Version Of Patient Health Questionnaire Research Articles

Mental Health Counseling From Conversational Content With Transformer-Based Machine Learning

Use of asynchronous text-based counseling is rapidly growing as an easy-to-access approach to behavioral health care. Similar to in-person treatment, it is challenging to reliably assess as measures of process and content do not scale. To use machine learning to evaluate clinical content and client-reported outcomes in a large sample of text-based counseling episodes of care. In this quality improvement study, participants received text-based counseling between 2014 and 2019; data analysis was conducted from September 22, 2022, to November 28, 2023. The deidentified content of messages was retained as a part of ongoing quality assurance. Treatment was asynchronous text-based counseling via an online and mobile therapy app (Talkspace). Therapists were licensed to provide mental health treatment and were either independent contractors or employees of the product company. Participants were self-referred via online sign-up and received services via their insurance or self-pay and were assigned a diagnosis from their health care professional. All clients received counseling services from a licensed mental health clinician. The primary outcomes were client engagement in counseling (number of weeks), treatment satisfaction, and changes in client symptoms, measured via the 8-item version of Patient Health Questionnaire (PHQ-8). A previously trained, transformer-based, deep learning model automatically categorized messages into types of therapist interventions and summaries of clinical content. The total sample included 166 644 clients treated by 4973 therapists (20 600 274 messages). Participating clients were predominantly female (75.23%), aged 26 to 35 years (55.4%), single (37.88%), earned a bachelor's degree (59.13%), and were White (61.8%). There was substantial variability in intervention use and treatment content across therapists. A series of mixed-effects regressions indicated that collectively, interventions and clinical content were associated with key outcomes: engagement (multiple R = 0.43), satisfaction (multiple R = 0.46), and change in PHQ-8 score (multiple R = 0.13). This quality improvement study found associations between therapist interventions, clinical content, and client-reported outcomes. Consistent with traditional forms of counseling, higher amounts of supportive counseling were associated with improved outcomes. These findings suggest that machine learning-based evaluations of content may increase the scale and specificity of psychotherapy research.

Depression Among Dialysis Dependent end-Stage Renal Disease Patients: A Study from Tertiary Care Hospital in Bahawalpur

Objective: To determine the frequency of depression among dialysis dependent end-stage renal disease patients, associated factors and effect on patients’ compliance and clinical performance parameters. Study Design: Cross-sectional study Place and Duration of Study: Department of Nephrology, Bahawal Victoria Hospital, Bahawalpur Pakistan, from Apr 2017 to Mar 2018. Methodology: End-stage renal disease patients above 16 years of age who were on maintenance haemodialysis for more than 6 months were requested to complete the questionnaire of Urdu version of Patient Health Questionnaire 9. The information about missed treatments, shortened sessions, fluid overload and monthly laboratory data was obtained from medical records. Patient Health Questionnaire 9 score was calculated for all the patients and categorized as mild (5), moderate (10), moderately severe (15) and severe (20) depression. Results: There were 146 dialysis dependent end-stage renal disease patients (95 males, 51 females) with mean age of 45.1±14.3 years. Duration of dialysis dependence was significantly higher among females (p=0.022). Out of 146 patients, 116 had depression and 27(18.5%) had severe depression. Patients with depression were younger (p=0.037) and lack of social support was significantly associated with depression (p=0.018). Severe depression was significantly more frequent among females (p=0.041). Serum albumin was significantly low among patients with depression (p=0.044). Conclusion: Depression is common among haemodialysis dependent end-stage renal disease patients. It is common among young patients and those who lack social support and it is associated with hypoalbuminemia.

Association of psychological distress with arm morbidity symptoms in breast cancer survivors: outcomes from the use of PHQ-9 and GAD-7 questionnaires.

