Concurrent Depressive Symptoms Research Articles

Experiences of physical and emotional intimate partner violence during the COVID-19 pandemic: a comparison of prepandemic and pandemic data in a longitudinal study of Australian mothers

ObjectiveThere is a lack of longitudinal population-based research comparing women’s experiences of intimate partner violence (IPV) prior to and during the COVID-19 pandemic. Using data from the Mothers’ and Young...

Prenatal insomnia disorder may predict concurrent and postpartum psychopathology: A longitudinal study.

While insomnia symptoms may be a risk factor for mental disturbances, few studies evaluated "Insomnia Disorder" and its relationship with perinatal psychopathology. Pregnant women were recruited during their last routine assessment before being hospitalized for delivery during the 3rd trimester at the Gynaecological Unit of the University Hospital of Ferrara and Udine, Italy, from January 2022 to January 2023. Our assessment included baseline evaluation (T0), and evaluations at 1 month (T1) and 3 months (T2) in the postpartum period, with specific questionnaires for insomnia disorder, such as Sleep Condition Indicator, mood and anxiety symptoms and psychosocial functioning, such as Edinburgh Postnatal Depression Scale, Mood Disorder Questionnaire, State-Trait Anxiety Inventory, Work and Social Adjustment Scale. At T0, 181 pregnant women were included. Insomnia disorder affected 22.3% at T0, 23.5% at T1 and 16.2% at T2. Women with insomnia disorder at baseline were significantly more affected by concurrent anxiety and depressive symptoms, had higher bipolar diathesis and poorer psychosocial functioning in the perinatal period. Prenatal insomnia disorder predicted anxiety (T0: odds ratio 4.44, p << 0.001; T1: odds ratio 4.009, p = 0.042) and depressive symptoms (T0: odds ratio 2.66, p = 0.015; T1: odds ratio 11.20, p = 0.001; T2: odds ratio 12.50 p = 0.049) in both the prenatal and postnatal period. It also predicted poor psychosocial function during the prenatal (odds ratio 3.55, p = 0.003) and postpartum periods (T1: odds ratio 2.33, p = 0.004). Insomnia disorder is emerging as an important prenatal factor that may contribute to concurrent and postpartum psychopathology.

Abstract P227: Association Between Depressive Symptoms and Insulin Resistance in Midlife Women: The Study of Women’s Health Across the Nation (SWAN)

Introduction: Recent meta-analyses and cross-sectional studies propose that insulin resistance (IR) is a transient and not a lasting feature of depression. However, longitudinal evidence is lacking, particularly in midlife women across the menopause and ethnically diverse cohorts. The goals of this study were to 1) assess the longitudinal association between IR and concurrent and prior depressive symptoms among midlife women and 2) determine if these associations vary by menopausal status and ethnicity. Methods: We included 2694 women (48.4% White, 27.3% Black, 6.5% Hispanic, 8.1% Chinese, and 9.7% Japanese) from The Study of Women’s Health Across the Nation (SWAN) followed for approximately 20 years. The Center for Epidemiologic Studies Depression Scale (CES-D) score was used to assess depressive symptoms (CES-D ≥16 indicating high depressive symptoms) and IR was obtained from the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and log-transformed for analysis. Multivariable linear mixed regression was used to estimate IR as a function of concurrent and prior depressive symptoms adjusting for baseline and time-varying covariates. We tested interactions between depressive symptoms and 1) time-varying menopausal status and 2) race/ethnicity in relation to IR. Results: At baseline women (mean age 45.86 ± 2.70 years, 48.4% white) were premenopausal (54.7%) or early perimenopausal (45.3%). In separate adjusted models, neither concurrent high depressive symptoms nor high depressive symptoms from the prior visit were statistically associated with log-HOMA-IR. When both concurrent and prior visit depressive symptoms were included in the model, the estimated effect of concurrent high depressive symptoms was comparable and statistically significant. High depressive symptoms were associated with a 0.03 increase in log-HOMA-IR (95% CI: 0.01, 0.06), equivalent to a 3% change in HOMA-IR compared to women with low depressive symptoms. Interaction effects were detected between high depressive symptoms and race/ethnicity (P=0.005) but not with menopausal status in relation to HOMA. The relationship between concurrent high depressive symptoms and IR was driven by the association observed among Hispanic women [β=0.18, 95% CI: 0.18 (0.08, 0.27), a 20% change in HOMA-IR]. Conclusion: Current reporting of high depressive symptoms, but not prior reporting, was associated with elevated future IR over time among midlife women. This study provides longitudinal evidence in support of IR as a transient and not a lasting feature of depression. Moreover, the results suggest that Hispanic women with high depressive symptoms may be particularly susceptible to IR. Supported by NIH/DHHS {Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, and U19AG063720}

