Pre-existing Depression Research Articles

Depression and its impact on stroke risk and mortality in post-percutaneous coronary intervention patients: a nationwide retrospective cohort study

Abstract Background/Introduction Cardiovascular disease (CVD) remains a leading cause of global mortality, with percutaneous coronary intervention (PCI) being a common therapeutic procedure for managing CVD. While depression is recognized as a risk factor for adverse cardiovascular outcomes post-PCI, its association with stroke risk in this patient group has been less explored. Purpose This study aims to evaluate the association between pre-existing depression and the incidence of stroke, alongside other cardiovascular outcomes and mortality, in patients undergoing PCI. Methods Utilizing the Korean National Health Insurance Service database, a population-based retrospective cohort study was conducted, encompassing individuals who underwent PCI between 2010 and 2017, with a follow-up until 2019. Depression was identified through ICD-10 codes prior to PCI. The primary outcome was acute stroke incidence, with all-cause mortality and revascularization as secondary outcomes. Adjustments were made for sociodemographic, lifestyle factors, and comorbidities. Results Among 164,198 individuals, those with pre-existing depression (17.4% of the cohort) exhibited a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20-1.35) and a 25% higher risk of all-cause mortality (aHR 1.25, 95% CI 1.21-1.29) compared to those without. The association was stronger in individuals under 65 years and varied by sex, with males showing a higher risk of mortality. Conclusion(s) Pre-existing depression in patients undergoing PCI is associated with a significantly increased risk of stroke and all-cause mortality, particularly in younger patients. These findings highlight the importance of depression management as part of comprehensive care in post-PCI patients, suggesting potential benefits in reducing stroke risk and improving survival outcomes. Further research is warranted to explore the mechanisms and intervention strategies that could mitigate these risks.Study FlowchartRisk of stroke and all-cause death

Resilience and distress among adolescents and young adults receiving hematopoietic cell transplantation: The Promoting Resilience in Stress Management randomized trial.

Adolescents and young adults (AYAs) receiving hematopoietic cell transplantation (HCT) are at high risk of poor psychosocial health. This study aimed to determine whether the Promoting Resilience in Stress Management (PRISM) intervention mitigated these risks during the first 6 months posttransplant. This multisite, parallel, randomized trial was conducted from April 2019 to March 2023. Eligible AYAs were aged 12-24 years, English speaking, and within 1 month of HCT for cancer or cancer predisposition syndrome. They were assigned 1:1 to PRISM (a brief, skills-based intervention targeting "resilience resources" [stress management, goal setting, cognitive reframing, and meaning making]) or usual care (UC). Outcomes included total symptoms of depression and anxiety (Hospital Anxiety and Depression Scale; primary outcome), hope (Snyder Hope Scale), resilience (10-item Connor-Davidson Resilience Scale), and health-related quality of life (HRQOL; Pediatric Quality of Life Inventory Cancer Module). Analyses leveraged multivariable linear regressions; exploratory analyses assessed the influence of baseline depression or anxiety. Of 94 enrolled and randomized AYAs, the mean age was 16.7 years (SD,4.2); 43 (46%) were female, 56 (60%) were non-Hispanic White, 22 (23%) were Hispanic, and nine (10%) were Black. Most (77%) had leukemia. Of n=50 randomized to PRISM and n=44 to UC, 37 (74%) and 33 (73%) completed all study procedures, respectively. In intention-to-treat analyses, PRISM did not affect 6-month depression and anxiety (β=-1.1; 95% CI, -3.7 to 1.5), hope (β=0.83; 95% CI, -3.3 to 4.9), resilience (β=-0.01; 95% CI, -3.0 to 3.0), or HRQOL (β=1.5; 95% CI, -4.7 to 7.9). Among AYAs with preexisting anxiety or depression, PRISM recipients reported greater 6-month improvements in hope (score change, +3.71; SD,6.9) versus UC recipients (score change, -2.76; SD,6.5) (p=.04). Resilience coaching did not influence outcomes in this sample. Exploratory findings suggest it may be more effective when directed toward those with concurrent distress.

