Higher Likelihood Of Depression Research Articles

Relationship Between Voice Problems and Depression Among American Adults.

Voice problems have a large impact on quality-of-life and societal participation. It has been previously reported that persons with voice problems have a higher likelihood of depression than those without voice problems. Despite this knowledge, little has changed in clinical practice related to screening for depression or incorporating the presence of depression in treatment planning. This study aims to provide an updated analysis of the prevalence of depressive symptoms in persons with voice disorders to elucidate the current magnitude of the relationship in hopes that this will provoke greater awareness of the co-occurrence of voice problems and depression and improve clinical care. Cross-sectional design with a national survey. None. The study examined the 23,706 adults from the 2022 National Health Interview Survey database. A series of logistic regression models with propensity score matching approaches were used to examine the association between voice problems and depression by accounting for demographics and health conditions. When comparing persons with and without voice problems, there were statistical differences in demographics and health conditions (all P < .05); however, those differences were balanced by propensity score matching methods (all P > .05). The balanced samples revealed that those with voice problems were approximately twice as likely to experience depressive symptoms (odds ratios ranged from 1.532 to 2.024, all P < .05) compared to those without voice problems. Depressive symptoms increased with the severity (P < .0001) and duration of the voice problem (P = .0328). The study found robust associations between voice problems and depression within the current American adult population in 2022. To achieve optimal treatment outcomes, it is critical that the co-occurrence of voice problems and depression is understood, and that treatment planning addressed both conditions, when applicable.

Patient-Reported and Economic Racial and Ethnic Disparities in Patients with Psoriatic Arthritis: Results from the National Health and Wellness Survey.

Psoriatic arthritis (PsA) is a chronic, autoimmune form of arthritis that is associated with a substantial humanistic and economic burden. Potential differences in patient-reported outcomes (PROs) and economic outcomes among groups of varying PsA severity and different races/ethnicities have not been well studied. This cross-sectional study assessed sociodemographic data, PROs, and economic outcomes for participants with PsA from the National Health and Wellness Survey (2018-2020). Multivariable analyses were used to assess the association of self-reported PsA severity and race/ethnicity with health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), healthcare resource utilization (HCRU), and medical costs. This study included 1544 participants with PsA (1073 non-Hispanic white, 114 non-Hispanic Black, 223 Hispanic, and 134 Other). Self-reported moderate/severe PsA was associated with significantly worse HRQoL and WPAI, greater HCRU, and higher costs than self-reported mild PsA. Black participants reported more absenteeism (31.11% vs. 16.69%; P = 0.007) and activity impairment (54.27% vs. 47.96%; P = 0.047) than white participants, and fewer healthcare provider (5.93 vs. 7.42; P = 0.039) and rheumatologist visits (0.29 vs. 0.53; P = 0.028) over the past 6months. No differences in outcomes were observed between Hispanic and white participants. Race/ethnicity moderated the association of perceived PsA severity and PROs and HCRU, such that white participants with self-reported moderate/severe PsA had a higher likelihood of depression (P < 0.001), lower HRQoL (P < 0.001), and more emergency room visits (P = 0.001) than those with self-reported mild PsA. Race/ethnicity did not moderate the relationship of PROs, HCRU, and economic outcomes among Black or Hispanic participants. Participants with self-reported moderate/severe PsA reported a greater burden than those with self-reported mild PsA. Black participants had a greater humanistic burden than white participants but reported lower HCRU. Moderation results were driven by white participants, suggesting important differences in PROs, HCRU, and perception of PsA severity across race/ethnicity groups. Small sample sizes in Hispanic and non-Hispanic racial/ethnic groups limited ability to discern differences related to disease severity in these groups. Further research is needed to better understand the differential burden of PsA among individuals with varying perceptions of PsA severity across different racial/ethnic groups.

