Depressive Symptom Scores Research Articles

Pandemic COVID 19 and healthcare professionals: Mental health impact and depression

IntroductionThe SARS-COV2 pandemic represents a problematic and disruption of global health. Repeated exposure to stressful situations leads to increased psychological distress.ObjectivesTo determine the psychoaffective impact of the Covid-19 pandemic on the mental health of health professionals in Tunisia, assess the intensity of depressive symptoms professionals and determine factors associated with the development of these symptoms.MethodsThis was a multicenter, cross-sectional, descriptive and analytical study conducted among health professionals, from May 2nd, 2020 to June 30th, 2020 in Tunisia. The health professionals included were physicians, nurses, dentists, and pharmacists. Using an electronic form << Google Form >>, a questionnaire was drawn up with 32 items. Assessment of depressive symptoms was performed using the PHQ-9 psychometric scale.Statistical analysis was performed using SPSS 21.0 statistical software. Regarding the analytical study, a professional with a PHQ-9 scale score between 10 and 27 was considered as having moderate to severe depressive symptoms while a score between 15-27 was in favor of severe depressive symptoms.ResultsCaregivers were predominantly female 69.5% with a mean age of 30.74 years. Anxiety-depressive psychiatric history was found in 11.8% of the subjects. The majority of the professionals were doctors (77.8%) and 9.4% of the participants were nurses. The majority of participants worked in university hospitals (84.2%). One third of the participants, (34.3%) worked in departments with Covid-19 patients with respective rates of 57% for nurses and 36% for physicians. Dentists and pharmacists did not work in Covid-19 circuits.The mean score on the PHQ-9 scale was equal to 8.62 ± 5.35. Depressive symptoms were noted in 37.4% of the professionals, with moderate to severe intensity in 35.5% of cases. Participants with a psychiatric history of depression or anxiety disorder had significantly higher depressive symptom scores (p<0.001) with 6 times higher the risk of developing moderate to severe depressive symptoms (p<0.0001, OR 6.25, CI [2.35-16.61] and almost 3 times higher the risk of experiencing severe depressive symptoms (p=0.05, OR=2.93, CI [1.09-7.88]). The nursing profession had high odds ratios for the occurrence of moderate to severe depressive symptoms (p=0.002, OR=4.41, CI [1.58-12.28]) and severe depressive symptoms (p=0.02, OR=3.82, CI [1.28-11.39]). A significant relationship was established, between the development of depressive symptoms of moderate to severe intensity with the history of depressive disorder or anxiety disorder (p=0.001) and the nursing profession (p=0.01).ConclusionsThe optimization of prevention, the creation of specific treatment, the promotion of health education and specific hygiene rules would participate in improving the mental health of health professionals.Disclosure of InterestNone Declared

Abstract P254: Mental Well-Being of Caregivers With Overweight and Obesity is Associated With Cognitive Stimulation Provided to Children in the Home

