Lower Depression Research Articles

Suicidal Ideation in People with Traumatic Spinal Cord Injury

Suicidal behavior is considered a worldwide social phenomenon and a serious public health problem. In this regard, people with traumatic spinal cord injury may be associated with low mood, depression, suicidal ideation, and behavior. To evaluate the factors associated with suicidal ideation in people with SCI, this is quantitative, cross-sectional, descriptive study was carried out in a virtual environment. In total, 200 people aged 18 or over with TSCI living in Brazil took part in the study. Data were collected using the Beck Scale for Suicidal Ideation, answered online by participants using SurveyMonkey®. The sample consisted of 200 participants, most of whom were male, from southeast Brazil, with a mean age of 36.22 years, a duration of injury of 134.4 months, and a 32.5% frequency of suicidal ideation, as suicidal ideation was also verified in relation to the variables of schooling, rehabilitation, and consequence of injury. A statistically significant relationship was found between the duration of injury and suicidal ideation. According to the results, a considerable percentage of these individuals still think about suicide. On the other hand, the duration of the injury showed a significant difference in relation to suicidal ideation, and it was observed that the shorter the duration of spinal cord injury, the greater the likelihood of suicidal ideation.

Cyberbullying Experiences and Coping Strategies in Ibadan Metropolis, Ibadan, Nigeria

Introduction/Aim: Cyberbullying of influential personalities or celebrities is a media menace. Psychological, depressional, and emotional suicidal ideation effects are some of the impacts on celebrities. A few studies have investigated celebrities' coping mechanisms against this, with the majority from developed countries. There is a dearth of information on this among celebrities in Nigeria. This study investigated the experience, effects, and coping mechanisms of cyberbullying among celebrities in the Ibadan metropolis, Oyo State, Nigeria. Material and method: A descriptive crosssectional purposive sampling method was adopted. An in-depth interview guide was used for data collection among 14 consented celebrities. Data were manually analysed thematically. Results: Most participants were 25-35 years old and were comedians. All have experienced cyberbullies, such as popularity attacks and defamation of character. The effects of cyberbullying on the victims include low self-esteem, mental stress, depression, substance abuse, and financial crisis. Jealousy, hatred, envy, and quest for popularity among the perpetrators fuelled this menace. However, some celebrities have overcome these effects through technical, preventive, corrective, social support, and spiritual approaches. Conclusion: Cyberbullying is prevalent among celebrities and many experienced psychological effects. Awareness, interventions aimed at its prevention, and adequate coping strategies are needed to solve this menace.

Identification of high likelihood of dementia in population-based surveys using unsupervised clustering: a longitudinal analysis

BackgroundDementia is defined as a cognitive decline that affects functional status. Longitudinal ageing surveys often lack a clinical diagnosis of dementia though measure cognition and daily function over time. We used unsupervised machine learning and longitudinal data to identify transition to probable dementia.MethodsMultiple Factor Analysis was applied to longitudinal function and cognitive data of 15,278 baseline participants (aged 50 years and more) from the Survey of Health, Ageing, and Retirement in Europe (SHARE) (waves 1, 2 and 4–7, between 2004 and 2017). Hierarchical Clustering on Principal Components discriminated three clusters at each wave. We estimated probable or “Likely Dementia” prevalence by sex and age, and assessed whether dementia risk factors increased the risk of being assigned probable dementia status using multistate models. Next, we compared the “Likely Dementia” cluster with self-reported dementia status and replicated our findings in the English Longitudinal Study of Ageing (ELSA) cohort (waves 1–9, between 2002 and 2019, 7840 participants at baseline).ResultsOur algorithm identified a higher number of probable dementia cases compared with self-reported cases and showed good discriminative power across all waves (AUC ranged from 0.754 [0.722–0.787] to 0.830 [0.800–0.861]). “Likely Dementia” status was more prevalent in older people, displayed a 2:1 female/male ratio, and was associated with nine factors that increased risk of transition to dementia: low education, hearing loss, hypertension, drinking, smoking, depression, social isolation, physical inactivity, diabetes, and obesity. Results were replicated in ELSA cohort with good accuracy.ConclusionsMachine learning clustering can be used to study dementia determinants and outcomes in longitudinal population ageing surveys in which dementia clinical diagnosis is lacking.

