Center For Epidemiologic Studies Depression Research Articles

The Relationship between Age at Initiation of Regular Drinking of Alcohol and Viral Suppression Status, and Depression Symptoms Among People Living with HIV in South-Western Uganda

Alcohol use is an important factor in achieving and maintaining viral suppression and optimal mental health among persons with HIV (PWH), however, the effect of age at first regular drinking on viral suppression and depression remains poorly understood. Here, using secondary data from the Alcohol Drinkers’ Exposure to Preventive Therapy for Tuberculosis (ADEPT-T) study, we used logistic regression analyses to explore whether there is an association between age at first regular drinking and viral suppression (< 40 copies/ml), or presence of depressive symptoms (Center for Epidemiologic Studies Depression, CES-D ≥ 16) among 262 PWH. The median age at first regular drinking was 20.5 years (IQR: 10), with high proportions starting under age 12 (12.2%) and as teens (13.4%). The majority had an undetectable viral load (91.7%) and 11% had symptoms of probable depression. We found no significant association between age at first regular drinking and viral suppression (i.e., child (aOR = 0.76 95%CI: 0.18, 3.26), adolescent (aOR = 0.74 95%CI: 0.18, 2.97) and young adult (aOR = 1.27 95%CI: 0.40, 3.97)) nor with depressive symptoms (i.e., child (aOR = 0.72 95%CI: 0.19, 2.83), adolescent (aOR = 0.59 95%CI: 0.14, 2.50) and young adult (aOR = 0.57 95%CI: 0.22, 1.53)). Age at first regular drinking among PWH did not appear to be associated with either viral suppression or the presence of depressive symptoms, suggesting interventions may best be focused on the harmful effects of current alcohol use.

Factors Associated With Dementia‐Related Behaviors Among Caregivers Experiencing Poor Sleep

AbstractBackgroundNeuropsychiatric symptoms of dementia are common and have the potential to negatively impact the physical and mental health of family caregivers, hindering their ability to provide care. Such impact may be worse among caregivers experiencing poor sleep. This study aimed to explore factors associated with the frequency of and caregivers’ distress to dementia‐related problematic behaviors.MethodThis was a cross‐sectional study, using data from a clinical trial of dyadic sleep intervention for persons living with dementia (PLWD) and their family caregivers. Dementia‐related behaviors were measured using a 24‐item, Revised Memory and Behavioral Problems Checklist (RMBPC): total scores of frequencies and caregivers’ distress; scores for three subscales (memory‐related, depression, and disruptive behaviors). Caregiver‐related variables included demographic background, Zarit Burden Interview (ZBI), Positive Aspects of Caregiving (PAC), Pittsburgh Sleep Quality Index (PSQI), and Center for Epidemiological Studies of Depression (CESD). Patient‐related variables included activities of daily living (ADLs), instrumental ADLs (IADLs), and Mini‐Mental State Examination (MMSE) scores. A total of 47 dyads were included in the analysis (caregivers: n = 29 spouses, n = 17 non‐spouses; 40% Whites). Pearson correlation analyses were conducted.ResultHigher ZBI and CESD scores were significantly associated with higher RMBPC frequency total (r = 0.41, r = 0.48, respectively; p&lt;0.01) and caregiver distress total scores (r = 0.58, r = 0.43, respectively; p&lt;0.01). Lower PAC (r = ‐0.31, p = 0.04) and higher MMSE scores (r = 0.37, p = 0.03) were also associated with higher caregiver distress total scores. ZBI and CESD scores were associated with RMBPC‐depression subscale scores (frequency/caregiver distress). There were positive associations between CESD and MMSE with RMBPC‐disruptive behaviors (frequency), and ZBI and PAC scores with RMBPC‐disruptive behaviors (caregiver distress). No patient or caregiver‐related factors were associated with RMBPC‐memory subscale scores. There was no significant association between PSQI scores and RMBPC total/subscale scores. Patient factors were not significantly associated with RMBPC frequency total or caregiver distress total scores.ConclusionDementia‐related problems, particularly depressive symptoms and disruptive behaviors of PLWD are associated with both positive and negative aspects of caregiving. Future studies will need to further examine how each RMBPC subscale of behavior contributes to caregiver burden or perceived caregiving experiences among family caregivers.

