Depressive Symptoms Research Articles

Abstract 4121039: Refining the American Heart Association Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations using depression and anxiety disorder

Background: Growing evidence has suggested associations of common mental health conditions including depression and anxiety disorder with CVD, but no studies have examined their incremental predictive values in PREVENT (AHA Predicting Risk of CVD EVENTs). Research questions: Does including anxiety and/or depression improve the PREVENT predictive performance? Aims: We used a range of measures of anxiety and depression and combinations to examine whether these conditions improved the prediction performance of PREVENT. Methods: New risk prediction models were developed and internally validated using 60% and 40% of the UK Biobank cohort data, respectively. Mental health predictors included: depressive symptom score based on the four-item Patient Health Questionnaire and self-reported and record-based anxiety and depression diagnoses before baseline. CVD events were ascertained through hospital admission and death certificate data after baseline. The Cox proportional hazards models were used to calculate coefficients and 95% confidence intervals. The incremental predictive values were examined by adding the mental health predictors to the PREVENT predictors based on Harrell’s C-indices, sensitivity, specificity, positive and negative predictive values, and net reclassification improvement indices (NRIs). Results: Of the 502,366 UK Biobank participants, 195,489 were included in the derivation set and 130,326 were included in the validation set. In the validation set, the inclusion of each mental health measure produced an increase in C-index and higher sensitivity, specificity, and positive and negative predictive values compared with the PREVENT equations, with the greatest improvements for depressive symptom score. Depressive symptom score produced the greatest improvements in net reclassification overall (NRI 0.84, 95% CI 0.46–1.20) and this was further improved by adding recorded anxiety and depression (NRI 0.89, 95% CI 0.52–1.24). In addition, depressive symptom score showed better discrimination and NRI in both female and male validation sets. Conclusions: Our findings suggest that including depressive symptom score in PREVENT could improve the prediction of CVD with low cost and without invasive procedures.

Who and how to screen for endogenous hypercortisolism in patients with mood disorders.

A strict association exists between mood disorders and endogenous hypercortisolism, namely Cushing's syndrome (CS). Indeed, CS is characterized by a wide range of mood disorders, such as major depression, generalized anxiety, panic disorders, bipolar disorders up to psychosis, with major depression being the most frequent, with a prevalence of 50-80%, and potentially representing the clinical onset of disease. Despite this observation, the exact prevalence of hypercortisolism in patients with mood disorders is unknown and who/how to screen for endogenous hypercortisolism among patients with mood disorders is still unclear. In this context, an accurate anamnestic and clinical examination are crucial in order to identify those patients who may benefit from CS screening. In particular, the presence of specific signs and symptoms of CS, comorbidities typically associated with CS, and lack of improvement of depressive symptoms with standard treatments can further guide the decision to screen for CS. Anyhow, it is noteworthy that mood disorders represent a cause of functional activation of hypothalamic-pituitary-adrenal (HPA) axis, a condition formerly known as non-neoplastic hypercortisolism (NNH). The differential diagnosis between CS and NNH is challenging. Beyond anamnestic and clinical features, various tests, including measurement of daily urinary cortisol and late-night salivary cortisol, together with low dose-dexamethasone suppression test, are used for initial screening. However, considering their low accuracy, a definitive diagnosis may require a longitudinal follow-up along with second-line dynamic tests like combined dexamethasone-CRH test and desmopressin test. In conclusion, available data suggest the need for a comprehensive assessment and follow-up of individuals with mood disorders to detect possible underlying CS, considering the pitfalls in diagnosis and the overlap of symptoms with other conditions like NNH. Specialized centers with expertise in CS diagnosis and differential testing are recommended for accurate evaluation and management of these patients.

Characterization of aGerman cohort with visual snow syndrome

Visual snow is adisorder of visual perception that is manifested as aconstant flickering or "TV-like" noise in the entire visual field. Visual snow syndrome (VSS) describes acombination with other additional visual symptoms, such as sensitivity to light, afterimages, night blindness and entoptic phenomena. Cases of VS have been described in the literature using awide variety of terms, often misunderstood as persistent migraine aura. Established diagnostic criteria have existed for more than 10years now; however, the pathophysiology is still incompletely understood. The exact prevalence also remains unknown and high numbers of unreported cases are suspected. This is the first detailed description of acohort of VSS patients from Germany. Patients with VSS from several studies conducted at our center were pooled and retrospectively evaluated with respect to demographic, epidemiological and clinical data. In this study 66patients with VSS were included (age 31.3 ± 8.3years, 30women). The most commonly associated visual symptoms were photophobia (67%) and afterimages (65%). Of the patients 36(54%) had comorbid migraine of whom 25(70%) had migraine with aura, 26(39%) reported depressive symptoms and 32(48%) symptoms of an anxiety disorder. Tinnitus was reported by 32(48%) patients. The characteristics of the German cohort described here are similar to other international descriptions. Due to the frequent psychological comorbidity there is still arisk of psychosomatic stigmatization.

