Likelihood Of Depressive Symptoms Research Articles

Association of social gatherings and physical exercise with depressive symptoms among middle-aged and older adults during the COVID-19 pandemic

Strict social isolation and physical distancing measures implemented during the COVID-19 pandemic had significant implications for the psychological well-being of middle-aged and older adults. This study aimed to investigate factors associated with depressive symptoms during the pandemic period among individuals who reported no significant depressive symptoms before the pandemic. Individuals from the Korean Longitudinal Study of Aging without a previous report of significant depressive symptoms across Waves 6 (2016) and 7 (2018) were investigated for the development of depressive symptoms in Wave 8 (2020). The multivariable logistic regression results revealed that both men and women who participated in social gatherings and physical exercise less than once a week were associated with an increase in the likelihood of depressive symptoms (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.80–4.61 and OR 2.61; 95% CI 1.64–4.15, respectively for men and OR 2.58; 95% CI 1.80–3.70 and OR 1.51; 95% CI 1.02–2.23, respectively for women). In addition, unmarried men (OR 2.38; 95% CI 1.37–4.14) and women with one chronic disease (OR 1.98; 95% CI 1.14–3.43) or two or more chronic diseases (OR 2.28; 95% CI 1.31–3.99) reported a significant increase in the likelihood of depressive symptoms. Regular social gatherings and physical exercise were identified as key factors in mitigating depressive symptoms among middle-aged and older adults. The findings can inform the development of public health strategies that promote regular social interactions and physical activity to enhance the psychological resilience and overall well-being of middle-aged and older adults in the endemic era.

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.

Thyroid dysfunction: an unlikely culprit behind psychotic symptoms

IntroductionA number of studies have demonstrated that hyperthyroidism increases the prevalence of psychiatric disorders and the likelihood of depressive symptoms, anxiety and hipomania. Apathetic hyperthyroidism is a syndrome, which presents with symptoms of depression, apathy, somnolence or pseudodementia in the absence of the usual symptoms and signs of hyperthyroidism. This condition is more common in the elderly although it has also been described in young adults and adolescents.In the majority of cases, treatment of hyperthyroidism results in an improvement in neuropsychiatric manifestations in parallel with an improvement of psychical (somatic?) symptoms and psychotropic medication is deemed unnecessary. Approximately one-third of patients with Graves’ hyperthyroidism are prescribed psychotropic drugs. Sometimes to treat mental symptoms like psychosis or severe agitation, sometimes to treat mental symptoms remaining after amelioration of hyperthyroidism, and sometimes when the diagnosis of Graves’ hyperthyroidism has been missed and the patient is treated as having a primary psychiatric disorder.ObjectivesTo present a case of a patient with neuropsychiatric symptoms caused by thyroid dysfunction.MethodsCase presentation and non-systematic review of existing literature on Pubmed using the following keywords: hyperthyroidism, psychiatric disorders, psychiatric symptoms, depression, psychosis.ResultsWe report the case of a 21-year-old female without history of psychiatric illness who presented to the emergency department with somnolence, apathy, cognitive impairment (answering “I don’t know” to most questions), poverty of speech, abulia, perplexity and delusional belief of ruin, in addition to physical symptoms namely alopecia and weight loss. According to her father, she was very active and dynamic person until two days prior, when he started noticing growing apathy, leading to job absenteeism. Urine analysis for elicit drugs was negative.Investigation for organic disease was undertaken and the blood analysis revealed overt hyperthyroidism.She was initially treated with aripiprazol. After thyroid dysfunction was identified, she was evaluated by an endocrinologist and started treatment with tiamazol and propanolol, presenting gradual remission of the psychiatric changes. Aripiprazole was discontinued and she was reevaluated in psychiatry consultation after about a month, with complete remission of psychiatric manifestations and normalized thyroid function.ConclusionsNeuropsychiatric manifestations of thyroid dysfunction are often misdiagnosed as a primary psychiatric disorder. It is necessary to optimize the medical management of these patients in whom the psychiatric symptoms masks a curable organic cause.Disclosure of InterestNone Declared

Neuroticism is associated with increase in depression symptoms over time in older adults with type 2 diabetes.

