Composite International Diagnostic Interview-Short Form Research Articles

Burden of undiagnosed depression among older adults in India: a population based study.

The study explored the levels and associated factors of undiagnosed depression among community-dwelling older Indian adults. It also identified the socio-demographic predictors of undiagnosed depression among the study population at national and state levels. The study employed data from the Longitudinal Ageing Study in India wave-I, 2017-18. Based on the data on depression from interviewee's self-reporting and measurement on Composite International Diagnostic Interview- Short Form (CIDI-SF) and Centre for Epidemiological Studies- Depression scale (CES-D) scales, we estimated undiagnosed depression among older adults (age 60+). We estimated multivariable binary logistic regressions to examine the socio-demographic and health-related predictors of undiagnosed depression among older adults. 8% (95% CI: 7.8-8.4) of the total older adults had undiagnosed depression on CIDI-SF scale and 5% (95% CI: 4.8-5.3) on the combined CIDI-SF and CES-D. Undiagnosed depression was higher among those who were widowed, worked in the past and currently not working, scheduled castes, higher educated and the richest. Lack of health insurance coverage, presence of any other physical or mental impairment, family history of Alzheimer's/Parkinson's disease/ psychotic disorder, lower self-rated health and poor life satisfaction were significant predictors of undiagnosed depression on both CIDI-SF and combined scales. To improve the health of older adults in India, targeted policy efforts integrating mental health screening, awareness campaigns and decentralization of mental healthcare to primary level is needed. Further research could explore the causal factors behind different levels of undiagnosed depression.

Too little or too much: nonlinear relationship between sleep duration and daily affective well-being in depressed adults

BackgroundIn addition to having higher negative affect and lower positive affect overall, depressed individuals exhibit heightened affective reactivity to external stimuli than non-depressed individuals. Sleep may contribute to day-to-day fluctuations in depressed individuals, given that sleep disturbance is a common symptom of depression. Yet, little is known about changes in daily affect as a function of nightly sleep duration in depressed adults and non-depressed adults. The current study examined whether and how naturally-occurring sleep duration is associated with negative and positive affect, and how these associations differ between depressed vs. non-depressed adults.MethodsData were drawn from the second wave of the National Study of Daily Experiences (NSDE), a daily diary project of the Midlife in the United States (MIDUS) study. The sample of 2,012 adults (Mage=56.5; 57% female; 84% white) completed eight-day diary interviews via telephone on their daily experiences including nightly sleep duration and negative and positive affect. They also completed assessments of the Composite International Diagnostic Interview-Short form, and depressed status was determined based on DSM-III. Multilevel regression models with linear, quadratic, and cubic terms of sleep duration examined the nonlinear relationship between nightly sleep duration and daily affect. Interaction terms with depression status were added to examine differences between depressed and non-depressed adults.ResultsDepressed adults exhibited significant and greater fluctuations in daily affect as a function of nightly sleep duration than non-depressed adults. Specifically, the degree of decrease in positive affect and increase in negative affect was greater when depressed adults slept 2 or more hours less or longer than their usual sleep hours. Non-depressed adults exhibited relatively stable daily affect regardless of their nightly sleep hours.ConclusionsSleep duration is nonlinearly associated with affect in daily lives of depressed adults, highlighting that both having too little sleep and excessive sleep are associated with adverse daily affective well-being. Implementing sleep interventions to promote an appropriate sleep duration may help improve daily affect among depressed adults.

The prevalence of depression, determinants, and linkage with functional disability amongst postmenopausal women in India: Evidence from the Longitudinal Ageing Study in India

