Higher Depression Scores Research Articles

Relationship of anxiety and depression with smoking cessation treatments: a follow-up study

ABSTRACT Background Smoking is known to be closely associated with a stress levels and anxiety. In this study, the effects of smoking cessation treatments were investigated on anxiety/depression. Methods Socio-demographic characteristics The Fagerström/Test/Nicotine/Dependence, the Hospital Anxiety and Depression (HAD) scale were applied at first time. The first group received “varenicline+counseling,” second group “bupropion+counseling,” and third group “counseling only.” The HAD scores were recorded in quit smokers. Anxiety and depression scores were compared between groups and between smokers and ex-smokers in the first and sixth month. Results Firstly, The HAD scores revealed that anxiety was present in 46.8%, depression in 11.2%, anxiety and/or depression in 48.9%. A significant decrease in both anxiety and depression scores was observed in quit smokers at 6 months (47.9% and 37.4%, respectively) (p < .001). At the sixth month, there was a significant decrease in anxiety scores in the varenicline and bupropion groups. In addition, a significant decrease in the depression score was observed in the varenicline group. In the bupropion group, the smoking cessation rate was higher in those with high anxiety and/or depression scores (66.7%). Conclusions Varenicline decreased anxiety/or depression scores in both smokers and quit smokers, whereas quit smoking rate increased in those with anxiety/depression in the bupropion.

Sex differences in the risk of excessive daytime sleepiness in mild and moderate ischaemic stroke patients: a retrospective database study

BackgroundExcessive daytime sleepiness (EDS) is a common complication of stroke that has a detrimental effect on patients’ daily life and functional recovery. The clinical characteristics and risk factors for poststroke EDS may differ between males and females.MethodsA retrospective study based on hospital medical records was conducted on patients with a diagnosis of stroke who participated in polysomnographic monitoring at the Affiliated Hospital of Yangzhou University from February 2022 to May 2024. Baseline data, laboratory test data, polysomnographic data, and related scale scores were retrospectively collected. The Epworth Sleepiness Scale (ESS) score was used to assess EDS after stroke. Binary logistic regression was used to determine the risk factors for daytime sleepiness. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Statistical analysis was performed via IBM SPSS 26.0.ResultsESS scores were higher in males than in females, whereas females had higher Pittsburgh Sleep Quality Index (PSQI) scores and Hospital Anxiety and Depression Scale (HADS) scores. Male sex and higher depression scores were risk factors for EDS; among male patients, higher anxiety scores were a risk factor for EDS, whereas smoking was a protective factor. Depression, a higher arousal index and a reduced proportion of N3 sleep periods were risk factors for EDS in females.ConclusionsThe characteristics and influencing factors of EDS differ between the sexes in patients with mild and moderate ischaemic stroke. Our study may provide evidence and guidance for clinical diagnosis and treatment. Interventional studies are needed to assess the impact of treating these risk factors in the future.

Gender differences in the association between inter-generational interaction and depressive symptoms among Chinese older adults

BackgroundInter-generational interaction is a carrier of Chinese traditional culture, and it can exert important influence on the depressive symptoms on Chinese older adults. The study aims to analyze gender differences in the association between inter-generational interaction and depressive symptoms among Chinese older adults and explore factors contributing to the differences.MethodData from China Family Panel Studies in 2020 were used. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. The latent class analysis was applied to identify patterns of inter-generational interaction of older adults (aged 60 and above). Before the comparison between older man and older woman, we used Coarsened Exact Matching to control confounding factors and improve causal inferences. Multiple linear regression was conducted to explore the association between inter-generational interaction and depression symptoms. Oaxaca-blinder decomposition method was used to analyze the gender difference and the sources.ResultOur study identified three types of inter-generational interaction: detached, nearby but discordant and two-way tight-knit. Analysis indicated that most of older man (54.39%) and older woman (49.78%) were in the type of nearby but discordant. Older man and older woman who in detached type had higher depression scores than other types, and the depression score of two-way tight-knit type accounted for 12.42 and 13.77 respectively. Our findings demonstrated that two-way tight-knit type (-11.89%) significantly decreased the gender differences in the depression symptoms. Other major contributors also included living without spouse (20.56%), primary school and junior middle school (15.95%), higher middle school and above (9.50%) and no illness for two weeks (47.70%).ConclusionOur study highlighted three patterns of inter-generational interaction, and most of older man and older woman were in the pattern of nearby but discordant. In addition, the two-way tight-knit pattern significantly can decrease gender differences in depression symptoms. The contributors should be taken into account in more targeted intervention strategies for narrowing gender differences in the depression symptoms, which could achieve a gender dividend in the era of China's aging population.

