scholarly journals To what extent is the elevated risk of psychological distress in people with diabetes accounted for by physical disability? Findings from a large population-based study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022767 ◽  
Author(s):  
Elza Elmira ◽  
Emily Banks ◽  
Grace Joshy

ObjectivesPeople with diabetes experience an elevated risk of psychological distress compared with people without diabetes. It is unclear how much of this elevated risk is attributable to the greater levels of physical disability in people with diabetes, and how this risk varies according to sociodemographic and health-behavioural characteristics. This study quantified levels of psychological distress in people with and without diabetes, considering these factors.DesignCross-sectional analysis of questionnaire data.SettingMen and women aged ≥45 years, in the 45 and Up Study, from New South Wales, Australia.Participants236 441 people who completed the baseline postal questionnaire (distributed from 1 January 2006–31 December 2008), with valid data for diabetes status and psychological distress.Primary outcome measuresHigh psychological distress (Kessler-10 >22). Modified Poisson regression with robust error variance was used to estimate prevalence ratios (PRs), comparing prevalence of high psychological distress among those with and without diabetes and across physical functional limitation (PFL) levels, adjusting for potential confounders.ResultsOverall, 8.4% (19 803/236 441) of participants reported diabetes. 11.8% (2339) of individuals with diabetes and 7.2% (15 664) without diabetes had high psychological distress: age-adjusted and sex-adjusted PR=1.89 (95% CI 1.81 to 1.97), becoming 1.58 (1.52 to 1.65) and 1.22 (1.17 to 1.27) following additional adjustment for sociodemographic factors, health behaviours and additionally for PFL, respectively. Compared with individuals with neither diabetes nor PFL, the adjusted PRs for high psychological distress were: 1.37 (1.17 to 1.60) with diabetes but no PFL, 7.33 (7.00 to 7.67) without diabetes but with severe PFL and 8.89 (8.36 to 9.46) with both diabetes and severe PFL.ConclusionsPeople with diabetes have a 60% greater risk of high psychological distress than people without diabetes; a substantial proportion of this elevation is attributable to higher levels of disability with diabetes, especially factoring in measurement error. Psychological distress is strongly related to physical impairment.

2021 ◽  
Author(s):  
Yousef Moradi ◽  
Negar Piri ◽  
Hojat Dehghanbanadaki ◽  
Ghobad Moradi ◽  
Mahdiyeh Fotouk-Kiai ◽  
...  

Abstract Background: The aim was to assess the validity of diabetes self-reporting based on oral anti-diabetic drugs, insulin injection, or high fasting blood sugar (FBS) in a large Kurdish population of Iran.Methods: We performed a cross-sectional analytical study on 4400 subjects aged 35-70 years of the Dehgolan Prospective Cohort Study (DehPCS). The reference for having diabetes was oral hypoglycemic drug consumption, insulin injection, or high FBS representing diabetes. Self-reported diabetes status was investigated by well-trained interviewers before the identification of diabetes status based on reference criteria. The accuracy and agreement of self-reported diabetes with reference were assessed in the overall population as well as in different sociodemographic and habitual conditions. Results: Out of 4400 adults, 3996 agreed to participate in this study (participation=90.8%). The diabetes prevalence among the study population was 13.1% based on self-report and 9.7% based on reference. Of the 523 people who reported diabetes, 213 (41.28%) did not have diabetes. We found a good agreement of 92.3% concordance with a kappa value of 65.1% between self-reported diabetes and reference. Self-reported diabetes also guaranteed sensitivity of 78.5%, specificity of 93.9%, positive predictive value of 58.7%, and negative predictive value of 98.0% to identify diabetic participants. Conclusion: Self-reported diabetes is identified as a valid tool that could accurately determine the diabetes prevalence in epidemiological studies on the Kurdish population of Iran.


2018 ◽  
Vol 95 (5) ◽  
pp. 682-690 ◽  
Author(s):  
M. Asadi-Lari ◽  
Y. Salimi ◽  
M. R. Vaez-Mahdavi ◽  
S. Faghihzadeh ◽  
A. A. Haeri Mehrizi ◽  
...  