BackgroundThe study objective was estimating the prevalence and determinants of depression amongst postmenopausal women in India. Additionally, we used panel mediation analysis to model the extent to which multimorbidity was associated with depression after adjusting for the effects of functional disability in the participants. MethodsData from 28,160 women aged 50 and above from the Longitudinal Aging Study in India (LASI) Wave 1 were analyzed. Depression was assessed using the Composite International Diagnostic Interview-Short Form (CIDI-SF), with multimorbidity and functional disability (ADL and IADL) considered as key predictor variables. Logistic regression and Karlson-Holm-Breen (KHB) mediation analysis were employed. ResultsThe weighted prevalence of depression among women aged ≥ 50 years was 21.76% (95% CI: 20.81, 22.73), significantly higher women aged < 50 years (17.60%, 95% CI: 16.33, 18.94). Factors independently associated with increased odds of depression included being unmarried, rural residence, and multimorbidity, while higher educational status was associated with lower odds of depression. The relationship between multimorbidity and depression was partially mediated by ADL and IADL disabilities. Notable regional (state) variations in the magnitude of depression were observed. ConclusionsNearly one in five postmenopausal women in India aged 50 years and older have clinical depression. Community screening for reaching the unreached with primary care mental health strengthening need enhanced policy focus.

Determinants of depression in Indian tribal adults: Evidence from the Longitudinal Ageing Study in India Wave-I survey.

The tribal populations are vulnerable to mental health issues owing to various reasons. However, limited research has been conducted to assess depression and related determinants among tribal adults aged ≥45 yr (45 years and older). The present study aimed to assess the prevalence and sociodemographic and health determinants of depressive symptoms among the scheduled tribe (ST) population aged ≥45 yr in India. The present study analyzed the Wave I data of the Longitudinal Ageing Study in India conducted between April 2017 to December 2018. The outcome variables in the present study were self-reported depressive symptoms. Two internationally recognised tools, the Centre for Epidemiologic Studies Depression scale (CES-D) and Composite International Diagnostic Interview-Short Form (CIDI-SF), were used to obtain the data, however, only the CES-D data are utilized in this study. The present study focused on 12,215 ST individuals aged ≥45 yr from whom information about depressive symptoms was collected and analyzed. Nearly 25 per cent ST population aged 45 yr or older experienced depressive symptoms. The likelihood of experiencing depressive symptoms among the ST population aged ≥45 yr was negatively associated with 10 or more years of education and living with children and others and positively associated with experiencing multiple morbidity conditions. Given the substantial burden of depression among the adult ST population, the present study lays emphasis on raising the awareness about depressive symptoms and strengthen the availability of mental health services among the ST community through intensive campaigns and engagement of ST individuals along with other key stakeholders. Higher education, living with spouse and children and a physically active lifestyle can play a crucial role in limiting depressive symptoms among the tribal adults (≥45 yr). It is paramount to regularly screen depressive symptoms and conduct more microlevel studies to evaluate socioeconomic and health determinants of depressive symptoms among ST communities living in different geographic regions.

REVISITING POSITIVE AFFECT: THE ROLE OF AFFECT MEAN LEVELS AND VARIABILITY ON DEPRESSION IN MID AND LATER LIFE

Abstract Recent research suggests that affect dynamics (e.g., variability) combined with mean levels are important predictors of psychological and physical health outcomes. This study explores the joint effect of affect levels and variability on depression across 10 years among middle-aged and older adults. We used the data from the second and third waves of Midlife in the United States (MIDUS) study. During telephone interviews, daily positive (PA) and negative affect (NA) were assessed across eight consecutive evenings. Daily affect mean levels were calculated by averaging daily affect across interview days, and daily affect variability was calculated as the individual’s standard deviation (iSD). Depression status was assessed using the Composite International Diagnostic Interview-Short form at baseline and 10-year follow-up. The final analytic sample includes 1,499 adults aged 55 years old on average (age range = 34-83; 55.7% female; 93% white). Logistic regression analysis was performed to test the interaction effect of daily affect mean levels and variability on depression. We found a significant interaction effect between PA mean levels and variability on depression status at follow-up. For individuals with high PA levels, higher PA variability was associated with higher odds of developing depression, after adjusting for depression and anxiety disorder at baseline. For NA, we only found main effects where higher NA variability was associated with higher odds of depression at follow-up. Findings suggest fragile high PA (i.e., variable high PA) may be a significant predictor of depression, highlighting the need for understanding PA as multidimensional construct.