Mental health disparities across sexual orientations during the COVID-19 pandemic: Longitudinal analysis of a UK nationally representative cohort

ObjectivesDuring COVID-19, sexual minority groups may have experienced heightened mental health challenges, amplified by unique stressors and the effects of pandemic-related restrictions. This study investigates the differential impact of the pandemic on mental health across sexual orientations, leveraging population-representative data to explore these disparities. Study designProspective cohort design. MethodsData from the United Kingdom Household Longitudinal Study (waves 8–12) was used. Monthly COVID-19 incidence rates at the regional level were used to indicate pandemic severity. Mental health outcomes were evaluated using the Mental Component Score of the Short Form-12 (MCS-12) survey. To examine whether COVID-19 led to differential impacts across sexual orientation, fixed-effect longitudinal models were employed, controlling for individual and time-variant covariates. ResultsLesbian women experienced a significant mental health decline during the COVID-19 pandemic, with a 3.10 MCS-12 score decrease (95 % confidence interval (CI): -5.77 to -0.43) and an 11.0 % higher likelihood of depression (95%CI: -0.3 % to 22.3 %, p = 0.057) compared to heterosexual women. Conversely, the impact on the mental health of heterosexual women was negative but not significant (-0.22; 95%CI: -0.47 to -0.04). Bisexual individuals and other women showed non-significant mental health declines. For men, COVID-19's effect on heterosexuals was similarly non-significant (-0.21; 95%CI: -0.48 to 0.1), with no significant differences observed in gay, bisexual, and other men. ConclusionsSexual minority individuals, especially lesbian women, faced heightened mental health challenges during COVID-19, emphasizing the urgency for targeted interventions.

Depression and Implantable Cardioverter-Defibrillator Implantation in Black Patients at Risk for Sudden Cardiac Death.

Black patients meeting indications for implantable cardioverter-defibrillators (ICDs) have lower rates of implantation compared with White patients. There is little understanding of how mental health impacts the decision-making process among Black patients considering ICDs. Our objective was to assess the association between depressive symptoms and ICD implantation among Black patients with heart failure. This is a secondary analysis of the VIVID (Videos to Address Racial Disparities in ICD Therapy via Innovative Designs) randomized trial, which enrolled self-identified Black individuals with chronic systolic heart failure. Depressive symptoms were assessed by the Patient Health Questionnaire-2 and the Mental Component Summary of the 12-Item Short-Form Health Survey. Decisional conflict was measured by an adapted Decisional Conflict Scale (DCS). ANCOVA was used to assess differences in Decisional Conflict Scale scores. Multivariable logistic regression was used to examine the association between depressive symptoms and ICD implantation. Among 306 participants, 60 (19.6%) reported depressed mood, and 142 (46.4%) reported anhedonia. Participants with the lowest Mental Component Summary of the 12-Item Short-Form Health Survey scores (poorer mental health and higher likelihood of depression) had greater decisional conflict regarding ICD implantation compared with those with the highest Mental Component Summary of the 12-Item Short-Form Health Survey scores (adjusted mean difference in Decisional Conflict Scale score, 3.2 [95% CI, 0.5-5.9]). By 90-day follow-up, 202 (66.0%) participants underwent ICD implantation. There was no association between either the Patient Health Questionnaire-2 score or the Mental Component Summary of the 12-Item Short-Form Health Survey score and ICD implantation. Depressed mood and anhedonia were prevalent among ambulatory Black patients with chronic systolic heart failure considering ICD implantation. The presence of depressive symptoms did not impact the likelihood of ICD implantation in this population.

Association between geriatric characteristics and falls in older patients with overweight and obesity

Objectives: To assess geriatric characteristics and associations with falls among older people with overweight and obesity. Subjects and Methods: A cross- sectional study on 233 older patients with overweight and obesity examined and treated at National Geriatric Hospital from January to May 2023. Falls in the last 12 months and geriatric characteristics were collected by interviewing using a questionnaire. Results: Of the total 233 participants, the proportion of patients with falls in the last 12 months was 16.7%. The majority of study participants had 2 or more diseases, accounting for 94%. Prevalence of polypharmacy was 63.1%. The rate of ADL impairment was 17.6% and IADL impairment was 16.7%. There was 75.5% of study participants had a high likelihood of depression. The majority of study participants rated quality of life at a high and very high level. There is a statistically significant difference in the rate of falls in the last 12 months between the dependent group and the non-dependent group in activities daily living ADL and IADL (p&lt;0.05). Conclusion: Multi- comorbidities, polypharmacy and depression are the common geriatric syndromes in overweight and obese elderly people. Fall in the past 12 months associated with activities daily living ADL and IADL.

