Diagnosis Of Depression Research Articles

Neuropsychiatric Comorbidities and Psychotropic Medication Use in Medicare Beneficiaries With Dementia by Sex and Race.

Neuropsychiatric symptoms affect the majority of dementia patients. Past studies report high rates of potentially inappropriate prescribing of psychotropic medications in this population. We investigate differences in neuropsychiatric diagnoses and psychotropic medication prescribing in a local US cohort by sex and race. We utilize Medicare claims and prescription fill records in a cohort of 100% Medicare North and South Carolina beneficiaries ages 50 and above for the year 2017 with a dementia diagnosis. We identify dementia and quantify diagnosis of anxiety, depression and psychosis using validated coding algorithms. We search Medicare claims for antianxiety, antidepressant and antipsychotic medications to determine prescriptions filled. Anxiety and depression were diagnosed at higher rates in White patients; psychosis at higher rates in Black patients. (P < .001) Females were diagnosed with anxiety, depression and psychosis at higher rates than males (P < .001) and filled more antianxiety and antidepressant medications than males. (P < .001) Black and Other race patients filled more antipsychotic medications for anxiety, depression and psychosis than White patients. (P < .001) Antidepressants were prescribed at higher rates than antianxiety or antipsychotic medications across all patients and diagnoses. Of patients with no neuropsychiatric diagnosis, 11.4% were prescribed an antianxiety medication, 22.8% prescribed an antidepressant and 7.6% prescribed an antipsychotic. The high fill rate of antianxiety (benzodiazepine) medications in dementia patients, especially females is a concern. Patients are prescribed psychotropic medications at high rates. This practice may represent potentially inappropriate prescribing. Patient/caregiver education with innovative community outreach and care delivery models may help decrease medication use.

Sex Differences in Diagnosis and Treatment Timing of Comorbid Depression/Anxiety and Disease Subtypes in Patients With ADHD: A Database Study.

Our study examined the impact of sex, ADHD subtype, and comorbid illnesses (depression/anxiety) on the timing of diagnosis and treatment for ADHD. To analyze ADHD patients, four health databases were used to assess subtype, comorbid mood, and antidepressant or anxiolytic drug exposure. Analyses were stratified by sex and age. Standardized mean differences measured intergroup differences. Females with ADHD were identified at older ages and had higher rates of depression and anxiety diagnoses and treatments before and after their initial ADHD diagnosis. Predominantly inattentive ADHD patients were diagnosed later and more likely to receive mood disorder diagnosis and treatment than hyperactive impulsive ADHD patients. Results suggest a more complex ADHD presentation in females, potentially causing late diagnosis and delayed treatment.

Clinical distinction between cognitive disengagement syndrome and ADHD presentations in a nationally representative sample of Spanish children and adolescents.

This study sought to determine whether cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) has different external correlates relative to ADHD-inattentive presentation (INP), ADHD-hyperactive/impulsive presentation (HIP), and ADHD-combined presentation (CP). Parents of a nationally representative sample of 5,525 Spanish youth (ages: 5-16, 56.1% boys) completed measures of CDS, ADHD-inattention (IN), and ADHD-hyperactivity/impulsivity (HI) and other measures. Scores greater/less than the top 5% on CDS, ADHD-IN, and ADHD-HI were used to create control (n = 5,013, 90.73%), CDS-only (n = 131, 2.37%), ADHD-INP-only (n = 83, 1.50%), ADHD-HIP-only (n = 113, 2.05%), ADHD-CP-only (n = 48, 0.97%), CDS + ADHD-INP (n = 44, 0.80%), CDS + ADHD-HIP (n = 25, 0.45%), and CDS + ADHD-CP (n = 68, 1.23%) groups. Forty-nine percent of youth with clinically elevated CDS did not qualify for any ADHD presentation, whereas 64% of youth with clinically elevated ADHD did not qualify for CDS. The CDS-only group was higher than the ADHD-INP-only, ADHD-HIP-only, and ADHD-CP-only groups on anxiety, depression, somatization, daytime sleep-related impairment, nighttime sleep disturbance, and peer withdrawal, whereas the CDS-only and ADHD-INP-only groups did not differ on ODD (ADHD-HIP-only and ADHD-CP-only higher) and academic impairment (ADHD-CP-only higher than CDS-only and ADHD-HIP-only lower than CDS-only). The CDS-only group also had higher rates of anxiety, depression, and bipolar disorder diagnoses than the ADHD-only group. A distinction was found between CDS and each ADHD presentation, thus providing support for CDS as a syndrome that frequently co-occurs with yet is distinct from each ADHD presentation.

