Patient Health Questionnaire Research Articles

Associations between magnesium depletion score and depression among individuals aged 20 to 60 years

BackgroundMagnesium is closely associated with depression. The study aims to explore the relationship between magnesium depletion score (MDS), used to evaluate the body’s magnesium deficiency status, and depression. MethodsThis population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2005-2018 and included adults aged 20 to 60 years. Depression was determined using the Patient Health Questionnaire-9 (PHQ-9). MDS was a practical assessment instrument used to assess the status of magnesium deficiency. Multivariable logistic and restricted cubic spline models were used to assess the associations between MDS and depression. ResultsAmong the 18247 adults, 1753 participants were diagnosed with depression. Multivariable logistic regression analysis indicated that when MDS was treated as a continuous variable, each one-unit increase in MDS was associated with an odds ratio (OR) for depression of 1.15 (1.04, 1.26). When MDS was considered a categorical variable, compared to participants with MDS of 0, the ORs for depression for those with MDS of 1, 2, and ≥3 were 1.03 (0.87, 1.21), 1.41 (1.12, 1.78), and 1.58 (1.06, 2.35), respectively. Restricted cubic spline analysis showed that there was no non-linear relationship between MDS and the prevalence of depression. Subgroup analyses indicated the positive associations between MDS and depression were generally similar in different populations. ConclusionsMDS may be positively associated with the prevalence of depression. In the future, additional longitudinal studies are needed to validate our findings and investigate potential mechanisms.

Effect of Age at Liver Transplant on Anxiety, Depression, and Quality of Life Among Adolescents.

Introduction: Life expectancy for pediatric liver transplant patients has increased over the past decade. Different stages of the transplant process can impact patients' quality of life (QOL) and create psychological and physical stressors. This study explored whether age at transplant affected adolescents' feelings of anxiety, depression, and QOL. Design: In this cross-sectional quantitative study, data were collected on 22 adolescent patients aged 13-18 who received a transplant at least 12 months before enrollment. This cohort was divided into 2 groups based on their age at transplant: Group 1 (0-5 years) and Group 2 (6-18 years). To assess transplant-related anxiety, depression, and QOL, participants completed 3 surveys: the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Pediatric Quality of Life Inventory™ Transplant Module (PedsQL TM). Results: Group 1 experienced less anxiety and fewer problems based on GAD-7 scores but reported stronger feelings of depression based on PHQ-9 scores. Based on the PedsQL TM scale, Group 1 had higher mean scores compared to Group 2 across all components (mean difference range: 7.2- 27.3; Cohen's d range: 0.27 - 1.13). The largest difference between the 2 groups was observed on the PedsQL TM scale's How I Look (Group 1 mean 81.1 vs. Group 2 mean 53.8; Cohen's d: 1.13; P = 0.015), Conclusion: In this cohort, age at transplant affected adolescents' feelings of anxiety, depression, and QOL. Awareness of these findings can help clinicians screen for and address mental health issues.

A network analysis on the relationship between depression symptoms and loneliness in elderly Peruvians

ABSTRACT Loneliness and depression are the most prevalent mental health issues among older adults, and their relationship has been documented in studies using reflective psychopathological models based on the total scores. However, mental health problems should be investigated at the level of individual symptoms in order to develop intervention strategies aimed at mitigating the adverse impact of both variables. The goal was to examine the extent to which symptoms of loneliness relate to symptoms of depression in elderly Peruvians using the network method in 328 Peruvian adults with an average age of 68.44 years (SD = 7.64). The participants were selected through non-probability convenience sampling, which may limit the generalizability of the results. The Patient Health Questionnaire-2 (PHQ-2) and three-item UCLA Loneliness Scale were used in this study. Network analysis was used to identify central and bridging symptoms within the network of loneliness and depressive symptoms. Furthermore, the invariance in symptom networks between men and women was estimated. The results indicated that ‘feeling excluded’ was the most central symptom. Furthermore, the symptoms ‘feeling excluded’ and ‘anhedonia’ have the strongest relationship and can be considered as bridge symptoms between loneliness and depressive disorders. Symptom networks were invariant between men and women (M = .26; p = .42; S = .09; p = .38). In conclusion, the network structure provides valuable insights into the relationship between the symptoms of loneliness and depression in older Peruvian adults. The results suggest that the symptoms ‘feeling excluded’ and ‘anhedonia’ could serve as potential targets for psychological interventions aimed at efficiently reducing loneliness and depression.