Introduction: Parents with poor mental health are less likely to engage in cognitively enriching parenting behaviors, such as reading and playing with their children. This, in turn, is associated with increased risk of obesity in the child and poor treatment outcomes for children enrolled in behavioral weight management. Parents and caregivers with obesity also have worse mental health and lower life satisfaction than their non-obese counterparts. Among parents with overweight and obesity who have a child with overweight/obesity, the relationship between parent mental health and cognitive enrichment provided in the home is unknown. Hypothesis: We hypothesize that higher depressive symptoms and lower subjective well-being scores among parents will be associated with less cognitive enrichment provided to children. Further, we hypothesize that these relationships will be moderated by the sex of the parent. Methods: This study was a secondary analysis of baseline data from 452 parent-child dyads with overweight/obesity enrolled in a family-based behavioral treatment study for obesity. Depression symptoms and subjective well-being were assessed using the Patient Health Questionnaire-9 scale and the MacArthur Scale of Subjective Social Status, respectively. Cognitive stimulation was measured with the Cognitive Stimulation subscale of the Environmental Enrichment scale. Univariable relationships were assessed using Pearson correlations. Multivariable linear regression models were used to control for study site, parent characteristics (age, BMI, sex, race/ethnicity, education), child characteristics (age, and sex), and family characteristics (health insurance status and household income). Results: Higher depression symptom score was correlated with lower cognitive stimulation (ρ = -0.165, p < 0.001), whereas higher subjective well-being was associated with higher cognitive stimulation (ρ = 0.377, p < 0.001). These relationships were maintained even after controlling for covariates in the multivariable models, with each one-unit increase in depression symptoms associated with a 0.16 unit decrease in cognitive stimulation (95% CI -0.27 to -0.06, p = 0.003) and each one-unit increase in subjective well-being associated with a 0.04 unit increase in cognitive stimulation (95% CI 0.01, 0.07, p = 0.01). Parent sex did not moderate these effects. Conclusions: Mental well-being of parents and caregivers with overweight/obesity is associated with the degree of cognitive enrichment provided to the child in the home, though the effect sizes after controlling for covariates were modest. Thus, interventions targeting parental wellbeing offer a potential avenue to improve their child’s cognitive wellbeing and response to obesity treatment.

Evolution of depressive symptoms from before to 24 months after bariatric surgery: A systematic review and meta-analysis.

Depression after bariatric surgery can lead to suboptimal health outcomes. However, it is unclear how depressive symptoms evolve over the 24 months after surgery. We determined the extent depressive symptoms changed up to 24 months after bariatric surgery and how this was impacted by measurement tool and surgical procedure. We conducted a systematic review and meta-analysis, searching five databases from database inception to June 2021 for studies that prospectively measured depressive symptoms before and up to 24 months after bariatric surgery. Change scores were converted to Hedge's g, and analyses were performed using mixed-effects models. Subgroup analyses examined differences across time of follow-up, measurement tool, and surgical procedure. Forty-six studies met inclusion criteria (32,342 patients). Meta-analysis indicated a postsurgical reduction in depressive symptom scores that were significant (large effect, g = 0.804; 95% CI: 0.73-0.88, I2 = 95.7%). Subgroup analyses found that symptom reductions did not differ between the timing of follow-up periods, measurement tool, and surgical procedure. Depressive symptom scores reduced substantially following surgery; comparable decreases occurred 6 through 24 months after surgery. These findings can help inform practitioners of the typical evolution of depressive symptoms following surgery and where deviations from this may require additional intervention.

Genetic propensity, socioeconomic status, and trajectories of depression over a course of 14 years in older adults

Depression is one of the leading causes of disability worldwide and is a major contributor to the global burden of disease among older adults. The study aimed to investigate the interplay between socio-economic markers (education and financial resources) and polygenic predisposition influencing individual differences in depressive symptoms and their change over time in older adults, which is of central relevance for preventative strategies. The sample encompassing n = 6202 adults aged ≥50 years old with a follow-up period of 14 years was utilised from the English Longitudinal Study of Ageing. Polygenic scores for depressive symptoms were calculated using summary statistics for (1) single-trait depressive symptoms (PGS-DSsingle), and (2) multi-trait including depressive symptoms, subjective well-being, neuroticism, loneliness, and self-rated health (PGS-DSmulti-trait). The depressive symptoms over the past week were measured using the eight-item Centre for Epidemiologic Studies Depression Scale. One standard deviation increase in each PGS was associated with a higher baseline score in depressive symptoms. Each additional year of completed schooling was associated with lower baseline depression symptoms (β = −0.06, 95%CI = −0.07 to −0.05, p < 0.001); intermediate and lower wealth were associated with a higher baseline score in depressive symptoms. Although there was a weak interaction effect between PGS-DSs and socio-economic status in association with the baseline depressive symptoms, there were no significant relationships of PGS-DSs, socio-economic factors, and rate of change in the depressive symptoms during the 14-year follow-up period. Common genetic variants for depressive symptoms are associated with a greater number of depressive symptoms onset but not with their rate of change in the following 14 years. Lower socio-economic status is an important factor influencing individual levels of depressive symptoms, independently from polygenic predisposition to depressive symptoms.