The likelihood of depression symptoms in those with type 2 diabetes (T2D) is high. Psychological risk factors enhancing comorbidity of depression symptoms in T2D are yet to be determined. The present study examines the cross-sectional and longitudinal relationship between personality traits and distinct depression dimensions in older adults with T2D. Participants were older adults (age ≥65yeas) with T2D from the Israel Diabetes and Cognitive Decline (IDCD) study (N=356), with complete data on depression [Geriatric Depression Scale (GDS) - 15 item version] and its dimensions- namely, dysphoric mood, apathy, hopelessness, memory complains and anxiety, and on personality [Big Five Inventory (BFI)]. Logistic and mixed linear regression models examined cross-sectional and longitudinal associations while adjusting for socio-demographics, cognition, cardiovascular and diabetes-related factors. Cross-sectionally, high neuroticism was associated with high scores in total GDS and in all depression-dimensions, except memory complaints. Higher extroversion was associated with lower total GDS and with lower scores on all depression dimensions, except anxiety. High levels of neuroticism were associated with increase in total number of depression symptoms over time. In older adults with T2D, neuroticism and extroversion are associated with most depression dimensions suggesting that these traits relate to a global depression symptomatology rather than to any specific dimension or phenomenology. High neuroticism was associated with increase in depression symptoms over time, highlighting its role in the development of depression symptoms in older adults with T2D.

Exploring accommodations along the education to employment pathway for deaf and hard of hearing healthcare professionals.

BackgroundDeaf and hard of hearing (DHH) people are an underserved population and underrepresented among healthcare professionals. A major barrier to success for DHH healthcare professionals is obtaining effective accommodations during education and employment. Our objective: describe DHH individuals’ experiences with accommodations in healthcare education.MethodsWe used an online survey and multipronged snowball sampling to recruit participants who identify as DHH and who had applied to a U.S. health professional school (regardless of acceptance status). One hundred forty-eight individuals representing multiple professions responded; 51 had completed their training. Over 80% had been accepted to, were currently enrolled, or had completed health professions schools or residency programs, and/or were employed. The survey included questions addressing experiences applying to health professions programs and employment; satisfaction with accommodations in school and training; having worked with a disability resource professional (DRP); and depression screening.ResultsUse and type of accommodation varied widely. While in school, respondents reported spending a mean of 2.1 h weekly managing their accommodations. Only 50% were highly satisfied with the accommodations provided by their programs. Use of disability resource providers (DRPs) for accommodations was highest during school (56%) and less frequent during post-graduate training (20%) and employment (14%). Respondents who transitioned directly from school to employment (versus via additional training) were more satisfied with their accommodations during school and were more likely to find employment (p = 0.02). Seventeen respondents screened positive for risk of depression; a positive screen was statistically associated with lower school accommodation satisfaction.ConclusionsDHH people study and practice across many health professions. While respondents were mostly successful in entering health professions programs, accommodation experiences and satisfaction varied. Satisfaction with accommodations was related to successful employment and wellness. Low satisfaction was associated with higher likelihood of depression symptoms. To increase representation in the workforce, healthcare professional schools, training programs, and employers should enhance support for the learning and working climates for people with disabilities.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-022-03403-w.

