Persistent Depressive Symptoms Research Articles

Hand grip strength and depression among rural older South Africans.

The study aimed to assess the relationship between hand grip strength (HGS) and depressive symptoms among ageing women and men in a longitudinal study in rural South Africa. We analyzed longitudinal data from two consecutive population-based surveys in Agincourt, South Africa, 2014/2015-2018/2019. Results indicate that in all, 835 adults of 3268 participants without depression in Wave 1 (25.0 percent) had incident depression in Wave 2, and 184 adults of 3866 participants who had depression in Wave 1 (4.8 percent) screened positive for depression at both Wave 1 and 2 (persistent depression). The prevalence of weak HGS was 51.5 percent at baseline. In the fully adjusted model, weak HGS increased the odds of incident depressive symptoms between both sexes (AOR: 1.24, 95 percent CI: 1.04-1.47) among women (AOR: 1.33, 95 percent CI: 1.05-1.68), but not among men. No models among both sexes, among men and women, showed an increased odds of weak HGS with persistent depressive symptoms. Weak HGS was independently associated with the incident, but not persistent depressive symptoms between the two sexes and between women but not between men.

Sleep quality: A common thread linking depression, post-traumatic stress, and post-concussive symptoms to biomarkers of neurodegeneration following traumatic brain injury

ABSTRACT Objective Following mild traumatic brain injury (mTBI), many individuals suffer from persistent post-concussive, depressive, post-traumatic stress, and sleep-related symptoms. Findings from self-report scales link these symptoms to biomarkers of neurodegeneration, although the underlying pathophysiology is unclear. Each linked self-report scale includes sleep items, raising the possibility that despite varied symptomology, disordered sleep may underlie these associations. To isolate sleep effects, we examined associations between post-mTBI biomarkers of neurodegeneration and symptom scales according to composite, non-sleep, and sleep components. Methods Plasma biomarkers and self-report scales were obtained from 143 mTBI-positive warfighters. Pearson’s correlations and regression models were constructed to estimate associations between total, sleep, and non-sleep scale items with biomarker levels, and with measured sleep quality. Results Symptom severity positively correlated with biomarker levels across scales. Biomarker associations were largely unchanged when sleep items were included, excluded, or considered in isolation. Pittsburgh Sleep Quality Index demonstrated strong correlations with sleep and non-sleep items of all scales. Conclusion The congruency of associations raises the possibility of a common pathophysiological process underlying differing symptomologies. Given its role in neurodegeneration and mood dysregulation, sleep physiology seems a likely candidate. Future longitudinal studies should test this hypothesis, with a focus on identifying novel sleep-related therapeutic targets.

The Association of Persistent Symptoms of Depression and Anxiety with Recurrent Acute Coronary Syndrome Events: A Prospective Observational Study.

The purpose of this study was to examine the role of persistent symptoms of depression and anxiety in a second acute coronary syndrome (ACS) event. Data presented in this study were from an RCT study. A follow-up for 24 months after baseline to detect a second ACS event among 1162 patients from five hospitals. Hierarchal Cox regression analyses were used. The results showed that persistent depression only (HR 2.27; 95% CI: 1.35–3.81; p = 0.002), and comorbid persistent depression and anxiety (HR 2.03; 95% CI: 1.03–3.98; p = 0.040) were the significant predictors of a second ACS event. Secondary education level compared to primary educational level (HR 0.63; 95% CI: 0.43–0.93; p = 0.020) and college or more education level compared to primary educational level (HR 0.47; 95% CI: 0.27–0.84; p = 0.011) were the only demographic variables that were significant predictors of a second event. The study reveals that attention must be paid by healthcare providers to assess and manage persistent depression; particularly when it is co-morbid with anxiety.

