General Depression Scale Research Articles

Examining the influence of anxiety and depression on medication adherence among patients diagnosed with acute myocardial infarction

BackgroundEffective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools.MethodsEmploying a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details.ResultsThe study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence.ConclusionThe study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.

Depressive symptoms in older prisoners : Results of two studies

The proportion of prisoners aged60 years and above is steadily rising both nationally and internationally. With advancing age the risk of developing physical and mental illnesses also increases. International studies have demonstrated ahigher prevalence of mental disorders among older prisoners compared to the general population; however, there are few data on this, at least for Germany. Collation of empirical data on the presence of depressive symptoms among older prisoners. There were two independent cross-sectional studies conducted in North Rhine-Westphalia (NRW) and Rhineland-Palatinate (RLP), which included prisoners aged50 years and above. In NRW apurely quantitative survey of depressive symptoms was carried out using the German version of the patient health questionnaire (PHQ-D) and in RLP the quantitative measurements using the general depression scale short form (ADS-K) were supplemented by qualitative interviews. In total, data from 315 inmates were available for ajoint analysis (222 from RLP, 93from NRW). Among the prisoners in RLP 63.4% exhibited mild to clinically significant depressive symptoms, while in NRW this was the case for 46.2%. The treatment with antidepressants was carried out only in a small proportion in both federal states. Both surveys showed aclearly elevated prevalence of depressive symptoms compared to the non-prison population. The results also suggest aneed for optimization in terms of treatment. Particularly concerning potential interactions with somatic illnesses, efforts should be made to improve the diagnostics and treatment of depressive symptoms.

A study on the correlations of PRL levels with anxiety, depression, sleep, and self-efficacy in patients with prolactinoma.

The purpose of this study was to explore the factors influencing PRL levels in patients with prolactinoma and to investigate the correlations between anxiety, depression, sleep, self-efficacy, and PRL levels. This retrospective study included 176 patients with prolactinoma who received outpatient treatment at the Affiliated Hospital of Zunyi Medical University from May 2017 to August 2022. The general information questionnaire, Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS), and General Self-Efficacy Scale (GSES) were used for data collection. A generalized estimating equation (GEE) model was used to analyze the factors influencing PRL levels in patients with prolactinoma. GEE single-effect analysis was used to compare PRL levels at different time points between anxiety group and nonanxiety group, between insomnia group and normal group, and between low, medium, and high self-efficacy groups. The median baseline PRL level and the PRL levels at 1, 3, 6, and 12 months of follow-up were 268.50 ng/ml, 122.25 ng/ml, 21.20 ng/ml, 19.65 ng/ml, and 16.10 ng/ml, respectively. Among patients with prolactinoma, 59.10% had anxiety (HADS-A score = 7.35 ± 3.34) and 28.98% had depression (HADS-D score = 5.23 ± 3.87), 9.10% had sleep disorders (AIS score = 6.10 ± 4.31) and 54.55% had low self-efficacy (GSES score = 2.13 ± 0.83). Educational level, tumor size, number of visits, sleep quality, anxiety level, and self-efficacy level were found to be factors influencing PRL levels in patients with prolactinoma (P<0.05). Higher PRL levels were observed in the anxiety group compared to the non-anxiety group (P<0.001), in the insomnia group compared to the normal group (P<0.05), and in the low self-efficacy group compared to the medium and high self-efficacy groups (P<0.05). PRL levels in patients with prolactinoma are related to education level, tumor size, number of visits, anxiety, self-efficacy, and sleep but not depression. PRL levels were higher in patients with anxiety, low self-efficacy, and sleep disorders.