Although higher survival rates of breast cancer are achieved these days, breast cancer survivors are challenged with unwanted side effects from treatment or management that affect physical, functional, and psychological well-being of an individual. This study aimed to assess psychological distress status in Malaysian breast cancer survivors and factors that affected the condition. A cross-sectional study design was conducted on 162 breast cancer survivors from various breast cancer support groups in Malaysia. Psychological distress status was assessed based on depression and anxiety scores by applying the Malay version of Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7). Both instruments were self-administered along with a set of questionnaires comprising demographic, medical history, quality of life, and upper extremity function assessment. Outcomes from the PHQ-9 and GAD-7 were analyzed for severity level of psychological distress, and its association with relevant variables, arm morbidity symptoms, as well as the duration of cancer survivorship. The univariate analysis showed that breast cancer survivors with arm morbidities after breast surgery had a higher score of depression (5.0 vs 4.0, p = 0.011) and anxiety (3.0 vs 1.0, p = 0.026) than those who did not. Besides that, receiving fewer post-rehabilitation treatments (p = 0.049) and having a family history of cancer (p = 0.022) were correlated with higher anxiety level. The level of depression and anxiety was inversely proportionate with quality of life and positively correlated with greater disability of the arm function (p < 0.05). Subsequent analysis showed that arm morbidity symptoms including difficulties in finding a t-shirt that fits and pain in the arm area after breast cancer surgery were positively associated with ahigher level of psychological distress. Our study demonstrated the association between psychological distress with arm morbidities in breast cancer survivors. Given that arm morbidities can affect not only physical, but psychological well-being, continuous or serial assessment on both aspects during cancer treatment may effectively help to address mental health issue experienced by this cancer population.

The relationship between unhealthy lifestyle patterns and depressive symptoms among residents in Beijing, China: A community-based cross-sectional study.

Depression is a prevalent mental disorder that has an irreversible impact on people's health status. Unhealthy lifestyles are modifiable and influence mental health significantly. The purpose of this study was to explore the impact of different unhealthy lifestyles and their patterns on depressive symptoms. The data for this study were obtained from the 2017 Community Diagnostic survey in Daxing District, Beijing. It was a cross-sectional study that included 6,252 samples. The Patient Health Questionnaire version 9 was used to measure depressive symptoms, and the self-administered questionaires were used to investigate five unhealthy lifestyles, including sleep deprivation, the inadequate intake of fruits and vegetables, physical inactivity, smoking, and excessive alcohol consumption. Respondents were assigned 1 point for each of their unhealthy lifestyles, and their overall unhealthy lifestyle scores were calculated. The total scores of unhealthy lifestyles ranged from 0 to 5. Descriptive analyses and Firth's logistic regression model were used to analyze the relationship between unhealthy lifestyle and depression symptoms. It was found that 12.1% of the participants had depressive symptoms. The respondents whose unhealthy lifestyle scores were 2 (OR1.45, 95%CI:1.01 to 2.12), 3 (OR2.29, 95%CI:1.57 to 3.42), 4 (OR 3.04, 95%CI:1.96 to 4.76), or 5 (OR4.08, 95%CI:2.09 to 7.78) were more likely to experience depressive symptoms in comparison with those whose unhealthy lifestyle scores were 0, and the OR increased with the unhealthy lifestyle scores. When the participants had 3 or more unhealthy lifestyles at the same time, different combination patterns of unhealthy lifestyles showed a different effect on depression. The OR was 3.01 (95%CI:1.45 to 5.95) for the combination of sleep deprivation-insufficient intake of fruit and vegetables-excessive alcohol consumption, and was 2.89 (95%CI:1.52 to 5.25) for the combination of sleep deprivation-insufficient intake of fruit and vegetables-physical inactivity-excessive alcohol consumption. The co-existence of multiple unhealthy behavioral lifestyles are associated with depressive symptoms. Among the five unhealthy lifestyles, sleep deprivation and the inadequate intake of fruits and vegetables may have a greater impact on depression.

Prevalence and associated factor of postpartum depression among mothers living with HIV at an urban postnatal clinic in Uganda.

Postpartum depression among mothers living with HIV is a significant public health problem due to its effects on engagement in care, HIV disease progression, and an increased risk of mother-to-child transmission of HIV. The objective of this study was to determine the prevalence and factors associated with postpartum depression among mothers living with HIV. The study employed a cross-sectional quantitative research design. In this cross-sectional survey, we consecutively recruited 290 participants among mothers attending postnatal, immunization, and family planning clinics at an urban clinic in Uganda. Using an interviewer-administered questionnaire, we collected data on socio-demographics, obstetric, and HIV-related characteristics. Postpartum depression was assessed using the Patient Health Questionnaire version 9. We classified participants with Patient Health Questionnaire version 9 scores of ⩾10 as having postpartum depression. We conducted logistic regression to examine the association between postpartum depression and independent variables. The prevalence of postpartum depression was 15.9%. After controlling for other variables, participants who reported poor male partner support were more likely to experience postpartum depression compared to those who had good partner support (adjusted odds ratio = 4.52, confidence interval = 2.31-8.84, p value < 0.001). Mothers living with HIV should be routinely assessed for the presence of depression and male partner support. Health care providers of HIV-infected women should design strategies to promote male partner support for better maternal, infant, and HIV treatment outcomes.

