Moderate Levels Of Depressive Symptoms Research Articles

A prospective cohort study to assess the prevalence and risk factors of antepartum depression and its effect on maternal and fetal outcome

Antepartum depression (APD) is a public health issue has negative repercussions on the health of the mother, child, and family. Early screening for APD will help in early detection and further prevention of postpartum depression and adverse maternal and fetal outcomes. This study was designed to determine i) the prevalence rate of APD in the Indian population and its associated risk factors, ii) the impact of APD on maternal and fetal outcomes. A retrospective cohort study was conducted among antenatal women in the third trimester and screened for antepartum depression between October 2021 and March 2022 by adopting the Edinburgh Postnatal Depression Scale (EPDS). In the study population, 36.6 % had mild to moderate level of depressive symptoms (EPDS score of 8–12) and 28 % had high levels of depressive symptoms (EPDS score of ≥13). An unplanned pregnancy, a history of abortion, and a history of any pregnancy complications were the likely maternal risk factors for developing antepartum depression. The APD risk was also likely to be increased by sociodemographic and personal factors such as insufficient family support, a history of domestic violence, marital dissatisfaction, and a partner with a poor level of education (P < 0.05). Women screened with antepartum depression had 58.34 times the likelihood of developing postpartum depression and a threefold greater risk of having premature delivery. These findings may help to improve pregnancy outcomes by early identification, referral for early treatment of antepartum depression, also inform maternal mental health service development and utilization for boosting women's mental wellbeing.

Daily Chronic Stressors in Combination with Resilience Are Associated with Adolescent School Bullying and the Mediating Role of Depressive Symptoms

(1) Background: Previous studies have shown that stress increases the risk of bullying (including perpetration and victimization) in adolescents, and depressive symptoms are associated with both stress and bullying. However, the relationship between stress, depressive symptoms, and bullying has not been fully elucidated. In addition, previous studies have focused only on stressors but have ignored the role of resilience in evaluating individual’s stress. This study aimed to incorporate resilience into the assessment of an individual’s stress, which we named comprehensive stress; to examine the relationship between comprehensive stress and bullying; and then to investigate the potential role of depressive symptoms in this relationship. (2) Methods: We recruited 6353 middle and high school students from the 2021 Shanghai CDC Youth Risk Behavior Surveillance Project. After signing informed consent, participants provided demographic information and completed effective measures of stressors, resilience, depressive symptoms, and bullying. (3) Results: Latent profile analysis revealed four profiles of comprehensive stress, labeled as Low stressor–High resilience (37.57%, n = 2216), Moderate high stressor–Average resilience (14.38%, n = 848), Average stressor–Moderate low resilience (33.33%, n = 1966), and High stressor–Low resilience (14.72%, n = 868). In comparison to students in the Low stressor–High resilience profile, students in other profiles demonstrated higher likelihoods of engaging in bullying victimization and perpetration, as well as higher levels of depressive symptoms. Specifically, students in the High stressor–Low resilience profile had the highest odds of bullying victimization (OR = 6.74, 95% CI: 4.92–9.22) and perpetration (OR = 5.15, 95% CI: 3.56–7.46), along with the highest level of depressive symptoms (β = 11.35, Se(β) = 0.17). Students in the Average stressor–Moderate low resilience profile had a moderate increase in the odds of bullying victimization (OR = 2.21, 95% CI: 1.63–3.00) and perpetration (OR = 2.69, 95% CI: 1.91–3.80), as well as a moderate level of depressive symptoms (β = 5.03, Se(β) = 0.13). Students in the Moderate high stressor–Average resilience profile also showed increased odds of bullying victimization (OR = 2.99, 95% CI: 2.12–4.20) and perpetration (OR = 2.80, 95% CI: 1.88–4.20), as well as a moderate level of depressive symptoms (β = 4.44, Se(β) = 0.16). Depressive symptoms were positively correlated with both perpetration and victimization. Furthermore, the mediating role of depressive symptoms between comprehensive stress and bullying was observed. (4) Conclusions: Combining stressors and resilience is crucial when evaluating an individual’s stress. Comprehensive stress is associated with bullying, and depressive symptoms may partially mediate this relationship.

The effect of social media and infodemic on mental health during the COVID-19 pandemic: results from the COMET multicentric trial.