Abstract 4140130: Association of Depression and Anxiety with Coronary Plaque: The Miami Heart Study (MiHeart)

Introduction: The prevalence of psychological disorders have been increasing, especially since the COVID-19 pandemic. Multiple mechanisms such as medication nonadherence, negative coping behaviors, and systemic inflammation may mediate the potential effects of depression and anxiety on atherosclerosis. Question: Is there an association of depression or anxiety with the presence of plaque assessed by coronary computed tomography angiography (CCTA) among adults free of clinical coronary artery disease (CAD)? Aim: We aim to examine the association of psychological factors with CCTA-based plaque, as they may be key targets for prevention and CCTA could be considered for enhanced risk characterization. Methods: This cross-sectional study analyzed baseline data from the community-based Miami Heart Study (MiHeart). Depression was assessed by the Patient Health Questionnaire 8-item scale with a score ≥10 indicating binary depression. Anxiety was assessed by the Generalized Anxiety Disorder 7-item questionnaire with a score ≥10 demonstrating binary anxiety. The outcome was the binary presence of any plaque on CCTA. Multivariable logistic regression models were adjusted for potential confounders and clinically relevant risk factors. Sensitivity analyses further examined the severity of depressive symptoms, severity of anxiety symptoms, individuals with either depression or anxiety, and individuals with both depression and anxiety as predictors of coronary plaque. Results: Of the 2,356 individuals (mean age 53.4±6.8 years), 50.4% were men and 47.1% were of Hispanic ethnicity. Depression and anxiety were reported in 143 (6.1%) and 224 (9.5%) of individuals, respectively. CCTA-identified plaque was present in 49.0% of participants with depression and 54.0% of those with anxiety, and plaque presence did not significantly differ when compared to those without depression or without anxiety, respectively. There were no significant associations between depression and plaque (adjusted odds ratio [aOR]: 1.03; 95%CI [0.70, 1.52]; p=0.891) or between anxiety and plaque (aOR: 1.27; 95%CI [0.93, 1.73]; p=0.138) in all regression models. On sensitivity analysis, there were also no statistically significant associations found. Conclusion: Our study found no association of depression, anxiety, their combination, or their severity with coronary plaque on CCTA in asymptomatic adults. To our knowledge, this is the first large study on this topic utilizing CCTA data in a U.S. population.

Abstract 4115222: Distinct Demographic, Cognitive, and Psychosocial Factors Associated with Different Types of Self-Care in Patients with Type 1 Diabetes and in Patients with Type 2 Diabetes

Background: Poor self-care in patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) leads to increased diabetes complications and health costs. While the goal of self-management for patients with T1DM and T2DM is to maintain normal blood glucose levels, the major methods for achieving this differ (exogenous insulin delivery vs. a combination of self-care techniques, respectively). This implies that factors associated with self-care in the two groups may differ. Hypothesis: Distinct demographic, cognitive, and psychosocial factors are associated with overall self-care, diet, exercise, blood glucose testing, foot care, and smoking in patients with T1DM and T2DM, in separate models. Methods: In this cross-sectional, correlational study, data were collected from 148 patients with T1DM (n = 64, mean age: 51.3 years) or T2DM (n = 84, mean age: 62.5) using REDCap during 2023. The participants were recruited from various organizations, institutions, and ResearchMatch in the United States. Several multiple regression analyses were done to test the hypothesis. Results: Patients with T1DM had better self-care, including overall diabetes self-care, exercise, and blood glucose testing than the T2DM group. Older age (p = .003), lower body mass index (BMI) (p = .040), and stronger knowledge (p = .028) in the T1DM group (F[10,53]= 2.290, p = .026, R 2 = .302), while lower BMI (p = .045) and higher levels of self-efficacy (p < .001) in the T2DM group were associated with better overall diabetes self-care (F[10,73] = 3.219, p = .002, R 2 = .306). Older age, lower BMI, stronger knowledge, stronger resilience, and lower self-esteem were associated with better self-care in diet, blood glucose testing, and/or foot care in the T1DM group, while lower BMI, stronger knowledge, higher levels of self-efficacy, and less severe depressive symptoms were associated with better self-care in diet, exercise, and/or blood glucose testing in the T2DM group. None were associated with smoking in both groups. Diabetes distress, self-compassion, and social support were not associated with any types of self-care. Conclusions: Factors associated with self-care differed based on types of self-care and types of diabetes, thus, supporting the hypothesis. When healthcare providers provide interventions to improve diabetes self-care in individual patients with diabetes, they need to consider types of diabetes, types of self-care, and distinct factors associated with each type of self-care.