Burden and Predictors of Depression in Populations With Coronary Heart Disease.

Depression significantly impacts the quality of life and medical care in patients with coronary heart disease (CHD). This study assesses the burden of depression in adults aged 40 years and above with CHD and evaluates predictors of depression in this population. It has been reported that approximately 17-44% of persons with CHD have a major depression diagnosis and that nearly 27% of individuals undergoing coronary artery bypass graft operation suffer depression following the procedure. Methods: Data from the 2022 National Health Interview Survey was used. The sample was made up of adults 40 years and above with CHD. A chi-square analysis was used to identify differences between those who were depressed and those who were not. Logistic and ordinal regression analyses were used to identify predictors of depression and severe depression, respectively. The proportion of adults 40 years and above with CHD who reported having depression was 863/1700 (50.5%). Among those who were ≥65, the proportion of those who reported depression and those who did not were similar (49.3% vs. 50.7%). Most women reported having depression (57.4% vs. 42.6%), while fewer men reported having depression (46.3% vs. 53.7%). The positive predictors of depression include being insured (odds ratio (OR) 1.26 (1.05-1.53), p = 0.016), college degree (OR 1.09 (1.01-1.18), p = 0.040), diabetes mellitus (OR 1.28 (1.15-1.42), p < 0.001), and hypertension (OR 1.34 (1.24-1.44), p < 0.001). The negative predictors of being depressed were age ≥65 (OR 0.74 (0.69-0.80), p < 0.001), male sex (OR 0.54 (0.50-0.58), p < 0.001), and ratio of family income (RFI) ≥1 (OR 0.68 (0.61-0.77), p < 0.001). The positive predictors of severe depression include diabetes mellitus (OR 1.38 (1.06-1.81), p = 0.019) and current cigarette use (OR 2.10 (1.44-3.07), p < 0.001). A significant proportion of adults 40 years and above with CHD have depression, and socioeconomic and cardiovascular risk factors are associated with a high likelihood of depression. Cardiovascular risk factors alone predict the likelihood of severe depression. Interventions to address depression in CHD should target specifically these high-risk individuals.

Income Shocks, Financial Hardship, and Changes in Depression Symptomatology Among Older Americans During the First Year of the COVID-19 Pandemic

Using data from the 2018 and 2020 waves of the Health and Retirement Study, this research examined the effect of financial hardship experienced during the COVID-19 pandemic on the mental health of older Americans. Estimates from the ordinary least squares and logistic regressions showed that individuals who experienced income shocks, particularly those with decreased retirement savings/assets income, reported more depressive symptoms and a higher likelihood of depression. Similarly, financial hardship measured as the number of financial arrears was found to be positively correlated with depression symptoms and the onset of depression. Depression symptomatology and onsets were mainly influenced by pandemic-related shocks to retirement/assets income among retired individuals and by earnings shocks among nonretired respondents. The effects were more pronounced among retired individuals and those without a preexisting history of psychiatric problems.

Cumulative Exposure to Natural Hazards and Mental Health in China: Are Older People More Vulnerable or More Resilient Than Younger and Middle-Aged Adults?

AbstractDespite the well-documented impacts of single natural hazards like earthquakes, less is known about the psychological adaptation to multiple natural hazards, particularly in rural areas. This study investigated the associations of multiple natural hazards with depression among Chinese adults. Data were retrieved from the China Family Panel Studies conducted during 2010–2018. With a sample of 11,633 Chinese adults, multilevel logistic regression was employed to examine the relationships between natural hazard exposure and depression in the total sample and different age groups. Overall, experiencing four or more natural hazards was associated with a higher risk of being depressed. Regarding hazard type, the number of hydrometeorological and biological hazards was associated with a higher likelihood of depression, whereas the number of geologic and other hazards was related to a lower risk of depression. Middle-aged adults from villages were more likely to be affected by natural hazard exposure than older and younger adults. The findings of this study show that cumulative exposure to natural hazards can generate lasting effects on depressive symptoms, particularly in middle adulthood. The findings also suggest that older adults from rural areas may have accumulated more resilience to mitigate the adverse well-being effects of hazard events. Policies and interventions should enhance disaster awareness and preparation for aging residents from multi-hazard communities.