Children’s Filial Piety and Parents’ Depressive Symptoms: Findings From a Dyadic Study

Filial piety is an important Chinese cultural value that prescribes child behavior towards their parents, but little is known about its relationship to the parents’ psychological wellbeing. This study utilizes dyad data from the PINE and PIETY Studies. Filial piety was measured by asking how much the participant thought children should 1) care; 2) respect; 3) greet; 4) please and make happy; 5) obey; and 6) provide financial support to their parents. Depressive symptoms were measured by Patient Health Questionaire-9 with a cutoff of 5 indicating the presence of depressive symptoms. Logistic regressions were used to examine the associations controlling for both children’s and parents’ sociodemographic characteristics. Higher filial piety in happy (OR:0.80, (0.65-0.99)) or obey (OR:0.83, (0.68-1.00)) was associated with a lower likelihood of depressive symptoms among parents. Future research should explore the potential causal relationships between children’s filial piety and parents’ mental health.

Adherence to the 24-hour Movement Behavior Guidelines and Associations with Depressive Symptoms among College Students

ABSTRACT Engaging in healthy daily 24-h movement behaviors (e.g., moderate-to-vigorous physical activity [MVPA] ≥ 60 minutes, screen time <2 hours, and sleep ≥ 7 hours) is suggested to be associated with favorable mental health outcomes (e.g., less depressive symptoms and higher quality of life). Given the high prevalence of depressive symptoms among young adults worldwide, the primary purpose of this study was to examine the effects of sociodemographic factors, weight status, and adherence to the 24-h movement behavior guidelines on depressive symptoms among college students. A total of 278 college students (187 women; Mage = 22.38, SD = 3.91) completed the validated depressive symptom survey and wore the accelerometers (GT9X ActiGraph) objectively assessing their light PA [LPA], moderate-to-vigorous PA [MVPA], sedentary behavior, and sleep duration. Significant associations of sociodemographic factors (sex, academic level, race) and weight status with the prevalence of depressive symptoms were observed (p < .05), but not with adherence to the 24-h movement behavior guidelines. No significant associations were found between adherence to the 24-h movement behavior guidelines and the likelihood of depressive symptoms (odds ratios ranged from 0.56 to 1.85; p > .05). Adherence to the 24-h movement behavior guidelines was associated with the prevalence of depressive symptoms among college students. Higher education institutions should focus on depression screening and prevention among college students who are women, minority, and in an overweight/obese weight status.

Hospitality workers' COVID-19 risk perception and depression: A contingent model based on transactional theory of stress model.

The hospitality industry worldwide is suffering under the COVID-19 pandemic. Drawing on the transactional theory of stress and coping, this study aims to investigate when hospitality workers' COVID-19 risk perception affects their likelihood of having depressive symptoms. Using data from 211 hospitality workers in 76 hotels in Peru, we examined the effects of perceived COVID-19 risk on the likelihood of experiencing depressive symptoms. We posited that this relationship is moderated by the workers' environment at work (job satisfaction) and at home (the number of children). The results indicate that job satisfaction weakens the link between hospitality workers' COVID-19 risk perception and their likelihood of depressive symptoms while the number of children exacerbates this link. We discuss the implications of our findings for research on COVID-19 risk perception and offer practical implications for hospitality workers under COVID-19 crisis.

Do opposite ends of same factors underlie life satisfaction vs. depressive symptoms among older people?

BackgroundAlthough depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ.AimTo study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people.MethodsThe data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one’s life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling.ResultsBetter physical performance, not perceiving loneliness, having special interests in one’s life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes.DiscussionThe opposite ends of the same factors underlie positive and negative dimensions of mental well-being.ConclusionFurther studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.

Adult Day Service Use Decreases Likelihood of Depressive Symptoms Among Black Dementia Caregivers

Black Americans are more likely than others to age with Alzheimer’s Disease (AD) in the community and rely on family members for support. Despite reported positive aspects of caregiving, Black caregivers report greater need for daytime respite and caregiving support. Little is known regarding the health-promoting benefits of daytime respite, like adult day services (ADS), among Black caregivers. Using a sample of 190 Philadelphia-area Black caregivers for community-living persons with dementia, pooled from two behavioral intervention trials: Advancing Caregiver Training and Care of Persons with Dementia in their Environments, the study examined the association between ADS use and depressive symptoms. About 36% of the caregivers used adult day services for their family member with AD. Controlling for demographic variables, social support, self-rated health, religious coping, caregiver burden, and number of years caregiving Black caregivers who utilized ADS had lower depressive symptoms (β= -1.60, p<.05) relative not using ADS.

