Risk Of Elevated Depressive Symptoms Research Articles

Perceived Discrimination Trajectories and Depressive Symptoms Among Middle-Aged and Older Black Adults.

Background and ObjectivesPerceived discrimination is a risk factor for poor mental health. However, most studies measure discrimination at one time point, which does not account for heterogeneity in the cumulative patterning of exposure to discrimination. To address this gap, we examine the association between discrimination trajectories and depressive symptoms among black middle-aged and older adults.Research Design and MethodsData were analyzed from a subsample of black Health and Retirement Study respondents (2006–2018, N = 2926, older than 50 years). General discrimination and racial discrimination trajectories were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses. We examined the extent to which the association between discrimination trajectories are differentially associated with depressive symptoms (8-item Center for Epidemiological Studies-Depression scale) using negative binomial regression models adjusted for potential confounders. Effect modification by age and gender was tested.ResultsIndividuals in the persistently high (incident rate ratio [IRR]: 1.70; 95% confidence interval [CI]: 1.49–1.95) and moderate general discrimination trajectories (IRR: 1.19; 95% CI: 1.06–1.33) were more likely to have elevated depressive symptoms in comparison to those in the persistently low trajectory. This relationship was strongest among older adults aged older than 65 years. Respondents in the persistently high racial discrimination trajectory (IRR: 1.50; 95% CI: 1.29–1.73) had a higher risk of elevated depressive symptoms in comparison to respondents in the persistently low trajectory. Sensitivity analyses indicated that there was an independent association between persistently high racial discrimination trajectory class and elevated depressive symptoms, after adjusting for racial discrimination measured at a single time point.Discussion and ImplicationsCharacterizing longitudinal patterns of perceived discrimination may facilitate the stratification of mental health risk and vulnerability among black middle-aged and older adults. Trajectories of racial discrimination may inform risk of worse depressive symptoms more accurately than a single assessment of discrimination.

Early implicit–explicit discrepancies in self-esteem as correlates of childhood depressive symptoms

This longitudinal study examined early social–cognitive markers that might be associated with the emergence of childhood depression and anxiety. At 5 years of age, 137 children completed an implicit self-esteem measure. At 9 years of age, the same children completed measures of implicit self-esteem, explicit self-esteem, depression, and anxiety. Two novel findings emerged. First, higher implicit self-esteem at age 5 than explicit self-esteem at age 9 (implicit > explicit discrepancy) was associated with depressive symptoms at age 9, but not with symptoms of anxiety. Second, this cross-age implicit > explicit discrepancy was associated with depressive symptoms more strongly than was the same implicit > explicit discrepancy measured concurrently at age 9. The overall pattern suggests that the appearance of depressive symptoms in children is associated with discrepancies between implicit and explicit self-esteem and not just lower levels of implicit self-esteem or lower levels of explicit self-esteem taken alone. It is the direction and discrepancy across time that is particularly informative, such that discrepancies between early implicit representations and later explicit reports of self-worth reflect a developmental pathway associated with elevated risk for depressive symptoms. Taken altogether, this study illustrates the benefits of combining work in developmental, child-clinical, and social psychology to provide a more complete view of the developing child. We believe that combining implicit and explicit measures of self-esteem across developmental time points can be used to examine early markers of depression in children at younger ages than typically possible with explicit measures alone.

Feelings of restriction and incompetence in parenting mediate the link between attachment anxiety and paternal postnatal depression.

Many fathers suffer from burdening depressive symptoms in the period after the birth of their child (postnatal depression [PND]). In mothers, attachment insecurity has been empirically linked to the development and maintenance of postpartum depression, but its role in father PND is not well understood. The present study investigated the link between attachment insecurity and paternal depressive symptoms in the postnatal period, employing multiple depression measures to capture both typical and male-specific depressive symptoms. Structural equation modeling was used to explore the potential mediating role of parenting stress (feelings of restriction and incompetence in parenting), and relational variables (consensus in, and satisfaction with, the couple relationship). Data were collected by an online survey responded to by fathers of infants 1–18 months old (N = 530). Both a direct link between attachment anxiety and father PND, and an indirect link, mediated by parenting stress, were found. A weaker, indirect link between attachment avoidance and father PND was found, also mediated by parenting stress. Especially men high in attachment anxiety may experience parenting as stressful and thereby have an elevated risk for depressive symptoms. Surprisingly, relational difficulties were not linked to father PND. The study contributes to the understanding of mechanisms underlying how attachment anxiety influences the risk of depression in the postnatal period in fathers. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Less)

Heart Rate Variability, Sleep Quality, and Depression in the Context of Chronic Stress.