Determinants of Psychological Problems among Widows Living under the Long Civil Unrest in the Southernmost Provinces of Thailand

People in the deep south region of Thailand have experienced civil unrest since 2004, and widows from the conflict have been severely stressed and faced various psychological problems. This study aims to investigate psychological problems and examine factors affecting the psychological problems among these widows. The psychological problems are post-traumatic stress disorder (PTSD), complicated grief (CG), and depression. The study’s sample consisted of 350 widows who voluntarily participated in the interviews and completed the questionnaires. PTSD symptom scale-interview version assesses post-traumatic stress disorder, and the complicated grief is measured using the inventory of the complicated grief, and the depression is evaluated with the Hamilton rating scale for depression (Thai version). The results indicate that the respondents had a high post-traumatic stress disorder state (M = 21, SD = 13.8), a high complicated grief state (M = 28.56, SD = 19.69), but a low depression state (M = 5.48, SD = 5.70). Thirty-two percent of the samples fulfilled the criteria for post-traumatic stress disorder, 48% for complicated grief, and 26.6% for depression. The factors significantly affecting post-traumatic stress disorder, complicated grief, and depression are low resilience, high external stressors, and the quality of life. However, the results should be interpreted with caution due to the risk of biases of the sensitive nature of the study. Therefore, to better understand the risks and protective factors of post-traumatic stress disorder, complicated grief, and depression of the bereaved widows, significantly different factors should be considered.

Sense of coherence, its components and depressive and anxiety symptoms in expecting women and their partners – A FinnBrain Birth Cohort Study

ObjectiveExpecting mothers with high sense of coherence (SOC) exhibit improved physical, emotional, and childbearing health. However, the dimensions of SOC and the factor structure of the SOC-13 scale during prenatal period is slightly known. Especially the differences in experiencing SOC and its components (comprehensibility, manageability, meaningfulness) among both expecting parents (mothers and fathers) is poorly understood. The association between SOC and mood disorder symptoms (depression and anxiety) during pregnancy is scarcely studied. MethodsThe structure of the SOC-13 scale, differences in SOC experiences, and the associations between SOC and depressive and anxiety symptoms were studied in a sample of 2784 pregnant women (mothers) and 1661 men/partners (fathers) belonging to the FinnBrain Birth Cohort Study. Self-reports (SOC-13, EPDS, SCL-90: ANX) from gestational week 24 were used. Confirmatory factor analysis (CFA) and invariance testing was carried out to investigate the factorial structure of SOC-13 among both groups (mothers and fathers). Group comparisons were used to study differences in the level of SOC among mothers vs. fathers, low vs. high depression and anxiety subgroups, and multiparous vs. nulliparous mothers. ResultsA two-factor model for SOC-13 consisting of comprehensibility-manageability and meaningfulness fitted the data best. Mothers reported higher levels of meaningfulness, whereas fathers reported higher levels of comprehensibility-manageability. SOC was significantly higher among fathers vs. mothers, but mothers with depressive symptoms reported higher SOC than fathers with depressive symptoms. ConclusionsDuring pregnancy, SOC can be viewed as a two-dimensional (vs. one- or three-dimensional) concept, and mothers and fathers have differences in the components of SOC. Importantly, mothers vs. fathers with depressive symptoms express higher overall SOC indicating that pregnancy may relate to higher than usual SOC especially among women with psychological distress. Understanding how expecting mothers and fathers experience SOC during pregnancy, particularly in relation to depressive symptoms, helps midwives and maternity care providers to focus health promoting support more precisely.

Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset.

Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor's warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03-1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90-4.71), low social support (RR = 1.94, 95%CI: 1.41-2.66), and PTSD and depression (RR's of 1.78 and 1.49, respectively, p-values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.