Associations of the density and proximity of the outlets of tobacco and other nicotine-containing products with increased levels of depression, anxiety and stress among the population of 3 Russian regions

Aim. To study the relationship of the density and proximity of tobacco products (TPs) and electronic nicotine delivery systems (ENDS) with increased levels of depression, anxiety and stress among the population in 3 constituent entities of the Russian Federation.Material and methods. The work used data from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study in 3 Russian regions (Arkhangelsk, Sverdlovsk and Tver regions) among the population aged 35-64 years (n=1674), who signed a consent to participate in the study. We analyzed data on the status of smoking and consumption of ENDS, passive smoking, attempts to quit smoking, as well as the presence of depression, anxiety (Hospital Anxiety and Depression Scale (HADS) score ≥8) and stress (Perceived Stress Scale (PSS) &gt;21). Elements of urban infrastructure (data collection: January-March 2022) selling TPs and ENDS were assessed using aт OpenStreetMap-based program. Associations were established using logistic regression analysis.Results. With a twofold increase in the distance of TP and ENDS outlets from the place of residence, the depression probability was reduced by 13% (odds ratio (OR) 0,87; 95% confidence interval (CI): 0,79-0,96) and by 12% (OR 0,88; 95% CI: 0,78-0,99), respectively. With increase in distance from of TP outlets, the anxiety decreased probability by 12% (OR 0,88; 95% CI: 0,81-0,97). With an increase in the number of TP outlets within a radius of 1000 m from the place of residence, there were an increase in the probability of depression (OR 1,18; 95% CI: 1,031,36), anxiety (OR 1,12; 95% CI: 1-1,26) and stress (OR 1,24; 95% CI: 1,05-1,46). A greater number of ENDS outlets within a radius of 1000 m and 400 m was associated with a high likelihood of depression (OR 1,17; 95% CI: 1,02-1,34 and OR 1,25; 95% CI: 1,04-1,47, respectively). An increased depression probability was found in those exposed to tobacco smoke at home (OR 1,88; 95% CI: 1,27-2,73) and at work (OR 1,67; 95% CI: 1,14-2,41). An increase in the number of attempts to quit smoking doubles the odds of depression (OR 2,40; 95% CI: 1,35-4,23) and anxiety (OR 2,00; 95% CI: 1,18-3,38).Conclusion. Unfavorable environmental factors, including the proximity and density of TP and ENDS outlets, can increase the probability of depression, anxiety and stress among the population living in these areas.

The association between nap time, nighttime sleep and depression in Chinese older adults: A cross-sectional study.

To explore the relationship among nap time, night sleep time, and depression among the elderly and to determine the recommended sleep time to provide a scientific and reasonable basis for the prevention and control of depression in residents. Based on the 2020 China Health and Elderly Care Longitudinal Survey (CHARLS) database, the demographic data and the health and lifestyle information of the study subjects were obtained. A total of 2,959 valid samples were included, and the relationship between sleep and depression was explored by logistic regression, restricted cubic spline, and isotemporal substitution model. In the cross-sectional analysis, no statistical relationship was observed between napping time and depression in the elderly. The optimal sleep interval for the elderly at night is 6-7.5 hours, and the health benefits are the largest. A sleep duration of < 6 hours at night (OR = 2.25, 95% CI: 1.90 to 2.65) was associated with a high likelihood of depression. The probability of depression in the elderly continues to decrease with the increase of time after the nighttime sleep duration reaches 6 hours and is at the lowest level of about 7.5 hours. Moreover, the probability of depression will increase after the sleep duration exceeds 9.5 hours. In the range of 6-7.5 hours of recommended sleep duration, the likelihood of depression in the elderly will be reduced by 0.311 for every 30-minute increase in nighttime sleep time instead of noon sleep time. The duration of nighttime sleep and the probability of depression have a U-shaped relationship. The likelihood of depression was lowest in the elderly who slept for 6-8 hours at night, and the likelihood of depression could be reduced by increasing the nighttime sleep time instead of napping time within the optimal nighttime sleep range.

The association between social determinants of health and patient-centred outcomes in adults with heart failure with reduced ejection fraction.

