Mean Patient Health Questionnaire-9 Score Research Articles

Assessment of depressive symptoms among medical students and doctors using PHQ-9

Medical students and doctors are at increased risk of experiencing depression. Doctors exhibit varying severity of depression symptoms at different stages of their careers. This study aimed to evaluate the prevalence of depressive symptoms among medical students and doctors using the Patient Health Questionnaire-9 (PHQ-9). We conducted a cross-sectional study in Lithuania from February to March 2024, using an anonymous online questionnaire that collected demographic data and included the PHQ-9. A score of ≥10 indicated criteria for depression. The questionnaire was completed by 146 respondents, comprising 77 medical students and 69 doctors or resident doctors. Overall, 40% of respondents met the criteria for depression, including 48% of medical students and 32% of doctors. Medical students had a higher mean PHQ-9 score compared to doctors, and the difference in PHQ-9 scores between students and doctors was significant (P = 0.045). No significant differences were found in PHQ-9 scores between genders (P = 0.430) or among respondents living in different city sizes (P = 0.780). Our data align with the literature findings that medical students exhibit higher depression scores than doctors. The study underscores the importance of regularly monitoring the emotional well-being of medical students and doctors and implementing interventions to improve their emotional health.

Factors associated with depressive and anxiety symptoms among anophthalmic patients wearing ocular prostheses

This study aimed to investigate the prevalence of anxiety and depression among individuals with ocular prostheses and to identify factors associated with these psychological symptoms. A sample of patients who underwent monocular enucleation and socket implantation participated in the study, responding to digital questionnaires covering demographics, psychosocial factors, and aspects related to their ocular prostheses. Depressive and anxiety symptoms were evaluated using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Optimal scale regression analysis was employed to explore factors linked to psychological symptoms in ocular prosthesis users. Results from 100 valid participants revealed a 51% prevalence of depressive symptoms and a 45% prevalence of anxiety symptoms. The mean PHQ-9 score was 4.91 ± 1.98, and the mean GAD-7 score was 4.99 ± 2.15. Factors such as undergoing right eye enucleation, longer duration of ocular prosthesis use, comfort with prosthesis wearing, and greater satisfaction correlated with milder depressive symptoms. In terms of anxiety, those who used ocular prostheses due to trauma or tumors were affected by more severe symptoms, while individuals who were comfortable with their prosthesis or using alumina-based prostheses reported fewer anxiety symptoms. In conclusion, ocular prosthesis users wrestle with significant challenges of depressive and anxiety symptoms. Factors including age, household registration, economic status, enucleation side, cause of anophthalmos, prosthetic material, and satisfaction and duration of prosthesis use were associated with depressive or anxiety symptoms. Long-term comprehensive care targeting these vulnerable individuals is imperative to alleviate depression and anxiety.

Prevalence of extra-intestinal symptoms according to irritable bowel syndrome subtype.

Irritable bowel syndrome (IBS) is a functional disorder commonly associated with extra-intestinal symptoms. However, the prevalence of these symptoms according to IBS subtype is not well established. To compare the prevalence of extra-intestinal symptoms among patients with different subtypes of IBS. A descriptive cross-sectional study including patients with IBS according to Rome IV criteria was performed between July 2022 and April 2023. Patients were classified according their subtype of IBS: IBS-D (diarrhea-predominant), IBS-C (constipation-predominant), and IBS-M (mixed bowel habits). Patients completed the IBS severity scoring system questionnaire (IBS-SSS) to determine severity of IBS symptoms and patient health questionnaire- 9 (PHQ-9) to define presence and severity of depressive symptoms. The prevalence of reported extra-intestinal symptoms was also assessed and compared between groups. A total of 4862 patients with IBS were included; 608 IBS-D (12.5%), 1978 IBS-C (40.7%), and 2276 IBS-M (46.8%). Patients with IBS-C had significantly lower IBS-symptoms severity (mean IBS-SSS 290 vs. 310 and 320 for IBS-D and IBS-M, respectively, p = 0.03). The prevalence of obesity was also significantly lower in these patients (17.1% vs. 30.9% IBS-D and 27.9% IBS-M, p = 0.0001). Patients with IBS-D showed a significantly higher prevalence of food intolerance perception (9.5%, p = 0.03), history of cholecystectomy (17.8%, p = 0.03), and fecal incontinence (36.2%, p = 0.0001) as compared to the other groups. Patients with IBS-M had significantly higher mean PHQ-9 score (12.7 vs. 11.1 IBS-D and 10.5 IBS-C, p = 0.001) and prevalence of depressive symptoms (80.0%, p = 0.01). Patients with IBS-M also had higher prevalence of extra-intestinal symptoms such as arthralgia (62.4%, p = 0.0001), extremity numbness (64.5%, p = 0.0001), atopic dermatitis (28.2%, p = 0.02), and chronic cervicalgia (81.0%, p = 0.01). The prevalence of most extra-intestinal symptoms is higher among patients with IBS-M. Further research is needed to better characterize IBS subtypes, which could potentially help refining tailored therapeutic strategies.

