Significant Independent Predictor Of Depression Research Articles

The mediating role of perceived social support on loneliness and depression in community-dwelling Nepalese older adults

BackgroundLoneliness has been identified as a significant independent predictor of depression among older adults. Social support has been reported to play a protective role against both loneliness and depression in older adults. However, few studies to date have investigated the three constructs concurrently and the mediating role of Perceived Social Support (PSS) on the relationship between loneliness and depression in this age group. The current study aimed to assess the relationship between loneliness and depression among community-dwelling Nepalese older adults based on the mediating role of PSS.MethodsThis descriptive cross-sectional research study included 367 community-dwelling older adults from a randomly selected ward in Kathmandu, Nepal. The University of California, Los Angeles Loneliness Scale, Geriatric Depression Scale, and Multidimensional Scale of Perceived Social Support were used. Correlation analysis, regression analysis, and the PROCESS 4.1 macro developed by Hayes with a bootstrapping procedure were used to test the mediating effect of the PSS on the relationship between loneliness and depression.ResultsLoneliness was negatively associated with the PSS (β = -0.405; 95% CI: −0.473, -0.337; P < 0.001), and the PSS was positively associated with depression (β = 0.057; 95% CI: 0.014, 0.099; P = 0.009). The direct effect of loneliness on depression was positive and significant (β = 0.151; 95% CI: 0.117, 0.184; P < 0.001), whereas the indirect effect of loneliness on depression through the PSS was negative (path c; β = -0.023, 95% CI: -0.041, -0.005). The results indicated that the PSS partially mediated the relationship between loneliness and depression.ConclusionThese findings suggest that interventions focusing on reducing loneliness and fostering social support may be able to lessen depressive symptoms in older adults. By addressing these factors, healthcare providers and carers can promote the mental health of older adults.

Long-Term Psychological Effects of the COVID-19 Pandemic: Anxiety and Depression among Physicians in a Tertiary Referral Hospital.

Since the COVID-19 pandemic peaked, few studies have thereafter assessed the continued effects of the COVID-19 pandemic on the mental health of healthcare workers. To determine the rate and predictors of self-reported symptoms of depression and anxiety among physicians at a public tertiary care teaching hospital in Saudi Arabia about 2 years after COVID-19 was declared a pandemic. This cross-sectional study was conducted from September 2021 to April 2022 and targeted all physicians working at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were used to elicit self-reported data regarding depression and anxiety, respectively. In addition, sociodemographic and job-related data were collected. A total of 438 physicians responded, of which 200 (45.7%) reported symptoms of depression and 190 (43.4%) of anxiety. Being aged 25-30 years, female, resident, and reporting reduction in work quality were factors significantly associated with both anxiety and depression. Female gender (AOR = 3.570; 95% CI = 2.283-5.582; P < 0.001), working an average 9-11 hours/day (AOR = 2.130; 95% CI = 1.009-4.495; P < 0.047), and self-perceived reduction in work quality (AOR = 3.139; 95% CI = 2.047-4.813; P < 0.001) were significant independent predictors of anxiety. Female gender (AOR = 2.929; 95% CI = 1.845-4.649; P < 0.001) and self-perceived reduction in work quality (AOR = 3.141; 95% CI = 2.053-4.804; P < 0.001) were significant independent predictors of depression. About half of the physicians reported symptoms of anxiety and depression. These findings are suggestive of the need for large-scale studies to determine the ongoing effects of the COVID-19 pandemic on the mental health of healthcare workers in Saudi Arabia.

Prevalence and risk factors of depression among undergraduate medical students in a Nigerian university.

This study assessed the prevalence and risk factors of depression among undergraduate medical students at the University of Benin, Benin City, Nigeria. This was a cross-sectional study. This study was carried out at the University of Benin. Three hundred medical students were recruited for this study. The Patient Health Questionnaire 9 (PHQ-9) and a structured pre-tested self-administered questionnaire were used to assess the prevalence and risk factors of depression, respectively. The students' age ranged from 15 - 34 years, with a mean age of 21.8 ± 3.3 years. Many risk factors which could predispose students to depression were identified. Overall, 96 (32.0%) students were found to have depression. Of these, 59 (19.0%) had mild depression, 4 (1.3%) had severe depression, 53 (39.3%) were pre-clinical students, and 43 (26.1%) were clinical students. Emotional problems (OR 2.205, 95% CI 1.122 - 3.749, p = 0.020), financial challenges (OR 3.971, 95% CI 2.170 - 7.269, p < 0.001) and smoking (OR 6.877, 95% CI 1.731 - 27.327, p = 0.006) were the significant independent predictors of depression. The prevalence of depression was high among medical students. There is a need to include screening for risk factors of depression in the routine medical examinations for new students admitted into medical schools. None declared.

