Burden Of Depression Research Articles

Prevalence and predictive factors for depressive symptoms among medical students in Germany - a cross-sectional study.

Background: Elevated levels of depressive symptoms among medical students have been the subject of international and national research before, yet associated risk factors and protective factors are to be determined. This study aims to show the burdens of depression at different stages of academic medical education with a special emphasis on correlated risk factors and protective factors. Methods: A total number of n=1103 medical students of a middle-sized German university were sampled and surveyed regarding depressive symptoms and correlating factors. The assessment of potential depressive symptoms was based on the BDI-II. Correlating factors were surveyed through a self-designed questionnaire consisting of possible cofactors for depressive symptoms based on established scientific literature. Results: Survey response rate was 90.2% (1103/1223). The prevalence of depressive symptoms was 11% for mild, 5.6% for moderate and 2.4% for severe symptoms. The sample’s most prevalent risk factors were feeling unable to confide one’s own worries to someone else (88%); and experiencing a lack of time for partner, friends and family (77%) or hobbies (76%). Significant predictors for depressive symptoms were neuroticism above all, insufficient emotional support, eating irregular meals, use of medication or drugs to calm down, and mental overload. Factors associated with less depressive symptoms could be identified as: spending time with partner, friends, family, hobbies and exercise; and confiding worries to classmates. Conclusions: Every fifth medical student surveyed reported at least mild depressive symptoms. The majority of the surveyed medical students felt unable to confide their worries to someone else and lamented not having enough time for social interaction with peers, family and hobbies. Certain personality traits – such as neuroticism – and insufficient emotional support showed to play important roles in making medical students more prone to developing depressive symptoms. Based on this research, control of the surveyed cofactors associated with depressive symptoms and possible intervention programs targeted to these are proposed to be a key subject of further research.

Major and sub-threshold depression and quality of life of displaced older persons: Community based cross sectional study in Nigeria

Introduction This study examined major and subthreshold depression, their relationships with sociodemographic/risk factors and quality of life (QOL) of internally displaced older persons in a rural community in north central Nigeria. Methods A community-based, cross-sectional study conducted among 200 older adults in Riyom, Nigeria. The respective modules of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and WHOQOL-BREF were used to conduct face to face interviews to assess major and subthreshold depression and QOL respectively. Data were analysed using SPSS version 23. Descriptive statistics and logistic regression analysis were performed using 95% confidence interval to analyse the significant relationships between depression, socio-demographic/risk factors, and QOL. Probability value of < 0.05 was considered statistically significant. Findings The prevalence of lifetime major and sub-threshold prevalence of depression were 58.5% and 12.5% respectively. The factors significantly associated with increased odds for major depression were average monthly income, history of traumatic event (s) and having a confidant to talk with after the event (s) with (OR=1.839, CI=1.364-2.480, p= 0.001); (OR=9.860, CI=1.025- 94.876, p= 0.048) (OR= 4.570, CI=1.783- 11.718, p= 0.002) respectively while access to health care and having a confidant after the event (s) similar to major depression (OR= 5.105, CI=1.037- 25.133, p= 0.045); (OR= 0.276, CI=0.088- 0.862, p= 0.027) respectively were found significantly associated for sub-threshold depression. Conclusions The prevalence of major and sub-threshold depression among internally displaced older persons in a Nigerian rural community were high and there were significant relationships with sociodemographic factors and QOL. While there is a need for more studies, intervention studies in internally displaced older persons would need to consider low socioeconomic status, social support, and traumatic events with substantial impairment in QOL in addressing the burden of major and sub-threshold depression among these growing populations.

A Multivariate Analysis of Depression Prevalence in Psoriasis Patients: A Cohort Study.

