Higher Odds Of Depressive Symptoms Research Articles

Screen exposure, mental health and emotional well-being in the adolescent population: is it time for governments to take action?

During the last decade, a multitude of epidemiological studies with different designs have been published assessing the association between the use of digital media and psychological well-being, including the incidence...

State-level structural racism and adolescent mental health in the United States.

We explored state-level indicators of structural racism on internalizing symptoms of depressive affect among US adolescents. We merged 16 indicators of state-level structural racism with 2015-19 Monitoring the Future surveys (N=41,258) examining associations with loneliness, self-esteem, self-derogation, and depressive symptoms using regression analyses. Students racialized as Black in states with bans on food stamp eligibility and temporary assistance for drug felony conviction had 1.37 times the odds of high depressive symptoms (95% C.I. 1.01-1.89) compared to students in states without bans. In contrast, students racialized as White living in states with more severe disenfranchisement of people convicted of felonies had lower odds of high self-derogation (OR=0.89, 95% C.I. 0.78-1.02) and high depressive symptoms (OR=0.83, 95% C.I. 0.70-0.99) compared to states with less severe disenfranchisement. These findings demonstrate the need to address the legacy of structural racism at the state level to reduce mental distress for US youth.

Psychosocial Risks and Adolescent Mental Health: The Moderating Role of Objective Neighborhood Characteristics

PurposeAlthough previous studies have examined the association between youth psychosocial risks and their perceptions of their neighborhood, it is unclear how objective neighborhood characteristics are associated with psychosocial risks and mental health symptoms among adolescents. We investigated how neighborhood characteristics moderate the relationship between youth psychosocial characteristics and mental health symptoms. MethodsThis cross-sectional study examined 13,837 emergency department visits by 14–18-year-olds who completed a standardized Behavioral Health Screening in a tertiary pediatric hospital in Philadelphia from 2013 to 2020. Psychosocial risk factors and mental health symptoms were assessed based on self-reported survey responses. We characterized neighborhoods as low-, moderate-, and high-stress based on gun violence incidence from 2013 to 2020 and the census tract–level Child Opportunity Index. Mixed effects logistic regression and Poisson models were used to examine moderation effects. ResultsThe 9,814 included patients were 64% female and 64% non-Hispanic Black. The following psychosocial risk factors were associated with two to eight times higher odds of depressive symptoms and suicide risk: exposure to trauma, bullying at school, at-risk substance use, fighting, and retaliation. Adolescents living in high-stress neighborhoods were twice as likely to report fighting and retaliation and reported more psychosocial risk factors than those in low-stress neighborhoods. Odds of mental health symptoms increased with the number of psychosocial risk factors, particularly in youth from low-stress neighborhoods. DiscussionObjective neighborhood characteristics had a significant interaction effect on the relationship between psychosocial risks and depression and suicide risk among adolescents seeking care in a pediatric emergency department.

Association Between Discrimination and Depressive Symptoms Among Hispanic or Latino Adults During the COVID-19 Pandemic: Cross-Sectional Study.

