Cause Of Depressive Symptoms Research Articles

COVID‐19 pandemic and the determinants of depressive symptoms among senior citizens of India: An empirical investigation

AbstractThe COVID‐19 pandemic inflicted multiple threats to individuals' physical, mental, and financial health conditions. The pandemic‐related restrictive behaviors pose serious consequences for public health and increase the risk of mental illness among individuals, particularly among older citizens. The combination of their pre‐existing illnesses, social isolation, COVID fear, and financial adversity frequently aggravates their condition and leads to depression and mental illness. Thus, the present study investigates the mental health status and the determinants of depressive symptoms among older adults of Bhubaneswar during the COVID pandemic context. The study used the Geriatric Depression Scale (GDS‐15) to measure their depressive symptoms. The social isolation parameter is measured with the De Jong Gierveld Loneliness Scale. Financial self‐efficacy, COVID‐19‐related psychological fear, and comorbidity health status are other determinants considered. A chi‐square test and multinomial logistic regression (MLR) models are adopted to find the probable risk factors that may influence depressive symptoms among older people. The results indicate that comorbidity health conditions, a social isolation mindset, and financial efficacy issues are the significant determinants that drive an older person towards different depression categories. The improvement of these influential factors can lead senior citizens to avoid any health emergency like COVID pandemic. In the event of a public health emergency, such as COVID pandemic, the government could use the study's findings to devise methods for assisting the elderly. Society as a whole should be aware of these findings, which can lead to depressive symptoms, and offer support to the elderly. Future research may concentrate on identifying the causes of depressive symptoms in different age groups or in the presence of specific comorbidity health conditions. Future research may also investigate the factors influencing depressive symptoms in a specific occupation.

Depression in regard to postcovid syndrome - literature review

Coronavirus disease-2019 (COVID-19) is a global pandemic health problem that causes a wide spectrum of clinical manifestations. Recovered patients who survive COVID-19 may continue to report a wide variety of clinical manifestations such as depression, which is named post covid syndrome. In our article, we sought to determine the frequency and possible causes of depressive symptoms and clinically-significant depression in the post COVID syndrome. We conducted a review of postcovid manifestations by searching PubMed, Scopus, World health organization (WHO) databases. The symptoms of postcovid syndrome have been shown as a weakness, cognitive impairment, sleep disturbance, and depression, among others. Persistent mental disorders among people who suffer from long-term COVID-19 may be related to psychological factors, as well as from infection and the associated neurobiological trauma. According to available studies, a significant percentage of depression symptoms is observed among people with postcovid syndrome, especially in older age groups. Also symptoms of mental, neurological and physical illness as well as inflammatory brain injury in people with post-COVID syndrome are likely to increase suicidal ideation and behavior in this patient population.

Parenting style and depression among students: The mediating role of self-esteem

Parenting style has been highlighted as one of the causes of depressive symptoms and also influences adolescent self-esteem. Although many studies have investigated the effect of self-esteem on depression, few have considered its role as a mediator variable. Therefore, this study aims to analyze the direct effect of parenting style on adolescent depression and its indirect effect on self-esteem. An online survey was completed voluntarily by 555 respondents from four senior high schools in Bekasi, Indonesia. The Patient Health Questionnaire, Parental Authority Questionnaire, Rosenberg Self-esteem Scale, and Path-SPSS analysis were employed to prove the hypothesis. The results show a significant direct effect of parenting [authoritative (β = -.257, p .01), authoritarian (β = .181, p .01) and permissive (β = .109, p .01)] on depression. In addition, there is an indirect effect of authoritative (β = -.182, p .01) and authoritarian (β = .055, p .01) parenting styles on depression as mediated by self-esteem. The study indicates the importance of positive parenting and the building of adolescents' self-esteem to avoid the risk of depression.

