Screening Tool For Depression Research Articles

Patient Perspectives on Portal-Based Anxiety and Depression Screening in HIV Care: A Qualitative Study Using the Consolidated Framework for Implementation Research.

Electronic patient portals represent a promising means of integrating mental health assessments into HIV care where anxiety and depression are highly prevalent. Patient attitudes toward portal-based mental health screening within HIV clinics have not been well described. The aim of this formative qualitative study is to characterize the patient-perceived facilitators and barriers to portal-based anxiety and depression screening within HIV care in order to inform implementation strategies for mental health screening. Twelve adult HIV clinic patients participated in semi-structured interviews that were audio recorded and transcribed. The transcripts were coded using constructs from the Consolidated Framework for Implementation Research and analyzed thematically to identify the barriers to and facilitators of portal-based anxiety and depression screening. Facilitators included an absence of alternative screening methods, an approachable design, perceived adaptability, high compatibility with HIV care, the potential for linkage to treatment, an increased self-awareness of mental health conditions, the ability to bundle screening with clinic visits, and communicating an action plan for results. The barriers included difficulty navigating the patient portal system, a lack of technical support, stigmatization from the healthcare system, care team response times, and the novelty of using patient portals for communication. The patients in the HIV clinic viewed the use of a portal-based anxiety and depression screening tool as highly compatible with routine HIV care. Technical difficulties, follow-up concerns, and a fear of stigmatization were commonly perceived as barriers to portal use. The results of this study can be used to inform implementation strategies when designing or incorporating portal-based mental health screening into other HIV care settings.

Validation and optimal cut-off score of the World Health Organization Well-being Index (WHO-5) as a screening tool for depression among patients with schizophrenia

BackgroundThe utility of the World Health Organization Wellbeing Index (WHO-5) as rapid screening tool for depression has not yet been researched in the context of schizophrenia. The goals of this study were twofold: (1) to test the psychometric properties of the WHO-5 in a sample of Arabic-speaking patients with schizophrenia from Lebanon, with particular emphasis on validating the WHO-5 as a screening tool for wellbeing and depression in patients with schizophrenia; and (2) to determine the optimal cut-off point to identify schizophrenia patients with depression.MethodsChronic, remitted patients with schizophrenia took part in this cross-sectional study between August and October 2023 (n = 117; mean age of 57.86 ± 10.88 years and 63.3% males). The Calgary Depression Scale for Schizophrenia (CDSS) was included as index of validity. For the validation of the WHO-5 scale, we performed a confirmatory factor analysis (CFA) using the original structure of the scale. To assess the discriminatory validity of the Arabic version of the WHO-5 as a screening tool for depression, we conducted a Receiver operating characteristic (ROC) curve analysis, taking the WHO-5 reversed score against the dichotomized CDSS score at a cut off value of 6.ResultsThe results of CFA supported the originally proposed unidimensional structure of the measure, with good internal consistency reliability (α = 0.80), concurrent validity, and cross-sex measurement invariance. The WHO-5 showed a sensitivity of 0.8 and a specificity of 0.7 in the detection of depression with a cut-off point of 9.5. The validity of the WHO-5 as a screening tool for depression was supported by the excellent discrimination AUC value of 0.838. Based on this WHO-5 cut-off value, 42.6% of the patients were screened as having a depression.ConclusionThe study contributes to the field by showing that the WHO-5 is a concise and convenient self-report measure for quickly screening and monitoring depressive symptoms in patients with schizophrenia. It is therefore highly recommended to apply this cut-off point for screening and follow-up assessments. The current findings will hopefully encourage clinicians and researchers working in Arab settings, who are often confronted with significant time and resource constraints, to start using the WHO-5 to aid their efforts in mitigating depression in this vulnerable population and fostering research in this under-researched area.

Involving stakeholders in designing a mental health curriculum for staff in the vision impairment sector

Depression and anxiety are common in people with congenital and acquired vision impairment but often go unaddressed. Staff from a variety of professions and roles in the sight impairment sector are well-placed to identify mental health issues and signpost individuals for support. However, many of these individuals need training to do this competently. The aim of this project was to develop a mental health training curriculum for staff. We used a seven-step method involving staff and service users from national sight loss charities and local authorities, and university researchers. The result was a curriculum containing five modules covering an introduction to mental well-being, the use of a standardised depression and anxiety screening tool, referral and support options and implementation issues to consider. Future work involves developing the curriculum into an online training programme for wide dissemination across the sight loss sector.

Assessing the Relationship between Physical Health, Mental Health and Students' Success among Universities in Lebanon: A Cross-Sectional Study.

