History Of Depressive Disorder Research Articles

Emotional risk factors before in vitro fertilization among infertile couples in daily clinical practice in Sari in 2020–2022

Background and AimThe relationship between psychological factors and treatment outcomes with assisted reproductive technology has sparked considerable debate. This study aims to investigate the emotional risk factors in couples seeking infertility treatment using assisted reproductive technology in Sari, Iran, from 2020 to 2022.Materials and methodsThis research is a cross-sectional study and emotional risk factors and other related factors were examined using the Persian version of the SCREENIVF demographic, social, and clinical status questionnaire, social, and clinical status questionnaire before using Assisted reproductive technology in 460 infertile couples selected from infertility treatment centers in Sari City, Iran. The samples were randomly selected using a table of random numbers. Data analysis was performed using SPSS version 22 software.ResultsThe mean age of the male and female participants were 31.70 ± 5.71 and 35.22 ± 5.48, respectively. The results regarding emotional risk factors and other related factors revealed that the variables of remarriage (P = 0.048) and exposure of spouse to emotional risk factors (P = 0.001), history of depression disorder (P = 0.007), and history of anxiety disorder (P = 0.009) were significantly correlated with the exposure of women to emotional risk factors. Furthermore, men’s exposure to emotional risk factors was significantly correlated with primary education (P = 0.026) and diploma (P = 0.043) levels, age (P = 0.006), and wife’s exposure to emotional risk factors (P = 0.001).ConclusionBy identifying infertile couples who are at risk of emotional risk factors, healthcare professionals can provide appropriate support and interventions to mitigate the emotional challenges associated with infertility. This proactive approach can significantly enhance couples undergoing infertility treatment’s well-being and mental health.

A Persian Validation of the Occupational Depression Inventory

Abstract: The present study examined the psychometric and structural properties of the Persian version of the Occupational Depression Inventory (ODI). The ODI focuses on depressive symptoms that employed individuals specifically ascribe to their work. A sample of 355 Iranian schoolteachers was surveyed. Exploratory structural equation modeling (ESEM) bifactor analysis indicated that the ODI meets the requirements for essential unidimensionality. ESEM bifactor analysis and scalability analysis supported the use of the ODI’s total score. The instrument exhibited high reliability. Cross-cultural measurement invariance was supported. As for the concurrent validity of the ODI, occupational depression correlated, in the expected direction, with job satisfaction, life satisfaction, well-being, work engagement, sick leave, and antidepressant intake. No association was observed with sex, age, length of employment, and a history of depressive disorders over the past year. The ODI displayed a balance of convergent and discriminant validity vis-a-vis an attribution-free measure of depressive symptoms. The prevalence of occupational depression was estimated at 2.8% in our sample. Our findings endorse the Persian version of the ODI and confirm the instrument’s overall robustness.

Prevalence of suicidality in children and adolescents with depressive disorders with and without epilepsy

ObjectiveChildren with epilepsy (CWE) are at risk for a range of adverse emotional, behavioral, and social outcomes. Approximately one-third of CWE experience depressive disorders, and up to 20% of children and adolescents with epilepsy may experience suicidality, suggesting that epilepsy increases the risk for suicidality among children and adolescents with depressive disorders. Consequently, the goal of the present study is to compare rates of suicidality in children and adolescents diagnosed with depressive disorders with or without co-morbid epilepsy. Participants and methodsA retrospective chart review was conducted for 100 pediatric patients with a history of both seizures and depressive disorders and 100 patients with a history of depressive disorders only. Cases were coded for depression diagnosis, suicidality, suicidal ideation, suicide attempts, psychiatric hospitalizations, and self-injury. The distributions of these variables for the two groups were compared. ResultsThe age and sex distributions of the two groups were comparable. Patients with co-morbid depressive disorders and epilepsy found a high rate of suicidal ideation (69%) but did not differ from those with depressive disorders without epilepsy on any of the suicidality variables (all p > 0.20), with the exception of self-injury, which was higher in those without epilepsy. ConclusionsCWE and co-morbid depression are at significant risk for suicidality, including ideation, attempts, and hospitalizations, but at rates that are comparable to those with depressive disorders without seizures. However, patients with co-morbid epilepsy are less likely to engage in other self-injurious behaviors. These findings support the need for careful monitoring of the psychiatric status of children and adolescents with epilepsy.