Mental health and quality of life of female breast cancer survivors in southeast Serbia

Background/Aim. Quality of life (QoL) is one of the outcome measures for patients with chronic diseases. Mental health issues often impact the QoL of cancer patients. Cancer patients with a good QoL have a longer life expectancy and are able to lead a more productive and social life. The aim of the study was to determine the association of mental health with the QoL, as well as to determine significant predictors of QoL in patients with breast cancer (BC). Methods. The study included 118 patients treated at the Specialized Breast Cancer Department of the Oncology Clinic of the University Clinical Center Nis. The study?s inclusion criteria were the presence of early-stage nonmetastatic BC and completed surgical treatment. The following questionnaires were used: the general sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS), Buss-Perry Aggression Questionnaire, Early Maladaptive Schema questionnaire - short form (SQ-SF), Flanagan?s Quality of Life Scale (QoLS), Holmes and Rahe Stress Scale, Berlin Social Support Scales (BSSS), Health Locus of Control. Results. A statistically significant negative correlation was found with emotional state, i.e., anxiety score, depressiveness score, total stress score, and physical aggression score, while QoL correlated positively with all subscales of the perceived social support (PSS) questionnaire. QoL was significantly different for patients with the following early maladaptive schemas: emotional deprivation, emotional inhibition, and a sense of entitlement/narcissism. Moreover, QoL differed significantly depending on partnership status, the presence of clinically significant anxiety, the presence of hormonesensitive cancer, the presence of human epidermal growth factor receptor 2 (HER2)-positive cancer, and time since diagnosis. Multiple linear regression was performed, and depression and PSS had the highest share. Conclusion. In our study, the presence of depressiveness and PSS were the best predictors of QoL of BC survivors.

Did the COVID-19 pandemic affect depressive symptoms? Longitudinal analysis of health worker data

Abstract Background Health workers play a vital role in response to outbreaks under pandemic circumstances, but are also highly vulnerable to stress-related mental health issues (e.g., due to pandemic workload). There are knowledge gaps regarding temporal development of the emergence of depressive symptoms among health workers during the COVID-19 pandemic and their determinants. This study examined the trajectory of depressive symptoms and their association with a) stress perception, b) own COVID-19 infection and c) COVID-19 exposure at work. Methods This cohort study with 91 health workers (90% female, x¯=45 years) from a German general hospital included (1) medical, nursing and therapeutic staff and (2) administrative staff. Data were collected longitudinally every month from July to December 2020. Linear multilevel models were used to evaluate associations between trajectories of depression scores (German ‘General Depression Scale’) with perceived stress (‘Perceived Stress Scale’). Laboratory-confirmed COVID-19 infection was tested as a moderator of depressive symptom development. Trajectoires of depressive symptom modalities (e.g., somatic, emotional) were analysed stratified by COVID-19 exposure at work. Results Depression scores increased across the study period (b=.03, .02-.05). Perceived stress was associated with depression scores (b=.12, .10-.14). The presence of health workers’ own COVID-19 infection was associated with a higher increase (b=.06, .01-.10). Somatic symptoms of depression increased over time only among health workers directly exposed to COVID-19 patients at work (b=.25, .13-.38). Conclusions The increase in depressive symptomatology among health workers exposed to COVID-19 in the workplace points to the need for further research. Since the infection with COVID-19 is associated with an increase of depressive symptoms across time, awareness should be raised about measures to protect against virus transmission, especially during a pandemic. Key messages • Perceived stress and own infection during the COVID-19 pandemic are additively linked to depressive symptoms among health workers. • Exposure to COVID-19 in the workplace is associated with increased somatic depressive symptoms.

Intervention effect of online and offline physical education model on anxiety disorder of undergraduates

Background The anxiety of college students has become a common phenomenon in The Times, and many colleges and universities have introduced the teaching mode combining online and offline to alleviate student’s anxiety. The purpose of this study is to explore the effect of this model on students’ anxiety disorders.Subjects and Methods The students in a university were randomly divided into an experimental group and a control group. The control group received regular offline physical education. The experimental group adopted the combination of online and offline physical education teaching mode with the introduction of an educational psychology strategy. The mode also includes students’ burnout emotion, information literacy and self-control ability. The study used the general hospital Anxiety and Depression Scale (HAD) to obtain the anxiety disorder score data of college students and used the statistical software SAS to process and analyze the data.ResultsThe study found that students in the experimental group had significantly lower anxiety disorder scores than those in the control group. The average anxiety score for the experimental group was 5.2, compared with 8.3 for the control group. T-test and analysis of variance were used to verify that the difference between the experimental group and the control group was statistically significant.ConclusionsResearch shows that online and offline physical education teaching mode can significantly reduce students’ anxiety. This provides a reference for the efficient education management model and helps to promote the development of new teaching strategies.