Low physical activity and depression are the prominent predictive factors for falling in older adults: the Birjand Longitudinal Aging Study (BLAS)

BackgroundFalling in the older adults has many irreparable consequences, including hospitalization to long-term care centers and loss of independence, depression and social isolation, financial burden, and death. The present study was conducted to estimate the incidence of falls and their associated factors among community-dwelling older adults.MethodsThis program is a population-based prospective cohort study (≥ 60 years) in Birjand City from 2019 to 2020. A total of 1418 participants were included in the study, and 1344 participants were analyzed according to the inclusion criteria. Thirty-nine risk factors were evaluated. Basic information included demographic information, lifestyle factors, general health and medical history, and mental and functional health.ResultThe incidence of falls among community-dwelling older adults in the previous approximately 24 months in the present study was 9.26% in women and 2.65% in men. In the multiple Cox proportional regression model based on fall risk factors, there was a strong significant relationship between male sex (HR = 0.37, CI = 0.21 to 0.64), being physically active (HR = 0.59, CI = 0.36 to 0.96), moderate-to-severe depression (HR = 2.97, CI = 1.47 to 6.01), severe depression (HR = 3.26, CI = 1.24 to 8.54), and high risk of falls according to the TUG test (HR = 1.73, CI = 1.10 to 2.72).ConclusionsInactivity and depression were recognized as important factors in falls in older adults. It is recommended for older adults to have an active lifestyle to prevent falls and to prioritize the diagnosis and treatment of depression in older adults. Women as a group at higher risk should be considered in prevention programs. In addition, the use of the TUG test to identify high-risk older adults should be considered.

Psychosocial factors associated with medication burden among community-dwelling older people with multimorbidity

BackgroundOlder people with multimorbidity are often prescribed multiple medication treatments, leading to difficulties in self-managing their medications and negative experiences in medication use. The perceived burden arising from the process of undertaking medication self-management practices has been described as medication burden. Preliminary evidence has suggested that patients’ demographic and clinical characteristics may impact their medication burden. Little is known regarding how psychosocial factors affect medication burden in older people with multimorbidity. The aim of this study was to identify psychosocial factors associated with medication burden among community-dwelling older people with multimorbidity.MethodsThis is a secondary analysis of a cross-sectional study. A total of 254 older people with three or more chronic conditions were included in the analysis. Participants were assessed for demographics, medication burden, psychosocial variables (depression, medication-related knowledge, beliefs, social support, self-efficacy, and satisfaction), disease burden, and polypharmacy. Medication burden was measured using items from the Treatment Burden Questionnaire. Univariate and multivariate linear regression models explored factors associated with medication burden.ResultsThe mean age of participants was 70.90 years. Participants had an average of 4.40 chronic conditions, and over one-third had polypharmacy. Multivariate analysis showed that the participants’ satisfaction with medication treatments (β = -0.32, p < 0.001), disease burden (β = 0.25, p = 0.009), medication self-efficacy (β = -0.21, p < 0.001), polypharmacy (β = 0.15, p = 0.016), and depression (β = 0.14, p = 0.016) were independently associated with medication burden. Other factors, including demographic characteristics, medication knowledge, medication beliefs, medication social support, and the number or specific types of chronic conditions, were not independently associated with medication burden.ConclusionsPoor medication treatment satisfaction, great disease burden, low medication self-efficacy, polypharmacy, and depression may increase individuals’ medication burden. Understanding psychosocial aspects associated with medication burden provides an important perspective for identifying older people who are overburdened by their medication treatments and offering individualised treatments to relieve their burden.

Acute and prolonged competing effects of activation history on human motor unit firing rates during contractile impairment and recovery

