Independent Risk Factor For Depression Research Articles

Analysis of risk factors for postoperative anxiety and depression in endometriosis patients with reproductive intention

BACKGROUND The occurrence of postoperative depression and anxiety in patients with endometriosis (EMS) not only causes psychological distress, but may also harm their physical health. AIM To explore the postoperative depression status, and its influencing factors, of EMS patients with reproductive intention. METHODS A total of 321 EMS patients with reproductive intent were included. Using the self-rating anxiety scale and self-rating depression scale, EMS patients with anxiety or depression were distinguished. A clinical model for predicting anxiety or depression in EMS patients was constructed and evaluated using a nomogram, receiver operating characteristic curve, and calibration curve. RESULTS The results of the single factor analysis showed that smoking, coffee, EMS stage, chronic pelvic pain, and sexual discomfort may be related to anxiety. Further, smoking, drinking, spouse, annual household income and EMS stage may be related to depression in EMS patients. Multivariate logistic regression illustrated that smoking, coffee, chronic pelvic pain and sexual discomfort may be independent risk factors for anxiety in EMS patients, while smoking, EMS stage (Phase III and Phase IV), spouse and high annual household income may be independent risk factors for depression in EMS patients. Additionally, the models used to predict the risk of anxiety or depression in EMS patients have good predictive value. CONCLUSION The anxiety and depression of EMS patients may be related to many factors. In clinical treatment, additional attention should be paid to the psychological status of EMS patients.

Prevalence and risk factors of depression in juvenile systemic lupus erythematosus

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organ systems, including the central nervous system. Depression is one of the neuropsychiatric manifestations of juvenile SLE . Objective To estimate the prevalence of depressive disorders in juvenile SLE and identify its potential risk factors. Methods This cross-sectional study was conducted in juvenile SLE patients at Dr. Mohammad Hoesin General Hospital, Palembang. Sociodemographic data and medications were recorded. Disease activity of SLE was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Physical activity was measured using the Physical Activity Questionnaire for Children (PAQ-C) and the Physical Activity Questionnaire for Adolescents (PAQ-A). All subjects were screened for depression using the Childhood Depression Inventory (CDI) questionnaire. Multiple linear regression analyses were used to determine risk factors for depressive disorders. Results We included 72 patients, of whom 67 (93.1%) were female. Mean age of the patients was 12 years 4 months (SD 2 years 6 months); most (67; 93.1%) were 10-18 years of age. Depression was found in 24 patients (33.3%). SLEDAI scores of ?3 (flare) were found in 54 patients (75%) and low physical activity was found in 62 (86.1%) patients. The prevalence of depression based on the Children's Depression Inventory was 33.3%. A SLEDAI score of ?3 and low physical activity were significantly associated with depression (P=0.009 and P=0.025, respectively). On multiple linear regression analysis, only SLEDAI score of ?3 remained significantly associated with depression (P= 0.017; OR 12.6; 95%CI 1.6–101.7). Gender, age, family economic status, father's education, mother's education, family history of depression, and duration of illness were not associated with depression. Conclusion A SLEDAI score indicating flare (?3) and low physical activity are significantly associated with an increased risk of depression. A SLEDAI score is an independent risk factor for depression when all other significant risk factors are considered.

Systemic immune inflammation index is a valuable marker for predicting hemodialysis patients with depression: a cross-sectional study.

Maintenance hemodialysis (MHD) patients suffer from enormous physical, mental stress and poor quality of life, so an increasing number of patients are in a long-term state of depression. A prominent feature of MHD patients is chronic persistent inflammation, which is also an important mechanism for the onset of depression. Therefore, finding economically convenient inflammatory markers to predict and diagnose the onset of depression in MHD patients is of great value. As a novel inflammatory marker, systemic immune inflammation index (SII) can more comprehensively reflect the inflammation and immunity level of patients. This study aims to explore the relationship between SII and depressive symptoms in MHD patients. A cross-sectional study was conducted on 206 MHD patients from three dialysis centers. Based on the Hospital Anxiety and Depression Scale (HADS) scores, patients were divided into non-depression and depression groups. Inter group comparison and multivariate logistic regression analysis were performed to determine whether SII is an independent risk factor for depression in MHD patients. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SII on depression symptoms in MHD patients. According to the HADS scale score, 38.83% of the included patients were in a state of depression. After adjusting for all confounding factors, MHD patients with SII>963.93 had a 4.709 times higher risk of depression than those with SII ≤ 478.32 (OR=4.709, 95% CI 1.821-12.178, P<0.01). ROC analysis showed that SII>685.11 was the best cutoff value for MHD depression patients, and the area under the curve (AUC) was 0.681. High SII is an independent risk factor for depressed MHD patients and an ideal inflammatory marker for predicting and identifying depression in MHD patients as assessed by the HADS scale.