On January 30, 2020, the World Health Organization (WHO) declared the status of pandemic due to the COVID-19 infection. The initial phases of the pandemic were characterized by uncertainty and public fears. In order to cope with such unexpected conditions, people adopted different coping strategies, including search for information, accessing Internet, and using social media. The present study based on the COMET collaborative research network aims to: (1) assess use of Internet and of social media among the Italian general population; (2) explore differences in web usage between people with pre-existing mental disorders and the general population; (3) identify changes over time in social media usage along the phase 1 of the pandemic; (4) identify the clinical, socio-demographic and contextual predictors of excessive use of social media. A significant increase in time spent on Internet, with an average time of 4.8 ± 0.02 h per day, was found in the global sample of 20,720 participants. Compared with the general population, Internet use was significantly higher in people with pre-existing mental disorders (5.2 ± 0.1 h vs. 4.9 ± 0.02; p < 0.005). According to the multivariate logistic regression model, the risk of excessive use of social media and Internet was significantly higher in people with moderate levels of depressive symptoms (OR: 1.26, CI 95%: 0.99 to 1.59, p < 0.0.005); while protective factors were being students (OR: 0.72, CI 95%: 0.53 to 0.96, p < 0.0029) and living in central Italy (OR: 0.46, CI 95%: 0.23 to 0.90, p < 0.002). The evaluation of social media and Internet use by the general population represents a first step for developing specific protective and supportive interventions for the general population, including practical suggestions on how to safely use Internet and social media.

One year later: mental health among employees in long-term care of the elderly after COVID-19 in Italy

IntroductionThe COVID-19 emergency have imposed a great burden on the Italian health and social health system. In this context, healthcare workers (HCWs) have been exposed to high levels of stress. While many studies addressed the consequences of COVID-19 on hospital workers, little interest has been devoted to the employees of nursing homes.ObjectivesTo evaluate levels of depressive, anxious and post-traumatic symptoms in a population of nursing homes workers in Italy one year after the begin of the pandemic.MethodsThe research involved 177 nursing homes, to evaluate the Mental Health outcome of the COVID-19 pandemic 12 months after the first lockdown on a large sample of workers. Participants answered a self-assessment tools aimed to assess the level of trauma experienced, the level of anxiety and depression, the quality of professional life and social and work adjustment.ResultsA consistent level of psychological suffering in the HCWs 12 months after the first lock-down and after the third wave of Covid-19 is highlighted, in accordance with what has been observed in similar research. It turns out that about 30% of subjects, more often women, have elements suggestive of symptoms related to PTSD, with moderate levels of anxiety. On the other hand, 15% of the sample presents moderate levels of depressive symptoms and a severe impact on social and occupational functioning. Of these about 40% of staff has significant interference and just over 15% has a severe impact (see figure 1).Image:ConclusionsInterventions tailored to support mental health are needed not only for HCWs from hospital units but also for those working in nursing homes and long-term care units.Disclosure of InterestNone Declared

Students’ emotional well-being and religiosity during the COVID-19 pandemic- an international study in 7 countries

