Center For Epidemiologic Studies Depression Scale-Revised Research Articles

Improved Scoring of the Center for Epidemiologic Studies Depression Scale – Revised: An Item Response Theory Analysis

The Center for Epidemiologic Studies Depression Scale – Revised (CESD-R) is a popular self-report screening measure for depression. A 20-item questionnaire with scores ranging from 0 to 4 for each item, the CESD-R can produce total scores ranging from 0 to 80. However, the typical scoring protocol for the CESD-R restricts the range of possible scores to between 0 and 60 to retain the same range and clinical cutoff scores as the original CES-D. Despite the widespread adoption of this scoring approach, the psychometric impact has never been systematically examined. In an undergraduate and community adult sample (n = 869), item response theory analyses indicated that scoring the CESD-R with all 5 response options (CESD-R5opt) provided nearly twice as much information about a person’s latent depression for individuals with high levels of depression than did scoring the CESD-R with 4 response options per item (CESD-R4opt). The CESD-R5opt retained the strong reliability and factor structure of the CESD-R4opt and was more sensitive to individual differences for participants at high levels of depression compared to the CESD-R4opt. Results provide preliminary evidence that researchers and clinicians should score the CESD-R using the full 0-to-80 scale and a clinical cutoff score of 29.

Correlation of stress, depression, sleep, and pain with race and body mass index (BMI): Secondary analysis from Alliance A011502.

e23171 Background: A011502 is a phase 3 trial that randomized high-risk nonmetastatic breast cancer (BC) patients (pts) to aspirin 300 mg daily vs. placebo. Obesity and Black race have been shown to be associated with worse clinical outcomes. We studied the association of stress, depression, sleep and pain with each other, and with BMI and race. Methods: At baseline, 2735, 2610, 2720, and 2422 pts completed Perceived Stress Scale (PSS), Center for Epidemiologic Studies Depression Scale Revised (CESD-R), Brief Pain Inventory (BPI), and Pittsburgh Sleep Quality Index (PSQI) respectively. Stress was categorized with PSS scores: low (0-13), moderate (14-26) or high (27-40). Depression was categorized with CESD-R scores: no depression (0-15) or depression (≥16). Pain was categorized with BPI scores: none/mild (0-3) or moderate/severe (≥4). Sleep quality was categorized with PSQI scores: good (0-5) or poor ( > 5). Associations of measures by race and BMI were analyzed using chi-square test. Results: There was a statistically significant association among stress, depression, pain, and sleep quality (p < 0.01 for all). Compared to pts with BMI < 25, overweight and obese women reported higher stress (2.9%, 2.3% vs. 1.7%, p = 0.04), depression (13.4%, 18% vs. 9.6%, p < 0.01), moderate/severe pain (16.5%, 20.3% vs. 12%, p < 0.01), and poor sleep (64.9%, 71.5% vs. 60.4%, p < 0.01). Black women reported more moderate/severe pain compared to White women or other races (32.9% vs. 14.2% vs. 27.8%, p < 0.01). There was no association of other symptoms with race (Table 1). Conclusions: Obesity was associated with higher stress, depression, poor sleep and pain among BC pts from A011502. Black women reported higher pain compared to other races. Future studies are warranted that determine causal associations, how symptoms may relate to outcome disparities, and develop approaches to address them. U10CA180821, U10CA180882, UG1CA233196; https://acknowledgments.alliancefound.org . Clinical trial information: NCT02927249 . [Table: see text]

Association of higher baseline stress and pain with clinical outcomes: Secondary analysis from Alliance A011502.