Relationship between Physical Activity, Handgrip Strength, Depressive Symptoms, and Cognitive Impairment in Korean older adults

AbstractBackgroundPhysical activity, muscle strength, depressive symptoms, and cognitive function are intertwined in later life. This study aimed to investigate the association physical activity (PA), relative handgrip strength (RHGS), depressive symptoms, and cognitive impairment in Korean older adults.MethodThis study consisting of 512 community‐dwelling Korean older adults (417 female, 95 male) aged 65 years and older (74.8±5.4 years) in S‐city, Gyeonggi‐do. PA and handgrip strength were assessed with the Global Physical Activity Questionnaire and using a dynamometer (GRIP‐D; Takei Ltd, Niigata, Japan). Depressive symptoms were evaluated using the Korean form of the Center for Epidemiologic Studies Depression (CES‐D) Scale. Cognitive impairment was assessed with the Mini‐Mental State Examination for Dementia Screening (MMSE‐DS) of Korean version. The PROCESS V3.4 macro for SPSS based on the bootstrap method was used to determine the mediating effects of PA and RHGS on the relationship between depressive symptoms and cognitive impairment.ResultMultiple logistic regression showed that insufficient PA was associated with high odds of a cognitive impairment ((OR = 2.972, 95%CI = 1.749‐5.052, p = .002) compared with sufficient PA (OR = 1). Weak RHGS (OR = 3.540, 95%CI = 2.156‐5.814, p&lt;.001) was associated with high odds of the cognitive impairment compared with normal RHGS (OR = 1). Depressive symptoms (OR = 2.676, 95%CI = 1.594‐4.492, p&lt;.001) were associated with higher odds of the cognitive impairment compared with normal depression status (OR = 1). Particularly, depressive symptoms were found to have both direct and indirect effects on cognitive impairment. As predicted, PA and RHGS partially mediated the relationship between depressive symptoms and cognitive impairment (PA: B = –0.017, 95%CI = –0.028 ‐ –0.009, p&lt;.001; RHGS: B = –0.005, 95%CI = –0.007 ‐ –0.003, p&lt;.001). In addition, serial mediation analysis indicates that the association between depressive symptoms and cognitive impairment was partially mediated by PA and RHGS in a sequential manner (B = –0.004, 95%CI = –0.006 ‐ –0.002, p&lt;.001).ConclusionAccording to the results of the serial multiple mediation model, the elderly should be encouraged to continue their physical activity in daily life, which not only improves and maintaining muscular strength but also reduces the negative impact of depressive symptoms on cognitive impairment.

Relationship between mental health, sleep status and screen time among university students during the COVID-19 pandemic: a cross-sectional study

ObjectiveOn 20 July 2021, after the outbreak of COVID-19 at Nanjing Lukou International Airport, several universities started closed management and online teaching. This had a large impact on students’ daily...

A Collaborative Care Coordination Model: Reaching older adults living alone with cognitive impairment.

AbstractBackgroundThe number of persons aged 65+ with Alzheimer’s Disease who live alone in Virginia was estimated at 42,000 in 2018. This population commonly has need for therapeutic, social, and other services, however, therapists and social and other service providers commonly lack knowledge of how to reach this population. We sought to identify people with dementia who live alone in Virginia, and to provide services that would be beneficial for psychological health.MethodWe conducted multifaceted outreach and delivered two programs for people with dementia living alone, (1) individualized care coordination provided by a Dementia Care Manager that focuses on behavioral symptom management training and education, (n = 51) and (2) the Effective Strategies Program (ESP) which includes education and support in memory, practical strategies, exercise, diet, home, and safety (n = 11). We assessed outcomes on depression using the Center for Epidemiologic Studies Depression Scale‐Revised and on behavioral symptoms using the Revised Memory and Behavior Problem Checklist &amp; Neuropsychiatric Inventory‐Questionnaire in the Care Coordination participants.ResultAt 12‐month follow‐up in the Care Coordination Program, depression significantly decreased and behavioral symptoms were significantly lower. Almost all (94%) of the participants reported overall the program in which they participated was beneficial.ConclusionDespite numerous challenges with reaching this population, gaining trust, and maintaining contact, it is possible to reach and provide beneficial services for people with dementia who live alone. Successes partnering with pre‐existing resources and recommendations for sustainability are highlighted.