Disrupted sleep quality is one of the proposed mechanisms through which chronic stress may lead to depression. However, there exist significant individual differences in sleep reactivity, which is the extent to which one experiences sleep disturbances in response to stress. The aim of the current study was to investigate whether low high-frequency heart rate variability (HRV), as a psychophysiological marker of poor emotional and physiological arousal regulation, predicts stress-related sleep disturbances associated with greater risk of depression symptoms. Using a chronic caregiving stress model, 125 mothers of adolescents with developmental disorders and 97 mothers of typically developing adolescents had their resting HRV and HRV reactivity recorded and completed a measure of depressive symptoms, as well as a 7 day sleep diary to assess their sleep quality. A moderated mediation model tested whether sleep quality mediated the association between chronic stress exposure and depressive symptoms and whether HRV moderated this mediation. After controlling for participant age, body mass index, ethnicity, socioeconomic status, and employment status, poor sleep quality mediated the association between chronic stress and depressive symptoms. Resting HRV moderated this indirect effect such that individuals with lower HRV were more likely to report poorer sleep quality in the context of chronic stressor exposure, which, in turn, was related to greater depressive symptoms. Lower HRV, a potential biomarker of increased sleep reactivity to stress, is associated with greater vulnerability to stress-related sleep disturbances, which, in turn, increases the risk for elevated depressive symptoms in response to chronic stress.

Exercise attenuates the association between household pesticide exposure and depressive symptoms: Evidence from NHANES, 2005–2014

BackgroundThe effect of household pesticide exposure on depressive symptoms in the general population is underexplored, and the role of exercise in the association between pesticide exposure and depressive symptoms is unclear. ObjectiveThe goals of this study are to examine whether the associations between household pesticide exposure and depressive symptoms exist in the general population, and whether exercise can attenuate these associations. MethodsWe used data from the 2005–2014 National Health and Nutrition Examination Surveys (NHANES), including a total of 14708 US adult participants who were 20 years or older. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Exercise information on the recreational physical activity (RPA) and pesticide exposure were self-reported in an interview. ResultsParticipants with exposure of household pesticide had a higher odds ratio ([OR]; OR = 1.32, 95% confidence intervals [CI]: 1.12–1.56) for depressive symptoms, compared to those who had not been unexposed. A significant interaction between exercise and pesticide exposure on depressive symptoms was observed (P = 0.038). Stratified analysis showed that household pesticide exposure was associated with a 50% higher risk of depressive symptoms (OR = 1.50, 95% CI: 1.20–1.86) in the population with light RPA. However, we did not find a significant association in the group with moderate + vigorous RPA (P = 0.305). ConclusionThis study further confirms that household pesticide exposure is associated with an elevated risk of depressive symptoms in the general population. More importantly, we for the first time reports that moderate + vigorous RPA attenuates the positive association between household pesticide exposure and depressive symptoms.

787-P: Mental Health Discussions during Routine Diabetes Care Visits with Adolescents and Young Adults