Association between depression and sarcopenia in patients with heart failure

Background: Prevalence of heart failure has been increasing worldwide. Decreased muscle mass, poor physical activity, and reduced physical performance or muscle strength might lead to sarcopenia among heart failure patients and therefore lead to low cardiac output, and vice versa. Symptoms of depression are also common mental health problems in heart failure. However, little is known about the prevalence of depressive symptoms in heart failure patients with sarcopenia and the relationship with its. This study aimed to explore the prevalence of and relationship between sarcopenia and depressive symptoms in heart failure patients. Methods: A cross-sectional study comprised of 150 participants aged 35 years or older. Sarcopenia and no sarcopenia were classified by using the Asian Working Group for Sarcopenia 2019 criteria. Physical performance, muscle strength, and skeletal muscle mass were examined. Symptoms of depression were assessed through utilization of the validated Thai version of Patient Health Questionnaire 9. Results: The prevalence of sarcopenia was 18.67% and depression was 5.33% in heart failure patients. In addition, the prevalence of depression in heart failure patients with sarcopenia were 3.57%. The relationship was observed based on depression scores and New York Heart Association functional classification (r = 0.319, p&lt;.001). Furthermore, heart failure patients with low New York Heart Association functional class had high depression scores (p&lt;.001). However, no significant differences between depression scores and sarcopenia in heart failure patients were identified. Conclusions: Prevalence of sarcopenia in heart failure patients was 18.67% and only 5.33% exhibited depressive symptoms. Only 3.57% exhibited both depression and sarcopenia. Additionally, New York Heart Association functional classification was related to depression.

Determinants of Depression among Malay Single Mothers Living in Community in Perak, Malaysia.

BackgroundBeing a single mother is challenging. Many single mothers developed depression, but some managed to survive. This study aimed to determine the proportion of depression among single mothers living in community and its associated factors.MethodsThis cross-sectional study involved conveniently sampled 213 Malay single mothers living in community in Perak, Malaysia. A Malay version of Patient Health Questionnaire (PHQ)-9 was used to determine significant depression at a cut-off point of 10. Malay version of Multidimensional Scale of Perceived Social Support (MSPSS-M) and Brief-Coping with Problems Experienced (COPE) scales were used to assess support and coping strategies.ResultsThe proportion of depression among Malay single mothers in this study was 20.2% (95% CI: 15.0, 26.2). Previous history of depression (adjusted odds ratio [aOR]: 10.27; 95% CI: 2.18, 48.35; P = 0.003) and coping by using self-blame (aOR: 2.00; 95% CI: 1.45, 2.77; P < 0.001) increased the risk of depression. Active coping (aOR: 0.66; 95% CI: 0.46, 0.96; P = 0.027) and use of emotional support (aOR: 0.61; 95% CI: 0.44, 0.84; P = 0.002) is protective of depression.ConclusionThere was a high proportion of depression among Malay single mothers living in the community. Personal history of depression and type of coping strategies used significantly influenced the occurrence of depression among these single mothers. Providing guidance to acquire adaptive coping strategies is a crucial preventive measure.

Depressive Illness in Patients with Eye Disease, A Hidden Entity

Purpose: To determine the frequency of depressive illness in patients presenting with ocular complaints. Study Design: Observational cross sectional study, Place and Duration of Study: Watim Medical College, Rawat, Rawalpindi, from October 2021 to November 2021. Methods: All the patients presenting with ocular diseases and visiting were included in the study. Patients were asked to complete an Urdu translated version of patient health questionnaire (PHQ 9). Inclusion criteria was patients more than 40 years of age, with ocular complaints and either gender. Patients with age less than 40 years, mentally and physically handicapped, having a previous history of psychiatric disease, deaf and mute, any terminal, chronic or debilitating ocular or systemic disease were excluded. The results were analyzed and expressed with descriptive data in frequencies and the numerical data in average and standard deviations. Chi square test of significance was applied taking p value of less than 0.05 as significant. Results: A total of 537 patients (43.95% males and 56.05% females) were included. 60.71% of the participants were suffering from moderate to severe depression. Among them 12.1% had moderately severe and 16.76% had severe depression. More females (19.55%) suffered from depression which required treatment than males (9.31%). Conclusion: Significant number of patients presenting with ocular complaints suffered from depression, which can affect or may be effected by the underlying ocular disease. The ophthalmologists should be aware of the entity and should take into account while treating the ocular disease. Key Words: Eye, Depression, Dry eye disease

