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Deshmukh HS, Adole VA, Wagh SB, Khedkar VM, Jagdale BS. Exploring N-heterocyclic linked novel hybrid chalcone derivatives: synthesis, characterization, evaluation of antidepressant activity, toxicity assessment, molecular docking, DFT and ADME study. RSC Adv 2025; 15:16187-16210. [PMID: 40376662 PMCID: PMC12079426 DOI: 10.1039/d5ra01929j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2025] [Accepted: 05/05/2025] [Indexed: 05/18/2025] Open
Abstract
In the search for novel antidepressant agents, twelve novel nitrogen-containing heterocycle-linked chalcone derivatives have been synthesized and comprehensively characterized using FT-IR, 1H NMR, 13C NMR, and Mass spectral methods. The synthetic strategy involves the preparation and optimization of reaction conditions for obtaining 4-carbazole-, indole-, and pyrrole-linked acetophenones, which were subsequently coupled with pyrazole aldehydes bearing piperidine, morpholine, benzotriazole, and imidazole ring systems. In vivo antidepressant activity of the compounds was evaluated using the Tail Suspension Test (TST) and Forced Swim Test (FST). Chalcone derivatives with a benzo[d][1,2,3]triazol-1-yl substituent exhibited significant reductions in immobility times, indicating enhanced antidepressant activity. Chalcone derivatives with piperidin-1-yl and morpholino groups demonstrated relatively lower activity. Molecular docking studies against the human serotonin transporter (hSERT) (PDB code: 5I6X) revealed that the chalcone derivatives exhibited excellent binding affinity (average docking score: -8.540, binding energy: -60.044 kcal mol-1) through favorable van der Waals, electrostatic, and hydrogen bonding interactions (only for 13b) within the active site. The binding interaction of compound 13b was particularly strong, with a Glide docking score of -9.120 and binding energy of -65.454 kcal mol-1, highlighting the contribution of both π-π stacking and hydrogen bonding interactions. Chalcone derivatives showed low acute oral toxicity (LD50 > 2000 mg kg-1, category 5) in female Swiss albino mice per OECD 423 guidelines, with no mortality or adverse effects at 300 and 2000 mg kg-1, and normal body weight gain over 14 days. These findings underscore the potential of benzo[d][1,2,3]triazol-1-yl-based chalcone derivatives as promising antidepressant agents with a favorable safety profile. Density Functional Theory (DFT) analysis was performed on the most active compound, 13c, to gain insights into its structural and electronic properties. Additionally, ADME (Absorption, Distribution, Metabolism, and Excretion) profiling of the synthesized compounds indicated favorable drug-like characteristics and balanced pharmacokinetic profiles, supporting their potential as promising candidates for further pharmaceutical development.
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Affiliation(s)
- Hemant S Deshmukh
- Research Centre in Chemistry, Mahatma Gandhi Vidyamandir's Loknete Vyankatrao Hiray Arts, Science and Commerce College (Affiliated to Savitribai Phule Pune University, Pune) Panchavati Nashik Maharashtra 422003 India
| | - Vishnu A Adole
- Research Centre in Chemistry, Mahatma Gandhi Vidyamandir's Loknete Vyankatrao Hiray Arts, Science and Commerce College (Affiliated to Savitribai Phule Pune University, Pune) Panchavati Nashik Maharashtra 422003 India
| | - Sanjay B Wagh
- TS Chemistry Solutions, Technology Development of API and API Intermediates, Dyes and Dyes Intermediates & Specialty Chemicals Taloja Raigad Maharashtra 422005 India
| | - Vijay M Khedkar
- School of Pharmacy, Vishwakarma University Pune Maharashtra 410208 India
| | - Bapu S Jagdale
- Research Centre in Chemistry, Mahatma Gandhi Vidyamandir's Loknete Vyankatrao Hiray Arts, Science and Commerce College (Affiliated to Savitribai Phule Pune University, Pune) Panchavati Nashik Maharashtra 422003 India
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Conway CR, Aaronson ST, Sackeim HA, George MS, Zajecka J, Bunker MT, Duffy W, Stedman M, Riva-Posse P, Allen RM, Quevedo J, Berger M, Alva G, Malik MA, Dunner DL, Cichowicz I, Banov M, Manu L, Nahas Z, Macaluso M, Mickey BJ, Sheline Y, Kriedt CL, Lee YCL, Gordon C, Shy O, Tran Q, Yates L, Rush AJ. Vagus nerve stimulation in treatment-resistant depression: A one-year, randomized, sham-controlled trial. Brain Stimul 2025; 18:676-689. [PMID: 39706521 DOI: 10.1016/j.brs.2024.12.1191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 12/13/2024] [Accepted: 12/14/2024] [Indexed: 12/23/2024] Open
Abstract
BACKGROUND Few treatments are available for individuals with marked treatment-resistant depression (TRD). OBJECTIVE Evaluate the safety and effectiveness of FDA-approved adjunctive vagus nerve stimulation (VNS) in patients with marked TRD. METHODS This 12-month, multicenter, double-blind, sham-controlled trial included 493 adults with marked treatment-resistant major depression who were randomized to active or no-stimulation sham VNS for 12 months. The primary outcome was percent time in response across months 3-12, with response defined as a ≥50 % change from baseline on the Montgomery-Åsberg Depression Rating Scale (MADRS). Several secondary endpoints were evaluated. RESULTS Overall, 88.4 % of participants completed the trial. Percent time in MADRS response did not distinguish active from sham VNS. However, ratings from on-site clinicians (Clinical Global Inventory-Impression [CGI-I]), patients (Quick Inventory of Depressive Symptomology-Self Report [QIDS-SR]), and offsite masked raters (Quick Inventory of Depressive Symptomology-Clinician [QIDS-C]) revealed antidepressant benefits significantly favoring active VNS. Active VNS demonstrated significantly more percent time in response on the CGI-I (P = 0.004) and QIDS-SR (P = 0.049), and significantly more percent time in partial response (PR; symptom improvement ≥30 %) on the CGI-I (P < 0.001) and QIDS-C (P = 0.006) versus sham VNS. Active VNS exceeded sham VNS in rate of dyspnea (P = 0.035), a known side effect of VNS. No new adverse events were identified. CONCLUSIONS Percent time in MADRS response did not distinguish the treatment groups, but on multiple instruments time in response and PR showed a positive treatment effect. VNS was found safe and effective in participants with marked TRD.
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Affiliation(s)
- Charles R Conway
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA.
| | - Scott T Aaronson
- Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Harold A Sackeim
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Mark S George
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Health Care System, Charleston, SC, USA
| | - John Zajecka
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Psychiatric Medicine Associates, LLC, Skokie, IL, USA
| | - Mark T Bunker
- LivaNova PLC (or a Subsidiary), London, Great Britain, UK
| | | | | | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - João Quevedo
- Center for Interventional Psychiatry, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Matthew Berger
- Offices of Psychiatry & Counseling Services, Moosic, PA, USA
| | | | - Mohd A Malik
- PsychCare Consultants Research, St Louis, MO, USA
| | - David L Dunner
- Center for Anxiety and Depression, Mercer Island, WA, USA
| | | | | | - Lucian Manu
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Ziad Nahas
- University of Minnesota, Minneapolis, MN, USA
| | | | - Brian J Mickey
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - Yvette Sheline
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Charles Gordon
- LivaNova PLC (or a Subsidiary), London, Great Britain, UK
| | - Olivia Shy
- LivaNova PLC (or a Subsidiary), London, Great Britain, UK
| | - Quyen Tran
- LivaNova PLC (or a Subsidiary), London, Great Britain, UK
| | - Laura Yates
- LivaNova PLC (or a Subsidiary), London, Great Britain, UK
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Feraldi A, Giudici C, Brouard N. Estimating the Sex Gap in Depression-Free Life Expectancy Among Widowed Americans Aged 50 and Older: An Application Using the Interpolated Markov Chain Approach. J Aging Health 2025; 37:117-130. [PMID: 38380998 PMCID: PMC11566097 DOI: 10.1177/08982643241233029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVES Using Interpolated Markov Chain software, we compare the length of life with and without depression among married individuals and widowers, and the related sex differences. METHODS We applied a multi-state life table approach to estimate depression-free life expectancy among recent cohorts of older married and widowed women and men in the United States, using data from the Health and Retirement Study over a 7-year period (2012-2018). RESULTS The study revealed that the difference in life expectancy between sexes widens in the context of widowhood. At age 50, the sex gap in depression-free life expectancy is 0.8 years among married people, whereas the gap almost doubles to 1.7 years among widowed people. DISCUSSION By quantifying disparities in the duration of life affected by depression between married and widowed women and men, policymakers could properly allocate resources specifically to address the mental health needs of these groups.