A pilot study on development and feasibility of the \u2018MyEducation: CABG application\u2019 for patients undergoing coronary artery bypass graft (CABG) surgery

BackgroundPatients scheduled for coronary artery bypass graft (CABG) surgery tend to have persistent symptoms of anxiety and depression. Course of hospital stay post-CABG procedure has become increasingly shorter over the last few decades. This pilot study was conducted to develop and test feasibility of MyEducation: CABG application as a learning tool to reduce anxiety and depression levels among patients undergoing CABG Surgery.MethodsThis study was quasi-experimental in design. Forty-five patients scheduled for CABG surgery were recruited via consecutive sampling from a Tertiary Referral Centre at Kuala Lumpur, Malaysia. MyEducation:CABG application (Web-based education application) was administered among the intervention group (N = 23); while the control group (N = 22) underwent standard care. Web-based education application were implemented by nurses at admission and prior to discharge. Patients were assisted in terms of queries and concerns, upon which corresponding information and support was provided. Sociodemographic data were obtained from patients, prior to administration of Hospital Anxiety and Depression Scale which was used to measure levels of anxiety and depression. The educational application was used to obtain satisfaction rating among intervention group. These measures were administered upon admission, on discharge and one-month post-discharge.ResultsMean anxiety and depression scores among the intervention group were lower compared to the control. This was significant for anxiety upon admission, on discharge and one-month post-discharge (p < 0.05). Reduced mean depression scores was only significant at one month post-discharge (p < 0.05). Intervention group were generally satisfied with design, content and usability of the application.ConclusionsUtilisation of MyEducation: CABG application as an educational platform were associated with reduced anxiety and depression among CABG patients, which probably explains positive user satisfaction levels reported. Hence, the study recommends implementation of this application among larger sample as a way to support patient scheduled for CABG aside, with further possibility of preventing complications.

The role of depression in the maintenance of gains after a prolonged exposure intensive outpatient program for posttraumatic stress disorder.

Intensive outpatient programs (IOPs) for trauma-focused therapy, such as prolonged exposure (PE), have the potential to deliver highly effective treatment, quickly and with minimal dropout. Identifying factors that predict maintenance of gains after treatment can help triage individuals who may need additional services. Growth mixture modeling (GMM) was used to identify classes of posttraumatic stress disorder (PTSD) and depression symptom trajectories across the year following a 2-week IOP, delivering daily PE for PTSD for post-9/11 Veterans. Predictors of trajectories were examined. Three classes of trajectories best-fit the data for PTSD and depression symptoms. Two classes made up the majority of the sample (85%) and both maintained significantly reduced PTSD symptoms across the year following therapy. For a minority of the sample (14.6%), PTSD symptoms rebounded after treatment. These individuals were highly likely to be categorized in the persistent depression class. IOP-delivered PE is effective, and gains are largely maintained. The minority of patients who do not maintain their gains as robustly are likely to report persistent depressive symptoms in treatment and higher PTSD symptoms on a self-report measure.

Explaining the gap in the experience of depression among arthritis patients.

To explain the factors contributing to the gap in depression between employed arthritis patients with and without paid sick leave. Blinder-Oaxaca decomposition analysis was used to identify factors that explain the gap in the experience of depressive symptoms among arthritis patients with paid and unpaid sick leave. Data from the 2018 National Health Interview Survey, USA, was used. A total of 7189 of the NHIS survey participants given the diagnosis of arthritis were identified, of which 39% were male and 61% were female, with mean age of 63.5years. The decomposition findings suggest patients in the unpaid sick leave group were more likely to report depressive symptoms compared to patients with paid sick leave. The major contributors to the gap in the report of depressive symptoms are sex (female) and annual income (less than 35,000 USD). Findings suggest that the absence of paid sick leave is a key determinant for experiencing depressive symptoms among individuals with arthritis. The provision of paid sick leave may reduce report of depressive symptoms among employed arthritis patients in the USA. • Individuals with arthritis are consistently at greater risk of depression and unemployment as compared to individuals without arthritis. • To date greater emphasis is put on determinants of unemployment, while there is no available data on benefits associated with being employed, such as sick leave, and how it affects mental health. • Patients with unpaid sick leave appear to experience more persistent depressive symptoms than patients with access to paid sick leave. • To tackle burden of depression among arthritis patients, provision of paid sick leave may be an effective intervention.

