Predictors of Depressive Symptoms Among Mid-Aged and Older Men With Diabetes in China

2019 ◽  
Vol 33 (1) ◽  
pp. 6-22 ◽  
Author(s):  
Ping He ◽  
Ying Hu ◽  
Changwei Li ◽  
Dongmei Wu ◽  
Song Ge ◽  
...  

Background and Purpose:Although mounting evidence has consistently shown that depressive symptoms are more common among diabetic women than among diabetic men, diabetic men are frequently overlooked in diabetes-related mental health studies, and research on predicators of depressive symptoms among diabetic men remains scarce. Therefore, the purpose of this study was to examine the gender-specific characteristics that predict depressive symptoms among mid-aged and elderly men with diabetes.Methods:A secondary data analysis was performed using the baseline data from the China and Health Retirement Longitudinal Study. A total of 824 men aged 45 years or older with diabetes were included in the analysis. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale short form. Age, education level, marital status, nighttime sleep duration, smoking status, duration of diabetes, treatment with insulin, and pain were based on self-reports. Information on hemoglobin A1c (HbA1c), functional impairment, weight, height, and blood lipids was also collected.Results:The prevalence of depressive symptoms was 22.7%. Male-specific significant predictors of depressive symptoms included nighttime sleep duration (short sleepers [p = .019], normal sleepers [p = .001], and long sleepers [p = .000]), instrumental activities of daily living (p = .001), and pain (mild pain [p = .003], moderate pain [p = .024], and severe pain [p = .017]).Implications for Practice:This study provides important findings about nighttime sleep duration, pain, and functional impairment and their relationships with presence of depressive symptoms in mid-aged and older men with diabetes. Screening tools should include these items to enable early detection and depression treatment for vulnerable men who may be otherwise missed.

2021 ◽  
Vol 12 ◽  
pp. 117955732198969
Author(s):  
Ralph de Similien ◽  
Milania D Al-Jammaly ◽  
Iuliana Predescu ◽  
Louis Belzie

Background: Symptoms of pseudobulbar affect (PBA) often are misinterpreted as those of a mood disorder. Symptoms seen in patients with PBA can be influenced by a mood disorder and vice versa. Our aim in this study was to determine the occurrence rate of PBA symptoms and comorbid depressive symptoms in a cohort of nursing home patients with different subtypes of neurocognitive disorders (NCD)/dementia. Methods: Eighty patients were screened and 61 met the inclusion criteria. These individuals were divided into 5 groups according to NCD subtypes: Alzheimer’s disease, vascular, HIV, unspecified, or combined types. The Center for Neurologic Study–Lability Scale (CNS-LS) and the Geriatric Depression Scale–Short Form (GDS-SF) were used to screen for PBA and depressive symptoms, respectively. The Mini-Mental Status Exam (MMSE) was used to determine patients’ baseline functioning. Fifty-nine patients successfully completed the CNS-LS and 42 completed the GDS. Results: Forty-four percent of individuals screened positive for PBA symptoms. Depressive symptoms were found among 23% of these patients. Not only were PBA-symptoms positive patients common among this nursing home residents, the PBA-symptoms positive patients were found to cluster mostly among those with NCD due to HIV (66.0%). PBA symptom-positive patients often received psychotropics. Conclusion: Better awareness, screening tools, and treatment approaches for patients with NCD expressing PBA-symptoms—especially those with NCD due to HIV Infection—are needed.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Yang ◽  
Dan Li ◽  
Jianmin Gao ◽  
Xiaojuan Zhou ◽  
Fuzhen Li

Abstract Background There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie’s decomposition was used to parse out differences into observed and unobserved components. Results After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie’s decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents. Conclusions Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers’ depressive symptoms.


2019 ◽  
Vol 31 (11) ◽  
pp. 1665-1674 ◽  
Author(s):  
Sheung-Tak Cheng ◽  
Phoon Ping Chen ◽  
Yu Fat Chow ◽  
Joanne W. Y. Chung ◽  
Alexander C. B. Law ◽  
...  

ABSTRACTObjective:The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.Design:Cross-sectional survey.Setting:Social centers for older people.Participants:664 Chinese older adults with chronic pain.Measurements:Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.Results:For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.Conclusions:The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.


2007 ◽  
Vol 25 (15) ◽  
pp. 2093-2099 ◽  
Author(s):  
Carolyn Cook Gotay ◽  
Carol M. Moinpour ◽  
Joseph M. Unger ◽  
Caroline S. Jiang ◽  
Dorothy Coleman ◽  
...  

