Patterns and predictors of naturally occurring change in depressive symptoms over a 30-month period in multiple sclerosis

2013 ◽  
Vol 20 (5) ◽  
pp. 602-609 ◽  
Author(s):  
Ipek Ensari ◽  
Robert W Motl ◽  
Edward McAuley ◽  
Sean P Mullen ◽  
Anthony Feinstein
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptoms ◽  
Latent Class ◽  
Depression Scale ◽  
Physically Active ◽  
Modifiable Factors ◽  
Relapsing Remitting ◽  
Class 1 ◽  
Time Class ◽  
Over Time

Background: Depressive symptoms are common in multiple sclerosis (MS), yet there is little information about the pattern and predictors of changes in depressive symptoms over time. Objective: We examined changes in depressive symptoms over a 30-month period and the demographic, clinical and behavioral predictors of such changes in relapsing–remitting MS (RRMS). Methods: 269 persons with RRMS completed the Hospital Anxiety and Depression Scale (HADS) and a demographic/clinical scale, Godin Leisure-Time Exercise Questionnaire (GLTEQ) and Patient Determined Disease Steps (PDDS) scale every 6 months over a 30-month period. Data were analyzed using latent class growth modeling (LCGM). Results: LCGM identified a two-class model for changes in HADS depression scores over time. Class 1 involved lower initial status (i.e. fewer depressive symptoms) and linear decreases in depressive symptoms over time (i.e. improving HADS scores), whereas Class 2 involved higher initial status (i.e. more depressive symptoms) and linear increases in depressive symptoms over time (i.e. worsening HADS scores). LCGM further indicated that being older (OR = 2.46; p < .05), married (OR = 2.62; p < .05), employed (OR = 4.29; p < .005) and physically active (OR = 2.71; p < .05) predicted a greater likelihood of belonging to C1 than C2. Conclusions: Depressive symptoms change over time in persons with RRMS, and the pattern of change can be predicted by modifiable and non-modifiable factors.

Patterns and Predictors of Change in Moderate-to-Vigorous Physical Activity Over Time in Multiple Sclerosis

2017 ◽  
Vol 14 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Rachel E. Klaren ◽  
Jeffer E. Sasaki ◽  
Edward McAuley ◽  
Robert W. Motl
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Latent Class ◽  
Vigorous Physical Activity ◽  
Clinical Predictors ◽  
Physical Activity Interventions ◽  
Time Period ◽  
Class 1 ◽  
Time Class ◽  
Over Time

Background:Physical inactivity is common in persons with multiple sclerosis (MS), but there is very little known about the pattern and predictors of changes in physical activity over time.Purpose:This study examined changes in moderate-to-vigorous physical activity (MVPA) over a 30-month time period and the demographic and clinical predictors of such changes in relapsing-remitting MS (RRMS).Methods:269 persons with MS wore an accelerometer for a 7-day period and completed a demographic/clinical scale every 6 months over a 30-month period. Data were analyzed using latent class growth modeling (LCGM).Results:LCGM identified a two-class model for changes in levels of MVPA over time. Class 1 involved higher initial levels of MVPA and linear decreases in MVPA over time, whereas Class 2 involved lower initial levels of MVPA and linear increases in MVPA over time. LCGM further indicated that males were more likely (OR = 5.8, P < .05) and those with higher disability status were less likely (OR = 0.51, P < .05) to belong to Class 1 than Class 2.Conclusion:Levels of MVPA change over time in persons with RRMS and the pattern of change suggests that behavioral physical activity interventions for persons with MS might target men and those with lower disability.

scholarly journals Longitudinal Health Behaviour Patterns Among Chinese Adults Aged ≥ 50 Years and Their Associations With Trajectories of Depressive Symptoms Over Time: A Latent Class Analysis

2020 ◽  
Author(s):  
Zeyun Feng ◽  
Thijs van den Broek ◽  
Jane Cramm ◽  
Anna Nieboer
Keyword(s):  
Depressive Symptoms ◽  
Health Behaviour ◽  
Social Participation ◽  
Latent Class ◽  
Health Behaviours ◽  
Physically Active ◽  
Longitudinal Patterns ◽  
Multiple Health Behaviours ◽  
Multiple Health ◽  
Over Time

Abstract Background Whether different longitudinal patterns of multiple health behaviours are associated with different trajectories of depressive symptoms is not well understood.Purpose To identify distinct longitudinal patterns of multiple health behaviours and their associations with trajectories of depressive symptoms among people aged ≥ 50 years in China.Methods We used longitudinal data from the Harmonized China Health and Retirement Longitudinal Study (three waves, 2010–2015; n = 8439). We performed latent class analyses to identify distinct patterns of multiple health behaviours at three timepoints. We estimated longitudinal random-effects models to predict differences in depressive symptoms trajectories by health behaviour class.Results The best-fitting model had five latent classes, all of which showed strong behavioural stability over time: 1) socially active, moderately physically active non-smokers (29.4%); 2) socially inactive, physically active non-smokers (22.3%); 3) socially and physically inactive non-smokers (17.9%); 4) socially inactive, moderately physically active smokers (14.6%); and (5) socially active, moderately physically active smokers (14.2%). All classes characterized by low social participation (classes 2–4) were associated with significantly higher predicted depressive symptom scores compared with the other classes (1 and 5). Conclusions Longitudinal behavioural patterns involving low probabilities of social participation were associated with more depressive symptoms. This overshadowing effect suggests that the damage caused by socially inactivity may render the effects of co-existing (un)healthy behaviours meaningless. The stability of the patterns of multiple health behaviours across survey waves suggests that interventions are needed earlier in life.

