Center For Epidemiologic Studies Depression Research Articles

Depression and Incident Hypertension: The Strong Heart Family Study.

Compared with White Americans, American Indian adults have disproportionately high depression rates. Previous studies in non-American Indian populations report depression as common among people with uncontrolled hypertension, potentially interfering with blood pressure control. Few studies have examined the association of depressive symptoms with hypertension development among American Indians despite that population's high burden of depression and hypertension. We examined the association of depressive symptoms with incident hypertension in a large cohort of American Indians. We studied 1,408 American Indian participants in the Strong Heart Family Study, a longitudinal, ongoing, epidemiologic study assessing cardiovascular disease and its risk factors among American Indian populations. Depressive symptoms were assessed by using the Center for Epidemiological Studies-Depression (CES-D) scale, 2001-2003. At each study examination in 2001-2003 and 2007-2009, blood pressure was measured 3 times. The average of the last 2 measurements taken at baseline and follow-up examinations was used for analyses. Incident hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or use of hypertension medications at follow-up. To account for within-family correlation, we used generalized estimating equations to examine the association of depressive symptoms with incident hypertension. During follow-up, 257 participants developed hypertension. Participants with symptoms consistent with depression (CES-D ≥16) at baseline had 54% higher odds of developing hypertension during follow-up (OR = 1.54; 95% CI, 1.06-2.23) compared with those without depression (CES-D <16) at baseline after adjustment for other risk factors. These data suggest that participants who experienced symptoms consistent with depression were at increased odds of incident hypertension.

Association between maternal mental health and early childhood development, nutrition, and common childhood illnesses in Khwisero subcounty, Kenya.

Despite the significant public health burden of maternal mental health disorders in sub-Saharan Africa (SSA), limited data are available on their effects on early childhood development (ECD), nutritional status, and child health in the region. This study investigated the association between maternal mental health and ECD, nutritional status, and common childhood illnesses, while controlling for biological, social, financial, and health-related factors and/or confounders. As part of the Innovative Partnership for Universal and Sustainable Healthcare (i-PUSH) program evaluation study, initiated in November 2019, a cohort of low-income rural families, including pregnant women or women of childbearing age with children under five, was recruited for this study. A total of 24 villages were randomly selected from a list of villages near two health facilities. Following a census to identify eligible households, 10 households per village were randomly selected. Data collection included maternal mental health, assessed using Centre for Epidemiological Studies Depression (CES-D) scale, ECD, nutritional status (anthropometric measurements), and common childhood illnesses, their symptoms, and healthcare utilization. This study presents a cross-sectional analysis of the data drawn from endline survey of 299 target mothers and 315 children. The majority of the mothers were aged between 25 and 34 years. The mean age of children was 3.2 years, with 53% being male. The overall maternal mental health score, as measured by the CES-D scale, was 28. Children of mothers with higher CES-D scores exhibited poorer ECD domains, lower nutritional status indicators, and increased incidence of ill-health in the previous two weeks, in both unadjusted and adjusted analyses. Individual, parental, and household factors-including maternal age, household wealth index, and decision-making regarding child healthcare-were significantly associated with children's development, nutrition status, and health outcomes. Children of mothers with low mental health scores demonstrated suboptimal developmental outcomes, nutritional status, and overall well-being, particularly for those from impoverished households. These findings suggest that improving the socioeconomic conditions of low-income households is essential for promoting children's development, nutritional status, and well-being. Longitudinal studies are needed to further investigate the impact of maternal mental health on child development, nutrition, and health outcomes, considering additional factors across the maternal, newborn, and child health continuum. ClinicalTrials.gov (NCT04068571), AEA Registry (AEARCTR-0006089) and PACTR (PACTR202204635504887).

Bidirectional Associations Between Alcohol Drinking and Depressive Symptoms Among US Adults Aged 50 to 75: The US Health and Retirement Study.