Time trends in mental health indicators in Germany's adult population before and during the COVID-19 pandemic.

Times of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce. We analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education. While mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022. Elevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.

The Role of Internet Use and Offline Social Engagement in the Health of Chinese Older Adults: Evidence from Nationally Representative Samples

This study investigated the association between internet use as a novel type of social engagement and the health of older adults, and evaluated the role of online versus offline social activities through nationally representative samples. Participants aged ≥ 60 in the datasets from the Chinese sample of the World Value Survey (NSample 1 = 598) and the China Health and Retirement Longitudinal Study (CHARLS, NSample 2 = 9434) were selected. Correlation analysis presented the positive relationships between internet use and self-reported health in both Sample 1 (r = 0.17, p < 0.001) and Sample 2 (r = 0.09, p < 0.001). In addition, the relationships between internet use and both self-reported health and depression (r = -0.14, p < 0.001) were stronger than the correlation between offline social activities and health outcomes in Sample 2. After accounting for the frequency of traditional social activities, regression analysis revealed the relationship between internet use and higher self-reported health (βSample 1 = 0.16, p < 0.001; βSample 2 = 0.04, p < 0.001) and lower depressive symptom scores (β = -0.05, p < 0.001) This research contributes to the existing body of literature on the favorable relationship between social engagement and health outcomes among Chinese older adults. Additionally, it identifies the social benefits of internet use for health promotion among older adults.

Association Between the Severity of Depressive Symptoms and Human-Smartphone Interactions: Longitudinal Study.

Various behavioral sensing research studies have found that depressive symptoms are associated with human-smartphone interaction behaviors, including lack of diversity in unique physical locations, entropy of time spent in each location, sleep disruption, session duration, and typing speed. These behavioral measures are often tested against the total score of depressive symptoms, and the recommended practice to disaggregate within- and between-person effects in longitudinal data is often neglected. We aimed to understand depression as a multidimensional process and explore the association between specific dimensions and behavioral measures computed from passively sensed human-smartphone interactions. We also aimed to highlight the nonergodicity in psychological processes and the importance of disaggregating within- and between-person effects in the analysis. Data used in this study were collected by Mindstrong Health, a telehealth provider that focuses on individuals with serious mental illness. Depressive symptoms were measured by the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult Survey every 60 days for a year. Participants' interactions with their smartphones were passively recorded, and 5 behavioral measures were developed and were expected to be associated with depressive symptoms according to either theoretical proposition or previous empirical evidence. Multilevel modeling was used to explore the longitudinal relations between the severity of depressive symptoms and these behavioral measures. Furthermore, within- and between-person effects were disaggregated to accommodate the nonergodicity commonly found in psychological processes. This study included 982 records of DSM Level 1 depressive symptom measurements and corresponding human-smartphone interaction data from 142 participants (age range 29-77 years; mean age 55.1 years, SD 10.8 years; 96 female participants). Loss of interest in pleasurable activities was associated with app count (γ10=-0.14; P=.01; within-person effect). Depressed mood was associated with typing time interval (γ05=0.88; P=.047; within-person effect) and session duration (γ05=-0.37; P=.03; between-person effect). This study contributes new evidence for associations between human-smartphone interaction behaviors and the severity of depressive symptoms from a dimensional perspective, and it highlights the importance of considering the nonergodicity of psychological processes and analyzing the within- and between-person effects separately.

Physical Disability, Psychological Resilience, and COVID-Related Changes in Depressive Symptoms Among U.S. OlderAdults.