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Affiliation(s)
- Alessandro Feraldi
- Research Group in Labor Demography, Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Statistica Science, Sapienza University of Rome, Rome, Italy
| | - Cristina Giudici
- Department of Statistica Science, Sapienza University of Rome, Rome, Italy
| | - Nicolas Brouard
- Department of Mortality Health and Epidemiology, French Institute for Demographic Studies, Paris, France
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Liao MC, Choi MSJ, Huang CHO, Lam SKK, Wong MYC, Wong JYH, Fung HW. The moderating role of mindfulness in the relationship between loneliness and depressive symptoms. Sci Rep 2024; 14:30807. [PMID: 39730587 DOI: 10.1038/s41598-024-81462-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 11/26/2024] [Indexed: 12/29/2024] Open
Abstract
Loneliness has been recognized as a pressing global health threat. Research shows that loneliness is associated with depressive symptoms, but less is known about what factors might influence this relationship. This study tested the hypothesis that mindfulness would buffer the association between loneliness and depressive symptoms. A total of 220 Chinese adults completed validated measures of loneliness, mindfulness, and depressive symptoms. Hierarchical multiple regression and moderator analyses were conducted. Mindfulness was significantly associated with depressive symptoms (β = -.485, p < .001) after controlling for demographic variables and loneliness. Furthermore, mindfulness was a statistically significant moderator. Loneliness was more strongly associated with depressive symptoms when the levels of mindfulness were low. Mindfulness buffered the association between loneliness and depressive symptoms. Encouraging mindfulness practices might offer community-wide benefits from a public health perspective. While some studies showed that mindfulness could reduce loneliness, future studies should further evaluate whether mindfulness-based programs could also prevent the mental health consequences of loneliness.
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Affiliation(s)
- Mei Chih Liao
- Department of Psychology, California State University, Fullerton, USA
| | | | - Chak Hei Ocean Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Janet Yuen-Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong.
| | - Hong Wang Fung
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong.
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Dahrendorff J, Currier G, Uddin M. Leveraging DNA methylation to predict treatment response in major depressive disorder: A critical review. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32985. [PMID: 38650309 DOI: 10.1002/ajmg.b.32985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
Major depressive disorder (MDD) is a debilitating and prevalent mental disorder with a high disease burden. Despite a wide array of different treatment options, many patients do not respond to initial treatment attempts. Selection of the most appropriate treatment remains a significant clinical challenge in psychiatry, highlighting the need for the development of biomarkers with predictive utility. Recently, the epigenetic modification DNA methylation (DNAm) has emerged to be of great interest as a potential predictor of MDD treatment outcomes. Here, we review efforts to date that seek to identify DNAm signatures associated with treatment response in individuals with MDD. Searches were conducted in the databases PubMed, Scopus, and Web of Science with the concepts and keywords MDD, DNAm, antidepressants, psychotherapy, cognitive behavior therapy, electroconvulsive therapy, transcranial magnetic stimulation, and brain stimulation therapies. We identified 32 studies implicating DNAm patterns associated with MDD treatment outcomes. The majority of studies (N = 25) are focused on selected target genes exploring treatment outcomes in pharmacological treatments (N = 22) with a few studies assessing treatment response to electroconvulsive therapy (N = 3). Additionally, there are few genome-scale efforts (N = 7) to characterize DNAm patterns associated with treatment outcomes. There is a relative dearth of studies investigating DNAm patterns in relation to psychotherapy, electroconvulsive therapy, or transcranial magnetic stimulation; importantly, most existing studies have limited sample sizes. Given the heterogeneity in both methods and results of studies to date, there is a need for additional studies before existing findings can inform clinical decisions.
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Affiliation(s)
- Jan Dahrendorff
- Genomics Program, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Glenn Currier
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, Florida, USA
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Safiri S, Mousavi SE, Nejadghaderi SA, Noori M, Sullman MJM, Kolahi AA, Shekarriz-Foumani R. The burden of major depressive disorder in the Middle East and North Africa region, 1990-2019. Acta Neuropsychiatr 2024; 36:139-152. [PMID: 37690795 DOI: 10.1017/neu.2023.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI). METHODS Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. RESULTS In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990-2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35-39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI. CONCLUSION The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life.
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Affiliation(s)
- Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Shekarriz-Foumani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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7
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Rodrigues M, Oprea A, Johnson K, Dufort A, Sanger N, Ghiassi P, Sanger S, Panesar B, D'Elia A, Parpia S, Samaan Z, Thabane L. Primary outcome reporting in clinical trials for older adults with depression. BJPsych Open 2024; 10:e60. [PMID: 38450491 PMCID: PMC10951853 DOI: 10.1192/bjo.2023.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/29/2023] [Accepted: 12/18/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Findings from randomised controlled trials (RCTs) are synthesised through meta-analyses, which inform evidence-based decision-making. When key details regarding trial outcomes are not fully reported, knowledge synthesis and uptake of findings into clinical practice are impeded. AIMS Our study assessed reporting of primary outcomes in RCTs for older adults with major depressive disorder (MDD). METHOD Trials published between 2011 and 2021, which assessed any intervention for adults aged ≥65 years with a MDD diagnosis, and that specified a single primary outcome were considered for inclusion in our study. Outcome reporting assessment was conducted independently and in duplicate with a 58-item checklist, used in developing the CONSORT-Outcomes statement, and information in each RCT was scored as 'fully reported', 'partially reported' or 'not reported', as applicable. RESULTS Thirty-one of 49 RCTs reported one primary outcome and were included in our study. Most trials (71%) did not fully report over half of the 58 checklist items. Items pertaining to outcome analyses and interpretation were fully reported by 65% or more of trials. Items reported less frequently included: outcome measurement instrument properties (varied from 3 to 30%) and justification of the criteria used to define clinically meaningful change (23%). CONCLUSIONS There is variability in how geriatric depression RCTs report primary outcomes, with omission of details regarding measurement, selection, justification and definition of clinically meaningful change. Outcome reporting deficiencies may hinder replicability and synthesis efforts that inform clinical guidelines and decision-making. The CONSORT-Outcomes guideline should be used when reporting geriatric depression RCTs.
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Affiliation(s)
- Myanca Rodrigues
- Health Research Methodology Graduate Program, Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
| | - Anna Oprea
- Life Sciences Undergraduate Program, School of Interdisciplinary Science, McMaster University, Canada
| | - Keily Johnson
- Psychology, Neuroscience and Behaviour Undergraduate Program, Faculty of Science, McMaster University, Canada
| | - Alexander Dufort
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Nitika Sanger
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Pegah Ghiassi
- Delivery Management Office, Canadian Partnership Against Cancer, Toronto, Canada
| | | | - Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Canada; and Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton, Ontario, Canada
| | - Alessia D'Elia
- Neuroscience Graduate Program, McMaster University, Canada; and Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton, Ontario, Canada
| | - Sameer Parpia
- Department of Oncology, McMaster University, Canada; and Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada; and Mood Disorders Program, St. Joseph's Healthcare Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada; Population Health Research Institute, Ontario, Canada; and Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, Ontario, Canada
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Mohd Tamil A, Ismail NH, Jaafar MH, Md Isa Z, Ismail R, Mat Nasir N, Miskan M, Zainol Abidin N, Ab Razak NH, Joundi R, Yusof KH. Depressive symptoms among adults: Baseline findings of PURE Malaysia cohort study. Heliyon 2024; 10:e23042. [PMID: 38192831 PMCID: PMC10772557 DOI: 10.1016/j.heliyon.2023.e23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction In Malaysia, the prevalence of depression has increased from 1.8 % to 2.3 % within a decade. Thus, this study was performed to identify depressive symptoms and its associated factors among Malaysian adults. Methods A cross-sectional study was conducted among the adult population aged 35-70 residing in rural and urban areas in Malaysia. Depressive symptoms were assessed using the short form Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Composite International Diagnostic Interview (CIDI) questionnaire. Logistic regression models were fitted to identify the associated factors related to depressive symptoms. Results About 3.7 % (95 % CI: 2.33-4.83) of the respondents reported having depressive symptoms. Younger adults aged 35-40 years old (AOR: 3.087; 95 % CI: 2.021-4.717), females (AOR: 2.318; 95 % CI: 1.669-3.219), widows and divorcees (AOR: 2.294; 95 % CI: 1.085-4.848), smokers (AOR: 1.843; 95 % CI: 1.334-2.545) and alcohol consumers (AOR: 1.843; 95 % CI: 1.264-2.688) showed a higher odds compared to their other counterparts. Underweight individuals (AOR: 1.899; 95 % CI: 1.177-3.065) and those diagnosed either with hypertension (AOR: 1.442; 95 % CI: 1.11-1.873), diabetes (AOR: 1.554; 95 % CI: 1.133-2.13), angina (AOR: 2.73; 95 % CI: 1.596-4.67), COPD (AOR: 4.187; 95 % CI: 1.528-11.472) or asthma (AOR: 1.906; 95 % CI: 1.309-2.774) were more likely to have depressive symptoms. Additionally, individuals with difficulty trusting people (AOR: 1.477; 95 % CI: 1.024-2.13) and those reported to experience either home or work-related stress (AOR: 2.584; 95 % CI: 2.003-3.331) were more prone to have depressive symptoms. Conclusion In this broad population-based study, about 3.7 % (95 % CI: 2.33-4.83) of respondents reported having depressive symptoms. Timely and well targeted collaborative intervention on the identified risk factors by the relevant authorities, would mitigate their effect on the quality of life and retard the progression into depression, especially among younger adults.