Background/Objectives: Low or moderate alcohol drinking may reduce the risk of depression, but depression may induce alcohol drinking. However, the bidirectional associations between alcohol drinking and depression were inconsistent, and many prior analyses were not properly conducted. This study explored the within-individual bidirectional associations between alcohol drinking and depressive symptoms under a causal analytic framework. Methods: Using data for the baby boomer cohorts (born between 1948 and 1965) from the Health and Retirement Study (HRS), we employed the unit fixed-effect models with lagged measures to examine the within-individual bidirectional associations between the number of alcohol drinks per week and the changes in the eight-item Center for Epidemiological Studies-Depression (CES-D) scores. Results: Among 11,057 participants at baseline, about 48% were drinkers and 19% had a CES-D ≥4, i.e., at a high risk of depression. Among male low/moderate drinkers, increasing alcohol drinking between consecutive visits was significantly associated with a decrease in depression scores after adjusting for prior alcohol drinking (-0.15 points per 7 drinks/week increase, p = 0.009). Conversely, among male drinkers and female heavy drinkers, increasing depression scores between visits increased alcohol drinking after adjusting for prior depression scores (ranging from 0.22 to 0.79 drinks/week per 1 point increase of depression score, all p values < 0.01). Conclusions: The bidirectional associations between alcohol drinking and depressive symptoms were evident only among male drinkers, and alcohol drinking should not be recommended as a solution for preventing or relieving depressive symptoms. Limitations: Measures of alcohol drinking and depression were coarse, and the study cohorts were limited to the US baby boomer generation. Generalizing findings to other populations should be cautious.

DEPRESSIVE SYMPTOMS, SLEEP, AND QUALITY OF LIFE IN ADULTS WITH CHRONIC CONDITIONS

Abstract Physical, mental, and sleep problems threaten well-being; however, there is limited research on the temporal connections of these issues. We investigated the longitudinal associations among depressive symptoms, sleep disturbances, and quality of life (QoL) among middle-aged and older adults (aged 50+) with diabetes, hypertension, and/or cardiovascular disease in the United States. Participants (N=17,283) drawn from the Health and Retirement Study (HRS) reported at least one of these medical conditions, and data from the 12th (T1), 13th (T2), and 14th (T3) waves (2014-2018) was used. Depressive symptoms were assessed via a modified version of the 8-item Center for Epidemiological Studies-Depression (CES-D) scale (scores: 0-7). Sleep disturbance was measured using the 4-item Jenkins Sleep Scale (JSS) (scores: 2-6). QoL was evaluated through the 5-item Satisfaction with Life Scale (SWLS) (scores: 5-35). Within-person associations showed short-term reciprocal links: higher depressive symptoms predicted higher sleep disturbance (T2–T3: β=0.036, p&amp;lt; 0.05), and higher sleep disturbance predicted higher depressive symptoms (T2–T3: β=0.035, p&amp;lt; 0.01). Higher QoL predicted lower sleep disturbance (T2–T3: β=-0.076, p&amp;lt; 0.001), and higher sleep disturbance predicted lower QoL (T2–T3: β=-0.064, p&amp;lt; 0.001). Within-person associations also indicated a one-way association over time: higher depressive symptoms predicted lower QoL (T1–T2: β=-0.104, p&amp;lt; 0.001; T2–T3: β=-0.141, p&amp;lt; 0.001). Future studies should evaluate the dynamic nature of the associations over longer study periods while assessing the influence of mediators/moderators at different time points. Policies should prioritize integrating sleep, depression, and QoL programs/services into primary care due to their temporal associations among individuals with physical illnesses.

Acculturative Family Distancing and Depressive Symptoms Among Korean American Adolescents: The Mediating Role of Family Conflicts

AbstractThis study investigated the associations among acculturative family distancing in communication and values, family conflicts (parent-adolescent conflict, interparental conflict), and depressive symptoms and the mediating effects of family conflicts in the associations between acculturative family distancing in communication and values, and depressive symptoms in KA adolescents. Path analysis was used to analyze data from a cross-sectional survey of 339 Korean American adolescents (Mage = 14.99, SD = 1.67; 53% female) residing in New York City and New Jersey. Measurements include the Center for Epidemiologic Studies-Depression (CES-D) Scale, Acculturative Family Distancing Youth Report Scale (AFD-YR), the Family Conflicts Scale (FCS), and the Children’s Perception of Interparental Conflict Scale. All path coefficients for the final model were statistically significant. There were significant mediating effects of parent-adolescent conflict and interparental conflict on the associations between acculturative family distancing in communication and values and depressive symptoms. The study suggests acculturative family distancing may be a contextual risk factor for depressive symptoms among KA youth. Additionally, greater acculturative family distancing may erode the strength and quality of family relationships. One of the objectives of this study was to test the AFD theory which identifies more problematic dimensions of intergenerational acculturation gap that increase risk for family conflict. The findings of the current study not only support but also build on the AFD theory by examining its relationship to both interparental and parent-adolescent conflicts.