P.318 Safety/tolerability of antipsychotics in the treatment of adult patients with major depressive disorder: a systematic review and meta-analysis

Youth with bipolar disorder (BP) exhibit poor medication adherence, contributing to affective recurrence. Brief Motivational Interventions (BMIs) improve adherence among adolescents with chronic conditions.In an open pilot series, we developed a 3-session BMI for BP adolescents targeting medication adherence and conducted a pilot randomized trial comparing Standard Care (SC) versus SC+BMI. Participants include 43 adolescents with BP prescribed psychotropic medications. We assessed medication adherence objectively via bluetooth-enabled electronic pillbox (MedTracker). A blinded evaluator assessed mood symptoms at intake, 3- and 6-months.The BMI was well-received. Average objective medication adherence increased with time in SC+BMI, but decreased in SC-Alone (p < 0.0001). Adolescents’ baseline self-rated expectation of improvement with treatment moderated the effect of treatment on improvement in adherence over time (p = 0.003). Across groups, poor adherence predicted increased likelihood of depression and hypo/mania symptoms in the subsequent two weeks; medication adherence mediated the effect of the BMI on the likelihood of depressive symptoms (p = 0.007).Electronic pillbox use (across groups) may enhance adherence, resulting in overestimates compared with naturalistic conditions. This pilot randomized trial may have been underpowered to detect some group differences.A BMI offers promise as a disseminable adjunctive intervention for improving medication adherence for adolescents with BP. Future studies with larger samples can establish efficacy. NCT03203720

A brief motivational intervention for enhancing medication adherence for adolescents with bipolar disorder: A pilot randomized trial

BackgroundYouth with bipolar disorder (BP) exhibit poor medication adherence, contributing to affective recurrence. Brief Motivational Interventions (BMIs) improve adherence among adolescents with chronic conditions. MethodsIn an open pilot series, we developed a 3-session BMI for BP adolescents targeting medication adherence and conducted a pilot randomized trial comparing Standard Care (SC) versus SC+BMI. Participants include 43 adolescents with BP prescribed psychotropic medications. We assessed medication adherence objectively via bluetooth-enabled electronic pillbox (MedTracker). A blinded evaluator assessed mood symptoms at intake, 3- and 6-months. ResultsThe BMI was well-received. Average objective medication adherence increased with time in SC+BMI, but decreased in SC-Alone (p < 0.0001). Adolescents’ baseline self-rated expectation of improvement with treatment moderated the effect of treatment on improvement in adherence over time (p = 0.003). Across groups, poor adherence predicted increased likelihood of depression and hypo/mania symptoms in the subsequent two weeks; medication adherence mediated the effect of the BMI on the likelihood of depressive symptoms (p = 0.007). LimitationsElectronic pillbox use (across groups) may enhance adherence, resulting in overestimates compared with naturalistic conditions. This pilot randomized trial may have been underpowered to detect some group differences. ConclusionsA BMI offers promise as a disseminable adjunctive intervention for improving medication adherence for adolescents with BP. Future studies with larger samples can establish efficacy. NCT03203720