Psychiatric Co-Morbidity and its Associated Risk Factors among Tuberculosis Patients

Aim: To assess psychiatric co-morbidity (i.e., depression and anxiety) and its associated risk factors among Multidrug/Rifampicin Resistant Tuberculosis (MDR/RR-TB) patients. Methods: It was an analytical cross-sectional study carried out in Department of Chest Medicine, Jinnah Post Graduate Medical Centre from February to August, 2015. Eighty diagnosed and registered patients of MDR/RR-TB, able to comprehend Urdu language, between the age range of 18 to 60 years were approached by using convenient sampling technique. Psychiatric co-morbidity i.e., depression and anxiety were assessed by using the Urdu adapted version of Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD – 7). Results: By applying the standard cut off score of 10 or more on PHQ-9 and GAD-7, the frequency of depression was 58 (72.5%) and for anxiety it was 53 (66.25%) out of 80 MDR/RR-TB patients. The multivariant analysis, intensive phase of TB treatment (OR = 3.02; 95% CI = 0.97-9.41) was found to be significantly associated with depression by using PHQ-9 and age group of 18 to 30 years (OR=0.156; 95% CI= 0.02-0.86), pulmonary TB (OR=6.33e+7; 95% CI=0.00-inf) and intensive phase of treatment (OR= 3.892; 95% CI=1.14-13.20) were significantly associated with anxiety by using GAD-7. Conclusion: Frequency of psychiatric co-morbidity was higher among MDR/RR-TB patients. Age group of 18 to 30 years, pulmonary TB and intensive phase of treatment were found to be the risk factors for depression and anxiety among TB patients. Psycho-social factors are strong factors in the successful treatment of tuberculosis. Early detection and proper management of psychiatric co-morbidity during the treatment of MDR-TB needs special attention. Keywords: Anxiety, Depression, Drug resistance, Multidrug resistance tuberculosis, psychiatric co-morbidity,

Screening for depressive symptoms in postbariatric surgery patients using a validated Arabic version of Patient Health Questionnaire.

BACKGROUND:The prevalence of depressive symptoms in obese patients is higher than nonobese patients. Evidence shows an improvement of depressive symptoms after bariatric surgery, but this improvement fluctuates 3–4 years after surgery. Some studies report a worsening of depressive symptoms, but that the type of surgery and surgical complications contribute to the high depression rate. Our objective was to assess depressive symptoms in postbariatric surgery patients using an Arabic version of Patient Health Questionnaire-9 (PHQ-9).MATERIALS AND METHODS:A cross-sectional study was conducted in a tertiary care hospital in Riyadh from January to December 2019 using a validated Arabic version of PHQ-9. The questionnaires sent through Google Survey link to patient phone numbers were registered in an electronic record system. Data analysis was analyzed using SPSS version 23. Frequency and percentages were computed for the categorical variables and mean and standard deviation were calculated for the continuous variables. Chi-square test performed to test for the association between categorical variables and depression and logistic regression analysis were performed to determine the risk factors for development of depression after bariatric surgery.RESULTS:A total of 152 patients were included in the study. Fifty percent patients did not have depression, 26.3% had mild depression, 15.8% had moderate depression, 7.2% had moderately severe depression, and only one patient (0.7%) had severe depression. Only marital status was significantly associated with depression after bariatric surgery (P = 0.019). Gender, education, marital status, and income when used in the multivariate logistic regression could not predict the incidence of depression.CONCLUSION:Using a score of 10 in PHQ-9 as a cutoff, the prevalence of depressive disorder in postbariatric surgery patients was 23.7%, which is similar to the prevalence of nonobese general Saudi population of 20%.

Psychological morbidity in pemphigus patients in clinical remission and its relation with clinico-demographic parameters.