The supervisory relationship as a predictor of mental health outcomes in doctoral students in the United Kingdom.

The process of a doctorate degree has been implicated in the onset and exacerbation of mental health problems among doctoral students. Previous studies have suggested that the student-supervisor relationship may predict emotional wellbeing and mental health outcomes in doctoral students in the UK. However, these studies were conducted before the COVID-19 pandemic and often used unstandardized measures to investigate supervisory styles. The present study was part of the Better Together project, a wellbeing initiative for doctoral students in the UK. It explored the predictive ability of aspects of the student-supervisor relationship with regards to doctoral students' mental health outcomes. The sample consisted of 141 students doing a research-based doctorate degree in the UK. The survey included demographic questions and questionnaires assessing supervisory styles, the discrepancy between actual and preferred supervisory relationship, depression, anxiety, and stress. A large proportion of participants fell in the severe and extremely severe categories in the depression, anxiety, and stress sub-scales. Multiple regression analyses indicated that both supervisory styles and discrepancy significantly predicted students' mental health outcomes. More specifically, higher scores in the uncertain supervisory style, which is characterized by indecisiveness and ambiguity, were linked with higher scores in depression, anxiety, and stress. The findings provided new insights concerning the aspects of the student-supervisor relationship that are related to the mental health issues of doctoral students in the UK. They have important implications for future research and supervision practice.

Post-COVID-19 condition-Clinical phenotyping in practice

The high number and clinical heterogeneity of neurological impairments in patients with apost-COVID-19 condition (PCC) poses achallenge for outpatient care. Our aim was to evaluate the applicability of the proposed subtypes according to the guidelines "Long/Post-COVID" (30 May 2024) and their phenotyping using clinical and neuropsychological findings from our post-COVID outpatient clinic. The evaluation was based on cross-sectional neurological and psychological test examinations of the patients, which were carried out using standardized questionnaires and test batteries. In addition, adetailed anamnesis of the current symptoms and aretrospective survey of the acute symptoms up to 4 weeks after the confirmed infection was conducted. The subtypes were classified according to the abovementioned guidelines based on the medical history and selected patient questionnaires, to which we added a5th subtype with reference to the previous guidelines "Long/Post-COVID" (as of 5 March 2023). Atotal of 157 patients were included between August 2020 and March 2022. The presentation was at a median of 9.4months (interquartile range, IQR = 5.3) after infection, with amean age of 49.9 years (IQR = 17.2) and more women (68%) presenting, with atotal hospitalization rate of 26%. Subtype1 (postintensive care syndrome) showed the highest proportion of men, highest body mass index (BMI) scores and the highest rates of subjective complaints of word-finding difficulties (70%). Subtype2 (secondary diseases) was dominated by cognitive impairment and had the highest depression scores. Subtype3 (fatigue and exercise-induced insufficiency) was the most common, had the most symptoms and most severe subjective fatigue and the largest proportion of women. Subtype4 (exacerbation) mainly showed affective symptoms. Subtype5 (complaints without relevance to everyday life) had the lowest scores for depression, fatigue and BMI. Neurological and psychological conditions were frequently pre-existing in all groups. The management of PCC can be improved at various levels. Astandardized subtype classification enables early individually tailored treatment concepts. Patients at risk should be identified at the primary care level and informed about risk factors and prevention strategies. Regular monitoring of cardiovascular risk factors and physical activity are essential for PCC treatment. In the case of cognitive deficits and concurrent affective symptoms, psychotherapeutic support and drug treatment with selective serotonin reuptake inhibitors (SSRI) should be provided at an early stage.

Association Between Level of Pain and Depression Among Chronically Ill Older Adults in Rural Alabama: A Pilot Study

There is a paucity of research on pain and depression among older adults in rural communities. To address such a gap, this study examined the association between pain and depression among older rural-community-dwelling adults. Recruited from rural senior centers, 100 chronically ill older adults (age 55 or older) experiencing pain completed a cross-sectional survey. Data were collected on their level of depression (a five-item version of the Center for Epidemiologic Studies Depression scale), pain (the six-item Philadelphia Geriatric Center Pain scale), and sociodemographic factors. A multiple linear regression was conducted. With sociodemographic variables controlled, those reporting higher pain scores were significantly more likely to have higher depression scores (p &lt; .05). Older participants had lower depression scores than younger participants (p &lt; .05). In view of poorer health outcomes and limited health care access in rural areas, our findings warrant interventions to promote better access to pain management and mental health services for rural older adults.

