Burden Of Depression Research Articles

Distressed but Highly Satisfied: Professional and Personal Distress of Nepali Doctors

Background: This research studied the prevalence of professional and personal distress of Nepali doctors, and examined the impact of their professional quality of life (ProQOL) on their distress. Aim: To examine the situation of personal and professional distress and explore interrelationships between measures of ProQOL (burnout - BO, secondary traumatic stress - STS, and compassion satisfaction - CS) with personal distress (anxiety, depression and somatic burden) of Nepali doctors. Methods: A survey design was used to examine the personal and professional distress of doctors using an online and a paper-and-pencil survey with the use of Somatic Symptoms Scale (SSS-8), Hopkins Symptoms Checklist (HSCL-25) and Professional Quality of life Scale in Nepali (ProQOL5-N) tools. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques were used to measure the influence of professional distress on personal distress. Results: The prevalence of anxiety, depression, psychosomatic distress and suicide risks of Nepali doctors (N= 557) were 30.89 %, 25.41 %, 20.50% and 5.70% respectively. BO and STS scores showed moderate risks (BO = 95.25% and STS = 76.23 %), with just over 1% doctors at high risk for BO and STS (1.28% and 1.65% respectively). Nepali doctors were highly satisfied with their service (CS = 93.42%). The data on SEM showed a reasonably good fit between the STS and CS measures and levels of personal distress of the studied population, but BO could not be tested. A moderate but statistically significant positive effect of STS on personal distress, except psychosomatic distress, was found. The effect of CS on personal distress could not be determined. Conclusions: One-fifth of Nepali doctors had a high level of personal distress. The risk for BO and STS was moderate. It was found that Nepali doctors found highly satisfied with their service. The impact of professional distress on personal distress could not be fully determined

Trends in U.S. Depression Prevalence From 2015 to 2020: The Widening Treatment Gap

IntroductionMajor depression is a common and potentially lethal condition. Early data suggest that the population-level burden of depression has been exacerbated by the COVID-19 pandemic. Prepandemic estimates of depression prevalence are required to quantify and comprehensively address the pandemic's impact on mental health in the U.S.MethodsData were drawn from the 2015–2020 National Survey on Drug Use and Health, a nationally representative study of U.S. individuals aged ≥12 years. The prevalence of past-year depression and help seeking for depression were estimated from 2015 to 2019, and time trends were tested with Poisson regression with robust SEs. Point estimates were calculated for 2020 and not included in statistical trend analyses because of differences in data collection procedures.ResultsIn 2020, 9.2% (SE=0.31) of Americans aged ≥12 years experienced a past-year major depressive episode. Depression was more common among young adults aged 18–25 years (17.2%, SE=0.78), followed closely by adolescents aged 12–17 years (16.9%, SE=0.84). Depression increased most rapidly among adolescents and young adults and increased among nearly all sex, racial/ethnic, income, and education groups. Depression prevalence did not change among adults aged ≥35 years, and the prevalence of help seeking remained consistently low across the study period.ConclusionsFrom 2015 to 2019, there were widespread increases in depression without commensurate increases in treatment, and in 2020, past 12‒month depression was prevalent among nearly 1 in 10 Americans and almost 1 in 5 adolescents and young adults. Decisive action involving a multipronged public health campaign that includes evidence-based prevention and intervention to address this ongoing mental health crisis is urgently needed.

Physical Environmental Hazards and Major Depression in Older U.S. Adults: The Health and Retirement Study