ВЗАИМОСВЯЗЬ ТИПА ТЕМПЕРАМЕНТА С ОСОБЕННОСТЯМИ ПСИХОЭМОЦИОНАЛЬНОГО СОСТОЯНИЯ У ЖЕНЩИН С ЗАБОЛЕВАНИЯМИ ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА

The topicality of the research is confirmed by data showing a high incidence of gastrointestinal (GI) diseases in the Russian Federation in comparison with other European countries. Patients with gastrointestinal (GI) disease have been reported by clinicians to be emotionally unstable during disease exacerbations. This article presents a study of the relationship between psycho-emotional states and individual typological characteristics in women of different ages with GI disease. Levels of indicators of anxiety and depression in women with GI disease were investigated. The purpose of the study was to determine the peculiarities of anxiety and depression levels in women with GI diseases in relation to temperament type and age; using correlation analysis, to determine the relationship between neuroticism and emotional state, temperament type, and levels of anxiety and depression in the study participants. The study involved 28 women with diseases of the gastrointestinal tract, aged 42 to 72 years. The Eysenck Personality Inventory (EPI), the Spielberger State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI) were used in the research. From the results obtained, it can be concluded that most women with gastrointestinal disorders have an introverted personality type with high neuroticism. It was found that women with a melancholic temperament type had the highest scores on the Personality Anxiety Scale and on the Cognitive-Affective Manifestations of Depression subscale and the General Depression Scale, whereas women with a sanguine temperament type had the lowest scores for all indicators. The results of the study may be of practical importance in providing psychological support to women with gastrointestinal diseases in hospital, taking into account their individual typological characteristics and emotional state.

Peripheral nerve stimulation for the treatment of chronic knee pain

The average age of our population is increasing, resulting in a high incidence of chronic degenerative knee pathologies. Several treatment options, including surgical procedures are available to help mitigate these pathologies. However, the percentage of subjects with chronic post-surgical knee pain is still estimated at 16–20%. Neuromodulation techniques such as spinal cord stimulation and dorsal root ganglion stimulation (DRGS) are treatment options for subjects with chronic knee pain. The evidence for peripheral nerve stimulation (PNS) is minimal due to a limited number of neuromodulation systems capable of targeting the distal part of the lower limbs. This study aimed to investigate the safety and efficacy externally powered PNS systems for the treatment of chronic intractable knee pain targeting the saphenous nerve. Patients suffering from chronic intractable post-surgical knee pain received landmark-guided peripheral nerve stimulation of the branches of the saphenous nerve. All implants were performed with an externally powered PNS system to avoid lead migration as a result of cross-joint lead positions tunneling towards an Implantable Pulse Generator to the trunk. Data were collected retrospectively. Subject-reported outcome was measured via numerical rating scale values on a 10-point scale measuring pain intensity at rest and in motion. Additional data were collected for the subjects treated at the Charité location, including quality of life with the SF-36 form, quality of sleep with the Pittsburgh Sleep Quality Index and mood states with the short form of the General Depression Scale. Thirty-three patients received direct to permanent implant, landmark-guided peripheral nerve stimulation of the saphenous nerve branches. Six (18.2%) subjects reported non-sufficient initial benefit from the therapy and were explanted. Two subjects were explanted due to wound infections. The total study population reported included 25 patients. These subjects reported significant improvements related to pain, quality of life, mood quality, and quality of sleep. Additionally, subjects were able to reduce their opioid medication significantly after PNS therapy. Externally powered PNS at the saphenous nerve branches is a straightforward, selective and safe technique for patients with chronic knee pain. The landmark-guided implantation technique is less invasive than classical neuromodulation techniques such as spinal cord or DRGS and complication rates remain low. Short-term results are promising and show considerable reductions in pain scores and opioid intake. Long-term results are pending.

Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers.

Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95% confidence interval). Depression scores increased significantly during the study period (β = .03, 95% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95% CI [0.13, 0.38]), but not in administrators (β = .03, 95% CI [-0.04, 0.11]). Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.

Prospective comparative analysis of cochlear implant patients with single-sided deafness and asymmetric hearing loss with regard to health-related quality of life, tinnitus distress and psychological comorbidities

Patients with single-sided deafness (SSD) and asymmetric hearing loss (AHL) are increasingly being treated with cochlear implants (CI) due to the demonstrated improvements in auditory abilities and quality of life. To date, there are few published studies in which these two groups are comparatively studied. The aim of the current study was to examine which factors differ between those two patient groups, especially preoperatively. Asecondary analysis of the previously published raw data of 66prospectively recruited CI patients (21SSD/45AHL) was performed. In addition to the hearing outcome, tinnitus distress (tinnitus questionnaire), health-related quality of life (Nijmegen Cochlear Implant Questionnaire, NCIQ), stress (Perceived Stress Questionnaire, PSQ), and psychological comorbidities (General Depression Scale, ADS‑L and Generalized Anxiety Disorder scale, GAD-7) were assessed in SSD and AHL patients pre- and postoperatively. Preoperatively, SSD patients showed significantly higher scores in the NCIQ subdomains "elementary" and "advanced sound perception" than the AHL group. Stress (PSQ) and anxiety symptoms (GAD-7) were significantly higher preoperatively in SSD patients than in AHL patients. After CI, these differences were strongly reduced, with minimal differences being detectable between the groups in the investigated domains postoperatively. SSD and AHL patients differ significantly preoperatively in terms of their subjective hearing assessment and psychosocial parameters. In SSD patients, psychological stress factors may have astronger impact on the quality of life than in AHL patients. These aspects should be taken into account in the preoperative counseling and postoperative rehabilitation.

Characteristics and Correlation Analysis of Negative Emotions, Quality of Life, and Chinese Medicine Syndromes in Patients with Lung Cancer after Surgery

Objective: The objective of the study was to observe and analyze the characteristics of negative emotions and quality of life (QoL) in patients with nonsmall cell lung cancer (NSCLC) from 1 to 3 months after surgery, and summarize their population characteristics after surgery. Materials and Methods: The consolidation rehabilitation period was defined as 1 to 3 months after surgery. The main observation indicators were the general Hospital Anxiety and Depression Scale, the European Organization for the Research and Treatment of Cancer Core QoL Questionnaire (EORTC QLQ-C30), and EORTC QLQ-Lung Cancer-13. The secondary observation indicators were peripheral blood cytokines and immune function indicators. Statistical methods such as one-way analysis of variance and logistic regression were used to analyze the characteristics of this part of the population. Results: Among patients who underwent lung surgery, the overall incidence of anxiety during consolidation recovery was 13.66%, and that of depression was 10.38%. The scores of fatigue, pain, dyspnea, insomnia, and loss of appetite were significantly higher than those of other symptoms (P = 0.000). The presence of anxiety was associated with the site of surgery (P &lt; 0.05) and the presence of depression was associated with emotional functioning and dyspnea (P &lt; 0.05). Conclusions: The occurrence of negative emotions in the postoperative NSCLC population is related to gender, and the degree of emotions is negatively correlated with QoL and positively correlated with the degree of symptoms. The main relevant syndromes are the pulmonary and meridian categories.

Effect of Nurse-Led Individualised Self-Care Model on Myocardial Infarction Patients with Diabetes: A Randomised Controlled Pilot Trial.

