scholarly journals Depression, Anxiety and Stress on Caregivers of Persons with Dementia (CGPWD) in Hong Kong amid COVID-19 Pandemic

2021 ◽  
Vol 19 (1) ◽  
pp. 184
Author(s):  
Tommy Kwan-Hin Fong ◽  
Teris Cheung ◽  
Wai-Chi Chan ◽  
Calvin Pak-Wing Cheng
Keyword(s):  
Hong Kong ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Depression Symptom ◽  
Full Time ◽  
Probable Depression

Background: Coronavirus disease 2019 (COVID-19) contributed to increasing prevalence of depressive symptoms and other psychological repercussions, particularly in the disease population in Hong Kong. Nonetheless, the caregiver burden of caregivers of persons with dementia (CGPWD), has been under-investigated. Aims: This study examined the psychological impact and its correlates on the CGPWD in Hong Kong amid the COVID-19 outbreak. Methods: CGPWD referred from rehabilitation clinics and online seminar were used to recruit participants to complete an online questionnaire by the end of the second-wave of the COVID-19 outbreak (June 2021). To be eligible, either full-time or part-time CGPWD, aged 18 or above, can understand Cantonese, currently reside in Hong Kong and offering care to PWD for at least one year, were recruited. Those CGPWD diagnosed with any type of psychiatric disorder were excluded from this study. The Chinese Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder (GAD-7), Zarit Burden Interview (ZBI-22), and Nonattachment Scale (NAS-7) were used to measure participants’ depression, perceived stress, anxiety symptoms, caregiver burden and wisdom in subjective feelings of internal stress. The modified Medical Outcomes Study Social Support Survey (mMOS-SS) and the SARS Appraisal Inventory (SAI) were also administered to measure participants’ perceived support and coping efficacy. Follow-up responses were gathered by the end of third-wave outbreak (October 2021). Results: A total of 51 CGPWD participated, of which, 33 (64.7%) suffered from probable depression (CES-D score ≥ 16). Participants also showed a significant increase in depression symptom scores at the three-month follow-up period (t = 2.25, p = 0.03). CGPWD with probable depression had less non-attachment awareness and higher scores in anxiety, stress, caregiving burden, and coronavirus impact (all p < 0.05) than those without. Conclusions: High prevalence of depressive symptoms was noted among our CGPWD sample and these symptoms seemed to worsen substantially. Contingent online mental health support should be prioritized to those CGPWD to reduce psychiatric morbidity and the global disease burden.

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.

Depressive Symptoms and Diurnal Salivary Cortisol Patterns Among Female Caregivers of Stroke Survivors

2012 ◽  
Vol 14 (4) ◽  
pp. 396-404 ◽  
Author(s):  
Karen L. Saban ◽  
Herbert L. Mathews ◽  
Fred B. Bryant ◽  
Timothy E. O’Brien ◽  
Linda Witek Janusek
Keyword(s):  
Depressive Symptoms ◽  
Chronic Stress ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Salivary Cortisol ◽  
Allostatic Load ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Stroke Survivors ◽  
Increased Risk

Informal caregivers of stroke survivors experience elevated chronic stress and are at risk of developing depressive symptoms. The cumulative effects of chronic stress can increase allostatic load and dysregulate biological processes, thus increasing risk of stress-related disease. Stress-induced alterations in the pattern of cortisol secretion vary with respect to stressor onset, intensity, and chronicity. Little is known about the psychoendocrine response to stress in female caregivers of stroke survivors. The purpose of this study was to examine perceived stress, caregiver burden, and the association between caregiver depressive symptoms and diurnal cortisol in 45 females caring for a significant other who experienced a stroke within the past year. Women completed the Center for Epidemiologic Studies Depression Scale (CES-D) and collected saliva for cortisol upon awakening, 30 min postawakening, noon, and bedtime for 2 consecutive days. Results revealed that women had high levels of perceived stress and caregiver burden. In women with CES-D scores ≥ 16, salivary cortisol levels were significantly lower across the day relative to women with CES-D scores < 16. This difference persisted after adjusting for age, number of caregiving hours per week, perceived social support, and quality of sleep. Younger age was associated with more depressive symptoms as well as lower levels of cortisol at awakening and 30 min postawakening. Results demonstrate that the burden of caregiving increases risk of depressive symptoms and hypocortisolism across the day. Hypocortisolism may contribute to increased risk of depressive symptoms as a result of the loss of glucocorticoid attenuation of stress-induced inflammation.

