Persistent Depression Research Articles

Risk factors of long term symptoms and outcomes among patients discharged after covid-19: prospective, multicentre observational study

ObjectiveTo investigate risk factors and subphenotypes associated with long term symptoms and outcomes after hospital admission for covid-19.DesignProspective, multicentre observational study.Setting93 hospitals in France.ParticipantsData from 2187 adults admitted to hospital...

Coping resources mediate the prospective associations between disrupted daily routines and persistent psychiatric symptoms: A population-based cohort study

This study examined the mediating effects of coping resources in the prospective associations between daily routine disruptions in the acute phase of COVID-19 and persistent probable anxiety and depression. A prospective, population-representative cohort of 1318 Hong Kong Chinese respondents completed a baseline survey between February and July 2020 (T1) and a 1-year follow-up survey between March and August 2021 (T2). Respondents reported demographics and disruptions to primary and secondary daily routines at T1, coping resources (i.e., self-efficacy and meaning making) at T2, and anxiety and depressive symptoms at T1 and T2. We found that 8.1% and 10.0% of respondents reached cutoff scores for probable anxiety and depression respectively at both T1 and T2. Logistic regression showed that T1 daily routine disruptions were positively associated with heightened risk of persistent probable anxiety and depression amid COVID-19. Path analysis showed that 15.3% and 13.1% of the associations of daily routine disruptions with persistent probable anxiety and depression were explained by coping resources, respectively, while the direct routine-outcome associations remained significant. Daily routine disruptions predict higher odds of persistent probable anxiety and depression directly and partially through reducing coping resources. Sustainment of regular daily routines should be advocated and fostered to enhance coping resources and reduce the risk of poorer adjustment among the affected populations amid public health crises.

EXPERIENCE IN THE TREATMENT OF PURULENT CORNEAL ULCERS WHILE WEARING SOFT CONTACT LENSES

Purulent corneal ulcer – a serious eye disease, which is the outcome of gross corneal scarring with persistent depression of vision and, in extreme cases, loss of an eye as an organ. It proceeds most aggressively against the background of wearing soft contact lenses.

Persistent Hemodynamic Depression After Carotid Artery Stenting: A Review and Update.

According to the American Heart Association, ischemic stroke is the second leading cause of death globally and is responsible for approximately 11% of deaths. Carotid endarterectomy (CEA) is the standard treatment for moderate or severe extracranial internal carotid artery (ICA) stenoses. With the development of materials and technology in neurointervention, the Centers for Medicare and Medicaid Services (CMS) have proposed that carotid artery stenting (CAS) can serve as an alternative treatment for CEA. As CAS is widely used worldwide, comorbidities, especially persistent hemodynamic depression (PHD) and stroke, have attracted public attention. In this review, we summarized the current advances in PHD after CAS. A better understanding of CAS-related PHD may inspire the design of potential prognostic and therapeutic tools.

Maternal depression and economic well-being: A quasi-experimental approach

Maternal depression is associated with adverse impacts on the health of women and their children. However, further evidence is needed on the extent to which maternal depression influences women's economic well-being and how unmeasured confounders affect estimates of this relationship. In this study, we aimed to measure the association between maternal depression and economic outcomes (income, employment, and material hardship) over a 15-year time horizon. We conducted longitudinal analyses using the Fragile Families and Child Wellbeing Study, an urban birth cohort study in the United States. We assessed the potential contribution of time-invariant unmeasured confounders using a quasi-experimental approach and also investigated the role of persistent versus transient depressive symptoms on economic outcomes up to 15 years after childbirth. In models that adjusted for time-invariant unmeasured confounders, maternal depression was associated with not being employed (an adjusted risk difference of 3 percentage points (95% CI 0.01 to 0.05)) and experiencing any material hardship (an adjusted risk difference of 14 percentage points (95% CI 0.12 to 0.16)), as well as with reductions in the ratio of household income to poverty by 0.10 units (95% CI -0.16 to -0.04) and annual household income by $2114 (95% CI -$3379 to -$850). Impacts at year 15 were strongest for those who experienced persistent depression. Results of our study strengthen the case for viewing mental health support services as interventions that may also foster economic well-being, and highlight the importance of including economic impacts in assessments of the cost-effectiveness of mental health interventions.