Purpose A first breast cancer recurrence creates considerable distress, yet few psychosocial interventions directed at this population have been reported. The Southwest Oncology Group conducted a phase III randomized trial to evaluate the effectiveness of a brief telephone intervention. Patients and Methods Three hundred five women experiencing a first recurrence of breast cancer were randomly assigned to standard care or intervention. The intervention consisted of four to eight telephone calls delivered over a 1-month period. The calls were conducted by trained peer counselors at a breast cancer advocacy organization, the Y-ME National Breast Cancer Organization, and followed a standard curriculum. Psychosocial distress (Cancer Rehabilitation Evaluation System–Short Form [CARES-SF]) and depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) outcomes were assessed at baseline and 3 and 6 months. The 3-month assessment was the primary end point and is the focus of this article. Results Analysis revealed no differences in distress or depressive symptoms at 3 months between the intervention and control groups; at 3 months, 70% of control patients and 66% of intervention patients reported psychosocial distress, and 40% of control patients and 47% of intervention patients exhibited depressive symptoms. Conclusion Telephone peer counseling did not lead to better psychosocial outcomes. The persistent distress in these women supports the urgent need for the development and testing of more intensive or different supportive interventions for this group of patients.


2011 ◽  
Vol 26 (S2) ◽  
pp. 837-837
Author(s):  
D. Ignjatovic Ristic ◽  
V. Janjic ◽  
B. Ristic ◽  
B. Radmanovic

IntroductionDepression is often occurred after surgical interventions and may have serious consequences on postoperative recovery. The treatment of early discovered depressive symptoms may have strong influence on the recovery of operated orthopedic patients.Simple and quick instrument for detection and evaluation of depressive symptoms could be of great use to doctors.Work objectives are1) determine the prevalence of depressiveness in preoperative period in patients with scheduled surgical interventions, and2) validation of Geriatric Depression Scale - short form (GDS-SF) in detection of depressiveness.MethodA sample of 120 orthopedic patients is the part of larger sample in prospective research of depressiveness in patients in preoperative period with scheduled surgical interventions (except cardio-surgical). For estimation of depressiveness we used battery of tests (GDS-SF, BDI - Beck's depression scale, MDI - major depressive disorder questionnaire), and patients were tested 3 times: to 14 days prior the surgery, 7 and 90 days after the surgery. Validation of GDS-SF was examined compared to BDI according to age and gender of examinees.ResultsIn preliminary sample of 120 orthopedic patients with scheduled orthopedic interventions, prevalence of depressiveness is greater than prevalence of depressiveness in general population (p < 0.001). Depressiveness is much more present in women than in men (p < 0.001). Correlation of depressive scores in BDI and in GDS-SF is satisfactory for all age groups.ConclusionPreliminary results indicate on further research of depressiveness in preoperative period in order to confirm validation of GDS-SF as simpler alternative for early detection of depressiveness.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 766-766
Author(s):  
Amber Kautz ◽  
Ying Meng ◽  
Emily S Barrett ◽  
Jessica Brunner ◽  
Richard Miller ◽  
...  

Abstract Objectives During pregnancy women are at increased risk of poor sleep quality and depression. Serotonin and melatonin are compounds that are involved in regulation of sleep and mood. Several nutrients are involved in the synthesis of these compounds, including tryptophan, docosahexaenoic acid (DHA), and vitamin D. Studies exploring associations between these nutrients and sleep, as well as mood, have been largely limited to the general population, showing mixed results. The aim of this study was to assess the associations of dietary intake of these nutrients with sleep quality and depression in pregnant women. Methods Participants enrolled in the Understanding Pregnancy Signals and Infant Development (UPSIDE) Study (n = 253) were included in this analysis if they completed dietary, sleep and depression assessments during the 2nd trimester. Dietary and supplement intake were measured using 24-hour dietary recalls. The NCI method was used to estimate usual intake. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was conducted to estimate the associations between nutrients and sleep/depression, adjusting for age, race/ethnicity, parity, education, early pregnancy body mass index, smoking status, energy and macronutrient intake. Results The NCI adjusted mean intakes of tryptophan, DHA, and vitamin D were 1.02 ± 0.11 g/day, 0.13 ± 0.11g/day, and 19.74 ± 21.80 mcg/day, respectively. Mean PSQI score was 6.15 ± 3.39, where higher scores indicated worse sleep quality, and mean EPDS score was 5.84 ± 4.77, where higher scores indicated increased severity of depressive symptoms. Tryptophan intake was inversely associated with EPDS scores (b = −15.23, 95%CI: −26.75, −3.72). The associations between DHA, vitamin D, and depression were not significant. The selected nutrients were not associated with PSQI scores. Conclusions In this study, higher tryptophan intake was associated with lower depressive symptoms among pregnant women during the second trimester. Additional research on the relationship between tryptophan intake and maternal mental health during pregnancy is warranted. Funding Sources NIH, Mae Stone Goode Foundation, Wynne Family Foundation.


