) in those reporting insufficient sleep in the absence of depression, 11-fold (6.26-17.77) in those with sufficient sleep and definite depression, and 15-fold (8.54-25.17) in those with both insufficient sleep and definite depression. The sensitivity analyses indicate that insufficient sleep remained a contributing risk factor for self-harm. Lack of sleep in young people is significantly associated with self-harm, particularly in the presence of depression. The provision of mental health care and attention to sleep deprivation are particularly important for college students.

PD26-08 ERECTILE DYSFUNCTION IN MEN WITH PREDIABETES AND TYPE 2 DIABETES: THE DIABETES PREVENTION PROGRAM OUTCOMES STUDY (DPPOS)

You have accessJournal of UrologyCME1 Apr 2023PD26-08 ERECTILE DYSFUNCTION IN MEN WITH PREDIABETES AND TYPE 2 DIABETES: THE DIABETES PREVENTION PROGRAM OUTCOMES STUDY (DPPOS) Yooni Blair, Lindsay Doherty, Marinella Temprosa, Hunter Wessells, Rodica Pop-Busui, Kishore Gadde, Prachi Singh, Aruna V. Sarma, and DPP Research Group Yooni BlairYooni Blair More articles by this author , Lindsay DohertyLindsay Doherty More articles by this author , Marinella TemprosaMarinella Temprosa More articles by this author , Hunter WessellsHunter Wessells More articles by this author , Rodica Pop-BusuiRodica Pop-Busui More articles by this author , Kishore GaddeKishore Gadde More articles by this author , Prachi SinghPrachi Singh More articles by this author , Aruna V. SarmaAruna V. Sarma More articles by this author , and DPP Research Group More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003304.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Erectile dysfunction (ED) is more common and less responsive to pharmacotherapy in men with T2D. Data in men with prediabetes (PreD) and risk profiles in those with T2D, are lacking. We determined the burden and risk factors for ED in men with PreD and with T2D enrolled in the DPPOS. METHODS: Between 1996-1999, 3,234 adults with PreD were randomized to intensive lifestyle intervention, metformin, or placebo in the DPP. In 2001, metformin was continued for those originally randomized with modified lifestyle intervention offered to all. In 2016-2017, 568 (88%) of 648 male participants completed the International Index of Erectile Function (IIEF). ED was defined as having low or very low confidence getting and keeping an erection and/or ED medication use. Backwards selection multivariable logistic regression models including DPP treatment estimated odds of ED for covariates significant in bivariate analysis in men with persistent PreD and T2D. RESULTS: Overall, 218 (38%) men met ED criteria. Prevalence of ED was similar in men with PreD (41%) and T2D (37%) (p=0.4). In all men, older age (p<0.001), non-white race (p<0.001) and depression (defined by Beck Depression Inventory or antidepressant use) (p<0.01) were associated with ED. Among men with PreD, those assigned to intensive lifestyle intervention, but not metformin, had decreased odds of ED compared with the placebo group (OR=0.26, 95% CI=0.09, 0.77). Among men with T2D, metabolic syndrome (MetS), defined by NCEP ATP III criteria, was associated with increased odds of ED (OR=1.72, 95% CI=1.05, 2.83). CONCLUSIONS: ED is highly prevalent in men with PreD and with T2D. In addition to demonstrated factors typically observed in the general population such as younger age and absence of depression, intensive lifestyle intervention was protective in men at increased risk for T2D. In men with T2D, ED was associated with MetS. Our findings suggest metabolic mechanisms contribute to the pathogenesis of ED in T2D. Source of Funding: National Institute of Diabetes and Digestive and Kidney Diseases (UDK048489, UDK048339, UDK048377, UDK048349, UDK048381, UDK048468, UDK048434, UDK048485, UDK048375, UDK048514, UDK048437, UDK048413, UDK048411, UDK048406, UDK048380, UDK048397, UDK048412, UDK048404, UDK048387, UDK048407, UDK048443, and UDK048400) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e738 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yooni Blair More articles by this author Lindsay Doherty More articles by this author Marinella Temprosa More articles by this author Hunter Wessells More articles by this author Rodica Pop-Busui More articles by this author Kishore Gadde More articles by this author Prachi Singh More articles by this author Aruna V. Sarma More articles by this author DPP Research Group More articles by this author Expand All Advertisement PDF downloadLoading ...