Intravenous versus oral iron for anaemia among pregnant women in Nigeria (IVON): an open-label, randomised controlled trial

Oral iron for anaemia in pregnancy is often not well tolerated, with poor adherence. Iron administered intravenously might address these tolerance and adherence issues. We investigated the effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate on anaemia and iron deficiency among pregnant women in Nigeria. We did a multicentre, open-label, parallel, randomised controlled trial of pregnant women (aged 15-49 years) with haemoglobin (Hb) concentrations of less than 10 g/dL at 20-32 weeks' gestation from 11 primary, secondary, or tertiary health facilities in Nigeria (five in Lagos and six in Kano). Exclusion criteria included vaginal bleeding, blood transfusion or major surgery within the past 3 months, symptomatic anaemia, anaemia known to be unrelated to iron deficiency, clinically confirmed malabsorption syndrome, previous hypersensitivity to any form of iron, pre-existing maternal depression or other major psychiatric illness, immune-related diseases, such as systemic lupus erythematosus or rheumatoid arthritis, or severe allergic reactions. Participants were randomly assigned (1:1) by nurses and doctors using a web-based randomisation service to either receive a single dose of intravenous ferric carboxymaltose (20 mg/kg to a maximum of 1000 mg) or oral ferrous sulphate (200 mg; 65 mg elemental iron) three times daily until 6 weeks postpartum. The study was primarily unmasked. Primary outcomes were maternal anaemia (Hb <11 g/dL) at 36 weeks' gestation and preterm birth at before 37 weeks' gestation, with analysis by intention to treat in participants with available data. This study was registered at the ISRCTN registry on Dec 10, 2020 (ISRCTN63484804) and on ClinicalTrials.gov (NCT04976179) on April 7, 2021. Between Aug 10, 2021, and Dec 15, 2022, 13 724 pregnant women were screened for eligibility. 12 668 were excluded due to ineligibility for inclusion, and 1056 provided consent to participate and were randomly assigned to either the intravenous or oral administration groups. 527 were assigned to the intravenous ferric carboxymaltose group and 529 were assigned to the oral ferrous sulphate group. 518 in the intravenous group were assessed at 36 weeks' gestational age and after 518 deliveries, and 511 completed the 6 weeks postpartum visit. 513 in the oral ferrous sulphate group were assessed at 36 weeks' gestational age and after 512 deliveries, and 501 completed the 6 weeks postpartum visit. No significant difference was found in anaemia at 36 weeks (299 [58%] of 517 in the intravenous group vs 305 [61%] of 503 in the oral group; risk ratio 0·95, 95% CI 0·85-1·06; p=0·36), nor in preterm birth (73 [14%] of 518 vs 77 [15%] of 513; 0·94, 0·70-1·26; p=0·66). There were no significant differences in adverse events. The most common adverse events were diarrhoea (in six participants) and vomiting (in three participants) in the oral group and fatigue (in two participants) and headache (in two participants) in the intravenous group. Although the effect on overall anaemia did not differ, intravenous iron reduced the prevalence of iron deficiency to a greater extent than oral iron and was considered to be safe. We recommend that intravenous iron be considered for anaemic pregnant women in Nigeria and similar settings. Bill & Melinda Gates Foundation.

Influence of pre-existing conditions and concussion history on post-concussion symptom severity and recovery time in collegiate athletes.

Mental health conditions and concussion history reported by a collegiate athlete may contribute to prolonged recovery and symptom severity after concussion. This work examined the potential associations among concussion history, pre-existing conditions, and sex relative to initial symptom severity and recovery duration following sport-related concussion (SRC) in a cohort of Division 1 NCAA athletes. This prospective cohort study analyzed symptom severity, recovery and return-to-play times reported post-SRC using data collected as part of the Pac-12 CARE Affiliated Program and Health Analytics Program. Health history questionnaires which included self-reported history of pre-existing conditions were completed at baseline. When consented athletes were diagnosed with a concussion, daily post-concussion symptom scores were evaluated until an athlete was clinically determined to be asymptomatic. Generalized linear and Cox proportional hazards models were used to determine associations between pre-existing conditions and recovery and return-to-play times. 92 concussions met inclusion criteria. Notable differences in initial symptom severity existed between females and males who had mood disorders ([Cohen's d] = 0.51) and ADHD (d = 0.93). The number of previous concussions was a strong predictor of athletes reporting pre-existing mood disorders, depression, anxiety, and ADHD (p = 0.008-0.04). Females with ≥2 previous concussions required more days to return-to-play than males (d = 0.31-0.72). Weekly recovery and return-to-play probabilities substantially differed between athletes that did or did not have learning disorders (HRRecovery = 0.32, HRRTP = 0.22, d = 1.96-2.30) and ADHD (HRRecovery = 3.38, HRRTP = 2.74, d = 1.71-4.14). Although no association existed between concussion history and acute symptom severity, collegiate athletes with a history of concussion had higher probabilities of reporting depression, mood disorders, anxiety, and ADHD. Having ADHD or learning disorders likely strongly affects time to recovery and return-to-play for collegiate athletes.