Changes in hippocampal volume and affective functioning after a moderate intensity running intervention

This study examined the effects of a moderately intense seven-week running intervention on the hippocampal volume and depressive symptoms of young men (20–31 years of age) from the general population (N = 21). A within-subjects-design involving a two-week baseline period before the running intervention, and two subsequent intervention cycles was applied. At four time points of assessment (t1: start of the study; t2: end of baseline period/start of the intervention; t3: end of the first intervention cycle; t4: end of the 2nd intervention cycle/study end) magnetic resonance imaging was performed and symptoms related to depression were assessed employing the Center for Epidemiological Studies Depression (CES-D) Scale. The intervention resulted in a significant increase in the estimated maximum oxygen uptake (VO2max), measured with a standardized walking test (average increase from 42.07 ml*kg− 1*min− 1 to 46.07 ml*kg− 1*min− 1). The CES-D scores decreased significantly over the course of the running intervention (average decrease from 12.76 to 10.48 on a 20-point scale). Significant volumetric increases in the hippocampus were found, most notably after the first intervention cycle in the left (average increase from 613.41 mm³ to 620.55 mm³) and right hippocampal tail (average increase from 629.77 mm³ to 638.17 mm³). These findings provide new evidence regarding the temporal dynamics of hippocampal changes following engagement in physical activity.

Association of COVID-19-related perceptions and experiences with depression and anxiety in Ugandan caregivers of young children with malaria and iron deficiency: A cross-sectional study.

Caregivers of young children may have been particularly vulnerable to mental health challenges during the COVID-19 pandemic due to its negative impacts on their housing, finances, and childcare demands. This study explored the associations between COVID-19-related experiences and symptoms of depression and anxiety among Ugandan caregivers. This cross-sectional study included 100 Ugandan caregivers of young children aged 6-59 months with uncomplicated malaria and iron deficiency (N = 85) and without malaria or anemia (N = 15) who were enrolled in the Optimizing Iron Status in Malaria-Endemic Areas (OptiM) study. Sociodemographic data and COVID-19 experiences were collected using an internally developed survey and symptoms of depression and anxiety were measured using the Hopkins Symptom Checklist (HSCL-25) and the Center for Epidemiologic Studies Depression (CESD-20) scale. Multiple linear regression models were used to assess the associations between COVID-19 survey scores with HSCL-25 or CESD-20 scores. Nearly half of caregivers reported clinically meaningful symptoms of depression (46%) and/or anxiety (49%). Caregivers had more severe symptoms of depression and/or anxiety if they experienced greater changes in living situations or decreases in physical activity (CESD-20: β = 3.35, 95% CI [1.00, 5.70], p = .01), food insecurity (HSCL-25: β = 3.25, 95% CI [0.41, 6.10], p = .03, CESD-25: β = 3.09, 95% CI [0.79, 5.39], p = .01), and domestic violence (HSCL-25: β = 3.82, 95% CI [0.94, 6.70], p = .01) during COVID-19. These associations did not vary depending on whether the caregivers had children with malaria. Negative COVID-19 experiences were significantly associated with more severe depression and anxiety in Ugandan caregivers, regardless of their children's malaria status. Urgent attention and action are needed to support the mental well-being of this vulnerable population. Further prospective studies should investigate the long-term impact of COVID-19 on caregivers and their children.