Significant psychological morbidity exists in patients with active pemphigus. Pemphigus being a chronic disease, psychological morbidity may exist in pemphigus patients in remission as well. The objectives of the study were to assess the psychological morbidity in pemphigus patients in clinical remission and to correlate it with clinico-demographic parameters. Pemphigus patients in clinical remission were consecutively included and were asked to respond to the Hindi/English version of Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) and panic disorder module of PHQ. Of 107 patients recruited, 41 (38.3%, 95% CI: 29.1-48.2%) patients were found to have either depression (33 [30.8%, 95% CI: 22.2-40.5%]) or anxiety (38 [35.5%, 95% CI: 26.5-45.4%] syndrome based on cut-offs of PHQ-9 score and GAD-7 score, respectively. Number of patients with mild, moderate and moderately severe/severe depression syndrome were 26 (24.3%, 95% CI: 17.2-33.2%), 7 (6.5%, 95% CI: 0.3-12.9%) and 0 respectively and patients with mild, moderate, severe anxiety syndrome were 29 (27.1%, 95% CI: 19.6-36.2%), 9 (8.4%, 95% CI: 4.5-15.2%) and 0 respectively. Patients with anxiety or depression syndrome had significantly higher clinical disease activity in the past, number of days spent in dermatology inpatient and significantly shorter clinical remission at the time of assessment as compared to those without these symptoms. Significant burden of mild/moderate depression or anxiety syndrome associated with past severity of disease and shorter duration of clinical remission was found.

Anxiety and depression among women with COVID-19 infection during childbirth—experience from a tertiary care academic center

BACKGROUNDPregnancy and postpartum are vulnerable periods for mental health problems and distress. Studies conducted worldwide have highlighted the role of the COVID-19 pandemic in adding to the rates of depression and anxiety in the perinatal period. However, there are very few reports on mothers who were identified as having COVID-19 infection at the time of childbirth.OBJECTIVEOur study aimed to find the prevalence of depression and anxiety among pregnant women who were admitted for labor and tested positive for COVID-19 infection. We also aimed to study the association of various sociodemographic, social support, and obstetrical factors and that of COVID-19-related worries with depression and anxiety.STUDY DESIGNThe study was conducted at the obstetrics inpatient setting in a public hospital in New Delhi, which had a separate designated COVID-19 block. Pregnant and postpartum women >18 years of age who were admitted to the COVID-19 maternity ward for delivery were included for this study. The women were interviewed within the first week of admission and after 6 to 8 weeks of childbirth. The sociodemographic and obstetrical details and COVID-19-related worries and concerns were assessed. Depression and anxiety were assessed using the Patient Health Questionnaire version 9 and the Generalized Anxiety Disorder 7-item Scale, respectively.The normally distributed variables are expressed as mean±standard deviation and continuous variables with skewed distribution as median (interquartile range). The categorical data presented as proportions of categorical variables were compared using the chi-square or the Fischer exact test. All the tests are 2-sided, with a significance level of 5%. The data were analyzed using the SPSS software version 24. The rates of depression and anxiety were calculated and univariate analysis was done to identify the factors associated with moderate and severe anxiety and depression using various sociodemographic and obstetrical variables, the total COVID anxiety scale scores, and the social support score.RESULTSThe mean age of the women was 26.86 years (±4.31). Of the 243 women assessed using the Patient Health Questionnaire version 9, 168 (69.13%) had mild depressive disorder, and 29 (11.3%) had moderate depressive disorder. Of the 187 women who were assessed at the 6-weeks follow-up, 31 (16.57%) had minimal depression, 131 (70.05%) had mild depression, and 25 (13.36%) had moderate depression. Mild anxiety was seen in 121 cases (49.79%) and 13 (5.34%) had moderate anxiety symptoms. Women reported several worries, especially about the stigma of COVID-19 infection, support for infant care, and access to infant health services.CONCLUSIONScreening for common mental illnesses with the timely identification of associated risk factors should be done, with a liaison between obstetricians and mental health professionals. Obstetricians can address and reassure pregnant women regarding concerns about contracting the infection, worries about the possible effects of COVID-19 on the fetus and the newborn, and concerns about future consultations. In case the worries are out of proportion and necessitate intervention by mental health professionals, referral services should be made available. Hence, identifying and addressing the mental health concerns will help provide the optimum perinatal care during the pandemic.

The Association Between Depression and Obesity Among Adults in the Eastern Province, Saudi Arabia.