Background: Adolescents and young adults (AYAs) with T1D are at risk for elevated depressive symptoms. Health care providers (HCPs) are in a unique position to discuss mental health (MH) and T1D self-care during routine diabetes medical visits. Objective: Evaluate the frequency and content of MH discussions during medical visits. Methods: Data were drawn from a longitudinal study of AYA-HCP communication and T1D care. Secondary analyses include evaluation of 108 medical visits (M duration=22.5 min; n=8 HCPs) with 33 AYAs with T1D (48.5% male; 45.5% non-Hispanic White; M age=17.5±1.1 yrs; M clinic visits=3.27). 22 AYAs self-reported elevated depressive symptoms using the Center for Epidemiologic Studies-Depression scale (M CES-D score=22.6±8.3); a matched sample of 11 AYAs without elevated depressive symptoms was selected for comparison (M CES-D score=5.7±3.9). Medical visits were audio-recorded, transcribed, and coded by trained coders to identify and characterize MH discussions. Results: Coding of transcripts identified 43/108 medical visits (39.8%) with ≥ 1 MH discussion. AYAs with elevated depressive symptoms were as likely to have a MH discussion (42.6%) as AYAs without elevated depressive symptoms (35.0%; p=.43); the elevated group had 2.48 distinct MH conversations/visit compared to 1.64 distinct MH conversations/visit for the non-elevated group (p=.10). MH discussions were initiated most often by HCPs (67.4%), followed by AYAs (23.3%) and parents (9.3%). MH resources were provided in 60.5% of all visits with MH discussion, including: referral for MH services (76.9%), general MH education (30.8%), and recommendation to continue current MH services (26.9%). Discussion: MH content is commonly discussed in routine T1D care. Results suggest a need to increase HCP-delivered resources for AYAs with MH concerns. Evaluation of MH discussions can improve the quality of AYA-HCP communication around MH symptoms and, ultimately, improve diabetes care. Disclosure M. Monaghan: Research Support; Self; American Diabetes Association. C. Wong: None. D.L. Polyakov: None. M. Rose: None. Funding American Diabetes Association/Pathway to Stop Diabetes (1-18-ACE-27 to M.M.); National Institutes of Health (R03DK110259)

Workplace bullying and depressive symptoms among employees in Germany: prospective associations regarding severity and the role of the perpetrator

ObjectivesThe aim of this study was to investigate the effect of self-reported workplace bullying on depressive symptoms in a prospective study among a representative sample of employees from Germany. We focused specifically on the role of the perpetrator (co-workers and superiors), which was never done before in a longitudinal design.MethodsWe used data from a nation-wide representative panel study with a 5-year follow-up (N = 2172). Data on bullying exposure were obtained separately for different perpetrators (co-workers and superiors) and degree of severity (severe bullying, i.e., at least weekly). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ). We used logistic regression analyses to examine the effect of workplace bullying at baseline on depressive symptoms at follow-up.ResultsAfter adjusting for baseline depressive symptoms, severe bullying by co-workers significantly increased the 5-year risk of depressive symptoms (OR = 2.50). Severe bullying by superiors had a nonsignificant effect.ConclusionsWorkplace bullying is a risk factor for depressive symptoms among employees in Germany. The type of perpetrator seems to be an important factor to consider, as indicated by the elevated risk of depressive symptoms when bullying is perpetrated by co-workers.

Prevalence and correlates of depressive symptoms among adults living with HIV in rural Kilifi, Kenya

BackgroundPublished research on depression among people living with HIV/AIDS (PLWHA) from Africa is increasing, but data from Kenya remains scarce. This cross-sectional study measured the prevalence and correlates of depressive symptoms among PLWHA in rural Kilifi, on the Kenyan coast.MethodsBetween February and April 2018, we consecutively recruited and interviewed 450 adults living with HIV and on combination antiretroviral therapy (cART). Depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9), with a positive depression screen defined as PHQ-9 score ≥ 10. Measures of psychosocial, health, and treatment characteristics were also administered.ResultsThe overall prevalence of depressive symptoms was 13.8% (95% Confidence Interval (95%CI): 10.9, 17.3). Multivariable logistic regression analysis identified current comorbid chronic illness (adjusted Odds Ratio (aOR) 5.72, 95% CI: 2.28, 14.34; p < 0.001), cART regimen (aOR 6.93, 95%CI: 2.34, 20.49; p < 0.001), perceived HIV-related stigma (aOR 1.10, 95%CI: 1.05, 1.14, p < 0.001) and difficulties accessing HIV care and treatment services (aOR 2.37, 95%CI: 1.14, 4.91; p = 0.02) as correlates of depressive symptoms.ConclusionThe prevalence of depressive symptoms among adults living with HIV on the Kenyan coast is high. Those at high risk for elevated depressive symptoms (e.g., with comorbid chronic illnesses, on second-line cART, experiencing perceived HIV-stigma or with problems accessing HIV care) may benefit from early identification, treatment or referral, which requires integration of mental health programmes into HIV primary care.