NURSING HOME EXPECTATIONS AND MENTAL HEALTH AMONG OLDER ADULTS IN THE HEALTH AND RETIREMENT STUDY

Abstract Three million older adults live in long-term care facilities. Transitioning into a nursing home is a major life event that can worsen mental health. Expectedness of nursing home transitions may have implications for mental health; however, this area is understudied. This study examined the relationship between expectations of transitioning into a nursing home in the next five years and depressive symptoms and passive suicidal ideation, and how social integration modified these relationships. Sample included respondents aged 65+ from the 2018 Health and Retirement Study (n=7,944, mean age=73.9, 55.4% female, 80.5% Non-Hispanic White). Nursing home transition expectations were modeled continuously (range: 0-100%). Mental health outcomes were assessed by the Composite International Diagnostic Interview-Short Form. Social integration measured composition, frequency of contact, and closeness with spouses/partners, children, other family members, and friends. Multivariate logistic regressions were fit for depressive symptoms and passive suicidal ideation separately, adjusting for demographic, health characteristics, and health-related reasons for moving. Additional models simultaneously adjusted for all social integration measures. Higher nursing home expectations were associated with elevated depressive symptoms (OR: 1.06, 95% CI: 1.01-1.11), major depressive episode (OR: 1.08, 95% CI: 1.02-1.15), and suicidal ideation (OR: 1.10, 95% CI: 1.03-1.16). These relationships persisted even after accounting for social integration. Future research can explore modifiable factors salient to these relationships, such as perceived social support and family care, to inform mental health-targeted interventions as older adults transition into long-term care.

Polygenic Analyses Show Important Differences Between Major Depressive Disorder Symptoms Measured Using Various Instruments

BackgroundSymptoms of major depressive disorder (MDD) are commonly assessed using self-rating instruments like the Patient Health Questionnaire-9 (PHQ-9) (current symptoms) and the Composite International Diagnostic Interview Short-Form (CIDI-SF) (worst-episode symptoms). We performed a systematic comparison between them for their genetic architecture and utility in investigating MDD heterogeneity. MethodsUsing data from the UK Biobank (n = 41,948–109,417), we assessed the single nucleotide polymorphism heritability and genetic correlation (rg) of both sets of MDD symptoms. We further compared their rg with non-MDD traits and used Mendelian randomization to assess whether either set of symptoms has more genetic sharing with non-MDD traits. We also assessed how specific each set of symptoms is to MDD using the metric polygenic risk score pleiotropy. Finally, we used genomic structural equation modeling to identify factors that explain the genetic covariance between each set of symptoms. ResultsCorresponding symptoms reported through the PHQ-9 and CIDI-SF have low to moderate genetic correlations (rg = 0.43–0.87), and this cannot be fully attributed to different severity thresholds or the use of a skip structure in the CIDI-SF. Both Mendelian randomization and polygenic risk score pleiotropy analyses showed that PHQ-9 symptoms are more associated with traits that reflect general dysphoria, whereas the skip structure in the CIDI-SF allows for the identification of heterogeneity among likely MDD cases. Finally, the 2 sets of symptoms showed different factor structures in genomic structural equation modeling, reflective of their genetic differences. ConclusionsMDD symptoms assessed using the PHQ-9 and CIDI-SF are not interchangeable; the former better indexes general dysphoria, while the latter is more informative about within-MDD heterogeneity.

Prevalence of past-year major depressive episode among young adults between 2005 and 2021: Results from four national representative surveys in France

BackgroundThe objectives are to examine time trends in the prevalence of past year major depressive episode (MDE) among young adults, and to identify differences by occupational status comparing students, those employed, and those who are not in employment, education or training (NEET). MethodsData were drawn from the Health Barometer survey, a cross-sectional computer-assisted telephone interview survey on a national representative sample of residents of metropolitan France and conducted approximately every 5 years. The surveys relied on the Composite International Diagnostic Interview-Short Form to determine the presence of DSM-IV past-year major depressive episode. Data from the 2005, 2010, 2017, and 2021 surveys were pooled and respondents aged 18 to 25 were selected (n = 7556) and categorized based on their occupational status: students, those employed, and NEET. ResultsOverall, significant differences in the prevalence of MDE was observed by occupational status: NEET had the highest rate (18.5 %) followed by students (14.3 %) and those employed (11.0 %). The prevalence of MDE among young adults was 10.1 % in 2005, 9.7 % in 2010 and 11.3 % in 2017, reflecting a stable prevalence between 2005 and 2017. The prevalence then nearly doubled in 2021, with 20.9 % of MDE, with a significant increase of 9.6 points between 2017 and 2021. LimitationsNo assessment of lifetime psychopathology. ConclusionsThe prevalence of major depression among young adults significantly increased between 2005 and 2021, those at greatest risk are females and those not in employment, education or training. The contribution of pandemic-related factors may be elucidated in future national health surveys.