This study pursued 3 goals: (1) to determine how depressive symptoms among U.S.older adults changed in 2018-2020, a period transitioning to the first wave of coronavirus disease (COVID) pandemic, compared to in prepandemic periods, (2) to determine whether physical disability predicts change in depressive symptoms in 2018-2020, and (3) to assess whether psychological resilience moderates the association between physical disability and change in depressive symptoms in 2018-2020. Based on biennial longitudinal data of the Health and Retirement Study from 2010 to 2020, we used a before-after design and latent change score model to examine whether depressive symptoms change in 2018-2020 represents a continuation or departure from the overall trend of between-wave changes in 2010-2018. We also used physical disability in 2018 and psychological resilience in 2016-2018 to predict depressive symptoms change score in 2018-2020. In contrast to the relatively stable between-wave change trend in 2010-2018, there was an abrupt elevation in the latent change score of depressive symptoms in 2018-2020, which was primarily driven by increased affective symptoms (e.g., depressed mood, loneliness, unhappiness, and sadness). Increase in depressive symptoms in 2018-2020 was associated positively with physical disability but negatively with psychological resilience. Moderation effect of psychological resilience, however, was not significant. Our findings reveal heavier COVID-related mental health burden for older adults with physical disabilities and the potential benefits of enhancing individual psychological resilience. They also suggest that health interventions addressing the COVID impacts need to particularly focus on the affective aspects of depressive symptoms.

Disrupted dynamic functional connectivity of hippocampal subregions mediated the slowed information processing speed in late-life depression.

Slowed information processing speed (IPS) is the core contributor to cognitive impairment in patients with late-life depression (LLD). The hippocampus is an important link between depression and dementia, and it may be involved in IPS slowing in LLD. However, the relationship between a slowed IPS and the dynamic activity and connectivity of hippocampal subregions in patients with LLD remains unclear. One hundred thirty-four patients with LLD and 89 healthy controls were recruited. Sliding-window analysis was used to assess whole-brain dynamic functional connectivity (dFC), dynamic fractional amplitude of low-frequency fluctuations (dfALFF) and dynamic regional homogeneity (dReHo) for each hippocampal subregion seed. Cognitive impairment (global cognition, verbal memory, language, visual-spatial skill, executive function and working memory) in patients with LLD was mediated by their slowed IPS. Compared with the controls, patients with LLD exhibited decreased dFC between various hippocampal subregions and the frontal cortex and decreased dReho in the left rostral hippocampus. Additionally, most of the dFCs were negatively associated with the severity of depressive symptoms and were positively associated with various domains of cognitive function. Moreover, the dFC between the left rostral hippocampus and middle frontal gyrus exhibited a partial mediation effect on the relationships between the scores of depressive symptoms and IPS. Patients with LLD exhibited decreased dFC between the hippocampus and frontal cortex, and the decreased dFC between the left rostral hippocampus and right middle frontal gyrus was involved in the underlying neural substrate of the slowed IPS.

Comparative effectiveness of a mindfulness-based intervention (M-Body) on depressive symptoms: study protocol of a randomized controlled trial in a Federally Qualified Health Center (FQHC)

BackgroundMindfulness-based interventions have been shown to improve psychological outcomes including stress, anxiety, and depression in general population studies. However, effectiveness has not been sufficiently examined in racially and ethnically diverse community-based settings. We will evaluate the effectiveness and implementation of a mindfulness-based intervention on depressive symptoms among predominantly Black women at a Federally Qualified Health Center in a metropolitan city.MethodsIn this 2-armed, stratified, individually randomized group-treated controlled trial, 274 English-speaking participants with depressive symptoms ages 18–65 years old will be randomly assigned to (1) eight weekly, 90-min group sessions of a mindfulness-based intervention (M-Body), or (2) enhanced usual care. Exclusion criteria include suicidal ideation in 30 days prior to enrollment and regular (>4x/week) meditation practice. Study metrics will be assessed at baseline and 2, 4, and 6 months after baseline, through clinical interviews, self-report surveys, and stress biomarker data including blood pressure, heart rate, and stress related biomarkers. The primary study outcome is depressive symptom score after 6 months.DiscussionIf M-Body is found to be an effective intervention for adults with depressive symptoms, this accessible, scalable treatment will widely increase access to mental health treatment in underserved, racial/ethnic minority communities.Trial registrationClinicalTrials.gov NCT03620721. Registered on 8 August 2018.