Utilizing daily mood diaries and wearable sensor data to predict depression and suicidal ideation among medical interns

BackgroundIntensive longitudinal methods (ILMs) for collecting self-report (e.g., daily diaries, ecological momentary assessment) and passive data from smartphones and wearable sensors provide promising avenues for improved prediction of depression and suicidal ideation (SI). However, few studies have utilized ILMs to predict outcomes for at-risk, non-clinical populations in real-world settings. MethodsMedical interns (N = 2881; 57 % female; 58 % White) were recruited from over 300 US residency programs. Interns completed a pre-internship assessment of depression, were given Fitbit wearable devices, and provided daily mood ratings (scale: 1–10) via mobile application during the study period. Three-step hierarchical logistic regressions were used to predict depression and SI at the end of the first quarter utilizing pre-internship predictors in step 1, Fitbit sleep/step features in step 2, and daily diary mood features in step 3. ResultsPassively collected Fitbit features related to sleep and steps had negligible predictive validity for depression, and no incremental predictive validity for SI. However, mean-level and variability in mood scores derived from daily diaries were significant independent predictors of depression and SI, and significantly improved model accuracy. LimitationsWork schedules for interns may result in sleep and activity patterns that differ from typical associations with depression or SI. The SI measure did not capture intent or severity. ConclusionsMobile self-reporting of daily mood improved the prediction of depression and SI during a meaningful at-risk period under naturalistic conditions. Additional research is needed to guide the development of adaptive interventions among vulnerable populations.

Depression before and after diagnostic procedures among women with abnormal finding of Papanicolaou screening test.

BackgroundSome studies did find significant differences in the level of depression of women while undergoing diagnostic evaluation of an abnormal Papanicolaou screening smear, but findings were not consistent. This study aimed to assess prevalence and correlates of depression in women with abnormal cervical screening results before and after diagnostic procedures.MethodsA cross‐sectional study was carried out during 2017 in a cohort of women with positive Papanicolaou screening test before and after diagnostic procedures (colposcopy/biopsy/endocervical curettage) at the university Clinical Centre Kragujevac, Serbia. Women completed a questionnaire about demographics, lifestyle, and other factors of interest. Also, questionnaire “Hospital Anxiety and Depression Scale” (HADS) was used immediately before and 2–4 weeks after the diagnostic procedures: a score of ≥8 on HADS‐D and HADS‐A subscales indicated depression and anxiety, respectively. Multivariate logistic regression was applied in the data analysis.ResultsThe study comprised 172 women, giving a response rate of 72.3%. The mean age of the participants was 47.8 ± 11.1 years (range 23–65). The frequency of depressive symptoms was significantly higher after diagnostic procedures (48.3%) than before diagnostic procedures (37.2%) (p = 0.038). Before diagnostic procedures, older age (OR = 1.60; 95% CI = 1.09–2.34; p = 0.017), and level of anxiety according to the HADS‐A subscale (OR = 1.61; 95% CI = 1.38–1.88; p < 0.001) were significant independent predictors of depression. After diagnostic procedures, significant independent predictors of depression were urban place of residence (OR = 0.12; 95% CI = 0.03–0.47; p = 0.002) and level of anxiety according to the HADS‐A subscale (OR = 1.85; 95% CI = 1.54–2.21; p < 0.001).ConclusionOur study showed that older age, rural residence, and anxiety play a role in shaping the risk of depression among women undergoing additional diagnostic procedures after receiving an abnormal Papanicolaou screening result.

Prevalence Estimates, Severity, and Risk Factors of Depressive Symptoms among Coronary Artery Disease Patients after Ten Days of Percutaneous Coronary Intervention.