Cross-national statistical harmonization of the Center for Epidemiologic Studies Depression (CES-D) Scale among older adults in China, England, India, Mexico, South Africa, and the United States

We examined differential item functioning (DIF) of the Center for Epidemiologic Studies-Depression Scale (CES-D) items by country and statistically harmonized common cross-national factor scores for the CES-D to aid further cross-national research. Data were from Harmonized Cognitive Assessment Protocol (HCAP) studies in China (N=9,639), England (N=1,262), India (N=4,048), Mexico (N=1,918), South Africa (N=631, and the US (N=3,321). Multiple indicators, multiple causes models (MIMIC) were estimated to test DIF in the CES-D items by country. DIF items were defined as having an Odds Ratio (OR) outside the range of 0.75-1.25 in MIMIC. We evaluated DIF impact and identified salient DIF by examining whether difference between DIF adjusted factor scores and non-DIF adjusted factor scores over a threshold of 0.30 SD units. Confirmatory factor analysis was used to create DIF-adjusted, cross-nationally harmonized CES-D factor scores. Controlling for underlying depressive symptoms, HCAP participants in India had higher odds of reporting being not hopeful about future (OR=1.38, 95% CI: 1.34-1.42), not enjoying life (OR=1.43, 95% CI: 1.38-1.48), and being unhappy (OR=1.29, 95% CI: 1.25-1.34), compared to HCAP participants in the US. These identified DIF items artificially increased mean harmonized CES-D factor scores by 0.48 standard deviation (SD) units in the India HCAP, with over 50% of the factor scores increased by over 0.30SD, indicating salient DIF in the India HCAP. Our findings demonstrate cross-national heterogeneity on the expression of depressive symptoms. We provide DIF-adjusted CES-D factor scores to improve the quality of cross-national comparisons in aging research.

Are depressive symptoms associated with biological aging in a cross-sectional analysis of adults over age 50 in the United States.

Major depressive disorder accelerates DNA methylation age, a biological aging marker. Subclinical depressive symptoms are common, but their link to DNA methylation aging in older adults remains unexplored. This study analyzed the cross-sectional relationship between depressive symptoms and accelerated DNA methylation aging, considering gender and race/ethnicity in U.S. adults aged over 50. We used data from 3,882 diverse participants in the 2016 Health and Retirement Study wave, measuring blood DNA methylation age against chronologic age for acceleration. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Multiple linear regression evaluated the association between depressive symptoms and DNA methylation age acceleration, adjusting for sociodemographic factors, blood cell proportions, and health behaviors (physical activity, alcohol use, smoking, and chronic conditions). Gender and race/ethnicity modifications were also tested. Depressive symptoms, measured by continuous CES-D score, high depressive symptoms (CES-D ≥ 4), or any symptoms (CES-D ≥ 1), significantly correlated with increased GrimAge DNA methylation age acceleration (all p ≤ .001) in unadjusted and sociodemographic-adjusted models but were nonsignificant in fully adjusted models. No significant gender or race/ethnicity effect modifications were found in fully adjusted models. Health behaviors significantly influence DNA methylation age acceleration and depressive phenotypes, underscoring the need to understand their roles in assessing psychological factors related to DNA methylation age acceleration. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Bidirectional longitudinal associations between subjective oral health and subjective well-being.

This study investigated the bidirectional longitudinal association between subjective oral health (SOH) and subjective well-being (SWB) over time. This cohort study was based on a four-wave surveys conducted by the English Longitudinal Study of Aging. SOH was measured by oral impacts on daily performance (OIDP), self-rated oral health (SROH), and SWB was measured by the Center for Epidemiologic Studies-Depression (CES-D) scale, Control, Autonomy, Self-Realization, and Pleasure (CASP-19), and satisfaction with life scale (SWLS). To evaluate the bidirectional associations between SOH and SWB, separate models were created using SOH and SWB as the outcome and exposure, respectively. Additionally, the synchronous and lagged effects of exposure on outcomes were checked by employing exposures measured at different time points. A generalized estimating equation model was fitted, including the exposure variables, outcome variables in the previous wave, and baseline covariates. Among 4,510 participants (mean age=61.7 years [1SD=7.9], men=43.1 %), 8.1 %, 18.2 %, 14.3 %, 30.5 %, and 25.0 % had poor SOH and SWB as measured by OIDP, SROH, CES-D, CASP-19, and SWLS at baseline, respectively. The results of the regression models with all combinations of SOH and SWB measures showed that poor conditions of SOH or SWB were significantly associated with poor conditions of the other measures (all p < 0.05). In almost all combinations of SOH and SWB measures, the synchronous effect was stronger than the lagged effect. SOH and SWB are closely linked, and comprehensive care that considers oral health could contribute to well-being later in life.