The effect of maternal childhood maltreatment on postpartum mother–child bonding and maternal hair glucocorticoids

ABSTRACT Background: Maternal experiences of childhood maltreatment (CM) constitute a risk factor for impairments in the mother–child relationship. One mechanism underlying this intergenerational transmission may be maternal hypothalamic–pituitary–adrenal axis dysregulation. Yet, few studies have examined different maltreatment subtypes, including emotional neglect, considered concurrent depressive symptoms, and used long-term integrated glucocorticoid measures. Objective: This study aimed to investigate associations between maternal CM history, postpartum glucocorticoids in hair, and mother–child bonding. In exploratory analyses, we tested whether specific subtypes of CM had differential implications for glucocorticoid secretion and bonding. Methods: During pregnancy, N = 269 mothers from the prospective cohort study DREAMHAIR provided retrospective information on CM and current information regarding psychological and hair-related variables. Hair samples were collected 8 weeks after delivery for quantification of maternal long-term hair cortisol and cortisone concentrations in 2-cm scalp-near hair samples. Mother–child bonding was measured 8 weeks and 14 months after birth using the Postpartum Bonding Questionnaire. Results: While bivariate correlations revealed significant associations of CM with bonding and hair cortisol, regression findings showed CM was associated with impaired bonding 8 weeks (overall CM trend-level; emotional neglect p = .038) and 14 months (emotional neglect trend level p = .041) after birth, however not after controlling for depressive symptoms at the time point of the outcome. In regression analyses, CM was not associated with maternal hair glucocorticoids 8 weeks postpartum. Maternal hair glucocorticoid concentrations were not related to mother–child bonding and did not mediate associations between CM and mother–child bonding. Conclusion: Data tentatively suggest that mothers with CM experiences, in particular emotional neglect, may be at risk for suboptimal bonding to their child, however current depressive symptoms seem to be more important. Our data provide no evidence for a crucial role of glucocorticoid secretion, yet aetiological processes of long-term glucocorticoid secretion and bonding are complex and more severely affected samples should be examined.

Association of white matter hyperintensities and clinical vascular burden with depressive symptoms in Black older adults.

Black older adults have a higher vascular burden compared to non-Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden was associated with depressive symptoms in Black older adults. Participants included 113 Black older adults from the Healthy Brain Project, a substudy of the Health, Aging, and Body Composition Study. In multiple regression analyses, clinical vascular burden (sum of vascular conditions) and white matter hyperintensity (WMH) volume predicted depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale, controlling for demographic variables. Follow-up analyses compared the associations in the Black subsample and in 179 NHW older adults. Higher total WMH volume, but not clinically-defined vascular burden, predicted higher concurrent depressive symptoms and higher average depressive symptoms over 4years. Similar associations were found between uncinate fasciculus (UF) WMHs and concurrent depressive symptoms and between superior longitudinal fasciculus WMHs and average depressive symptoms. The association between depressive symptoms and UF WMH was stronger in Black compared to NHW individuals. This research is consistent with the VaDep hypothesis and extends it to Black older adults, a group that has historically been underrepresented in the literature. Results highlight WMH in the UF as particularly relevant to depressive symptoms in Black older adults and suggest this group may be particularly vulnerable to the negative effects of WMH.

Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009-2022).

