Prior Diagnosis Of Depression Research Articles

Prospective prediction of anxiety onset in the Canadian longitudinal study on aging (CLSA): A machine learning study

BackgroundAnxiety disorders are among the most common mental health disorders in the middle aged and older population. Because older individuals are more likely to have multiple comorbidities or increased frailty, the impact of anxiety disorders on their overall well-being is exacerbated. Early identification of anxiety disorders using machine learning (ML) can potentially mitigate the adverse consequences associated with these disorders. MethodsWe applied ML to the data from the Canadian Longitudinal Study on Aging (CLSA) to predict the onset of anxiety disorders approximately three years in the future. We used Shapley value-based methods to determine the top factor for prediction. We also investigated whether anxiety onset can be predicted by baseline depression-related predictors alone. ResultsOur model was able to predict anxiety onset accurately (Area under the Receiver Operating Characteristic Curve or AUC = 0.814 ± 0.016 (mean ± standard deviation), balanced accuracy = 0.741 ± 0.016, sensitivity = 0.743 ± 0.033, and specificity = 0.738 ± 0.010). The top predictive factors included prior depression or mood disorder diagnosis, high frailty, anxious personality, and low emotional stability. Depression and mood disorders are well known comorbidity of anxiety; however a prior depression or mood disorder diagnosis could not predict anxiety onset without other factors. LimitationWhile our findings underscore the importance of a prior depression diagnosis in predicting anxiety, they also highlight that it alone is inadequate, signifying the necessity to incorporate additional predictors for improved prediction accuracy. ConclusionOur study showcases promising prospects for using machine learning to develop personalized prediction models for anxiety onset in middle-aged and older adults using easy-to-access survey data.

Longitudinal course and predictors of health-related quality of life, mental health, and fatigue, in non-hospitalized individuals with or without post COVID-19 syndrome.

Long-term information on health-related quality of life (HRQOL) and mental health of non-hospitalized individuals with "post COVID-19 syndrome" (PCS) is scarce. Thus, the objectives of the present study were to compare HRQOL and mental health of individuals with and without PCS in a German sample of non-hospitalized persons after SARS-CoV-2 infection, to characterize the long-term course up to 2 years and to identify predictors for post COVID-19 impairments. Individuals with past SARS-CoV-2 infection were examined at the University Hospital of Augsburg from November 2020 to May 2021 and completed a postal questionnaire between June and November 2022. Participants who self-reported the presence of fatigue, dyspnea on exertion, memory problems or concentration problems were classified as having PCS. HRQOL was assessed using the Veterans RAND 12-Item Health Survey, mental health was measured by the Patient Health Questionnaire and the Fatigue Asessment Scale was used to assess fatigue severity. Multivariable linear regression models with inverse probability weighting were used to determine the association between PCS and health outcomes. From the 304 participants (58.2% women, median age 52 years), 210 (69.1%) were classified as having PCS in median 26 months after SARS-CoV-2 infection. Persons with PCS showed significantly more often depressive and anxiety disorders. PCS was independently and significantly associated with higher levels of depression, post-traumatic stress and fatigue, as well as poorer physical and mental HRQOL in median 9 months as well as 26 months after SARS-CoV-2 infection. A large number of acute symptoms and a prior diagnosis of depression were independently associated with poor mental health and HRQOL. While post-traumatic stress and mental HRQOL improved from 9 months to 26 months post infection onset, depressiveness, fatigue and physical HRQOL remained stable in both, persons with and without PCS. PCS in non-hospitalized persons after SARS-CoV-2 infection is often associated with long-term impairments of mental health and HRQOL outcomes.

Prevalence of Moderate to Severe Depressive Symptoms among Adults in the UAE: A Cross-sectional Study

