TRAJECTORIES AND CORRELATES OF POST-LOSS DEPRESSIVE SYMPTOMS IN FORMER DEMENTIA CAREGIVERS

Abstract Approximately 30-40% of family caregivers of relatives living with dementia report depression, compared to 9.5% of the general adult population. Studies suggest that depressive symptoms persist for many years following the care recipient’s death, despite resolution of caregiving responsibilities. However, long-term patterns of post-loss depressive symptoms remain poorly understood. The aim of this integrative review was to examine longitudinal trajectories and correlates of depressive symptoms in dementia caregivers following the care recipient’s death. A literature search was conducted using CINAHL, MEDLINE, and PsycINFO databases. Studies met the eligibility criteria if they were peer-reviewed, primary sources and reported research exploring correlates and/or longitudinal patterns of post-loss depressive symptoms in dementia caregivers. Data quality was evaluated using the widely-used quality appraisal tool developed by Hawker and colleagues (2002). Data were extracted, displayed in matrix format, and synthesized into themes. Fourteen studies met the eligibility criteria and were rated as high quality. Overall, depressive symptom severity trended down during the first year post-loss but did not reduce to levels reported by non-caregiving controls. Symptom trajectories varied among unique caregiver subgroups and included persistent-distressing symptoms, persistent-mild symptoms, and asymptomatic. Greater severity of post-loss depressive symptoms was associated with female gender, lower income, less social support, pre-loss depression, neurotic and optimistic personality traits, and avoidant coping style. The findings indicate that many caregivers could benefit from mental health screening and psychosocial support during the first year post-loss and underscore the need for longitudinal studies that explore depressive symptom trajectories beyond the first 1-2 years post-loss.

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The Impact of Academic Achievement and Parental Practices on Depressive Symptom Trajectories Among Chinese Adolescents

Research on Child and Adolescent Psychopathology ◽

10.1007/s10802-021-00826-9 ◽

2021 ◽

Author(s):

Xingna Qin ◽

Tessa Kaufman ◽

Lydia Laninga-Wijnen ◽

Ping Ren ◽

Yunyun Zhang ◽

...

Keyword(s):

Academic Achievement ◽

Depressive Symptoms ◽

Depressive Symptom ◽

Autonomy Support ◽

Psychological Control ◽

Chinese Adolescents ◽

Parental Practices ◽

Symptom Trajectories ◽

Symptom Profile ◽

The Impact

AbstractThough depressive symptoms tend to increase in early adolescence, the trajectories of these symptoms may vary strongly. This longitudinal study investigated the extent to which the distinct developmental trajectories of depressive symptoms were predicted by adolescents' academic achievement and perceived parental practices in a sample of Chinese young adolescents (N = 2,576). The results showed four trajectory profiles of depressive symptoms: low-stable (75%), low-increasing (11%), high-stable (9%), and high-decreasing (5%). Adolescents with high academic achievement were more likely to be classified into the low-stable, low-increasing, and high-decreasing profiles than into the high-stable depressive symptom profile. Moreover, students who perceived greater parental autonomy support were more likely to be in the low-stable and low-increasing profiles than the high-stable profile, whereas adolescents perceiving more parental psychological control had higher odds of being in the low-increasing rather than the low-stable profile. Parental educational involvement was unrelated to students' depressive symptom trajectories. In sum, Chinese adolescents with higher academic achievement and who perceived more parental autonomy support, and less psychological control, were at lower risk of experiencing depressive symptoms.

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Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

International Journal for Equity in Health ◽

10.1186/s12939-020-01375-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sara Lena Lueckmann ◽

Jens Hoebel ◽

Julia Roick ◽

Jenny Markert ◽

Jacob Spallek ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Primary Care Physicians ◽

Web Of Science ◽

Adult Population ◽

Socioeconomic Inequalities ◽

Eligibility Criteria ◽

Physician Visits ◽

General Adult Population ◽

Registration Number

Abstract Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.