Increasing social concern surrounds the potential adverse health effects of precarious employment (PE). In this study, we explored the association between PE and the onset of depressive symptoms. A total of 11,555 Korean waged workers (5700 females) contributed 62,217 observations from 2009 to 2022. PE was operationalized as a multidimensional construct, including employment insecurity, income inadequacy and lack of rights and protection. Depressive symptoms were evaluated using the Center for Epidemiological Studies-Depression Scale (11-item version). The association between PE and the onset of depressive symptoms in the subsequent year was estimated using generalized estimating equations. Effect sizes were reported as odds ratio (OR) and 95% confidence interval (CI). The overall incidence of depressive symptoms was 8.3% during the study period. In cross-sectional analysis, daily employment, disguised employment, lower monthly wages and lack of social insurance coverage were associated with concurrent depressive symptoms in both men and women. Longitudinally, fixed-term employment (OR: 1.17, 95% CI: 1.07-1.29), daily employment (OR: 1.64, 95% CI: 1.45-1.85) and disguised employment (OR: 1.36, 95% CI: 1.17-1.57) were associated with the onset of depressive symptoms among the overall sample. Among men, the lowest quartiles of wage were associated with the onset of depressive symptoms (OR: 1.34, 95% CI: 1.13-1.60), while the absence of a trade union was associated among women (OR: 1.18, 95% CI: 1.01-1.39). Employment insecurity, inadequate income and lack of rights and protection may contribute to depressive symptoms. Therefore, PE serves as a significant social determinant of mental health among workers in Korea. Active policy efforts are warranted to improve the overall quality of employment in the workforce.

Peer popularity and self-discipline as protective factors against depressive symptoms in Chinese adolescents: Do boys and girls benefit equally?

The current study examined the concurrent and longitudinal protective effects of peer popularity and self-discipline (control, planning, and the ability to prioritize important things) against depressive symptoms among adolescents. We used multilevel modeling to examine the data of 1676 adolescents aged 12-15 years from the China Family Panel Studies (CFPS) survey, a large-scale panel survey with a nationally representative sample. Results showed that both peer popularity and self-discipline predicted lower levels of depressive symptoms measured concurrently. The buffering effect of self-discipline against concurrent depressive symptoms was stronger for girls than for boys, especially in middle adolescence. Peer popularity additionally predicted lower levels of depressive symptoms 4 years later, and this effect was stronger for girls than for boys. These patterns of results were maintained after controlling for self-rated physical health and society-level factors. We discuss these findings against the background of distinct traditional gender roles.

Maternal social support during and after pregnancy and child cognitive ability: examining timing effects in two cohorts.

Maternal anxiety, depression, and stress during and after pregnancy are negatively associated with child cognitive development. However, the contribution of positive maternal experiences, such as social support, to child cognitive development has received less attention. Furthermore, how maternal experience of social support during specific developmental periods impacts child cognitive development is largely unknown. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 5784) and the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study (PREDO; n = 420), we investigated the associations between maternal perceived social support during and after pregnancy and child's general cognitive ability at 8 years of age, assessed with the Wechsler Intelligence Scale for Children (WISC). Bayesian relevant life course modeling was used to investigate timing effects of maternal social support on child cognitive ability. In both cohorts, higher maternal perceived social support during pregnancy was associated with higher performance on the WISC, independent of sociodemographic factors and concurrent maternal symptoms of depression and anxiety. In ALSPAC, pregnancy emerged as a sensitive period for the effects of perceived social support on child cognitive ability, with a stronger effect of social support during pregnancy than after pregnancy on child cognitive ability. Our findings, supported from two prospective longitudinal cohorts, suggest a distinct role of maternal perceived social support during pregnancy for cognitive development in children. Our study suggests that interventions aimed at increasing maternal social support during pregnancy may be an important strategy for promoting maternal and child well-being.

