Impact Of Depressive Symptoms Research Articles

Impact of depressive symptoms on motivation in persons with post-COVID-19 condition.

The World Health Organization (WHO) has defined Post-COVID-19 Condition (PCC) as the onset of symptoms within three months after resolution of an acute SARS-CoV-2 infection, wherein symptoms persist for at least two months and cannot be explained by another medical/psychiatric condition.Persons living with PCC report debilitating symptoms including, but not limited to, depressive symptoms and motivational deficits. The aim of this post-hoc analysis was to evaluate the association between depressive symptoms and motivation in adults with PCC. We conducted a post-hoc analysis of an 8-week, double-blind, randomized, placebo-controlled trial evaluating adults (18 years or older) in Canada with WHO-defined PCC and cognitive symptoms. This post-hoc analysis is comprised of baseline data that evaluates the association between depressive symptom severity measured by the 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR-16) and motivational systems measured by the Behavioral Inhibition System/Behavioral Activation System Questionnaire (BIS/BAS). There was a statistically significant association between depressive symptoms and BIS(β = -0.041 95% CI [-0.066, -0.016], p<0.05), BAS reward responsiveness (β = 0.043 95% CI [0.012, 0.074], p<0.05), sex (β = -0.137 95% CI [-0.266,-0.008], p<0.05), and confirmed COVID-19 infection (β = 0.196 95% CI [0.061, 0.332], p<0.05). Depressive symptoms were associated with motivational deficits in persons living with PCC. Optimizing treatment for depressive symptoms may potentially improve aspects of motivational impairment amongst persons with PCC. All patients presenting with MDD and a history of COVID-19 infection should be assessed for the presence of PCC.

Social factors that promote resilience in adolescents with depression: a systematic review

Abstract Background A socially protective environment matters. Social factors can protect against the development of depression among adolescents in community samples. There is however scant knowledge about their buffering role on the impact of depressive symptoms in adolescents in a clinical setting. Understanding these factors can help explaining why some children function well despite of their depression symptoms. In this review, we aimed to identify which social protective factors mitigate impairment from depression in adolescents. Methods We included peer-reviewed, cross-sectional and longitudinal studies using the following search strategy: Social protective factors AND depression or depression symptoms AND adolescents AND daily impairment, yielding 1737 hits. Included studies focused on social protective factors in relation to a depression diagnosis or depression symptoms severity, in adolescents age 11-24. Preliminary results We found 6 studies that examined the relationship between social protective factors and impairment or severity of depression symptoms in adolescents with a clinical depression or elevated symptoms. In these studies, higher rates of parental attachment, parental monitoring and school belonging moderated the relation between depression symptoms and daily impairment. Higher rates of family support and peer belonging were associated with the low depressed mood group. The rest of the studies tested the association of social protective factors on the development of depression symptoms in non-clinical populations. Conclusions There are limited studies on the buffering role of social protective factors in adolescents with clinical depression. Next, we will focus on non-clinical, longitudinal studies to explore which social protective factors moderate the development of depression over time. We aim to identify social factors that can mitigate the development of depression in community samples and are potentially important for clinical settings. Key messages • There is a scarcity of studies that explored the relation between social protective factors in adolescents with elevated depression symptoms or depression diagnosis. • The role of social protective factors that moderate the development of adolescent depression symptoms over time should be prioritized in the development of intervention programs.

The Prevalence of Depression and Acceptance Rate of Referral to Psychiatrist Among Psoriatic Patients in Saudi Arabia.