Late chronotype and associated health problems

Introduction: Chronotype reflects an individual's preference for activity and rest within a 24-hour period, governed by the internal circadian clock system located in the suprachiasmatic nuclei of the hypothalamus. There are three chronotypes: Morning, Evening, and Intermediate. The evening type is also called “night owls” or late chronotype. Night owls prefer to be active in the evening and sleep and wake up late. The misalignment between the sleep patterns in late chronotype and the social schedules puts the night owls in danger of physical and mental health issues. Purpose of work: The primary aim of this review is to provide a comprehensive overview of current knowledge on the impact of late chronotype on health. Methods and materials: A review of the literature available in the PubMed database, the following keywords and their combinations were searched: "chronotype", “mental health", "cancer", “late chronotype”, “circadian rhythm”, “type 2 diabetes”, “depression”. State of knowledge: Studies have confirmed that late chronotype is associated with a higher risk of type 2 diabetes, obesity, cancer, alcohol and cigarette addiction, and unhealthy eating habits. Furthermore, the evening chronotype is an independent risk factor for depression. It is also linked with anxiety, bipolar disorder, and schizophrenia. Summary: In this review, we have summarized the latest research on late chronotype, circadian misalignment, and their potential consequences on human health. Most studies on evening chronotype and related health issues are cross-sectional. Further longitudinal or experimental research is needed to examine the potential cause-and-effect relationships on this cause.

Frequency and Determinants of Depression in Hypothyroidism Patients at a Tertiary Care Hospital in the Western Region of Saudi Arabia.

Several studies have reported a strong association between depression and hypothyroidism, including from several regions of Saudi Arabia. However, studies on the frequency of depression among patients with hypothyroidism from the Western region of Saudi Arabia is limited. To determine the frequency and risk factors of depression among patients with hypothyroidism in the Western Region of Saudi Arabia. This cross-sectional study was conducted at a tertiary care hospital in Jeddah, Saudi Arabia, and included adult patients diagnosed with hypothyroidism. After contacting the patients through phone calls and obtaining their consent, a questionnaire weblink was sent. The first part of the questionnaire elicited details regarding demographics and history of hypothyroidism, while the second part comprised the Arabic version of the Patient Health Questionnaire-9 to evaluate depression. A total of 100 patients completed the survey, of which 80% were found to have depression (mild: 35%, moderate: 26%, moderate to severe: 12, severe: 7%). There was no significant association between depression and gender, age group, employment status, and marital status. In the bivariate analysis, a significant association was found between depression and reporting fatigue (P < 0.001), constipation (P < 0.001), hair loss (P = 0.002), cold intolerance (P = 0.014), dry skin (P = 0.028), memory problems (P = 0.029), and menorrhagia (P = 0.037). However, in the multivariate analysis, only reporting fatigue was found to be significantly associated with depression (P = 0.040; OR = 15.215). This study found that the prevalence of depression was very high among patients with hypothyroidism in the Western region of Saudi Arabia, and that fatigue is an independent risk factor of depression.

Fatigue, depression, and sleep disorders are more prevalent in patients with metabolic-associated fatty liver diseases.

To determine the prevalence and risk factors for depression, sleep disturbances, and exhaustion in MAFLD patients. Two hundred twenty-four consecutive patients with MAFLD attending the outpatient clinic from April to October 2023; were subjected to clinical evaluation, laboratory testing including non-invasive laboratory markers, fibroscan (measuring steatosis and fibrosis), and different quantitative and qualitative fatigue scores. A control group including 342 patients without MAFLD was taken. The prevalence of fatigue, depression, and sleeping disorders in the MAFLD group was 67.8%, 75%, 62.5% vs 21%, 16.4%, and 19.5% in the control group respectively ( P = <0.001, P = <0.001 and P = <0.001). MAFLD with fatigue was significantly associated with the presence and severity of steatosis and fibrosis by fibroscan ( P = <0.0001). By univariate and multivariate analysis: age, BMI, waist circumference, T2DM, hypertension, steatosis, fibrosis, and Fib-4 were considered risk factors for fatigue in the MAFLD group. The age, high social level, diabetes, hypertension, steatosis, fibrosis, and fib-4 were considered, by univariate and multivariate analysis, independent risk factors for depression in the MAFLD group. age, BMI, waist circumference, diabetes, hypertension, steatosis, fibrosis, and fib-4 were independent risk factors for sleep disorders in MAFLD. Fatigue, sleeping disorders, and depression are more prevalent in MAFLD patients than in the general population. The lower health utility scores in patients with MAFLD are associated with more advanced stages of the disease.