11016 Background: A011502 is a phase 3 randomized double-blind clinical trial that enrolled high-risk nonmetastatic breast cancer (BC) patients (pts) and randomized pts to aspirin 300 mg daily vs. placebo. There was no significant difference in invasive disease-free survival (iDFS) between the two arms. A secondary objective was to determine the association of inflammation-affiliated factors (stress, depression, poor sleep quality and pain) with iDFS and overall survival (OS). We hypothesized that these baseline factors are associated with worse clinical outcomes. Methods: At baseline, 2735, 2720, 2422 and 2610 pts completed Perceived Stress Scale (PSS), Brief Pain Inventory (BPI), Pittsburgh Sleep Quality Index (PSQI) and Center for Epidemiologic Studies Depression Scale Revised (CESD-R) respectively. Stress was categorized with PSS scores: low (0-13), moderate (14-26) or high stress (27-40). Pain was categorized with BPI scores: none/mild (0-3) or moderate/severe (≥4). Sleep quality was categorized with PSQI scores: good (0-5) or poor ( > 5).Depression was categorized with CESD-R scores: no depression (0-15) or depression (≥16). Associations between the measures of interest and outcomes were performed with multivariable Cox models controlling for age, body mass index, time since diagnosis, race, ethnicity, hormone receptor status and treatment arm. Results: Median follow up was 35 months. The associations from multivariable Cox model are shown in Table 1. Pts who reported high PSS had significantly worse iDFS and (non-significant) worse OS. Moderate/severe average (avg) pain was significantly associated with worse iDFS and OS. Poor sleep quality and depression were associated with worse iDFS and OS but not statistically significant. Conclusions: Pts reporting higher stress and pain at baseline had worse outcomes. We acknowledge that both pain and stress may be related to other non-cancer issues (chronic comorbidities). Our study highlights the need for clinical trials to consider including questionnaires to assess pt-reported outcomes. Future studies are warranted to determine if measures to decrease pain and stress would improve BC outcomes. U10CA180821, U10CA180882, UG1CA233196; https://acknowledgments.alliancefound.org . NCT02927249: Clinical trial information: NCT02927249 . [Table: see text]

Minority stress, perceived social support, and depression in people diverse in sexual and gender minority status

ABSTRACT The study examines the relationships between experienced heterosexism, perceived social support, and depression in people diverse in sexual and gender minority (SGM) identity. The cross-sectional online study was performed in Poland among 509 SGM people, with an average age of 22 years (M = 22.39, SD = 4.78). Minority stress was assessed using the Daily Heterosexist Experiences Questionnaire (DHEQ), perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS), and depression symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R). The study supported a buffering effect of social support from family and friends in the relationship between minority stress and depression symptoms. Network analysis (NA) showed that minority stress from family of origin, mediated by low family support, plays a key and bridging role in increasing suicidal ideation, especially in dual SGM individuals. Friends are the most important source of support for people with a single SGM identity. Therefore, to prevent suicidal thoughts in LGBTQ+ people at increased risk of depression, systemic therapy should be used in addition to interventions focusing on coping with minority stress and symptoms of depression.

Athletic retirement: factors contributing to sleep and mental health problems.

The aim of this investigation was to determine which factors were associated with symptoms of sleep and mental health disorders in former athletes. Former athletes (N = 173, 50% women) who retired from any competition level within the last 20 years participated in an online survey. The survey consisted of the Athlete Sleep Screening Questionnaire (ASSQ), Personal Wellbeing Index-Adult (PWI-A), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Generalised Anxiety Disorder Assessment (GAD-7). Binary logistic regressions revealed that both age (OR = 0.95 [95% CI:0.92, 0.99], p = 0.007) and gender (OR = 2.28 [95% CI:1.09, 4.79], p = 0.029) were associated with anxiety, with women and younger ex-athletes presenting greater risk of anxiety symptoms. Higher body mass was associated with an increased risk for sleep difficulty (OR = 1.13 [95% CI:1.03, 1.23], p = 0.008), sleep disordered breathing (OR = 1.20 [95% CI:1.10, 1.30], p < 0.001), and compromised wellbeing (OR = 0.89 [95% CI:0.83, 0.96], p = 0.001). Athletes who subjectively placed a lower priority on sport while competing presented greater risk of sleep disordered breathing (OR = 2.00[95% CI:1.05, 3.80], p = 0.035). No associations between recency retirement and any outcome measures were observed. Findings suggest potential predictive factors for difficulty transitioning out of sport. Future longitudinal research should consider the interplay between sport re-engagement and the incidence and chronicity of sleep and mental health disorders.

Clinically Recognized Depression and Mental Health Treatment in a Single Center Cohort of Patients with Systemic Sclerosis.

