Prevalence Of Depression In People Research Articles

Depression in diabetes mellitus-A comprehensive systematic review of literature from an Indian perspective.

Systematic review of the epidemiological data, risk factors and relationship between depression and glycaemic control among the Indian studies. We searched Pubmed, Pubmed Central, Google Scholar and Directory of Open Access Journal (DOAJ) databases to identify relevant Indian studies. Substantial variation in the prevalence of depression in people with diabetes was found across the 41 selected studies; according to this review the range is 2% to 84% (T1DM - 2-7%; T2DM - 8%-84%). Correlates of depression in diabetic patients are advancing age, female gender, low literacy rate, burden of being from a lower socioeconomic status, rural domicile, marriage and duration of diabetes of >2years, diabetes related complications and poor glycaemic control. Sedentary life without adequate physical activities, lack of self-care are often the factors that precipitates depression in a T2DM patient and vice versa. According to this review, among Indian population there is a significant association between depression and diabetes.

Prevalence and independent risk factors of depression in Chinese patients with type 2 diabetes: a systematic review and meta-analysis

BackgroundStudies of the prevalence of depression in patients with type 2 diabetes in China have reported inconsistent findings. The purpose of this study was to assess the prevalence and independent risk factors of depression in patients with type 2 diabetes in China. MethodsWe did a systematic review and meta-analysis of papers published in PubMed (1980–2016), Embase (1980–2016), China National Knowledge Infrastructure (1999–2016), and Wanfang Medical database (1998–2016). We selected population-based, cross-sectional studies investigating the prevalence of depression in patients with type 2 diabetes in China. We used a random-effects meta-analysis to pool the prevalence and relative risks (RR) with 95% CIs. This study was registered at PROSPERO, number CRD42016039795. Findings26 studies published between May, 2003, and February, 2016, were included. The studies included 66 475 patients with type 2 diabetes in China. A meta-analysis of six studies comparing the depression prevalence in diabetes patients and healthy controls suggested that type 2 diabetes was associated with a doubled risk of depression in Chinese people (RR 2·06; 95% CI 1·46–2·92; p<0·0001). The overall prevalence of depression in people with type 2 diabetes in China was 28·9% (95% CI 20·5–39·1; 66 475 participants from 26 studies). There was heterogeneity in the prevalence of depression and meta-regression analysis suggested the heterogeneity was mainly attributable to differences in the methods used to assess depression. Meta-analysis of data by gender suggested that the prevalence of depression in men was 23·0% (95% CI 12·2–39·1; 24 390 participants from 11 studies), while the prevalence rate of depression in women was 27·8% (95% CI 17·1–41·9; 37 416 participants from 12 studies). Meta-analysis of data for risk factors of depression found several independent risk factors of depression in patients with type 2 diabetes: female sex (RR 1·53, 95% CI 1·16–2·02; p=0·0025), comorbidities (RR=3·57, 95% CI 2·08–6·13; p<0·0001), diabetic complications (RR 2·11, 95% CI 1·32–3·39; p=0·002), per 1 year increment in diabetes duration (RR 1·10, 95% CI 1·03–1·17; p=0·0049), high concentrations of HbA1c (RR 1·44, 95% CI 1·11–1·88; p=0·0068), and use of insulin (RR 2·08, 95% CI 1·28–3·37; p=0·0030). InterpretationWe found a high prevalence of depression in Chinese patients with type 2 diabetes. Patients with diabetes and depression should receive more attention than at present in the medical settings of China and effective interventions to decrease depression risk in patients with diabetes are needed. FundingNational Natural Science Foundation of China (number 81471004).

The assessment of depression in people with multiple sclerosis: a systematic review of psychometric validation studies.

