Prevalence Of Severe Depression Research Articles

Prevalence and Factors Associated with Severe Depression Among Caregivers of Children with Sickle Cell Disease in Northern Uganda

Depression is a mental disorder characterized by low mood and affects more than 300 million people globally. Caregivers of children with Sickle cell disease (SCD) experience psychosocial distress which predisposes them to depression. This study aimed to determine the prevalence of and factors associated with severe depression among caregivers of children with SCD attending a large hospital in post conflict northern Uganda. A cross sectional study was conducted at the SCD clinic of St. Mary’s Hospital Lacor (SMHL). Caregivers of children aged between 0 to 17 years with SCD were interviewed using Patient Health Questionnaire-9 and socio-demographics questionnaire developed by the researchers. Bivariable analysis using chi square test and multivariable logistic regression were conducted to assess associated factors. 310 participants were recruited consecutively of whom 90% were female and 10% male with mean age of 32.7 years. The prevalence of severe depression among caregivers of children with SCD at SMHL was 18.4% and was associated with increasing age of caregiver (adjusted odds ratio (aO.R =1.06, C.I = 1.02-1.10). Having more than one child (aO.R= 0.321, C.I = 0.107-0.967), and extended family type (aOR= 0.284, CI= 0.114-0.537) were protective against depression. The study findings indicate that a substantial proportion of caregivers of children with SCD suffer from severe depression which is mostly undiagnosed and hence untreated. Therefore, policymakers need to focus on designing strategies aimed at controlling and managing depression among caregivers of children with SCD such as routine screening.

Assessment of mental health and food service satisfaction of the elderly in old-age homes in and around Vadodara

ABSTRACT Background: Aging causes changes in the sensory and dental problems of an individual. For the elderly, eating is not only an important activity for the maintenance of life but also a great pleasure, and therefore, the desire to eat their favorite food becomes a source of motivation to get out of bed and improve their quality of life. Materials and Methods: The current study was framed to examine the mental health and food service satisfaction (FSS) of residents under three domains (diet, food service, and food safety) staying in old-age homes (OAHs) in and around Vadodara. A purposive sampling design was used where consent was obtained from nine OAHs in and around Vadodara and the elderly (n = 123). Assessment of mental health was made using standard tools such as the Geriatric Depression Scale (GDS), mini-mental state examination (MMSE), and six-item cognitive impairment test (6CIT), whereas the FSS of residents was assessed by a validated semi-structured questionnaire. Results: The elderly enrolled in charitable and private institutes were 54% and 46%, respectively. The mean age of participants was 75.07 ± 9.22 years, GDS was 4.13 ± 4.67, MMSE was 23.24 ± 6.37, 6CIT was 8.02 ± 8.20, and FSS of residents was 25.89 ± 5.32, respectively. The prevalence of severe depression (100%) and poor FSS (66.7%) was found more in females than male elderly. 6CIT and FSS of residents showed a significant association (P < 0.05) with the type (private or charitable) of OAHs, showing the prevalence of impaired cognition and poor FSS higher among the charitable OAHs elderly than private homes. FSS of residents was highly significantly correlated (P < 0.05) with GDS, MMSE, and 6CIT of the elderly. Severely depressed elderly showed a significant association (P < 0.05) with severe cognitive impairment and poor FSS. Dependency in the elderly showed a significant association (P < 0.05) with severe cognitive impairment. Poor FSS of residents was significantly associated (P < 0.05) with charitable homes. Conclusion: FSS is affected by the poor mental health of the elderly. Thus, administrative staff of OAHs are suggested to assist with better diet, food service, and food safety for supporting the health and well-being of the elderly.

Bio-Psycho-Social Profile of People with Substance Use Disorders Treated in Locally Assigned Treatment Facilities in Kandahar, Afghanistan.