Depression proteomic profiling in adolescents with transcriptome analyses in independent cohorts

IntroductionDepression is a major global burden with unclear pathophysiology and poor treatment outcomes. Diagnosis of depression continues to rely primarily on behavioral rather than biological methods. Investigating tools that might aid in diagnosing and treating early-onset depression is essential for improving the prognosis of the disease course. While there is increasing evidence of possible biomarkers in adult depression, studies investigating this subject in adolescents are lacking.MethodsIn the current study, we analyzed protein levels in 461 adolescents assessed for depression using the Development and Well-Being Assessment (DAWBA) questionnaire as part of the domestic Psychiatric Health in Adolescent Study conducted in Uppsala, Sweden. We used the Proseek Multiplex Neuro Exploratory panel with Proximity Extension Assay technology provided by Olink Bioscience, followed by transcriptome analyses for the genes corresponding to the significant proteins, using four publicly available cohorts.ResultsWe identified a total of seven proteins showing different levels between DAWBA risk groups at nominal significance, including RBKS, CRADD, ASGR1, HMOX2, PPP3R1, CD63, and PMVK. Transcriptomic analyses for these genes showed nominally significant replication of PPP3R1 in two of four cohorts including whole blood and prefrontal cortex, while ASGR1 and CD63 were replicated in only one cohort.DiscussionOur study on adolescent depression revealed protein-level and transcriptomic differences, particularly in PPP3R1, pointing to the involvement of the calcineurin pathway in depression. Our findings regarding PPP3R1 also support the role of the prefrontal cortex in depression and reinforce the significance of investigating prefrontal cortex-related mechanisms in depression.

Mental health in nursing homes: The role of immigration in the long-term care workforce

One-fourth of nursing home residents are diagnosed with anxiety disorders and approximately half live with depression. Nursing homes have long struggled with staffing shortages, and the lack of care has further heightened the risk of poor mental health. A key solution to both problems could be immigration. Prior studies have documented how immigrant labor could strengthen the long-term care workforce. We add to this picture by exploring the impact of immigrant inflows on the mental health outcomes of nursing home residents. Using a nationally representative dataset and a shift-share instrumental variable approach, we find empirical evidence that immigration reduces diagnoses of depression and anxiety, the use of antidepressant and antianxiety drugs, and self-assessed symptoms of depression. The results are robust to several sensitivity tests. We further find that the effect is more substantial in facilities with lower direct care staff hours per resident and with likely more immigrants without citizenship. Language barriers tend to be a minor issue when providing essential care. The findings suggest that creating a policy framework that directs immigrant labor to the long-term care sector can mutually benefit job-seeking immigrants and nursing home residents.