Assessing a pharmacist provided mental health screening service in a rural community to address anxiety and depression

BackgroundThe current state of the mental health crisis has been a topic of discussion around the nation, with those in rural communities being at a particularly higher risk. Community pharmacists are uniquely positioned to screen patients for mental health disorders and provide education and patient monitoring following medication changes by prescribers. ObjectiveThe objective of this study is to assess mental health screening outcomes provided by rural community pharmacists. MethodsThis retrospective evaluation of a pilot project describes a behavioral health service. Eligible patients were 18 years of age or older, taking one or more mental health medications and covered by the specific Medicaid health plan. Participating pharmacies were those that had a significant patient population participating with that plan, as well as credentialed and trained pharmacists. Pharmacists performed telehealth visits with eligible patients where they confirmed their mental health diagnosis and medications. Based on patient confirmed diagnosis, a Generalized Anxiety Disorder Questionnaire-7 (GAD-7) or Patient Health Questionnaire-9 (PHQ-9) test was administered. The pharmacists then made recommendations to the patients or their prescribers and created a plan with the patient for implementation based on their score.Follow-up calls were conducted to readminister the appropriate test to identify changes in mental health scores. ResultsThere were 61 patients who participated in the services across 4 pharmacies. Mean GAD-7 scores were 8.1 at initial appointment and 6.4 at follow-up (n = 24). Mean PHQ-9 scores were 11.2 initially and 10 at follow-up (n = 37). ConclusionThis implementation project supports the creation of additional mental health services in the community pharmacy setting to reinforce and encourage follow-up provider visits in areas where there are mental health provider shortages and may possibly improve patient outcomes.

Adjunctive Naturopathic Medicine in the Management of Depression and Anxiety Symptoms: A Retrospective Chart Review

Background: Naturopathic medicine uses natural and evidence-based treatments to promote health. The objective of this study was to characterize and evaluate the effectiveness of naturopathic medicine in reducing symptoms of anxiety and depression in patients seeking care from the Mental Health Shift at a Canadian naturopathic teaching clinic. Methods: Charts of 192 consecutive patients who attended appointments between 1 January 2019 and 6 March 2020 were reviewed. Subjects were included if they screened positive on the General Anxiety Disorder 7 (GAD7) or the Patient Health Questionnaire 9 (PHQ9) and attended follow up at least 4 weeks after initial treatment. Results: Of the 22 included subjects, a clinically significant decrease of at least 5 points occurred in 76% of individuals with elevated baseline PHQ9 scores and 59% of individuals with elevated GAD7 scores. Mean PHQ9 and GAD7 scores decreased 7.5 (p<0.0001) and 4.6 (p<0.008) points, respectively. Mild adverse events were reported in 9 charts (41%). No serious adverse events were reported. Most subjects were also in the care of a medical doctor and counsellor. Conclusion: Naturopathic medicine as performed on the Mental Health Shift may be effective in reducing depression and anxiety symptoms as an adjunctive treatment. Further research incorporating comparison groups is warranted.

Abstract 14315: Does Gender Moderate the Effect of Virtual Cognitive Behavioral Therapy Interventions on Depressive Symptoms in Rural Cardiac Patients? Preliminary Analysis of the Combat Study

Background: Depressive symptoms are common in patients with coronary heart disease (CHD) and heart failure (HF) living in rural areas and are associated with worse health outcomes. Cognitive behavioral therapy (CBT) can effectively improve depressive symptoms in patients with CHD and HF, however, traditional CBT is not accessible to most rural individuals, and some, particularly males, may be reluctant to participate in traditional CBT even if available. Therefore, we developed and tested two types of virtual CBT, video conferences with a therapist (vCBT) and self-directed CBT (iCBT). Aim: To determine whether gender moderated the effect of vcCBT or iCBT interventions on depressive symptoms in rural people with CHD and HF. Methods: This is a preliminary analysis of 4-month outcomes in an ongoing 12-month randomized comparative effectiveness trial. Depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9). Gender was self-identified. Participants with at least mild depressive symptoms were enrolled. Participants were randomly assigned to either a 6-8 week vcCBT or iCBT without a face-to-face therapist. Repeated measures ANOVA was performed to determine whether gender interacted with either intervention to produce an effect on depressive symptoms at 4-months compared with baseline. Results: Participants (N=143) were on average 57 years old, 51% female, and 99.3 % non-Hispanic. At baseline, mean PHQ-9 score for males was 10 ± 5 and 12 ± 5 for females (p-value=0.002). Both intervention groups had a significant decrease in depressive symptoms over time (p<0.001 for group by time interaction). There was no between-group difference in improvement of depressive symptoms (p=0.415). There was no moderating interaction of gender by intervention group on depressive symptoms (p=0.502). Conclusion: Both interventions resulted in a significant decrease in depressive symptoms. The lack of a gender moderating effect demonstrates that both interventions were equally effective in males and females.

Persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms: a one-year follow-up study

ABSTRACT Background: Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has been proposed, little is known about the persistence and clinical consequences of these symptoms. Objective: This one-year follow-up study investigated the persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms. Methods: We analyzed longitudinal data from an international sample of people self-reporting depressive emotions (N = 152) (mean Patient Health Questionnaire-9 score = 17.27; SD = 6.31). Results: More than half (58.4%) of participants with baseline post-traumatic stress disorder (PTSD) still met the criteria for PTSD after one year. Participants with dissociative symptoms at baseline were significantly more likely to report lifetime psychiatric hospitalization (31.2% vs 14.7%), past-year use of psychiatric hospitalization (10.4% vs 0%) and emergency services (16.9% vs 4%) than those without dissociative symptoms. All post-traumatic and dissociative symptom clusters were cross-sectionally (r = .286 to .528, p < .001) and longitudinally (r = .181 to .462, p < .001) correlated with depressive symptoms. A sense of current threat (β = .146, p < .05) and negative self-concept (β = .173, p < .05) at baseline significantly predicted depressive symptoms after one year. Conclusions: These findings contribute to the increasing body of knowledge regarding the PTSD/dissociation-depression comorbidity. Given their persistence and clinical consequences, we recommend that post-traumatic and dissociative symptoms be regularly screened for in clinical settings. The existence of a possible trauma-related subtype of depression should receive more attention in both research and clinical practice.

The Association Between Thyroid Stimulating Hormone and Depression: A Historical Cohort Study

ObjectiveTo investigate the association between thyroid-stimulating hormone (TSH) and clinically relevant depression (CRD) in a population-based study. Patients and MethodsAdult patients (≥18 years of age) who received care at Mayo Clinic in Rochester, Minnesota, and completed a TSH and Patient Health Questionnaire - 9 (PHQ-9) within 6 months of each other, between July 8, 2017, and August 31, 2021, were included. Demographics, medical comorbidities, thyroid function laboratory data, psychotropic medications, presence of primary thyroid disorder, thyroid hormone replacement (T4 and/or T3), and mood disorder diagnoses (using International Classification of Diseases, 10th version, Clinical Modifications codes) were extracted electronically. The primary outcome, CRD, was defined as a PHQ-9 score greater than or equal to 10. Logistic regression analysis was conducted to assess the association between TSH categories (low ≤0.3 mIU/L; normal >0.3-4.2 mIU/L; high >4.2 mIU/L) and CRD. ResultsThe cohort included 29,034 patients, mean age 51.4 years, 65% females, 89.9% White, and a mean body mass index of 29.9 kg/m2. The mean ± standard deviation for TSH was 3.0±8.5 mIU/L, and the mean PHQ-9 score was 6.3±6.2. After adjustment, the odds of CRD were significantly higher among the low TSH category (odds ratio, 1.37; 95% CI, 1.18-1.57; P<.001) compared with the normal TSH category, especially in people 70 years of age or younger compared with people older than 70 years of age. Subgroup analysis did not show an increase in odds of CRD among patients with subclinical/overt hypothyroidism/hyperthyroidism (after adjustment). ConclusionIn this large population-based cross-sectional study, we report that low TSH was associated with higher odds of depression. Future longitudinal cohort studies are needed to investigate the relationship between thyroid dysfunction and depression as well as sex differences.