Decreased IL-4 is the risk factor of depression in patients with Takayasu arteritis.

Depression is a common complication in Takayasu arteritis (TA). Disorders of the immune system play an important role in both diseases. This study aimed to clarify the feature of cytokines in TA patients with depression. In this cross-sectional study, serum cytokines were tested in 40 TA patients and 11 healthy controls using the Bio-Plex Magpix System (Bio-Rad®). The state of depression was measured by the Zung Self-Rating Depression Scale (SDS) in TA patients. Logistic regression analysis was performed to find the risk factors of depression in patients with TA. TA patients with depression had higher ESR, hsCRP, NIH, and ITAS.A than patients without depression (16.00 [10.00, 58.50]mm/H vs. 7.50 [4.50, 17.75]mm/H, p = 0.013; 7.60 [2.32, 46.52]mg/L vs. 0.71 [0.32, 4.37]mg/L, p = 0.001; 2.00 [2.00, 3.00] vs. 1.00 [0.00, 2.00], p = 0.007; 7.00 [4.00, 9.50] vs. 1.50 [0.00, 5.75], p = 0.012, respectively). Additionally, the lower age of onset and levels of IL-4, IL-13, eotaxin, and IP-10 were observed in the depressed group compared with the non-depressed (23.50 [19.25, 32.50]pg./ml vs. 37.00 [23.25, 42.50]pg./ml, p = 0.017; 2.80 [2.17, 3.18]pg./ml vs. 3.51 [3.22, 4.66]pg./ml, p < 0.001; 0.66 [0.60, 1.12]pg./ml vs. 1.04 [0.82, 1.25]pg./ml, p = 0.008; 46.48 [37.06, 61.75]pg./ml vs. 69.14 [59.30, 92.80]pg./ml, p = 0.001; 184.50 [138.23, 257.25]pg./ml vs. 322.32 [241.98, 412.60]pg./ml, p = 0.005, respectively). The lower level of IL-4 and age of onset were the independent risk factors for depression in TA patients (OR [95% CI] 0.124 [0.018, 0.827], p = 0.031; 0.870 [0.765, 0.990], p = 0.035, respectively). Our data suggested that lower cytokine levels, especially IL-4, might be involved in the development of TA patients with depression. Clinicians can probably use serum IL-4 level testing as a potential indicator of depression in TA.

Are TNF-α and IL-1β Independently Associated with Depression in Axial Spondyloarthritis Patients? A Case-Control Study

Objectives: The aim of this study was to investigate whether serum TNF-α and IL-1β levels are independent risk factors for depression in axSpA patients. Methods: All axSpA patients with BASDAI ≥4 were invited consecutively between March 2021 and August 2021 to participate. Depression was evaluated with the WHO-5 Well-Being scale. Disease activity was assessed using BASDAI (0–10), ASDAS-CRP (0.61–7.22), ASDAS-ESR (0.29–7.61), and health status by ASAS-HI (0–17). Serum TNF-α and IL-1β levels were measured by ELISA. An association between depression and cytokine levels was investigated with Spearman’s rank correlation coefficient test. Results: A total of 252 axSpA patients (155 men) could be included; of these, 123 (48.81%) were depressed, and of these, 75 were male. Serum TNF-α and IL-1β were not significantly associated with depression (r −0.041 and 0.110, respectively). Serum TNF-α levels were higher in depressed female axSpA patients (20.05 vs. 17.87; p = 0.03). Differences between depressed and non-depressed patients were respectively: TNF-α (19.7 vs.18.0; p= 0.84), IL-1β (32.3 vs. 21.2; p= 0.04), BASDAI (5.47 vs. 4.77; p = 0.000), ASDAS-CRP (4.17 vs. 3.78; p = 0.000), ASDAS-ESR (3.86 vs. 3.39; p = 0.000), CRP (48.43 vs. 37.93 mg/L; p = 0.000), and ASAS-HI (13.37 vs. 10.24; p = 0.000). Factors associated with depression were: peripheral joint involvement (OR = 1.073, 95% CI 1.012–1.138), BASDAI (OR = 1.534, 95% CI 1.011–2.335), and ASAS-HI (OR = 1.39, 95% CI 1.239–1.557). Only in depressed patients with peripheral SPA were higher IL-1β levels found, though the differences were probably not clinically relevant. Conclusions: Serum TNF-α and IL-1β were not independently related to depression in axSpA patients. Disease activity, peripheral joint involvement, and reduced health status showed the highest association with depression.