BackgroundThe prevalence of depression in people with multiple sclerosis (PwMS) is high; however, symptoms common to both conditions makes measurement difficult. There is no high quality overview of validation studies to guide the choice of depression inventory for this population.MethodsA systematic review of studies validating the use of generic depression inventories in people with MS was conducted using MEDLINE and PsycINFO. Studies validating the use of depression inventories in PwMS and published in English were included; validation studies of tests for cognitive function and general mental health were excluded. Eligible studies were then quality assessed using the COSMIN checklist and findings synthesised narratively by instrument and validity domain.ResultsTwenty-one studies (N = 5,991 PwMS) evaluating 12 instruments were included in the review. Risk of bias varied greatly between instrument and validity domain.ConclusionsThe review of validation studies was constrained by poor quality reporting and outcome reporting bias. Well-conducted evaluations of some instruments are unavailable for some validity domains. This systematic review provides an evidence base for trade-offs in the selection of an instrument for assessing self-reported symptoms of depression in research or clinical practice involving people with MS. We make detailed and specific recommendations for where further research is needed.Trial RegistrationPROSPERO CRD42014010597

Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012.

BackgroundDepression in people with diabetes can result in increased risk for diabetes-related complications. The prevalence of depression has been estimated to be 17.6 % in people with type 2 diabetes mellitus (T2DM), based on studies published between 1980 and 2005. There is a lack of more recent estimates of depression prevalence among the US general T2DM population.MethodsThe present study used the US National Health and Nutrition Examination Survey (NHANES) 2005–2012 data to provide an updated, population-based estimate for the prevalence of depression in people with T2DM. NHANES is a cross-sectional survey of a nationally representative sample of the civilian, non-institutionalized US population. Starting from 2005, the Patient Health Questionnaire (PHQ-9) was included to measure signs and symptoms of depression. We defined PHQ-9 total scores ≥ 10 as clinically relevant depression (CRD), and ≥ 15 as clinically significant depression (CSD). Self-reported current antidepressant use was also combined to estimate overall burden of depression. Predictors of CRD and CSD were investigated using survey logistic regression models.ResultsA total of 2182 participants with T2DM were identified. The overall prevalence of CRD and CSD among people with T2DM is 10.6 % (95 % confidence interval (CI) 8.9–12.2 %), and 4.2 % (95 % CI 3.4–5.1 %), respectively. The combined burden of depressive symptoms and antidepressants may be as high as 25.4 % (95 % CI 23.0–27.9 %). Significant predictors of CRD include age (younger than 65), sex (women), income (lower than 130 % of poverty level), education (below college), smoking (current or former smoker), body mass index (≥30 kg/m2), sleep problems, hospitalization in the past year, and total cholesterol (≥200 mg/dl). Significant predictors of CSD also include physical activity (below guideline) and cardiovascular diseases.ConclusionsThe prevalence of CRD and CSD among people with T2DM in the US may be lower than in earlier studies, however, the burden of depression remains high. Further research with longitudinal follow-up for depression in people with T2DM is needed to understand real world effectiveness of depression management.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0800-2) contains supplementary material, which is available to authorized users.

Obstructive Sleep Apnea and Depression: A Review

Obstructive sleep apnea (OSA) is a common sleep disorder associated with several medical conditions, increased rates of motor vehicle accidents, and higher overall health care expenditure. There is a higher prevalence of depression in people with sleep-disordered breathing in clinical and community samples. Depression and OSA share many symptoms, which may explain the underdiagnosis of OSA in depressed patients. OSA may be responsible for treatment resistance in depression. The relationship between depression and OSA is complex and remains unclear; however, several pathophysiologic mechanisms could be involved. Increased understanding of the relationship between these two disorders will likely improve clinical outcomes. [ Psychiatr Ann . 2016;46(3):187–191.]

Differences in depression between unknown diabetes and known diabetes: results from China health and retirement longitudinal study.

