Depression Index Research Articles

Prediction of Depression Index Based on LSTM and CNN

Prediction of Depression Index Based on LSTM and CNN

Pilot study of telehealth delivery of horticultural therapy (TeleHT) as an acceptable intervention and in reducing suicide risk factors in veterans

ObjectivesConverging evidence indicates that Horticultural Therapy (HT) contributes to significant reductions in stress, loneliness, and depression, notable risk factors for suicidality. This pilot study aimed to assess the initial feasibility and acceptability of HT when virtually administered. InterventionTelehealth-delivered horticultural therapy (TeleHT) was administered to groups of Veterans, including those with elevated suicide risk over the course of four weeks. Participants were each sent a package through the mail of at-home gardening supplies that were used to facilitate multisensory, nature experiences during weekly HT sessions administered via Zoom. Outcome measuresParticipants completed thermometer-based scales for the suicide risk factors of stress, loneliness, depression, and pain before and after each TeleHT session. Post-intervention qualitative assessments were completed upon the conclusion of the four-week intervention. ResultsSignificant reductions in stress, depression, and loneliness risk were observed from weekly pre- to post-session measures (p < 0.05), with 89.1 % HT completion rate. Stress, pain, depression, and loneliness indices also showed small to medium sized symptom reduction amongst Veterans with no history of suicidality (Cohen’s d=−0.70, d=−0.49, d=−0.62, d=−0.71), while those with elevated suicide risk at baseline also showed reduction in these risk factors with small to medium effect sizes (d=−0.58, d=−.018, d=−0.46, d=−0.41). Qualitative post-intervention assessments indicated a high degree of acceptability and pointed to the inclusion of mailed gardening packages as particularly relevant to positive experiences. ConclusionsWhile future work is needed to fully assess efficacy, findings from this pilot study demonstrate an initial feasibility and acceptability through a high retention rate and positive qualitative assessments for TeleHT that mirror that of the in-person intervention.

Unraveling the causality between gastroesophageal reflux disease and increased cancer risk: evidence from the UK Biobank and GWAS consortia

BackgroundGastroesophageal reflux disease (GERD) is a common condition characterized by the reflux of stomach contents into the esophagus. Despite its widespread prevalence worldwide, the causal link between GERD and various cancer risks has not been fully established, and past medical research has often underestimated or overlooked this relationship.MethodsThis study performed Mendelian randomization (MR) to investigate the causal relationship between GERD and 19 different cancers. We leveraged data from 129,080 GERD patients and 473,524 controls, along with cancer-related data, obtained from the UK Biobank and various Genome-Wide Association Studies (GWAS) consortia. Single nucleotide polymorphisms (SNPs) associated with GERD were used as instrumental variables, utilizing methods such as inverse variance weighting, weighted median, and MR-Egger to address potential pleiotropy and confounding factors.ResultsGERD was significantly associated with higher risks of nine types of cancer. Even after adjusting for all known risk factors—including smoking, alcohol consumption, major depression, and body mass index (BMI)—these associations remained significant, with higher risks for most cancers. For example, the adjusted risk for overall lung cancer was (OR, 1.23; 95% CI: 1.14–1.33), for lung adenocarcinoma was (OR, 1.18; 95% CI: 1.03–1.36), for lung squamous cell carcinoma was (OR, 1.35; 95% CI: 1.19–1.53), and for oral cavity and pharyngeal cancer was (OR, 1.73; 95% CI: 1.22–2.44). Especially noteworthy, the risk for esophageal cancer increased to (OR, 2.57; 95% CI: 1.23–5.37). Mediation analyses further highlighted GERD as a significant mediator in the relationships between BMI, smoking, major depression, and cancer risks.ConclusionsThis study identifies a significant causal relationship between GERD and increased cancer risk, highlighting its role in cancer development and underscoring the necessity of incorporating GERD management into cancer prevention strategies.

Assessment of depression, anxiety, stress, and insomnia among government school teachers in the rural catchment areas of Nandyal district: A cross-sectional study.