A Narrative Review of Anatomy and Clinical Biopsychosocial Assessment of Sacroiliac Joint Pain

Sacroiliac Joint (SIJ) pain is a severe disorder that affects 15% to 25% of individuals having axially low back pain. The most common causes of depressive symptoms are fear of movement, pain catastrophising, stress, and nervous system sensitisation. Recent research has shown that radiological imaging, are inadequate for diagnosing SIJ pain. For immersive and patient centred experiences, a comprehensive professional Biopsychosocial (BPS) physiotherapy evaluation is suggested. A new biopsychosocial model has been proposed that acknowledges all critical health and disease factors and promotes the interaction of biological, psychological, and social influences, but moves further than a narrow perspective. Psychosocial influences on well-being have generated an interest in physician services, physiotherapy evaluation, and implementation in a more systematic approach to a patient. This method is used to determine the current pain mechanism (predominant nociceptive, neuropathic, or non neuropathic central sensitisation pain) as well as the underlying pain mechanism. Patient’s biopsychosocial variables can establish and maintain SI discomfort. For a better plan of therapy to manage SIJ dysfunction, the biopsychosocial clinical assessment takes precedence over the examination of sacroiliac joint discomfort alone.

Fluoxetine modulates the pro-inflammatory process of IL-6, IL-1β and TNF-α levels in individuals with depression: a systematic review and meta-analysis

Clinical evidence suggests that inflammation is a key factor to understand the causes of depressive symptoms. Fluoxetine is one of the main first-line medications used for depression, and it is hypothesized that it participates in the decrease of pro-inflammatory cytokines. Hence, our aim was to perform a meta-analysis and systematic review to understand the interaction of fluoxetine in the IL-1β, IL-6 and TNF-α inflammatory process. Studies identified in PubMed and Scopus databases were used to perform a meta-analysis via the Comprehensive software. Standardized mean difference (SMD) was used as a summary statistic. The analysis included a total of 292 individuals with major depressive disorder who received fluoxetine for a period longer than 6 weeks; additionally, IL-1β, IL-6 or TNF-α levels were measured at the end of the antidepressant treatment. The findings were significant revealed decreased levels of the cytokines studied. In conclusion, the pooled data suggest that fluoxetine treatment improved depressive symptomatology by the modulation of pro-inflammatory process such as IL-1β, IL-6 or TNF-α.

Pro-Inflammatory Cytokines: Potential Links between the Endocannabinoid System and the Kynurenine Pathway in Depression.

Substance use/abuse is one of the main causes of depressive symptoms. Cannabis and synthetic cannabinoids in particular gained significant popularity in the past years. There is an increasing amount of clinical data associating such compounds with the inflammatory component of depression, indicated by the up-regulation of pro-inflammatory cytokines. Pro-inflammatory cytokines are also well-known to regulate the enzymes of the kynurenine pathway (KP), which is responsible for metabolizing tryptophan, a precursor in serotonin synthesis. Enhanced pro-inflammatory cytokine levels may over-activate the KP, leading to tryptophan depletion and reduced serotonin levels, which can subsequently precipitate depressive symptoms. Therefore, such mechanism might represent a possible link between the endocannabinoid system (ECS) and the KP in depression, via the inflammatory and dysregulated serotonergic component of the disorder. This review will summarize the data regarding those natural and synthetic cannabinoids that increase pro-inflammatory cytokines. Furthermore, the data on such cytokines associated with KP activation will be further reviewed accordingly. The interaction of the ECS and the KP has been postulated and demonstrated in some studies previously. This review will further contribute to this yet less explored connection and propose the KP to be the missing link between cannabinoid-induced inflammation and depressive symptoms.

A hormetic approach to understanding antidepressant effectiveness and the development of antidepressant tolerance - A conceptual view.