Association between activities of daily living and depressive symptoms among older adults in China: evidence from the CHARLS.

The limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and aimed to explore the relationship between the two limitations and depressive symptoms among Chinese older adults by using nationally representative cross-sectional data. Data from the China Health and Retirement Longitudinal Study (CHARLS, wave 4) were used, and 9,789 older adults aged 60 years and above were screened. The 10-item Center for Epidemiologic Studies Depression (CES-D-10) scale was used to measure the depressive symptoms of older adults, and a 12-item scale for ADL was used to estimate functional limitations. Generalized linear mixed-effect models were employed to examine the relationship between BADL/IADL and depressive symptoms among older adults. The prevalence of high-risk depression among older adults was 43.5%, and the rates of limitation in BADL and IADL were 19.02 and 25.29%, respectively. The prevalence of high-risk depression significantly differed among subgroups of smoking, drinking, chronic diseases, duration of sleep, having social activities or not, and the type of medical insurance. Older adults with limited BADL or IADL were at a higher risk of depression than those without limitations of BADL or IADL; BADL (OR-adjusted = 2.71; 95% CI: 2.40-3.06) and IADL (OR-adjusted = 2.68; 95% CI: 2.41-2.98) had various influences on the risk of depression in older adults. ADL was a related factor in the risk of depression among older adults in China. BADL and IADL had different effects on the risk of depression, suggesting that older adults with physical function limitations might be more likely to suffer from depression.

Isoflavone intake and depressive symptoms among workers

Background & AimHigh intake of isoflavones has been reported to be associated with decreased prevalence of depressive symptoms. However, no prospective study has examined this association. We prospectively investigated the association between isoflavone intake and depressive symptoms in a Japanese working population. MethodsParticipants were 1162 workers (1033 men and 129 women aged 18-68 years) without depressive symptoms at baseline. Dietary intake was assessed using a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Cox proportional hazards regression for interval-censored data was used to estimate the hazard ratio of depressive symptoms (CES-D ≥16) according to the tertile of isoflavone intake with adjustment for covariates. ResultsDuring 5065 person-years of follow-up, 276 (23.8%) workers were newly identified as having depressive symptoms. Isoflavone intake was not associated with risk of depressive symptoms. After adjustment for lifestyle and dietary factors and baseline CES-D score, the multivariable-adjusted hazard ratios (95% confidence interval) for the lowest through highest tertile of isoflavone intake were 1.00 (reference), 0.93 (0.66-1.31), and 0.93 (0.62-1.38) (P for trend = 0.70). ConclusionsOur findings suggest that higher isoflavone intake is not associated with decreased risk of depressive symptoms among Japanese.

Depressive symptoms and anti-N-methyl-D-aspartate-receptor GluN1 antibody seropositivity in the PROSpective cohort with incident stroke

BackgroundAnti-NMDA-receptor GluN1 antibodies (NMDAR1-abs) are present in an autoimmune encephalitis with severe neuropsychiatric symptoms. We aimed to estimate the impact of serum NMDAR1-abs on depressive symptoms years after first-ever ischemic stroke (IS). MethodsData were used from the PROSpective Cohort with Incident Stroke-Berlin (PROSCIS-B; NCT01363856). Serum NMDAR1-abs (IgM/IgA/IgG) were measured within 7 days after IS using cell-based assays. We defined seropositivity as titers ≥1:10, thereof low titers as ≤1:100 and high titers as >1:100. We used the Center for Epidemiological Studies–Depression (CES-D) scale to measure depressive symptoms at year one, two and three following IS. We calculated crude and confounder adjusted weighted generalized linear models to quantify the impact of NMDAR1-abs on CES-D assessed at three annual time-points. ResultsNMDAR1-abs were measured in 583 PROSCIS-B IS patients (mean age = 67 [SD = 13]; 42%female; median NIHSS = 2 [IQR = 1–4]) of whom 76 (13%; IgM: n = 49/IgA: n = 43/IgG: n = 2) were seropositive, 55 (9%) with low and 21 (4%) with high titers. CES-D regarded over all follow-up time-points was higher in seropositive patients (βcrude = 2.56 [95%CI = −0.34 to 5.45]; βadjusted = 2.26 [95%CI = −0.68 to 5.20]) and effects were highest in patients with high titer (low titers: βcrude = 1.42 [95%CI = −1.79 to 4.62], βadjusted = 0.53 [95%CI = −2.47 to 3.54]; high titers: βcrude = 5.85 [95%CI = 0.20 to 11.50]; βadjusted = 7.20 [95%CI = 0.98 to 13.43]). ConclusionPatients with serum NMDAR1-abs (predominantly IgM&IgA) suffer more severe depressive symptoms after mild-to-moderate IS compared to NMDAR1-abs seronegative patients.

