A-115 Predictors of Depressive Symptoms in Adolescent Patients Following Concussion

Abstract Objective The present study sought to examine specific predictors and factors associated with depressive symptoms at initial(V1) and subsequent(V2) visits following concussion in adolescents. Methods This study enrolled adolescents aged 10–18 (14.5 ± 2.2 years) within 30 days of a diagnosed concussion. Patients completed Mood and Feelings Questionnaire-Short-Child Report (MFQC), Postconcussion Symptom Scale (PCSS), neurocognitive testing(ImPACT), and Vestibular-Ocular Motor Screening. Logistic regression (LR) analyses evaluated risk factors and clinical presentation as predictors of post-injury MFQP scores above a cutpoint of 8. Results Participants included 113 adolescents (50.4% male; 77% sport-related) who presented for V1 8.9 ± 6.2 days post-injury and V2 18.43 ± 11.9 days after V1. Overall, 5.3% reported pre-injury depression and 15.8% reported post-injury depressive symptoms above clinical cutoff on the MFQC. The LR model predicting increased depressive symptoms at V1 was significant (R2 = 45.0%, p = .007), supporting post-traumatic amnesia(PTA; OR = 3.15, 1.01–9.88) as a predictor. The LR model predicting depressive symptoms at V2 was significant (R2 = 62.2%, p = .021), supporting history of depression(OR = 25.5, 3.86–168.2) as the only significant predictor. Those scoring above 8 on the MFQC at V1 were more likely to have a prolonged recovery(over 30 days; OR = 10.4, 1.29–83.6). Conclussions The primary findings indicated that PTA was associated with increased depressive symptoms earlier, whereas a history of depression was associated with increase depressive symptoms later following concussion. Patients scoring higher on depressive symptoms were 10 times more likely to have a prolonged recovery. Together, these findings highlight the importance of evaluating depressive symptoms and factors that are associated with these symptoms to inform prognosis and earlier treatment for depressive symptoms following concussion.

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Abstract P543: Association Of Tanning Bed Use With Depression In A Preventive Medicine Cohort: The Cooper Center Longitudinal Study

Circulation ◽

10.1161/circ.141.suppl_1.p543 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Katie Kinser ◽

Beth B Wright ◽

David Leonard ◽

Laura F Defina

Keyword(s):

Depressive Symptoms ◽

Preventive Medicine ◽

Personal History ◽

Healthy Population ◽

Cross Sectional ◽

Tanning Beds ◽

Increased Risk ◽

Tanning Bed ◽

History Of ◽

History Of Depression

Importance: The use of tanning beds continues despite evidence of increased skin cancer risk among users. In the US, the prevalence of indoor tanning ranges from 35% of adults to 59% of college students. Objective: To investigate the association between depressive symptoms and tanning bed use. Design: Cross-sectional study. Setting: A preventive medicine clinic in Dallas, Texas. Participants: Between September 2013 and June 2019, a total of 11,823 generally healthy men and women presented for preventive medical examinations. Exposure: Self-reported tanning bed use. Main Outcome and Measures: Depressive symptoms as indicated by a score of greater than or equal to 10 on the Center for Epidemiologic Studies Depression (CES-D) Scale. Results: Fifteen percent of participants had used a tanning bed prior to their examination. For men, tanning bed use was associated with an increased risk of depressive symptoms (OR: 1.86; 95% CI:1.41-2.44). For women, the association between the use of tanning beds and depressive symptoms was significant in an unadjusted model, but was no longer significant after adjustment for confounders (OR: 1.26; 95% CI:0.99-1.61). However, the odds ratio was still in the direction of increased risk. Women with a personal history of depression were more likely to tan frequently and have higher CES-D scores than women with no personal history of depression ( p = .003). Conclusions and Relevance: In a generally healthy population, depressive symptoms were associated with the use of a tanning bed. This association was more evident in those with a history of depression, although remained true for those without a history of depression. As recurrent tanning bed use is known to contribute to the diagnosis of melanoma, it is critical to help patients identify other options to treat depression as well as to educate them on the risks of routine tanning bed use.