Longitudinal course and predictors of depressive symptoms in atopic dermatitis

Atopic dermatitis (AD) is associated with eczematous lesions, pruritus, pain, and sleep disturbance, which may negatively impact mental health over time. To determine the predictors and longitudinal course of depressive symptoms in adults with AD. A prospective, dermatology practice-based study was performed (N= 695). AD signs, symptoms, and severity and patient health questionnaire-9 (PHQ-9) were assessed. At baseline, of the 695 participants, 454 (65.32%) had minimal, 139 (20.00%) had mild, 57 (8.20%) had moderate, 27 (3.88%) had moderately severe, and 8 (2.59%) had severe depression. Most had fluctuating levels of depressive symptoms. Feeling bad, thoughts of self-harm, difficulty concentrating, and slow movement were most persistent. Predictors of persistent depression included older age, non-White race, male sex, public or no insurance, more severe itch, skin pain, facial erythema, nipple eczema, sleep disturbance, and presence of pityriasis alba. Single center study. Depressive symptoms are closely related to and fluctuate with AD severity over time. Improved control of AD signs and symptoms, particularly itch, may secondarily improve mental health.

The protective role of father behaviour in the relationship between maternal postnatal depression and child mental health.

Maternal depression, especially when severe and long-lasting, is associated with adverse mental health outcomes in children. We aimed to assess, for children of mothers with persistent postnatal depression symptoms, whether positive father behaviours would decrease risk for conduct and emotional symptoms. Using data from 4009, mother-father-child trios from the Avon Longitudinal Study of Parents and Children we examined associations between maternal depression trajectories and positive father behavioural profiles across the postnatal period (child age: 2-21months), and child conduct and emotional symptom trajectories across middle childhood (child age: 3.5-11years). Positive father behaviour was much less common in families where mothers experienced high-persistent depression symptoms (33%) than in families where mothers did not (56%); of note, these fathers also had higher levels of depression symptoms. Using person-level analysis, exposure to high-persistent maternal depression symptoms increased child risk for a high trajectory of both conduct (odds ratio, 2.69; 95% CI: 2.00, 3.60) and emotional symptoms (odds ratio, 2.47; 95% CI: 1.83, 3.31). However, positive father behaviour (toward child and mother) reduced the odds of following high trajectories of conduct symptoms by 9% (x=4.52, p<.001) and of emotional symptoms by 10% (x=4.12, p<.001), even after controlling for father depression symptoms. Using variable-level analysis, we did not identify an interaction between maternal depression and positive father behaviour. For conduct problems, we identified a direct effect of positive father behaviour and lower conduct problems. For emotional symptoms, father behaviour interacted with child age, where the largest decrease was seen at age 9, when symptoms were highest across the sample. Positive father behaviour can be protective against chronic mental health problems for children exposed to persistent maternal postnatal depression symptoms.

Psychological Morbidity Among COVID-19 Survivors: A Cross-Sectional Study Among Health Care Workers.

Objective: A range of psychiatric morbidities such as persistent depression, anxiety, insomnia, and posttraumatic stress disorder (PTSD) has been observed in coronavirus disease 2019 (COVID-19) survivors. The objective of this study was to explore the psychological status of health care workers after recovery from COVID-19 and to examine the sociodemographic and clinical factors associated with psychiatric morbidity.Methods: A cross-sectional study was conducted among health care workers of a tertiary care hospital in South India. The study included health care workers who tested positive for COVID-19 according to the provisional guidelines of the World Health Organization. The data were collected after they tested negative for COVID-19 from September 2020 to October 2020. The study used a semistructured proforma and rating scales such as the 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, and Posttraumatic Stress Disorder Checklist for DSM-5 to assess for depression, anxiety, and PTSD.Results: The results indicate that the prevalence of depression, anxiety, and PTSD among 107 post-COVID patients was 26.2%%, 12.1%, and 3.7%%, respectively. Female sex (P = .017), patients with post-COVID persistent physical symptoms (P = .05), and the duration of fever during the acute phase of COVID-19 infection (P = .005) were found to have a statistically significant association with a higher rate of depression among the study population.Conclusions: The study findings indicate that all COVID-19 survivors working in the health care sector should be screened for depression and anxiety disorders regularly for early detection and effective management.