Physical activity and its fluctuations in relation to depressive symptoms: A national longitudinal study among Chinese adults

BackgroundPhysical activity (PA) may prevent depressive symptoms, however, PA fluctuations may have different effects. Using three waves of nationally representative data, this study aimed to examine the effects of PA fluctuations on depressive symptoms. MethodsParticipants comprised 7633 adults free of depressive symptoms at the first two waves (Mage = 45.26, 54.70 % males). They completed the China Family Panel Study in 2016 (T1), 2018 (T2), and 2020 (T3), respectively. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression (CES–D) scale using a cutoff of 16. Participants' PA levels were split into regular PA or infrequent PA groups. Changes in PA levels between T1 and T2 were classified into four groups: maintained infrequent PA, initiated regular PA, ceased regular PA, and persisted regular PA. ResultsThe incidence of depressive symptoms was 20.22 % (19.05 % possible and 1.17 % severe depression). After multivariate adjustment, Poisson regression showed that persistent regular PA had 17.8 % (95 % CI: 0.724, 0.934) lower risks of incident depressive symptoms compared to maintained infrequent PA. And adults who ceased regular PA were more likely to experience depressive symptoms than those who persisted in regular PA (RR = 1.188, 95 % CI: 1.010, 1.398). LimitationsAll items were self-reported. CES–D only examined self-diagnosed depressive symptoms, not medical diagnoses. ConclusionAdults who persisted in regular PA may have a lower possibility of developing depressive symptoms. The finding might serve as an empirical reference to depression prevention.

Time-varying treatment effect modification of oral analgesic effectiveness by depressive symptoms in knee osteoarthritis: an application of structural nested mean models in a prospective cohort.

Depressive symptoms are common in knee osteoarthritis (OA), exacerbate knee pain severity and may influence outcomes of oral analgesic treatments. The aim was to assess whether oral analgesic effectiveness in knee OA varies by fluctuations in depressive symptoms. The sample included Osteoarthritis Initiative (OAI) participants not treated with oral analgesics at enrolment (n = 1477), with radiographic disease at the first follow-up visit (defined as the index date). Oral analgesic treatment and depressive symptoms, assessed with the Center for Epidemiological Studies Depression [(CES-D) score ≥16] Scale, were measured over three annual visits. Knee pain severity was measured at visits adjacent to treatment and modifier using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (rescaled range = 0-100). Structural nested mean models (SNMMs) estimated causal mean differences in knee pain severity comparing treatment versus no treatment. The average causal effects of treated versus not treated for observations without depressive symptoms showed negligible differences in knee pain severity. However, causal mean differences in knee pain severity comparing treatment versus no treatment among observations with depressive symptoms increased over time from -0.10 [95% confidence interval (CI): -9.94, 9.74] to -16.67 (95% CI: -26.33, -7.01). Accordingly, the difference in average causal effects regarding oral analgesic treatment for knee pain severity between person-time with and without depressive symptoms was largest (-16.53; 95% CI: -26.75, -6.31) at the last time point. Cumulative treatment for 2 or 3 years did not yield larger causal mean differences. Knee OA patients with persistent depressive symptoms and chronic pain may derive more analgesic treatment benefit than those without depressive symptoms and less pain.

