Self-rating Depression Research Articles

Assessment of Psychological Status and Oxidative Stress in Postmenopausal Women: A Cross-Sectional Study.

ObjectivesDuring menopause, women may experience some physical changes that can affect their psychological status. Oxidative stress also increases with menopause, as decreasing levels of estrogen reinforce the deterioration of antioxidant status. To assess total antioxidative capacity, malondialdehyde, superoxide dismutase, and glutathione peroxidase and the correlation between psychological status and oxidative stress in postmenopausal women.MethodsThis cross-sectional study was undertaken on 100 postmenopausal women (40–59 years). Blood malondialdehyde, superoxide dismutase, glutathione peroxidase, and total antioxidative capacity were analyzed, and psychological status was assessed using Rosenberg's self-esteem test, Zung's self-rating anxiety scale, and Zung's self-rating depression scale.ResultsOf the women, 38.0% had mild to moderate symptoms of anxiety (mean ± standard deviation, 50.15 ± 4.89), 21.0% showed depression, and 19.0% had low self-esteem. Twelve percent of the study population had mild to moderate symptoms of all three disorders. A statistically significant difference was found in the scores of anxiety and self-esteem (P = 0.001 and P < 0.001 in women with and without psychological disturbances, respectively). With regard to oxidative stress parameters, only superoxide dismutase levels showed a statistically significant difference (P = 0.001), with lower levels found in women with psychological disturbance.ConclusionsWomen with depression, anxiety, and low self-esteem are in an oxidative challenge, which might be associated with estrogen depletion. A lower superoxide dismutase level is associated with higher depression and anxiety scores in postmenopausal women.

Understanding the Pathways of Neighborhood Environmental Influences on Health Among U.S. Chinese Older Immigrants

Neighborhood environment has proven to be consequential for older Americans’ physical, mental and cognitive health. However, this topic is much less studied among older Asian immigrants, a fast growing immigrant group who embrace values of collectivism and community connections. The current study used the first wave data (N=2920) of the Population Study of Chinese Elderly (PINE), the largest population-based sample of Chinese older adults in the U.S., 1) to examine the direct associations between neighborhood environment (social cohesion, physical disorder) and health outcomes (self-rated health, depression, and cognitive health); and 2) to identify possible mediators at intrapersonal (sense of hopelessness, sense of mastery) and interpersonal levels (social engagement, cognitive engagement) through which neighborhood environment influences health. The results of Sobel tests from path analysis showed that neighborhood social cohesion was associated with better health outcomes on all the domains: self-rated health (b= 0.050, p<.01), depression (b= -0.202 p<.001), and cognitive health (b=0.092, p<.001), whereas neighborhood physical disorder was associated with poorer self-rated health (b= -0.069, p<.01) and more depressive symptoms (b=0.174, p<.001). Full and partial mediations were detected. For example, neighborhood physical disorder influences depression completely through intrapersonal traits, higher sense of hopelessness (b=1.879, p<0.001) and reduced sense of mastery (b= -2.656, p<0.001). Neighborhood social cohesion contributes to better cognitive health partially through increased social engagement (b=1.696, p<0.001) as well as cognitive activities (b=1.392, p<0.001). The findings identified the ecological component in resilience building processes, and provide evidence for mezzo-level intervention to improve health among aging U.S. Chinese immigrants.

Childlessness, Individual Socioeconomic Resources, and Health: Exploring Variation in 20 Countries

Childless older adults may be at risk for poorer health cross-nationally, yet most studies on this topic analyze only a small number of countries and only 1 or 2 health outcomes. To our knowledge, two papers exist that explore associations between childlessness and multiple indicators of health using data from a large number of regionally diverse countries (e.g., 20 countries from North America, Asia, and Europe), but neither study includes an examination of socioeconomic resources. The level of health risk faced by childless older adults is likely to be distinctly shaped by older adults’ socioeconomic resources (e.g., education, income, wealth). Associations between childlessness, socioeconomic resources, and health may also differ by country context. Using harmonized, cross-national data for adults aged 50 and older across 20 high- and middle-income countries (United States (HRS), European Union (SHARE), Mexico (MHAS), and China (CHARLS) from the Gateway to Global Aging data repository), we explore if and how individual-level socioeconomic resources (income, education, wealth) moderate associations between childlessness and five health indicators (self-rated health, ADL limitations, IADL limitations, chronic conditions, and depression). Results suggest that associations between childlessness and health outcomes vary by individual socioeconomic resources in some country contexts, but not in others. We discuss these findings in light of the impact of individual-level socioeconomic resources on older adults’ support options and health outcomes cross-nationally.