Background Psoriasis is a chronic inflammatory disease that primarily affects the skin and can significantly impact the quality of life. Previous studies have shown that psoriasis increases the risk of depression; however, there is a lack of information about the prevalence of depression and psoriatic patients' acceptance of referral to a psychiatric clinic in Saudi Arabia. This study aims to estimate the prevalence of depression among psoriatic patients in Saudi Arabia, determine their referral acceptance rate to psychiatric clinics, and assess their knowledge regarding the impact of depressive symptoms on psoriasis. Methods This questionnaire-based cross-sectional study included patients with psoriasis who presented to dermatology clinics in Saudi Arabia. All patients were instructed to complete three sets of questionnaires encompassing sociodemographic information, the clinical characteristics of their illness, and the Beck Depression Inventory. Results Of 406 patients, 54.9% had symptoms of depression, and 46.3% were willing to go to a psychiatrist when symptoms of depression were present. Most of the patients (70%) thought that depression affects psoriasis. Conclusions More than half of the psoriatic patients in this study were depressed. The patients understood that depression can lead to a worsening of their symptoms, but the majority refused to see a psychiatrist. To remove barriers to seeing a psychiatrist, psoriasis patients should be provided with mental health assistance, taught to identify psychological stressors and effective strategies to cope with these stressors, and educated about available services, including telemedicine.

Impairment in acquisition of conditioned fear in people with depressive symptoms.

Depression is one of the primary global public health issues, and there has been a dramatic increase in depression levels among young people over the past decade. The neuroplasticity theory of depression postulates that a malfunction in neural plasticity, which is responsible for learning, memory, and adaptive behavior, is the primary source of the disorder's clinical manifestations. Nevertheless, the impact of depression symptoms on associative learning remains underexplored. We used the differential fear conditioning paradigm to investigate the effects of depressive symptoms on fear acquisition and extinction learning. Skin conductance response (SCR) is an objective evaluation indicator, and ratings of nervousness, likeability, and unconditioned stimuli (US) expectancy are subjective evaluation indicators. In addition, we used associability generated by a computational reinforcement learning model to characterize the skin conductance response. The findings indicate that individuals with depressive symptoms exhibited significant impairment in fear acquisition learning compared to those without depressive symptoms based on the results of the skin conductance response. Moreover, in the discrimination fear learning task, the skin conductance response was positively correlated with associability, as estimated by the hybrid model in the group without depressive symptoms. Additionally, the likeability rating scores improved post-extinction learning in the group without depressive symptoms, and no such increase was observed in the group with depressive symptoms. The study highlights that individuals with pronounced depressive symptoms exhibit impaired fear acquisition and extinction learning, suggesting a possible deficit in associative learning. Employing the hybrid model to analyze the learning process offers a deeper insight into the associative learning processes of humans, thus allowing for improved comprehension and treatment of these mental health problems.

Impact of depressive symptoms on direct medical cost among medicare recipients with knee osteoarthritis

ObjectiveDepressive symptoms are prevalent among knee osteoarthritis (KOA) patients and may lead to additional medical costs. We compared medical costs in Medicare Current Beneficiary Survey (MCBS) respondents with KOA with and without self-reported depressive symptoms. MethodsWe identified a KOA cohort using ICD-9/10 diagnostic codes in both Part A and Part B claims among community-dwelling MCBS respondents from 2003-2019. We determined the presence of depressive symptoms using self-reported data on sadness or anhedonia. We considered three groups: 1) without depressive symptoms, 2) with depressive symptoms, no billable services, and 3) with depressive symptoms and billable services. We used a generalized linear model with log-transformed outcomes to compare annual total direct medical costs among the three groups, adjusting for age, gender, race, history of fall, Total Joint Replacement, comorbidities, and calendar year. ResultsThe analysis included 4,118 MCBS respondents with KOA. Of them, 27% had self-reported depressive symptoms, and 6% reported depressive symptoms and received depression-related billable services. The adjusted mean direct medical costs were $8,598/year for those without depressive symptoms, $9,239/year for those who reported depressive symptoms and received no billable services, and $14,229/year for those who reported depressive symptoms and received billable services. ConclusionWhile over one quarter of Medicare beneficiaries with KOA self-reported depressive symptoms, only 6% received billable medical services. The presence of depressive symptoms led to higher direct medical costs, even among those who did not receive depression-related billable services.