Both diabetes and depression have become serious public health problems and are major contributors to the global burden of disease. People with diabetes have been shown to have higher risk of depression. The purpose of this study was to observe the differences in depression between older Chinese adults with known or unknown diabetes. Data came from the national baseline survey of China Health and Retirement Longitudinal Study (CHARLS). The Center for Epidemiologic Studies Depression Scale was used to assess depression. Participants with a history of diabetes diagnosis were considered to have known diabetes, and those with newly-diagnosed diabetes were considered to have unknown diabetes. Multiple logistic regression analysis was applied to estimate odds ratio (OR) for depression in predictor variables. Overall, 39.1% of the 2,399 participants with diabetes suffered from depression. The prevalence of depression was significantly higher (p < 0.001) in people with known diabetes (43.5%) than those with unknown diabetes (35.1%). The biggest differences between the two groups were found in the middle aged, in women, in the less educated and in married people. In known diabetes, people treated with traditional Chinese medicine (TCM) coupled with oral western medicine (WM) and/or insulin had two-fold odds of depression compared to those without treatment. The knowledge of having diabetes, treatments and suffering from other chronic diseases were associated with the higher prevalence of depression in people with known diabetes compared to those with unknown diabetes. Prevention of depression in diabetics should receive more attention in the middle aged, women and the less education.

A study of sertraline in dialysis (ASSertID): a protocol for a pilot randomised controlled trial of drug treatment for depression in patients undergoing haemodialysis.

BackgroundThe prevalence of depression in people receiving haemodialysis is high with estimates varying between 20 and 40 %. There is little research on the effectiveness of antidepressants in dialysis patients with the few clinical trials suffering significant methodological issues. We plan to carry out a study to evaluate the feasibility of conducting a randomised controlled trial in patients on haemodialysis who have diagnosed Major Depressive Disorder.Methods/DesignThe study has two phases, a screening phase and the randomised controlled trial. Patients will be screened initially with the Beck Depression Inventory to estimate the number of patients who score 16 or above. These patients will be invited to an interview with a psychiatrist who will invite those with a diagnosis of Major Depressive Disorder to take part in the trial. Consenting patients will be randomised to either Sertraline or placebo. Patients will be followed-up for 6 months.Demographic and clinical data will be collected at screening interview, baseline interview and 2 weeks, and every month (up to 6 months) after baseline. The primary outcome is to evaluate the feasibility of conducting a randomised, double blind, placebo pilot trial in haemodialysis patients with depression. Secondary outcomes include estimation of the variability in the outcome measures for the treatment and placebo arms, which will allow for a future adequately powered definitive trial. Analysis will primarily be descriptive, including the number of patients eligible for the trial, drug exposure of Sertraline in haemodialysis patients and the patient experience of participating in this trial.DiscussionThere is an urgent need for this research in the dialysis population because of the dearth of good quality and adequately powered studies. Research with renal patients is particularly difficult as they often have complex medical needs. This research will therefore not only assess the outcome of anti-depressants in haemodialysis patients with depression but also the process of running a randomised controlled trial in this population. Hence, the outputs of this feasibility study will be used to inform the design and methodology of a definitive study, adequately powered to determine the efficacy of anti-depressants in patient on haemodialysis with depression.Trial registrationISRCTN registry ISRCTN06146268 and EudraCT reference: 2012-000547-27.

Discrepancies between physician's perception of depression in HIV patients and self-reported CES-D-20 assessment: the DHIVA study

ABSTRACTDepression in HIV/AIDS patients affects adherence and disease progression and often goes unnoticed. DHIVA is a cross-sectional epidemiologic survey, investigating the prevalence of depression in people living with HIV through use of a validated self-administered scale (CES-D-20), as well and the degree of concordance between the physician's perception and patients' reports. A total of 690 HIV-infected patients attending 24 centers across Italy were enrolled. Concordance was calculated by K statistics. Association between depression and subject characteristics were evaluated through univariate and multivariate logistic models (OR and 95%CI). The prevalence of depressive symptoms was 48.8% from patient's questionnaires and 49.5% from physicians' reports, with a low/fair concordance (K = .38, p < .001). CES-D-20 found severe depression in 22.5% of the patients vs 4% identified by physicians. 135/155 (87%) of the severely depressed patients (according to CES-D-20) were considered as non or mildly/moderately depressed by physicians. Risk of severe depression was associated with unemployment (p < .001), previous depression (p < .001), treatment failure (p = .001), and former smoking status (p = .018). Depression is frequent in HIV-infected patients in the HAART era, with significant discrepancy between physician perception and the self-reported CES-D-20 results. Screening should be mandatory in all HIV patients.