Antidepressants such as the selective serotonin reuptake inhibitors (SSRIs) have complex temporal effects. They may worsen symptoms during early treatment, they may reduce depressive symptoms over several weeks of treatment, and they may lose effectiveness over more prolonged treatment or after repeated treatment trials. Conceptually, these effects fall within the domain of hormesis, which refers to a biphasic or multiphasic response to a drug or toxin. Hormetic effects are commonly triggered when a drug interacts with homeostatic mechanisms. We develop and evaluate a theoretical framework for understanding how adaptations to SSRIs that restore synaptic homeostasis may partially contribute to their hormetic effects. Specifically, the serotonin system adapts to SSRIs by suppressing the firing of serotonergic neurons, inhibiting the synthesis of serotonin, and reducing the overall content of serotonin in the brain. Moreover, rodent models such as inescapable shock show that serotonin neurotransmission to specific forebrain regions is a necessary, but insufficient cause of depressive symptoms. Our review suggests: (1) early worsening of symptoms may be related to the direct effects of SSRIs on synaptic serotonin; (2) the symptom-reducing effects could be related to the loss of serotonin content in the brain during SSRI exposure; (3) the loss of efficacy over prolonged exposure could be related to the central nervous system equilibrating to the SSRIs. The serotonin system's adaptations to SSRIs may play a clinically meaningful role in their hormetic effects on depressive symptoms. A complete understanding of SSRIs' hormetic effects will require exploring temporal dynamics in other neurotransmitter systems.

Differences in beliefs about mood between people with and without bipolar disorder.

Psychological models of bipolar disorder (BD), such as the self‐regulation model (SRM; Leventhal, Nerenz, & Steele, 1984), highlight the crucial role of beliefs about mood in relapse vulnerability. To date, no studies have directly compared these beliefs between people with and without BD. Based on the SRM, the current research examined beliefs about mood in people with and without BD and explored the impact of current affect on these beliefs. Fifty euthymic people with a diagnosis of BD and 50 controls were recruited through an online screening study, clinical services, and support organizations. Experience sampling methodology (ESM) was used to assess beliefs (according to the Brief Illness Perceptions Questionnaire; Broadbent, Petrie, Main, & Weinman, 2006) across a typical week of everyday life. Data were analysed using multilevel modelling. Forty‐two people with a diagnosis of BD and 50 controls were included in the analyses. Results indicated that the BD group reported less control over mood, a shorter duration of mood, and less understanding of mood and were more likely to report the cause of depressive symptoms as something internal, compared with controls. When controlling for current affect, the BD group also reported more positive consequences, made more internal attributions for hypomanic symptoms, and reported less concern about mood, compared with controls. Findings suggest important differences in beliefs about mood between people with and without BD that are not the result of current affect. These beliefs may be particularly important in understanding underlying vulnerability to future relapse into depression and/or mania.

Serum IL-6 levels and oxidation rate of LDL cholesterol were related to depressive symptoms independent of omega-3 fatty acids among female hospital and nursing home workers in Japan

BackgroundChronic low-grade inflammation and oxidative stress are commonly observed in persons with depression or depressive symptoms. We explored the degree of depressive symptoms under psychological stress in relation to serum LDL oxidation, inflammatory markers, and fatty acid (FA) distribution among female population. The purpose of this study was to identify peripheral factors that are related to depressive symptoms, and to assess how each factor is related to depressive symptoms. Methods133 female workers in a hospital and nursing homes were recruited in Japan. Depressive symptoms were assessed using the Japanese version of the Centre for Epidemiologic Studies Depression Scale (CES-D), and perceived stress was assessed using the visual analogue scale. Cytokine levels and oxidation rate of LDL cholesterol (ox-LDL/LDL) were measured as indices of inflammation and oxidation. Omega-3 FA distribution was also measured. Path analysis and hierarchical regression analysis were used to determine if each factor was predictive of depressive symptoms. ResultsIt was identified that serum ox-LDL/LDL was positively connected with depressive symptoms, but was more strongly related to perceived psychological stress. Elevated serum IL-6 was positively correlated with depressive symptoms, though the effect was partly transmitted via ox-LDL/LDL. Additionally, serum ω3 PUFAs were inversely associated with depressive symptoms independently of IL-6 or ox-LDL/LDL. ConclusionAlthough this study is unlikely to fully explain the causes of depressive symptoms, it suggests that psychological stress and somatic factors such as inflammation, oxidation and nutrition are related to depressive symptoms. These findings suggest the therapeutic potential of lifestyle targets to alleviate the identified depression risk factors, anti-oxidative therapies, anti-inflammatory therapies and nutritional interventions to prevent depression.

