Center For Epidemiologic Studies Depression Research Articles

Depressive symptoms over the final menstrual period: Study of Women's Health Across the Nation (SWAN)

BackgroundWomen may be vulnerable to elevated depressive symptoms during the menopause transition (MT). Studies generally have not considered premenopausal depressive symptom history or examined symptoms in relation to the final menstrual period (FMP). ObjectiveTo identify specific time points in relation to the FMP when depressive symptoms increase or decrease. MethodsParticipants were 1582 multiracial/ethnic women from the longitudinal Study of Women's Health Across the Nation (SWAN). Biological, psychosocial, and depressive symptom data were collected approximately annually. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CESD) scale. ResultsWomen with high baseline depressive symptoms (CES-D > 16) declined in symptoms (M = −1.04/yr., 95 % CI = -1.58, −0.50) until 4 years before the FMP, followed by a smaller decrease (M = −0.50/yr., 95 % CI = −0.72, −0.28) until 18 months after the FMP. Depressive symptoms increased (M = 0.21/yr., 95 % CI = 0.11, 0.30) in those with low baseline symptoms until 1 year before the FMP, and decreased (M = -0.06/yr., 95 % CI = −0.11, −0.008) going forward. Greater social support, higher levels of follicle stimulating hormone and estradiol, and less sleep disturbance contributed to greater decline in depressive symptoms among those with high baseline depressive symptoms. Anxiety, experiencing stressful life events, lower body mass index, and poor role-physical function contributed to an increase in depressive symptoms among those with low baseline symptoms. LimitationsExcluded women had higher baseline CES-D scores. Lacked pre-MT depression for pre/early perimenopausal women at baseline. ConclusionAccounting for baseline depressive symptom level and focusing on the FMP more precisely characterize depressive symptom change over the MT.

Continued Homelessness and Depressive Symptoms in Older Adults

Depression is common in adults experiencing homelessness. It is unclear whether continued homelessness is associated with more depressive symptoms. To examine the association between residential status and depressive symptoms in adults aged 50 years or older experiencing homelessness at study entry. This cohort study analyzed results from the Health Outcomes of People Experiencing Homelessness in Older Middle Age (HOPE HOME) project, which in 2013 began enrolling adults aged 50 years or older experiencing homelessness in Oakland, California, and conducted structured interviews every 6 months for a mean duration of 5.5 years through 2023 (for this cohort study). Eligible participants included those aged 50 years or older, able to speak English, and experiencing homelessness at enrollment. We analyzed data collected from 2013 to 2023. The exposure of interest was residential status. At follow-up visits, residential status was categorized as (1) homelessness (meeting the HEARTH [Homeless Emergency Assistance and Rapid Transition to Housing] Act definition) or (2) housed (living in a noninstitutional environment and not meeting the HEARTH Act definition). The primary outcome was moderate to severe depressive symptoms (with Center for Epidemiologic Studies-Depression [CES-D] scale score ≥22). The augmented inverse probability of treatment weighting (AIPTW) approach was used to examine the association between continued homelessness and depressive symptoms. The AIPTW adjusted for the following variables: number of chronic health conditions, age, sex, visiting a health care practitioner, receiving outpatient mental health treatment, receiving mental health medication, exposure to abuse, substance use disorder, and binge drinking. The cohort was composed of 450 participants, of whom 343 (76.2%) were males, and the mean (SD) age was 58.5 (5.2) years. Participants completed a median (IQR) of 8.9 (8-11) follow-up visits. With 1640 person-years of observation time, participants continued homelessness for 880 person-years (57.1%) and experienced being housed for 715 person-years (44.3%). Many participants (304 [78.0%]) were housed during at least 1 follow-up visit. The odds of a CES-D scale score of 22 or higher was significantly higher among participants who continued experiencing homelessness than among housed participants (marginal causal odds ratio, 1.08; 95% CI, 1.04-1.11; P < .001). This cohort study found that continued homelessness was associated independently with increased odds of depressive symptoms. Obtaining housing may have a favorable role in depression and overall well-being of older adults experiencing homelessness and may be considered as a mental health intervention.

