Mood In Depressed Patients Research Articles

A mindfulness- and relaxation-based nature intervention improves mood in depressed patients in psychosomatic rehabilitation: Results from the GREENCARE non-randomized controlled clinical trial.

IntroductionGuided contact with nature has positive effects on well-being. Little is known about the effectiveness of adding nature-based interventions to inpatient treatment for depression. Therefore, we evaluated a mindfulness- and relaxation-based nature intervention for depressed patients in psychosomatic rehabilitation treatment. MethodPsychosomatic rehabilitation inpatients with depression were allocated to either a Greencare mindfulness- and relaxation-based nature intervention (n = 116) or to treatment as usual plus waitlist control group (TAU+WL) (n = 111) in two centres. All patients received questionnaires on admission (T1) and discharge (T2). Greencare patients received follow-up questionnaires three months after the intervention (T3). Main outcome was mood, assessed by the Positive and Negative Affect Schedule (PANAS). Secondary outcomes were depression, mindfulness, state self-compassion, and contact with nature. Data were analysed as intent-to-treat using mixed models for repeated measures, adjusted for propensity score and centre. Patients’ ratings of the effectiveness of the sessions and their well-being, and situational aspects of each session, were recorded. ResultsWe found significant interactions of time*group for PANAS, showing greater positive affect (Cohen’s d at T2 = 0.48) and lower negative affect (Cohen’s d at T2 = 0.52) in the Greencare group compared to the TAU+WL group at T2. At follow-up (T3), the effects in the Greencare group decreased, but remained significant compared to T1. Significant results for self-compassion and non-significant effects for depression and mindfulness were found. The groups did not differ in the amount of contact with nature. Sensitivity analyses revealed more favourable follow-up effects for patients with higher levels of depression. Patients reported high ratings of effectiveness and well-being for each session, and these ratings were not related to the weather conditions. No adverse events were reported. DiscussionDepressed inpatients benefitted from a Greencare mindfulness- and relaxation-based nature intervention by improving positive and negative affect. The effects were slightly reduced after three months, but less in patients with higher levels of depression on admission. Results show that the intervention is feasible and effective even for patients with higher symptom burden. Trial RegistrationGerman Clinical Trials Register (trial registration number: DRKS00023369, universal trial registration number: U1111-1260-7305)

A mindfulness- and relaxation-based nature intervention improves mood in depressed patients in psychosomatic rehabilitation: Results from the GREENCARE non-randomized controlled clinical trial

A mindfulness- and relaxation-based nature intervention improves mood in depressed patients in psychosomatic rehabilitation: Results from the GREENCARE non-randomized controlled clinical trial

Classification of high-risk depressed mood groups in cancer patients based on Health Ecology Model

BackgroundDepressed mood affects a significant number of patients with cancer, and can impair their quality of life and interfere with successful treatment. Our study aims to create a predictive model for identifying high-risk groups of depressed mood in cancer patients, offering a theoretical support for preventing depressed mood in these individuals. MethodsThe China Health and Retirement Longitudinal Study (CHARLS) provided the data for this research, which used CES-D as a tool to identify individuals with depressed mood. Influencing factors of depressed mood in cancer patients was analyzed using a binary logistic regression model. Using the Harvard Cancer Index, we classified the high-risk patients for depressed mood. ResultsIn present study, 52.96 % of cancer patients met criteria for depressed mood based on the CES-D. Significant correlations were found between depressed mood and factors such as gender, self-rated health, sleep duration, exercise, satisfaction with family, residence, education, life satisfaction, and medical insurance. Utilizing the Harvard Cancer Index, we classified patients into five risk levels for depressed mood, revealing a significant variation in the number of depressive patients across these levels (x2=99.82, P < 0.05). Notably, the incidence of depressed mood increased with the risk level among cancer patients (x2=103.40, P < 0.05). LimitationsLack of data on tumor typing and subgroups makes it unlikely to explore the specifics of depressed mood in patients with various types of cancer. ConclusionThe determinants of depressed mood in cancer patients are multi-dimensional. The Harvard Cancer Index may be helpful in identifying high-risk populations.