scholarly journals Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors—results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)

2021 ◽  
Author(s):  
Salome Adam ◽  
Melissa S. Y. Thong ◽  
Eva Martin-Diener ◽  
Bertrand Camey ◽  
Céline Egger Hayoz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Depressive Symptoms ◽  
Cancer Survivorship ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Symptom Cluster ◽  
Depression Symptom ◽  
Class 1 ◽  
Eortc Qlq

Abstract Purpose Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). Methods Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. Results Three classes were identified: class 1 (61.4%) – “low pain, low physical and emotional fatigue, moderate depressive symptoms”; class 2 (15.1%) – “low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms”; class 3 (23.5%) – high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. Conclusion Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors’ needs.

scholarly journals Effects of social support, hope and resilience on depressive symptoms within 18 months after diagnosis of prostate cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xinxin Zhao ◽  
Ming Sun ◽  
Ye Yang
Keyword(s):  
Prostate Cancer ◽  
Social Support ◽  
Depressive Symptoms ◽  
Perceived Social Support ◽  
Depression Scale ◽  
Psychosocial Interventions ◽  
Epidemiologic Studies ◽  
Depression Symptoms ◽  
Cross Sectional ◽  
Modifiable Factors

Abstract Background The prevalence of depression symptoms and related modifiable factors in prostate cancer (PCa) are not well evaluated. We aimed to assess the effects of perceived social support, hope and resilience on depressive symptoms within 18 months after diagnosis of PCa, and to evaluate the role of hope and resilience as mediators of that relationship. Method A cross-sectional study was analyzed in consecutive inpatients with PCa during the months of January 2018 and August 2019. A total of 667 patients eligible for this study completed questionnaires on demographic and clinic variables, Center for Epidemiologic Studies Depression Scale, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Resilience Scale (14 items). All registered patients were all volunteers and anonymous. Depressive symptoms, perceived social support, hope and resilience were measured anonymously. Out of 667 patients, a total of 564 effective respondents (< 30% missing data) became our subjects. Hierarchical linear regression was used to identify the factors associated with depressive symptoms. Asymptotic and resampling strategies were used to conduct the mediating effects of hope and resilience. Results The prevalence of depressive symptoms was 65.9% in PCa patients. Hierarchical regression analyses indicated that perceived social support, hope, and resilience together accounted for 27.5% variance of depressive symptoms. Support from family, hope, and resilience significantly associated with depressive symptoms, respectively. Hope (a*b = − 0.0783, BCa95% CI: − 0.134 to − 0.0319, p < 0.05), and resilience (a*b = − 0.1315, BCa95% CI: − 0.1894 to − 0.0783, p < 0.05) significantly mediated the association between perceived social support and depressive symptoms. Conclusions The high prevalence of depressive symptoms among PCa patients should receive more attention. Perceived social support, hope and resilience could be positive resources for combating depressive symptoms, and hope and resilience mediated the association between perceived social support and depressive symptoms. Enhancing social support, particularly the support form family, and improving patients’ outlook and resilience may be potential targets for future psychosocial interventions aimed at reducing depressive symptoms.

Olfactory dysfunction in multiple sclerosis: association with secondary progression

2011 ◽  
Vol 18 (5) ◽  
pp. 616-621 ◽  
Author(s):  
Ana Martins Silva ◽  
Ernestina Santos ◽  
Inês Moreira ◽  
Andreia Bettencourt ◽  
Ester Coutinho ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Clinical Markers ◽  
Systematic Assessment ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Threshold Score ◽  
State Examination ◽  
Smell Identification

Objective: The Brief Smell Identification Test (B-SIT) was used to explore odour identification capacities in multiple sclerosis (MS). Methods: In total, 153 consecutive patients with MS and 165 healthy controls (HC) participated in the study. All participants were asked to answer the B-SIT and the Hospital Anxiety and Depression Scale (HADS). The Expanded Disability Status Scale (EDSS), the Multiple Sclerosis Severity Scale (MSSS), and the Mini-Mental State Examination (MMSE) were used for patients’ clinical and cognitive characterization. Results: Patients with MS (11.1%) were more impaired on the B-SIT than HC participants (3%). The frequency of impairment was higher for patients with secondary progressive (SPMS; 11/16, 68.8%) than relapsing–remitting (RRMS; 4/121, 3.3%) or primary progressive (2/16, 12.5%) courses. A threshold score of ≤ 8 on the B-SIT provided a sensitivity of 69% and a specificity of 97% in the identification of SPMS among patients with relapsing onset. The association between SPMS and impaired B-SIT remained statistically significant after adjusting for demographic (i.e. age and education), clinical (i.e. disease duration, EDSS, and MSSS), psychopathological (i.e. HADS anxiety and depression scores), and cognitive (i.e. MMSE) variables. Conclusions: A brief odour identification measure provided a good discrimination between SPMS and RRMS courses. A systematic assessment of olfactory functions may contribute to the development of clinical markers of SPMS.

