Depressive Trajectories Research Articles

Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study.

To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories. Recently diagnosed nonmetastatic breast cancer survivors (n= 272), ages 60-98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories. Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08-1.23) or recovery (OR = 1.26; 95% CI = 1.15-1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90-7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15-0.99), but greater improvement in emotional (F= 4.13; p= 0.0006) and tangible (F= 2.86; p= 0.01) social support over time, was associated with recovery from depressive symptoms. Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes. Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.

Trajectories of depressive symptoms 10 years after stroke and associated risk factors: a prospective cohort study

BackgroundPrevious studies have investigated the risk factors for post-stroke depression at only one timepoint, neglecting its dynamic nature. We aimed to identify trajectories of post-stroke depression from multiple assessments and explore their risk factors. MethodsWe did a population-based cohort study with the South London Stroke Register (1995–2019). All stroke patients with three or more measurements of the Hospital Anxiety and Depression Scale were included. We identified trajectories of post-stroke depression over a 10-year follow-up using group-based trajectory modelling. We determined the optimal number and shape of trajectories based on the lowest Bayesian information criterion, average posterior probability of assignment of each group over 0·70, and inclusion of at least 5% of participants within each group. We used multinomial logistic regression adjusted for age, sex, ethnicity, comorbidity, physical disability, stroke severity, history of depression and cognitive impairment to explore associations with different trajectories. FindingsThe analysis comprised 1968 participants (mean age 64·9 years [SD 13·8], 56·6% male and 43·4% female, 65·1% white ethnicity, 30·7% severe disability and 32·7% severe stroke). We identified four patterns of symptoms: no depressive symptoms (14·1%, n=277), low symptoms (41·7%, n=820), moderate symptoms and symptoms worsening early and then improving (34·6%, n=681), and high and increasing symptoms (9·7%, n=190). Compared with no depressive symptom trajectory, patients with severe disability, severe stroke, pre-stroke depression, and cognitive impairment were more likely to be in the moderate and high symptom groups (adjusted odds ratios [ORs] 2·26 [95% CI 1·56–3·28], 1·75 [1·19–2·57], 2·20 [1·02–4·74], and 2·04 [1·25–3·32], respectively). Female sex was associated with high depression (OR 1·65 [1·13–2·41]), while older age (≥65 years) was associated with moderate depression (OR 1·82 [1·36–2·45]). In men, the ORs for patients with severe disability, severe stroke, pre-stroke depression, and cognitive impairment being in the high depression group were 1·91 (1·01–3·60), 2·41 (1·26–4·60), 2·57 (0·84–7·88), and 2·68 (1·28–5·60), respectively. In women, the ORs were 1·08 (0·52–2·23), 1·30 (0·60–2·79), 19·2 (2·35–156·05), and 3·80 (1·44–10·01), respectively. InterpretationFemale sex and older age were associated with distinct courses of depressive symptoms. In men, high depressive symptom trajectory was associated with severe stroke and severe disability, which was not the case in women. These findings were limited to patients with three or more assessments, who tended to have less severe disabilities than excluded patients and might not generalise to all stroke survivors. FundingNational Institute for Health and Care Research (NIHR).

Twelve-month trajectories of depression after group-based psychotherapy led by nonspecialists at primary health centers: A case study from Vietnam

Twelve-month trajectories of depression after group-based psychotherapy led by nonspecialists at primary health centers: A case study from Vietnam

Association of depression trajectories and subsequent hypertension and cardiovascular disease: findings from the CHARLS cohort.