Discrepancies between self-rated depression and observed depression severity: The effects of personality and dysfunctional attitudes

BackgroundPatient self-reports and clinician ratings of depression severity can differ substantially. The aim of the current study was to explore factors associated with discrepancies between depressed patients' Patient Health Questionnaire (PHQ-9) self-reports and clinicians' Hamilton Rating Scale for Depression (HAMD-17) ratings. MethodsWe first computed discrepancy scores defined as the standardized weighted HAMD-17 total score minus the standardized PHQ-9 total score. To assess correlates of inconsistent scores, results of patients with similar standardized scores were removed (i.e., within ½ standard deviation, n = 270). Positive values indicate underreporting (HAMD-17 > PHQ-9), i.e., the underreporting group (n = 200); and negative discrepancy scores indicate overreporting (PHQ-9 > HAMD-17), i.e., the overreporting group (n = 221). We examined the relationship of demographic, dysfunctional attitudes and personality variables to the discrepancies between self and observer rated depression. ResultsThere were significant differences in extraversion, psychoticism, neuroticism, dysfunctional attitudes and occupation between the underreporting group and the overreporting group (all p < .05). When controlling for potential confounding variables, being a working professional and having high neuroticism and dysfunctional attitudes were significantly associated with overestimating symptoms of depression (e.g., professional: OR, 2.89; 95% CI, 1.67–5.00; p < .001; high neuroticism: OR, 7.08; 95% CI, 1.47–34.08; p < .001;dysfunctional attitudes: OR, 1.01; 95% CI, 1.00–1.02; p = .030). People with average, or high extraversion tended to underestimate scores (average extraversion: OR, 0.59; 95% CI, 0.37–0.95; high extraversion: OR, 0.48; 95% CI, 0.24–0.98). ConclusionsThis study is the first to use PHQ-9 and HAMD-17 to explore the discrepancies between self and observer rated depression. Discrepancies occurred between the PHQ-9 score and HAMD-17 score, which were related to neuroticism, extraversion, dysfunctional attitudes and being a working professional. Future research should clarify the relationship between these factors and therapeutic effects of treatments, including adverse outcomes.

PIN166 Health-Related Quality of Life (HRQOL) Outcomes and Potential Interventions in Patients Diagnosed with COVID-19.

To identify evidence on the Quality of life measures and potential interventions in patients diagnosed with COVID-19. A systematic literature review was conducted based on a reproducible search strategy designed to identify HRQoL outcomes in COVID-19 patients. Evidence indexed in Embase/MEDLINE (until 30th June 2020) and clinical trials.gov (until 8th July 2020) was screened for inclusion per pre-defined criteria. 621 abstracts were screened followed by an evaluation of 91 full text citations. 10 studies were finally included and analysed. Among included studies, a study conducted in China investigated the effect of respiratory rehabilitation on pulmonary function, functional status (6-minute walk distance), QoL (SF-36 scores), functional independence and mental status (Self-rating depression and anxiety scales) in elderly patients. The QoL scores showed statistically significant improvement in the patients receiving respiratory rehabilitation besides improvement in the anxiety associated with COVID-19 diagnosis and isolation. Another study investigated the effect of progressive muscle relaxation (PMR) on anxiety and sleep quality and reported significant improvement in sleep quality and anxiety scores based on sleep state self-rating scale (SRSS) and Speilberger State-trait Anxiety scale (STAI). A case report examined the benefits of DBT (Dialectical behavior therapy) based psychological intervention on a pregnant patient and reported improvement in psychological features with reduction in HAMD-17 (Hamilton Depression scale 17), HAMA (Hamilton Anxiety scale) and MADRS (Montgomery-Asberg Depression rating scale) scores. Other ongoing studies Investigated interventions like pulmonary physiotherapy, pulmonary and motor rehabilitation, post discharge tele rehabilitation (resistive training, breathing and aerobic exercise) and behavioral interventions. A majority of these involved EuroQoL assessment. COVID-19 is unfolding as a complex illness affecting multiple organs with currently unknown long-term effects. Interventions aimed at managing physical and mental QOL measures are necessary particularly in hospitalized patients. These interventions need to be potentially combined with hospitalization and post discharge management protocols.

Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults.

BACKGROUNDAlthough nonpharmacological interventions (NPI) for irritable bowel syndrome (IBS) have been applied clinically, their relative efficacy and safety are poorly understood.AIMTo compare and rank different NPI in the treatment of IBS.METHODSFive electronic databases were searched from their inception to January 12, 2020. Data of included publications were analyzed using network meta-analysis (NMA). Quality of endpoints were assessed by tools of the Cochrane Handbook and the GRADEpro software. Pooled relative risk or standardized mean difference with their corresponding 95% confidence intervals were used for statistical analysis. Surface under the cumulative ranking curve (SUCRA) probability value was conducted to rank the examined interventions. Sensitivity analysis was performed to verify the robustness of results and test the source of heterogeneity.RESULTSForty randomized controlled trials with 4196 participants were included in this NMA. Compared with routine pharmacotherapies and placebo, acupuncture and cognitive behavioral therapy (CBT) had better efficacy in relieving IBS symptoms. Based on the SUCRA values, acupuncture ranked first in improving overall clinical efficacy and avoiding adverse effects. CBT ranked first in lowering the scores of IBS symptom severity scale, self-rating anxiety scale and self-rating depression scale.CONCLUSIONThis study confirmed the efficacy and safety of NPI for improving IBS symptoms, which to some extent recommended several interventions for clinical practice.

Depression and Sleep Quality in Outpatients attending Penjaringan Primary Health Care, North Jakarta: A Cross-sectional Study

Introduction: Depression is the most common mental disorder. Depression of outpatients in primary health care is frequently unrecognized. It might affect sleep quality, which is associated with worse quality of life, poor medication adherence, higher morbidity, and mortality. The study aimed to determine the association between depression and sleep quality of outpatients in Penjaringan Primary Health Care, Jakarta. Method: This research was observational analytic using a cross-sectional approach involving 434 outpatients in Penjaringan Primary Health Care, Jakarta. The study was conducted from August until September 2019. Instruments used in this research were the demographic questionnaire, the Zung Self-Rating Depression (SDS) questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data analytics were bivariate. Results: There were 19.1% of respondents had depression, including 12.2% mild depression, 5.8% moderate depression, and 1.2% severe depression. There were 53.5% of respondents had poor sleep quality. There was a significant relationship (p&lt;0.001, OR=7.814) between depression and sleep quality in outpatients. The results also showed that depression scores were moderately correlated with sleep disturbances (r=0.434). Conclusion: This study showed a high prevalence of depression and poor sleep quality among outpatients. Depression was associated with a 7.8 times higher risk of having poor sleep quality and also correlated with the components of sleep quality especially sleep disturbance.&#x0D;

Disentangling the Role of Working Memory in Parkinson’s Disease

Working memory (WM) represents a core cognitive function with a major striatal contribution, and thus WM deficits, commonly observed in Parkinson’s disease (PD), could also relate to many other problems in PD patients. Our online study aimed to determine the subdomains of WM that are particularly affected in PD and to clarify the links between WM and everyday cognitive deficits, other executive functions, psychiatric and PD symptoms, as well as early cognitive impairment. Fifty-two mild-to-moderate PD patients and 54 healthy controls performed seven WM tasks tapping selective updating, continuous monitoring, or maintenance of currently active information. Self-ratings of everyday cognition, depression, and apathy symptoms, as well as screenings of global cognitive impairment, were also collected. The data were analyzed using structural equation modeling. Of the three WM domains, only selective updating was directly predictive of PD group membership. More widespread WM deficits were observed only in relation to global cognitive impairment in PD patients. Self-rated everyday cognition or psychiatric symptoms were not linked to WM performance but correlated with each other. Our findings suggest that WM has a rather limited role in the clinical manifestation of PD. Nevertheless, due to its elementary link to striatal function, the updating component of WM could be a candidate for a cognitive marker of PD also in patients who are otherwise cognitively well-preserved.