Association Between Changes in Depressive Symptoms and Hazardous Drinking: Findings From the Korea Welfare Panel Study (2013-2018).

Objective: This study aimed to evaluate the longitudinal association between changes in depressive symptoms and hazardous drinking among South Korean adults.Participants/Methods: This study was conducted using a sample drawn from participants enrolled in the Korea Welfare Panel Study (KoWePS) from 2013 to 2018. Hazardous drinking was defined as a score of 11 points for men and seven points for women on the Korean version of the Alcohol Use Disorders Identification Test. Depressive symptoms were evaluated using an 11-item version of the Center for Epidemiologic Studies Depression Scale. A generalized estimating equation model was used to analyze the association between changes in depressive symptoms and hazardous drinking.Results: Of the 12,878 people registered with KoWePS and without follow-up losses from 2013 to 2018, a total of 2,341 were included in this study, excluding those under the age of 19 and those with missing data. Persistent depressive symptoms (men, odds ratio [OR]: 2.20, 95% confidence interval [CI]: 1.48–3.21; women, OR: 2.64, 95% CI: 1.66–4.22) and the changes from non-depressive symptoms to depressive symptoms (men, adjusted OR: 2.18, 95% CI: 1.80–2.64; women, OR: 1.71, 95% CI: 1.27–2.29) increased the likelihood of hazardous drinking.Conclusions: Persistent depressive symptoms and changes from non-depressive to depressive symptoms are associated with increased prevalence of hazardous drinking. This suggests that an evaluation of the underlying mental illness or emotion should be made when counseling for abstaining from alcohol for chronic drinkers or the general public.

Impact of Somatic Conditions and Lifestyle Behaviours on Depressive Symptoms and Low Life Satisfaction among Middle-Aged and Older Adult Men in South Africa.

The purpose of this study was to assess the association between somatic disorders, lifestyle factors, incident and persistent depressive symptoms, and low life satisfaction in a longitudinal study in South Africa. We analyzed longitudinal data from two consecutive waves, 2346 men aged 40 years or older in 2014/2015 in wave 1 and 1864 men of wave 1 in 2018/2019 in wave 2 of the "Health and Ageing in Africa: A Longitudinal Study of an International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) Community in South Africa (HAALSI)". In total, 360 of 1932 male participants without depressive symptoms in wave 1 (24.3%) had incident depressive symptoms in wave 2 and 77 of 349 men had depressive symptoms in both waves 1 and 2 (persistent depressive symptoms). In all, 457 of 1258 male participants without low life satisfaction in Wave 1 (47.6%) had incident low life satisfaction in Wave 2, and 360 of 998 men had low life satisfaction at both Wave 1 and 2 (persistent low life satisfaction). In the unadjusted logistic regression analysis, having kidney disease and living with HIV had greater odds of incident depressive symptoms. In adjusted analysis, alcohol dependence (Adjusted Odds Ratio-AOR: 4.54, 95% Confidence Interval-CI: 1.05-19.66) was positively correlated and 1-7 and 8-11 years of education (AOR: 0.45, 95% CI: 0.27-0.74, and AOR: 0.20, 95% CI: 0.07-0.54, respectively) were negatively associated with persistent depressive symptoms. Increasing age increased the odds (AOR: 1.03, 95% CI: 1.01-1.04), while higher education (≥12 years) (AOR: 0.50, 95% CI: 0.33-0.76), and high physical activity (AOR: 0.68, 95% CI: 0.52-0.89) decreased the odds of incident low life satisfaction. Increasing age (AOR: 1.03, 95% CI: 1.02-1.04) and tobacco use (AOR: 1.64, 95% CI: 1.23-2.19) increased the odds and high physical activity (AOR: 0.73, 95% CI: 0.56-0.96) decreased the odds of persistent low life satisfaction. Of the seven chronic conditions and five lifestyle factors evaluated, alcohol dependence increased the odds of persistent depressive symptoms and low physical activity, and tobacco use increased the odds of incident and/or persistent low life satisfaction among men in rural South Africa.