Paternal postpartum depression scale

Postpartum depression in fathers has an impact on the harmony of household relationships, children's emotional development disorders, children's behavior disorders, even children can also be 2-4 times at risk of depression before adulthood. This study aims to review several instruments used to assess fathers' PPD (Postpartum Depression). The database used in this literature review is PubMed. Based on 10 studied, there are 9 different father PPD instruments, including EPDS (Edinburgh Postnatal Depression Scale), GMDS (Gotland Male Depression Scale), BDI (Beck Depression Inventory), BDI-II, GHQ-12 (General Health Questionnaire- 12), PHQ-9 (Patient Health Questionnaire - Depression Module) CES-D (Center for Epidemiological Studies Depression), Zung SAS (Zung's Self-rated Anxiety Scale), and HAD-A (Hospital Anxiety and Depression Scale. EPDS is an instrument most frequently used in detecting paternal PPD, appeared in 10 out of 10 studies. This study concludes that there are 9 different instruments for detecting PPD in the father, and the EPDS is the most frequently used instrument in detecting PPD in the father, which consists of 10 questions with a score limit of 10/11.

Bidirectional longitudinal associations between depressive symptoms and somatic conditions after adverse childhood experiences in middle-aged and older Chinese: A causal mediation analysis

BackgroundWhether adverse childhood experiences (ACEs) preferentially induce depressive symptoms or somatic conditions remains to be explored. MethodsData were from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018. Fourteen ACEs were retrospectively reported and divided into 0, 1, 2, 3, and 4 or more. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression (CESD-10) scale. Somatic conditions were assessed by pain, falls, chronic diseases, multimorbidity, activities of daily living (ADL), and instrumental activities of daily living (IADL). Weibull regression and mediation analysis were used to explore the bidirectional associations between depressive symptoms and somatic conditions after ACEs. Results4 or more (vs. 0) ACEs were associated with new-onset pain, falls, chronic diseases, multimorbidity, ADL limitations, and IADL limitations, with HRs (95% CIs) of 1.57 (1.37–1.79), 1.84 (1.55–2.18), 1.43 (1.19–1.72), 1.55 (1.32–1.83), 1.85 (1.54–2.23), and 1.46 (1.24–1.71), all of which were mediated by depressive symptoms by 12.3%, 8.6%, 9.6%, 11.9%, 15.3%, and 22.5%, respectively. 4 or more (vs. 0) ACEs were also associated with about 1.90-time higher risk of new-onset depressive symptoms. However, only pain, chronic diseases, and multimorbidity mediated the association by 4.1%, 3.3%, and 2.2%. All the above associations were more pronounced in women than men. ConclusionACEs tend to induce depressive symptoms before somatic conditions assessed by pain, falls, chronic diseases, multimorbidity, and functional limitations rather than vice versa. Future strategies should focus first on mental health in older Chinese to lessen the burden attributed to ACEs to the greatest extent.

Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents

Depressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines. To examine the course and stability of depressive symptoms across the perinatal period in multiple, ethnically diverse independent observational cohorts. This cohort study included self-reported depressive symptoms at multiple time points from 7 prospective cohorts spanning 3 continents (United Kingdom: Avon Longitudinal Study of Parents and Children from 1991 to 1995; Canada: Maternal Adversity, Vulnerability and Neurodevelopment from 2003 to 2007; Montreal Antenatal Well-being Study from 2019 to 2022; Alberta Pregnancy Outcomes and Nutrition from 2009 to 2014; and Singapore: Growing Up in Singapore Toward Healthy Outcomes from 2009 to 2013; Singapore Preconception Study of Long-Term Maternal and Child Outcomes from 2015 to 2019; and Mapping Antenatal Maternal Stress from 2019 to 2022). Participants were recruited either during preconception or pregnancy and observed into the postnatal period. All data from each cohort were analyzed from July 2022 to April 2023. Self-reported depressive symptoms from pregnancy to 2 years following childbirth using either the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies Depression were analyzed independently within each cohort using item response theory (IRT) techniques. K-means clustering was used to identify groups of participants with similar trajectories. A total of 11 563 pregnant women (mean [SD] age, 29 [5] years; 569 [4.9%] East Asian women; 304 [2.6%] Southeast Asian women; 10 133 [87.6%] White women) self-reported depressive symptoms from pregnancy to 2 years following childbirth. Analytic methods from Item Response Theory identified 3 groups of mothers based on depressive symptoms: low, mild, and high levels in each of the 7 cohorts. Mothers within and across all cohorts had stable trajectories of maternal depressive symptoms from pregnancy onwards. Mothers with clinical levels of depressive symptoms likewise showed stable trajectories from pregnancy into the postnatal period. In this study, trajectories of depressive symptoms remained stable from pregnancy across the perinatal period, a finding that conflicts with a continuing emphasis on postpartum or postnatal onset of depression that persists in some health policy guidelines. Interventions and public health initiatives should focus on reducing depressive symptoms during pregnancy in addition to following birth.

Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017

After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.

The Cross-sectional and Longitudinal Association Between Thyroid Function and Depression: A Population-Based Study.

An association of thyroid function with mood disorders has been widely suggested, but very few studies have examined this association longitudinally. We assessed the cross-sectional and longitudinal association between thyroid function and depression in a population-based cohort. A total of 9471 individuals were included in cross-sectional analyses, of whom 8366 had longitudinal data. At baseline, we assessed thyroid function using serum samples (thyrotropin [TSH], free thyroxine (FT4), and thyroid peroxidase antibodies) and depressive symptoms using the Centre for Epidemiologic Studies Depression (CES-D) scale. Incident depressive events (n = 1366) were continuously followed up with the CES-D and clinical interviews. We analyzed the cross-sectional association of thyroid function and thyroid disease with depressive symptoms using linear and logistic regression, and the longitudinal association with Cox proportional hazard models for depressive events. Lower TSH levels and lower and higher FT4 levels were cross-sectionally associated with more depressive symptoms with a B value of -0.07 per 1 unit increase of natural log-transformed TSH (95% CI -0.11; -0.04). Furthermore, hypothyroidism was cross-sectionally associated with less depressive symptoms and hyperthyroidism with more depressive symptoms. Longitudinally, there was a U-shaped association between FT4 and incident depressive events but only in euthyroid participants. We show a cross-sectional association between thyroid (dys)function with depressive symptoms, and a U-shaped association between FT4 and incident depressive events in euthyroid individuals. Our findings suggest an association of thyroid function with the risk of developing depression, albeit small. Reverse causation and additional underlying factors may also contribute to the association.

Link between depression and bone mineral density in Cooper Center Longitudinal Study: Indirect effects of vitamin D, inflammation, and physical activity

BackgroundTo examine the effect of depressive symptom severity on bone mineral density (BMD) and the potential mediators of the relationship. MethodThis study used data from n = 7273 participants in the Cooper Center Longitudinal Study at the Cooper Clinic in Dallas. Participants were included if they had data for all study variables, including left and right femoral neck (BMD), age, sex, body mass index, smoking status, antidepressant (SSRI/SNRI) use, standard alcoholic drinks consumed per week, and depressive symptom severity as measured with the Center for Epidemiological Studies-Depression (CESD)-10. To evaluate the effect of depressive symptoms on both L/R femur BMD, two multiple linear regression analyses were conducted. To examine effects of vitamin D, high sensitivity C-reactive protein (hs-CRP), and physical activity (MET units) on the relationship between depressive symptom severity and BMD, parallel mediation analyses were conducted. ResultsDepressive symptom severity (CES-D 10 score) significantly predicted both L/R BMD (L: β = −0.048, R: β = −0.047, both p ≤ .001). Only physical activity significantly mediated the relationship between depressive symptom severity and L/R BMD (L: β = −0.008, 95 % CI [−0.011, −0.005]; R: β = −0.007, 95 % CI [−0.010, −0.005]). LimitationsThe sample may not be generalizable to all patient populations. ConclusionDepressive symptom severity was inversely related to both L/R femur BMD in a large cohort of relatively healthy adults. Physical activity, but not vitamin D or hs-CRP, mediated this relationship. Future research might examine the effect of physical activity interventions both on depression and BMD. Impact statementWe certify that this work is both novel and confirmatory of recent clinical research (Lee et al., 2015; Amsterdam and Hooper, 1998; Hlis et al., 2018; Wainstein et al., 2016; Blair et al., 1989; Farrell et al., 2022; Ainsworth et al., 2011). We demonstrated a negative relationship between depression and BMD in a large cohort of adults and expanded on previous findings by demonstrating that physical activity acts as a mediator of this relationship. Physical activity is known to stimulate osteogenesis in osteoporotic patients, and this study further expands on its role in depressive symptoms in this population. Key points•This study of a large cohort of adults adds to the growing body of evidence associating depression severity with low bone mineral density.•Physical activity acts as a mediator on the negative relationship between bone mineral density and depression.