Longitudinal mental health trends in cystic fibrosis

BackgroundMental health screening in accordance with consensus guidelines became routine clinical practice in our cystic fibrosis (CF) Center in 2015. We hypothesized improvement in anxiety and depression symptoms over time and associations between elevated screening scores and disease severity. We aimed to observe the impact of the COVID-19 pandemic and modulator use on mental health symptoms. MethodsRetrospective chart reviews were conducted for people 12 years and older with at least one Generalized Anxiety Disorder-7 (GAD-7) or Patient Health Questionnaire-9 (PHQ-9) screening for six years. Descriptive statistics were used to summarize demographic variables and logistic regression and linear mixed models were used to evaluate the relationship between screening scores and clinical variables. ResultsAnalyses included 150 participants (ages 12–22 years). The percentage of minimal to no symptom scores increased over time for anxiety and depression. Increased mental health visits and CFRD were associated with higher PHQ-9 and GAD-7 scores. Higher FEV1pp was associated with lower GAD-7 and PHQ-9 scores. More effective modulator use was associated with lower PHQ-9 scores. Mean PHQ-9 and GAD-7 scores were not significantly different when comparing pre-pandemic and pandemic scores. ConclusionDisruptions in screening during the pandemic were minimal and symptom scores remained stable. Individuals with higher mental health screening scores were more likely to have CFRD and utilization of mental health services. Consistent mental health monitoring and support is needed so individuals with CF can endure anticipated and unanticipated stressors including changes in physical health, healthcare, and societal stressors such as COVID-19 pandemic.

Improving Integrated Mental Health Care Through an Advanced Practice Registered Nurse-Led Program: Challenges and Successes.

Integrated and collaborative care delivery models have demonstrated efficacy for the management of psychiatric conditions in the primary care environment, yet organizations struggle with implementation of integrated efforts in clinical practice. Delivering care with a population focus versus face-to-face encounters with individual patients requires financial investment and adjustment in care delivery. We discuss the early implementation process of an advanced practice registered nurse (APRN)-led integrated behavioral health care program, including the challenges, barriers, and successes in the first 9 months of the program (January-September 2021), for an academic institution in the Midwest. A total of 161 Patient Health Questionnaire 9 (PHQ-9) and 162 Generalized Anxiety Disorder (GAD-7) rating scales were completed on 86 patients. The mean PHQ-9 score at the initial visit was 11.3 (moderate depression); after 5 visits, it decreased significantly to 8.6 (mild depression) (P < .001). The mean GAD-7 score at the initial visit was 10.9 (moderate anxiety); after 5 visits, it decreased significantly to 7.6 (mild anxiety) (P < .001). A survey completed by 14 primary care physicians 9 months after program launch revealed improvements in satisfaction with collaboration but, most notably, in perception of access to and overall satisfaction with behavioral health consultation/patient care services. Program challenges included adapting the environment to enhance leadership roles for the program and adjusting to virtual availability of psychiatric support. A case example highlights the value of integrated care along with improved depression and anxiety-related outcomes. Next steps should include efforts that capitalize on nursing leadership strengths while also promoting equity among integrated populations.

Age and Sex Differences in the Association between Serum Vitamin E Levels and Depressive Symptoms: Korea National Health and Nutrition Examination Survey.

Studies have reported inconsistent results regarding the relationship between serum vitamin E levels and depressive symptoms. Furthermore, the potential modulating role of age and sex has been underexplored. We conduct an age- and sex-stratified investigation of the association between serological vitamin E status and depressive symptoms in a large nationwide sample. Data from the Korean National Health and Nutrition Examination Survey were analyzed (n = 4448). The participants were stratified into four groups according to age (<65 vs. ≥65 years) and sex. Each group was divided into tertiles of vitamin E/total lipid ratio, and Patient Health Questionnaire-9 (PHQ-9) scores were compared among the tertiles via multivariable linear regression analyses. The relationship between dietary supplement use and the proportions of tertiles was assessed in each group. With the middle tertile as the reference group, the low tertile of vitamin E/total lipid ratio was associated with increased PHQ-9 scores in younger females and older males after adjusting for all covariates, while the high tertile showed no significant associations with PHQ-9 scores in any group. The low tertile was associated with increased adjusted mean PHQ-9 scores by 0.53 and 1.02 compared to the middle tertile in younger females and older males, respectively. Dietary supplement use was related to higher vitamin E/total lipid ratio in all four groups. In conclusion, younger females and older males with a low vitamin E status showed worse depressive symptoms. These individuals may benefit from dietary interventions to prevent depressive symptoms.