To explore the associations between social determinants of health and patient-centred outcomes among adults with chronic heart failure with reduced ejection fraction. Cross-sectional online self-report survey. A survey assessing social determinants of health (demographics, socio-economic position, affordability of care and social support) and patient-centred outcomes, including the Kansas City Cardiomyopathy Questionnaire-12 and validated measures of medication adherence, treatment satisfaction, treatment burden and mental health, was completed by 512 adults with chronic heart failure with a reduced ejection fraction between 06 March and 29 June 2020. Multivariable analyses included linear and logistic regression. Female gender, having a care partner, and being offered financial assistance with medications were associated with worse health status, while perceiving medication as affordable and being married were associated with better health status. Females and having Medicaid, dual Medicaid/Medicare or no medical insurance were associated with a higher likelihood of depression, and non-white race/ethnicity was associated with less depression. Medication adherence was lower in patients having a care partner and offered financial assistance. Patients being offered financial and medication management assistance were more likely to be overwhelmed by the treatment burden, whereas those having some college education were less so. Social determinants of health are associated with patients' disease-specific health status, mental health and treatment satisfaction and burden. These findings underscore the importance of assessing social determinants of health in clinical practice and the need for developing and testing novel strategies to determine whether they improve patients' health. The relationship between social determinants of health- and patient-centred outcomes was assessed; affordability of care and social support factors were most strongly associated with outcomes for patients with chronic heart failure and reduced ejection fraction, underscoring the importance of assessing social determinants of health in routine clinical care. Social determinants of health data could potentially inform care delivery for patients with heart failure and reduced ejection fraction by helping to identify those who require additional support to manage their symptoms, access care and adhere to treatment. Social support and affordability of treatment were associated with most patient-centred outcomes, suggesting these factors may provide clinicians with an indicator of a patient's level of general well-being that could be assessed during routine follow-up care. This research followed the STROBE checklist for cross-sectional studies. Adults who have heart failure with reduced ejection fraction that consented to participate in the study provided the data used for all analyses reported on in the manuscript. Service users, caregivers or members of the public had no involvement in the study.

Structural, functional and behavioral impact of allergic rhinitis on olfactory pathway and prefrontal cortex

BackgroundAllergic rhinitis (AR) has been identified as a cause of olfactory dysfunction. Beyond the classic symptoms, AR has been associated with altered sleep patterns, a decline in cognitive performance and higher likelihood of depression and anxiety. The olfactory pathway has been postulated to be a possible link between nasal inflammation and central nervous system (CNS) modifications. Thus, we aimed to investigate the structural, functional and behavioral changes in the olfactory pathway and related areas in an animal model of AR. MethodsAR was induced in adult Wistar rats by ovalbumin sensitization and challenge. Following olfactory and behavioral tests we investigated the synaptic structure of the olfactory bulb (OB), anterior olfactory nuclei (AON), piriform cortex and prefrontal cortex (PFC), by immunofluorescence detection of synaptophysin (Syn) and glutamatergic, GABAergic and dopaminergic neuronal markers. ResultsWe detected a significant decrease in Syn in the glomerular layer (GL) of OB and in the PFC of the AR group. Additionally, the optical density of GAD67 and VGLUT2 was reduced in the OB, AON and PFC, compared to controls. The behavioral tests demonstrated olfactory dysfunction and reduced male aggressiveness in AR rats, but we did not find any difference in the cognition and anxiety-like behavior. ConclusionsWe confirmed olfactory dysfunction in a rat model of AR and we identified modifications in synaptic activity by reduction of Syn optical density in the GL of the OB and in the PFC. This was accompanied by structural changes in glutamatergic and GABAergic activity in essential components of the olfactory pathway and PFC.

