scholarly journals Prevalence and Course of Depression During the First Year After Mild to Moderate Stroke

2021 ◽  
Author(s):  
Liming Dong ◽  
Linda S. Williams ◽  
Devin L. Brown ◽  
Erin Case ◽  
Lewis B. Morgenstern ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Mexican Americans ◽  
First Year ◽  
Transition Analysis ◽  
Corpus Christi ◽  
Symptom Pattern ◽  
Affective Symptoms ◽  
Patient Health ◽  
Depression Assessment ◽  
Course Of Depression

Background This study examined the prevalence and longitudinal course of depression during the first year after mild to moderate stroke. Methods and Results We identified patients with mild to moderate ischemic stroke or intracerebral hemorrhage (National Institutes of Health Stroke Scale score <16) and at least 1 depression assessment at 3, 6, or 12 months after stroke (n=648, 542, and 533, respectively) from the Brain Attack Surveillance in Corpus Christi project (2014–2016). Latent transition analysis was used to examine temporal profiles of depressive symptoms assessed by the 8‐item Patient Health Questionnaire between 3 and 12 months after stroke. Mean age was 65.6 years, 49.4% were women, and 56.7% were Mexican Americans. The prevalence of depression after stroke was 35.3% at 3 months, decreased to 24.9% at 6 months, and remained stable at 25.7% at 12 months. Approximately half of the participants classified as having depression at 3 or 6 months showed clinical improvement at the next assessment. Subgroups with distinct patterns of depressive symptoms were identified, including mild/no symptoms, predominant sleep disturbance and fatigue symptoms, affective symptoms, and severe/all symptoms. A majority of participants with mild/no symptoms retained this symptom pattern over time. The probability of transitioning to mild/no symptoms was higher before 6 months compared with the later period, and severe symptoms were more likely to persist after 6 months compared with the earlier period. Conclusions The observed dynamics of depressive symptoms suggest that depression after stroke tends to persist after 6 months among patients with mild to moderate stroke and should be continually monitored and appropriately managed.

Depressive symptoms in black and Puerto Rican adolescent mothers in the first 3 years postpartum

1992 ◽  
Vol 4 (3) ◽  
pp. 451-468 ◽  
Author(s):  
Bonnie J. Leadbeater ◽  
Oriana Linares
Keyword(s):  
Depressive Symptoms ◽  
Puerto Rican ◽  
Life Events ◽  
Adolescent Mothers ◽  
Stressful Life Events ◽  
Social Supports ◽  
Stressful Life ◽  
First Year ◽  
Affective Symptoms ◽  
Depressed Mothers

AbstractWhile depressive symptoms in adolescent mothers may affect both their own and their babies' development, little research has focused on the mothers. Self-reported symptoms on the Beck Depression Inventory were collected at 1, 6, 12, and 28–36 months postpartum. Concurrent and reciprocal longitudinal relations among symptom levels, stressful life events, and social supports were investigated. Symptom levels declined over the four assessments, with changes in somatic, rather than cognitive affective, symptoms accounting for the decrease. Stressful life events and all sources of social supports predicted concurrent levels of depressive symptoms, but only social supports predicted declines in symptoms in the first year postpartum. Reciprocally, depressive symptoms tended (p = .06) to predict increases in stressful life events over time. Mothers were also categorized as reporting few (50%), intermittent (27.5%), or chronic (22.5%) symptoms in the first 12 months postpartum. Intermittently and chronically depressed mothers perceived their own mothers as less accepting than nondepressed mothers. Compared to nondepressed and intermittently depressed mothers, chronically depressed mothers also reported more stressful life events, were more likely to live alone, and experienced more moves by 28–36 months postpartum. The reciprocal causal relations among depressive symptoms, stress, and attachments to grandmothers and peers are discussed.

scholarly journals Comparing Approaches to Mobile Depression Assessment for Measurement-Based Care: Prospective Study (Preprint)

2018 ◽  
Author(s):  
Amy M Bauer ◽  
Scott A Baldwin ◽  
Joaquin A Anguera ◽  
Patricia A Areán ◽  
David C Atkins
Keyword(s):  
Depressive Symptoms ◽  
Assessment Methods ◽  
Self Report ◽  
Patient Health Questionnaire ◽  
Care Practice ◽  
Unique Contribution ◽  
Health Questionnaire ◽  
Measurement Based Care ◽  
Patient Health ◽  
Depression Assessment

