Predictive Factors Of Depression Research Articles

Depressive Symptom Level, Sleep Quality, and Internet Addiction among Medical Students in Home Quarantine during the COVID-19 Pandemic

The COVID-19 pandemic has a major impact on the mental health of people around the world. Due to the possible impact of quarantine conditions on mental health, we decided to assess internet addiction, depressive symptom level (DSL), and sleep disorders among medical students during the quarantine of COVID-19. This cross-sectional study was performed among medical students during the COVID-19 quarantine in Iran. Participants were selected using the available sampling method. Sleep quality, internet addiction, and depression were assessed using an online survey of the Pittsburgh Sleep Quality Index (PSQI), Internet Addiction Test (IAT), and Patient Health Questionnaire-9 (PHQ-9), respectively. Also, sociodemographic data including age, gender, marital status, smoking status, living circumstances, and educational status were asked. Participants were asked to share the link in their class social media groups. SPSS (version 16) was used for statistical analysis. Students participated; 64.9% of whom were female ( n = 564 ), and the mean age of participants was 21.3 years. 74.1% of students’ educational status was not mainly clinical. 48.2%, 28.6%, and 27.1% had poor sleep quality, DSL, and internet addiction, respectively. Smoking (AOR: 3.49, 95% CI: 1.56-7.76), living with family (AOR: 1.75, 95% CI: 1.16-2.66), and using social media for more than 2 hours were defined as predictive factors for depression. 165 participants (19%) were diagnosed with both poor sleep quality and DSL. There was a positive correlation between PSQI and PHQ-9 ( r : 0.51, P value <0.001). A positive correlation was observed between IAT and PHQ-9 ( r : 0.56, P value <0.001). The rate of DSL, internet addiction, and poor sleep quality were increased and strong correlations between them were concluded. Variables of gender, GPA, and smoking status were the most important associated variables.

Prevalence and predictive factors of depression among medical health care workers and medical residents

Mental health is one of the 3 essential health columns which is defined according to WHO as "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".

Co-occurrence of sibling and peer bullying victimization and depression and anxiety among Chinese adolescents: The role of sexual orientation

BackgroundBullying victimization is a robust predictor of mental distress among lesbian/gay, bisexual, and questioning (LGBQ) adolescents. However, few research accounted bullying victimization within the context of both sibling and peer relationships. ObjectiveTo examine the effect of sibling and peer bullying victimization on depression and anxiety between heterosexual adolescents and LGBQ adolescents. MethodThis was a cross-sectional study with a random sample of 3062 Chinese senior high school students (56.0% female) aged 14 to 18. Related information was collected through a self-reported questionnaire. The associations were examined via a set of logistic regression analysis. ResultsOf the participants, 12.5% were victims of sibling bullying only, 10.1% reported peer victimization only, and 4.7% were involved in both sibling and peer victimization. Compared to heterosexuals, LGBQ adolescents had increased risks of sibling victimization only, peer victimization only, and both sibling and peer victimization. The prevalence of major depression and generalized anxiety disorder were 24.9% and 18.7% respectively. Bullying victimization and sexual orientation were independently associated with depression and anxiety. Furthermore, the stratified analysis indicated that sibling victimization only was significantly associated with depression and anxiety for heterosexual adolescents, while the associations were not significant for LGBQ adolescents. ConclusionsSexual orientation and bullying victimization are predictive factors of depression and anxiety. In particular, bullying victimization shows the different effects on depression and anxiety between heterosexual and LGBQ adolescents. Anti-bullying intervention could take distinct strategies based on different sexual orientation to reduce risks of adolescents' mental health problems.

Psychosocial Distress of Head Neck Cancer (HNC) Patients Receiving Radiotherapy: A Systematic Review.