Background and Aim. Major depression is a leading cause of disability. Although much research focuses on individual risk factors and interventions, environmental risk factors may also play an important role in major depression. We quantified associations of road noise and light at night with prevalent major depression. Methods. We used data from the 2008-2016 biennial interviews of the Health and Retirement Study, a nationally-representative cohort of older adults in the United States. Major depression status was determined using the Composite International Diagnostic Interview Short Form, with a cutoff of ≥5. We estimated average road noise and light at night for the year prior to each interview at participant residences using the Department of Transportation Road Noise Model and satellite imagery from the Defense Meteorological Satellite Program, respectively. To estimate prevalence ratios, we used a modified Poisson regression model that accounted for sampling weights and design effects, adjusted for demographic characteristics, individual and neighborhood SES, time, co-exposures, and geographic area. Results. There were 23,874 participants with complete data. The mean baseline age was 63 years, 53% were female, 74% were Non-Hispanic White, and 15% ever reported major depression. Compared to the lowest exposure quartiles, those in the highest quartiles of noise and light exposure were more likely to be Black, have less than a high school education and reside in an urban area. In fully adjusted models, interquartile differences in both noise and light were suggestively associated with an approximately 10% greater prevalence of major depression (PR per IQR of noise: 1.08, 95% CI: 0.98, 1.20; and light: 1.12, 95%CI: 0.96, 1.31). Conclusion. Exposure to noise and light at night may increase depression in older adults, possibly by disrupting health sleep. Modifying physical hazards in the environment may be a way to reduce the burden of depression. Keywords. Noise, Light, Depression

Physical Activity and Depression and Anxiety Disorders in Australia: A Lifetable Analysis

Mental disorders, in particular, depressive and anxiety disorders, are a leading cause of disability in Australia and globally. Physical activity may reduce the incidence of anxiety and depression, and this supports the inclusion of physical activity in strategies for the prevention of mental ill health. Policy makers need to know the potential impact and cost savings of such strategies. We aimed to quantify the impact of changes in physical activity on the burden of anxiety and depression and healthcare costs in Australia. We used a proportional multistate lifetable model to estimate the impact of changes in physical activity levels on anxiety and depression burdens for the 2019 Australian population (numbering 24.6 million) over their remaining lifetime. The changes in physical activity were modeled through 3 counterfactual scenarios informed by policy targets: attainment of the Australian Physical Activity Guidelines and achievement of the WHO Global Action Plan on Physical Activity targets of a 10% relative reduction in the prevalence of insufficient physical activity by 2025 and a 15% relative reduction by 2030. If all Australians adhered to the recommended minimum physical activity levels, in 25 years' time, the burden of anxiety could be reduced by up to 6.4% (95% uncertainty intervals=2.5, 10.6), and that of depression could be reduced by 4.4% (95% uncertainty intervals=2.3, 6.5). Over the lifetime of the 2019 Australian population, the gains could add up to 640,592 health-adjusted life years for anxiety (26 health-adjusted life years per 1,000 persons), 523,717 health-adjusted life years for depression (21 health-adjusted life years per 1,000 persons), and healthcare cost savings of 5.4 billion Australian dollars for anxiety (220 Australian dollars per capita) and 5.8 billion for depression (237 Australian dollars per capita). Adherence to the Australian physical activity guidelines and achievement of the 2025 and 2030 global physical activity targets could lead to a substantial reduction of the burden of anxiety and depression. This study provides empirical support for the inclusion of physical activity in strategies for the prevention of mental ill health. Future studies should also assess the size and distribution of the benefits for different socioeconomic and ethnic groups.

Effects of extreme precipitation on hospital visit risk and disease burden of depression in Suzhou, China

BackgroundThe purpose of this study was to explore the impact of extreme precipitation on the risk of outpatient visits for depression and to further explore its associated disease burden and vulnerable population.MethodsA quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was used to investigate the exposure-lag-response relationship between extreme precipitation (≥95th percentile) and depression outpatient visits from 2017 to 2019 in Suzhou city, Anhui Province, China.ResultsExtreme precipitation was positively associated with the outpatient visits for depression. The effects of extreme precipitation on depression firstly appeared at lag4 [relative risk (RR): 1.047, 95% confidence interval (CI): 1.005–1.091] and lasted until lag7 (RR = 1.047, 95% CI: 1.009–1.087). Females, patients aged ≥65 years and patients with multiple outpatient visits appeared to be more sensitive to extreme precipitation. The attributable fraction (AF) and numbers (AN) of extreme precipitation on outpatient visits for depression were 5.00% (95% CI: 1.02–8.82%) and 1318.25, respectively.ConclusionsOur findings suggested that extreme precipitation may increase the risk of outpatient visits for depression. Further studies on the burden of depression found that females, aged ≥65 years, and patients with multiple visits were priority targets for future warnings. Active intervention measures against extreme precipitation events should be taken to reduce the risk of depression outpatient visits.