AbstractThe purpose of this study was to investigate the effect of inducing post‐activation potentiation (PAP) during prolonged low‐frequency force depression (PLFFD) on motor unit (MU) firing rates. In 10 participants, grouped firing rates of 3027 MUs from the tibialis anterior were recorded with tungsten microelectrodes. Baseline MU firing rates at 25% isometric maximal voluntary contraction (MVC) were ∼14 Hz. A 1 min dorsiflexion MVC reduced torque and maximal MU firing rates (36 Hz) by 49% and 52%, respectively. Following task completion, firing rates at 25% of baseline MVC torque and torque in response to electrically evoked (single twitch, 10 Hz and 50 Hz) stimulation were assessed before and after a 5 s MVC (to induce PAP) every 10 min for 60 min. From 10 to 60 min after task completion, the torque ratios (twitch:50 Hz and 10:50 Hz) were depressed (∼30%) relative to baseline (P &lt; 0.001), indicating PLFFD; and firing rates were higher by ∼15% relative to baseline (P &lt; 0.001). This occurred despite recovery of MVC rates (∼99%) and torque (∼95%) by 10 min (P &gt; 0.3). Inducing PAP during PLFFD increased both low to high torque ratios (twitch and 10:50 Hz) by ∼200% and ∼135%, respectively (P &lt; 0.001) and firing rates were ∼18% lower relative to PLFFD rates (P &lt; 0.001), despite a speeding of evoked contractile properties (P = 0.001). Thus, firing rates appear strongly matched to alterations in torque, rather than contractile speed when modified by contractile history, and lower rates during PAP may be a mechanism to mitigate effects of PLFFD. The effect of activation history on contractile function demonstrates acute compensatory responses of motoneuron output. imageKey points Prolonged low frequency force depression (PLFFD) following a sustained 1 min isometric maximal voluntary contraction causes an increase in submaximal mean motor unit (MU) firing rates. Inducing post‐activation potentiation (PAP) during PLFFD, however, causes a reduction in mean submaximal MU firing rates to a level below those at baseline. The mean firing rate reduction during PAP occurs despite a speeding of evoked contractile properties and thus firing rates are more strongly matched to alterations in torque, rather than contractile speed when modified by various contractile histories. The reductions in firing rates during PAP may mitigate the effects of PLFFD during voluntary contractions. These results demonstrate that firing rates are highly responsive to opposing influences on the contractile state and can make rapid compensatory rate adjustments dependent on the active state of the muscle.

Abstract 13289: Medicaid Patients in Cardiac Rehabilitation: Underrepresented, High Risk, High Need

Purpose: Patients with lower-socioeconomic status (SES) have higher rates of cardiovascular (CV) events and therefore, have the most to gain from cardiac rehabilitation (CR). Unfortunately, those with lower-SES are much less likely to engage in CR which has made characterization of this population quite difficult. Our CR program specifically increased recruitment of lower-SES patients, allowing for careful comparison of medical, psychosocial, and behavioral risk factors between lower and higher-SES patients eligible for secondary prevention. Methods: Demographic and clinical characteristics were prospectively gathered on consecutive individuals entering Phase 2 CR from 1/2014-12/2022. Patients were classified as lower-SES if they had Medicaid insurance. Statistical methods included chi-square and non-paired t-tests. A p value of &lt;0.01 was used to determine significance. Results: The entire cohort consisted of 3131 individuals. Compared to higher-SES patients, lower-SES individuals (n=405, 13%) were a decade younger, almost 6 times more likely to be current smokers, nearly 3 times more likely to have elevated depressive symptoms, and had significantly higher body mass index, waist circumference, and hemoglobin A1c, with more abnormal lipid profiles (all p&lt;0.001). Despite being a decade younger, lower-SES patients had lower measures of peak VO 2 and self-reported lower levels of physical function (both p&lt;0.001). Conclusion: Lower-SES patients have a remarkably prominent high-risk CV profile resulting in a substantially higher risk for a recurrent coronary event than higher-SES patients. Accordingly, strong efforts must be placed to engage this high-risk population in CR. It is imperative for CR programs to ensure that they are appropriately equipped to intervene on risk factors such as low fitness, depression, and smoking.

Cognitive Performance and Diabetic Retinopathy: What Your Eyes Can Reveal About Your Brain.