Combined effects of physical activity and life events on depression and PTSD in Chinese students aged 16-24 years.

Life events are important risk factors for depression and post-traumatic stress disorder (PTSD). Physical activity is a beneficial behavior to physiological and psychological health. While it has not been reported at present the combined effect of physical activity and life events on individual depression and PTSD, and whether it can alleviate the psychological risks induced by life events. To comprehensively investigate the current status of life events experiences in Chinese students aged 16-24 years and analyze the combined effects of physical activity and life events on their depression and PTSD. An online cross-sectional survey was conducted on physical activity levels, life events experiences, depression and PTSD of 1,552 Chinese students aged 16-24 using short version of International Physical Activity Questionnaire (IPAQ-S), adolescent self-rating life events checklist (ASLEC), PTSD Check List-Civilian Version (PCL-C) and Patient Health Questionnaire Depression Scale. Then, logistic regression equation and stratified analysis were used to explore the combined effects of physical activity and life events on depression and PTSD. Regression analysis showed that, except for female, <8 h of sleep, smoking, single parent/reorganized families and poor family economic status, experiencing medium-intensity and high-intensity life events were both risk factors for depression. Compared with those who experienced low-intensity life events, those who experienced medium- and high-intensity life events had a 27 and 131% increased risk of depression, respectively. In contrast, medium- and high-level physical activity could reduce the risk of depression by 49 and 53%, respectively. Similar results were obtained with PTSD as a dependent variable. Combined correlation analysis showed that, compared with those with high-level physical activity and low-intensity life events, those with low-level physical activity and high-intensity life events had a 209 and 121% increased risk of depression and PTSD, respectively. Stratified analysis showed that the threshold for life events induced depression and PTSD rose with the increase in the level of physical activity. Lack of physical activity and experience of high-intensity life events are independent risk factors for depression and PTSD, and strengthening physical activity can compensate for the harm of depression and PTSD caused by life events to some extent.

Vitamin D Deficiency Participates in Depression of Patients with Diabetic Peripheral Neuropathy by Regulating the Expression of Pro-Inflammatory Cytokines.

Vitamin D deficiency is associated with patients with diabetic peripheral neuropathy (DPN), and low levels of vitamin D are common in patients with depression. Depression is common in DPN patients and the definite pathogenesis remains unclear. This study aimed to determine vitamin D deficiency in the onset of depression in DPN and evaluate the effect of vitamin D supplementation on depression. A total of 192 patients with DPN were enrolled in this study. Clinical and laboratory information was collected. Chemiluminescent immunoassay was used to measure the level of 25(OH)D. Enzyme-linked immunosorbent assay was employed to measure the concentrations of interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), and IL-17A. Subjects with low 25(OH)D received 5000IU vitamin D daily for 12 weeks. Depression scores and levels of 25(OH)D, IL-1β, TNF-α, and IL-17A were re-evaluated after supplementation. The incidence of vitamin D deficiency and depression was high in DPN patients. Compared with vitamin D sufficient participants, Hamilton Depression Rating Scale (HAMD) scores and the levels of inflammatory markers IL-1β, TNF-α, and IL-17A were significantly higher in insufficient group (all p<0.05). HAMD score, IL-1β, TNF-α, and IL-17A were negatively correlated with 25(OH)D (all p<0.05). A linear relationship existed among IL-1β, TNF-α, IL-17A, and 25(OH)D (p<0.05). HAMD scores, IL-1β, TNF-α, and IL-17A were all reduced significantly after supplementation of vitamin D (p<0.05). Binary logistic analysis revealed that vitamin D insufficiency was an independent risk factor for depression in patients with DPN. Receiver operating characteristic (ROC) curve analysis showed a high sensitivity (87.20%) of 25(OH)D in discriminating DPN patients with depression. Vitamin D deficiency participated in occurrenceof depression in DPN patients and could be mediated, at least in part, by upregulation of pro-inflammatory cytokines. Vitamin D supplementation may be effective in improving depressive symptoms in DPN patients.