Abstract P044: Associations Between Depression And Hypertension Among Women And Men Veterans

Background: Hypertension increases the risk of cardiovascular disease. Literature describing associations between depression and blood pressure is inconsistent, potentially due to differing associations by sex. Veterans have high burdens of both depression and hypertension, respectively, and thus are a critical population in which to understand possible individual differences. Thus, among Veterans, we estimated the association between depression and hypertension and determined if this differs by sex. Methods: We used 2001-2017 nationwide Veterans Health Administration data from Veterans who served in support of conflicts in Afghanistan and Iraq. Major depressive disorder (MDD), mild depression, or no depression (reference group) were defined based on ICD-9/ICD-10-CM codes. Multivariable logistic regression models tested if depression status (independent variable) affected the risk of hypertension (dependent variable; defined as ≥2 blood pressure readings ≥140 systolic or ≥90 diastolic), controlling for sociodemographic factors, smoking, and comorbid mental health conditions. The adjusted model was also stratified by sex. Results: Among 761,627 Veterans (13.0% women; median age [interquartile range]= 29.5 [25.2-39.2] years), 24.1% had MDD, 18.8% mild depression, and 57.1% no depression. MDD was more prevalent for women than men (32.4% vs. 22.8%; p <0.001). Hypertension was more common among Veterans with MDD (48.6%), compared to those with mild depression (40.7%) or no depression (28.0%; p <0.001). In adjusted analyses, those with MDD had a 2.46xgreater risk of hypertension (95% CI, 2.43-2.49) and those with mild depression had 1.76xgreater risk (95% CI, 1.73-1.78) vs. those with no depression. In sex-stratified analyses, adjusted odds ratios were similar for women and men (MDD: 2.43 for women, 2.46 for men; mild depression: 1.74 for women, 1.75 for men). Conclusion: Both major and minor depression are associated with an increased risk of hypertension, with similar risk observed for women and men. Given the high burden of both depression and hypertension in this younger population, the potential long-term health implications of these conditions may warrant targeted intervention to prevent cardiovascular disease.

Cost of Mental Illness and Depression in Developing Countries: A Case Study of Pakistan

Depression causes a substantial burden to persons, their beloved ones, and the nations as a whole. Major depression results in disability, high morbidity, high mortality, suicides, physical and mental impairment, and deteriorates the quality of life in a society. Depression is common in developing countries like Pakistan. This study analyzes the economic burden of depression and depressive disorders in Pakistan. The study was conducted in Pakistan’s third largest city, Faisalabad. Respondents were selected using a multistage sampling technique. As a first step, hospitals were selected from both the public and private sectors. In step two, respondents were selected and interviewed using a well-structured and pre-tested questionnaire. Review of literature reveals that the largest share of the burden of depression and depressive disorders is in the form of indirect cost. Direct healthcare cost is mostly in the form of outpatient care, doctor fee, and medicine bills, etc. This study, therefore, estimated both types of costs using cost of illness (COI) analysis. In order to find out the level of depression in patients, the center of epidemiologic studies depression (CES-D) scale was used. Then the direct and indirect cost of depression was estimated. Additionally, multiple regression analysis was used to examine the determinants of health cost, including the level of depression. The direct and indirect costs of depression were 11,108 Pakistani Rupees (PKR) and 4,869 PKR per month, respectively. Results of regression analysis revealed that besides the level of depression, monthly income, age, education, and the number of visits to a doctor’s clinic determine health cost, positively and statistically significant. Additionally, the occurrence of depression and anxiety was evident in adults more than other age groups. Females were suffering from this disorder comparatively more than male respondents. The economic burden related to depression is considerable, especially for those who belong to low-income group. Government should provide facilities for treatment for depression in public hospitals by keeping a special focus on less privileged groups of the population.