Background: Depression is a primary cause of disability-adjusted life years lost globally. It is a common mental disorder with roughly more than 264 million adults affected. Obesity is another major health problem affecting more than 650 million adults worldwide. The presence of depression and obesity, along with each other, is associated with more negative health outcomes.Objectives: To explore the correlation between depression and obesity among adults in the Eastern Province of Saudi Arabia and analyze this association with other variables, including patients' demographics, body mass index (BMI), and presence of chronic and psychiatric illness. Method: A cross-sectional study was done in the Eastern Province, Saudi Arabia. A total number of 711 participants were enrolled. Arabic version of Patient Health Questionnaire 9 (PHQ-9) was used. Body mass index (BMI) scores were used to classify participants into underweight, average weight, overweight, and obese.Result: It was found that 41.7% of the obese participants have moderate to severe depression, and this result was statistically significant (P = 0.027, 95% CI 1.69-1.98). The prevalence was more marked among young participants (P = 0.001). Other variables such as marital status, the presence of a chronic illness, psychiatric disorders, regular intake of medications, effect of depressive symptoms on daily activity, and the number of years diagnosed with obesity and depression all showed a statistically significant association in the presence of comorbidity of obesity and depression (P < 0.05).Conclusion: The association between depression and obesity is most prominent in young adults aged between 18 to 25 years (11.2%), being single (12.8%), having a BMI of 30 or more for 10 years or more (45.4%), the presence of associated chronic illnesses (17.6%), the presence of associated psychiatric disorder (18.3%) and intake of regular medications (18.3%). Depression and obesity are major health challenges worldwide. Many studies were done to assess the relationship between obesity and depression, but only a few were conducted in Saudi Arabia. This study was done to investigate this relationship. It will help raise awareness about the comorbidity of depression and obesity to address preventative and therapeutic measures.

English

The purpose of this study was to document potential effect of depression on academic outcomes. We collected a cross sectional data from 710 pre-engineering university students in northwestern part of Ethiopia using cluster sampling. Depressive symptoms were assessed using a locally validated version of Patient Health Questionnaire (PHQ-9) at a cut off 5-9 and 10 or more indicating mild and major depressive symptoms, respectively. The types of substances that students experienced in the last three months were assessed. Multivariable linear regression was carried out to examine whether depressive symptoms predicted academic outcomes (cumulative GPA and perceived difficulties in learning process). Higher PHQ-9 scores were reported by 71.4% (30% mild and 41.4% major levels): of the students. Increment in depression (β=0.296, 95% CI: 0.223, 0.370), anxiety score (β=0.119, 95% CI: 0.011, 0.227), substance use (β=0.169, 95% CI: 0.045, 0.293) and stressful life events (β=0.306, 95% CI: 0.080, 0.532) scores were positively correlated with perceived difficulties in learning. Each increment in self-efficacy score (β=0.006, 95% CI: 0.001, 0.012) was positively associated with semester GPA. However, PHQ-9 score did not independently associate with semester GPA (β = -0.001, 95% CI: -0.007, 0.00). Depressive symptoms were associated with perceived difficulties in learning. Future follow-up studies and intervention strategies are needed to demonstrate causality. Key words: Depression, academic outcomes, substance use, universities students.

Psychiatric morbidity and substance use in migrant workers: A population based study.

The prevalence of mental health problems and substance abuse in the migrant population is higher than the general population. To assess the prevalence and pattern of mental health issues and substance use in the migrant population and highlight the association with the reverse migration of migrant workers. The field staff visited the shelter homes for migrant population in four cities of Northern India (Chandigarh (UT), Bhatinda (Punjab), Panchkula (Haryana) and Jaipur (Rajasthan). After maintaining the social distance and wearing masks by the staff and migrants, written informed consent was taken for participation in the study. The socio-demographic details of reverse migrants were noted down and Hindi version of Patient Health Questionnaire (PHQ-9) for mental health problems and screening tool for pattern of substance abuse was administered. Geographically matched undisplaced were also administered these tools. A total of 275 reverse migrants and 276 undisplaced were included in the study. The prevalence of ever use for all the substances among reverse migrants was 44.4% (122/275) and among undisplaced, it was 45.3%. The prevalence of alcohol, tobacco and cannabis was higher than the general population. The prevalence of at least one diagnosis on PHQ-9 is 13.45% (reverse migrants 19.3% and undisplaced 7.6) and the prevalence of other depressive disorder is significantly higher in reverse migrants (17.1%) than undisplaced (4.0%). The study concludes that prevalence of mental health issues and substance abuse in migrant population is significantly higher than the general population and the prevalence of at least one diagnosis and other depressive disorder is significantly higher in reverse migrants than undisplaced.