Association of food insecurity with mental health status, mental health services utilisation and general healthcare utilisation among US adults

BackgroundFood insecurity poses a substantial threat to mental health. However, there is limited understanding of how food-insecure adults experience mental health challenges and access necessary health services. We examined the...

Center M Pilot Trial: Integrating Preventive Mental Health Care in Routine Prenatal Care.

Perinatal depression is a leading cause of preventable US maternal morbidity and mortality. Although Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD) is highly effective, it faces significant scalability challenges. Center M, a brief, group-based, mindfulness-based cognitive behavioral therapy (CBT) intervention, is an adaptation of MBCT-PD designed to overcome these challenges. The purpose of this pilot study was to evaluate Center M's preliminary acceptability, feasibility, mechanisms of action, and efficacy. In this mixed-methods pilot study, data were collected from 99 pregnant people at 3 time points: preintervention, postintervention, and 6-weeks postpartum (Clinical Trials no. NCT06525922). Participants engaged in 4 one-hour, weekly group telehealth Center M sessions facilitated by social workers. Participants strengthened mindfulness CBT skills using home practice materials between group sessions. Data included self-report measures evaluating depressive symptoms, mindfulness skills, and emotion regulation. Satisfaction was assessed via focus groups or surveys. Depressive symptoms significantly decreased preintervention to postintervention (Patient Health Questionnaire-8 score: preintervention mean [SD] 5.02 [3.52], postintervention mean [SD] 4.23 [2.84]; P =.03), and mindfulness capacity significantly increased preintervention to 6 weeks postpartum (Five Facets of Mindfulness Questionnaire score: preintervention mean [SD] 125.56 [18.68], 6 weeks postpartum mean [SD] 130.10 [17.15]; P =.004). Linear regression analyses indicate that higher mindfulness at 6 weeks postpartum significantly predicted fewer depression symptoms at 6 weeks postpartum (β, -0.07; 95% CI, -0.123 to -0.021, R2 = 0.22; P =.006). Reduction in the use of maladaptive emotion regulation was significantly associated with decreased depressive symptoms at 6 weeks postpartum (β, 0.21; 95% CI, 0.048 to 0.376, R2 =.21; P =.012). Qualitative themes indicated high Center M acceptability and appeal. Our findings support the feasibility, acceptability, and appeal of Center M. Results suggest Center M may be effective in reducing depression and enhancing mindfulness skills. Future research must confirm these initial findings to more widely address Center M implementation capacity and sustainability.

Association between body fat percentage and depression: A cross-sectional study of NHANES

BackgroundObesity and depression often co-occur and are interdependent. However, evidence regarding the association between body fat percentage in different regions and depression is scarce. Additionally, the impacts of sex-specific and BMI-stratified differences on the relationship between body fat percentage and depression remain unclear. MethodsData were drawn from the NHANES for the years 2005–2006 and 2011–2018. Body fat percentage was assessed using dual-energy X-ray absorptiometry (DXA). Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted binary logistic regression analyses were employed to investigate the relationship between body fat percentage and depression. Stratification analysis were stratified by sex and BMI. ResultsThis study comprised 10,694 participants. Controlling confounders, the higher quartile of total body fat percentage was associated with increased OR for depression (Q4 vs Q1: OR, 1.46; 95 % CI, 1.04–2.05) as well as for leg (Q4 vs Q1: OR, 1.48; 95 % CI, 1.07–2.05), gynoid (Q4 vs Q1: OR, 1.51; 95 % CI, 1.11–2.05), subtotal (Q4 vs Q1: OR, 1.47; 95 % CI, 1.06–2.03) and head (Q3 vs Q1: OR, 1.30; 95 % CI, 1.00–1.68). In stratification analysis by sex and BMI, body fat percentage seemed to be more closely associated with depression in males or in the underweight and overweight groups. LimitationCross-sectional study design and self-reported depression. ConclusionsElevated body fat percentage was strongly associated with higher prevalence of depression, especially in males or in the underweight and overweight groups.

Violence, mental health and nutritional status in pregnant women: the Araraquara Cohort Study.