Mental health of junior college students in China during COVID-19 school lockdown: Findings of on-line cross-sectional survey

During the COVID-19 pandemic, junior students who had recently entered university may have experienced particular difficulties. This study aimed to investigate the incidence of anxiety, depression, and sleep status among junior college students during school closure. Junior college students from 3colleges in Anhui Province participated in this study from 6th to 20th April, 2022. The students’ data were collected using a designed online questionnaire developed on the “Wen juan xing” website and submitted via cell phone. Ordinal logistic regression analysis indicated that female sex was an independent risk factor for increased anxiety, depression, and insomnia (anxiety: OR 1.503, 95% CI 1.191–1.897; depression: OR 1.14, 95% CI 1.023–1.270; ISI OR 2.052, 95% CI 1.646–2.559). Notably, medical specialty was an independent risk factor for depression and anxiety (anxiety: OR 1.367, 95% CI 1.078–1.734; depression: OR 1.289, 95% CI 1.148–1.448). Moreover, being a freshman was a risk factor for increased depression and insomnia (depression: OR 1.036,95% CI 0.931–1.153; insomnia: (OR 1.157,95% CI 0.961–1.394). The findings indicate that a considerable portion of junior college students experienced psychological problems due to lockdowns during the COVID-19 pandemic.

Depression and Other Geriatric Syndromes in Institutionalized Oldest Old

Background. Oldest old are the fastest growing age group in Russia. The prevalence of depression increases with age and occurs more commonly among oldest old compared to lower age groups. At the same time, the frequency of depression and its association with geriatric syndromes in institutionalized oldest old is poorly studied.Aim. To assess the frequency of depression, the presence and nature of its associations with other geriatric syndromes in persons aged ≥90 years, who live in long term care facilities (LTCF).Materials and methods. The study involved 351 men and women aged 90 years and older permanently residing in the LTCF of Moscow. Depression was ascertained with the Geriatric Depression Scale. (GDS-15). All the subjects underwent a comprehensive geriatric assessment. To diagnose the frailty, we used the Short Physical Performance Battery (SPPB). The Bartel index was used to assess performance of activities of daily living. Instrumental activities of daily living were assessed using the Lawton scale. Nutritional status was assessed based on the Mini-Nutritional Assessment (MNA). To detect urinary and fecal incontinence, a scale of activities of daily living (Bartel index) was used, which contains relevant questions. Constipation syndrome was diagnosed in the presence of less than 3 bowel movements per week. An orthostatic test was performed to detect orthostatic hypotension. The presence of falls, sensory deficits, chronic pain and drug therapy were also assessed.Results. Depression was diagnosed in 67.2% of oldest old. A higher incidence of depression was found in women (77.5% vs. 68.7%; p=0.074). Only 2.73% of oldest old with depression received antidepressants. The presence of chronic pain (OR 1.89; 95% CI 1.16–3.08; p=0.010), hearing deficiency (OR 2.20; 95% CI 1.29–3.74; p=0.004) and frailty (OR 5.33; 95% CI 2.56–11.12; pp&lt;0.001) is independently associated with the presence of depression.Conclusion. The study showed a high incidence of depression with insufficient therapy in institutionalized oldest old. Independent risk factors of depression that are of practical importance for clinicians have been identified: frailty, hearing impairment and chronic pain syndrome.

Thyroid function, renal function, and depression: an association study.