Perceived learning difficulty associates with depressive symptoms and substance use among students of higher educational institutions in North Western Ethiopia: A cross sectional study.

The potential role of perceived learning difficulty on depressive symptoms and substance use in the context of student population was seldom studied. This study aimed to investigate the association of perceived learning difficulty with depressive symptoms and substance use among university students in northwest Ethiopia. A cross sectional study was conducted on 710 pre-engineering students. A locally validated version of Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms at a cut off 5-9 indicating mild depressive symptoms and at a cut off 10 for major depressive symptoms. Perceived difficulty in school work was assessed by items dealing about difficulties in areas of course work. The response alternatives of these items were 0 = not at all, 1 = not so much, 2 = quite much, 3 = very much. The types of substances that students had used in their life and in the last three months were assessed. Negative binomial regression and multinomial regressions were employed to investigate the predictors of number of substance use and depressive symptoms respectively. The prevalence of depressive symptoms was 71.4% (Mild: 30% and Major 41.4%). About 24.6% of participants had the experience of using at least one substance. Increment in perceived difficulties in learning score was associated with more use of substances (aRRR = 1.03, 95% CI: 1.01-1.06), mild level depressive symptoms (aOR = 1.10, 95% CI: 1.04, 1.56 and major depressive symptoms (aOR = 1.19, 95% CI: 1.13, 1.26). Every increment in anxiety score was associated with increased risk of mild level of depressive symptoms (aOR = 1.09, 95% CI: 1.01, 1.17) and major depressive symptoms (aOR = 1.28, 95% CI: 1.18, 1.37). Being male (aRRR = 5.54, 95% CI: 3.28, 9.36), urban residence (aRRR = 2.46, 95% CI: 1.62, 3.72) and increment in number of life threatening events (aRRR = 1.143, 95% CI: 1.08, 1.22) were associated with increased risk of substance use. Perceived difficulties in learning independently predicted increased depressive symptoms as well as substance use among participants.

Prevalence and risk factors of depression in patients with drug-resistant tuberculosis in Nepal: A cross-sectional study

BackgroundPatients with drug-resistant tuberculosis (DR TB) have a protracted course of illness and the available treatment has a low success rate. These factors combined with the associated stigma and financial implications put the patients with DR TB at an increased risk of depression. The psychiatric side effects of anti-tuberculosis drugs further aggravate the problem. This study aimed to estimate the prevalence of depression among patients with DR TB in Nepal and identify risk factors. MethodsWe conducted this cross-sectional study in April 2018 at all the functioning 11 programmatic DR TB treatment centers across Nepal. We selected 129 patients aged ≥ 16 years receiving treatment for DR TB by non-probability quota sampling. Six trained data collectors conducted face-to-face interviews and administered the Nepali language version of Patient Health Questionnaire 9 (PHQ-9) to screen for depression. We summarized sociodemographic and treatment characteristics with median (Interquartile Range [IQR]) and proportions as appropriate. We performed univariate analysis for the variables hypothesized as risk factors for depression. We fitted a multivariable binary logistic regression model with depression as the outcome variable and the variables with a significance level of < 0.25 as explanatory variables. We regarded a p-value of < 0.05 as significant for individual variables in the logistic regression model. ResultsOf the 129 patients studied, 92 (71.3%) were male and the median age was 36 years (IQR 25–48). The majority (109, 84.4%) had multi-drug resistant tuberculosis (MDR TB). We identified 81 patients (62.7%, 95% Confidence Interval [CI] 53.7–71) with the PHQ-9 score of 10 or more signifying probable depressive disorder. In univariate analyses, age, treatment center location, DR TB treatment duration, and duration of current illness had a p-value lower than the pre-specified cut-off of 0.25. In the multivariable logistic regression model, we found a statistically significant association of depression with the duration of illness (adjusted Odds Ratio 1.15, 95% CI 1.07–1.26, p < 0.001). ConclusionThis study has found that a large proportion of the patients with DR TB screened have depression suggesting the need for screening and management of comorbid depression within the National TB Control Program.

Associations between systemic inflammation and somatic depressive symptoms: Findings from the Moli-sani study.