Cesarean Section Can Be Related With Postpartum Depression: A Cross-sectional Study

Objectives: Depression is highly prevalent during pregnancy and after childbirth, and many factors, including the type of delivery, can contribute to developing this condition. Considering the increased use of remifentanil in painless labor and the need for conducting more studies on the consequences of this method this study aimed to determine the mean score of postpartum depression in women giving birth by either remifentanil-induced painless delivery or elective cesarean section. Materials and Methods: The present study was a longitudinal investigation conducted on140 women referred to private hospitals, Tabriz, Iran, between 2020 and 2021 in two groups: women with elective cesarean delivery and women with vaginal delivery with remifentanil analgesia (n=70/each). Depression during pregnancy was assessed at 35-37th weeks’ gestation, and postpartum depression was determined four weeks after childbirth using the Edinburgh Postnatal Depression Scale (EPDS). Independent t test and paired t test were used to compare depression scores. Results: Postpartum depression was significantly higher in women who had undergone a cesarean section than in those giving birth by remifentanil-induced painless vaginal delivery (P = 0.009). Conclusions: The prevalence of postpartum depression was higher in women who underwent elective cesarean section than women who underwent painless vaginal delivery with remifentanil. Considering the steady rise in worldwide cesarean section rate and the health burden and consequences of postpartum depression on mothers and children, health legislators should take measures to reduce women’s tendency towards the cesarean section in the long run.

Humanistic and economic burden associated with depression in the United States: a cross-sectional survey analysis

BackgroundDepression (major depressive disorder [MDD]) affects the functioning of patients in many facets of life. Very few large-scale studies to date have compared health and economic related outcomes of those with versus without depression, and across various depression severity groups. We aimed to evaluate humanistic and economic burden in respondents with and without depression diagnosis, and across symptom severity groups.MethodsData from the 2017 US National Health and Wellness Survey (NHWS) were utilized. Of the adult respondents (N = 75,004), 59,786 were < 65 years old. Respondents not meeting eligibility criteria were excluded (e.g., those self-reporting bipolar disorder or experiencing depression in past 12 months but no depression diagnosis). Overall, data from 39,331 eligible respondents (aged 18–64 years) were analyzed; and comprised respondents ‘with depression diagnosis’ (n = 8853; self-reporting physician diagnosis of depression and experiencing depression in past 12 months) and respondents ‘without depression diagnosis’ (n = 30,478; no self-reported physician diagnosis of depression and not experiencing depression). Respondents with depression were further examined across depression severity based on Patient Health Questionnaire-9 (PHQ-9). Outcome measures included health-related quality-of-life (HRQoL; Medical Outcomes Study 36-item Short Form [SF-36v2]: mental and physical component summary [MCS and PCS]; Short-Form 6 Dimensions [SF-6D]; and EuroQol 5 Dimensions [EQ-5D]), work productivity and activity impairment (WPAI), and health resource utilization (HRU). Multivariate analysis was performed to examine group differences after adjusting covariates.ResultsRespondents with depression diagnosis reported significantly higher rates of diagnosed anxiety and sleep problems versus those without depression (for both; P < 0.001). Adjusted MCS, PCS, SF-6D, and EQ-5D scores were significantly lower in respondents with depression versus those without depression (all P < 0.001). Consistently, respondents with depression reported higher absenteeism, presenteeism, and overall WPAI, as well as greater number of provider visits, emergency room visits, and hospitalizations compared with those without depression (all P < 0.001). Further, burden of each outcome increased with an increase in disease severity.ConclusionsDiagnosed depression was associated with lower health-related quality-of-life and work productivity, and higher healthcare utilization than those without depression, and burden increased with an increase in symptom severity. The results show the burden of depression remains high even among those experiencing minimal symptoms.

Associations between total dairy, high-fat dairy and low-fat dairy intake, and depressive symptoms: findings from a population-based cross-sectional study

PurposeEvidence on the association between dairy intake and depression is conflicting. Given numerous dietary guidelines recommend the consumption of low-fat dairy products, this study examined associations between total dairy, high-fat dairy, and low-fat dairy intake and the prevalence of elevated depressive symptoms. Associations between dairy products, which differed in both fat content and fermentation status, and depressive symptoms were also explored.MethodsThis cross-sectional study included 1600 Finnish adults (mean age 63 ± 6 years; 51% female) recruited as part of the Kuopio Ischaemic Heart Disease Risk Factor Study. Dairy intake was assessed using 4-day food records. Elevated depressive symptoms were defined as having a score ≥ 5 on the Diagnostic and Statistical Manual of Mental Disorders-III Depression Scale, and/or regularly using one or more prescription drugs for depressive symptoms.ResultsIn total, 166 participants (10.4%) reported having elevated depressive symptoms. Using multivariate logistic regression models, intake in the highest tertile of high-fat dairy products (OR 0.64, 95% CI 0.41–0.998, p trend = 0.04) and high-fat non-fermented dairy products (OR 0.60, 95% CI 0.39–0.92, p trend = 0.02) were associated with reduced odds for having elevated depressive symptoms. Whereas no significant association was observed between intake of total dairy, low-fat dairy, or other dairy products, and depressive symptoms.ConclusionHigher intake of high-fat dairy and high-fat non-fermented dairy products were associated with reduced odds for having elevated depressive symptoms in middle-aged and older Finnish adults. Given the high global consumption of dairy products, and widespread burden of depression, longitudinal studies that seek to corroborate these findings are required.