To investigate the correlations between thyroid function, renal function, and depression. Clinical data of 67 patients with Major depressive disorder (MDD) and 36 healthy control subjects between 2018 and 2021 were collected to compare thyroid and renal function. Thyroid and renal functions of depressed patients were then correlated with the Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Rating Scale (HAMA).Spearman correlation analysis was used to find the correlation between renal function, thyroid function, and depression. A logistic regression was performed to find significant predictors of depression. Triiodothyronine protamine (T3), thyroxine (T4), free triiodothyronine protamine (FT3), uric acid, sodium, and anion gap were lower in the MDD group than in the control group (p < 0.05). Correlation analysis of thyroid function, renal function, and factor terms of HAMD in the MDD group suggested that diurnal variation, hopelessness, and depression level were positively correlated with thyrotropin (TSH) (p < 0.05). Cognitive disturbance, retardation, and depression level were negatively correlated with creatinine (p < 0.05). Diurnal variation was negatively correlated with sodium ion (p < 0.01); hopelessness and depression level were positively correlated with chloride ion (p < 0.05); diurnal variation, retardation, and depression level were negatively correlated with anion gap (p < 0.05). Diurnal variation (p < 0.01) and retardation (p < 0.05) were negatively correlated with osmolality. Cognitive disturbance and depression level were positively correlated with estimated glomerular filtration rate (eGFR) (p < 0.05). In the MDD group, correlation analysis of thyroid function, renal function, and HAMA factor terms suggested that the total HAMA score and anxiety level were positively correlated with chloride ion (p < 0.05); psychic anxiety, total HAMA score, and anxiety level were negatively correlated with anion gap (p < 0.05). Furthermore, a low level of anion gap was an independent risk factor for depression and anxiety levels (p < 0.05). Low thyroid function and reduced waste metabolized by the kidneys in patients with MDD suggest a low intake and low metabolism in depressed patients. In addition, subtle fluctuations in the anion gap in depressed patients were strongly correlated with the degree of depression and anxiety.

Osteoporosis is associated with depression among older adults: a nationwide population-based study in the USA from 2005 to 2020

ObjectivesThe global prevalence of osteoporosis is rising, yet it is unclear whether people with osteoporosis have a higher risk of depression than those without osteoporosis. Study designA cross-sectional study. MethodsWe used nationally representative data from the US National Health and Nutrition Examination Survey (NHANES) in 2005–2006, 2007-2008, 2009-2010, 2013-2014, and 2017-2020. The diagnosis of osteoporosis was based on the bone mineral density of the femoral neck measured by dual-energy X-ray absorptiometry. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a score ≥5 as depressive symptoms and a score ≥10 as probable depression. We used logistic regression models to evaluate the association between osteoporosis and depressive symptoms and probable depression. ResultsWe included 11,603 adults (aged 50 years and older, 52.3% male) and observed 5.2% of them had osteoporosis. 31.9% of these osteoporotic people had depressive symptoms, and 10.0% had probable depression. Compared to participants without osteoporosis, those with osteoporosis were 1.73 times more likely to experience depressive symptoms (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.20–2.50) and 1.91 times more likely to experience probable depression (OR = 1.91, 95% CI 1.02–3.59), after adjusting for sex, age, race/ethnicity, education, marital status, family income, body mass index, smoking, physical activity, and alcohol abuse. Moderate-to-vigorous activities mediated the associations between osteoporosis and depression and depressive symptoms. ConclusionsOsteoporosis is an independent risk factor for depression. This study highlights the need to evaluate the mental well-being of patients with osteoporosis in clinical and primary health care.

Independent risk factors for depression in older adult patients receiving peritoneal dialysis for chronic kidney disease

BACKGROUND According to the trend of global population aging, the proportion of elderly patients with chronic kidney disease (CKD) is expected to increase. However, there are more than 20 million people in China with decompensated kidney function, of which 19.25% are elderly people. Therefore, special attention should be paid to the education years, sleep quality, anxiety status, comorbidities with diabetes, cardiovascular disease (CVD), and anemia as independent risk factors for depression in elderly CKD patients. This study explores the clinical mana-gement of elderly CKD patients that should address these risk factors to prevent depression and improve their prognosis. AIM To investigate depression risk factors in older patients receiving peritoneal dialysis, aiding future prevention of depression in these patients. METHODS This retrospective study included a primary study population of 170 patients with CKD who received peritoneal dialysis from January 2020 to December 2022. We assessed the patients’ mental status using the Beck Depression Inventory Score-II (BDI-II), Self-Rating Anxiety Scale (SAS), Anxiety Inventory Score, and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was employed to identify depression independent risk factors among these patients. RESULTS The non-depressed group had a significantly longer education period than the depressed group (P &lt; 0.05). The depressed group exhibited significantly higher mental status scores than the non-depressed group (P &lt; 0.001). Patients with diabetes mellitus (DM) or CVD had a higher probability of developing dep-ression. Patients with depression had significantly lower hemoglobin and albumin levels than patients without depression (P &lt; 0.05). Spearman correlation analysis of BDI-II scale scores, measuring depression, indicated positive correlations with BDI-II and SAS scores as risk factors for depression in patients with CKD. In contrast, years of education, hemoglobin levels, and peritoneal Kt/V were negatively correlated, serving as protective factors against depression. An analysis of variance for influences with significant differences in the univariate analysis revealed that years of schooling, BDI-II, SAS, PSQI, DM, CVD, and hemoglobin levels independently influenced depression in older patients with CKD. CONCLUSION Education, BDI-II, SAS, PSQI, DM, and CVD are independent risk factors for depression in older patients with CKD; therefore, post-treatment psychological monitoring of high-risk patients is crucial to prevent depression.