NOT ENJOYING THE MEAL WAS ASSOCIATED WITH DEPRESSIVE SYMPTOMS, DESPITE THE SIZE OF SOCIAL CONNECTIONS

Conventional studies report that the enjoyment of the meal is related to likelihood of contracting depressive mood. The Japanese assisted living facilities currently support seniors build social connections to maintain their health and well-being, but psychological feeling during mealtime is often left unquestioned. Because seniors engage in conversation with tablemates while dining, the feeling during mealtime should not be ignored. This study aimed to explore the relationship among social connection, enjoyment during mealtime, and depressive mood. A cross-sectional questionnaire study was performed for independent residents at assisted living facility in Kanagawa Prefecture, Japan. The size of social connection (the number of facility residents that one can easily talk to) and enjoyment during the meal were assessed by a single item, respectively. The 15-item Geriatric Depression Scale was used to measure depressive symptoms. The analysis included 190 questionnaires. A logistic regression analysis showed that enjoyment during mealtime was associated with less likelihood of depressive symptoms, but the size of social connection was not, after adjusting for socio-demographics and health conditions. Moreover, a significant interaction between social connection and enjoyment during mealtime was observed. This indicated that greater size of social connection was inversely related to depressive symptoms among those who enjoyed the meal; however, among those who did not enjoy the meal, the likelihood of depressive symptoms were stably higher despite the size of social connection. The findings suggested that along with helping seniors build social connection, care takers should focus on improving the dining environment of seniors.

Likelihood of depressive symptoms in US older adults by prescribed opioid potency: National Health and Nutrition Examination Survey 2005-2013.

To investigate the relationships between depressive symptoms and opioid potency among adults aged 50years and older reporting use of one or more prescription opioids in the past 30days. Adjusted multiple linear regression models were conducted with 2005-2013 files from a secondary cross-sectional dataset, the National Health and Nutrition Examination Survey (NHANES). Respondents were community-dwelling, noninstitutionalized adults 50years or older (n=1036). Predictor variables included a positive screen for minor depression symptoms (Patient Health Questionnaire [PHQ-9] score greater than or equal to 5 and less than or equal to 9), moderate depression symptoms (PHQ-9 greater than or equal to 10 and less than or equal to 14), and severe depression symptoms (PHQ-9 greater than or equal to 15). Criterion variables included weaker-than-morphine analgesics (eg, codeine and tramadol) and morphine-equivalent opioids (eg, morphine and hydrocodone), which served as the reference category, as well as stronger-than-morphine opioid analgesics (eg, fentanyl and oxycodone). Prevalence rates for symptoms of minor depression, moderate depression, and severe depression were n=236 (22.8%), n=135 (13.0%), and n=122 (11.8%), respectively. Severe depression was significantly associated with high-potency opioid use (odds ratio [OR]: 2.27; confidence interval [CI], 1.16-4.46). In post hoc tests, severe depression remained significantly associated with high-potency opioid use only among respondents without arthritis (OR: 5.80; CI, 1.59-21.13). Compared with older adults without depressive symptoms, older adults with severe depressive symptoms are more likely to be taking high-potency opioid medications. Future prescription opioid medication research should prioritize investigations among older adults with pain-related diagnoses, other than arthritis, reporting preexisting or new symptoms of severe depression.

Is caregiving by baby boomer women related to the presence of depressive symptoms? Evidence from eight national surveys

BackgroundA common hypothesis is that caregiving is deleterious to women’s mental health. International studies continue to emphasize the importance of mental health issues for women. Yet only a few researchers have used population-based surveys to explore the association between caregiving and depressive symptomatology in the context of the community, and even less is known about this aspect of Baby Boomer women in a global context.MethodsThe present study uses eight international surveys covering nineteen nations (N = 15,100) and uses multilevel logistic models to examine possible linkages between caregiving and the likelihood of depressive symptoms among Baby Boomer women, when taking individual-level and country-level social factors into consideration.ResultsThe various analyses found a significant variation in the likelihood of depressive symptoms among these Boomer women across the nations investigated and across both individual-level and country-level characteristics. The significant association of caregiving by women and the likelihood of depressive symptoms is related to their social status in some nations (OR = 1.30; p < 0.001). Boomer women living in countries with high rates of female participation in managerial/professional work (OR = 1.04; p < 0.05) and living in countries where women are often in vulnerable employment (OR = 1.01; p < 0.05) are at greater risk of depressive symptomatology.ConclusionsThese findings demonstrate that the depressive consequences of caregiving by women are, to some degree, contingent upon social context and structure. Policies aimed at promoting mental health among female Baby Boomers should therefore be context specific.