Daily Vinegar Ingestion Improves Depression and Enhances Niacin Metabolism in Overweight Adults: A Randomized Controlled Trial.

Depressive disorders are the most prevalent mental health conditions in the world. The commonly prescribed antidepressant medications can have serious side effects, and their efficacy varies widely. Thus, simple, effective adjunct therapies are needed. Vinegar, a fermented acetic acid solution, is emerging as a healthful dietary supplement linked to favorable outcomes for blood glucose management, heart disease risk, and adiposity reduction, and a recent report suggests vinegar may improve symptoms of depression. This randomized controlled study examined the 4-week change in scores for the Center for Epidemiological Studies Depression (CES-D) questionnaire and the Patient Health Questionnaire (PHQ-9) in healthy overweight adults ingesting 2.95 g acetic acid (4 tablespoons vinegar) vs. 0.025 g acetic acid (one vinegar pill) daily. A secondary objective explored possible underlying mechanisms using metabolomics analyses. At week 4, mean CES-D scores fell 26% and 5% for VIN and CON participants respectively, a non-significant difference between groups, and mean PHQ-9 scores fell 42% and 18% for VIN and CON participants (p = 0.036). Metabolomics analyses revealed increased nicotinamide concentrations and upregulation of the NAD+ salvage pathway for VIN participants compared to controls, metabolic alterations previously linked to improved mood. Thus, daily vinegar ingestion over four weeks improved self-reported depression symptomology in healthy overweight adults, and enhancements in niacin metabolism may factor into this improvement.

Biomarkers Associated with Depression Improvement in Veterans with Gulf War Illness Using the Low-Glutamate Diet.

Gulf War Illness (GWI) is a chronic multi-symptom neurological disorder affecting veterans of the Gulf War that is commonly comorbid with depression. A secondary data analysis was conducted to examine serum homocysteine and inflammatory cytokines (IFN-γ, IL-6, IL-1β, TNF-α) as potential biomarkers of depression improvement among veterans with GWI after a one-month dietary intervention aimed at reducing excitotoxicity and increasing micronutrients. Analyses, including multiple linear and logistic regression, were conducted in R studio. Dietary adherence was estimated using a specialized excitotoxin food frequency questionnaire (FFQ), and depression was measured using the Center for Epidemiologic Studies Depression (CES-D) scale. After one month on the diet, 52% of participants reported a significant decrease in depression (p < 0.01). Greater dietary adherence (FFQ) was associated with increased likelihood of depression improvement; OR (95% CI) = 1.06 (1.01, 1.11), (p = 0.02). Reduced homocysteine was associated with depression improvement after adjusting for FFQ change (β = 2.58, p = 0.04), and serum folate and vitamin B12 were not mediators of this association. Reduction in IFN-γ was marginally associated with likelihood of depression improvement (OR (95% CI) = 1.11 (0.00, 1.42), (p = 0.06)), after adjustment for potential confounders. Findings suggest that homocysteine, and possibly IFN-γ, may serve as biomarkers for depression improvement in GWI. Larger trials are needed to replicate this work.

Childhood Sexual Abuse and Compulsive Sexual Behavior Among Men Who Have Sex with Men Newly Diagnosed with HIV.