Depression interacts with allostatic load to predict cognitive decline in middle-age

Allostatic load (AL) indicates the cumulative impact of stress on homeostatic mechanisms. Depression and AL have been associated with cognitive deficits, but it is unclear if they do so independently. Using data from middle-aged participants in the observational longitudinal Midlife in the United States (MIDUS) study (n=708, 57.5% female, 63.8±10.6 years old in 2014), we assessed whether the effect of prior depression (Composite International Diagnostic Interview Short-Form in 1995) on cognitive decline between 2004 and 2013 (composite Z-scores derived from the Brief Test of Adult Cognition by Telephone and the Stop & Go Switch Task) was moderated by AL Z-scores in 2004 (calculated from biomarkers in blood, urine, and electrocardiography). A significant depression × AL interaction predicted a decline in a composite cognitive score (β=-0.066, SE=0.029, p=0.024) and executive function (β=-0.068, SE=0.025, p=0.007). Depression predicted a decline in composite cognition among those with AL Z-scores above -0.055. AL subdomains of lipid metabolism, glucose metabolism, cardiovascular function, and inflammation showed evidence of moderation. Middle-aged adults with depression who had higher allostatic load were at greater risk of cognitive decline. Future studies should evaluate whether the interaction predicts dementia and whether midlife interventions targeting depression and AL attenuate cognitive decline.

Household air pollution from solid fuel use and depression among adults in rural China: evidence from the China Kadoorie Biobank data

BackgroundSolid fuels are still widely used for cooking in rural China, leading to various health implications. Yet, studies on household air pollution and its impact on depression remain scarce. Using baseline data from the China Kadoorie Biobank (CKB) study, we aimed to investigate the relationship between solid fuel use for cooking and depression among adults in rural China.MethodsData on exposure to household air pollution from cooking with solid fuels were collected and the Chinese version of the World Health Organization Composite International Diagnostic Interview short-form (CIDI-SF) was used to evaluate the status of major depressive episode. Logistic regression analysis was performed to investigate the association between solid fuel use for cooking and depression.ResultsAmongst 283,170 participants, 68% of them used solid fuels for cooking. A total of 2,171 (0.8%) participants reported of having a major depressive episode in the past 12 months. Adjusted analysis showed that participants who had exposure to solid fuels used for cooking for up to 20 years, more than 20 to 35 years, and more than 35 years were 1.09 (95% CI: 0.94–1.27), 1.18 (95% CI: 1.01–1.38), and 1.19 (95% CI: 1.01–1.40) times greater odds of having a major depressive episode, respectively, compared with those who had no previous exposure to solid fuels used for cooking.ConclusionThe findings highlight that longer exposure to solid fuels used for cooking would be associated with increased odds of major depressive episode. In spite of the uncertainty of causal relationship between them, using solid fuels for cooking can lead to undesirable household air pollution. Reducing the use of solid fuels for cooking by promoting the use of clean energy should be encouraged.