Diabetic retinopathy (DR) is a chronic diabetes complication. People with Type 2 Diabetes Mellitus (T2DM) have two times the risk for dementia, suggesting it is a new chronic diabetes complication. Evaluate the association of DR with cognitive performance in a T2DM population. Cross-sectional study with 400 T2DM adults from whom socio-demographic, clinical, laboratory data were collected, and screening test for depression symptoms (Patient Health Questionaire- 9 (PHQ-9)), Mini-Mental State Examination (MMSE), Semantic Verbal Fluency Test, Trail Making Test A and B, Word Memory test were performed. All cognitive test scores were converted into Global Cognition z-Score (GCS(z)). The association between GCS(z) < 0 with DR was performed using a multivariate binary logistic regression model adjusted for age ≥ 65 years, school years ≤ 6 years, DM duration ≥ 10 years, depression symptoms score > 9 at PHQ-9, arterial hypertension, physical activity, diabetic retinopathy, macular edema, and cardiovascular disease. After exclusions, the 251 eligible patients were 56.6% female, with a mean age of 61.1 (±9.8) years, DM duration of 12.6 (±8.9) years, and 7.6 (±4.2) years of school education. DR prevalence was 46.5%. Multivariate Logistic Regression Model showed an association between DR and GCS(z) < 0, with odds ratio (CI95%) of 2.50 (1.18-5.34), adjusted for age, low education level, arterial hypertension and depression symptoms (OD and CI95% respectively: 5.46(2.42-12.34); 12.19 (5.62-26.46); 2.55 (0.88-7.39); 3.53 (1.55-8.07)). In this T2DM population, having DR increased the chance for worse cognitive performance even when adjusted for age, low education level, presence of arterial hypertension, and depression symptoms.

Impact of Perceived Social Support and Depression in Married Turkish Women on the Sexual Quality of Life: An Online Survey.

Sexual life is very important for people's physical health, psychological health, and reproductive health. Depression and social support are among the factors that affect the quality of sexual life. The present study aimed to determine the impact of perceived social support on the sexual quality of life and depression in married women between the ages of 18 and 49. A total of 976 married women aged 18 to 49 were included in this cross-sectional study in which an online data collection method was used Sexual Life Quality Scale, Multidimensional Perceived Social Support Scale, and Beck Depression Scale, which were used as data collection tools. Statistical analysis used: Analyses were performed using SPSS version 26.0. Descriptive statistics were used for number, percentage, mean, and standard deviation, as well as independent group t-test, correlation, and regression analysis. The "Enter" model was used in the logistic regression analysis. It was established that nearly one-third of married women aged 18-49 had low levels of perceived social support and sexual quality of life, and almost half of them experienced symptoms of depression. The quality of sexual life was 3.6 times (P = 0.001) lower in those with low social support and 1.6 times (P = 0.024) lower in those with depression. Considering the fact that women's sexual problems, low social support and depression are important predictors of sexual quality of life, special attention should be paid to increasing social support to women, handling women's sexual problems more carefully, and detecting and treating such problems.

11 The Moderating Effect of Depression on Workload Perception in Traumatic Brain Injury

Objective:Individuals who have experienced traumatic brain injury (TBI) are at an elevated risk for worsened physical and psychological outcomes. Increased rates of anxiety and depression, along with cognitive issues, are common post-TBI. While there is some evidence that anxiety and depression may affect objective cognitive performance, less is known about their effect on other factors that are associated with the individual’s capacity to complete the task, such as perceived workload of the cognitive task. Workload represents an individual’s perception of task difficulty and serves as a proxy for the magnitude of mental demands a given task places on an individual. Preliminary findings in the literature suggest that individuals with TBI commonly report greater workload when completing cognitive tasks compared to neurotypical peers, but the influence of anxiety and depression on survivors’ workload remains unclear. Considering the elevated rates of psychological and cognitive problems in individuals with TBI, the present study examined the moderating role of anxiety and depression on TBI survivor workload perception of a stress-inducing working memory task.Participants and Methods:Ten participants with moderate to severe TBI and eight neurologically healthy controls performed the Paced Auditory Serial Addition Task (PASAT). After completing the PASAT, participants reported their subjective workload using the NASA task load index (NASA-TLX). Participants also completed measures of psychological functioning, including the Chicago Multiscale Depression Inventory (CMDI) and the State-Trait Anxiety Inventory (STAI). Relationships between workload and depression and trait anxiety were examined using linear regression.Results:Linear regression was employed for both the TBI and the healthy control groups to assess the influence of trait anxiety and depression on perceived workload. There was no significant difference between the TBI and HC NASA perceived workload scores. Within the TBI group, there was a significant anxiety by depression interaction (b = -.015, p &lt; .001). Simple slopes analyses revealed that for TBI participants reporting low depression, perceived workload increased with increased anxiety (b = .093, p &lt; .001). For TBI participants reporting high depression, perceived workload decreased as anxiety increased (b = -.38, p = .03). While there was also significant anxiety by depression interaction in the healthy control group (b = .033, p = .04), simple slopes analyses revealed that there were no significant associations for healthy controls.Conclusions:These results demonstrate that in TBI, level of depression moderates the relationship between anxiety and workload perception. The pattern observed in the TBI group was unique from controls. The present findings suggest that post-TBI, higher depression may temper the influence of anxiety on stressful cognitive task performance and workload rating. The tempering effect of high depression in TBI may represent a biased reporting style or impaired assessment of task difficulty, which may ultimately affect the individual’s capacity to accomplish a task well.