Modeling brain sex in the limbic system as phenotype for female-prevalent mental disorders

BackgroundSex differences exist in the prevalence and clinical manifestation of several mental disorders, suggesting that sex-specific brain phenotypes may play key roles. Previous research used machine learning models to classify sex from imaging data of the whole brain and studied the association of class probabilities with mental health, potentially overlooking regional specific characteristics.MethodsWe here investigated if a regionally constrained model of brain volumetric imaging data may provide estimates that are more sensitive to mental health than whole brain-based estimates. Given its known role in emotional processing and mood disorders, we focused on the limbic system. Using two different cohorts of healthy subjects, the Human Connectome Project and the Queensland Twin IMaging, we investigated sex differences and heritability of brain volumes of limbic structures compared to non-limbic structures, and subsequently applied regionally constrained machine learning models trained solely on limbic or non-limbic features. To investigate the biological underpinnings of such models, we assessed the heritability of the obtained sex class probability estimates, and we investigated the association with major depression diagnosis in an independent clinical sample. All analyses were performed both with and without controlling for estimated total intracranial volume (eTIV).ResultsLimbic structures show greater sex differences and are more heritable compared to non-limbic structures in both analyses, with and without eTIV control. Consequently, machine learning models performed well at classifying sex based solely on limbic structures and achieved performance as high as those on non-limbic or whole brain data, despite the much smaller number of features in the limbic system. The resulting class probabilities were heritable, suggesting potentially meaningful underlying biological information. Applied to an independent population with major depressive disorder, we found that depression is associated with male–female class probabilities, with largest effects obtained using the limbic model. This association was significant for models not controlling for eTIV whereas in those controlling for eTIV the associations did not pass significance correction.ConclusionsOverall, our results highlight the potential utility of regionally constrained models of brain sex to better understand the link between sex differences in the brain and mental disorders.

Everyday ostracism experiences of depressed individuals: Uncovering the role of attributions using experience sampling

BackgroundDepression is linked to more frequent experiences of ostracism (being excluded and ignored). Here, we examine attributions of everyday ostracism that may play an important role in individuals’ experience of and reactions to ostracism. Based on interpersonal and attribution theories of depression, we hypothesize that internal (compared to external) attributions of ostracism and attributions to being burdensome are particularly frequent among depressed individuals. MethodsWe use an experience sampling approach including retrospective reports of ostracism (N = 490) and event-contingent reports of ostracism (n = 323, k = 1107 experiences in 14 days) to analyze the frequency of everyday ostracism experiences, subsequent need threat, and attributions of ostracism by depressed individuals (i.e., individuals with stronger current depressive symptoms and those who had been diagnosed with depression before). ResultsDepressed individuals report more frequent retrospective ostracism, and more frequent everyday ostracism, as well as higher need threat following everyday ostracism. Depressed individuals do not attribute ostracism more internally, but they attribute being ostracized more frequently to being burdensome, as well as to hostile intent of the ostracizer(s). LimitationsThis research used a non-clinical sample and self-reports of current depressive symptoms and previous diagnoses of depression. Future research in patient populations and longitudinal designs will fruitfully complement the present findings. ConclusionsMaladaptive attributions of everyday ostracism may perpetuate the cycle between ostracism experiences and depression. This warrants attention from clinical practitioners, specifically in interventions against cognitive biases in depression.

Hemorrhoids are associated with an increased risk of depression in Germany: A retrospective cohort study in primary care outpatients

BackgroundThe aim of the present study was to analyze the cumulative incidence of depression diagnosis in patients with hemorrhoids and to evaluate the association between hemorrhoids and subsequent depression diagnosis. MethodsThis retrospective cohort study was based on electronic medical records from the Disease Analyzer database (IQVIA) and included 87,264 individuals with hemorrhoids (mean age: 54.2 years; 42% women) and 87,264 propensity score-matched individuals without hemorrhoids in 1284 general practices in Germany between January 2005 and December 2021. Univariable Cox regression analysis was conducted to assess the association between hemorrhoids and depression. ResultsAfter up to 10 years of follow-up, 21.4% of patients with hemorrhoids versus 16.3% of the matched cohort (p < 0.001) were diagnosed with depression. There was a significant association between hemorrhoids and a subsequent diagnosis of depression (HR: 1.32; 95% CI: 1.28–1.37), which was confirmed in age- and sex-stratified analyses. The association was stronger with increasing degree of hemorrhoids, from HR: 1.29 (95% CI: 1.15–1.45) for Grade 1 to HR: 1.73 (95% CI: 1.11–2.69) for Grade 4 compared to no hemorrhoids. ConclusionsThe present study provides compelling evidence of an association between hemorrhoids and subsequent depression. Addressing the mental health of individuals with hemorrhoids may not only improve their overall well-being but could also lead to better treatment outcomes for the primary condition.