Lower maternal emotional availability is related to increased attention toward fearful faces during infancy

It has been suggested that infants’ age-typical attention biases for faces and facial expressions have an inherent connection with the parent–infant interaction. However, only a few previous studies have addressed this topic. To investigate the association between maternal caregiving behaviors and an infant’s attention for emotional faces, 149 mother–infant dyads were assessed when the infants were 8 months. Caregiving behaviors were observed during free-play interactions and coded using the Emotional Availability Scales. The composite score of four parental dimensions, that are sensitivity, structuring, non-intrusiveness, and non-hostility, was used in the analyses. Attention disengagement from faces was measured using eye tracking and face-distractor paradigm with neutral, happy, and fearful faces and scrambled-face control pictures as stimuli. The main finding was that lower maternal emotional availability was related to an infant’s higher attention to fearful faces (p = .042), when infant sex and maternal age, education, and concurrent depressive and anxiety symptoms were controlled. This finding indicates that low maternal emotional availability may sensitize infants’ emotion processing system for the signals of fear at least during this specific age around 8 months. The significance of the increased attention toward fearful faces during infancy is an important topic for future research.

Longitudinal associations between paternal mental health and child behavior and cognition in middle childhood.

Paternal mental health has been associated with adverse consequences on offspring psychosocial development, and family environmental factors may partly explain those associations. To clarify this, we need comprehensive prospective studies, particularly in middle-childhood when the child enters school and is expected to make use of behavioral and cognitive skills as part of their interactions and learning. Using data from a sub-sample of the prospective 3D birth cohort study comprised of mother-father-child triads, and a follow-up of the parents and the children at 6-8 years of age (n = 61; 36 boys, 25 girls), we examined whether paternal anxious and depressive symptoms measured during the pregnancy period (i.e., prenatally) or concurrently when the child was assessed at 6-8 years old were associated with children's cognition/behavior. In contrast to our hypotheses, we found that greater prenatal paternal depressive symptoms predicted fewer child behavioral difficulties; and that greater concurrent childhood paternal depression or anxiety symptoms were associated with higher child full-scale IQ, controlling for the equivalent maternal mental health assessment and parental education. Father parenting perception did not mediate these associations, nor were they moderated by maternal mental health at the concurrent assessment, or paternal ratings of marital relationship quality. These findings suggest that higher symptoms of paternal mental health symptoms are associated with fewer child behavioral difficulties and higher cognitive performance in middle childhood. Potential clinical implications and future research directions are discussed.

Blunted neural response to errors prospectively predicts increased symptoms of depression during the COVID-19 pandemic.

Symptoms of depression have increased during the COVID-19 pandemic, possibly due to increases in both chronic and episodic stress exposure. Yet these increases are being driven by a subset of people, leading to questions of what factors make some people more vulnerable. Individual differences in neural response to errors may confer vulnerability to stress-related psychopathology. However, it is unclear whether neural response to errors prospectively predicts depressive symptoms within the context of chronic and episodic stress exposure. Prior to the pandemic, neural response to errors, measured by the error-related negativity (ERN), and depression symptoms were collected from 105 young adults. Beginning in March 2020 and ending in August 2020, we collected symptoms of depression and exposure to pandemic-related episodic stressors at eight time points. Using multilevel models, we tested whether the ERN predicted depression symptoms across the first 6 months of the pandemic, a period of chronic stress. We also examined whether pandemic-related episodic stressors moderated the association between the ERN and depression symptoms. A blunted ERN predicted increased depression symptoms across the early part of the pandemic, even after adjusting for baseline depression symptoms. Moreover, episodic stress interacted with the ERN to predict concurrent symptoms of depression: For individuals exposed to greater episodic stress, a blunted ERN was associated with increased depressive symptoms at each timepoint during the pandemic. These findings indicate that blunted neural response to errors may enhance risk for depression symptoms under conditions of real-world chronic and episodic stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Childhood maltreatment predicts maternal sensitivity to distress: Negative attributions during the transition to parenthood.