Discrimination and xenophobia toward Hispanic and Latino communities increased during the COVID-19 pandemic, likely inflicting significant harm on the mental health of Hispanic and Latino individuals. Pandemic-related financial and social instability has disproportionately affected Hispanic and Latino communities, potentially compounding existing disparities and worsening mental health. This study aims to examine the association between discrimination and depressive symptoms during the COVID-19 pandemic among a national sample of Hispanic and Latino adults. Data from a 116-item web-based nationally distributed survey from May 2021 to January 2022 were analyzed. The sample (N=1181) was restricted to Hispanic or Latino (Mexican or Mexican American, Puerto Rican; Cuban or Cuban American, Central or South American, and Dominican or another Hispanic or Latino ethnicity) adults. Depression symptoms were assessed using the 2-item Patient Health Questionnaire. Discrimination was assessed using the 5-item Everyday Discrimination Scale. A multinomial logistic regression with a block entry model was used to assess the relationship between discrimination and the likelihood of depressive symptoms, as well as examine how controls and covariates affected the relationship of interest. Mexican or Mexican American adults comprised the largest proportion of the sample (533/1181, 45.13%), followed by Central or South American (204/1181, 17.3%), Puerto Rican (189/1181, 16%), Dominican or another Hispanic or Latino ethnicity (172/1181, 14.6%), and Cuban or Cuban American (83/1181, 7.03%). Approximately 31.26% (367/1181) of the sample had depressive symptoms. Regarding discrimination, 54.56% (634/1181) reported experiencing some form of discrimination. Compared with those who did not experience discrimination, those who experienced discrimination had almost 230% higher odds of depressive symptoms (adjusted odds ratio [AOR] 3.31, 95% CI 2.42-4.54). Also, we observed that sociodemographic factors such as age and gender were significant. Compared with participants aged 56 years and older, participants aged 18-35 years and those aged 36-55 years had increased odds of having depressive symptoms (AOR 3.83, 95% CI 2.13-6.90 and AOR 3.10, 95% CI 1.74-5.51, respectively). Women had higher odds of having depressive symptoms (AOR 1.67, 95% CI 1.23-2.30) than men. Respondents with an annual income of less than US $25,000 (AOR 2.14, 95% CI 1.34-3.41) and US $25,000 to less than US $35,000 (AOR 1.89, 95% CI 1.17-3.06) had higher odds of depressive symptoms than those with an annual income of US $50,000 to less than US $75,000. Our findings provide significant importance especially when considering the compounding, numerous socioeconomic challenges stemming from the pandemic that disproportionately impact the Hispanic and Latino communities. These challenges include rising xenophobia and tensions against immigrants, inadequate access to mental health resources for Hispanic and Latino individuals, and existing hesitations toward seeking mental health services among this population. Ultimately, these findings can serve as a foundation for promoting health equity.

Assessing Trends in Internalizing Symptoms among Racialized and Minoritized Adolescents: Results from the Monitoring the Future Survey 2005-2020.

Depressive symptoms have rapidly accelerated among recent US adolescent birth cohorts, yet there remains little understanding of trends among racialized and minoritized groups. These groups may experience depressive symptoms due to the deleterious effects of structural racism. Using 2005-2020 Monitoring the Future survey data, we examine all racialized groups using within-group analyses to observe trends in high depressive symptoms across cohorts. Generally, across racialized groups and ages, the odds of high depressive symptoms increased in recent birth cohorts. For example, among 15-16-year-old students racialized as American Indian or Alaska Native and Black-Hispanic/Latine, the 2003-2006 birth cohort had 3.08 (95% CI: 2.00, 4.76) and 6.95 (95% CI: 2.70, 17.88) times higher odds, respectively, of high depressive symptoms compared to the 1987-1990 birth cohorts. Moreover, in a given year 15-16-year-olds generally experienced the highest depressive symptoms compared to 13-14 and 17-18-year-olds, suggesting that age-effects peaked during mid-adolescence. Depressive symptoms increased among US adolescents by birth cohort, within all racialized and minoritized groups assessed. Public health efforts to reduce disparities may consider barriers such as structural racism that may impact the mental health of racialized/minoritized adolescents while increasing access to culturally competent mental health providers and school-based services.

Association between drinking behaviors, sleep duration, and depressive symptoms

Excessive alcohol consumption has been consistently linked to depression. This study, utilizing nationwide samples from the Korea National Health and Nutrition Examination Survey (n = 21,440) examined the association between drinking behaviors and depressive symptoms while also exploring the influence of sleep duration on this relationship. Demographic, socioeconomic, and health-related factors were included as covariates in the multivariable logistic regression analysis to assess their relationships with depressive symptoms. Based on their sleep duration, the participants were divided into subgroups to explore how sleep duration affects the relationship between drinking behaviors and depressive symptoms. Moderate alcohol consumption (1–4 times a month) was associated with reduced likelihood of experiencing depressive symptoms in women (p = 0.024), with a similar trend observed among men (p = 0.001). Men who started consuming alcohol before the age of 19 had a higher likelihood of experiencing depressive symptoms (p = 0.048). Only women who consumed more alcohol per occasion (≥ 7 drinks) had higher odds of depressive symptoms (p = 0.001). This study revealed complex factors that influence depressive symptoms, including alcohol consumption and sleep duration. This highlights the importance of tailored interventions based on sleep duration and sociodemographic characteristics for preventing and treating depression.