Vacancy-Driven High-Performance Metabolic Assay for Diagnosis and Therapeutic Evaluation of Depression.

Depression is one of the most common mental illnesses and is a well-known risk factor for suicide, characterized by low overall efficacy (<50%) and high relapse rate (40%). A rapid and objective approach for screening and prognosis of depression is highly desirable but still awaits further development. Herein, a high-performance metabolite-based assay to aid the diagnosis and therapeutic evaluation of depression by developing a vacancy-engineered cobalt oxide (Vo-Co3O4) assisted laser desorption/ionization mass spectrometer platform is presented. The easy-prepared nanoparticles with optimal vacancy achieve a considerable signal enhancement, characterized by favorable charge transfer and increased photothermal conversion. The optimized Vo-Co3O4 allows for a direct and robust record of plasma metabolic fingerprints (PMFs). Through machine learning of PMFs, high-performance depression diagnosis is achieved, with the areas under the curve (AUC) of 0.941-0.980 and an accuracy of over 92%. Furthermore, a simplified diagnostic panel for depression is established, with a desirable AUC value of 0.933. Finally, proline levels are quantified in a follow-up cohort of depressive patients, highlighting the potential of metabolite quantification in the therapeutic evaluation of depression. This work promotes the progression of advanced matrixes and brings insights into the management of depression.

Antidepressant exposure and long-term dementia risk in a nationwide retrospective study on US veterans with midlife major depressive disorder.

The use of antidepressants in major depressive disorder (MDD) has been reported to influence long-term risk of Alzheimer's disease (AD) and AD-related dementias (AD/ADRD), but studies are conflicting. We used inverse probability weighted (IPW) Cox models with time-varying covariates in a retrospective cohort study among midlife veterans with MDD within the US Veterans Affairs healthcare system from January 1, 2000 to June 1, 2022. A total of 35,200 patients with MDD were identified. No associations were seen regarding the effect of being exposed to any antidepressant versus no exposure on AD/ADRD risk (events=1,056, hazard ratio=0.94, 95% confidence interval: 0.81 to 1.09) or the exposure to specific antidepressant classes versus no exposure. A risk reduction was observed for female patients in a stratified analysis; however, the number of cases was small. Our study suggests that antidepressant exposure has no effect on AD/ADRD risk. The association in female patients should be interpreted with caution and requires further attention. We studied whether antidepressant use was associated with future dementia risk. We specifically focused on patients after their first-ever diagnosis of depression. We used IPW Cox models with time-varying covariates and a large observation window. Our study did not identify an effect of antidepressant use on dementia risk. A risk reduction was observed in female patients, but the number of cases was small.

Clozapine Efficacy and Adverse Drug Reactions Among a Nationwide Study of 1021 Australians Prescribed Clozapine: The ClozaGene Study.