Prevalence and factors associated with depression and suicidal ideation among French students in 2016: A national study

Depression is one of the leading causes of morbidity worldwide and increases the risk of suicide. Students are known as a population at risk for depression. This study aimed to evaluate the prevalence of 12 months major depressive episode (MDE) and suicidal thoughts in French students and investigate associated factors. A questionnaire was sent by email to a representative sample of the French student population between April 28th and June 27th 2016. MDE was assessed using the Composite International Diagnostic Interview Short Form (CIDI-SF). The response rate was 18.7% (N= 18,875). Prevalence of 12 months MDE was 15.8%, and suicidal thoughts was 9%. Factors associated with MDE were being a woman, study field (law/eco, human/social sciences, and medical), having failed midterms exams or dropout, refusal or stop social scholarship, and subjective financial difficulties. Factors associated with suicidal thoughts were study field (human/social sciences), having failed midterms exams or dropout, and important subjective financial difficulties. The use of CIDI-SF allows comparison with the 2017 French national study, and showed more MDE in students than in the general population. This is the only national study on French students before COVID 19 pandemic.

The mediating effect of stress reactivity in the 18-year bidirectional relationship between generalized anxiety and depression severity

BackgroundGeneralized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Heightened stress reactivity may be a mediation mechanism underlying the long-term connections between GAD and MDD. However, cross-sectional studies on this topic have hindered directional inferences. MethodThe present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults (M age = 45.6, range = 20–74). Participants completed three waves of measurement (T1, T2, and T3) spaced nine years apart. GAD and MDD symptom severity were assessed at T1, T2, and T3 (Composite International Diagnostic Interview-Short Form). Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2. ResultsStructural equation mediation modeling demonstrated that higher T1 GAD symptoms positively predicted more severe T3 MDD symptoms via T2 stress reactivity, controlling for T1 MDD (d = 0.45–0.50). However, T2 stress reactivity was not a significant mediator in the relationship between T1 MDD severity and T3 GAD symptoms after controlling for T1 GAD. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later and vice versa (d = 1.29–1.65). LimitationsStress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. physiologically indexed) stress reactivity. ConclusionsThese findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.

Positive relations mediate the bidirectional connections between depression and anxiety symptoms

IntroductionMajor depressive disorder (MDD) and generalized anxiety disorder (GAD) co-occur at high rates, often preceding and predicting one another over long durations. Interpersonal theories propose that relationships with others may contribute to the longitudinal connections between MDD and GAD. Therefore, the current study examined the mediational effect of positive relations with others in these connections over 18 years. MethodsCommunity-dwelling adults (n = 3294) participated in data collection at three time-points (Time 1 [T1], Time 2 [T2], and Time 3 [T3]) spaced about nine years apart. MDD and GAD symptoms were assessed using the Composite International Diagnostic Interview–Short Form. Positive relations was measured with the Psychological Well-Being Scale–Positive Relations with Others subscale. Structural equation mediation modeling was used for data analysis. ResultsResults indicated that lower T2 positive relations significantly mediated the relationship between higher T1 MDD severity predicting more severe T3 GAD symptoms (d = 0.375) and explained 10.7% of the variance. T2 positive relations also had a significant mediational effect in the association between T1 GAD symptoms positively predicting T3 MDD severity (d = 0.360), accounting for 12.2% of the variance of this connection. These mediational effects were significant after adjusting for age, gender, education, and T1 symptoms (d = 0.277–0.677). ConclusionsSupporting interpersonal theories, lack of positive relations with others mediated the bidirectional connections between MDD and GAD symptoms across 18 years. Future research should continue to explore the influence of positive relations on mental health and whether treatments that enhance interpersonal functioning could improve treatment for depression and anxiety.

The changing relationship between health risk behaviors and depression among birth cohorts of Canadians 65+, 1994-2014.