New goals for depression therapy

The review is devoted to the consideration of the effectiveness of treatment of depression, the ratio of symptomatic and functional remission, factors associated with the achievement of high-quality remission and recovery of patients. Currently, between 29 and 66% of patients do not fully recover from antidepressant therapy and have residual symptoms of depression. Persistent depressive symptoms, neurocognitive deficits predict increased risk of relapse, social disability, impair interpersonal relationships, and represent a barrier to functional recovery. The results of a comparative analysis of antidepressants in terms of their effect on the restoration of the functioning of patients with depression are presented. It has been established that the positive impact on the social functioning of patients should be an important criterion when choosing an antidepressant for supporting therapy. Effective therapeutic approaches that maintain symptomatic remission increase the potential for functional recovery.

Trajectories of depressive symptoms and risk of cardiovascular disease: Evidence from the China Health and Retirement Longitudinal Study

BackgroundPrevious studies have reported that depression is associated with higher risk of cardiovascular disease (CVD). However, the association between long-term depressive symptom patterns and the risk of CVD was not well characterized. MethodsA total of 8621 participants with three Center for Epidemiological Studies Depression Scale (CES-D) measurements from the China Health and Retirement Longitudinal Study were included. Trajectories of depressive symptoms were identified by latent mixture modeling. Cox proportional hazards regression models were used to examine the association of depressive symptom trajectories with CVD (stroke or cardiac events), and accounting for mortality as a competing risk for CVD. ResultsWe identified four distinct depressive symptoms trajectories, characterized by maintaining low CES-D score throughout the follow-up (no depressive symptoms; 5642 participants [65.44%]); high starting CES-D scores but then decreasing scores (decreasing depressive symptoms; 1329 participants [14.91%]); low starting CES-D scores then increasing scores (increasing depressive symptoms; 1154 participants [13.39%]) and maintained high CES-D scores throughout the follow-up (persistent depressive symptoms; 496 participants [6.26%]). During the follow-up period, 853 CVD events (including 362 strokes and 535 cardiac events) were recorded. Compared to participants in the no depressive symptom trajectory, those in the increasing depressive symptoms and persistent depressive symptom trajectories had an increased risk of CVD, with multiple-adjusted hazard ratios (95% confidence intervals) of 1.53 (1.28–1.82) and 1.68 (1.34–2.12), respectively. Individuals with increasing and persistent depressive symptoms trajectories also had higher risks of stroke and cardiac events. ConclusionsIndividuals with increasing and persistent depressive symptom over time were associated with increased risk of incident CVD.

Latent trajectories of anxiety and depressive symptoms among adults in early treatment for nonmedical opioid use

BackgroundUnderstanding the course of anxiety and depressive symptoms in early opioid use disorder (OUD) treatment may inform efforts to promote positive early treatment response and reduce treatment attrition. MethodsPersons in treatment for nonmedical opioid use were identified from 86 addiction treatment facilities. Growth mixture modeling was used to identify trajectories of anxiety and depression symptoms during the first month of treatment among individuals who screened positive for depression (N = 3016) and/or anxiety (N = 2779) at intake. ResultsA three-class solution best fit the data for anxiety symptoms and included the following trajectories: (1) persistent moderate-to-severe anxiety symptoms, (2) remitting severe anxiety symptoms, and (3) persistent minimal-to-mild anxiety symptoms. Similarly, a three-class solution best fit the data for depressive symptoms and included trajectories characterized by (1) persistent moderate-to-severe depressive symptoms, (2) persistent moderate depressive symptoms, and (3) mild/remitting depressive symptoms. Persistent moderate-to-severe anxiety and depressive symptoms were predicted by female gender and heavy past-month benzodiazepine co-use. LimitationsFine grained-information about substance use was not collected. Results may not be generalizable to individuals receiving treatment outside of specialty addiction clinics. ConclusionsAnalysis of anxiety and depression symptom trajectories in early treatment suggest that a subset of individuals entering treatment for opioid use experienced persistent and significant anxiety and depressive symptoms, whereas others experience a remission of symptoms. Interventions designed to target individuals at the greatest risk, such as women and individuals reporting opioid/benzodiazepine co-use, may help improve mental health symptoms in early OUD treatment.