조기발병 치매환자의 역할유지를 위한 지역사회 기반 활동프로그램 사례연구

This study aimed to understand the effects of a community-based activity program on instrumental activities of daily living (IADL), cognitive function, and depressive mood in patients with early onset dementia (EOD), and to provide basic data for community-based activity programs to maintain the role of patients with EOD. One patient with EOD who visited the Center for Dementia in S city, Seoul, from August to November 2021 was enrolled in the program. This was conducted for 120 min once a week for 8 weeks. The activity program was implemented based on the Model of Human Occupation (MOHO), focusing on solving problems recognized by patients and caregivers. Compared with before and after the implementation of the activity program, the IADL and cognitive function of patients with dementia improved, and depressive mood decreased. As EOD rapidly progresses, active intervention in the early stages is necessary to delay symptoms and prevent the deterioration of activities of daily living (ADL) and social activity performance skills. Therefore, establishing a systematic treatment and system that can promote participation in community activities so that EOD patients living in the community can maintain their social role as well as interventions to delay the deterioration of symptoms is necessary, and institutional support should be provided.

Effects of CPAP and Mandibular Advancement Devices on depressive symptoms in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials.

Studies show that patients with obstructive sleep apnea (OSA) are more likely than the general population to have psychological disorders such as depression. However, it is less clear how OSA treatment affects this association. This meta-analysis aimed to assess whether or not continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) reduce depression symptoms in patients with OSA. We searched Pubmed, Embase, Web of Science, and Cochrane Library from creating the databases until November 2022. Our analysis included RCTs that examined CPAP and MAD treatment effectiveness for depression in patients with OSA. We identified 17 CPAP studies comprising 1,931 patients for inclusion in the meta-analysis. The results of the meta-analysis using a fixed effects model found that CPAP improved depressed mood in patients with OSA relative to controls (SMD = 0.27;95% CI:0.18,0.36), with small heterogeneity among trials (I2 = 8.1% < 50%, P = 0.359). We performed subgroup analyses on three factors: the length of trial follow-up, patient adherence data, and depression assessment scales. The meta-analysis also identified six MAD studies involving 315 patients. According to this analysis, there was no heterogeneity between studies (I2 = 0%, P = 0.748). MADs did not significantly improve depression symptoms compared to controls, indicating a combined effect of SMD = 0.07 (95% CI: - 0.15,0.29), P > 0.05. The present findings confirm that CPAP may improve depressive symptoms inpatients with OSA. However, the review results suggest that MADs have no significant effect on depressive symptoms in patients with OSA, a finding that is different from the results of previous meta-analyses.

Journal Digest: CBT With Cardiac Rehab, PMDD Neurochemistry, and More

Journal Digest: CBT With Cardiac Rehab, PMDD Neurochemistry, and More

Severity of REM sleep without atonia correlates with measures of cognitive impairment and depressive symptoms in REM sleep behaviour disorder.

This study aimed to correlate REM sleep without atonia (RSWA) and neuropsychological data in patients with idiopathic/isolated REM sleep behaviour disorder (iRBD) and those with RBD associated with Parkinson's disease (PDRBD), in order to assess whether higher degrees of RSWA are related to poorer cognitive performance. A total of 142 subjects were enrolled: 48 with iRBD, 55 with PDRBD, and 39 PD without RBD (PDnoRBD). All participants underwent video-polysomnographic recording, clinical and neuropsychological assessment. RSWA was quantified according to two manual scoring methods (Montréal, SINBAR) and one automated (REM atonia index, RAI). Mild cognitive impairment (MCI) was diagnosed according to diagnostic criteria for MCI in Parkinson's disease. The relationship between neuropsychological scores and RSWA metrics was explored by multiple linear regression analysis and logistic regression models. Patients with iRBD showed significantly lower visuospatial functions and working memory, compared with the others. More severe RSWA was associated with a higher risk of reduced visuospatial abilities (OR 0.15), working memory (OR 2.48), attention (OR 2.53), and semantic fluency (OR 0.15) in the iRBD. In the whole group, a greater RSWA was associated with an increased risk for depressive symptoms (OR 3.6). A total of 57(40%) MCI subjects were found (17 iRBD, 26 PDRBD, and 14 PDnoRBD). Preserved REM-atonia was associated with a reduced odds of multi-domain MCI in the whole study population (OR 0.54). In conclusion, a greater severity of RSWA was associated with an increased risk for poor cognitive performance and depressive mood in patients with RBD. Moreover, higher RAI was associated with a lower risk of multi-domain MCI.