Patient Health Questionnaire-9, Body Mass Index, Household Income According to Sleep Duration: Findings From a Community Health Survey

Background and Objective Research on the relationship between sleep duration and Patient Health Questionnaire-9 (PHQ-9), body mass index (BMI), and income in South Korea was scarce. This study aimed to investigate the relationship between sleep duration and the PHQ-9, BMI, and household income.Methods We used data from the Korean Community Health Survey (KCHS) conducted by the Korean Center for Disease Control and Prevention in 2018 which included a total of 228340 participants from across the country. We divided the participants into four groups based on their sleep duration and used one-way analysis of variance (ANOVA) to compare the mean values of PHQ-9, BMI, and household income among the groups.Results A total of 227899 respondents were included in the study. Based on a one-way ANOVA, the mean PHQ-9 score tended to increase as sleep duration decreased. However, the group with a sleep duration of 9 hours or more had an exceptionally higher mean PHQ-9 score than the group with a sleep duration of 7 to 9 hours. The BMI score generally decreased as the sleep duration increased. Additionally, the group with a sleep duration of 5 to 7 hours and 7 to 9 hours had higher household income than the group with a sleep duration of 5 hours or less or 9 hours or more.Conclusions This study demonstrated the association between sleep duration and PHQ-9, BMI, and household income. Sleep duration was found to be a factor influencing PHQ-9, BMI, and household income.

Mental health evaluation in senior year medical students

IntroductionMedical studies are known for being difficult and hard. They require a lot of dedication and hard work from students. This takes a toll on their mental health over the years.ObjectivesDetect signs of anxiety, depression, and stress levels in 5th-year medical students.MethodsThis study was cross-sectional through a self-administered pre-established questionnaire for medical students during September and October 2022. We used the General Anxiety Disorder-7 (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9) and the Perceived Stress Scale-10 (PSS-10). The satisfaction level with the choice of the medical field as a career was assessed on a scale ranging from 1 to 10.ResultsOur population consisted of 54 5th-year medical students. The average age was 22.94±0.78 and 64.8% were female. All our population were singles. Active smokers represented 9.3% and alcohol consumption was reported by 9.3% of the participants. More than half of the population (51.9%) had a regular leisure activity. Most of the students had no medical history (72.2%) or psychiatric history (94.4%). The mean satisfaction level from choosing the medical field was 7.43±1.84. The mean GAD-7 and PHQ-9 scores were respectively 3.50±3.80 and 4.70±4.42. The PSS-10 score had a mean of 14.07±5.29. Five students (7.4%) presented self-harm thoughts. Students who were less satisfied with their choice of the medical field as a career had significantly higher scores of PHQ-9 (p&lt;0.001), GAD-7 (p=0.004) and PSS-10 (p=.042).ConclusionsMedical studies are the first step for these young doctors in their professional careers, which presents further psychological stressors. More attention towards the mental health of this population is needed to properly prepare them for their future.Disclosure of InterestNone Declared

Nuclear Anxiety Amid the Russian-Ukrainian War 2022 (RUW-22): Descriptive Cross-Sectional Study.

Nuclear anxiety, which refers to the fear of nuclear war and its consequences, is expected to increase amid the Russian-Ukrainian War of 2022 (RUW-22). This study aimed to evaluate the prevalence of nuclear anxiety and its associated variables among university students in the Czech Republic during the first weeks of RUW-22. A cross-sectional survey-based study was carried out from March-April 2022, utilizing a digital self-administered questionnaire (SAQ) to collect data from the target population. The SAQ consisted of multiple-choice items inquiring about demographic characteristics; generalized anxiety symptoms using generalized anxiety disorder-7 (GAD-7); depressive symptoms using patient health questionnaire-9 (PHQ-9); and attitudes towards civilian uses of nuclear power, and nuclear war-related anxiety. Of the 591 participating students, 67.7% were females, 68.2% were Czech nationals, and 61.8% followed the RUW-22 news at least once daily. The mean GAD-7 score of our participants was 7.86 ± 5.32 (0-21); and their mean PHQ-9 score was 8.66 ± 6.29 (0-27). Regarding the civilian uses of nuclear power, most participants agreed that nuclear power was safe (64.5%), denied being afraid that civilian use of nuclear power might deteriorate their health (79.7%), and thought that public acceptance was important for building new nuclear power plants (56.9%). About 42.1% and 45.5% of the participants reported feeling depressed at the possibility of nuclear war and agreed that the chances that there would be a nuclear war in their lifetime were very high, respectively. When asked about their preparedness measures during the previous four weeks, less than one quarter (23.9%) reported looking for recommendations for protection against nuclear accidents, and less than one-fifth (19.3%) were looking for the nearest bomb shelter. The depression about nuclear war possibility was positively and relatively strongly correlated with the level of "feeling concerned about the RUW-22" (rs = 0.401), and it was moderately correlated with GAD-7 (rs = 0.377) and PHQ-9 (rs = 0.274) scores and weakly correlated with RUW-2-related news-following frequency (rs = 0.196). Within the limitations of the present study, nuclear anxiety was common among Czech university students. Its associated factors may include but are not limited to the female gender; common psychological disorders such as generalized anxiety and depression; RUW-22-related news following-frequency; and the level of "feeling concerned".