The literature reported higher depression rates in psoriasis patients compared to the general population. Our study aimed to verify whether variability in depression prevalence was due to using different diagnostic tools. We also aimed to determine whether dysfunctional coping strategies might increase the depression burden. We assessed psoriasis severity by the Psoriasis Area Severity Index (PASI) and PSOdisk. We analyzed mental alterations of 120 outpatients by Hamilton Depression and Anxiety Rating Scales (HAM-D and HAM-A), Symptom Checklist-90-Revised (SCL-90-R), plus coping strategies and quality of life by Coping Orientation to Problems Experienced (COPE) Inventory and 36-Item Short Form Health Survey (SF-36). We divided our cohort into five subgroups from minimal to severe psoriasis using the PSOdisk total score. Depression prevalence varied according to the assessment criteria for specificity, frequency, and severity. Different mood disorders other than major depression emerged when we used DSM-IV-TR criteria. Correlation analysis of the criteria we used to diagnose depression or depressed mood indicated that a dysfunctional coping strategy was highly and positively correlated only in patients of the severe subgroup. Differently, a negative correlation emerged between the SF-36 Mental Summary Component (MSC) and behavioral disengagement, thus suggesting that psychopathological distress might induce patients with a marked/severe psoriasis to adopt dysfunctional coping strategies. Dermatologists are fundamental in detecting comorbid depression, referring psoriasis patients to mental health specialists to achieve adequate treatments, and preventing suicide risk.

The Neuropsychiatric Changes After COVID-19 Quarantine in Patients With Cognitive Impairment and Their Caregivers in Chongqing, China: A Cohort Study.

BackgroundThe follow-up study on neuropsychiatric changes after the lifting of coronavirus disease 2019 (COVID-19) quarantine in patients with cognitive impairment and their caregivers is still lacking, and relative information is needed to formulate more comprehensive healthcare prevention measures worldwide.AimsTo provide data on the changes in neuropsychiatric performance after the lifting of COVID-19 quarantine in patients with cognitive disorders and their caregivers.MethodsTwo surveys in Chongqing, China were conducted via telephonic interview with 531 patients and their caregivers. The baseline survey was performed from February 11 to 23, 2020, and the follow-up was from October 24 to November 9, 2020. The data of neuropsychiatric symptoms (NPSs), sleep, nutrition, and chronic diseases of patients, as well as the burden of care, anxiety, and depression of caregivers were evaluated.ResultsSignificant alleviation of NPSs after the lifting of COVID-19 quarantine was observed in patients with mild cognitive impairment (MCI) and dementia (both P < 0.05). Compared with baseline, the prevalence for NPSs of all participants dropped from 57.94 to 38.82%. Among NPS subdomains, apathy displayed the biggest decline at follow-up by 10.72%, followed by nighttime behavior by 8.65%. Mixed effect generalized estimation equation analysis showed significant amelioration in hallucination, depression, apathy, irritability, aberrant motor behavior, and nighttime behavior (all P < 0.05), with the most prominent changes in nighttime behavior and apathy. Among the patients with unsatisfactory control of chronic disease, the medication adherence rate dropped by approximately 30% after the lifting of quarantine. More importantly, around 13% increase of care burden was observed among the caregivers at follow-up, with both depression and anxiety rising by nearly 4%.ConclusionThe prolonged quarantine may exacerbate NPS in patients with memory disorders, while the care burden and mental stability of the caregivers after the pandemic should also be concerned.

Burden and risk factors for antenatal depression and its effect on preterm birth in South Asia: A population-based cohort study.

IntroductionWomen experience high rates of depression, particularly during pregnancy and the postpartum periods. Using population-based data from Bangladesh and Pakistan, we estimated the burden of antenatal depression, its risk factors, and its effect on preterm birth.MethodsThe study uses the following data: maternal depression measured between 24 and 28 weeks of gestation using the 9–question Patient Health Questionnaire (PHQ-9); data on pregnancy including an ultrasound before 19 weeks of gestation; data on pregnancy outcomes; and data on woman’s age, education, parity, weight, height, history of previous illness, prior miscarriage, stillbirth, husband’s education, and household socioeconomic data collected during early pregnancy. Using PHQ-9 cutoff score of ≥12, women were categorized into none to mild depression or moderate to moderately severe depression. Using ultrasound data, preterm birth was defined as babies born <37 weeks of gestation. To identify risk ratios (RR) for antenatal depression, unadjusted and adjusted RR and 95% confidence intervals (CI) were calculated using log- binomial model. Log-binomial models were also used for determining the effect of antenatal depression on preterm birth adjusting for potential confounders. Data were analyzed using Stata version 16 (StataCorp LP).ResultsAbout 6% of the women reported moderate to moderately severe depressive symptoms during the antenatal period. A parity of ≥2 and the highest household wealth status were associated with an increased risk of depression. The overall incidence of preterm birth was 13.4%. Maternal antenatal depression was significantly associated with the risk of preterm birth (ARR, 95% CI: 1.34, 1.02–1.74).ConclusionThe increased risk of preterm birth in women with antenatal depression in conjunction with other significant risk factors suggests that depression likely occurs within a constellation of other risk factors. Thus, to effectively address the burden of preterm birth, programs require developing and providing integrated care addressing multiple risk factors.