The ClozaGene Study is a nationwide cohort of adults who have been treated with clozapine. While clozapine is indicated in the management of treatment-resistant schizophrenia, it is associated with a considerable adverse drug reaction (ADR) burden, and not all patients achieve adequate symptomatic response. The current study focuses on self-reported experiences of clozapine use and response, clozapine-associated ADRs, and mental health comorbidity. A total of 1021 participants (41.0% female; aged 46.2 ± 10.6 years [range 18-66]) were recruited via a mail-out based on prescriptions for clozapine. Participants completed a self-report questionnaire. Most participants (90.1%, n = 912) were living with schizophrenia while 41.5% reported a lifetime diagnosis of depression, 15.6% bipolar disorder, and 8.1% schizoaffective disorder. Clozapine was currently prescribed to 944 (92.5%) participants and 37.8% of these participants self-reported currently taking additional antipsychotic medication. Nearly 3 quarters of participants living with schizophrenia reported that clozapine helped control their schizophrenia symptoms moderately to very well. The most commonly reported ADRs were sialorrhea (80.3%), weight gain (71.0%), constipation (56.9%), and sedation (52.8%). The prevalence of clozapine cessation due to clozapine-induced myocarditis and neutropenia was 1% and 0.4%, respectively. Our findings highlight the high rate of psychotic and metabolic symptoms and ADRs among adults prescribed clozapine in the general Australian population. Future genomic analyses will focus on identifying genetic variants influencing clozapine treatment response and side effects.

Study on plasma metabolomics profiling of depression in Chinese community-dwelling older adults based on untargeted LC/GC‒MS

Depression is a serious psychiatric illness that causes great inconvenience to the lives of elderly individuals. However, the diagnosis of depression is somewhat subjective. Nontargeted gas chromatography (GC)/liquid chromatography (LC)–mass spectrometry (MS) was used to study the plasma metabolic profile and identify objective markers for depression and metabolic pathway variation. We recruited 379 Chinese community-dwelling individuals aged ≥ 65. Plasma samples were collected and detected by GC/LC‒MS. Orthogonal partial least squares discriminant analysis and a heatmap were utilized to distinguish the metabolites. Receiver operating characteristic curves were constructed to evaluate the diagnostic value of these differential metabolites. Additionally, metabolic pathway enrichment was performed to reveal metabolic pathway variation. According to our standard, 49 people were included in the depression cohort (DC), and 49 people age- and sex-matched individuals were included in the non-depression cohort (NDC). 64 metabolites identified via GC‒MS and 73 metabolites identified via LC‒MS had significant contributions to the differentiation between the DC and NDC, with VIP values > 1 and p values < 0.05. Three substances were detected by both methods: hypoxanthine, phytosphingosine, and xanthine. Furthermore, 1-(sn-glycero-3-phospho)-1D-myo-inositol had the largest area under the curve (AUC) value (AUC = 0.842). The purine metabolic pathway is the most important change in metabolic pathways. These findings show that there were differences in plasma metabolites between the depression cohort and the non-depression cohort. These identified differential metabolites may be markers of depression and can be used to study the changes in depression metabolic pathways.

Changes in mental distress among employees during the three years of the COVID-19 pandemic in Germany.

The COVID-19 pandemic changed the future of work sustainably and led to a general increase in mental stress. A study conducted during the second and third pandemic wave with a retrospective survey of the first wave among 1,545 non-healthcare workers confirmed an increase in anxiety and depression symptoms and showed a correlation with the occupational SARS-CoV-2 infection risk. This online follow-up survey aims to examine changes in mental distress as the pandemic progressed in Germany and to identify factors influencing potential changes. Longitudinal data from 260 subjects were available for this analysis. Mental distress related to anxiety and depression symptoms, assessed by the Patient Health Questionnaire-4 (PHQ-4), and occupational risk factors were solicited at the end of 2022 and retrospectively at the fifth wave. Categorized PHQ-4 scores were modelled with mixed ordinal regression models and presented with odds ratios (OR) and 95% confidence intervals (95% CI). A previous diagnosis of a depressive or anxiety disorder was a strong risk factor for severe symptoms (OR 3.49, 95% CI 1.71-7.11). The impact of occupational SARS-CoV-2 infection risk on mental distress was increased, albeit failing to reach the formal level of statistical significance (high risk OR 1.83, 95% CI 0.59-5.63; probable risk OR 1.72, 95% CI 0.93-3.15). Mental distress was more pronounced in those with a previous diagnosis of anxiety and depression. Confirmed occupational risk factors were protective measures against occupational SARS-CoV-2 infection perceived as inadequate, chronic work-related stress, overcommitment, reduced interactions with fellow-workers, and work-privacy conflicts. The pandemic had a negative impact on anxiety and depression symptoms among the studied non-healthcare workers, particularly early in the pandemic, although this effect does not appear to be permanent. There are modifiable risk factors that can protect workers' mental health, including strengthening social interactions among employees and reducing work-privacy conflicts.