Among the most demanding careers that many Indians choose is teaching. Teachers are under a lot of stress because of all the extra responsibilities and duties they have from the school, education boards, and institutions. This can be a fertile ground for psychological problems among teachers. To assess depression, anxiety, stress, and sleep disturbances among school teachers and to find out their correlates. A cross-sectional observational study was planned in 100 teachers working in the government schools of the rural catchment of Nandyal district, Andhra Pradesh. Teachers were assessed through a semistructured proforma containing sociodemographic information, information about job-related factors, and DASS 21 to assess depression, anxiety, and stress and Insomnia Severity Index to assess sleep disturbances. The overall prevalence of depression, anxiety, and stress symptoms among teachers was found to be 28%, 61%, and 24%, respectively, and sleep disturbances were 38%. Depression was found to be independently associated with marital status (married > single, P < 0.001), position at workplace (secondary grade > primary grade, P < 0.001), mode of transport (public transport > personal, P = 0.001), source of income (single > family, P = 0.013), higher level of income (P < 0.001), stress (P < 0.001), and anxiety (P < 0.001). Anxiety was associated with migration for the job (P < 0.001), stress (P < 0.001), and depression (P < 0.001), while insomnia was associated with the type of family (nuclear > joint, P = 0.015), source of income (single > family, P = 0.039), no interaction with a colleague (P = 0.007), being dissatisfied with job (P = 0.002), and stress (P = 0.005). The significantly moderate proportion of depression, anxiety, stress, and insomnia among government schoolteachers is suggestive of the need for the necessary psychological aid and counseling for such teachers. Therefore, appropriate methods must be introduced to address the concerns of teachers, thereby reducing anxiety and stress among them.

Eating Styles Profiles and Correlates in Chinese Postpartum Women: A Latent Profile Analysis.

Postpartum women present a high risk of disordered eating behaviors, but the heterogeneity between groups was not identified. This cross-sectional study aimed to identify eating styles profiles in postpartum women and explore the correlates based on demographic characteristics and psychosocial factors. Questionnaires were administered to 507 Chinese postpartum women. Latent profile analysis (LPA) was conducted to identify eating styles profiles. Multinomial logistic regression was used to investigate the correlates of these profiles among postpartum women. The LPA identified three eating styles profiles: postpartum women with low emotional, external, and restrained eating (Profile 1, 6.9%); postpartum women with medium emotional, external, and restrained eating (Profile 2, 66.1%); and postpartum women with high emotional, external, and restrained eating (Profile 3, 27.0%). Compared to Profile 1, higher postpartum depression (PPD) and body mass index (BMI) were more likely to be associated with Profile 2 and Profile 3, whereas higher postpartum weight retention (PPWR) was more likely to be associated with Profile 1. Compared to Profile 2, higher PPD and BMI were more likely associated with Profile 3. Disordered eating behaviors in postpartum women with three eating styles were associated with BMI, PPD, and PPWR. This study can guide healthcare professionals in developing targeted interventions to improve maternal and child health globally.

Development and validation of dietary depression index in Chinese adults

ABSTRACT Objective: Previous studies have suggested diet was associated with depressive symptoms. We aimed to develop and validate Dietary Depression Index (DDI) based on dietary prediction of depression in a large Chinese cancer screening cohort. Methods: In the training set (n = 2729), we developed DDI by using intake of 20 food groups derived from a food frequency questionnaire to predict depression as assessed by Patient Health Questionnaire-9 based on the reduced rank regression method. Sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the performance of DDI in evaluating depression in the validation dataset (n = 1176). Results: Receiver operating characteristic analysis was constructed to determine the best cut-off value of DDI in predicting depression. In the study population, the DDI ranged from −3.126 to 1.810. The discriminative ability of DDI in predicting depression was good with the AUC of 0.799 overall, 0.794 in males and 0.808 in females. The best cut-off values of DDI for depression prediction were 0.204 overall, 0.330 in males and 0.034 in females. DDI was a validated method to assess the effects of diet on depression. Conclusion: Among individual food components in DDI, fermented vegetables, fresh vegetables, whole grains and onions were inversely associated, whereas legumes, pickled vegetables and rice were positively associated with depressive symptoms.