B - 38 Concussion Clinical Outcomes and Recovery Time in Individuals with Pre-Existing Anxiety and/or Depression

Abstract Objective Post-injury anxiety and mood difficulties are common symptoms following concussion. However, limited research has explored the impact of anxiety and/or depression history on individuals’ clinical outcomes and recovery time post- concussion. This study aims to determine the influence of anxiety and/or depression history on individuals’ clinical outcomes and examine outcomes of those with both anxiety and depression history. Method We conducted a retrospective review of 297 concussed patients. All participants completed a clinical interview, Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Clinical Profile Screen (CP-Screen), and Vestibular/Ocular-Motor Screening (VOMS). Participants were categorized into one of three anxiety-depression subgroups — no anxiety or depression history (NONE), anxiety or depression history (EITHER), or anxiety and depression history (BOTH)— based on clinical interviews. Results The BOTH group reported higher symptom burden (CP Screen Total Score; p &amp;lt; 0.001) and performed worse on ImPACT Visual Memory (p = 0.03) compared to NONE and EITHER groups. Overall, recovery time differed significantly between groups (p = 0.006). The NONE group recovered significantly faster than the EITHER group (p = 0.04), and the BOTH group (p = 0.03). However, no significant difference in recovery time was noted between the EITHER and BOTH groups (p = 0.58). Conclusions Our results suggest that anxiety/depression history is associated with more severe post-concussion symptoms, worse visual memory, and longer recovery times when compared to those with no history of anxiety or depression. These findings highlight the importance of screening for anxiety and depression history in clinical settings and exploring ways to improve concussion recovery for individuals with anxiety and/or depression history.

Parathyroidectomy and the Development of New Depression Among Adults With Primary Hyperparathyroidism

Primary hyperparathyroidism (PHPT) is a common endocrine disorder associated with neuropsychiatric symptoms. Although parathyroidectomy has been associated with improvement of preexisting depression among adults with PHPT, the effect of parathyroidectomy on the development of new depression is unknown. To determine the effect of early parathyroidectomy on the incidence of new depression among adults with PHPT compared with nonoperative management. Analyzed data included observational national Veterans Affairs data from adults with a new diagnosis of PHPT from 2000 through 2019 using target trial emulation with cloning, a biostatistical method that uses observational data to emulate a randomized clinical trial. New depression rates were compared between those treated with early parathyroidectomy vs nonoperative management using an extended Cox model with time-varying inverse probability censoring weighting, adjusted for patient demographics, comorbidities, and depression risk factors. Eligible adults with a new biochemical diagnosis of PHPT, excluding those with past depression diagnoses, residing in an assisted living/nursing facility, or with Charlson Comorbidity Index score higher than 4 were included. These data were analyzed January 4, 2023, through June 15, 2023. Early parathyroidectomy (within 1 year of PHPT diagnosis) vs nonoperative management. New depression, including among subgroups according to patient age (65 years or older; younger than 65 years) and baseline serum calcium (11.3 mg/dL or higher; less than 11.3 mg/dL). The study team identified 40 231 adults with PHPT and no history of depression of whom 35896 were male (89%) and the mean (SD) age was 67 (11.3) years. A total of 3294 patients underwent early parathyroidectomy (8.2%). The weighted cumulative incidence of depression was 11% at 5 years and 18% at 10 years among patients who underwent parathyroidectomy, compared with 9% and 18%, respectively, among nonoperative patients. Those treated with early parathyroidectomy experienced no difference in the adjusted rate of new depression compared with nonoperative management (hazard ratio, 1.05; 95% CI, 0.94-1.17). There was also no estimated effect of early parathyroidectomy on new depression in subgroup analyses based on patient age or serum calcium. In this study, there was no difference in the incidence of new depression among adults with PHPT treated with early parathyroidectomy vs nonoperative management, which is relevant to preoperative discussions about the benefits and risks of operative treatment.

Interpersonal differences in postoperative pain scores after bariatric surgery: a systematic review

Background: Despite intensive and better multimodal pain management schemes during bariatric surgery, many obese patients still experience severe early postoperative pain. Furthermore, postoperative pain varies considerably between patients who undergo the same kind of surgery. The main purpose of this study is to investigate psychological and demographic predictors for interpersonal differences of acute postoperative pain after laparoscopic bariatric surgery. Methods: A search of Pubmed, Web of Science, Cochrane database, PsycARTICLES, Google Scholar from 2008 to 2023 was conducted with the following search criteria: psychological, psychometric, catastrophizing, anxiety, pain, fear, stress, depression, vulnerability, self-efficacy, somatization, perception, bariatric surgery and postoperative pain. Results: Younger age, higher ASA physical status, higher educational level, pre-existing anxiety, pre-existing depression and pre-existing alexithymia may contribute to interpersonal differences in acute postoperative pain scores after bariatric surgery. Conclusion: Limited evidence exists on demographic and psychological factors. Further research is warranted to clarify these demographic and psychological predictors of acute postoperative pain in bariatric surgery to provide a more effective intervention and perioperative care.

