Mild Depressive Symptomatology Research Articles

Brushing Away the Blues: Self-Reported Oral Hygiene Practices Are Associated With Mild Depressive Symptoms in Airline Pilots.

Introduction Airline pilots are susceptible to mental health issues, with depression prevalence ranging from 1.9% to 12.6%. Recent research in the general population indicates a potential link between depression and oral health. In this cross-sectional study, we soughtto investigate the association between self-reported oral hygiene practices and depressive symptoms among airline pilots. Methods One hundred actively working male airline pilots of Caucasian descent voluntarily enrolled in the study during routine occupational health visits. Depressive symptoms were assessed using the Beck Depression Inventory II (BDI-II). Self-reported oral hygiene practices, including toothbrushing frequency and mouthwash usage, were examined. Univariable and multivariable logistic regression analyses were performed to investigate associations between depressive symptoms and oral hygiene practices. Results Twelve pilots (12%) demonstrated mild depressive symptomatology (BDI-II scores 14-19). Pilots with mild depression reported significantly lower rates of brushing teeth twice or more per day (33.3% vs. 80.7%) and higher rates of rarely brushing (16.7% vs. 1.1%) compared to those with minimal depressive symptoms (p < 0.001). Nonuse of mouthwash was more prevalent among pilots with mild depression (66.6% vs. 23.9%, p = 0.008). Multivariable logistic regression analysis revealed that pilots who rarely brushed their teeth (adjusted odds ratio (OR) = 14.6; 95% confidence interval (CI) = 1.3-197.9; p < 0.05) or did not use mouthwash (adjusted OR = 5.7; 95% CI = 1.4-25.2; p< 0.05) had significantly higher odds of mild depressive symptoms. Conclusions Self-reported oral hygiene habits may serve as a proxy indicator for mild depressive symptoms among airline pilots. Incorporating oral health assessments into routine aeromedical examinations could provide a practical method of identifying pilots at risk for depression, supporting timely interventions and enhancing flight safety.

Vitamin B12 deficiency and cognitive impairment: Is there a distinctive cognitive domain affected? A descriptive study in Buenos Aires

AbstractBackgroundVitamin B12 deficiency is associated with cognitive‐behavioral disorders, which may be potentially reversible. No specific associated cognitive domain has been established and alterations in episodic memory, verbal fluency, attention and executive functions, praxia and visuoconstruction have been described. The objective of this work is to evaluate and describe the cognitive domains affected in patients with cognitive impairment associated with vitamin B12 deficiency.MethodCross‐sectional observational study conducted at the Trinidad Mitre sanatorium of Buenos Aires City. Patients with cognitive impairment and vitamin B12 deficiency were analyzed. Information was collected on the cognitive domain affected (taking as altered value the Z score ≤‐1.5 according to age and educational level, obtained in the neurocognitive evaluations), cognitive profile, magnetic resonance imaging features and mean consultation‐supplementation time.Result25 patients with vitamin B12 deficiency and cognitive complaint were analyzed, with a mean age of 68.5 years. 83% presented multidomain mild cognitive impairment being 60% with subcortical pattern. Memory and attention were the most affected domains in 80% of the sample, followed by executive functions with 52%. The most deficient tests were the direct digit test (68%), serial memory (56%), deferred logical memory (52%) and Trail Making B (52%). Nearly 52% presented mild depressive symptomatology. A 56% of the sample presented with severe B12 deficiency with 32% elevation of plasma homocysteine. Supplementation was performed intramuscularly in 68% of the patients with a mean symptomatology‐supplementation onset time of 10.8 months. 92% of the patients presented subjective improvement after supplementation, 32% had control global test evaluation with improvement in all of them and 50% of this group presented control cognitive evaluation with improvement in previously deficient domains.ConclusionAccording to our findings we conclude that these patients with vitamin B12 deficiency present a multidomain pattern with special affectation of memory, attention and executive functions; of mild degree and potentially reversible. The reversibility of the picture could be related to high doses of B12 and early supplementation, using control cognitive assessments as an objective measure of improvement.ReferencesReynolds E. Lancet Neurol. 2006 Nov;5(11):949‐60. Eastley R. Int J Geriatr Psychiatry. 2000 Mar;15(3):226‐33. Robins Wahlin. Biol Psychol. 2001 Jun;56(3):247‐65.

B-61 Single-Item Reporting on the Neurobehavioral Symptom Inventory to Determine Clinical Levels of Depression: How Brief is too Brief?