Pectus excavatum: the effect of tricuspid valve compression on cardiac function

BackgroundPectus excavatum (PE) is a common congenital chest wall deformity with various associated health concerns, including psychosocial impacts, academic challenges, and potential cardiopulmonary effects.ObjectiveThis study aimed to investigate the cardiac consequences of right atrioventricular groove compression in PE using cardiac magnetic resonance imaging.Materials and methodsA retrospective analysis was conducted on 661 patients with PE referred for evaluation. Patients were categorized into three groups based on the degree of right atrioventricular groove compression (no compression (NC), partial compression (PC), and complete compression(CC)). Chest wall indices were measured: pectus index (PI), depression index (DI), correction index (CI), and sternal torsion.ResultsThe study revealed significant differences in chest wall indices between the groups: PE, NC=4.15 ± 0.94, PC=4.93 ± 1.24, and CC=7.2 ± 4.01 (P<0.0001). Left ventricle ejection fraction (LVEF) showed no significant differences: LVEF, NC=58.72% ± 3.94, PC=58.49% ± 4.02, and CC=57.95% ± 3.92 (P=0.0984). Right ventricular ejection fraction (RVEF) demonstrated significant differences: RVEF, NC=55.2% ± 5.3, PC=53.8% ± 4.4, and CC=53.1% ± 4.8 (P≥0.0001). Notably, the tricuspid valve (TV) measurement on the four-chamber view decreased in patients with greater compression: NC=29.52 ± 4.6; PC=28.26 ± 4.8; and CC=24.74 ± 5.73 (P<0.0001).ConclusionThis study provides valuable insights into the cardiac consequences of right atrioventricular groove compression in PE and lends further evidence of mild cardiac changes due to PE.Graphical abstract

A - 37 Baseline Mental Health Functioning in University Student Athletes.

Abstract Purpose Examine the prevalence of mental health difficulties in university student-athletes during baseline concussion assessment. Method Two hundred and forty-three university athletes (male = 163, female = 80) completed the. Sideline Concussion Assessment Tool, 3rd Edition (SCAT3) Symptom Evaluation scale and the Brief Symptom Inventory (BSI-18) self-report questionnaire at baseline evaluation across two consecutive seasons. The BSI-18 measured psychological distress using 5-point rating scales to calculate three emotional scales (Somatization, Depression, Anxiety) and one total scale (Global Severity Index). The four psychological symptoms from the SCAT3 Symptom Evaluation scale (more emotional, irritability, sadness, and nervous or anxious) were selected to calculate a total psychological symptom score out of 24. Existing normative data informed the SCAT3 symptom severity, including classifications of mild (1–2), moderate (3–4), and severe (5–6). Results Descriptive statistics indicated that 7.5% of athletes reported depressive symptoms and. 9.5% reported anxious symptoms on the BSI-18. The SCAT3 psychological symptoms score showed that 6.5% of athletes were within the mild range. Significant correlations existed between the SCAT3 total psychological symptom score and the BSI’s Anxiety, Depression, Somatization, and Global Severity Index scales (p &amp;lt; 0.01). Conclusions A small but significant number of collegiate athletes reported experiencing psychological symptoms during baseline concussion evaluation. These results indicate that the psychological symptoms of the SCAT’s Symptom Evaluation scale may help identify players with more significant mental health concerns who will likely benefit from mental health support.

A - 30 Head-Injury Exposure and Later-in-Life Cognitive and Psychiatric Outcomes among Former Collegiate Football Players