THE ASSOCIATION OF AIR POLLUTION AND CLIMATE FACTORS WITH DEPRESSIVE SYMPTOMS AMONG OLDER MEXICAN AMERICAN ADULTS

Abstract Air pollution, drought, and extreme heat are associated with elevated depressive symptoms. Older Mexican American adults experience high levels of depressive symptoms compared to other demographic groups, but little is known about the role of environmental factors in depressive symptoms for this population. Mexican American adults are resilient to the harmful health effects of socioeconomic disadvantage, but it is unclear if this resilience extends to air pollution and climate change. This study uses data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) linked to air pollution and climate data from the Centers for Disease Control and Prevention, to assess the association of air pollution (PM2.5 and ozone) and climate factors (drought and extreme heat) with elevated depressive symptoms. We used data from the 2005 H-EPESE which includes Mexican American adults aged 75 and older. We used generalized estimation equations to test the association between air pollution and climate factors and depressive symptoms, adjusting for sociodemographic and health characteristics. Our sample (n=1,699) was 62.0% female with a mean age of 81.6 (standard deviation: 5.0). About 19% of participants reported elevated depressive symptoms. PM2.5 concentration was associated with higher odds of depressive symptoms (odds ratio: 1.11; 95% confidence interval: 1.04, 1.19). Ozone concentration, drought, and extreme heat were not associated with depressive symptoms. Our results suggest PM2.5 is a risk factor for elevated depressive symptoms. It is unclear if older Mexican American adults are resilient to the effects of environmental risk factors relative to other demographic groups.

Associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese: the Guangzhou biobank cohort study

BackgroundPoor sleep quality has been linked to depression in older adults, but results of the association between daytime napping and depression remains limited and conflicting. Moreover, whether the association of daytime napping with depression varies by nighttime sleep quality is unclear. Hence, we examined the associations of daytime napping and nighttime sleep quality with depressive symptoms in older Chinese.MethodsA total of 16,786 participants aged ≥50 from the Guangzhou Biobank Cohort Study second-round examination (2008–2012) were included in this cross-sectional study. Geriatric Depression Scale (GDS-15), Pittsburgh Sleep Quality Index (PSQI), napping and demographic data were collected by face-to-face interview using a computerized questionnaire. Logistic regression was used to calculate odds ratio (OR) of depressive symptoms for napping and sleep quality.ResultsThe prevalence of depressive symptoms (GDS score > 5) and poor global sleep quality (PSQI score ≥ 6) was 5.3 and 31.9%, respectively. Compared to non-nappers, nappers showed significantly higher odds of depressive symptoms, with OR (95% confidence interval (CI)) being 1.28 (1.11–1.49). The odds of depressive symptoms for daytime napping varied by nighttime sleep quality (P for interaction = 0.04). In good-quality sleepers, compared to non-nappers, nappers had significantly higher odds of depressive symptoms, with OR (95% CI) being 1.57 (1.23–2.01), whereas no association was found in poor-quality sleepers (OR = 1.13, 0.94–1.36).ConclusionNapping was associated with higher odds of depressive symptoms in older people, and the association was stronger in good-quality sleepers.

Prevalence and factors associated with depression, anxiety, and stress symptoms among home isolated COVID-19 patients in Western Nepal.