Role of Telehealth Use in Chronic Care Management and Disparity Reduction Among the Aging Population.

Introduction: To examine telehealth use in chronic care management and disparity reduction among the aging population. Methods: This longitudinal cohort study compared the changes in chronic care quality measures among patients with and without telehealth visits during the COVID-19 pandemic relative to patients in the previous years and by patient sociodemographic subgroup. Participants were Medicare fee-for-service beneficiaries 65 years or older from an Accountable Care Organization in the Midwest United States. Three utilization-based measures included having 2+ A1C tests, breast cancer screening, and depression screening. Three outcome-based measures included A1C control, blood pressure control, and depression diagnosis. Results: During the study period, the pandemic cohort experienced 5-17 percentage points' decrease in utilization-based measures (e.g., 2+ A1C tests 63.9% vs. 51.1%; OR [95% confidence intervals] = 0.35 [0.34-0.36]) from baseline relative to the control cohort. The outcome-based measures also significantly decreased but at smaller magnitudes (3-5 percentage points). About 51.5% patients had at least one telehealth visit. The utilization-based measures for these patients were significantly higher than those without any telehealth visit (e.g., 2+ A1C 57.1% vs. 51.1%, p < 0.01). However, the outcome-based measures were comparable. Patients from historically underserved groups had a larger decline in health care outcomes than their counterparts. Among patient with at least one telehealth visit, these disparities were no longer significant. Discussions: Telehealth was associated with less negative impact of the pandemic and better performance in chronic care management, but more for utilization-based measures and less for outcome-based measures. Telehealth was also associated with less disparities in care outcomes.

Treatment of Patient with Recurrent Major Depressive Disorder: A Case Report

Introduction: The alteration of biogenic amines, in particular norepinephrine and serotonin, is a hypothesis that is frequently put forward in relation to the etiology of major depressive disorder. This study was aimed to present the recurrent major depressive disorder in a forty years old woman. Case presentation: A 40-year-old woman, presented to our mental health unit with symptoms of a low mood, which she described as similar to previous episodes of depression. Two decades ago, she underwent an evaluation and received a diagnosis of severe depression for the first time. Throughout that duration, she received imipramine (tricyclic antidepressant/TCA) at dosages of up to 150 mg per day, resulting in favorable outcomes. She claimed that she abstained from illicit substances and has not undergone any distressing events in the recent past. Although she was confident that she was experiencing another severe depression, she expressed a desire to avoid using imipramine this time due to its adverse effects, including dry mouth, dry eyes, and diarrhea. The patient was diagnosed as recurrent major depressive disorder without psychotic symptoms. Conclusion: The likelihood of experiencing additional bouts of major depression is higher when there have been multiple prior episodes, residual symptoms of depression between episodes, and the coexistence of other psychiatric or chronic medical conditions. Prior episodes of serious depression that responded well to treatment have a greater probability of reaching remission in future episodes. First-line treatment options for major depressive disorder include selective serotonin reuptake inhibitors (SSRIs) such as bupropion, venlafaxine, mirtazapine, and duloxetine.