Association of hemoglobin-to-red blood cell distribution width ratio and depression in older adults: A cross sectional study

BackgroundThe association between hemoglobin-to-red blood cell distribution width ratio (HRR) and the depression in old adults was not clear. MethodsWe extracted data on depression, general characteristics, lifestyle, medical history, drug use, and blood indicators from the National Health and Nutrition Examination Survey 2005–2018 to investigate the relationship between HRR and depression. ResultsA total of 4141 individuals were evaluated, among whom 266 (6.4 %) were identified as having depression. HRR was significantly lower in the low depression group, and Spearman correlation analysis revealed an inverse association between HRR and depression scores (r = −0.148, P < 0.001). Multiple linear regression showed that HRR was associated with depression after adjusted for general characteristics, life style, medical history, drug use and blood indicators (P = 0.010). ROC analysis demonstrated that in participants with depression, the area under the curve (AUC) for HRR was 0.612, surpassing both Hb(0.586) and RDW(0.401). These findings were statistically significant (P < 0.05). LimitationsOnly participants aged 65–79 years are selected for this study and this was a cross-sectional study that can only represent an association between HRR and depression, but not a cause-and-effect relationship. ConclusionsHRR, being more potent than Hb or RDW, emerges as an independent risk factor for depression. It has the potential to facilitate early depression detection, aiding in the prevention of clinical deterioration or relapses, and could also serve as a viable treatment target.

Poor sleep quality is an overlooked risk for geriatric syndromes in older adults with type 2 diabetes mellitus

ABSTRACT Background Aging and type 2 diabetes mellitus (DM) are two different conditions that impair sleep quality. The primary objective of this study was to investigate the impact of sleep quality on geriatric syndromes in older diabetic adults. Methods Comprehensive geriatric assessment was performed on 236 patients. The assessment included the Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life Questionnaire (EQ-5D), Mini Mental Statement Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment, and measurement of handgrip strength (HGS). Results Of the participants, 55% had DM, and 61.4% had poor sleep quality. Poor sleep prevalence was higher in diabetic patients (68.5%) than in non-diabetics (52.8%). Diabetic patients with poor sleep quality had higher frequencies of chronic pain, recurrent urinary tract infections, confirmed sarcopenia, and frailty (p = 0.015, p < 0.001, p = 0.027, and p < 0.001, respectively), a higher number of comorbidities and higher GDS and BAI scores (p = 0.046, p < 0.001 and p < 0.001, respectively), and lower scores of activities of daily living, HGS, and EQ-5D index (p = 0.023, p = 0.004, and p < 0.001, respectively) compared to diabetic patients with good sleep quality. According to the correlation analysis results, PSQI score had a positive correlation with GDS score (r = 0.461, p < 0.001) and a negative correlation with Mini Nutritional Assessment score (r = –0.317, p < 0.001), skeletal muscle mass index (r = –0.283, p = 0.002) and HGS (r = –0.307, p < 0.001) scores in diabetic older adults. Conclusion Poor sleep quality in older diabetic patients has a negative impact on several geriatric syndromes. Our findings suggest that poor sleep quality is an independent risk factor for depression, malnutrition, and lower muscle mass in older diabetic adults. Improving sleep quality may play a crucial role in preventing and managing geriatric syndromes in this population.

Anxiety and Depression in Patients With Inflammatory Bowel Disease at King Fahad Specialist Hospital, Qassim Region.