Globally, COVID-19 pandemic has a significant impact on mental health. In Nepal, COVID-19 positive cases have to self-isolate at home in multi-generational and multi-family households. This could be strongly associated with depression, anxiety, and stress-related health outcomes. Additionally, COVID-19 related stigma and fear of transmission may intensify depression, anxiety, and stress symptoms. This study determined the prevalence of depression, anxiety, and stress symptoms and their association with presence of COVID-19 symptoms and comorbid conditions among home isolated COVID-19 positives in the Karnali province, Nepal. We conducted a cross-sectional study to assess depression, anxiety, and stress symptoms among 402 home isolated COVID-19 patients of Karnali province from January to May 2021 using "Depression, Anxiety and Stress Scale-21 (DASS-21)". We interviewed patients to collect socio-demographic, DASS-21, COVID-19 symptoms, comorbid conditions, and self-treatment. We conducted a telephonic interview using a standardized questionnaire using Kobotoolbox. We calculated the prevalence of depression, anxiety, and stress symptoms. We utilized univariate and multivariate logistic regression to determine their association with the presence of COVID-19 symptoms and comorbid conditions. In multivariate logistic regression, we adjusted sociodemographic factors (age, gender, ethnicity, marital status, monthly family income, education level), smoking status and history of self-treatment. We reported adjusted odds ratios (aOR) with 95% confidence intervals. All analyses were conducted in R (version: 4.0.3). The prevalence of depression, anxiety and stress symptoms among home isolated COVID-19 patients were 8.0% (95% CI: 5.5 to 11.1), 11.2% (95% CI: 8.3 to 14.7), and 4.0% (95% CI: 2.3 to 6.4) respectively. Higher odds of depression symptoms (aOR: 2.86; 95% CI: 1.10-7.44,p= 0.03), anxiety symptoms (aOR: 3.81; 95% CI: 1.62 to 8.93;p= <0.01) and stress symptoms (aOR: 7.78; 95% CI: 1.43 to 42.28;p= 0.02) were associated significantly with presence of COVID-19 symptoms in past week. Higher odds of anxiety symptoms were associated with the presence of comorbid conditions (aOR = 2.92; 95% CI: 1.09 to 7.80;p= 0.03). Depression, anxiety, and stress symptoms were present in a significant proportion of home isolated COVID-19 patients in western Nepal and positively associated with the presence of COVID-19 symptoms. In this global COVID-19 pandemic, it is important to provide timely counseling to high-risk groups like those with comorbidities and COVID-19 symptoms to maintain a high level of mental health among home isolated COVID-19 patients.

1479. Analysis of Depression in People Living with Human Immunodeficiency Virus (HIV) During the Coronavirus Disease 2019 Pandemic in 4 African Countries

Abstract Background We previously demonstrated higher odds of depression in PLWH during COVID-19 pandemic in our African Cohort Study (AFRICOS) between 07May2020 and 01Dec2021.1 This analysis updates the previous and estimates odds of depressive symptoms through 01Dec2022. Hypothesis: If the pandemic was truly associated with depressive symptoms in PLWH then odds of depressive symptoms will continue the downward trend identified in later timepoints of our first analysis. Methods AFRICOS: Ongoing prospective cohort study enrolling PLWH at 12 clinics in Kenya, Uganda, Tanzania, Nigeria.2 Longitudinal evaluations every 6 months include physical evaluation, medical record abstraction, extensive questionnaires including CES-D; depression defined by score &amp;gt;16.3 We compared odds of depression in preCOVID-19 period (1 Jan 2019 to 19 Mar 2020) with five timepoints in COVID-19 era (7 May 2020 to 1 Dec 2022). Logistic regression with generalized estimating equations for OR and 95% CI comparing depression before and during pandemic. Models a priori adjusted for sex, age, and site. Results 2,038 AFRICOS participants with complete cases and visits before and during COVID-19 periods included. Median age at first visit included: 43 years (IQR 36-51) 1,181 (57.9%) were female Depression varied significantly by: sex, participants by site, marital status, ART adherence at first timepoint included (Table 1). 60 (2.9%) participants had CES-D score suggestive of depression at first visit included. Compared with pre-pandemic: PLWH had higher odds of reporting depressive symptoms throughout pandemic. After adjusting for age, sex, and site, PLWH had higher odds of reporting depressive symptoms only in second, third, fourth parts of pandemic period, aORs: 1.62 (95% CI 1.13 – 2.31), 1.72 (95% CI 1.27-2.31), 1.41 (1.01 – 1.96) respectively (Table 2, Figure). Conclusion COVID-19 pandemic is associated with higher odds of depressive symptoms in PLWH in AFRICOS. Odds of depression increased as pandemic progressed, peaking in third period and decreasing sequentially in fourth, fifth periods to confirm our hypothesis. Given the strong association between depression and HIV outcomes, aggressive public health mental health response to pandemics may improve HIV clinical outcomes. Disclosures All Authors: No reported disclosures

Association between secondhand smoke exposure across the life course and depressive symptoms among Chinese older adults