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History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease

Neurology ◽

10.1212/01.wnl.0000308937.30473.d1 ◽

2008 ◽

Vol 70 (15) ◽

pp. 1258-1264 ◽

Cited By ~ 133

Author(s):

M. I. Geerlings ◽

T. den Heijer ◽

P. J. Koudstaal ◽

A. Hofman ◽

M.M.B. Breteler

Keyword(s):

Depressive Symptoms ◽

Alzheimer Disease ◽

Temporal Lobe ◽

Medial Temporal Lobe ◽

Medial Temporal Lobe Atrophy ◽

History Of ◽

History Of Depression ◽

Lobe Atrophy

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Clinical features and sex differences in pediatric post-traumatic headache: A retrospective chart review at a Boston area concussion clinic

Cephalalgia ◽

10.1177/0333102419896754 ◽

2019 ◽

Vol 40 (7) ◽

pp. 701-711 ◽

Cited By ~ 2

Author(s):

Haley McEvoy ◽

David Borsook ◽

Scott A Holmes

Keyword(s):

Clinical Features ◽

Chart Review ◽

Pediatric Patients ◽

Clinical Presentation ◽

Retrospective Chart Review ◽

Post Injury ◽

Equivalent Representation ◽

Childhood Education ◽

History Of ◽

Post Traumatic

Background Often concussion/mTBI triggers a chronic headache syndrome called persistent post-traumatic headache (P-PTH) that can last from months to years post-injury, and produce significant disruption of childhood education, social interaction and development. Although prevalent and highly disabling, P-PTH is underrepresented in headache and pain research and lacks clear definition and pathophysiology. Clinical presentation of P-PTH frequently resembles that of other headache disorders, like migraine, yet the pathophysiological mechanisms are distinct and not fully understood, making the disorder difficult to treat in the clinical setting. Methods In a retrospective analysis of 1506 pediatric patients attending Boston Children’s Hospital clinics, demographic trends, symptom features, and the influence of sex on clinical presentation of PTH are presented. We compare clinical characteristics of P-PTH with a published cohort of migraine patients to evaluate the clinical features that are unique to P-PTH. Results Findings show that despite equivalent representation of sex in the clinic, P-PTH is expressed more in females than males and is weighted towards somatic symptoms. Relative to migraine, PTH is less associated with a family history of headache. Conclusions The ability to identify persons with PTH can help manage risk factors and identify persons likely to develop persistent post-concussion symptoms.

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Acceptability and feasibility of two interventions in the MooDFOOD Trial: a food-related depression prevention randomised controlled trial in overweight adults with subsyndromal symptoms of depression

BMJ Open ◽

10.1136/bmjopen-2019-034025 ◽

2020 ◽

Vol 10 (9) ◽

pp. e034025

Author(s):

Matthew Owens ◽

Edward Watkins ◽

Mariska Bot ◽

Ingeborg Annemarie Brouwer ◽

Miquel Roca ◽

...

Keyword(s):

Depressive Symptoms ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Secondary Outcome ◽

Depression Prevention ◽

History Of ◽

Randomised Controlled ◽

Subsyndromal Symptoms ◽

Overweight Adults ◽

History Of Depression

ObjectivesWe report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention trial (the Multi‐country cOllaborative project on the rOle of Diet, Food‐related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Trial). We also assessed baseline determinants of adherence and assessed whether better adherence resulted in lower depressive symptoms.DesignRandomised controlled trial with a 2×2 factorial design conducted between 2015 and 2017.SettingGermany, the Netherlands, UK and Spain.ParticipantsCommunity sample of 1025 overweight adults with elevated depressive symptoms without a current episode of major depressive disorder. Main eligibility criteria included age (18–75 years), being overweight or obese, and having at least mild depressive symptoms, shown by a Patient Health Questionnaire Score of ≥5. A total of 76% of the sample was retained at the 12-month follow-up.InterventionsDaily nutritional supplements versus pill placebo or an F-BA therapy, delivered in individual and group sessions versus no behavioural intervention over a 1-year period.Primary and secondary outcome measuresPrimary outcome: self-reported acceptability of the interventions. Secondary outcomes: adherence and self-reported depressive symptoms.ResultsMost participants reported that the F-BA was acceptable (83.61%), feasible to do (65.91%) and would recommend it to a friend (84.57%). Individual F-BA sessions (88.10%) were significantly more often rated as positive than group F-BA sessions (70.17%) and supplements (28.59%). There were statistically significant reductions in depressive symptoms for those who both adhered to the F-BA intervention and had a history of depression (B=−0.08, SE=0.03, p=0.012) versus those who had no history of depression. Supplement intake had no effect on depressive symptoms irrespective of adherence.ConclusionsF-BA may have scope for development as a depression prevention intervention and public health strategy but further refinement and testing are needed.Trial registration numberNCT02529423.