Влияние пандемии COVID-19 на психологическое благополучие студентов и преподавателей медицинских высших учебных заведений

Aim: to assess the psychological well-being of students and teachers of higher medical educational institutions during the COVID-19 pandemic. Patients and Methods: the study included students (n=746) and university teaching staff (n=1184). Among teachers were 296 men (25%) and 888 women (75%). The mean age was 41.1±15.1 years. Among students were 301 men (40.3%) and 445 women (59.7%). The mean age was 21.2±5.5 years. An online questionnaire, Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ-4), GAD-2 questionnaire, 5-point Likert scale, and 10-point assessment of the conspiracy worldview were used to assess psychological well-being. Results: the results of the PSS-10 have demonstrated that 352 teachers (29.7%) and 213 students (28.6%) experience moderate neuropsychic stress, whereas 39 teachers (3.2%) and 36 students (4.8%) experience severe neuropsychic stress. A high probability of stress was reported in 70 teachers (5.9%) and 35 students (4.6%). During the study period, 72.2% of teachers and 68.2% of students experienced moderate stress, whereas 6.3% of teachers and 11.7% of students experienced severe stress. A significant predominance of severe stress in students was reported (p≤0.05). A high likelihood of depression was reported in 106 teachers (8.9%) and 79 students (10.6%), whereas the need to assess depression severity was reported in 178 teachers (15.0%) and 109 students (14.6%). The need for an in-depth anxiety assessment (GAD-7) was reported in 106 teachers (8.9%) and 79 students (10.6%). 458 teachers (38.7%) and 327 students (43.8%) requested psychological support, while 461 teachers (38.9%) and 307 students (41.2%) were completely excluded from seeking psychological support. The level of social optimism about the long-term future was low. Meanwhile, 661 teachers (55.8%) and 426 students (57.1%) believed that their children would live better. Only 649 teachers (54.8%) and 403 students (54.0%) are confident that Russians are able to change their lives for the better in the country. A conspiracy worldview was typical for 514 teachers (43.4%) and 302 students (40.5%). Conclusion: our findings show a high level of emotional and psychological stress both among teachers and students, which entailed the development of depression and anxiety, the ap-appearance of negative thoughts, a decrease in positive attitude and faith in the future, and consequently, reduced motivation and distrust in social, psychological, and medical aspects. KEYWORDS: psychological well-being, depression, anxiety, teachers, students, stress, medical higher education institutions. FOR CITATION: Mar'in G.G., Medvedeva E.A., Usol'ceva N.I., Gorbeshko G.A., Svitich O.A., Zykov K.A., Ploskireva A.A., Nazarov D.A., Kinkul'kina M.A., Romanova K.G., Chernogorova M.V. Effect of the COVID-19 pandemic on the psychological well-being of students and teachers of medical higher education institutions. Russian Medical Inquiry. 2023;7(11):733–741 (in Russ.). DOI: 10.32364/2587-6821- 2023-7-11-6.

The COVID-19 pandemic and mental health in Kazakhstan.

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1-3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11-2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32-4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32-4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91-6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11-4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36-5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

GROUP-BASED TRAJECTORY MODELING OF NURSING HOME RESIDENT PAIN SCORES

Abstract Up to 80% of older adults living in a nursing home (NH) experience pain and up to 32% have substantial pain. Pain in NH residents is associated with poor quality of life, higher likelihood of depression, and decreased life satisfaction. Pain in NH residents has often been studied using a cross-sectional approach, which fails to consider the temporal nature of pain. Therefore, the purpose of this analysis was to identify and characterize clinically meaningful, dynamic pain trajectories in NH residents using data from the Minimum Data Set. A retrospective longitudinal analysis was conducted using group-based trajectory modeling with pain scores from admission to discharge or a maximum of 28 assessments. We identified four distinct trajectories: 1) consistent pain absence (48.9%), 2) decreasing-increasing pain presence (21.8%), 3) increasing-decreasing pain presence (15.3%), and 4) persistent pain presence (14.0%). Relative to residents’ in the consistent pain absence trajectory, the likelihood of being in the persistent pain presence trajectory was more than twice as high for those living in a rural versus (AOR 2.7, CI 2.2-3.4, p&amp;lt;.001), over 4 times higher for those with hip fracture (AOR 4.3 CI 2.6-7.0, p&amp;lt;.001), nearly 3 times higher for those with a fracture other than hip (AOR 2.9, CI 2.0-4.1, p&amp;lt;.001), and almost twice as high for those with contracture (AOR 1.7, CI 1.4-2.1, p&amp;lt;.001). Using residents’ characteristics associated with persistent pain such as hip fracture or contracture may improve care planning based on early identification or risk stratification and can improve mitigation of persistent pain.