Author(s):  
Mduduzi Colani Shongwe ◽  
Song-Lih Huang

The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household telephone survey of 993 conveniently sampled adults (18+ years) from all the four administrative regions of Eswatini. Data were collected between 9 June and 18 July 2020 during the first wave of the COVID-19 pandemic, when the country was under a partial lockdown. COVID-19-related psychological distress was assessed using the Kessler 6-item Psychological Distress Scale (K6). We performed weighted modified Poisson regression analyses to identify significant predictors of moderate/severe psychological distress (K6 scores: ≥5). The weighted prevalences of moderate (K6 scores: 5–12) and severe psychological distress (K6 scores: ≥13) were 41.7% and 5.4%, respectively. Participants reported several perceived COVID-19-related stressors, including worries and fears of the contagion-specific death, serious need for food and money, and concerns about loss of income or business. The weighted prevalence of suicidal ideation was 1.5%. Statistically significant predictors of increased risk for moderate/severe psychological distress included living in the Hhohho and Manzini regions; feeling not well informed about COVID-19; feeling lonely; having received COVID-19 food or financial relief from the government; feeling burdened by the lockdown; being married; and being youth (18–24 years). The results call for the government to urgently augment the provision of mental health services during the pandemic. Mental health practitioners and programs may use several stressors and risk factors identified in this study to inform interventions and government policies aimed at reducing psychological distress induced by the pandemic.


BMJ Open ◽  
2017 ◽  
Vol 7 (5) ◽  
pp. e013548 ◽  
Author(s):  
Masoomeh Alimohammadian ◽  
Azam Majidi ◽  
Mehdi Yaseri ◽  
Batoul Ahmadi ◽  
Farhad Islami ◽  
...  

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012916
Author(s):  
Aline Thomas ◽  
Fabrice Crivello ◽  
Bernard Mazoyer ◽  
Stephanie Debette ◽  
Christophe Tzourio ◽  
...  

Background and Objective:Fish intake may prevent cerebrovascular disease (CVD), yet the mechanisms are unclear, especially regarding its impact on subclinical damage. Assuming that fish may have pleiotropic effect on cerebrovascular health, we investigated the association of fish intake with global CVD burden based on brain MRI markers.Methods:This cross-sectional analysis included participants from the Three-City Dijon population-based cohort (aged ≥65 years) without dementia, stroke, or history of hospitalized cardiovascular disease, who underwent brain MRI with automated assessment of white matter hyperintensities, visual detection of covert infarcts, and grading of dilated perivascular spaces. Fish intake was assessed through a frequency questionnaire and the primary outcome measure was defined as the first component of a factor analysis of mixed data applied to MRI markers. The association of fish intake with the CVD burden indicator was studied using linear regressions.Results:In total, 1,623 participants (mean age, 72.3 years; 63% women) were included. The first component of factor analysis (32.4% of explained variance) was associated with higher levels of all three MRI markers. Higher fish intake was associated with lower CVD burden. In a model adjusted for total intracranial volume, compared to participants consuming fish <1 per week, those consuming fish 2-3 and ≥4 times per week had a β = -0.19 (95% CI, -0.37; -0.01) and β = -0.30 (-0.57; -0.03) lower indicator of CVD burden, respectively (P trend <0.001). We found evidence of effect modification by age, so that the association of fish to CVD was stronger in younger participants (65-69 years) and not significant in participants aged ≥75 years. For comparison, in the younger age group, consuming fish 2-3 times a week was roughly equivalent (in opposite direction) to the effect of hypertension.Discussion:In this large population-based study, higher frequency of fish intake was associated with lower CVD burden, especially among participants younger than 75 years, suggesting a beneficial effect on brain vascular health before manifestation of overt brain disease.Classification of Evidence:This study provides Class II evidence that in individuals without stroke or dementia, higher fish intake is associated with lower subclinical CVD at MRI.


2021 ◽  
Vol 12 ◽  
Author(s):  
Faezeh Saghafian ◽  
Nafiseh Sharif ◽  
Parvane Saneei ◽  
Ammar Hassanzadeh Keshteli ◽  
Mohammad Javad Hosseinzadeh-Attar ◽  
...  