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Antidepressant use in Alzheimer's disease patients: results of the REAL.FR cohort

International Psychogeriatrics ◽

10.1017/s1041610209990780 ◽

2009 ◽

Vol 22 (1) ◽

pp. 120-128 ◽

Cited By ~ 17

Author(s):

Christophe Arbus ◽

Virginie Gardette ◽

Eric Bui ◽

Christelle Cantet ◽

Sandrine Andrieu ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Depressive Symptoms ◽

Previous History ◽

Natural Setting ◽

Antidepressant Prescription ◽

History Of ◽

Antidepressant Use ◽

Clinically Significant ◽

History Of Depression

ABSTRACTBackground: Psychotropic medication is widely prescribed in clinical practice for the management of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). However, there have been few pharmaco-epidemiological studies or studies conducted in a natural setting on the real use of antidepressants in AD. The aim of this survey was to assess the prevalence of antidepressant use in AD and to identify the clinical factors associated with antidepressant prescription.Methods: REAL.FR is a four-year, prospective, multi-center study. Baseline data including demographic characteristics, clinical variables and drug intake were obtained. Depressive symptoms were determined using the Neuropsychiatric Inventory (NPI).Results: A total of 686 AD patients were included. Antidepressant treatment was prescribed for 34.8% of patients. Clinically significant depressive symptoms (NPI ≥ 4) were observed in 20.5% of the total population. Although depressed subjects were significantly more likely to be treated with antidepressants than non-depressed subjects (p<0.0001), only 60% of depressed subjects overall were prescribed an antidepressant. In multivariate analysis, clinically significant depressive symptoms were associated with antidepressant prescription although this result was only observed in subjects without a previous history of depression.Conclusions: The available data on antidepressant efficacy in BPSD other than depression (in particular, agitation, aggression and, occasionally, psychotic symptoms) do not influence prescription choices. Depressive symptoms may be taken more seriously in the absence of a previous history of depression, leading to increased antidepressant prescription rates in individuals presenting with depression for the first time.

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Prediction of global outcome with acute neuropsychological testing following closed-head injury

Journal of the International Neuropsychological Society ◽

10.1017/s1355617704106012 ◽

2004 ◽

Vol 10 (6) ◽

pp. 807-817 ◽

Cited By ~ 21

Author(s):

NICHOLAS J. PASTOREK ◽

H. JULIA HANNAY ◽

CHARLES S. CONTANT

Keyword(s):

Head Injury ◽

Rating Scale ◽

Neuropsychological Testing ◽

Closed Head Injury ◽

Post Injury ◽

Disability Rating Scale ◽

Traumatic Amnesia ◽

Research Findings ◽

Post Traumatic ◽

Disability Rating

Delaying assessment until emergence from post-traumatic amnesia increases completion rates, but this practice causes variable time delays from the date of injury to testing, which can complicate the interpretation of research findings. In the current study, the performance of 105 head injury survivors on simple tests of language comprehension and attention was used to predict global outcome. It was hypothesized that 1 month performance on these measures would aid in the prediction of Disability Rating Scale (DRS) and Glasgow Outcome Scale (GOS) scores collected at 6 months post injury. Only raw scores on the modified Test of Complex Ideational Material accounted for a significant amount of the variance in DRS scores (4.4%) above that accounted for by age, education, Glasgow Coma Scale score, and pupil response. However, testability at 1 month post injury on all four tests consistently accounted for a larger portion of the variance in DRS scores (10.1–13.2%) and significantly improved prediction of GOS scores. Galveston Orientation and Amnesia Test scores collected at 1 month post injury accounted for substantially less variance in DRS scores (7.7–8.4%). Neuropsychological data, including the testability of patients, collected uniformly at 1 month following injury can contribute to the prediction of global outcome. (JINS, 2004, 10, 807–817.)

