Impact of Personality Traits and Socio-Demographic Factors on Depression among Doctors and Nurses

The workplace is not immune to conflict and stress, specifically when fulfilling people's responsibilities at great personal costs. Doctors and nurses are always on the frontline in hospitals, vaulting from one stressful high-stakes situation to the next. The HEXACO model of personality traits: Honesty-humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness, has long been hypothesized to be a major predicting factor when determining individuals' responses to stress and susceptibility to experiencing depression. Most research suggests that personality traits resonate with a person's cognitive abilities and how they can deal with stress and depression. However, there is a lack of research on their correlation to depression severity in the Middle East. The current study aimed to investigate the impact of HEXACO personality traits and socio-demographic factors on depression amongst doctors and nurses. A sample of 170 doctors and nurses (62.1% doctors) completed HEXACO-60 and PHQ-9 depression severity questionnaires. The data were analyzed through descriptive statistics, independent samples t-test, ANOVA, correlation, and regression analysis. The findings showed that Honesty-humility was the strongest predictor, while extraversion was the second strongest. Emotionality had the least impact on depression. The relationship between Agreeableness and Openness to Experience with depression was insignificant. However, gender, age, working hours, and work experience were significant predictors of depression. Marital status and level of specialization were insignificant predictors. Thus, it was concluded that not all HEXACO traits and socio-demographics predict depression. Study findings could be utilized in the implementation of employee recruitment, job crafting, positive psychology, and coaching.

Fibroblast growth factor 21 (FGF21) is increased in MDD and interacts with body mass index (BMI) to affect depression trajectory

Fibroblast growth factor 21 (FGF21) is a key regulator of metabolic function and nutrient preference. It also affects biological pathways associated with major depressive disorder (MDD), including corticotrophin-releasing hormone (CRH), leptin, and sympathetic activity. Lower levels of cerebrospinal fluid FGF21 have been associated with higher Beck Depression Inventory scores. FGF21 was examined as a metabolic marker that could be associated with MDD and evaluated as a biomarker of antidepressant treatment response in a large, randomized placebo-controlled trial in chronic, early-onset MDD participants. FGF21 levels at baseline and during treatment were determined for participants in the Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) study. FGF21 was analyzed by ELISA in individuals with chronic, early-onset MDD (first major depressive episode before 30 years) compared to healthy control participants. Participants with MDD had higher levels of FGF21 compared to healthy controls (HCs), even after controlling for baseline age, sex, race, Hispanic ethnicity, BMI, and site (β-coefficient = 1.20, p < 0.0001, Cohen’s d = 0.60). FGF21 did not change over time nor differ between treatment groups. Interestingly though, those with normal BMI and lower FGF21 levels showed a reduction in depression severity over time compared to all other groups. In conclusion, depression is associated with higher levels of FGF21 compared to healthy controls and those with lower levels of FGF21 (25th percentile of the sample) in the context of normal-weight BMI seem to have improved depression severity over time.

Salivary Cortisol Awakening Response as a Predictor for Depression Severity in Adult Patients with a Major Depressive Episode Performing a Daily Exercise Program

<b><i>Introduction:</i></b> The hypothalamic-pituitary-adrenal axis function in depression has been the subject of considerable interest, and its function has been tested with a variety of methods. We investigated associations between saliva cortisol at awakening and the 24-h urine cortisol output, both measured at study baseline, with endpoint depression scores. <b><i>Methods:</i></b> Patients were admitted to a psychiatric inpatient ward with a major depressive episode and were started on fixed duloxetine treatment. They delivered saliva samples at awakening and 15, 30, and 60 min post-awakening and sampled urine for 24 h. Subsequently, they started a daily exercise program maintained for a 9-week period. Clinician-rated depression severity was blindly assessed with the Hamilton Depression Rating 6-item subscale (HAM-D₆). The cortisol awakening response was quantified by the area under the curve with respect to the ground (AUC_G) and with respect to the rise (AUC_I) using saliva cortisol levels in the 1-h period after awakening. Analysis of expected associations between depression severity, AUC_G, AUC_I, exercise, and 24-h cortisol output was performed in a general linear model. <b><i>Results:</i></b> In all, 35 participants delivered saliva or 24-h urine samples. The mean age was 49.0 years (SD = 11.0) with 48.6% females with a mean baseline HAM-D₆ score of 12.2 (SD = 2.3). In a statistical model investigating the association between HAM-D₆ at week 9 as a dependent variable and AUC_I, concurrent HAM-D₆, gender, smoking, and exercise volume as covariates, we found a significant effect of AUC_I, concurrent HAM-D₆, and exercise. The following statistics were found: AUC_I (regression coefficient 0.008; <i>F</i> value = 9.1; <i>p</i> = 0.007), concurrent HAM-D₆ (regression coefficient 0.70; <i>F</i> value = 8.0; <i>p</i> = 0.01), and exercise (regression coefficient −0.005; <i>F</i> value = 5.7; <i>p</i> = 0.03). The model had an <i>R</i>² of 0.43. The association between HAM-D₆ endpoint scores and the AUC_I showed that higher AUC_I values predicted higher HAM-D₆ endpoint values. The association between HAM-D₆ endpoint scores and the exercise level showed that a high exercise level was associated with lower HAM-D₆ endpoint values. <b><i>Conclusion:</i></b> The results thus showed that high AUC_I values predicted less improvement of depression and high exercise levels predicted more improvement of depression. These findings need to be confirmed in larger samples to test if more covariates can improve prediction of depression severity.