IntroductionThere are no conclusive findings about the possible protective role of religion on students’ mental health during the COVID-19 pandemic. Therefore, more research is needed.ObjectivesThe purpose of this study was to assess the relationship between the level of emotional distress and religiosity among students from 7 different countries during the COVID-19 pandemic.MethodsData were collected by an online cross-sectional survey that was distributed amongst Polish (N = 1196), Bengali (N = 1537), Indian (N = 483), Mexican (N = 231), Egyptian (N = 565), Philippine (N = 2062), and Pakistani (N = 506) students (N = 6642) from 12th April to 1st June 2021. The respondents were asked several questions regarding their religiosity which was measured by The Duke University Religion Index (DUREL), the emotional distress was measured by the Depression, Anxiety, and Stress Scale-21 (DASS-21).ResultsEgypt with Islam as the dominant religion showed the greatest temple attendance (organizational religious activity: M=5.27±1.36) and spirituality (intrinsic religiosity: M=5.27±1.36), p&lt;0.0001. On another hand, Egyptian students had the lowest emotional distress measured in all categories DASS-21 (depression: M=4.87±10.17, anxiety: M=4.78±10.13, stress: M=20.76±11.46). Two countries with the dominant Christian religion achieved the highest score for private religious activities (non-organizational religious activity; Mexico: M=3.94±0.94, Poland: M=3.63±1.20; p&lt;0.0001) and experienced a moderate level of depressive symptoms, anxiety, and stress. Students from Mexico presented the lowest attendance to church (M=2.46±1,39) and spirituality (M=6.68± 3.41) and had the second highest level of depressive symptoms (M=19.13±13.03) and stress (M=20.27±1.98). Philippines students had the highest DASS-21 score (depression: M=22.77±12.58, anxiety: M=16.07±10.77, stress: M=4.87±10.08) and their level of religiosity reached average values in the whole group. The performed regression analysis confirmed the importance of the 3 dimensions (organizational religious activity, non-organizational religious activity, intrinsic religiosity) of religiosity for the well-being of students, except for the relationship between anxiety and private religious activities. The result was as presented for depression: R2=0.0398, F(3.664)=91.764, p&lt;0.0001, SE of E: 12.88; anxiety: R2=0.0124, F(3.664)=27.683, p&lt;0.0001, SE of E: 10,62; stress: R2= 0.0350, F(3.664)=80.363, p&lt;0.0001, SE of E: 12.30.ConclusionsThe higher commitment to organizational religious activity, non-organizational religious activity, and intrinsic religiositywas correlated with the lower level of depressive symptoms, stress, and anxiety among students during the COVID-19 pandemic, but taking into account factors related to religiosity explains the level of emotional well-being to a small extent.Disclosure of InterestNone Declared

Depressive Symptoms Are Associated With Decreased Quality of Life and Work Ability in Currently Working Health Care Workers With Recurrent Low Back Pain.

This study investigates the association between depressive symptoms and multisite pain and health-related quality of life and work ability in currently employed health care workers with recurrent low back pain (LBP). Multisite pain, depressive symptoms, quality of life, and work ability were assessed by validated questionnaires. A generalized linear model was used for statistical analysis. Notably, 28% of female health care workers with LBP had at least moderate levels of depressive symptoms. Depressive symptoms were significantly associated with decreased health-related quality of life and work ability. Multisite pain was not significantly associated with work ability. Depressive symptoms are relatively common in female health care workers with LBP, and treatment of these symptoms may be crucial to improve their work ability.

Family responsibilities and mental health of kindergarten educators during the first COVID-19 pandemic lockdown in Ontario, Canada

The present study, conducted during the first wave of the COVID-19 pandemic in Ontario, Canada, addressed the association between family responsibilities and mental health (depression and anxiety) among kindergarten educators. Participants comprised 1790 (97.9% female) kindergarten educators (73.6% kindergarten teachers; 26.4% early childhood educators) across Ontario. Results revealed that educators were more likely to report moderate levels of depressive symptoms if they had the responsibility of caring for their own children, and more likely to report moderate levels of depressive and anxious symptoms if they had the responsibility of caring for an older adult. Theoretical and practical implications are discussed.

Pandemija Kovid-19 i mentalno zdravlje zdravstvenih radnika u Srbiji

The COVID-19 pandemic was a challenging experience for many professionals worldwide. Healthcare workers in particular had to invest a lot of efforts to cope with the stressors related to professional challenges, which can adversely affect their mental health and cause burnout syndrome. However, it is important to explore mental health outcomes of the pandemic among healthcare workers in the context of a specific country. This study examined the effects of increased professional and personal demands on the health workers' mental health after almost two years of dealing with the pandemic. A cross-sectional online anonymous survey was conducted during October 2021. The sample consisted of 286 healthcare workers (76.7% male) from all regions of Serbia. The questionnaire included socio-demographic data, professional and personal experiences during the pandemic, mental health difficulties, and burnout. The results indicate that more than half of the participants experienced a high or moderate level of depressive symptoms, anxiety and stress. Emotional exhaustion as a symptom of burnout was reported by almost all participants (91.9%), followed by moderate compassion fatigue (60.8%) and lower level of self-efficiency (23.8%). The most significant predictors of burnout and mental health difficulties referred to impaired working conditions and insufficient instructions from superiors, a high level of personal concern about the infection, and maladaptive coping strategies. The results point to the importance of providing psychosocial support to healthcare workers in order to prevent further mental health impairments. Still, interventions should be focused on the external organizational factors instead of addressing solely individual vulnerability.