To assess the effectiveness of the nurse-led individualised self-care model on myocardial infarction (MI) patients with diabetes. A total of 120 MI patients were enrolled from May 2020 to December 2021. The intervention group received the nurse-led individualised self-care model (n = 60), whereas the control group only received routine health education (n = 60). The Myocardial Infarction Dimensional Assessment Scale (MIDAS), Coronary Heart Disease Self-Management Behavior Scale (CSMS), Self-Rated Abilities for Health Practices (SRAHP) scale, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), blood glucose and nursing satisfaction in both groups were observed and recorded. The six MIDAS subscales except for insecurity, and all dimensions of the CSMS, SRAHP, GSES and HADS scores, of the intervention group were significantly improved compared to those of the control group (p 0.05). Compared with the control group (5.69 1.43 mmol/L), the intervention group showed a decrease in the serum levels of fasting blood glucose (4.83 1.57 mmol/L; p 0.01). Our pilot study provides preliminary evidence supporting the feasibility of implementing nurse-led individualised self-care, suggesting its preliminary effects in improving health-related quality of life, self-care ability, health behaviours, self-efficacy, social support and nursing satisfaction among MI patients with diabetes. However, considering the unblinded and pilot nature of this study, these positive results should be interpreted with caution. OSF Registration number: DOI 10.17605/OSF.IO/DVW95 (https://archive.org/details/osf-registrations-dvw95-v1).

Prevalence of Psychiatric Morbidity Among Victims of Terrorist Attacks: Comparative Study

To evaluate the occurrence of psychiatric morbidity Posttraumatic Stress Disorder (PTSD); mood state; (state of depression, anxiety, stress) and its effect on general health among victims of terrorist attacks (mild injuries, severe injuries &amp; amputation) in Peshawar, Khyber Pakhtunkhwa. Current study was a cross-sectional correlational research applied on three groups of admitted patients; who were injured during attacks (with mild injuries, severe injuries &amp; severe injuries along with amputation), the data were collected after one week of attack during from the patients who had direct exposure to terrorist attacks and sought treatment from Combined Military Hospital, Peshawar, Pakistan, during the period of November 2021 to September 2022. Sample included all the survivors who sought medical assistance from the hospital. The instruments comprised upon Impact of Event Scale Revised (IES-R 22), General Health Questionnaire (GHQ-12), and Depression, Anxiety and Stress Scale (DASS-21). PTSD has positive association with Depression, Anxiety and Stress but negative association with General Health Questionnaire among terrorists’ attack victims. The terrorist attack victims had significantly higher psychiatric morbidity than non-exposed participants. Psychiatric morbidity was found highest in the victims of survivors of bomb blasts.

Decompression with or without fusion in degenerative adjacent segment stenosis after lumbar fusions

Adjacent segment stenosis can occur after lumbar fusion surgery, leading to significant discomfort and pain. If further surgeries are required, the choice of the operative technique is an individual decision. In patients without over instability, it is still uncertain whether patients with adjacent spinal stenosis should be treated like primary lumbar spinal stenosis via decompressive surgery alone or with decompression and fusion. This is a retrospective analysis with prospective collected data. We included patients with adjacent segment stenosis after lumbar fusion. Patients with spinal deformity and/or obvious instability and/or significant neuroforaminal stenosis were excluded. All patients were divided into two groups according to the surgical technique that has been used: (a) treated via microsurgical decompression (MDG), (b) decompression and fusion of the adjacent segment (FG). Treatment decision was at discretion of the surgeon. Primary outcome was the need for further lumbar surgery after 1 year. In addition, patient reported outcome was measured via numerical rating scale (NRS), SF-36, Oswestry disability Index (ODI), Pittsburgh Sleep Quality Index (PSQI), and General Depression Scale before and after 1 year after surgery. In a further follow-up, need for additional lumbar surgery was redetermined. Total study population was 37 patients with a median age of 72 years. A total of 86.1% of patients suffered from a proximal adjacent segment stenosis and most common level was L3/4 (51.4%). A total of 61.1% of included patients developed adjacent segment stenosis after fusion of one single lumbar segment. Eighteen patients were included in MDG and 19 patients in FG. Both groups benefited from surgical interventions and there was no significant difference concerning pain, pain associated disability, sleeping, life quality, and mood after 1 year or the need of follow-up surgeries 1 year after primary fusion (5 in MDG vs. 5 in FG, p = 0.92) and at the second follow-up with a median time after surgery of 30 months (6 in MDG vs. 7 in FG, p = 0.823). Duration of surgery and hospital stay was significant shorter in MDG. There was no difference concerning operative complications rate. Both groups improved significantly in pain associated disability index, pain in motion, and concerning the sleeping quality. The present study indicates that decompression may not be inferior to decompression and fusion in patients suffering from degenerative adjacent segment stenosis without obvious signs of instability, deformation, and neuroforaminal stenosis after lumbar fusion in short-term follow-up. Due to significant shorter time of surgery, a pure microsurgical decompression may be a sufficient alternative to a decompression and fusion, particular regarding old age of this patient cohort.