Assessing the Acceptability of a Mindfulness-Based Cognitive Therapy Intervention for African-American Women Living with HIV/AIDS.

African-American HIV-seropositive women are at elevated risk for depressive symptoms compared to their seropositive counterparts. Depressive symptoms have been linked to HIV/AIDS-related health predictors and outcomes such as medication and care adherence, and viral load. Project UPLIFT, a mindfulness-based cognitive therapy intervention originally designed for persons with epilepsy has been shown effective to reduce depressive and anxiety symptoms. Focus groups were conducted to assess the appropriateness and acceptability of UPLIFT for African-American HIV-seropositive women and to obtain feedback on needed modifications. The focus groups, including cisgender and transgender African-American HIV-seropositive women, revealed, while well received, modifications should include lowering the reading level of content and altering specific mindfulness-based exercises to make them relevant and acceptable to the target population. This qualitative work demonstrates UPLIFT could be a promising avenue to improve the mental health of African-American HIV-seropositive women, a group for which mindfulness interventions had not been previously considered. SIGNIFICANCE: Mindfulness-based interventions have been found effective in reducing depression, anxiety, and chronic pain. Further, it has been used for groups living with chronic illness, particularly HIV/AIDS. It has helped to improve mental and behavioral health, as well as increase CD4 count and reduce viral load for some samples of people living with HIV/AIDS. African-American women living with HIV/AIDS are especially vulnerable to poor mental and behavioral health given their experience of mental illness and hesitancy to engage mental healthcare. Though used for other groups of people living with HIV/AIDS, mindfulness-based cognitive therapy has not previously been considered for this population. This study explored the acceptability and feasibility of an MBCT intervention for this group. The data suggests that this intervention could be potentially useful in improving the mental health of this population, and includes suggestions for making the intervention culturally relevant.

Emerging Adulthood and Prospective Depression: A Simultaneous Test of Cumulative Risk Theories.

Past research indicates that a history of depression and exposure to abuse and neglect represent some of the most robust predictors of depression in emerging adults. However, studies rarely test the additive or interactive risk associated with these distinct risk factors. In response, the present study explored how these three risk factors (prior depression, abuse, and neglect) synergistically predicted prospective depressive symptoms in a sample of 214 emerging adults (Mage = 21.4 years; SDage = 2.4; 78% females). Subtypes of maltreatment and lifetime history of depression were assessed through semi-structured interviews, and depressive symptoms were assessed annually for three years via self-report measures. The results indicated that for both males and females, a lifetime history of depression, abuse, and neglect-exposure uniquely conferred risk for elevated depressive symptoms. Furthermore, the interaction between neglect and prior depression forecasted increasing depressive symptoms, and a history of abuse also predicted increasing depressive symptoms, but only in females. These findings are contextualized within extant developmental psychopathology theories, and translational implications for trauma-informed depression prevention efforts are discussed.

Association between family conflict resolution methods and depressive symptoms in South Korea: a longitudinal study.

We investigated the relationship between family conflict resolution and depression, focusing on each component of family conflict resolution to determine which factors have stronger associations with depression. We used data from 2008 to 2015 of the Korea Welfare Panel Study. Our final sample included 3565 participants. For each participant, we included at least 2-8years of follow-up data with a mean follow-up time of 4.05 ± 2.52years. To identify the relationship between new-onset depressive symptoms and participants' family conflict resolution styles, we performed generalized estimating equation analysis with autoregressive working correlations to estimate adjusted odds ratios for new-onset depressive symptoms adjusted for covariates. Compared with positive family conflict resolution, negative family conflict resolution had a higher odds ratio for depressive symptoms (aOR 1.80, 95% CI 1.42-2.29). This relationship was strongly founded on participants who were women (aOR 2.35, 95% CI 1.55-3.94) with experience of verbal aggression (aOR 1.84, 95% CI 1.42-2.37) and threatening behaviors (aOR 1.89, 95% CI 1.25-2.85). Negative family conflict resolution has long-term associations with an elevated risk of depressive symptoms. In particular, we observed higher risks of depression with verbal and psychological conflict than with physical conflict. Health care providers and health policymakers should support the management and development of methods for dealing with family conflict to improve mental health at a family level, as well as an individual level.