Abstract Purpose Current understanding of potential long-term negative cognitive and psychiatric outcomes following head-injury exposure is limited, and this study aimed to evaluate these relationships in former collegiate football players. Method Former collegiate football players completed the College Level Aging Athlete Study (CLEAATS) survey including playing career, concussion/medical/psychiatric history, self-reported cognitive functioning, and measures of depression, anxiety symptoms, positive affect/resilience, emotional dysregulation, and objective cognitive function. A head-injury exposure estimate (HIEE, modified from Kerr et al., 2015) was calculated to determine total sports-related head-injury exposure. Partial correlations (controlling for age and education) examined the relationship between HIEE and cognitive functioning and emotional/mood symptoms. Results Participants (n = 216) were 50–87 years old (M = 63.4 [8.5]), 91% White, and well-educated (bachelor’s or graduate degree = 92%). HIEE (M = 763.8 [342.9]) was not correlated with any cognitive or emotional/mood symptom measures (p’s &amp;gt; 0.075). Depression (r = 0.65), anxiety (r = 0.48), and emotional dysregulation indices (r = 0.50) showed moderate positive correlations with subjective cognitive symptoms. Grit (r = −0.36) and positive affect/well-being (r = −0.49) were negatively correlated with cognitive symptom reporting. Conclusions HIEE was not found to be related to cognitive or emotional/mood outcomes, and results suggest that current emotional/mood symptoms have greater associations with subjective cognitive symptoms. Alternatively, positive affect/resilience were found to be negatively associated with cognitive symptoms, and may serve as protective factors against cognitive complaints. These findings are consistent with previous studies that have reported associations between cognitive symptoms, psychological distress, and resilience in former athletes, highlighting the importance of considering potential impact of current emotional/mood symptoms when evaluating retired players with cognitive concerns.

P-500 Digital support tools for fertility patients – a systematic review and meta-analysis of the effect of these tools on psychological outcomes and pregnancy rates

Abstract Study question Do digital support tools for fertility patients improve psychological outcomes and pregnancy rates? Summary answer Overall, digital support tools for fertility patients do not improve depression, anxiety or Fertility Problem Index scores but have a beneficial effect on pregnancy rates. What is known already There are numerous mobile and web-based digital health tools in reproductive medicine, but the research evidence supporting the effect on clinical outcomes and to mitigate the psychological effects of infertility is sparse. If existing digital tools have demonstrated effectiveness in their stated aims of providing psychological support to patients during the arduous process of fertility treatment, it is vital to identify this so they can be implemented and further developed to tackle this important problem. In addition, if any digital tools have shown a positive impact on pregnancy rates, this would be of great interest to patients and clinicians alike. Study design, size, duration The study was prospectively registered (PROSPERO-CRD42020156441). An initial systematic review identified digital support tools and their salient features. This study presents meta-analysis of the data from RCT studies of digital support tools identified. Meta-analysis was performed of pregnancy rates, FPI (Fertility Problem Index), Depression and Anxiety scores between the digital support tool user and waiting list control groups. Studies were assessed for risk of bias (Cochrane risk of bias, robvis tool) and graded for quality. Participants/materials, setting, methods All studies were published after 2006. The RCT studies were conducted in the USA, Switzerland, Germany, UK, and The Netherlands. The total number of patients involved was 1268 (1059 women and 209 men). The average age of participants was 34.3 years. All studies reported psychological outcome scores. In 5 of the 10 studies identified pregnancy rates were reported. Meta-analysis was performed using the ‘meta’ package in R using random effects model to generate forest plots. Main results and the role of chance Overall, digital tools have a small positive impact on pregnancy rates, suggesting a beneficial effect for users of digital tools compared to non-user controls. Comparing digital support tools users with non-users, the clinical pregnancy rate (CPR) odds ratio (OR, with confidence interval) was 1.715 (1.042:2.82). The meta-analysis of the effect sizes of digital interventions on psychological outcomes, measured using validated measures of anxiety, depression, or the fertility specific FPI, identified no significant effects of digital interventions on patients’ psychological wellbeing. There was no significant standardized mean difference seen with the FPI analysis, SMD -0.10 (95% CI -0.26:0.05). As a variety of depression and anxiety outcome scales were used, there was insufficient comparable data to perform a quantitative meta-analysis for these outcomes and so this data is presented narratively. No convincing benefit of the digital tools to reduce symptoms of depression during fertility treatment is demonstrated in these studies. The impact of digital support tools on anxiety scores is somewhat mixed, with most studies demonstrating no significant difference in the anxiety scores between intervention and control group and a small number of statistically and clinically significant reductions in anxiety severity. Limitations, reasons for caution Meta-analysis was limited by the range of psychological outcome scales used. There were issues with deviation from intended interventions and missing outcome data. There is a risk the results of this meta-analysis were affected by publication bias, particularly the reporting of pregnancy rate, which was not included in all studies. Wider implications of the findings Establishing an agreed framework or core outcome set for evaluation of tools aiming to ameliorate the psychological distress associated with fertility treatments would be useful. Further research to explore the potential of digital support tools to impact pregnancy rates, particularly within fixed time frames/ treatment cycles, is warranted. Trial registration number N/A