Childhood sexual abuse (CSA) continues to be a public health challenge. The prevalence of experiencing CSA is higher among men who have sex with men (MSM) than the general population. CSA has been linked to compulsive sexual behavior (CSB) among varying populations but has not been examined among MSM who were newly diagnosed with HIV. Therefore, the aims of this study were to assess the direct association between CSA and CSB among newly diagnosed MSM living with HIV, and to identify the potential mediating roles of depressive symptoms and emotion regulation in the association between CSA and CSB. The study was a secondary data analysis using data obtained from 2012 to 2017 from two community HIV clinics in New York City (n = 202). CSA was operationalized with questions asking about sexual abuse during childhood/adolescence. CSB was measured using the 13-item Compulsive Sexual Behavior Inventory (CSBI). Depressive symptoms were measured using the 20-item Centers for Epidemiologic Studies Depression (CES-D) scale and emotion regulation was measured using a 36-item Difficulties in Emotion Regulation Scale (DERS). Path analysis was conducted to determine the mediating role of depressive symptoms and emotion regulation in the association between CSA and CSB. There was a statistically significant association between CSA and CSB (β = 0.160; p = 0.019). There were statistically significant indirect associations between CSA, depressive symptoms, emotion regulation, and CSB (depressive symptoms β = 0.0.071; p = 0.010; DERS: β = 0.080; p = 0.006). Depressive symptoms were also correlated with emotion regulation (r = 0.596; p < 0.001). The relationship between CSA and CSB was significantly mediated by depressive symptoms and emotion regulation. Trauma-informed interventions addressing depressive symptoms and difficulties in emotion regulation may help to reduce CSB among MSM living with HIV.

Malnutrition and Its Determinants among Older Adults Living in French Caribbean Nursing Homes: A Cross-Sectional Study.

This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in French Caribbean nursing homes. This cross-sectional study was taken from the KASEHAD (Karukera Study of Ageing in EHPAD) study. Nutritional status was assessed with the Mini Nutritional Assessment Short-Form (MNA-SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies-Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted were performed to test the association between nutritional status and both socio-demographic variables and geriatric scales. A total of 332 older adults from six nursing homes were included in the KASEHPAD study. Among the participants, 319 had an MNA-SF score. The mean age was 81.3 ± 10.6 years, and half of the participants were men. The frequency of malnutrition (MNA-SF ≤ 7) was 27.6% (95% confidence interval (CI): 22.0-32.5) (n = 88). Based on the multivariable analysis, a low MMSE was associated with malnutrition (OR: 0.81 (0.68-0.92); p = 0.015) and there was a borderline significant link between a higher CESD score and malnutrition (OR: 1.05 (1.00-1.12); p = 0.07). Cognitive decline and a tendency toward depression were associated with malnutrition in nursing homes in the French West Indies. Although this study cannot establish causal relationships, the identification of these three geriatric syndromes in nursing homes is crucial for preventing adverse health events.

Organophosphate ester flame retardant chemicals and maternal depression during pregnancy

BackgroundDepression substantially contributes to pregnancy-related morbidity, and pregnancy is increasingly recognized as a vulnerable window for exposure effects on maternal mental health. Exposures to organophosphate esters (OPEs) are ubiquitous and may have neurotoxic effects; however, their impacts on prenatal depression remain unknown. We evaluated associations of third trimester OPE metabolites on maternal depressive symptoms during pregnancy. MethodsThis study included 422 participants in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort, a prospective pregnancy cohort of primarily low-income and Hispanic participants residing in Los Angeles, California. We measured concentrations of nine OPEs in third trimester spot urine samples (mean gestational age = 31.5 ± 2.0 weeks). Using the Center for Epidemiologic Studies-Depression (CES-D) scale, we classified participants as having probable depression during pregnancy (N = 137) or not (N = 285) if one or more CES-D scores administered at each trimester met the suggested cutoff score for clinically significant depressive symptoms (≥16). We estimated associations of prenatal OPE metabolite concentrations in tertiles and risk of prenatal depression using modified Log-Poisson regression. We examined associations of the OPE mixture on depression during pregnancy using Bayesian kernel machine regression (BKMR). ResultsParticipants with the highest tertiles of DPHP and BDCIPP exposure had a 67% (95% CI: 22%, 128%) and 47% (95% CI: 4%, 108%) increased risk of maternal depressive symptoms during pregnancy, respectively. No associations between other OPE metabolites and maternal depression symptoms were observed. In mixture analyses, we observed a positive and linear association between higher exposure to the OPE metabolite mixture and odds of prenatal maternal depression, primarily driven by DPHP. ConclusionsOur findings provide new evidence of associations between frequently detected OPE metabolites on maternal depression symptoms during pregnancy. Results could inform future intervention efforts aimed at reducing perinatal maternal depression.