Long-term medical treatment of patients with severe burns at exposed sites.

BACKGROUNDBody parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas. In addition, residual wounds, scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas, which may affect patients’ appearance, movements, and mental health. However, inadequate attention has been paid to this issue which can result in problems, such as difficulty in healing, possibility of carcinoma, chronic pain and a heavy mental burden.AIMTo investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODSA retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment. A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds. Active and passive functional exercises with massage, Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands. A combination of physical, chemical and photoelectrical measures was adopted for anti-scar treatment. A psychological intervention and recovery guide was provided which corresponded to the patients’ psychological status.RESULTSCompared to patients who did not simultaneously receive the same treatment, patients who underwent systematic treatment recovered with a lower wound infection rate (P < 0.05), a shorter healing time (13.6 ± 3.2 d) compared with (19.1 ± 3.5 d) and more bearable pain during wound dressing at three days, one week and two weeks after a Chinese herbal bath (P < 0.05). Satisfactory results were achieved with regard to restored function of patients’ joints and blood supply to nerve endings, closure of the eyelids and the size of mouth opening tended to be normal, and only 7.1% of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7% in the control group. In addition, the color, thickness, vascular distribution and softness score of the scars improved (P < 0.01), and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSIONA better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair, limb functional exercise, anti-scar and psychological rehabilitation.

Body Concept and Quality of Life in Patients with Idiopathic Dystonia.

Patients with dystonia experience unusual postures and disfigurement. The aim of the study was to examine changes in the body concept in relation to quality of life and severity of dystonia. Our cohort consisted of 20 patients with idiopathic dystonia resistant to medical therapy who were planned for pallidal deep brain stimulation. The results were compared to 25 healthy controls. The patients were assessed with Frankfurt Body Concept Scale, Short Form 36 (SF-36) Health Survey, Hamilton Depression Scale, Beck Depression Inventory, Social Phobia Inventory and Social Interaction Anxiety Scale. The disease severity was evaluated with Burke–Fahn–Marsden Dystonia Rating Scale and Toronto Western Spasmodic Torticollis Rating Scale. Patients with dystonia had a significantly impaired body concept in eight out of nine subscales in comparison to healthy controls. The differences were most pronounced for the subscales general health, body care, physical efficacy, sexuality and physical appearance (p < 0.001). Furthermore, all eight subscales of SF-36 exhibited significantly lower values in patients with dystonia compared to controls. We also found significant positive correlations between SF-36 and body concept subscales. Impairment of body concept was not associated with disease severity or levels of social anxiety symptoms. However, there was a significant association between self-rated depression and disease severity. Our patients suffered from increased depression and social anxiety symptoms except social interaction anxiety. We conclude that patients with dystonia have significant body concept impairment that interferes with quality of life in both physical and emotional domains. Future studies should focus on assessing these symptoms after adequate therapeutic management of motor symptoms.

Self-rated health and mental health among older incarcerated males

Objectives Older incarcerated persons are a rapidly growing population with considerable mental health needs. We evaluated perceived worth and meaningfulness in life as mediators in the relationship between self-rated health (SRH) and depression and anxiety. Method Mediation analyses were conducted among 222 older incarcerated males from eight correctional facilities in Connecticut.PHQ-9 and GAD-7 assessed depression and anxiety, respectively. Subscales of the Geriatric Suicidal Ideation Scale (GSIS) measured perceived worth and meaningfulness in life. Results Greater SRH was associated with lower depression and anxiety. More perceived worth and meaningfulness in life were associated with better SRH and lower depression and anxiety. There is evidence of perceived worth and meaningfulness in life mediating the SRH-depression (β = −0.86; 95% CI = −1.32 to −0.48; β= −0.46, 95% CI = −0.82 to −0.17, respectively) and SRH-anxiety (β = −0.71; 95% CI = −1.08 to −0.39; β = −0.34, 95% CI = −0.65 to −0.10) relationships. Conclusion SRH has both direct and indirect effects on depression and anxiety, by working through perceived worth and meaningfulness in life, in older incarcerated males. Assessing SRH, and focusing on ways to maintain self-worth and meaning, may be instrumental in promoting and sustaining their good mental health.