Little evidence regarding the associations of longitudinal trajectories of depressive symptoms and incident hypertension and cardiovascular diseases (CVDs). This study aimed to evaluate the relationships between trajectories of depressive symptoms and new-onset hypertension and CVDs among the Chinese middle-aged and older general population. This prospective cohort study used data from a nationally representative sample aged older than 45 years of Chinese residents recruited for the China Health and Retirement Longitudinal Study (CHARLS). The depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). The outcomes of the study were new-onset hypertension and CVDs. A total of 6071 participants were included in the final analysis and four trajectories of CES-D-10 were identified, including low-stable, medium-decreasing, medium-increasing, and high-stable trajectories. Until 2018, 1668 (27.5%) and 959 (15.8%) participants were newly diagnosed with hypertension and CVDs, respectively. Compared with participants with a low-stable trajectory, individuals with other three trajectories had a significantly higher risk of hypertension and CVDs. The results remained robust in several sensitivity analyses. The restricted cubic spline (RCS) showed an S-shaped relationship between the mean CES-D-10 score and hypertension/CVDs ( P for nonlinear <0.001). Hypertension partially mediated the association between CES-D-10 and CVDs. Among Chinese aged older than 45 years' general adults, depressive symptoms were prevalent and associated with higher risks of incident hypertension and CVDs. Depressive symptoms mediated the development of CVDs by promoting hypertension progression. Immediate efforts are needed to improve depression management in China to further prevent CVDs.

Maternal depression in first 1000days of life and early childhood caries prevalence at 48months of age.

The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort. All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders. A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24months increased the risk for ECC at 48months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35). Children from mothers with high depression trajectory had higher risk of having dental caries at 48months compared to children from mothers with low depression trajectory. Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.

Anxiety and depression among women with newly diagnosed vulvar cancer - A nationwide longitudinal study.

Our objective was to investigate the trajectories of anxiety, depression, emotional and social functioning in women with newly diagnosed vulvar cancer from the time of diagnosis to 12 months after treatment. A further aim was to identify risk factors for high levels of anxiety. PROVE (PROspective Vulvar Cancer Evaluation) is a nationwide longitudinal cohort study investigating quality of life in women with newly diagnosed vulvar cancer by the following validated patient-reported outcome measures at diagnosis, and 3 and 12 months after treatment: The Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Vulvar module VU34. Mean scores, changes over time and associations were analyzed by generalized estimated equations and log-linear regression models, adjusted for possible confounders. Between 2019 and 2021, 105 (69%) women completed the questionnaires at all three time points. At diagnosis, 42% of the women reported elevated anxiety levels, decreasing significantly to 30% during the first 12 months. Insomnia, persisting vulvar symptoms and high information needs were significantly associated with a high level of anxiety (relative risk [RR] 2.1, 95% CI 1.2-3.7 for insomnia; RR 2.8, 95% CI 1.7-4.6 for vulvar symptoms, RR 2.7, 95% CI 1.5-4.9 for information needs). We found a trend towards a higher level of anxiety in younger women (<65 years: RR 1.5, 95% CI 1.0-2.5). Participants reported a low and stable prevalence of depression (14%) and high social functioning throughout the study period. Women with newly diagnosed vulvar cancer report a high level of anxiety at diagnosis. Despite a significant improvement, anxiety remains widely prevalent during the first year of follow-up. Targeting insomnia, vulvar symptoms and unmet needs may decrease anxiety during surveillance.

Developmental trajectories of depression, anxiety, and stress among college students: a piecewise growth mixture model analysis

Mental health issues are becoming increasingly common among college students, but not all students follow the same developmental trends of mental health. This study aims to identify the developmental trajectories of depression, anxiety, and stress among college students and the related factors for different trajectory classes. The data were collected from a longitudinal survey of college students over four consecutive years, and 2473 students were included in the analysis. The study used a piecewise growth mixture model to determine the subtrajectories, and a multinomial logistic regression model was constructed to investigate the related factors affecting students in subtrajectories. The results revealed that subtrajectories include the low and stable class, increasing class, decreasing then stable class, increasing then decreasing class, and decreasing and high class. The decreasing and high class only presents in the trajectories of anxiety and stress. Regarding related factors, high BMI and high sleep hours were identified as related factors for the increasing class of depression; gender and high sleep hours were associated with the increasing class of anxiety; and hometown location was related to the increasing class of stress. Extroversion personality, relationship with classmates, siblings, and father’s education level are related factors for other subtrajectories. Considering that college students experience multiple trajectories of depression, anxiety, and stress, mental health education and psychological intervention should be carried out for students in each class.