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Affiliation(s)
- Azmi Mohd Tamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Noor Hassim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Hasni Jaafar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Zaleha Md Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Rosnah Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
| | - Maizatullifah Miskan
- Department of Primary Care Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Najihah Zainol Abidin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
- Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, 40100 Shah Alam, Selangor, Malaysia
| | - Nurul Hafiza Ab Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Raed Joundi
- Division of Neurology, Hamilton Health Sciences, McMaster University and Population Health Research Institute, Hamilton General Hospital, Hamilton, ON, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Khairul Hazdi Yusof
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
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Arifkhanova A, Elhabr A, Murray C, Khushalani J, Neri A, PhD JK, Puddy RW, Ayer T. Telemental Health Utilization in Commercial Health Insurance Plans in the United States From 2010 Through 2019. J Clin Psychiatry 2023; 85:23m14931. [PMID: 38019591 PMCID: PMC12039812 DOI: 10.4088/jcp.23m14931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Objective: We sought to characterize patterns of utilization of telemental health among commercially insured individuals over the decade preceding COVID-19. Methods: We developed telemental health service groups from the US PharMetrics Plus database, using diagnostic codes to identify those diagnosed with mental health conditions and procedure codes to capture mental health visits delivered via telehealth sessions. We analyzed 2 indicators of utilization between January 1, 2010, and December 31, 2019: (1) the percentage of patients with mental health needs who used telemental health services and (2) the percentage of all mental health services provided via telehealth. We stratified our analyses by year, patient gender, patient age, and geographic region. Results: The proportion of mental health visits delivered via telemental health increased from 0.002% to 0.162% between 2010 and 2019. A larger proportion of males received telemental health services as compared to females; however, the proportion of mental health visits delivered via telehealth was higher for females than for males. Patients aged 18 to 34 years and those in the western US had the highest utilization compared to other age groups and geographic regions. Conclusions: Telemental health utilization comprised a small fraction of overall mental health services and beneficiaries in the IQVIA PharMetrics Plus claims data, but increased over time, with differences documented in utilization based on patient gender, patient age, geographic region, and type of telemental health claim. Evidence from this study may serve as a pre-pandemic baseline for comparison against future evaluations of telehealth expansion policies.
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Affiliation(s)
- Aziza Arifkhanova
- Centers for Disease Control and Prevention, Atlanta, Georgia
- Corresponding Author: Aziza Arifkhanova, PhD, 1600 Clifton Rd MS V24-5, Atlanta, GA 30329
| | | | | | - Jaya Khushalani
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Antonio Neri
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Richard W Puddy
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Turgay Ayer
- Georgia Institute of Technology, Atlanta, Georgia
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Parperis K, Kyriakou A, Voskarides K, Koliou E, Evangelou M, Chatzittofis A. Insights into suicidal behavior among psoriatic arthritis patients: A systematic review and a genetic linkage disequilibrium analysis. Semin Arthritis Rheum 2023; 62:152241. [PMID: 37429140 DOI: 10.1016/j.semarthrit.2023.152241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/15/2023] [Accepted: 06/25/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To systematically assess the magnitude of suicidal behavior among PsA patients and identify associated risk factors. Also identify common genes or coinherited single nucleotide polymorphisms (SNPs) implicated in suicidal behavior and PsA. METHODS Based on the PRISMA guidelines, we conducted a systematic literature review of the online databases PubMed/Medline, Web of Science, and EMBASE from inception to May 2022. Full-text original articles that describe suicidal behavior in PsA patients were eligible. All registered genome-wide association study (GWAS) data in the GWAS catalog database for PsA and psychiatric traits, such as suicidal behavior, and depression, were downloaded for further analysis. RESULTS A total of 48 articles were identified, and 6 were relevant to the study question .Among the 122,160 PsA patients, 700 had suicidal behavior (0,57%). The range of age in one study was between 30 and 49 years, and 64% of PsA patients with suicidal behavior were female. Among 13,899 PsA patients 74 had suicidal ideation (0.53%) and 125 suicide attempts occurred (0.9%). In two studies, among 17,383 patients, 13 complete suicides occurred (0.07%). A genetic haplotype on chromosomal region 6p21.1, spanning from 29,597,596 to 32,251,264 Mb, contains predisposing SNPs for PsA and depression. 6p21.1-6p21.3 is the chromosomal region containing the HLA genes of classes I, II and III. CONCLUSION Suicide behavior in PsA patients was associated with depression and other psychiatric comorbidities. Further evidence supports a genetic origin, at least partly. Awareness of these findings can help clinicians to recognize suicide behavior and prevent suicide attempts.
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Affiliation(s)
- Konstantinos Parperis
- Division of Rheumatology, Department of Medicine, University of Cyprus Medical School, Nicosia, Cyprus
| | - Avgoustina Kyriakou
- Internal Medicine Resident Larnaca General Hospital, Department of Medicine, University of Cyprus Medical School, Nicosia, Cyprus.
| | - Konstantinos Voskarides
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus; School of Veterinary Medicine, University of Nicosia, Nicosia, Cyprus
| | - Eleni Koliou
- Department of Medicine, University of Cyprus Medical School, Nicosia, Cyprus
| | - Marina Evangelou
- Department of Medicine, University of Cyprus Medical School, Nicosia, Cyprus
| | - Andreas Chatzittofis
- Department of Psychiatry, University of Cyprus Medical School, Nicosia, Cyprus and Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
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Shirali A, M Y, Shirali PA, Sarah. Depression in Diabetes-The Hidden Bane. Ann Neurosci 2023; 30:163-168. [PMID: 37779552 PMCID: PMC10540763 DOI: 10.1177/09727531221144112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/14/2022] [Indexed: 10/03/2023] Open
Abstract
Background In India, a number of diabetes patients are rising, around 41 million Indians are suffering from diabetes. The depressed mood of an individual restricts the performance of that individual-socially, financially, and health-wise. Purpose Patients with diabetes having depression have shown worst diabetes outcomes in contrast to those suffering from type II diabetes mellitus (T2DM) only, perhaps due to neglect at retaining a specific dietary regimen to control blood sugar levels, and/or not complying with regular exercise, consistent lifestyle, and treatment course. Our study aimed to analyze the presence of undiagnosed depression among adult diabetes patients and correlate complications and duration of T2DM with depression. Methods This cross-sectional observational study was conducted on diabetes cases visiting Out Patient Department (OPD) at Tertiary Care Hospital in South India. After obtaining ethics committee clearance, known diabetes adult patients on regular treatment fulfilling selection criteria, and willing to join in the study were randomly selected. Participants were interviewed, clinically examined and data pertaining to sociodemographic characteristics, comorbid conditions, clinical parameters etc., were collected. Depression was judged using the Hamilton Depression Rating Scale (HDRS17) questionnaire. The association of depression with glycemic control, duration, and comorbidities associated with T2DM was studied. Results Of 224 T2DM patients studied, the average age was 58 years, with a Male-to-Female ratio 2:1. In total, 49 (22%) had undiagnosed depression, and 175 (78%) were not having clinically obvious depression. In our study, depression was significantly associated with older age, occurrence of complications like retinopathy, neuropathy, nephropathy, and heart disease, and duration of diabetes (p < .005). Conclusion Almost a fifth of diabetes individuals had undiagnosed depression. Proper diagnosis of depression among T2DM patients and intervention at right time can change the prognosis for patients, preventing further morbidities.
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Affiliation(s)
- Arun Shirali
- Department of General Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Yeshoda M
- Department of General Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Priyanka Arun Shirali
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sarah
- Department of General Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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12
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Abd-Alrazaq A, AlSaad R, Shuweihdi F, Ahmed A, Aziz S, Sheikh J. Systematic review and meta-analysis of performance of wearable artificial intelligence in detecting and predicting depression. NPJ Digit Med 2023; 6:84. [PMID: 37147384 PMCID: PMC10163239 DOI: 10.1038/s41746-023-00828-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023] Open
Abstract
Given the limitations of traditional approaches, wearable artificial intelligence (AI) is one of the technologies that have been exploited to detect or predict depression. The current review aimed at examining the performance of wearable AI in detecting and predicting depression. The search sources in this systematic review were 8 electronic databases. Study selection, data extraction, and risk of bias assessment were carried out by two reviewers independently. The extracted results were synthesized narratively and statistically. Of the 1314 citations retrieved from the databases, 54 studies were included in this review. The pooled mean of the highest accuracy, sensitivity, specificity, and root mean square error (RMSE) was 0.89, 0.87, 0.93, and 4.55, respectively. The pooled mean of lowest accuracy, sensitivity, specificity, and RMSE was 0.70, 0.61, 0.73, and 3.76, respectively. Subgroup analyses revealed that there is a statistically significant difference in the highest accuracy, lowest accuracy, highest sensitivity, highest specificity, and lowest specificity between algorithms, and there is a statistically significant difference in the lowest sensitivity and lowest specificity between wearable devices. Wearable AI is a promising tool for depression detection and prediction although it is in its infancy and not ready for use in clinical practice. Until further research improve its performance, wearable AI should be used in conjunction with other methods for diagnosing and predicting depression. Further studies are needed to examine the performance of wearable AI based on a combination of wearable device data and neuroimaging data and to distinguish patients with depression from those with other diseases.
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Rawan AlSaad
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
- College of Computing and Information Technology, University of Doha for Science and Technology, Doha, Qatar
| | - Farag Shuweihdi
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Javaid Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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Phosphodiesterase inhibitor and selective serotonin reuptake inhibitor combination therapy versus monotherapy for the treatment of major depressive disorder: a systematic review and meta-analysis. Int Clin Psychopharmacol 2023:00004850-990000000-00045. [PMID: 36752703 DOI: 10.1097/yic.0000000000000457] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Selective serotonin reuptakeinhibitors (SSRIs) are the gold standard treatment for major depressive disorder (MDD). However, the use of phosphodiesterase (PDE) inhibitors in the treatment of MDD remains unclear. Our study aims to compare the effect of PDE inhibitor combination therapy to SSRI monotherapy for the treatment of MDD. METHODS We performed a comprehensive literature search using PubMed, EMBASE, and Web of Science databases, for studies that assess the impact of PDE inhibitor therapy on MDD patients. The primary outcome of our study was treatment response rate at the end of study time. Pooled odds ratio (OR) and corresponding 95% confidence intervals (CIs) were calculated using the random-effects model. A P-value <0.05 was considered statistically significant. RESULTS A total of four randomized control trials (RCTs), including 270 patients with MDD, were included in the analysis. Follow-up periods ranged from 6 to 12 weeks. The PDE inhibitor group was associated with a significantly higher treatment response rate (OR, 4.77; 95% CI, 2.05-11.12; P = 0.0003). CONCLUSION Our meta-analysis demonstrated that MDD patients receiving PDE inhibitor combination therapy had a higher treatment response rate than MDD patients receiving SSRI monotherapy. Further large-scale RCTs with long-term follow-ups are necessary to validate our findings.