Association between depressive symptoms and prediabetes: NHANES 2007–2016 findings

IntroductionThe association between diabetes and depressive symptoms is well recognized. However, the impact of depressive symptoms on prediabetes remains unclear. This study aims to explore the specific correlation between depressive symptoms and prediabetes. MethodsA total of 7467 participants from the National Health and Nutrition Examination Survey (NHANES) were included in this study, spanning five rounds of surveys conducted between 2007 and 2016. Weighted logistic regression was utilized to assess the relationship between depressive symptoms and prediabetes. ResultsCompared with the normoglycemic population, individuals with prediabetes had a significantly higher probability of experiencing trouble sleeping (P = 0.020). After adjusting for non-glucose factors, there was no significant correlation between PHQ-9 and prediabetes; however, severe depressive symptoms were positively associated with abnormal fasting plasma glucose (FPG) levels (OR = 1.093 [95 % CI 1.002, 1.192]). There was a positive correlation between trouble concentrating and FPG abnormalities (OR = 1.065 [95 % CI 1.004, 1.129]). LimitationsThe cross-sectional design limits causal inference. ConclusionIndividuals with depressive symptoms, especially severe cases, should be targeted for prediabetes prevention and management efforts. The diverse symptom presentations may have distinct impacts on glucose, necessitating personalized prevention and management strategies.

Impact of depressive symptoms on medication adherence in older adults with chronic neurological diseases

BackgroundNonadherence to medication contributes substantially to worse health outcomes. Especially among older adults with chronic illness, multimorbidity leads to complex medication regimes and high nonadherence rates. In previous research, depressive symptomology has been identified as a major contributor to nonadherence, and some authors hypothesize a link via motivational deficits and low self-efficacy. However, the exact mechanisms linking depressive symptomology and nonadherence are not yet understood. This is in part because the often-employed sum scores cannot do justice to the complexity of depressive symptomology; instead, it is recommended to assess the influence of individual symptoms.MethodsFollowing this symptom-based approach, we performed correlation, network and regression analysis using depressive symptoms as depicted by the items of the revised Beck Depression Inventory II (BDI) to assess their influence with nonadherence in N = 731 older adults with chronic neurological diseases. Nonadherence was measured with the self-report Stendal Adherence to Medication Score (SAMS).ResultsEven when controlling for sociodemographic and health-related covariates, the BDI remained the most influential contributor to nonadherence. Across different methods, Loss of Interest and Difficulty with Concentration were identified as particularly influential for nonadherence, linking nonadherence with other affective or somatic BDI items, respectively. Additionally, Fatigue, Problems with Decision Making, Suicidal Thoughts, and Worthlessness contribute to nonadherence.ConclusionUsing a symptom-driven approach, we aimed to understand which depressive symptoms contribute to higher levels of nonadherence. Our results refine previous hypotheses about motivation and control beliefs by suggesting that it is not merely a lack of beliefs in the efficacy of medication that connects depressive symptoms and nonadherence, but rather an overall lack of interest in improving one’s health due to feelings of worthlessness and suicidal tendencies. This lack of interest is further substantiated by already sparse resources caused by changes in concentration and fatigue. In order to improve health outcomes and reduce nonadherence, these associations between depressive symptoms must be further understood and targeted in tailored interventions.

Psycho‐social risk factors for worse cognitive performance in sexual minority older adults

AbstractBackgroundSexual minority older adults (SMOA) may have a greater risk of developing cognitive impairment than heterosexual older adults (HOA), but currently available findings are inconsistent. Minority stress (i.e. sexual orientation‐related stigma) has been suggested to drive worse cognitive health in this population. Therefore, the present study aimed to investigate whether minority stress and other risk factors for worse cognition in SMOA, namely depression and marital status, were associated with worse cognitive performance in SMOA.MethodA total of 336 SMOA and 5561 HOA participants aged 50+, non‐institutionalised and free from neurodegenerative diseases from Wave 6 of the English Longitudinal Study of Ageing were included. Cognitive performance (i.e. temporal orientation, episodic memory and fluid intelligence) of SMOA and HOA was compared using general linear models including age, sex and education as covariates. The impact of depressive symptoms, marital status and minority stress on cognition in the two groups was also investigated. Weighting was performed to correct for sampling probability and differential non‐response.ResultSMOA were more likely to be single and to report stressful social experiences due to sexual orientation than HOA participants. SMOA had better episodic memory than HOA and depressive symptoms and being single were associated with worse cognitive performance across all tests. Associations between cognitive performance and all risk factors were found not to be significantly different between the two groups. However, minority stress was negatively associated (b = ‐2.116, p = 0.016) with fluid intelligence in the SMOA group only.ConclusionConsistently with previous evidence, the SMOA had better episodic memory performance than the HOA group and both more severe depression and not being in a relationship had a generalised detrimental impact on cognition. However, this study provided the first evidence of a potential negative impact of a proxy measure of minority stress on cognitive performance, i.e. worse fluid intelligence, in SMOA. Further investigations are needed to assess minority stress more comprehensively and to clarify the potential mechanisms driving decline in both self‐reported and objectively assessed cognitive health in SMOA.

