scholarly journals Prevalence trends of depression and anxiety symptoms in adults with cardiovascular diseases and diabetes 1995–2019: The HUNT studies, Norway

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ivana Bojanić ◽  
Erik R. Sund ◽  
Hege Sletvold ◽  
Ottar Bjerkeset

Abstract Background Symptoms of depression and anxiety are common in adults with cardiovascular diseases (CVDs) and diabetes mellitus (DM). The literature on depression and anxiety in CVDs and DM populations is extensive; however, studies examining these relationships over time, directly compared to adults without these conditions, are still lacking. This study aimed to investigate trends in depression and anxiety symptom prevalence over more than 20 years in adults with CVDs and DM compared to the general population. Methods We used data from the population-based Trøndelag Health Study (HUNT), Norway, including adults (≥ 20 years) from three waves; the HUNT2 (1995–97; n = 65,228), HUNT3 (2006–08; n = 50,800) and HUNT4 (2017–19; n = 56,042). Depressive and anxiety symptom prevalence was measured independently by the Hospital Anxiety and Depressions scale (HADS) in sex-stratified samples. We analyzed associations of these common psychological symptoms with CVDs and DM over time using multi-level random-effects models, accounting for repeated measurements and individual variation. Results Overall, the CVDs groups reported higher levels of depression than those free of CVDs in all waves of the study. Further, depressive and anxiety symptom prevalence in adults with and without CVDs and DM declined from HUNT2 to HUNT4, whereas women reported more anxiety than men. Positive associations of depression and anxiety symptoms with CVDs and DM in HUNT2 declined over time. However, associations of CVDs with depression symptoms remained over time in men. Moreover, in women, DM was associated with increased depression symptom risk in HUNT2 and HUNT4. Conclusions Depression and anxiety symptoms are frequent in adults with CVDs. Further, our time trend analysis indicates that anxiety and depression are differentially related to CVDs and DM and sex. This study highlights the importance of awareness and management of psychological symptoms in CVDs and DM populations.

Author(s):  
Emily McGlinchey ◽  
Karen Kirby ◽  
Eoin McElroy ◽  
Jamie Murphy

AbstractDepression and anxiety are highly comorbid constructs. However little is known about the mechanisms that underpin this comorbidity/connectivity or the divergence between constructs that seems to occur in adolescence. The current study targeted emotion regulation (ER) as a potential plausible mechanism for explaining how anxiety and depression symptoms in adolescence might begin to connect, perpetuate, and ultimately diverge from one another. Using data from a cross-sectional school-based study, of adolescent females (age 11–18 years; N = 615; majority were white (97.7%)), we modelled variation in ER using latent profile analysis. Then, using network analysis (NA), we generated separate depression-anxiety symptom networks for adolescents at varying levels of ER. Three latent classes of ER were identified (low ER 15%, intermediate ER 34%, high ER 51%). The results of the network comparison test found no significant differences in global strength between the ‘low ER’ and the ‘intermediate ER’ ability network. This study is among the first to attempt to model change in depression-anxiety symptom connectivity in adolescence in relation to a common contextual/risk factor. The current study therefore offers a unique contribution to the examination of the role of transdiagnostic factors in the study of adolescent depression and anxiety from a network perspective, and provides a promising framework for the study of ER among anxiety and depression symptomatology in adolescence.


2020 ◽  
Author(s):  
Thomas Hull ◽  
Jacob Levine ◽  
Niels Bantilan ◽  
Angel Desai ◽  
Maimuna S. Majumder