Effects of genetic deficiency of tryptophan hydroxylase 2 on attentional processes in the five choice serial reaction time task in rats

Chronic low-grade inflammation and oxidative stress are commonly observed in persons with depression or depressive symptoms. We explored the degree of depressive symptoms under psychological stress in relation to serum LDL oxidation, inflammatory markers, and fatty acid (FA) distribution among female population. The purpose of this study was to identify peripheral factors that are related to depressive symptoms, and to assess how each factor is related to depressive symptoms.133 female workers in a hospital and nursing homes were recruited in Japan. Depressive symptoms were assessed using the Japanese version of the Centre for Epidemiologic Studies Depression Scale (CES-D), and perceived stress was assessed using the visual analogue scale. Cytokine levels and oxidation rate of LDL cholesterol (ox-LDL/LDL) were measured as indices of inflammation and oxidation. Omega-3 FA distribution was also measured. Path analysis and hierarchical regression analysis were used to determine if each factor was predictive of depressive symptoms.It was identified that serum ox-LDL/LDL was positively connected with depressive symptoms, but was more strongly related to perceived psychological stress. Elevated serum IL-6 was positively correlated with depressive symptoms, though the effect was partly transmitted via ox-LDL/LDL. Additionally, serum ω3 PUFAs were inversely associated with depressive symptoms independently of IL-6 or ox-LDL/LDL.Although this study is unlikely to fully explain the causes of depressive symptoms, it suggests that psychological stress and somatic factors such as inflammation, oxidation and nutrition are related to depressive symptoms. These findings suggest the therapeutic potential of lifestyle targets to alleviate the identified depression risk factors, anti-oxidative therapies, anti-inflammatory therapies and nutritional interventions to prevent depression.

Depressive Syndromes in Autoimmune Disorders of the Nervous System: Prevalence, Etiology, and Influence.

Autoimmune diseases of the nervous system (ADNS) consist of a group of severely disabling disorders characterized by abnormal immune attack against protein components of the nervous system. This type of attack behavior may occur in the central or peripheral nervous system, and in the neuromuscular junction, resulting in neuronal damage, axonal injury, demyelination or destruction of the neuromuscular junction. While the neurological deficits of patients with ADNS have received significant research attention, the manifestation of depression tends to be ignored. In fact, depressive manifestation is common in ADNS and adds significant burden upon patients suffering from this disease. Here, we systematically reviewed the current literature to highlight the prevalence, etiology and influence of depressive manifestation in ADNS. Most autoimmune diseases of the nervous system are discussed in this paper, from multiple sclerosis, acute disseminated encephalomyelitis and autoimmune encephalitis to acute myelitis, neuromyelitis optica, Guillain-Barré syndrome and myasthenia gravis. Depressive symptoms usually develop as a comorbidity during the course of disease, but sometimes exist as a primary presentation of the disease. Psychosocial factors, long periods of disablement and chronic pain are the three most common causes of depressive symptoms in many chronic conditions, particularly in peripheral neuropathy. Furthermore, the higher prevalence of depressive symptoms in ADNS suggests that immunological dysregulation may contribute to the elevated morbidity of depression. Finally, structural lesions of the brain, and some medications for ADNS, are also thought to precipitate depressive states in ADNS.