Does Parent–Child Separation in Childhood Influence Individuals’ Depressive Symptoms in Emerging Adulthood? The Roles of Sympathetic Nervous System Activity and Beliefs About Adversity

Childhood separation may have a long-term impact on individuals’ depressive symptoms when they enter emerging adulthood. However, the biological and cognitive protective factors that could buffer the negative effect of parent–child separation remain unclear. In this study, 215 young adults ( Mage = 18.46 years, SD = 0.69, 40% male) were selected as participants to examine the association between duration of parent–child separation in childhood and depressive symptoms and to investigate the moderating roles of sympathetic nervous system activity and beliefs about adversity in this relationship. Results revealed that duration of parent–child separation and beliefs about adversity were associated with young adults’ depressive symptoms. Sympathetic nervous system activity moderated the association between duration of parent–child separation and young adults’ depressive symptoms, and this moderation varied by beliefs about adversity and gender. These findings have significant implications for future research and development of interventions for young adults with parent–child separation experience.

QOL-31. RESULTS OF A TELEHEALTH-BASED PSYCHOLOGICAL INTERVENTION FOR CAREGIVERS OF PATIENTS WITH PRIMARY MALIGNANT BRAIN TUMORS: A MODERATION ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Abstract BACKGROUND In a recent randomized controlled trial, caregivers of patients with primary malignant brain tumors (PMBT) who received NeuroCARE—a six-session, telehealth-based psychological intervention—demonstrated improved anxiety and depression symptoms, coping, and self-efficacy at 11-weeks compared to usual care (UC) participants. We now explore how sociodemographic variables, disease-specific factors, and baseline mood symptoms moderate intervention effects on anxiety and depression symptoms. METHODS We examined data from 120 enrolled caregivers (Mage=53 years; 83% female, 92% White, 70% spouses/partners) of PMBT patients (84% glioblastoma). Eligible caregivers had elevated anxiety (Generalized Anxiety Disorder-7 ≥ 5). Participants were randomized 1:1 to NeuroCARE or UC and completed baseline sociodemographic questionnaires and the Hospital Anxiety and Depression Scale at baseline and 11-weeks. We used linear regression to evaluate whether selected sociodemographic characteristics (gender, age, relationship to patient), tumor characteristics (tumor location/laterality, IDH mutation status), and baseline mood symptoms moderated intervention effects on anxiety and depression symptoms. We report the group-by-moderator (b) effects, using a 0.20 significance level. RESULTS The beneficial effects of NeuroCARE on reducing 11-week anxiety symptoms were greater in women compared to men (b=-2.63, CI: -6.17, 0.91, p=0.14) and greater in caregivers who reported higher baseline anxiety symptoms (b=-0.43, CI: -0.78, -0.08, p=0.02) and depression symptoms (b=-0.56, CI: -0.96, -0.17, p=0.01). The beneficial effects of NeuroCARE on reducing 11-week depression symptoms were greater in caregivers of patients with IDH-wildtype tumors compared to caregivers of patients with IDH-mutant tumors (b=2.49, CI: -0.26, 5.24, p=0.08). Caregiver age, relationship to patient, and tumor location/laterality did not significantly moderate NeuroCARE effects on mood. CONCLUSIONS The positive effects of NeuroCARE were particularly salient for caregivers with elevated anxiety and/or depression symptoms and those caring for patients with IDH-wildtype tumors. Content may be further tailored to account for the unique needs of men and caregivers of patients with IDH-mutant tumors.