Coping style and psychopathological morbidity in patients with advanced melanoma: differences between cancer therapy, metastatic location and staging.

The incidence of melanoma has been steadily increasing in recent years and remains one of the most frequent cancers in adolescents and young adults. The literature shows how a high percentage of melanoma patients present with high anxiety and depression scores and a correlation between worsening quality of life and impaired body image has been shown. The present study aimed to investigate the relationship between cutaneous and visceral metastasis in a group of 73 patients with advanced melanoma in relation to body image, anxiety, depression, and coping style. Hospital Anxiety and Depression Scale, Body Image Scale and Mini-Mac questionnaires were administered to a sample of 73 subjects with advanced melanoma (stage III and IV); Analyses were performed with SPSS version 28.01 and a P value <0.05 was considered significant. Emerging results indicated greater body image impairment in patients with skin metastasis, no significant difference in anxiety and depression by staging. Patients receiving target therapy showed a reduction in anxiety and depression compared with patients receiving immunotherapy. In line with the literature, cutaneous metastatic involvement negatively affected body image, a prevalence rate of anxiety and depression of 28,8% and 19.2%, respectively, emerged in the sample, while 17.8% reported significant body image impairment, suggesting how melanoma impacts in patient's quality of life.

Sex Differences in Indicators of Mental and Cardiovascular Health in Cannabis-Using Undergraduates

This study investigated sex differences in indicators of mental health (anxiety, depression) and cardiovascular health (e.g., physical activity levels, heart rate, VO2 max) in a sample of cannabis-using undergraduates. The sample included 209 participants (65% female) who completed two daily diaries for 14 days on their mobile devices; half of whom ( n = 100) also wore a Fitbit Charge 4. Females (vs. males) reported significantly more psychological distress at baseline; greater use of cannabis to cope with symptoms of both physical and mental ill-health; and more risks to cardiovascular health. Discriminant function analysis revealed that the variables that significantly distinguished females from males were: 1. Lower VO2 max percentile; 2. Fewer “moderate-to-very active” minutes of physical activity; 3. Higher depression scores plus poorer perceptions of mental health and physical health. Findings from this study suggest that female emerging adults who use cannabis regularly may be uniquely vulnerable to cannabis-related risks.

Impact of dry eye disease on psychological symptoms among Chinese doctoral students studying abroad.

This study aimed to evaluate the impact of dry eye disease (DED) on depression, anxiety, and stress among Chinese doctoral students studying abroad. This is a cross-sectional study. This study enrolled 185 Chinese doctoral students pursuing education in the Philippines. DED was assessed using the Ocular Surface Disease Index, while psychological symptoms were evaluated using the abbreviated version of the Depression, Anxiety, and Stress Scale-21 questionnaire. A survey encompassing demographic information, potential DED risk factors, and individual habits was also administered. Of the 185 students, 129 completed the survey, of which 40 (31.0%) were male and 89 (69.0%) were female. The average age was 36.3 ± 7.0 (mean ± SD; range, 22-57) years. The prevalence of DED, depression, anxiety, and stress was 73.6% (95/129), 43.4% (56/129), 50.4% (65/129), and 22.5% (29/129), respectively. Univariate analysis revealed that aging (P < .001), prolonged visual display terminal (VDT) use (P = .004), extended paperwork time (P < .001), higher depression score (P = .006), higher anxiety score (P < .001), and higher stress score (P < .001) were associated with increased influence of DED. After adjusting for age, duration of VDT use, duration of paperwork, and depression score, age (P = .030) had significant association with DED. Additionally, after adjusting for age, duration of VDT use, duration of paperwork, and anxiety score, age (P = .026) and anxiety score (P = .047) were significantly associated with DED. Moreover, after adjusting for age, duration of VDT use, duration of paperwork, and stress score, age (P = .035) and stress score (P = .028) showed significant associations with DED. In the multivariate analysis of variance, there was a significant impact of DED severity classification on psychological distress (V = 0.19, F(9, 375) = 2.83, P = .003). Univariate analysis of variances indicated that DED severity had a significant impact on anxiety F(3, 125) = 6.06, P = .001 and stress F(3, 125) = 3.00, P = .033. A higher influence of DED was related to stress and anxiety. Anxiety and stress levels increase with the severity of DED.