Smartphone-delivered multicomponent lifestyle medicine intervention for depressive symptoms: A randomized controlled trial.

To evaluate the efficacy and credibility of a smartphone-delivered multicomponent lifestyle medicine (LM) intervention, Lifestyle Hub, as a primary modality for managing depressive symptoms in an adult Chinese population. Participants with at least a moderate level of depressive symptoms (n = 79), as indicated by a Patient Health Questionnaire-9 score of ≥10, were randomly assigned to an LM intervention group (LMG; n = 39; eight weekly sessions) or a waitlist control group (WLG; n = 40). The intention-to-treat analysis revealed significant improvements in depressive symptoms (d = 0.66), generalized anxiety symptoms (d = 0.93), insomnia symptoms (d = 0.20), functional impairment (d = 0.22), and health-related quality of life (HRQoL; d = 0.11) from Week 0 (baseline) to Week 9 (immediate post-intervention assessment) in the LMG relative to the WLG. Moreover, significantly more health-promoting behaviors (overall health behaviors, health responsibility, physical activity level, nutrition, spiritual growth, and stress management) (d = 0.40-0.89) and higher levels of total activity (d = 0.55) and walking activity (d = 0.55) were found at Week 9 in the LMG relative to the WLG. However, no significant differences were observed in interpersonal relationships, vigorous and moderate exercise levels, sedentary behavior levels, or food frequency questionnaire measures at Week 9 between the LMG and the WLG. From Week 9 to Week 13 (1-month follow-up assessment), a significant within-group reduction in HRQoL (d = 0.50) and an increase in alcohol intake (d = 0.41) were observed in the LMG. The smartphone-delivered multicomponent LM intervention Lifestyle Hub may serve as a primary modality for managing depressive symptoms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Benchmarking Depressive Symptoms in Cardiac Rehabilitation.

Depression affects cardiac health and is important to track within cardiac rehabilitation (CR). Using two depression screeners within one sample, we calculated prevalence of baseline depressive symptomology, improvements during CR, and predictors of both. Data were drawn from the University of Vermont Medical Center CR program prospectively collected database. A total of 1781 patients who attended between January 2011 and July 2019 were included. Two depression screeners (Geriatric Depression Scale-Short Form [GDS-SF] and Patient Health Questionnaire-9 [PHQ-9]) were compared on proportion of the sample categorized with ≥ mild or moderate levels of depressive symptoms (PHQ-9 ≥5, ≥10; GDS-SF ≥6, ≥10). Changes in depressive symptoms by screener were examined within patients who had completed ≥9 sessions of CR. Patient characteristics associated with depressive symptoms at entry, and changes in symptoms were identified. Within those who completed ≥9 sessions of CR with exit scores on both screeners (n = 1201), entrance prevalence of ≥ mild and ≥ moderate depressive symptoms differed by screener (32% and 9% PHQ-9; 12% and 3% GDS-SF; both P< .001). Patients who were younger, female, with lower cardiorespiratory fitness (CRF) scores were more likely to have ≥ mild depressive symptoms at entry. Most patients with ≥ mild symptoms decreased severity by ≥1 category by exit (PHQ-9 = 73%; GDS-SF = 77%). Nonsurgical diagnosis and lower CRF were associated with less improvement in symptoms on the PHQ-9 (both P< .05). Our results provide initial benchmarks of depressive symptoms in CR. They identify younger patients, women, patients with lower CRF, and those with nonsurgical diagnosis as higher risk groups for having depressive symptoms or lack of improvement in symptoms.