Background: The novel coronavirus disease 2019 (COVID-19) has negatively impacted mortality, economic conditions, and mental health. A large scale study on psychological reactions to the pandemic to inform ongoing population-level symptom tracking and response to treatment is currently lacking.Methods: Average intake scores for standard depression and anxiety symptom scales were tracked from January 1, 2017 to June 9, 2020 for patients seeking treatment from a digital mental health service to gauge the relationship between COVID-19 and self-reported symptoms. We applied natural language processing (NLP) to unstructured therapy transcript data from patients seeking treatment during the height of the pandemic in the United States between March 1, 2020 and June 9, 2020 to identify words associated with COVID-19 mentions. This analysis was used to identify symptoms that were present beyond those assessed by standard depression and anxiety measures.Results: Depression and anxiety symptoms reported by 169,889 patients between January 1, 2017 and June 9, 2020 were identified. There was no detectable change in intake depression symptom scores. Intake anxiety symptom scores increased 1.42 scale points [95% CI: 1.18, 1.65] between March 15, 2020 and April 1, 2020, when scores peaked. In the transcript data of these 169,889 patients, plus an expanded sample of 49,267 patients without symptom reports, term frequency-inverse document frequency (tf-idf) identified 2,377 positively correlated and 661negatively correlated terms that were significantly (FDR<.01) associated with mentions of the virus. These terms were classifiable into 24 symptoms beyond those included in the diagnostic criteria for anxiety or depression.Conclusions: The COVID-19 pandemic may have increased intake anxiety symptoms for individuals seeking digital mental health treatment. NLP analyses suggest that standard symptom scales for depression and anxiety alone are inadequate to fully assess and track psychological reactions to the pandemic. Symptoms of grief, trauma, obsession-compulsion, agoraphobia, hypochondriasis, panic, and non- suicidal self-injury should be monitored as part of a new COVID-19 Syndrome category.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Ren ◽  
Yifei Wang ◽  
Lin Wu ◽  
Zihan Wei ◽  
Long-Biao Cui ◽  
...  

Abstract Background Comorbidity between depressive and anxiety disorders is common. From network perspective, mental disorders arise from direct interactions between symptoms and comorbidity is due to direct interactions between depression and anxiety symptoms. The current study investigates the network structure of depression and anxiety symptoms in Chinese female nursing students and identifies the central and bridge symptoms as well as how other symptoms in present network are related to depression symptom “thoughts of death”. Methods To understand the full spectrum of depression and anxiety, we recruited 776 Chinese female nursing students with symptoms of depression and anxiety that span the full range of normal to abnormal. Depression symptoms were measured by Patient Health Questionnaire-9 while anxiety symptoms were measured by Generalized Anxiety Disorder 7-Item Questionnaire. Network analysis was used to construct networks. Specifically, we computed the predictability, expected influence and bridge expected influence for each symptom and showed a flow network of “thoughts of death”. Results Nine strongest edges existed in network were from the same disorder. Four were between depression symptoms, like “sleep difficulties” and “fatigue”, and “anhedonia” and “fatigue”. Five were between anxiety symptoms, like “nervousness or anxiety” and “worry too much”, and “restlessness” and “afraid something will happen”. The symptom “fatigue”, “feeling of worthlessness” and “irritable” had the highest expected influence centrality. Results also revealed two bridge symptoms: “depressed or sad mood” and “irritable”. As to “thoughts of death”, the direct relations between it and “psychomotor agitation/retardation” and “feeling of worthlessness” were the strongest direct relations. Conclusions The current study highlighted critical central symptoms “fatigue”, “feeling of worthlessness” and “irritable” and critical bridge symptoms “depressed or sad mood” and “irritable”. Particularly, “psychomotor agitation/retardation” and “feeling of worthlessness” were identified as key priorities due to their strongest associations with suicide ideation. Implications for clinical prevention and intervention based on these symptoms are discussed.