Achieving high academic success is known to be influenced by many factors including, but not limiting to, physical and mental health. The present study aimed to assess the relationship between physical health, mental health, and university students' success, and to explore the associations between these factors and their academic achievement. A cross-sectional, self-administered online survey was used to collect data from college students in three different universities in Lebanon during the Fall 2023 semester. Mental health was evaluated using validated screening tools for depression, anxiety, and stress, specifically the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7), and Cohen's Perceived Stress Scale (PSS), respectively. Additionally, general questions regarding physical health and lifestyle factors were incorporated into the questionnaire. Academic achievement was measured using students' grade point average (GPA). A total of 261 students completed the self-administered online survey. The results revealed that approximately 42% and 36% of students were experiencing moderate to severe symptoms of depression and anxiety, respectively, and 75.1% of students exhibited symptoms of moderate stress. The majority of participants (99.2%) did not report any physical disability. Chi-square analysis revealed a significant association between mental health status (depression, anxiety, and stress) and GPA level (p = 0.03, p = 0.044, p = 0.015, respectively). Multiple logistic regression models identified eight correlates of GPA and highlighted the relationship between physical health and student success. For instance, students who considered themselves moderately active had lower odds of achieving a higher GPA than those who considered themselves active (OR = 0.41, p = 0.045). This is the first investigation into Lebanese university students' academic success in relation to lifestyle and mental health profiles. The findings indicate that implementing public health programs and interventions targeting mental health and lifestyle behaviors is essential for enhancing student success.

Patterns of peripartum depression and anxiety during the pre-vaccine COVID-19 pandemic

BackgroundPregnant people are vulnerable to new or worsening mental health conditions. This study aims to describe prevalence and course of depression and anxiety symptoms in pregnancy during the pre-vaccine COVID-19 pandemic.MethodsThis is a prospective cohort study of pregnant individuals with known or suspected COVID-19. Participants completed Edinburgh Postnatal Depression Scale (EPDS) and Generalized-Anxiety Disorder-7 (GAD-7) questionnaires, screening tools for depression and anxiety, at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum. Prevalence of elevated depressive and anxiety symptoms at each visit was described. Univariable logistic regression analysis was used to determine the association between demographic and clinical factors and those with elevated depression or anxiety symptoms.Results317 participants were included. The prevalence of elevated antepartum depression symptoms was 14.6%, 10.3%, and 20.6% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. The rate of elevated anxiety symptoms was 15.1%, 10.0%, and 17.3% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. A prior history of depression and/or anxiety (p’s < 0.03), as well as higher EPDS and GAD-7 scores at enrollment (p’s < 0.04) associated with elevated depression and anxiety symptoms throughout pregnancy and the postpartum period. Quarantining during pregnancy was associated with elevated anxiety symptoms at 34weeks gestational age in univariate (P = 0.027) analyses. COVID-19 diagnosis and hospitalization were not associated with elevated depression or anxiety symptoms.ConclusionsElevated depression and anxiety symptoms were prevalent throughout pregnancy and the postpartum period, particularly in those with prior depression and/or anxiety and who quarantined. Strategies that target social isolation may mitigate potential adverse consequences for pregnant people, and continued vigilance in recognition of depression and anxiety in pregnancy should be considered.

Prevalence of major depressive disorder and its associated factors among adult patients with neurolathyrism in Dawunt District, Ethiopia; 2022: community-based cross-sectional study.

Major Depressive Disorder (MDD) is one of the commonest mental disorders affecting more than 250million people globally. Patients with chronic illnesses had higher risks for developing MDD than the general population. Neurolathyrism is a chronic illness characterized by lifelong incurable spastic paralysis of lower extremities; causing permanent disability. It is highly prevalent in Dawunt district, Ethiopia; with a point prevalence of 2.4%. Despite this, there were no previous studies assessing the prevalence of MDD among patients with neurolathyrism in Ethiopia. To assess the prevalence of MDD and to identify its associated factors among patients with neurolathyrism in Dawunt district, Ethiopia. A community based cross-sectional study was conducted on 260 samples in Dawunt district from February 01 to March 30/ 2021. Multistage sampling technique was used to select study participants. The patient Health Questionnaire-9 (PHQ-9) depression screening tool was used to diagnose MDD. PHQ-9 is a standardized depression screening tool and a PHQ-9 score of ≥ 10 has a sensitivity and specificity of 88.0% [95% CI (83.0-92.0%)] and 85.0% [95% CI (82.0-88.0%)] for screening MDD. Data were collected by interview; entered to EpiData version 4.2.0; exported to SPSS version 25.0 for analysis; descriptive statistics and binary logistic regression model were used; AOR with 95% CI was used to interpret the associations; and finally results were presented by texts, charts, graphs, and tables. A total of 256 adult patients with neurolathyrism were participated; and the prevalence of MDD was found to be 38.7%. Being female [AOR = 3.00; 95% CI (1.15, 7.84)], living alone [AOR = 2.77; 95% CI (1.02-7.53)], being on neurolathyrism stage-3 [AOR = 3.22; 95% CI (1.09, 9.54)] or stage-4 [AOR = 4.00; 95% CI (1.28, 12.48)], stigma [AOR = 2.69; 95% CI (1.34, 5.39)], and lack of social/ family support [AOR = 3.61; 95% CI (1.80, 7.24)] were found to have statistically significant association with an increased odds of MDD; while regular exercise and ever formal counselling were found to have statistically significant association with a decreased odds of MDD. The prevalence of MDD among neurolathyrism patients in Dawunt district was high. Lack of social support, stigma, not getting formal counselling, and not involving in regular exercise were modifiable risk factors. Therefore, social support, reducing stigma, formal counselling, and encouraging regular exercise might help to reduce the burden of MDD among neurolathyrism patients.