Cognitive dysfunction and brain mechanisms in major depression disorder

The prevalence of major depressed disorder increased rapidly in recent year all over the world and has become a heavy burden of society. So research on depression has become a hot topic. A great amount of studies found that patients with major depression disorder had impaired cognition. Cognitive dysfunction, the important symptom of depression, has been regarded as not only an indicator of illness, but also an obstacle to the elimination of depressive mood and the overall recovery of the disease. Exploring cognitive dysfunction and the potential brain mechanism meant significantly to understanding the etiology of major depression disorder, which could benefit the prevention, diagnosis, treatment of this mental disease. Therefore, the current research aimed to discuss cognitive dysfunction, the potential brain mechanism of the impaired dysfunction as well as the molecular factors behind major depression disorder, try to threw light on the abnormal macro-brain activity and micro-molecular marker of major depression disorder. The literatures showed that patients with major depression disorder had abnormalities in executive function, attention, memory and reaction speed. Deficit in executive function was mainly related to abnormality in prefrontal lobe and the connected subcutaneous nuclei; attention deficits had connection with abnormality in the frontal network connection, occipital lobe and cingulate gyrus; and memory defects are corresponded to abnormality in the hippocampus, cingulate gyrus, and medial temporal cortex. In addition, the abnormal neurotransmitters or brain-derived neuronal factors, and long-term stress state may also be the cause of depressive symptoms and abnormal cognitive levels. At present, the study of brain structure is relatively rough, mainly focusing on the changes in a big brain area, such as the hippocampus, prefrontal cortex, etc. In the future, high-resolution magnetic resonance imaging technology are needed to study more refined brain structures, such as CA1-3, entorhinal cortex to provide biological targets for neuromodulation treatment of various non-pharmacological interventions. Future studies also need to balance as much as possible irrelevant variables such as disease progression, severity of depression, gender, and neuropsychological tests. Besides, the causal link between neuroimaging and molecular biomarkers and depression remains unclear and longitudinal studies should be taken into consideration. As for clinical studies, we suggested to improve the traditional criteria of mental illness classification by combining the biological abnormality found by research evidence. Specifically, future studies of major depression disorder can consider cognitive dysfunctions assessed by psychological cognitive tasks; multimodal brain image and neurophysiological data to construct multidimensional computational modeling, in order to systematically explore potential biomarkers of depression, further identify the subtypes of depression. New classification criteria would provide full understanding of the pathogenesis as well as individual diagnosis and treatment of major depression disorder.

Polychlorinated biphenyls and depression: cross-sectional and longitudinal investigation of a dopamine-related Neurochemical path in the German HELPcB surveillance program

BackgroundExposure to polychlorinated biphenyls (PCBs) is associated with depressive symptomatology. A cause of depressive symptoms is a disturbance in the neurotransmitter system of dopamine (DA). Animal as well as human studies report that PCBs can influence the DA system. This study examined whether PCB-related depressive symptoms are affected by DA metabolites in humans with high PCB body burden.MethodsThis study is part of the German HELPcB surveillance program (Health Effects in high Level exposure to PCB) for occupationally exposed workers and their relatives. Data was collected from 178 participants on two measurement time points (t1 and t2) with a one-year time lag in between the two time points. PCBs were analyzed in plasma via human biomonitoring and a validated questionnaire was used to identify existence and severity of depressive symptoms. As a surrogate for DA, we measured its metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA) in urine. Mediation analyses were performed to test whether the association between PCB exposure and severity of depressive symptoms is mediated by urinary concentration of DA metabolites HVA and VMA. The mediation was tested with the SPSS macro MEDIATE.ResultsWe found a significant mediation over time for lower-chlorinated, higher-chlorinated and dioxin-like PCBs. The positive association between PCB exposure with severity of depressive symptoms was mediated by the main DA metabolite HVA. At t1 a higher exposure with PCBs was associated with lower concentration in urinary HVA. A reduced HVA concentration at t1 was correlated with increased depressive symptoms severity at t2. No meditations were found for VMA.ConclusionsThis work indicates that the association of PCB exposure and an increase of depressive symptoms after one year is mediated by the DA metabolite HVA as a surrogate for DA. These are first steps towards finding an explanation for an underlying neurochemical pathomechanism of PCB-related depressive symptomatology.

The effects of supportive care interventions on depressive symptoms among patients with lung cancer: A metaanalysis of randomized controlled studies.

Our aim was to examine the effect of supportive care interventions on depressive symptoms in patients with lung cancer. We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and the Chinese Electronic Periodical Services (CEPS) from their inception until September of 2015. We included randomized controlled trial studies that compared standard care with supportive care interventions. The standardized mean difference (SMD) (Cohen's d) was calculated to estimate the effect of interventions. Subgroup analysis was conducted to identify possible sources of heterogeneity. A total of 1,472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74, CI 95% = -1.07 to -0.41), and the effects could be maintained at weeks 4, 8, and 12 of follow-up. Three types of supportive care interventions were identified: psychotherapy combined with psychoeducation, psychoeducation alone, and an exercise program. Both psychotherapy combined with psychoeducation and exercise significantly improved depressive symptoms, while psychoeducation alone did not yield significant effects. The moderating effects indicated that greater improvements in depressive symptoms were found in lung cancer patients with a severe level of depressive symptoms at baseline. Personalized supportive care interventions can be developed based on the main causes of depressive symptoms. Psychotherapy combined with psychoeducation can target the causes of depressive symptoms, including both physical distress and psychological trauma due to lung cancer, while exercise programs can effectively improve depressive symptoms for lung cancer patients with impaired respiratory function.