ВЗАИМОСВЯЗЬ ДЕПРЕССИИ И СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ (ОБЗОР ЛИТЕРАТУРЫ)

The article deals with the important issue in the field of consultative psychiatry - comorbid depressive disorders in patients with cardiovascular diseases. Depression is highly prevalent in cardiac patients. Patients with coronary artery disease, heart failure, atrial fibrillation and those undergoing implantable cardioverter-defibrillator placement are at increased risk for elevated depressive symptoms and for major depressive disorder. In patients with heart diseases, depression is chronic, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. At present, pharmacologic and psychotherapeutic interventions appear to be safe and effective at reducing depressive symptoms in patients with cardiovascular diseases and may impact cardiac outcomes. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with cardiovascular diseases. In this review, we summarize the evidence linking depression to increased risk of cardiovascular diseases and worse patient outcomes. The paper presents a review of the literature on the physiologic mechanisms implicated in the connection between depression and cardiovascular diseases. Impaired adherence to health behaviors and adverse physiological effects of depression, including inflammation, endothelial dysfunction, platelet hyperactivity, and autonomic nervous system abnormalities, may link depression with adverse cardiac outcomes. Future studies in this direction with involvement of cardiologists and psychiatrists should be held.

ДЕПРЕССИЯ И КАРДИОЛОГИЧЕСКИЕ ЗАБОЛЕВАНИЯ (ОБЗОР ЛИТЕРАТУРЫ)

The article deals with the important problem in the field of consultative psychiatry - comorbid depressive disorders in patients with cardiovascular diseases. Depression is highly prevalent in cardiac patients. Between 31-45 % of patients with coronary artery disease suffer from clinically significant depressive symptoms. Furthermore, 20 % of patients with coronary heart disease meet criteria for the major depressive disorder. Patients with heartfailure, atrial fibrillation and ones undergoing implantable cardioverter-defibrillator placement are similarly at increased risk for elevated depressive symptoms and for major depressive disorder. In patients with heart diseases, depression is chronic, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. At present, pharmacologic and psychotherapeutic interventions appear to be safe and effective at reducing depressive symptoms in patients with cardiovascular diseases and may impact cardiac outcomes. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with cardiovascular diseases. In this review, we summarize the evidence linking depression to increased risk of cardiovascular diseases and worse patient outcomes. The paper presents a review of the literature on epidemiology, comorbid conditions, and risk factors for depression in heart diseases. Future studies in this direction with involvement of cardiologists and psychiatrists should be held.

Dietary inflammatory index and mental health: A cross-sectional analysis of the relationship with depressive symptoms, anxiety and well-being in adults

The relationship between diet, inflammation and mental health is of increasing interest. However, limited data regarding the role of dietary inflammatory potential in this context exist. Therefore the aim of this work was to examine associations between the inflammatory potential of habitual diet and mental health outcomes in a cross-sectional sample of 2047 adults (50.8% female). Diet was assessed using a self-completed food frequency questionnaire from which dietary inflammatory index (DII®) scores were determined. Depressive symptoms, anxiety and well-being were assessed using the CES-D, HADS-A and WHO-5 screening tools. Logistic regression analyses revealed that higher energy-adjusted DII (E-DII®) scores, reflecting a more pro-inflammatory diet, were associated with increased risk of depressive symptoms (odds ratios (OR) 1.70, 95% confidence intervals (CI) 1.23-2.35, p=0.001) and anxiety (OR 1.60, 95% CI 1.15-2.24, p=0.006) and lower likelihood of well-being (OR 0.62, 95% CI 0.46-0.83, p=0.001), comparing highest to lowest tertile of E-DII. In gender-stratified analyses associations were noted in women only. Women with the highest E-DII scores were at elevated risk of depressive symptoms (OR 2.29, 95% CI 1.49-3.51, p<0.001) and anxiety (OR 2.00, 95% CI 1.30-3.06, p=0.002), while likelihood of reporting good well-being was lower (OR 0.55, 95% CI 0.36-0.79, p=0.002), relative to those with the lowest E-DII scores. These findings, which suggest that a pro-inflammatory diet is associated with adverse mental health, may be of clinical and public health significance regarding the development of novel nutritional psychiatry approaches to promote good mental health.

Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies.

Research has suggested that sexual minority young people are more likely to have depressive symptoms or depressive disorder, but to date most studies in the field have relied on convenience-based samples. This study overcomes this limitation by systematically reviewing the literature from population-based studies and conducting a meta-analysis to identify whether depressive disorder and depressive symptoms are elevated in sexual minority youth. A systematic review and meta-analysis were conducted and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to determine if rates of depressive symptoms or depressive disorder differ for sexual minority youth, relative to heterosexual adolescents. MEDLINE, PsycINFO, EMBASE and ERIC databases were searched. Studies reporting depressive symptom data or the prevalence of depressive disorder in population-based samples of adolescents, which included sexual minority youth and heterosexual young people, were included in the review. A meta-analysis was conducted to examine differences between groups. Twenty-three articles met the inclusion criteria. The proportion of sexual minority youth in the studies ranged from 2.3% to 12%. Sexual minority youth reported higher rates of depressive symptoms and depressive disorder (odds ratio = 2.94, p < 0.001 and standardized mean difference, d = 0.39, p < 0.001) in comparison to heterosexual young people. Female sexual minority youth were more likely to report depressive symptoms when compared to male sexual minority youth (standardized mean difference, d = 0.34, p < 0.001). Limitations included variations in how sexuality was operationalized and how depressive symptoms or depressive disorder was measured. There is robust evidence that rates of depressive disorder and depressive symptoms are elevated in sexual minority youth in comparison to heterosexual young people. Despite the elevated risk of depressive symptoms or depressive disorder for sexual minority youth, the treatment for this group of young people has received little attention.

Diabetes Complications and Depressive Symptoms: Prospective Results From the Montreal Diabetes Health and Well-Being Study.

Prospective studies testing the potential impact of diabetes complications on depression are limited. The present study examined the longitudinal associations between diabetes complications and the risk and recurrence/persistence of depressive symptoms. Data were from a prospective community cohort telephone survey of adults with diabetes (N = 1314). Diabetes complications and depressive symptoms were assessed via self-report (Diabetes Complications Index and Patient Health Questionnaire-9, respectively) at baseline and annually for 5 years. Statistical models adjusted for sociodemographic, lifestyle, and diabetes characteristics. The number of diabetes complications at baseline was positively associated with a greater risk of elevated depressive symptoms, with the highest risk found for those with four to six complications at baseline (risk ratio = 2.73, 95% confidence interval = 1.64-4.56). Cerebrovascular disease was the complication most strongly associated with incident depressive symptoms (risk ratio = 2.22, 95% confidence interval = 1.59-3.10). Coronary artery disease, peripheral vascular disease, and neuropathy were also associated with the risk of depression, whereas foot problems and eye problems were not. In addition, a greater number of diabetes complications were associated with recurrent/persistent depression, though with a small effect size (Δr = .02). A parallel process latent growth curve model indicated that increases in diabetes complications were associated with increases in depressive symptoms during the course of the follow-up period (β = .74, p < .001). This study demonstrates the temporal relation between diabetes complications and depressive symptoms and underscores the psychological burden of diabetes complications by prospectively demonstrating the increased risk and recurrence of depressive symptoms associated with diabetes complications.

Negative wealth shock and short-term changes in depressive symptoms and medication adherence among late middle-aged adults

BackgroundExperiencing a negative wealth shock in late middle age may cause high levels of stress and induce reductions in health-related consumption.MethodsWe used data on late middle age individuals (51–64 years)...