The Staff Mental Health Service in Cambridgeshire and Peterborough: a new model for assessment and treatment of healthcare workers in the context of COVID-19 pandemic

AimsStaff mental health is a major determinant of a well-functioning health system that has become ever more important during the COVID-19 pandemic. Poor mental health is the most common reason for NHS staff sickness absences, usually accounting for 25% of all reported sick leave. At a time when the NHS most needs an available and efficient workforce, government and NHS employers lack the necessary evidence to inform decisions about how best to support the mental health needs of its staff. In this report, we share our experience and the initial figures from a newly developed multidisciplinary assessment and treatment service for NHS staff.MethodThe Staff Mental Health Service (SMHS) at the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) launched in September 2020. The SMHS is commissioned by the Cambridgeshire and Peterborough sustainability and transformation partnership and is accessible to the 25,513 staff based at five NHS trusts within the region. The service received 235 referrals within 5 months of the launch. All patients had a first clinical contact within three working days and more than 80% had their initial assessment within two weeks. The SMHS clinical team is comprised of consultant psychiatrists, senior clinical psychologists, specialist mental health nurses, and an occupational health nurse set to provide rapid access, confidential, evidence-based treatments for the NHS staff. As part of service evaluation within CPFT, we collected routine screening data (Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), and Posttraumatic Symptom Check List – 6 (PCL-6)) from patients completing the initial assessment (n = 130).ResultAccording to the initial figures (n = 130) from a diverse group of healthcare staff, on average the patients presented with moderate level of depressive symptoms (PHQ-9: 16.22 ± 5.94). Anxiety levels were in moderate to severe range (GAD-7: 13.45 ± 4.70). Average score of PCL-6 checklist for traumatic stress symptoms was higher than the established cut-off (&gt;14): 19.43 ± 5.65.ConclusionThe Staff Mental Health Service offers an innovative, multi-disciplinary rapid assessment and treatment clinic for NHS staff. The demand for the service has been immense, reaching double the number of predicted referrals. Initial data suggested high rates of moderate to severe depression, anxiety, and traumatic stress symptoms in healthcare workers. Our clinical observations was that many healthcare workers have had longstanding significant mental health conditions that saw deterioration during the COVID-19 pandemic. We hope that our experience in the SMHS will help inform models across the UK to address the clear unmet need for staff mental health.

Perinatal depression among mothers in a South African birth cohort study: Trajectories from pregnancy to 18 months postpartum

BackgroundPerinatal depression affects 21–50% of women in South Africa and poses significant health risks to mothers and children. Trajectories of depressive symptoms change over time and have not been well characterized during the perinatal period in low and middle-income countries. MethodsData from women enrolled in a population-based birth cohort study in Paarl, South Africa with at least 3 depression measures from pregnancy through 18 months postpartum (N = 831) were analyzed. Depressive symptoms were measured continuously using the Edinburgh Postnatal Depression Scale (EPDS). Group-based trajectory models were used to estimate trajectories of depressive symptoms during the perinatal period and multinomial multivariable models to identify predictors of trajectory group membership. ResultsFive distinct trajectory patterns of depressive symptoms were identified: moderate levels of depressive symptoms during pregnancy but minimal postpartum (3.5%), minimal levels during pregnancy and increasing postpartum (3.7%), unstable levels peaking at 12 months postpartum (6.6%), mild levels with slight decrease postpartum (82.9%), and severe levels during pregnancy and postpartum (3.1%). Membership in the chronic severe symptom group was associated with stressful life events, sexual intimate partner violence and tobacco use. LimitationsModeling limitations prevented determining how changes in psychosocial predictors over time may influence depressive symptom trajectories. ConclusionsMild to severe depressive symptoms during pregnancy/postpartum were common among this South African cohort. Interventions to treat women with severe chronic depressive symptoms with co-occurring psychosocial issues are urgently needed.

A Pro-Inflammatory Diet Is Associated With an Increased Odds of Depression Symptoms Among Iranian Female Adolescents: A Cross-Sectional Study.

Background: The relation between dietary inflammation and risk of depression has not been widely explored. We examined the association between the inflammatory effect of the diet and the odds of depression among Iranian female adolescents.Methods: Using a stratified cluster sampling technique, 300 female adolescents aged 15–18 years were recruited from schools in Tehran between years 2014–2015. Depression was assessed using the Depression, Anxiety and Stress Scale (DASS)- a 21-point scale. The dietary inflammatory index (DII®) was used to evaluate the inflammatory potential of the diet. Dietary intake was assessed using a validated food frequency questionnaire. In addition to descriptive statistics, multivariable linear and logistic regression were used to calculate confounder-adjusted beta estimates and odds ratios.Results: In total, 88 females (30%) had at least a moderate level of depressive symptoms (DASS > 6). Females with the most pro-inflammatory diet had higher DASS depression score (β = 1.67; 95% CI = 0.03, 3.31) and were at 3.96 (95% CI = 1.12, 13.97) times higher odds of having at least moderate depressive symptoms, compared to females with the least anti-inflammatory diets.Conclusion: These data suggest that Iranian adolescent females eating a pro-inflammatory diet, as indicated by higher DII scores, had greater odds of having at least moderate depressive symptoms.