COVID-19-related fear, stress and depression in school principals: impacts of symptoms like COVID-19, information confusion, health-related activity limitations, working hours, sense of coherence and health literacy

Background School principals have been reported to have a higher prevalence of burnout and psychological problems than their colleagues. During the pandemic, extra workload and pressure from unprecedented situations potentially cause fear, stress and depression. Therefore, we aimed to explore associated factors of stress, fear of COVID-19 (F-CoV-19S) and depressive symptoms among school principals. Methods A cross-sectional online survey was conducted in Taiwan from 23 June to 16 July 2021. Data of 413 school principals were collected, including socio-demographic factors, COVID-19-related factors, work-related information, health status, sense of coherence (SoC), health literacy (HL), F-CoV-19S, stress and depression. Multiple linear and logistic regression models were utilized to explore associations. Results School principals with symptoms like COVID-19 (S-COVID-19-S), or with health-related activity limitations had a higher score of stress (B = 0.92; p = .039) (B = 1.52; p < .001) and a higher depression likelihood (OR = 3.38; p < .001) (OR = 3.06; p < .001), whereas those with a better SoC had a lower stress score (B = −1.39; p < .001) and a lower depression likelihood (OR = 0.76; p = .020). School principals confusing about COVID-19-related information had a higher score of stress (B = 2.47; p < .001) and fear (B = 3.77; p < .001). The longer working time was associated with a higher fear score (B = 1.69; p = .006). Additionally, school principals with a higher HL score had a lower stress score (B = −1.76; p < .001), a lower fear score (B = −1.85; p < .001) and a lower depression likelihood (OR = 0.53; p = .043). Conclusions Health-related activity limitations, S-COVID-19-S, COVID-19-related information confusion and longer working hours were positively associated with at least one mental health problem (e.g. stress, fear and depression), whereas better SoC and HL showed the benefits to mitigate fear, stress and depressive symptoms in school principals. Our study provides evidence for appropriate strategies to improve principals’ mental health during the pandemic. Key messages: School principals with health-related activity limitations or with symptoms like COVID-19 were more likely to be stressed and depressed. Higher levels of stress and fear were observed in school principals who confused about COVID-19-related information, and who had longer working time than before the pandemic. Better sense of coherence and higher health literacy could potentially mitigate the fear, stress and depressive symptoms in school principals.

Depression and Complicated Grief, and Associated Factors, of Bereaved Family Members of Patients Who Died of Malignant Pleural Mesothelioma in Japan.

Objectives: we investigated the prevalence and associated factors of depression and complicated grief (CG) among bereaved family members of malignant pleural mesothelioma (MPM) patients in Japan. Methods: Bereaved family members of MPM patients (n = 72) were surveyed. The Japanese version of the Patient Health Questionnaire-9 (PHQ-9) and the Japanese version of the Brief Grief Questionnaire (BGQ) were used to assess depression and complicated grief (CG), respectively. Socio-economic factors, anger toward asbestos, care satisfaction, achievement of good death, and quality of end-of-life care were assessed in relation to depression and CG. Results: In the family members of MPM patients, the frequencies of depression and CG were 19.4% and 15.3%, respectively. The bereaved family members who were not compensated by the asbestos-related health-damage relief system (p = 0.018) and who felt the financial impacts of the patient’s MPM on the family (p = 0.006) had a higher likelihood of depression. The bereaved family members who were not satisfied with the care given when the patient became critical (p = 0.034), who were not compensated by the asbestos-related health-damage relief system (p = 0.020), who felt the financial impact of the patient’s MPM on the family (p = 0.016), and whose deceased relative underwent surgery (p = 0.030) had a higher likelihood of CG. Conclusions: For bereaved family members of MPM patients, routine screening for depression and CG and the provision of grief care are suggested. In addition, for family members of MPM patients, financial support, including the promotion of the asbestos-related health-damage relief system, and improved care for patients who undergo surgery and when patients become critical, are recommended.

Impact of Diabetes Duration on Functional and Clinical Status in Older Adults With Type 1 Diabetes.