The effects of potentially traumatic events on the recovery from pre-existing anxiety and depression symptomatology and the risk of PTSD.

The extent to which recent potentially traumatic events (PTEs) hinder the recovery from pre-existing mental health problems is largely unknown. The same applies to the extent to which non-recovery from pre-existing mental health problems increases the risk of posttraumatic stress disorder (PTSD). The aim of the present study is to gain insight in these effects. Data were extracted from six annual surveys of the Dutch population-based Victims in Modern Society (VICTIMS) study. Of the adult respondents who participated in two subsequent surveys (labeled T1 and T2, n = 6942), those with severe anxiety and depression symptoms (ADS) at T1 (n = 487) were selected. We distinguished respondents exposed to PTEs (PTE-group, n = 162) and not exposed to PTEs (comparison group, n = 325) between T1 and T2. We applied five indicators of recovery [based on the Reliable Change Index (RCI), degrees of symptom reduction, and the cut-off score at T2]. Differences in the recovery from ADS and probable PTSD at T2 were examined using multivariate logistic regression. The PTE group less often recovered from severe ADS between T1 and T2 than the comparison group according to all five indicators of recovery, while controlling for 11 different variables (0.40 ≤ adjusted OR's ≤ 0.66). Those in the PTE group who did not recover, considerably more often suffered from probable PTSD at T2 (63%-82%) than those who did recover (0%-29%; 8.96 ≤ adjusted OR ≤ 26.33). Recent potentially traumatic events hinder the recovery from pre-existing anxiety and depression symptomatology and thereby increase the risk of probable PTSD.

Chemodenervation is Associated With Reduced Mental Health Disorders in Patients With Synkinesis.

To compare the prevalence of mental health disorders in individuals with facial synkinesis, facial paralysis alone, and the general population. Retrospective cohort. Eighty-two health care organizations across the United States. The TriNetX Research Network was queried from 2011 to 2021 for patients with facial paralysis without synkinesis, facial paralysis and documented synkinesis, and controls, matched for age, sex, race, and ethnicity. Cases included infectious, iatrogenic, or idiopathic facial paralysis. Patients with pre-existing depression or anxiety were excluded. Two-year rates of newly diagnosed depression, anxiety, and mental health prescriptions were compared. Among 127,573 patients with facial paralysis, 92.5% (n = 117,976) had facial paralysis alone, and 7.5% (n = 9597) also had documented synkinesis. Compared to controls, patients with facial paralysis alone had increased risks of new depression (8.9% vs 7.3%, P < .001) and anxiety (10.1% vs 9.6%, P < .001), with higher mental health medication rates (16.6% vs 13.1%, P < .001). Patients with documented synkinesis, in comparison to controls, had the highest risks of depression (19.8% vs 8.6%, P < .001), anxiety (20.5% vs 10.5%, P < .001), and prescriptions (28.1% vs 15.8%, P < .001). The 27.8% (n = 2669) of synkinetic patients treated with chemodenervation had lower rates of depression (8.5% vs 23.5%, P < .001), anxiety (9.0% vs 23.8%, P < .001), and prescriptions (21.6% vs 30.0%, P < .001) compared to synkinetic patients who were not. Facial paralysis, particularly synkinesis, is linked to increased mental health disorders. Integrating mental health screening and treatment into a comprehensive approach is crucial. Chemodenervation is associated with decreased mental health disorders in synkinesis, highlighting its therapeutic potential.

The association of depression and patient and resuscitation characteristics with survival after out-of-hospital cardiac arrest: a cohort study.

Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide, with cardiovascular disease (CVD) being a key risk factor. This study aims to investigate disparities in patient/OHCA characteristics and survival after OHCA among patients with vs. without depression. This is a retrospective cohort study using data from the AmsteRdam REsuscitation Studies (ARREST) registry from 2008 to 2018. History of comorbidities, including depression, was obtained from the patient's general practitioner. Out-of-hospital cardiac arrest survival was defined as survival at 30 days post-OHCA or hospital discharge. Logistic regression models were used to obtain crude and adjusted odds ratios (ORs) for the association between depression and OHCA survival and possible effect modification by age, sex, and comorbidities. The potential mediating effects of initial heart rhythm and provision of bystander cardiopulmonary resuscitation were explored. Among 5594 OHCA cases, 582 individuals had pre-existing depression. Patients with depression had less favourable patient and OHCA characteristics and lower odds of survival after adjustment for age, sex, and comorbidities [OR 0.65, 95% confidence interval (CI) 0.51-0.82], with similar findings by sex and age groups. The association remained significant among the Utstein comparator group (OR 0.63, 95% CI 0.45-0.89) and patients with return of spontaneous circulation (OR 0.60, 95% CI 0.42-0.85). Initial rhythm and bystander cardiopulmonary resuscitation partially mediated the observed association (by 27 and 7%, respectively). Out-of-hospital cardiac arrest patients with depression presented more frequently with unfavourable patient and OHCA characteristics and had reduced chances of survival. Further investigation into potential pathways is warranted.

Validation of the delirium diagnostic tool-provisional (DDT-Pro) in geriatric medical inpatients with diagnostic permutations of the 3Ds with and without delirium

ObjectiveValidations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia. MethodsCross-sectional study using two delirium reference standards, DSM-5-TR and Delirium Rating Scale-Revised-98 (DRS-R98). We assessed concurrent and construct DDT-Pro validity too. ResultsThere were 117 (27.7%) delirium cases using DDT-Pro, 104 (24.6%) per DSM-5-TR and 93 (22.0%) per DRS-R98; 133 patients (31.5%) had depression and 105 (24.9%) dementia, some comorbid with delirium. DDT-Pro accuracy (AUC under ROC curve) ranges were 88.3–95.9% vs DSM-5-TR and 92.7–95.0% vs DRS-R98 for whole sample and four diagnostic groups, without statistical differences. DDT-Pro ≤6 had the most balanced sensitivity-specificity for delirium diagnosis against both DSM-5-TR and DRS-R98 with similar specificity but higher sensitivity for DRS-R98 than DSM-5-TR delirium, with the highest values in patients with depression and dementia (≥92% sensitivity, ≥81% specificity). Positive and negative likelihood ratios support diagnostic strength. Concurrent validity was high reflected by significant correlations (p < 0.001) of DDT-Pro total and item scores with DRS-R98 and Delirium Frontal Index scores, highest in groups with comorbid depression and/or dementia. The DDT-Pro represented a single construct for delirium demonstrated by one factor with high item loadings and high internal consistency reliability of its items. ConclusionsThe DDT-Pro demonstrated strong performance metrics in general hospital elderly inpatients with preexisting depression and/or dementia, which is unique among brief delirium tools. Its optimized cutoff score was the same as in other populations.

Impact of the COVID-19 pandemic on suicide-related risk among college students: A cross-sectional analysis

This study aimed to investigate the factors contributing to suicide-related risks among college students during a stressful life event, specifically the COVID-19 pandemic. Employing a Classification and Regression Tree (CART) model, data from 808 college students were analyzed, revealing key interactions and predictive insights into suicide-related risk. Results indicated that preexisting depression emerged as the most significant risk factor, followed by anxiety, discrimination, stress, and younger age. These findings emphasize the importance of preventive measures targeting depression and anxiety to enhance college students’ mental health and well-being. The study’s implications extend to informing future research, practical interventions, and policy-making efforts addressing suicide-related risk among college students.

Association between pre-hip fracture depression and days at home after fracture and assessing sex differences.

Hip fracture and depression are important public health issues among older adults, but how pre-fracture depression impacts recovery after hip fracture is unknown, especially among males who often experience greater depression severity. Days at home (DAH), or the days spent outside a hospital or healthcare facility, is a novel, patient-centered outcome that can capture meaningful aspects of fracture recovery. How pre-fracture depression impacts DAH after fracture, and related sex differences, remains unclear. Participants included 63,618 Medicare fee-for-service beneficiaries aged 65+ years, with a hospitalization claim for hip fracture surgery between 2010 and 2017. The primary exposure was a diagnosis of depression at hospital admission, and the primary outcome was total DAH over 12 months post-discharge. Longitudinal associations between pre-fracture depression and the count of DAH among beneficiaries were estimated using Poisson regression models after adjustment for covariates; sex-by-depression interactions were also assessed. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) reflecting relative differences were estimated from these models. Overall, beneficiaries with depression were younger, White females, and spent 11 fewer average DAH compared to counterparts without depression when demographic factors (age and sex) (IRR = 0.91; 95% CI = 0.90, 0.92; p < 0.0001) and social determinants of health (race, Medicaid dual eligibility, and poverty) were adjusted for (IRR = 0.92; 95% CI = 0.91, 0.93; p < 0.0001), but this association attenuated after adjusting for medical complexities (IRR = 0.99; 95% CI = 0.98, 1.01; p = 0.41) and facility and geographical factors (IRR = 1.0037; 95% CI = 0.99, 1.02; p = 0.66). There was no evidence of effect modification by sex. The comorbidity burden of preexisting depression may impact DAH among both male and female Medicare beneficiaries with hip fracture. Results suggest a holistic health approach and secondary prevention of depressive symptoms after hip fracture.