Feasibility of Using Serum, Plasma, and Platelet 5-hydroxytryptamine as Peripheral Biomarker for the Depression Diagnosis and Response Evaluation to Antidepressants: Animal Experimental Study

Feasibility of Using Serum, Plasma, and Platelet 5-hydroxytryptamine as Peripheral Biomarker for the Depression Diagnosis and Response Evaluation to Antidepressants: Animal Experimental Study

Abstract PO5-12-05: A Retrospective Study of the Rate of Cognitive Impairment and Influencing Factors during Postoperative Endocrine Therapy for Breast Cancer

Abstract Background Although cancer-related cognitive impairment (CRCI) has been gradually recognized, general cognitive function tests such as the MMSE are not sensitive enough to diagnose CRCI. There is also a lack of evidence on the incidence and its response. However, even mild cognitive impairment can have a significant impact on quality of life. In this study, we retrospectively analyzed the prevalence of cognitive impairment in patients undergoing endocrine therapy at our hospital and the factors influencing the symptoms. Subjects 349 patients who continued single-agent postoperative endocrine therapy for at least 6 months between January 1 and October 31, 2022, and who responded to the cognitive dysfunction questionnaire at least once. Data from the cognitive dysfunction items of the endocrine therapy questionnaire administered during the period were used to retrospectively examine the CRCI awareness rate and factors involved. Results and Discussion The patients who were aware of cognitive dysfunction was 170, or 49% of all patients, and univariate analysis showed that age was significantly higher in the group with CRCI, but there were no significant differences in type of endocrine therapy or history of chemotherapy between the groups with and without CRCI. Physical symptoms such as menopausal symptoms (hot flashes and sweats), arthralgia, myalgia, fatigue, depressed mood, and malaise were significantly more frequent in patients with CRCI, which could be considered side effects of endocrine therapy. Risk factors such as low cognitive reserve, low level of education, advanced age, race, depression, fatigue, and anxiety have been reported in the past, and in this study, fatigue, depressed mood, and malaise were found significantly more frequently in patients with cognitive dysfunction. However, the diagnosis of depression and dementia may also be important.Non-pharmacological interventions, especially cognitive rehabilitation and exercise, are expected to be effective in improving symptoms, but there is no certain opinion yet. The limitation of this study is that it was a single-center, retrospective analysis. In addition, it was difficult to evaluate the results over time, including before the start of oral medication, so we are considering conducting a prospective data collection study so that comparisons can be made in the future. Conclusion: This study was a simple screening, based only on subjective symptoms. In recent years, postoperative endocrine therapy has been prolonged to 10 years, and there is a possibility to improve the quality of life of patients by recognizing the possibility of cognitive dysfunction in both providers and patients, and by taking measures that include multiple factors. Citation Format: Akari Murakami, Mayuko Aono, Kaho Utsunomiya, Kumiko Okujima, Kana Takemoto, Megumi Takaoka, Erina Kusakabe, Kana Taguchi, Kanako Nishiyama, Yoshiaki Kamei, Yasutsugu Takada, Hitoshi Tanimukai. A Retrospective Study of the Rate of Cognitive Impairment and Influencing Factors during Postoperative Endocrine Therapy for Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-05.

Perceived Need for Mental Health Care in a Cohort of Persons With Inflammatory Bowel Disease.

Psychiatric comorbidity is common in inflammatory bowel disease (IBD) and can negatively affect disease outcomes. We explored the perceived need for mental health care among persons with IBD. Persons with IBD completed self-report questionnaires, including the Hospital Anxiety and Depression Scale (HADS), and reported whether they wanted help with their mood. Each was also assessed using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorders (SCIDs). We used logistic regression analyses to determine factors associated with the perceived need for mental health care. Of 245 participants, 28% met the criteria for a past diagnosis of depression or anxiety disorder by SCID, and nearly 23% met the criteria for a current diagnosis of depression or anxiety disorder. One-third (n = 74) reported a perceived need for mental health care. Among those meeting criteria for a current SCID diagnosis of depression or anxiety, only 58% reported needing mental health care. Need for mental health care was reported by 79% of persons currently treated for either depression or 71% treated for anxiety. Persons with a perceived need for mental health care had higher mean HADS for depression and HADS for anxiety scores and also higher IBD symptom activity scores. Of those reporting no perceived need for mental health care, 13% had a current diagnosis of depression or anxiety disorder by SCID; even fewer had symptoms of depression or anxiety. Symptoms of depression or anxiety are more important than a formal diagnosis of depression or anxiety in predicting which persons with IBD will perceive a need for mental health care.