Longitudinal assessment of inflammatory markers in the peripartum period by depressive symptom trajectory groups

ObjectiveMechanisms driving temporal fluctuations of inflammatory markers during pregnancy, and how these might differ between distinct perinatal depressive trajectories, are not well understood. The aim of this study was to investigate cytokines levels over the course of pregnancy in women with different trajectories of depressive symptoms peripartum, and relate the levels to levels of non-pregnant controls. MethodsBased on the Edinburgh Postnatal Depression Scale and/or selective serotonin reuptake inhibitors use, 131 women were categorized into: no (n = 65); antepartum (APD, n = 19), postpartum (PPD, n = 17) and persistent (n = 30) depressive symptoms. Plasma samples (n = 386) were analyzed for levels of interleukin (IL)-8, IL-18, Tumor necrosis factor-α, macrophage colony-stimulating factor (M-CSF), vascular endothelial growth factor A (VEGF-A) and fractalkine, at four different time-points (twice during pregnancy, during childbirth, and postpartum) using Bio-Plex Pro Human Cytokine Assays. Generalized linear mixed models were applied to analyze the associations between cytokine levels, time-point, perinatal depressive symptom trajectory group and their interaction. ResultsFor all markers but VEGF-A, pregnancy was associated with higher cytokine levels compared to the non-pregnant controls, with delivery being the most prominent time-point. For M-CSF, IL-18 and VEGF-A, levels were back to the non-pregnant status at postpartum week 8. An effect of perinatal depressive symptom trajectory groups on cytokine levels was found for VEGF-A. Women with PPD and women with APD had lower levels of VEGF-A throughout the study period compared to women with persistent depression, and women with PPD had lower levels compared to non-depressed women. ConclusionsLower levels of VEGF-A were noted among women in some trajectories of depressive symptoms peripartum. The peripartum period is a time of tremendous immune system adaptations. Standardization of time-points for cytokine measurements in studies of perinatal depression are important in order to draw valid conclusions on the role of the immune system in perinatal depression.

Closed Head Traumatic Brain Injury Drives Protracted Inflammation and Remodeling of Serotonergic Architecture in the Dorsal Raphe Nucleus

Traumatic Brain Injury (TBI) presents a monumental public health burden that affects over 3 million Americans annually, with mild TBI (mTBI)/concussion being the most common form of closed head injury. Chronic neuropsychiatric sequalae are common following TBI, with many individuals spontaneously developing persistent depression, anxiety, social withdrawal and/or PTSD, disorders that have been previously linked to alterations in serotonin (5‐HT) signaling. Currently, the effects of various forms of TBI on the function of the 5‐HT signaling system within the CNS are poorly understood and selective serotonin reuptake inhibitors (SSRIs) fail to mitigate the clinical neuropsychiatric sequalae elicited by TBI. The lack of any FDA‐approved therapies for the treatment of acute or chronic symptoms of TBI necessitates a greater understanding of how TBI alters the environmental milieu of the CNS, including normal, physiologic 5‐HT signaling. We hypothesize that TBI drives the formation of aberrant behavioral states linked to neuropsychiatric disorders through alterations of normal, physiologic 5‐HT signaling stemming from 5‐HT neurons located within the dorsal raphe nucleus (DRN). To test this hypothesis, adult, wild type C57Bl/6J mice were subjected to a single, blast induced mTBI or sham treatment, followed by behavioral and/or molecular analyses 0‐10 days post‐injury (dpi). mTBI subjects exhibited significantly increased righting reflex times (RRT) compared to their sham counterparts immediately post‐injury. Ten dpi, mTBI subjects exhibited significant reductions in sociability and social dominance as compared to their sham counterparts in the Crawley three chamber sociability assay and tube test, respectively. High performance liquid chromatography (HPLC) revealed a time‐dependent increase in total levels of 5‐HT and its metabolite, 5HIAA within the DRN 10 dpi. No effect of mTBI on 5‐HT or 5HIAA levels were found in prefrontal cortex (PFC) or somatosensory cortex (SSC), areas of high 5‐HT innervation. Ten dpi, DRN punches were subjected to RNA‐sequencing to delineate differential gene‐expression profiles elicited by mTBI. Genes indicative of cellular remodeling, cell‐to‐cell adhesion, monoaminergic processing, and proliferation were identified. Crucially, genes involved in ongoing inflammation including those relevant to peripheral immune recruitment and blood brain barrier permeation were found to be differentially expressed. Quantitative real‐time PCR was subsequently used to confirm differential expression of genes of interest, notably Vegfc, Slc18a1, and Icam1. These studies provide critical insight into ongoing molecular processes following closed head injury that may impact normal, physiologic 5‐HT signaling within the DRN. Further, these studies may provide critical insight into regulation of 5‐HT neuron function within the DRN and yield novel drug candidates for ameliorating the neuropsychiatric complications elicited by TBI.