Adults with type 1 diabetes (T1D) are aging successfully. The impact of diabetes duration on clinical and functional status as people age with T1D is not well known. We performed a cross-sectional study of older adults (age ≥65 years) with T1D. We evaluated 165 older adults, mean age 70 ± 10 years. After adjustment for age, sex, and A1C, longer duration of T1D, ≥50 years, was associated with a higher likelihood of depression (odds ratio [OR] 2.8; P = 0.008), hypoglycemia unawareness (OR 2.6; P = 0.01), lower scores on 6-Minute Walk Test (OR 0.99; P = 0.01) and the Physical Component Summary (PCS) of Short Form-36 (SF-36) (OR 0.96; P = 0.02), and greater daily medication use (OR 1.1; P = 0.004) compared with those with duration <50 years. In older adults with T1D, duration of diabetes impacts clinical and functional status, independent of age and glycemic control, and should be considered in development of management strategies for safety and success.

Predictors of Depression and Anxiety Symptoms in Brazil during COVID-19.

The COVID-19 pandemic in Brazil is extremely severe, and Brazil has the third-highest number of cases in the world. The goal of the study is to identify the prevalence rates and several predictors of depression and anxiety in Brazil during the initial outbreak of COVID-19. We surveyed 482 adults in 23 Brazilian states online on 9–22 May 2020, and found that 70.3% of the adults (n = 339) had depressive symptoms and 67.2% (n = 320) had anxiety symptoms. The results of multi-class logistic regression models revealed that females, younger adults, and those with fewer children had a higher likelihood of depression and anxiety symptoms; adults who worked as employees were more likely to have anxiety symptoms than those who were self-employed or unemployed; adults who spent more time browsing COVID-19 information online were more likely to have depression and anxiety symptoms. Our results provide preliminary evidence and early warning for psychiatrists and healthcare organizations to better identify and focus on the more vulnerable sub-populations in Brazil during the ongoing COVID-19 pandemic.

MR Elastography demonstrates reduced white matter shear stiffness in early-onset hydrocephalus

IntroductionHydrocephalus that develops early in life is often accompanied by developmental delays, headaches and other neurological deficits, which may be associated with changes in brain shear stiffness. However, noninvasive approaches to measuring stiffness are limited. Magnetic Resonance Elastography (MRE) of the brain is a relatively new noninvasive imaging method that provides quantitative measures of brain tissue stiffness. Herein, we aimed to use MRE to assess brain stiffness in hydrocephalus patients compared to healthy controls, and to assess its associations with ventricular size, as well as demographic, shunt-related and clinical outcome measures. MethodsMRE was collected at two imaging sites in 39 hydrocephalus patients and 33 healthy controls, along with demographic, shunt-related, and clinical outcome measures including headache and quality of life indices. Brain stiffness was quantified for whole brain, global white matter (WM), and lobar WM stiffness. Group differences in brain stiffness between patients and controls were compared using two-sample t-tests and multivariable linear regression to adjust for age, sex, and ventricular volume. Among patients, multivariable linear or logistic regression was used to assess which factors (age, sex, ventricular volume, age at first shunt, number of shunt revisions) were associated with brain stiffness and whether brain stiffness predicts clinical outcomes (quality of life, headache and depression). ResultsBrain stiffness was significantly reduced in patients compared to controls, both unadjusted (p ≤ 0.002) and adjusted (p ≤ 0.03) for covariates. Among hydrocephalic patients, lower stiffness was associated with older age in temporal and parietal WM and whole brain (WB) (beta (SE): −7.6 (2.5), p = 0.004; −9.5 (2.2), p = 0.0002; −3.7 (1.8), p = 0.046), being female in global and frontal WM and WB (beta (SE): −75.6 (25.5), p = 0.01; −66.0 (32.4), p = 0.05; −73.2 (25.3), p = 0.01), larger ventricular volume in global, and occipital WM (beta (SE): −11.5 (3.4), p = 0.002; −18.9 (5.4), p = 0.0014). Lower brain stiffness also predicted worse quality of life and a higher likelihood of depression, controlling for all other factors. ConclusionsBrain stiffness is reduced in hydrocephalus patients compared to healthy controls, and is associated with clinically-relevant functional outcome measures. MRE may emerge as a clinically-relevant biomarker to assess the neuropathological effects of hydrocephalus and shunting, and may be useful in evaluating the effects of therapeutic alternatives, or as a supplement, of shunting.