Longitudinal trajectories and associated risk factors of paternal mental illness in the nine years surrounding the transition to fatherhood

BackgroundThe arrival of one's first child is a known risk factor for mental illness, yet investigations on fathers' mental health are limited. We conducted a longitudinal investigation on paternal depression and anxiety in the nine years surrounding the transition to fatherhood. MethodsUsing a national cohort of French men (CONSTANCES, n = 6299), we investigated the prevalence and associated risk factors of mental illness amongst first-time fathers. Responses to the Center for Epidemiological Studies Depression (CES-D) and 12-item General Health Questionnaire (GHQ-12) scales were used to identify clinically significant symptom scores. Self-declared mental illness was also reported by participants. Group-based modelling was used to identify latent trajectory groups for both measures. ResultsLevels of self-declared anxiety (averaging 4.9 % pre-fatherhood, 7.8 % post) exceeded that of depression (1.9 % pre- fatherhood, 3.3 % post) or other disorders. However, rates of clinically significant symptom scores (17–27 %) were consistently higher. Participants' mental health appeared to worsen from two-years prior to their child's arrival and improve from two-years after. We identified three trajectory groups for fathers' self-declared mental illness: Low stable (90.3 %); Low risk with high temporary increase (5.6 %); and Consistent high risk (4.1 %). Risk factors associated with worsening mental health trajectories were unemployment, not living with one's partner, having had adverse childhood experiences and foregoing healthcare due to financial reasons. LimitationsAll measures of mental illness relied on participant self-reports and are thus subject to bias. ConclusionsThis study reveals an important period of heightened psychological vulnerability amongst first-time fathers, emphasising the need for increased and better adapted paternal mental health screening.

Sociodemographic Factors, Health-Risk Behaviors, and Chronic Conditions Are Associated with a High Prevalence of Depressive Symptoms: Findings from the Indonesian Family Life Survey-5

Depression is a significant public health challenge. However, limited research exists regarding the risk of sociodemographic factors, health-risk behavior, and chronic conditions in relation to the development of depression in Indonesia. This study assesses the prevalence of depressive symptoms in adolescents and adults, and identifies its potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions. A national cross-sectional population-based survey was performed, using the Indonesian Family Life Survey (IFLS-5), to assess depressive symptoms in respondents aged 15 years and older. Depression was evaluated using the Center for Epidemiologic Studies-Depression (CES-D) scale, and potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions were examined using logistic regression analysis. The study revealed a high prevalence of depressive symptoms, with the highest incidence observed in the age group of 25–34 years. Factors such as unmarried status, younger age, good physical activity, and having chronic conditions showed associations with depression. These findings have implications for developing public mental health strategies to reduce the prevalence of depression in Indonesia.

Associations Between Early-Pregnancy Vitamin D Status and Postpartum Depressive and Anxiety Symptoms.

Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations. In 2483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks' gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30-49.9 nM), sufficient (50-79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum. After adjustments for confounders, vitamin D deficiency was only associated with increased postpartum anxiety symptoms ( B = 0.17, 95% confidence interval [CI] = 0.03-0.30, p = .017) compared to normal vitamin D levels (≥80 nM). In women not taking vitamin D supplementation ( n = 2303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms ( B = 0.14, 95% CI = 0.03-0.28, p = .045; and B = 0.17, 95% CI = 0.03-0.32, p = .015). Antepartum CRP did not mediate these links. We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.