2020 ◽  
Vol 66 (8) ◽  
pp. 799-809
Author(s):  
Miriam Engel ◽  
Karl-Heinz Jöckel ◽  
Nico Dragano ◽  
Miriam Engels ◽  
Susanne Moebus

Background: Depressive symptoms are volatile over time but empirical studies of intra-individual variations of depressive symptoms over longer periods are sparse. Aims: We aim to examine fluctuation patterns of depressive symptoms and to investigate the possible influence of age, sex and socioeconomic factors on fluctuation in a population-based sample over a period of 13 years. Methods: We used data of 4,251 participants (45–75 years; 51.0% women at baseline) of the Heinz Nixdorf Recall Study with at least two of nine possible measurements obtained in the period between 2000 and 2017. Depressive symptoms were assessed via the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Based on the individual mean values and standard deviation from all measurements, we categorized participants as G1 ‘stable low’, G2 ‘stable high’, G3 ‘stable around cutoff’ and G4 ‘large fluctuations’. Results: Most participants (82.3%) showed stable low depressive symptoms (G1), whereas 2.3% performed stable high values (G2), 6.9% stable around the cutoff (G3) and 8.6% large fluctuations (G4). Conclusion: Our longitudinal results reveal that almost 18% (G2, G3 and G4) of the participants have an increased depression score or strong fluctuations at times. According to our classification, a higher proportion of the participants show anomalies with regard to depression compared to a simple classification into depressed and nondepressed, especially if this is based on a single measurement. Thus, longitudinal measurements of depression can prevent misclassification and provide valuable information about the course of depressive symptoms for a better understanding of the changes of depression.


2019 ◽  
Vol 45 (4) ◽  
pp. 359-369
Author(s):  
Sarah R Martin ◽  
Lonnie K Zeltzer ◽  
Laura C Seidman ◽  
Katherine E Allyn ◽  
Laura A Payne

Abstract Objective Pediatric chronic pain evaluation includes self-reports and/or caregiver proxy-reports across biopsychosocial domains. Limited data exist on the effects of caregiver–child discrepancies in pediatric pain assessment. In children with chronic pain, we examined associations among discrepancies in caregiver–child reports of child anxiety and depressive symptoms and child functional impairment. Methods Participants were 202 children (Mage=14.49 ± 2.38 years; 68.8% female) with chronic pain and their caregivers (95.5% female). Children and caregivers completed the Revised Child Anxiety and Depression Scale (RCADS) and RCADS-Parent, respectively. Children also completed the Functional Disability Inventory. Mean difference tests examined caregiver–child discrepancies. Moderation analyses examined whether associations between child self-reported anxiety and depressive symptoms and functional impairment varied as a function of caregiver proxy-report. Results Children reported more anxiety and depressive symptoms compared with their caregivers’ proxy-reports (Z = −4.83, p &lt; .001). Both informants’ reports of child anxiety and depressive symptoms were associated with child functional impairment (rs = .44, rs = .30, p &lt; .001). Caregiver proxy-report moderated associations between child-reported anxiety and depressive symptoms and functional impairment (B = −0.007, p = .003). When caregiver proxy-report was low, child self-reported anxiety and depressive symptoms were positively related to functional impairment (B = 0.28, SE = 0.07, 95% CI [0.15, 0.41], p &lt; .001). Conclusions Discrepant caregiver–child perceptions of child anxiety and depressive symptoms may be associated with functioning in children with chronic pain, especially when caregivers report less child internalizing symptoms. These findings highlight the need for further examination of the effects of caregiver–child discrepancies on pediatric chronic pain outcomes and may indicate targets for intervention.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Cari J Clark ◽  
Qi Wang ◽  
Hongfei Guo ◽  
Joyce T Bromberger ◽  
Peter Mancuso ◽  
...  