Increase in Serotonin Transporter Binding in Patients With Premenstrual Dysphoric Disorder Across the Menstrual Cycle: A Case-Control Longitudinal Neuroreceptor Ligand Positron Emission Tomography Imaging Study

BackgroundPremenstrual dysphoric disorder (PMDD) disrupts the lives of millions of people each month. The timing of symptoms suggests that hormonal fluctuations play a role in the pathogenesis. Here, we tested whether a heightened sensitivity of the serotonin system to menstrual cycle phase underlies PMDD, assessing the relationship of serotonin transporter (5-HTT) changes with symptom severity across the menstrual cycle. MethodsIn this longitudinal case-control study, we acquired 118 [11C]DASB positron emission tomography scans measuring 5-HTT nondisplaceable binding potential (BPND) in 30 patients with PMDD and 29 controls during 2 menstrual cycle phases (periovulatory, premenstrual). The primary outcome was midbrain and prefrontal cortex 5-HTT BPND. We tested whether BPND changes correlated with depressed mood. ResultsLinear mixed effects modeling (significant group × time × region interaction) showed a mean increase of 18% in midbrain 5-HTT BPND (mean [SD] periovulatory = 1.64 [0.40], premenstrual = 1.93 [0.40], delta = 0.29 [0.47]: t29 = −3.43, p = .0002) in patients with PMDD, whereas controls displayed a mean 10% decrease in midbrain 5-HTT BPND (periovulatory = 1.65 [0.24] > premenstrual = 1.49 [0.41], delta = −0.17 [0.33]: t28 = −2.73, p = .01). In patients, increased midbrain 5-HTT BPND correlated with depressive symptom severity (R2 = 0.41, p < .0015) across the menstrual cycle. ConclusionsThese data suggest cycle-specific dynamics with increased central serotonergic uptake followed by extracellular serotonin loss underlying the premenstrual onset of depressed mood in patients with PMDD. These neurochemical findings argue for systematic testing of pre–symptom-onset dosing of selective serotonin reuptake inhibitors or nonpharmacological strategies to augment extracellular serotonin in people with PMDD.

Men's Depression, Externalizing, and DSM-5-TR: Primary Signs and Symptoms or Co-occurring Symptoms?

Men's Depression, Externalizing, and DSM-5-TR: Primary Signs and Symptoms or Co-occurring Symptoms?

A Data-Driven Clustering Method for Discovering Profiles in the Dynamics of Major Depressive Disorder Using a Smartphone-Based Ecological Momentary Assessment of Mood.

BackgroundAlthough major depressive disorder (MDD) is characterized by a pervasive negative mood, research indicates that the mood of depressed patients is rarely entirely stagnant. It is often dynamic, distinguished by highs and lows, and it is highly responsive to external and internal regulatory processes. Mood dynamics can be defined as a combination of mood variability (the magnitude of the mood changes) and emotional inertia (the speed of mood shifts). The purpose of this study is to explore various distinctive profiles in real-time monitored mood dynamics among MDD patients in routine mental healthcare.MethodsEcological momentary assessment (EMA) data were collected as part of the cross-European E-COMPARED trial, in which approximately half of the patients were randomly assigned to receive the blended Cognitive Behavioral Therapy (bCBT). In this study a subsample of the bCBT group was included (n = 287). As part of bCBT, patients were prompted to rate their current mood (on a 1–10 scale) using a smartphone-based EMA application. During the first week of treatment, the patients were prompted to rate their mood on three separate occasions during the day. Latent profile analyses were subsequently applied to identify distinct profiles based on average mood, mood variability, and emotional inertia across the monitoring period.ResultsOverall, four profiles were identified, which we labeled as: (1) “very negative and least variable mood” (n = 14) (2) “negative and moderate variable mood” (n = 204), (3) “positive and moderate variable mood” (n = 41), and (4) “negative and highest variable mood” (n = 28). The degree of emotional inertia was virtually identical across the profiles.ConclusionsThe real-time monitoring conducted in the present study provides some preliminary indications of different patterns of both average mood and mood variability among MDD patients in treatment in mental health settings. Such varying patterns were not found for emotional inertia.