Weight-cycling over 6 years is associated with pain, physical function and depression in the Osteoarthritis Initiative cohort

Body weight significantly impacts health and quality of life, and is a leading risk factor for the development of knee osteoarthritis (OA). Weight cycling may have more negative health consequences compared to steady high or low weight. Using the Osteoarthritis Initiative dataset, we investigated the effects of weight cycling on physical function, quality of life, and depression over 72-months compared to stable or unidirectional body weight trajectories. Participants (n = 731) had knee OA and were classified as: (1) stable-low (BMI < 25), (2) stable-overweight (BMI = 25–29.9), and (3) stable-obese (BMI ≥ 30); (4) steady-weight-loss; (5) steady-weight-gain (weight loss/gain ≥ 2.2 kg every 2-years); (6) gain–loss–gain weight cycling, and (7) loss–gain–loss weight cycling (weight loss/gain with return to baseline), based on bi-annual assessments. We compared Knee Injury and Osteoarthritis Outcome Knee-Related Quality of Life, Function in Sports and Recreation, Physical Activity in the Elderly, Short Form SF-12, repeated chair rise, 20-m gait speed, and Center for Epidemiological Studies Depression using repeated-measures ANOVA. The steady weight loss group demonstrated the worst pain, physical function, and depressive symptoms over time (p’s < 0.05). More research is needed to confirm these findings, and elucidate the mechanisms by which steady weight loss is associated with functional decline in knee OA.

FRI588 Effect Of Covid-19 On Depression In Girls With Obesity And Pcos Or Type 2 Diabetes

Abstract Disclosure: D. Ebedes: None. C.J. Noar: None. J. Benson: None. S. Simon: None. L.D. Gulley: None. L.B. Shomaker: None. L. Pyle: None. M.G. Cree: Consulting Fee; Self; Pollie Inc. Grant Recipient; Self; NIH. Research Investigator; Self; Amino Corp. Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age and is associated with elevated body mass index (BMI), and depression in adolescent girls. Prior to the COVID epidemic, we demonstrated elevated rates of depressive symptoms in adolescent girls with obesity suffering from PCOS or T2D. Studies examining how the mental health of this at-risk group of adolescents has changed since the start of the COVID-19 pandemic is limited. Methods: Data were collected from 70 new girls with obesity and PCOS or T2D, who presented for care in an obesity complications clinic between 6 to 18 months into the COVID epidemic (7/1/2020-6/30/2021). Patients were included if they had Center for Epidemiologic Studies-Depression (CES-D, 20 items) scores obtained within 6 months of PCOS or T2D diagnosis. A chart review was performed to collect data on demographics, physical exam findings, psychiatric care, and metabolic measures. CES-D scores ≥16, indicate elevated depression symptoms, and CES-D scores ≥24, indicate severe depression symptoms. This post COVID data was compared to already collected pre-COVID data. Data from pre vs post were compared within PCOS or T2D with a t-test or Mann Whitney U, and proportions with Chi-squared tests. Results: The pre-COVID-19 cohort included 91 girls (47 with PCOS, 44 with T2D) age 15±2 years and BMI z-scores (2.2±0.4). The post-COVID-19 cohort included 70 girls (33 with PCOS and 37 with T2D) aged 14.2±2.3 years and BMI z-scores 2.1±0.7. Pre-Covid moderate or severe depressive symptoms were observed in 30% and 23% of girls with PCOS vs 24% and 39% post-covid (p=0.306). In those with T2D, pre-COVID 18% and 14% had moderate or severe depressive symptoms, respectively, whereas post-COVID these rose to 27% and 43% (P=0.002). There was no change pre/post COVID in the mean CESD score in those with PCOS (18.8±11.6 vs 22.1±13.6; p=0.253), whereas there was a significant increase in overall CESD scores in T2D (12.9±10.6 vs 21.8±11.8; p&amp;lt;0.001). Dysglycemia was worse post-COVID in T2D only, HbA1c (Pre 7.25%[6.6,9.5] vs Post 8.6[7.7,11.4] p=0.006) but neither group demonstrated changes in systolic blood pressure, high density lipoprotein or alanine aminotransferase. Rates of home schooling were greatly elevated during COVID (PCOS pre 15% vs post 76% and T2D pre 5% vs post 55%). Both post-Covid groups reported high rates of loss of sports activities, social activity and friendships. Conclusions: Girls with PCOS and obesity had double the prevalence of depressive symptoms compared to youth with T2D prior to COVID. 6-18 months into the COVID epidemic, CESD scores remained unchanged in girls with PCOS, but were significantly worse in girls with T2D. Presentation: Friday, June 16, 2023