IJCM_335A: Geriatric depression and associated factors: a community-based study in a rural area of Central Kerala

Background: Aging is a complex biological process associated with cellular and molecular damages. Rural India comprises 70 percent of the total geriatric population of the country. Kerala being a demographically advanced state have greater proportions of older population than the national average. Elderly constitutes a vulnerable group for depression, as they are especially prone to suffer adverse consequences of a depressive episode. Depression can cause great suffering and can lead to impaired functioning in daily life. Objective: : To estimate the prevalence of depression and determine the associated factors among elderly aged 60 years and above using Geriatric Depression Scale in Tholur Panchayath of Thrissur district, Kerala Methodology: A cross-sectional study was done among 200 older adults aged 60 years and above in October 2022 in Tholur village panchayat area of Thrissur District in Kerala. Using cluster sampling technique study participants were identified. After obtaining informed consent, a pretested questionnaire is administered to obtain sociodemographic characteristics and details of comorbid illness. The Geriatric Depression Scale, short-form questionnaire, was used as a screening tool for depression. Data was entered in MS Excel and statistically analyzed using the IBM SPSS software (trial version). Results: The mean age of the study population was 70.59 ± 7.89 years. 64.5% of the study population were females. 16.5% had mild depression, 10% had moderate depression and 11% had severe depression as per the geriatric depression scale (GDS) scoring. Conclusion: The prevalence of depression among the elderly was 37.8 %, and hence early diagnosis and prompt treatment are essential to reduce its burden in the community

Taste dysfunction as a predictor of depression in schizophrenia: A systematic review and meta-analysis.

This study aims to investigate the relationship between taste dysfunction and depression among patients with schizophrenia, to achieve early detection of depression in clinical practice. Following PRISMA guidance, a comprehensive literature search was conducted globally, covering papers published from 1961 to June 2023. A total of 17 manuscripts were selected through meta-analysis and sensitivity analysis after examining available materials from seven databases to determine the correlation between depression and taste dysfunction. The comparison of the 17 selected manuscripts revealed that individuals with gustatory dysfunction may be more likely to experience depressive symptoms (SMD, 0.51, 95% CI, 0.08 to 0.93, p = 0.02). Depression is associated with taste dysfunction in certain aspects, as indicated by the pleasantness ratings of sucrose solutions (SMD, -0.53, 95% confidence interval [CI] -1.11 to 0.05, p = 0.08), gustatory identification ability (SMD, 0.96, 95% CI, 0.03 to 1.89, p = 0.04), and the perception threshold of sweet taste (MD, 0.80, 95% CI, 0.79 to 0.81, p < 0.00001). Due to variations in the methods, designs, and selection criteria employed in the included studies, it is necessary to establish a feasible framework. Future research using detailed and targeted approaches can provide clearer and more unified conclusions on the relationship between taste dysfunction and depression. Moreover, further high-quality research is needed to obtain clearer conclusions and explore the potential of taste dysfunction as an effective tool for early screening of depression. This review has been registered in the PROSPERO on April 2022 with the identifier CRD42023400172.

Moderate or major anxiety and depression versus high alcohol consumption in women in Honduras

&lt;b&gt;Introduction:&lt;/b&gt; The role of women in society is diverse and fundamental.&lt;b&gt; &lt;/b&gt;&lt;br /&gt; &lt;b&gt;Objectives&lt;/b&gt;: To determine whether anxiety and moderate or major depression were associated with high alcohol consumption in Honduran women.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; A cross-sectional and analytic study was conducted using the self-reporting questionnaire test as a screening tool for anxiety, depression, and alcohol consumption.&lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;: Moderate or greater anxiety was more frequent among those with high alcohol consumption (aPR: 1.49; 95% CI: 1.09-2.04; p=0.013), was also frequent among those reporting violence at home (aPR: 1.63; 95% confidence interval [CI]: 1.36-1.94; p&amp;lt;0.001) and some history of mental pathology at home (aPR: 1.64; 95% CI: 1.44-1.87; p&amp;lt;0.001). Moderate or major depression was more frequent among those reporting violence at home (aPR: 1.54; 95% CI: 1.30-1.83; p&amp;lt;0.001) and having some history of mental pathology at home (aPR: 1.38; 95% CI: 1.18-1.63; p&amp;lt;0.001).&lt;br /&gt; &lt;b&gt;Conclusions: &lt;/b&gt;A significant association was observed between anxiety and high alcohol consumption in this population of women from Honduras.