Dyadic Coping in Aging: Linking Self-Perceptions of Aging to Depression

Negative self-perceptions of aging have been linked to poorer health and quality of life and predict significantly depressive symptomatology. The support provided by the partner may have an impact on the effects of self-perceptions of aging on depressive symptoms; a close relationship can go along with additional stress or resources and benefits. The present study analyzes the relationship between negative self-stereotypes and depressive symptomatology, considering positive and negative dyadic coping (DC) as moderator variables in this association. Method: Participants were 365 individuals (convenience sample) 40 years or older (M = 60.86) involved in a partner relationship. Participants completed a questionnaire that included the following variables: negative self-perceptions of aging, positive DC (e.g., “My partner shows empathy and understanding to me”), negative DC (e.g., “When I am stressed, my partner tends to withdraw”), and depressive symptomatology. Two moderation models were tested by linear regression. Results: The effect of negative self-perceptions of aging on depressive symptoms was moderated by positive and negative DC only in women. The effect of negative self-perceptions of aging appears to be smaller among those women with higher levels of positive DC and lower levels of negative DC. Conclusions: Positive DC might buffer the association between negative self-perceptions of aging and depressive symptoms. Negative DC might amplify this association, as it is associated with lower well-being among women who express negative self-perceptions of aging. Implications: Training couples in strategies for providing supportive dyadic coping may be a resource to buffer the negative effect of negative self-perceptions of aging on well-being.

Are the functions of non-suicidal self-injury associated with its persistence and suicide risk in university students? Insights from a network analysis

BackgroundTo date, a number of intra- and interpersonal functions of non-suicidal self-injury (NSSI) have been identified. Yet, their association with persistence of NSSI and suicide risk remains unknown. The study aimed to investigate which functions of NSSI are associated with its persistence and suicide risk in university students using a network analysis.MethodsAltogether, 830 university students reporting a lifetime history of NSSI were enrolled. The persistence of NSSI was defined as its presence over preceding 12 months.ResultsPersistent NSSI was directly connected to the nodes representing two functions of NSSI: affect regulation and self-punishment. Suicide risk was directly connected to the anti-suicide function of NSSI. The shortest pathway from persistent NSSI to suicide risk led through depressive symptoms. Other likely pathways (three mediating nodes) led through the functions of NSSI (affect regulation or self-punishment, anti-dissociation, and anti-suicide). Depressive symptoms had the highest centrality. However, it did not differ significantly compared to some functions of NSSI (marking distress, anti-dissociation, toughness, and affect regulation).DiscussionIn university students, persistent NSSI might be directly associated with its functions related to affect regulation and self-punishment, while suicide risk might be directly associated with the anti-suicide function. The observations posit a role of intrapersonal functions in shaping the outcomes of NSSI. Depressive symptoms and some NSSI functions might be the most promising targets for interventions in this population.

Postnatal depressive symptoms in mothers of infants at high risk of cerebral palsy: the role of delayed infant communicative development

Purpose Recent diagnostic advantages enable detection of cerebral palsy (CP) in infants before five months of age. Parents of children with CP often face mental health problems, but specific knowledge for infancy is needed. In this study, depressive symptoms in mothers of 16-week-old infants and associations with infant development were investigated. Materials and methods This cross-sectional study involves 56 families, 22 high-risk and 34 infants without risk of CP. High-risk-CP was identified following international clinical guidelines. We assessed infant cognitive and language development using the Bayley-III and motor development using the Alberta Infant Motor Scale. Maternal depressive symptoms were self-reported using the Edinburgh Postnatal Depression Scale. Results Mothers of CP high-risk infants were 15.6 times more likely to experience risk of postnatal depression compared to mothers of infants without risk. Additionally, linear regression analyses showed that having an infant at high-risk of CP (β = .359, p = .006) and delayed language development (β = −0.510, p < .001) were associated with increased maternal depressive symptoms. Conclusions We recommend systematic screening of postnatal depressive symptoms following detection of high-risk-CP in infants. Early interventions could include a mother-infant interactional component to support caregivers in interpreting and responding to infant communicative cues.