Factors associated with the intensity of anxiety and depression symptoms in health workers of two centres of reference for COVID 19 patient care in Antioquia, Colombia – A latent class analysis

ObjectiveTo classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes. MethodsCross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression. Results486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91−0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99–8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27–7.56), and anxiety (OR = 5.5; 95%CI, 2.36–12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95−0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60−7.25), living with someone at risk of death from COVID-19 (OR = 1.86; 95%CI, 1.19−2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01−2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11−3.59). ConclusionsThree classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.

The prevalence and risk factors of suicidal ideation in women with and without postpartum depression

AimSuicidal ideation (SI) is a severe mental health issue in the postpartum period. As depression is a major risk factor of SI, it is often considered that the risk factors of SI are the same as those of postpartum depression. However, SI occurs in women without postpartum depression as well. The aim of this study is to separately examine the prevalence and risk factors of SI in postpartum women with and without depression. MethodsWe used data of 5688 postpartum women from a 2021 Japanese nation-wide survey, whose age and geographical distributions were nationally representative. Postpartum depression was evaluated with the Edinburgh Postnatal Depression Scale (EPDS) and SI was measured with the 10th item of EPDS. ResultsThe prevalence of SI in women with and without depression (EPDS≥9) was 51.8 % and 3.3 %, respectively. Younger age and low family support were risk factors common to both women with and without depression. Being single, currently working, history of depressive disorders, and family members' visits to support being cancelled were risk factors of SI for women with depression. In contrast, primipara, history of psychiatric disorders other than depressive disorders, infectious disease other than colds during pregnancy, and feeling of loneliness increased since COVID-19 were risk factor of SI for women without depression. ConclusionAlthough with a low prevalence, SI occurs in women without postpartum depression, which has unique risk factors indicating distinct psychopathological mechanisms. These findings call for tailored SI intervention strategies according to whether postpartum depression is present or not.

Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort

ABSTRACT Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [P M ] = 8.0%) or clinical depression (P M = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.

Factors associated with admissions for suicidal ideation in two cancers: A national database analysis.

e24197 Background: In recent years, there have been advances in medical therapy and surgical options for cancer patients, yet mental health remains to be an unmet need. Suicide in patients with cancer is about twice that of the general population. Studies have shown that any admission for suicidal ideation is associated with an increased risk of death in the next year. There is limited literature on the factors associated with admissions for suicidal ideation in patients with cancer. Hence, we sought to identify the patient characteristics associated with the principal admission diagnosis of suicidal ideation in the high-risk population of head and neck cancer (HNC) and lung cancer (LC) through the National Inpatient Sample database (NIS). Methods: Patients of ages ≥18 years, admitted with a principal diagnosis of "Suicidal ideation/attempt/intentional self-harm", were recruited from 2016-2020 National Inpatient Sample (NIS). Cases of LC and HNC were isolated via their appropriate ICD-10 codes. All other forms of cancer were excluded. Prevalence of various patient characteristics were estimated and the adjusted odds ratio(aOR) of different psychiatric diagnoses were calculated via multiple logistic regression models. SPSS 29.0 was used for all statistical analyses and statistical significance maintained at a p < 0.05. Results: We evaluated 491045 admissions for suicidal ideation, of which 715 patients had lung cancer and 240 had head and neck cancer. 35.4% of HNC and 49.0% of LC patients were females. Medicare was the principal form of insurance in both HNC (50.0%) and LC (58.7%) patients. Majority of the patients were white (91.7% for HNC and 87.9% for LC). Most of these admissions were in urban teaching hospitals (58.3% for HNC and 65% for LC) in the Southern regions of the United States (47.9% for HNC and 46.9% for LC). 60% of the patients had depressive and related disorders, 60 % were smokers and 10 % had opioid use disorders. As compared to non-cancer (NC) patients, the mean age for these patients was higher (60.71-HNC, 65.54 -LC 40.58-NC), mean length of stay was longer (5.15 days-HNC, 7.31 days-LC, 3.85 days-NC), mean hospital charge was higher ($40218-HNC, $66244-LC, $36608-NC). The most significant factors associated with increased risk of admission for suicidal ideation were the presence of depressive disorders (aOR 1.031 for HNC and 1.132 for LC), nicotine abuse (aOR of 2.465 for LC and 1.536 for HNC), and opioid abuse (aOR of 1.571 for LC and 1.155 for HNC). Interestingly, the aOR for in-hospital mortality for LC patients when admitted for suicidal ideation was 3.308. Conclusions: Our study demonstrates factors associated with suicidal intent in patients with HNC and LC. Patients with a history of depressive disorders, tobacco abuse and opioid abuse should be screened regularly for distress and given prompt referral to mental health services. This can help in better utilization of limited mental health resources.