Predictors of anxiety and depression in patients with oral cancer undergoing radical resection with reconstructive surgery

ObjectivesThe reduced survival rate and diminished quality of life (QOL) observed in cancer patients with depression have garnered significant attention in recent years. Oral cancer can cause psychological and social stress because its incidence and treatment not only impair oral functions, such as mastication, swallowing, and articulation, but also disfigure the face. In this study, we investigated the factors that predict worsening psychiatric symptoms, such as anxiety and depression, in patients with oral cancer. Materials and methodsThirty-seven patients with oral cancer who underwent radical resection with reconstructive surgery between 2017 and 2022 were enrolled. The Japanese version of the Hospital Anxiety and Depression Scale (HADS), a screening tool for anxiety and depression, was used to obtain preoperative scores and up to 9-month postoperative scores. ResultsThe number of patients that exceeded the cut-off values for adjustment disorder and depression was 19 (51.4%) preoperative and 20 (54.1%), 13 (35.1%), and 14 (37.8%) at 3, 6, and 9 postoperative months, respectively. The analysis of covariance showed that the primary site (F = 218.267, p = 0.0216) and marital status (F = 105.758, p = 0.0269) were factors that affected the HADS scores. ConclusionThe risk of postoperative anxiety and depression in patients with oral cancer undergoing radical resection with reconstruction may be increased in patients whose tongue is the primary site and in patients who are single.

An empirical comparison of statistical methods for multiple cut-off diagnostic test accuracy meta-analysis of the Edinburgh postnatal depression scale (EPDS) depression screening tool using published results vs individual participant data

BackgroundSelective reporting of results from only well-performing cut-offs leads to biased estimates of accuracy in primary studies of questionnaire-based screening tools and in meta-analyses that synthesize results. Individual participant data meta-analysis (IPDMA) of sensitivity and specificity at each cut-off via bivariate random-effects models (BREMs) can overcome this problem. However, IPDMA is laborious and depends on the ability to successfully obtain primary datasets, and BREMs ignore the correlation between cut-offs within primary studies.MethodsWe compared the performance of three recent multiple cut-off models developed by Steinhauser et al., Jones et al., and Hoyer and Kuss, that account for missing cut-offs when meta-analyzing diagnostic accuracy studies with multiple cut-offs, to BREMs fitted at each cut-off. We used data from 22 studies of the accuracy of the Edinburgh Postnatal Depression Scale (EPDS; 4475 participants, 758 major depression cases). We fitted each of the three multiple cut-off models and BREMs to a dataset with results from only published cut-offs from each study (published data) and an IPD dataset with results for all cut-offs (full IPD data). We estimated pooled sensitivity and specificity with 95% confidence intervals (CIs) for each cut-off and the area under the curve.ResultsCompared to the BREMs fitted to the full IPD data, the Steinhauser et al., Jones et al., and Hoyer and Kuss models fitted to the published data produced similar receiver operating characteristic curves; though, the Hoyer and Kuss model had lower area under the curve, mainly due to estimating slightly lower sensitivity at lower cut-offs. When fitting the three multiple cut-off models to the full IPD data, a similar pattern of results was observed. Importantly, all models had similar 95% CIs for sensitivity and specificity, and the CI width increased with cut-off levels for sensitivity and decreased with an increasing cut-off for specificity, even the BREMs which treat each cut-off separately.ConclusionsMultiple cut-off models appear to be the favorable methods when only published data are available. While collecting IPD is expensive and time consuming, IPD can facilitate subgroup analyses that cannot be conducted with published data only.