Maternal depression in first 1000days of life and early childhood caries prevalence at 48months of age.

The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort. All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders. A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24months increased the risk for ECC at 48months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35). Children from mothers with high depression trajectory had higher risk of having dental caries at 48months compared to children from mothers with low depression trajectory. Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.

Reduction of genetic diversity in 'Alalā (Hawaiian crow; Corvus hawaiiensis) between the late 1800s and the late 1900s.

Genetic and genomic data are increasingly used to aid conservation management of endangered species by providing insights into evolutionary histories, factors associated with extinction risks, and potential for future adaptation. For the 'Alalā, or Hawaiian crow (Corvus hawaiiensis), genetic concerns include negative correlations between inbreeding and hatching success. However, it is unclear if low genetic diversity and inbreeding depression are consequences of a historical population bottleneck, or if 'Alalā had historically low genetic diversity that predated human influence, perhaps as a result of earlier declines or founding events. In this study, we applied a hybridization-based sequence capture to generate a genome-wide single nucleotide polymorphism (SNP) dataset for comparing historical specimens collected in the 1890s, when 'Alalā were more numerous, to samples taken between 1973 and 1998, when 'Alalā population densities were near the lowest documented levels in the wild, prior to all individuals being collected for captive rearing. We found low genome-wide diversity in both sample groups, however, the modern sample group (1973 to 1998 cohort) exhibited relatively fewer polymorphic alleles, a lower proportion of polymorphic loci, and lower observed heterozygosity, consistent with a population decline and potential bottleneck effects. These results combined with a current low population size highlight the importance of continued efforts by conservation managers to mitigate inbreeding and maintain founder representation to preserve what genetic diversity remains.

Lower-Socioeconomic Status Patients Have Extremely High-Risk Factor Profiles on Entry to Cardiac Rehabilitation.

Patients with lower socioeconomic status (SES) have higher rates of cardiovascular events, yet are less likely to engage in secondary prevention such as cardiac rehabilitation (CR). Given the low number of lower-SES patients entering CR, characterization of this population has been difficult. Our CR program specifically increased recruitment of lower-SES patients, allowing for careful comparison of medical, psychosocial, and behavioral risk factors between lower- and higher-SES patients eligible for secondary prevention. Demographic and clinical characteristics were prospectively gathered on consecutive individuals entering phase 2 CR from January 2014 to December 2022. Patients were classified as lower SES if they had Medicaid insurance. Statistical methods included chi-square and nonpaired t tests. A P value of <.01 was used to determine significance. The entire cohort consisted of 3131 individuals. Compared with higher-SES patients, lower-SES individuals (n = 405; 13%) were a decade younger (57.1 ± 10.4 vs 67.2 ± 11.2 yr), 5.8 times more likely to be current smokers (29 vs 5%), 1.7 times more likely to have elevated depressive symptoms, and significantly higher body mass index, waist circumference, and glycated hemoglobin A 1c , with more abnormal lipid profiles (all P s < .001). Despite being a decade younger, lower-SES patients had lower measures of cardiorespiratory fitness and self-reported physical function (both P s < .001). Lower-SES patients have a remarkably prominent high-risk cardiovascular disease profile, resulting in a substantially higher risk for a recurrent coronary event than higher-SES patients. Accordingly, efforts must be made to engage this high-risk population in CR. It is incumbent on CR programs to ensure that they are appropriately equipped to intervene on modifiable risk factors such as low cardiorespiratory fitness, obesity, depression, and smoking.

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.

A - 134 The Impact of Pre-Treatment Mental Health Symptoms on the Efficacy of Cognitive Rehabilitation for Warfighters with a History Mild TBI.