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

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

Italian version of the Occupational Depression Inventory: Validity, reliability, and associations with health, economic, and work-life characteristics.

The Occupational Depression Inventory (ODI) reflects a new approach to job-related distress centered on work-attributed depressive symptoms. The instrument was developed with reference to the characterization of major depression found in the Diagnostic and statistical manual of mental disorders, fifth edition. The ODI has been validated in English, French, and Spanish. This study (a) investigated the psychometric and structural properties of the ODI's Italian version and (b) inquired into the nomological network of occupational depression. A convenience sample of 963 employed individuals was recruited in Italy (69.9% female; mean age = 40.433). We notably relied on exploratory structural equation modeling bifactor analysis, common-practice confirmatory factor analysis, and Mokken scale analysis to examine our dataset. Our analyses indicated that the Italian version of the ODI meets the requirements for essential unidimensionality, thus justifying the use of the instrument's total score. The ODI's reliability was excellent. Measurement invariance held across sexes, age groups, and occupations. Occupational depression was negatively associated with general wellbeing and positively associated with a 12-month history of depressive disorder, current antidepressant intake, 12-month sick leave, 6-month physical assault at work, 6-month verbal abuse at work, lack of money for leisure activities, and financial strain in the household. The ODI's Italian version exhibits robust psychometric and structural properties, suggesting that the instrument can be fruitfully used for addressing job-related distress in Italian-speaking populations. Furthermore, the present study relates occupational depression to important health, economic, and work-life characteristics, including past depressive episodes, antidepressant medication, sickness-related absenteeism, workplace violence, and economic stress.

Socioeconomic and demographic determinants of radiation treatment and outcomes in glioblastoma patients.

Poor outcomes in glioblastoma patients, despite advancing treatment paradigms, indicate a need to determine non-physiologic prognostic indicators of patient outcome. The impact of specific socioeconomic and demographic patient factors on outcomes is unclear. We sought to identify socioeconomic and demographic patient characteristics associated with patient survival and tumor progression, and to characterize treatment options and healthcare utilization. A cohort of 169 patients with pathologically confirmed glioblastomas treated at our institution was retrospectively reviewed. Multivariable cox proportional hazards analysis for overall survival (OS) and cumulative incidence of progression was performed. Differences in treatment regimen, patient characteristics, and neuro-oncology office use between different age and depressive disorder history patient subgroups were calculated two-sample t-tests, Fisher's exact tests, or linear regression analysis. The median age of all patients at the time of initiation of radiation therapy was 60.5 years. The median OS of the cohort was 13.1 months. Multivariable analysis identified age (Hazard Ratio 1.02, 95% CI 1.00-1.04) and total resection (Hazard Ratio 0.52, 95% CI 0.33-0.82) as significant predictors of OS. Increased number of radiation fractions (Hazard Ratio 0.90, 95% CI 0.82-0.98), depressive disorder history (Hazard Ratio 0.59, 95% CI 0.37-0.95), and total resection (Hazard Ratio 0.52, 95% CI 0.31-0.88) were associated with decreased incidence of progression. Notably, patients with depressive disorder history were observed to have more neuro-oncology physician office visits over time (median 12 vs. 16 visits, p = 0.0121). Patients older than 60 years and those with Medicare (vs. private) insurance were less likely to receive as many radiation fractions (p = 0.0014) or receive temozolomide concurrently with radiation (Odds Ratio 0.46, p = 0.0139). Older glioblastoma patients were less likely to receive as diverse of a treatment regimen as their younger counterparts, which may be partially driven by insurance type. Patients with depressive disorder history exhibited reduced incidence of progression, which may be due to more frequent health care contact during neuro-oncology physician office visits.