P18.11 Examining the effect of case management on levels of depression among newly diagnosed people living with hiv in taiwan

Introduction Over half of Taiwan’s HIV patients have been enrolled in case management. One of goals of HIV case management is to provide physical and mental consultations for the clients’ need. The prevalence of depression in people living with HIV (PLWHA) is higher than that in the general public and possibly leads to worse HIV related outcomes. The aims of this study were to evaluate the efficacy of PLWHA in case management services so as to improve any depression and/or related symptoms. Methods With various levels of depression, as according to the Centre for Epidemiological Studies - Depression (CES-D) scale, 88 HIV newly diagnosed subjects were enrolled in the study. After 6-month intervention of case management, their depression status were re-evaluated and compared. Results No significant differences for depression status were found 6 months after the intervention of case management among study subjects (p = 0.345). However, the results of linear regression analysis indicated that those who had family support (beta = 0.303, p = 0 .012) and lower HIV viral load (beta = -0.265, p = 0 .041) would have better improvement for depression. Conclusion Our findings indicate case management offers no apparent help lowering depression among PLWHA. However, HIV case managers should remind and assist physicians to paying more attention to PLWHA with lower family support or higher HIV viral load to avoid depression symptoms happened. Disclosure of interest statement The Australasian Society for HIV Medicine recognises the considerable contribution that industry partners make to professional and research activities. We also recognise the need for transparency of disclosure of potential conflicts of interest by acknowledging these relationships in publications and presentations. Nothing to declare.

Prevalence of Depression in People Living with HIV/AIDS Undergoing ART and Factors Associated with it.

HIV/AIDS is one of the most devastating illnesses that humans have ever faced. Depression in HIV/AIDS patients is very common but the factors affecting it are not well studied. HIV/AIDS though such a big public health problem worldwide, not enough data is available regarding association of HIV and Depression. Therefore this study was undertaken to evaluate the association between HIV/AIDS and depression in an Indian setting. The study was conducted in Guru Teg Bahadur Hospital and University College of Medical Sciences, Delhi. One hundred sixty patients were interviewed using a questionnaire containing factors that affect depression. CES-D (Center for Epidemiologic Studies - Depression) scale was used to measure depression. The data collected was analyzed using SPSS software. The prevalence of depression in patients with HIV under ART was 58.75%. The prevalence of depression increased with the severity of symptoms. The unemployed, uneducated, unmarried, belonging to joint families, having no or low family income, migrants, having indifferent or poor relationship with spouse, poor social support and had visited commercial sex workers had a greater prevalence of depression. The rate of depression in patients with HIV/AIDS is very high. Detecting depression early and treating it goes a long way in improving the compliance to treatment as well as quality of life.

Response Letter to Savikko et al

We are pleased that Savikko et al. have studied the association between chewing ability and dementia in elderly persons living in long-term care (LTC). Although their findings do not agree with ours, their study adds to the existing literature concerning the complex association between oral health and cognition. As Savikko et al. point out, differences in the studied populations and their stages of cognitive decline may contribute to the differing results. Savikko et al. studied a LTC population, whereas our study was representative of the national population aged 77 and older (including people in LTC). The indicators used for cognition, chewing ability, and depression, for example, differ. Therefore, the prevalence rates for dependent and independent variables differed in the two studies. The Finnish study used a diagnosis of dementia confirmed by medical records, whereas the Swedish study used an indicator of cognitive impairment. In the Finnish LTC sample, 73.2% had dementia; in the Swedish population, 20.1% showed signs of cognitive impairment. The Finnish sample was older than the Swedish sample; there were also more women, more people who had had strokes, and more people with more than 8 years of education in the Finnish sample. The prevalence of chewing difficulty among the LTC residents was 28.9%, whereas it was only 20.8% in our national sample. The associations between some of the variables also differed in the two studies. The Finnish study reported a higher prevalence of depression in people without dementia (24.9%) than in those with dementia (18.1%). The relationship in the Swedish study was inverse; in people without cognitive impairment, 12.5% showed signs of depression, compared with 28.7% of persons with cognitive impairment (calculated from Table 1 in the article). In both studies, the association was significant. Because depression is an important confounding factor,1, 2 this may have contributed to the contradictory results. Education, another important confounding factor, also differed in the two populations. There was no significant association between education and dementia in the LTC sample, whereas in our study, more education was significantly protective for cognition. These different prevalence rates and associations reflect the complexity of the association between oral health and cognition, as Savikko et al. noted. Studies in different populations—at different ages and different levels of disability—can add to a better understanding of this association. Studies that follow people over time will provide even more insight. Ultimately, these epidemiological findings must be combined with clinical and animal experimental studies to understand mechanisms and causality. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Authors Contributions: Duangjai Lexomboon: literature review, writing drafts, and finalizing of the manuscript. Mats Trulsson, Inger Wårdh: comments on the manuscript. Marti G. Parker: comments and finalizing of the manuscript. Sponsor's Role: No role in any part of the original study or this letter.