Exploring the associations of depressive symptoms with healthy eating self-efficacy over time amongst women in the READI cohort study

BackgroundThere is growing evidence that diet is associated with both depressive symptoms and clinical depression, likely through biological mechanisms. However, it is also plausible that depression impacts diet, for example by impairing the personal drivers of healthy eating behaviors such as self-efficacy. This study is one of the first to explore the association of depressive symptoms with healthy eating self-efficacy over time.MethodsData was drawn from the Resilience for Eating and Activity Despite Inequality (READI) longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 1264 women. Linear mixed models, with random intercepts for suburb of residence, were performed to explore the relationships between total healthy eating self-efficacy at 5-years follow-up and depressive symptoms over time, whilst adjusting for potential confounders. To assess different trajectories of depressive symptoms over time, four categories were created; 1. no depressive symptoms (n = 667), 2. resolved depressive symptoms (n = 165), 3. new depressive symptoms (n = 189), and 4. persistent depressive symptoms (n = 243).ResultsThere was very strong evidence of a difference in total healthy eating self-efficacy at follow-up between the four depressive symptoms trajectory categories (F(3,235) = 7.06,p < .0001), after adjusting for potential confounders. Pairwise comparisons indicated strong evidence of higher healthy eating self-efficacy among individuals with no depressive symptoms compared to individuals with persistent depressive symptoms (B = 1.97[95%CI: 0.60,3.33],p = .005). Similarly, there was evidence of higher healthy eating self-efficacy in individuals with resolved depressive symptoms than those with persistent depressive symptoms (B = 1.95[95%CI: 0.18,3.72],p = .031).ConclusionsThis study provides new insights demonstrating differences in total healthy eating self-efficacy at 5-year follow-up according to trajectory of depressive symptoms over time. Future interventions should focus on strategies that enhance self-efficacy among individuals with or at risk of depressive symptoms for supporting healthier dietary practices, which in turn, may contribute to reducing the highly burdensome mental health condition.

Journal Digest: Post-COVID Depression; Locus Coeruleus and Alzheimer’s; CY-BOCS Reliability; and More

Journal Digest: Post-COVID Depression; Locus Coeruleus and Alzheimer’s; CY-BOCS Reliability; and More

Quality of life, depressive symptoms, anxiety, and sexual function in mothers of neonates with congenital syphilis in the Northeast Brazil: A cohort study

Congenital syphilis is an important public health problem in low- and middle-income countries. Poor neonatal health outcomes associated with the disease may lead to maternal psychological distress and feelings of helplessness. This study aimed to evaluate the quality of life, anxiety levels, depressive symptoms, and sexual function in mothers of neonates with congenital syphilis in the Northeast of Brazil. This cohort study compared patient-centered outcomes between mothers of neonates with congenital syphilis and mothers of healthy neonates during the first three months of the postpartum period. The study was conducted in Sergipe state, Northeast Brazil, a region with one of the highest rates of congenital syphilis (14·1 cases per 1000 live births). Quality of life, depressive symptoms, anxiety levels, and sexual function were evaluated by using the World Health Organization Quality of Live - shortened version (WHOQoL-BREF) instrument, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Female Sexual Function Index, respectively. Unadjusted differences between groups were anayzed by using the Mann-Whitney test. Glass's delta with 95% confidence interval (CI) was used to measure the effect size. Sixty-three women were included in each group. During the in-hospital stay, mothers of neonates with congenital syphilis had lower scores for overall quality of life (p<0·001; large effect size: -0·559 [95% CI -0·683 to -0·405]) and higher levels of anxiety (p<0·001; large effect size: 0·558 [95% CI 0·403 to 0·681]) and depressive symptoms (p<0·001; large effect size: 0·561 [95% CI 0·407 to 0·684]) than mothers of healthy neonates. Three months after childbirth, we found persistent depressive symptoms (p=0·021; small effect size: 0·239 [95% CI 0·041 to 0·419]) and low overall sexual function (p=0·041; small effect size: -0·211 [95% CI -0·394 to -0·012]) among mothers of neonates with congenital syphilis compared to the control group. Mothers of neonates with congenital syphilis present poorer quality of life, mental health, and sexual function compared to mothers of healthy neonates. Brazilian Federal Agency for Coordination of Improvement of Higher Education Personnel (CAPES).