Hyperhomocysteinemia is a result, rather than a cause, of depression under chronic stress.

BackgroundAlthough the accumulation of homocysteine (Hcy) has been implicated in the pathogenesis of depression, whether Hcy is directly involved and acts as the primary cause of depressive symptoms remains unclear. The present study was designed to clarify whether increased Hcy plays an important role in stress-induced depression.ResultsWe employed the chronic unpredictable mild stress model (CUMS) of depression for 8 weeks to observe changes in the plasma Hcy level in the development of depression. The results showed that Wistar rats exposed to a series of mild, unpredictable stressors for 4 weeks displayed depression-like symptoms such as anhedonia (decreased sucrose preferences) and a decreased 5-Hydroxy Tryptophan (5-HT) concentration in the hippocampus. At the end of 8 weeks, the plasma Hcy level increased in the CUMS rats. The anti-depressant sertraline could decrease the plasma Hcy level and improve the depression-like symptoms in the CUMS rats. RhBHMT, an Hcy metabolic enzyme, could decrease the plasma Hcy level significantly, although it could not improve the depressive symptoms in the CUMS rats.ConclusionsThe results obtained from the experiments did not support the hypothesis that the increased Hcy concentration mediated the provocation of depression in CUMS rats, and the findings suggested that the increased Hcy concentration in the plasma might be the result of stress-induced depression.

To What Factors Do Rural-Dwelling Hispanics Attribute Depressive Symptoms?

This study is a retrospective chart review comparing rural-dwelling Caucasian and Hispanic outpatients' attribution of depressive symptoms. Based on the data gathered at intake, Hispanics were more likely to attribute depression to curse/spell and supernatural causes, while Caucasians were more likely to attribute symptoms to hereditary factors or job stress. Among both groups, higher CESD score was associated with problems with significant others or how they got along with others. Among Hispanics, depression severity was additionally associated with problems related to job or finances. Our findings point to a consequential role for clinical inquiry into attributed causes of depressive symptoms.

Causas orgánicas y comórbidas de la depresión: el primer paso

The primary objective of this review is to obtain a clinical orientation as to evidence-supported common «other» causes of depressive symptomatology, which predominantly are: medical issues; life events; vitamin, mineral and diet-related deficiencies; and hormones. A secondary goal was to reflect those more frequent “other” causes in a checklist for clinical use, comprising also the preferred treatment (medical/dietary, antidepressants, or psychological) resulting from the available evidence.Medline, Cochrane and main related databases were searched from 4th October 2010 to 27th April 2011, no language limits, with keywords: depression; organic; comorbid; medication; life events; hormones; vitamin; mineral; diet; disease; as well as further searches into each upcoming possibly related issue.Total studies contemplated: 3.211; total studies reviewed: 301, with criteria of relevancy; date of study or review; size and type; journal status.Data were abstracted based upon probable clinical relevancy and use.The main results obtained were evidence-supported indications as to these other causes of depressive symptomatology, that warrant early screening, attention and treatment, possibly before antidepressant or psychological therapy is started. Preliminary conclusionThere appears to be a clinical rationale for early checking of a number of evidence-based causes of depressive symptoms for which first-line testing is readily available. In several cases clinical treatment may be simple, and improvements in depressive symptoms rapidly obtainable. Using a pre-treatrment protocol, both patients and health systems could benefit from biological and comorbid causes of depressive symptoms being established early. An enhanced response to low-cost corrective measures can decrease the risk of suicide.

Can Reporting Heterogeneity Explain Differences in Depressive Symptoms Across Europe?