Targeted Primary and Secondary Preventive Strategies for Depression among Malaysian Pharmacy Students.

The global depression burden has remained a challenge throughout the pre- and post-pandemic era. The pandemic effect has led to the spiraling of mental disorders among young people who will be the next generation of leaders. This study aims to identify university students’ sociodemographic, psychosocial and academic backgrounds and performance associated with depression symptoms for the development of primary and secondary preventive strategies for mental health. A cross-sectional study was conducted using an online questionnaire distributed to 19 institutions in Malaysia offering a Bachelor of Pharmacy degree program. The self-rated Depression Anxiety Stress Scale (DASS-42) was used to assess depression symptoms. Pearson’s chi-square test and Fisher’s exact test were used to assess the investigated variables with depression symptoms. Independent T-test and one-way ANOVA were used to compare means of depression score across variables. Binary logistic regression was employed to examine the relationship between the investigated variables and depression symptoms. A total of 610 pharmacy students participated, of which 47% (n = 289/610) were having depression symptoms. Students who smoke nicotine and those who have separated parents, family history of mental illness, and poor academic performance were associated with depression symptoms (p < 0.05). Differences in geographical areas, race and religion also showed significant associations with depression symptoms. Parental marital status, poor academic performance, history of mental illness and comorbidities were statistically predicting depression symptoms (p < 0.05). Primary preventive strategies allowing students to harness healthy coping skills for stress, nicotine-free campaigns and a holistic curriculum are warranted. Secondary measures on mindfulness and compassion skills activities to benefit students who experienced early life crises are highly recommended. Enforcing these targeted strategies in collaboration with health and social sectors should be the primary agenda of universities to ensure their uptake.

An adapted behavioural activation intervention (DiaDeM) for people with diabetes and depression in South Asia: A feasibility study protocol

Background: The burden of depression is a rapidly growing problem worldwide. Its prevalence is particularly high among individuals with chronic physical conditions such as Type 2 Diabetes (T2DM), precipitating poorer health outcomes. There is a lack of evidence around treatments that can work among such groups, particularly in Low and Middle-Income Countries (LMICs). This study aims to test the feasibility and acceptability of a culturally adapted Behavioural Activation (BA) intervention (DiaDeM) for people with T2DM and depression in two LMICs in South Asia. Methods: A multicentre, randomised-controlled feasibility trial will be conducted from March 2022 to February 2023. We will recruit 128 adults from health facilities in Bangladesh and Pakistan with a diagnosis of T2DM and depression. Using a 1:1 allocation ratio, consenting individuals will be randomised to either optimised usual care or the DiaDeM intervention. The latter will involve six face-to-face or remotely delivered BA sessions conducted by non-mental health facilitators over six to twelve weeks. Participants will be followed up at three and six months post-randomisation. Feasibility outcomes include the feasibility and acceptability of recruitment and retention, the feasibility of intervention delivery and the feasibility of data collection at baseline and follow-up (including economic data). An embedded mixed-methods process evaluation will also be carried out to inform the main trial. Conclusions: BA is a low resource intervention for depression treatment that can be optimised for delivery in LMIC settings such as South Asia. The planned feasibility trial will directly inform a larger trial to assess the effectiveness and cost-effectiveness of such an intervention in people with T2DM and depression. It will also contribute to the wider evidence base around BA in patients with chronic physical illnesses, with particular relevance to South Asian, as well as wider LMIC regions and populations. Trial registration: ISRCTN 75501608