Functional and structural social support in DSM-5 mood and anxiety disorders: A population-based study

BackgroundSocial support has been found to be a key correlate of many psychiatric disorders including several mood and anxiety disorders. However, research on social support is largely investigated in individual disorders, despite the high co-occurrence of these diagnoses, and has typically relied on pre-DSM-5 diagnostic criteria. Additionally, differences in structural and functional social support are rarely explored. Thus, the present study investigated the unique association between these two aspects of social support and past-year DSM-5 mood and anxiety disorders while adjusting for comorbidity and socio-demographic variables. MethodsMultivariate regression and relative weights analyses were conducted to determine the association of functional and structural social support with these disorders in the National Epidemiologic Survey on Alcohol and Related Conditions consisting of 36,309 participants. ResultsResults indicated depression, bipolar I, social anxiety, generalized anxiety, and posttraumatic stress disorder were significantly associated with functional support, while depression and agoraphobia were uniquely associated with structural support. Major depression and persistent depression were the two most important predictors of functional social support. LimitationsThe current study utilized cross-sectional data and does not allow for causal or directional conclusions. Further, additional studies with diverse samples are needed to determine the generalizability of the current results. ConclusionsThis study highlights differences in functional and structural social support in various disorders and explores how this varies when accounting for comorbidity. A deeper understanding of how specific aspects of social support relate to individual psychiatric disorders could inform future prevention and treatment efforts.

Using Single-Photon Emission Computerized Tomography on Patients With Positive Quantitative Electroencephalogram to Evaluate Chronic Mild Traumatic Brain Injury With Persistent Symptoms.

BackgroundFollowing mild traumatic brain injury (mTBI), also known as concussion, many patients with chronic symptoms (>3 months post injury) receive conventional imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). However, these modalities often do not show changes after mTBI. We studied the benefit of triaging patients with ongoing symptoms >3 months post injury by quantitative electroencephalography (qEEG) and then completing a brain single positron emission computed tomography (SPECT) to aid in diagnosis and early detection of brain changes.MethodsWe conducted a retrospective case review of 30 outpatients with mTBI. The patients were assessed by a neurologist, consented, and received a qEEG, and if the qEEG was positive, they consented and received a brain SPECT scan. The cases and diagnostic tools were collectively reviewed by a multidisciplinary group of physicians in biweekly team meetings including neurology, nuclear medicine, psychiatry, neuropsychiatry, general practice psychotherapy, neuro-ophthalmology, and chiropractic providers. The team noted the cause of injury, post injury symptoms, relevant past medical history, physical examination findings, and diagnoses, and commented on patients' SPECT scans. We then analyzed the SPECT scans quantitatively using the 3D-SSP software.ResultsAll the patients had cerebral perfusion abnormalities demonstrated by SPECT that were mostly undetectable by conventional imaging (CT/MRI). Perfusion changes were localized primarily in the cerebral cortex, basal ganglia, and cingulate cortex, and correlated with the patients' symptoms and examination findings. Qualitative and quantitative analyses yielded similar results. Most commonly, the patients experienced persistent headache, memory loss, concentration difficulties, depression, and cognitive impairment post mTBI. Because of their symptoms, most of the patients were unable to return to their previous employment and activity level.ConclusionOur findings outline the physical basis of neurological and psychiatric symptoms experienced by patients with mTBI. Increased detection of mTBI can lead to development of improved targeted treatments for mTBI and its various sequelae.

Nomogram for Persistent Post-Stroke Depression and Decision Curve Analysis.