To investigate the relationship between violence and the nutritional status of pregnant women, and whether mental health could be a mediator in this relationship. Cross-sectional study. Violence and mental health status were investigated using the following questionnaires: World Health Organization Violence Against Women (WHO-VAW), Abuse Assessment Screen (AAS), Patient Health Questionnaire (PHQ-9), and General Health Questionnaire (GHQ). Demographic, socioeconomic, obstetric, and lifestyle factors (smoking/alcohol consumption) were also investigated. The nutritional status of the women was assessed by the body mass index. Data were collected from February 2021 to August 2022 in Araraquara city, Brazil. Four hundred pregnant women recruited at 34 health units and the municipal maternity hospital. Experience of violence was reported by 52.2% of the women and psychological violence in the last 12 months was the most prevalent type of domestic violence (19.5%). Approximately 43% of the women showed mental health changes and 59.7% had a risk of major depression. Women with mental health changes had an increased risk (OR=2.34) of obesity. Psychological violence in the last 12 months was associated with obesity (p=0.01) when mediated by mental health changes. The mediation effect was significant (β=0.708; 95%BCa CI=0.004-1.460), with mental health changes mediating 46.1% of the relationship between psychological violence and obesity. The relationship between psychological violence and obesity during pregnancy was mediated by changes in mental health. This original study shows that nutritional status is not limited to biological factors and highlights the importance of social, mental, and psychological factors.

The association of distress and depression screening measures and other electronic health record information with adjuvant endocrine therapy persistence.

Few risk factors for early adjuvant endocrine discontinuation have been identified, but clinical trials suggest pre-AET symptom burden might be important. We sought to assess this in an academic practice. We examined baseline and up to five years of follow-up information for postmenopausal women with stage I-III hormone-receptor positive breast cancer 2014-2019 receiving oncologist prescriptions for AET. The Distress Thermometer (DT) and its problem list, the Patient Health Questionnaire 2/9 (PHQ 2/9), cancer extent of disease and treatments, comorbidities, sociodemographics, and pharmacy prescription fill dates were abstracted from the cancer registry and electronic health record (EHR). The association of these variables with early AET prescription fill discontinuation (prior to 5years) was examined using survival analysis and Bayesian machine learning, with censoring for recurrence, death, or provider change. Among the cohort of 961 women (mean 68.8years, SD 2.88), 91.6% were white, 74.6% had Stage I disease, and 45.0% a pre-AET DT showing high distress (> 3). The median follow-up time was 820 (25, 75% 448,1282) days, and 29.6% discontinued early. Neither the DT score nor the PHQ 2/9 was associated with nonadherence, although three physical problems were modestly associated. Over 25% of women who stopped filling prescriptions did not have their prescriptions discontinued in the EHR. Several commonly available baseline EHR variables were not associated with early discontinuation, although some symptoms may have modest effects. Many women who discontinued still had EHR prescriptions, suggesting that physicians could use prescription fill information to intervene earlier.

Effect of electroacupuncture on the characteristic signal of electroencephalogram in the patients with chronic insomnia： a randomized controlled trial

To observe the effect of electroacupuncture (EA) on sleep quality and electroencephalogram (EEG) signal in the patients with chronic insomnia and to explore its mechanism. Sixty patients with chronic insomnia were randomized into an EA group (30 cases, 3 cases dropped out) and a health learning group (30 cases, 3 cases dropped out). In the health learning group, the sleep health education was provided. In the EA group, besides the health education as the health learning group, EA was delivered at Baihui (GV20), Yintang (GV24+), bilateral Shenmen (HT7), bilateral Sanyinjiao (SP6), with continuous wave, 2 Hz in frequency, once every other day, and 3 interventions a week. EA was given for 4 weeks successi-vely, composed of 12 treatments. The score of Pittsburgh sleep quality index (PSQI), Hamilton anxiety scale (HAMA), and patient health questionnaire-9 (PHQ-9) before and after treatment were compared between the two groups. The EEG signals were collected and the relative power and entropy of EEG before and after treatment were compared between the two groups. After treatment, the scores of PSQI, HAMA and PHQ-9, the relevant power of β wave in F8 and T3 channels, and that of α wave in T4 channel, and the entropy in T3 channel under the eyes-open (EO) resting state, as well as the relevant power and the entropy of γ wave in F8 channel under the eyes-closed (EC) resting state in the EA group were lower (P<0.05) than those before the treatment. All of the above results were lower than those of the health learning group at the same time points (P<0.05). Under the EO resting state, the relevant power of the θ and δ waves of T3 channel and θ wave of T4, O2 and Pz channels of patients in the EA group after the treatment were increased (P<0.05) than those before the treatment, and higher (P<0.05) than those of the health learning group at the same time points. Acupuncture is effective on chronic insomnia, which may be related to the regulation EEG signals.