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Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood

The British Journal of Psychiatry ◽

10.1192/bjp.157.1.81 ◽

1990 ◽

Vol 157 (1) ◽

pp. 81-86 ◽

Cited By ~ 147

Author(s):

Alistair Burns ◽

Robin Jacoby ◽

Raymond Levy

Keyword(s):

Alzheimer’S Disease ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Depressive Symptom ◽

Previous History ◽

Ventricular Enlargement ◽

Trained Observer ◽

History Of ◽

Interhemispheric Fissure ◽

History Of Depression

Of 178 patients with AD, at least one depressive symptom was reported by 63%, 24% were rated as being depressed by a trained observer, and 43% were considered depressed by their relatives. Ten per cent had a previous history of depression. Elevated mood was rare, occurring in only six patients (3.5%). Subjects with depressive symptoms had less cognitive impairment and less ventricular enlargement on CT compared with those without symptoms. Widening of the interhemispheric fissure was associated with symptoms of mania but was inversely related to presence of depressive symptoms.

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Obstructive sleep apnea is associated with depressive symptoms in pregnancy

SLEEP ◽

10.1093/sleep/zsz270 ◽

2019 ◽

Vol 43 (5) ◽

Author(s):

Karen Redhead ◽

Jennifer Walsh ◽

Megan Galbally ◽

John P Newnham ◽

Stuart J Watson ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Depressive Symptoms ◽

Sleep Apnea ◽

Apnea Hypopnea Index ◽

Targeted Interventions ◽

Obstructive Sleep ◽

History Of ◽

Depressive Episodes ◽

History Of Depression ◽

In Pregnancy

Abstract Study Objectives In pregnancy, the prevalence of both obstructive sleep apnea (OSA) and depression increases. Research reveals an association in the general population with up to 45% of patients diagnosed with OSA having depressive symptoms. Therefore, this study aimed to investigate the relationship between OSA and depression in pregnant women. Methods One hundred and eighty-nine women ≥26 weeks pregnant were recruited from a tertiary perinatal hospital. This cross-sectional study measured OSA (Apnea Hypopnea Index, AHI, using an ApneaLink device) and symptoms of depression (Edinburgh Postnatal Depression Scale, EPDS). Data were collected from medical records including participant age, ethnicity, parity, BMI, smoking status, history of depression, and use of antidepressants. Results Of the consenting women, data from 124 were suitable for analysis. Twenty women (16.1%) had OSA (AHI ≥ 5 events/h) and 11 (8.8%) had depressive symptoms (EPDS > 12). Women with OSA were more likely to have depressive symptoms after adjusting for covariates, odds ratio = 8.36, 95% CI [1.57, 44.46]. OSA was also related to higher EPDS scores and these were greater in women with a history of depression. Conclusions During late pregnancy women with OSA had eight times the odds of having depressive symptoms. Furthermore, an interaction was found between OSA and history of depression. Specifically, in women with no history of depression, OSA increases depressive symptoms. In women with a history of depression, OSA has an even stronger effect on depressive symptomology. This suggests screening for OSA in pregnancy may identify women prone to future depressive episodes and allow for targeted interventions.