Vagus nerve stimulation for drug-resistant epilepsy induced by tuberous sclerosis complex

ObjectiveThis study investigated the dynamic and long-term efficacy of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE) induced by tuberous sclerosis complex (TSC). In addition, the impact of VNS on cognition and emotion after a one-year follow-up was evaluated. MethodsA total of 17 patients diagnosed with DRE induced by TSC were retrospectively recruited between 2008 and 2019. Dynamic changes in seizure frequency were observed in the responders (≥50% reduction of seizure frequency at last follow-up) and non-responders. Clinical characteristics and seizure outcomes were comprehensively analyzed to determine factors associated with seizure outcomes. The Wechsler intelligence scale was applied in a subgroup of six pediatric patients, whereas the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were assessed in a subgroup of nine patients to determine the impact of VNS therapy on cognitive performance and emotional state. ResultsThe follow-up duration for the 17 patients who underwent VNS treatment ranged from 0.5 to 10 years (mean ± SD: 4.1 ± 3.2 years). Monthly seizures decreased significantly from three months to four years post-treatment (p < 0.05). At the last follow-up, 70.6% of the patients achieved at least a 50% reduction in seizure frequency, and three patients were completely seizure free. Comparatively, non-responder patients experienced deterioration of seizure frequency after the first year. Notably, after one-year follow-up the mean standard score of full-scale intelligence quotient increased from 67.33 to 69.5 (p = 0.078) while the mean, standard score of SDS decreased from 49.22 to 45.67 (p = 0.003) compared to preoperative neuropsychological evaluation results. ConclusionVNS is a safe and effective treatment for patients with DRE caused by TSC. Although early outcomes were encouraging, a follow-up of at least one-year was required to predict long-term outcomes in patients receiving VNS treatment. Moreover, VNS may improve depressive mood in patients with DRE caused by TSC. Further investigations are needed to validate the present results.

Different scoring rules for respiratory event-related leg movements: effects on the prevalence of periodic limb movements during sleep and their association with depressive symptoms in patients with obstructive sleep apnea

BackgroundWe compared the prevalence of periodic leg movements during sleep (PLMS) according to two different scoring rules of the American Academy of Sleep Medicine (AASM) 2012 and World Association of Sleep Medicine (WASM) 2016 and determined their association with depressed mood in patients with obstructive sleep apnea (OSA). MethodsPLMS, defined as a periodic leg movements index of >15, were diagnosed on a diagnostic and continuous positive airway pressure (CPAP) titration polysomnography using the AASM 2012 and WASM 2016 rules. The Beck Depression Inventory (BDI) and Epworth Sleepiness Scale (ESS) were used, and multiple regression analyses were performed. ResultsAmong 160 OSA patients, the proportion with PLMS scored by the WASM 2016 criteria was significantly higher than that scored by the AASM 2012 criteria in a diagnostic study (20.6% vs. 16.3%, respectively; P = 0.016) but not in CPAP titration study and only in patients with severe OSA. In adjusted models, PLMS were positively associated with BDI scores and a BDI of ≥10 on both diagnostic and CPAP titration studies when scored by the WASM 2016. By contrast, when scored by the AASM 2012, PLMS were associated with BDI scores (but not BDI of ≥10) only in a CPAP titration study. ConclusionsThere are significant differences in the prevalence of PLMS and their association with depressed mood depending on the scoring rules in patients with OSA. The current AASM scoring criteria underestimate the prevalence of PLMS, and PLMS are more likely associated with depressed mood according to the WASM scoring criteria.

The Impacts of Prognostic Awareness on Mood and Quality of Life Among Patients With Advanced Cancer

Accurate awareness of the prognosis is an important factor in the treatment decision of patients with advanced cancer; however, prognostic disclosure is still subject to debate because it can reduce patient's satisfaction and increase depression. The purpose of this study is to assess whether patients' prognostic awareness is associated with decreased quality of life (QoL) or increased depressive mood in patients with advanced cancer. In this cohort study, 386 patients with advanced cancer were recruited across 3 periods from December 2016 to August 2018. The outcome of this study was a change in QoL and depression according to the patients' prognostic awareness at baseline, 3 months, and 6 months. This study found significant differences in changes of QoL based on patients' prognostic awareness. From baseline to 3 months, emotional functioning (P = .039), pain (P = .042), existential well-being (P = .025), and social support (P = .038) subscale scores improved significantly more in those with lack of prognostic awareness. Over 6 months, the group without prognostic awareness improved significantly in terms of physical functioning (P = .037), emotional functioning (P = .002), nausea/vomiting (P = .048), and constipation (P = .039) subscale scores and existential well-being scores (P = .025). No significant difference between the groups was found in terms of depression. Accurate prognostic awareness may pose harm and may provide no additional benefits in terms of QoL and mood among patients with advanced cancer for a short period of time.