A prospective study of antenatal anxiety and depression in pregnant women with polycystic ovary syndrome.

Women with polycystic ovary syndrome (PCOS) experience higher rates of depression and anxiety. There is limited research relating to perinatal mental health in women with PCOS. Studies suggest PCOS is associated with a higher prevalence of perinatal mental health disorders. Perinatal guidelines currently do not recognise PCOS as a risk factor for perinatal mental health disorders. We aimed to prospectively assess the prevalence of mental health disorders in pregnant women with PCOS. Consenting pregnant women, with and without PCOS, were invited to participate. Standardised validated questionnaires were carried out including Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS). Fifty-one with PCOS and 49 without PCOS responded. Pregnant women with PCOS had a higher mean (SD) anxiety score (GAD-7) than those without PCOS (8.2 [6.7] vs. 5.89 [4.7], p = 0.04). Pregnant women with PCOS had higher mean (SD) depression scores than those without PCOS on EPDS (9.1 [6.4] vs. 6.4 [4.5], p = 0.02) but not PHQ-9 score (median (IQR) 4 (3-9) vs. 4 (2-7.5), p = 0.25). Women with PCOS were more likely to experience moderate/severe anxiety (PCOS 34%, control 20%) and moderate/severe depression (PCOS 34%, control 20%) symptoms than women without PCOS. Twenty-nine percent of pregnant women with PCOS had an EPDS score >13 showing significantly higher rates of severe depression (PCOS 29%, control 12%, p = 0.03). Our findings suggest a higher prevalence of perinatal depression and anxiety in women with PCOS. Our findings may suggest increased need for screening for mental health disorders in women with PCOS.

Relationship between oxidative balance score and post-stroke depression: insights from the NHANES 2005–2018 cross-sectional study

IntroductionThe Oxidative Balance Score (OBS) represents an integrated measure of oxidative-reductive homeostasis. Despite the established role of oxidative stress in the development of post-stroke depression (PSD), the association between OBS and PSD in the general population remains unclear. This study aims to explore this relationship using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005–2018.MethodsThe OBS was calculated using validated methods that incorporate dietary and lifestyle factors, whereas PSD status was determined using self-reported data and the Patient Health Questionnaire-9 (PHQ-9) scores. Multivariable logistic regression was employed to evaluate the associations of total OBS, dietary OBS, and lifestyle OBS with PSD prevalence, adjusting for potential confounders. Dose–response relationships were further assessed using restricted cubic splines (RCS).ResultsAmong the 26,668 participants included in the analysis, 201 were diagnosed with PSD. After adjusting for confounding variables, higher total OBS, dietary OBS, and lifestyle OBS were each significantly associated with reduced odds of PSD. The adjusted odds ratios (OR) and 95% confidence intervals (CI) for the highest versus lowest quartiles were 0.31 (95% CI: 0.15–0.67) for total OBS, 0.45 (0.27–0.73) for dietary OBS, and 0.28 (0.13–0.60) for lifestyle OBS. RCS analyses indicated a linear dose–response relationship for all three OBS categories with PSD risk. In sex-stratified analyses, significant inverse associations were observed between all OBS categories and PSD in females, whereas only lifestyle OBS was significantly associated with PSD in males.ConclusionHigher OBS was associated with reduced odds of PSD, with a particularly pronounced effect in females. These findings suggest that adherence to an antioxidant-rich diet and lifestyle may mitigate PSD risk.

Virtual Reality Exposure Therapy Protocol for Post-Traumatic Stress Disorder Treatment in Military Veterans: Cross-Cultural Adaptation of Virtual Exposure Therapy in Ukraine