Objective:: The objectives of the study were to assess the prevalence of moderate to severe depressive symptoms among adults aged 18 years or older, assess the relationship between the severity of depression and selected socio-demographic, psycho-social, lifestyle, and health-related factors, and identify the determinants of moderate-to-severe depressive symptoms in the adult population of 18 years and older in the United Arab Emirates (UAE). Methods:: This was a cross-sectional study conducted in the United Arab Emirates that targeted residents above 18 years of age. A research questionnaire was developed and approved by three specialists in the field, along with the Patient Health Questionnaire-9 (PHQ9). The Chi-square test was used to assess the association between variables, and multiple logistic regression analysis was used to find the predictive risk factors for moderate to severe depressive symptoms. Results:: The study encompassed a group of 562 participants, achieving a response rate of 97.33%. Initially, a Google Form was distributed electronically to the entire participant pool; however, 15 individuals declined to participate, resulting in a final sample size of 547 (n). Amongst the variables that showed significant prevalence of moderate to severe depressive symptoms were age (P <0.001), sex (P <0.001), marital status (P <0.001), occupation classification (P <0.001), religiosity (P <0.001), education level (P <0.001), job stress (P <0.001), domicile and residence (P <0.001), responsibility towards family (P <0.001), post-traumatic stress disorder (PTSD) (P <0.001), consumption of alcohol (P <0.001), coronavirus disease pandemic (P <0.001), employment status (P = 0.002), family size (P = 0.001), and smoking (P = 0.004). Amongst the variables, the subgroups that showed significant predictive factors of moderate to severe depressive symptoms were the ages between 18 and 25 years old (P = 0.01), the female gender (P <0.001), and low levels of religiosity (P <0.001). Conclusion:: The prevalence of moderate-to-severe depressive symptoms was 48% (n=260). In our study on the prevalence of depression, we have investigated several predictive factors, including age, gender, religiosity, and a history of prior depression diagnosis. While numerous factors contribute to depression, additional research is imperative to identify and validate additional predictive factors.

(166) Safety of Flibanserin in Men with Hypoactive Sexual Desire Disorder

Abstract Introduction Flibanserin possesses unique properties and displays selective agonistic and antagonistic activity against serotonin receptors. Originally, its primary application was in the treatment of hypoactive sexual desire disorder (HSDD) in women, where it showed promising results in improving sexual desire. However, as our understanding of its mechanism of action has expanded, researchers have begun to explore its potential utility in treating HSDD in males. This emerging trend has led to an increased interest in the use of flibanserin as a potential therapeutic option for men experiencing a decline in sexual desire. Objective We aimed to elucidate the demographic profiles, clinical attributes, and comprehensive safety implications of men receiving off-label flibanserin at our institution. Methods A retrospective analysis encompassing a cohort of men who initiated flibanserin treatment between July 2022 and July 2023 was performed. Basic demographic information, levels of total and free testosterone, pertinent medical history, scores from the International Index of Erectile Function (IIEF) and Patient Health Questionnaire-9 (PHQ-9), and overall manifestation of side effects were collected. Descriptive statistics were performed. Results A total of 26 patients were identified, with a mean age of 57.9 years (range, 31–80 years). Among these patients, seven had a prior diagnosis of depression and had previously received treatment with selective serotonin reuptake inhibitors (SSRIs). The mean levels of total testosterone and free testosterone were found to be 611.3 ng/dL and 116.8 pg/mL, respectively. Notably, a significant majority of patients (22 of 26 [81.4 %]) were diagnosed with erectile dysfunction. Importantly, all patients exhibited euthyroid status. The mean baseline score on the PHQ-9 was 5.30 (ranging, 0–17), indicating mild depressive symptoms, whereas the mean IIEF total score was 40 (range, 6–67). Furthermore, the mean score on the IIEF-desire subdomain was 5.65 (ranging: 2–10), reflecting relatively diminished levels of sexual desire. Upon conducting a follow-up assessment at the 3-month mark, it was observed that seven patients discontinued flibanserin medication, with reasons such as ineffectiveness and high cost being cited as the primary factors. Notably, only one patient (3.8%) discontinued the medication because of side effects. Conclusions In summary, our study sheds light on the fundamental characteristics associated with off-label utilization of flibanserin in men with HSDD, underscoring the increasing interest in investigating its potential therapeutic advantages within this specific population. However, additional research is warranted to comprehensively elucidate the clinical benefits and potential risks of flibanserin administration in men. Such investigations will contribute to a more thorough understanding of its efficacy and safety profile. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Disclosures: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast Investor: Sprout.