Youths with extreme obesity: A high-risk group for pain and mental health impairments.

Youths with extreme obesity (Body mass index (BMI)&gt;40) are at increased risk for physical and mental health impairments but this patient group has received little attention in research. This study aimed to analyze the pain experience and mental health impairments of youths with extreme obesity compared to those with mild and moderate obesity (BMI=30-39.9) by considering gender differences. Cross-sectional data of 431 youths (M=16.6; SD=2.3; 53.1% female) were analyzed. Of these, 159 (36.8%) youths were characterized by extreme obesity. Self-reported sociodemographic data, pain-related variables, depression, and health-related quality of life (HRQoL) were assessed with standardized questionnaires. Data were analyzed with univariate tests and logistic regression models. Youths with extreme obesity reported more pain in the last 4 weeks (p=.018), increased pain-related impairments in daily life (p=.009), more pain-related days of absence (p=.030), higher depression scores (p = .030), and reduced HRQoL (p=.005) compared to youths with mild and moderate obesity. In regression models, extreme obesity and pain in the last 4 weeks were associated when additionally including sex and age in the model (odds ratio 1.88; 95 % confidence interval 1.16 - 30.40, p=.010). In the subgroup of extreme obesity (n=159), women (n=83) reported more pain in the last 4 weeks (p=.001), higher depression scores (p&lt;.001), and lower HRQoL (p&lt;.001) compared to men (n=76). These findings underpin the need for standardized assessments of pain and mental health, especially in the treatment of female youths with extreme obesity. Upcoming studies may analyze reciprocal interactions since both aspects are important barriers for lifestyle changes and weight loss.

The role of affective control, strategy repertoire and subjective emotion regulation success in developmental internalising psychopathology

Adolescence poses significant challenges for emotion regulation (ER) and is thus a critical phase in the emergence of various mental disorders, specifically internalising disorders such as anxiety and depression. Affective control, defined as the application of cognitive control in affective contexts, is crucial for effective ER. However, the relationship between ER and affective control is unclear. This study examined the predictive role of ER strategies and difficulties in affective control, measured as the congruency effect and error rate on an Emotional Stroop task (EST), in a sample of adolescents and young adults (aged 14–21, M = 17.28, 22% male). It was hypothesised that participants with internalising disorders would show higher congruency effects and error rates on the EST than healthy controls after a psychosocial stress induction, indicating lower affective control. Surprisingly, our findings revealed no significant differences in these measures between the groups. However, higher depression scores were associated with increased EST errors. While ER strategies and difficulties did not predict affective control, exploratory analyses unveiled associations between depression scores and ER strategy repertoire, perceived ER success and the ER strategy Acceptance. These findings underscore the importance of implicit ER facets, particularly perceived ER success and flexibility to change between applied strategies for adolescents and young adults with elevated depressive symptoms.

Religious Affiliation, Internalized Homonegativity and Depressive Symptoms: Unveiling Mental Health Inequalities among Brazilian Gay Men.

Different religious narratives associate same-sex sexuality, in its various manifestations, with moral deviation or sin. Gay men who are socialized in more religious communities appear to experience and internalize greater levels of homonegativity, as well as to present greater indicators of depressive symptoms. The purpose of this study was to evaluate indicators of perceived homonegativity in the community and internalized, and signs/symptoms of depression reported by Brazilian gay men with a nominal religion and compare them to those reported by Atheists or Agnostics. Our sample comprised 194 Brazilian gay men, distributed into three groups: Christians (Protestants and Catholics, n = 71; 36.6%); Spiritualists (Kardecists or religions of African origin, n = 52; 26.8%) and Atheists or Agnostics (n = 71; 36.6%). The following measurement instruments were used: sociodemographic questionnaire, Internalized Homophobia Scale and Beck Depression Scale. High mean scores of depression were verified in all groups, and 60% of the sample presented some level of depression. There was a higher level of self-reported homonegativity among Christians and Spiritualists compared to that reported by Atheists or Agnostics, with the differences between the groups being significant. The regression analysis indicated a significant effect of religion on homonegativity, but not on depression. Our results suggest that gay men's chronic exposure to non-affirming religious affiliation contexts may harm the construction of a positive gay identity and should be taken into consideration when addressing mental health inequalities of sexual minorities.