Background:Depression and cardiovascular disorders are significant determinants of health that affect the quality of life and life expectations. Despite the high importance of depression screening among Coronary Artery Disease (CAD) patients, the time being to assess and treat it remains controversial.Objectives:This study aims to assess the prevalence estimates and severity of depressive symptoms and determine the risk factors associated with developing such symptoms among CAD patients after ten days of Percutaneous Coronary Intervention (PCI).Methods:All patients who underwent elective PCI between October 5, 2019, and Mid-March 2020 and diagnosed with CAD were included in this cross-sectional study. CAD was defined as intra-luminal stenosis of ≥ 50% in one or more of the coronary arteries. Depressive symptoms were screened after ten days of the PCI utilizing the patient health questionnaire-9 (PHQ-9) tool. A linear regression model was used to assess the adjusted effects of independent variables on PHQ-9 scores. Electronic medical records, clinical charts, and PCI and echocardiogram reports were reviewed.Results:Out of 385 CAD patients, a total of 335 were included in this study, with a response rate of 87%. The participants' mean (±SD) age was 57.5±10.7 years, 75.2% were males, 43% were current smokers, and 73.7% had below bachelor's education. The prevalence estimates of patients with moderate to severe depressive symptoms (PHQ-9 ≥10) was 34%, mild depression 45.1%, and normal 20.9%. Female gender, low educational level and diabetes mellitus were found to be the significant independent predictors of depression among our cohort with (t(333) = 3.68, p<0.001); (t(333) = 5.13, p<0.001); and (t(333) = 2.79, p=0.042), respectively.Conclusion:This study suggests a high prevalence of depressive symptoms among CAD patients after ten days of PCI. Approximately one out of three patients with CAD have significant symptoms of depression, which is an alarming finding for clinicians. Moreover, this study demonstrates a lack of sufficient depression recognition and management in similar study settings. Integration of mental health assessment and treatment among patients with CAD as soon as after PCI is recommended for optimal and effective treatment and to obtain the best outcomes.

Predictors and Correlates of Depression in Retired Elite Level Rugby League Players.

Background: There is considerable interest in determining whether later-in-life depression is associated with lifetime history of concussions or the duration of a career in professional contact and collision sports. Rugby league is a high-intensity collision sport involving a large number of tackles per game and a high rate of concussions. We examined predictors and correlates of depression in retired elite level rugby league players in Australia.Methods: Retired elite level rugby league players (N = 141, age: M = 52.6, SD = 13.8; Range = 30–89 years) completed the Depression, Anxiety, and Stress Scale (DASS), Brief Pain Inventory, Connor-Davidson Resilience Scale (CD-RISC), and Epworth Sleepiness Scale; they also reported on lifetime history of concussions. The DASS depression score was regressed on age, total number of self-reported concussions, years played professionally, CD-RISC score, BPI pain interference score, and ESS score.Results: The retired players reported a median of 15 total lifetime concussions [interquartile range (IQR) = 6–30], and a median of 8 years playing professional sports (IQR = 3.5–11). The proportion of the sample endorsing at least mild current depression was 29%. The DASS depression score was positively correlated with the DASS anxiety (r = 0.54) and DASS stress scores (r = 0.58). The CD-RISC score was negatively correlated with the depression score (r = −0.53). Depression scores were not significantly correlated with pain severity (r = 0.14), and were weakly correlated with life interference due to pain (r = 0.20) and years playing professional sports (r = −0.17). Depression scores were not significantly correlated with lifetime history of concussions (r = 0.14). A multiple regression model, with age, total number of self-reported concussions, years played professionally, the CD-RISC, Brief Pain Inventory-pain interference score, and Epworth Sleepiness Scale score as predictors was significant, with 35% of the variance in DASS depression accounted for. The two significant independent predictors of depression were lower resilience and greater life interference due to pain.Conclusions: This is the first large study of depression in retired rugby league players. Depression in these retired players was not meaningfully associated with lifetime history of concussions or number of years playing elite level collision sport. Depression was associated with current anxiety, stress, resilience, and life interference due to chronic pain.