Association Between Frontal Alpha Asymmetry With Cognitive Symptoms, Depression Severity, and Insomnia

Objective: Previous studies have compared depressive episodes between bipolar disorder (BD) and major depressive disorder (MDD) using quantitative electroencephalogram (QEEG); however, there are no distinct discriminating feature between them. Here, we used QEEG to directly compare the alpha asymmetry and absolute power of each band between patients with BD and MDD.Methods: Fifty in-patients with major depressive episodes between 2019 and 2021 were retrospectively enrolled. Self-reported questionnaires including the Beck Depression Inventory (BDI), Korean version of the Childhood Trauma Questionnaire, and Adult Attention-Deficit/Hyperactivity Disorder Self Report Scale (ASRS) were used to evaluate the symptoms. The absolute power of QEEG delta, theta, alpha, beta, high beta waves, and the Z-scores of frontal alpha asymmetry were collected. A t-test and Pearson’s correlation test were conducted using these data and based on these results, an analysis of covariance was conducted.Results: There were no significant differences between MDD and BD in QEEG power or alpha asymmetry. Patients with severe depression (BDI ≥29) had higher alpha power at FP1 (p=0.037), FP2 (p=0.028), F3 (p=0.047), F4 (p=0.016), and higher right frontal alpha asymmetry at F3–F4 (p=0.039). Adult patients with features consistent with ADHD (ASRS ≥4) had higher right frontal alpha asymmetry at F3–F4 (p=0.046). Patients with insomnia had higher left frontal alpha asymmetry at F3–F4 (p=0.003).Conclusion: QEEG limited the differential diagnosis of MDD and BD. However, frontal alpha asymmetry did exist in depression and affected cognitive impairment, insomnia, and depression severity in particular. Future studies with improved methodologies are needed for a better comparison.

Depression Severity and Sexual Satisfaction in Fertile and Infertile Women in Iran: A Population-Based Case-Control Study

Background: Depression and sexual dissatisfaction are among the most common psychological factors caused by infertility. Infertility is an essential topic in the Iranian culture, and many studies have already investigated it. Objectives: This study aimed to compare the depression severity and sexual dissatisfaction between fertile and infertile women in Iran. Methods: This case-control study enrolled 180 infertile women and 540 fertile women in 2019. The participants were selected through multistage stratified and cluster sampling methods. For each infertile woman, three fertile women were randomly selected. The data collection instruments consisted of a demographic form, the Depression Inventory Scale (Second Edition), and the Linda Berg Sexual Satisfaction Questionnaire. The multivariate marginal model and SPSS version 21 were used for data analysis at a significance level of 0.05. Results: After adjustment for confounding variables, the marginal model showed that the odds of depression increased by approximately 21.305 times among cases compared to controls (OR = 21.305, 95% CI = 14.75 - 32.021, P < 0.001). This model also found that by moderating the effects of confounding variables, infertility increased the odds of low sexual satisfaction by approximately 15.560 times (OR = 15.560, 95% CI = 5.089 - 47.571, P < 0.001). The chi-square test showed a significant relationship between infertility treatment and depression severity in infertile women (P = 0.001). Conclusions: The overall depression severity and sexual dissatisfaction were higher in the infertile group than in the fertile one. Most cases of severe depression were observed in IVF clinics with higher depression levels. The study may help reveal infertility's psychological and social aspects in Iran.

Spanish Adaptation of the Overall Anxiety and Depression Severity and Impairment Scales in University Students

The lifetime prevalence of emotional disorders in Spain is 4.1% for anxiety and 5.2% for depression, increasing among university students. Considering the scarcity of screenings with adequate psychometric properties, this study aims to explore the validity evidence of the Overall Anxiety/Depression Severity and Impairment Scales (OASIS and ODSIS). A total of 382 university students from the general population were assessed on anxiety and depressive symptoms, as well as quality of life. The one-dimensional structure of both the OASIS and ODSIS explained 87.53% and 90.60% of variance, with excellent internal consistency (α = 0.94 and 0.95, respectively) and optimal cut-offs of 4 and 5, respectively. Both scales show a significant moderate association with other measures of anxiety, depression and quality of life. The OASIS and ODSIS have shown good reliability and sound validity evidence that recommend their use for the assessment and early detection of anxiety and depressive symptoms, and associated quality of life impairment in Spanish youth.