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Abd-Alrazaq A, AlSaad R, Aziz S, Ahmed A, Denecke K, Househ M, Farooq F, Sheikh J. Wearable Artificial Intelligence for Anxiety and Depression: Scoping Review. J Med Internet Res 2023; 25:e42672. [PMID: 36656625 PMCID: PMC9896355 DOI: 10.2196/42672] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/18/2022] [Accepted: 12/11/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anxiety and depression are the most common mental disorders worldwide. Owing to the lack of psychiatrists around the world, the incorporation of artificial intelligence (AI) into wearable devices (wearable AI) has been exploited to provide mental health services. OBJECTIVE This review aimed to explore the features of wearable AI used for anxiety and depression to identify application areas and open research issues. METHODS We searched 8 electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, IEEE Xplore, ACM Digital Library, Scopus, and Google Scholar) and included studies that met the inclusion criteria. Then, we checked the studies that cited the included studies and screened studies that were cited by the included studies. The study selection and data extraction were carried out by 2 reviewers independently. The extracted data were aggregated and summarized using narrative synthesis. RESULTS Of the 1203 studies identified, 69 (5.74%) were included in this review. Approximately, two-thirds of the studies used wearable AI for depression, whereas the remaining studies used it for anxiety. The most frequent application of wearable AI was in diagnosing anxiety and depression; however, none of the studies used it for treatment purposes. Most studies targeted individuals aged between 18 and 65 years. The most common wearable device used in the studies was Actiwatch AW4 (Cambridge Neurotechnology Ltd). Wrist-worn devices were the most common type of wearable device in the studies. The most commonly used category of data for model development was physical activity data, followed by sleep data and heart rate data. The most frequently used data set from open sources was Depresjon. The most commonly used algorithm was random forest, followed by support vector machine. CONCLUSIONS Wearable AI can offer great promise in providing mental health services related to anxiety and depression. Wearable AI can be used by individuals for the prescreening assessment of anxiety and depression. Further reviews are needed to statistically synthesize the studies' results related to the performance and effectiveness of wearable AI. Given its potential, technology companies should invest more in wearable AI for the treatment of anxiety and depression.
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Rawan AlSaad
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Science, Bern, Switzerland
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Faisal Farooq
- Qatar Computing Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - Javaid Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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Hosokawa R, Ojima T, Myojin T, Kondo K, Kondo N. Geriatric symptoms associated with healthy life expectancy in older people in Japan. Environ Health Prev Med 2023; 28:44. [PMID: 37423739 DOI: 10.1265/ehpm.22-00300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND We investigated the relationship between characteristic geriatric symptoms and healthy life expectancy in older adults in Japan. Additionally, we determined relationship predictors that would help formulate effective approaches toward promoting healthy life expectancy. METHODS The Kihon Checklist was used to identify older people at high risk of requiring nursing care in the near future. We evaluated the association of geriatric symptoms with healthy life expectancy while considering risk factors (frailty, poor motor function, poor nutrition, poor oral function, confinement, poor cognitive function, and depression). Data from the 2013 and 2019 Japan Gerontological Evaluation Studies were used. Healthy life expectancy was assessed using the multistate life table method. RESULTS Overall, 8,956 individuals were included. For both men and women, healthy life expectancy was shorter in the symptomatic group than in the asymptomatic group for several domains of the Kihon Checklist. For men, the difference between individuals with risk factors and those with no risk factors was the maximum for confinement (3.83 years) and the minimum for cognitive function (1.51 years). For women, the difference between individuals with risk factors and those with no risk factors was the maximum for frailty (4.21 years) and the minimum for cognitive function (1.67 years). Healthy life expectancy tended to be shorter when the number of risk factors was higher. Specifically, the difference between individuals with ≥3 risk factors and those with no risk factors was 4.46 years for men and 5.68 years for women. CONCLUSIONS Healthy life expectancy was negatively associated with characteristic geriatric symptoms, with strong associations with frailty, physical functional decline, and depression. Therefore, comprehensive assessment and prevention of geriatric symptoms may increase healthy life expectancy.
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Affiliation(s)
- Rikuya Hosokawa
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine
| | - Tomoya Myojin
- Department of Public Health, Health Management and Policy, Nara Medical University
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University
- Center for Well-being and Society, Nihon Fukushi University
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology
| | - Naoki Kondo
- School of Public Health and Graduate School of Medicine, Kyoto University
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García-Gutiérrez MS, Navarro D, Austrich-Olivares A, Manzanares J. Unveiling behavioral and molecular neuroadaptations related to the antidepressant action of cannabidiol in the unpredictable chronic mild stress model. Front Pharmacol 2023; 14:1171646. [PMID: 37144214 PMCID: PMC10151764 DOI: 10.3389/fphar.2023.1171646] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/03/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction: This study aims to further characterize cannabidiol's pharmacological and molecular profile as an antidepressant. Methods: Effects of cannabidiol (CBD), alone or combined with sertraline (STR), were evaluated in male CD1 mice (n = 48) exposed to an unpredictable chronic mild stress (UCMS) procedure. Once the model was established (4 weeks), mice received CBD (20 mg·kg-1, i.p.), STR (10 mg·kg-1, p.o.) or its combination for 28 days. The efficacy of CBD was evaluated using the light-dark box (LDB), elevated plus maze (EPM), tail suspension (TS), sucrose consumption (SC) and novel object recognition (NOR) tests. Gene expression changes in the serotonin transporter, 5-HT1A and 5-HT2A receptors, BDNF, VGlut1 and PPARdelta, were evaluated in the dorsal raphe, hippocampus (Hipp) and amygdala by real-time PCR. Besides, BDNF, NeuN and caspase-3 immunoreactivity were assessed in the Hipp. Results: CBD exerted anxiolytic and antidepressant-like effects at 4 and 7 days of treatment in the LDB and TS tests, respectively. In contrast, STR required 14 days of treatment to show efficacy. CBD improved cognitive impairment and anhedonia more significantly than STR. CBD plus STR showed a similar effect than CBD in the LBD, TST and EPM. However, a worse outcome was observed in the NOR and SI tests. CBD modulates all molecular disturbances induced by UCMS, whereas STR and the combination could not restore 5-HT1A, BDNF and PPARdelta in the Hipp. Discussion: These results pointed out CBD as a potential new antidepressant with faster action and efficiency than STR. Particular attention should be given to the combination of CBD with current SSRI since it appears to produce a negative impact on treatment.
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Affiliation(s)
- María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández, Alicante, Spain
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Daniela Navarro
- Instituto de Neurociencias, Universidad Miguel Hernández, Alicante, Spain
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | | | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández, Alicante, Spain
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- *Correspondence: Jorge Manzanares,
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Multidimensional evaluation of healthy life expectancy indicators based on mental health among the rural older population: A large-scale cross-sectional study. J Affect Disord 2022; 319:318-324. [PMID: 36116604 DOI: 10.1016/j.jad.2022.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND This study aimed to estimate healthy life expectancy (HLE) regarding anxiety, depression and their comorbidity among rural older adults. METHODS A total of 12,851 subjects (5790 men and 7061 women) enrolled from the Henan Rural Cohort Study were used to evaluate healthy status expectancy (HSE), and 10,096 (4475 men and 5621 women) of them were used to estimate health-adjusted life expectancy (HALE). The life expectancy was calculated using period life table, and HSE and HALE indicators were calculated via the Sullivan method. RESULTS For participants aged 60, the depression-free life expectancy (DFLE), anxiety-free life expectancy (AFLE), and depression- and anxiety-free life expectancy (DAFLE) were 23.0993, 23.3314, and 22.7206 years, respectively. The quality-adjusted life expectancy (QALE) of those with neither anxiety nor depression, with anxiety, with depression, and with comorbidity was 22.0727, 20.8751, 18.1484, and 17.0823 years, respectively. The ratio of DFLE (AFLE) to LE increased with age among both genders, while the DAFLE/LE showed a decreasing trend. Regardless of HSE or HALE indicators, women tended to have higher HLE, while HLE/LE was lower than men. Furthermore, all HLE indicators associated with anxiety were the largest in both genders compared to indicators regarding depression. LIMITATIONS The HLE may be overestimated ignoring institutional population in the study. CONCLUSION Anxiety and depression played essential roles in the quality of life among rural older adults, especially depression. Comorbidity would intensify the adverse effect in rural areas, especially for older men. More attention should be paid to the psychological problems among rural older population.