The link between systemic inflammation and depression has been deeply investigated, but relatively few studies explored symptom-specific associations, mostly focusing on common inflammatory biomarkers like C-reactive protein (CRP) levels. We investigated associations of low-grade inflammation with depressive symptoms assessed through a reduced version of Patient Health Questionnaire 9 (PHQ-9) in a large population-based cohort of adult Italians (N = 13 301). We built logistic regressions between each depressive symptom and composite index of systemic inflammation based on four circulating biomarkers, namely CRP, Plt, WBC, and GLR (INFLA)-score, a composite blood-based inflammation index, and with its component biomarkers, namely CRP, platelets count (Plt), white blood cells count (WBC), and granulocyte-to-lymphocyte ratio (GLR). We observed a strong association of the altered appetite/eating symptom with standardized INFLA-score (OR [95% CI] = 1.19 [1.12-1.26]; corrected p = 3.0 × 10-7 ), CRP (1.28 [1.20-1.36]; p = 1.9 × 10-13 ), and WBC (1.13 [1.06-1.20]; p = 2.3 × 10-3 ), and of tiredness/low energy with GLR (1.11 [1.05-1.17]; p = 9.4 × 10-3 ). These associations remained stable within nondepressed participants (PHQ-9 < 10), and after adjustment for the use of antidepressants, main chronic conditions, and lifestyle factors; while they were notably attenuated within depressed participants (PHQ-9 ≥ 10) and-for altered appetite only-by adjustment for obesity. This study provides a robust replication of the association previously reported between CRP and altered appetite in a large US population cohort, and supports a link between systemic inflammation, altered appetite, and tiredness. Moreover, it extends this evidence to inflammatory markers other than CRP and suggests new targets for the treatment of atypical depression.

Prevalence and key predictors of perinatal depression among postpartum women in Ghana.

To determine the prevalence and key predictors of perinatal depression among women in Accra. A two-step hospital-based cross-sectional study from May to July 2016. Patient Health Questionnaire version 9 was administered to postpartum mothers, and those aged 18years or older with scores above 5 who delivered at LEKMA, Ridge, and Korle Bu Hospitals were recruited. A modified Edinburgh Postnatal Depression Scale was used to assess depression at 2weeks postpartum. Associations between perinatal depression and sociodemographic/obstetric variables were assessed by χ2 and multivariate logistic regression. Among 1456 women screened, the prevalence of mental health disorders was 27.5% (400/1456). Of 350 women recruited, perinatal depression at 2weeks postpartum was 8.6%, 31.6%, and 41.1% at LEKMA, Ridge, and Korle Bu, respectively. Mothers younger than 20years and older than 35years at Korle Bu had depression. Vaginal delivery increased the odds of perinatal depression at Ridge and Korle Bu. Blood transfusion was associated with depression at all three hospitals. Blood transfusion, but not other variables, was associated with perinatal depression at 2weeks postpartum in Accra. Understanding the prevalence of perinatal depression and its associated risk factors in Ghana will aid policy decisions, planning, and clinical management.

Depression among adolescents in a rural community of north India: A cross-sectional study

Background:There is a paucity of literature on depression among adolescents in the north Indian community.Objectives:The aim of this study was to estimate the prevalence of depression among adolescents residing in a rural community of north India, and to determine associated factors, psychiatric comorbidities, and functional impairment.Methods:A simple random sample of 630 adolescents aged 10-19 years was drawn. Participants were enrolled in house-to-house visits, and screened for depression using the nine-item version of Patient Health Questionnaire (PHQ-9). Diagnostic confirmation and assessment of psychiatric comorbidities was done using Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) for 10-17-year-old adolescents, and MINI for 18 year olds. Prevalence was reported with 95% confidence interval. Multivariable logistic regression analysis was done to determine the association of depression with socio-demographic and other factors. Children's Global Assessment Scale (CGAS) was used to assess functional impairment.Results:The prevalence of depression was 3.7% (95% CI: 2.3–5.2) (n = 583), comparable in both sexes. Over half the participants with depression had psychiatric comorbidities; the most common were conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder; nearly two-fifth had suicidal ideas/attempt. About two-third of participants with depression had functional impairment. Depression was associated with perceived frequent conflicts at home [adjusted odds ratio (aOR) = 4.0 (95% CI: 1.0-16.0), P = 0.049], and perceived stressful event (s) in past six months [aOR = 7.0 (95% CI: 2.4-20.3), P < 0.01], which were predominantly related to academics.Conclusion:Study results indicate the need to strengthen diagnostic and therapeutic/rehabilitative mental health services in adolescent age group. Low-stress lifestyle could be a promising approach to sidestep depressive symptoms.