The Impact of Depression on Adherence to Diabetes Self-Management Behaviors in Breast Cancer Survivors.

Breast cancer survivors (BCS) have higher rates of depression which is associated with lower adherence to medications, diet, and physical activity. Managing diabetes (DM) requires adherence to several of these self-management behaviors (SMB), and BCS have an increased risk of DM. We investigated whether depressive symptoms were associated with adherence to DM SMB in a cohort of BCS. BCS with DM were surveyed semiannually for 2years. Depression was assessed with the Hospital Anxiety and Depression Scale (HADS). Adherence to DM medication, diet, and physical activity was self-reported using the Medication Adherence Report Scale (MARS), Summary of Diabetes Self-Care Activities Assessment (SDSCA), and International Physical Activity Questionnaire (IPAQ), respectively. Using generalized linear equation modeling, the association of depressive symptoms with nonadherence to SMB was assessed, adjusting for age, race, marital status, education level, and beliefs about cancer and DM risk. Among 244 BCS with DM, those who were nonadherent to medication, diet, and/or physical activity had higher depression scores (p<0.01). In adjusted analyses, higher depression scores were independently associated with dietary (OR=1.16, p<0.001) and physical activity nonadherence (OR=1.18, p<0.001) but not with medication nonadherence. Concerns about medications was independently associated with medication nonadherence (OR=1.17, p=0.024). Higher depression scores are associated with nonadherence to DM SMB in this cohort of BCS. These findings highlight the importance of addressing depressive symptoms in BCS to help improve adherence to DM medications, diet, and physical activity.

Physical activity and depression during the COVID-19 pandemic in Australia: A twin study

Background and aimsLow levels of physical activity (PA) have been associated with depression. However, shared familial (genetic and environmental) factors might confound this association, given PA and depression tend to cluster in families. We investigated the association between levels of PA and depression symptoms during the COVID-19 pandemic, and then controlled for shared familial factors by design, and assessed if being in lockdown modified this association. MethodsWe applied within-individual and within-pair regression models to questionnaire data from adult same-sex twin pair members of Twins Research Australia collected between August and November 2020. Depression score was measured using the Depression, Anxiety and Stress Scale (DASS-21), and PA levels and changes since the onset of the pandemic were self-reported. Adjusted models included body-mass-index, sleep adequacy, smoking, and alcohol consumption. ResultsThe sample of 1148 twins was predominantly female (80%) and had a mean age of 52.5 (Standard Deviation = 15.7). Reduced PA was associated with higher depression scores (β = 1.22, 95% Confidence Interval: 0.70–1.73, P < 0.001) in the adjusted within-individual model, but evidence of a within-pair association was weak. Lockdown status was an effect modifier (P = 0.006); relative to the co-twin, increased PA was associated with lower depression scores for those not in lockdown but higher scores for those in lockdown. ConclusionShared familial factors play a role in the association between PA and depression. Health interventions and educational campaigns for families rather than just individuals might be better suited to improve mental health outcomes, especially when opportunities for PA and exercise are limited.

Screening for depression in patients with epilepsy: What are the benefits for physicians and patients in the real-life setting.

Screening for depression in people with epilepsy (PWE) is highly recommended in order to avoid underdiagnosis, misdiagnosis, or delayed diagnosis of this highly impacting comorbidity. Here we evaluated the impact of reporting and suggesting depression via the Beck Depression Inventory (BDI) on medical decision-making, and thereby the value of a depression screening for good medical practice. Of 445 BDI data sets, PWE with scores indicating moderate (BDI 19-29) to severe depressive disorder (BDI >29) were extracted and clinical reports were retrospectively reviewed regarding decisions on antidepressants, anti-seizure medications (ASMs), and non-pharmaceutical interventions. Sixty-four PWE (14%; 56% female; mean age 39.7 years) showed elevated BDI scores, with 40 (63%) categorized as moderate depression and 24 (37%) as severe depression. Thirty-nine percent of PWE already had a pre-existing diagnosis of depression and 53% left the clinic with the diagnosis of depression, half of them with antidepressants. High depression scores were associated with any intervention in 53%, interventions with potentially mood affecting ASM in 19%, treatment with antidepressants in 11%, and non-pharmaceutical interventions in 41%. Non-pharmaceutical interventions were related to BDI scores. Changes of potentially mood-affecting ASMs were more frequent in PWE with moderate scores, and introduction of antidepressants appeared as a trend related to higher depression scores. The finding of an only weak relation between high depression scores, diagnoses of depression, and treatment consequences questions the diagnosis and treatment pathway and the clinical value of the BDI screening in PWE. Prospective standard procedures need to be established for depression diagnosis and treatment including follow-up evaluations of the validity of the diagnosis and effectiveness of the decisions taken.