Patients' perceptions of depression and coronary heart disease: a qualitative UPBEAT-UK study.

BackgroundThe prevalence of depression in people with coronary heart disease (CHD) is high but little is known about patients’ own perceptions and experiences of this. This study aimed to explore (i) primary care (PC) patients’ perceptions of links between their physical condition and mental health, (ii) their experiences of living with depression and CHD and (iii) their own self-help strategies and attitudes to current PC interventions for depression.MethodQualitative study using consecutive sampling, in-depth interviews and thematic analysis using a process of constant comparison. 30 participants from the UPBEAT-UK cohort study, with CHD and symptoms of depression. All participants were registered on the General Practitioner (GP) primary care, coronary register.ResultsA personal and social story of loss underpinned participants’ accounts of their lives, both before and after their experience of having CHD. This theme included two interrelated domains: interpersonal loss and loss centred upon health/control issues. Strong links were made between CHD and depression by men who felt emasculated by CHD. Weaker links were made by participants who had experienced distressing life events such as divorce and bereavement or were living with additional chronic health conditions (i.e. multimorbidity). Participants also felt ‘depressed’ by the ‘medicalisation’ of their lives, loneliness and the experience of ageing and ill health. Just under half the sample had consulted their GP about their low mood and participants were somewhat ambivalent about accessing primary care interventions for depression believing the GP would not be able to help them with complex health and social issues. Talking therapies and interventions providing the opportunity for social interaction, support and exercise, such as Cardiac Rehabilitation, were thought to be helpful whereas anti-depressants were not favoured.ConclusionsThe experiences and needs of patients with CHD and depression are diverse and include psycho-social issues involving interpersonal and health/control losses. In view of the varying social and health needs of patients with CHD and depression the adoption of a holistic, case management approach to care is recommended together with personalised support providing the opportunity for patients to develop and achieve life and health goals, where appropriate.

Assessment of depression in people with diabetes attending outpatient clinics for the treatment of foot ulceration

Background: People with diabetes and foot ulceration experience more depressed mood particularly when healing does not occur after prolonged treatment. Those who have depression and diabetes have poorer adherence to selfcare or treatment regimes, poor glycaemic control along with a greater risk of diabetes related complications and mortality. Screening for depression has been shown to be effective to determining the severity of depression as well as the type of treatment required. Methods: The study required participants to complete a validated self-reporting 9 item Patient Health Questionnaire (PHQ) that provides a diagnosis of major depressive syndrome and continuous severity score. Participants were classified in the depressed category if they had PHQ score ≥5. Group differences were examined using chisquare for categorical variables and t-tests for continuous variables. Results: A higher proportion of participants had diabetes for >10 years, however no other demographic variables were associated with depression. Of the 60 participants, 31 (51.7%) were categorised as depressed, with 10 (17%) having had a prior diagnosis of depression and 21 (35%) participants had unrecognised cases of depression. Conclusion: This study demonstrated the prevalence of depression in people with diabetes and the often hidden impact it has in managing diabetes foot ulceration.