The Mediator Effect of Visual Impairment in the Relationship between Poor Oral Health and Depression

Purpose: Visual impairment (VI) with a global estimate of 161 million has been associated with a lot of health concerns and physical conditions. This study investigates the mediator effect of visual impairment on the relationship between poor oral health and depression.&#x0D; Methods: This was a cross-sectional study involving secondary analysis using data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS). Self-reported visual impairment was categorized as no and yes (a little difficulty, moderate difficulty, extreme difficulty and unable to do because of eyesight). The responses to oral health were dichotomized to 0-5 teeth removed and 6+ teeth removed (poor oral health). For depression, we used physician-diagnosed depression (yes or no) and self-rated depression (validated Patient Health Questionnaire-8) (PHQ-8). We examined the association between visual impairment and depression using multivariable logistic regression accounting for the survey’s complex design.&#x0D; Results: After adjusting for socio-demographic variables, health behavior, BMI and diabetes; the model produced a significant relationship between poor oral health and depression. Controlling for visual impairment resulted in the attenuation of the effect poor oral health has on depression. Furthermore, after improving eyesight, a previously significant relationship between poor oral and depression became non-significant.&#x0D; Conclusion: Controlling for visual impairment, by treating or preventing visual impairment, in patients with poor oral health, merely indicates a reduction in the outcome of depression.

The Effects of Intensity of Physical Activity on Mental Health

Modern, complicated society has brought various stressors, and consequentially, more and more people are suffering from mental health problems. The purpose of this study is to investigate the effects of physical activity at different intensities (high, moderate and low) on mental health-related factors (self-rated health, stress, sleep time, and depression). The raw data of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) were utilized. Data of 1,622 samples were extracted for analysis regarding self-rated health, stress, sleep time, and depression in adults aged over 20 years who participated in physical activity. The collected data were analyzed using SPSS 18.0. The differences between the groups were verified through the analysis of variance and post-hoc analysis. All statistical significance levels were set at .05. There were statistically significant differences in self-rated health status, sleep time, and depression between intensities of physical activity (p &lt; .05). Specifically, the self-rated health status and depressive moods present the lowest score in the high-intensity physical activity group among 3 groups. The moderate-intensity of physical activity group showed the longest sleep time. In conclusion, it is necessary to pay attention to the selecting appropriate intensity of physical activity to manage mental health.

Abnormal Rich Club Organization of Structural Network as a Neuroimaging Feature in Relation With the Severity of Primary Insomnia.

PurposeInsomnia is the most prevalent sleep complaint in the general population but is often intractable due to uncertainty regarding the underlying pathomechanisms. Sleep is regulated by a network of neural structures interconnected with the core nodes of the brain connectome referred to as the “rich club”. We examined alterations in brain rich-club organization as revealed by diffusion tensor imaging (DTI) and the statistical relationships between abnormalities in rich-club metrics and the clinical features of primary insomnia (PI).MethodsThis study recruited 43 primary insomnia (PI) patients and 42 age-, sex-, and education level-matched healthy controls (HCs). Differences in global and regional network parameters between PI and healthy control groups were compared by nonparametric tests, and Spearman's correlations were calculated to assess associations of these network metrics with PI-related clinical features, including disease duration and scores on the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Self-Rating Anxiety Scale, and Self-Rating Depression Scale.ResultsWeighted white matter networks exhibited weaker rich-club organization in PI patients than HCs across different thresholds (50%, 75%, and 90%) and parcellation schemes [automated anatomical labeling (AAL)-90 and AAL-1024]. Aberrant rich-club organization was found mainly in limbic-cortical-basal ganglia circuits and the default-mode network.ConclusionsAbnormal rich-club metrics are a characteristic feature of PI-related to disease severity. These metrics provide potential clues to PI pathogenesis and may be useful as diagnostic markers and for assessment of treatment response.