Longitudinal study of mental health changes in residents affected by an initial outbreak of COVID-19 in China.

The COVID-19 pandemic is ongoing, and the world continues to work to defeat it. We designed this study to understand the longitudinal change in the mental health of residents who experienced the initial disease outbreak in China and to explore the long-term influencing factors. The Perceived Stress Scale (PSS), Generalized Anxiety Scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were administered to the same sample four times: during the initial outbreak (T1), 1 month later (T2), 18 months later (T3), and 26 months later (T4). A total of 397 participants completed all of the follow ups. The mean PSS scores among the four time points showed significant differences (F = 183.98, P < 0.001), with the highest score at T1 (15.35 ± 7.14), a sharp decline at T2 (11.27 ± 6.27), an obvious rebound at T3 (15.17 ± 7.46), and finally a slight decrease at T4 (14.41 ± 7.99). Among the four mean GAD-7 scores, significant differences were also found (F = 242.0, P < 0.001), with the trend that from T1 (7.42 ± 6.03) to T2 (7.35 ± 5.88), the scores remained steady, while they showed an apparent decline at T3 (5.00 ± 5.30) and no obvious change at T4 (4.91 ± 4.81). There were no significant differences among the mean PHQ-9 scores (F = 1.256, P < 0.284). The long-term influencing factors differed for stress, anxiety and depression, but all three were influenced by a history of psychosis at T4, quarantine status and whether the participants' family members were infected during the initial outbreak. The survey revealed that repeated outbreaks in other areas also had an impact on those who experienced the initial outbreak, with a return of stress, a decline in anxiety, and no change in depression, which provides direction for interventions in the future.

Psychosocial Screening in an Outpatient Community Radiation Oncology Center

<h3>Purpose/Objective(s)</h3> Cancer patients frequently suffer from depression and psychosocial impairments due to their disease and treatment. Depression in cancer patients has been reported to decrease quality of life, increase morbidity, lengthen hospital stay, decrease motivation to obtain treatment, and reduce therapy adherence. Psychosocial services have been shown to help patients cope with treatment-related stress. However, there is currently very little data on the best way to identify patients who would benefit from these services. Resources are needed to screen for depressive symptoms among oncology outpatients. The aim of this study was to investigate the frequency of depression among radiation oncology patients and evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool to identify patients that may benefit from a referral to psychosocial services. <h3>Materials/Methods</h3> The PHQ-9 was incorporated into routine clinical evaluation of outpatient radiation oncology patients. Patients with a diagnosis of any cancer completed the PHQ-9. Patients with a score of 5 to 9 were given educational material on available support services and re-screened at their next appointment. Patients with a score equal to or greater than 10 were referred for further evaluation for psychotherapy by a psychologist. <h3>Results</h3> From January to December 2021, a total of 2457 patients underwent PHQ-9 screening. 19.4% were screened during their initial consult, 78.6% were screened during a follow-up appointment, 1.6% were screened during a re-consult, and 0.2% were screened while they were on treatment. PHQ-9 scores ranged from 0 to 24. The majority of patients (97.8%) who underwent screening, scored less than 10 (n = 2404) and 1.8% of patients scored equal to or greater than 10 (n = 45). Data were missing on 8 patients. A total of 57 referrals were made. Of the referrals made, 59.6% refused referral (n = 34) and 40.3% accepted a referral (n = 23). 21% of the patients who accepted a referral had scored less than 10 on the PHQ-9 and self-referred themselves (n = 12). Of the patients who were referred or self-referred to Psychology, the mean PHQ-9 score was 10.5 (SD = 4.7). <h3>Conclusion</h3> Cancer necessitates an enhanced continuum of care. With the significant burden of depression among cancer patients, the integration of mental health services, particularly mental health screenings, and psychosocial consultation and referral, is critically needed and should be scaled up in cancer treatment facilities. Clinic-based interventions provided by healthcare providers are imperative to address cancer patient mental health needs. These findings provide a practical means to incorporate protocols for depression screening enhancing mental health access among cancer patients.

The correlation between OSA-related quality of life and two mental statuses in adolescent Chinese patients with cleft palate: A comprehensive study.