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Psychological prognosis after newly diagnosed chronic conditions: socio-demographic and clinical correlates

International Psychogeriatrics ◽

10.1017/s1041610216001630 ◽

2016 ◽

Vol 29 (2) ◽

pp. 281-292 ◽

Cited By ~ 2

Author(s):

Ching-Ju Chiu ◽

Yu-Ching Hsu ◽

Shuo-Ping Tseng

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Chronic Conditions ◽

Liver Diseases ◽

Lung Diseases ◽

Heart Diseases ◽

Psychological Burden ◽

Symptom Trajectories ◽

Physical Limitations ◽

Over Time

ABSTRACTBackground:This study was aimed toward discerning depressive symptom trajectories associated with different chronic conditions and toward finding modifiable factors associated with those trajectories.Methods:Data were drawn from the 1996–2007 Taiwan Longitudinal Study on Aging. Nine chronic conditions were selected, and mood trajectories were measured with the Center of Epidemiological Studies-Depression scale.Results:Among the nine chronic conditions we examined, four patterns of depressive symptom trajectories were identified: (1) elevated depressive symptoms and worsened over time after diagnosed with heart disease (n= 681), arthritis (n= 850), or hypertension (n= 1,207); (2) elevated depressive symptoms without worsening over time after diagnosed with stroke (n= 160), lung diseases (n= 432), gastric conditions (n= 691), or liver diseases (n= 234); (3) no elevated depressive symptoms after diagnosis but an increase in depressive symptoms over time for participants with diabetes (n= 499); and (4) no significant patterns after diagnosed with cancer (n= 57). Cumulative psychological burden over time was significant for participants with hypertension, diabetes, heart diseases, or arthritis. However, these effects disappeared after controlling for comorbidities and physical limitations. Moreover, psychiatric condition was found to play an important role in baseline depressive symptoms among participants diagnosed with lung diseases, arthritis, or liver diseases.Conclusions:Findings from this study provide information in addressing psychological burden at different times for different conditions. In addition, minimizing the incidence of comorbidities, physical limitations, or psychiatric conditions may have the prospective effect of avoiding the trend of increased depressive symptoms, especially when adults diagnosed with hypertension, diabetes, heart diseases, arthritis, lung diseases, arthritis, or liver diseases.

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Psychosocial and health-related risk factors for depressive symptom trajectories among midlife women over 15 years: Study of Women's Health Across the Nation (SWAN)

Psychological Medicine ◽

10.1017/s0033291718000703 ◽

2018 ◽

Vol 49 (2) ◽

pp. 250-259 ◽

Cited By ~ 4

Author(s):

Joyce T. Bromberger ◽

Laura L. Schott ◽

Nancy E. Avis ◽

Sybil L. Crawford ◽

Sioban D. Harlow ◽

...

Keyword(s):

Risk Factors ◽

Social Support ◽

Depressive Symptoms ◽

Depressive Symptom ◽

Midlife Women ◽

Role Functioning ◽

Symptom Trajectories ◽

Related Risk ◽

Health Related ◽

Symptom Trajectory

AbstractBackgroundPsychosocial and health-related risk factors for depressive symptoms are known. It is unclear if these are associated with depressive symptom patterns over time. We identified trajectories of depressive symptoms and their risk factors among midlife women followed over 15 years.MethodsParticipants were 3300 multiracial/ethnic women enrolled in a multisite longitudinal menopause and aging study, Study of Women's Health Across the Nation. Biological, psychosocial, and depressive symptom data were collected approximately annually. Group-based trajectory modeling identified women with similar longitudinal patterns of depressive symptoms. Trajectory groups were compared on time-invariant and varying characteristics using multivariable multinomial analyses and pairwise comparisons.ResultsFive symptom trajectories were compared (50% very low; 29% low; 5% increasing; 11% decreasing; 5% high). Relative to whites, blacks were less likely to be in the increasing trajectory and more likely to be in the decreasing symptom trajectory and Hispanics were more likely to have a high symptom trajectory than an increasing trajectory. Psychosocial/health factors varied between groups. A rise in sleep problems was associated with higher odds of having an increasing trajectory and a rise in social support was associated with lower odds. Women with low role functioning for 50% or more visits had three times the odds of being in the increasing symptom group.ConclusionsChanges in psychosocial and health characteristics were related to changing depressive symptom trajectories. Health care providers need to evaluate women's sleep quality, social support, life events, and role functioning repeatedly during midlife to monitor changes in these and depressive symptoms.