Effect of vitamin D deficiency on depressive symptoms in child and adolescent psychiatric patients: results of a randomized controlled trial

PurposeWhile observational studies revealed inverse associations between serum vitamin D levels [25(OH)D] and depression, randomized controlled trials (RCT) in children and adolescents are lacking. This RCT examined the effect of an untreated vitamin D deficiency compared to an immediate vitamin D3 supplementation on depression scores in children and adolescents during standard day and in-patient psychiatric treatment.MethodsPatients with vitamin D deficiency [25(OH)D ≤ 30 nmol/l] and at least mild depression [Beck Depression Inventory II (BDI-II) > 13] (n = 113) were 1:1 randomized into verum (VG; 2640 IU vitamin D3/d) or placebo group (PG) in a double-blind manner. During the intervention period of 28 days, both groups additionally received treatment as usual. BDI-II scores were assessed as primary outcome, DISYPS-II (Diagnostic System for Mental Disorders in Childhood and Adolescence, Self- and Parent Rating) and serum total 25(OH)D were secondary outcomes.ResultsAt admission, 49.3% of the screened patients (n = 280) had vitamin D deficiency. Although the intervention led to a higher increase of 25(OH)D levels in the VG than in the PG (treatment difference: + 14 ng/ml; 95% CI 4.86–23.77; p = 0.003), the change in BDI-II scores did not differ (+ 1.3; 95% CI − 2.22 to 4.81; p = 0.466). In contrast, DISYPS parental ratings revealed pronounced improvements of depressive symptoms in the VG (− 0.68; 95% CI − 1.23 to − 0.13; p = 0.016).ConclusionWhereas this study failed to show a vitamin D supplementation effect on self-rated depression in adolescent in- or daycare patients, parents reported less depressive symptoms in VG at the end of our study. Future trials should consider clinician-rated depressive symptoms as primary outcome.Trial registration“German Clinical Trials Register” (https://www.drks.de), registration number: DRKS00009758

Effects of positive music stimulation combined with cognitive intervention on ICU patients with severe pneumonia

Objective To investigate the effect of positive music stimulation combined with cognitive intervention on ICU patients with severe pneumonia. Methods A total of 80 patients with severe pneumonia admitted from May 2017 to May 2018 were selected as study subjects, and randomly divided into study group and control group with 40 cases each.The control group received routine nursing intervention, while the study group received positive music stimulation combined with cognitive intervention.The differences in sleep index, emotional state and self-perceived burden between the two groups before and after the intervention were compared. Results After intervention, the Pittsburgh Sleep Quality Index (PSQI) of the study group was lower than that of the control group before intervention, and the difference was statistically significant(P<0.05). After intervention, the score of the self-perceived burden scale between the study group and the control group was lower than that before intervention, and the difference was statistically significant( P<0.05). After intervention, the score of anxiety self-rating scale (SAS) and depression self-rating scale (SDS) in the study group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusions Positive music stimulation combined with cognitive intervention can significantly improve the sleep quality of ICU patients with severe pneumonia, at the same time, it is beneficial to alleviate patients' negative emotions and reduce the burden of self-perception. Key words: Severe pneumonia; Positive music stimulation; Cognitive intervention; Sleep index; Self-perceived burden

Youth Depression Alleviation with Anti-inflammatory Agents (YoDA-A): a randomised clinical trial of rosuvastatin and aspirin