Adolescent dating violence and leader role occupancy

AbstractWho becomes a leader is of considerable importance to employees, organizations and society. Recently, researchers have considered whether early life events outside of the workplace affect who occupies leadership roles within organizations. Informed by the lifespan approach to leadership, and the work–home resources model, we investigate whether violence in adolescent dating relationships is associated with leader role occupancy in adulthood. We hypothesize that experiencing psychological aggression and physical violence indirectly lowers the likelihood of occupying a leadership role through depressive symptoms. Moreover, we hypothesize that the indirect effects will be weaker when parent–adolescent relationship quality is higher, when adolescents come from higher household incomes, and stronger for women. Drawing on four waves of ADD Health, results showed that experiencing early psychological aggression in dating relationships increased depressive symptoms, hindering leader role occupancy; however, this effect was buffered by income, and stronger for women. Experiencing physical violence exerted indirect negative effects on leader role occupancy via depressive symptoms, regardless of parent–adolescent relationship quality, income or gender. There were no direct effects of aggression or violence on leader role occupancy. Our findings suggest that early personal relationships can impact young adult's mental health, which in turn can influence leadership outcomes into adulthood.

Personality trait change during adolescence as a predictor of later substance use, depressive symptoms, and perceived maturity

Adolescence is considered a critical period for understanding how individuals develop their self-concepts and personality dispositions, with the assumption that these changes presage important life outcomes. However, this tenet has been infrequently tested; few studies have included rigorous, frequent assessment of personality traits during adolescence, particularly from multiple rater perspectives. The current study utilizes data from the Oregon Youth Substance Use Project (OYSUP; N = 951), which followed students throughout their school years into early adulthood. Student- and teacher-reports of the Big Five personality traits were assessed yearly from grades 7 to 10, as well as drug use, well-being, and maturity outcomes later in emerging adulthood. Using latent growth curve models and true intraindividual change score models, results indicated that youth exhibited relative stability but significant trait changes on multiple domains during adolescence. Moreover, individual differences in these changes predicted likelihood for drug use and depressive symptoms later, as well as the students’ perceptions of their status as being developed adults, even when accounting for initial trait levels. Findings differed somewhat between youth- and teacher-reports of personality, with both demonstrating value for predicting young adult outcomes, indicating multiple perspectives of personality development are important.

Understanding the connection and relation between sleep and depression in a tertiary health-care center: Insights from a cross-sectional study

Abstract Background: There is a bidirectional relationship between sleep disturbance and depression, with which a new hypothesis could be generated, that is, sleep disturbance can be a prodromal event rather than a symptom of depression. Many long-term studies have identified insomnia as a risk factor for the onset or recurrence of depression in young, middle-aged, and older people and it can also increase the risk of self-harm and suicide, which can also exacerbate the medical comorbidity conditions and also increase the substance intake. Materials and Methods: Those patients attending the psychiatry outpatient department of tertiary Health-care center for 6 months were considered. Those patients who were diagnosed with depression as per the International Classification of Diseases-11 depression criteria were taken after getting proper informed consent from them. Then, those patients who satisfied the inclusion criteria were taken into the study and evaluated with self-structured pro forma including details regarding the sociodemographic profile, Hamilton Depression Rating Scale, and Insomnia Severity Index Scale to assess the severity of depression and sleep disturbance. Results: The prevalence of sleep disturbance in depressive individuals was found to be 78% (140). The significance was established between the severity of depression and the severity of insomnia (P&lt;0.001), along with sleep duration (P&lt;0.001), insomnia type (P=0.002), benzodiazepine usage (P&lt;0.001) and self-harm ideas/attempts (P&lt;0.001). Conclusion: Sleep is considered a major aspect of holistic care, as it may have an impact on the severity, frequency and duration of depression and its remission along with quality of life and mortality rate.