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Burger F, Neerincx MA, Brinkman WP. Using a conversational agent for thought recording as a cognitive therapy task: Feasibility, content, and feedback. Front Digit Health 2022; 4:930874. [PMID: 35928046 PMCID: PMC9343632 DOI: 10.3389/fdgth.2022.930874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
E-mental health for depression is increasingly used in clinical practice, but patient adherence suffers as therapist involvement decreases. One reason may be the low responsiveness of existing programs: especially autonomous systems are lacking in their input interpretation and feedback-giving capabilities. Here, we explore (a) to what extent a more socially intelligent and, therefore, technologically advanced solution, namely a conversational agent, is a feasible means of collecting thought record data in dialog, (b) what people write about in their thought records, (c) whether providing content-based feedback increases motivation for thought recording, a core technique of cognitive therapy that helps patients gain an understanding of how their thoughts cause their feelings. Using the crowd-sourcing platform Prolific, 308 participants with subclinical depression symptoms were recruited and split into three conditions of varying feedback richness using the minimization method of randomization. They completed two thought recording sessions with the conversational agent: one practice session with scenarios and one open session using situations from their own lives. All participants were able to complete thought records with the agent such that the thoughts could be interpreted by the machine learning algorithm, rendering the completion of thought records with the agent feasible. Participants chose interpersonal situations nearly three times as often as achievement-related situations in the open chat session. The three most common underlying schemas were the Attachment, Competence, and Global Self-evaluation schemas. No support was found for a motivational effect of providing richer feedback. In addition to our findings, we publish the dataset of thought records for interested researchers and developers.
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Affiliation(s)
- Franziska Burger
- Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands
| | - Mark A. Neerincx
- Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands
- Department of Perceptual and Cognitive Systems, Netherlands Organisation of Applied Scientific Research (TNO), Soesterberg, Netherlands
| | - Willem-Paul Brinkman
- Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands
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Lindsay M, Decker VB. Improving Depression Screening in Primary Care. J Dr Nurs Pract 2022; 15:84-90. [DOI: 10.1891/jdnp-2021-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundDepression is a serious problem in the United States. It not only impacts chronic illness and healthcare utilization, but it can also result in death, intentional or unintentional. Despite the seriousness associated with depression, it continues to be underdiagnosed and undertreated. The primary care setting provides an ideal location to screen and initiate treatment for depression in individuals who would otherwise not be screened.ObjectiveThe objective of this evidence-based practice project was to improve the diagnosis and treatment of depression in an adult primary care office.MethodAn intervention consisting of a HealthWatcher reminder for depression screening, the administration of the PHQ-9 instrument, and a treatment algorithm was incorporated into the office workflow. The charts of a pre-intervention random sample were compared to a post-intervention random sample to test for significant differences in depression screening and treatment rates.ResultsUsing the chi-squared test, the post-intervention sample screening rate was significantly higher than pre-intervention sample rate (90% vs 23.3%; χ2 = 54.3, df = 1, P < .000).Conclusion/ImplicationsIt is feasible to improve the diagnosis and treatment of depression for adult primary care patients by modifying office protocols and using the PHQ-9 screening instrument and a treatment algorithm.
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20
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The Potential of Polygenic Risk Scores to Predict Antidepressant Treatment Response in Major Depression: A Systematic Review. J Affect Disord 2022; 304:1-11. [PMID: 35151671 DOI: 10.1016/j.jad.2022.02.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/29/2021] [Accepted: 02/09/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Understanding the genetic underpinnings of antidepressant treatment response in unipolar major depressive disorder (MDD) can be useful in identifying patients at risk for poor treatment response or treatment resistant depression. A polygenic risk score (PRS) is a useful tool to explore genetic liability of a complex trait such as antidepressant treatment response. Here, we review studies that use PRSs to examine genetic overlap between any trait and antidepressant treatment response in unipolar MDD. METHODS A systematic search of literature was conducted in PubMed, Embase, and PsycINFO. Our search included studies examining associations between PRSs of psychiatric as well as non-psychiatric traits and antidepressant treatment response in patients with unipolar MDD. A quality assessment of the included studies was performed. RESULTS In total, eleven articles were included which contained PRSs for 30 traits. Studies varied in sample size and endpoints used for antidepressant treatment response. Overall, PRSs for attention-deficit hyperactivity disorder, the personality trait openness, coronary artery disease, obesity, and stroke have been associated with antidepressant treatment response in patients with unipolar MDD. LIMITATIONS The endpoints used by included studies differed significantly, therefore it was not possible to perform a meta-analysis. CONCLUSIONS Associations between a PRS and antidepressant treatment response have been reported for a number of traits in patients with unipolar MDD. PRSs could be informative to predict antidepressant treatment response in this population, given advances in the field. Most importantly, there is a need for larger study cohorts and the use of standardized outcome measures.
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Parperis K, Kyriakou A, Voskarides K, Chatzittofis A. Suicidal behavior in patients with systematic lupus erythematosus: systematic literature review and genetic linkage disequilibrium analysis. Semin Arthritis Rheum 2022; 54:151997. [DOI: 10.1016/j.semarthrit.2022.151997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/09/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
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22
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Bradfield J, Buckner L, Amati F, Burridge J, Ray S. From observation to intervention: time to put 'food and mood' to the test. BMJ Nutr Prev Health 2021; 4:359-361. [PMID: 35028507 PMCID: PMC8718859 DOI: 10.1136/bmjnph-2021-000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/13/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- James Bradfield
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
- Department of Nutrition and Dietetics, King's College Hospital NHS Foundation Trust, London, UK
| | - Luke Buckner
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
| | - Federica Amati
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Juliet Burridge
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
- Nutritank, Bristol, UK
| | - Sumantra Ray
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge, UK
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
- University of Cambridge School of Humanities and Social Sciences, Cambridge, UK
- Ulster University School of Biomedical Sciences, Coleraine, UK
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Stevens M, Lieschke J, Cruwys T, Cárdenas D, Platow MJ, Reynolds KJ. Better together: How group-based physical activity protects against depression. Soc Sci Med 2021; 286:114337. [PMID: 34450391 DOI: 10.1016/j.socscimed.2021.114337] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 01/05/2023]
Abstract
Against the backdrop of evidence that physical activity can protect against depression, there has been growing interest in the mechanisms through which this relationship operates (e.g., biological adaptations), and the factors that might moderate it (e.g., physical activity intensity). However, no attempt has been made to examine whether, or through what mechanisms, depression-related benefits might arise from belonging to groups that engage in physical activity. Across two studies, we addressed these shortcomings by (a) examining whether engaging in physical activity specifically in the context of sport or exercise groups protects against depression and (b) testing two pathways through which benefits might arise: greater physical activity and reduced loneliness. Study 1 (N = 4549) used data from three waves of a population study of older adults residing in England. Sport or exercise group membership predicted fewer depression symptoms four years later. This relationship was underpinned by sport or exercise group members engaging in physical activity more frequently and feeling less lonely. Clinical depression rates were almost twice as high among non-group members than group members. Study 2 (N = 635) included Australian adults who were members of sport and exercise groups, recruited during the enforced suspension of all group-based sport and exercise due to COVID-19 restrictions. The more sport or exercise groups participants had lost physical access to, the more severe their depression symptoms. Clinical depression rates were over twice as high among those who had lost access to >2 groups compared to those who had lost access to <2 groups. The relationship between number of groups lost and depression symptom severity was mediated by greater loneliness, but not by overall physical activity. Overall, findings suggest that belonging to groups that engage in physical activity can protect against depression, and point to the value of initiatives that aim to promote people's engagement in such groups.
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Affiliation(s)
- Mark Stevens
- Research School of Psychology, The Australian National University, Canberra, ACT 2601, Australia.
| | - Jacqueline Lieschke
- Research School of Psychology, The Australian National University, Canberra, ACT 2601, Australia
| | - Tegan Cruwys
- Research School of Psychology, The Australian National University, Canberra, ACT 2601, Australia
| | - Diana Cárdenas
- Research School of Psychology, The Australian National University, Canberra, ACT 2601, Australia
| | - Michael J Platow
- Research School of Psychology, The Australian National University, Canberra, ACT 2601, Australia
| | - Katherine J Reynolds
- Research School of Psychology, The Australian National University, Canberra, ACT 2601, Australia
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Niazi SK, Memon SH, Lesser ER, Brennan E, Aslam N. Assessment of psychiatric comorbidities and serotonergic or noradrenergic medication use on blood pressure using 24-hour ambulatory blood pressure monitoring. J Clin Hypertens (Greenwich) 2021; 23:1599-1607. [PMID: 34184385 PMCID: PMC8678783 DOI: 10.1111/jch.14311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022]
Abstract
In this study, the authors aimed to assess both nighttime and daytime blood pressure (BP) variability using 24-hour ambulatory BP monitoring (ABPM) in persons with and without psychiatric conditions and with or without selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) treatment. In this retrospective study, patients who underwent psychiatric evaluation and ABPM within 6 months of each other between January 1, 2012 and December 31, 2017 were identified using billing data. Participants were divided into three groups-participants with no psychiatric diagnosis and no psychiatric medicine (-Diagnosis/-Medication), those with psychiatric diagnosis and on SSRIs/SNRIs (+Diagnosis/+Medication), and psychiatric diagnosis but no psychiatric medications (+Diagnosis/-Medication). Day and nighttime systolic and diastolic BPs were compared between groups controlling for relevant variables using multivariable linear regression models. A total of 475 participants met inclusion criteria including 135 in the -Diagnosis/-Medication group, 232 in the +Diagnosis/+Medication group, and 108 in the +Diagnosis/-Medication group. In adjusted multivariable analysis, the +Diagnosis/+Medication group had higher nighttime systolic BP (median 120 vs 110 mm (Hg); p = .01) and nighttime diastolic BP (median 68 vs 63 mm (Hg); p = .006) as compared to -Diagnosis/-Medication. No statistically significant differences in BPs between the -Diagnosis/-Medication and +Diagnosis/-Medication groups were observed, after adjustment. Use of SSRIs/SNRIs was associated with significantly higher nocturnal systolic and diastolic BP among patients with psychiatric diagnosis using SSRIs/SNRIs but not associated with psychiatric diagnosis without SSRI/SNRI use. SSRIs/SNRIs use may be associated with higher BP levels and this merits future prospective studies using ABPM to assess day and nighttime BP changes with SSRIs/SNRIs use.