scholarly journals Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manee Pinyopornpanish ◽  
Kanokporn Pinyopornpanish ◽  
Atiwat Soontornpun ◽  
Surat Tanprawate ◽  
Angkana Nadsasarn ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

scholarly journals Association of FKBP5 genotype with depressive symptoms in patients with coronary heart disease: a prospective study

2020 ◽  
Vol 127 (12) ◽  
pp. 1651-1662
Author(s):  
Julia Brandt ◽  
Katharina Warnke ◽  
Silke Jörgens ◽  
Volker Arolt ◽  
Katja Beer ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Depressive Symptoms ◽  
Coronary Revascularization ◽  
Central Element ◽  
Depression Scale ◽  
Stress System ◽  
Linear Regression Models ◽  
A Prospective Study

AbstractDepression and coronary heart disease (CHD) are prevalent and often co-occurring disorders. Both have been associated with a dysregulated stress system. As a central element of the stress system, the FKBP5 gene has been shown to be associated with depression. In a prospective design, this study aims to investigate the association of FKBP5 with depressive symptoms in CHD patients. N = 268 hospitalized CHD patients were included. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS-D) at four time points (baseline, and after 1 month, 6 months, and 12 months). The functional FKBP5 single-nucleotide polymorphism (SNP) rs1360780 was selected for genotyping. Linear regression models showed that a higher number of FKBP5 C alleles was associated with more depressive symptoms in CHD patients both at baseline (p = 0.015) and at 12-months follow-up (p = 0.025) after adjustment for confounders. Further analyses revealed that this effect was driven by an interaction of FKBP5 genotype with patients’ prior CHD course. Specifically, only in patients with a prior myocardial infarction or coronary revascularization, more depressive symptoms were associated with a higher number of C alleles (baseline: p = 0.046; 1-month: p = 0.026; 6-months: p = 0.028). Moreover, a higher number of C alleles was significantly related to a greater risk for dyslipidemia (p = .016). Our results point to a relevance of FKBP5 in the association of the two stress-related diseases depression and CHD.

scholarly journals Prospective association between adherence to dietary recommendations and incident depressive symptoms in the French NutriNet-Santé cohort

2018 ◽  
Vol 120 (3) ◽  
pp. 290-300 ◽  
Author(s):  
Moufidath Adjibade ◽  
Cédric Lemogne ◽  
Chantal Julia ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depression Scale ◽  
Healthy Eating Index ◽  
Continuous Variables ◽  
Dietary Recommendations ◽  
Nutritional Recommendations ◽  
Dietary Record ◽  
Prospective Association ◽  
Incident Cases

AbstractA posteriorihealthier dietary patterns and several nutrients have been associated with lower risks of depression in various studies; however, evidence is lacking with regard to the prospective association between adherence to nutritional recommendations (food-based and nutrient-based recommendations) and incident depression or depressive symptoms. In this study, we investigate such associations in the NutriNet Santé cohort. The study sample included 26 225 participants (aged 18–86 years) who were initially free of depressive symptoms. Adherence to nutritional recommendations was measured by four scores namely modified French Programme National Nutrition Santé-Guideline Score (mPNNS-GS), Alternative Healthy Eating Index-2010 (AHEI-2010), Probability of Adequate Nutrient Intake Dietary Score (PANDiet) and Diet Quality Index-International (DQI-I), using non-consecutive dietary record data during the first 2 years of follow-up (mean number of recording days=8,sd2). Depressive symptoms were defined by a Center for Epidemiologic Studies Depression Scale (CES-D) score ≥17 for men and ≥23 for women. We used Cox proportional hazards models to estimate hazard ratios and 95 % CI, modelling the dietary scores as standardised continuous variables and as tertiles. Over a mean follow-up of 6 years, we identified 2166 incident cases of depressive symptoms. All dietary scores with the exception of the AHEI-2010 were significantly inversely associated with incident depressive symptoms. In the fully adjusted model, an increase of 1sdin the mPNNS-GS, PANDiet and DQI-I was, respectively, associated with an 8 % (95 % CI 4, 13), 5 % (95 % CI 1, 9) and 9 % (95 % CI 5, 13) reduction in the risk of depressive symptoms. Overall, these findings suggest that diet in accordance with national or international guidelines could have beneficial effects with regard to mental health.