Adolescent Mental Health, Connectedness, and Mode of School Instruction During COVID-19

BackgroundBecause COVID-19 was declared a pandemic in March 2020, nearly 93% of U.S. students engaged in some distance learning. These school disruptions may negatively influence adolescent mental health. Protective factors, like feeling connected to family or school may demonstrate a buffering effect, potentially moderating negative mental health outcomes. The purpose of the study is to test our hypothesis that mode of school instruction influences mental health and determine if school and family connectedness attenuates these relationships. MethodsThe COVID Experiences Survey was administered online or via telephone from October to November 2020 in adolescents ages 13–19 using National Opinion Research Center’s AmeriSpeak Panel, a probability-based panel recruited using random address–based sampling with mail and telephone nonresponse follow-up. The final sample included 567 adolescents in grades 7–12 who received virtual, in-person, or combined instruction. Unadjusted and adjusted associations among four mental health outcomes and instruction mode were measured, and associations with school and family connectedness were explored for protective effects. ResultsStudents attending school virtually reported poorer mental health than students attending in-person. Adolescents receiving virtual instruction reported more mentally unhealthy days, more persistent symptoms of depression, and a greater likelihood of seriously considering attempting suicide than students in other modes of instruction. After demographic adjustments school and family connectedness each mitigated the association between virtual versus in-person instruction for all four mental health indicators. ConclusionAs hypothesized, mode of school instruction was associated with mental health outcomes, with adolescents receiving in-person instruction reporting the lowest prevalence of negative mental health indicators. School and family connectedness may play a critical role in buffering negative mental health outcomes.

Trajectories of depressive symptoms and subsequent cognitive decline in older adults: a pooled analysis of two longitudinal cohorts.

the course of depression is variable, but it is unknown how this variability over time affects long-term cognitive decline. to examine the relationship of different trajectories of depressive symptoms on rates of subsequent cognitive decline in older adults. population-based cohort study. communities in the USA and England. 17,556 older adults from the Health and Retirement Study and the English Longitudinal Study of Ageing. depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and trajectories were calculated using group-based trajectory modelling. Global cognitive function and three cognitive domains of memory, executive function and temporal orientation were assessed for up to 18years. five trajectories of depressive symptoms were identified. Compared with the 'non-depressed' trajectory, the 'worsening depressive symptoms' trajectory (pooled β = -0.016 standard deviation (SD)/year, 95% confidence interval (CI): -0.021 to -0.010), 'persistent depressive symptoms' trajectory (pooled β = -0.016 SD/year, 95% CI: -0.024 to -0.008), and 'mild depressive symptoms' trajectory (pooled β = -0.008 SD/year, 95% CI: -0.014 to -0.003) were associated with faster rates of cognitive decline, while no such association was found for the 'improving depressive symptoms' trajectory (pooled β = 0.001 SD/year, 95% CI: -0.010 to 0.012). subthreshold depressive symptoms are associated with an increased rate of cognitive decline, while individuals who show improving depressive symptoms do not exhibit accelerated cognitive decline. These findings raise the possibility that maintaining depressive symptoms as low as possible and ignoring the clinical threshold, might mitigate cognitive decline in older adults.