Substance use and its associated bio-psycho-social problems are public health concerns with harmful individual and social consequences. This study assessed the bio-psycho-social profile of people with substance use disorders (SUD) treated at locally assigned treatment facilities in Kandahar, Afghanistan. We conducted this facility-based cross-sectional study among 621 substance users receiving care at three locally assigned treatment facilities in November-December 2022. We performed multiple linear regression to determine factors associated with psychological symptoms. The mean age of the participants was 34.41 (± 10.10 SD) years. The majority of our subjects (81.2%) perceived their physical health as very good or fair. More than two-thirds (73.4%) rated their social support as high. Of all participants, 541 (87.1%) had symptoms of depression, 569 (91.6%) of anxiety, and 442 (71.2%) of stress. The prevalence of severe depression, anxiety, and stress was 34.8%, 65.8%, and 27.3%, respectively. The multiple linear regression showed that several attributes of people with substance use disorders [ie, having a low level of education (β=0.12, p=<0.001), being unemployed (β=0.31, p=<0.001), having a low level of social support (β=-0.35, p=<0.001), had a pre-existing medical condition (β=-0.28, p=<0.001), and having lived abroad in the past ten years (β=0.10, p=0.001)] were significantly associated with higher DASS-21 total scores. This study highlights the importance of providing bio-psycho-social support programs and implementing therapeutic interventions to help people with substance use disorders, particularly those who are most susceptible to higher levels of bio-psycho-social problems.

Comparison of the Performance of Machine Learning-based Algorithms for Predicting Depression and Anxiety among University Students in Bangladesh

Introduction: The purpose of this research was to predict mental illness among university students using various machine learning (ML) algorithms. Methods: A structured questionnaire-based online survey was conducted on 2121 university students (private and public) living in Bangladesh. After obtaining informed consent, the participants completed a web-based survey examining sociodemographic variables and behavioral tests (including the Patient Health Questionnaire (PHQ-9) scale and the Generalized Anxiety Disorder Assessment-7 scale). This study applied six well-known ML algorithms, namely logistic regression, random forest (RF), support vector machine (SVM), linear discriminate analysis, K-nearest neighbors, Naïve Bayes, and which were used to predict mental illness among university students from Dhaka city in Bangladesh. Results: Of the 2121 eligible respondents, 45% were male and 55% were female, and approximately 76.9% were 21–25 years old. The prevalence of severe depression and severe anxiety was higher for women than for men. Based on various performance parameters, the results of the accuracy assessment showed that RF outperformed other models for the prediction of depression (89% accuracy), while SVM provided the best result than other models for the prediction of anxiety (91.49% accuracy). Conclusion: Based on these findings, we recommend that the RF algorithm and the SVM algorithm were more moderate than any other ML algorithm used in this study to predict the mental health status of university students in Bangladesh (depression and anxiety, respectively). Finally, this study proposes to apply RF and SVM classification when the prediction of mental illness status is the core interest.

Impact of resilience on college student mental health during COVID-19

Objective The aim of this study was to investigate how the COVID-19 pandemic impacted college student mental health and alcohol use and to determine how resilience could alleviate negative outcomes. Participants Students attending an Appalachian university during spring 2020 were surveyed shortly after on-campus activities stopped. Methods Survey items included resilience, demographics, self-rated health, and depression symptoms, anxiety symptoms, and alcohol use before and since COVID-19. Results There was a significant increase in prevalence of severe depression, severe anxiety, and high stress, and a significant decrease in prevalence high risk for problem drinking before and since COVID-19. Four separate standard least squares regression models were conducted with each of the dependent variables. Self-rated health was the strongest predictor for changes in depression, anxiety, and stress in each of the models, displaying a negative relationship. Conclusions Universities should prepare students using resilience training and provide employment and other resources to mitigate effects of stressful situations.

Association of polymorphic marker Val158Met of COMT gene with depression in an open population 25–44 years old (WHO international program MONICA, epidemiological study)