QOL-23. MEASURING BODY FUNCTIONALITY APPRECIATION IN PATIENTS WITH PRIMARY BRAIN TUMORS

Abstract BACKGROUND Body image is a multifaceted construct consisting of thoughts, feelings, and perceptions about one’s body and its functioning. Perception of one’s own physical functioning and capabilities may be an important consideration in neuro-oncology given the sequalae of brain tumors and associated treatment; however, it is understudied in this population. One brief measure of body image, the Functionality Appreciation Scale (FAS) is a comprehensive tool, focused on one’s perceived physical functioning and capabilities, rather than perceived appearance. We aimed to examine the psychometric properties of the recently developed Functionality Appreciation Scale (FAS) among patients with primary brain tumors. METHODS Adult patients with primary brain tumors (N=237) completed the FAS and other measures of psychological distress as well as medical and demographic characteristics. An exploratory variance factor analysis (EFA) using principal axis factoring and a Promax rotation was conducted. Convergent validity was examined via correlations to measures of psychological distress. RESULTS The EFA supported the single-factor structure, which accounted for 62.71% of the variance with all items loading significantly onto this factor. The FAS had good internal consistency (Cronbach’s a=.90). Convergent validity was demonstrated by negative associations (ps&amp;lt;.05) with symptoms of depression (r=-.30), generalized anxiety (r=-.21), and death anxiety (r=-.17). CONCLUSION Results confirmed the single factor structure of the FAS in primary brain tumor patients. Furthermore, the expected negative relationships with measures of psychological distress provide evidence of convergent validity. The FAS is valid and reliable in patients with primary brain tumors. Our findings suggest that body functionality and appreciation may be important to target in psychosocial interventions for those with primary brain tumors.

Preliminary findings of a randomized controlled trial investigating the efficacy of transcranial magnetic stimulation in treatment-resistant depression: a post-hoc analysis on the role of co-occurring personality disorders

IntroductionDespite the high hopes for the use of transcranial magnetic stimulation (TMS) in the treatment of depression, between 30% and 60.5% of patients do not respond to stimulation. The factors contributing to non-response, especially those related to personality, remain insufficiently investigated. The main aim of our study was to compare the efficacy of active TMS and sham–placebo protocols in combined therapy of treatment-resistant depression with evaluation of possible personality disorders comorbidity.MethodsThe study was conducted between December 2019 and December 2022, as a randomized, double-blind, active comparator-controlled and sham-controlled parallel trial. Patients (n = 41) were randomized into one of two experimental conditions (active TMS vs. placebo) and screened before and after stimulation as well as at a 3-month follow-up. Personality disorders were assessed with The Structured Clinical Interview for DSM-5 Personality Disorders.ResultsThere were no significant differences between the TMS active and sham groups in terms of general characteristics, coexisting personality disorders, and Montgomery–Åsberg Depression Rating Scale scores before stimulation, at the end of stimulation, and after 3 months of stimulation. However, linear regression analysis revealed significant negative associations between the coexistence of personality disorders and the reduction of depressive symptoms from baseline to the end of stimulation. The post-hoc exploratory analysis on the first phase of the RCT confirmed the presence of personality disorders to be a consistent negative influence on the reduction of depressive symptoms post-stimulation, regardless of protocol and experimental condition and demonstrated a smaller percentage reduction in depressive symptoms after stimulation in patients with personality disorders.DiscussionA central conclusion, based on our study, is that transcranial magnetic stimulation for treatment-resistant depression cannot be considered as a method independent of co-occurring personality disorders.

Multifunctional, fluorene-based modulator of cholinergic and GABAergic neurotransmission as a novel drug candidate for palliative treatment of Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by memory loss and behavioral and psychological symptoms of dementia (BPSD). Given that cholinergic neurons are predominantly affected in AD, current treatments primarily aim to enhance cholinergic neurotransmission. However, imbalances in other neurotransmitters, such as γ-aminobutyric acid (GABA), also contribute to AD symptomatology. In the presented research, by using a combination of crystallography and computational methods we developed 6 as a dual modulator of GABAergic and cholinergic neurotransmission systems. Compound 6 demonstrated inhibition of BuChE (IC50 = 0.21 μM) and GABA transporter 1 (IC50 = 10.96 μM) and 3 (IC50 = 7.76 μM), along with a favorable drug-likeness profile. Subsequent in vivo studies revealed effectiveness of 6 in enhancing memory retention and alleviating anxiety and depression symptoms in animal models, while also proving safe and bioavailable for oral administration. The innovative multi-target-directed ligand 6 offers a new approach to treating cognitive deficits and BPSD in AD.

Depression in geriatrics: a systematic review and meta-analysis of prevalence and risk factors in Egypt.