In this study, we investigated the prevalence of depression, depression treatment, and symptom burden in patients with systemic sclerosis (SSc) and examined their associations with the center for epidemiologic studies depression scale revised (CESD-R) scores. The Prospective Registry in Scleroderma at Massachusetts General Hospital (PRISM) is a longitudinal registry of patients with SSc. Among participants with CESD-R score ≥ 16, indicating possible depression, a chart review was performed for mental health diagnoses and treatments. We examined the relation of demographic and clinical factors to the presence of mental health diagnoses or treatment using logistic regression. We evaluated the association of SSc symptoms and the COVID-19 pandemic with a CESD-R score using quantile regression. Of 214 patients enrolled in PRISM, 129 participants (38% diffuse and 59% limited) completed at least one CESD-R questionnaire. In the first survey, 29% had possible depression (CESD - R ≥ 16) and 16% had probable depression (CESD - R ≥ 23). Of 20 participants with probable depression, 90% received treatment for a mood disorder. In a multivariable logistic regression model among participants with CESD - R ≥ 16, none of the evaluated variables (CESD-R score, age, gender, employment status, race, and ethnicity) was associated with mental health diagnosis or treatment. Higher baseline dyspnea index, modified Rodnan skin score, and the University of California Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal total score and subscores were associated with higher CESD-R score. In this single-center cross-sectional study, 16% of participants had significant depressive symptoms. Dyspnea, extent of skin involvement, and gastrointestinal symptoms were associated with depression symptoms.

P095 Factors associated with sleep and mental health problems following athletic retirement

Abstract Introduction Despite growing research on the sleep and mental health of athletes, there is limited literature on their sleep health following retirement from sport. The aim of this study was to investigate potential factors associated with symptoms of sleep and mental health disorders in former athletes. Methods Former athletes (N=173, 50% women) who retired from any sport or competition level ≤20 years ago completed an online survey, consisting of the Athlete Sleep Screening Questionnaire (ASSQ), Personal Wellbeing Index-Adult (PWI-A), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Generalised Anxiety Disorder Assessment (GAD-7). Results Self-disclosed lifetime diagnosis of sleep disorder(s) and mental health disorder(s) was reported by 28.3% and 45.1% of former athletes, respectively. Binary logistic regressions showed that age (OR=0.95[95% CI:0.92, 0.99], p=.007) and gender (OR=2.28[95% CI:1.09, 4.79], p=.029) were associated with anxiety symptoms, with women and younger ex-athletes presenting greater risk. Increased BMI was associated with risk for sleep disordered breathing (OR=1.20[95% CI:1.10, 1.30], p&amp;lt;.001), sleep difficulty (OR=1.13[95% CI:1.03, 1.23], p=.008), and poor wellbeing (OR=0.91[95% CI:0.85, 0.98], p=.010). Those who placed a lower priority on sport whilst competing had greater risk for sleep disordered breathing (OR=2.00[95% CI:1.05, 3.80], p=.035). Recency of retirement was not associated with any measures. Discussion Findings indicate that former athletes are not exempt from poor sleep and mental ill-health. Results provide preliminary insight into predictive factors for difficulty transitioning out of sport. Future longitudinal research should consider the interplay between sport reintegration and the timing of sleep and mental health problems.

Mental Health Component Scale Is Positively Associated with Riboflavin Intake in People with Central Obesity.

Micronutrient deficiencies are a well-established fact in obesity. However, few studies exist on the relationship between micronutrient intake and mental health. In this study, we investigated the associations between daily intakes of vitamins and minerals and scoring items that measure mental health in people living with central obesity. One hundred males and females with central obesity and metabolic abnormalities were included in the study. Demographic, clinical, anthropometric, and biochemical data were collected. Mental health statuses were assessed with validated questionnaires, and daily micronutrient intakes were assessed with food diaries and Nutritionist ProTM software v7.9. The mental component score (MCS-12) positively correlated with vitamin A (Rho = 0.249, p = 0.038), vitamin C (Rho = 0.293, p = 0.014), riboflavin (Rho = 0.264, p = 0.026), and folate (Rho = 0.238, p = 0.046). Rosenberg Self-Esteem Scale (RSES) correlated with sodium (Rho = 0.269, p = 0.026), and the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) correlated with chromium (Rho = 0.313, p = 0.009). In the regression analysis, after potential confounders were adjusted for, only riboflavin was positively associated with the MCS-12 log (beta ± SD = 0.047 ± 0.023, p = 0.044). Our study provides evidence of the link between dietary riboflavin and mental health in people with obesity, and it highlights the importance of monitoring both nutritional status and mental health when managing obesity.