What are the effects of taking 300 pills of sodium valproate? - case report

INTRODUCTION: Sodium valproate is one of the most important antiepileptic drugs. It can be effective as a preventive treatment for migraine, it has also found use in the maintenance treatment of bipolar disorder and acute mania,it is sometimes used in the treatment of chronic neuropathic pain and fibromyalgia, in the treatment of schizophrenia borderline personality disorder and acquired brain injury, this drug is used off-label. Its overdose can be fatal.
 MATERIALS AND METHOD: Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on sodium valproate treatment, its toxicity, side effects and pharmacokinetics using PubMed.
 CASE REPORT: A 57-year-old patient with a history of depressive disorders was admitted to the Clinical Department of Toxicology and Cardiology in Lublin for intentional intoxication with the drug Absenor (sodium valproate). The patient had taken 3 packages of Absenor 500 mg (300 tablets in total) for suicidal purposes. The determined concentration of valproic acid was 841 µg/ml, and the patient's condition was very severe. Despite the treatment administered-multiple attempts at gastric lavage, administration of activated charcoal, performance of hemodialysis procedures, administration of infusion of catecholamines, the patient died on the fifth day of hospitalization.
 CONCLUSION: An overdose of sodium valproate can be fatal. Keep this in mind when ordering this drug for patients with a positive history of suicide attempts.

Functional decline, long term symptoms and course of frailty at 3-months follow-up in COVID-19 older survivors, a prospective observational cohort study

BackgroundAging is one of the most important prognostic factors increasing the risk of clinical severity and mortality of COVID-19 infection. However, among patients over 75 years, little is known about post-acute functional decline.ObjectiveThe aim of this study was to identify factors associated with functional decline 3 months after COVID-19 onset, to identify long term COVID-19 symptoms and transitions between frailty statesafter COVID-19 onset in older hospitalized patients.MethodsThis prospective observational study included COVID-19 patients consecutively hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital. Functional decline, frailty status and long term symptoms were assessed at 3 month follow up. Functional status was assessed using the Activities of Daily Living simplified scale (ADL). Frailty status was evaluated using Clinical Frailty Scale (CFS). We performed multivariable analyses to identify factors associated with functional decline.ResultsAmong the 318 patients hospitalized for COVID-19 infection, 198 were alive 3 months after discharge. At 3 months, functional decline occurred in 69 (36%) patients. In multivariable analysis, a significant association was found between functional decline and stroke (OR = 4,57, p = 0,003), history of depressive disorder (OR = 3,05, p = 0,016), complications (OR = 2,24, p = 0,039), length of stay (OR = 1,05, p = 0,025) and age (OR = 1,08, p = 0,028). At 3 months, 75 patients described long-term symptoms (49.0%). Of those with frailty (CFS scores ≥5) at 3-months follow-up, 30% were not frail at baseline. Increasing frailty defined by a worse CFS state between baseline and 3 months occurred in 41 patients (26.8%).ConclusionsThis study provides evidence that both the severity of the COVID-19 infection and preexisting medical conditions correlates with a functional decline at distance of the infection.This encourages practitioners to establish discharge personalized care plan based on a multidimensional geriatric assessment and in parallel on clinical severity evaluation.