P1113 Depressive symptoms in ulcerative colitis and Crohn's disease – differences in improvement at 1 year follow-up

Abstract Background Mental health (MH) has been reported to be poorer among patients with inflammatory bowel disease (IBD) than general population. However, it is not known whether MH is more driven by inflammation itself or related to gastrointestinal (GI) symptoms. Also, the dynamics of MH following IBD diagnosis is not well understood. Methods In the Swedish Inception Cohort of IBD (SIC-IBD), patients with Crohn’s disease (CD), ulcerative colitis (UC) and unclassified IBD (IBD-U) as well as symptomatic controls (SC) and healthy controls (HC) filled in Patient Health Questionnaire-9 (PHQ-9), a validated screening tool for depression. Patients completed PHQ-9 at diagnosis and at one year follow-up while the controls completed it once. Disease outcome was defined at one year based on requirement of advanced treatments/ surgery. Results In total, 286 individuals (16 HC, 89 SC, 62 CD, 104 UC, 15 IBD-U) completed the questionnaire at baseline. HC had significantly lower PHQ-9 score, (fewer depressive symptoms), at baseline compared to all the other groups (p&amp;lt;0.01). The baseline PHQ-9 score was not significantly different between SC and CD, UC and IBD-U patients (p=0.06). At one year follow-up, 38 CD and 53 UC patients completed the PHQ-9. Between baseline and follow-up, UC patients had a significant drop in their PHQ-9 score (p&amp;lt;0.0000001), whereas CD patients did not have any significant change in their PHQ-9 score (p=0.06). Furthermore, UC patients had significantly lower PHQ-9 score compared with CD patients at follow-up (p=0.04, Figure 1). Baseline PHQ-9 score was not correlated with calprotectin at baseline neither in UC nor CD patients (p=0.7 and 0.5 respectively). Also, there was no positive correlation between PHQ-9 score change and calprotectin change in either UC or CD patients, and neither baseline nor follow-up PHQ-9 scores were significantly different in patients with poor or good outcome (p&amp;gt;0.05). When analysed separately by sex, there was still no correlation between baseline PHQ-9 score and outcome in neither CD nor UC patients (p&amp;gt;0.05) Conclusion IBD patients have at the time of diagnosis more depressive symptoms than HC, but not different from SC. Depressive symptoms are more related to GI symptoms than IBD specific inflammation or disease outcome. UC patients show more of an improvement in their depressive symptoms one year after diagnosis than CD patients.

Evaluating the development and well-being assessment (DAWBA) in pediatric anxiety and depression

Enhancing screening practices and developing scalable diagnostic tools are imperative in response to the increasing prevalence of youth mental health challenges. Structured lay psychiatric interviews have emerged as one such promising tool. However, there remains limited research evaluating structured psychiatric interviews, specifically their characterization of internalizing disorders in treatment-seeking youth. This study evaluates the relationship between the Development and Well-Being Assessment (DAWBA), a structured psychiatric interview, and established measures of pediatric anxiety and depression, including the Screen for Child Anxiety Related Disorders (SCARED), the Pediatric Anxiety Rating Scale (PARS), and the Mood and Feelings Questionnaire (MFQ). The study comprised two independent clinical samples of treatment-seeking youth: sample one included 55 youth with anxiety and 29 healthy volunteers (HV), while sample two included 127 youth with Major Depressive Disorder and 73 HVs. We examined the association between the DAWBA band scores, indicating predicted risk for diagnosis, the SCARED and PARS (sample one), and the MFQ (sample two). An exploratory analysis was conducted in a subset of participants to test whether DAWBA band scores predicted the change in anxiety symptoms (SCARED, PARS) across a 12-week course of cognitive behavioral therapy. The results revealed that the DAWBA significantly predicted the SCARED, PARS and MFQ measures at baseline; however, it did not predict changes in anxiety symptoms across treatment. These findings suggest that the DAWBA may be a helpful screening tool for indexing anxiety and depression in treatment-seeking youth but is not especially predictive of longitudinal trajectories in symptomatology across psychotherapy.

Mental Health Assessments in Emergency Department Patients: Assessing Longitudinal Follow-up and Retest Reliability (MCAT-2) [Provisional Baseline Analysis

Background/Objective:The prevalence of anxiety and depression in adults in the United States is high with many experiencing ≥1 episode of anxiety or depression over a given year. Despite this, diagnoses of anxiety and depression in patients presenting to the ED for somatic complaints are seldom, relative to the population prevalence. Current fixed-item anxiety and depression screening tools have variable specificity and sensitivity, but adaptive screening tools such as the Computerized Adaptive Testing-Mental Health tool (CAT-MH) are thought to provide improved diagnostic characteristics and precision over fixed item tools. Our objective is to establish the reliability ofits depression and anxiety severity assessments in patients initially screened in an ED setting and reassessed over 30 days.&#x0D; Methods:We are conducting a longitudinal observational study among adult ED patients presenting with somatic, non-mental health complaints. The CAT-MH, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-8 (PHQ-8), are administered to randomly selected patients meeting enrollment criteria after informed consent. Participants are reassessed at 1-, 2-, and 4 weeks after ED discharge and analyzed for longitudinal test-retest reliability and sensitivity to change in score severity over time.&#x0D; Results:In this ongoing study, we present baseline anxiety and depression severity assessments for the first 49 enrolled patients (Mean age of 37, 73% female, 49% white, 47% black). Fixed item tools (GAD-7 and PHQ-8) categorized 16% and 6% of patients as moderate and severe anxiety respectively vs 19% and 15% as moderate, and moderately-severe/severe depression. In comparison, CAT-MH categorized 8% and 10% as moderate and severe anxiety.10% and 6% were categorized as moderate and severe depression.&#x0D; Conclusion:In this longitudinal observational study, we present baseline data for the first 49 out of 100 planned patients. Upon completion of the study, we hope to find that the severity assessments from CAT-MH remain stable over 30 days.