Introduction: Depressive symptoms have been linked to CVD risk factors, including metabolic dysregulation. One pathway by which depression may influence CVD risk is via alterations in adiponectin, an abundant adipocytokine with anti-inflammatory effects. This mechanism has not been studied in population-based samples. Hypothesis: The relationship of depressive symptoms with metabolic syndrome (MetSyn) and Framingham Risk Score (FRS) will be partly mediated by adiponectin. Methods: Participants were 581 women (61.3% white; 38.7% black) from the Chicago and Pittsburgh sites of the Study of Women’s Health Across the Nation. Adiponectin was measured from stored serum specimens and assayed in duplicate using a commercially available enzyme linked immunosorbent assay and log transformed for analysis. Depressive symptoms were measured with the 20-item Center for Epidemiological Studies Depression Scale (CES-D); a standard cutoff (>16) was used to determine clinically significant symptoms. MetSyn was defined by ATP-III criteria and considered present if the participant had at least 3 of the following: waist circumference >88cm; triglycerides >150 mg/dl; HDL cholesterol < 50 mg/dl; blood pressure > 130 mmHg systolic and / or 85 mmHg diastolic; impaired fasting glucose (>110 mg/dl) or diabetes. The FRS was defined by the participant’s age, smoking status, blood pressure, cholesterol, and use of anti-hypertensives. Logistic regression models were constructed to examine the cross-sectional relationship between depressive symptoms and MetSyn controlling for age, race and study site. A subsequent model included adiponectin to evaluate whether it attenuated the observed association. Linear regression models were used to conduct the same analysis with FRS as the outcome. Due to missing values, analytic sample sizes were 558 for MetSyn and 568 for FRS. Results: 147 women (25.3%) had elevated CES-D scores and 113 (20.7%) met criteria for MetSyn. Average FRS was 8.7 (sd=4.6) and the mean, untransformed adiponectin value was 9.9 (sd=4.9) μ g/mL. In models adjusted for age, race, and study site, women with high CES-D scores had increased odds of MetSyn (OR=1.64; 95% CI=1.03, 2.60) and a higher FRS (estimate=0.98; se=0.41, p<.02). Separate bivariate analyses showed that adiponectin was inversely related to CES-D scores (p=.03), MetSyn (p<.001) and FRS (p<.001). Subsequently including adiponectin in the regression models attenuated the associations between CES-D and MetSyn (OR=1.45; 95% CI=0.89, 2.36) and FRS (estimate=0.76; se=0.41; p=.06). Conclusions: Adiponectin may partially explain the relation between depressive symptoms and measures of cardiometabolic health. Longitudinal studies are needed to more fully understand the temporality of these associations. Supported by NIH/DHHS grants HL091290, AG012505, AG012546, MH59770, AG17719.


2017 ◽  
Vol 52 (4-6) ◽  
pp. 315-327 ◽  
Author(s):  
Karolina Schantz ◽  
Chelsea Reighard ◽  
James E Aikens ◽  
Amparo Aruquipa ◽  
Bismark Pinto ◽  
...  

Objective We assessed the validity and reliability of the Center for Epidemiologic Studies-Depression scale (CES-D) short form and the Patient Health Questionnaire-8 (PHQ-8) (two measures of depressive symptoms) among urban, low-income patients from a heavily indigenous area of Andean Latin America. This is a patient population that is in many ways culturally distinct from the populations that have been included in previous Spanish language validation studies of these instruments. Methods We administered the CES-D Yale version short form and the PHQ-8 to 107 outpatients at public hospitals in La Paz and El Alto, Bolivia. We conducted exploratory factor analysis, checked internal reliability, and examined concordance between the two measures in identifying patients with clinically significant depressive symptoms. Results Internal reliability was high for both scales: PHQ-8 (Cronbach’s α = 0.808) and CES-D (α  = 0.825). A one-factor solution for the PHQ-8 was maintained after the removal of one poorly loading item. The CES-D showed a two-factor solution, with items for somatic symptoms and interpersonal problems loading on the same factor as negative affect. Using both the cutoff for depression recommended in prior studies and a sample specific cutoff of ≥1 standard deviation above the mean, the two scales demonstrated only moderate agreement (κ = 0.481–0.486). Conclusions The PHQ may be more appropriate for clinical use in the Andean region, given its greater specificity; however, lower than expected agreement between the scales suggests that they also measure different elements of depression. Irregularities with the factor structure of both scales suggest that further research with this population is needed to better understand depressive symptomology and improve screening in the region.


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