The Impact of Obesity as a Peripheral Disruptor of Brain Inhibitory Mechanisms in Fibromyalgia: A Cross-Sectional Study.

Background/Objective: Obesity, characterized by chronic inflammation, may serve as a surrogate marker for more dysfunctional peripheral inflammation, potentially exacerbating FM symptomatology. Given this premise, this study aimed to investigate the effects of obesity as an effect modifier on neural and clinical variables, specifically those indexing pain-compensatory mechanisms in FM symptoms. Methods: A cross-sectional study was conducted with 108 participants who underwent a standardized TMS protocol assessment to measure resting motor threshold (MT), intracortical facilitation (ICF), and intracortical inhibition (ICI). Clinical data were collected using Beck's Depression Index (BDI), PROMIS, the Brief Pain Inventory (BPI), and conditioned pain modulation (CPM). Linear regression models were used to explore the relationship between these variables while examining Body Mass Index (BMI) as a potential effect modifier. If it was found to be a modifier, we stratified the sample into two groups with a BMI cutoff of 30 and performed another regression model within the subgroups. Results: BMI was identified as an effect modifier in the relationships between ICI and BDI, PROMIS fatigue, and CPM and in MT versus CPM. After stratification, non-obese fibromyalgia subjects demonstrated significant correlations between clinical symptoms and CPM and ICI activity. However, these correlations were absent in the obese group, suggesting obesity disrupts pain mechanisms and their compensatory effects. Higher MT values were associated with weaker endogenous pain control, particularly evident in the obese group. Conclusions: Obesity appears to be a significant effect modifier and delineates two patient groups across multiple clinical and neural assessments of fibromyalgia. Additionally, it suggests a role for obesity in exacerbating fibromyalgia symptoms and disrupting physiological pain-inhibitory mechanisms.

Huangqin Qingre Chubi Capsule improves rheumatoid arthritis accompanied depression through the Wnt1/β-catenin signaling pathway

Aim of the studyResearch on the mechanism of Huangqin Qingre Chubi Capsules (HQC) in improving rheumatoid arthritis accompanied depression (RA-dep) model rats. MethodsWe employed real-time qPCR (RT-qPCR), western blotting (WB), confocal microscopy, bioinformatics, and other methods to investigate the anti-RA-dep effects of HQC and its underlying mechanisms. ResultsHQC alleviated the pathological indexes of inflammation and depression in RA-dep model rats, decreased the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6, increased the levels of norepinephrine(NE) and serotonin(5-HT), and improved the injury of hippocampus. The analysis of network pharmacology suggests that HQC may target the Wnt/β-catenin pathway in the treatment of RA-dep. Furthermore, molecular dynamics simulations revealed a strong affinity between HQC and the Wnt1 molecule. RT-qPCR and Western Blot (WB) experiments confirmed the critical role of the Wnt1/β-catenin signaling pathway in the treatment of RA-dep model rats with HQC. In vitro, the HQC drug-containing serum (HQC-serum) activates the Wnt1/β-catenin signaling pathway in hippocampal cells and, in conjunction with Wnt1, ameliorates RA-dep. In summary, HQC exerts its anti-inflammatory and antidepressant effects in the treatment of RA-dep by binding to Wnt1 and regulating the Wnt1/β-catenin signaling pathway. ConclusionsHQC improved the inflammatory reaction and depression-like behavior of RA-dep model rats by activating Wnt1/β-catenin signal pathway. This study revealed a new pathogenesis of RA-dep and contributes to the clinical promotion of HQC in the treatment of RA-dep.

Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective: To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor. Methods: According to the order of admission, 74 elderly women were divided into the control group and the observation group. In addition to the routine perinatal nursing interventions, the observation group strengthened the implementation of midwives’ psychological nursing interventions. The duration of labor, mode of delivery, psychological state, and stress response indexes of the two groups were analyzed and compared. Results: The observation group had a shorter duration of all labor stages and total duration of labor than the control group, a lower cesarean section rate than the control group, and a higher degree of improvement in anxiety, depression, and stress response indexes in the 3-day postpartum period as compared to the control group (P &lt; 0.05). Conclusion: The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor, reduce the cesarean section rate, and improve the psychological state and stress indicators, which is worth promoting.

Impact of Ocrelizumab on Disease Progression, Memory Improvement, and Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal MRI and Clinical Criteria Analysis.

Multiple sclerosis (MS) is a chronic, progressive neurological disorder that significantly impacts quality of life and functionality. Ocrelizumab, a monoclonal antibody targeting CD20-positive B cells, has emerged as a treatment for relapsing-remitting MS (RRMS). This study aimed to assess the impact of ocrelizumab on disease progression and quality of life over a longitudinal course, utilizing clinical criteria and magnetic resonance imaging (MRI) analyses. Conducted at the Neurology Department of Pius Brinzeu Clinical Emergency Hospital in Western Romania from 2020 to 2023, this observational study enrolled 93 patients with RRMS who commenced ocrelizumab therapy. The study employed the Expanded Disability Status Scale (EDSS) and MRI to evaluate disease progression, while quality of life was assessed using the World Health Organisation Quality of Life (WHOQOL) questionnaire, Beck Depression Index (BDI), and MOCA scales. Significant improvements were observed post-treatment. EDSS scores decreased from 4.61 to 4.08 (p = 0.038), indicating reduced disability. MRI analyses showed a substantial decrease in expansive lesions (from 67.74% to 26.88%, p < 0.001) and an increase in stationary lesions (from 32.26% to 73.12%, p < 0.001). Quality of life improvements were notable in the physical (from 58.42 to 64.84, p = 0.005) and environmental domains (from 63.21 to 68.44, p = 0.033). Cognitive functions, assessed via Montreal Cognitive Assessment (MOCA), showed a significant total score increase from 20.38 to 22.30 (p < 0.001). Subgroup analysis revealed more pronounced effects in females and younger patients, with a significant reduction in depressive symptoms measured by BDI scores (from 14.35 to 11.62, p = 0.003). Ocrelizumab significantly reduced disease activity and disability in RRMS patients, as demonstrated by improvements in EDSS scores and MRI findings. Quality of life and cognitive functions also showed considerable enhancements. These findings support ocrelizumab's efficacy in not only managing MS symptoms but also improving overall patient well-being.

The Body Appreciation Scale-2: Psychometric evaluation of the Puerto Rican Spanish version among women aged ≥ 50 years who are breast cancer survivors

Purspose Self-perceived body image may impact women’s well-being and levels of depressive symptomatology after cancer-related treatment. The Body Appreciation Scale-2 (BAS-2) is a 10-item, unidimensional tool used to assess body appreciation, a facet of body image. A culturally relevant version of the BAS-2 was needed for the Spanish spoken in Puerto Rico. A cross-cultural adaptation of the BAS-2 for Spanish spoken in Puerto Rico was conducted and tested its psychometric properties, using a methodological design. It was hypothesized that the BAS-2 adapted for Puerto Rican Spanish would have an internal consistency with a Cronbach α value greater than 0.70 and a unidimensional structure; and that body appreciation would be positively and significantly correlated to mental health and would be negatively and significantly correlated to depression and body mass index. Methods One hundred-nine participants were recruited with a diagnosis of breast cancer (stages 0 to III) who completed adjuvant curative therapy at least two months to five years prior to recruitment. Results Participants had an average age of 61.5 years (SD = 7.1), and 64.2% had a bachelor’s degree or higher educational level. The internal consistency of the BAS-2 adapted for the Puerto Rican Spanish was Cronbach α = 0.92. Exploratory factor analysis indicated one-dimensionality of the test. Body appreciation was negatively correlated with higher levels of depressive symptomatology and with a higher body mass index, and positively correlated with higher levels of mental health. Conclusion The BAS-2 adapted for the Spanish of Puerto Rico is a psychometrically sound instrument to assess body image.