Impact of breast cancer diagnosis, personal characteristics and lifestyle factors on depressive symptoms

Breast cancer (BCA) is associated with risk of an array of psychoneurological symptoms (PNS) including disturbances in sleep, anxiety, and depression. Lifestyle factors and personal characteristics, with potential impact on PNS, remain largely unexplored.METHODSA secondary exploratory analysis was conducted evaluating depressive symptoms in a cohort of women with stage I or II BCA during treatment for BCA and non‐BCA controls (n=58). Center for Epidemiologic Studies Depression Scale (CES‐D) assessments were observed at 3 time points (baseline, month 4 and month 9). With generalized linear mixed model and estimating equation approach the impact of cancer diagnosis, age, alcohol consumption, race, smoking, and BMI was evaluated related to CES‐D score.RESULTBreast cancer diagnosis (p=0.0298), smoking (p=0.0002), and mixed race identity (&gt;1 race, p=0.0069) were significant predictors of CES‐D score. Age, alcohol consumption and BMI were not significant.CONCLUSIONWomen undergoing active treatment for BCA were at elevated risk for depressive symptoms supporting a need for more extensive evaluation and interventions for depressive symptoms during treatment for BCA. Additionally, smoking and mixed race identity, predictive of depressive symptoms, may compound risk in women with BCA. Further work is necessary evaluating the association of dietary factors with BCA depressive symptomatology.Support or Funding InformationResearch reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number P30NR011403. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Sleep problems, short sleep and a combination of both increase the risk of depressive symptoms in older people: a 6-year follow-up investigation from the English Longitudinal Study of Ageing

Study objectivesThis study investigated whether sleep problems, sleep duration and a combination of short or long sleep with sleep problems were predictive of depressive symptoms six years later. MethodsParticipants were 4545 men and women aged 50 years or older from the English Longitudinal Study of Ageing. Sleep problems were indexed through self-report enquiring about the most frequent insomnia symptoms including difficulties falling asleep, waking up several times a night and waking up in the morning feeling tired. Sleep duration was ascertained by asking about average sleep in the weeknight. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. ResultsSleep problems were predictive of elevated depressive symptoms at follow-up (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.19–1.56). When explored separately, waking up in the morning feeling tired (OR = 1.71, 95% CI = 1.24–2.37) followed by difficulties falling asleep (OR = 1.49, 95% CI = 1.06–2.11) were also predictors of future depressive symptoms. Compared to optimal duration, short (OR = 1.90, 95% CI = 1.34–2.71) but not long sleep hours were also linked to elevated depressive symptoms. Participants reporting short sleep hours combined with high sleep problems also had an elevated risk of depressive symptoms six years later (OR = 1.85, 95% CI = 1.15–3.00). Long sleep combined with high sleep problems was not predictive of depressive symptoms. ConclusionsShort and disturbed sleep and their combination increase the risk of future depressive symptoms in older adults.

Lipids, lipoprotein distribution and depressive symptoms: the Multi-Ethnic Study of Atherosclerosis.

Previous studies suggest lower concentrations of total and high-density lipoprotein (HDL) cholesterol to be predictive of depression. We therefore investigated the relationship of lipids and lipoprotein distribution with elevated depressive symptoms (EDS) in healthy men and women from the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were followed up over a 9.5-year period. EDS were defined as a Center for Epidemiological Studies Depression (CES-D) score ⩾16 and/or use of antidepressant drugs. Lipoprotein distribution was determined from plasma using nuclear magnetic resonance spectroscopy. Among 4938 MESA participants (mean age=62 years) without EDS at baseline, 1178 (23.9%) developed EDS during follow-up. In multivariable Cox regression analyses, lower total, low-density lipoprotein (LDL) and non-HDL cholesterol concentrations at baseline were associated with incident EDS over 9.5 years (hazards ratio (HR)=1.11–1.12 per s.d. decrease, all P<0.01), after adjusting for demographic factors, traditional risk factors including LDL cholesterol, HDL cholesterol and triglycerides. Lipoprotein particle subclasses and sizes were not associated with incident EDS. Among participants without EDS at both baseline and visit 3, a smaller increase in total or non-HDL cholesterol between these visits was associated with lower risk of incident EDS after visit 3 (HR=0.88–0.90 per s.d. decrease, P<0.05). Lower baseline concentrations of total, LDL and non-HDL cholesterol were significantly associated with a higher risk of incident EDS. However, a short-term increase in cholesterol concentrations did not help to reduce the risk of EDS. Further studies are needed to replicate our findings in cohorts with younger participants.