Abstract TP181: Pre-existing Depression And Stroke During Pregnancy

Introduction: There is increasing evidence linking depressive symptoms and stroke. While several studies have investigated the association between depression and stroke in the elderly population, there are few that have examined the relationship in pregnant women. Additionally, health inequities persist in pregnancy which may increase the burden of depression on pregnant Black women. The current study examined the impact of depression on stroke during pregnancy. Methods: We used data from the National Inpatient Sample (NIS, 2015-2018). Our sample included women between the ages of 20-44 with a maternal or neonatal admission diagnosis. Data were analyzed using weighted logistic regression models in SAS version 9.4. Covariates included age, insurance status, history of hypertension (HTN), high cholesterol (HCL), physical health comorbidities (PHC), and obesity status. PHC included those defined by the Elixhauser Comorbidity Software from AHRQ, except for hypertension, diabetes, and obesity. Depression was determined using of ICD-9 or ICD-10 codes. All analyses were stratified by race. Results: Overall, depression was associated with an increase in the incidence of stroke during pregnancy (aOR=1.55, 95%CI 1.11-2.18), however when stratified by race, Black women with depression had nearly 3 times higher odds of stroke (aOR=2.91, 95% CI 1.67-5.07) compared to Black women who did not have depression; there was not a statistically significant effect of depression on stroke among White women or Latinas. Conclusions: This study shows that, among Black women, depression is related to an increased odds of stroke during pregnancy, regardless of HTN and HCL history. While stroke primarily affects older adults, this study shows that it is important to ensure proper prenatal care and monitor Black women during pregnancy for signs and symptoms of stroke, especially if they have a PHC or history of depression.

Mapping Normative Trajectories of Cognitive Function and Its Relation to Psychopathology Symptoms and Genetic Risk in Youth

BackgroundAdolescence hosts a sharp increase in the incidence of mental disorders. The prodromal phases are often characterized by cognitive deficits that predate disease onset by several years. Characterization of cognitive performance in relation to normative trajectories may have value for early risk assessment and monitoring. MethodsYouth aged 8 to 21 years (N = 6481) from the Philadelphia Neurodevelopmental Cohort were included. Performance scores from a computerized neurocognitive battery were decomposed using principal component analysis, yielding a general cognitive score. Items reflecting various aspects of psychopathology from self-report questionnaires and collateral caregiver information were decomposed using independent component analysis, providing individual domain scores. Using normative modeling and Bayesian statistics, we estimated normative trajectories of cognitive function and tested for associations between cognitive deviance and psychopathological domain scores. In addition, we tested for associations with polygenic scores for mental and behavioral disorders often involving cognition, including schizophrenia, bipolar disorder, attention-deficit/hyperactivity disorder, and Alzheimer’s disease. ResultsMore negative normative cognitive deviations were associated with higher general psychopathology burden and domains reflecting positive and prodromal psychosis, attention problems, norm-violating behavior, and anxiety. In addition, better performance was associated with higher joint burden of depression, suicidal ideation, and negative psychosis symptoms. The analyses revealed no evidence for associations with polygenic scores. ConclusionsOur results show that cognitive performance is associated with general and specific domains of psychopathology in youth. These findings support the close links between cognition and psychopathology in youth and highlight the potential of normative modeling for early risk assessment.

Declining Student Performance and Satisfaction following Back-to-Back Scheduling of Foundational Science Exams: Experience at a Large US Osteopathic Medical School

Examinations are a significant source of academic stress, particularly in the demanding environment of medical education. In order to reduce the burden of anxiety, burnout and depression among students, medical schools aim at reducing academic stress by exploring alternatives to frequent, high-stakes assessment schedules. The bundling of examinations into integrated block assessments has emerged as a successful strategy to reach this goal, as the resulting reduction in examination days can provide uninterrupted periods of study time that allows for a deeper understanding of material as well as an opportunity for students to take wellness breaks between exams. The present study examines the outcomes of a natural experiment on back-to-back exam scheduling in two related medical school courses post hoc. The outcomes of the scheduling change on the academic performance and satisfaction of examinees were analyzed with a mixed-methods approach. The data show that the transition from a spaced-out to a back-to-back exam schedule was accompanied by a drop in academic performance and student satisfaction with the curricular schedule. The data presented suggest that without proper curricular integration, the block scheduling of exams has negative effects on learning outcomes and student satisfaction.