Temperament and character profiles are associated with depression outcome in psychiatric secondary care patients with harmful drinking

BackgroundTemperament and character profiles have been associated with depression outcome and alcohol abuse comorbidity in depressed patients. How harmful alcohol use modifies the effects of temperament and character on depression outcome is not well known. Knowledge of these associations could provide a method for enhancing more individualized treatment strategies for these patients. MethodsWe screened 242 depressed patients with at least moderate level of depressive symptoms. The Alcohol Use Disorders Identification Test (AUDIT) was used for identifying patients with marked alcohol use problems (AUP, AUDIT≥11). After 6 weeks of antidepressive treatment 173 patients were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Temperament and Character Inventory (TCI-R). Outcome of depression (MADRS scores across three follow-up points at 6 weeks, 6 months and 24 months) was predicted with AUP, gender, and AUP x Gender and AUP x Time interactions together with temperament and character dimension scores in a linear mixed effects model. ResultsPoorer outcome of depression (MADRS scores at 6 weeks, 6 months and 24 months) was predicted by AUP × Time interaction (p = 0.0002) together with low Reward Dependence (p = 0.003). Gender and all other temperament and character traits were non-significant predictors of the depression outcome in the mixed effects model. ConclusionsPossibly due to the modifying effect of alcohol use problems, high Reward Dependence was associated with better depression treatment outcome at 6 months. Harm Avoidance and Self-Directedness did not predict depression outcome when alcohol use problems were controlled.

Psychometric Properties of the DASS-21 Among Latina/o College Students by the US-Mexico Border.

Anxious-depression symptomatology is frequently encountered among Latina/o individuals. There is a dearth of studies that examine this mixed class of anxiety and depression symptomatology, especially among Latina/o college students by the US-Mexico border. A total of 505 participants from rural institutions of higher education completed the DASS21. Psychometric properties were measured by means of confirmatory and exploratory factor analysis (EFA). A multivariate analysis of variance (MANOVA) was conducted to determine gender differences in depression, anxiety and stress. Among women, 18% reported at least moderate levels of depressive symptoms, 33.1% reported at least moderate levels of anxiety symptoms, and 16.4% reported at least moderate levels of stress. In men, 15.9% reported at least moderate levels of depressive symptoms, 34.1% reported at least moderate levels of anxiety symptoms, and 12.9% reported at least moderate levels of stress. The EFA supported a one dimension factor (anxious/stress-depression) among this sample of Latina/o college students (Bartlett's test=4960.9; df=210; p≤0.01; Kaiser-Meyer-Olkin=0.95). The MANOVA found no significant gender differences in depression, anxiety symptomatology and stress [Wilks'Λ=0.99; F=(3, 500)=2.41; p=0.07]. The DASS-21 showed a one dimensional construct of anxious/stress-depression symptomatology in a Latina/o rural undergraduate sample, raising awareness to the need to screen and monitor this constellation of symptoms.

A seven day actigraphy-based study of rumination and sleep disturbance among young adults with depressive symptoms

ObjectivesTrait ruminators exhibit significantly higher levels of sleep disturbance than those without this cognitive vulnerability. However, support for the sleep disruptive effects of state rumination, especially in the pre-sleep period, is rare, and hindered by methodological drawbacks such as self-report and single night assays of sleep. Finally, despite the pervasiveness of the ruminative response style among individuals with depression, the association between rumination and sleep disturbance has not been explored in this population. The present study employed a week-long daily sampling approach to examine the effects of naturally occurring pre-sleep rumination on self-reported and actigraphy-based sleep among individuals with high depressive symptomatology. MethodsForty-two university students (19.6±3.2yo;73.8% female), all of whom reported at least moderate levels of depressive symptoms, completed a short questionnaire after waking each morning for seven days. On this questionnaire, they self-reported sleep indices from the previous night and levels of engagement in pre-sleep rumination. Sleep was also monitored throughout this period via wrist actigraphy. Hierarchical-linear-modeling was used to examine the association between nightly rumination and sleep. ResultsNightly variations in pre-sleep rumination were predictive of significantly longer actigraphy- and diary-based sleep onset latency (SOL). Notably, a 1 SD increase on the pre-sleep rumination scale was associated with an approximately 7minute increase in actigraphy-based SOL, even after controlling for baseline sleep disturbance and depressive symptoms. ConclusionsThese data offer compelling evidence for the impact of pre-sleep rumination on sleep onset, providing insight into one potential mechanism that triggers sleep disturbance among individuals with depressive symptoms.