Wernicke Encephalopathy: A case report

IntroductionWe report a case of a 56-year old woman with a history of depressive disorder between 2012 and 2017 achieving full remission after treatment with antidepressants and anxiolytics. In the year 2021 was presented to the emergency department manifesting alteration of behavioral patterns, ataxia, mental confusion and horizontal nystagmus. A chronic alcohol abuse was also discovered while interviewing. She also exhibited low mood, anterograde amnesia and confabulations that improved rapidly after following treatment with thiamine.ObjectivesReviewing clinical manifestations and treatment of Wernicke encephalopathy and the development of Korsakoff syndrome.MethodsWe systematically reviewed articles using PubMed.ResultsWernicke encephalopathy is a well-known complication of thiamine deficiency, mostly associated with alcohol use disorder. Classically, the syndrome comprises changes in mental status, gait ataxia and ophthalmoplegia. However, the full triad has been described in only 10-17 % of cases, which in our the case is report. After the diagnosis was established and was treated with thiamine, a rapid improvement in the patient´s clinical status was observed. Cognitive impairment was later identified, taking into account the possibility of a Korsakoff syndrome characterized by irreversible brain damage and subsequent loss of anterograde memory. In our patient, this specific diagnosis was dismissed due to the clinical improvement after thiamine treatment.ConclusionsIt is relevant to emphasize the importance of a precise diagnosis and treatment of patients with Wernicke Encephalopathy to avoid the development of a Korsakoff syndrome.DisclosureNo significant relationships.

Individual factors associated with workaholism among Tunisian engineers

IntroductionGlobalization and increased competition in the engineering profession induce to work longer and harder, which predisposes to workaholism or work addiction. Identifying individual factors associated with workaholism could help to maintain the mental health at work.ObjectivesThe aim of this study was to assess the prevalence of workaholism and its associated socio-demographic and historic factors among Tunisian engineers.MethodsA cross-sectional descriptive and analytical study conducted among Tunisian engineers during July 2021. The data were collected by an online questionnaire including the socio-demographic and historic information and the “the Work Addiction Risk Test” (WART) which was used to assess the workaholism.ResultsA total of 52 engineers participated in this study (40.4% female and 59.6% male). The average age was 30.75 years (SD=6.25 years). Concerning marital status, thirty-five engineers (67.3%) were single. Of the participants, 17.3% had a history of chronic somatic-disorders and 25 % of them had a history of a psychiatric disorder, such as depressive disorder in 11.5% of cases. The prevalence of workaholism in Tunisian engineers was 23.1%. Workaholism was associated to older age with no significant difference (p = 0.11). The analysis showed that workaholics had more history of depressive disorder (p = 0.02) compared to non-workaholics. However, no significant difference was found by the other socio-demographic factors according to workaholism.ConclusionsWorkaholism is a significant phenomenon among Tunisian engineers. It may depend of personal characteristics and induce negative consequences on mental health and lead to depression.DisclosureNo significant relationships.

Analysis of Suicidal Behavior and Chronicity of Depressive Symptoms in the Presence of Hypovitaminosis D

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.

Increased In-Hospital Lengths of Stay, Readmission Rates, Complications, and Costs in Patients Who Have Depressive Disorders Following Primary Total Hip Arthroplasty