Depression, a Hidden Co-Morbidity in Patients of Chronic Ailments; An Outpatient-Based Study

Objective: To identify the rate of depression among patients with chronic diseases attending outpatient clinics. Methodology: This cross-sectional study was conducted at the Department of Medicine in a Tertiary care Hospital, Rawalpindi, from December 2023 to May 2024. A total of two hundred and forty-six patients visiting the outpatient department (OPD) were chosen through consecutive sampling, adhering to specific exclusion and inclusion criteria. All participants provided informed written consent. Demographic data, information on comorbidities, and clinical and laboratory details were collected. The (CESD-10) scale “Center for Epidemiologic Studies Depression” was utilized to evaluate depression. Results: Among the 246 patients with chronic ailments in the medical OPD, 115 were male, and 131 were female. Depression was prevalent in 57 (86.4%) cases of diabetes mellitus (p-value 0.014), 37 (61.7%) cases of hypertension (p-value 0.005), 40 (64.5%) cases of chronic kidney disease (p-value 0.024), and 51 (87.9%) cases of asthma (p-value 0.010). Conclusion: Patients with chronic ailments are more susceptible to depression, highlighting the importance of considering this comorbidity in their treatment plans.

Social Isolation and Loneliness in Varied Levels of Cognition Among Racially/Ethnically Diverse Older Americans

AbstractBackgroundSocial isolation and loneliness affect 20%‐30% of older Americans, increasing their risk of depression, admission to nursing homes, early disability, and mortality. This study examines the association of social isolation and loneliness with cognitive impairment‐not‐dementia (CIND) and dementia among racially/ethnically diverse older Americans.MethodWe analyzed data from the Health Retirement Study (2020 interviews) using logistic regression analyses with cognition as a response. Our sample consisted of 2,625 participants (age &gt; 64). Measures included the 27‐item HRS cognition scale, five‐item social isolation scale, UCLA loneliness scale, and Center for Epidemiological Studies Depression scale.ResultThe characteristics of our sample were: mean age of 75.5 years, Blacks (16%), Hispanics (11.4%), women (59%), College educated (55%), and residing in rural areas (26.3%). Participants who experienced loneliness were 40% more likely to have cognitive impairment and 20% more likely to have dementia. The likelihood of having cognitive impairment was 20% higher among socially isolated participants than those without social isolation. However, there was no significant association between social isolation and dementia. The relationship of depressive symptoms with CIND or dementia was also non‐significant. Black participants were about seven times more likely to have CIND and two times more likely to have dementia than Whites. Hispanic participants had nearly three times higher risk of CIND than non‐Hispanics, but their risk of dementia was non‐significant. Further interaction analyses showed no statistically significant difference in social isolation or loneliness with CIND or dementia risk by race or ethnicity. The odds of having CIND were significantly higher in men (20%) than women and in rural participants (31%) than urban participants. Conversely, the association of gender groups or rurality with dementia was non‐significant. The risk of CIND and dementia was significantly less in participants with a high school degree and above.ConclusionThese findings support research on the importance of social connectedness in cognitive aging. Further investigation into temporal trends in social isolation and loneliness regarding the changes in cognitive trajectories is needed.

Traumatic life events as predictors for depression in middle-aged men and women: A Finnish twin study