Physical illness and changes in spousal depression: a register study on Finnish middle-aged couples

Abstract Background Physical health decline may affect family members’ mental health by causing distress and, in case of functional impairments, need to provide care. We examined how diseases common in midlife but with different disease progression and level of impairment are associated with short-term and long-term changes in spousal depression. Methods We used Finnish total population register data from 2000-2019 to identify 91,849 men and 70,836 women aged 30-70 that experienced onset of severe diseases without cognitive impairment (myocardial infarction, prostate cancer, breast cancer), conditions with sudden onset and immediate impairment (stroke, traumatic brain injury) or progressive conditions with increasing impairment (Parkinson's disease, multiple sclerosis, dementia) while living with a spouse. We measured depression with antidepressant purchases and used fixed-effects linear probability models to examine spouses’ depression trajectories before and after onset of spousal disease Results Preliminary findings show that the onset of any type of spousal illness is associated with an increase in depression. Among men this increase is similar in magnitude irrespective of the type of spouse's illness, whereas among women the increase is smaller if the spouse is diagnosed with a disease without cognitive impairment. When the spouse is diagnosed with a progressive condition, female spouses’ depression increases more gradually, whereas a large immediate increase in depression follows sudden onset conditions. One year after diagnosis there are little changes in spousal depression. Conclusions Diseases common in midlife increase spouse's risk of depression around the time of diagnosis, and the effect appears persistent. Adequate support should thus be available to family members from the start of physical illness. When planning support to female spouses, the male spouse's cognitive impairment and associated care needs should be carefully evaluated. Key messages • Diseases common in midlife increase spouse's depression risk around the time of diagnosis, and the effect appears persistent. Support to spouses should be available from the start of illness. • Cognitive impairment of the male spouse seems to increase female spouse's depression particularly strongly, suggesting that caregiving help could be especially beneficial for women.

Perceived social support and longitudinal trajectories of depression and anxiety in World Trade Center responders

PurposeWhile severely distressing events are known to affect mental health adversely, some survivors develop only short-lived or no psychiatric symptoms in the aftermath of a disaster. In the WTC Health Program General Responder Cohort (WTCHP GRC) we examined whether social support was protective against the development of depression or anxiety symptoms after the 9/11 WTC attacks and explored in a subsample whether trait resilience moderated this relationship.MethodsWe analyzed data from 14,033 traditional and 13,478 non-traditional responders who attended at least three periodic health monitoring visits between 2002 and 2019. Linear mixed-effects models were used to examine depression (Patient Health Questionnaire-9; PHQ-9) and anxiety (Generalized Anxiety Disorder screener; GAD-7) scores. In a subsample of 812 participants, we also assessed if the association between social support and symptoms was moderated by an individual’s trait resilience level (Connor-Davidson Resilience Scale, CD-RISC).ResultsFor both traditional and non-traditional responders, perceived social support around 9/11 was associated with lower levels of depressive (β = − 0.24, S.E. = 0.017, z = − 14.29, p < 0.001) and anxiety symptoms (β = − 0.17, S. E. = 0.016, z = − 10.48, p < 0.001). Trait resilience scores were higher in responders with at least one source of social support during the aftermath of 9/11 compared to those without (mean 71.56, SD 21.58 vs mean 76.64, SD 17.06; β = 5.08, S.E. = 0.36, p < 0.001). Trait resilience moderated the association between social support and depressive (p < 0.001) and anxiety trajectories (p < 0.001) for traditional responders.ConclusionOur findings suggest that perceived social support around a severely distressing event may have long-term protective effects on symptoms of depression and anxiety.

Profiles of activity engagement and depression trajectories as COVID-19 restrictions were relaxed.