Effectiveness of Short-Acting Opioid Escalation vs Initiation of a Long-Acting Opioid in Nursing Home Residents

ObjectivesModifications to opioid regimens for persistent pain are typically made after an initial period of short-acting opioid (SAO) use. Regimen changes may include an escalation of the SAO dosage or an initiation of a long-acting opioid (LAO) as a switch or add-on therapy. This study evaluates the comparative effectiveness between these alternative regimens in nursing home residents. DesignA retrospective observational cohort analysis of US long-stay nursing home residents. Setting and ParticipantsNursing home resident data were obtained from the national Minimum Dataset (MDS) version 3.0 and linked Medicare data, 2011–2016. MethodsOpioid regimen changes were identified using Part D dispensing claims to identify dosage escalation of SAOs, initiation of an LAO, or a switch to an LAO. Outcomes included indices of pain occurrence, frequency, and severity reported on the earliest MDS assessment within 3 months following the opioid regimen change. Resident attributes were described by opioid regimen cohort. Prevalence ratios of pain and depression indices were quantified using doubly robust inverse probability of treatment (IPT)-weighted log-binomial regression. ResultsThe study cohorts included 2072 SAO dose escalations, 575 LAO add-on initiations, and 247 LAO switch initiations. After IPT weighting, we observed comparable effects on pain and mood across the opioid regimen cohorts. A substantial number of residents continued to report frequent/constant pain (36% in SAO Escalation Cohort, 42% in LAO Add-on Cohort, 42% in the LAO Switch Cohort). The distribution of depressive symptoms was similar regardless of the opioid regimen change. Conclusions and ImplicationsInitiation of an LAO as an add-on to SAO or a switch from SAO had comparable effects on pain and mood to SAO dose escalation without initiation of an LAO. Although fewer residents reported any pain after the regimen change, persistent pain was reported by most residents.

Association of physical performance with cognitive impairment in middle-aged to older haemodialysis patients: a multicentre cross-sectional observational study.

To determine the prevalence of cognitive impairment (CI) among middle-aged to older patients receiving maintenance haemodialysis (MHD) and to investigate the potential association between CI and physical performance. This cross-sectional observational study enrolled participants aged 55-85 years who received MHD. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Physical performance was measured by hand grip strength, the Timed Up and Go Test (TUGT) and the 4-m walking speed. Sociodemographic, clinical and laboratory parameters were recorded for each patient. The study included 592 patients (363 males); and of these, 126 (21.3%) were diagnosed with CI. Compared with patients with normal cognitive function, those with CI were significantly older and had significantly longer dialysis duration, lower educational level, higher Malnutrition Inflammation Score, higher depression and higher Charlson Comorbidity Index score. After adjustment for covariates, multiple regression analysis suggested that grip strength (odds ratio [OR] = 0.959, 95% confidence interval [CI] = 0.924, 0.996) and 4-m walking speed (OR = 0.161, 95% CI = 0.070, 0.368) were protective factors. TUGT (OR = 1.037, 95%CI = 1.003, 1.071) was a risk factor. Physical performance was correlated with CI and might be a significant indicator for the early identification of CI in middle-aged to older MHD patients.

Depression, Anxiety, Emotional Eating, and Body Mass Index among Self-Reported Vegetarians and Non-Vegetarians: A Cross-Sectional Study in Peruvian Adults.