Impact of long working hours on depressive symptoms among COVID-19 frontline medical staff: The mediation of job burnout and the moderation of family and organizational support.

During the COVID-19 pandemic, the frontline medical staff faced more workload and heavier physical and mental stress, which increased their job burnout and negative emotions. However, little is known about the potential factors mediating and moderating these relations. This study investigates the association between long working hours and depressive symptoms among frontline medical staff in China, and explores the potential mediating effect of job burnout, and moderating effect of family and organizational support on these associations. Data of 992 frontline medical staff who participated in the prevention and control of COVID-19 was obtained from the online survey conducted in November to December 2021 in China. Depressive symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9). Moderated mediating model was employed to understand the relationship between long working hours (X), depressive symptoms (Y) mediated through job burnout (M), moderated by family support (W1) and organizational support (W2), while controlling all possible covariates. 56.96% of participants worked more than 8 h per day. 49.8% of them had depressive symptoms (PHQ-9 ≥ 5) and 65.8% experienced job-related burnout. Long working hours was positively associated with depressive symptoms score (β = 0.26, 95% CI:0.13 ~ 0.40). Mediation analyses revealed that job burnout significantly mediated this relationship (indirect effect = 0.17, 95% CI: 0.08 ~ 0.26). Moderated mediation further indicated that both two interactions of social support (family support W1, organizational support W2) and job burnout were negatively related to depressive symptoms among frontline medical staff, indicating that higher social support being less job burnout with lower depressive symptoms. Longer working hours and higher job burnout may contribute to worse mental health among frontline medical staff. Social support could buffer the detrimental effects by reducing their job burnout. The main contribution of this study was to estimate the negative effect of long working hours on depressive symptoms among frontline medical staff and explore the potential mediating role of job burnout and moderating role of social support on these associations.

Association of Cardiovascular Health With Risk of Clinically Relevant Depressive Symptoms

Cardiovascular health may be used for prevention of depressive symptoms. However, data on the association of cardiovascular health across midlife with depressive symptoms are lacking. To evaluate whether better baseline cardiovascular health and improvement of cardiovascular health over time are associated with a lower risk of both incident depressive symptoms and unfavorable trajectories of depressive symptoms. Participants without depressive symptoms were included from a prospective community-based cohort in France (GAZEL cohort). Cardiovascular health examinations occurred in 1990 and 1997 and assessment of depressive symptoms in 1997 and every 3 years thereafter until 2015. Data were analyzed from January to October 2022. Number of cardiovascular health metrics (smoking, body mass index, physical activity, diet, blood pressure, glucose, and cholesterol) at an intermediate or ideal level in 1997 (range, 0-7) and 7-year change in cardiovascular health between 1990 and 1997. Primary outcome was incident depressive symptoms (20-item Center for Epidemiologic Studies-Depression Scale [CES-D] score of 17 or greater in men or 23 or greater in women); secondary outcome was trajectories of depressive symptoms scores. Trajectories included consistently low scores, moderately elevated scores, low starting then increasing scores, moderately high starting, increasing, then remitting scores, and moderately high starting then increasing scores. Of 6980 included patients, 1671 (23.9%) were women, and the mean (SD) age was 53.3 (3.5) years. During a follow-up spanning 19 years after 1997, 1858 individuals (26.5%) had incident depressive symptoms. Higher baseline cardiovascular health in 1997 and improvement in cardiovascular health over 7 years were each associated with lower risk of depressive symptoms (odds ratio [OR] per additional metric at intermediate or ideal level at baseline, 0.87; 95% CI, 0.84-0.91; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.91; 95% CI, 0.86-0.96). Also, better cardiovascular health was associated with lower risk of unfavorable depressive symptoms trajectories. Compared with the consistently low score trajectory, the lowest risks were observed for the low starting then increasing score trajectory (OR per additional metric at intermediate or ideal level at baseline, 0.70; 95% CI, 0.64-0.76; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.73; 95% CI, 0.68-0.79) and the moderately high starting then increasing score trajectory (OR per additional metric at intermediate or ideal level at baseline, 0.71; 95% CI, 0.64-0.79; OR per 1 higher metric at intermediate or ideal level over 7 years, 0.71; 95% CI, 0.64-0.77). In this prospective community-based cohort study of adults, higher cardiovascular health was associated with a lower risk of depressive symptoms over time. Elucidating which set of cardiovascular factors may affect depression risk could be important for prevention.