Objective : to investigate the association of the polymorphic marker Val158Met in the catechol-O-methyl transferase (COMT) gene with depression in an open population aged 25–44 years. Patients and methods . A representative sample of the population living in Oktjabr'skij district of Novosibirsk aged 25– 44 years (427 men, median age – 34±0.4 years, response rate – 71%; 548 women, median age 35±0.4 years, response rate – 72%) was screened in 2013–2016 (budget framework № 0324- 2018-0001, Reg. № AAAA-A17-117112850280-2). In addition to the standard epidemiological examination, screening participants underwent psychological testing, which determined the level of depression. Study participants who underwent COMT Val158Met (rs4680) polymorphism genotyping were randomly assigned to a cohort of 224 men and 217 women. Pearson's χ2 test was used to test the statistical significance of differences between these groups; p≤0.05 was considered statistically significant in all types of analysis. Results and discussion . In an open population aged 25–44 years, the prevalence of severe depression (SD) was 13.2%, moderate depression – 24.4%. SD was more prevalent in COMT G/G genotype carriers (61.8%), compared to A/A genotype carriers (38.2%; χ 2 =6.097; df=2, p=0.047); the G allele carriers also had a higher prevalence of SD (55.3%), compared to A allele carries (44.7%; χ 2 =5.408; df=1; p=0.02). SD was less prevalent among male COMT A/A genotype carriers (15.8%), compared to G/A genotype carriers (84.2%; χ 2 =4.603; df=1; p=0.032). SD was more prevalent in female G/G genotype carriers (65.5%), compared to A/A genotype carriers (34.5%; χ 2 =4.769; df=1; p=0.029). The G allele was more common among women with SD (58.2%) than the A allele (41.8%; χ 2 =6.658; df=2; p=0.01). In a logistic regression model, COMT Val/Val genotype in the studied population [Relative risk (RR) 1.594], as well as G (Val) allele in the studied population (RR=1.378) and women (RR=1.557), significantly increased the risk of depression. Conclusion. The data allows us to assume that COMT G/G polymorphism may be linked to a high depression level.

An exploration of recent life stress, psychological resilience, purpose in life, and optimism as correlates of depression in social housing residents in rural Australia

Homeless persons are often reported to be more depressed than the general community, but little previous research has examined their depressive state after being housed. In addition, the kinds of traits, attributes, and cognitive factors that have been found to be inversely correlated with the depressive effects of life stressors in the general population have not been compared within the previously-homeless. To investigate these issues, a sample of 79 previously-homeless persons from Regional Australia completed a series of questionnaires about their recent life stressors, depression, and three sets of attributes. Results indicated that the prevalence of severe depression was several times that reported for the general population and that only one of the three attributes measured was significantly inversely correlated with the depression severity of participants. The clinical significance of these findings is discussed with a view to the provision of targeted interventions to this population.

Mental Health Status of Healthcare Professionals and Students of Health Sciences Faculties in Kuwait during the COVID-19 Pandemic.

Objectives: This study aimed to assess the impact of the COVID-19 pandemic on the mental health status of healthcare professionals (HCPs) and undergraduate students in the health sciences center (HSCUs). In addition, it explored the factors associated with the increased levels of mental health burden among the study population. Methods: A cross-sectional study was performed using two online-administered questionnaires: the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7), which were distributed in parallel to HCPs and HSCUs in Kuwait. These instruments are validated assessment scales to assess mental health status: depression (PHQ-9) and anxiety (GAD-7). Statistical analyses were carried out using SPSS- version 25. Results: A total of 857 individuals (559 HCPs and 298 HSCUs) participated in this study. The prevalence of moderately severe depression or severe depression (PHQ-9 total score of ≥15) among respondents was 66.6%. The median (interquartile range, IQR) PHQ-9 score was significantly higher among HSCUs (20 {11.5}) compared to HCPs (17 {8}). The prevalence of severe anxiety (GAD-7 total score of ≥15) among respondents was 36.7%. There were no significant differences between the median (IQR) GAD-7 scores among the HCPs (14 {7}) and HSCUs (13 {8}). Binary logistic regression analysis revealed that three variables were significantly and independently associated with severe depression among HCPs. The prevalence of severe depression was found to be greater among females compared to males. In addition, it was significantly lower among those who were aged ≥50 years, and those who reported that they were not in direct contact with COVID-19 patients. Among HSCUs, females showed greater depression than males. In contrast, those aged >29 years and who had no history of chronic disease showed lower depression compared to their counterparts in the 18–29 years age group and who had a chronic disease history. Conclusions: The COVID-19 pandemic had a significant negative impact on the mental health of HCPs and HSCUs in Kuwait. This highlights the need for proactive efforts to support their mental health and well-being through educational campaigns and psychological support programs.

The Psychological Burden of COVID-19 Stigma: Evaluation of the Mental Health of Isolated Mild Condition COVID-19 Patients.