Introduction. The integration of virtual reality technologies into PTSD treatment in Ukraine presents new opportunities for enhancing the mental health of military personnel, veterans, and individuals affected by war-related trauma. During military operations, soldiers often experience intense stress, anxiety, and intrusive memories, which can lead to PTSD. VR therapy uses fully and partially immersive technologies to create a safe virtual environment where patients can explore and process traumatic experiences under the guidance of a qualified specialist. The use of VR technologies for PTSD treatment during the ongoing conflict in Ukraine may become a crucial tool for addressing and healing trauma in both military personnel and civilians. This method provides a structured setting that fosters emotional processing and therapeutic engagement, aiming to alleviate psychological burdens and improve mental health outcomes. Purpose: To conduct a cross-cultural adaptation of the physiologically facilitated Virtual Reality Exposure Therapy (VRET) protocol with gradually increasing exposure, develop a Ukrainian version of the protocol tailored to the specific needs of Ukrainian PTSD patients, create VR technology and content that reflect the unique aspects of the Ukrainian war experience, and pilot test this protocol with a focus group of Ukrainian war veterans diagnosed with PTSD and carrying war-related traumatic memories. Methodology: For the cross-cultural adaptation of the Virtual Reality Exposure Therapy (VRET) protocol, a physiologically facilitated version with gradually increasing exposure was selected. This protocol was translated by two independent translators, followed by synthesis into a single version, back-translation, analysis, and final approval by a working group. The finalized Ukrainian version was prepared for field studies with a focus group of Ukrainian war veterans (n=50). All veterans underwent diagnostic assessments both before and after the VRET intervention, using the following standardized scales: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD evaluation, the Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety disorders, the Patient Health Questionnaire-9 (PHQ-9) for depression, the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicidal intentions, the Short Form Survey (SF-36) for quality of life, and the Alcohol Use Disorders Identification Test (AUDIT) for alcohol dependence. A series of VR scenarios were developed specifically to address the needs of Ukrainian war PTSD patients, designed to trigger common PTSD responses. A unique administrative panel was also created for therapists to adjust the presence and intensity of various triggers in real time, allowing for personalized tuning of the VR experience throughout the session. Results: Over a 6-month period, 50 Ukrainian war veterans participated in the study to assess the effectiveness of the adapted Ukrainian version of the VRET protocol for PTSD treatment. Comparison of baseline and post-intervention assessments showed significant improvements in clinical outcomes, including reductions in PTSD symptoms, anxiety, depression, and an overall improvement in quality of life. Conclusions: The cross-cultural adaptation and testing of the Virtual Reality Exposure Therapy protocol with a focus group of Ukrainian veterans with PTSD demonstrated reductions in PTSD symptoms, anxiety, and depression, alongside improvements in quality of life. Virtual reality allowed veterans to safely re-experience traumatic events under professional supervision, with gradually increased realism, enhancing the therapy's effectiveness. This method also reduces stigma by offering a confidential setting for therapist interaction, showing substantial promise in helping veterans manage their mental health more effectively

Determinants of depression among ever-married adolescent girls in Bangladesh: Evidence from the Bangladesh Adolescent Health and Wellbeing Survey 2019-2020.

Common mental health disorders in early life represent a major challenge and these conditions become more complicated and substantial during the development period of adolescence. Despite the global concern over the increasing prevalence of mental health issues among adolescents, it remains largely a neglected area of research and health policy in Bangladesh, where the burden of child marriage is significantly higher. This study aimed to investigate the prevalence and factors associated with depression among married adolescent girls in Bangladesh. The study utilized the data from first-ever Bangladesh Adolescent Health and Wellbeing Survey (BAHWS), conducted in 2019-2020. A total of 1,693 married adolescent girls were included in the final analysis. Depressive symptoms were measured using the standardized Patient Health Questionnaire-9 (PHQ-9) tool. Descriptive statistics were applied to assess the prevalence of depression, while bivariate analysis was done to measure the significance of the variables. Furthermore, logistic regression was used to examine the association between any form of depression and selected covariates. The overall prevalence of mild to severe levels of depression among the participants was 53.1% (Mild: 40.3%; Moderate: 9.9%; Moderately severe: 2.3%; Severe: 0.6%). In the multivariable logistic regression model, it was found that adolescents from richest wealth quintile were 35% less likely to suffer from depression (AOR = 0.65; 95% CI = 0.45-0.92; P value = 0.02). Additionally, physical violence (AOR = 1.55; 95% CI = 1.14-2.09; P value = 0.004), sexual harassment (AOR = 1.50; 95% CI = 1.11-2.01; P value = 0.007), social bullying (AOR = 2.25; 95% CI = 1.73-2.91; P value < .001), and cyberbullying (AOR = 1.75; 95% CI = 1.10-2.77; P value = 0.01) were associated with depression. This study demonstrated that more than half of the married adolescents suffer from mild to severe levels of depression, while any form of violence and harassment significantly increases their risk of depression. Therefore, a more inclusive policy is needed, engaging with communities and local stakeholders, to lay out key actions and intervention pathways to address the issue of violence against married adolescent girls as the extent and spectrum of violence continue to evolve.