Local, collaborative, stepped, and personalized care management for older people with chronic diseases – results from the randomized controlled LoChro-trial

BackgroundIn the aging population of Western societies, an increasing number of older adults have multiple chronic diseases. As multifaceted health problems imply the involvement of several healthcare professionals, multimorbid older people frequently face a fragmentation of health care. Addressing these challenges, we developed a local, collaborative, stepped, and personalized care management approach (LoChro-Care) and evaluated its effectiveness.MethodsA two-group, parallel randomized controlled trial was conducted comparing LoChro-Care recipients (IG) to participants with usual care (CG). Patients aged 65 + with chronic conditions were recruited at inpatient and outpatient departments of the Medical Center, University of Freiburg. Participants were allocated using block randomization (nIG = 261, nCG = 263). LoChro-Care comprised individualized care provided by chronic care managers with 7 to 13 contacts over 12 months. Questionnaires were given at 3 time points (T0: baseline, T1: after 12 months, T2: after 18 months). The primary outcome was the physical, psychological, and social health status represented by a composite score of functional health and depressive symptoms. Secondary outcomes were the participants’ evaluation of their health care situation, health-related quality of life (HRQL), and life-satisfaction (LS). The data were analyzed using linear mixed modelling.ResultsWe analyzed N = 491 participants (nIG = 244, nCG = 247), aged M = 76.78 years (SD = 6.35). For the composite endpoint, neither a significant difference between IG and CG (p = .88) nor a group-time interaction (p = .52; p = .88) could be observed. Participants in both groups showed a significant decline on the primary outcome between T0 and T2 (p < .001). Post hoc analyses revealed a decline in both functional health (p < .001) and depressive symptoms (p = .02). Both groups did not differ in their evaluation of their health care situation (p = .93), HRQL (p = .44) or LS (p = .32). Relevant confounding variables were female gender and multimorbidity.ConclusionSupporting patients’ self-management in coordinating their individual care network through LoChro-Care did not result in any significant effect on the primary and secondary outcomes. A decline of functional health and depressive symptoms was observed among all participants. Potential future intervention adaptations are discussed, such as a more active case management through direct referral to (in-)formal support, an earlier treatment initiation, and the consideration of specific sociodemographic factors in care management planning.Trial registrationGerman Clinical Trials Register (DRKS): DRKS00013904 (02.02.2018), https://drks.de/search/de/trial/DRKS00013904

Psychometric Properties of the 11-Item De Jong Gierveld Loneliness Scale in a Representative Sample of Mexican Older Adults

Recent studies have focused on the negative effects of loneliness on health and quality of life in older adults. The De Jong Gierveld Loneliness Scale (DJGLS) has been widely used and has proven to be a valid and reliable instrument for loneliness assessment. However, research on this topic and on the validation of measurement scales among the older population is still incipient. The objective of this study was to examine the psychometric properties of the Spanish version of the 11-item DJGLS in Mexican older adults. Data from a representative sample of cognitively intact older adults aged 60 years and over (mean, standard deviation [SD]) age = 72.0 years (SD 8.1) from two Mexican cities (n = 1913), interviewed face to face at their homes during 2018-2019, were analyzed. The psychometric properties of the DJGLS were examined, including (1) construct validity, examined by Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), discriminate validity and convergent validity, (2) reliability, calculated using Cronbach's alpha. The overall data quality was high, and the scaling assumptions were generally met with few exceptions. Using EFA and CFA, the findings showed that the DJGLS presents a two-factor structure (Social Loneliness and Emotional Loneliness), with 11 items that explain 67.2% of the total variance. Reliability is adequate at the full-scale level (Cronbach´s α = 0.899), also for the two subscales Social and Emotional Loneliness (Cronbach´s α = 0.892 and 0.776, respectively). These results highlight that most participants with a low score for depressive symptoms and or with a high social support score belonged to the "No loneliness" group. The results showed that the Spanish version of the 11-item DJGLS is adequate for use in Mexican older adults and should be used not only for loneliness screening but also for social and emotional loneliness assessment.