Background: Head and Neck Cancer (HNC) patients are at increased risk of psychosocial distress compared with patients with other forms of cancer. Various symptoms of the disease and side effects of treatment are attributing factors for distress. This systematic review aimed to identify the prevalence of psychosocial distress among HNC patients receiving radiotherapy. Methods:The following search engines from 2000-2021 were searched: PubMed, CINAHL, Cochrane, Web of Science, ProQuest, Scopus, and Embase. Citation checking and extensive reference checking were also conducted. Cross-sectional, longitudinal, cohort, exploratory and prospective, repeated measure studies published in English were included. Newcastle Ottawa Scale assessed the quality, and the data were extracted on a validated data extraction form. Results:Out of 782 articles, eleven records met the eligibility criteria, including 776 HNC patients receiving radiotherapy. Data were synthesized and summarized descriptively as measurements were not homogenous. Prevalence estimates of depression or depressive symptoms were calculated. Outcomes were measured with various measuring tools and reported in frequency, percentage, mean, and standard deviation in various studies. All studies reported depression ranging from 9.8% to 83.8%, and pooled estimated prevalence of depression among HNC patients receiving radiotherapy is 63% (95% CI 42-83) with significant heterogeneity (I2= 97.66%; p<0.001). An increase in the trend is observed along with treatment progression. Another three studies reported anxiety along with depression. Physical symptoms, body image, low social support, fatigue specific radiotherapy regimens were the predictive factors of depression. Conclusion:HNC patients are psychosocially distressed during radiotherapy, and the distress is steadily increased during the therapy. The predictive factors could serve as potential areas of intervention and supportive therapy during radiotherapy.

Effects of the COVID-19 lockdown on mental health in a UK student sample

BackgroundThe COVID-19 pandemic and the resulting restrictions placed upon society have had a profound impact on both physical and mental health, particularly for young people.AimsThe current study assesses the impact of COVID-19 on student mental health.MethodFour hundred and thirty four first year Undergraduate students completed a battery of self-report questionnaires (PHQ-P, GAD-7 and SAS-SV) to assess for depression, anxiety and mobile phone addiction respectively with data being collected over a 2 year period. The data from each year was compared (216 and 218 students respectively).ResultsA MANOVA revealed that COVID-19 had a significant impact on self-reported levels of depression, anxiety and smartphone addiction—which all significantly increased from the 2020 to the 2021 group. The percentage of students who had a score which warranted a classification of clinical depression increased from 30 to 44%, and for anxiety increased from 22 to 27%—those students who showed a comorbidity across the two rose from 12 to 21%. Smartphone addiction levels rose from 39 to 50%. Correlational analysis showed a significant relationship between Smartphone usage and depression and anxiety.ConclusionsThis research suggests that COVID-19 has had a major impact upon student mental health, and smartphone addiction. The importance of identifying predictive factors of depression and anxiety is emphasised, and suggestions for intervention are discussed.

Prevalencia de síntomas depresivos y diagnóstico de sospecha de depresión en pacientes con EPOC

Objectiveto determine the prevalence of and predictive factors for depression in patients diagnosed with COPD and referred from primary care to pneumology departments, departments that share care for COPD patients. Designobservational, multicentric, prospective with non-probabilistic sample, transversal study. Settingtwo pneumology visit offices at two hospitals offering different levels of care. Participants293 patients diagnosed with COPD in a stable phase of the disease. InterventionsCarryng out common clinical questionnaires in COPD & HADS. Main measurementsDemographic, clinical, and functional variables of COPD, and HADS depression scale. ResultsIncluded were 229 men (78.16%) and 64 women (21.8%), with an average age of 68.2 ± 10.3 years of whom 93 (31.7%) were active smokers and 200 (68.3%) ex-smokers. 19.45% of patients had a previous diagnosis of clinical depression but the HADS test established a diagnosis of suspicion of depression in 32.6%. Predictive factors included: being female, living alone, and variables related to the severity of the disease (FEV1 postbronchodilator, being a high-risk patient, exacerbating phenotype criteria, and C and D GOLD criteria levels). ConclusionsThe prevalence of depression in patients with COPD is high and is infra-diagnosed. The HADS diagnostic test is useful for establishing a diagnosis of suspicion of depression at primary care and pneumology visit offices. There are personal and clinical factors that may be considered predictive and aid healthcare professionals in determining which patients should take the HADS test and, based on results, referring patients to the mental health department to confirm or reject the diagnosis.

Predictive Factors for Depression and Anxiety in Men During the Perinatal Period: A Mixed Methods Study.