Early childhood psychopathology and parental mental health during the COVID-19 pandemic: the effects of pandemic restrictions on 0- to 3-year-olds

IntroductionThe COVID-19 pandemic placed many restrictions on families and affected the mental health of parents and children. The present study examines how the restrictions imposed during the pandemic and parental mental health affect early childhood psychopathology.MethodFrom September 2019 to December 2021, the Outpatient Department of Family Therapy at the Institute for Psychosocial Prevention, Heidelberg surveyed a clinical sample of 249 families who sought consultation for early childhood psychopathology. Early childhood psychopathology in children aged 0–3 years was assessed using the German Questionnaire for Crying, Feeding and Sleeping and the German version of the Child Behavior Checklist 1½–5. The Patient Health Questionnaire provided information on parental depressiveness and generalized anxiety. At the same time, the Stringency Index as part of the Oxford Coronavirus Government Response Tracker indicated the severity of COVID restrictions in Germany.ResultsDependent comparisons did not reveal significant differences in the infants' regulatory problems (n = 165, mean age = 8 months) during the lockdown compared to reopening phases. However, older children (n = 84, mean age = 25 months) exhibited more behavioral problems during lockdowns compared to reopening phases (Cohen's d = 0.32, p = .04). Subsequent regression analyses confirmed a slight increase in behavioral problems only among children aged 1.5–3 years (p = .047, R2 = .08), but did not indicate any increase in parental mental health problems when more restrictions were in place. However, parental depressiveness had a strong independent effect on early childhood psychopathology. A hierarchical regression analysis indicated that psychopathology in children aged 1.5–3 years is best explained by female child gender, high parental depressiveness, and more severe restrictions during the COVID-19 pandemic (p &amp;lt; .001, R2 = .17) whereas early childhood psychopathology in infants aged 0-1.5 years is more prevalent in younger and male children with parents experiencing higher levels of depressiveness (p &amp;lt; .001, R2 = .26).DiscussionThe study found no increase in infant regulatory disorders or parental depressiveness and generalized anxiety during the pandemic. However, older children exhibited more behavioral problems during more severe pandemic restrictions. The study supports the provision of parent-child support during crises and beyond, as early childhood psychopathology was strongly associated with parental depressiveness.

Urban Environmental Threat Moderates the Relationship Between Depression and Insulin Resistance Among Latinxs With Type 2 Diabetes.

As the largest minoritised ethnic group in the United States, Latinxs face a greater risk for type 2 diabetes and depression. The aim of the present study was to explore whether the relationship between depressive symptoms and insulin resistance among Latinxs with type 2 diabetes was moderated by toxic stressors arising from urban environmental threat (i.e., uncomfortable or unsafe aspects of city life). A community sample of Latinx adults with type 2 diabetes (n=121) was recruited from Hartford, Connecticut. Participants self-reported depressive symptoms and exposure to urban environmental threat using items from the Patient Health Questionnaire and Urban Hassles Index, respectively. Insulin and glucose levels assessed via fasting blood draw were used to calculate insulin resistance using the HOMA-IR formula. After controlling for demographic, financial and health-related factors, results from a regression analysis revealed a significant interaction between depressive symptoms and urban environmental threat; more severe symptoms of depression predicted greater insulin resistance, but only amongst those with frequent exposure to urban environmental threats. Findings from the current study suggest that improving urban living conditions may offer an alternate avenue for attenuating the deleterious impacts of depression on type 2 diabetes progression in Latinxs.