Impact of pre-existing depression and food insecurity on the trajectory of depressive symptomatology during the COVID-19 pandemic outbreak in South Africa: A panel analysis of nationally representative South African data

We investigated the trajectory of depressive symptoms (“depression”) from the start of the COVID-19 pandemic in South Africa (March 2020) until 2021, between individuals with and without pre-pandemic depression, specifically regarding the role of food security. Our investigation used publicly available panel data (N = 6,930) from the South African National Income Dynamics Study Coronavirus Rapid Mobile Survey (SA-NIDS-CRAM from 2020–2021) on those who had also participated in the pre-pandemic South African National Income Dynamics Study (SA-NIDS, 2017) depression interview. We investigated trends in depressive symptomatology (based on a 2-item Patient Health Questionnaire) at SA-NIDS-CRAM Wave 2 (July 2020), Wave 3 (February 2021) and Wave 5 (May 2021). Generalized estimating equations (GEE) with post-estimation linear combinations of estimators were fitted to investigate the roles of pre-pandemic depression (based on 2017 SA-NIDS data) and food insecurity during the pandemic on depressive symptomatology. During the pandemic, the highest levels of depression were observed consistently among those with pre-pandemic depression and food insecurity; and were lowest among those without pre-pandemic depression and food security. Depressive symptomatology rose in nearly equal magnitude during the early phases of the pandemic in two groups: those without pre-pandemic depression but food insecure during the pandemic; as well as those with pre-pandemic depression but food secure during the pandemic. However, this dynamic changed later in the pandemic, when higher depressive symptomatology was observed in the group with both pre-pandemic depression and food insecurity, widening the gap between them from Wave 3 (adj β = 0.63, p < 0.01) to Wave 5 (adj β = 0.79, p < 0.01). Our results highlight the importance of addressing both population mental health and food insecurity, particularly at the early stages of a crisis/disaster. As we showed that mental health impact is linked to food insecurity during a pandemic, strengthening social protection measures, especially around food and nutrition, would help build resilience to crises in the long term.

Risk of pharmacological treatment of anxiety and depression after admission for acute exacerbation of chronic obstructive pulmonary disease

BackgroundAnxiety and depression are very common in patients with COPD and may lead to lower quality of life and higher risk of exacerbations and mortality. This study aimed to examine the incidence of anxiety and depression within one year after admission with acute exacerbation in COPD (AECOPD). The secondary aim was to examine the characteristics of the patients who develop anxiety and depression. MethodsThis retrospective cohort study used the Danish National Patient Registry. Patients aged 40–90 years admitted for COPD between 01.01.99 and 31.12.18 were included. Patients with mental disorders within 10 years before admission were excluded. Age, sex, educational level, inhaled medication, and comorbidities were evaluated. Anxiety or depression were defined by redemption of anxiolytics or antidepressants within one year after admission. ResultsWe included 97,929 patients. Anxiolytics and antidepressants were redeemed by 4 and 5 % of patients respectively. Higher age, male sex, treatment with short acting β2-agonists and short acting muscarinic antagonists, cancer and heart failure were positively associated to risk of anxiety or depression, while diabetes and treatment with triple inhalation therapy showed an inverse association. ConclusionRespectively four and five per cent of patients redeemed anxiolytics and antidepressants within the first year after their first severe AECOPD. Several patient characteristics were significantly associated to risk of anxiety or depression. The results from this study support that there is a risk of anxiety and depression after AECOPD in addition to the known risk of preexisting anxiety and depression.