Psychosocial and socioeconomic factors are most predictive of health status in patients with claudication

BackgroundAs a key treatment goal for patients with symptomatic peripheral artery disease (PAD), improving health status has also become an important end point for clinical trials and performance-based care. An understanding of patient factors associated with 1-year PAD health status is lacking in patients with PAD. MethodsThe health status of 1073 consecutive patients with symptomatic PAD in the international multicenter PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) registry was measured at baseline and 1 year with the Peripheral Artery Questionnaire (PAQ). The association of 47 patient characteristics with 1-year PAQ scores was assessed using a random forest algorithm. Variables of clinical significance were retained and included in a hierarchical multivariable linear regression model predicting 1-year PAQ summary scores. ResultsThe mean age of patients was 67.7 ± 9.3 years, and 37% were female. Variables with the highest importance ranking in predicting 1-year PAQ summary score were baseline PAQ summary score, Patient Health Questionnaire-8 depression score, Generalized Anxiety Disorder-2 anxiety score, new onset symptom presentation, insurance status, current or prior diagnosis of depression, low social support, initial invasive treatment, duration of symptoms, and race. The addition of 19 clinical variables in an extended model marginally improved the explained variance in 1-year health status (from R2 0.312 to 0.335). ConclusionsPatients’ 1-year PAD-specific health status, as measured by the PAQ, can be predicted from 10 mostly psychosocial and socioeconomic patient characteristics including depression, anxiety, insurance status, social support, and symptoms. These characteristics should be validated and tested in other PAD cohorts so that this model can inform risk adjustment and prediction of PAD health status in comparative effectiveness research and performance-based care.

Evaluating depressive symptoms and risk of cognitive decline using longitudinal electronic health records

AbstractBackgroundDepression is associated with increased risk of Alzheimer’s disease and related dementias (ADRD). Many population‐based and convenience sample studies have examined depression and depressive symptoms in this context. However, fewer studies employed electronic health records (EHR) to assess this relationship. Because depression might be under‐ or mis‐diagnosed, diagnostic codes alone may be insufficient. We aimed to assess whether prior depression diagnosis and/or depressive symptoms–derived from natural language processing (NLP) in the EHR–predicts future mild cognitive impairment (MCI)/dementia using a large EHR‐based dataset.MethodThe Massachusetts Electronic Health Records Aging Dataset (MEAD) is a retrospective cohort of patients who were ≥50 years old with normal cognition at their first encounter between 1/1/2000‐12/31/2005. Depression diagnoses and incident MCI/dementia were identified from structured encounter diagnoses and problem lists, and depressive symptoms from clinical notes using NLP. Follow‐up time was calculated from index date until date of cognitive diagnosis, death, loss to follow‐up or end of study (12/31/2021). We performed Cox proportional hazards models using age as the time scale to examine the association of depression and incident MCI/dementia, using the Fine‐Gray approach to account for competing risk of death.ResultThe MEAD cohort included 162,069 patients. Of those, 135,272 did not have depressive symptoms or a depression diagnosis at their first encounter, 14,985 had only depressive symptoms, 4,883 had only a depression diagnosis, and 6,929 had both depressive symptoms and a depression diagnosis. The incidence rate of MCI/dementia per 1,000 person‐year was 7.8 for patients without depressive symptoms or depression diagnosis, 10.0 for depressive symptoms only, 12.4 for depression diagnosis only, and 10.3 for both. Compared with those without depressive symptoms or depression diagnosis, the multivariable‐adjusted hazard ratios for incident MCI/dementia were 1.05 (95% confidence interval [CI] 0.99,1.11) for depressive symptoms only, 1.45 (95% CI 1.34,1.56) for depression diagnosis only, and 1.15 (95% CI 1.07,1.23) for both, respectively.ConclusionIn a large sample, diagnosis of depression appears to be a stronger predictor than depressive symptoms of all‐cause MCI/dementia. Further research is needed to understand the utility of reported depressive and other neuropsychiatric symptoms in clinic notes for predicting cognitive decline.

Mapping the Relationship of White Matter Lesions to Depression in Multiple Sclerosis