Assessing perceived participation among older adults total hip arthroplasty and total knee arthroplasty patients six months post-surgery: a cross-sectional study.

This research sought to assess the perceived levels of participation and autonomy in senior patients who had received total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Hangzhou, China. Furthermore, the study aimed to identify the factors linked to these outcomes. This investigation will utilize a cross-sectional study design to assess perceived participation and autonomy among older adults total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. The research was conducted in Hangzhou, China, at a tertiary hospital. Convenient sampling was utilized to select 139 patients who underwent THA or TKA between March 2022 and March 2023 and met the inclusion criteria at a tertiary hospital in Hangzhou. The Impact on Participation and Autonomy Questionnaire, Hip/Knee Injury and Osteoarthritis Outcome Score (HOOS/KOOS), 5-Item Geriatric Depression Scale, Multidimensional Scale of Perceived Social Support, and Elders Health Empowerment Scale were used to assess perceived participation, hip/knee-related symptoms and functional restrictions, depression symptoms, social support, and health empowerment. The mean score for perceived participation and autonomy was 22.554 (SD: 13.042). The mean scores for participation in indoor autonomy, outdoor autonomy, family roles, and social relations were 0.654 (SD: 0.608), 1.324 (SD: 0.792), 1.053 (SD: 0.657), and 0.664 (SD: 0.542), respectively. Negative correlations were observed between perceived participation/autonomy scores and HOOS/KOOS, social support, and health empowerment scores. Conversely, a positive correlation was found between perceived participation/autonomy scores and depression scores. The detrimental effect of HOOS/KOOS, social support, and health empowerment scores on perceived participation and autonomy was notable, while the impact of depressive symptoms was comparatively minor. Older Chinese patients, at first six months post THA/TKA surgery, reported higher levels of perceived participation compared to individuals with other conditions, such as stroke patients. Functional limitations resulting from hip/knee-related symptoms, as well as social support and health empowerment, emerged as significant influencing factors for perceived participation and autonomy. This research enhances our comprehension of the elements influencing perceived participation among older adults individuals who have undergone THA/TKA procedures.

The Impact of Depressive Symptoms on Outcomes in Incident Hemodialysis Patients

The Impact of Depressive Symptoms on Outcomes in Incident Hemodialysis Patients

Depressive symptoms prospectively increase risk for new onset cigarette and ENDS dependence symptoms

Little research has examined the new onset of cigarette and Electronic Nicotine Delivery System (ENDS) dependence symptoms among young adults. This study aims to 1) examine new onset cigarette and ENDS dependence symptoms over a 4.5-year period and 2) examine how depressive symptoms impact new onset dependence symptoms among young adults. Participants were drawn from 24 colleges in Texas who were participating in a multi-wave cohort study (2014–2019). The present study included 4536 participants aged 18–25 who did not report cigarette or ENDS dependence symptoms at wave 1 (64.1% female; 65.2% non-white; m age = 20.62 [SD = 1.80] at wave 1). Cox’s regression models were employed to determine the hazard of new onset cigarette and ENDS dependence symptoms overall and the impact of depressive symptoms. Models controlled for sociodemographic factors and other tobacco product use. 14.4% of participants reported new onset cigarette dependence symptoms and 14.6% reported new onset ENDS dependence symptoms over the 4.5 years of the study. Depressive symptoms significantly predicted increased risk for new onset cigarette (HR = 1.30, CI = [1.21, 1.39]) and ENDS (HR = 1.20, CI = [1.12, 1.29]) dependence symptoms. Young adults exhibited dependence symptoms for cigarettes and ENDS products at similar rates across the 4.5 years of the study. Elevated depressive symptoms increased risk of new onset cigarette and ENDS dependence symptoms, advancing evidence for the self-medication hypothesis. Tobacco and nicotine prevention and cessation programs and messaging are needed particularly among young adults who experience depressive symptoms.