The Impact of COVID-19 Pandemic on Mental Health of Adolescents With Chronic Medical Conditions: Findings From a German Pediatric Outpatient Clinic

PurposeThe impact of the COVID-19 pandemic on the mental health of adolescents is of great concern, especially in the vulnerable group of adolescents with chronic medical conditions. The aim of this study was to examine this impact on the mental health of adolescents with chronic medical conditions treated in a German pediatric outpatient clinic. MethodsChanges in the mental health status of adolescents with chronic medical conditions treated in a German pediatric outpatient clinic during the COVID-19 pandemic were explored via validated screening tools for anxiety and depression. ResultsThe relative risk for adolescents with chronic medical conditions to develop clinically relevant symptoms of anxiety or depression was significantly higher (odds ratio 1,78 [confidence interval 1.06–3.04]) during the pandemic. DiscussionThis study identifies the COVID-19 pandemic as a potential additional risk for adolescents with chronic medical conditions to develop clinically relevant signs of anxiety or depression.

Age matters: association between age and depression severity at the time of OSA diagnosis and PAP adherence in adult patients.

Numerous studies have shown an association and symptom overlaps between obstructive sleep apnea (OSA) and depression. However, data are limited on the association between age, sex, the severity of depression at the time of OSA diagnosis, and its impact on positive airway pressure (PAP) adherence. The Patient Health Questionnaire (PHQ-9) is a validated depression screening and severity scoring tool recommended by the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). In this retrospective observational study, we evaluate the interrelationship between age at OSA diagnosis, depression severity, and PAP adherence. Patients with new OSA diagnosis, seen at the University of California San Francisco-Fresno Sleep Center between February and October of 2022, were evaluated. PHQ-9 scores for depression severity uses a 1 to 5 scale (1 = none, 2 = mild, 3 = moderate, 4 moderately severe, 5 = severe). The PHQ-9 was administered at the time of OSA diagnosis and follow-up. Average daily PAP usage hours were obtained from PAP devices between 1 to 3 months after therapy initiation. IBM SPSS version 29.0.0 was used to calculate descriptive statistics, Pearson correlation, and Mann-Whitney test. Seventy-seven patients fit the inclusion criteria, of which 28 were women (36.4%). The average baseline apnea-hypopnea index was 34.5 (standard deviation 31.8), with a PHQ-9 mean of 8.3 with standard deviation ± 5.9. A Mann-Whitney comparison between the group with normal PHQ-9 scores and the group with PHQ-9 scores consistent with depression (score of 5 or greater) showed no statistically significant differences in apnea-hypopnea index (P = .470) or average night hour use (P = .195). There was a statistically significant difference in age between both groups (P = .031). Spearman correlation confirmed a negative, statistically significant correlation between PHQ-9 scores and age in patients with OSA. This study showed that PHQ-9 scores at the time of OSA diagnosis are moderately correlated with younger age, with those patients younger than 50 years old having more moderate to severe depression scores than older patients. We did not find a correlation between age and PAP adherence or between PHQ-9 scores and PAP adherence. Our findings can help identify high-risk depression patients early in the diagnosis of OSA and bring awareness that the young adult population can be particularly vulnerable. Niraula R, Singh A, DelRosso LM, Meghpara S, Keenan L. Age matters: association between age and depression severity at the time of OSA diagnosis and PAP adherence in adult patients. J Clin Sleep Med. 2024;20(6):859-862.

Cluster Analysis of the Positive and Negative Indicators of Complete Mental Health State Model