Psychological Distress and Mental Health Diagnoses in Adults by Disability and Functional Difficulty Status: Findings from the 2021 National Health Interview Survey

BackgroundEvidence suggests that disabled people have worse mental health than non-disabled people, but the degree to which disability contributes to mental health is unclear. ObjectiveThis paper uses 2021 National Health Interview Survey (NHIS) data to estimate the association between disability and depression and anxiety diagnoses as well as psychological distress among adults. MethodsWe calculated disability population prevalence and mental health diagnoses and associated symptoms among 28,534 NHIS respondents. Logistic regressions estimated the odds of depression or anxiety diagnoses and recent psychological distress, controlling for disability and mental health diagnoses. We measured disability using binary and continuum measures of functional disability with the Washington Group Short Set on Functioning. ResultsDisabled people have significantly greater odds of both depression and anxiety diagnoses compared to non-disabled people. Those with high functional disability have 552% greater odds of an anxiety diagnosis (95% CI: 5.61 – 7.58; p<0.01) and 697% greater odds of a depression diagnosis (95% CI: 6.97 – 9.12; p<0.01) compared to those with no functional disability. Similarly, those with any level of functional disability are more likely to have elevated psychological distress in the past 30 days compared to those with no functional disability. ConclusionsFindings support the idea that mental health is worse for disabled people compared to non-disabled people, with increasing functional disability associated with worse mental health. This suggests that mental health is not being adequately addressed for those with the greatest functional disability. Future work should seek to better understand the systemic causes of disparities.

The mental health impact of the October 7th terror attack on Jews and Arabs in Israel: A nationwide prospective study

IntroductionOn October 7, 2023, Israeli citizens came under an unprecedented terrorist attack that impacted the entire country. Recent research has begun to document the mental health impact of the attack but has yet to address the question of whether the attack had a differential impact across ethnic communities. In this nationwide prospective cohort study, we aimed to determine possible differences in psychopathology between Jews and Arabs in the post-October 7th attack. Specifically, we aimed to understand the role ethnicity may play in changes in probable PTSD, depression, and anxiety diagnoses from pre- to post-attack. MethodsThe sample comprised 656 participants (332 female, 50.7%) aged 18-85 (M = 41.01, SD = 13.72). Of this cohort, 557 participants (84.9%) were Jews, and 99 (15.1%) were Arabs, reflecting their national proportionality. Validated self-report questionnaires were completed to assess PTSD, depression, and anxiety at two time points: August 20 to 30th, 2023 (T1; 6–7 weeks before the attack) and November 9–19, 2023 (T2; 5–6 weeks after the attack). ResultsAt T2, Arab Israeli participants reported significantly higher prevalences of probable PTSD, depression, and anxiety diagnoses than Jewish Israeli participants. A series of hierarchical logistic regressions revealed that, compared with Jews, Arab participants presented with higher prevalence of probable PTSD (OR = 2.53 95% CI = 1.46-4.37, p < 0.0001), depression (OR = 1.68 95% CI = 1.35-3.01, p < 0.0001) and anxiety (OR = 6.42 95% CI = 3.95-10.52, p < 0.0001), controlling for prevalences of probable diagnoses at T1 as well as for trauma-related variables. DiscussionCitizens belonging to the Arab ethnic minority in Israel were found to be at higher risk for psychopathology in the aftermath of the October 7, 2023, terrorist attack compared with their Jewish majority counterparts. Thus, it becomes critical to employ culturally sensitive assessments and interventions following the attack to prevent the development of chronic symptoms and disorders.