Abstract Objective The Neurobehavioral Symptom Inventory (NSI) is frequently used in the Department of Veterans Affairs as a self-report measure to assess for a variety of medical and mental health concerns in veterans who have suffered traumatic brain injury (TBI). Only one item on the NSI (item 20) relates to depressive symptoms (i.e., feeling depressed or sad). The purpose of the study was to compare responses on the Beck Depression Inventory-II (BDI-II) with item 20 of the NSI to determine classification for mild depressive symptomatology. Method Retrospective data collected from veteran patients (N = 325) of a polytrauma outpatient clinic were used in the analysis. Veterans were excluded if cutoff scores exceeded an embedded validity scale (i.e., NSI Validity-10) or had missing data. Receiver Operating Curve (ROC) analysis was conducted to determine which item score (i.e., score of 0-4) on the NSI best classified the presence of depressive symptoms as measured by a BDI-II cut-off score greater than 13 (i.e., mild depression). Results There were 55 subjects who tested positive for depression based on a cut-off score of 3 on the NSI. The ROC analysis was significant (AUC = .822, p &lt; .001; 95% CI = .774 - .871). A cut-off score of greater than 13 on the BDI-II yielded a sensitivity rate of .982 and a specificity rate of .607. Conclusions These results indicate that item 20 of the NSI is indicative of a positive screen for depressive symptomatology with scores of 3 or greater indicating that further evaluation for depression is warranted.

The Relationship Between Depression and Violence Risk Predictors on Elderly

The purpose of this study was to understand the correlation between the elderly with depressive symptomatology and the predictors of the risk of violence against them. The method used was a quantitative approach using the Statistical Package program for Social Sciences. There was a participation of 237 elderly people aged 65-96 years, of the project “Aging in Safety in Alentejo-Understanding to Act”, at the University of Évora. The Geriatric Depression Scale and the Predictors of Risk of Violence (an adaptation of the Elder Abuse and Neglect-Risk Assessment Tool and Vulnerability to Abuse Screening Scale) were applied. About the results, 50 elderly (21.1%) had mild depressive symptomatology, and 14 (5.9%) had severe depressive symptomatology. Of the 64 elderly individuals who presented depressive symptomatology 55 were female. In the relationship between the severity of depressive symptomatology and predictors of risk of violence, significant results were found in three dimensions: current supports and relationships, family context and cognitive/emotional difficulties. The main conclusion of the study is that factors like no social support networks, complex family context and cognitive and emotional changes, contribute to greater physical and mental vulnerability of the elderly, resulting in cases of anxiety and stress, which present a depressive symptomatology and the risk of violence.

The longitudinal course of depression symptomatology following a palliative rehabilitation program.

Patients with advanced cancer have increased life expectancy but suffer from ongoing burden. Depressive symptomatology is their most common mental health concern. The Ottawa Palliative Rehabilitation Program (PRP) offers rehabilitation for this population. It offers 8 weeks of individualized interdisciplinary rehabilitation, post cancer treatment. Interventions include medical (physician and nurse), physiotherapy, occupational therapy, dietary, and social work using a general self-efficacy framework. Pilot data suggest benefits in a range of domains, including ratings of feeling "depressed." We examined whether reduced symptomatology was maintained 3months after PRP completion. Participants with advanced heterogeneous cancers who completed the PRP were mailed the Hospital Anxiety and Depression Scale (among others) 3-month post-PRP (n = 44). Demographic and medical information were obtained from patient files. There was a significant linear trend (mean T1: 6.79 ± 2.29; T2: 5.23 ± 3.06; T3: 4.59 ± 3.34; p = 0.007) with statistically and clinically significant decreases in reported depressive symptomatology between T1 and T2 (p = 0.042) and T1 and T3 (p = 0.007). There was a significant decreases in number of cases reporting symptomatology scores in the clinical range from T1 to T3 (p = 0.038). Patients who undergo a palliative rehabilitation program may experience relief of mild depressive symptomatology, maintainable 3-month post-PRP. The sample was exhibiting mild symptomatology and these results may not be generalizable to those with higher scores; a lack of specialized psychosocial clinician may have affected the acquired sample. Experimental designs are needed to more thoroughly compare these findings to independent rehabilitation interventions.

Incidence of dementia: evidence for an effect modification by gender. The ILSA Study

Gender differences for incidence of dementia among elderly people have been usually investigated considering gender as a predictor and not as a stratification variable. Analyses were based on data collected by the Italian Longitudinal Study on Aging (ILSA), which enrolled 5,632 participants aged 65-84 years between 1992 and 2000. During a median follow-up of 7.8 years, there were 194 cases of incident dementia in the participants with complete data. Cox proportional hazard models for competing risks, stratified by sex, were defined to determine risk factors in relation to developing dementia. The incidence rate of dementia increased from 5.57/1,000 person-years at 65-69 years of age to 30.06/1,000 person-years at 80-84 years. Cox proportional hazard models for competing risks of incidence of dementia and death revealed that, among men, significant risk factors were heart failure, Parkinson's disease, family history of dementia, mild depressive symptomatology and age, while triglycerides were associated with a lower risk of developing dementia. Significant risk factors in women were age, both mild and severe depressive symptomatology, glycemia ≥109 mg/dL, and a BMI < 24.1 kg/m². Even as little as three years of schooling was found to be a significant protective factor against the incidence of dementia only for women. Our results suggest that there is an effect modification by gender in our study population in relation to the association between low education level, lipid profile, BMI, and glycemia and dementia.