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Interpersonal sensitivity mediates the effects of child abuse and affective temperaments on depressive symptoms in the general adult population

Neuropsychiatric Disease and Treatment ◽

10.2147/ndt.s144788 ◽

2017 ◽

Vol Volume 13 ◽

pp. 2559-2568 ◽

Cited By ~ 9

Author(s):

Ayano Otsuka ◽

Yoshikazu Takaesu ◽

Mitsuhiko Sato ◽

Jiro Masuya ◽

Masahiko Ichiki ◽

...

Keyword(s):

Child Abuse ◽

Depressive Symptoms ◽

Adult Population ◽

Interpersonal Sensitivity ◽

Affective Temperaments ◽

General Adult Population

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Associations between different types and sources of dietary fibre intake and depressive symptoms in a general population of adults: a cross-sectional study

British Journal Of Nutrition ◽

10.1017/s0007114520003566 ◽

2020 ◽

pp. 1-10

Author(s):

Yang Xia ◽

Yashu Liu ◽

Shunming Zhang ◽

Qing Zhang ◽

Li Liu ◽

...

Keyword(s):

Depressive Symptoms ◽

Dietary Fibre ◽

Adult Population ◽

Depression Scale ◽

Cross Sectional Study ◽

Dietary Factors ◽

Sectional Study ◽

Cross Sectional ◽

General Adult Population ◽

Dietary Fibre Intake

Abstract This cross-sectional study aimed to examine the associations between dietary fibre (DF) intake and depressive symptoms in a general adult population in Tianjin, China. A total of 24 306 participants (mean age 41 years; range 18–91 years) were enrolled. DF intake was assessed using a validated self-administered FFQ. Depressive symptoms were assessed using the Self-Rating Depression Scale. Associations between DF intake and depressive symptoms were estimated using logistic regression analysis. Socio-demographic, behavioural, health status and dietary factors were adjusted. In men, compared with participants in the lowest quartiles for total, soluble, vegetable and soya DF, OR for depressive symptoms in the highest were 0·83 (95 % CI 0·69, 0·99), 0·74 (95 % CI 0·63, 0·87), 0·79 (95 % CI 0·65, 0·96) and 0·69 (95 % CI 0·60, 0·81), respectively. In women, compared with participants in the lowest quartiles for vegetable and soya DF, the OR for depressive symptoms in the highest were 0·77 (95 % CI 0·64, 0·93) and 0·82 (95 % CI 0·70, 0·95), respectively. No association was found between total or soluble DF intake and depressive symptoms in women. No association was found between insoluble, cereal, fruit or tuber DF intake and depressive symptoms in men and women. Linear associations between DF intake and depressive symptoms were only detected for soya DF (men, β = –0·148, P < 0·0001; women, β = –0·069, P = 0·04). Results suggest that intake of soluble, vegetable and soya DF was inversely associated with depressive symptoms. These results should be confirmed through prospective and interventional studies.

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Prevalence and clinical associations of wheezes and crackles in the general population: the Tromsø study

BMC Pulmonary Medicine ◽

10.1186/s12890-019-0928-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

J. C. Aviles-Solis ◽

C. Jácome ◽

A. Davidsen ◽

R. Einarsen ◽

S. Vanbelle ◽

...