Given elevated depression rates since the onset of the pandemic and potential downstream implications, this research examined the association between activity engagement and depression among middle-aged and older adults postlockdown. This study aimed to (a) identify activity engagement profiles among middle-aged and older adults, (b) understand factors associated with profile memberships, and (c) compare depression trajectories across profiles as COVID-19 restrictions eased over 16 months in Singapore. This longitudinal study involved 6,568 middle-aged and older adults. Latent growth analysis was first conducted to obtain estimates of depression trajectories for each individual. Latent profile analysis was then conducted to identify different activity profiles. Finally, profile characteristics and depression trajectories across these different profiles were compared. Results indicated four profiles that varied in social and physical activity. Although digital activity was negatively associated with depression at baseline, it did not explain depression trajectories as restrictions eased. Over time, depression decreased for all profiles; however, those who were inactive on all activities except digital contact tended to experience more persistent symptoms, compared with those who were highly engaged in physical and outdoor activities. Individuals who were only active digitally tended to experience more prepandemic negative affect, were more introverted and neurotic, less open, agreeable, and conscientious, and had worse health and mobility, lower income, and lower education. Findings highlight how imprecise conceptualizations of activity engagement may obscure subtle activity engagement-depression relations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Profiles of Activity Engagement and Depression Trajectories as COVID-19 Restrictions Were Relaxed

Supplemental Material for Profiles of Activity Engagement and Depression Trajectories as COVID-19 Restrictions Were Relaxed

Long-Term Effects of Maternal Depression during Postpartum and Early Parenthood Period on Child Socioemotional Development.

Most research on the impact of maternal depressive symptoms on child development is conducted during the first year postpartum. Findings on long-term effects of maternal depression are still contradictory and underexplored. The present study investigates the long-term impact of maternal depression during the postpartum and early parenthood periods on child behavioral problems at the mean age of 2.25 years. The Edinburgh postnatal depression scale and Beck depression Inventory were used to assess postpartum and early parenthood depression, respectively. The Child Behavior Checklist was used to examine child's behavioral problems. The regression analysis showed statistically significant associations between child behavioral problems and maternal depression during early parenthood and no significant associations with postpartum depression. Four maternal depressive symptoms' trajectories were identified: consistently low, consistently high, decreased, and increased. The children of mothers with consistently high depressive symptoms at both research stages had the most significant total, internalizing, and externalizing problems. Children of mothers whose depressive symptoms decreased over time had the lowest scores in all three domains of behavioral problems. It is extremely important to implement programs for screening and early intervention for maternal mental health problems that could greatly influence the well-being of women and their children's development.

Longitudinal Associations Between Pet Relationship Quality and Socio-Emotional Functioning in Early Adolescence.

Adolescence is a key developmental period for socio-emotional skills, and companion animal relationships may be one potential source of emotional support and resilience during this time. This study used longitudinal data from 940 pet-owning adolescents, collected over four time points, from youth in the Northeastern United States. We assessed whether pet relationship quality (indexed by relationship satisfaction, companionship, and emotional disclosure) predicted trajectories of loneliness, social anxiety, and depression. Results indicated that high satisfaction with a pet relationship was associated with more favorable trajectories, but companionship (i.e., regarding frequency of interacting with the pet) was not related significantly to socio-emotional functioning. High levels of disclosure to a pet were linked with less favorable trajectories for loneliness and depression, but not related to social anxiety. These results suggest that a pet relationship can, in some cases, be associated positively with socio-emotional development, but that there is significant complexity in these associations. Families, educators, and practitioners should take a nuanced approach to understanding individual adolescent-pet relationships as a contextual asset for specific youth.

Trajectory of prenatal anxiety and depression and its association with fetal growth development