&lt;p&gt;本研究目的在了解正負向指標篩檢心理健康型態集群分佈情形，是否符合Keyes主張以主觀幸福感與憂鬱症狀雙指標區分的完整心理健康模式。研究設計以心理健康BMI幸福感問卷、病人健康狀況憂鬱問卷，做為正負向指標篩檢工具，架構完整心理健康模式；以問卷調查法立意取樣739份樣本，經群集分析法作統計分群。結果能區分出有意義的四群集，包括擁有高幸福低憂鬱之完整圓滿心理健康型態的「心盛型」群集（46.28%）、不完整心理健康型態三個群集:「冷靜型」（低幸福低憂鬱之不完整心理亞健康型態，31.94%）、「奮戰型」（高幸福高憂鬱之不完整心理健康型態，11.10%）、「混沌型」（低幸福高憂鬱之不完整心理健康型態，10.69%）。低憂鬱者佔全體 78.22%，其中59.17%擁有高幸福而處於完整圓滿心理健康型態；高憂鬱者佔全體21.78%，其中50.93%擁有高幸福感。驗證了幸福感、憂鬱傾向作為正負向心理健康指標，篩檢完整或不完整心理健康型態。建議:（1）高憂鬱者參照「奮戰型」這群人高幸福感來源，藉由參與社團獲得人際支持、找到工作及收入來增加自我價值感；（2）「冷靜型」不能單看低憂鬱的心理健康篩檢，需提升「友善人際支持 正念情緒平穩 認同自我價值意義」之正向心理健康BMI幸福感，以獲得完整心理健康；（3）未來研究可依據正負向心理健康指標去發展心理健康素養能力，作為心理健檢與自主管理完整心理健康之用。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This study aimed to understand the cluster distribution of positive and negative indicators for screening mental health patterns and whether they conform to Keyes’ claim that positive and negative indicators should be included in the complete mental health state model. The positive mental health indicators included social, emotional, and psychological well-being, which should be measured using the Mental Health Continuum Short Form (MHC-SF). Negative indicators measure the level of symptoms of mental illness concurrently, serving as a complete assessment of whether the individual is in a healthy state of positive and negative mental health indicators. Keyes employed these to distinguish four clusters of people with four mental health modes, of which the incomplete mental health cluster was in the state. Even if they have a negative mental illness, they could have positive mental health and well-being. Although some people do not have negative mental illness, they cannot have positive mental health and well-being. Therefore, Taiwanese scholar Li corresponded to these three well-being developments and selected three operational mental health skills: &amp;quot;&amp;quot;Befriend-Mindfulness-Identity&amp;quot;&amp;quot; as the Mental Health BMI Well-Being Index questionnaire (mBMI). After using them to evaluate 739 people, it was evident that the scores of the above two questionnaires were significantly correlated, and the mBMI questionnaire total score and Questions B, M, and I could effectively predict the total score, social, emotional, and psychological well-being of the MHC-SF, with a total explanatory power of 30.3%. This test should be used as a simple screening for well-being and as a positive mental health screening tool. Additionally, a Depression Scale Screening Tool for Negative Mental Health Depression was combined to explore the complete mental health state model of Taiwanese people. &lt;/p&gt; &lt;p&gt; Therefore, in this study, the mBMI questionnaire was selected as a simple tool to measure positive mental health well-being, and the patients&amp;rsquo; health questionnaire for depression was used as a screening tool for negative mental health indicators. These are used as positive and negative indicators to test whether a complete or incomplete mental health state model fits. The questionnaire survey method was used to deliberately sample the data from 739 valid samples, and the cluster analysis method was used for statistical grouping to verify its suitability. According to the results of the aforementioned positive and negative indicators, four meaningful clusters were distinguished, including one complete and three incomplete mental health models. One cluster was &amp;quot;&amp;quot;Flourishing type&amp;quot;&amp;quot;(46.28%) of high well-being and low depression, which belonged to the complete mental health state model. The other three clusters were incomplete mental health state models. &amp;quot;&amp;quot;Fighting type&amp;quot;&amp;quot; (31.94%) of high well-being and high depression, &amp;quot;&amp;quot;Calm type&amp;quot;&amp;quot; (11.10%) of low well-being and low depression, and &amp;quot;&amp;quot;Chaos type&amp;quot;&amp;quot; (10.69%) of low well-being and high depression could fight for high well-being. It was verified that well-being and depression could be used as positive and negative mental health indicators to screen for complete or incomplete mental health state models. When we identified people with high depression, we encouraged them to refer to the source of high well-being of the &amp;quot;&amp;quot;fighting type&amp;quot;&amp;quot; group and increase their sense of self-worth by participating in clubs to obtain interpersonal support, find jobs, and earn income. We reminded the &amp;quot;&amp;quot;calm type&amp;quot;&amp;quot; people with low depression to promote their high well-being to have a complete mental health state. Finally, we monitored positive and negative indicators of mental health using screening tools of the Mental Health BMI Well-Being Index and the Patient Health Questionnaire (PHQ-9) to screen for complete or incomplete mental health states as a reference for promoting positive and negative mental health. The befriend-mindfulness-identity skills should be improved to promote well-being and adjust depression to achieve complete mental health.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Psychometric Properties of the Patient Health Questionnaire-9 for Saudi Caregivers: A Cross-Sectional Study in Saudi Arabia.