BACKGROUND To inform measurement-based care, practice guidelines suggest routine symptom monitoring, often on a weekly or monthly basis. Increasingly, patient-provider contacts occur remotely (eg, by telephone and Web-based portals), and mobile health tools can now monitor depressed mood daily or more frequently. However, the reliability and utility of daily ratings are unclear. OBJECTIVE This study aimed to examine the association between a daily depressive symptom measure and the Patient Health Questionnaire-9 (PHQ-9), the most widely adopted depression self-report measure, and compare how well these 2 assessment methods predict patient outcomes. METHODS A total of 547 individuals completed smartphone-based measures, including the Patient Health Questionnaire-2 (PHQ-2) modified for daily administration, the PHQ-9, and the Sheehan Disability Scale. Multilevel factor analyses evaluated the reliability of latent depression based on the PHQ-2 (for repeated measures) between weeks 2 and 4 and its correlation with the PHQ-9 at week 4. Regression models predicted week 8 depressive symptoms and disability ratings with daily PHQ-2 and PHQ-9. RESULTS The daily PHQ-2 and PHQ-9 are highly reliable (range: 0.80-0.88) and highly correlated (r=.80). Findings were robust across demographic groups (age, gender, and ethnic minority status). Daily PHQ-2 and PHQ-9 were comparable in predicting week 8 disability and were independent predictors of week 8 depressive symptoms and disability, though the unique contribution of the PHQ-2 was small in magnitude. CONCLUSIONS Daily completion of the PHQ-2 is a reasonable proxy for the PHQ-9 and is comparable to the PHQ-9 in predicting future outcomes. Mobile assessment methods offer researchers and clinicians reliable and valid new methods for depression assessment that may be leveraged for measurement-based depression care.

Abstract T P146: The Impact of Pre-stroke Depressive Symptoms, Fatalism, and Social Support on Disability after Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Anjail Z Sharrief ◽  
Brisa N Sánchez ◽  
Lynda D Lisabeth ◽  
Lesli E Skolarus ◽  
Darin B Zahuranec ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Mexican American ◽  
Stroke Care ◽  
Cognitive Outcomes ◽  
Stroke Recurrence ◽  
Corpus Christi ◽  
Patient Health ◽  
Social Support Scale ◽  
The Impact

Background: Fatalism and depression have been linked to post-stroke mortality and stroke recurrence. Our objective was to evaluate the impact of pre-stroke fatalism, depressive symptoms, and social support on neurological, functional, and cognitive outcomes after stroke. Methods: Ischemic strokes (2008 -2011) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project. At baseline interviews, pre-stroke depressive symptoms, fatalism, and social support were assessed using Patient Health Questionnaire (PHQ-9; 0-27; higher worse), modified Mental Adjustment for Stroke and Pearlin scales (8-40; higher worse), and a 7-item social support scale (0 -14; higher better); respectively. Outcome among survivors was assessed at 90 days using the National Institutes of Health Stroke Scale (NIHSS; 0-44, higher worse); activities/ instrumental activities of daily living (ADL/IADL; 1-4, higher worse); and Modified Mini-Mental State Exam (3MSE; 0-100, lower worse). Regression models were used to evaluate associations of interest, adjusting for demographic and clinical factors. Results: Among 364 participants with outcome interviews and complete covariate data, mean age was 66, 49.5% were female and 58.8% were Mexican American. In adjusted models, higher pre-stroke fatalism (median 17; IQR 12, 20) was associated with poorer functional (0.17 point higher ADL/IADL score per IQR higher fatalism score; 95% CI 0.05, 0.30) and cognitive (2.81 point lower 3MSE per IQR higher fatalism score; 95% CI 0.95, 4.67) outcomes. Similarly, higher pre-stroke depressive symptoms (median 3; IQR 0, 9) were associated with poorer functional (0.16 point higher ADL/IADL per IQR higher PHQ-9; 95% CI .04, 0.28) and cognitive (2.28 point lower 3MSE per IQR higher PHQ-9; 95% CI 0.46, 4.10) outcomes. There were no significant associations between fatalism or depressive symptoms and NIHSS or between social support (median 10; IQR 7, 12) and 90-day outcomes. Conclusions: Among ischemic stroke survivors, pre-stroke fatalism and depressive symptoms, but not social support, impact 90-day functional and cognitive outcomes. These findings reinforce the importance of evaluating and addressing psychological factors in stroke care.