BackgroundThere are limited data on the association between secondhand smoke (SHS) exposure across the life course and depressive symptoms among older adults. We aimed to investigate the association of childhood household SHS exposure, adulthood household SHS exposure, lifetime social SHS exposure, and their coexistence with depressive symptoms in older adults. MethodsData were from the 2011–2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. About 4000 participants (aged 60 years or older) were recruited in a randomly selected half of the counties and cities in China. Data on SHS exposure, past-year depressive symptoms, and covariates were collected using a questionnaire. The chi-square test (for categorical variables) and t-test (for continuous variables) were used to assess differences in the participant characteristics across groups of SHS exposures. We estimated the odds ratios (ORs) and 95 % confidence intervals (CIs) of depressive symptom according to different types of SHS exposure. ResultsChildhood household SHS exposure (OR = 1.42, 95%CI = 1.22–1.66), adulthood household SHS exposure (OR = 1.41, 95%CI = 1.21–1.63) and lifetime social SHS exposure (OR = 1.35, 95%CI = 1.14–1.58) were associated with higher odds of depressive symptoms. Additionally, those with a higher SHS exposure score had higher odds of depressive symptoms (1 point: OR = 1.56, 95%CI = 1.22–2.00; 2 points: OR = 1.77, 95%CI = 1.39–2.25; 3 points: OR = 1.83, 95%CI = 1.45–2.31). The results were similar when stratified by lifetime nonsmoking, former smoking, and current smoking. LimitationsRetrospective design may introduce recall bias. ConclusionsSHS exposure was associated with higher odds of depressive symptoms in older adults, with the effect seeming to be addictive.

Time trends in sexual harassment exposure among adolescents in Norway between 2017 and 2021

Abstract Background Sexual harassment is linked to a range of negative psychosocial factors such as depressive symptoms, anxiety, self-harm, low self-esteem, and substance-use. Preventing and reducing sexual harassment is therefore important in a public health perspective. There is a large variety in the reported prevalence of sexual harassment among adolescents, and knowledge about the development over time is limited. The aim of this study is to study time trends in sexual harassment between 2017 and 2021 among adolescents (aged 16-19) in Norway. Methods This study is based on cross-sectional data from the Ungdata Survey carried out in upper secondary schools in Norway from 2017 to 2021. Adolescents completing the survey these years were respectively; 2017: n = 43 163, 2018: n = 30 400, 2019: n = 54 981, 2020: n = 17 467, 2021: n = 56 544. Descriptive analysis and Chi-square test were used to study changes in sexual harassment exposure across years according to sex, age and sexual experience. Logistic regression was used to study possible changes in the association between sexual harassment and depressive symptoms. Results Preliminary results indicated a stable trend in exposure to all types of sexual harassment (touching, sexual name calling and negative sexual rumours). Approximately 31 % of the adolescents had experienced one or more of the types of sexual harassment (2017 30.7 % - 2021 30.5%). The time trend was stable according to sex, age, and sexual experience. Adolescents exposed to sexual harassment had higher odds for depressive symptoms than adolescents not exposed to sexual harassment (ranging from OR: 1.4, 95% CI:1.2-1.6 to OR:2.3, 95% Cl: 1.8-2.9), and this association was also stable over the years. Conclusions The prevalence of sexual harassment among adolescents is high and surprisingly stable between 2017 and 2021. More knowledge about time trends in sexual harassment is needed, and new public health strategies to prevent sexual harassment should be developed. Key messages • The prevalence of exposure to sexual harassment among adolescents seems to be stable over time. • Being aware the negative public health consequences of sexual harassment more effort needs to be made in developing effective prevention strategies.

Noise at school: any implications for teachers’ health? Findings from the French CONSTANCES study

Abstract Background While noise at school is a well-known issue concerning students’ well-being, data on its potential effect on teachers’ health are limited. Methods Among teachers (n = 13,843) and a sample of non-education employees (n = 34,338) participating in the French CONSTANCES cohort (enrollment phase 2012-2020), we evaluated self-reported noise exposure at inclusion with the question “do you work in an environment where you sometimes have to raise your voice to talk to people 2 or 3 meters away?”(yes/no). First, we compared proportions of teachers who reported noise exposure to different groups of non-education employees. Second, among teachers, we cross-sectionally assessed, using logistic regressions adjusted for potential confounders, how combined exposure to occupational noise and work-related stress (defined alternately as effort-reward imbalance or tension with the public) was associated with two health indicators: self-perceived health (poor vs. good) and depressive symptoms (Centre of Epidemiologic Studies Depression scale, sex-specific cut-points, high vs. low to moderate), respectively. Results Thirty-two percent of teachers declared working in a noisy environment compared to 14% among non-education employees included. Primary school teachers were particularly exposed (42.6%), in comparable proportions to manual workers (43.3%). Among teachers, noise alone was not significantly related to self-perceived health but slightly associated with higher odds of depressive symptoms. We further observed evidence of an interaction effect on depressive symptoms between noise and tension with the public. Conclusions This large study highlights that noise is a common occupational exposure among teachers in France. As it may interact with sense of physical insecurity to weight particularly on mental health, our results advocate for a better considering of such every day and long-term exposure on teachers’ health. Key messages • Noise is a common occupational exposure for French teachers. • As it may interact with work-related stress to affect mental health, noise at school should not be overlooked as an occupational hazard.