Cognitive Bibliotherapy for Mild Depressive Symptomatology: Randomized Clinical Trial of Efficacy and Mechanisms of Change

It has been increasingly recognized that subthreshold depression is associated with considerable personal, social and economic costs. However, there is no accepted definition or clear-cut treatment for subthreshold depression. Cognitive bibliotherapy is a promising approach, but further research is necessary in order to assess its clinical efficacy and key mechanisms of change. This study aimed to investigate the efficacy of bibliotherapy for subthreshold depression and test whether maladaptive cognitions mediate the effects of bibliotherapy on depressive symptoms. A total of 96 young adults with subthreshold depression were randomized in one of the following treatment conditions: immediate treatment, delayed treatment, placebo and no treatment. The main outcome was represented by depressive symptoms assessed before, during and immediately after the treatment, as well as at 3-month follow-up. Automatic thoughts, dysfunctional attitudes and irrational beliefs were also assessed throughout the study, and we investigated their involvement as mediators of bibliotherapy effects on depressive symptoms. The results indicated that cognitive bibliotherapy resulted in statistically and clinically significant changes both in depressive symptoms and cognitions, which were maintained at follow-up. In contrast, placebo was only associated with a temporary decrease in depressive symptoms, without significant cognitive changes. No changes in symptoms or cognitions were found in the delayed treatment and no treatment groups. We also found that automatic thoughts significantly mediated the effect of bibliotherapy on depressive symptoms. This study provided compelling evidence for the efficacy of cognitive bibliotherapy in subthreshold depression and showed that changes in automatic thoughts mediated the effect of bibliotherapy on depressive symptoms. Cognitive bibliotherapy is an effective treatment of subthreshold depression. Changing automatic thoughts is important, as they mediate the bibliotherapy effect on depressive symptoms. Cognitive bibliotherapy is a potential alternative or adjunct to psychotherapy for mildly depressed adults.

Convergence of Children's Depression Rating Scale-revised Scores and Clinical Diagnosis in Rating Adolescent Depressive Symptomatology.

The Children’s Depression Rating Scale-Revised (CDRS-R) is a widely used instrument for research on depression in minors. A raw score of ≥40 has often been used as indicator of depressive symptomatology. As a validated German version of the CDRS-R has recently became available, we assessed CDRS-R raw summary scores of a video taped interview session in two different rater groups and compared them with clinical ratings of International Classification of Diseases (ICD-10) depression diagnosis as observed by a third independent group. We found that for the German version a raw score between 35 and 40 is indicative for mild depressive symptomatology as described by the ICD-10. CDRS-R scores show potential clinical applicability to deduct levels of depression.

Late life depression and incident activity limitations: Influence of gender and symptom severity

Mental disorders, especially depression, are one of the principal causes of disablement. Previous research has been limited partly due to the failure to take into account sub-syndromal states and the very large number of candidate mediating and confounding factors. Longitudinal associations between baseline depressive symptomatology and activity limitations were examined in a community-dwelling elderly cohort of 3191 participants. Mixed logistic models were used to determine associations between mild or severe depressive symptoms (Center for Epidemiologic Studies-Depression Scale, CES-D), and 7-year incident disability on four limitation scales assessing instrumental and basic activities of daily living, mobility using the Rosow and Breslau scale, and social restriction. In men, mild depressive symptomatology was associated with increased incident limitations on instrumental activities of daily living (IADL) (odds ratio (OR) (95% CI)=5.07 (2.25-11.42)). In women, severe depressive symptomatology was related to social restriction (OR (95% CI)=2.36 (1.31-4.25)), IADL (OR (95% CI)=1.89 (1.13-3.15)) and activities of daily living (OR (95% CI)=11.15 (3.43-36.23)). Men and women with a 2-year increase in CES-D score were highly at risk for social restriction and limitations in mobility and IADL. Depression is an independent predictor of disability in the elderly population; the relation is gender-dependent and varies with symptom load.