Perseverative negative thinking predicts depression in people with acute coronary syndrome

ObjectiveDepression is common in people who have experienced recent Acute Coronary Syndrome (ACS), and predicts worse medical outcomes. Mechanisms underpinning the development of depression and its association with poor medical outcomes are unclear however. The aim of this study was to investigate the role of perseverative negative thinking (e.g. worry and rumination) in predicting depression in people with recent ACS. MethodsAdults attending specialist inpatient and outpatient cardiology services who had recently experienced ACS were invited to participate in this observational prospective cohort study. Questionnaire assessments were completed within 6months of index ACS (baseline), then 2months and 6months later. Results169 participants (131 male (78%), median age 68 (±16) years) completed baseline questionnaires, and 111 completed follow-ups. After controlling for the effects of key covariates, baseline rumination was a significant predictor of depression at 6months, accounting for 2% of the variance in depression. This association was partially mediated by poor problem-solving ability and lack of social support. Neither worry nor rumination at baseline were significant predictors of quality of life at 6months. ConclusionsRumination is a significant independent predictor of depression, and this association may be partially explained by deficits in problem-solving ability and reduced social support. Both rumination and problem solving may provide useful targets for the development of evidence-based interventions to reduce depression among people with coronary heart disease.

Internet Addiction, Problematic Smartphone Use and Psychological Health of Nigerian University Undergraduates

Aim: This study examined Internet Addiction (IA) and Problematic Smartphone Use (PSU) as predictors of severities of anxiety, depression and psychological distress among university undergraduates in Nigeria.&#x0D; Study Design: Exploratory /Descriptive survey design.&#x0D; Place and Duration of Study: Redeemer’s University Nigeria, between April and August 2018.&#x0D; Methodology: A total of 854 university undergraduates made up of 342 males and 512 females, mean age 20.5 years, were purposively selected from four universities in Osun state, southwestern Nigeria. Internet Addiction Test (IAT), Smartphone Addiction Scale – Short Version (SAS-SV), Beck Anxiety Inventory (BAI), Centre for Epidemiological Studies Depression Scale (CES-D) and General Health Questionnaire (GHQ-12) were used for data collection. &#x0D; Results: Observed prevalence of studied variables among respondents are: Internet Addiction (IA) 48.6%, Problematic Smartphone Use (PSU) (47.4%), anxiety disorder (50.6%), depression (49.8%) and psychological distress (47.6%). IA independently and significantly predicted severities of anxiety disorder (R² = .01, p = .025), depression (R² = .057, p = .000) and psychological distress (R² = .105, p = .000). PSU independently and significantly predicted severities of depression (R² = .073, p = .000) and psychological distress (R² = .094, p = .000). However PSU failed to significantly predict severity of anxiety disorder (R² = .00, p = .650) among the participants.&#x0D; Conclusion: High prevalence of IA, PSU, anxiety disorder, depression and psychological distress exist among the participants. IA is a significant independent predictor of anxiety, depression and psychological distress. PSU is a significant independent predictor of depression and psychological distress but is not a significant predictor anxiety disorder among Nigerian undergraduates.

Vitamin D deficiency is significantly associated with depression in patients with chronic kidney disease.

BackgroundDepression is reported to be the most common psychological problem in patients with chronic kidney disease (CKD). Several studies have reported that lower levels of serum vitamin D are significantly associated with depression. Both vitamin D deficiency and depression are prevalent in patients with CKD, yet the relationship between these two factors remains poorly understood. This study aimed to investigate the association between vitamin D levels and depression among CKD patients.MethodsTotally, 21,257 individuals who participated in the Korean National Health and Nutrition Examination Survey (KNHANES V, VI) from 2010–2014 were screened for the study; 533 CKD patients were included. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D3 [25(OH)D3] ≤10 ng/mL. Patients were divided into vitamin D deficient or sufficient groups. Depression was screened for using the Korean version of the WHO Composite International Diagnostic Interview-Short Form. The association between vitamin D deficiency and depression was evaluated by multivariate logistic regression analysis.ResultsThe mean participant age was 70.1±9.4 years; 262 patients (49.2%) were male. The median 25(OH)D3 level was 19.1±6.9 ng/mL. The prevalence of depression was higher in CKD patients than in the general population (14.3 vs. 11.1%, P = 0.03). Additionally, the prevalence of depression was significantly higher in CKD patients with (vs. without) vitamin D deficiency (32.5% vs. 50.0%, P<0.001). Multivariate logistic regression analysis showed that vitamin D deficiency was a significant independent predictor of depression after adjusting for confounding factors (adjusted odds ratio, 6.15; 95% confidence interval, 2.02–8.75; P = 0.001).ConclusionDepression was highly prevalent in CKD patients, in whom vitamin D deficiency was a significant independent predictor of depression. Therefore, management of vitamin D deficiency might help prevent depression in CKD patients.