BackgroundWe examined exposure to adulthood traumatic life events (TLEs) and their associations with depression in women and men. Then we examined whether those associations are independent of exposure loading and vulnerability including familial confounding. MethodsThe fourth survey in 2011 of the population-based Finnish Twin Cohort had 8410 participants (45 % men, mean age 60 years). Using the Center for Epidemiologic Studies Depression (CES-D) scale, depression was defined using a cut-off value ≥20. Participants reported exposure to TLEs during adulthood. Logistic regression adjusted for multiple covariates was used as the individual-based analyses. Familial confounding was tested using conditional logistic regression in 399 twin pairs discordant for depression. ResultsMore women (15 %) than men (11 %) were depressed. Men reported more traffic accidents (men: 11.8 %, women: 7.4 %), other serious accidents (11.8 %, 5.8 %), and violent crime (3.1 %, 2.0 %) whereas women reported more sexual assault (0.7 %, 10.6 %). Violent crime (Odds Ratio 3.86; 95 % Confidence Intervals 2.59, 5.73), sexual assault (3.49; 2.67, 4.55), physical assault (3.10; 2.45, 3.93), and other serious accidents (1.36; 1.01, 1.85) were associated with depression. These associations, except other serious accidents, remained significant after adjusting for multiple covariates including shared familial factors. The associations did not differ by sex. LimitationsA relatively small set of relevant TLEs was reported retrospectively and the order of TLEs was not assessed. ConclusionsWomen and men differ in exposure to TLEs but, if exposed, they are equally vulnerable for depression. Because traumatic life events are robustly associated with depression, they should be considered in treatment.

The relationship between asthma and suggested alcohol dependence and heavy alcohol use in the Cooper Center Longitudinal Study: The role of depressive symptom severity

BackgroundAsthma appears to be associated with a variety of psychiatric illnesses including depression and alcohol use disorder. The current study examined the relationship between asthma, heavy alcohol intake and suggested alcohol dependence controlling for depressive symptom severity. MethodsData from 37,625 adult patients at the Cooper Clinic who enrolled in the Cooper Center Longitudinal Study, completed a medical history questionnaire including information on asthma, depressive symptoms and alcohol use were used. The association between lifetime asthma and heavy alcohol intake, while accounting for depressive symptoms (10-item Center for Epidemiological Studies-Depression (CESD)), and demographic variables was examined employing logistic regression with heavy alcohol intake (yes/no) as the outcome. Logistic regression was similarly utilized to examine the association between asthma and suggested alcohol dependence (CAGE scores ≥2: yes/no) among current drinkers (n = 29,235). ResultsMultivariable analysis revealed no significant association between asthma and heavy alcohol consumption with or without controlling for CES-D scores. Asthma was, however, associated with higher odds for suggested alcohol dependence (OR 1.18, 95 % CI 1.07, 1.31), which was attenuated but still significant when controlling for CES-D scores. ConclusionAsthma was associated with higher risk for suggested alcohol dependence while current heaving drinking risk was not increased. The suggested drinking findings were slightly less strong when controlling for CES-D scores. The differences between current heavy drinking and CAGE findings might be due to differences in perception of problematic drinking by people with asthma or the timeframe of the assessments (current for drinking, lifetime for CAGE).

Exploring Traits Associated With Central Sensitization Features in Patients With Chronic Cough.

The concept of cough hypersensitivity suggests that central sensitization plays a role in the pathophysiology of chronic cough. However, it remains unclear which traits are associated with central sensitization features in patients with chronic cough. A cohort of 317 Korean patients with newly referred chronic cough underwent clinical evaluations. The Central Sensitization Inventory (CSI), a questionnaire originally developed as a screening tool to identify patients with Central Sensitization Syndrome, was also administered. Other patient-reported outcomes (PROs), such as the cough severity visual analogue scale, Leicester Cough Questionnaire (LCQ), Cough Hypersensitivity Questionnaire (CHQ), and the Center for Epidemiological Studies Depression (CES-D) scale, were also administered. Follow-up assessments were conducted one month later. At baseline, the presence of CSI scores of ≥ 40 was associated with being female (89.6% vs. 63.4%; P < 0.001), older age, concomitant symptoms, and cough-related complications. CSI scores correlated with PRO scores, including LCQ (r = -0.424, P < 0.001), CHQ (r = 0.373, P < 0.001), and CES-D (r = -0.660, P < 0.001). Their patterns of correlations were similar in the 1-month longitudinal follow-up data analysis. In conclusion, CSI scores in patients with chronic cough correlated with cough-specific and depression-related PROs, suggesting the potential relevance of central sensitization in certain phenotypes of chronic cough.