Association between eating disorders and sleep duration among college students: Findings from the National Healthy Minds study

Objectives Explore associations between eating disorders (EDs) and sleep duration and the impact of depression symptoms (DSs) in American college students. Participants College students from 2018 to 2019 Healthy Minds Study. Methods Multivariate logistic regression evaluated associations between EDs (bulimia, anorexia, binge eating [BED]) and sleep duration. Stratified analyses assessed effect modification by DSs and gender. Results Students reporting any eating disorder had no greater risk of not recommended sleep duration during weekdays compared to those with no eating disorder history (Adjusted OR = 0.99, 95% CI: 0.89-1.13). However, subjects reporting BED were at greater risk of deficient sleep during weekends compared to those with no EDs (Adjusted OR = 1.26, 95% CI: 1.01-1.58). This association was not impacted by DSs. However, all EDs were associated with not-recommended sleep duration among those who identified as other gender identity in comparison to those with no EDs. Conclusion Health educators should monitor academic performance in students with EDs for adequate sleep duration.

The impact of depression symptoms on postmorbid adaptation of patients who have undergone SARS-CoV-2 infection (assessment from the position of the multimorbidity model)

To evaluate the impact of psychosomatic and anxiety symptoms of depression on the formation of postmorbid adaptation in patients who have undergone SARS-CoV-2 infection. The data of 54 patients, aged 18-55 years, with a current depressive episode who had outpatient SARS-CoV-2 infection were analyzed. The Hamilton depression rating scale (HDRS) was used and somatic condition was assessed using a general assessment of the patient's function limitation at the stage of reconvalescence. A linear regression analysis was performed to assess the association of psychosomatic and anxiety symptoms with somatic condition in SARS-CoV-2 infection, regardless of other factors. The multimorbidity model took into account, in addition to SARS-CoV-2 caused by organic somatic disorders, psychosomatic manifestations (B=-1.9, p=0.004) and anxiety (B=-3.7, p=0.04) symptoms of depression. Somatic anxiety was significantly correlated with a pronounced impairment of postmorbid readaptation (p<0.05), while mental anxiety did not demonstrate such a relationship (p=0.46). The observed trend seems to be due to the overlap of manifestations of somatic anxiety with the construct of residual somatic symptoms, even though there is no multicollinearity between them. Identification of clusters of symptoms associated with reduced opportunities for full recovery in the SARS-CoV-2-postmorbid period can significantly help in providing a high-quality and targeted psychopharmacological care.

Predicting the presence of depressive symptoms in the HIV-HCV co-infected population in Canada using supervised machine learning

BackgroundDepression is common in the human immunodeficiency virus (HIV)-hepatitis C virus (HCV) co-infected population. Demographic, behavioural, and clinical data collected in research settings may be of help in identifying those at risk for clinical depression. We aimed to predict the presence of depressive symptoms indicative of a risk of depression and identify important classification predictors using supervised machine learning.MethodsWe used data from the Canadian Co-infection Cohort, a multicentre prospective cohort, and its associated sub-study on Food Security (FS). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was administered in the FS sub-study; participants were classified as being at risk for clinical depression if scores ≥ 10. We developed two random forest algorithms using the training data (80%) and tenfold cross validation to predict the CES-D-10 classes—1. Full algorithm with all candidate predictors (137 predictors) and 2. Reduced algorithm using a subset of predictors based on expert opinion (46 predictors). We evaluated the algorithm performances in the testing data using area under the receiver operating characteristic curves (AUC) and generated predictor importance plots.ResultsWe included 1,934 FS sub-study visits from 717 participants who were predominantly male (73%), white (76%), unemployed (73%), and high school educated (52%). At the first visit, median age was 49 years (IQR:43–54) and 53% reported presence of depressive symptoms with CES-D-10 scores ≥ 10. The full algorithm had an AUC of 0.82 (95% CI:0.78–0.86) and the reduced algorithm of 0.76 (95% CI:0.71–0.81). Employment, HIV clinical stage, revenue source, body mass index, and education were the five most important predictors.ConclusionWe developed a prediction algorithm that could be instrumental in identifying individuals at risk for depression in the HIV-HCV co-infected population in research settings. Development of such machine learning algorithms using research data with rich predictor information can be useful for retrospective analyses of unanswered questions regarding impact of depressive symptoms on clinical and patient-centred outcomes among vulnerable populations.