Psycho-Demograhic Factors as Predictors of Depression Among Person With Diabete Mellitus

The study examined psycho-demographic factors as predictors of depression among persons with diabetes mellitus in Ibadan metropolis. A cross-sectional survey method was adopted to collect data from two hundred and thirty eight respondents with one hundred and fifteen (48.3%) males; and one hundred and twenty-three (51.7%) females and age ranging from 17 – 74 years with mean (χ) 44.3 years and standard deviation (SD) 12.1. The result of regression analysis suggested that hopelessness, life purpose, and gender were significant independent predictors of depression, while the variables jointly predicted depression; R = .44; F (7, 237) = 8.12; P < .005. Also, the variables jointly accounted for 17% (Adj. R 2 = .174) variance on the depression. Low life purpose has a significant influence on depression (t = 3.48; P <.05). In conclusion, the study found that the above psycho-demographic variable has significant influence on depression. Therefore, it was recommended that government, and non-governmental organizations should create more public awareness on the possible effect of those variables that was found to have negative influence on depression in our society.

The relationship between sexual orientation and depression in a national population sample.

The aim of this study was to examine the relationship between sexual orientation and depression in a nationally representative population to determine if sexual minorities report higher levels of depression than the remainder of the population. Depression is a highly prevalent and disabling chronic disorder worldwide. Prior research utilizing national population samples have reported that members of sexual minorities are at higher risk for depression when compared to heterosexual people. More recent studies have revealed differences in depression risk based on sexual orientation, sexual activity and sex. There have been significant shifts in societal attitudes towards sexual minorities in recent decades. Continuing research into predictors for reporting depression amongst sexual minorities is needed. National Health and Nutrition Examination Survey cycles 2005-2012 were used to identify sexual minority status based on declared sexual orientation and presence of same-sex sexual activity. Complex samples logistic and multivariate regression models were used to predict depression adjusted for sexual orientation, sexual activity, age, sex, marital status, education, income, race/ethnicity, employment and health status. Sexual orientation was not a significant independent predictor of depressive symptoms overall. Gay men reported lower levels of depressive symptoms than heterosexual men. In the sex stratified analyses, men who reported having sex with men were five times more likely to report depressive symptomatology compared to men who reported opposite sex partners (2005-2008 adjusted odds ratios: 5·00; 95% confidence interval: 1·44-17·38; 2009-2012 adjusted odds ratios: 5·10; 95% confidence interval: 1·33-19·54) after controlling for sexual orientation. Results of our analyses indicate that homosexually experienced heterosexual men appear to be at highest risk for depression. Furthermore, reported physical health status was a significant independent predictor of depression in all models, suggesting a strong link between physical and mental health. Health care providers should inquire about sexual orientation and sexual behaviour as part of a routine health history and be familiar with the unique health needs of sexual minorities to tailor clinical practice and foster safe, inclusive, health care environments.

Vitamin D is independently associated with depression in overweight women with and without PCOS

Background: Depression, anxiety, and inflammation are common in polycystic ovary syndrome (PCOS). Inflammation may adversely impact on mood and vitamin D has been associated with both mood disorders and inflammation in the general population, but these relationships have not been studied in PCOS. The aim of this study was to investigate the association among 25 hydroxy-Vitamin D (25OHVD) status, anxiety, depression, and inflammation in women with and without PCOS.Methods: Cross-sectional study in overweight or obese premenopausal women with (n = 50) and without (n = 23) PCOS. Primary outcome measures were 25OHVD, mood (Hospital Anxiety and Depression questionnaire), and inflammation (highly sensitive C-reactive protein (hsCRP)).Results: Vitamin D deficiency (25OHVD<50 nmol/L) (46% versus 39%, p = 0.311) and 25OHVD (50.4 ± 22.2 nmol/L versus 51.6 ± 19.0 nmol/L, p = 0.828) were not significantly different in women with and without PCOS. For all women combined, 25OHVD was the only significant independent predictor of depression (β = −0.063 ± 0.021, p = 0.005) and hsCRP (β = −0.041 ± 0.015, p = 0.010).Conclusions: Vitamin D deficiency is common in both women with and without PCOS with no differences between the groups. Vitamin D is independently associated with depression and inflammation in overweight women both with and without PCOS. Further investigation to clarify the interrelationship among vitamin D, inflammation and depression is required to identify optimal prevention and treatment strategies for psychological and metabolic dysfunction in PCOS.