Associations between sarcopenia and depression in middle-aged and older adults: the moderating effect of smoking

The aim of this study were to estimate associations of sarcopenic status with depressive symptoms. We used mixed-effects linear model to estimate longitudinal association between sarcopenic status and rate of change in 10-item Center for Epidemiologic Studies Depression (CES-D) scores, and used Cox regression model to estimate the association between sarcopenic status and incident depression (CES-D ≥ 10). Stratification analyses were performed when the interactions between sarcopenic status and covariates were significant. A total of 6522 participants were ultimately included. After adjusting for covariates, participants with possible sarcopenia (β = 0.117; 95% CI 0.067 to 0.166; P < 0.001) and sarcopenia (β: 0.093; 95% CI 0.027–0.159; P < 0.001) had a faster increase in CES-D scores compared with normal individuals. Interactions between smoking and sarcopenic status were significant (Pinteraction < 0.05). We found significantly positive associations of sarcopenic status with CES-D scores in nonsmokers, but not in current and past smokers. Besides, compared with normal participants, those with possible sarcopenia (HR 1.15; 95% CI 1.05 to 1.27) and sarcopenia (HR 1.28; 95% CI 1.12 to 1.46) (Ptrend < 0.001) had elevated risks of incident depression. Sarcopenia is associated with a faster increase in CES-D scores and increased risks of depression among Chinese middle-aged and older adults. Stronger associations between sarcopenia and trajectory of CES-D scores were found in nonsmokers than in smokers.

Prevalence and Factors Associated with Depression among High School Students in Ho Chi Minh City, Vietnam

Background: Depression in high school students is a common mental health problem and requires evaluation for early intervention. The study was carried out to determine the prevalence of depression symptoms and associated characteristics among high school students in Ho Chi Minh City, Vietnam. Methods: This cross-sectional study enrolled participants between February 2022 and June 2022. The instrument utilized was a questionnaire of socioeconomic-demographic variables, educational characteristics, and the self-reported depression scale obtained from the Centre for Epidemiological Studies-Depression (CES-D). Results: 384 high school students (165 males and 219 females) were questioned. The CES-D had a mean score of 17.3, with 57.6% of participants reporting depressed symptoms. The frequency was 63.3% among male students (OR = 1.84, 95% CI = 1.19-2.83, p = .005). Multiple logistic regression revealed that adolescents with poor health, weak friendships, limited participation in school activities, family problems, financial worries, and negative educational environments were significantly more likely to experience depressive symptoms (odds ratios ranging from 1.60 to 9.97, confidence intervals spanning 1.03 to 78.05, and p-values from &lt;.001 to .044). Conclusion: The study emphasized the necessity of health promotion programs that target mental health awareness, improve social support networks, and introduce stress reduction techniques in schools to reduce the prevalence of depression among teenagers in Ho Chi Minh City, Vietnam.

Tumor location is associated with mood dysfunction in patients with diffuse glioma

Gliomas are primary brain tumors that can cause neuropsychiatric symptoms, including severe depressive symptoms (SDS; in 14%) and an absence of depressive symptoms (ADS; in 29%), determined by Center for Epidemiologic Studies Depression (CES-D) scores. We examined the association between both SDS and ADS and brain tumor location in 201 patients with diffuse glioma before surgery. Tumors and white matter disconnectomes did not relate to CES-D using sparse canonical correlation analysis. SDS were associated with tumors in the right corticospinal tract, fornix, and inferior fronto-occipital fasciculus and the left uncinate fasciculus, whereas ADS was associated with tumors in the left uncinate fasciculus and first segment of the superior longitudinal fasciculus and the right temporal cingulum and thalamus using Bayesian regression analyses. ADS occurs even more frequently in patients with diffuse glioma than does SDS, which is explained partly by tumor location. This research aids the understanding of gliomas and mood dysfunction in general.