Recent studies have shown the prevalence of depressive disorders has increased within the United States. Studies investigating the impact of depressive disorders following primary THA are limited. Therefore, the purpose of this study was to determine whether patients with depressive disorders have higher rates of: 1) in-hospital lengths of stay (LOS); 2) readmission rates; 3) medical complications; and 4) implant-related complications. A retrospective query of the Humana claims database was performed. Patients undergoing primary THA with a history of depressive disorders were identified by International Classification of Disease, Ninth Revision (ICD-9), and Current Procedural Terminology (CPT) codes. Study group patients were matched to controls in a 1:5 ratio by age, sex, and comorbidities. The query yielded 67,245 patients with (n=11,255) and without (n=55,990) depressive disorders. Welch's t-tests were used to test for significance in LOS between the cohorts; whereas, logistics regression analyses were used for complications and readmissions. A p-value less than 0.003 was statistically significant. Patients with depressive disorders undergoing primary THA had significantly longer in-hospital LOS (6.59 days vs. 2.96 days, p <0.0001). Additionally, patients with depressive disorders had higher incidence and odds of readmission rates (46.02 vs. 35.43%; OR: 1.55, p <0.0001), medical complications (7.05 vs. 1.84%; OR: 4.04, p <0.0001), and implant-related complications (5.76 vs. 2.75%; OR: 2.16, p <0.0001) compared to patients without depressive disorders. After matching age, sex, and medical comorbidities, the results of the study demonstrate patients with depressive disorders have longer in-hospital LOS and increased rates of complications and readmission rates. The study is useful as it can allow orthopedic surgeons to properly counsel these patients of the potential complications which may arise following their procedure.

Parental Knowledge/Monitoring and Depressive Symptoms During Adolescence: Protective Factor or Spurious Association?

Parental knowledge/monitoring is negatively associated with adolescents’ depressive symptoms, suggesting monitoring could be a target for prevention and treatment. However, no study has rigorously addressed the possibility that this association is spurious, leaving the clinical and etiological implications unclear. The goal of this study was to conduct a more rigorous test of whether knowledge/monitoring is causally related to depressive symptoms. 7940 youth (ages 10.5–15.6 years, 49% female) at 21 sites across the U.S. completed measures of parental knowledge/monitoring and their own depressive symptoms at four waves 11–22 weeks apart during the COVID-19 pandemic. First, monitoring and depression were examined in standard, between-family regression models. Second, within-family changes in monitoring and depression between assessments were examined in first differenced regressions. Because the latter models control for stable, between-family differences, they comprise a stronger test of a causal relation. In standard, between-family models, parental monitoring and youths’ depressive symptoms were negatively associated (standardized beta= −0.22, 95% CI = [−0.25, −0.20], p < 0.001). In first-differenced, within-family models, the association shrunk by about 55% (standardized beta= −0.10, 95% CI = [−0.12, −0.08], p < 0.001). The magnitude of within-family association remained similar when adjusting for potential time-varying confounders and did not vary significantly by youth sex, age, or history of depressive disorder. Thus, in this community-based sample, much of the prima facie association between parental knowledge/monitoring and youths’ depressive symptoms was driven by confounding variables rather than a causal process. Given the evidence to date, a clinical focus on increasing parental knowledge/monitoring should not be expected to produce meaningfully large improvements in youths’ depression.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10802-021-00896-9.

Association between a history of clinical depression and dementia, and the role of sociodemographic factors: population-based cohort study.

Depression is associated with an increased dementia risk, but the nature of the association in the long-term remains unresolved, and the role of sociodemographic factors mainly unexplored. To assess whether a history of clinical depression is associated with dementia in later life, controlling for observed sociodemographic factors and unobserved factors shared by siblings, and to test whether gender, educational level and marital status modify the association. We conducted a national cohort study of 1 616 321 individuals aged 65 years or older between 2001 and 2018 using administrative healthcare data. A history of depression was ascertained from the national hospital register in the period 15-30 years prior to dementia follow-up. We used conventional and sibling fixed-effects Cox regression models to analyse the association between a history of depression, sociodemographic factors and dementia. A history of depression was related to an adjusted hazard ratio of 1.27 (95% CI 1.23-1.31) for dementia in the conventional Cox model and of 1.55 (95% CI 1.09-2.20) in the sibling fixed-effects model. Depression was related to an elevated dementia risk similarly across all levels of education (test for interaction, P = 0.84), but the association was weaker for the widowed than for the married (P = 0.003), and stronger for men than women (P = 0.006). The excess risk among men attenuated following covariate adjustment (P = 0.10). This study shows that a history of depression is consistently associated with later-life dementia risk. The results support the hypothesis that depression is an aetiological risk factor for dementia.