BackgroundMultiple sclerosis (MS) is an immune-mediated neurological disorder, and up to 50% of patients experience depression. We investigated how white matter network disruption is related to depression in MS. MethodsUsing electronic health records, 380 participants with MS were identified. Depressed individuals (MS+Depression group; n = 232) included persons who had an ICD-10 depression diagnosis, had a prescription for antidepressant medication, or screened positive via Patient Health Questionnaire (PHQ)-2 or PHQ-9. Age- and sex-matched nondepressed individuals with MS (MS−Depression group; n = 148) included persons who had no prior depression diagnosis, had no psychiatric medication prescriptions, and were asymptomatic on PHQ-2 or PHQ-9. Research-quality 3T structural magnetic resonance imaging was obtained as part of routine care. We first evaluated whether lesions were preferentially located within the depression network compared with other brain regions. Next, we examined if MS+Depression patients had greater lesion burden and if this was driven by lesions in the depression network. Primary outcome measures were the burden of lesions (e.g., impacted fascicles) within a network and across the brain. ResultsMS lesions preferentially affected fascicles within versus outside the depression network (β = 0.09, 95% CI = 0.08 to 0.10, p < .001). MS+Depression patients had more lesion burden (β = 0.06, 95% CI = 0.01 to 0.10, p = .015); this was driven by lesions within the depression network (β = 0.02, 95% CI = 0.003 to 0.040, p = .020). ConclusionsWe demonstrated that lesion location and burden may contribute to depression comorbidity in MS. MS lesions disproportionately impacted fascicles in the depression network. MS+Depression patients had more disease than MS−Depression patients, which was driven by disease within the depression network. Future studies relating lesion location to personalized depression interventions are warranted.

The Association of Perceived Labor Agentry and Depression and/or Anxiety.

Pregnancies complicated by perinatal mood disorders or a history of mental health disorder are at increased risk for complications including postpartum depression/anxiety. Patients' perceived control over childbirth is known to be an important factor for development of postpartum depression/anxiety. It is unclear whether women with preexisting and/or current depression and/or anxiety have different perceptions of control during childbirth compared with those without these comorbidities. This study aimed to evaluate the association between a current and/or prior diagnosis of depression and/or anxiety and scores on the Labour Agentry Scale (LAS), a validated tool evaluating patient's experience of control over their labor and delivery. This is a cross-sectional study of nulliparous patients admitted at term to a single center. Participants completed the LAS after delivery. A trained researcher performed detailed chart reviews for all participants. Participants were identified as having a current or historical diagnosis of depression/anxiety by self-report confirmed by chart review. Scores on the LAS were compared between those with versus without a diagnosis of depression/anxiety prior to admission for delivery. A total of 73 (44.8%) of the 149 participants held a current and/or prior diagnosis of depression and/or anxiety. Baseline demographics were similar between those with and without depression/anxiety. Mean scores on the LAS (range: 91-201) were significantly lower for those with depression/anxiety than those without a prior diagnosis (150.0 vs. 160.5, p < 0.01). Even after controlling for mode of delivery, admission indication, anesthesia, and Foley balloon usage, participants with anxiety and depression had scores that were on average 10.4 points lower on the LAS (95% confidence interval: -19.25, -1.62). Participants with a current and/or prior diagnosis of depression and/or anxiety scored lower on the LAS as compared with those without psychiatric diagnoses. Patients with psychiatric diagnoses may benefit from increased education and support during childbirth. · Control over childbirth is an important factor in the development of postpartum depression/anxiety.. · Patients with a prior or current diagnosis of anxiety and depression have lower labor agentry scores.. · These differences remained significant even when controlling for confounders such as delivery mode..

Relationship of Psychological and Cognitive Factors to Pain During Hip Fracture Rehabilitation: A Retrospective Analysis

<h3>Research Objectives</h3> To determine if impairments in cognition, expressive language, or pre-existing anxiety and/or depression were associated with pain perception, opioid use, and progress during inpatient rehabilitation following hip fracture. <h3>Design</h3> Retrospective Cohort. <h3>Setting</h3> Inpatient rehabilitation facility. <h3>Participants</h3> One hundred patients admitted for rehabilitation following petrochanteric hip fracture between January 1, 2018 and December 30, 2020. Patients with intact, mild, or moderate/severe cognitive impairments were randomly selected for inclusion at a 1:1:1 ratio. Patients with dementia were excluded. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Prior diagnosis of depression of anxiety, self-reported pain levels (rated 1-10) and opioid use during first week of admission, rehabilitation efficiency (change in functional independence [GG] per day), length of stay. <h3>Results</h3> Expressive language was assessed using language domains on the Montreal Cognitive Assessment (MoCA) and therapist assessments of patients' abilities to express their needs and wants (Section BB of CMS IRF-PAI 3.0). A positive correlation between the Expression of Ideas and Wants and the average maximum pain levels (ρ = 0.243, P=0.015) was observed, using Spearman's correlation. Language assessments on the MoCA were not related to pain (ρ=-0.078, P=0.46). Higher average pain scores were associated with a diagnosis of anxiety and/or depression (ρ = 0.252, P=0.012), lower MoCA scores (ρ = -0.225, P=0.031) and younger age (-0.243, P=0.015). These three factors were all independently associated with pain in a multivariable model (P< 0.05). Anxiety and/or depression was also associated with higher opioid frequency (ρ = 0.308, P=0.002). There was a significant relationship between maximal pain scores and level of functional independence on admission and rehabilitation efficiency (ρ = -0.259, P=0.009). <h3>Conclusions</h3> Higher self-reported pain is associated with less efficient progress in rehabilitation. Patient cognition and ability to express oneself may affect pain reporting. Patients with anxiety and/or depression reported higher pain and used opioids more frequently than those without a diagnosis. Additional pain-management strategies should be considered in these populations. <h3>Author(s) Disclosures</h3> None.