Childhood maltreatment is a predictor of subsequent parenting behaviors; however, the mechanisms explaining this association have been understudied. The present study examined the indirect effect of childhood maltreatment on maternal sensitivity to distress via (a) emotion regulation difficulties, (b) negative attributions about infant crying, (c) minimizing attributions about infant crying, and (d) situational attributions about infant crying. The sample included 259 primiparous mothers (131 Black and 128 White) and their 6-month-old infants (52% female). Mothers retrospectively reported on their childhood history of maltreatment when their infants were about 2 years old. Emotion regulation difficulties and causal attributions about infant crying were assessed prenatally. Maternal sensitivity to distress was rated during three distress-eliciting tasks when children were 6 months old. Results from the structural equation model demonstrated that maternal childhood maltreatment was significantly positively associated with negative attributions about infant crying but not with emotion regulation difficulties, minimizing attributions, or situational attributions about crying. Furthermore, negative attributions about crying were associated with lower sensitivity to distress, and there was an indirect effect of childhood maltreatment on sensitivity to distress via negative attributions about infant distress. These effects were significant above and beyond the effects of coherence of mind, concurrent depressive symptoms, infant affect, maternal age, race, education, marital status, and income-to-needs ratio. The results suggest that altering negative attributions about infant crying may be an important area to intervene during the prenatal period to reduce continuity in maladaptive parenting across generations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Telomere Erosion and Depressive Symptoms Across Development Following Institutional Care

A large literature has identified exposure to early caregiving adversities as a potent risk for developing affective psychopathology, with depression, in particular, increasing across childhood into adolescence. Evidence suggests telomere erosion, a marker of biological aging, may underlie associations between adverse early-life experiences and later depressive behavior; yet, little is understood about this association during development. The current accelerated longitudinal study examined concurrent telomere length and depressive symptoms concurrently, 2 and 4 years later, from the preschool period through adolescence among children exposed (n=116) and not exposed (n= 242) to early previous institutional (PI) care. PI care was associated with shorter telomeres on average and with quadratic age-related growth in depressive symptoms, indicating a steeper association between PI care and depressive symptoms in younger age groups that leveled off in adolescence. Contrary to studies in adult samples, telomere length was not associated with depressive symptoms, and it did not predict future symptoms. These findings indicate that early caregiving disruptions increase the risk for both accelerated biological aging and depressive symptoms, although these variables did not correlate with each other during this age range.

Distinct hemodynamic and functional connectivity features of fatigue in clinically isolated syndrome and multiple sclerosis: accounting for the confounding effect of concurrent depression symptoms

PurposeThis study aims to identify common and distinct hemodynamic and functional connectivity (FC) features for self-rated fatigue and depression symptoms in patients with clinically isolated syndrome (CIS) and relapsing–remitting multiple sclerosis (RR-MS).MethodsTwenty-four CIS, 29 RR-MS patients, and 39 healthy volunteers were examined using resting-state fMRI (rs-fMRI) to obtain whole-brain maps of (i) hemodynamic response patterns (through time shift analysis), (ii) FC (via intrinsic connectivity contrast maps), and (iii) coupling between hemodynamic response patterns and FC. Each regional map was correlated with fatigue scores, controlling for depression, and with depression scores, controlling for fatigue.ResultsIn CIS patients, the severity of fatigue was associated with accelerated hemodynamic response in the insula, hyperconnectivity of the superior frontal gyrus, and evidence of reduced hemodynamics–FC coupling in the left amygdala. In contrast, depression severity was associated with accelerated hemodynamic response in the right limbic temporal pole, hypoconnectivity of the anterior cingulate gyrus, and increased hemodynamics–FC coupling in the left amygdala. In RR-MS patients, fatigue was associated with accelerated hemodynamic response in the insula and medial superior frontal cortex, increased functional role of the left amygdala, and hypoconnectivity of the dorsal orbitofrontal cortex, while depression symptom severity was linked to delayed hemodynamic response in the medial superior frontal gyrus; hypoconnectivity of the insula, ventromedial thalamus, dorsolateral prefrontal cortex, and posterior cingulate; and decreased hemodynamics–FC coupling of the medial orbitofrontal cortex.ConclusionThere are distinct FC and hemodynamic responses, as well as different magnitude and topography of hemodynamic connectivity coupling, associated with fatigue and depression in early and later stages of MS.