Factors Associated Depression In Secondary Schools Adolescents In Gombe, North-eastern, Nigeria

Background: Depression is a mood disorder characterised by loss of interest and enjoyment (anhedonia), and reduced energy leading to increased fatigability and diminished activity. Depression is a major contributor to the overall global burden of disease. It has a profound effect on adolescents because those who experience depression at an early age often struggle with depression throughout their lives, and in many cases, early onset of depression predicts more severe depression during adulthood. Objectives: This study aimed to determine the prevalence of depression and associated factors among secondary school adolescents in Gombe, Nigeria. Methodology: Three hundred and ninety-five adolescents aged 13- 18 years were selected using a multistage sampling method. The Beck Depression Inventory-II (BDI-II) was used to assess depression and a structured questionnaire was used to obtain the sociodemographic characteristics of the subjects. Results: The mean age of subjects was 16.2±1.4 years. The prevalence of depression was 37.7% (142/377). Subjects from low socio-economic class (χ2= 30.601, p&lt; 0.001). Subjects with non-parental caregivers were 4.8 times more likely to be depressed than those that had parental caregivers (OR 4.760, CI 1.882-12.04). Depression was significantly higher among subjects from public schools (χ2= 22.698, p&lt; 0.001). Also, the majority of the subjects who failed the exams preceding the study had depression as compared to those that passed the exams (χ2=5.389, p= 0.030). Conclusion: The burden of depression is high among adolescent secondary school students in Gombe. Psychosocial stressors such as low social class, non-parental care, parental divorce and poor academic performance are significant determinants of depression among adolescents. Early detection of depression is recommended as it has a strong relationship with suicidal ideation among adolescents.

Non-emergent obstetric complications and their management in primary care

Maternal mortality is a significant challenge faced worldwide. Reduction in maternal mortality is one of the integral goals of Millennium development goal and sustainable development goal. Obstetric complications are the leading cause of maternal mortality. Untreated non-emergent obstetric complications can also lead to severe implications and complications thus assessment, early detection and management of such complications is critical especially at primary healthcare level since it is the immediate contact. The purpose of this research is to review the available information about non-emergent obstetric complications and their management in primary care. During pregnancy, women often visit their primary care providers because of common ailments which may be caused or exacerbated during pregnancy, also may require special attention for healthy maternal and fetal outcomes. Primary care physicians should be familiar with the distinct diagnosis of obstetric complications and in case of emergency provide timely referrals. Primary care physicians by their effective intervention and management of non-emergent obstetric complications can efficiently reduce health risk of serious complications including routine screening for anaemia, pre-eclampsia and gestational diabetes to avoid significant morbidity. Primary care physicians can also reduce the burden of antenatal depression by providing psychological counselling at primary centres. Primary healthcare services have critical role in assessment and management of non-emergent obstetric complications however the available literature is quite limited and scarce in this aspect and further research can only be beneficial in highlighting its role.

Online social network individual depression detection using a multitask heterogenous modality fusion approach

In recent years, the number of people who endanger their lives has been increasing rapidly due to the mental burden of depression. The online social network (OSN) provides researchers with another perspective for detecting individuals suffering from depression. However, existing machine learning-based depression detection studies still leave relatively low classification performance, suggesting that there is significant improvement potential in their feature engineering. In this paper, we manually build and publish a large dataset on Sina Weibo (a leading OSN with the largest number of active users in the Chinese community), namely the Weibo User Depression Detection Dataset (WU3D). It includes more than 20,000 normal users and more than 10,000 depressed users, both of which are labeled and rechecked following the DSM-5 official medical and psychological depression document by professionals. Then, we conclude and propose ten statistical features by analyzing the user’s text, social behavior, and posted pictures. In the meantime, text-based word features are extracted using the popular pretrained model XLNet. Moreover, we fuse these features from heterogeneous modalities and implement a multitask learning scheme to train our proposed deep neural network classification model, i.e. FusionNet (FN). The experimental results show that FN has excellent to recognize depressed users on the OSN, achieving the highest F1-Score of 0.9772 on the test set. Compared to existing studies, the proposed method has better classification performance and robustness for unbalanced training samples, as well as reasonable training and inference time. Our work provides a method to fuse multimodal information to detect individual-level depression and has reference significance for similar studies on other OSNs.