Psychometric characteristics of the Center for Epidemiologic Studies Depression Scale-Revised in a population of Polish university students.

The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) has already been validated on the Polish population. However, the structure of the scale obtained at that time was not confirmed by confirmatory factor analysis (CFA) in subsequent studies on the Polish sample and measurement invariance for gender was not performed. The purpose of this article is to present the results of psychometric analyses to verify the structure of the CESD-R in a university student sample. An online cross-sectional study was conducted with 1519 university students (March/April 2021). The dataset was randomly divided into three subsets to perform principal component analysis (PCA, Subset 1) and CFA for CESD-R versions with different numbers of factors and items (Subsets 2 and 3). Measurement invariance for gender was verified for the whole sample. PCA pointed to a three-factor solution that was analyzed in the subsequent CFA. Due to high correlation coefficients between factors, further steps were taken using only one factor. For CFA, 20-, 18- and 9-item versions of the CESD-R were used, but the 9-item version obtained the best model fit parameters and was used to evaluate the measurement invariance for gender, which was confirmed. The 9-item CESD-R has the best model fit compared to other versions of this scale and is gender invariant. Further research is needed to verify the criterion validity of this shortened scale.

Measuring Depression in Young Adults: Preliminary Development of an English Version of the Teate Depression Inventory.

Depression is a common and debilitating condition that impacts individuals with various cultural backgrounds, medical conditions, and life circumstances. Thus, assessment tools need to be useful among different cultural groups. The 21-item Teate Depression Inventory (TDI) was developed in Italy, is designed to assess major depression, and focuses on cognitive and affective rather than somatic symptoms. This study aims to examine the factor structure and concurrent validity of the TDI English version among a non-clinical population in the United States. Participants included 398 adults (mean age 19.89 years, SD = 2.72, range: 18 to 46 years old) who completed the TDI and The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). The results supported a three-factor bifactor structure of the TDI (Positive Affect, Negative Affect, and Daily Functioning), which largely corresponds to the Tripartite Model of affective disorders. These findings support the use of TDI scores as measures of depressive symptoms among U.S. young adults, offering researchers and practitioners a brief and useful tool.

The Relationship between Minority Stress and Depressive Symptoms in the LGBTQA Population from Poland.

The cross-sectional study examines minority stress and depression symptoms regarding various sexual and gender minority (SGM) identities in lesbian, gay, bisexual, transgender, queer, and asexual (LGBTQA) individuals from Poland. The online survey was conducted among 509 people. Participants aged between 18 and 47 (M = 22.39, SD = 4.78). Gender identity included 262 cisgender women, 74 cisgender men, 31 transgender women, 53 transgender men, and 89 nonbinary individuals. Sexual identity comprises 197 bisexual, 150 homosexual, 78 pansexual, 33 asexual, 21 undefined, 14 heterosexual, 9 demisexuals, 6 queer, and 1 sapiosexual individual. The Daily Heterosexist Experiences Questionnaire (DHEQ) and the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) were used to measure minority stress and depression symptoms, respectively. Among LGBTQA participants, 99.80% declared minority stress at least once during the past year. In particular, vicarious trauma was experienced in 99.80% of participants, vigilance in 95.87%, harassment and discrimination in 80.35%, stress related to the family of origin in 69.16%, and to gender expression in 68.76% of respondents. Depression symptoms were found in 62.50% of respondents. Significantly higher rates of depression and minority stress were presented in dual than single SGM individuals. Binomial logistic regression showed that such sources of minority stress as vigilance, harassment, and gender expression could predict depression symptoms. Therefore, prevention and intervention programs should be designed for the LGBTQA population focusing on coping with these sources of minority stress, especially among those of dual SGM identity.

Investigating the Structure of the CESD-R and DASS-21 Across Adults with Low and High Levels of Autistic Traits.