BackgroundThe objective of this article is to assess the mental health issues of the mild condition coronavirus disease 2019 (COVID-19) patients admitted to a community treatment center (CTC) in Korea.MethodsA total of 107 patients admitted to a CTC were included as the study population, and their mental health problems including depression (patient health questionnaire-9), anxiety (generalized anxiety disorder scale-7), post-traumatic stress disorder (PTSD) (PTSD checklist-5) and somatic symptoms (by patient health questionnaire-15) were evaluated every week during their stay. The stigma related to COVID-19 infection was evaluated with an adjusted version of the Middle East respiratory syndrome (MERS) stigma scale.ResultsDuring the first week of isolation, the prevalence of more-than-moderate depression was 24.3%, more-than-moderate anxiety was 14.9%, more-than-moderate somatic symptoms was 36.5% and possible PTSD was 5.6% of total population. For depression and anxiety, previous psychiatric history and stigma of COVID-19 infection were significant risk factors. For PTSD, previous psychiatric history and stigma of COVID-19 infection as well as total duration of isolation were found to be significant risk factors. Prevalence of depression, anxiety and possible PTSD remained similar across the four weeks of observations, though the prevalence of severe depression, increased after four weeks of stay. Somatic symptoms seemed to decrease during their stay.ConclusionThe results suggest that social mitigation of COVID-19 related stigma, as well as care of patients with pre-existing mental health problems are important mental health measures during this crisis period. It is also important that clinical guidelines and public health policies be well balanced over the protection of the public and those quarantined to minimize the negative psychosocial consequences from isolation of the patients.

Depression and suicidal ideation among the geriatric population of Kashmir, India.

Depression is a common disorder that can lead to suicidal behaviours among the geriatric population. We aimed to assess depression, hopelessness, and suicidal ideation among the elderly population of Kashmir. A community-based cross-sectional study was conducted in three districts of Kashmir between June and August 2019. The sample consisted of 200 persons aged >65 years. Beck's Depression Inventory, Beck's Hopelessness Scale, and the Beck Suicide Ideation scale were used to determine depression, hopelessness, and suicide ideation. Pearson's correlation was performed to assess the relationships between depression, hopelessness, and suicide. The prevalence of severe depression with a score of ⩾31 on Beck's Depression Inventory was 56% among the studied population. Most of these elderly were found to have moderate levels of suicidal ideation (62.5%) and hopelessness (61%). Depression had a positive correlation with suicidal ideation (r = 0.35). Hopelessness and suicidal intent had a more significant positive correlation (r = 0.54), as compared to depression and hopelessness (r = 0.43). More than half of the older persons in Kashmir had depression with superimposed hopelessness which is an important risk factor of suicidal ideation.

Prevalence of Severe Depression in Iranian Women with Breast Cancer: A Meta-Analysis.

Background Breast cancer is one of the most common cancers in women and has mental and emotional effects, which lead to a decline in their quality of life. This study is aimed at determining the prevalence of severe depression in Iranian women with breast cancer. Methods This meta-analysis study was conducted at Zabol University of Medical Sciences in 2019. Seven electronic databases were searched and evaluated for original research papers published on the prevalence of severe depression in Iranian women with breast cancer. Finally, 13 articles were selected and analyzed via Comprehensive Meta-Analysis software. Results Overall, the prevalence of severe depression in Iranian women with breast cancer was 11% (95% CI (7.2, 16.5)). The highest prevalence was 44% in Tehran City in 2015 (95% CI (31, 57.9)), and the lowest prevalence was 0.8% in Qom City in 2017 (95% CI (0.01, 6.2)). A significant statistical correlation was observed between the prevalence of severe depression and sample size (p < 0.05). Conclusion According to the results of this study, the prevalence of severe depression affects more than one-tenth of women with breast cancer.