Persistent depressive symptoms during COVID-19: a national, population-representative, longitudinal study of U.S. adults

BackgroundThe COVID-19 pandemic and its consequences have been associated with an increase in poor population mental health. We assessed how depressive symptoms changed among U.S. adults over the course of the COVID-19 pandemic and identified the key risk factors for these symptoms.MethodsLongitudinal panel study of a nationally representative group of U.S. adults ages 18 years and older surveyed in March-April 2020 (Time 1; N=1441) and March-April 2021 (Time 2; N=1161) in the COVID-19 and Life Stressors Impact on Mental Health and Well-being study (CLIMB). The Patient Health Questionnaire-9 (PHQ-9) was used to define elevated depressive symptoms (cut-off ≥10) and depressive symptoms score (0-27).FindingsThe prevalence of elevated depressive symptoms persisted from 27.8% in 2020 (95% CI: 24.9, 30.9) to 32.8% in 2021 (95% CI: 29.1, 36.8). Over time, the central drivers of depressive symptoms were low household income, not being married, and experiencing multiple stressors during the COVID-19 pandemic. The odds ratio of elevated depressive symptoms for low income relative to high income persons increased from 2.3 (95% CI: 1.2, 4.2) in 2020 to 7.0 (95% CI: 3.7, 13.3) in 2021. Fewer people reported experiencing 4 or more COVID-19 stressors in 2021 than in 2020 (47.5% in 2020 vs 37.1% in 2021), but the odds ratio of elevated depressive symptoms associated with 4 or more stressors relative to 1 stressor or less increased from 1.9 (95% CI: 1.2, 3.1) in 2020 to 5.4 (95% CI: 3.2, 9.2) in 2021.InterpretationThe burden of depressive symptoms in the U.S. adult population increased over the course of the COVID-19 pandemic. Mental health gaps grew between populations with different assets and stressor experiences during the COVID-19 pandemic.FundingCLIMB Time 1 was sponsored by the Rockefeller Foundation-Boston University 3-D Commission. CLIMB Time 2 was sponsored by the de Beaumont Foundation.

Cerebral Small Vessel Disease and Depression Among Intracerebral Hemorrhage Survivors.

Intracerebral hemorrhage (ICH) is an acute manifestation of cerebral small vessel disease (CSVD), usually cerebral amyloid angiopathy or hypertensive arteriopathy. CSVD-related imaging findings are associated with increased depression incidence in the general population. Neuroimaging may, therefore, provide insight on depression risk among ICH survivors. We sought to determine whether CSVD CT and magnetic resonance imaging markers are associated with depression risk (before and after ICH), depression remission, and effectiveness of antidepressant treatment. We analyzed data from the single-center longitudinal ICH study conducted at Massachusetts General Hospital. Participants underwent CT and magnetic resonance imaging imaging and were followed longitudinally. We extracted information for neuroimaging markers of CSVD subtype and severity. Outcomes of interest included pre-ICH depression, new-onset depression after ICH, resolution of depressive symptoms, and response to antidepressant treatment. We followed 612 ICH survivors for a median of 47.2 months. Multiple CSVD-related markers were associated with depression risk. Survivors of cerebral amyloid angiopathy-related lobar ICH were more likely to be diagnosed with depression before ICH (odds ratio, 1.68 [95% CI, 1.14-2.48]) and after ICH (sub-hazard ratio, 1.52 [95% CI, 1.12-2.07]), less likely to achieve remission of depressive symptoms (sub-hazard ratio, 0.69 [95% CI, 0.51-0.94]), and to benefit from antidepressant therapy (P=0.041). Cerebral amyloid angiopathy disease burden on magnetic resonance imaging was associated with depression incidence and treatment resistance (interaction P=0.037), whereas hypertensive arteriopathy disease burden was only associated with depression incidence after ICH. CSVD severity is associated with depression diagnosis, both before and after ICH. Cerebral amyloid angiopathy-related ICH survivors are more likely to experience depression (both before and after ICH) than patients diagnosed with hypertensive arteriopathy-related ICH, and more likely to report persistent depressive symptoms and display resistance to antidepressant treatment.