Sex-Specific Association of Low Muscle Mass with Depression Status in Asymptomatic Adults: A Population-Based Study.

The objective of this study was to examine the correlation between low muscle mass (LMM) and depression, with a specific focus on identifying the sex-specific relationship between LMM and depression in a large sample. This population-based cross-sectional study involved 292,922 community-dwelling adults from 2012 to 2019. Measurements were taken using the Center for Epidemiological Studies Depression (CESD) scale and body composition analyses. Depression was defined as a CESD score ≥ 16, and severe depression as a CESD score ≥ 22. LMM was defined as an appendicular muscle mass/height2 below 7.0 kg/m2 in men and below 5.4 kg/m2 in women. Sex-based multivariable logistic regression analyzed the LMM-depression association, adjusting for confounders, with depression status and severe depression status as dependent variables. Both men and women in the LMM group had an increased odds of depression (men, adjusted odds ratio = 1.13 [95% confidence interval = 1.03-1.12]; women, 1.07 [1.03-1.23]) and severe depression (men, 1.20 [1.05-1.36]; women, 1.10 [1.04-1.15]) compared to those in the control group. Men showed a stronger association between LMM and the presence of depression (p for interaction = 0.025) and the presence of severe depression (p for interaction = 0.025) compared to women. Decreased muscle mass was independently associated with increased chances of depression and severe depression in both sexes, with a significantly stronger association in men compared to women. This highlights the potential significance of LMM as a predictor of depression, particularly in men.

A mindfulness-based intervention for Substance Use Disorder in a Brazilian vulnerable population: a feasibility mixed method study.

Substance Use Disorder (SUD) is a chronic condition that impacts various facets of an individual's life, and society as a whole. The Mindfulness-Based Relapse Prevention (MBRP) protocol is an innovative intervention that can help to prevent relapse, particularly when used as a post-treatment approach. However, although there is significant evidence of its effectiveness in studies from high-income countries (HICs), there is a dearth of studies examining its feasibility and efficacy in low- and middle-income countries (LMICs). Thus, this study investigates the feasibility of MBRP as an adjunct to outpatient treatment for SUD in a socially vulnerable Brazilian population. The study employed a mixed-methods design in eight Psychosocial Care Centers for Alcohol and Drugs (CAPS-ad) in the city of São Paulo, and involved 140 participants, 24 healthcare professionals and 7 CAPS-ad managers. In total, 17 MBRP intervention groups were conducted. The study assessed qualitative indicators of acceptability, demand, implementation, adaptation, integration, and limited efficacy testing through group interviews, in-depth interviews and field diary records. It also included limited efficacy testing of the protocol using a quantitative pre-post pilot study to investigate consumption behavior, using the Timeline Followback (TLFB) assessment method; depression, using the Center for Epidemiologic Studies Depression (CES-D) scale; anxiety, using the state trait anxiety index (STAXI-2); craving, using the Penn Alcohol Craving Scale (PACS); readiness to change, using the Readiness-to-Change Ruler (RCR); and severity of dependence, using the Severity of Dependence Scale (SDS). The qualitative data were triangulated with the quantitative data to comprehensively evaluate the feasibility of the intervention. The sample comprised socially vulnerable participants with a high dropout rate, primarily due to social factors. Despite facing challenges in respect of regular engagement and initial cultural misperceptions of meditation, the intervention showed positive acceptance and mental health benefits, including impacts on consumption behavior. The study emphasizes the importance of adapting the format of the protocol to better suit vulnerable populations, and to ensure its effective integration into the public healthcare system. Future research should explore protocol modifications, assess its effectiveness in different contexts, and conduct cost-benefit analyses for broader implementation.

The effect of depression on the outcome of infertile females underwent the first In Vitro Fertilization procedure

Background: Infertility affects married adults, and In Vitro Fertilization (IVF) is an Assisted Reproductive Technology (ART) that can treat it. Women undergoing IVF are more likely to experience depression. There is a need to reduce depression by supporting and advising sufferers. The aim of this study is to evaluate the effect of depression on pregnancy rates among infertile females underwent IVF treatment. Materials and Methods: This observational study analyzed 149 patients attending the infertility center at Kamal Al-Samaraie hospital seeking a chance of a conception. The participants received a traditional hospital protocol. The study assessed depression status using the CES-D (Center for Epidemiologic Studies Depression) scale at the beginning of the IVF cycle. Results: Conclusion: Our findings show that the pregnancy rate was not related to baseline depression of women underwent the first IVF procedure. .