Afghanistan National Depression Screening (ANDs) scale: development and psychometric testing

BackgroundDepression is a complex mental health disorder marked by persistent sadness, hopelessness, and reduced interest in daily activities. The present study developed the Afghanistan National Depression Screening (ANDs) scale and examined its psychometric properties within the Afghan population.MethodsThe study enrolled 1245 Afghan individuals as participants. The items within the ANDs scale were developed through a thorough examination of pre-existing depression scales, expert assessments, and participant interviews. Multiple psychometric evaluations were administered to ensure the reliability and validity of the scale.ResultsAfter review and corrected item-total correlation testing, 15-items exhibiting acceptable corrected item-total correlation coefficients (ranging from 0.315 to 0.647) were retained and further validated through significant factor loadings (ranging from 0.358 to 0.725). Additionally, various properties assessed through classical test theory demonstrated satisfactory results on the 15-item scale. Specifically, measures of reliability such as internal consistency (α = 0.846) and Spearman-Brown coefficient (0.975) were deemed acceptable. Convergent validity was evidenced by strong correlations with established scales, including the DASS-21 (depression subscale, r = 0.854), GHQ-28 (depression subscale, r = 0.693), CES-D 20 (r = 0.922), and PHQ-9 (r = 0.758).ConclusionThe 15-item ANDs scale is developed to assess depression in Afghan populations, showing promise in correlation with established measures like PHQ-9, DASS-21, CESD-20, and GHQ-28. Its potential for identifying depression symptoms warrants further investigation in epidemiological studies and clinical settings, though replication across diverse samples is necessary for generalizability.

Association of pre-existing depression and anxiety with Omicron variant infection.

Pre-existing psychiatric disorders were linked to an increased susceptibility to COVID-19 during the initial outbreak of the pandemic, while evidence during Omicron prevalence is lacking. Leveraging data from two prospective cohorts in China, we identified incident Omicron infections between January 2023 and April 2023. Participants with a self-reported history or self-rated symptoms of depression or anxiety before the Omicron pandemic were considered the exposed group, whereas the others were considered unexposed. We employed multivariate logistic regression models to examine the association of pre-existing depression or anxiety with the risk of any or severe Omicron infection indexed by medical interventions or severe symptoms. Further, we stratified the analyses by polygenic risk scores (PRSs) for COVID-19 and repeated the analyses using the UK Biobank data. We included 10,802 individuals from the Chinese cohorts (mean age = 51.1 years, 45.6% male), among whom 7841 (72.6%) were identified as cases of Omicron infection. No association was found between any pre-existing depression or anxiety and the overall risk of Omicron infection (odds ratio [OR] =1.04, 95% confidence interval [CI] 0.95-1.14). However, positive associations were noted for severe Omicron infection, either as infections requiring medical interventions (1.26, 1.02-1.54) or with severe symptoms (≥3: 1.73, 1.51-1.97). We obtained comparable estimates when stratified by COVID-19 PRS level. Additionally, using clustering method, we identified eight distinct symptom patterns and found associations between pre-existing depression or anxiety and the patterns characterized by multiple or complex severe symptoms including cough and taste and smell decline (ORs = 1.42-2.35). The results of the UK Biobank analyses corroborated findings of the Chinese cohorts. In conclusion, pre-existing depression and anxiety was not associated with the risk of Omicron infection overall but an elevated risk of severe Omicron infection, supporting the continued efforts on monitoring and possible early intervention in this high-risk population during Omicron prevalence.

Preference and Associated Factors for Cesarean Delivery Among Pregnant Women: A Cross-Sectional Study.

A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its frequency has risen in both industrialized and developing nations. Maternal request for cesarean delivery has been explained for the escalating rate along with other factors like anxiety, fear of childbirth, previous cesarean delivery, previous negative vaginal birth experience, maternal age, maternal education, and socioeconomic factors. Hence, this study was undertaken to assess pregnant women's tendency to have a cesarean birth and to investigate the factors associated with the inclination for cesarean delivery. A hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, a systematic sampling procedure was utilized, and 368 antenatal mothers after 36 weeks of gestation, who do not have any specific medical reasons against vaginal delivery were included in the study. Data collection was done by questionnaire. The information regarding socio-demographic factors, preexisting comorbidities, current obstetric risk factors, emotional factors, previous delivery experience, and their information preference toward the mode of delivery were collected. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery. The preference for cesarean delivery and non-preference for cesarean delivery was 114 (30.9%) and 201 (54.6%), respectively whereas 53 (14.4%) participants remained neutral. The Chi-square analysis revealed a notable connection between the inclination towards a preference for cesarean delivery and factors such as obstetric score, parity, comorbidities, and among obstetric risk factors such as pregnancy after in-vitro fertilization (IVF), with a history of abortion, and having a prior history of cesarean delivery. Nevertheless, no meaningful association was observed between the preference for cesarean delivery and the remaining variables. On multivariate logistic analysis, independent variables like preexisting anxiety or depression, pregnancy through IVF, and having a history of previous cesarean delivery have increased the odds of preferring cesarean delivery. The independent variables like increasing gestational age, graduates, and unemployed have decreased the odds of preferring a cesarean delivery. In conclusion, the prevalence of cesarean delivery is influenced by a complex interplay of medical, cultural, socioeconomic, and healthcare system factors. While cesarean delivery is essential in cases of medical necessity, efforts should be made to avoid unnecessary cesarean delivery that does not provide clear benefits over vaginal delivery. Balancing the risks and benefits of cesarean delivery and promoting evidence-based obstetric practices are crucial for ensuring optimal maternal and infant outcomes.