Programs combating food insecurity could yield mental health benefits

Results of a newly published study suggest that initiatives to reduce food insecurity could generate mental health benefits that often are not considered when these programs are designed. The study found that participants in a mobile market intervention conducted by the Greater Boston Food Bank experienced statistically significant improvement in self‐reported depression symptom scores.

Associations between fecal short-chain fatty acids, plasma inflammatory cytokines, and dietary markers with depression and anxiety: Post hoc analysis of the ENGAGE-2 pilot trial

BackgroundThe microbiome-gut-brain-axis (MGBA) is emerging as an important mechanistic link between diet and mental health. The role of significant modifiers of the MGBA, including gut microbial metabolites and systemic inflammation, in individuals comorbid with obesity and mental disorders, is under-investigated. ObjectivesThis exploratory analysis examined associations among microbial metabolites—fecal SCFAs, plasma inflammatory cytokines, and diet with depression and anxiety scores in adults comorbid with obesity and depression. MethodsStool and blood were obtained from a subsample (n = 34) of participants enrolled in an integrated behavioral intervention for weight loss and depression. Pearson partial correlation and multivariate analyses determined associations among changes in fecal SCFAs (propionic, butyric, acetic, and isovaleric acids), plasma cytokines [C-reactive protein, interleukin 1 beta, interleukin 1 receptor antagonist (IL-1RA), interleukin 6, and TNF-α], and 35 dietary markers over 2 mo, and changes in SCL-20 (Depression Symptom Checklist 20-item) and GAD-7 (Generalized Anxiety Disorder 7-Item) scores over 6 mo. ResultsChanges in the SCFAs and TNF-α at 2 mo were positively associated (standardized coefficients: 0.06–0.40; 0.03–0.34) with changes in depression and anxiety scores at 6 mo, whereas changes in IL-1RA at 2 mo were inversely associated (standardized coefficients: –0.24; –0.05). After 2 mo, changes in 12 dietary markers, including animal protein, were associated with changes in SCFAs, TNF-α, or IL-1RA at 2 mo (standardized coefficients: –0.27 to 0.20). Changes in 11 dietary markers, including animal protein, at 2 mo were associated with changes in depression or anxiety symptom scores at 6 mo (standardized coefficients: –0.24 to 0.20; –0.16 to 0.15). ConclusionsGut microbial metabolites and systemic inflammation may be biomarkers of importance within the MGBA, linking dietary markers, such as animal protein intake, to depression and anxiety for individuals with comorbid obesity. These findings are exploratory and warrant replication.

Posttraumatic stress disorder in demobilized ex-combatants from illegal armed groups in Colombia: Cross-sectional study.

The objective of this study was to describe the psychological and quality of life outcomes in demobilized Colombian ex-combatants. A cross-sectional study was conducted on 58 ex-combatants from the Colombian government's reintegration program. Posttraumatic stress disorder (PTSD) was measured by the Mini-International Neuropsychiatric Interview. We applied the Beck-II Depression Inventory, Resilience Scale, Everyday Discrimination Scale, and World Health Organization Quality of Life-Short Version (WHOQOL-BREF) for measuring symptoms of depression, resilience, discrimination, and quality of life, respectively. The prevalence of PTSD was 63,8%, principally on ex-combatants with ≤10 years in the reinstatement program. Females with primary/elementary school, extremely low social status, unipersonal family type, family income <1 minimal wage, and symptoms of depression showed a higher prevalence ratio (>1.30). The mean scores of depression symptoms, resilience, and quality of life were systematically poorer in the group with PTSD. Significant differences were found Resilience scale domains Personal Competence (p = .043) and Acceptance of Self and Life (p = .012), WHOQOL-BREF Psychological (p = .029) and Environment domains (p = .015). Colombian ex-combatants with PTSD attending a reinstatement program presented a higher frequency of depression symptoms, lower quality of life, and lower resilience than those without PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Early Bereavement Psychosocial Outcomes in Parents of Children Who Died of Cancer With a Focus on Social Functioning.