The older adult residents of Canada form an increasingly larger proportion of the population and are becoming better educated and have more income. Depression is a common mental disorder, particularly among seniors. Several health risk behaviors-physical inactivity, tobacco use, and alcohol consumption-are linked to mental health problems. This study examines whether these health risk behaviors and their association with depression among Canadians 65+ born in eight cohorts between 1910-1914 and 1945-1949, have changed. Pooled data drawn from 11 nationally representative health surveys conducted by Statistics Canada between 1994 and 2014 are analyzed-88,675 survey participants met inclusion criteria. Depression was assessed by the Composite International Diagnostic Interview-Short Form. Health risk behaviors examined were physical activity/inactivity, smoking, and alcohol use. A Cochran Armitage trend test for categorical outcomes and a log-binomial modeling for binary outcomes were used to estimate the risk ratios across cohorts. The proportions of Canadians 65+ who are physically active, regular drinkers, and regular smokers have increased; however, depression prevalence fluctuated non-significantly. Depression increased among all health risk behaviors, particularly in recent birth cohorts. Depression among physically inactive seniors, current smokers, and non-drinkers was significantly higher than among active, non-smokers, and regular drinkers (all P < 0.05). Physical inactivity and smoking-attributable depression risk showed an increasing linear trend across birth cohorts (RR = 1.67, P < 0.001; RR = 1.79, P < 0.001). For seniors born between 1915 and 1944, regular drinking was associated with a significant decrease in depression (all P < 0.001), but the protective effects of regular drinking became non-existent in the most recent 1945-1949 birth cohort (RR = 1.09, P < 0.05, after adjusting for covariates). Inactivity and smoking were consistently associated with a significantly increased risk of depression among Canadian residents 65+, with smoking becoming more firmly connected to depression risk in more recent birth cohorts. In contrast, moderate alcohol use was associated with a decreased risk of depression, but that protective effect ceased in most recent birth cohort. Identifying the changing relationships between health risk behaviors and depression is meaningful for developing prevention strategies for depression and other emotional and mental health problems.

Indigenous population and major depressive disorder in later life: a study based on the data from Longitudinal Ageing Study in India

BackgroundExisting evidence suggests that the indigenous older population who live with their families and friends might experience lesser depressive symptoms due to better emotional support and well-being. The present study aimed to investigate the differentials in the prevalence of the major depressive disorder among tribal and non-tribal older populations in India and to explore the contribution of socio-demographic, health-related, and household factors in such disparities.MethodsA cross-sectional study was conducted using data from the Longitudinal Aging Study in India (2017–18). The analytical sample included 30,637 older adults, among whom 5,025 and 25,612 belonged to the Scheduled Tribe (ST) and non-Scheduled Tribe (non-ST) social groups, respectively. Major depressive disorder assessed by the Composite International Diagnostic Interview short-form (CIDI-SF) scale was the outcome variable. Descriptive statistics, bivariate and multivariable regression and, decomposition analyses were conducted.ResultsAbout 4.8% and 8.9% of older adults from the ST and non-ST social groups had major depression. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression. Findings from differences due to characteristics (E) revealed that if the regional differences were minimized, it would decrease the ST-non-ST gap in major depression by about 19.6%. Similarly, equal self-rated health status and chronic conditions among ST and non-ST groups would decrease the gap in major depression by almost 9.6% and 7.9%, respectively. Additionally, an equal status of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) among older adults would decrease the gap in major depression by about 3.8% and 3% respectively. Also, findings from differences due to coefficients (C) revealed that if older adults from the ST group had the same status of ADL as of older adults from the non-ST group, it would decrease the gap in major depression by about 11.8%.ConclusionThe findings revealed a greater prevalence of major depression in older adults belonging to the non-ST group than the ST group. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression and these factors along with health-related variables contributed to significant ST-non-ST gap in depression, advantageous to tribal population; suggesting further research on the coping mechanisms of mental illnesses among indigenous population in India.

Depression interacts with allostatic load to predict cognitive decline in middle age

BackgroundAllostatic load (AL) indicates the cumulative impact of stress on homeostatic mechanisms. Depression and AL have been associated with cognitive deficits, but it is unclear if they do so independently. MethodsUsing data from middle-aged participants in the observational longitudinal Midlife in the United States (MIDUS) study (n = 704, 57.5 % female, 63.8 ± 10.6 years old in 2014), we assessed whether the effect of prior depression (Composite International Diagnostic Interview Short-Form in 1995) on cognitive decline between 2004 and 2013 (composite Z-scores derived from the Brief Test of Adult Cognition by Telephone and the Stop & Go Switch Task) was moderated by AL Z-scores in 2004 (calculated from biomarkers in blood, urine, and electrocardiography). ResultsA significant depression × AL interaction predicted a decline in a composite cognitive score (β = −0.066, SE=0.029, p = 0.024) and executive function (β = −0.068, SE=0.025, p = 0.007). Depression predicted a decline in composite cognition among those with AL Z-scores above − 0.055. AL subdomains of inflammation and lipid metabolism showed evidence of moderation. ConclusionMiddle-aged adults with depression who had higher allostatic load were at greater risk of cognitive decline. Future studies should evaluate whether the interaction predicts incident dementia, and whether interventions targeting depression or elevated AL in people who have both can attenuate cognitive decline.