Can Sri Lankan Australians Recognise Depression? The Influence of Acculturation, Age and Experiences with Depression on Recognition.

Mental health literacy is an important determinant of mental health help-seeking and is associated with improved mental health. There is evidence that mental health literacy may be lower amongst some migrant communities in Australia. The present study conducted the first cross-sectional survey of mental health literacy in Sri Lankan Australians between April and October 2020. Participants (N = 404) were presented with a culturally-tailored vignette describing an individual with symptoms of major depressive disorder, with correct recognition determined by the coding of an open text response to the question 'what's wrong with Mr Silva?'. Binomial linear regression modelling was conducted to identify predictors of the correct recognition of depression. Approximately 74% of participants recognised the presented symptoms as depression, though multiple other labels were also used by the respondents. The results also suggested that younger age and having a prior diagnosis of depression were significant predictors of recognising depression in the vignette. In the first study of Sri Lankan migrants' mental health literacy in an Australian context, the rates of depression recognition were comparable to those found in the general Australian population. Further research is urgently required to replicate and extend the present findings and ultimately support the development of tailored interventions aimed at improving mental health literacy across the diverse Sri Lankan Australian community.

Depression among Adult Diabetics in the UAE

Background: Diabetes and depression are costly and prevalent chronic medical conditions. Limited data about the relationship between depression and diabetes in the UAE Objectives: To assess the risk of depression among diabetics in the UAE Materials and Methods: A cross-sectional study was conducted among 20 -year-old- and above adults attending the medical outpatients of a teaching hospital, Ajman, with no prior diagnosis of depression and who agreed to participate and give informed consent. The participants were recruited conveniently and screened for depression using beck depression inventory second edition (BDI-II) questionnaire. A validated pilot-tested self-administered questionnaire was also used, including information on socioeconomic status, lifestyle, being diagnosed to have diabetes. Results: The study included 775 participants; 189 had depressive symptoms (24.4%). A significant association was found between depression and gender and education level (p=0.001 for both variables). The percentage of depression was significantly higher among participants diagnosed with diabetes (p=0.016). Performing regular physical activity was associated with a lower rate of depression. Multiple logistic analysis showed that the risk of depression is increased by; gender (being a female compared to a male, or: 2.374 (CI: 1.644 - 3.428, p &lt; 0.001); having a lower education level compared to a higher (or: 1.744, CI:11.155 - 2.635, p=0.008); being diabetic (or 1.656, 1.125 - 2.436, p=0.01). Performing physical activity reduces the risk for depression (or 0.521, CI: 0.298-0.909, p=0.022). Conclusion: Diabetes increases the risk of depression. Predictors of depression are gender and having diabetes. Performing physical activity reduces the risk of depression.

Prevalence and Correlates of Suicidal Ideation and Suicide Attempt Among Transgender Men in San Francisco