The purpose of this study was to identify the risk factors associated with paternal perinatal mental distress in a sample of Australian men. A mixed-methods design was used. The qualitative component (N = 13) using thematic analysis identified maternal depression, marital distress, masculine gender role stress, unplanned pregnancy, work–family conflict, and sleep disturbance as risk factors for paternal perinatal mental distress. The quantitative component (N = 525) expanded on the qualitative findings and examined the associations between the identified risk factors and mental distress of fathers in the perinatal period measured by Edinburgh postnatal depression scale. Hierarchical multiple regression analysis revealed six significant predictors of paternal perinatal mental distress with masculine gender role stress being the most significant risk factor for paternal perinatal mental distress. The results from this study provide an insight into how masculine gender role may affect the expression and experience of mental distress in fathers within the perinatal period. Implications of research findings are discussed.

Mental Health Assessment of Cancer Patients: Prevalence and Predictive Factors of Depression and Anxiety.

Background:Patients with oncological diseases often have mental disorders in the form of comorbidity. The aim of this study was to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients.Methods:This prospective observational study done in 2020 included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD- and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms.Results:The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression. The level of depression was higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. All subjects were characterized as persons with severe anxiety (score 26–63). The level of anxiety was higher in older respondents, in the presence of long-term illness, with greater limitations of activities and difficulties in performing daily activities, with a more pronounced influence of pain on performing activities and the influence of the media.Conclusion:Caring for the mental health of cancer patients must occupy a significant part of each country’s national health policy.

Understanding of the prevalence of depression in a sample of gifted children by identifying the developmental trajectory of risk and protective factors

IntroductionDevelopmental studies in infancy remain rare. Studies measuring depressive symptoms in gifted children are contradictory, considering more anxiety or depression than in non-gifted children. Furthermore, questionnaires or anxiety scales are used without taking into account all aspects of mood disorders and thus, rarely depression scales have been conducted.ObjectivesTo refine the developmental trajectory of depression in a national sample of French gifted children by identification of the specific risk and protective factors.MethodsA self-reported depression scale MDI-C (Multiscore-Depression-Inventory-for-Children) were sent to families to be administered to their gifted children from preschool to high school, aged from 4 to 20 years-old (IQ &gt;125) looking for help from gifted associations. A larger wave of data collection on different aspects of child and family history was collected (pregnancy, term and delivery mode, neonatal period, psychomotor development, health, schooling, interpersonal relationships with family and friends, personality, parental socio-economic status).Results438 children (&gt; 130) were eligible. Regarding anamnestic fields, Exploratory-Factor-Analysis highlighted six predictive factors of depression with eigenvalues from 1.09 to 3.17. Major factors explaining 62.96% of total variance are: Factor-1 “motor skills disorder” (14.53%). Factor-2 “positive family relationships” (14.04%). Factor-3 “positive social relationships with peers” (14.02%). Factor-4 “integration of social codes” (11.23%). Factor-6 “Learning disabilities and rehabilitation” (10.1%).ConclusionsOur findings highlight specifics risk factors of depression in the field of learning disabilities or social cognition, while a good quality of social relationships since childhood seems to be a preventive factor.DisclosureNo significant relationships.

Prevalence and Associated Factors of Antenatal Depressive Symptoms in Pregnant Women Living in an Urban Area of Thailand.

BackgroundDepression is a major public health problem in middle- and low-income countries. Depression in pregnancy has adverse effects on obstetric outcomes. Maternal depression remains under-recognized, under-diagnosed and undertreated in Thailand. Antenatal screening of depression is an important strategy to improve maternal and neonatal outcomes. This problem has rarely been investigated in Thailand, especially in urban areas.ObjectiveTo discover the prevalence, associated factors, and predictive factors of depression in pregnant women living in an urban area.Materials and MethodsThis cross-sectional study of 402 pregnant women was conducted during antenatal care at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, from 10 September to 31 November 2019. The participants were interviewed using a structured questionnaire that included a demographic profile, obstetric conditions, socio-cultural characteristics, and a Thai language version of the Center for Epidemiologic Studies-Depression Scale to assess depressive symptoms.ResultsAmong a total 402 pregnant women, the prevalence of depressive symptoms in pregnant women in an urban area was 18.9%. Depressive symptoms in pregnant women were significantly associated with divorce (p < 0.001), low family income (p < 0.03), financial insufficiency (p < 0.001), extended family (p < 0.001), history of previous abortion (p = 0.033), history of previous pregnancy complications (p = 0.044), current alcohol use (p = 0.03), current tobacco use (p = 0.009), current substance abuse (p = 0.002), marital conflict (p < 0.001), and family conflict (p < 0.001). The significant factors predicting depression in pregnant women were extended family (AOR 3.0, 95% CI 1.59–5.51, p=0.001) and marital conflict (AOR 4.7, 95% CI 2.37–9.11, p<0.001).ConclusionThis study revealed that the prevalence of depressive symptoms in pregnant women living in an urban area in Thailand was 18.9%. The significant associated factors of depressive symptoms were divorce, low family income, financial insufficiency, extended family, previous abortion, previous pregnancy complications, current alcohol use, current tobacco use, current substance abuse, marital conflict, and family conflict. Extended family and marital conflict were significant predictive factors for antenatal depressive symptoms.