Nursing intervention to enhance outpatient chemotherapy symptom management: Patient-reported outcomes of a randomized controlled trial.

The authors conducted a randomized controlled trial to evaluate a nurse practitioner (NP)-delivered symptom management intervention for patients initiating chemotherapy for nonmetastatic cancer. The aim was to reduce patient-reported symptom burden by facilitating patient-NP collaboration and the early management of symptoms. At the time of the first chemotherapy visit, adult participants with nonmetastatic breast, colorectal, or lung cancer (120 participants) completed self-report measures and were then randomly assigned to standard care plus the intervention or standard care alone. Intervention participants received proactive telephone calls from their oncology team NP during the week after each of the first 2 chemotherapy administration visits. Measures were repeated at the second and third chemotherapy visits. Group differences were analyzed with regard to patient-reported symptoms (Memorial Symptom Assessment Scale-Short Form items), satisfaction with care (Family Caregiver Satisfaction-patient scale), and the likelihood of depression or anxiety symptoms (Patient Health Questionnaire-4). At the time of the first visit, 50.8% of participants reported ≥1 physical symptom, most commonly lack of energy (35.8%) and drowsiness (30.8%). The number of symptoms (gamma coefficient [γ] = 0.16; P<.001), symptom distress (γ = 0.45; P<.001), and satisfaction with care (γ = 0.24; P = .004) increased whereas the likelihood of anxiety symptoms decreased (γ = -0.19; P = .02) and the likelihood of depression symptoms did not change (γ = 0.01; P = .91). Outcomes did not differ by randomized group. Randomized group interacted with emetogenic potential in predicting symptom distress (γ = 0.43; P = .03) and satisfaction with care (γ = -0.45; P = .045). The intervention did not appear to reduce symptom burden compared with standard care. Early symptoms highlight the importance of continuing to examine strategies to improve symptom management during chemotherapy for nonmetastatic disease.

Longitudinal Pattern of Depressive Symptoms Around Natural Menopause

An increased risk of depressive symptoms has been associated with the transition to menopause, but the risk of depressive symptoms in the early postmenopausal years has not been well characterized. To identify within-woman changes in depressive symptoms during a 14-year period around menopause, determine associations of a history of depression with the pattern of depressive symptoms, and evaluate the rate of change in reproductive hormones as predictors of depressive symptoms following menopause. A randomly identified, population-based sample in Philadelphia County, Pennsylvania, of 203 late-reproductive-age women who were premenopausal at baseline and reached natural menopause. Center for Epidemiologic Studies Depression Scale. The prevalence of high scores on the Center for Epidemiologic Studies Depression Scale decreased from 10 years before to 8 years after the final menstrual period (FMP), with a decrease of approximately 15% of baseline per year (odds ratio, 0.85; 95% CI, 0.81-0.89; P < .001). Relative to the FMP, the risk of depressive symptoms was higher in the years before and lower in the years after the FMP. Among women with a history of depression, the likelihood of depressive symptoms was more than 13 times greater overall and 8 times greater after menopause compared with women with no depression history. Among women who first experienced depressive symptoms approaching menopause, the risk of depressive symptoms declined after the FMP, with a significantly lower risk the second year after menopause. The risk of depressive symptoms after menopause decreased by 35% for each unit (SD) increase before the FMP in the log rate of change of follicle-stimulating hormone (odds ratio, 0.65; 95% CI, 0.46-0.91; P = .01). The FMP was pivotal in the overall pattern of decreasing depressive symptoms in midlife women, with higher risk before and lower risk after the FMP. A history of depression strongly increased the risk both before and after menopause. Women who had no history of depression before the menopause transition had a low risk of depressive symptoms 2 or more years after the FMP.