Heterogeneity in Symptoms in Depression - A replication study in a Digital Mental Health Intervention using the PHQ-9 Questionnaire (Preprint)

2021 ◽  
Author(s):  
Silvan Hornstein ◽  
Valerie Forman-Hoffman ◽  
Nicholas C. Peiper ◽  
Markus J. Rantala
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Severe Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Symptom Pattern ◽  
Patient Health ◽  
Symptom Patterns ◽  
Treatment Procedures ◽  
Core Symptoms

BACKGROUND Past work has shown massive variation in depressive symptoms between patients, challenging the perception of major depressive disorder (MDD) as being uniform. This appears quite relevant also for digital mental health (DMH) interventions. While individualization is one of the key potentials of these approaches, this is regularly not utilized and the same static depression treatment is offered to all patients. OBJECTIVE This paper aims to replicate the approach from Fried & Nesse (2015), analyzing the variation of depressive symptoms within 1757 participants in a DMH intervention for depression and anxiety. METHODS Participants’ answers to the single items of the Patient Health Questionnaire 9-item scale (PHQ-9) were used to identify distinct patterns out of the 9 core symptoms of the DSM-5. RESULTS Overall, the 1757 participants showed 231 different patterns of symptoms. The most regular pattern occurred for 8% of the patients. 85% of the participants had a symptom pattern that was shared with less than 4% of the whole sample. The number of unique symptom patterns per participant decreased with higher symptom severity, but the 342 patients with overall severe depression symptoms still exhibited 34 different constellations of single symptoms. CONCLUSIONS The large variation in symptoms challenges the assignment of static depression interventions in DMH and calls for more individualized treatment procedures. Luckily, such procedures can be implemented particularly easily in an app-based context, for example by modular program structures.

Perfectionism in the transition to university: Comparing diathesis-stress and downward spiral models of depressive symptoms

2019 ◽  
Author(s):  
Shelby L. Levine ◽  
Marina Milyavskaya
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Poor Mental Health ◽  
First Year ◽  
First Year Students ◽  
Personal Standards ◽  
Downward Spiral ◽  
Personal Standards Perfectionism ◽  
Spiral Model ◽  
Diathesis Stress Model

Transitioning to university may be especially difficult for students who expect perfection from themselves. Self-critical perfectionism has consistently been linked to poor mental health. The current study compares a diathesis-stress and a downward spiral model, to determine why self-critical perfectionism is detrimental for mental health during this transition. First-year students (N=658) were recruited prior to beginning university in August and contacted again in October, January, and April. Participants completed measures on perfectionism, stress and depressive symptoms. Evidence was found for a downward spiral model with self-critical perfectionism, but not a diathesis-stress model. Students higher in self-critical perfectionism were more likely to experience increased stress and depressive symptoms in a circular and additive manner. Conversely, students higher in personal standards perfectionism experienced less stress and subsequent depressive symptoms. This research provides a theoretical model for why self-critical perfectionism is related to poor mental health outcomes which become sustained over time.

scholarly journals Toll-like receptor 4-mediated cytokine synthesis and post-stroke depressive symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michal Korostynski ◽  
Dzesika Hoinkis ◽  
Marcin Piechota ◽  
Slawomir Golda ◽  
Joanna Pera ◽  
...  
Keyword(s):  
Gene Expression ◽  
Depressive Symptoms ◽  
Ex Vivo ◽  
Toll Like Receptor ◽  
Toll Like Receptor 4 ◽  
Post Stroke ◽  
Cytokines And Chemokines ◽  
Patient Health ◽  
Post Stroke Depression ◽  
Cytokine Synthesis

AbstractAltered cytokine synthesis thought to contribute to the pathophysiology of post-stroke depression (PSD). Toll-like receptor 4 (TLR4) is a master regulator of innate immunity. The aim of this study was to explore the putative association between TLR4-mediated cytokine synthesis and subsequent symptoms of PSD. In total, 262 patients with ischemic stroke and without a history of PSD were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9 in 170 patients on Day 8 and in 146 at 3 months after stroke. Blood samples taken on Day 3 after stroke were stimulated ex vivo with lipopolysaccharide (LPS). Ex vivo synthesized cytokines (TNFα, IP-10, IL-1β, IL-6, IL-8, IL-10, and IL-12p70) and circulating cytokines (TNFα, IL-6, sIL-6R, and IL-1ra) were measured using the enzyme-linked immunoassay or cytometric method. RNA sequencing was used to determine the gene expression profile of LPS-induced cytokines and chemokines. LPS-induced cytokine synthesis and the gene expression of TLR4-dependent cytokines and chemokines did not differ between patients with and without greater depressive symptoms. The plasma level of IL-6, but not TNFα, sIL-6R, and IL-1ra, was higher in patients who developed depressive symptoms at 3 months after stroke (median: 4.7 vs 3.4 pg/mL, P = 0.06). Plasma IL-6 predicted the severity of depressive symptoms at 3 months after stroke (β = 0.42, P = 0.03). In conclusion, TLR4-dependent cytokine synthesis was not associated with greater post-stroke depressive symptoms in this study. Circulating IL-6 might be associated with depressive symptoms occurring at 3 months after stroke.

scholarly journals Associations of Dietary Patterns with Incident Depression: The Maastricht Study