Authors' responses to the comments on "Attitude, practice, behavior, and mental health impact of COVID-19 on doctors".

Sir, We would like to thank the authors for their valuable comments and queries on the article by us, Chatterjee et al.,[1] titled “Attitude, practice, behavior, and mental health impact of COVID-19 on doctors.” Though not in specific, comprehensively knowledge and attitude were assessed with the questions such as – “when you heard about COVID-19,” inquiring “whether doing duty,” “the duty hours,” “whether involved in high-risk procedures,” “feeling proud to be a doctor,” and “being ostracized by the society.” We collected data using Google Form and then transferred them to excel and subsequently to SPSS version 25 (IBM Corp., Armonk, NY, USA).[2] The higher standard deviation in depression and anxiety subscale points that it is spread out over a large range of values around mean, depending on responses. Here, running a normality test would have been better. However, more than the between-group difference, the goal was to find out the predictive factors of depression, anxiety, and stress. There were typographical errors in Table 1 (corrigendum attached) and another in the reference number 6,[3] both of which are corrected in this reply. We found that 87 doctors had no comorbid illness and 9 doctors have all the major three comorbidities (diabetes mellitus, hypertension, and chronic obstructive pulmonary disease).Table 1: CorrigendumThe study has been approved by the institutional ethics committee. The repetitiveness of the table was done for better comprehensibility. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Factors Influencing Depression in Chinese Civil Servants

We analyzed depression in Chinese civil servants, using the Hamilton Depression Rating Scale (HAMD) and a survey completed by people employed by the Civil Service in 6 cities in eastern China. The results showed that the HAMD is a valid and effective measure for assessing depression in Chinese civil servants. As we had assumed, Chinese civil servants manifested a strong sense of despair, which was consistent between the genders. In general, however, depression had a greater impact on female than on male civil servants. In the linear regression model with demographic variables as independent variables, we found that gender, education level, and marital status were significant predictive factors of depression, but income and age were not. We suggest that although civil servants may enjoy a more lucrative job and a better material lifestyle compared to other people in China, the issue of their mental health merits attention.

Prevalence and predictors of depression and well-being after hysterectomy: An observational study

ObjectivesTo assess risk and predictive factors for depression and well-being, 3 and 12 months after elective hysterectomy. Secondary objectives were to assess the incidence of depression, level of well-being, and feelings of femininity. Study designA prospective multicenter cohort study was performed among 419 women, undergoing hysterectomy for benign indication. Data were collected in the week prior to surgery, and in the per- and postoperative period up to the fourth postoperative day and 3 and 12 months after surgery. Sociodemographic variables, baseline health status, psychosocial predictors, and surgery data were assessed. Outcome measures were Center for Epidemiological Studies-Depression scale (CES-D, range 0–60), the 12-item well-being questionnaire energy and positive well-being subscales (range 0–12), and feelings of femininity. Predictor analyses were performed using linear mixed model analyses. ResultsLevels of depression, energy, and positive well-being after hysterectomy were predicted by their corresponding baseline levels (estimate 0.62 p<0.001, 0.39 p<0.001, 0.37 p<0.001, respectively) and baseline pain (0.31 p=0.003, −0.09 p=0.026, −0.10 p=0.008). Postoperative infection reported at 12 months affected CES-D and energy level. Several other gynaecological, psychosocial, or perioperative factors were also predictive for one of the outcomes. Prevalence of depression at baseline, 3 and 12 months was 24%, 19%, and 21%, respectively. In general, well-being scores were slightly higher 3 and 12 months after hysterectomy than at baseline. Feelings of femininity were not negatively affected in 92% of the patients. ConclusionsPreoperative psychosocial status, perioperative pain, and postoperative infection were found as predictors of psychological outcome after hysterectomy. In the majority of patients we observed small but significant improvements with regard to postoperative depression and well-being, while feelings of femininity were unaffected.