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Prevalence, detection and associations of depression in Australian dialysis patients

Australasian Psychiatry ◽

10.1177/1039856219859281 ◽

2019 ◽

Vol 27 (5) ◽

pp. 444-449 ◽

Cited By ~ 1

Author(s):

Elaine Kwan ◽

Brian Draper ◽

Samuel B Harvey ◽

Zoltan H Endre ◽

Mark A Brown

Keyword(s):

Depressive Symptoms ◽

Depression Scale ◽

Linguistically Diverse ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Dialysis Patients ◽

Cross Sectional ◽

History Of ◽

Poor Outcomes ◽

History Of Depression

Objective:Depression in dialysis patients is often undetected despite associations with poor outcomes. The aim was to determine the prevalence and associations of depressive symptoms and physician recognition of depression within a typical Australian dialysis population.Method:A cross-sectional study examined haemodialysis and peritoneal dialysis patients of two hospitals in Sydney. Participants were screened for depression using the Hospital Anxiety and Depression Scale (HADS).Results:One hundred and ten patients completed the HADS. Subjects had a mean age of 63.7 years, 37% from a culturally and linguistically diverse background, and median dialysis duration of 2 years. Forty-one per cent of participants had significant depressive symptoms, of whom 42% had been diagnosed with depression by their clinicians. After adjustment for sociodemographic factors, having >10 medications prescribed, >3 hospitalisations in the last 12 months, and a history of depression were associated with depression.Conclusion:Depressive symptoms are prevalent in Australian dialysis patients. Robust evidence is needed on the effectiveness of treatments for depression in changing outcomes in chronic kidney disease.

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Abstract 138: Characterizing Depressed Symptoms in Younger Women and Men Who Experienced an Acute Myocardial Infarction: Insights from the VIRGO Study

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.138 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Kim Smolderen ◽

Kelly Strait ◽

Dreyer Rachel ◽

Gail D’Onofrio ◽

Shengfan Zhou ◽

...

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Cardiovascular Risk ◽

Health Status ◽

Symptom Burden ◽

Prior History ◽

Younger Women ◽

History Of ◽

History Of Depression

Background: This study aimed to determine the prevalence of the depressive symptom burden among younger men and women, and to better characterize those experiencing depressive symptoms in the weeks leading up to their AMI. Method: The VIRGO study enrolled 3,572 AMI patients (2:1 ratio for women: men; 67.1% women) between 2008 and 2012 (103 US hospitals, 24 in Spain and 3 in Australia) at their index AMI admission. The PHQ-9 (clinically relevant depressive symptoms = PHQ-9 scores ≥10) was administered to assess patients’ depressive symptoms. Demographic, socio-economic, cardiovascular risk, AMI risk factor, perceived stress (PSS-14), and health status information (Seattle Angina Questionnaire [SAQ], EQ-5D) was obtained through patient interviews during the index hospitalization and medical chart abstraction. Information about history of depression was also documented through interviews. Results: A total of 886 (39%) women experienced clinically relevant depressive symptoms vs. 245 (22%) men (P<0.0001). Overall, about half (n=1141, 48%) of women reported a prior history of depression vs. 1 in 4 in men (n=280, 24%) (P<0.0001). Women had higher rates of somatic depressive symptoms (10% vs. 6% in men), as well as a combination of cognitive and somatic symptoms of depression (23% vs. 11% in men) (P<0.0001). High levels of stress (mean score 32±8 vs. 21±8 for men; 34±8 vs. 23±8 for women on PSS-14) and low quality of life scores (mean SAQ Quality of Life score 50±22 vs. 63±21 for men; 45±25 vs. 61±22 for women) were noted among depressed patients, regardless of their gender (all P-values <0.0001 for depressed vs. non-depressed). In both women and men, depression was more prevalent among patients with a lower socio-economic profile (e.g. lower education, uninsured), among those with cardiovascular risk factors (e.g. diabetes, smoking). As compared with men, women had a 2.28-increased odds of experiencing depressive symptoms. This relationship persisted after adjusting for demographic, socio-economic, cardiovascular and AMI risk factors, and health status (OR=1.64; 95%CI 1.36, 1.98). Conclusions: A high depressive symptom burden and prior history of depression was observed among younger women admitted with AMI. Regardless of gender, depression affected those with a lower socio-economic status and cardiovascular risk factors; it was also accompanied with high levels of stress and worse health status. Targeted interventions and preventive strategies should consider addressing this high burden of depressive symptoms among younger depressed AMI patients.

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