Association between Depression and Physical Fitness, Body Fatness and Serum Vitamin D in Elderly Population

Background: This study examined the association of depression with functional physical fitness, body fatness, and serum vitamin D in elderly persons. Methods: This was a cross sectional study involving 21 men with mean age of 75.4 ± 6.8 years and 96 women with mean age of 75.0 ± 6.8 years. Body mass index, percent body fat, and waist circumference were measured according to a standardized protocol. Functional physical fitness including strength, cardiorespiratory endurance, agility, dynamic balance and flexibility was measured in accordance to a standardized fitness assessment manual. Serum levels of vitamin D, lipoprotein lipids, fasting glucose and insulin were measured with standardized procedures. Korean form of Geriatric Depression Scale (K-GDS) was used to assess depression level and status. Pearson correlation analyses were used to calculate bivariate correlations between measured variables. Multiple linear regression analyses were used to identify any independent predictors for K-GDS-based depression score. Results: Depression score was significantly and inversely associated with functional physical fitness including strength (P < 0.001), cardiorespiratory endurance (P < 0.001), agility (P = 0.002) and dynamic balance (P < 0.001). A similar trend in correlation was observed between depression and serum vitamin D level. Multiple linear regression analyses showed that strength (P < 0.001), cardiorespiratory endurance (P = 0.005), and percent body fat (P = 0.045) were significant independent predictors of depression in this study population. Conclusion: The finding of the study suggest that fitness promotion along with a healthy diet habit should be a key component of intervention against depression in elderly persons.

Prevalence of Depression in Patients With Chest Pain and Non-Obstructive Coronary Artery Disease

Many studies have demonstrated the prevalence of depression in patients with coronary artery disease (CAD), but few have examined this relation in those with chest pain who do not have obstructive CAD on angiography. The aim of this study was to compare the prevalence of depression amongst patients with chest pain in the presence or absence of obstructive CAD and a healthy control group without chest pain. This prospectively designed, observational cohort study used 2 independent data sets: (1) The Queen Elizabeth Hospital Coronary Angiogram Database (n = 1,144), consisting of 819 patients with obstructive CAD and 325 patients with nonobstructive CAD (NoCAD), all of whom had chest pain and (2) the North West Adelaide Health Study (NWAHS; n = 3,168), a population-based biomedical cohort, from which patients with chest pain were excluded. The presence of depression was determined by a previously validated method using the Short Form 36. The prevalence of depression differed among the 3 groups, with 63% in those with NoCAD, 53% in those with CAD, and only 24% in the healthy NWAHS cohort. Analysis of the angiography cohort revealed age, gender, antidepressant medication, previous myocardial infarction, previous airway disease, Short Form 36 physical summary score, Seattle Angina Questionnaire physical limitation score, and NoCAD on angiography to be independent predictors of depression. In conclusion, these findings highlight the importance of screening for depression in patients with NoCAD.

Anxiety and depression in Chinese patients with glaucoma: Sociodemographic, clinical, and self-reported correlates