Depression is the most common psychiatric disorder in older adults, even though it is commonly misdiagnosed and undertreated, leading to exacerbations of preexisting medical conditions and even a higher mortality rate. In the present systematic review with meta-analysis, we quantify the magnitude of depression and its associated risk factors among the older adult population in Egypt. A thorough literature search was performed from 2010 up to October 2023. The results were presented as proportions or risk difference with a 95% confidence interval (CI) calculated using the random effects model. A sensitivity analysis was performed to examine the robustness of the results. Our study included 14 articles with 5857 older adults published between 2011 and 2023. All the included studies assessed depression in geriatrics using the Geriatric Depression Scale. Of the 14 studies, 5 were for community-dwelling older adults, 3 were for older adults attending primary health care (PHC) centers, 2 were for hospitalized older adults, 3 were for residing in geriatric homes, and one for residing in geriatric homes, hospitalized older adults, and community-dwelling older adults. The overall prevalence of depression among Egyptian geriatrics was 64.6%. The pooled prevalence of depression was 59.6%, 67.0%, 67.0%, and 62.0% for community-dwelling older adults, older adults people attending PHC, hospitalized older adults, and older adults residing in geriatric homes, respectively. Older adults with chronic illness, female sex, and low-income elders and elders who were not employed had a higher risk for depression with pooled risk differences of 34.9%, 17.8%, 23.8%, and 15.1% (P < 0.05), respectively. In contrast, there was no significant difference in risk for depression in the older adults residing in urban areas compared to rural areas, the older adults aged + 70 compared to those less than 70, individuals with low levels of education or who are illiterate compared with those with higher levels of education and the older adults who live alone compared with those living with family. More than half of the older adults in Egypt suffer from depressive symptoms. Chronic diseases, female sex, unemployment, and low-income inequality are the most significant factors contributing to depression among Egypt's older adults.

Associations between iron status and psychosocial wellbeing among pregnant women in Cape Coast, Ghana: a longitudinal study.

To determine the associations among iron status, depressive/anxiety symptoms, and quality of life (QoL) throughout pregnancy. This longitudinal study recruited participants in their 1st trimester (< 13 weeks; n=116) and followed in their 2nd (n=71) and 3rd (n=71) trimesters. Sociodemographic, food security, anxiety, depressive symptoms, and QoL questions were collected. Hemoglobin (Hb), ferritin (Ft), and transferrin saturation (TSAT) were determined. Women were categorized as iron improvers or non-improvers based on changes in iron status. Associations were assessed using difference-in-difference analyses. Cape Coast, Ghana between October 2017 to September 2018. Pregnant women, 18-38 years. Improvement in Ft levels from the 1st to 2nd trimester were associated with reduced depressive symptoms (-2.96 vs -0.58, p=0.028), and higher overall QoL (13.99 vs 1.92, p=0.006) particularly role physical (23.32 vs -2.55, p=0.025) and role emotional (27.50 vs 10.06, p=0.025) subscales. Improvement in Hb levels during the same period were linked to less anxiety, particularly fear factor (-2.62 vs -0.51, p=0.020); and worsened physical health aspect of QoL (-21.80 vs -3.75, p=0.005). Improvement in TSAT levels from 2nd to 3rd trimester were associated with increased total anxiety (1.56 vs -0.64, p=0.030) and panic factor (0.45 vs -0.26, p=0.004) and decreased total QoL (-1.08 vs 7.94, p=0.017), specifically role physical (-10.98 vs 11.93, p=0.018). Increases in iron status from first to second trimester were related to improvements in psychosocial wellbeing, implying potential benefit of iron supplementation on affect in early pregnancy. Larger studies are needed to confirm these findings.

Several meta-analyses missing from an umbrella review of n-3 fatty acids on depression symptoms: comments concerning Lu et al.

Several meta-analyses missing from an umbrella review of n-3 fatty acids on depression symptoms: comments concerning Lu et al.

The association between temporomandibular disorders signs and symptoms, bruxism, and health variables: A cross‐sectional study

ABSTRACT Objective The study aimed to determine the associations between several important and potentially modifiable health variables and TMD signs and symptoms. Methods A total of 209 adult dental patients from two clinics completed surveys on demographics, self-reported awake and sleep bruxism, TMD signs and symptoms, stress, depression, chronic pain, and sleep quality. Correlations and regression analyses were used to identify associations between these health variables and TMD symptoms. Results Awake bruxism was significantly associated with chronic pain intensity, jaw pain, clenching pain, and headaches. Stress and depression correlated with chronic pain intensity and clenching pain. No correlation was found between BMI and TMD symptoms. In multivariate analysis, both awake and sleep bruxism were associated with TMD symptoms, while sleep quality was related to pain on chewing and depression was associated with chronic pain intensity. Conclusions Identifying these associations can guide clinicians in assessing, educating and managing TMD-related issues by addressing bruxism, sleep quality, and depressive symptoms.