Mild traumatic brain injury (mTBI) is common among warfighters. Most have a full recovery but some have persistent cognitive complaints. Cognitive rehabilitation is the primary treatment; however, mTBI is highly co-morbid with depression and post-traumatic stress (PTS). This study investigated if high levels of mental health symptoms negatively impacted the efficacy of cognitive rehabilitation. 82 military personnel with at least one diagnosed mTBI and persistent cognitive complaints completed 4-6weeks of cognitive rehabilitation. PTS was measured by the Post-Traumatic Checklist-5 (PCL-5) and depression was measured with the Patient Health Questionnaire 8 (PHQ8); scores were dichotomized based on published cut-offs (>33 and > 10, respectively). Outcomes included change pre-post treatment on: Neurobehavioral Scale Inventory (NSI), Key Behavior Change Index (KBCI), and Global Deficit Scale (GDS). GDS was derived from: Hopkins Verbal Learning Test-Revised, Color Word, Trail Making, Paced Auditory Serial Addition Test, and the Symbol Digit Modality Test. A MANOVA revealed PTS had no effect on the NSI, KBCI, or GDS (p = 0.659). There was a significant effect for depression (p = 0.017); however, this was specific to change in GDS (p = 0.002). The average reduction was 0.98 (SD = 0.87) in high depression and 0.43 (SD = 0.68) in low depression. Depression did not impact NSI or KBCI. In contrast to the initial hypothesis, high levels of depression or PTS did not negatively impact the efficacy of cognitive rehabilitation. In fact, warfighters with high levels of depression had greater improvements in cognitive functioning.

Examining factors that influence medication adherence with children seen at outpatient department in Western China: a cross-sectional survey

We aimed to evaluate the prevalence of medication adherence, assess the association between guardians’ mental health and medication adherence for children seen at outpatient department from western China, and identify characteristics associated with nonadherence. We conducted a cross-sectional survey. Participants were recruited by consecutive sampling from the outpatient of the West China Second Hospital from October 2021 to April 2022. The Morisky Medication Adherence Scale (MMAS-8) was used to evaluate patients’ medication adherence. A multivariate linear regression model was used to analyze influencing factors. 1206 children with a mean age of 6.02 ± 3.86 years were included. Seventeen percent (208/1206) of patients showed good adherence, 24.7% (298/1206) showed moderate adherence, and 58% (700/1206) showed poor adherence. Thirty-five percent (428/1206) of guardians had anxiety. Factors that influenced medication adherence included anxiety score of guardian (P = 0.030), education level of guardian (P = 0.003), annual household income (P = 0.001), and days the patient is on the medication (P = 0.023). A majority of children seen at outpatient department from West China had low medication adherence, and depression and anxiety among guardians were common. Implementing health education measures will be important for improving medication adherence in future.

A Cross-Sectional Study on the Assessment of Sleep Quality and Associated Factors Among Diabetes Mellitus Patients

Background: Sleep is a fundamental factor associated with chronic illness. Lack of quality sleep and the extent of sleep may affect several aspects of physical, emotional, and cognitive health. Aim and objective: The study aims to assess sleep quality and associated factors in subjects diagnosed with diabetes mellitus using Pittsburgh Sleep Quality Index Questionnaire (PSQI). Materials and methods: An eight-month prospective cross-sectional study involving 356 patients with diabetes mellitus was carried out. The patient data collection form was prepared per the study's needs. Patients' responses to questionnaires about their sleep quality, anxiety, depression possibility, and physical activity were recorded. The data were analysed using a statistical tool for the social sciences (SPSS) version 28.0. Results: Among 356 subjects enrolled, 43 (12%) had poor sleep quality, rest of the 313 (88%) patients had good sleep quality. Poor sleep quality was observed between the age group of 51-70 years. When compared to women, men were generally shown to have poor sleep quality. When compared to patients with mild and moderate anxiety, it was observed that most of the subjects with severe anxiety had poor sleep quality. Poor sleep quality was reported by the majority of patients who tested positive for depression and inadequate physical activity. Conclusion: The study concluded that diabetes mellitus does not significantly affect sleep quality in most patients. However, patients with low physical activity, severe anxiety and depression had poor sleep.