Iron Deficiency is Related to Depressive Symptoms in United States Nonpregnant Women of Reproductive Age: A Cross-Sectional Analysis of NHANES 2005-2010

BackgroundFindings of the association between iron status and depressive symptoms in nonpregnant women of reproductive age (WRA) are equivocal, limited by a small sample size, or did not consistently control for confounders. ObjectiveWe tested the association between iron status and depressive symptoms in WRA with the NHANES data (2005-2010). MethodsNonpregnant WRA (20-44 y) with complete data on iron (ferritin and transferrin receptor (TfR)) and anemia (hemoglobin) biomarkers, depressive symptoms (Patient Health Questionnaire-9), and sociodemographic variables were included. Logistic and negative binomial regressions were used to estimate presence (odds ratios) and magnitude (prevalence ratios), respectively, for depressive symptoms by iron deficiency (ID)/anemia/ID anemia in the total sample and stratified by poverty:income ratio (≤ 1.85 or >1.85). ResultsAmong 2516 females, the prevalence of ID was 8 to 16% (depending on the iron biomarker used), of anemia 8%, of which 52 to 65% were also ID. The prevalence of depressive symptoms was 10%. Crude logistic models showed that females with ID (TfR ≥ 8.3 mg/L or body iron <0 mg/kg) from the total sample had 1.82 (95% confidence interval [CI]: 1.24, 2.68) and 1.62 (95% CI: 1.05, 2.48), respectively, higher odds of depressive symptoms than females with iron sufficiency; these associations were attenuated after adjustments for confounders. Adjusted negative binomial models showed that females with ID (TfR ≥ 8.3 mg/L) from the total and low-income samples showed 1.19 (95% CI: 1:00, 1.40) and 1.27 (95% CI: 1.03, 1.58), respectively, higher prevalence ratios of depressive symptoms scores than females with iron sufficiency. ConclusionsThese nationally representative data indicate that nonpregnant WRA with ID (based on high TfR) in the United States have higher prevalence of somatic depressive symptoms scores than those with iron sufficiency, especially if they are of low income.

Association between food insecurity and depressive symptoms among adolescents aged 12-15 years from 22 low- and middle-income countries

Food insecurity may be a risk factor for depression in adolescents. However, data on this topic from low- and middle-income countries (LMICs) are scarce, despite food insecurity being most common in LMICs. Therefore, we aimed to examine the association between food-insecurity and depressive symptoms among school-going adolescents from 22 LMICs.Cross-sectional data from the Global school-based Student Health Survey were analyzed. Self-report measures assessed past 12-month depressive symptoms and past 30-day food insecurity (hunger). Multivariable logistic regression and meta-analysis were conducted to assess associations.Data on 48,401 adolescents aged 12–15 years were analyzed [mean (SD) age 13.8 (0.9) years; 51.4 % females]. The prevalence of depressive symptoms was 29.3 %, and those of moderate and severe food insecurity were 45.0 and 6.3 %, respectively. After adjustment for potential confounders, compared to no food insecurity, the pooled OR (95 %CI) of moderate and severe food insecurity were 1.36 (1.30–1.42) and 1.81 (1.67–1.97), respectively. The level of between-country heterogeneity was low.Food insecurity was associated with significantly higher odds for depressive symptoms among adolescents in LMICs. Policies to address food insecurity may also help prevent depression in this population, pending future longitudinal research.

Comparison of depressive symptoms among healthcare workers in high-risk versus low-risk areas during the first month of the COVID-19 pandemic in China.