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Affiliation(s)
- Shehzad K. Niazi
- Department of Psychiatry & PsychologyMayo Clinic FloridaJacksonvilleFloridaUSA
- Mayo ClinicRobert D. & Patricia E. Kern Center of Science of Health Care DeliveryJacksonvilleFloridaUSA
| | - Sobia H. Memon
- Department of MedicineDivision of Nephrology & HypertensionMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Elizabeth R. Lesser
- Department of BiostatisticsHealth Science ResearchMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Emily Brennan
- Mayo ClinicRobert D. & Patricia E. Kern Center of Science of Health Care DeliveryJacksonvilleFloridaUSA
| | - Nabeel Aslam
- Department of MedicineDivision of Nephrology & HypertensionMayo Clinic FloridaJacksonvilleFloridaUSA
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Dollenberg A, Moeller S, Lücke C, Wang R, Lam AP, Philipsen A, Gschossmann JM, Hoffmann F, Müller HHO. Prevalence and influencing factors of chronic post-traumatic stress disorder in patients with myocardial infarction, transient ischemic attack (TIA) and stroke - an exploratory, descriptive study. BMC Psychiatry 2021; 21:295. [PMID: 34098930 PMCID: PMC8186229 DOI: 10.1186/s12888-021-03303-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 05/25/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cardio- and cerebrovascular events such as myocardial infarction (MI), stroke and transient ischemic attack (TIA) are leading causes of death and disability and have also been associated with poor mental outcomes. In addition, cardio- and cerebrovascular events may pose the risk of experiencing a sudden traumatic occurrence of symptoms during ictus and thus contribute to high rates of PTSD as well as high rates of subsequent depression and anxiety. Moreover, MI, TIA and stroke survivors with PTSD, depressive and anxiety symptoms may have poorer health-related quality of life (HRQoL) and poorer disease prognosis than patients who do not develop psychiatric symptoms after ictus. However, data on the prevalence of PTSD, anxiety and depression, as well as the HRQoL, coping strategies and potential risk factors for development of PTSD in these patients, are rare. METHODS In an exploratory, descriptive study we interviewed 112 patients (54 MI, 18 TIA, 40 stroke; mean age: 69.5 years, 55.4% males) from three general physician practices and used psychometric self-assessment tools to determine the occurrence of PTSD and psychosomatic comorbidity, anxiety and depression and to assess HRQoL and coping strategies. We evaluated disease severity and compared the patient groups to each other. Moreover, we assessed psychological outcome differences between patients with or without PTSD after ictus. RESULTS The prevalence of PTSD after MI, TIA and stroke was 23.2%. The patients who developed PTSD had higher rates of depression, anxiety and maladaptive coping as well as reduced HRQoL. Adaptive coping was positively related to better mental HRQoL and negatively related to anxiety and depression. Disease severity of MI, TIA and stroke was not related to PTSD, depression, anxiety or physical HRQoL. CONCLUSIONS Experiencing MI, TIA or stroke means confronting a life-threatening event for those affected and, therefore, these can be regarded as traumatic events. Cerebral and cardiovascular events increase the risk of developing chronic PTSD with subsequent increased depression and anxiety and reduced HRQoL. These findings emphasize the need for early screening and diagnosis of PTSD in somatically ill patients, which should be followed by specialized treatment, as PTSD hampers overall (somatic) disease prognosis. TRIAL REGISTRATION German Clinical Trials Register, DRKS00021730, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021730 , registered 05/19/2020 - Retrospectively registered.
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Affiliation(s)
- Aurora Dollenberg
- School of Medicine and Health Sciences, Medical Campus, University of Oldenburg, Oldenburg, Germany
- Faculty of Health/School of Medicine, Integrative Psychiatry and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Sebastian Moeller
- Faculty of Health/School of Medicine, Integrative Psychiatry and Psychotherapy, Witten/Herdecke University, Witten, Germany
- Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie, Bonn, Germany
| | - Caroline Lücke
- School of Medicine and Health Sciences, Medical Campus, University of Oldenburg, Oldenburg, Germany
- Faculty of Health/School of Medicine, Integrative Psychiatry and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Ruihao Wang
- Universitätsklinikum Erlangen, Klinik und Poliklinik für Neurologie, Erlangen, Germany
| | - Alexandra P. Lam
- Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie, Bonn, Germany
| | - Alexandra Philipsen
- Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie, Bonn, Germany
| | - Jürgen M. Gschossmann
- Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Klinikum Forchheim-Fränkische Schweiz gGmbH, Forchheim, Germany
| | - Falk Hoffmann
- School of Medicine and Health Sciences, Medical Campus, University of Oldenburg, Oldenburg, Germany
| | - Helge H. O. Müller
- School of Medicine and Health Sciences, Medical Campus, University of Oldenburg, Oldenburg, Germany
- Faculty of Health/School of Medicine, Integrative Psychiatry and Psychotherapy, Witten/Herdecke University, Witten, Germany
- Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie, Bonn, Germany
- Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Division of Medical Psychology, Universitätsklinikum Bonn, Bonn, Germany
- Abteilung für Psychiatrie und Psychotherapie, Lehrstuhl für integrative Psychiatrie und Psychotherapie Private Universität Witten/Herdecke Gemeinschaftskrankenhaus Herdecke gGmbH, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
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Wu Y, Zheng H, Liu Z, Wang S, Chen X, Yu H, Liu Y, Hu S. Depression and Anxiety-Free Life Expectancy by Sex and Urban-Rural Areas in Jiangxi, China in 2013 and 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041991. [PMID: 33670818 PMCID: PMC7922042 DOI: 10.3390/ijerph18041991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 11/29/2022]
Abstract
Objective: To quantitatively estimate life expectancy (LE) and depression and anxiety-free life expectancy (DAFLE) for the years 2013 and 2018 in Jiangxi Province, China, by sex and urban–rural areas. Additionally, to compare the discrepancy of DAFLE/LE of different sexes and urban-rural areas over various years. Methods: Based on the summary of the health statistics of Jiangxi Province in 2013 and 2018 and the results of the 5th and 6th National Health Service Surveys in Jiangxi Province, the model life table is used to estimate the age-specific mortality rate by sex and urban–rural areas. Sullivan’s method was used to calculate DAFLE. Results: Data from 2013 indicate that those aged 15 can expect to live 56.20 years without depression and anxiety for men and 59.67 years without depression and anxiety for women. Compared to 2013, DAFLE had not fluctuated significantly in 2018. The proportion of life expectancy without depression and anxiety (DAFLE/LE) declined between 2013 and 2018. DAFLE/LE in urban areas was higher than in rural areas. Men had higher DAFLE/LE than women. From 2013 to 2018, the DAFLE aged 15 decreased by 0.18 years for urban men and decreased by 0.52 years for urban women, rural areas also decreased to varying degrees. Conclusions: Even if women had a longer life span than men, they would spend more time with depression or anxiety. DAFLE did not increase with the increase in LE from 2013 to 2018, suggesting an absolute expansion of the burden, especially in rural areas. Depression and anxiety health services in Jiangxi, China will face more serious obstacles and challenges, which may lead to more disability. This requires more attention and more effective measures from the public, medical departments and the government.
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Gupta A, Dhar R, Patadia P, Funaro M, Bhattacharya G, Farheen SA, Tampi RR. A systematic review of ketamine for the treatment of depression among older adults. Int Psychogeriatr 2021; 33:179-191. [PMID: 32600480 DOI: 10.1017/s1041610220000903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To review the currently available data on the use of ketamine in the treatment of depression among older adults from randomized controlled studies. DESIGN Randomized controlled trials. SETTING Variable. PARTICIPANTS 60 years and older with depression. INTERVENTION Ketamine. MEASUREMENTS Change in Montgomery-Asberg Depression Rating Scale (MADRS) scores. RESULTS Two studies met the inclusion criteria. The first study showed a significant reduction in depression symptoms with use of repeated subcutaneous ketamine administration among older adults with depression. The second study failed to achieve significance on its primary outcome measure but did show a decrease in MADRS scores with intranasal ketamine along with a higher response and remission rates in esketamine group compared with the placebo group. The adverse effects from ketamine generally lasted only a few hours and abated spontaneously. No cognitive adverse effects were noted in either trial from the use of ketamine. CONCLUSIONS The current evidence for use of ketamine among older adults with depression indicates some benefits with one positive and one negative trial. Although one of the trials did not achieve significance on the primary outcome measure, it still showed benefit of ketamine in reducing depressive symptoms. Ketamine was well tolerated in both studies with adverse effects being mild and transient.