Effectiveness of therapeutic ultrasound for the treatment of carpal tunnel syndrome (the USTINCTS trial): study protocol for a three-arm, prospective, multicentre, randomised controlled trial

IntroductionThere has no consensus on optimal management of carpal tunnel syndrome (CTS), the most common compression neuropathy. Conservative therapy is generally accepted as first-line intervention. Therapeutic ultrasound has been widely...

Efficacy of ultrasound therapy for the treatment of lateral elbow tendinopathy (the UCICLET Trial): study protocol for a three-arm, prospective, multicentre, randomised controlled trial

IntroductionLateral elbow tendinopathy (LET) is a highly prevalent disease among the middle-aged population, with no consensus on optimal management. Non-operative treatment is generally accepted as the first-line intervention. Ultrasound (US)...

The role of inflammation on the association between apathy and motoric‐cognitive outcomes

AbstractBackgroundRecent literature indicates that apathy is associated with poor cognitive outcomes in community dwelling older adults, including motoric cognitive risk syndrome (MCR), a predementia syndrome defined by subjective cognitive complaints and slow gait. The role of biological markers in the association between apathy and motoric‐cognitive outcomes has not been established. The objectives of this study were to 1) examine the association between inflammation and apathy and 2) to evaluate the moderating effect of inflammation on the association between apathy and motoric‐cognitive outcomes.MethodWe measured apathy in 347 community dwelling older adults enrolled in the Central Control of Mobility in Aging study using an apathy scale score derived from confirmatory factory analysis of the Geriatric Depression Scale Long Form. We conducted cross‐sectional analyses of the following: the association between IL‐6 and CRP with apathy and the moderating effect of IL‐6 on the association between apathy and MCR and slow gait, using logistic regression and linear regression models, respectively. Linear associations were reported using β‐coefficients, while logistic associations were reported using odds ratio (OR) with 95% confidence intervals (CI), adjusting for age, gender, general health status and depression scale score.ResultlogIL‐6 but not logCRP was associated with apathy, in adjusted models (β=.037, 95% CI: .002‐.072, p=.04). Apathy was not significantly associated with MCR at cross‐section (OR: 0.48, 95% CI: .08‐2.97, p=.43), but apathy was significantly associated with gait velocity (β=‐14.45, 95% CI: ‐24.89 ‐ 4.01, p=.01). IL‐6 was associated with gait velocity (β=‐4.48, 95% CI: ‐7.42 ‐ 1.53, p=.003) and moderated the association between apathy and gait velocity by a change in β of 14.5%.ConclusionWe found that IL‐6, but not CRP was associated with apathy in a cohort of community dwelling older adults. Furthermore, IL‐6 moderated the association between apathy and gait velocity, a risk factor for dementia. Apathy was not associated with MCR at cross‐section, despite being associated with incident MCR in prior studies, suggesting that apathy is an early predictor of motoric‐cognitive decline.