Data on unmet mental health needs is limited for transgender men. This analysis aims to determine the prevalence and correlates of lifetime suicidal ideation and suicide attempt among transgender men in San Francisco. Between 2014 and 2015, 122 transgender men aged ≥18 years from the San Francisco Bay Area were recruited using a hybrid venue- and peer referral-based sampling method (starfish sampling) to participate in a survey that included mental health indicators. Multivariable Poisson regression models determined associations of lifetime suicidal ideation and lifetime suicide attempt, separately, with demographic, substance use, and psychosocial factors. Mean age of participants was 29.6 years (range 18–56); 22% identified as transgender men of color (6 Asian, 8 Black/African American, 4 Hispanic/Latinx, and 9 other/mixed race); 52% reported ever receiving a depression diagnosis. Overall, 81% (n = 98) reported suicidal ideation, of whom 48% (n = 47) reported suicide attempt. Identification as a transgender man of color (adjusted prevalence ratio [PR] 1.23, p = .03) and prior depression diagnosis (PR 1.46, p &lt; .01) were associated with lifetime suicidal ideation. Perceived social support was associated with a decreased risk of suicidal ideation (PR 0.82, p = .02). Prior depression diagnosis (PR 2.23, p &lt; .01) and low to moderate (≤3 episodes vs. none) binge alcohol use in the last 6 months (PR 1.60, p = .03) were correlates of lifetime suicide attempt. Suicidal behaviors were highly prevalent among this community-derived sample of transgender men. Targeted mental health-focused interventions, specifically among ethnic minorities, may help to address these disparities in this underserved group.

Post-Traumatic Stress Disorder, Major Depressive Disorder, and Wildfires: A Fifth-Year Postdisaster Evaluation among Residents of Fort McMurray.

Background: Over 90,000 residents had to be evacuated from Fort McMurray (FMM), Alberta, Canada due to the wildfire that engulfed the city in May 2016. Overall, about 2400 homes or 10% of the housing stock in Fort McMurray were destroyed. The fire consumed about 200,000 hectors of forest, reaching into Saskatchewan. During major disasters, communities’ infrastructure is disrupted, and psychological, economic, and environmental effects are felt for years afterwards. Objective: Five years after the wildfire disaster, this study assessed the prevalence rate of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in Fort McMurray residents and determined the demographic, clinical, and other risk factors of probable MDD and PTSD. Methodology: A quantitative cross-sectional survey was conducted to collect data through an online questionnaire administered via REDCap between 24 April and 2 June 2021. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of MDD symptoms in respondents. The PTSD Checklist for DSM-5 (PCL-C) was used to assess likely PTSD in respondents. Descriptive, univariate, and multivariate regression analyses were employed. Results: 186 out of 249 individuals who accessed the survey link completed it (74.7% response rate). The median age of the subscribers was 42. The sample included a majority of 159 (85.5%) females; 98 (52.7%) > 40 years of age; 175 (94.1%) employed; and 132 (71%) in a relationship. The overall prevalence of MDD symptoms in our study sample was 45.0% (76). Four variables independently predicted MDD symptoms in the multivariate logistic regression model, including: unemployed (OR = 12.39; 95% CI: 1.21–126.37), have received a mental diagnosis of MDD (OR = 4.50; 95% CI: 1.57−12.92), taking sedative-hypnotics (OR = 5.27; 95% CI: 1.01−27.39), and willingness to receive mental health counseling (OR = 4.90; 95% CI: 1.95–12.31). The prevalence of likely PTSD among our respondents was 39.6% (65). Three independent variables: received a mental health depression diagnosis from a health professional (OR = 4.49; 95% CI: 1.40–14.44), would like to receive mental health counseling (OR = 4.36, 95% CI: 1.54–12.34), and have only limited or no support from family (OR = 11.01, 95% CI: 1.92–63.20) contributed significantly to the model for predicting likely PTSD among respondents while controlling the other factors in the regression model. Conclusions: According to this study, unemployment, taking sleeping pills, having a prior depression diagnosis, and the willingness to receive mental health counseling significantly increase the odds of having MDD and PTSD following wildfires. Family support may protect against the development of these conditions.

Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health is still being unravelled. It is important to identify which individuals are at greatest risk of worsening symptoms. This study aimed to examine changes in depression, anxiety and post-traumatic stress disorder (PTSD) symptoms using prospective and retrospective symptom change assessments, and to find and examine the effect of key risk factors. Online questionnaires were administered to 34 465 individuals (aged 16 years or above) in April/May 2020 in the UK, recruited from existing cohorts or via social media. Around one-third (n = 12 718) of included participants had prior diagnoses of depression or anxiety and had completed pre-pandemic mental health assessments (between September 2018 and February 2020), allowing prospective investigation of symptom change. Prospective symptom analyses showed small decreases in depression (PHQ-9: -0.43 points) and anxiety [generalised anxiety disorder scale - 7 items (GAD)-7: -0.33 points] and increases in PTSD (PCL-6: 0.22 points). Conversely, retrospective symptom analyses demonstrated significant large increases (PHQ-9: 2.40; GAD-7 = 1.97), with 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Across both prospective and retrospective measures of symptom change, worsening depression, anxiety and PTSD symptoms were associated with prior mental health diagnoses, female gender, young age and unemployed/student status. We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias-related underestimation of prior symptom severity.