PurposePrevious studies have shown that persistent post-stroke depression (PSD) was associated with unfavorable prognosis. The aim of this multicenter prospective study was to investigate the predictors associated with persistent PSD, develop a nomogram and validate its clinical usefulness by decision curve analysis (DCA).Patients and MethodsA total of 875 acute ischemic stroke patients from four hospitals were consecutively recruited and completed 1-year follow-ups. Sociodemographic indicators, vascular risk factors, clinical information, serum biochemical indicators and cytokines were collected on admission. The functional outcome was assessed at 1 year after stroke. Persistent depression was defined as having a presentation of depression at each follow-up points and the depressive symptoms occurring persistently since the diagnosis of depression.ResultsThere were 513 patients who experienced PSD during the 1-year follow-up, the cumulative incidence of PSD within 1 year was 58.6%. Persistent PSD was recorded in 289 patients, of which 59 (20.4%) result in unfavorable outcomes. The risk factors of persistent PSD in 1 year after stroke were the Hamilton Depression Scale-17 items (HAMD-17) score at admission, serum direct bilirubin and free serum thyroxine (FT4) level and activated partial thromboplastin time (APTT). Nomogram conducted based on these factors has a C-index (± standard deviation) of 0.655 ± 0.039, and the DCA demonstrated that the nomogram had a favorable clinical utility.ConclusionWe found that persistent depression after stroke in the first-year time course after stroke was associated with HAMD-17 score at admission, lower serum direct bilirubin and FT4 level, and APTT. A nomogram was developed with advisable clinical usefulness in our study.

Effectiveness of Using a Mixed of CBT, CT-R, and Oral Treatment in Reducing Depression and Anxiety

This qualitative research with case study method aims to determine the effectiveness of the combined use of CBT, CT-R and oral treatment to reduce depression and anxiety. The subject in this study was a 55 years old woman. Data were obtained through observation, interviews, and measurement of depression and anxiety levels using the DASS and MCMI-IV instruments. The results of this study showed that the combined use of CBT, CT-R and oral treatment reduced depression level and anxiety as indicated by a decrease in persistent depression scores 75 to 14, major depression scores 102 to 12 and generalized anxiety scores 115 to 30 on MCMI-IV scale. Measurements using the DASS show a decrease in depression scores 25 as major depression to 3 as normal depression, and a decrease in anxiety 16 as severe anxiety to 4 as normal anxiety. The measurement results supported by physical, psychological and behavioral changes. In addition, there are changes in personalities from borderline, melancholic and dependent to turbulent, histrionic and compulsiveon MCMI-IV scale..

Gender differences in the association of depression trajectories with executive and memory functions: Evidence from the longitudinal study of the Survey of Health, Ageing and Retirement in Europe (2004–2017)

Gender differences in depression trajectories and their effects on cognitive function are poorly understood. This article aims to identify depression trajectories in both genders and further explore the association of depression trajectories with executive and memory functions by gender. A total 3990 participants aged 50 years or older with repeated measurements from waves 1 to 7 (wave 3 excluded) of the Study of the Survey of Health, Ageing and Retirement in Europe (SHARE) were included. Group-based trajectory modeling (GBTM) was conducted to identify the optimal number of depression trajectories. Generalized estimating equation (GEE) models were used to examine the relation of depression trajectories to cognitive function after stratification by gender. Three distinct depression trajectories were identified in both genders, but the patterns of trajectories among genders were nonidentical. The trajectories of depression in males were characterized by non-low, moderate, persistent-depressive symptoms but with an unstable trend, while in females, they were characterized by non-low, moderate, persistent-depressive symptoms and with a worsening trend. The prevalence of persistent high depression in women (20.08%) was higher than that in men (3.13%). Moderate and persistent high depression trajectories were negatively associated with episodic memory (β = −0.53 and −0.72, respectively, p < 0.001) and verbal fluency in females (β = −0.96 and −1.47, p=0.01 and < 0.001, respectively). Older women had a greater frequency of developing depression than older men. Gender differences in depression trajectories existed. Moderate and persistent high depression trajectories exerted a negative effect on some domains of cognitive impairment only in females.

Assets, stressors, and symptoms of persistent depression over the first year of the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has been accompanied by an increase in depression in U.S. adults. Previous literature suggests that having assets may protect against depression. Using a nationally representative longitudinal panel survey of U.S. adults studied in March and April 2020 and in March and April 2021, we found that (i) 20.3% of U.S. adults reported symptoms of persistent depression in Spring 2020 and Spring 2021, (ii) having more assets was associated with lower symptoms of persistent depression, with financial assets—household income and savings—most strongly associated, and (iii) while having assets appeared to protect persons—in particular those without stressors—from symptoms of persistent depression over the COVID-19 pandemic, having assets did not appear to reduce the effects of job loss, financial difficulties, or relationship stress on symptoms of persistent depression. Efforts to reduce population depression should consider the role played by assets in shaping risk of symptoms of persistent depression.