COVID-19 pandemic-prevalence of depression, anxiety and insomnia during COVID-19 lockdown and its associated factors in Karachi, Pakistan

We aimed to determine the frequency of depression, anxiety and insomnia; identify associated factors; and compare these outcomes amongst a privileged and underprivileged class of Pakistan. A cross-sectional online and face to face survey was conducted in Karachi from April 2020 to May 2020. Validated depression (World Health Organization self-reporting questionnaire), anxiety (general anxiety and depression scale) and insomnia (insomnia severity index) scales were used. Out of 447 participants, the majority were less than 30 years (63.8%) and females (57.7%); 20.8% study participants belonged to poor or very poor socioeconomic status; 17% respondents were from lower middle status and 38% belonged to the higher middle or rich class. Depression, anxiety and insomnia were identified in 30%, 30.63% and 8.5% of participants, respectively. The prevalence of depression, anxiety and insomnia among privileged people was 37.8%, 16.6% and 11.3% respectively whereas among underprivileged were 17.8%, 16.6% and 4.1% respectively. There were significant differences in frequencies of depression (p<0.001), anxiety (p<0.001) and insomnia (p=0.009) among the privileged and underprivileged classes. We found a high prevalence of depression, anxiety and insomnia among both the privileged and underprivileged Pakistani population and a policy needs to be devised to ensure the mental health of Pakistani population.

Evidence on the Conceptual Distinctness of Normal Grief From Depression

Abstract. Background: The distinctness of grief from depression has been the subject of a long scholarly debate, even influencing definitions of diagnostic criteria. Aims: This study aims at clarifying the issue by a multifaceted analysis of data from a large German sample. Method: A community sample of 406 bereaved persons answered the Wuerzburg Grief Inventory (WGI), a multidimensional grief questionnaire designed to measure normal grief in the German language, and the General Depression Scale – Short Version (GDS-S), a self-report depression scale. Data were analyzed by factor analysis to identify structural (dis-)similarities of the constructs, and analysis of variance (ANOVA) to identify the influence of the factors relationship to the deceased, type of death, and time since loss on grief measures and depression scores. Results: Factor analysis clustered items referring to grief-related impairments and depression into one factor, items referring to other dimensions of grief on separate factors, however. Relationship to the deceased influenced the grief measures impairments and nearness to the deceased, but not depression scores if controlled for impairments. Type of death showed specific effects on grief scores, but not on depression scores. Time since loss influenced grief scores, but not depression scores. Limitations: The analysis is based on a self-selected community sample of grieving persons, self-report measures, and in part, on cross-sectional data. Conclusion: Factor analysis and objective data show a clear distinction of dimensions of grief and depression. The human experience of grief contains a sense of nearness to the lost person, feelings of guilt, and positive aspects of the loss experience in addition to components resembling depression.

The mediating and moderating roles of resilience in the relationship between anxiety, depression, and post-traumatic growth among breast cancer patients based on structural equation modeling: An observational study.

This study aimed to analyze the moderation and moderation effects of resilience on the anxiety, depression impact on post-traumatic growth (PTG) among breast cancer patients undergoing chemotherapy based on structural equation modeling, and confirmed whether resilience was a mediating and regulating variable between anxiety, depression, and post-traumatic growth. In addition, whether anxiety and depression have different effects on PTG under different levels of psychological resilience.This cross-sectional study was conducted from November 2017 to January 2019, with subjects of 260 breast cancer patients undergoing chemotherapy in the department of breast and general surgery of a tertiary general hospital in Shanxi Province of China.Data were collected according to the General Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale, and the posttraumatic growth inventory. Estimated values of model path coefficients and significance test were performed to confirm the mediation effect. Hierarchical regression and simple slope test were used to analyze the regulation effect.Resilience showed significant correlations with anxiety, depression and PTG (all P < .01). Estimated values of model path coefficients and significance test results indicated that the mediating role of resilience was remarkable and it could regulate anxiety, depression, and PTG.The anxiety, depression and resilience affected their PTG of breast cancer patients during chemotherapy, suggesting the need to establish a cooperative mechanism based on the concept of multidisciplinary collaboration. Professional psychological intervention should be used to reduce anxiety and depression and to explore the potential of resilience to promote their PTG.