The pattern of medication use, and determinants of the prevalence of polypharmacy among patients with a recent history of depressive disorder: results from the pars cohort study

BackgroundInappropriate medication use among individuals with depressive disorders (DD) is a rising public health challenge. We aimed to investigate the polypharmacy and its determinants among individuals with DD in a less developed region, and evaluate the pattern of medication use in this population.MethodsData was extracted from Pars Cohort Study (PCS) between 2016 and 2019. Participants were asked to bring all the medication they were using regularly, and history of DD during the last 12 months prior to study was obtained. The Anatomical Therapeutic Chemical classification was applied and polypharmacy was defined as concurrent use of five or more medications. Logistic regression models were developed to estimate the associations between polypharmacy and DD, adjusted for relevant covariates. The prevalence of consumption of each drug class was estimated among males, females, and elders. Logistic regression was applied and the adjusted odds ratio (OR) and its 95% confidence interval (CI) were estimated.ResultsA total of 9264 participants with a mean age of 52.6 (SD: 9.7) were enrolled. The prevalence of polypharmacy was 22.6% [95% CI (20.7–24.6)]. The most common drug classes were genitourinary system (55.4%) and nervous system (29.1%) medication, respectively. Recent history of DD was reported among 19.4% (n = 1795) participants, the majority of whom were females. Factors associated with polypharmacy include female gender (OR: 1.51), Fars ethnicity (OR: 1.52), lower physical activity (OR: 1.74), and higher socioeconomic status (OR: 1.40). The prevalence of antidepressant use among males was higher than females (P < 0.001).ConclusionThe prevalence of polypharmacy is high among patients with a recent history of depressive disorder. Females, individuals with higher socioeconomic status and lower physical activity, and those who use tobacco are more likely to be polymedicated. Surveillance measures need to be established to monitor the patterns of medication use among individuals with depressive disorders.

Use of potentially driver-impairing drugs among older drivers

BackgroundRoad safety is a major issue among seniors. Potentially Driver-Impairing (PDI) drugs are known to increase the risk of car accident. The aim of this cross-sectional study was to describe PDI-drug consumption among older drivers and determine associated factors.MethodsThe S.AGES cohort is a French non-interventional real-life prospective study of 3700 community-dwelling participants aged ≥65 years old, suffering from type 2 diabetes (T2DM), chronic pain or atrial fibrillation (AF). Baseline data of drivers with known treatment (n = 1783) were used for the analyses. PDI drugs were defined according to the French classification.ResultsOne thousand seven hundred eighty-three drivers were included (66% males; mean age 76 (Standard deviation = 5.78) years old). 21% (n = 373) took PDI drugs, 64% of which took only one (n = 239). The most frequent PDI drugs were: Zolpidem (11%; n = 60); Zopiclone (8%; n = 45); Bromazepam (8%; n = 44); Tramadol (7%; n = 39); Pregabalin (6%; n = 31). Drivers taking PDI drugs had more often chronic pain (OR [95% CI] = 2.30 [1.54–3.46]), history of depressive disorder (4.28 [3.00–6.14]) and polypharmacy (taking at least 5 different medications; 4.32 [2.97–6.41]), and less often T2DM (0.54 [0.37–0.79]), and AF (0.48 [0.32–0.71]). Conversely, they had a lower Activities of Daily Living score (0.34 [0.17–0.68]).ConclusionsThe rate of aged drivers in the S.AGES cohort taking PDI drugs is concerning and highlights the need to carefully assess and reassess PDI-drug prescriptions in this population, particularly hypnotics, anxiolytics and opioids.Trial registrationClinicalTrials.gov NCT01065909 (First posted: February 9th, 2010).