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1034
Author(s):  
Vincenza Gianfredi ◽  
Annemarie Koster ◽  
Anna Odone ◽  
Andrea Amerio ◽  
Carlo Signorelli ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Dietary Patterns ◽  
Proportional Hazards ◽  
A Priori ◽  
Preventive Measure ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Healthy Diet ◽  
Patient Health

Our aim was to assess the association between a priori defined dietary patterns and incident depressive symptoms. We used data from The Maastricht Study, a population-based cohort study (n = 2646, mean (SD) age 59.9 (8.0) years, 49.5% women; 15,188 person-years of follow-up). Level of adherence to the Dutch Healthy Diet (DHD), Mediterranean Diet, and Dietary Approaches To Stop Hypertension (DASH) were derived from a validated Food Frequency Questionnaire. Depressive symptoms were assessed at baseline and annually over seven-year-follow-up (using the 9-item Patient Health Questionnaire). We used Cox proportional hazards regression analyses to assess the association between dietary patterns and depressive symptoms. One standard deviation (SD) higher adherence in the DHD and DASH was associated with a lower hazard ratio (HR) of depressive symptoms with HRs (95%CI) of 0.78 (0.69–0.89) and 0.87 (0.77–0.98), respectively, after adjustment for sociodemographic and cardiovascular risk factors. After further adjustment for lifestyle factors, the HR per one SD higher DHD was 0.83 (0.73–0.96), whereas adherence to Mediterranean and DASH diets was not associated with incident depressive symptoms. Higher adherence to the DHD lowered risk of incident depressive symptoms. Adherence to healthy diet could be an effective non-pharmacological preventive measure to reduce the incidence of depression.

Family Interaction and Depressive Symptoms in Chinese Emerging Adults: A Mediation Model of Gratitude

2021 ◽  
pp. 003329412110006
Author(s):  
Kelly Ka Lai Lam ◽  
Wei-Wen Chen
Keyword(s):  
Depressive Symptoms ◽  
Emerging Adults ◽  
Structural Equation ◽  
Family Interaction ◽  
Assessment Instrument ◽  
Equation Modeling ◽  
Mediation Model ◽  
Online Questionnaire ◽  
Patient Health ◽  
Healthy Family

In this study, we investigated the relations between family interaction, gratitude, and depressive symptoms among Chinese emerging adults. It also investigated gratitude as a mediator in the relation between family interaction and depression. Data were obtained from 321 college students who completed the online questionnaire about the Family Assessment Instrument, Gratitude Questionnaire, Patient Health Questionnaire, and demographic information. Structural equation modeling (SEM) was used to test hypotheses and bootstrapping with 5,000 resamplings (95% confidence interval) was used to confirm the mediation model. Results showed that gratitude partially mediated the relation between family interaction and depression. In other words, students with healthy family interaction, as indicated by perceived better family communication, mutuality, and harmony with family members, tended to report higher general gratitude, and subsequently diminished depressive symptoms. The practical implications were discussed.

Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour

2009 ◽  
Vol 39 (11) ◽  
pp. 1855-1865 ◽  
Author(s):  
G. Schomerus ◽  
H. Matschinger ◽  
M. C. Angermeyer
Keyword(s):  
Depressive Symptoms ◽  
Help Seeking ◽  
Theory Of Planned Behaviour ◽  
Population Sample ◽  
Path Model ◽  
Control Beliefs ◽  
Planned Behaviour ◽  
Telephone Interviews ◽  
Patient Health ◽  
Analogous Model

BackgroundMany people suffering from mental disorders do not seek appropriate help. We have examined attitudes that further or hinder help-seeking for depression with an established socio-psychological model, the Theory of Planned Behaviour (TPB), comparing models for respondents with and without depressive symptoms.MethodA qualitative preparatory study (n=29) elicited salient behavioural (BB), normative (NB) and control beliefs (CB) that were later included in the TPB questionnaire. Telephone interviews with a representative population sample in Germany (n=2303) started with a labelled vignette describing symptoms of a major depression, followed by items covering the components of the TPB. Intention to see a psychiatrist for the problem described was elicited at the beginning and at the end of the interview. We screened participants for current depressive symptoms using the mood subscale of the Patient Health Questionnaire (PHQ-9).ResultsIn non-depressed respondents (n=2167), a TPB path model predicted 42% of the variance for the first and 51% for the second question on intention. In an analogous model for depressed respondents (n=136), these values increased to 50% and 61% respectively. Path coefficients in both models were similar. In both depressed and non-depressed persons, attitude towards the behaviour was more important than the subjective norm, whereas perceived behavioural control was of minor influence.ConclusionsWillingness to seek psychiatric help for depression can largely be explained by a set of attitudes and beliefs as conceptualized by the TPB. Our findings suggest that changing attitudes in the general population are likely to effect help-seeking when people experience depressive symptoms.

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