2020 ◽  
Author(s):  
Anita Lungu ◽  
Janie Jihee Jun ◽  
Okhtay Azarmanesh ◽  
Yan Leykin ◽  
Connie E-Jean Chen

BACKGROUND The past few decades saw considerable advances in research and dissemination of evidence-based psychotherapies, yet available treatment resources are not able to meet the high need for care for individuals suffering from depression or anxiety. Blended care psychotherapy, which combines the strengths of therapist-led and internet interventions, can narrow this gap and be clinically effective and efficient, but has rarely been evaluated outside of controlled research settings. OBJECTIVE This study evaluated the effectiveness of a blended care intervention (video-based cognitive behavior therapy and internet intervention) under real-world conditions. METHODS This is a pragmatic retrospective cohort analysis of 385 participants with clinical range depression and/or anxiety symptoms at baseline, measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), who enrolled in blended care psychotherapy treatment. Participants resided in the United States and had access to the blended care intervention as a mental health benefit offered through their employers. Levels of depression and anxiety were tracked throughout treatment. Hierarchical linear modeling was used to examine the change in symptoms over time. The effects of age, gender, and providers on participants’ symptom change trajectories were also evaluated. Paired sample t-tests were also conducted, and rates of positive clinical change and clinically significant improvement were calculated. RESULTS The average depression and anxiety symptoms at 6 weeks after the start of treatment were 5.94 and 6.57, respectively. There were significant linear effects of time on both symptoms of depression and anxiety (β=–.49, <i>P</i>&lt;.001 and β=–.64, <i>P</i>&lt;.001). The quadratic effect was also significant for both symptoms of depression and anxiety (β=.04, P&lt;.001 for both), suggesting a decelerated decrease in symptoms over time. Approximately 73% (n=283) of all 385 participants demonstrated reliable improvement, and 83% (n=319) recovered on either the PHQ-9 or GAD-7 measures. Large effect sizes were observed on both symptoms of depression (Cohen d=1.08) and of anxiety (d=1.33). CONCLUSIONS Video blended care cognitive behavioral therapy interventions can be effective and efficient in treating symptoms of depression and anxiety in real-world conditions. Future research should investigate the differential and interactive contribution of the therapist-led and digital components of care to patient outcomes to optimize care.


2021 ◽  
Author(s):  
Gowranga Kumar Paul ◽  
Meshbahur Rahman ◽  
Shayla Naznin ◽  
Mashfiqul Haq Chowdhury ◽  
Md Jamal Uddin

Abstract Background: The current COVID-19 pandemic is the biggest public health concern. It harmed everyone, both physically and mentally. Because of panic situations in COVID-19 pandemic, students all over the world, including those in Bangladesh, are suffering from depression and anxiety. Considering this, we aimed to assess psycho-emotional changes of the university students through investigating their level of depression and anxiety effects during panic and post-panic period of COVID-19 pandemic in Bangladesh.Methods: Cross-sectional online surveys were conducted among university students in Bangladesh from April to July 2020 (panic period, n=170) and then from August to November 2020 (post-panic period, n=170). The PHQ-9 and GAD-7 questionnaires were used to assess respondents' depression and anxiety levels, respectively. We used continuous scores to assess the severity of depression and anxiety symptoms. We also computed binary depression and anxiety scores. Multivariable logistic regression models were used to analyze the data. Results: The proportion of depression symptoms was 49.4% during the panic period and 52.4% after the panic period. Anxiety symptoms were experienced by 38.2% of students during the panic period, and this percentage was nearly identical in the post-panic interval. Depression levels increased in the post-panic period and urban students have significantly (P< 0.05) higher levels of depression and anxiety than their counterparts. Female students also exhibited significantly more anxious symptoms (p=0.002) than male. Depression symptoms significantly vary by family types, students place of residence whereas students age, gender, education, family head's occupation, time period and family economic condition found no significant association with the depression.Conclusions: Students during the post-panic period have a higher prevalence of depression and anxiety symptoms than during the panic period. Although the difference was small, it was still concerning for university students in Bangladesh because it interfered with their academic life.


2019 ◽  
Vol 95 (4) ◽  
pp. 254-261 ◽  
Author(s):  
Rachel Margaret Coyle ◽  
Fiona C Lampe ◽  
Ada Rose Miltz ◽  
Janey Sewell ◽  
Jane Anderson ◽  
...  

ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013–2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status.ResultsQuestionnaires were completed by 676 women and 470 heterosexual men. Depression symptoms were reported by 100 (14.8%) women and 33 men (7.0%). Anxiety symptoms were reported by 79 women (11.7%) and 21 men (4.5%). Among women reporting recent sex, those with depression symptoms were more likely to report condomless sex with a non-regular partner, aPR 1.38 (1.07–1.77) and recent condomless sex with two or more partners, 1.80 (1.25–2.59). Women with anxiety symptoms more likely to report recent condomless sex with two or more partners, 1.68 (1.13–2.50), low self-efficacy for condom use, 1.54 (1.02–2.31) and STI diagnosis in the last year 1.51 (1.04–2.20). Among heterosexual men reporting recent sex, depression and anxiety symptoms were associated with low self-efficacy with condom use, 2.32 (1.29–4.19) for depression and 2.23 (1.26–3.94) for anxiety, but not with measures of condomless sex.DiscussionThe associations between psychological symptoms and sexual risk behaviours highlight the importance of holistic assessment of need by both general and sexual health clinicians. We highlight the challenge in delivering holistic care associated with fragmentation of sexual health services.


2017 ◽  
Vol 47 (10) ◽  
pp. 1794-1805 ◽  
Author(s):  
J. R. Vittengl

BackgroundHigh neuroticism is a well-established risk for present and future depression and anxiety, as well as an emerging target for treatment and prevention. The current analyses tested the hypothesis that physical, social and socio-economic disadvantages each amplify risks from high neuroticism for longitudinal increases in depression and anxiety symptoms.MethodA national sample of adults (n = 7108) provided structured interview and questionnaire data in the Midlife Development in the United States Survey. Subsamples were reassessed roughly 9 and 18 years later. Time-lagged multilevel models predicted changes in depression and anxiety symptom intensity across survey waves.ResultsHigh neuroticism predicted increases in a depression/anxiety symptom composite across retest intervals. Three disadvantage dimensions – physical limitations (e.g. chronic illness, impaired functioning), social problems (e.g. less social support, more social strain) and low socio-economic status (e.g. less education, lower income) – each moderated risks from high neuroticism for increases in depression and anxiety symptoms. Collectively, high scores on the three disadvantage dimensions amplified symptom increases attributable to high neuroticism by 0.67 standard deviations. In contrast, neuroticism was not a significant risk for increases in symptoms among participants with few physical limitations, few social problems or high socio-economic status.ConclusionsRisks from high neuroticism are not shared equally among adults in the USA. Interventions preventing or treating depression or anxiety via neuroticism could be targeted toward vulnerable subpopulations with physical, social or socio-economic disadvantages. Moreover, decreasing these disadvantages may reduce mental health risks from neuroticism.


Author(s):  
Simeng Wang ◽  
Qi Sun ◽  
Lingling Zhai ◽  
Yinglong Bai ◽  
Wei Wei ◽  
...  