BackgroundThe stability of anxiety and depression during pregnancy and the impact on women and offspring has been recognized, yet the distinction of impact between them remains unclear. The aim of this study was to investigate the trajectory of prenatal anxiety and depression and their coexistence, as well as to examine the potential variations in pregnancy outcomes and fetal/neonatal growth development. MethodAt baseline (11–13+6 weeks), women were recruited and subsequently monitored in the second (16–20+6 weeks) and third (28–31+6 weeks) trimesters. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. In the second (16–20+6 weeks), third (28–31+6 weeks), and prenatal period (37–40+6 weeks), fetal growth was assessed by ultrasound scans. The joint trajectory model was used to determine the trajectory groups of depressive/anxiety dominant or coexistence. Comparisons of fetal/neonatal growth between groups were conducted using analysis of covariance and a multilevel model. ResultA total of 457 pregnant women were finally included. Four trajectory groups were identified: none-negative emotion (n = 190, 41.6 %), anxiety dominant (n = 195, 42.6 %), depression dominant (n = 33, 7.2 %), and anxiety and depression coexistence (n = 39, 8.6 %). There were significant differences in the antenatal abdominal circumference (335.44 vs 333.92 vs 330.82 vs 325.13 mm, p = 0.007) of fetuses and the birth length (50.14 vs 50.03 vs 49.91 vs 49.18, p = 0.008) of newborns among four groups, showing a clear decreasing trend. Anxiety and depression coexistence displayed a notable and statistically significant difference when compared to the other groups and had a lower increase of fetal abdominal circumference (β = −8.91, 95%CI: −16.15, −1.67, p = 0.016) after controlling for confounding factors. Anxiety and depression dominant groups found no difference in fetal/neonatal growth. ConclusionsThe more severe the negative emotional state of mothers, the more restricted their offspring's development, especially in terms of fetal abdominal circumference and birth length. The impact of anxiety or depressive symptoms does not show a pronounced difference. However, what is noteworthy is the tendency and evident impact on offspring development when anxiety and depression coexistence work synergistically. As a result, healthcare professionals should place greater emphasis on addressing anxiety and depression in expectant mothers, particularly among those experiencing anxiety and depression coexisting symptoms.

Correlates of Longitudinal Trajectories of Depressive Symptoms in Adolescents With Traumatic Brain Injuries.

Depression poses a significant threat to the health and well-being of adolescents with traumatic brain injury. Existing research has limitations in longitudinal follow-up period, consideration of sample heterogeneity, and outcome measurement modeling. This study aimed to address these gaps by applying the second-order growth mixture model (SO-GMM) to examine the 10-year post-injury depression trajectories in adolescents with TBI. A total of 1,989 adolescents with TBI 16-21 years old from the Traumatic Brain Injury Model System National Data Bank were analyzed up to 10 years post-injury. Depressive symptoms were measured by Patient Health Questionnaire-9. Covariates included age, sex, race/ethnicity, employment, Functional Independence Measure Cognition, TBI severity, pre-injury disability, and substance use. Longitudinal measurement invariance was tested at the configural, metric, and scalar levels before SO-GMM was fit. Logistic regression was conducted for disparities in depression trajectories by covariates. A 2-class SO-GMM was identified with a low-stable group (85% of the sample) and a high-increasing group (15% of the sample) on depression levels. Older age, being a Native American, and having Hispanic origin was associated with a higher likelihood of being in the high-increasing class (odds ratios [ORs] = 1.165-4.989 and 1.609, respectively), while patients with higher education and being male were less likely to be in the high-increasing class (ORs = 0.735 and 0.557, respectively). This study examined the disparities in depression among two distinct longitudinal groups of adolescents with TBI 10 years post-injury. Findings of the study are informative for intervention development to improve long-term mental health in adolescents with TBI.

Sex Differences in Adolescent Depression Trajectory Before and Into the Second Year of COVID-19 Pandemic

Evidence on the impact of the COVID-19 pandemic on adolescent mental health is mixed and does not disentangle natural age-related changes. We compared depressive symptoms among 16-year-olds surveyed, at a fourth wave, before or during the pandemic, while accounting for expected trajectories of within-person change based on 3 prior waves. In this longitudinal cohort of 3,171 adolescents in Tokyo, Japan, adolescents were grouped based on their age 16 survey timing: pre-pandemic (February 2019 to February 2020) and during-pandemic (March 2020 to September 2021). Depressive symptoms were self-reported using the Short Mood and Feelings Questionnaire. Mixed-effect models were fitted to assess group differences while controlling for previous trends. Variations by sex, household income, and pandemic phase (early, late first-year, and second-year) were examined. Of 2,034 eligible adolescents, 960 (455 girls) were assessed before and 1,074 (515 girls) during the pandemic. Overall, depressive symptoms increased by 0.80 points (95% CI 0.28-1.31, 0.15 SD of the population average). This increase varied by sex and pandemic phase. For boys the increase emerged in the late first-year phase and enlarged in the second-year phase (mean difference from pre-pandemic: 1.69, 0.14-3.24), whereas for girls it decreased in the early school-closure phase (mean difference: -1.98, -3.54 to -0.41) and returned to the pre-pandemic level thereafter, with no additional increases during the pandemic. Into the second year of the COVID-19 pandemic, depressive symptoms of 16-year-olds worsened above the expected age-related change only in boys. Continuous monitoring and preventive approaches for adolescents at the population level are warranted. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Depression, Perceived Burdensomeness, Thwarted Belongingness, and Suicide Risk Trajectories among Emerging Adults during the Early Covid-19 Pandemic