Editorial Comment

In their original article, investigators from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium report short-term changes in health-related quality of life (HRQOL) in patients receiving neoadjuvant androgen deprivation therapy before initiating external beam radiation or brachytherapy for localized prostate cancer. Using the Expanded Prostate Cancer Index Composite-26 instrument, the study found statistically and clinically significant declines in the sexual and vitality/hormonal domain summary scores and in multiple individual items 2 months after initiating neoadjuvant androgen deprivation therapy. After 2 months of therapy, patients were more than twice as likely to report erectile dysfunction and orgasmic dysfunction. In addition, and perhaps not surprisingly, the risk of hot flashes increased with ADT administration, as did the likelihood of depressive symptoms and lack of energy. These data provide physicians and patients both with some sense of the short-term functional declines presumably attributable to ADT administration and should be used to guide expectations in the early treatment period. Neoadjuvant Androgen Deprivation Therapy Leads to Immediate Impairment of Vitality/Hormonal and Sexual Quality of Life: Results of a Multicenter Prospective StudyUrologyVol. 82Issue 6PreviewTo evaluate the immediate effects of neoadjuvant androgen deprivation therapy (NADT) on health-related quality of life (HRQOL) among patients undergoing radiation therapy (RT) for newly diagnosed prostate cancer. Full-Text PDF ReplyUrologyVol. 82Issue 6PreviewWe greatly appreciate the thoughtful commentary on our study. The effect of neoadjuvant androgen deprivation therapy (NADT) on health-related quality of life (HRQOL) deserves further study. It is our intention to publish the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium long-term data in the future. In the context of NADT, the relationship between testosterone levels and HRQOL, testosterone recovery rates, and kinetics, and the effect of diminished muscle strength and cognitive functioning from NADT on HRQOL are some research areas that deserve further exploration so we can best advise our patients. Full-Text PDF

Prevalence of depressive symptoms among elderly in the city of Tremembé, Brazil: preliminary findings of an epidemiological study.

Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%.OBJECTIVETo establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older.METHODSResults of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of depressive symptoms.RESULTSA total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005).CONCLUSIONThe prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completed.

Sitting-Time, Physical Activity, and Depressive Symptoms in Mid-Aged Women

Associations of sitting-time and physical activity with depression are unclear. To examine concurrent and prospective associations between both sitting-time and physical activity with prevalent depressive symptoms in mid-aged Australian women. Data were from 8950 women, aged 50-55 years in 2001, who completed mail surveys in 2001, 2004, 2007, and 2010. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression questionnaire. Associations between sitting-time (≤ 4 hours/day, >4-7 hours/day, >7 hours/day) and physical activity (none, some, meeting guidelines) with depressive symptoms (symptoms/no symptoms) were examined in 2011 in concurrent and lagged mixed-effect logistic modeling. Both main effects and interaction models were developed. In main effects modeling, women who sat >7 hours/day (OR=1.47, 95% CI=1.29, 1.67) and women who did no physical activity (OR=1.99, 95% CI=1.75, 2.27) were more likely to have depressive symptoms than women who sat ≤ 4 hours/day and who met physical activity guidelines, respectively. In interaction modeling, the likelihood of depressive symptoms in women who sat >7 hours/day and did no physical activity was triple that of women who sat ≤ 4 hours/day and met physical activity guidelines (OR 2.96, 95% CI=2.37, 3.69). In prospective main effects and interaction modeling, sitting-time was not associated with depressive symptoms, but women who did no physical activity were more likely than those who met physical activity guidelines to have future depressive symptoms (OR=1.26, 95% CI=1.08, 1.47). Increasing physical activity to a level commensurate with guidelines can alleviate current depression symptoms and prevent future symptoms in mid-aged women. Reducing sitting-time may ameliorate current symptoms.