Prevalence Of Depression Diagnoses Research Articles

Anxiety and Depression in Youth With Chronic Pain

For youth with chronic pain, anxiety and depression are reported as consequences of experiencing pain and maintaining factors of ongoing pain and disability. However, prevalence estimates of anxiety and depression remain unclear. To report the prevalence of clinical anxiety and depression for youth with chronic pain and compare symptoms of anxiety and depression between youth with and without chronic pain. MEDLINE, PsycINFO, CENTRAL, and Embase from inception to April 30, 2023. Included studies that reported prevalence data or symptom scores for anxiety and/or depression in individuals younger than 25 years (mean, ≤18 years) with chronic pain and were published in English. From 9648 nonduplicate records, 801 full-text articles were screened. Screening and data extraction occurred in duplicate. Prevalence was determined using event rate calculations. Between-group symptom differences were calculated using Hedges g. Analyses were conducted using the random-effects model. Reporting bias and Grading of Recommendation, Assessment, Development, and Evaluation assessments were conducted. Prevalence of anxiety and depression (based on diagnosis and clinical cutoff scores) and differences in anxiety and depression symptoms. Moderators of prevalence and symptom differences were analyzed when data allowed. A total of 79 studies were included with a total sample of 22 956 youth (n = 12 614 with chronic pain). Most youth were female (mean, 74%), with an age range of 4 to 24 (mean [SD], 13.7 [2.10]) years. The prevalence estimate of anxiety diagnoses was 34.6% (95% CI, 24.0%-47.0%) and the portion that exceeded clinical cutoff scores was 23.9% (95% CI, 18.3%-30.6%). The prevalence of depression diagnoses was 12.2% (95% CI, 7.8%-18.7%) and the portion that exceeded clinical cutoff scores was 23.5% (95% CI, 18.7%-29.2%). Youth with chronic pain had greater symptoms of anxiety (g = 0.61; 95% CI, 0.46-0.77) and depression (g = 0.74; 95% CI, 0.63-0.85) compared with controls. Sex, age, pain location, and recruitment sample may moderate anxiety and depression. Considerable heterogeneity was reported for all outcomes. Studies had a low reporting bias, and outcomes were moderate to high quality. The findings of this meta-analysis suggest that 1 in 3 youth with chronic pain meet criteria for anxiety disorder, and 1 in 8 meet criteria for a depressive disorder. This represents a major clinical comorbidity. Moving forward, screening, prevention, and treatment of mental health should be important health care priorities for youth with chronic pain.

Prenatal and postpartum depression diagnosis in a large health system: prevalence and disparities

Background/objectives/introduction Depression during pregnancy or postpartum carries the same risks as general depression as well as additional risks specific to pregnancy, infant health and maternal well-being. The purpose of this study is to document the prevalence of depression symptoms and diagnosis during pregnancy and in the first 3 months postpartum among a cohort of women receiving prenatal care in a large health system. Secondarily, we examine variability in screening results and diagnosis by race, ethnicity, language, economic status and other maternal characteristics during pregnancy and postpartum. Patients/materials and methods A retrospective study with two cohorts of patients screened for depression during pregnancy and postpartum. Out of 7807 patients with at least three prenatal care visits and a delivery in 2016, 6725 were screened for depression (87%) at least once during pregnancy or postpartum. Another 259 were excluded because of missing race data. The final sample consisted of 6523 prenatal care patients who were screened for depression; 4914 were screened for depression in pregnancy, 4619 were screened postpartum (0–3 months). There were 3010 screened during both periods who are present in both the pregnancy and postpartum cohorts. Depression screening results are from the Patient Health Questionnaire (PHQ-9) and diagnosis of depression was measured using ICD codes. For patients screened more than once during either time period, the highest score is used for analysis. Results Approximately, 11% of women had a positive depression screen as indicated by an elevated PHQ-9 score (>10) during pregnancy (11.3%) or postpartum (10.7%). Prevalence of depression diagnosis was similar in the two periods: 12.6% during pregnancy and 13.0% postpartum. A diagnosis of depression during pregnancy was most prevalent among women who were age 24 and younger (19.7%), single (20.5%), publicly insured (17.8%), multiracial (24.1%) or Native American (23.8%), and among women with a history of depression in the past year (58.9%). Among women with a positive depression screen, Black women were less than half as likely as White women to receive a diagnosis in adjusted models (AOR 0.40, CI: 0.23–0.71, p = .002). This difference was not present postpartum. Conclusions Depression symptoms and diagnoses differ by maternal characteristics during pregnancy with some groups at substantially higher risk. Efforts to examine disparities in screening and diagnosis are needed to identify reasons for variability in prenatal depression diagnosis between Black and White women. Key messages Women who were young, single, have public insurance, and women who identify as multiracial or non-Hispanic (NH) Native American were most likely to have a positive depression screen or a diagnosis for depression. After adjustment for confounders, NH Black women with a positive depression screen were about half as likely to have a diagnosis of depression during pregnancy as NH White women. Awareness of the differing prevalence of depression risk screening results, diagnoses and potential for variation in diagnosis may identify opportunities to improve equity in the delivery of essential mental health care to all patients.