Epidemiology of depression in diabetes: International and cross-cultural issues

This paper reviews the most up-to-date epidemiological evidence of the relationship between depression and diabetes, and considers the risk factors for the development of depression and the consequences of depression in diabetes with an emphasis on international and cross-cultural data. The difficulties that researchers face when epidemiological studies require assessment of psychological phenomena, such as depression, across different cultural settings are explored. Relevant papers were sought on the epidemiology of diabetes and depression in people with diabetes by undertaking a literature search of electronic databases including MEDLINE, Psych-INFO, CINAHL and EMBASE. These papers were assessed by the authors and a narrative review of the relevant literature was composed. Systematic reviews of the prevalence of depression in people with diabetes have focused on studies conducted in English speaking countries and emerging data suggest that there may be international variations in prevalence and also in how symptoms of depression are reported. There appears to be a bi-directional relationship between depression and diabetes, with one influencing the other; however, research in this area is further complicated by the fact that potential risk factors for depression in people with diabetes often interact with each other and with other factors. Further research is needed to elucidate the causal mechanisms underlying these associations. Data from non-English speaking countries remain scarce and so it is difficult to come to any firm conclusions as to the international variation in prevalence rates of co-morbid diabetes and depression in these countries until further research has been conducted. It is important to take a culture-centered approach to our understanding of mental health and illness and consider the key issues related to the development of culturally sensitive depression screening tools. In order to come to any firm conclusions about the international variation in prevalence of co-morbid diabetes and depression, issues of culture and diversity must be taken into account prior to conducting international epidemiological studies.

Prevalence of co-morbid depression in out-patients with type 2 diabetes mellitus in Bangladesh

BackgroundLittle is known about the prevalence of depression in people with diabetes in Bangladesh. This study examined the prevalence and factors associated with depression in out-patients with Type 2 diabetes in Bangladesh.MethodsIn this cross-sectional study a random sample of 483 diabetes out-patients from three diabetes clinics in Bangladesh was invited to participate. Of them 417 patients took part. Depressive symptoms were measured using previously developed and culturally standardized Bengali and Sylheti versions of the World HealthOrganization-5 Well Being Index (WHO-5) and the Patient Health Questionairre-9 (PHQ-9) with predefined cut-off scores. Data was collected using two different modes; e.g. standard assisted collection and audio questionnaire methods. Associations between depression and patient characteristics were explored using regression analysis.ResultsThe prevalence of depressive symptoms was 34% (PHQ-9 score ≥ 5) and 36% (WHO-5 score < 52) with audio questionnaire delivery method. The prevalence rates were similar regardless of the type (PHQ-9 vs. WHO-5) and language (Sylheti vs. Bengali) of the questionnaires, and methods of delivery (standard assisted vs. audio methods). The significant predictors of depressive symptoms using either the PHQ-9 or WHO-5 questionnaires were; age, income, gender, treatment intensity, and co-morbid cardiovascular disease. Further, depression was strongly associated with poor glycaemic control and number of co-morbid conditions.ConclusionsThis study demonstrated that depression prevalence is common in out-patients with type 2 diabetes in Bangladesh. In a setting where recognition, screening and treatment levels remain low, health care providers need to focus their efforts on diagnosing, referring and effectively treating this important disease in order to improve service delivery.

Depression and chronic physical illness: its prevalence and diagnosis, and implications for therapeutic practice

Background: This article explores the prevalence of depression comorbid with physical illness, issues in recognition of depression, and the implications for health professionals’ practice. The authors are British physiotherapists, but the issues raised will be relevant to other clinicians in other countries too. Content: Prevalence of depression in the UK and worldwide is examined and the implications for this on health policy are considered. Prevalence rates for depression in people with chronic physical illnesses are explored, and some of the possible reasons for the wide range in these figures are discussed, including difficulties that arise in the recognition and diagnosis of depression in this group. Implications for therapeutic practice are considered including some suggestions for practice. Conclusion: The prevalence of depression in people with chronic physical conditions is high, so clinicians working in diverse settings will be involved in the management of people with this condition. It is vital therefore that health professionals are alert to the possible presence and impact of depression, so that appropriate monitoring, management, and referral can be undertaken.