P676 Burden of depression and anxiety among inflammatory bowel disease patients in a national cohort in Israel – Data from the EPI-IIRN

Abstract Background Depression and anxiety in inflammatory bowel disease (IBD) patients have been receiving much deserved attention in recent years, as consecutive studies demonstrated that these emotional disorders are both common and detrimental for IBD patients. The aim of the current study was to examine the prevalence of depression and anxiety in a national cohort of IBD patients in Israel. Methods The epi-IIRN is a validated cohort of all IBD patients in Israel, ensured in four health maintenance organizations (HMOs). In this historical cohort study we included data from three HMOs, encompassing ~85% of Israeli population, between December 1997 [TD1] [UM2] and December 2019. Data included demographic data (age, sex and socioeconomic status), medical data (diagnosis type, time of diagnosis, medical regiments) and mental health status (a diagnosis of depression / anxiety defined by the relevant ICD9 codes or use of antidepressants / anxiolytics for at least two year quarters). For each IBD patient identified, three non-IBD subjects were allocated. Patients younger than 18 years or with a diagnosis of depression / anxiety preceding the diagnosis of IBD were excluded. Using cox regression and Kaplan Meier survival curve, we evaluated the prevalence of comorbid depression / anxiety at 5, 10 and 15 years following the diagnosis of an IBD. Results A total of 31340 IBD patients (48.1% females, mean age at diagnosis 38.6±15.9) and 91535 controls (48.7% females, mean age 39.9±16.1) were identified. The risk of depression / anxiety comorbidity was higher in IBD patients in comparison to controls at all evaluated timepoints: At 5 years following a diagnosis of IBD the hazard risk ratio (HR) was 1.48 (95% CI 1.43 – 1.53, p &amp;lt; 0.001, 15.5% vs 10.6%,); at 10 years HR was 1.38 (95% CI 1.34 – 1.42, p &amp;lt; 0.001, 22.9% vs. 17.0%) and at 15 years 1.37 (95% CI 1.33 – 1.40, p &amp;lt; 0.001, 27.5% vs 21.0%). For all analyses, female gender was a risk factor for development of depression/anxiety (HR~1.5, p &amp;lt; 0.001). IBD type (Crohn’s disease / ulcerative colitis) was not significantly associated with the risk of comorbid depression / anxiety. Conclusion Our national study highlights the substantial burden of depression and anxiety in IBD patients that is persistent for up to 15 years after diagnosis. Our findings emphasize the need to monitor for potential symptoms of depression and anxiety among our patients, as well as the need for prompt intervention and follow-up by a mental health care provider when such symptoms are identified.

Predicting relapse or recurrence of depression: systematic review of prognostic models.

Relapse and recurrence of depression are common, contributing to the overall burden of depression globally. Accurate prediction of relapse or recurrence while patients are well would allow the identification of high-risk individuals and may effectively guide the allocation of interventions to prevent relapse and recurrence. To review prognostic models developed to predict the risk of relapse, recurrence, sustained remission, or recovery in adults with remitted major depressive disorder. We searched the Cochrane Library (current issue); Ovid MEDLINE (1946 onwards); Ovid Embase (1980 onwards); Ovid PsycINFO (1806 onwards); and Web of Science (1900 onwards) up to May 2021. We included development and external validation studies of multivariable prognostic models. We assessed risk of bias of included studies using the Prediction model risk of bias assessment tool (PROBAST). We identified 12 eligible prognostic model studies (11 unique prognostic models): 8 model development-only studies, 3 model development and external validation studies and 1 external validation-only study. Multiple estimates of performance measures were not available and meta-analysis was therefore not necessary. Eleven out of the 12 included studies were assessed as being at high overall risk of bias and none examined clinical utility. Due to high risk of bias of the included studies, poor predictive performance and limited external validation of the models identified, presently available clinical prediction models for relapse and recurrence of depression are not yet sufficiently developed for deploying in clinical settings. There is a need for improved prognosis research in this clinical area and future studies should conform to best practice methodological and reporting guidelines.

Explaining the gap in the experience of depression among arthritis patients.