Associations of Subjective Memory with Life Space and Neighborhood Built Environment in Older Adults in the ACTIVE Study.

Objectives: To investigate the longitudinal association of life space and neighborhood and built environment (NBE) with subjective memory among individuals 65 and older, and the mediating role of depressive symptoms, a major correlate of life space mobility, NBE, and subjective memory. Methods: We examined community-dwelling participants in the Advanced Cognitive Training for Independent and Vital Elderly study (N = 2,622, Mean age = 73.7 years, 24.9% Black) across annual assessments of up to 3years. Results: Baseline life space and NBE were positively associated with subjective memory, and these associations were partly mediated by depressive symptoms. Over time, higher baseline life space predicted a better subjective memory as one aged. Life space was concurrently associated with subjective memory across time, mediated by concurrent depressive symptoms. Discussion: Potentially modifiable environmental factors such as life space and NBE appear to influence level and change in subjective memory as we age. Interventions supporting movement in our environments may help offset subjective memory problems, a potential early sign of dementia.

Psychological Correlates of Self-Rated Resilience in the Context of Subjective Cognitive Concerns in Older Adults.

The purpose of this study was to evaluate psychological correlates of self-rated resilience, as assessed with the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC-10), in older adults. In particular, we were interested in the degree to which self-rated resilience might be a protective factor against cognitive decline. In total, 100 adults aged 60-90years who had been referred because of subjective cognitive concerns completed self-report measures of resilience, symptoms of anxiety and depression, and satisfaction with life. They also completed a test of learning and memory. Ratings about daily functioning at home and in the community were obtained from both participants and proxy informants. Resilience ratings correlated strongly negatively with concurrent self-rated symptoms of anxiety and depression, and strongly positively with self-rated life satisfaction. However, only informant ratings of daily functioning correlated with actual participant performance on a test of learning and memory, with lower ratings being associated with worse test performance. Self-rated resilience, as measured by the CD-RISC-10, is primarily related to subjective well-being and does not inform sufficiently about relative risk for cognitive dysfunction in older adults.

Infant externalizing behavior and parent depressive symptoms: Prospective predictors of parental pandemic related distress.

Understanding predictors and effects of the COVID-19 Pandemic is a top-priority in research endeavors. The impact of COVID-19 on all components of family life and mental health cannot be overstated. This study emphasizes the need to investigate predictors of parents' responses to disaster by conceptualizing the depth of the impact of the pandemic using Bronfenbrenner's Bioecological Systems Model. We evaluate parents of infants as the center of the microsystem and discuss the importance of parents' responses to the pandemic for children's development. Specifically, utilizing a prospective design involving a sample of 105 infant-mother-father triads, we test the predictive effects of mothers' and fathers' mental health and infant externalizing behavior assessed prior to the pandemic when infants were 16-months on later pandemic related distress (PRD) approximately 1year later. Results indicate that for both mothers and fathers, more depressive symptoms during their child's infancy predicted more PRD. Although mothers' reports of more child externalizing behavior significantly predicted more PRD, fathers' reports of externalizing were strongly, positively correlated with their concurrent depressive symptoms but not directly related to PRD. We demonstrate the importance of pre-existing mental health and parents' perceptions of their children's behavior as early as 16months, in coping with disaster.

Abstract WP61: Impact Of Post-stroke Post Traumatic Stress Disorder On Quality Of Life