Cross-sectional and longitudinal associations between late-life depressive symptoms and cognitive deficits: 20-year follow-up of the Kuakini Honolulu-Asia aging study

ObjectiveTo examine depressed affect, somatic complaints, and positive affect as longitudinal predictors of fluid, crystallized and global cognitive performance in the Kuakini Honolulu-Asia Aging Study (HAAS), a large prospective cohort study of Japanese-American men. MethodsWe assessed 3,088 dementia-free Kuakini-HAAS participants aged 71–93 (77.1 ± 4.2) years at baseline (1991–1993). Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression (CES-D) Scale. Baseline CES-D depression subscales (depressed and positive affects; somatic complaints) were computed. The Cognitive Abilities Screening Instrument (CASI) measured cognitive performance on a 100-point scale; fluid and crystallized cognitive abilities were derived from CASI factor analysis. Cognition was also evaluated at 4 follow-up examinations over a 20-year period. Multiple regression assessed baseline CES-D subscales as predictors of cognitive change. The baseline covariates analyzed were CASI, age, education, prevalent stroke, APOE ε4 presence, and the longevity-associated FOXO3 genotype. ResultsCross-sectionally, baseline CES-D subscales were related to cognitive measures; e.g., higher depressed affect was associated with lower crystallized ability (β = −0.058, p ≤ 0.01), and somatic complaints were linked to poorer fluid ability (β = −0.045, p ≤ 0.05) and to worse global cognitive function as measured by total CASI score (β = −0.038, p ≤ 0.05). However, depression subscales did not significantly or consistently predict fluid ability, crystallized ability, or global cognitive performance over time. ConclusionPsychological and physical well-being were associated with contemporaneous but not subsequent cognitive functioning. Assessment of depressive symptoms may identify individuals who are likely to benefit from interventions to improve mood and somatic health and thereby maintain or enhance cognition.

Polygenic risk, childhood abuse and gene x environment interactions with depression development from middle to late adulthood: A U.S. national life-course study

ObjectiveUtilizing national longitudinal data, this study examines how polygenic depression risk and childhood abuse interactively influence the life-course development of depressive conditions from middle to late adulthood. MethodData from 7512 participants (4323 females and 3189 males) of European ancestry aged 51–90, retrieved from the U.S. Health and Retirement Study (1992–2020), were analyzed. Childhood physical abuse and polygenic depression score were the primary predictors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CESD) scale, and clinical depression risk was a binary indicator. Growth-curve linear mixed and logit mixed-effects models were conducted for analysis. ResultsIncreasing polygenic depression scores were associated with elevated CES-D levels and potential risks of clinical depression. Males experienced more detrimental effects of childhood abuse on depression development from ages 51 to 90 years. In contract, non-maltreated females generally exhibited higher depressive symptoms and clinical depression risk than males. A significant interactive effect was found between polygenic depression risk and childhood abuse among males. Higher depression levels and clinical risk were observed with increasing polygenic depression score among maltreated males, surpassing those of females with standardized polygenic score ≥0 from age 51 to 90 years. ConclusionsThe interaction between childhood abuse and genetic factors significantly shaped lifelong depression trajectories in males, while the negative impact of abusive parenting remained constant regardless of polygenic depression risk among females. Individualized prevention and intervention strategies could be crucial in mitigating lifelong depression development, especially for high-genetic-risk males with a history of childhood physical abuse.

Internal migration and depressive symptoms: Exploring selection and outcomes in a South African cohort

IntroductionInvestigations of migration effects on mental health conditions, including depression are sparse in low- and middle-income countries (LMIC), yet mental health may play a role in a decision to migrate, and migration in turn can impact on mental health outcomes. MethodsThis paper uses two waves of data from the Migrant Health Follow-Up Study, a young adult cohort of 2967 internal migrants and residents of the Agincourt study site in rural northeast South Africa to explore the relationship between internal migration and depressive symptoms, as measured on the Center for Epidemiological Studies Depression (CES-D) scale. We employ logistic regression analysis to investigate selectivity of migrants in relation to depressive symptoms, and we fit generalized linear models to analyse depressive symptoms (CES-D scores) as a function of migration status and sociodemographic and health characteristics, accounting for temporal sequence. ResultsAlthough we observe systematically low reporting of depressive symptoms, average CES-D scores are lower among migrants (comprising approximately 53% of the cohort) compared to Agincourt residents at both survey timepoints. We do not find evidence of a selection effect in relation to mental health among those newly migrating between Wave 2 and 3 (n = 1393). In analyses of the CES-D score outcome, the significant influence of migration status on depressive symptoms is reduced with the inclusion of controls in the models. Consistent employment and higher levels of education are associated with lower CES-D scores, while diagnosis of a chronic condition is associated with higher scores. ConclusionThe relationship between migration and depressive symptoms is influenced by factors preceding a migration and destination-place characteristics and experiences. Further examination of the role of migration at different stages of the process, along with continuing attention to psychosocial measurement considerations for LMIC subpopulations, can improve our understanding of these complex interrelationships and contribute to evidence.