To explain the factors contributing to the gap in depression between employed arthritis patients with and without paid sick leave. Blinder-Oaxaca decomposition analysis was used to identify factors that explain the gap in the experience of depressive symptoms among arthritis patients with paid and unpaid sick leave. Data from the 2018 National Health Interview Survey, USA, was used. A total of 7189 of the NHIS survey participants given the diagnosis of arthritis were identified, of which 39% were male and 61% were female, with mean age of 63.5years. The decomposition findings suggest patients in the unpaid sick leave group were more likely to report depressive symptoms compared to patients with paid sick leave. The major contributors to the gap in the report of depressive symptoms are sex (female) and annual income (less than 35,000 USD). Findings suggest that the absence of paid sick leave is a key determinant for experiencing depressive symptoms among individuals with arthritis. The provision of paid sick leave may reduce report of depressive symptoms among employed arthritis patients in the USA. • Individuals with arthritis are consistently at greater risk of depression and unemployment as compared to individuals without arthritis. • To date greater emphasis is put on determinants of unemployment, while there is no available data on benefits associated with being employed, such as sick leave, and how it affects mental health. • Patients with unpaid sick leave appear to experience more persistent depressive symptoms than patients with access to paid sick leave. • To tackle burden of depression among arthritis patients, provision of paid sick leave may be an effective intervention.

Sex differences in sleep and psychological disturbances among patients admitted for cardiovascular diseases

Understanding sex differences is critical for improving outcomes in patients with cardiovascular conditions. Sleep and psychological disturbances contribute to the development and progression of cardiovascular diseases, and important sex differences persist in their incidence and association with clinical outcomes. Sex-based variation in sleep and psychological disturbances were assessed in consecutive patients with cardiovascular diseases in a single university hospital. The prevalence of insomnia, sleep disordered breathing (SDB), anxiety, and depression was assessed using the Pittsburgh Sleep Quality Index (PSQI), nocturnal pulse oximeter, and the Hospital Anxiety and Depression Scale (HADS). The effect of sex on the prevalence of sleep and psychological disturbances as well as their associations was quantified using multivariate logistic regression models. Among 1,233 patients (mean age 63.6 years, 25% women), women were significantly less likely than men to experience SDB (17.5% vs 31.5%, p < 0.001), but more likely to report an increased burden of insomnia (54.7% vs 43.3%, p = 0.001) and depression (23.9% vs 16.7%, p = 0.004). Insomnia was associated with depression, which was more remarkable among women (p value for interaction: 0.039). SDB was associated with anxiety among women but not men (p value for interaction: 0.003). There was no significant difference in the prevalence of anxiety between women and men. Among patients with cardiovascular disease, women reported an increased burden of insomnia and depression compared to men. The association between sleep and psychological disturbances may be more pronounced in women, suggesting that cardiologists should increase efforts for identification of such comorbidities and administer corresponding treatment, especially in women.

Reliability and validity of a perinatal depression screening instrument in rural Mali

BackgroundIn order to reduce the burden of perinatal depression in low- and middle-income countries, health systems must be able to identify and treat women suffering from depression. The objective of our study was to develop a locally valid and reliable screening instrument for use in identifying pregnant women and mothers of young children with a local depression syndrome, dusukasi, in rural Mali. MethodsWe administered a locally adapted screening instrument containing items from the Edinburgh Postpartum Depression Scale (EPDS) and Hopkins Symptom Checklist (HSCL-25) to 180 pregnant women and mothers of children under age 2 in Sélingué, Mali to assess the instrument's psychometric properties and validity. Item Response Theory was used to develop an abbreviated version of the measure and the validity and psychometric properties of this shortened version were compared with the full-length scale. ResultsThe full 28-item scale exhibited a single factor structure with good internal consistency (Cronbach's alpha ​= ​0.92). Women who self-identified as suffering from dusukasi (n ​= ​87) in a known groups analysis to assess construct validity had significantly higher depression and anxiety symptom scores (p ​< ​0.0001) and functional impairment scores (p ​< ​0.0001) compared to women not reporting dusukasi (n ​= ​93). The shortened 16-item scale performed as well as the full scale in identifying women with dusukasi. ConclusionsConstruct validity of our adapted screening instrument was supported for identifying dusukasi in rural Malian women. Our methodology can be applied in other settings to develop similarly valid screening instruments for perinatal depression.

Symptom burden in advanced breast cancer patients and its association between death anxiety and psychological distress.