Association of Maternal Depressive Symptoms During the Perinatal Period With Oppositional Defiant Disorder in Children and Adolescents

An association between perinatal maternal depression and risk of oppositional defiant disorder (ODD) in offspring has not been established. Identifying early determinants of ODD can help inform preventative intervention efforts. To investigate the association between maternal perinatal depressive symptoms and the risk of ODD in offspring aged 7 to 15 years. This population-based longitudinal birth cohort study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), in Bristol, UK. All pregnant women residents in Avon, UK, with expected delivery dates from April 1, 1991, to December 31, 1992, were invited to participate in the study. The study cohort ranged from approximately 8000 (at 7 years of age) to 4000 (at 15 years of age) mother-offspring pairs. Data were analyzed from November 2020 to July 2021. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) antenatally at 18 and 32 weeks of gestation and postnatally at 8 weeks and 8 months. This study primarily used a cutoff score of 12 or more on the EPDS to identify mothers with symptoms of depression, and the continuous EPDS scores were used to confirm the results of the main analyses. Offspring ODD at 7, 10, 13, and 15 years of age were diagnosed using the parent-reported Development and Well-Being Assessment. Of 7994 mother-offspring pairs for whom data were available on offspring ODD at 7 years, 4102 offspring (51.3%) were boys. The mean (SD) age of mothers was 28.6 (4.6) years. Maternal antenatal depressive symptoms (measured at 32 weeks of gestation) were associated with offspring ODD (adjusted odds ratio [AOR], 1.75; 95% CI, 1.33-2.31). Offspring of mothers with postpartum depressive symptoms at 8 weeks and 8 months were more than 2 times more likely to have a diagnosis of ODD over time (AOR at 8 weeks, 2.24 [95% CI, 1.74-2.90]; AOR at 8 months, 2.04 [95% CI, 1.55-2.68]), and maternal persistent depressive symptoms were associated with a 4-fold increased risk of offspring ODD (AOR, 3.59; 95% CI, 1.98-6.52). These findings suggest that perinatal depressive symptoms are associated with ODD in offspring and further support the need for early identification and management of prenatal and postnatal depression in women of childbearing age.

The effect of persistent anxiety and depressive symptoms on quality of life among patients with heart failure

BackgroundAnxiety and depressive symptoms interfere with physical and psychological status, worsening symptoms and quality of life (QoL) among patients with heart failure (HF). This study assesses the impact of persistent anxiety and depressive symptoms on QoL among patients with HF in Jordan. MethodsThis was a prospective observational study of a consecutive sample with a confirmed diagnosis of HF, recruited from four hospitals in Jordan during the period 1–31 March 2020. QoL was measured using the Arabic version of the Short Form 36 Health Survey, while anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale. Data were analyzed using descriptive statistics and stepwise multiple regression. ResultsOf 127 patients who participated in the study, 72 (56.7%) were persistently anxious and 60 (47.3%) were persistently depressed. In multiple regression models, persistent anxiety, persistent depression, and higher levels of New York Heart Association functional class were independent predictors for both Physical Component Summary (of which history of DM was another predictor) and Mental Component Summary. The model explained 78.4% of the variance for PCS, P < 0.05. These predictors reduced QoL/(PCS) by 0.261, 0.398, 0.09, and 0.325 units respectively. Mental Component Summary (MCS) regression model explained 76.1% of the variance, P < 0.001. These predictors reduced QoL/(MCS) by 0.286, 0.346, and 0.359 units respectively. ConclusionsPersistent anxiety and depressive symptoms were associated with poor QoL among patients with HF. It is highly recommended to assess psychological health for the patients with HF, especially anxiety and depression, and to include this dimension in treatment protocols.