The current study examined factorial invariance of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) and the Depression Anxiety Stress Scales-21 (DASS-21) using a convenience sample of 434 adults surveyed though Amazon Mechanical Turk. Participants were sorted into two groups based on their score on the Autism-Spectrum Quotient. Results indicated that the CESD-R did not demonstrate configural invariance. The DASS-21 demonstrated evidence of scalar invariance, indicating cross-group equality in factor loadings and factor intercepts. Findings suggest that the DASS-21 measures symptoms of depression, anxiety, and stress consistently across individuals with high and low levels of ASD-related traits, whereas the CESD-R may not be valid when assessing symptoms of depression in those with a high level of ASD-related traits.

Depressed Symptomatology in Systemic Lupus Erythematosus Patients.

Depression is a prevalent (24-30%) and significant comorbidity in patients with systemic lupus erythematosus (SLE). In the present study, we leveraged the longitudinal SLE cohort at the Washington University Lupus Clinic to address 1) what is the longitudinal course of depressed affect among outpatients with SLE and 2) what is the longitudinal relationship between SLE disease activity and depressed affect? Longitudinal data from patients with American College of Rheumatology- or Systemic Lupus International Collaborating Clinics-classified SLE were analyzed. Depressed symptoms were assessed at each visit using the Center for Epidemiologic Studies Depression Scale, Revised (CESD-R), and SLE disease activity was measured via the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Group-based trajectory modeling (GBTM) and linear mixed models were used for analysis. The study sample (n=144) was 56.3% Black and 38.9% White. GBTM revealed 5 distinct groups of patients who demonstrated consistent trends in depression over time. Members of groups 4 (n=44, 30.6%) and 5 (n=44, 30.6%) demonstrated CESD-R scores consistent with depression. Of note, Black patients were much more common in group 5 (n=32, 72.7%, P< 0.02). Analyses identified an association between SLEDAI disease activity and depression scores in multivariate analysis but did not show significance in GBTM and univariate analysis. The majority (61.2%) of patients had CESD-R scores consistent with persistent depressed affect or major depression over a period of up to 4 years. The lack of a consistent relationship of CESD-R with SLE disease activity highlights the need to regularly monitor, treat, and better understand the causes behind this comorbidity.

Psychometric Synthesis of the Center for Epidemiologic Studies Depression Scale – Revised English and Translated/Adapted Versions

We reviewed 19 English version scholarly works and 11 other language translation articles from 2004–2018 for the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R). Alpha was .92 (.90, .94; N = 13,150); convergent, factorial, and diagnostic validity were robust. Implications for counseling practice and research were discussed.

The intensity of coronavirus anxiety and its associations with depressive symptoms and burnout among Polish nurses and firefighters: a preliminary cross-sectional study

IntroductionNurses and firefighters are professions characterized by exposure to high occupational stress.ObjectivesThe purpose of the present study was to investigate the intensity of coronavirus anxiety and its associations with depressive symptoms and burnout in samples of Polish nurses and firefighters during the COVID-19 pandemic.MethodsFifty nurses and 55 firefighters were recruited for the study. Respondents were administered the Coronavirus Anxiety Scale (CAS), the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) and the Oldenburg Burnout Inventory (OLBI). Descriptive statistics, Pearson product-moment correlations and one-way ANOVA were used to analyze the data.ResultsNurses scored significantly higher than firefighters on the CAS (M = 2.76, SD = 4.18 vs. M = 1.15, SD = 2.24; p &lt; 0.05), the CESD-R (M = 11.64, SD = 10.80 vs. M = 5.85, SD = 7.34; p &lt; 0.01) and both dimensions of the OLBI, i.e. exhaustion (M = 2.38, SD = 0.56 vs. M = 1.91, SD = 0.55; p &lt; 0.001) and disengagement from work (M = 2.28, SD = 0.48 vs. M = 1.93, SD = 0.43; p &lt; 0.001). In the both study groups coronavirus anxiety significantly correlated with depressive symptoms and exhaustion, and only in nurses also with disengagement from work.ConclusionsThis study demonstrated that coronavirus anxiety was more pronounced in nurses than in firefighters. The findings provide preliminary evidence for the positive associations of coronavirus anxiety with depressive symptoms and burnout in both groups.DisclosureThe study was supported by the grant of the National Centre for Research and Development (NCBR) No. I.PB.08 “Occupational burnout and depression in professions with exposure to high levels of occupational stress: determinants, prevalence, interrelations a

Abstract MP46: Adverse Childhood Experiences Are Linked To Disrupted Sleep And Diurnal Cortisol Concentrations In Young Adult Women.