To analyze obstructive sleep apnea (OSA)-related quality of life (QoL), the statuses of depression and anxiety, and to reveal the correlation between OSA-related QoL and two mental statuses in Chinese adolescent patients with cleft palate (CP). The Obstructive Sleep Apnea Questionaire-18 (OSA-18), the Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were applied to assess OSA-related QoL and the statuses of anxiety and depression in Chinese adolescent patients with CP, respectively. Non-CP adolescents were also included in the control group. OSA-related QoL and the two mental statuses were compared between the study and control groups. The correlation between the OSA-related QoL and two mental statuses was estimated in Chinese adolescent patients with CP. A total of 8.7% patients showed a moderate or high impact of OSA on QoL, while all the adolescents from the control group showed little impact. The mean total OSA-18 score of the study group (36.261 ± 13.500) was significantly higher than the control (28.435 ± 8.934). The mean PHQ-9 scores of the study group and the control group were statistically different (3.957 vs. 2.113). The GAD-7 score in the study group was slightly higher than the control group (3.043 vs. 2.194), while the proportion of moderate-severe anxiety in the study group was relatively larger than that in the control group (6.5% vs. 1.6%). Moreover, there was a positive correlation between the OSA-related QoL and the statuses of anxiety and depression respectively, and the differences in GAD-7 and PHQ-9 scores between the moderate or high impact group and the little impact group were statistically significant. Chinese adolescents with CP reported a rate of moderate or high impact of OSA on QoL of 8.7%, which was significantly higher than adolescents without CP. The OSA-related QoL was worse and depression was severer in Chinese CP adolescents than in the control, while anxiety and depression in Chinese CP adolescents were associated with OSA-related QoL.

Vitamin D Alleviates Anxiety and Depression in Elderly People with Prediabetes: A Randomized Controlled Study.

Older people are prone to frailness, present poor adherence to pharmacotherapy, and often have adverse drug effects. Therefore, it is important to develop effective and safe interventions to mitigate the burden of anxiety and depression disorders in this population. The aim of this study was to investigate the effect of vitamin D supplementation on the anxiety and depression status of elderly people with prediabetes. Participants were randomly assigned a weekly dose of vitamin D3 of 25,000 IU (n = 45, mean age 73.10 ± 7.16 years) or nothing (n = 45, mean age 74.03 ± 7.64 years), in addition to suggested lifestyle measures. The State-Trait Anxiety Inventory subscales (STAI-T and STAI-S) and the Patient Health Questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression levels, respectively, at baseline, 6, and 12 months. A total of 92.68% of the participants in the vitamin D group and 97.14% of the controls exhibited vitamin D deficiency (<20 ng/mL) at baseline. Mean STAI-T scores were lower in supplemented individuals than in the control group at 6 (38.02 ± 9.03 vs. 43.91 ± 7.18, p = 0.003) and 12 months (32.35 ± 7.77 vs. 44.97 ± 7.78, p < 0.001). The same pattern was evident for STAI-S scores at 6 (37.11 ± 7.88 vs. 43.20 ± 9.33, p = 0.003) and 12 months (32.59 ± 6.45 vs. 44.60 ± 9.53, p < 0.001). Supplemented participants demonstrated lower mean PHQ-9 scores compared to controls at 6 (15.69 ± 6.15 vs. 19.77 ± 8.96, p = 0.021) and 12 months (13.52 ± 5.01 vs. 20.20 ± 8.67, p < 0.001). Participants with deficiency and insufficiency at baseline experienced equal benefits of supplementation in terms of anxiety and depression scores. In conclusion, in a high-risk population, a weekly vitamin D supplementation scheme was effective in alleviating anxiety and depression symptoms. More studies are needed to elucidate the relevant mechanisms.

Covid-19 anksiyete sıklığında sosyal medya bağımlılığının rolü nedir? Kesitsel bir çalışma.