Mental health in medical, dental and pharmacy students: A cross-sectional study.

BackgroundThe mental health of health students is considered a public health issue which increased dramatically with the COVID 19’s pandemic. Few studies have assessed the prevalence of depression in medical, pharmacy, and dental students. Our goal was to assess mental health in health students from the same university and identify the associated factors.MethodsAn online survey was sent to the health students of the University of Paris in 3 specialties (medicine, pharmacy, and dentistry). We used the Hospitalization Anxiety and Depression scale, the Composite International Diagnostic Interview-Short Form and the Maslach Burnout Inventory (with 2 versions: the Human Services Survey for clinical students and residents and the Student survey for the others). The presence of suicidal ideation, humiliation, sexual harassment, and sexual aggression over twelve-months was also measured. We performed multivariable logistic regression analyses to identify the associated factors of Major Depressive Episodes (MDE).Findings1925 students answered the survey. The overall prevalence of 7-day anxiety and depressive symptoms, MDE, suicidal ideation, humiliation, sexual harassment, and sexual aggression were 55%, 23%, 26%, 19%, 19%, 22%, and 5.5%, respectively. Burnout was present in 42% of nonclinical students and 65% of clinical students and residents. Multivariable logistic regression identified several associated factors of MDE: moderate (OR = 1.49,CI95[1.17-1.90]) or major (OR = 2.32,CI95[1.68-3.20]) subjective financial difficulties, humiliation (OR = 1.71,CI95[1.28-2.28]), sexual abuse (OR = 1.65,CI95[1.04-2.60]), and sexual harassment (OR = 1.60,CI95[1.19-2.16]).InterpretationThis is one of the largest studies comparing dental, pharmacy and medical students from the same university. We found elevated prevalences of psychiatric symptoms with variation depending on specialty.

Association of anxiety with cardiovascular disease in a Chinese cohort of 0.5 million adults

BackgroundAnxiety might be a potentially modifiable risk factor of cardiovascular diseases (CVDs). Evidence relating anxiety symptoms and generalized anxiety disorder (GAD) to CVDs from prospective cohort study was still lacking in China. MethodsParticipants aged 30 to 79 years old from 10 areas across China were recruited during 2004–2008 and were followed up until 2017. 487,209 participants without CVDs at baseline remained for analyses. Anxiety symptoms (panic attacks and continuous anxiety) during the past 12 months were identified in a face-to-face interview. Participants with continuous anxiety were further assessed for GAD using Composite International Diagnostic Interview-Short Form. The primary outcomes were incident CVD, ischaemic heart disease (IHD), haemorrhagic stroke (HS), and ischaemic stroke (IS). ResultsDuring 4.7 million person-years of follow-up, we documented 140,365 incident cases of CVD. For panic attacks, the multivariable-adjusted HRs (95 % CI) were 1.08 (1.04–1.13), 1.10 (1.02–1.19), 1.20 (1.05–1.38) and 1.20 (1.11–1.30) for CVD, IHD, HS and IS, respectively. Continuous anxiety was positively associated with incident CVD and IHD, and the corresponding HRs were 1.12 (1.04–1.20) and 1.21 (1.07–1.37). LimitationsAnxiety symptoms were examined according to self-reported questionnaires, which could constitute key study limitations. ConclusionsAmong the Chinese adults, those with anxiety symptoms or GAD might be important at-risk population of CVD.

Work Expectations, Depressive Symptoms, and Passive Suicidal Ideation Among Older Adults: Evidence From the Health and Retirement Study.