Introduction: Early life psychosocial stress and adversity - referred to as adverse childhood experiences (ACEs) - are highly prevalent, with ~60% of American adults reporting exposure to at least one ACE. ACEs occur during critical developmental periods and are related to cardiovascular morbidity and mortality in a graded, dose-dependent manner. Sleep is an emerging lifestyle behavior that has been associated with cardiometabolic morbidity and mortality, and poor sleep has been associated with ACEs. Hypothesis: We hypothesized that ACEs would be associated with disrupted sleep and altered diurnal cortisol slopes in young adult women. Methods: Forty-two young adult women (mean ± SD, age = 21 ± 3 y) completed this study. Twenty-eight women reported an ACE score ≥4 and were classified as having moderate to severe ACEs, while 14 women reported an ACE score of 0. Women provided saliva samples collected using the passive drool technique upon waking and 8 h later. Cortisol concentrations were then quantified from the saliva samples by ELISA and diurnal cortisol slopes (DCS) were calculated by expressing the difference between morning and afternoon concentrations relative to the time between sampling (μg/dL/h). The participants also completed the Center for Epidemiologic Studies Depression Scale Revised (CESD-R), from which a composite sleep score (CSS; range = 0 - 12) was created from the three sleep-related items and reverse-scored such that a higher score indicated better sleep. Women also completed the Maltreatment and Abuse Chronology of Exposure Scale, from which a total maltreatment and abuse severity score was calculated (MACE TSS ). Mann-Whitney tests were used to examine differences in DCS and CSS between those with versus without a history of ACEs. Median values are reported. Spearman correlations were used to examine associations among DCS, CSS, and MACE TSS . Results: DCS was greater (-0.0396 vs. -0.0661 μg/dl/h; U = 94, p = 0.01), indicating lower variability, and CSS was lower (5 vs. 7; U = 118.5, p = 0.04), indicating poorer sleep, in the women with versus without a history of ACEs. Further, MACE TSS was related to DCS (ρ = 0.397, p = 0.007) and to CSS (ρ = -0.358, p = 0.011). The relationship between DCS and CSS (ρ = -0.218, p = 0.092) was not significant. Conclusions: Our preliminary evidence indicates that ACEs are associated with poorer sleep and disrupted diurnal cortisol patterns. While we are limited by subjective sleep assessments and small sample size, these findings suggest a link between early life psychosocial stress, poor sleep and circadian disruption that could contribute to lifetime cardiometabolic disease risk. Future, large-scale studies are needed to further explore these associations.

Depression and Suicidal Ideation among University Students

Purpose of the study: Depression is a common mental disorder which had become a powerful trigger of suicidal ideation. The aim is to identify the difference and relationship of depression and suicidal ideation among university students. Methods: A total of four hundred and fifty-six (N=456) students were recruited through proportionate sampling. The Center for Epidemiologic Studies Depression Scale Revised (CESD-R) and Adult Suicidal Ideation Questionnaire (ASIQ) were used to measure depression and suicidal ideation, respectively. Results: The results show that there was a weak and positive relationship between depression and suicidal ideation among university students (r=.22). A significant difference of depression was found between genders (p<.05), on the contrary no significant difference on suicidal ideation between genders (p>.05) Conclusion: This study helps in examining the relationship and difference in depression and suicidal ideation among university students. Female has higher depression than male counterpart due to poor control over emotion. In conclusion, as depression increases, the suicidal ideation also increases among university students.

Establishing the content validity of an online depression screening tool for South Africa

Depression is a global concern as with an estimated 300 million individuals worldwide experiencing depression. In South Africa, the prevalence rate of depression is estimated at 9.7% of the population. With the increase in mobile internet usage in South Africa, an online depression screening tool could provide opportunities for the screening of depression symptoms aiding access to mental health interventions. This project identified an open access tool for screening depression, the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R), and adapted it for online use by the adult South African population. This study followed on from the adaptation phase on the CESD-R and aimed to determine the content validity of the adapted CESD-R for online use in South Africa using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. The study followed a two-phased design. Study one utilised a qualitative approach, where 50 experts commented on the content validity of the tool. The results were used to further adapt the tool which resulted in a 20-item depression screening tool. Study two followed a quantitative design in order to establish the content validity in terms of determining the Content Validity Ratios, Item-Content Validity Index as well as the Kappa Statistic of the 20 items. Based on these statistics, 19 of the 20 items were retained. Overall, the adapted online depression screening tool displays good content validity and holds potential as a screening tool where access to mental health may be limited.