Amaç: Pandemi sürecinde gerek iletişim gerek bilgilenme amacı ile sosyal medya maruziyeti artmıştır. Bu çalışmanın amacı koronavirüs anksiyetesi ile sosyal medya bağımlılığı arasındaki ilişkiyi saptamaktır.&#x0D; Gereç ve Yöntem: Tek merkezli, kesitsel tipte olan araştırmaya Gaziosmanpaşa Eğitim ve Araştırma Hastanesi Aile Hekimliği Polikliniği’ne 15 Eylül 2020- 15 Ekim 2020 tarihleri arasında başvuran 297 hasta alındı. Katılımcılara Koronavirüs Anksiyete Ölçeği (KAÖ) kısa formu, Hasta Sağlık Anketi-9 (PHQ-9), Bergen Sosyal Medya Bağımlılığı Ölçeği (BSMBÖ) uygulandı. Elde edilen verilerin istatistiksel analizleri için IBM SPSS Statistics 22 (IBM SPSS, Türkiye) programı kullanıldı. Anlamlılık p≤0,05 düzeyinde değerlendirildi.&#x0D; Bulgular: Ortalama yaşı 37,30±13,86 yıl ve %66 ‘ı (n:196) kadın, %34’ü (n:101) erkek olan 297 hastanın %11,8’inde (n= 35) koronavirus anksiyetesi, %23,2’sinde (n= 69) olası depresyon ve %9,1’inde (n= 27) sosyal medya bağımlılığı izlenmiştir. KAÖ puanı ortalaması 3,06±3,71, PHQ-9 puanı ortalaması 5,13±5,87, BSMBÖ puanı ortalaması 11,15±4,99 saptanmıştır. PHQ-9 puanının sırasıyla KAÖ (p= 0,043; r= 0,118) ve BSMBÖ (p= 0,004; r= 0,166) puanı arttıkça arttığı gözlenmiştir. KAÖ ile BSMBÖ puanları arasında anlamlı bir ilişki gözlenmemiştir (p= 0,525; r= -0,037). Düşük eğitim düzeyinin (ilkokul / ortaokul) KAÖ puanı üzerine 2,7 kat risk arttırıcı (OR= 2,691; C.I.= 1,300-5,571; p= 0,008) etkisi olduğu bulunmuştur.&#x0D; Sonuç: Koronavirus anksiyetesi görülenlerle görülmeyenlerin sosyal medya bağımlılık sıklığının benzer olması, medya kaynaklı artan bilgi maruziyetinde korkulduğu gibi koronavirus anksiyetesinin artmayabileceğini, eğitim düzeyinin asıl risk faktörü olduğunu göstermiştir.

A Comparative Analysis of Depressive Symptoms Following Sports-Related Concussion in Youth Athletes Versus Their Age-Matched Non-concussed Counterparts.

Background and objectiveAthletics is the leading cause of pediatric concussion, and depression is a major comorbidity associated with concussion in the pediatric population. Prior studies have described the risk of depression after concussion in high school-, collegiate-, and elite-level athletes, but there is scarce data on younger athletes. Interpretation of existing research on the association of depression with concussions in youth athletes is complicated by diverse study designs, varying measures of depression, differing timelines for symptom development, and a lack of control groups. Furthermore, limited research exists on sex-related differences in the development of depressive symptoms following sports-related concussions (SRC) in younger athletes. This study used the Seattle Pediatric Concussion Research Collaborative (SPCRC) Data Repository to compare depressive symptoms between youth athletes at one month post-SRC and non-concussed age-matched controls by using a standardized measure of depressive symptoms: the Patient Health Questionnaire-9 (PHQ-9). The secondary goal was to compare PHQ-9 scores between males and females for both concussed and non-concussed groups.MethodsThis study entailed a secondary analysis of data collected as part of the SPCRC Data Repository. We conducted a retrospective subgroup analysis of PHQ-9 scores at one month post-concussion for concussed youth athletes. We compared the PHQ9 scores of concussed youth athletes with PHQ-9 scores collected at the time of enrollment for non-concussed youth athletes.ResultsAfter random age-matching, a cohort of 266 patients (133 in the concussed group and 133 in the non-concussed control group) was included in the final analysis. The mean age was 13.8 years (range: 5-18 years). For the concussed group, a history of SRC was associated with a higher mean total PHQ-9 score at one month post-concussion compared with the control group at the time of enrollment (6.14 ±5.46 versus 1.53 ±1.81, respectively, p<0.0001). All nine subdomains of the PHQ-9 showed significantly higher scores in the concussion group compared with the control group (p<0.0001). Significantly higher scores were observed when comparing mean total PHQ-9 scores for male athletes in the concussion group with male athletes in the control group (7.03 ±5.72 versus 1.59 ±1.66, p<0.0001) and for female athletes in the concussion group compared with female controls (5.28 ±5.10 versus 1.49 ±1.92, p<0.0001). No significant differences were observed between sexes for total PHQ-9 scores or PHQ-9 subscores.ConclusionAt one month post concussion, youth with SRC demonstrated higher levels of depressive symptoms as measured by PHQ-9 compared with age-matched typically developing controls. No significant differences were identified in total PHQ-9 scores and subscores between male and female participants for either the concussion or control group. This study suggests that clinicians need to be vigilant and monitor for symptoms of depression in young athletes for at least one month post-concussion.