Gender Differences in Depression and Sex Hormones among Patients Receiving Long-Term Opioid Treatment for Chronic Noncancer Pain in Taiwan-A Multicenter Cross-Sectional Study.

Background: Long-term use of opioids for chronic noncancer pain is associated with sex hormone disturbances. The interferences with sex hormones, sexual function, and depression were investigated in patients with chronic noncancer pain. Methods: A cross-sectional multicenter survey was conducted on 170 officially registered outpatients receiving long-term opioid treatment in nine medical centers in Taiwan between October 2018 and July 2019. Serum sex hormone levels were examined after the collection of self-administered questionnaires containing the Taiwanese version of the Brief Pain Inventory, depressive status, and sexual function interference. Results: Among 117 (68.8%) questionnaire responses from 170 enrolled outpatients, 38 women and 62 men completed the sex hormone tests, among whom only 23 (23%) had previously received blood hormone tests. Low serum total testosterone levels were detected in 34 (89.5%) women (<30 ng/dL) and 31 (50%) men (<300 ng/dL). Over 60% of women and men reported reduced sexual desire and function despite a nearly 50% reduction in pain intensity and daily function interference over the previous week after opioid treatment. Women generally had higher risks of a depression diagnosis (p = 0.034) and severe depressive symptoms (p = 0.003) and nonsignificantly lower opioid treatment duration (median 81 vs. 120 months) and morphine milligram equivalent (median 134 vs. 165 mg/day) compared with men. Conclusions: This survey demonstrated the high prevalence of depression diagnosis, low sex hormone levels, and reduced sexual function among Taiwanese patients with chronic noncancer pain receiving prolonged opioid therapy. Regular hypogonadal screenings are recommended for further management.

Depression and neuroticism decrease among women but not among men between 1976 and 2016 in Swedish septuagenarians.

We evaluated birth-cohort differences in depressive symptom burden, prevalence of depression diagnoses, and neuroticism, among Swedish 70-year-olds examined between 1976 and 2016. We used a repeated cross-sectional design examining four representative population samples of Swedish 70-year-olds (total n=2279) with identical methods in 1976-77 (n=392), 1992-93 (n=226), 2000-02 (n=487), and 2014-16 (n=1166). Depressive symptom burden was rated with the Montgomery Åsberg Depression Rating Scale. Major depression was diagnosed according to DSM-5, and minor depression according to DSM-IV-TR research criteria. Neuroticism was rated with the Eysenck Personality Inventory. For women in 2014-16, MADRS score (4.4 vs. 6.1 vs. 5.8; P<0.05) and neuroticism (6.6 vs. 7.7 vs. 9.2; P<0.05) were lower compared with 1992-93 and 1976-77, and the prevalence of any depression was lower compared with 2000-02 and 1992-93 (10.9% vs. 16.9% vs. 18.1%; P<0.05). For men, we observed no birth-cohort differences in depression, while neuroticism was found to be lower in 2014-16 compared with 1976-77 among men without depression (5.1 vs. 5.9; P<0.01). The sex difference for MADRS and neuroticism declined between 1976-77 and 2014-16 (cohort*sex P<0.05). Depressive burden and neuroticism decreased in 70-year-old women between 1976 and 2016.

Act In case of Depression: The evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol

BackgroundThe aim of this study is evaluating the (cost-) effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment.Methods/DesignIn a 19-month longitudinal controlled study using a stepped wedge design, 14 somatic and 14 dementia special care units will implement the care program. All residents who give informed consent on the participating units will be included. Primary outcomes are the frequency of depression on the units and quality of life of residents on the units. The effect of the care program will be estimated using multilevel regression analysis. Secondary outcomes include accuracy of depression-detection in usual care, prevalence of depression-diagnosis in the intervention group, and response to treatment of depressed residents. An economic evaluation from a health care perspective will also be carried out.DiscussionThe care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents. The study will further provide insight in the cost-effectiveness of the care program.Trial registrationNetherlands Trial Register (NTR): NTR1477

Prevalence of depression diagnosis and prescription of antidepressants in East and West Germany: an analysis of health insurance data