ObjectivesTo assess the prevalence of anxiety and depression in Chinese glaucoma patients, and explore their predictive factors. MethodsThis cross-sectional study included 506 Chinese glaucoma patients. Hospital Anxiety and Depression Scales (HADS) and the Chinese-version Glaucoma Quality of Life-15 questionnaire (CHI-GQL-15) were administered to all participants to evaluate their psychological distresses and quality of life (QoL). Visual functions (habitual-corrected visual acuity (HCVA), intraocular pressure (IOP), and mean defect (MD) of visual field) were assessed through clinical examinations by professionals. Sociodemographic information and other treatment histories were collected via interviews and chart review. Multiple linear regression analyses were performed to identify predictors of anxiety and depression. To evaluate the impact of anxiety or depression on patients QoL, the CHI-GQL-15 summary and subscores of patients with and without psychological disturbances were compared using covariate-adjusted regression analyses. ResultsThe prevalence of anxiety and depression in Chinese glaucoma patients was 22.92% and 16.40%, respectively. A younger age (β=−0.058, p<0.001), female gender (β=1.219, p=0.001), moderate and heavy economic burden (β=1.186, p=0.009; β=2.705, p<0.001, respectively) and the CHI-GQL-15 summary score (β=0.101, p<0.001) were independent predictors of anxiety. Significant independent predictors of depression included the duration of glaucoma (β=−0.065, p=0.019) and the CHI-GQL-15 summary score (β=0.147, p<0.001). Difference in the CHI-GQL-15 summary and its subscores of patients with and without psychological disturbance were statistically significant (p<0.001). ConclusionsPrevalence of anxiety and depression among Chinese glaucoma patients is relatively high. Self-reported measures were informative in evaluating patients' psychological disturbances, whereas objective measures of visual function were not.

Depressive symptoms among older adults: The impact of early and later life circumstances and marital status

Objective: This article contributes to the literature on depression and the life course by examining the impact of both early and later life circumstances on depressive symptoms among men and women aged 65 and over in Ireland. Method: Data are from the first wave of The Irish Longitudinal Study on Ageing, a nationally representative sample of 8504 community-dwelling adults aged 50 years and older. About 3507 respondents aged 65 years and over were included in the analysis. Multinomial logistic regression was used to examine the childhood and early adult life circumstances associated with marital status. A series of nested models were estimated to evaluate which childhood and adulthood circumstances are associated with depressive symptoms. Models were estimated separately for men and women. Results: Ill health in childhood and in later life has a strong and direct effect on depression in later life for both men and women. Other early stressors are mediated by later circumstances. Marital status is a significant independent predictor of depression in later life. Later life circumstances mediate between some marital statuses and depressive symptoms. When later life circumstances are included, widowhood and, for men, divorce, are directly associated with depression, but singlehood is not. Income in later life is strongly associated with depressive symptoms for women. Conclusion: Both early and later life circumstances affect late-life depressive symptoms. Our findings indicate that previous studies which did not consider both may have underestimated or overestimated the effect of marital status, education, current health and education on depressive symptoms.

Outcomes of Minor and Subsyndromal Depression among Elderly Patients in Primary Care Settings

Although depressive conditions in later life are a major public health problem, the outcomes of minor and subsyndromal depression are largely unknown. To compare outcomes among patients with minor and subsyndromal depression, major depression, and no depression, and to examine putative outcome predictors. Cohort study. Patients from primary care practices in greater New York City, and Philadelphia and Pittsburgh, Pennsylvania. 622 patients who were at least 60 years of age and presented for treatment in primary care practices that provided usual care in a randomized, controlled trial of suicide prevention. Of the 441 (70.9%) patients who completed 1 year of follow-up, 122 had major depression, 205 had minor or subsyndromal depression, and 114 did not have depression at baseline. One year after a baseline evaluation, data were collected by using the following tools: Hamilton Depression Rating Scale, the depressive disorders section of the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition), Charlson Comorbidity Index, Multilevel Assessment Instrument for measuring instrumental activities of daily living, Physical Component Summary of the Medical Outcomes Study Short Form-36, and Duke Social Support Index. Patients with minor or subsyndromal depression had intermediate depressive and functional outcomes. Mean adjusted 1-year Hamilton depression score was 10.9 (95% CI, 9.6 to 12.2) for those with initial major depression, 7.0 (CI, 5.9 to 8.1) for those with minor or subsyndromal depression, and 2.9 (CI, 1.6 to 4.2) for those without depression (P < 0.001 for each paired comparison). Compared with patients who were not depressed, those who had minor or subsyndromal depression had a 5.5-fold risk (CI, 3.1-fold to 10.0-fold) for major depression at 1 year after controlling for demographic characteristics (P < 0.001). Cerebrovascular risk factors were not associated with a diagnosis of depression at 1 year after controlling for overall medical burden. Initial medical burden, self-rated health, and subjective social support were significant independent predictors of depression outcome. Participants received care at practices that had personnel who had been given enhanced education about depression treatment; 29.1% of participants withdrew from the study before completing 1 year of follow-up. The intermediate outcomes of minor and subsyndromal depression demonstrate the clinical significance of these conditions and suggest that they are part of a spectrum of depressive illness. Greater medical burden, poor subjective health status, and poorer subjective social support confer a higher risk for poor outcome.