Background: Vegetarianism is commonly associated with various health benefits. However, the association between this dietary regimen and aspects of mental health remains ambiguous. This study compared the symptoms of depression and anxiety, emotional eating (EmE), and body mass index (BMI) in Peruvian vegetarian and non-vegetarian adults. Methods: A cross-sectional study was conducted on 768 Peruvian adults, of whom 284 (37%) were vegetarians and 484 (63%) were non-vegetarians. The Depression Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2), and an EmE questionnaire were applied; additionally, the BMI was calculated. Simple and multiple linear regression and Poisson regression models with robust variance were used to evaluate the association between depression, anxiety, EmE, and BMI with dietary patterns. Results: The vegetarians (Adjusted Prevalence Ratio [PR] = 0.24, 95% CI 0.16-0.31; p < 0.001) reported more depressive symptoms than the non-vegetarians. This trend persisted for anxiety, with an adjusted PR of 0.17 (95% CI: 0.01-0.29; p = 0.012). However, the vegetarians (adjusted PR = -0.38, 95% CI: -0.61--0.14; p < 0.001) reported lower EmE scores compared to the non-vegetarians. Likewise, the vegetarians had a lower mean BMI than the non-vegetarians (B = -0.16, 95% CI: -0.21--0.08; p < 0.001). Conclusions: Vegetarian diets are associated with increased symptoms of depression and anxiety, as well as lower EmE and BMI scores. Further longitudinal studies are needed to elucidate these associations and determine causality and the underlying mechanisms involved.

Exploring the L-shaped relationship between Atherogenic Index of Plasma and depression: Results from NHANES 2005–2018

BackgroundThe Atherogenic Index of Plasma (AIP) is a novel metric linked to several diseases. However, there is inadequate evidence to investigate the relationship between AIP and depression. Therefore, we aim to elucidate the non-linear association between AIP and depression. Methods12,453 participants from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 were included. The AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). The Patient Health Questionnaire (PHQ-9) was used to identify depression (PHQ-9 ≥ 10). Weighted multivariate logistic regression, restricted cubic splines (RCS) models, subgroup analysis, and interaction tests were employed to reveal the relationship between AIP and depression. ResultsAIP was found to be significantly correlated with depression. In the fully adjusted model, elevated AIP levels were associated with higher odds of depression (odds ratio [OR] = 1.50; 95 % CI: 1.06–2.12). The RCS analysis indicated an L-shaped pattern in the relationship between depression and AIP, with inflection points at −0.289. Beyond this inflection point, individuals with elevated AIP levels were associated with higher odds of depression (OR = 2.25; 95 % CI: 1.49–3.39). Notably, the association was particularly pronounced among individuals with diabetes. LimitationThis cross-sectional study is unable to establish causal relationships. ConclusionThere was an L-shaped association between AIP and depression among US adults. AIP has the potential value as a biological marker for depression, and maintaining AIP values below a certain threshold may help in managing depression.

Genetic propensity to depression and the role of partnership status

Social relationships and genetic propensity are known to affect depression risk, but their joint effects are poorly understood. This study examined the association of a polygenic index for depression with time to antidepressant (AD) purchasing and the moderating role of partnership status. We analysed data from 30,192 Finnish individuals who participated in the FINRISK and Health 2000 and 2011 surveys and had register and medication data available. We measured genetic risk with a polygenic index (PGI) for depression. Depression was assessed through antidepressant purchases. We estimated an accelerated failure time model with partnership status as time-varying and different sets of confounder adjustments. The predicted cumulative hazard of antidepressant purchasing varied across PGI and partnership status. At follow-up year 10, being widowed was associated with the largest cumulative hazard of 0.34 (95%CI: 0.28–0.39) in the 80th and 0.20 (95%CI: 0.17–0.23) in the 20th PGI percentile, followed by divorced, single, married and cohabiting. Cohabiting was associated with a cumulative hazard of 0.19 (95%CI: 0.16–0.23) in the 80th and 0.11 (95%CI: 0.1–0.13) in the 20th PGI percentile. We found no evidence for an interaction between the PGI and partnership status. Results were robust to different model specifications, gender stratification, and the choice of PGI. Although antidepressant purchasing correlated with both PGI and partnership status, we found no evidence that partnership status could partially offset or amplify the association between the PGI for depression and antidepressant purchasing incidence.