Background: Previous observational studies suggested a relationship between dietary fiber consumption and mental health, but the findings were conflicting. We evaluated the link between dietary fiber intake and prevalence of depression, anxiety, and psychological distress among a large population of Iranian adults.Methods: A cross-sectional study among 3,362 Iranian adults working in 50 health centers was done. Data of dietary intakes were collected through a validated semiquantitative dish-based 106-item food frequency questionnaire (FFQ). Anxiety, depression, and psychological distress were defined based on the Iranian validated version of Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ).Results: After adjustment for potential confounders, participants in the top quartile of total dietary fiber intake had a 33% and 29% lower risk of anxiety and high psychological distress [odds ratio (OR): 0.67; 95% CI: 0.48, 0.95 and OR: 0.71; 95% CI: 0.53, 0.94, respectively] compared to the bottom quartile of intake. The highest total dietary fiber intake was also inversely related to a lower risk of depression in women (OR: 0.63; 95% CI: 0.45, 0.88) but not in men. Among overweight or obese participants, higher intake of dietary fiber was related to a decreased risk of high psychological distress (OR: 0.52; 95% CI: 0.34, 0.79). A high level of dietary fiber intake was related to a lower risk of anxiety in normal-weight individuals (OR: 0.50; 95% CI: 0.31, 0.80).Conclusion: Significant inverse associations between total dietary fiber intake with anxiety and high psychological distress were found in Iranian adults. More consumption of dietary fiber was also related to reduced odds of depression in women. More investigations with prospective nature are needed to affirm these findings.


SLEEP ◽  
2021 ◽  
Author(s):  
Xin Liu ◽  
Guowei Wang ◽  
Xiaoyan Wang ◽  
Yueye Wang ◽  
Yan Min ◽  
...  

Abstract Study Objectives To investigate the association between daytime napping and retinal microcirculation. Methods This is a cross-sectional study from a prospective population-based cohort. 2,662 participants were recruited after quota sampling. Information on napping was collected through face-to-face interviews. Retinal vascular calibers (RVCs), including central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arterio-to-venous ratio (AVR), were obtained from fundus photography. Multivariate regression and restricted cubic spline curve were performed to determine the association between RVCs and daytime napping duration. Results 56.4% participants reported daytime napping regularly. Compared to no nap, daytime nap was related to higher CRAE, with nap duration of 0.5–1 h showing the most significant association. 0.5–1 h daytime nappers displayed an average of 4.18 µm (95% confidence interval [CI] 2.45–5.91, p &lt; 0.001) wider CRAE than non-nappers after adjustment. No significant association was found between CRVE and daytime napping. Moreover, individuals with 0.5–1 h daytime napping had a lower risk for AVR reduction (odds ratio [OR] 0.70, 95% confidence interval [CI] 0.56–0.86, p = 0.001) than non-nappers. Similar association persisted in non-hypertensive population. Restricted cubic spline indicated a J-shaped relationship between AVR reduction and nap duration. Conclusion Retinal microcirculation was positively associated with self-reported 0.5–1 h daytime napping. Better indicators of retinal microcirculation were probably related to nap duration in a J-shaped manner. Also, the possibly beneficial role of 0.5–1 h daytime napping on retinal microcirculation might be independent of clinically diagnosed vascular diseases.


2020 ◽  
pp. 1-11
Author(s):  
Gemma Lewis ◽  
Katherine S. Button ◽  
Rebecca M. Pearson ◽  
Marcus R. Munafò ◽  
Glyn Lewis

Abstract Background Large population-based cohort studies of neuropsychological factors that characterise or precede depressive symptoms are rare. Most studies use small case-control or cross-sectional designs, which may cause selection bias and cannot test temporality. In a large UK population-based cohort, we investigated cross-sectional and longitudinal associations between inhibitory control of positive and negative information and adolescent depressive symptoms. Methods Cohort study of 2328 UK adolescents who completed an affective go/no-go task at age 18. Depressive symptoms were assessed with the Clinical Interview Schedule Revised (CIS-R) and short Mood and Feeling Questionnaire (sMFQ) at age 18, and with the sMFQ 1 year later (age 19). Analyses were multilevel and traditional linear regressions, before and after adjusting for confounders. Results Cross-sectionally, we found little evidence that adolescents with more depressive symptoms made more inhibitory control errors [after adjustments, errors increased by 0.04% per 1 s.d. increase in sMFQ score (95% confidence interval 0.02–0.06)], but this association was not observed for the CIS-R. There was no evidence for an influence of valence. Longitudinally, there was no evidence that reduced inhibitory control was associated with future depressive symptoms. Conclusions Inhibitory control of positive and negative information does not appear to be a marker of current or future depressive symptoms in adolescents and would not be a useful target in interventions to prevent adolescent depression. Our lack of convincing evidence for associations with depressive symptoms suggests that the affective go/no-go task is not a promising candidate for future neuroimaging studies of adolescent depression.


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