Employment and work transitions (e.g., retirement) influence mental health. However, how psychosocial contexts such as anticipation and uncertainty about work transitions, irrespective of the transitions themselves, relate to mental health is unclear. This study examined the relationships of work expectations with depressive symptoms, major depression episodes (MDE), and passive suicidal ideation over a 10-year period among the "Baby Boom" cohort of the Health and Retirement Study. Analysis was limited to 13,247 respondents aged 53-70 observed from 2008 to 2018. Past-year depressive symptoms, MDE, and passive suicidal ideation were indexed using the Composite International Diagnostic Interview-Short Form. Expectations regarding working full-time after age 62 were assessed using a probability scale (0%-100%). Mixed-effect logistic regressions with time-varying covariates were used to assess the relationship of work expectations with mental health, accounting for demographics, health status, and functioning, and stratified by baseline employment status. At baseline, higher work expectations were inversely associated with depressive symptoms. Longitudinally, higher expectations were associated with lower odds of depressive symptoms (odds ratio [OR] = 0.93, 95% CI: 0.91, 0.94). This association was more pronounced among respondents not working at baseline (ORNot working = 0.93 vs ORWorking = 0.96). Greater uncertainty (i.e., expectations near 50%) was also inversely associated with depressive symptoms. Results were similar for past-year MDE and passive suicidal ideation. Expectations (overall likelihood and uncertainty), as indicators of psychosocial context, provide insight into the processes that link work transitions with depression risk.

Sub-national patterns and correlates of depression among adults aged 45 years and older: findings from wave 1 of the Longitudinal Ageing Study in India

Depression is a major public health challenge linked with several poor health outcomes and disabilities among adults aged 45 years and older in India. We aimed to describe the prevalence of depression and its association with a variety of sociodemographic correlates and co-existing health conditions for this age group in India and its states. In this prospective cohort study, data from wave 1 (baseline) of the Longitudinal Ageing Study in India were used to estimate the national and subnational state level age-standardised prevalence of depression-major depressive episodes-using the internationally validated Composite International Diagnostic Interview-Short Form (CIDI-SF) scale. Hierarchical mixed effect multivariate logistic regression models were used to study the sociodemographic correlates and co-existing health conditions of major depressive episodes among the nationally representative sample of 72 250 adults aged 45 years and older from 35 states or union territories (except the state of Sikkim). Associations between depression and self-rated health, co-morbid conditions, functional health, and life satisfaction measures were also examined. A total of 40 335 (58·3%) females and 29 407 (41·7%) males aged 45 to 116 years (median age 58 years) participated. The overall age-standardised prevalence of depression based on CIDI-SF scale was 5·7% (95% CI 5·5-5·8) compared with 0·5% (0·5-0·6) self-reported prevalence of depression among adults aged 45 years and older in India. Wide sub-national variations were seen in depression prevalence, ranging from 0·8% (95% CI 0·3-1·3) in Mizoram state to 12·9% (11·6-14·2) in Madhya Pradesh. Prevalence was higher in females (6·3% [95% CI 6·1-6·6] vs 4·3% [4·1-4·6]) for India, and this higher prevalence was more pronounced in some of the northern states. The risk of depression was higher in those residing in rural areas, widowed, with no or low education, and in the poorest quintile. Depression showed a strong positive association with poor self-rated health (OR 2·39 [95% CI 2·21-2·59]; p<0·0001), with one or more limitations in the activities of daily living (ADL; OR 1·60 [1·46-1·75]; p<0·0001), instrumental ADL limitations (OR 1·51 [1·40-1·64]; p<0·0001), and low cognitive judgment of life satisfaction (OR 1·94 [95% CI 1·78-2·10]; p<0·0001). Despite the substantial burden, depression remains undiagnosed and strongly linked with poor health and wellbeing outcomes in adults aged 45 years and older in India. The ageing population of India and the subnational variations amplify the implications of this new evidence to address the substantial gaps in prevention and treatment of depression. LASI was funded by the Ministry of Health and Family Welfare, Government of India, the National Institute of Ageing, USA and the United Nations Population Fund, India.