Depression, Perceived Burdensomeness, Thwarted Belongingness, and Suicide Risk Trajectories among Emerging Adults during the Early Covid-19 Pandemic

4.36 Prediction of Different Treatment Trajectories of Depression and Anxiety Using Machine Learning Approach in Adolescents

4.36 Prediction of Different Treatment Trajectories of Depression and Anxiety Using Machine Learning Approach in Adolescents

Psychological distress among early medical residents: A 2-year longitudinal cohort study over seven years in Japan

BackgroundEarly medical residents are expected to have a higher prevalence of burnout due to physical and psychological stressors. However psychological distress associated with burnout has not been adequately investigated in a longitudinal manner. We therefore examined the longitudinal trajectory of depression and its associated factors among early medical residents. MethodsIn this cohort study, medical residents (n = 215) who started rotation at the University of Yamanashi Hospital during 2012 to 2018 were recruited and asked to complete the Brief Job Stress Questionnaire (BJSQ), Center for Epidemiologic Studies Depression Scale (CESD), Brief Scale for Coping Profile (BSCP) and Athens Insomnia Scale (AIS) at the time of exit from each clinical department for up to two years over seven years. Factors associated with the CES-D scores were statistically explored, with a cutoff score of 16 to denote depression. ResultsThe CES-D was completed by 205 residents. The average CES-D score was 10.3 ± 8.0 and the scores were lower in the 2nd versus 1st year of residency (11.3 ± 6.7 versus 9.2 ± 7.0). Multiple regression analysis of BJSQ/BSCP/AIS on CES-D revealed that insomnia had a significant impact on the CES-D scores. Apart from insomnia, avoidance and suppression and peer support had significant effects. Resilient residents, who showed the maximum CES-D score of under 16 consistently throughout the residency, was better in terms of changing a point of view, active solution and changing mood. Women were more likely to express emotions to others, while they reported more job control in the first year. ConclusionsOur results have high clinical relevance to challenge psychological burnout among early medical residents, offering some possible clues for prevention such as reduced burden, more flexibility during the first year and strengthening coworker support. Insomnia exerted moderate to strong effects on depression and monitoring of sleep appears indispensable in this specific population.

Study on the trajectory of depression among middle-aged and elderly disabled people in China: Based on group-based trajectory model

BackgroundPrevious studies have shown that middle-aged and elderly adults with disabilities are at higher risk for depressive symptoms. However, there are few studies on the long-term trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population. ObjectiveThis study aimed to identify the different development trajectories of depressive symptoms and their influencing factors in middle-aged and elderly people with disabilities in China. MethodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, a longitudinal cohort was formed for the study. A total of 2053 participants underwent at least two measures of depressive symptoms, assessed using the Center for Epidemiological Studies Depression Scale (CES-D10), a depression symptom assessment scale. We constructed a Group-Based Trajectory Model (GBTM) to identify the development trajectory of depressive symptoms in 2053 middle-aged and elderly disabled individuals, screened the potential predictors using lasso regression, and analyzed the factors affecting the development trajectory of depression through multivariate logistic regression. ResultsWe identified four depression symptom trajectories throughout the follow-up process: “low depressive symptom group”, “worsening depressive symptom group”, “relieved depressive symptom group”, and “high depressive symptom group”. We found that there were differences in basic characteristics among different subgroups of depression trajectory. However, middle-aged and elderly disabled women living in rural areas, with limited ADL or IADL, physical pain, poor self-reported health and self-reported memory, short sleep time, and no relatives and friends to take care of them were the key groups for the prevention and treatment of depressive symptoms. ConclusionThere is heterogeneity in the trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population, it is necessary to focus on the characteristics of the trajectories of different subgroups.