This study aimed to analyse depression-related factors. The prevalence of depression has been shown in prior surveys to vary between East and West Germany. Do these differences also appear in health insurance data? The outpatient data of a large German statutory health insurance company were analysed for regional differences in (a) the prevalence of depression diagnosis, (b) prescription rates of antidepressants and (c) risk factors of being diagnosed with depression or prescribed antidepressants. Diagnosis rates of depression in outpatient care (ICD-10 diagnosis F32/33) were analysed for the first quarter of 2004, and prescription rates of antidepressants were analysed for the first half of 2004. Odds ratios were calculated for the likelihood of being diagnosed with depression and of being prescribed antidepressants whilst considering socio-demographic and regional variables. The prevalence of depression diagnosis is up to 41% lower in East Germany than the expected mean rate and 30% above the expected mean rate in Berlin. Regional distribution rates of antidepressant prescriptions largely follow the same pattern as rates for depression diagnosis, with the exception of Berlin where prescription rates are 10% below the expected mean rate. Unemployed persons in West Germany have a higher chance of being diagnosed with depression and of being prescribed antidepressants than those unemployed in East Germany. Results correspond greatly to findings of epidemiologic surveys. However, the lower rate of depression diagnosis and prescription rates in East Germany might also be due to fewer mental health professionals practising there and possible differences in reporting style of emotional symptoms. This might contribute to the differences in diagnosis and prescription prevalence but cannot be solely responsible for this phenomenon. Probable causes of the different depression prevalence rates in East and West Germany will be discussed in this analysis. More research into factors impacting on regional differences in the prevalence of depression is needed.

Prevalence of Depression Diagnoses and Use of Antidepressant Medications by Veterans with Spinal Cord Injury

The objectives of this study were to examine the prevalence of depression diagnoses among veterans with spinal cord injuries and disabilities (SCI&D) for a 3-yr period, and to characterize patterns of antidepressant medication use in this population. This study was a retrospective analysis of clinical and administrative data. The sample consisted of 3678 veterans with SCI&D who had received any health care at a Department of Veterans Affairs facility between fiscal years 1999 and 2001, a depression diagnosis, and complete data. Logistic regression analysis was used to examine associations between patient characteristics, antidepressant types, and prescription patterns. Approximately 22% of veterans with SCI&D received a diagnosis of depression during at least one encounter with a healthcare provider. Of those diagnosed, 72% received antidepressant prescriptions. However, a large percentage (67%) did not continue antidepressant use for 6 mos. Patients started on a selective serotonin reuptake inhibitor were more likely to have at least 6 mos of continuous use than patients started on other, newer antidepressants. Many veterans with SCI&D may not be receiving adequate treatment for depression. Veterans with SCI&D should be aggressively screened and treated for depression, and further research is necessary to determine which treatments for depression are most effective for persons with SCI&D.

Who is diagnosed as suffering from depression in the German statutory health care system? An analysis of health insurance data

Depressive disease is becoming increasingly relevant in industrialised countries. For public health policy and planning it is important to know about the epidemiology of this disease as well as the extent to which this epidemiology impacts on health service provision. Analysis of data from a major German statutory health insurance company: Longitudinal micro-level claims data containing information about diagnoses obtained from inpatient and outpatient sources as well as information collected from prescriptions issued for antidepressants. Data was analysed with regard to the differences in drug utilisation and the risk of being diagnosed with depression according to age, sex, marital status and area of residence. Results correspond significantly with the findings of population surveys on depression epidemiology. They also confirm the finding of a lower prevalence of depression in East Germany compared to West Germany. However, the claims data revealed an unexpectedly high prevalence of depression diagnosis in older age groups. Statutory health insurance data seems to be a reliable source of epidemiological information that is both easily accessible and longitudinally available, and thus provides important information that is needed for health policy and service planning. With regard to service provision it should be considered that depression in old age is a greater problem than is suggested by most epidemiological surveys.

Gender Differences in Dependence Symptoms and Psychiatric Severity in Adolescents with Substance Use Disorders

ABSTRACT One hundred adolescent inpatients (42% female) seeking treatment for a substance use disorder (SUD) were compared by gender on several substance use and psychiatric variables. Adolescents were assessed with the Comprehensive Addiction Severity Index (C-ASI) and other standardized assessment instruments. Results showed that females were more likely than males to endorse dependence symptoms and report experiencing dependence symptoms at a younger age. Females also progressed faster to regular use of drugs than males. Females were more likely than males to begin substance use with cigarettes, whereas males typically began substance use with alcohol. Suicidality was more common in females, but groups did not differ on the prevalence of depression diagnoses or on previous psychiatric treatment history. Future studies are needed to investigate possible physiologic/psychologic bases of the greater susceptibility for females to report substance dependence symptoms.