Recent research has documented psychological distress in advanced breast cancer (ABC) patients, but few studies have examined how death anxiety is affected by the symptom burden. Therefore, this study aims to explore the association among symptom burden, death anxiety and psychological distress (depression and anxiety) in ABC patients. This cross-sectional study used the Death and Dying Anxiety Scale (DADDS), 9-item Patient Health Questionnaire (PHQ-9), General Anxiety Disorder-7 (GAD-7) and MD Anderson Symptom Inventory (MDASI) to assess death anxiety, depression, anxiety, and symptom burden, respectively. Bias-corrected bootstrapping methods were used to estimate indirect effects and 95% confidence intervals. Two hundred ABC patients completed the questionnaires. All of the respondents were females, with a mean age of 50±10 years. Initial correlation analyses revealed significant associations of death anxiety with depression (r=0.57, P<0.001), anxiety (r=0.60, P<0.001) and symptom burden (r=0.43, P<0.001). Moreover, depression (r=0.53, P<0.001) and anxiety (r=0.45, P<0.001) were significantly correlated with symptom burden. An analysis using Hayes' PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden, and between anxiety and symptom burden (contributions to the total effect of 0.247 and 0.469, respectively). This study provides insight into the relationship between death anxiety and symptom burden. The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.

Burden and Severity of Depression in Nigeria: Relationship and Association with Visual Impairment

The study investigated the burden and severity of depression in relationship with visual impairment in Nigeria. Four hundred (400) male and female in and outpatients with various degrees of visual impairment attending a clinic in the department of ophthalmology, Enugu State University Teaching Hospital, Parklane Enugu were used. They were selected through the purposive sampling method. The socio-demographic questionnaire, Beck depression inventory and WHO-VFQ (visual function questionnaire were used to collect data. The result showed that the domains of vision-related health status were negatively related to depression at (-0.4) also general vision (-0.09), ocular pain (-0.23), vision-specific mental health (-0.03), role difficulties (-0.03), role difficulties (-0.03), dependency (-0.09), color vision (-0.30) and peripheral vision (-0.13) and vision-specific social functioning. Domains of near acuity and vision specific social functioning were positively related, but the only statistically significant domain was vision-specific social functioning at (0.30, p 0.001). It was suggested that hospitals, families and other social groups should ensure that they provide social and emotional support to the visually impaired using their facilities.

Burden of Depression and its Correlates among Patients of Skin Diseases: a Snap-shot from Dermatology Outpatient Clinic in Karachi, Pakistan

Background: Skin problems are widespread health issues that account for a significant portion of the burden of disease worldwide and because of this dermatologists frequently face mood disorders. Objective: The present study has been planned to determine the prevalence and correlates of depression among skin disease patients presenting in dermatology clinics in Karachi, Pakistan. Methods: This cross-sectional study was performed at the dermatology clinic at Noor-e-Zia Consultant Clinics from April to August 2022. Depression screening was performed using the Patient Health Question-naire of 9 items (PHQ-9). The cut-off for positive depression screening was 10 and above. Results: A total of 385 patients were studied with a median age of 38 (IQR=27-48) years and the ma-jority of them were females (n=256, 66.5%). Patients presented with a median disease duration of one month with a range of 1-24 months. 188 (48.8%) had a PHQ-9 score ≥10. On multivariable logistic regression, low-er education, occupation of a student, patients living in a joint family system, current smokers, presence of comorbid, severe diseases, and diagnosis of urticaria and folliculitis were associated with higher odds of de-pression. Conclusion: The depression burden is higher in dermatology clinics with significantly higher depression among patients of lower education, students, current smokers, patients with comorbid, severe diseases, and diagnoses with urticaria and folliculitis.

POSB170 Economic Burden of Depression with Concurrent Anxiety in a General Population of US Adults Based on National Health and Wellness Survey (NHWS)

Depression impacts over 16 million people in the US; many do not seek treatment which can increase health system costs. Digital Therapeutics (DTx) can improve depression severity. In order to estimate DTx’s population-level impact, an understanding of how depression severity impacts economics needs to be established. The objective was to estimate the economic burden of self-reported depression with comorbid anxiety over one year in US adults.

A meta-analysis on burden of postpartum depression and its predictors among lactating women in East African countries from 1998 up to 2018.