The psychological health of healthcare workers (HCWs) has become a significant concern, particularly during the initial stage of a pandemic. This study compared the depressive symptoms among HCWs in high-risk areas (HRAs) and low-risk areas (LRAs) with matching demographics. A cross-sectional study was employed to compare the depressive symptoms (Patient Health Questionnaire score ≥ 10), workplace environment characteristics, the Health Belief Model (HBM) and socio-demographics of the HCWs working in HRAs and LRAs in several accessible regions (mainly Hubei Province and Guangdong-Hong Kong-Macao Greater-Bay-Area) in China. Eight hundred eighty-five HCWs were recruited for unmatched analysis between March 6 and April 2, 2020. After matching with occupation and years of service using a 1:2 ratio, 146 HCWs in HRAs and 290 HCWs in LRAs were selected for matched analysis. Subgroup analyzes were performed using two individual logistic regressions to delineate the associated factors in LRAs and HRAs, respectively. HCWs in LRAs (Prevalence = 23.7%) had 1.96 times higher odds of depressive symptoms than those in HRAs (Prevalence = 15.1%) after adjusting for occupation and years of service (p < 0.001). Significant differences in workplace environment characteristics (p < 0.001) and the 5-dimension of the HBM of HCWs (p < 0.001 to p = 0.025) were found between HRAs and LRAs.Logistic regression showed that workers with years of service between 10 and 20 years (OR:6.27), ever had contact with COVID-19 patients (OR:14.33) and had higher scores of "perceived barrier" of HBM (OR:4.48) predicted depressive symptoms in HRAs while working in pneumology departments and infectious disease units (OR:0.06), and high "self-efficacy" in the HBM (OR:0.13) was a protective factor against depressive symptoms.Contrarily, in LRAs, those HCWs who worked in ICUs (OR:2.59), had higher scores of "perceived susceptibility toward the COVID-19 outbreak" (OR:1.41), "perceived severity of the pandemic" (OR:1.25), and "perceived barriers of wearing masks" (OR:1.43) in the HBM predicted depressive symptoms. High "cues to action" (OR:0.79), and better "knowledge" (OR:0.79) in the HBM were protective factors against depressive symptoms. The risk of depressive symptoms of HCWS was double in LRAs than in HRAs in the first month of the COVID-19 pandemic. Furthermore, salient predictors for depressive symptoms among HCWs in HRAs and LRAs were very different.

Association between Possible Sarcopenia and Depressive Symptoms in Korean Older Adults: Results from the Korea National Health and Nutrition Examination Survey in 2018.

Despite increased clinical and research interest in sarcopenia, even in Asia, not much is known about the association between sarcopenia and depressive symptoms. Sarcopenia and depressive symptoms are associated with several health problems in older adults; therefore, we investigated the association between sarcopenia and depression in Korean older adults. The study sample included 1,929 participants aged over 60 years (44.6% men; mean age, 69.7 years) from nationally representative data of the 2018 Korea National Health and Nutrition Examination survey. Possible sarcopenia was defined according to the diagnostic algorithm of the Asian Working Group for Sarcopenia 2019; however, we measured only hand-grip strength (kg) in this study. Patient Health Questionnaire-9 was used for screening for symptoms of depression. A cross-sectional analysis was used to examine the relationship between possible sarcopenia and depressive symptoms. Possible sarcopenia and depressive symptoms were identified in 538 (27.9%) and 97 (5.0%) participants, respectively. After adjusting for age, sex, and other potential covariates, possible sarcopenia was positively associated with higher odds of depressive symptoms (odds ratio, 2.06; 95% confidence interval, 1.36-3.11; P<0.001). Possible sarcopenia was significantly associated with depressive symptoms in Korean older adults. Early interventions for possible sarcopenia and depressive symptoms in routine clinical practice could help Korean older adults to have healthy aging. Future studies are required to explore any causal relationship between possible sarcopenia and depressive symptoms in Korean older adults.