Association of serum total folate and serum vitamin D concentrations with W-shape in depressed older adults with cognitive dysfunction: A cross-sectional observational study

Depression and cognitive dysfunction are prevalent in the elderly population and have a serious impact on patients' quality of life and social functioning. Nutritional factors play a key role in the prevention and management of these disorders, particularly folate and vitamin D. The aim of this study was to elucidate the association between serum total folate and serum vitamin D concentrations and depressive symptoms and cognitive dysfunction in older adults. Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, 2042 participants aged 60 years and older were analyzed. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Animal Fluency test and the Digit Symbol Substitution Test (DSST). Associations between serum total folate and vitamin D concentrations and depression with cognitive dysfunction were analyzed using multivariate logistic regression models, incorporating stratification and sensitivity analyses. For every 1nmol/L increase in serum vitamin D concentration, there was a 1% reduction in the risk of depression in older adults (OR=0.99 95% CI 0.98-0.99). Serum total folate showed a significant W-shaped association with depression with cognitive dysfunction: when serum total folate concentration was below 33.00nmol/L, the risk of depression was reduced by 7.6% for every 1nmol/L increase in its concentration (OR=0.924 95% CI 0.89-0.959); this association was not significant when the concentration was above 33.00nmol/L (OR=1.006 95% CI 0.998-1.013). Adequate levels of vitamin D and folate may help prevent and manage depression and cognitive dysfunction in older adults. The W-shaped association between serum total folate and these conditions suggests that folic acid supplementation could be effective within a specific range, warranting further exploration and validation through clinical studies.

Using network analysis to understand the association between menopause and depressive symptoms

It has been proposed that depressive symptoms occurring throughout the menopause may be linked to specific menopause symptoms. The objectives of this study were (i) to use network analysis to explore the symptom structure of menopause and depressive symptoms, and (ii) to compare the symptom structure of menopause and depressive symptoms between the perimenopause and the post-menopause. The Menopause-specific Quality of Life (MENQOL) and the eight-item Patient Health Questionnaire (PHQ-8) were used to measure menopause and depressive symptoms, with online survey data from 858 respondents included for analysis. The most central symptoms were decreased stamina, decreased physical strength, feeling depressed, and change in sexual desire. The network demonstrated good stability (CS-strength = 0.75 and CS-influence = 0.75), with no significant differences in structure between the perimenopause and post-menopause groups. Addressing decreased stamina and psychosocial symptoms could prove instrumental in managing menopause symptoms. Early intervention is crucial for overcoming barriers and providing essential support.

Comorbid anxiety, loneliness, and chronic pain as predictors of intervention outcomes for subclinical depressive symptoms in older adults: evidence from a large community-based study in Hong Kong

BackgroundDepression is among the leading causes of the global burden of disease and is associated with substantial morbidity in old age. The importance of providing timely intervention, particularly those with subclinical symptoms, has thus increasingly been emphasised. Despite their overall effectiveness, a small but notable subgroup tends to be less responsive to interventions. Identifying predictors of non-remission and non-response is critical to inform future strategies for optimising intervention outcomes.MethodsA total of 4153 older adults aged 60 years and above with subclinical depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] = 5–19) were recruited from JC JoyAge, a large-scale collaborative stepped-care intervention service across Hong Kong. A wide range of clinical and modifiable risk and protective factors at baseline were assessed, including depressive symptoms, anxiety symptoms, loneliness, suicidal ideation, cognitive capacity, multimorbidity, chronic pain, need for informal care due to mental health reasons, history of abuse, and sociodemographic characteristics. Separate multivariable logistic regression models were applied to identify predictors of non-remission (PHQ-9 ≥ 5) and non-response (< 50% reduction in PHQ-9) following intervention.ResultsThe rates of non-remission and non-response were 18.9% (n = 784) and 23.0% (n = 956), respectively. Comorbid anxiety symptoms (adjusted odds ratio [aOR] = 2.08, CI = 1.72–2.51; 1.28, 1.05–1.57), loneliness (2.00, 1.66–2.42; 1.67, 1.38–2.01), need for informal care (1.86, 1.49–2.33; 1.48, 1.18–1.85), lower cognitive capacity (0.95, 0.93–0.97; 0.94, 0.92–0.96), and absence of chronic pain (0.59, 0.48–0.72; 0.76, 0.64–0.91) predicted both non-remission and non-response. Meanwhile, moderate-to-severe depressive symptoms predicted higher odds of non-remission (1.41, 1.18–1.69) and lower odds of non-response (0.28, 0.23–0.34), respectively. Subgroup analyses conducted separately in older adults with mild and moderate-to-severe depressive symptoms at baseline revealed that comorbid anxiety, loneliness, need for informal care, and absence of chronic pain were consistent predictors of non-remission. Those with non-remission and non-response showed more depression-related functional impairments and poorer health-related quality of life post-intervention.ConclusionsOlder adults with subclinical depressive symptoms showing comorbid anxiety, higher loneliness, need for informal care, and chronic pain may be offered more targeted interventions in future services. A personalised risk-stratification approach may be helpful.Trial registrationClinicalTrials.gov identifiers: NCT03593889 (registered 29 May 2018), NCT04863300 (registered 23 April 2021).