COVID-19: Factors Predicting Depressive Symptoms in People Aging With Long-Term Physical Disabilities.

The mental health impact of the COVID-19 pandemic may be greater than that of the viral infection. This impact is likely greater for disadvantaged groups such as people with long-term physical disabilities (PwLTPD). This cross-sectional study used a multiple linear regression model to examine factors associated with depressive symptoms and to understand their relative importance during the onset of the COVID-19 pandemic. The model explained 58% of the variance in depressive symptoms. Anxiety was the most important predictor, accounting for 8% of variance. Higher levels of anxiety, loneliness, and financial stress; prior diagnosis of depression; and non-Black race predicted a higher level of depressive symptoms in PwLTPD during the onset of the COVID-19 pandemic. Occupational therapy practitioners should strategically acknowledge predictors of depression that cannot be modified and actively address those that can be modified through evidence-based interventions to improve depressive symptoms in PwLTPD.

Prevalence and Determinants of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray 12 Months Following the 2020 Flooding.

BackgroundThe flood in Fort McMurray (FMM) which occurred between April 26 and May 2, 2020, is known to have displaced an estimated population of 1,500 people, and destroyed or damaged about 1,230 buildings. In all, it is estimated to have caused about $228 million in losses.ObjectiveThis study aims to identify the prevalence and determinants of likely Generalized Anxiety disorder (GAD) in among respondents 12-months after the 2020 flooding.MethodsData for the study were collected through a cross-sectional survey sent through REDCap and hosted online from the 24th of April to the 2nd of June 2021. The self-administered questionnaire was emailed to respondents using community, government, school, and occupational platforms. Demographic, flooding-related variables, and clinical data were collected. A validated instrument, the GAD-7 was used to collect information on likely GAD. Consent was implied by completing the survey forms, and the University of Alberta Health Research Ethics Committee approved the study.ResultsOf the 249 residents surveyed, 74.7% (186) respondents completed the online survey, 81.6% (80) were above 40 years, 71% (132) were in a relationship, 85.5% (159) were females, and 94.1% (175) were employed. The prevalence of likely GAD was 42.5% in our study. Predictors of likely GAD among respondents included positive employment status (OR = 30.70; 95% C.I. 2.183–423.093), prior diagnosis of depression (OR = 3.30; 95% C.I. 1.157–9.43), and the perceived need to have mental health counseling (OR = 6.28; 95% C.I. 2.553–15.45).ConclusionThis study showed that there was an increased magnitude of moderate to high anxiety symptoms among respondents following the natural disaster particularly the flood in 2020. The predictors of likely GAD include positive employment status, history of depression diagnosis, and the need to have mental health counseling. Policymakers may mitigate the rise of anxiety after flooding in vulnerable areas by addressing these and other factors.

Factors Associated With Early and Late Post-stroke Fatigue in Patients With Mild Impairment. Results From the Stroke Cohort Study Augsburg.

BackgroundPost-stroke fatigue is a common symptom after stroke. However, studies on the factors associated with early and late fatigue are scarce. The objective of this study was to identify variables associated with early and late fatigue.MethodsIn the German Stroke Cohort Augsburg (SCHANA) study, participants were interviewed during their hospital stay and completed a postal questionnaire 3 and 12 months post-stroke. Fatigue was assessed using the Fatigue Assessement Scale (FAS). In addition, depression was measured by the Patient Health Questionnaire (PHQ-9), general health status by the EQ-5D visual analog scale, and physical activity by the International Physical Activity Questionnaire (IPAQ). Multivariable regression models were used to determine the associations between FAS scores at 3 and 12 months post-stroke and demographic, psychosocial and health-related covariables.ResultsAmong 505 participants, the frequency of fatigue was 31.1% 3 months and 29.1% 12 months post-stroke. Prior stroke (ß = 2.37, p = 0.0076), prior diagnosis of depression (ß = 5.04, p = 0.0001), higher NIHSS (ß = 0.25, p = 0.0360) and higher PHQ-9 scores (ß = 0.55, p < 0.0001) were significantly associated with higher fatigue levels 3 months post-stroke. Additionally, younger age (ß = −0.07, p = 0.0219), a worse rating of general health at baseline (ß = −0.04, p = 0.0287) and low pre-stroke physical activity (ß = −0.0004, p = 0.0089) were significantly associated with higher fatigue levels 12 months after stroke.ConclusionsFatigue is a common and persisting symptom even in patients with mild impairment. Prior depressive disorder and early depressive symptoms were the most relevant predictors of both early and late fatigue.