Association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China: the mediation effect of activities of daily living (ADL) disability

BackgroundDepressive symptoms and sarcopenia, often observed among middle-aged and elderly individuals, are significant health concerns in China, particularly given the country’s rapidly aging population. Depressive symptoms, characterized by persistent feelings of sadness and loss of interest, can significantly impact quality of life. Little is known about the underlying pathway connecting these two conditions.MethodsThe data for this study were derived from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were evaluated using the Centre for Epidemiological Studies Depression (CSED) scale. Logistic regression analyses were employed to investigate the association between depressive symptoms, activities of daily living (ADL) disability, and sarcopenia, while adjusting for potential confounding factors. The selection of predictor variables, including social activity, chronic diseases, demographic factors, and lifestyle habits, was based on their known associations with mental health, physical functioning and sarcopenia. These variables were included to ensure a comprehensive adjustment for potential confounding factors and to provide a more accurate estimation of the relationship between depressive symptoms and sarcopenia. Additionally, mediation analysis was conducted to assess the mediating role of ADL disability in the relationship between depressive symptoms and sarcopenia.ResultsA comprehensive study was conducted on a total of 8,238 participants aged 45 years and older, comprising 3,358 men and 4,880 women. Logistic regression analyses were conducted to identify significant associations between depressive symptoms (OR = 1.30, P = 0.0269,95%CI = 1.03–1.63), ADL disability (OR = 1.94, P < 0.001,95%CI = 1.37–2.75) and sarcopenia. The results revealed significant relationships among these variables. Furthermore, mediation effect analyses demonstrated that ADL disability partially mediated the association between depressive symptoms and sarcopenia (estimated indirect effect: 0.006, 95% CI: 0.003, 0.008, proportion of mediation effect: 20.00%).ConclusionsThe study underscores a significant association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China, with ADL disability acting as a mediator. These findings offer novel insights for targeted health interventions. Future interventions should effectively combat sarcopenia by integrating psychological support with muscle-strengthening exercise programs. By addressing both depressive symptoms and ADL disability, clinicians and public health professionals can enhance outcomes for this demographic. Collaborative efforts across disciplines are essential for providing comprehensive health management tailored to the needs of middle-aged and elderly individuals. Future research should longitudinally assess the impact of such integrated interventions on sarcopenia prevention and depressive symptom alleviation. Additionally, investigating the role of social and environmental factors in mediating this relationship is crucial for developing more effective health strategies for this vulnerable population.

Associations and attributable burdens in late-life exposure to PM2.5 and its major components and depressive symptoms in middle-aged and older adults: A nationwide cohort study