Predictive Factors of Anxiety and Depression in Patients with Acute Coronary Syndrome

To identify the predictive factors of anxiety and depression in patients with acute coronary syndrome. Cross-sectional and retrospective study conducted with 120 patients hospitalized with acute coronary syndrome. Factors interfering with anxiety and depression were assessed. Anxiety was related to sex, stress, years of education, and depression, while depression was related to sex, diabetes mellitus, obesity, years of education, and trait-anxiety. Obesity and anxiety were considered predictive factors for depression, while depression and fewer years of education were considered predictive factors for anxiety.

Predictive factors of depression symptoms among adolescents in the 18-month follow-up after Wenchuan earthquake in China

Background: It is unclear about the change and risk factors of depression among adolescent survivors after earthquake.Aims: This study aimed to explore the change of depression, and identify the predictive factors of depression among adolescent survivors after the 2008 Wenchuan earthquake in China.Methods: The depression among high school students at 6, 12 and 18 months after the Wenchuan earthquake were investigated. The Beck Depression Inventory (BDI) was used in this study to assess the severity of depression.Results: Subjects included 548 student survivors in an affected high school. The rates of depression among the adolescent survivors at 6-, 12- and 18-month after the earthquake were 27.3%, 42.9% and 33.3%, respectively, for males, and 42.9%, 61.9% and 53.4%, respectively, for females. Depression symptoms, trauma-related self-injury, suicidal ideation and PTSD symptoms at the 6-month follow-up were significant predictive factors for depression at the 18-month time interval following the earthquake.Conclusions: This study highlights the need for considering disaster-related psychological sequela and risk factors of depression symptoms in the planning and implementation of mental health services. Long-term mental and psychological supports for victims of natural disasters are imperative.

Prevalence and Predictive Factors of Depression in Community-Dwelling Older Adults in South Korea.

The aims of the study were to investigate the levels of depression and to identify the predictors of depression among older adults in 3 different environments based on their primary place of leisure time activity, including their homes, small community halls, and senior welfare centers. A convenience sample of 833 older adults participated in the study. Instruments for measuring functional independence, social support, life satisfaction, and depression were used. The data were analyzed using a one-way analysis of variance (ANOVA) and multiple hierarchical regressions. The level of depression in older adults at home was significantly greater than the level of depression in those in both small community halls and senior welfare centers. Life satisfaction was the strongest negative predictor of depression in older adults both at home and in senior welfare centers, whereas employment status was the one in those in small community halls. Across the 3 groups, poor subjective health was the strongest positive predictor of depression. The levels of depression and predictors differed among the settings. Nurses should have a thorough understanding of these differences when planning effective strategies for managing depression in older adults.

Prevalence and predictive factors of depression and anxiety in patients with pancreatic cancer: a longitudinal study.

It is known that depression and anxiety occur more frequently in pancreatic cancer patients than in those with other malignancies. However, few studies have assessed depression and anxiety using reliable psychiatric diagnostic tools. The purpose of this study was to determine the prevalence of depression and anxiety among pancreatic cancer patients before and 1 month after the start of anticancer treatment using reliable psychiatric diagnostic tools, and to identify factors that predict their occurrence. Pancreatic cancer patients were consecutively recruited. Structured clinical interviews were used to determine the presence of affective disorders, anxiety disorders and adjustment disorders. Baseline interviews were performed prior to initiation of anticancer treatment, while follow-up interviews were performed 1 month after treatment was started. Medical, demographic and psychosocial backgrounds were also assessed as predictive factors. One hundred and ten patients participated in the baseline interview and 91 in the follow-up interview. Depression and anxiety were observed in 15 patients (13.6%) at the baseline, and 15 patients (16.5%) at the follow-up. Lack of confidants was associated with depression and anxiety at the baseline. At the baseline, sadness, lower Karnofsky Performance Status and prior experience with the death of a family member due to cancer predicted newly diagnosed depression and anxiety at the follow-up. A considerable percentage of pancreatic cancer patients experienced depression and anxiety. Multidimensional psychosocial predictive factors were found and optimal psychological care should incorporate early detection of sadness.