Quality of life and depressive symptoms in patients with chronic renal failure undergoing hemodialysis

Introduction: during the initial periods of the use of dialysis, all effort is devoted to the maintenance of life. Following the progress reached in this regard, there is now concern about the emotional aspects of chronic renal patients and their quality of life. Objective: This study aims to investigate the relationship between quality of life and depressive symptoms in chronic renal failure patients undergoing hemodialysis. Methods: The sample consisted of 30 patients interviewed using the the Major Depression Inventory (MDI) and abbreviated WHOQOL quality of life questionnaires. Results: The prevalence of depression was 37%. Quality of life was considered good for 89.6% of the sample. There was a weak association (Pearson 0.455) between the depression and quality of life variables. Conclusions: This sample showed good levels of quality of life and moderate levels of depressive symptoms.

Social problem solving among depressed adolescents is enhanced by structured psychotherapies.

Changes in adolescent interpersonal behavior before and after an acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescents' interpersonal behavior. Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% White) engaged in videotaped interactions with their mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST) and after 12-16 weeks of treatment. Adolescent involvement, problem solving, and dyadic conflict were examined. Improvements in adolescent problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on adolescents' problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive symptoms. Improvements in adolescents' problem solving were associated with higher rates of remission across treatment conditions, but there were no significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low. Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and suggest one pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT.

Gender Differences in Self-Reported Symptoms of Depression among Patients with Acute Coronary Syndrome

This study examined the prevalence of self-reported depressive symptoms and the self reported somatic depressive symptoms as measured by the Beck Depression Inventory-II (BDI-II) among patients hospitalized for acute coronary syndrome (ACS), and explored the impact of gender on both. A convenience sample of 789 adults (248 women and 541 men) was recruited for the study during hospital admission for ACS and participants were screened for self-reported depressive symptoms. BDI-II scores of ≥14 indicate a moderate level of depressive symptoms and this cut-off score was used to categorize patients into depressed and non-depressed groups. Pearson chi-square tests for independence (categorical variables) and t tests for independent samples (continuous variables) were used for gender comparisons. Results showed that depressive symptoms during ACS episodes were different between women and men. Women reported greater overall depressive symptoms (BDI-II mean = 11.89, S.D. = 9.68) than men (BDI-II mean = 9.00, S.D. = 7.93) (P < 0.000). Significantly more women (7.66%) were identified positive for somatic depressive symptoms (sleep and appetite disturbances and fatigue) than men (2.22%) (P = 0.0003). Findings support that there are gender differences in depressive symptoms experienced by patients hospitalized for ACS. Somatic symptoms of depression may be important indicators of depression especially among female ACS patients.

Evaluating Culturally Responsive Group Work with Black Women

Purpose: This study examined the efficacy of a culturally congruent group treatment model, entitled “Claiming Your Connections” (CYC) aimed at reducing depressive symptoms and perceived stress, and enhancing psychosocial competence (i.e., locus of control and active coping) among Black women. Method: A total of 58 Black women recruited from health and human service community-based organizations were randomly assigned to either the CYC intervention or a wait-list control group. Women in the CYC program attended weekly group intervention sessions over a 10-week period, and the wait-list control group did not receive any treatment for the same duration. Results: At pretreatment both groups indicated moderate levels of depressive symptoms, perceived stress, and psychosocial competence. After the intervention, the CYC group reported a significant reduction in depressive symptoms and perceived stress. There was no statistically significant change on these variables for the control group. Implications: Results suggest that the CYC group intervention program is effective with Black women who report having difficulty managing stressors of daily life.