To evaluate the psychometric properties of the Arabic-language Patient Health Questionnaire-9 (PHQ-9) among Saudi caregivers of patients with chronic diseases. Using a cross-sectional design, 94 Saudi caregivers (37 male and 57 female) in the medical city participated in the study. A comparative assessment was conducted on 4 models proposed in the existing PHQ-9 literature to gauge their compatibility through confirmatory factor analyses. This study evaluates convergent validity through a correlation analysis, examining the relationship between the PHQ-9 and the Depression, Anxiety, and Stress Scale-21 (DASS-21). Among the various models we examined, the single-factor structure of the PHQ-9 displayed the best fit with the data we gathered. Notably, the Cronbach alpha coefficient for the PHQ-9 registered at .81, indicating a high level of internal consistency. Factor loadings spanned a range from .39 to .76. The convergent validity of the PHQ-9 and DASS-21 was deemed satisfactory. It is established that the PHQ-9 serves as an effective tool for depression screening among Saudi caregivers in Saudi Arabia. Its strengths lie in its demonstrated validity, dependability, brevity, and convenience of administration, positioning it as a valuable resource for preventative measures and performance assessment within mental health settings.

Prevalence of and optimal screening tool for postpartum depression in a community-based population in China

BackgroundPostpartum depression (PPD) is an important public health problem worldwide. China is planning to launch PPD screening in community settings, but there are questions on the community prevalence of PPD and validated screening tools. MethodsWe sought to recruit all eligible new mothers during postnatal home visits in two districts of Changsha, China, and after informed consent, screened them for PPD using three self-administered questionnaires—the Edinburgh Postpartum Depression Scale (EPDS), the Patient Health Questionnaire (PHQ-9), and Whooley Questions for Depression Screening. Video structured diagnostic interviews were performed online according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) by qualified specialists who were blinded to screening results. Optimal screening was determined based on the acceptability of scales and diagnostic accuracy metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). ResultsOut of 3004 eligible women, 2730 (90.9 %) completed the screening questionnaires. Among those screened, the video structured diagnostic interview was administered to 1862 (68.2 %) and 62 (3.3 %) were diagnosed with a current depressive condition. The optimal screening approach involved combining Whooley Questions (at least one “yes”) with EPDS (cutoff >10) in series, with sensitivity of 0.76 (95 % CI 0.63 to 0.85), specificity of 0.93 (0.92 to 0.94), PPV of 0.28 (0.21 to 0.36) and NPV of 0.99 (0.98 to 1.00). LimitationsDue to the regional sample and exclusion of mothers with telephone contact rather than home visits, our findings may not be fully generalizable to the entire population. ConclusionsThe prevalence of PPD among women in this sample was substantially lower than those reported in previous studies in China, the majority of which used screen positivity in measuring prevalence. Combining Whooley Questions with EPDS in series is the most optimal screening approach in this population, though this would still result in a high number of false positives at current prevalence.

Optimal cut-offs of depression screening tools during the COVID-19 pandemic: a systematic review

BackgroundStudies have reported an increase in the prevalence of depression during the COVID-19 pandemic. The accuracy of screening tools may change with the prevalence and distribution of a disease in a population or sample: the “Spectrum Effect”.MethodsFirst, we selected commonly used screening tools and developed search strategies for the inclusion of original studies during the pandemic. Second, we searched PsycINFO, EMBASE, and MEDLINE from March 2020 to September 2022 to obtain original studies that investigated the accuracy of depression screening tools during the pandemic. We then searched these databases to identify meta-analyses summarizing the accuracy of these tools conducted before the pandemic and compared the optimal cut-offs for depression screening tools during the pandemic with those before.ResultFour original studies evaluating the optimal cut-offs for four screening tools (Beck Depression Inventory [BDI-II], Hospital Anxiety and Depression Scale-Depression [HADS-D], Patient Health Questionnaire-9 [PHQ-9], and Geriatric Depression Scale-4 [GDS-4]) were published during the pandemic. Four meta-analyses summarizing these tools before the pandemic. We found that the optimal cut-off of BDI-II was 14 during the pandemic (23.8% depression prevalence, screening patients with Type 2 diabetes) and 14.5 before the pandemic (17.6% depression prevalence, screening psychiatric, primary care, and healthy populations); HADS-D was 10 during the pandemic (23.8% depression prevalence, screening patients with type 2 diabetes) and 7 before the pandemic (15.0% depression prevalence, screening medically ill patients); PHQ-9 was 11 during the pandemic (14.5% depression prevalence, screening university students) and 8 before the pandemic (10.9% depression prevalence, screening the unrestricted population), and GDS-4 was 1.8 during the pandemic (29.0% depression prevalence, screening adults seen in a memory clinic setting) and 3 before the pandemic (18.5% depression prevalence, screening older adults).ConclusionThe optimal cut-off for different screening tools may be sensitive to changes in study populations and reference standards. And potential spectrum effects that should be considered in post-COVID time which aiming to improve diagnostic accuracy.