Anosognosia in patients with Alzheimer's disease: current perspectives.

Alzheimer's disease (AD) is a neurodegenerative disease characterised by neurocognitive impairments, especially memory impairment, as core symptoms linked to reductions in activities of daily life. As marginal symptoms, neuropsychiatric symptoms (NPSs) appear during the progressive course of the disease. A lack of self-awareness (anosognosia) of cognitive and functional impairments is often seen in patients with AD, and associations between anosognosia and other NPSs have been previously reported. To account for anosognosia pathogenesis neurocognitively, the cognitive awareness model (CAM) has been helpful for explaining the stream of events from sensory input to behavioural/affective and metacognitive outputs. According to CAM, there are three types of anosognosia: (i) primary anosognosia, (ii) executive anosognosia, and (iii) mnemonic anosognosia. These types of anosognosia are generated from different neurocognitive modulations leading to metacognitive outputs or behavioural/affective regulations. Primary anosognosia is considered to be caused by deficits in the metacognitive awareness system (MAS). While preserved MAS function is associated with milder depression and anxiety in AD, a severer depressive mood in patients with mild AD can inversely cause self-underestimation. The modulation of executive anosognosia is thought to be associated with dangerous/disinhibition behaviours and apathy among NPS sub-symptoms, via impairments of comparator mechanism (Cm) within the central executive system. Other neurobehavioral reactions linked to self-awareness include 'denying' and 'confabulation', and each of these reactions is thought to be affected by the MAS and a Cm. Denial of one's own memory impairments appears as a defensive reaction to protect against dysphoric feelings, and the confabulatory comment is instantly reaction constructed by fabrications according to misinterpretations of memory information about oneself. Similarly, the innovative development of a theoretical model (CAM) has contributed to explaining the mechanism of anosognosia and some neurobehavioral outputs from a neurocognitive perspective.

Fatigue is Related to Insulin Use by Acting Via Depressive Mood in Patients with Diabetes Mellitus

Fatigue is Related to Insulin Use by Acting Via Depressive Mood in Patients with Diabetes Mellitus

The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors

ObjectiveWe investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. MethodsFrom patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). ResultsAt baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. ConclusionQuality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

Does early depressive mood expire following radical retropubic prostatectomy in patients with localized prostate cancer?

In this study, the pattern of depressive mood in patients following radical prostatectomy (RP) for localized prostate cancer (PCa) was determined. A total of 30 patients (aged 68.03±6.1 years) who were diagnosed with localized PCa and underwent RP within 1 month entered the study. Evaluations included body mass index, prostate-specific antigen, testosterone, underlying disease, international prostate symptom score and quality of life (QoL), international index of erectile function as well as Beck depression inventory (BDI), both at the initial stage and 3 months later. Basic demographic data, laboratory results, and questionnaires were analyzed statistically. The BDI score significantly decreased 3 months after the surgery. In correlation analysis, BDI was related with the international prostate symptom score but not with the underlying disease, QoL or international index of erectile function. Body mass index was identified as one of the risk factors to decrease the probability of BDI score (≥3) significantly. Underlying disease increased the probability of BDI score. In the assessment of the correlation between BDI and each subscale, sadness, self-dislike, self-criticalness, and worth-lessness showed high correlation. In the early period, depressive mood was improved at the short-term follow-up in localized PCa patients after RP. Voiding symptoms were only related with the depressive mood, but not with other parameters, including sexual function. The depressive mood had no effect on the QoL in the early stage.