Lower sexual satisfaction in women with polycystic ovary syndrome and metabolic syndrome.

BackgroundPolycystic ovary syndrome (PCOS) is a multi-symptom disorder linked with a range of metabolic and hormonal disturbances. Psychological and sexual aspects of PCOS also need to be considered.Objective of the study This study aimed to assess sexual satisfaction (SS) in PCOS patients and eumenorrheic controls (CON). The relationships between SS, depressive symptoms, health-related quality of life (HRQoL), and hormonal and metabolic profiles were evaluated.Methods In this study, 190 patients with PCOS (mean age 26.34 ± 5.47 years) and 197 age-matched CON (mean age 27.12 ± 4.97 years) were enrolled. All subjects completed Polish version of the Sexual Satisfaction Questionnaire (SSQ), WHO Quality of Life-BREF (WHOQOL-BREF), and the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) questionnaire. Fasting blood samples were collected to assess hormonal, lipid, and glucose profiles. Anthropometric measures were collected. Metabolic syndrome (MS) was evaluated according to the IDF-AHA/NHLBI criteria.Results Patients with PCOS and MS had lower SS vs non-MS-PCOS. There were no significant differences in the level of SS, presence of depressive symptoms, or HRQoL between PCOS and CON (P > 0.05). Negative correlations were found between the SS level and BMI, waist circumference, and waist-to-height ratio in PCOS women. However, overweight or obese PCOS women did not differ in SS levels vs normal-weight PCOS patients. The social dimension of WHOQOL-BREF was the only significant predictor of SS in PCOS patients.Conclusions SS in PCOS women appears to be undisturbed. However, MS in PCOS patients could negatively influence SS. The level of SS should be assessed in PCOS women, especially if MS is present.

Feasibility, acceptability, and potential effectiveness of an online expressive writing intervention for COVID-19 resilience

Background & purposeThe COVID-19 pandemic has negatively impacted mental health in the general population. In this trial, our objective was to assess whether a 6-week expressive writing intervention improves resilience in a sample from the general population in the midst of the COVID-19 pandemic. Materials & methodsThis 6-week trial was conducted online. Eligible participants (n=63) were a sample of adults who self-identified as having been significantly affected by the COVID-19 pandemic. Primary outcomeConnor-Davidson Resilience Scale (CD-RISC). Secondary outcomesPerceived Stress Scale – 10-Item (PSS-10); Center for Epidemiologic Studies Depression Scale – Revised (CESD-R); Post-Traumatic Growth Inventory (PTGI). ResultsResilience measures (CD-RISC) increased from baseline (66.6 ± 14.9) to immediately post-intervention (73.0 ± 12.4; p=0.014; Cohen’s d =0.31), and at a 1- month follow-up (72.9 ± 13.6; p=0.024; Cohen’s d =0.28). Across the same timepoints, perceived stress scores (PSS-10) decreased from baseline (21.8 ± 6.6) to immediately post-intervention (18.3 ± 7.0; p=0.008; Cohen’s d =0.41), and at the 1- month follow-up to (16.8 ± 6.7; p=0.0002; Cohen’s d =0.56). Depression symptoms (CESD-R) decreased from baseline (23.3 ± 15.3) at 6 weeks (17.8 ± 15.4; p=0.058; Cohen’s d =0.22), and 10 weeks (15.5 ± 12.7; p=0.004; Cohen’s d =0.38). Posttraumatic growth (PTGI) increased from baseline (41.7 ± 23.4) at 6 weeks (55.8 ± 26.4; p=0.004; Cohen’s d =0.44), and at the 1-month follow-up (55.9 ± 29.3; p=0.008; Cohen’s d =0.49). ConclusionAn online expressive writing intervention was effective at improving resilience in the midst of the COVID-19 pandemic. NCT#NCT04589104