Background Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). It carries a risk of annual relapses and multiple intense flares, which require lifelong treatment and, sometimes, surgical interventions. This affects patients negatively in various aspects of their functioning, and they are left with an increased risk of disturbed quality of life and mental illnesses. Aim This study is carried out to describe the prevalence and risk factors of anxiety and depression symptoms among adult patients with IBD at King Fahad Specialist Hospital, Qassim, Saudi Arabia, and to examine the relationship between mental illness and disease activity. Patient and methods This cross-sectional descriptive study targets adult patients with IBD attending a gastroenterology clinic and medical day care unit. A self-administered questionnaire was given to patients with the help of an IBD nurse. The questionnaire includes the patient's demographic data (i.e., age, gender, etc.), symptoms and treatment patterns, the General Anxiety Disorder (GAD) questionnaire to measure anxiety, and the Patient Health Questionnaire (PHQ-9) to measure depression. Results Among the 179 IBD patients, 60.9% were males, and 40.8% were in the age group of 25-35 years. CD was the most prevalent IBD (73.2%). Perineal CD was detected in 45%. The prevalence of patients who were positive for anxiety symptoms was 17.3%, while the prevalence of depressive symptoms was 19.6%. The independent risk factor for anxiety was female gender, while the independent risk factor for depression was extraintestinal manifestation. The preventive factor for depression was treatment with IV medication. Conclusion Almost one-fifth of IBD patients were considered to have either anxiety or depression. Female gender was a risk factor for anxiety while extraintestinal manifestation of IBD was a risk factor for depression. Interestingly, treatment with IV medication was found to be the protective factor for depression. More investigations are warranted to give more insights regarding the prevalence and risk factors of psychological disorders among patients with IBD in our region.

Depression and its association with psychological factors among adolescents living with HIV in Southwestern Nigeria.

The aim was to determine the prevalence of depressive disorder and associated psychological factors among adolescents living with HIV/AIDS. One hundred and five adolescents with HIV were assessed for self-esteem, internalized HIV stigma and diagnosed of depressive disorder. Chi square and t tests were used to test associations and hierarchical logistic regression used to identify independent risk factors for depression. The mean age of participants was 16.5 (± 1.97) years and 55.2% were males. Mean stigma scores were significantly higher in those with depressive disorder (16.53 ± 3.85) when compared with those without (13.42 ± 3.464) and this difference was statistically significant (t = 3.17, p = 0.01). The mean self-esteem scores were significantly lower in participants with depressive disorder (17.53 ± 4.69) compared to those without depressive disorder (19.71 ± 3.86), though not significant (t = 1.96, p = 0.053). Depressive disorder was further significantly associated with female sex, being in romantic relationship, decline in work output due to HIV and HIV stigma. Independent risk factors were sex and HIV stigma. Depressive disorder is common among adolescents living with HIV infection in Nigeria. The association between HIV stigma and depression, thus suggests the need for prevention strategies targeting the impacts of HIV infection among adolescents.

Correlation analysis between sleep quality and the mental health status of female sex workers during the COVID-19 pandemic in Hubei Province.

Female sex workers (FSWs) in entertainment venues are subject to condemnation and rejection by their families and the outside world. As a result, they are prone to psychological problems, including anxiety and even suicidal tendencies. The aim of the current study was to understand the sleep and mental health status of local FSWs and to identify associated risk factors, so as to provide a scientific basis for improving the social recognition of FSWs and establishing effective psychological interventions. A stratified cluster random sampling method was used to select women engaged in commercial sex in bathing, sauna, karaoke halls and other entertainment venues. A self-designed questionnaire assessing mental health-related factors was administered face-to-face with the respondents. 90 participants were randomly selected for blood tests to analyze the relationship between biological indicators and sleep quality. The rates of depression, anxiety and somnipathy among FSWs were 32.7%, 43.1% and 8.6%, respectively. The correlation coefficients (r) between sleep quality and depression, anxiety and social support were 0.07, 0.09 and -0.09, respectively. Divorce or widowhood, technical secondary school education, alcohol consumption and exercise were independent risk factors for depression in FSWs (p< 0.05) while living in urban areas and counties and having a sense of social support were protective factors (P< 0.05). Quarantining due to the pandemic and exercise were independent risk factors for anxiety in FSWs (P< 0.05) while living in counties and having a sense of social support were protective factors (P< 0.05). Quarantining due to the pandemic was an independent risk factor for somnipathy in FSWs (P< 0.05) while being married was a protective factor (P< 0.05). NE/NA was a protective factor for sleep disorders (OR=0.042, P=0.05), with an AUC of 0.87. FSWs should appropriately adjust their work form during the pandemic period, maintain a positive and optimistic attitude, establish long-term stable social relationships, and seek a greater sense of social support. The government should provide comprehensive bio-psycho-social interventions to address the mental and physical health status of this population.