Depression and its risk factors in a conflict-affected population: findings from a nationwide survey

Abstract Introduction The impact of armed conflict and war on mental health is well documented, with limited data on populations living in unrecognized states. In this study, we examined the prevalence and risk factors of symptoms of depression among the Nagorno-Karabakh population during a ceasefire period, prior to a blockade, full-scale military attack, and their forced displacement. Methods A total of 1023 women, aged 18-49 years, from all regions of Nagorno-Karabakh, participated in a population-based household survey in 2022, which included the Center for Epidemiologic Studies-Depression (CES-D) 16-item scale to assess their depression symptoms. Simple and multivariable linear regression analyses explored the socio-demographic factors associated with CES-D score. Results The mean CES-D score was 8.90 (SD = 8.93), and 13.1% of the respondents had a score &amp;gt;18 (presence of depressive symptoms). The adjusted linear regression showed that CES-D score was higher among divorced (2.66, SE = 1.15, p-value=0.021) or widowed (3.09, SE = 1.57, p-value=0.049) vs. married, and among those having war-related deaths in the household in the previous 2 years (8.60, SE = 1.65, p-value&amp;lt;0.001) vs. not having. Conversely, a vocational/university level (-2.33, SE = 0.70, p-value=0.001) or post-graduate education (-3.81, SE = 1.72, p-value=0.027) vs less than secondary/secondary level, and 3-5 members in the household (-2.71, SE = 1.16, p-value=0.020) vs.1-2 members were significantly associated with lower CES-D score. Conclusions Our findings suggest that depression symptoms are highly prevalent among women in conflict-affected areas, with specific socio-demographic factors increasing the risk of depression symptoms. These results highlight the importance of providing mental health support and interventions for women in conflict-affected areas, particularly for those who experienced loss in the family due to war, are divorced or widowed, live in small households, and have lower education. Key messages • Depression symptoms are highly prevalent among women of reproductive age in areas affected by armed conflict and war. • Mental health intervention is recommended for women in conflict-affected areas who experienced loss due to war, are divorced or widowed, live in small households and/or have lower education.

Longitudinal association of homocysteine with depressive and anxiety symptoms among urban adults: healthy aging in neighborhoods of diversity across the life span study.

Longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults remain under-studied, especially across sex, race and levels of anxiety. We examined longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults, before and after stratifying by sex, race and anxiety level, using data from 1460 Healthy Aging in Neighborhoods of Diversity across the Lifespan Study (HANDLS) participants aged 30-64 y at v1 (2004-2009), followed across 3 visits up to 2017. In addition to LnHcyv1, we used group-based trajectory models predicting z-transformed likelihood of greater LnHcy with age (Hcytraj). Total and domain-specific depression symptoms were scored using Center for Epidemiologic Studies Depression (CES-D) scale. Mixed-effects linear regression models and Cox proportional hazards models were utilized. A positive association was found between baseline LnHcyv1 and CES-D total scores in reduced socio-demographic- adjusted Model 1 (β (standard error [SE]) = + 2.337 (0.902), P = 0.010), a relationship slightly attenuated in fully adjusted Model 2 (Model 1 adjusting for lifestyle and health factors) with a β (SE) = + 1.825 (0.883), P = 0.039. Individuals with lower anxiety levels experienced faster CES-D domain 2 score annualized increase over time (interpersonal problems) with higher LnHcyv1 (β (SE) = 0.041 (0.018), P = 0.024). Hcytraj was linked to incident elevated depressive symptoms (CES-D total score ≥16) overall (fully adjusted model: HR = 1.09, 95% CI: 1.03-1.14, P = 0.001), particularly among women and those living in poverty. Baseline and "high trajectory" of LnHcy were positively associated with depressive symptoms and elevated depressive symptom incidence, in a sex-, race-, poverty status- and anxiety-level specific manner.