With the dramatic growth of the Chinese economy, the number of children/adolescents with being overweight/having obesity is increasing, which has a certain impact on their psychology, such as depression and anxiety symptoms. Our purpose was to conduct a meta-analysis to assess the prevalence and odds ratios of depression and anxiety symptoms among overweight/obese children/adolescents and non-overweight/obese children/adolescents in China. As of July 2018, the three most comprehensive computerized academic databases in China have been systematically screened, namely China national knowledge infrastructure (CNKI) databases, Wanfang databases and Vip databases. The same operations are performed in PubMed and Web of Science (SCIE) databases without language restrictions. Case-control studies on prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China were analyzed. Study selection and evaluation were performed independently by three authors. Unweighted prevalence, pooled random-effects estimates of odds ratio (OR), and 95% confidence intervals (CI) were all calculated. A total of 11 eligible studies involving 17,894 subjects were included. The prevalence of depression and anxiety symptoms in overweight/obese children/adolescents was significantly higher than that in non-overweight/non-obese children/adolescents (depression: 21.73% vs. 17.96%, OR = 1.46, 95% CI: 1.14, 1.87, p = 0.003; anxiety: 39.80% vs. 13.99%, OR = 1.47, 95% CI: 1.21, 1.79, p < 0.001). Subgroup analyses conducted according to scale types showed that scale types have certain significance to evaluate the relationship between depression symptoms and overweight/obesity. The OR of depression symptoms between overweight/obese children/adolescents and non-overweight/non-obese children/adolescents was greatest on the Middle School Student Mental Health Scale (MSSMHS) was 2.06 (95% CI: 1.41, 3.02, I2 = 0.00%), Center for Epidemiologic Studies Depression Scale (CES-D) was 1.03 (95% CI: 0.84, 1.25, I2 = 0.00%), and Children’s Depression Inventory (CDI) was 1.21 (95% CI: 1.02, 1.42, I2 = 0.00%). We concluded that the prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China is higher than that in the non-overweight/obese children/adolescents. The results of the study indicate that the prevalence of depression and anxiety symptoms among overweight/obese children/adolescents in Chinese medical institutions should receive more attention. Physical exercise and psychological interventions should be strengthened to prevent psychological problems. However, because of some clear limitations (no clinical interview and few studies), these results should be interpreted with caution.


2020 ◽  
Vol 185 (9-10) ◽  
pp. e1662-e1670
Author(s):  
Gina Evans-Hudnall ◽  
Mary O Odafe ◽  
Adrienne Johnson ◽  
Nicholas Armenti ◽  
Jennifer O’Neil ◽  
...  

Abstract Introduction Obesity is highly comorbid with psychological symptoms in veterans, particularly post-traumatic stress disorder (PTSD), depression, and anxiety. Obese veterans with comorbid psychological symptoms often display suboptimal weight loss and poor physical functioning when participating in weight management programs. The MOVE! program aims to increase healthy eating and physical activity to promote weight loss in obese veterans. Adequately addressing psychological barriers is necessary to maximize outcomes in MOVE! for veterans with PTSD, depression, and anxiety. We examined the preliminary outcomes of administering the Healthy Emotions and Improving Health BehavioR Outcomes (HERO) intervention. HERO is adjunctive cognitive-behavioral therapy to MOVE! that addresses PTSD, depression, and anxiety symptom barriers to engagement in physical activity. Materials and Methods All recruitment and study procedures were approved by the institutional review board and research and development committees of the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, Texas. Participants gave written informed consent before enrollment. Thirty-four obese veterans with a diagnosis of PTSD, depression, and/or anxiety who were attending MOVE! were assigned to the 8-session HERO group or the usual care (UC) group. Veterans completed assessments of PTSD, depression and anxiety symptoms, physical activity, physical functioning, and weight at baseline, 8 and 16 weeks post treatment. Changes from baseline to 8- and 16-week follow-up on the self-report and clinician-rated measures were assessed, using independent samples t-tests and analyses of covariance. Results At 8 weeks post treatment, participants in the HERO group had significantly higher step counts per day than participants in the UC group. Similarly, at 16 weeks post-treatment, participants in the HERO group continued to experience a significant increase in daily steps taken per day, as well as statistically and clinically significantly lower scores on the depression symptom and PTSD symptom severity. Participants in the HERO group also demonstrated significantly higher scores on the physical functioning inventory than participants in the UC group (44.1 ± 12.1 vs. 35.7 ± 10.7, P = 0.04) at 16 weeks post treatment. Conclusions Findings of this small trial have important implications pending replication in a more rigorously designed large-scale study. Providing an adjunctive treatment to MOVE! that addresses psychological distress has potential benefits for psychological symptom reduction, engagement in healthy dietary habits, and greater physical activity for individuals who traditionally experience barriers to making positive weight management changes.


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