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Affiliation(s)
- Aarti Gupta
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Romika Dhar
- Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Palak Patadia
- Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Melissa Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA
| | | | - Syeda A Farheen
- Department of Psychiatry, Case Western Reserve University MetroHealth Program, Cleveland, OH, USA
| | - Rajesh R Tampi
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry and Behavioral Sciences, Cleveland Clinic Akron General, Akron, OH, USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
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Mashaba BL, Moodley SV, Ledibane NRT. Screening for depression at the primary care level: Evidence for policy decision-making from a facility in Pretoria, South Africa. S Afr Fam Pract (2004) 2021; 63:e1-e7. [PMID: 33567836 PMCID: PMC8378166 DOI: 10.4102/safp.v63i1.5217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Depression is a serious public health issue that has clinical, social and economic implications. Adult patients attending a primary healthcare (PHC) facility were screened in order to estimate the prevalence of depressive features and identify potential risk factors for screening positive. Methods This was an analytical cross-sectional study conducted at a clinic in Pretoria, South Africa. A self-administered questionnaire, which included the Patient Health Questionnaire-9 (PHQ-9) screening tool, was completed by patients attending the clinic. A PHQ-9 score of less than five was deemed as a negative screen for depressive features; with a score of five or more being considered a positive screen. A multivariate logistic regression model was developed to identify factors associated with a positive screen for depressive features. Results A total of 199 patients participated and the proportion screened positive for depressive features using the PHQ-9 tool was 46.23% (n = 92). Employed participants had significantly lower odds (odds ratio [OR] = 0.48; 95% confidence interval [CI]: 0.25 – 0.94) of screening positive, whilst the participants with significantly higher odds were those with co-morbidities (OR = 2.12; 95% CI: 1.08 – 4.17) and a history of stressful life events (OR = 3.21; 95% CI: 1.64 – 6.28). Conclusion Depression appears to be a significant problem in PHC settings in South Africa. Screening for depressive features at primary level, targeting those with chronic medical conditions, history of recent stressful life events and other known risk factors may improve detection rates, lead to earlier diagnosis and improved health outcomes.
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Affiliation(s)
- Bahupileng L Mashaba
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, Gauteng Department of Health, Pretoria.
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Páez G, Lopez Gabeiras P, Moreno D'Anna M. Alcance de la calidad de vida en atención médica. PERSONA Y BIOÉTICA 2020. [DOI: 10.5294/pebi.2020.24.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
La expresión calidad de vida tiene un uso cada vez más generalizado en la práctica biomédica, sobre todo en situaciones de final de la vida. La experiencia demuestra que, muchas veces, esa expresión se emplea con alcances muy diversos, en ocasiones contrapuestos. En el presente artículo se exponen los resultados de una revisión bibliográfica que muestra tlas diferentes posturas y se propone una delimitación del tema. El análisis compara los términos “calidad de vida”, “dignidad humana” y “valor de la vida humana”.
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Moshe I, Terhorst Y, Cuijpers P, Cristea I, Pulkki-Råback L, Sander L. Three Decades of Internet- and Computer-Based Interventions for the Treatment of Depression: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2020; 9:e14860. [PMID: 32207695 PMCID: PMC7139420 DOI: 10.2196/14860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Depression is one of the leading causes of disability worldwide. Internet- and computer-based interventions (IBIs) have been shown to provide effective, scalable forms of treatment. More than 100 controlled trials and a growing number of meta-analyses published over the past 30 years have demonstrated the efficacy of IBIs in reducing symptoms in the short and long term. Despite the large body of research, no comprehensive review or meta-analysis has been conducted to date that evaluates how the effectiveness of IBIs has evolved over time. OBJECTIVE This systematic review and meta-analysis aims to evaluate whether there has been a change in the effectiveness of IBIs on the treatment of depression over the past 30 years and to identify potential variables moderating the effect size. METHODS A sensitive search strategy will be executed across the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and PsycINFO. Data extraction and evaluation will be conducted by two independent researchers. Risk of bias will be assessed. A multilevel meta-regression model will be used to analyze the data and estimate effect size. RESULTS The search was completed in mid-2019. We expect the results to be submitted for publication in early 2020. CONCLUSIONS The year 2020 will mark 30 years since the first paper was published on the use of IBIs for the treatment of depression. Despite the large and rapidly growing body of research in the field, evaluations of effectiveness to date are missing the temporal dimension. This review will address that gap and provide valuable analysis of how the effectiveness of interventions has evolved over the past three decades; which participant-, intervention-, and study-related variables moderate changes in effectiveness; and where research in the field may benefit from increased focus. TRIAL REGISTRATION PROSPERO CRD42019136554; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136554. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/14860.
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Affiliation(s)
- Isaac Moshe
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yannik Terhorst
- Department of Research Methods, University of Ulm, Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ioana Cristea
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Lasse Sander
- Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
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Hsu CL, Tsai SJ, Shen CC, Lu T, Hung YM, Hu LY. Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study. BMJ Open 2019; 9:e026936. [PMID: 30928959 PMCID: PMC6475146 DOI: 10.1136/bmjopen-2018-026936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The association between depression and benign paroxysmal positional vertigo (BPPV) remains debated. This study aimed to investigate the risk of BPPV in patients with depressive disorders. DESIGN Longitudinal nationwide cohort study. SETTING National health insurance research database in Taiwan. PARTICIPANTS We enrolled 10 297 patients diagnosed with depressive disorders between 2000 and 2009 and compared them to 41 188 selected control patients who had never been diagnosed with depressive disorders (at a 1:4 ratio matched by age, sex and index date) in relation to the risk of developing BPPV. METHODS The follow-up period was defined as the time from the initial diagnosis of depressive disorders to the date of BPPV, censoring or 31 December 2009. Cox proportional hazard regression analysis was used to investigate the risk of BPPV by sex, age and comorbidities, with HRs and 95% CIs. RESULTS During the 9-year follow-up period, 44 (0.59 per 1000 person-years) patients with depressive disorders and 99 (0.33 per 1000 person-years) control patients were diagnosed with BPPV. The incidence rate ratio of BPPV among both cohorts calculating from events of BPPV per 1000 person-years of observation time was 1.79 (95% CI 1.23 to 2.58, p=0.002). Following adjustments for age, sex and comorbidities, patients with depressive disorders were 1.55 times more likely to develop BPPV (95% CI 1.08 to 2.23, p=0.019) as compared with control patients. In addition, hyperthyroidism (HR=3.75, 95% CI 1.67-8.42, p=0.001) and systemic lupus erythematosus (SLE) (HR=3.47, 95% CI 1.07 to 11.22, p=0.038) were potential risk factors for developing BPPV in patients with depressive disorders. CONCLUSIONS Patients with depressive disorders may have an increased risk of developing BPPV, especially those who have hyperthyroidism and SLE.
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Affiliation(s)
- Chiao-Lin Hsu
- Department of Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
- Department of Medical Education and Research and Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shih-Jen Tsai
- Top Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Che Shen
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Taichung Veterans General Hospital Chiayi Branch, Chiayi, Taiwan
| | - Ti Lu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yao-Min Hung
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Yu Hu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Top Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Social Work, Soochow University, Taipei, Taiwan
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Matsuyama Y, Tsakos G, Listl S, Aida J, Watt R. Impact of Dental Diseases on Quality-Adjusted Life Expectancy in US Adults. J Dent Res 2019; 98:510-516. [DOI: 10.1177/0022034519833353] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Comparing the burden of dental conditions to other health outcomes provides useful insight for public policy. We aimed to estimate quality-adjusted life expectancy (QALE) loss due to dental conditions in the US adult population. Social inequalities in QALE loss by dental conditions were also examined. Data from 3 cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES waves 2001 to 2002, 2003 to 2004, and 2011 to 2012) were pooled and analyzed. The average age of study participants ( n = 9,445) was 48.4 y. Disutility scores were derived from self-rated health and the numbers of physically unhealthy days, mentally unhealthy days, and days with activity limitation, employing a previously published algorithm. The associations between the disutility scores and the numbers of decayed teeth, missing teeth, and periodontitis were examined by multiple linear regression stratified by age groups (20–39, 40–59, and ≥60 y), adjusted for other covariates (age, sex, wave fixed effect, educational attainment, smoking, and diabetes). The QALE loss due to dental conditions at the age of 20 was estimated using life tables. Decayed and missing teeth, but not periodontitis, were associated with a larger disutility score. The coefficient for decayed teeth was larger among the older population, whereas that of missing teeth was smaller among them. The estimated QALE loss was 0.43 y (95% confidence interval [CI], 0.28–0.59), which reached 5.3% of QALE loss (8.15 y; 95% CI, 8.03–8.27) due to overall morbidity. There were clear social gradients in QALE loss by dental conditions across the life course, and people with high school or less education had 0.32 y larger QALE loss in total compared with people with college or more education. This study suggests that improvements in people’s dental health may yield substantial gains in population health and well-being. The necessity of more comprehensive public health strategies is highlighted.