P01-275 - Depression in diabetics-a serious comorbidity

ObjectiveDiabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycaemia due to either the deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. Depressive disorders have been found to occur at increased prevalence rates among patients with Type 1 and Type 2 Diabetes Mellitus 9. Depression has the additional importance in diabetes because of its association with poor compliance with diabetic treatment, poor glycemic control and an increased risk of micro and macro vascular complications. An accurate estimate of depression prevalence is needed to keep and gauge the potential impact of depression management in patients with co-morbid diabetes 22. Better recognition and better treatment of depression are important in themselves but they could also improve medical outcome by substantial portion in patients of diabetesMethodsTotal of 527 cases of Diabetes were screened for major depressive disorder (MDD) by using DSMIV based criteria system. Montgomeny Asberg Depression rating scale (MADRS) and Clinical Global Impression (Severity) (CGI) scale to access severity.Conclusion:1.Major depressive disorder is inordinately high among the sample of adult diabetic patients occurring at the rates of 2 - 6 times greater than those observed in general population.2.Majority of patients with diabetes who have major depressive disorder have depression of moderate severity and not just mild depressive symptomatology.3.The presence of major depressive disorder is significantly associated with poorer glycemic control.

Charles Bonnet Syndrome: successful treatment of visual hallucinations due to vision loss with selective serotonin reuptake inhibitors

Visual hallucinations are a common and often distressing consequence of vision loss, particularly in age-related macular degeneration. Charles Bonnet Syndrome (CBS) is defined by the triad of complex visual hallucinations, ocular pathology causing visual deterioration and preserved cognitive status. So far, although this condition is frequent, no established treatment for CBS has been stated. We report here the case of a 78-year-old woman, who came in our hospital because of a 4-week long mild depressive symptomatology. For 1 year she experienced daily sudden, unexpected, vivid and elaborate hallucinations. Insight was completely present, so the patient stated that the hallucinations were unreal and that the faces, geometrical figures and animals she saw every day were possibly due to her vision loss. The Mini Mental State Examination, digit span and verbal fluency were administered and no cognitive impairment was reported. The visual acuity was hand motion. After 4 days of treatment with venlafaxine the hallucinations completely disappeared. This is the first case to show that selective serotonin (and noradrenalin) reuptake inhibitors may be an effective and well-tolerated treatment for visual hallucinations associated with vision loss, and it adds to evidence implicating serotonergic pathways in the pathogenesis of visual hallucinations.

The Prevention of Depression in Children: A Pilot Study

AbstractTwenty, fifth- and sixth-grade students who reported mild depressive symptomatology were placed into a brief intervention program. The program was conducted over eight, weekly, 90-minute sessions and aimed to teach students depression management strategies and positive coping skills. Significant reductions in symptoms of depression, anxiety and externalising behaviour were found and maintained for six months. The results lend support to the effectiveness of this brief program for early intervention in depression. The potential for the program to prevent the later development of clinical depression and related problems is discussed.

Post-partum blues and mild depressive symptomatology at days three and five after delivery: A French cross sectional study.

This cross-sectional work studies the prevalence of post-partum blues on days 3 and 5 after delivery and the links between post-partum blues and depressive symptomatology, using standardised interviews and rating scales (Kennerley and Gath Blues Scale, MADRS) to screen a consecutive series of 104 women on days three and five after a normal delivery. This study stresses the possibility of a difference between the symptomatology of a benign “classical” post-partum blues, and that of a more intense blues closer to the spectrum of depressive mood disorders and perhaps post-natal depression.

Factorial study of the BDI in pregnant women.

This study was carried out to investigate the significance of Beck Depression Inventory (BDI) scores and the influence of somatic items in a non-psychiatric population presenting with somatic complaints. Internal consistency, item frequency, factor dimensions, and correlation with Eysenck's 'N' were analysed in a sample of 882 non-psychiatric pregnant women. The BDI showed a high level of internal consistency (Cronbach alpha coefficient was 0.85). Factor analysis yielded two major factors. Low BDI scores were determined mainly by items related to somatic complaints or decreased activity without unequivocal depressive content. In contrast, it was unambiguous depressive items that were endorsed in high scores, and these showed higher correlations with neuroticism. It is concluded that in non-psychiatric populations the BDI may measure conditions other than depression and that low or medium range scores should not be interpreted as indicators of mild depressive symptomatology.

Dysfunctional attitudes and psychosocial stress: The differential prediction of future psychological symptomatology

The interactive effects of dysfunctional attitudes, stressful life events, and social support on symptoms of depression and general psychological distress were investigated in the present study. Self-report measures of these five constructs were administered to 57 female undergraduates twice, with 3 months between testing sessions. Whereas the interactions of dysfunctional attitudes with stressful life events and with social support were expected to predict the subsequent severity of symptoms of depression, it was hypothesized that these two-way interactions would not predict symptoms of general psychological distress. These predictions were confirmed, with the exception that the interaction between dysfunctional attitudes and stressful life events was not a significant predictor of depressive symptoms. Specifically, it was found that the combination of a high number of dysfunctional attitudes measured at Time 1 with a low level of social support measured at Time 2 was positively related to the level of depressive symptoms assessed at Time 2. These results suggest that dysfunctional attitudes moderate the relationship between stress and mild depressive symptomatology. The implications of these findings for an interactional model of depression, as well as for directions for future research, are discussed.