Introduction: After an ischemic stroke or transient ischemic attack (TIA), patients may have post-event anxiety and re-experience transient neurological symptoms. However, some stroke patients develop persistent and disabling symptoms of post-traumatic stress disorder (PTSD). Data on post-stroke post-traumatic stress disorder (PS-PTSD) is sparse. Methods: We conducted a single-center observational pilot study of 20 adult patients diagnosed with stroke or TIA in the previous 31 days to 1 year. Patients completed the PTSD Check List-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), stroke specific Quality of Life Scale-12 (SS-QOL-12), modified Rankin Scale of disability, and the National Institutes of Health Stroke Scale. The PCL-5 is a 20 item self-report score assessing symptoms of re-experiencing (Criterion B), avoidance (Criterion C), negative alterations in cognition or mood (Criterion D), and hyperarousal (Criterion E). Subjects were classified as having PS-PTSD with PCL-5 score ≥33 or endorsement of moderate symptoms in at least one B item, one C item, two D items, and two E items. Results: Twenty patients completed the PCL-5 and 19 completed the follow up scales. Seven patients (35%) were found to have PS-PTSD. Higher PCL-5 scores were significantly correlated with lower SS-QOL12 scores indicating worsened quality of life (r= -0.709, P=.001) and higher PHQ9 scores representing more depressive symptoms (r= 0.727, P&lt;0.001). The effect was most prominent in the SS-QOL-12 domains of mood, language, upper extremity function, and family roles (Table 1). Conclusion: PS-PTSD was found to be prevalent after stroke and TIA with 35% of patients having significant PTSD symptomology. These patients were also more likely to have concurrent depressive symptoms and worsened quality of life.

Understanding the relationship between subclinical depressive symptoms and physical activity in behavioral weight loss treatment.

Many adults with overweight or obesity experience subclinical symptoms of depression, but little is known about how such symptoms are associated with physical activity (PA) or the experience of PA during behavioral weight loss (BWL) treatment. In the current study, adults recruited from the community (N = 320) received 18 months of group-based BWL treatment and wore accelerometers at months 0, 6, and 18 to objectively measure PA. Participants with a mood disorder that was not well controlled were not eligible for the study and were referred for individual treatment. Depressive symptoms, PA barriers, discomfort avoidance, and self-control were self-reported with validated measures. At baseline, the majority of participants indicated some depressive symptoms, mostly at subclinical levels. Results of multilevel models suggest that depressive symptoms were not significantly associated with concurrent measures of PA engagement (minutes/week) or sedentary behavior (minutes/week) at a given time point (i.e., baseline, 6 months, or 18 months). Results of cross-level interactions suggest that baseline depressive symptoms did not moderate the change in PA or sedentary behavior across time. Concurrent depressive symptoms and PA barriers were significantly and positively associated at a given time point (i.e., baseline, 6 months, or 18 months); however, baseline depressive symptoms did not moderate the improvement in perceived PA barriers across time. At baseline, higher discomfort avoidance and lower self-control each independently and partially mediated the relationship between depressive symptoms and PA barriers. Results suggest that, among BWL samples in which most participants do not have clinically significant depressive symptoms, the likelihood of adopting and sustaining PA does not depend on the extent of depressive symptoms, but those with elevated symptoms may benefit from approaches that address their perception that engaging in PA is especially challenging.

Symptom management needs of patients with irritable bowel syndrome and concurrent anxiety and/or depression: A qualitative study.

To understand the experiences and needs of symptom management among individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. This study used a qualitative descriptive research design. Individuals with a diagnosis of irritable bowel syndrome and concurrent symptoms of anxiety and/or depression participated were recruited through an online ResearchMatch and a listserv. Semi-structured interviews focused on symptoms and experiences with symptom management interventions conducted from June to August 2020. Interviews were transcribed and data were analysed based on thematic analysis. Twelve individuals participated in this study; all reported current irritable bowel syndrome and anxiety/depression symptoms. The data analysis cumulated with three themes related to symptom management: (a) irritable bowel syndrome negatively impacts physical and mental well-being; (b) a trial and error approach to symptom management; and (c) challenges with healthcare professionals supporting symptom management including negative interactions with healthcare professionals and lack of nutritional expertize and support. There is a need for individualized approaches which consider patients' current symptoms of anxiety and depression, previous experiences with the trial-and-error process and consideration for intervention delivery methods. There is a limited qualitative research focusing on the experiences of individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. This research highlights the need for individualized approaches to enhance symptom management that acknowledges patients' psychological state and past negative experiences with providers and prior dietary regimens.