The association between abdominal obesity and depressive symptoms among Chinese adults: Evidence from national and regional communities

BackgroundThe association between body shape and depressive symptoms has been reported in adults. The present study aimed to investigate the association between body shape-specific abdominal obesity and depressive symptoms among multi-regional Asian adults. MethodsThe 2011–2012 China Health and Retirement Longitudinal Study and 2022–2023 Hangzhou study were used as the discovery and validation datasets, respectively. Body shape was assessed by body mass index categories. Abdominal obesity was defined as a body shape index (ABSI) ≥ 75th centile. Depression was measured using 10-item Centre for Epidemiological Studies Depression Scale and Geriatric Depression Scale short 15-item version, respectively. General linear and multinomial logistic models were used to explore the association of ABSI, abdominal obesity with depressive scores and presence, respectively. ResultsA total of 12,229 and 1210 participants were included in the discovery and validation datasets, respectively. A non-linear reverse L-shaped association was found between ABSI and depressive scores. Participants with abdominal obesity had higher depressive scores (β = 0.05, 95%CI = 0.01–0.09; and β = 0.13, 95%CI = 0.01–0.24; respectively). Stratified analyses showed that abdominal obesity was associated with higher depressive scores (β = 0.09, 95%CI = 0.00–0.17; and β = 0.25, 95%CI = 0.05–0.46; respectively) and presence (OR = 1.46, 95%CI = 1.02–2.10; and OR = 3.95, 95%CI = 1.58–9.84; respectively) in overweight adults. Furthermore, abdominal obesity was associated with depressive symptoms among overweight females, but not among males. LimitationCausal links weren't addressed because of the observational study design. ConclusionAbdominal obesity exhibited a positive association with depressive symptoms among Asian overweight adults, particularly in females. Prevention and early diagnosis of depressive symptoms should focus on overweight females.

The Impact of Misaligned Perceived and Objective Fall Risk in Cognitively Impaired Older People.

Cognitive impairment (CI) may impair the ability to accurately perceive physical capacity and fall risk. We investigated perceived (measured as concern about falls) and physiological fall risk in community-dwelling older people with CI, the characteristics of the aligned and misaligned groups and the impact of misaligned perceptions on falls. Participants (n= 293) with mild-moderate CI were classified into four groups based on validated physiological and perceived fall risk assessments: 1) vigorous: low perceived and physiological fall risk; 2) anxious: high perceived and low physiological fall risk; 3) unaware: low perceived and high physiological fall risk; and 4) aware: high perceived and physiological fall risk. Groups were compared with respect to neuropsychological and physical function, activity and quality of life measures, and prospective falls (12-months). The anxious (IRR = 1.70, 95% CI = 1.02-2.84), unaware (IRR = 2.00, 95% CI = 1.22-3.26), and aware (IRR = 2.53, 95% CI = 1.67-3.84) groups had significantly higher fall rates than the vigorous group but fall rates did not significantly differ among these groups. Compared with the vigorous group: the anxious group had higher depression scores and reduced mobility and quality of life; the unaware group had poorer global cognition, executive function and mobility and lower physical activity levels; and the aware group had an increased prevalence of multiple physical and cognitive fall risk factors. Fall rates were increased in participants who had increased perceived and/or physiological fall risk. Contrasting fall risk patterns were evident in those who under- and over-estimated their fall risk. Understanding these characteristics will help guide fall risk assessment and prevention strategies in community-dwelling older people with CI.