Effect of female genital mutilation on mental health: a case–control study

Objectives: The study aimed to investigate the mental health status of women with female genital mutilation/cutting (FGM/C) and compare it with that of a similar group of women without FGM/C.Methods: A case–control study was carried out in 2018 among 122 women with FGM/C and 125 women without FGM/C who had been referred to one of the general health service centres in Kermanshah Province, western Iran. The 28 item General Health Questionnaire (GHQ-28) was used to collect data on participants’ mental health. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with the outcome variable, mental health status.Results: The mean age of the FGM/C and control groups was 35.7 (standard deviation [SD] 8.6) and 31.3 (SD 7.2) years, respectively. According to the GHQ-28 questionnaire, 65.6% (n = 80) of the FGM/C group and 52% (n = 65) of the control group had symptoms of a mental health disorder; the difference between the groups was statistically significant (p = .03). The prevalence of severe depression in the FGM/C group was significantly higher than in the control group (p = .021). Multivariate logistic regression showed that having a history of FGM/C (adjusted OR 1.79; 95% confidence interval [CI] 1.05, 3.05) and being in employment (adjusted OR 3.46; 95% CI 1.23, 9.74) had a significant effect on presentation with symptoms of a mental health disorder (p < .05).Conclusion: Women who suffer from FGM/C are more vulnerable to mental health disorders such as depression.

Prevalence of psychiatric disorders among older adults in Jodhpur and stakeholders perspective on responsive health system.

Background:Ageing is an inescapable reality of human existence. The elderly population of India is steadily increasing with growing mental health needs which pose many challenges for the health care system. The aim of this study is to assess anxiety, depression, and cognitive disorders among urban and rural elderly and to explore the availability of social support mechanisms and a responsive health system for elderly.Methods:This study is a mixed-method approach. For a quantitative study, a community-based cross-sectional survey is conducted in Jodhpur, Rajasthan. A total of 330 elderly persons aged 60 years and above are randomly screened for depression (GDS), anxiety (GAD), and cognitive impairment (HMSE). Further for a qualitative study, in-depth interviews are conducted with 7 key informants including policy and program managers, service providers, and facilitators from the state. For quantitative data analysis, Excel and SPSS are used and for Qualitative data analysis, Thematic Framework Approach is used.Results:The mean age of the respondents is 67.9 ± 7.8. The prevalence of severe depression is 17%, severe anxiety is 10.3%, and cognitive impairment is 51.2%. The prevalence of all the three is more in rural elderly as compared to urban elderly as well as more in female individuals as compared to males. Qualitative analysis revealed that there are challenges in early identification of mental disorders at both the levels: service providers and elderly. Psychological and financial issues are also seen in elderly who are not supported by their children. There are cases of fear for elder abuse and influence of western culture in the society.Conclusion:There is a sizeable prevalence of psychological issues in elderly population. Therefore, there is a need to adopt holistic and integrated psychogeriatric services for the improvement of quality of life in elderly.

Factors associated with depression among medical students in a private tertiary care hospital in South India

Background: Undergraduate medical training is perceived more stressful compared to other undergraduate program. Medical students to undergo strenuous curriculum and evaluation added to that other factors like homesickness, heavy workload, sleep deprivation, financial concern, environment not ideally suited for learning, information over load and career planning make them more susceptible to depression compared of students of other profession. Objectives: to estimate the prevalence of depression and assess the factors associated with depression among medical students. Methodology: A cross-sectional study was conducted among medical undergraduate students of a tertiary care hospital in Tamil Nadu situated in the suburban area of Chennai. A total of 232 students was studied to estimate the prevalence of depression using Beck’s Depression Inventory (BDI) questionnaire was used. Results: A total of 232 medical students were included in the study based on the inclusion criteria, of which 49.5% (115/232) were males while 50.5% (117/232) were females. Prevalence of severe depression was 12.5% and very severe depression was 3.4%.. Higher number of students in the age group 17 -19 years were with severe and very severe depression compared to 20-22 years of age group and it was found statistically significant(p=0.001). Compared to males higher number of females were having severe and very severe depression and it was found statistically significant (p=0.04) severe and very severe depression was higher in first year students compare to final year students and it was found statistically significant (p=0.000). Significance association was found between higher BMI, consuming alcohol, previous exam failure and do not do regular exercise with depression. Conclusion: The burden of depression among medical Students found to be common that do more in the first year of college life compared to final years an effective counseling of the students at the time of induction will reduce the burden of depression in medical colleges.

Comments on psychological impact of COVID-19 lockdown: An online survey from India.

Comments on psychological impact of COVID-19 lockdown: An online survey from India.