BackgroundInflammation contributes to the pathophysiology of major depressive disorder (MDD), and anti-inflammatory strategies might therefore have therapeutic potential. This trial aimed to determine whether adjunctive aspirin or rosuvastatin, compared with placebo, reduced depressive symptoms in young people (15–25 years).MethodsYoDA-A, Youth Depression Alleviation with Anti-inflammatory Agents, was a 12-week triple-blind, randomised, controlled trial. Participants were young people (aged 15–25 years) with moderate to severe MDD (MADRS mean at baseline 32.5 ± 6.0; N = 130; age 20.2 ± 2.6; 60% female), recruited between June 2013 and June 2017 across six sites in Victoria, Australia. In addition to treatment as usual, participants were randomised to receive aspirin (n = 40), rosuvastatin (n = 48), or placebo (n = 42), with assessments at baseline and weeks 4, 8, 12, and 26. The primary outcome was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to week 12.ResultsAt the a priori primary endpoint of MADRS differential change from baseline at week 12, there was no significant difference between aspirin and placebo (1.9, 95% CI (− 2.8, 6.6), p = 0.433), or rosuvastatin and placebo (− 4.2, 95% CI (− 9.1, 0.6), p = 0.089). For rosuvastatin, secondary outcomes on self-rated depression and global impression, quality of life, functioning, and mania were not significantly different from placebo. Aspirin was inferior to placebo on the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) at week 12. Statins were superior to aspirin on the MADRS, the Clinical Global Impressions Severity Scale (CGI-S), and the Negative Problem Orientation Questionnaire scale (NPOQ) at week 12.ConclusionsThe addition of either aspirin or rosuvastatin did not to confer any beneficial effect over and above routine treatment for depression in young people. Exploratory comparisons of secondary outcomes provide limited support for a potential therapeutic role for adjunctive rosuvastatin, but not for aspirin, in youth depression.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12613000112763. Registered on 30/01/2013.

EMOTIONS AND WELL-BEING IN LATER LIFE CHILDHOOD HAPPINESS, SELF-MASTERY, AND LATER-LIFE HEALTH

Considerable work has documented that positive childhood memories, especially childhood happiness, predict better health among young adults. However, it is not known whether growing up happy has enduring health consequences across the life course. Using two waves of the National Social Life, Health and Aging Project (2010-2011 and 2015-2016; N = 1,937), we investigate the relationship between childhood happiness and changes in physical, mental, and biological functioning in later life. Childhood happiness was retrospectively assessed using a question: “When I was growing up, my family life was always happy.” Self-rated health, depressive symptoms, and frailty over a five-year period were examined to reflect changes in functional status. Childhood SES and living arrangement were examined to assess childhood sociodemographic background. Educational attainment, family support and strain, and self-mastery were considered as potential mediators. We find that, among other childhood factors, childhood happiness significantly predicts older adult health. Specifically, childhood happiness was associated with better self-rated health and lower depressive symptoms at follow-up, net of baseline health conditions. We did not find a relationship between frailty and childhood happiness. Unlike prior work, we found no significant effect of childhood SES on the measured outcomes. Associations between childhood happiness and self-rated health and depression were mediated by psychosocial resources including self-mastery and perceived social support from family members. This implies that growing up in nurturing, cherished family environment has the potential to cultivate social relationships and build resilience which could provide an important pathway to successful aging.

Effects of focused solving mode on the care preparedness and negative emotions of the main caregivers of patients with stroke

Objective To explore the effects of focused solving mode on the care preparedness and negative emotions of the main caregivers of patients with stroke. Methods Totally 87 main caregivers of patients with stroke were enrolled from the department of Neurology,North Jiangsu People′s hospital in Yangzhou from January 2018 to October 2018. Forty-three caregivers were recruited in the control group from January to May 2018. From June to October in 2018, 44 caregivers were recruited in the intervention group. Both groups received routine care, and the intervention group also received focused solving mode. Applying Caregiver Preparedness Scale、Self-rating Anxiety and Depression Scale to evaluate the effects of intervention. Two cases in intervention group were lost to follow-up while one case in control group. Results Before the intervention, there were no statistical differences in caregiver preparedness scores and anxiety and depression scores between two groups (P>0.05). After the implementation of the focused solving mode, the caregiver preparedness score was (24.14±3.25) points in the intervention group and (20.95±2.56) points in the control group, the difference was statistically significant (t=5.000, P<0.01); the anxiety and depression scores of caregivers were (47.64±6.54), (48.39 ±7.07) points in the intervention group, (50.33±4.68), (53.68±6.73) points in the control group, there were significant differences (t=-2.165,-3.511, P<0.05 or 0.01). Conclusion Focused solving mode can improve the care preparedness of the main caregivers of patients with stroke and alleviate anxiety and depression effectively. Key words: Focused solving mode; Stroke; Caregivers; Care preparedness; Anxiety; Depression

한국 성인의 주관적 건강상태와 폭음, 우울 간의 종단적 관계

한국 성인의 주관적 건강상태와 폭음, 우울 간의 종단적 관계