Abstract 183: Depressive Symptoms and Incident Stroke in Black and White Participants in the REGARDS Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Audrey L Austin ◽  
Michael G Crowe ◽  
Martha R Crowther ◽  
Virginia J Howard ◽  
Abraham J Letter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Depressive Symptoms ◽  
Racial Differences ◽  
Stroke Risk ◽  
Depression Scale ◽  
Stroke Incidence ◽  
Blacks And Whites ◽  
The Impact

Background and Purpose: Research suggests that depression may contribute to stroke risk independent of other known risk factors. Most studies examining the impact of depression on stroke have been conducted with predominantly white cohorts, though blacks are known to have higher stroke incidence than whites. The purpose of this study was to examine depressive symptoms as a risk factor for incident stroke in blacks and whites, and determine whether depressive symptomatology was differentially predictive of stroke among blacks and whites. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS), is a national, population-based longitudinal study designed to examine risk factors associated with black-white and regional disparities in stroke incidence. Among 30,239 participants (42% black) accrued from 2003-2007, excluding those lacking follow-up or data on depressive symptoms, 27,557 were stroke-free at baseline. As of the January 2011 data closure, over an average follow-up of 4.6 years, 548 incident stroke cases were verified by study physicians based on medical records review. The association between baseline depressive symptoms (assessed via the Center for Epidemiological Studies Depression scale, 4-item version) and incident stroke was analyzed with Cox proportional hazards models adjusted for demographic factors (age, race, and sex), stroke risk factors (hypertension, diabetes, smoking, atrial fibrillation, and history of heart disease), and social factors (education, income, and social network). Results: For the total sample, depressive symptoms were predictive of incident stroke. The association between depressive symptoms and stroke did not differ significantly based on race (Wald X 2 = 2.38, p = .1229). However, race-stratified analyses indicated that the association between depressive symptoms and stroke was stronger among whites and non-significant among blacks. Conclusions: Depressive symptoms were an independent risk factor for incident stroke among a national sample of blacks and whites. These findings suggest that assessment of depressive symptoms may warrant inclusion in stroke risk scales. The potential for a stronger association in whites than blacks requires further study.

Abstract 14087: Psychosocial Determinants of Health Predict Depressive Symptoms and Anxiety in Rural Caregivers

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jennifer L Smith ◽  
Misook L Chung ◽  
Jennifer Miller ◽  
Martha J Biddle ◽  
Donna Schuman ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Brief Symptom Inventory ◽  
Determinants Of Health ◽  
Future Research ◽  
Cvd Risk ◽  
Rural Caregivers ◽  
Increased Risk

Introduction: Caregivers have an 82% increased risk of cardiovascular disease (CVD) compared to non-caregivers. Depressive symptoms (DS) and anxiety increase CVD risk, and these are worse in rural dwellers. Knowing predictors of DS and anxiety in rural caregivers of patients with chronic illness is important to reduce CVD risk. Purpose: To identify predictors of DS and anxiety in rural caregivers at risk for CVD using a social determinants of health (SDH) model. Method: In this cross-sectional study we measured multiple SDH. These variables included sociodemographic (i.e., age, gender, race, marital status, health insurance, education, financial status), behavioral (i.e., smoking and body mass index [BMI]), and psychosocial (i.e., caregiver burden measured by the Zarit Burden Interview, perceived stress by the Cohen Perceived Stress Scale, and social support by the Medical Outcomes Study Social Support Survey) factors. The outcomes of DS were measured by the Patient Health Questionnaire-9 and anxiety by the Brief Symptom Inventory – Anxiety subscale. Data were analyzed using two separate multiple regression models, one for DS and one for anxiety. As depression and anxiety are often comorbid, they were considered predictors in the appropriate models. Results: In the 262 participants (mean age 53±13, 78% female, 96% Caucasian, 70% were married), mean years of education were 14±2, 56.1% had enough money to make ends meet, and 55% had no insurance or Medicaid only. Significant predictors of worse DS were higher caregiver burden (β=0.05, p=0.004), higher perceived stress (β=2.04, p=0.001), and higher anxiety (β=3.79, p= <0.001). Predictors of worse anxiety, were younger age (β=-0.006, p=0.03), higher caregiver burden (β=0.006, p=0.009), lower social support (β=-0.004, p=0.05), and higher DS (β=0.08, p=<0.001). Conclusion: Predictors of DS and anxiety in these rural caregivers were psychosocial variables. Caregiver CVD Interventions could be optimized by including stress management, education about the psychological effects of caregiving, and social support components. Future research is needed on the role of DS and anxiety in CVD to better support rural caregivers at highest risk.