Intimate partner violence against women and its association with depression in three regions of China: a cross-sectional study

BackgroundIntimate partner violence (IPV) is recognised as a major public health and social problem globally, with consequences for the individual, the family, and society. However, research on IPV in China is scarce. We aimed to estimate the prevalence of different types of violence among Chinese women, determine risk factors, and explore the associations with depression. MethodsWe did a cross-sectional study in six provinces across the three regions of China using a self-completion questionnaire developed for the study. We purposively selected the provincial capital and one rural county in each province. Questionnaires were distributed in hospitals and public places to women aged 18 years and older who had ever been in an intimate relationship. We used the Center for Epidemiologic Studies Depression Scale to measure depression. We used binary logistic regression to analyse risk factors and the associations between violence and depression. Ethical approval was obtained from the Medical Ethics Committee of Zhejiang University, School of Public Health. FindingsFrom July 10 to Sept 3, 2018, 2987 women were enrolled. The prevalence of psychological, physical, and sexual violence was 77·7% (2322), 40·2% (1201), and 11·0% (330), respectively: 52·0% (1553) had experienced two or three types of violence in their life. Risk factors were low education attainment, having one child or more, residence in western provinces, having an income lower than the partner's, and economic pressure. The prevalence of severe depression was 18·3% (425/2322), 23·8% (286/1201), and 39·4% (130/330) in women experiencing psychological, physical and sexual violence, respectively. The odds of severe depression were 6·62 (95% CI 4·49–9·76) for psychological violence, 4·31 (3·39–5·48) for physical violence, and 5·47 (4·01–7·45) sexual violence, after controlling for age, occupation, education attainment, and residence. InterpretationThere is a clear need for measures to raise awareness and prevention of all types of IPV. The recent announcement of the Domestic Violence Law represents a first step in this process. FundingGlobal Health Centre of Zhejiang University.

Mediators of gender effects on depression among cardiovascular disease patients in Palestine

BackgroundAmong patients suffering from coronary heart disease (CHD) and comorbid depression, women experience a higher burden compared to men. Little is known on the characteristics that differentiate men and women with both diseases and whether these factors mediate gender effects on depression. This study assessed whether women are more likely to suffer from depression and which characteristics mediate gender effects on depression among a cardiac population in Palestine, specifically addressing the role of post-traumatic stress disorder (PTSD).MethodsUsing a cross-sectional design, patients consecutively admitted with a CHD to one of the four main hospitals in Nablus, Palestine, were interviewed using a structured questionnaire with validated instruments. Data was also obtained from hospital medical records. Patients were assessed for depression using the Cardiac Depression Scale (CDS). Bivariate analysis was conducted to compare characteristics of women and men with and without depressive symptoms. Mediators (direct and indirect effects) of the association between gender and depression were evaluated using a structural equation model (SEM).ResultsWomen were more likely to suffer from severe depression than men (28.7% vs. 18.8%). Female gender was positively associated with higher PTSD symptoms, comorbidities, somatic symptoms and income, and with lower resilience, self-esteem, quality of life, education, prevalence of smoking and physical activity. Structural equation modeling revealed negative indirect effects of gender on depression (CDS score) through resilience, self-esteem and physical activity, whereas positive indirect effects of gender on depression were observed through PTSD, comorbidities, somatic symptoms and smoking. There was no direct effect of gender on depression.ConclusionThis study found a higher prevalence of severe depression in female patients with cardiac disease compared to male cardiac patients. Our findings provide novel information on mediating factors of the association between gender and depression among cardiac patients, in particular PTSD. The results emphasize the need for further research on potential mediating factors that could account for gender differences in depression and the need to provide support programs for female patients with comorbid CHD and depression to improve their psycho-social well-being.

Prevalence of depression and its associated sociodemographic factors among Iranian female adolescents in secondary schools