Postpartum depression is a common mental illness that affects lactating women. This not only makes daily activities difficult for them, but it also affects child's future lives. There is little evidence of about postpartum depression and its factors in East African countries, which piqued the authors' interest in conducting a study on this matter for future decision- and policy-making. The protocol for Preferred Reporting Items for Systematic Reviews and Meta-Analyses was followed. To identify published articles, all major databases such as PubMed/MEDLINE, WHOLIS, Cochrane Library, Embase, PsycINFO, ScienceDirect, Web of Science, and reference lists were used. In addition, shelves, author contact, Google and Google Scholar were also used to identify unpublished studies. Joanna Briggs Institute-Meta-Analysis of Statistical Assessment and Review Instrument was used for critical appraisal of studies. STATA software version 14 was used for the analysis. The random-effect model was used to estimate postpartum depression with 95% confidence interval, while subgroup analysis and meta-regression were used to identify potential sources of heterogeneity and associated factors, respectively. Furthermore, Egger's test and trim-and-fill analysis were used to check for publication bias. Postpartum depression was found in 24% of lactating women in East African countries (95% confidence interval: 17.79-30.20). Postpartum depression was associated with being married (odds ratio = 2; 95% confidence interval: 1.05-3.81), domestic violence (odds ratio = 6.34; 95% confidence interval: 4:11-9.78), a lack of support (odds ratio = 6.59; 95% confidence interval: 1.98-21.89), and a lack of empowerment (odds ratio = 2.79; 95% confidence interval: 1.12-6.92). In East Africa, the prevalence of postpartum depression among lactating women is high and rising, as per global postpartum depression estimates. Therefore, the primary focus should be on women's domestic violence prevention mechanisms. Existing national policies and development agendas must prioritize strategies for women's support and empowerment. Future research into the relationship between marriage and postpartum depression is required.

The Role of Preparedness for Caregiving on the Relationship Between Caregiver Distress and Potentially Harmful Behaviors.

This work extends research suggesting a link between indicators of distress among informal caregivers (CG) (e.g., depression and burden), and potentially harmful behaviors (PHB), including feeling like yelling or screaming at the care recipient (CR). We tested three hypotheses regarding the role of a novel predictor, CG preparedness for caregiving, which were: 1) a direct effect between CG preparedness and PHB, 2) CG distress mediates the relationship between the direct effect of CG preparedness on PHB, and finally, 3) CG preparedness is only related to PHB through their shared associations with indicators of caregiver distress, an indirect effects model. Examining two indicators of PHB and CG depression and CG burden, results supported the indirect effects model. Higher CG preparedness was associated with lower CG distress, which in turn was associated with lower risk of PHB. These findings highlight the importance of CG preparedness as a target for caregiver intervention research.

The efficacy of short-term individual interpersonal psychotherapy in augmentation with pharmacotherapy in major depressive disorder

Background The high prevalence rates and persistently increasing burden of depression indicate that there are still many unmet needs in the management of depression. Interpersonal psychotherapy (IPT) is one of the main evidence-based psychotherapeutic interventions for depression.Aim To evaluate the efficacy of short-term individual IPT in combination with pharmacotherapy, compared with pharmacotherapy alone, in the treatment of depression and assess its role in improving social functioning.Setting and design This study was conducted in Mansoura University hospitals and was an interventional randomized controlled trial.Patients and methods A total of 40 patients were recruited and randomized into either the interventional group or the control group. The interventional group received IPT in combination with selective serotonin reuptake inhibitor. IPT was in the form of once weekly session for 12 weeks. Patients in the control group received treatment with an selective serotonin reuptake inhibitor with appointments once every 2 weeks. Patients from both groups were assessed by the Montgomery–Asberg Depression Rating Scale and the Social Adjustment Scale Self-Report at the beginning and after 12 weeks.Statistical analysis IBM SPSS Statistics version 20.0 was used for statistical analysis.Results There were highly statistically significant improvements in depressive symptoms and in social functioning between the baseline assessments and after 12 weeks on the used scales in both groups. There was a trend for better improvement in the interventional group (IPT+pharmacotherapy) in depressive symptoms and in overall and specific domains of social functioning when compared with the control group. The interventional group showed statistically significant better improvements in social functioning when compared with the control group.Conclusions Combined IPT and pharmacotherapy shows clear benefits over pharmacotherapy alone, in both alleviating depressive symptoms and improvement of social functioning.