Depression is one of the leading causes of disability in the developed world. Previous studies have shown varying depression prevalence rates between European countries, and also within countries, between socioeconomic groups. However, it is unclear whether these differences reflect true variations in prevalence or whether they are attributable to systematic differences in reporting styles (reporting heterogeneity) between countries and socioeconomic groups. In this study, we examine the prevalence of three depressive symptoms (mood, sleeping and concentration problems) and their association with educational level in 10 European countries, and examine whether these differences can be explained by differences in reporting styles. We use data from the first and second waves of the COMPARE study, comprising a sub-sample of 9,409 adults aged 50 and over in 10 European countries covered by the Survey of Health, Ageing and Retirement in Europe. We first use ordered probit models to estimate differences in the prevalence of self-reported depressive symptoms by country and education. We then use hierarchical ordered probit models to assess differences controlling for reporting heterogeneity. We find that depressive symptoms are most prevalent in Mediterranean and Eastern European countries, whereas Sweden and Denmark have the lowest prevalence. Lower educational level is associated with higher prevalence of depressive symptoms in all European regions, but this association is weaker in Northern European countries, and strong in Eastern European countries. Reporting heterogeneity does not explain these cross-national differences. Likewise, differences in depressive symptoms by educational level remain and in some regions increase after controlling for reporting heterogeneity. Our findings suggest that variations in depressive symptoms in Europe are not attributable to differences in reporting styles, but are instead likely to result from variations in the causes of depressive symptoms between countries and educational groups.

An ethnic/racial comparison of causal beliefs and treatment preferences for the symptoms of depression among patients with diabetes.

The purpose of the study was to explore African American, Latino, and Non-Hispanic White adult patients with type 2 diabetes cultural perceptions of symptoms of depression and factors that predict depression care treatment preferences between these groups. A community sample of African Americans, Latinos, and White diabetic adults receiving services in 1 of 2 central Austin, Texas facilities participated in the study. Each participant was given a survey, which consisted of the following 5 components: (1) illness screener questions, (2) demographic questions, (3) Patient Health Questionnaire, (4) Depression Treatment Questionnaire, and (5) Illness Perception Questionnaire. A binary logistic regression was used to examine the relationship between cultural perceptions of symptoms and the predictor variables. A multinomial logistic regression analyses was used to examine the relationship between treatment and provider preferences for the symptoms of depression and ethnicity. The first research question addressed whether there were differences across ethnicity in how symptoms of depression are attributed among patients with diabetes. There were 7 causal beliefs that were associated with differences in cultural endorsements of the causes of depressive symptoms. In addition, culture was associated with treatment preferences but not with provider preferences. The utility of assessing a patient's understanding of symptoms of depression to determine how personal illness models impact treatment preferences and clinical implications of how knowledge of patient's causal attributions can aid medical and behavioral health providers working in collaborative management of diabetes and depression are discussed.

Determinants of depressive symptoms in Jordanian working women

Depressive symptoms are an epidemic problem affecting different subgroups of women in clinical and non-clinical settings. However, depressive symptoms experienced by working women have rarely been studied. This study aimed at identifying depressive symptoms and their determinants in a sample of 101 Jordanian working women recruited from a higher educational institution. Data about women's depressive symptoms, their educational level, presence of children, sharing a job with an intimate partner, health status, diagnosis with chronic illnesses, and complaints of spousal abuse were collected. Logistic regression analysis was used to test for the significance of the selected factors on women's experiences of depressive symptoms. Findings indicated that 51.2% (n = 42) women complained of moderate and severe levels of depressive symptoms. Factors identified as significant in predicting depressive symptoms were women's experiences of spousal abuse (odds ratio adjusted = 3.5, 95% confidence interval = 1.05-11.7) and being diagnosed with chronic illnesses (odds ratio adjusted = 7.09, 95% confidence interval = 1.2-42.2). It was concluded that causes of women's depressive symptoms were imbedded in their familial and social environment, rather than their job per se. Mental health nurses can change the practice of nursing to better standards. Being familiarized with causes of depressive symptoms can empower nurses to be active advocates for depressed women.