Psychopathology and autobiographical memory in stroke and non‐stroke hospitalized patients

Psychopathology and autobiographical memory were investigated in a cohort of stroke and non-stroke hospitalized patients. Both these cohorts have been identified as having high levels of psychopathology (Katon and Sullivan 1990; Burvill et al., 1995). Difficulties recalling specific autobiographical memories (overgeneral memory) have been identified as important psychological variables in depression and predictors of outcome (Williams and Scott 1988; Brittlebank et al., 1993). Intrusive autobiographical memories have also been found to be associated with depression and overgeneral memory in depressed women (Kuyken and Brewin, 1995) and depressed cancer patients (Brewin et al., 1998a). This study looked at levels of psychopathology and autobiographical memories in stroke and non-stroke hospital patients. 417 patients were screened, of the 176 eligible 103 agreed to participate (54 stroke and 49 non-stroke). Participants were assessed for overgenerality using the Autobiographical Memory Test and intrusiveness of memories using the Impact of Events Scale. Also assessed were PTSD-like symptoms (PCL-S), mood (HADS, GHQ-28) and cognitive ability (MMSE, verbal fluency, digit span and estimated pre-morbid IQ). No significant differences were found between stroke and non-stroke patients on severity of depression, anxiety, severity of PTSD-like symptoms or autobiographical memories. Backward multivariate regression analyses for combined data (stroke and non-stroke) indicated that overgeneral memory recall, intrusive memories of past events and intrusive memories of illness were significant independent predictors of depression (HADS). Avoidance of intrusive memories and reported childhood distress were not predictors of overgeneral memory recall. Significant predictors of overgeneral memory recall were; Gender, antidepressant medication, and estimated IQ. Significant levels of psychopathology were identified in this cohort. However, there were no significant differences in the levels of depression, anxiety, PTSD symptoms and autobiographical memory between stroke and non-stroke hospitalized patients. Of particular interest was the finding that PTSD-like symptoms did not appear to be influenced by the nature of the person's illness. In combined data (stroke and non-stroke) autobiographical memories (intrusive images of their illness, intrusive memories of other events and overgeneral memory recall variables) were significant predictors of depression in this cohort. This suggests that psychological intervention of memory processes may be a worthwhile target in psychological intervention for depression in these cohorts. Gender, cognitive impairment, antidepressant medication, and estimated IQ were significant predictors of overgeneral memory recall and further investigation into the validity of these findings are warranted. Suggestions for further research and limitations of the study are also discussed.

The relationship between disability and depression in multiple sclerosis: the role of uncertainty, coping, and hope.

The relationship between disability and depression was studied in 188 patients with clinically definite multiple sclerosis (MS). Patients were administered the Zung Self-Rating Depression Scale, Ways of Coping, Uncertainty of Illness Scale, and Hope Scale during their regular clinic appointments. Their current level of disability was rated by the attending physician using the Expanded Disability Status Scale. Even when the depression measure was corrected for items overlapping with other symptoms or consequences of MS, depression was correlated with disability. Depression was also correlated with an array of psychological variables, including uncertainty concerning ones illness, hope, and the use of various emotion-centered, though not problem-centered coping strategies. Multiple regression analyses revealed that none of these psychological correlates mediated or moderated the relationship between disability and depression. Instead, disability, uncertainty, hope, and emotion-centered coping were significant independent predictors of depression, together accounting for approximately 40% of the variance in patients' self-reported depression. The relationship between disability and depression in MS is usually interpreted as evidence that depression is psychogenic and reactive to the demands and limitations of this disease. The demonstration that this relationship is not diminished when an array of potentially intervening psychological variables are included in the analysis raises questions concerning the validity of this interpretation.