Relationship between depressive symptoms and adherence to direct-acting antivirals: Implications for Hepatitis C treatment among people who inject drugs on medications for opioid use disorder

BackgroundInterferon-based regimens exacerbated depressive symptoms, which interfered with treating hepatitis C virus (HCV) among people who inject drugs (PWID). Direct-acting antivirals (DAA) are not associated with worsening depressive symptoms; however, the impact of depressive symptoms on adherence remains little known. We examined the association between depressive symptoms and adherence to DAA among HCV-infected PWID. A secondary aim was to identify the optimal cut-off for major depressive disorder for this population. MethodsParticipants were 150 HCV-infected PWID on maintenance treatment enrolled in a randomized clinical trial testing three HCV care models. Severity of depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) at baseline and every 4 weeks during treatment. Current major depressive disorder at baseline was diagnosed by the Mini-International Neuropsychiatric Interview. Adherence was measured during treatment (weeks 1–12) using electronic blister packs ResultsBDI-II scores ≥ 18 were identified as the optimal threshold for diagnosing major depressive disorder. Participants with BDI scores ≥ 18 at baseline had significantly lower adherence rates at weeks 1–4 of treatment compared to those with BDI scores < 18 (b = −0.23, 95% CI: 0.45–0.01, p = 0.044), but not in any other time intervals (weeks 5–8, b = −0.03, 95% CI: −0.32, 0.26, p = 0.825; weeks 9–12, b = −0.33, 95% CI −0.70, 0.02, p = 0.066). ConclusionsElevated depressive symptoms were associated with lower adherence to DAA only during the first 4 weeks of HCV treatment. Neither severe depressive symptoms nor major depressive disorder appears to be a barrier to DAA adherence among PWID.

The impact of depressive symptoms and social support on resilience among older adult caregivers

In this study the authors explored how depressive symptoms and social support were related to the resilience of older caregivers (N = 117) caring children affected by HIV/AIDS in rural Northern Namibia, Africa. Our findings showed that lower levels of depressive symptoms and high levels of social support from significant others and family were statistically associated with increased resilience in older caregivers. There is a need for mental health services and social supports to improve the resilience of older caregivers caring for children affected by HIV and AIDS. There is an increasing need for more vigorous and concerted efforts from public and private sector practitioners and policy makers to expand social protection safety nets and develop more targeted economic interventions aimed at enhancing the resilience of older caregivers, especially those residing in rural HIV endemic communities in Namibia.

Sense of Purpose in Life Promotes Resilience to Memory Deficits Related to Depressive Symptomatology

Individuals higher in depressive symptoms commonly present with neuropsychological deficits including poorer memory performance. Sense of purpose in life, a component of psychological well-being, has been shown to promote resilience to cognitive impairment in older adulthood, but it is unclear whether it may also protect against cognitive deficits associated with higher depressive symptoms. This study examined whether purpose in life moderated the effect of depressive symptoms on cognitive functioning in a large longitudinal study of 4599 American older adults (Mage = 74.33 years, range = 65–104 years, 56.84% female) across a 12-year follow-up period. Depressive symptomatology was assessed at each wave using the 8-item Center for Epidemiologic Studies Depression Scale. Multilevel models assessed the influence of depressive symptoms and the interaction with sense of purpose in life on changes in word recall and mental status. Higher depressive symptoms were associated with poorer recall at baseline, but not rate of change over time. A negative interaction was observed between sense of purpose in life and depressive symptoms such that individuals higher in purpose experienced a less negative impact of depressive symptoms on word recall. No significant interaction of sense of purpose and depressive symptoms was observed on mental status. Having a sense of purpose in life may help protect older adults from memory deficits associated with higher depressive symptoms. The present findings underscore the potential for sense of purpose to promote cognitive reserve in older adulthood, allowing individuals to maintain cognitive performance in the face of accruing neuropsychological challenges.