The Association between Depression and Overactive Bladder: A Cross-Sectional Study of NHANES 2011-2018.

The relationship between depression and overactive bladder (OAB) is unknown. This study aimed to explore the association between depression and OAB in the U.S. A cross-sectional study was performed utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Depression status and severity among participants were assessed via the Patient Health Questionnaire-9 (PHQ-9). The OAB symptoms of the participants were assessed via the OAB symptom score (OABSS) scale. Multivariate logistic regression was conducted to evaluate the association between depression and OAB. A total of 19,359 participants were enrolled in the study, with 91.01% (N = 17618) exhibiting minimal or mild depression, 7.92% (N = 1533) presenting with moderate or moderately severe depression, and 1.07% (N = 208) identified as severe depression. The overall prevalence of OAB was 21.62%. We found that depression was positively associated with OAB before and after adjustments for all covariates. After adjusting for covariates, individuals with moderate or moderately severe depression presented an elevated risk of OAB (OR = 2.52, 95% CI 2.11-3.01, p < 0.01), while those with severe depression presented a greater risk (OR = 3.74 95% CI 2.37-5.90, p < 0.01) than did participants with minimal or mild depression. Age may modify the correlation between depression and OAB. Our study highlighted a positive association between depression and OAB in the U.S. population, and the association between depression and OAB was modified by age. However, more studies are needed in the future to verify the associations between depression and OAB and their underlying mechanisms.

Assessing the impact of COVID-19 on outpatient psychiatric population well-being and symptomology utilizing COVID-19 Events Checklist (CEC) and Measurement Based Care

BackgroundThis study examines the impact of SARS-CoV-2 (i.e., coronavirus, COVID, COVID-19) using data from a measurement-based care (MBC) system utilized in an outpatient psychiatric clinic providing telemedicine care. A novel Patient Rated Outcome Measure (PROM), the COVID-19 Events Checklist (CEC) was administered in a hospital system based ambulatory clinic beginning April 2020 to track COVID-19-19’s impact on patients’ mental, emotional, and health-related behaviors during the pandemic. The study (1) provides descriptive CEC data, and (2) compares CEC results with PROMs evaluating anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire; PHQ-9), and psychological distress (Brief Adjustment Scale-6; BASE-6).MethodsThis retrospective observational study included patient intake data collected from April 2020 to March 2021. Patient (N = 842) reports on the CEC’s five domain questions were aggregated to calculate average reports of COVID-19 related impacts at intake over the initial 12 months of the pandemic. Trends in COVID-19 related impacts were examined, and non-aggregated scores on the PHQ-9, GAD-7, and BASE-6 were compared to primary dichotomous (yes/no) CEC survey questions via Wilcoxon rand sum testing.ResultsResults capture the relationship between COVID-19 exposure, COVID-19- related sequelae and behaviors, and psychological symptom severity. Specifically, Wilcoxon rank-sum tests indicate that social determinants of health (SDOH), negative mental health impacts, and positive coping skill use were significantly associated with psychological symptomatology including overall psychological functioning via the BASE-6, anxiety via the GAD-7, and depressive symptoms via the PHQ-9. Results regarding SDOH were as follows: BASE-6 (w = 44,005, p < 0.001), GAD-7 (w = 44,116, p < 0.001), and PHQ-9 (w = 43,299, p < 0.001). Regarding negative mental health outcomes, the results were: BASE-6 (w = 38,374, p < 0.001), GAD-7 (w = 39,511, p < 0.001), and PHQ-9 (w = 40,154, p < 0.001). As the initial year of the pandemic elapsed, incoming patients demonstrated increased rates of suspected or confirmed exposure to COVID-19, (+2.29%, t = 3.19, p = 0.01), reported fewer negative impacts of COVID-19 on SDOH (−3.53%, t= −2.45, p = 0.034), and less engagement in positive coping strategies (−1.47%, t = −3.14, p = 0.010).ConclusionsPsychosocial factors related to COVID-19 are discussed, as well as opportunities for further research on the relationship between psychological symptomatology and the impact of COVID-19 on health-related behaviors.