Impact of COVID-19 pandemic on depression incidence and healthcare service use among patients with depression: an interrupted time-series analysis from a 9-year population-based study

BackgroundMost studies on the impact of the COVID-19 pandemic on depression burden focused on the earlier pandemic phase specific to lockdowns, but the longer-term impact of the pandemic is less well-studied. In this population-based cohort study, we examined the short-term and long-term impacts of COVID-19 on depression incidence and healthcare service use among patients with depression.MethodsUsing the territory-wide electronic medical records in Hong Kong, we identified all patients aged ≥ 10 years with new diagnoses of depression from 2014 to 2022. We performed an interrupted time-series (ITS) analysis to examine changes in incidence of medically attended depression before and during the pandemic. We then divided all patients into nine cohorts based on year of depression incidence and studied their initial and ongoing service use patterns until the end of 2022. We applied generalized linear modeling to compare the rates of healthcare service use in the year of diagnosis between patients newly diagnosed before and during the pandemic. A separate ITS analysis explored the pandemic impact on the ongoing service use among prevalent patients with depression.ResultsWe found an immediate increase in depression incidence (RR = 1.21, 95% CI: 1.10–1.33, p < 0.001) in the population after the pandemic began with non-significant slope change, suggesting a sustained effect until the end of 2022. Subgroup analysis showed that the increases in incidence were significant among adults and the older population, but not adolescents. Depression patients newly diagnosed during the pandemic used 11% fewer resources than the pre-pandemic patients in the first diagnosis year. Pre-existing depression patients also had an immediate decrease of 16% in overall all-cause service use since the pandemic, with a positive slope change indicating a gradual rebound over a 3-year period.ConclusionsDuring the pandemic, service provision for depression was suboptimal in the face of increased demand generated by the increasing depression incidence during the COVID-19 pandemic. Our findings indicate the need to improve mental health resource planning preparedness for future public health crises.

Machine learning models predict the emergence of depression in Argentinean college students during periods of COVID-19 quarantine.

The COVID-19 pandemic has exacerbated mental health challenges, particularly depression among college students. Detecting at-risk students early is crucial but remains challenging, particularly in developing countries. Utilizing data-driven predictive models presents a viable solution to address this pressing need. 1) To develop and compare machine learning (ML) models for predicting depression in Argentinean students during the pandemic. 2) To assess the performance of classification and regression models using appropriate metrics. 3) To identify key features driving depression prediction. A longitudinal dataset (N = 1492 college students) captured T1 and T2 measurements during the Argentinean COVID-19 quarantine. ML models, including linear logistic regression classifiers/ridge regression (LogReg/RR), random forest classifiers/regressors, and support vector machines/regressors (SVM/SVR), are employed. Assessed features encompass depression and anxiety scores (at T1), mental disorder/suicidal behavior history, quarantine sub-period information, sex, and age. For classification, models' performance on test data is evaluated using Area Under the Precision-Recall Curve (AUPRC), Area Under the Receiver Operating Characteristic curve, Balanced Accuracy, F1 score, and Brier loss. For regression, R-squared (R2), Mean Absolute Error, and Mean Squared Error are assessed. Univariate analyses are conducted to assess the predictive strength of each individual feature with respect to the target variable. The performance of multi- vs univariate models is compared using the mean AUPRC score for classifiers and the R2 score for regressors. The highest performance is achieved by SVM and LogReg (e.g., AUPRC: 0.76, 95% CI: 0.69, 0.81) and SVR and RR models (e.g., R2 for SVR and RR: 0.56, 95% CI: 0.45, 0.64 and 0.45, 0.63, respectively). Univariate models, particularly LogReg and SVM using depression (AUPRC: 0.72, 95% CI: 0.64, 0.79) or anxiety scores (AUPRC: 0.71, 95% CI: 0.64, 0.78) and RR using depression scores (R2: 0.48, 95% CI: 0.39, 0.57) exhibit performance levels close to those of the multivariate models, which include all features. These findings highlight the relevance of pre-existing depression and anxiety conditions in predicting depression during quarantine, underscoring their comorbidity. ML models, particularly SVM/SVR and LogReg/RR, demonstrate potential in the timely detection of at-risk students. However, further studies are needed before clinical implementation.