Occupational factors and subsequent major depressive and generalized anxiety disorders in the prospective French national SIP study.

BackgroundThe literature has been extensive on the associations between psychosocial work factors and mental health. Nevertheless, the studies using prospective design, various concepts and more than one measurement point in time for these factors and diagnostic interview to assess mental disorders remain seldom in the literature. This study is an attempt to fill the gap in this topic.MethodsThe study was based on a national representative sample of 4717 workers of the French working population (SIP survey), interviewed in 2006 and reinterviewed again in 2010 and free of mental disorders at baseline. Psychosocial work factors, measured in both 2006 and 2010, included: psychological demands, decision latitude, social support, reward, emotional demands, role conflict, ethical conflict, tensions with the public, job insecurity and work-life imbalance. Other occupational factors related to working time/hours and physical work environment were also studied. Major depressive (MDD) and generalized anxiety disorders (GAD) were measured using a standardised diagnostic interview (MINI). Covariates were age, occupation, marital status, having a child under 3 y, social support outside work and stressful life events. Multivariate analyses were performed using weighted logistic regression models.ResultsUsing models taking all occupational factors into account simultaneously, low reward and job insecurity predicted MDD. Psychological demands, low reward, emotional demands and job insecurity were predictive of GAD. The more frequent the exposure to job insecurity, the higher the risk of MDD and GAD, and the more frequent the exposure to psychological demands and low reward, the higher the risk of GAD. No effect was observed for repeated exposure to occupational factors.ConclusionsClassical and emergent psychosocial work factors were predictive factors of depression and anxiety with dose–response associations in terms of frequency of exposure. More attention may be needed on emergent psychosocial work factors and frequent exposure to these factors.

Depressive symptoms and cognitive dysfunctions in patients with chronic hepatitis B

Pronounced symptoms of depression and disorders of cognitive functions can be observed in patients with chronic hepatitis B. The objective of the study was evaluation of the severity of symptoms and predictive factors for depression and the existence of cognitive disorders in patients with chronic hepatitis B. A total of 150 respondents were included in this prospective study (50 patients with chronic hepatitis B, 50 patients with other chronic liver diseases and 50 healthy persons). The patients with chronic hepatitis B were homogeneous by age compared to healthy subjects (p = 0.566) and patients with other chronic liver diseases (p = 0.528). Assessment of intensity of depression was determined by the Hamilton Depression Rating Scale (HAMD). A Mini Mental State Examination (MMSE) test was used to investigate the presence of cognitive disorders. Significantly expressed depression was observed in patients with chronic hepatitis B compared with healthy persons as well as the occurrence of cognitive dysfunction (p = 0.00), while in comparison with the patients with chronic nonviral liver diseases, depression was statistically significantly less markedly expressed (p = 0.003). Depression and cognitive dysfunction were more noticeable in patients with chronic hepatitis B in the stage of liver cirrhosis in relation to the early stage of the disease. Multivariate analysis of variables related to the sociodemographic characteristics showed that the most significant positive predictor of depression was more expressed in older age (over 50 years) (B = 0.276; SE = 0.092; p = 0.004). Patients with chronic hepatitis B have a higher intensity of depression compared to healthy people, which is intensified with the progression of the disease. The highest expression of depression is expected in the elderly. Patients with chronic hepatitis B have a lower intensity of depression and fewer disorders of cognitive functions than patients with other chronic liver diseases.

Predictive factors of depression and its therapy

Predictive factors of for the occurrence of depressive episodes include psychosocial and biological risk factors. These factors reflect the heterogeneity and complexity of the disease. They can identify groups that would benefit from preventive measures and provide indications for suitable preventive strategies. In recent decades considerable scientific effort, for example in the field of psychiatric genetics, has been undertaken to identify predictive factors for individual antidepressant therapy response and as an aid for individual treatment decisions. However, no clinically usable conclusions could yet be drawn from the respective findings. In practice clinical factors, such as symptom cluster of the depressive disorder and specific properties of the antidepressant, individual factors and contextual factors, such as the type of treatment facility, decision support and economic aspects, are factors influencing the choice of a specific antidepressant. Early clinical improvement under antidepressant medication in the first 2 weeks of treatment is one of the best predictors for the long-term treatment outcome in patients with major depressive disorder.