Six-month trajectories of self-reported depressive symptoms in long-term care

2015 ◽  
Vol 28 (1) ◽  
pp. 71-81 ◽  
Author(s):  
Jane McCusker ◽  
Martin G. Cole ◽  
Philippe Voyer ◽  
Johanne Monette ◽  
Nathalie Champoux ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Long Term Care ◽  
Secondary Analysis ◽  
Depression Scale ◽  
Depression Symptom ◽  
Term Care ◽  
Symptom Trajectory ◽  
Over Time

ABSTRACTBackground:Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.Methods:This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model.Results:Three clusters of depression symptom trajectory were found that described “lower,” “intermediate,” and “higher” levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment.Conclusions:The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.

scholarly journals Latent Profile Analyses of Depressive Symptoms in Younger and Older Oncology Patients

Assessment ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1383-1398 ◽  
Author(s):  
Rebecca M. Saracino ◽  
Heining Cham ◽  
Barry Rosenfeld ◽  
Christian J. Nelson
Keyword(s):  
Depressive Symptoms ◽  
Older Patients ◽  
Latent Profile Analysis ◽  
Latent Class ◽  
Profile Analysis ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Class Differences ◽  
Patients With Cancer ◽  
Latent Profile

The aging of America will include a significant increase in the number of older patients with cancer, many of whom will experience significant depressive symptoms. Although geriatric depression is a well-studied construct, its symptom presentation in the context of cancer is less clear. Latent profile analysis was conducted on depressive symptoms in younger (40-64 years) and older (≥65 years) patients with cancer ( N = 636). The sample was clinically heterogeneous (i.e., included all stages, dominated by advanced stage disease). Participants completed questionnaires including the Center for Epidemiological Studies Depression Scale, which was used for the latent profile analysis. A four-class pattern was supported for each age group. However, the four-class pattern was significantly different between the younger and older groups in terms of the item means within each corresponding latent class; differences were primarily driven by severity such that across classes, older adults endorsed milder symptoms. An unexpected measurement issue was uncovered regarding reverse-coded items, suggesting that they may generate unreliable scores on the Center for Epidemiological Studies Depression Scale for a significant subset of patients. The results indicate that cancer clinicians can expect to see depressive symptoms along a continuum of severity for patients of any age, with less severe symptoms among older patients.

scholarly journals Stability of ARDS subphenotypes over time in two randomised controlled trials

Thorax ◽  
2018 ◽  
Vol 73 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Kevin Delucchi ◽  
Katie R Famous ◽  
Lorraine B Ware ◽  
Polly E Parsons ◽  
B Taylor Thompson ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Outcomes ◽  
Randomised Controlled Trials ◽  
Latent Class ◽  
Lung Protective Ventilation ◽  
Controlled Trials ◽  
Transition Analysis ◽  
Class 1 ◽  
Randomised Controlled ◽  
Over Time

RationaleTwo distinct acute respiratory distress syndrome (ARDS) subphenotypes have been identified using data obtained at time of enrolment in clinical trials; it remains unknown if these subphenotypes are durable over time.ObjectiveTo determine the stability of ARDS subphenotypes over time.MethodsSecondary analysis of data from two randomised controlled trials in ARDS, the ARMA trial of lung protective ventilation (n=473; patients randomised to low tidal volumes only) and the ALVEOLI trial of low versus high positive end-expiratory pressure (n=549). Latent class analysis (LCA) and latent transition analysis (LTA) were applied to data from day 0 and day 3, independent of clinical outcomes.Measurements and main resultsIn ALVEOLI, LCA indicated strong evidence of two ARDS latent classes at days 0 and 3; in ARMA, evidence of two classes was stronger at day 0 than at day 3. The clinical and biological features of these two classes were similar to those in our prior work and were largely stable over time, though class 2 demonstrated evidence of progressive organ failures by day 3, compared with class 1. In both LCA and LTA models, the majority of patients (>94%) stayed in the same class from day 0 to day 3. Clinical outcomes were statistically significantly worse in class 2 than class 1 and were more strongly associated with day 3 class assignment.ConclusionsARDS subphenotypes are largely stable over the first 3 days of enrolment in two ARDS Network trials, suggesting that subphenotype identification may be feasible in the context of clinical trials.

Geriatric Depression Scale: Consistency of Depressive Symptoms over Time

1991 ◽  
Vol 73 (3) ◽  
pp. 1032-1032 ◽  
Author(s):  
Jerome A. Yesavage
Keyword(s):  
Depressive Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Over Time

The following is a comment on the importance of the 1991 finding by I. L. Abraham of the unchanging nature of depressive symptoms over time: one concludes that such patients will not change unless major interventions, both pharmacologic or psychosocial, can be made.

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