A Cross-Sectional Investigation of the Association between Arterial Stiffness and Depressive Symptoms, Anxiety Symptoms, and Quality of Life

Background and Objectives: Previous studies have assessed the association between arterial stiffness and depressive and anxiety symptoms, but the results were inconsistent. We aimed to conduct a cross-sectional study to assess the relationship between arterial stiffness, depressive and anxiety symptoms, and quality of life. Materials and Methods: We analyzed the 2014-2015 Korea Institute of Sport Science Fitness Standards project data. Brachial-ankle pulse wave velocity (baPWV) was measured to assess arterial stiffness. High baPWV was defined as a baPWV higher than 1400 cm/s. Participants completed Beck's depressive symptoms inventory (BDI), Beck's anxiety symptoms inventory (BAI), and the World Health Organization's Quality of Life Questionnaire (WHOQOL-Bref). We performed a logistic regression analysis by adjusting confounding factors and used the inverse probability of treatment weighting (IPTW) method. Results: 1936 participants were included in the analysis (men 43.9%, median age 47). Participants with a high baPWV had higher odds of depressive symptoms compared to those with a normal baPWV (aOR 1.920, 95% CI 1.062-3.472, p = 0.031; IPTW OR 2.637, 95% CI 1.219-5.704, p = 0.014). In addition, baPWV was significantly associated with depressive symptoms in the IPTW model in men but not in women (OR 2.497, 95% CI 1.004-6.207, p = 0.049). High baPWV was not associated with anxiety symptoms in all models, but it was associated with poor QOL in women (OR 4.561, 95% CI 1.465-14.199, p = 0.009). Conclusions: High baPWV was associated with higher odds of depressive symptoms, especially in men. Our study suggests a modest association between arterial stiffness and depressive symptoms in Korean adults.

Associations among past trauma, post-displacement stressors, and mental health outcomes in Rohingya refugees in Bangladesh: A secondary cross-sectional analysis.

The Rohingya endured intense trauma in Myanmar and continue to experience trauma related to displacement in Bangladesh. We aimed to evaluate the association of post-displacement stressors with mental health outcomes, adjusting for previously experienced trauma, in the Rohingya refugee population in Cox's Bazar, Bangladesh. We analyzed data from the Cox's Bazar Panel Survey, a cross sectional survey consisting of 5,020 household interviews and 9,386 individual interviews completed in 2019. Using logistic regression, we tested the association between post-displacement stressors such as current exposure to crime and conflict and two mental health outcomes: depression and post-traumatic stress disorder (PTSD). In adjusted analyses, we controlled for past trauma, employment status, receiving an income, food security, and access to healthcare and stratified by gender. The prevalence of depressive symptoms was 30.0% (n = 1,357) and PTSD 4.9% (n = 218). Most (87.1%, n = 3,938) reported experiencing at least one traumatic event. Multiple post-displacement stressors, such as current exposure to crime and conflict (for men: OR = 2.23, 95% CI = 1.52-3.28, p < 0.001; for women: OR = 1.92, 95% CI = 1.44-2.56, p < 0.001), were associated with higher odds of depressive symptoms in multivariable models. Trauma (OR = 4.98, 95% CI = 2.20-11.31, p < 0.001) was associated with increased odds of PTSD. Living in a household that received income was associated with decreased odds of PTSD (OR = 0.74, 95% CI = 0.55-1.00, p = 0.05). Prevalence of depressive symptoms was high among Rohingya refugees living in Cox's Bazar. Adjusting for past trauma and other risk factors, exposure to post-displacement stressors was associated with increased odds of depressive symptoms. There is a need to address social determinants of health that continue to shape mental health post-displacement and increase mental healthcare access for displaced Rohingya.

Association between incense burning and prenatal depressive symptoms: evidence from the Born in Guangzhou Cohort Study.

This study aimed to examine the association of incense burning alone, a source of indoor air pollution, and jointly with passive smoking, with prenatal depressive symptoms. Information on incense exposure and depressive symptoms were collected at both early and late pregnancy using questionnaires in the Born in Guangzhou Cohort Study. Mixed-effects logistic regression models were used to assess the associations of incense exposure separately, and together with passive smoking, with prenatal depressive symptoms. Compared to the non-users, pregnant women with household incense burning had higher odds of depressive symptoms (odds ratio (OR), 1.17, 95% CI, 1.06, 1.28). Compared with non-users, women who occasionally (OR, 1.22, 95% CI, 1.09, 1.36) and frequently (1.51, 95% CI, 1.26, 1.80) smelled incense had higher odds of prenatal depressive symptoms. Higher duration of incense smelling was associated with higher odds of prenatal depressive symptoms compared with non-users. There was no strong evidence for an interaction of frequency of incense smelling and passive smoking in prenatal depressive symptoms. Prenatal exposure to incense burning was associated with higher odds of having depressive symptoms during pregnancy, and there is no evidence for interaction with concurrent exposure to passive smoking.