BackgroundDepression in late life has been associated with reduced quality of life and increased mortality. Whether the chronic fine particular matter (PM2.5) and its components exposure are contributed to the older depression symptoms remains unclear. MethodMiddle-aged and older adults (>45 years) were selected from the China Health and Retirement Longitudinal Study during the four waves of interviews. The concentrations of PM2.5 and its major constituents were calculated using near real-time data at a spatial resolution of 10 km during the study period. The depressive symptom was evaluated by the Depression Center for Epidemiologic Studies Depression (CES-D)-10 score. The fix-effect model was applied to evaluate the association between PM2.5 and its major constituents with depressive symptoms. Three three-step methods were used to explore the modification role of sleep duration against the depressive symptoms caused by PM2.5 exposure. ResultsIn our study, a total of 52,683 observations of 16,681 middle-aged and older adults were assessed. Each interquartile range (IQR) level of PM2.5 concentration exposure was longitudinally associated with a 2.6 % (95 % confidence interval [CI]: 1.3 %, 4.0 %) increase in the depression CES-D-10 score. Regarding the major components of PM2.5, OM, NO3-, and NH4+ showed the leading toxicity effects, which could increase the depression CES-D-10 score by 2.2 % (95 %CI: 1.0 %, 3.4 %), 2.2 % (0.6 %, 3.9 %), and 2.0 % (95 %CI: 0.6 %, 3.4 %) correspondingly. Besides, males were more susceptible to the worse depressive symptoms caused by PM2.5 and its major components exposure than female subpopulations. Shortened sleep duration might be the mediator of PM2.5-associated depressive symptoms. ConclusionOur results suggest that long-term exposure to PM2.5 and its major components were associated with an increased risk for depressive symptoms in middle-aged and older adults. Reducing the leading components of PM2.5 may cost-effectively alleviate the disease burden of depression and promote healthy longevity in heavy pollutant countries.

The possible association of dietary fiber intake with the incidence of depressive symptoms in the Korean population

ABSTRACT Objectives This study investigates the effect of dietary fiber on the prevention of depressive symptoms. Methods In a cohort of 88,826 Korean adults (57,284 men and 31,542 women), we longitudinally evaluated the risk of depressive symptoms according to quartiles of dietary fiber intake for 5.8 years of follow-up. A food frequency questionnaire was used in evaluating dietary fiber intake. Depressive symptoms were assessed by the Center for Epidemiological Studies-Depression (CES-D) scale, in which CES-D ≥ 16 was defined as depressive symptoms. The Cox proportional hazards model was used to calculate the adjusted hazard ratio (HR) and 95% confidence intervals (CI) for depressive symptoms (adjusted HR [95% CI]). Subgroup analysis was performed for gender and BMI (≥25 or <25). Result In men, the risk of depressive symptoms significantly decreased with the increase of dietary fiber (quartile 1: reference, quartile 2: 0.93 [0.87–0.99], quartile 3: 0.91 [0.85–0.98] and quartile 4: 0.84 [0.77–0.92]). This association was more prominently observed in men with BMI ≥ 25 (quartile 1: reference, quartile 2: 0.95 [0.86–1.06], quartile 3: 0.88 [0.79–0.99] and quartile 4: 0.84 [0.73–0.97]). Women did not show a significant association between quartile groups of dietary fiber intake and the risk of depressive symptoms across subgroup analysis for BMI. Conclusion High intake of dietary fiber is potentially effective in reducing depressive symptoms in Korean men. The protective effect of dietary fiber on depressive symptoms may vary by gender and obesity.

"He Stole My Meds to Get High:" The Mental Health and Well-Being of Women Abused by Intimate Partners and Their Disability Status.

While population-based research confirms that women with disabilities abused by their intimate partners experience significant mental health issues, few studies compare this in intimate partner violence (IPV)-specific samples of women with or without disabilities and none analyze possible impacts based on disability type. This secondary mixed methods analysis examined 660 Canadian women (50.6% Indigenous, 43.1% White, and 6.1% visible minority) with respect to whether they reported having a disability that impacted their employability or daily living (291 or 44% yes; 369 or 56% said no). In the 291 women with disabilities, about one-third (30.7%) had a physical disability-only, one-quarter had a mental health disability-only, and 44.1% reported both physical and mental health disabilities. Women with mental health and both physical and mental health disabilities reported significantly more Severe Combined IPV on the Composite Abuse Scale, depression (CES-D-10; Center for Epidemiological Studies-Depression), psychological distress (Symptom Checklist Shortform-10; SCL-10; in the clinical range), PTSD symptoms (PTSD Checklist), and lower quality of life (Quality of Life Questionnaire or QoL-9) than women without disabilities. Education about disabilities is needed for IPV advocates and disability practitioners need education about IPV. Developing services specific to survivors of IPV with disabilities is recommended.