The early grief experience of parents of children who died of cancer remains understudied. Understanding psychosocial symptomology and functioning of parents early in their bereavement is essential to developing supportive interventions aimed at offsetting poor mental and physical outcomes. Parents of children from two centers who died of cancer 6 to 24 months before were mailed a survey that included validated tools and additional Likert scale-based questions. We used correlation and univariate and multiple regression analyses to assess the associations between psychosocial and grief outcomes and parental social functioning. One hundred twenty-five parents representing 88 children completed the survey. Most respondents identified as female (63%), White (84%), and non-Hispanic (91%). The mean time since child's death was 14.7 (range, 8-26) months. Bereaved parents' mean score for social functioning was only slightly below normative values, and most parents indicated post-traumatic growth and adaptive coping. Parents had high symptom levels for depression, anxiety, post-traumatic stress, and prolonged grief, with those identifying as female having significantly higher symptom scores. Using multivariate analysis, parental scores for resilience and continuing bonds were associated with higher social functioning scores and parental scores for depressive symptoms and prolonged grief were associated with lower social functioning scores. Although bereaved parents exhibit resilience and positive coping, they also show high levels of psychosocial distress in the first 2 years after their child's death, which may reflect the typical parental bereavement experience. Screening for low parental social functioning may identify parents who would benefit from additional support early in bereavement.

Psychological Nursing Combined with Biofeedback to Promote the Rehabilitation of Patients with Anxiety Disorder

Objective: To explore the effect of psychological nursing combined with biofeedback on the rehabilitation of patients with anxiety disorder. Methods: 100 patients with anxiety disorders in our hospital from January to December 2021 were randomly divided into two groups: control group (n = 50) and study group (n = 50). The control group was given routine nursing, while the study group was given psychological nursing combined with biofeedback. The changes of self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, symptom score, and quality of life of the two groups were compared before and after nursing. Results: Before nursing, there was no significant difference in the scores of SAS and SDS between the two groups, but after nursing, the scores of SAS and SDS in the study group were lower than those in the control group, and the degree of improvement in the study group was higher than that of the control group. Before nursing, there was no significant difference in the scores of symptoms between the two groups (P &gt; 0.05), but after nursing, the scores of stress, crying spells, tremor, and general discomfort in the study group were lower than those of the control group (P &lt; 0.05). Besides, before nursing, there was no significant difference in the quality of life between the two groups (P &gt; 0.05), but after nursing, the scores of physical function, psychological activity, social ability, and material life in the study group were higher than those in the control group (P &lt; 0.05). Moreover, the degree of improvement after nursing in the study group was better than that of the control group. Conclusion: Psychological nursing combined with biofeedback to promote the rehabilitation of patients with anxiety disorder effectively improves the negative emotion of patients, reduces stress, depression, tremor, and general discomfort, and improve the overall quality of life. Therefore, it is worth further popularization.

Re-examining the relationship between education and adult mental health in the UK: A research note

Previous studies using variation in education arising from compulsory schooling laws have found no causal effects of education on mental health in the UK. We re-examine the relationship between education and mental health in the UK by taking a different approach: sibling fixed-effects with controls for polygenic scores (summary measures of genetic predisposition) for educational attainment and adult depressive symptoms. We find that higher educational attainment is associated with better adult mental health, that sibling controls reduce these associations by ∼40–70% but important associations remain and find evidence for non-monotonic effects. We also find suggestive evidence that education partially “rescues” genetic predictors of poor mental health.