Which Patients With Chronic Pain Do The Primary Care Refers to a Tertiary Hospital in a Developing Country? Experience From a University Hospital

PurposeThe study aimed to profile patients with uncontrolled chronic pain referred from primary care to a tertiary hospital in a developing country, and identify factors associated with pain intensity, interference, and its link with mental health. DesignCross-sectional design. MethodsData from 906 adult patients with nonmalignant chronic pain during their first visit to the multidisciplinary pain center at the State University of Rio de Janeiro in 2019 were used. The brief pain inventory and the Hospital Anxiety and Depression Scale questionnaire assessed pain intensity, its impact on daily activity, and symptoms of anxiety and depression. ResultsThe population was predominantly female (68.8%), over 50 (66.3%), with less than 11 years of education (86.5%), and 75.2% were overweight or obese. Most (81.9%) reported moderate or severe pain, significantly interfering with daily activities (>50%). The lower back was the most commonly affected site. Widespread pain was present in 43.6% of patients. High scores for anxiety (67.4%) and depression (52.2%) were observed. Severe pain was predominantly seen in middle-aged women and individuals with high levels of anxiety and depression. ConclusionPatients with uncontrolled chronic pain referred from primary care to a tertiary hospital were predominantly female, overweight or obese, and exhibited a high prevalence of depression and anxiety. Their pain significantly interfered with daily activities. Clinical ImplicationsThe study provides valuable insight into the biopsychosocial characteristics of uncontrolled chronic pain patients in primary care, emphasizing the importance of implementing multidisciplinary approaches to manage chronic pain effectively within primary care settings.

Substance use moderates relationships between apolipoprotein E genotype, hepatitis C, cognition, and depression in Miami Adult Studies on HIV (MASH) participants.

The impact of APOE on HIV and HCV disease course, cognition, and memory has been understudied in minoritized populations. This study examined whether scores on cognition and depression measures differed by APOE ε4 carrier status while considering HCV and HIV seropositivity and whether these measures were moderated by substance use. A retrospective analysis examined cognitive and psychological data from participants (n = 493) in the Miami Adult Studies on HIV (MASH) cohort. APOE genotyping was performed on banked blood samples. Multiple linear regression was employed to examine differences across participants living with and without HIV and/or HCV and by APOE ε4 genotype. APOE ε4 carriers living with HCV who used cannabis had higher depression scores than non-ε4 carriers, while nonusers had fewer depressive symptoms. APOE ε4 carriers living with HCV had better cognition scores after adjusting for cocaine, opiate, and cannabis use than non-ε4 carriers. Scores on cognitive and depression measures did not differ between APOE ε4 carriers and non-ε4 carriers in participants living with HIV, and substance use did not moderate this relationship. This study was the first of its kind to examine substance use as a moderator for cognition and depression among individuals with HIV and/or HCV stratified by APOE genotype. Findings support further research evaluating the frequency and duration of 1) domains of cognitive functioning impacted by APOE genotype relevant to substance use and 2) the influence of substance use on cognitive and depressive outcomes among adults living with HIV and HCV, HIV, or HCV.

Depression scores and its relationship with sexual quality of life in women with type 1 and type 2 diabetes: A cross-sectional study.

Diabetes is an important public health problem with increasing prevalence worldwide. However, the prevalence of diabetes in women is increasing. Women with diabetes have many physical and psychological complications. It has been reported that complications experienced by women with diabetes negatively affect both their sexual and mental health. This study aimed to determine the sexual quality of life (SQoL) and depression scores in women with type 1 diabetes (T1D) and type 2 diabetes (T2D), the relationship between them, and to examine the factors predicting the SQoL. This study was analytical and cross-sectional. This study was conducted with 440 women with diabetes (206 women with type 1 and 234 women with type 2 diabetes) who came to the endocrine policlinic of a university hospital in Izmir, western Türkiye, between April and October 2023. Data were collected using the "Individual Description Form," "Sexual Quality of Life Questionnaire" and "Beck Depression Inventory." Correlation and multiple regression analyses were conducted to investigate the relationship between SQoL and depression scores. When women with T1D and T2D were compared, it was determined that women with T2D had worse SQoL and higher depression scores (P < .05). Both T1D and T2D women were found to have a strong negative correlation between SQoL and depression scores (r = -0.753; -0.837; P < .05). Age (B = -0.291), body mass index (BMI; B = -2.747), type 2 diabetes (B = -3.074), and depression scores (B = -1.898) were predictive factors of SQoL in women with diabetes (R2 = 0.670; P < .05). In our study, it was determined that depression scores were increased in women with diabetes mellitus with decreased SQoL. When T1D and T2D were compared, T2D had worse SQoL and higher depression scores. It also revealed that age, BMI, T2D, and depression scores affected SQoL. Healthcare professionals especially nurses should provide education and counseling to women with T1D and T2D about sexual life and mental health.