Keyword(s):

Lung Function ◽

General Population ◽

Smoking Status ◽

Adult Population ◽

Female Gender ◽

Lung Sounds ◽

Current Smoking ◽

General Adult Population ◽

Multivariable Analyses ◽

Logistic Regressions

Abstract Background Wheezes and crackles are well-known signs of lung diseases, but can also be heard in apparently healthy adults. However, their prevalence in a general population has been sparsely described. The objective of this study was to determine the prevalence of wheezes and crackles in a large general adult population and explore associations with self-reported disease, smoking status and lung function. Methods We recorded lung sounds in 4033 individuals 40 years or older and collected information on self-reported disease. Pulse oximetry and spirometry were carried out. We estimated age-standardized prevalence of wheezes and crackles and associations between wheezes and crackles and variables of interest were analyzed with univariable and multivariable logistic regressions. Results Twenty-eight percent of individuals had wheezes or crackles. The age-standardized prevalence of wheezes was 18.6% in women and 15.3% in men, and of crackles, 10.8 and 9.4%, respectively. Wheezes were mostly found during expiration and crackles during inspiration. Significant predictors of expiratory wheezes in multivariable analyses were age (10 years increase - OR 1.18, 95%CI 1.09–1.30), female gender (1.45, 1.2–1.8), self-reported asthma (1.36, 1.00–1.83), and current smoking (1.70, 1.28–2.23). The most important predictors of inspiratory crackles were age (1.76, 1.57–1.99), current smoking, (1.94, 1.40–2.69), mMRC ≥2 (1.79, 1.18–2.65), SpO2 (0.88, 0.81–0.96), and FEV1 Z-score (0.86, 0.77–0.95). Conclusions Nearly over a quarter of adults present adventitious lung sounds on auscultation. Age was the most important predictor of adventitious sounds, particularly crackles. The adventitious sounds were also associated with self-reported disease, current smoking and measures of lung function. The presence of findings in two or more auscultation sites was associated with a higher risk of decreased lung function than solitary findings.

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Trajectories of maternal depressive symptoms over her child's life span: Relation to adrenocortical, cardiovascular, and emotional functioning in children

Development and Psychopathology ◽

10.1017/s0954579409000133 ◽

2009 ◽

Vol 21 (1) ◽

pp. 207-225 ◽

Cited By ~ 45

Author(s):

Brooks B. Gump ◽

Jacki Reihman ◽

Paul Stewart ◽

Ed Lonky ◽

Tom Darvill ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Life Span ◽

Acute Stress ◽

Depression Scale ◽

Cardiovascular Responses ◽

Epidemiological Studies ◽

Maternal Depressive Symptoms ◽

Symptom Trajectories ◽

Maternal Depressive Symptom

AbstractMaternal depression has a number of adverse effects on children. In the present study, maternal depressive symptoms were assessed (using the Center for Epidemiological Studies Depression Scale) when their child was 3 months, 6 months, 1 year, 2 years, 4.25 years, 6 years, 7 years, 8 years, and 10 years of age. At 9.5 years of age, children's (94 females, 82 males) depressive symptoms as well as cardiovascular and cortisol levels during baseline and two psychologically stressful tasks were measured. Using multilevel modeling, maternal depressive symptom trajectories were considered in relation to their child's adrenocortical and cardiovascular responses to acute stress. Our goal was to determine maternal depressive symptom trajectories for children with elevated cardiovascular and cortisol reactivity to acute stress and elevated depressive symptoms. In general, those mothers with chronically elevated depressive symptoms over their child's life span had children with lower initial cortisol, higher cardiac output and stroke volume in response to acute stress, lower vascular resistance during acute stress tasks, and significantly more depressive symptoms at 9.5 years of age. These results are discussed in the context of established associations among hypothalamic–pituitary–adrenal axis dysregulation, depression, and cardiovascular disease.

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