Menstrual function and mental health of medical students during the COVID-19 pandemic: a continuous cross-sectional study

Aim. To assess the impact of new coronavirus infection (NCI) and COVID-19 vaccination on menstrual function in comparison with the frequency of depressive disorders during the COVID-19 pandemic among female students of a medical university.&#x0D; Materials and methods. Data for a continuous transverse (cross-sectional) study were obtained using an online survey. The questions included demographics, characteristics of menstrual function, the history of COVID-19 and vaccinations against it, and the standard CES-D (Center for Epidemiologic Studies Depression Scale) questionnaire. The survey included 1.879 female medical students. The exclusion criteria were age under 18 and over 25 years, hormonal contraceptives, pregnancy, childbirth during the last year, and vaccination after COVID-19. After applying the exclusion criteria, three study groups were formed. Group 1 included female students with a history of NCI (n=140), group 2 included students with no history of NCI, who were initially vaccinated against COVID-19 (n=647), group 3 (control group) included unvaccinated students with no history of NCI (n=55).&#x0D; Results. There were no differences in the prevalence of changes in menstrual function in female students after the NCI (49.3%) and after COVID-19 vaccination (39.6%) compared to the control group (43.6%); p=0.477. The rate of depression in the overall study cohort was 43.3%, without any significant differences between the study groups. Significant predictors of changes in menstrual function during the pandemic were marriage (odds ratio OR 2.33 [1.513.61]), depression (OR 1.72 [1.282.3]), a history of menstrual dysfunction (OR 1.5 [0.121.99]), and later menarche (OR 1.76 [1.023.04]). Multivariate analysis did not show the significance of the history of NCI and vaccination as factors of menstrual dysfunction (OR 1.61 [0.892.90] and OR 0.91 [0.591.41], respectively).&#x0D; Conclusion. During the COVID-19 pandemic, female medical students reported frequent changes in menstrual function and depressive disorders. During the pandemic, the most significant predictors of menstrual disorders in female students were depression, a history of menstrual dysfunction, and marriage. A multicenter prospective study is necessary to clarify the mechanisms of the pandemic's impact on menstrual function.

Mother-Father Relationship and Depressive Symptoms Among Pregnant Black Women.

Black women report higher levels of depressive symptoms during pregnancy than white women. A supportive relationship with the father of the baby may be protective and decrease depressive symptoms. We sought to examine the association between mother-father relationship and depressive symptoms among pregnant black women. Using a cross-sectional design, we conducted a secondary data analysis from a subsample of 405 pregnant black women who participated in the Biosocial Impact on Black Births study, a prospective cohort study. Participants completed questionnaires at 19- to 29-week gestation, including 6 measures of their relationship with the father of the baby: (1) contact, (2) involvement, (3) overall relationship, (4) change in relationship from prior to pregnancy to during pregnancy, (5) support, and (6) conflict. Latent class analysis was used to identify and classify the relationship construct. The Center for Epidemiologic Studies-Depression (CES-D) scale was used, with scores ≥23 considered high levels of depressive symptoms. Data were analyzed with logistic regression. Following adjustment for maternal sociodemographic characteristics, comorbid conditions, and health behaviors, women in a conflictual relationship had higher odds of having depressive symptom scores ≥23 (adjusted odds ratio: 3.50, 95% confidence interval: 2.00, 6.12) than those having no relationship (adjusted odds ratio: 2.81, 95% confidence interval: 1.43, 5.52), when compared with those with a good relationship. These findings suggest that having either a conflictual or no relationship with the father of the baby during pregnancy increases the odds for higher maternal depressive symptoms (CES-D scores ≥ 23) among pregnant black women.