Detecting clinically significant depressive burden in sleep clinics through physiological parameters: Preliminary data as to sleep stages and heart rate

Detecting clinically significant depressive burden in sleep clinics through physiological parameters: Preliminary data as to sleep stages and heart rate

388 Impact of crisaborole & tacrolimus 0.03% on patient-reported outcomes and caregiver burden in children with atopic dermatitis

Poor quality of life (QoL) is common in children with atopic dermatitis (AD) and their caregivers. This study used patient-reported outcomes (PROs) to monitor the impact of crisaborole (CRIS) and tacrolimus 0.03% (TAC) on children (2-15 years) with mild/moderate AD and on caregiver burden. This open-label study randomized 47 child-caregiver dyads to CRIS or TAC for 12 weeks. Disease severity (Eczema Area & Severity Index [EASI], % body surface area, Investigator Global Assessment [IGA]), QoL (Children’s Dermatology Life Quality Index, Family Dermatology Life Quality Index), itch (PROMIS Peds Itch-Short Form), anxiety (PROMIS Anxiety-Peds), pain interference (PROMIS Pain Interference-Peds), depression (PROMIS Depression-Peds), sleep (Children’s Sleep Habits Questionnaire), and caregiver burden (Caregiver Burden Inventory) were assessed at baseline, 6 and 12 weeks.

The Construct Structures of Psychological and Behavioral Responses to COVID-19 Pandemic in Pregnant Women.

AimThe present study aimed to investigate the construct structure behind the psychosocial response, behavioral response, prenatal depression, and post-traumatic stress disorder (PTSD) in pregnant women during the COVID-19 pandemic in China.MethodThe validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), PTSD CheckList (PCL)-6, and two newly established scales for COVID-19-related psychological and behavioral responses were used. Structural equation modeling (SEM) analysis was applied to evaluate the structural relationships of psychological and behavioral responses during the COVID-19 pandemic.ResultsOf the 1,908 mothers who completed the questionnaires, 1,099 met the criteria for perinatal depression, and 287 were positively screened for PTSD, where 264 women exceed the cut-off points for both. Pregnant women with full-time or part-time jobs tended to have the lowest scores of EPDS (10.07 ± 5.11, P < 0.001) and stress levels (23.85 ± 7.96, P = 0.004), yet they were more likely to change their behavior in accordance with the COVID-19 outbreak (13.35 ± 3.42, P = 0.025). The structural model fit the data (χ2 = 43.260, p < 0.001) and resulted in satisfactory fit indices (CFI = 0.984, TLI = 0.959, RMSEA = 0.072, and χ2/df = 10.815), all path loadings were significant (p < 0.05). The SEM indicates that the level of QoL was attributable to the occurrence of PND, leading to PTSD, and COVID-19 related behavioral and psychological responses.ConclusionThe inter-relationships between the COVID-19-related psychosocial and behavioral responses have been assessed, indicating that the pandemic increased the burden of perinatal depression. Psychoeducation, as well as other psychological interventions, may be needed to alleviate the COVID-19-based anxiety and increase their engagement in protective behaviors.

Universal prevention of depression at schools: dead end or challenging crossroad?

Universal school programmes aimed at the prevention of depression and other common mental health problems in adolescents are attractive because they are less stigmatising than targeted interventions, have a high...

Characteristics of dementia family caregivers who use paid professional in-home respite care

ABSTRACT Caring for a person living with dementia (PLWD) can be challenging, making support services like respite important. Of the types of respite, research on paid professional in-home care specific to family caregivers of PLWD is limited. This study aimed to identify characteristics of dementia caregivers using paid in-home respite. A self-administered online survey (N = 98) examined use of in-home respite. Measures assessed depressive symptoms, burden, and self-rated health. Analyses included descriptive statistics and qualitative coding. Most respondents utilized weekly schedules of in-home respite with a moderate correlation between dependency and hours of respite. Caregivers’ self-reported average health, depressive symptoms, and mild-to-moderate burden. The majority of users had lowered perceived stress, were satisfied with services, and indicated the importance of in-home respite during a pandemic. Future research should assess changes in use of paid in-home respite services and overall landscape of respite options for dementia caregivers.