Depression, anxiety, and diabetes-related distress in type 2 diabetes in primary care in Greece: Different roles for glycemic control and self-care.

Objectives:The psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care.Methods:This is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded.Results:The frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score ⩾10), anxiety 17.7% (GAD-7 score ⩾10), and DRD 22.6% (DDS score ⩾2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group.Conclusion:DRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC.

Prevalence and Correlates of Attention Deficit Hyperactivity Disorder among College Students in Jeddah, Saudi Arabia.

Background:Childhood attention deficit hyperactivity disorder (ADHD) is commonly diagnosed in Saudi Arabia, but there is negligible evidence regarding adult ADHD in college students.Objective:To determine the prevalence and correlates of ADHD among undergraduates at King Abdulaziz University, Jeddah, Saudi Arabia.Methods:In this cross-sectional study, 2280 undergraduate students from 11 colleges at King Abdulaziz University, one of the largest university in Saudi Arabia, were approached in person with a questionnaire that elicited information regarding demographics, education, psychiatric history, health behaviors, and ADHD. A validated Arabic version of the Adult ADHD Self-Report Scale was used.Results:A total of 2059 students (90%) completed the questionnaire (mean age: 21.2 years). Almost one-tenth (11.9%) of the sample met the criteria for adult ADHD; only 6.5% had been diagnosed with ADHD in childhood and <1% (0.8%) had taken medication for the same. Multivariate analyses revealed that high family income, low grade in the last semester, parental divorce, diagnosis of childhood ADHD, prior diagnosis of depression, greater severity of current depression and anxiety, and cigarette smoking increased the likelihood of adult ADHD.Conclusion:A notable proportion of students in this study had suspected adult ADHD. Early evaluation of students with ADHD and identification of those at risk may potentially help in improving their academic performance and quality of life.

Exposure to COVID-19 during the First and the Second Wave of the Pandemic and Coronavirus-Related PTSD Risk among University Students from Six Countries-A Repeated Cross-Sectional Study.

This study aimed to reveal differences in exposure to coronavirus disease (COVID-19) during the first (W1) and the second (W2) waves of the pandemic in six countries among university students and to show the prevalence and associations between exposure to COVID-19 and coronavirus-related post-traumatic stress syndrome (PTSD) risk during W2. The repeated cross-sectional study was conducted among university students from Germany, Poland, Russia, Slovenia, Turkey, and Ukraine (W1: n = 1684; W2: n = 1741). Eight items measured exposure to COVID-19 (regarding COVID-19 symptoms, testing, hospitalizing quarantine, infected relatives, death of relatives, job loss, and worsening economic status due to the COVID-19 pandemic). Coronavirus-related PTSD risk was evaluated by PCL-S. The exposure to COVID-19 symptoms was higher during W2 than W1 among students from all countries, except Germany, where, in contrast, the increase in testing was the strongest. Students from Poland, Turkey, and the total sample were more frequently hospitalized for COVID-19 in W2. In these countries, and Ukraine, students were more often in quarantine. In all countries, participants were more exposed to infected friends/relatives and the loss of a family member due to COVID-19 in W2 than W1. The increase in job loss due to COVID-19 was only noted in Ukraine. Economic status during W2 only worsened in Poland and improved in Russia. This was due to the significant wave of restrictions in Russia and more stringent restrictions in Poland. The prevalence of coronavirus-related PTSD risk at three cutoff scores (25, 44, and 50) was 78.20%, 32.70%, and 23.10%, respectively. The prediction models for different severity of PTSD risk differed. Female gender, a prior diagnosis of depression, a loss of friends/relatives, job loss, and worsening economic status due to the COVID-19 were positively associated with high and very high coronavirus-related PTSD risk, while female gender, a prior PTSD diagnosis, experiencing COVID-19 symptoms, testing for COVID-19, having infected friends/relatives and worsening economic status were associated with moderate risk.