Maternal depression trajectories from 3 months to 11 years postpartum and offspring body composition in early adolescence

2020 ◽  
Vol 23 (13) ◽  
pp. 2327-2335
Author(s):  
Simone Farías-Antúnez ◽  
Alicia Matijasevich ◽  
Aluísio Jardim Dornellas de Barros ◽  
Iná da Silva dos Santos
Keyword(s):  
Body Composition ◽  
Maternal Depression ◽  
Depression Scale ◽  
Depression Symptom ◽  
Community Based ◽  
High Group ◽  
Symptom Trajectories ◽  
Trajectory Group ◽  
The City

AbstractObjective:To investigate the effect of maternal depressive symptom trajectories, from 3 months to 11 years postpartum, on the offspring’s body composition at 11 years of age.Design:Data from the Pelotas 2004 Birth Cohort, from the perinatal interview and from the 3-, 12-, 24- and 48-month and 6- and 11-year follow-ups.Setting:Community-based sample from the city of Pelotas, located in southern Brazil with approximately 350 000 inhabitants. The maternal depression symptom trajectories were identified through a semi-parametric group-based modelling approach, using the Edinburgh Postnatal Depression Scale (EPDS), with data from 3 months to 11 years postpartum.Participants:A total of 3467 (81·9 % of the total cohort).Results:Five trajectory groups of EPDS scores were identified (‘Low’, ‘Moderate low’, ‘Increasing’, ‘Decreasing’ and ‘Chronic high’). A total of 170 women (4·9 %) from the sample belonged to the ‘Chronic high’ group, having scored ≥13 EPDS points at every follow-up. Mean BMI in the ‘Low’ trajectory group was 0·77 (z-score 1·4), compared with 0·56 (z-score 1·4) in the ‘Chronic high’ group. Children from mothers in the ‘Chronic high’ group had lower fat mass (FM) (–1·34 ± 0·64 kg), FM% (–2·02 ± 0·85 percentage points) and FM index (–0·57 ± 0·27 kg/m2), compared with children from mothers in the ‘Low’ trajectory group. Adjusted analyses showed that sustained or transitory maternal depressive symptoms during childhood had no effect on the offspring’s body composition indices at 11 years of age.Conclusion:Children raised by chronically depressed mothers have body composition indices at 11 years of age that are similar to those of children whose mothers have never been depressed.

scholarly journals Influence of Prenatal Exposure to Mercury, Perceived Stress, and Depression on Birth Outcomes in Suriname: Results from the MeKiTamara Study

2020 ◽  
Vol 17 (12) ◽  
pp. 4444
Author(s):  
Anisma R. Gokoel ◽  
Wilco C. W. R. Zijlmans ◽  
Hannah H. Covert ◽  
Firoz Abdoel Wahid ◽  
Arti Shankar ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Birth Outcomes ◽  
Prenatal Exposure ◽  
Perceived Stress ◽  
Apgar Score ◽  
Low Birthweight ◽  
Depression Scale ◽  
Study Cohort ◽  
Adverse Birth Outcomes ◽  
Probable Depression

Prenatal exposure to mercury, stress, and depression may have adverse effects on birth outcomes. Little is known on the influence of chemical and non-chemical stressors on birth outcomes in the country of Suriname. We assessed the influence of prenatal exposure to mercury, perceived stress, and depression on adverse birth outcomes in 1143 pregnant Surinamese women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study. Associations between mercury (≥1.1 μg/g hair, USEPA action level/top versus bottom quartile), probable depression (Edinburgh Depression Scale ≥12), high perceived stress (Cohen’s Perceived Stress Scale ≥20), and adverse birth outcomes (low birthweight (<2500 g), preterm birth (<37 completed weeks of gestation), and low Apgar score (<7 at 5 min)) were assessed using bivariate and multivariate logistic regressions. Prevalence of elevated mercury levels, high perceived stress, and probable depression were 37.5%, 27.2%, and 22.4%, respectively. Mercury exposure was significantly associated with preterm birth in the overall study cohort (OR 2.47; 95% CI 1.05–5.83) and perceived stress with a low Apgar score (OR 9.73; 95% CI 2.03–46.70). Depression was not associated with any birth outcomes. These findings can inform policy- and practice-oriented solutions to improve maternal and child health in Suriname.

scholarly journals Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
DeAnnah R Byrd ◽  
Roland J Thorpe ◽  
Keith E Whitfield
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Ordinary Least Squares ◽  
Community Dwelling ◽  
Stressful Events ◽  
Age Group ◽  
The Impact ◽  
Over Time

Abstract Background and Objectives Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks. Research Design and Methods The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age. Results Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p &lt; .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates. Discussion and Implications Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.

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