Adolescents' Long-Term Experiences of Manageability, Comprehensibility, and Meaningfulness of a Group-Based Exercise Intervention for Depression.

Physical exercise is a potentially effective treatment for adolescents with mild to moderate depression. However, there is a lack of long-term follow-ups to reveal adolescents’ experiences of exercise as a treatment for depression. The salutogenic concept of sense of coherence (SOC), comprising the domains manageability, comprehensibility, and meaningfulness is important to understand behaviour change. This study aimed to describe adolescents’ long-term experiences of manageability, comprehensibility, and meaningfulness of a group-based exercise intervention for depression. Fourteen adolescents with persistent depression were recruited from a psychiatric outpatient clinic and interviewed one year after participating in a 14-week moderate to vigorous exercise intervention for depression. An abductive qualitative content analysis was conducted, based on the three SOC domains manageability, comprehensibility, and meaningfulness. The results revealed that participation in the intervention was made manageable by a supportive environment, including: the intervention design, togetherness with peer group, and encouragement from adults. The comprehensibility of the intervention emerged through the insights regarding health benefits of exercise and the aim of the intervention. Meaningfulness was achieved through improved health behaviour, well-being and self-esteem, along with strengthened belief in the future and increased commitment to everyday life. The group-based exercise intervention was experienced as manageable, comprehensible, and meaningful.

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.

Long-term effect of persistent postpartum depression on children's psychological problems in childhood

BackgroundMaternal postpartum depression (PPD) is a well-established risk factor for psychological problems in children; however, little is known about the sustained impact of persistent PPD patterns and severity on these problems in children. MethodsData were obtained from mothers (N = 714) and children (N = 768) from the Hamamatsu Birth Cohort for Mothers and Children. Maternal depression was measured using the Edinburgh Postpartum Depression Scale at 2, 4, 10 weeks and 10 months postpartum. Children's internalizing and externalizing problems were assessed using the Strengths and Difficulties Questionnaire at 6 years and 8–9 years old. Mothers were divided into 4 groups based on the trajectory of their PPD persistence: “No PPD,” “Transient PPD,” “Worsening PPD” and “Persistent PPD.” Linear regression analysis was used to examine the association of PPD persistence and severity with children's internalizing and externalizing problems. Results“Persistent PPD” was significantly associated with children's internalizing problems at 6 years old (Coefficient [95%CI] = 2.74 [1.30–4.19], P < .001), but no association was found at 8–9 years old. No associations were found between PPD severity and children's internalizing and externalizing problems in either age category. Limitations“Persistent PPD” and “Worsening PPD” groups had a relatively small sample size. The mothers' depression statuses were not ascertained simultaneously with the children's behavioral assessments. There was no information regarding the mothers' treatment for PPD. ConclusionPPD persistence negatively affected children's internalizing problems but was not long-lasting. Future studies are needed to identify protective factors against PPD persistence in children's psychological problems.

Life Events, Barriers to Care, and Outcomes Among Minority Women Experiencing Depression: A Longitudinal, Mixed-Method Examination.

The long-term course of depression is not well-understood among minority women. We assessed depression trajectory, barriers to depression care, and life difficulties among minority women accessing health and social service programs as part of the Community Partners in Care study. Data include surveys ( N = 339) and interviews ( n = 58) administered at 3-year follow-up with African American and Latina women with improved versus persistent depression. The majority of the sample reported persistent depression (224/339, 66.1%), ≥1 barrier to mental health care (226/339, 72.4%), and multiple life difficulties (mean, 2.7; SD, 2.3). Many barriers to care ( i.e. , related to stigma and care experience, finances, and logistics) and life difficulties ( i.e. , related to finances, trauma, and relationships) were more common among individuals reporting persistent depression. Results suggest the importance of past experiences with depression treatment, ongoing barriers to care, and negative life events as contributors to inequities in depression outcomes experienced by minority women.