BackgroundAcross the globe, depression is a common psychiatric disorder and is the main cause of disability among adolescents. To this end, this study was conducted to screen for the prevalence of depression among secondary school female students in the city of Hamadan, in western Iran.MethodsIn this cross-sectional study, a total of 670 secondary school female students, within the age range of 15–18 years were investigated using multistage random sampling method. Moreover, the Persian version of Center for Epidemiologic Studies Depression Scale (CES-D) and a researcher-designed questionnaire containing demographic variables were employed as research instruments. Analyses of the findings were made using SPSS version 16 software followed by stratified logistic regression model, which was performed for correlation analysis.ResultsThe mean (standard deviation) age of students was 16.2 (0.68) years. The prevalence of severe depression in female students estimated by the Center for Epidemiologic Studies Depression Scale (CES-D) was equal to 52.6%. A statistically significant relationship was also observed to exist between prevalence of depression and type of school (P < 0.001), family income (P < 0.001), living in the suburbs (P < 0.001), and field of study at school (P < 0.001). However, no statistically significant correlation was found between depression among students and school grade, type of living with parents, father’s education and occupation, mother’s education and occupation, and family size.ConclusionDepression was prevalent among the secondary school female students examined and it significantly correlated with socioeconomic status. Therefore, periodic screening, psychological training programs, proper diagnosis of high-risk individuals in secondary schools, and early intervention among secondary school female students are urgently needed.

Associations between childhood abuse, mental health problems, and suicide risk among male prison populations in Spain

There are few studies exploring associations between different types of childhood abuse and mental health problems among adult prisoners. To explore associations between history of childhood abuse, depression or anxiety, and near-lethal suicide attempts among adult prisoners, and test the hypothesis that post-traumatic stress disorder (PTSD) may be a mediator between childhood abuse and adult disorder among prisoners. We enrolled 943 men from three prisons in Spain. Childhood abuse was assessed with the Childhood Trauma Questionnaire at interview and current symptoms were assessed using the 21-item Depression Anxiety and Stress Scale (DASS-21). Self-reported histories of near-lethal suicide attempts were recorded. Overall, 360 (40%) of the men reported at least one type of childhood abuse; 231 (24.5%) described exposure to emotional abuse, 236 (25%) to physical abuse, and 97 (10%) to sexual abuse. Survivors of all types of childhood abuse had over twice the prevalence of severe depression, anxiety, stress disorder, and near-lethal suicide attempts than men who had not been exposed. Survivors of sexual and emotional violence during childhood had more symptoms of PTSD than survivors of physical abuse. Statistically, PTSD had a mediating effect, but it was very small. Although other studies have shown high rates of childhood abuse histories among prisoners, this is the first to link such a history to near-lethal suicide attempts in this population.

561. Co-occurring Psychosocial Barriers to Viral Suppression Among Men Who Have Sex with Men (MSM) in India

BackgroundThere is a paucity of data on factors associated with viral suppression in representative populations of HIV-positive MSM in low-middle income country (LMIC) settings. We characterized factors associated with viral suppression among a community-recruited sample of MSM across India with a particular focus on depression, alcohol use and recreational drug use.MethodsOf 10,024 MSM recruited using respondent-driven sampling (RDS) from 10 Indian cities between August 2016 and April /2017, 1,460 were HIV-positive and eligible for ART. Alcohol dependence was defined as AUDIT score ≥15; severe depression as PHQ-9 score ≥15; recreational drug use included both injection and non-injection use of drugs common in India, excluding marijuana. Prevalence ratios (aPrR) were obtained using multivariable Poisson regression incorporating RDS2 weights and accounting for clustering by site.ResultsMedian age was 37 years, 34.1% had at least high school education and 66.0% reported monthly income >$115. Prevalence of viral suppression among HIV+ ART eligible MSM was 66.2% overall, ranging from 35.2% in Bhopal to 76.1% in Madurai with no regional trends. Prevalence of severe depression was 4.0%, alcohol dependence 66.3% and recreational drug use 9.5%. Viral suppression was significantly more common among those who were older and had higher treatment literacy. In analyses that adjusted for these factors and sexual identity, those who reported drug use and had evidence of severe depression had a significantly lower likelihood of being virally suppressed (aPrR 0.38; [95% CI: 0.16–0.89]) than those with neither (P-value for interaction = 0.05). Similarly, compared with those who used neither alcohol nor drugs, those using both had a lower prevalence of viral suppression (aPrR: 0.61; [95% CI: 0.40–0.94]) although the interaction did not achieve statistical significance (P = 0.07).ConclusionIn this population of MSM in an LMIC, recreational drug use appeared to be a key barrier to achieving viral suppression. Moreover, the impact of drug use was greater in the context of co-occurring severe depression or co-occurring alcohol dependence. It is critical that HIV programming in India and other resource-limited settings incorporate interventions to address these conditions in differentiated care models to maximize viral suppression.Disclosures All authors: No reported disclosures.