The Depression in Visual Impairment Trial (DEPVIT): trial design and protocol

BackgroundThe prevalence of depression in people with a visual disability is high but screening for depression and referral for treatment is not yet an integral part of visual rehabilitation service provision. One reason for this may be that there is no good evidence about the effectiveness of treatments in this patient group. This study is the first to evaluate the effect of depression treatments on people with a visual impairment and co morbid depression.Methods /designThe study is an exploratory, multicentre, individually randomised waiting list controlled trial. Participants will be randomised to receive Problem Solving Therapy (PST), a ‘referral to the GP’ requesting treatment according to the NICE’s ‘stepped care’ recommendations or the waiting list arm of the trial. The primary outcome measure is change (from randomisation) in depressive symptoms as measured by the Beck’s Depression Inventory (BDI-II) at 6 months. Secondary outcomes include change in depressive symptoms at 3 months, change in visual function as measured with the near vision subscale of the VFQ-48 and 7 item NEI-VFQ at 3 and 6 months, change in generic health related quality of life (EQ5D), the costs associated with PST, estimates of incremental cost effectiveness, and recruitment rate estimation.DiscussionDepression is prevalent in people with disabling visual impairment. This exploratory study will establish depression screening and referral for treatment in visual rehabilitation clinics in the UK. It will be the first to explore the efficacy of PST and the effectiveness of NICE’s ‘stepped care’ approach to the treatment of depression in people with a visual impairment.Trial registrationISRCTN46824140

Antidepressants for the treatment of depression in neurological disorders: a systematic review and meta-analysis of randomised controlled trials

BackgroundDespite the high prevalence of depression in people with neurological disorders, no previous study has sought to summarise existing evidence on the use of antidepressants in this population. A systematic...

B‐vitamins reduce the long‐term risk of depression after stroke: The VITATOPS‐DEP trial

The consumption of certain B-vitamins through diet or supplementation decreases the total plasma concentration of homocysteine (tHcy) and may enhance response to standard antidepressant treatment. It is unclear if treatment with B-vitamins can reduce the long-term prevalence of depression in people at risk, such as stroke survivors. The purpose of this research was to determine if treatment with B-vitamins reduces the hazard of poststroke depression compared with placebo. Randomized, double-blind, placebo-controlled trial of tHcy-lowering treatment with daily folic acid (2 mg), vitamin B6 (25 mg), and vitamin B12 (0.5 mg) for 1 to 10.5 years in survivors of stroke. The primary endpoint was the onset of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) major depression after randomization. Secondary outcomes were the prevalence of DSM-IV major or minor depression at the end of treatment. Other measured factors included age, gender, poststroke handicap associated with stroke, recurrence of strokes, cognitive impairment, and use of antidepressants. Among 273 people who completed the final assessment after 7.1 ± 2.1 years (mean ± standard deviation) of follow up, random assignment to B-vitamins was associated with a lower hazard of major depression compared with placebo (18.4% vs 23.3%, adjusted hazard ratio [HR] = 0.48; 95% confidence interval [CI] = 0.31-0.76) and a trend toward a lower odds of major or minor depression at the end of the trial compared with placebo (19.1% vs 27.7%; adjusted odds ratio [OR] = 0.58; 95%CI = 0.31-1.09). Long-term treatment of poststroke survivors with folic acid, B6, and B12 was associated with a reduction in the hazard of major depression in our patient population. If these findings can be validated externally, B-vitamin supplementation offers hope as an effective, safe, and affordable intervention to reduce the burden of poststroke depression.

Prevalence of diagnosed depression in South Asian and white European people with type 1 and type 2 diabetes mellitus in a UK secondary care population

Aim:To examine the prevalence and correlates of diagnosed depression among South Asians and white Europeans with type 1 and type 2 diabetes mellitus, attending a specialist diabetes clinic in the...