Health-related quality of life in hospitalized non-psychiatric medical patients: The impact of depressive symptoms

• This is a multicentric cross-sectional study assessing HRQoL in hospitalized non-psychiatric medical patients. • HRQoL in these patients is lower than that reported in the general population. • Depressive symptoms impair not only the mental domain of HRQoL but also the physical domain. • Being older is also associated with lower levels of the physical composite of the HRQoL.

Emotion regulation deficits and depression-related maladaptive interpersonal behaviours

ABSTRACT Coyne’s interpersonal theory of depression posits that those with depressive symptoms engage in maladaptive interpersonal behaviours that, although intended to assuage distress, push away social supports and increase depressive symptoms (Coyne, 1976). Excessive reassurance seeking, negative feedback seeking, and conversational self-focus are three behaviours implicated in Coyne’s theory, yet their correlates- apart from depressive symptoms- are poorly understood. The current study considered the potential role of intrapersonal emotion regulation deficits as an additional vulnerability factor for these behaviours. Mediation models further tested whether linkages between emotion regulation deficits and maladaptive interpersonal behaviours helped to explain short-term increases in depressive symptoms, as further suggested by theory. Older adolescents (N = 291, M age = 18.9) completed self-report measures of emotion regulation deficits, depressive symptoms, and the three maladaptive interpersonal behaviours during an initial lab visit and again four weeks later. A series of multiple regression models suggested that emotion regulation difficulties are uniquely associated with each of the behaviours over and above the impact of depressive symptoms. Mediation analyses suggested that only excessive reassurance seeking mediated the association between initial emotion regulation deficits and increased depressive symptoms over time. The clinical implications of these findings are discussed.

The Impact of Depression and Exercise Self-Efficacy on Benefits of Pulmonary Rehabilitation in Veterans with COPD

Pulmonary rehabilitation (PR) improves health-related quality of life (HRQoL) and exercise capacity. Little is known about the impact of depression symptoms and exercise self-efficacy on improvements in these key PR outcomes. This study examined the impact of baseline depression status and change in depression symptoms (Beck Depression Inventory-II [BDI-II] score) over the course of PR on change in HRQoL assessed by the Chronic Respiratory Disease Questionnaire-Self Reported (CRQ-SR) and exercise capacity as measured by the 6-Minute Walk Test (6MWT). We also examined whether baseline exercise self-efficacy moderated the association between baseline depression symptoms and change in these key PR outcomes. We studied 112 US veterans (aged 70.38 ± 8.49 years) with chronic obstructive pulmonary disease (COPD) who completed PR consisting of twice-weekly 2-hour classes for 18 sessions. Depressed (BDI-II >13) and nondepressed (BDI-II ≤13) patients at baseline demonstrated comparable and significant improvement in CRQ-SR total score, subscales, and 6MWT. Greater reduction in depression over the course of treatment was significantly associated with greater improvement in CRQ-SR total score and the following subscales: fatigue, mastery, and emotional function. Change in depression did not predict change in 6MWT distance. Baseline exercise self-efficacy moderated the association between baseline depression symptoms and change in CRQ-SR fatigue. Specifically, when baseline exercise self-efficacy was <30.4, greater baseline depression was associated with less improvement in CRQ-SR fatigue. When baseline self-efficacy was >152.0, greater baseline depression was associated with greater improvement in CRQ-SR fatigue. PR programs should address mood and confidence to exercise given their impact on key PR outcomes.