19 - INVESTIGATING CAUSAL RELATIONSHIPS BETWEEN MAJOR DEPRESSIVE DISORDER AND GENETICALLY CORRELATED TRAITS USING MENDELIAN RANDOMISATION

Background Major Depressive Disorder is a common, complex, heterogeneous disorder that has been found to be associated with a wide array of traits and diseases such as coronary heart disease, type 2 diabetes and cancer. Due to the limitations of observational studies, it is not possible to establish whether such associations are causal, due to reverse causality or due to confounding. Mendelian Randomisation (MR) is an analytical technique that uses genetic instruments that are associated with the exposure of interest, to evaluate whether the association between exposure and outcome is causal in observational data. We sought to investigate the causal relationship between MDD and traits showing phenotypic and genetic correlation. Methods We used a novel multi-SNP MR method called Generalised Summary-based Mendelian Randomisation (GSMR) to investigate direction of causality between MDD and 4 traits with high genetic correlation with MDD – years of education (at the genetic level this is a proxy for general intelligence together with other psychosocial factors), body mass index (BMI), schizophrenia and coronary artery disease, for which GWAS summary statistics are publically available. Bi-directional analysis was performed. Sample sizes for risk factors ranged from 150,064 to 405,072, and the number of genome-wide significant SNPs included as independent instruments ranged from 59 to 124. A primary assumption of the MR method is that the genetic instrument does not have pleiotropic effects on the exposure and outcome. The GSMR method filters out SNPs with significant evidence of pleiotropy. Results GSMR analyses provided evidence for a 1.15 fold increase in MDD per standard deviation of BMI (P =2.7×10-7) and a 0.89 fold decrease in MDD per standard deviation of years of education (P=8.8×10-7). There was no evidence of reverse causality of MDD for BMI (P=0.81) or EDY (P =0.28). For BMI there was some evidence of pleiotropy, as eight SNPs were excluded as outliers. For CAD, the MR analyses were not significant when considering MDD as an outcome (P =0.39) or as an exposure (P = 0.13). There was significant evidence of bidirectional causality with a correlation in effect sizes of schizophrenia SNPs in MDD (P = 7.7×10–46) and MDD SNPs in schizophrenia (P = 6.3 × 10–15). Results from other MR methods such as inverse-weighted meta-analysis, weighted median and MR-Egger were similar to those from GSMR Discussion Our results suggest that MDD is not a causal risk factor for decreased years of education and increased BMI. In contrast, our results suggest that decreased years of education and increased BMI could be investigated as causal risk factors for MDD recognising that an alternative explanation is that these factors are correlated with other risk factors for MDD. Evidence from randomised control trials that have shown improved mood in depressed patients who adhere to a weight-loss plan is consistent with our results. Direction of causality could not be established for the association between MDD and CAD, indicating that the association may be due to other confounding factors. Lastly, our results suggest that MDD and schizophrenia have overlapping causal genetic pathways.

Serotoninergic antidepressants amplify the influence of the living condition on mood in depressed patients enrolled in the STAR*D study

Serotoninergic antidepressants amplify the influence of the living condition on mood in depressed patients enrolled in the STAR*D study

Depressed Mood, Perceived Health Competence and Health Behaviors: aCross-Sectional Mediation Study in Outpatients with Coronary Heart Disease.

Identifying potential mechanisms that link depressed mood with worse health behaviors is important given the prevalence of depressed mood in patients with coronary heart disease (CHD) and its relationship with subsequent mortality. Perceived health competence is an individual's confidence in his/her ability to successfully engineer solutions to achieve health goals and may explain how depressed mood affects multiple health behaviors. Examine whether or not perceived health competence mediates the relationship between depressed mood and worse health behaviors. A cross-sectional study conducted by the Patient-Centered Outcomes Research Institute-funded Mid-South Clinical Data Research Network between August 2014 and September 2015. Bootstrapped mediation was used. Patients with coronary heart disease (n = 2334). Two items assessing perceived health competence, a single item assessing depressed mood, and a Health Behaviors Index including: the International Physical Activity Questionnaire (IPAQ); select items from the National Adult Tobacco Survey and the Alcohol Use Disorder Inventory Test; and single items assessing diet and medication adherence. Depressed mood was associated with lower perceived health competence (a = - 0.21, p < .001) and lower perceived health competence was associated with worse performance on a Health Behaviors Index(b = 0.18, p < .001). Perceived health competence mediated the influence of depressed mood on health behaviors (ab = - 0.04, 95% CI = - 0.05 to - 0.03). The ratio of the indirect effect to the total effect was used as a measure of effect size (PM = 0.26, 95% CI: 0.18 to 0.39). Depressed mood is associated with worse health behaviors directly and indirectly via lower perceived health competence. Interventions to increase perceived health competence may lessen the deleterious impact of depressed mood on health behaviors and cardiovascular outcomes.