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Affiliation(s)
- Y. Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Japan
- Department of Epidemiology and Public Health, University College London, London, UK
| | - G. Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - S. Listl
- Department of Dentistry-Chair for Quality and Safety of Oral Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Conservative Dentistry–Section for Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - J. Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - R.G. Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Quality-adjusted Life Years (QALY) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older. Med Care 2018; 56:740-746. [DOI: 10.1097/mlr.0000000000000943] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jia H, Zack MM, Gottesman II, Thompson WW. Associations of Smoking, Physical Inactivity, Heavy Drinking, and Obesity with Quality-Adjusted Life Expectancy among US Adults with Depression. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:364-371. [PMID: 29566844 DOI: 10.1016/j.jval.2017.08.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 07/20/2017] [Accepted: 08/05/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To examine associations between four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity) and three health indices (health-related quality of life, life expectancy, and quality-adjusted life expectancy (QALE)) among US adults with depression. METHODS Data were obtained from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System data. The EuroQol five-dimensional questionnaire (EQ-5D) health preference scores were estimated on the basis of extrapolations from the Centers for Disease Control and Prevention's healthy days measures. Depression scores were estimated using the eight-item Patient Health Questionnaire. Life expectancy estimates were obtained from US life tables, and QALE was estimated from a weighted combination of the EQ-5D scores and the life expectancy estimates. Outcomes were summarized by depression status for the four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity). RESULTS For depressed adults, current smokers and the physically inactive had significantly lower EQ-5D scores (0.040 and 0.171, respectively), shorter life expectancy (12.9 and 10.8 years, respectively), and substantially less QALE (8.6 and 10.9 years, respectively). For nondepressed adults, estimated effects were similar but smaller. Heavy alcohol drinking among depressed adults, paradoxically, was associated with higher EQ-5D scores but shorter life expectancy. Obesity was strongly associated with lower EQ-5D scores but only weakly associated with shorter life expectancy. CONCLUSIONS Among depressed adults, physical inactivity and smoking were strongly associated with lower EQ-5D scores, life expectancy, and QALE, whereas obesity and heavy drinking were only weakly associated with these indices. These results suggest that reducing physical inactivity and smoking would improve health more among depressed adults.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, NY, USA.
| | - Matthew M Zack
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Irving I Gottesman
- Departments of Psychology and Psychiatry, University of Minnesota, Twin Cities, MN, USA
| | - William W Thompson
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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35
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Joshi PK, Pirastu N, Kentistou KA, Fischer K, Hofer E, Schraut KE, Clark DW, Nutile T, Barnes CLK, Timmers PRHJ, Shen X, Gandin I, McDaid AF, Hansen TF, Gordon SD, Giulianini F, Boutin TS, Abdellaoui A, Zhao W, Medina-Gomez C, Bartz TM, Trompet S, Lange LA, Raffield L, van der Spek A, Galesloot TE, Proitsi P, Yanek LR, Bielak LF, Payton A, Murgia F, Concas MP, Biino G, Tajuddin SM, Seppälä I, Amin N, Boerwinkle E, Børglum AD, Campbell A, Demerath EW, Demuth I, Faul JD, Ford I, Gialluisi A, Gögele M, Graff M, Hingorani A, Hottenga JJ, Hougaard DM, Hurme MA, Ikram MA, Jylhä M, Kuh D, Ligthart L, Lill CM, Lindenberger U, Lumley T, Mägi R, Marques-Vidal P, Medland SE, Milani L, Nagy R, Ollier WER, Peyser PA, Pramstaller PP, Ridker PM, Rivadeneira F, Ruggiero D, Saba Y, Schmidt R, Schmidt H, Slagboom PE, Smith BH, Smith JA, Sotoodehnia N, Steinhagen-Thiessen E, van Rooij FJA, Verbeek AL, Vermeulen SH, Vollenweider P, Wang Y, Werge T, Whitfield JB, Zonderman AB, Lehtimäki T, Evans MK, Pirastu M, Fuchsberger C, Bertram L, Pendleton N, Kardia SLR, Ciullo M, Becker DM, Wong A, Psaty BM, van Duijn CM, Wilson JG, Jukema JW, Kiemeney L, Uitterlinden AG, et alJoshi PK, Pirastu N, Kentistou KA, Fischer K, Hofer E, Schraut KE, Clark DW, Nutile T, Barnes CLK, Timmers PRHJ, Shen X, Gandin I, McDaid AF, Hansen TF, Gordon SD, Giulianini F, Boutin TS, Abdellaoui A, Zhao W, Medina-Gomez C, Bartz TM, Trompet S, Lange LA, Raffield L, van der Spek A, Galesloot TE, Proitsi P, Yanek LR, Bielak LF, Payton A, Murgia F, Concas MP, Biino G, Tajuddin SM, Seppälä I, Amin N, Boerwinkle E, Børglum AD, Campbell A, Demerath EW, Demuth I, Faul JD, Ford I, Gialluisi A, Gögele M, Graff M, Hingorani A, Hottenga JJ, Hougaard DM, Hurme MA, Ikram MA, Jylhä M, Kuh D, Ligthart L, Lill CM, Lindenberger U, Lumley T, Mägi R, Marques-Vidal P, Medland SE, Milani L, Nagy R, Ollier WER, Peyser PA, Pramstaller PP, Ridker PM, Rivadeneira F, Ruggiero D, Saba Y, Schmidt R, Schmidt H, Slagboom PE, Smith BH, Smith JA, Sotoodehnia N, Steinhagen-Thiessen E, van Rooij FJA, Verbeek AL, Vermeulen SH, Vollenweider P, Wang Y, Werge T, Whitfield JB, Zonderman AB, Lehtimäki T, Evans MK, Pirastu M, Fuchsberger C, Bertram L, Pendleton N, Kardia SLR, Ciullo M, Becker DM, Wong A, Psaty BM, van Duijn CM, Wilson JG, Jukema JW, Kiemeney L, Uitterlinden AG, Franceschini N, North KE, Weir DR, Metspalu A, Boomsma DI, Hayward C, Chasman D, Martin NG, Sattar N, Campbell H, Esko T, Kutalik Z, Wilson JF. Genome-wide meta-analysis associates HLA-DQA1/DRB1 and LPA and lifestyle factors with human longevity. Nat Commun 2017; 8:910. [PMID: 29030599 PMCID: PMC5715013 DOI: 10.1038/s41467-017-00934-5] [Show More Authors] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/08/2017] [Indexed: 01/03/2023] Open
Abstract
Genomic analysis of longevity offers the potential to illuminate the biology of human aging. Here, using genome-wide association meta-analysis of 606,059 parents’ survival, we discover two regions associated with longevity (HLA-DQA1/DRB1 and LPA). We also validate previous suggestions that APOE, CHRNA3/5, CDKN2A/B, SH2B3 and FOXO3A influence longevity. Next we show that giving up smoking, educational attainment, openness to new experience and high-density lipoprotein (HDL) cholesterol levels are most positively genetically correlated with lifespan while susceptibility to coronary artery disease (CAD), cigarettes smoked per day, lung cancer, insulin resistance and body fat are most negatively correlated. We suggest that the effect of education on lifespan is principally mediated through smoking while the effect of obesity appears to act via CAD. Using instrumental variables, we suggest that an increase of one body mass index unit reduces lifespan by 7 months while 1 year of education adds 11 months to expected lifespan. Variability in human longevity is genetically influenced. Using genetic data of parental lifespan, the authors identify associations at HLA-DQA/DRB1 and LPA and find that genetic variants that increase educational attainment have a positive effect on lifespan whereas increasing BMI negatively affects lifespan.
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Affiliation(s)
- Peter K Joshi
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK.
| | - Nicola Pirastu
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Katherine A Kentistou
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK.,Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, Scotland
| | - Krista Fischer
- Estonian Genome Center, University of Tartu, University of Tartu, Tartu, 51010, Estonia
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, 8036, Austria.,Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, 8036, Austria
| | - Katharina E Schraut
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK.,Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, Scotland
| | - David W Clark
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Teresa Nutile
- Institute of Genetics and Biophysics "A. Buzzati-Traverso" - CNR, Naples, 80131, Italy
| | - Catriona L K Barnes
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Paul R H J Timmers
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Xia Shen
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Ilaria Gandin
- Department of Medical Sciences, University of Trieste, Trieste, 34100, Italy.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, 34137, Italy
| | - Aaron F McDaid
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, 1010, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, 1015, Switzerland
| | - Thomas Folkmann Hansen
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Mental Health Services Copenhagen, Roskilde, DK-4000, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, DK-8000, Denmark
| | - Scott D Gordon
- QIMR Berghofer Institute of Medical Research, Brisbane, QLD, 4006, Australia
| | - Franco Giulianini
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, 02215, USA
| | - Thibaud S Boutin
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - Abdel Abdellaoui
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam Public Health Institute (APH), Amsterdam, 1081BT, Netherlands
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, 98101, USA
| | - Stella Trompet
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, 2300RC, The Netherlands.,Department of Cardiology, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
| | - Leslie A Lange
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Laura Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Ashley van der Spek
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - Tessel E Galesloot
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, 6500 HB, The Netherlands
| | - Petroula Proitsi
- MRC Unit for Lifelong Health & Ageing at UCL, University College London, London, WC1B 5JU, UK
| | - Lisa R Yanek
- Department of Medicine, GeneSTAR Research Program, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lawrence F Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Antony Payton
- Centre for Epidemiology, Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, Greater, Manchester, M13 9PL, UK
| | - Federico Murgia
- Center for Biomedicine, European Academy of Bozen/Bolzano (EURAC), (Affiliated Institute of the University of Lübeck, Lübeck, Germany), Bolzano, 39100, Italy
| | - Maria Pina Concas
- Institute of Genetic and Biomedical Research - Support Unity, National Research Council of Italy, Sassari, 07100, Italy
| | - Ginevra Biino
- Institute of Molecular Genetics, National Research Council of Italy, Pavia, 27100, Italy
| | - Salman M Tajuddin
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore City, MD, 21224, USA
| | - Ilkka Seppälä
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33014, Finland
| | - Najaf Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - Eric Boerwinkle
- Health Science Center at Houston, UTHealth School of Public Health, University of Texas, Houston, TX, 77030, USA
| | - Anders D Børglum
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, DK-8000, Denmark.,Department of Biomedicine-Human Genetics, Aarhus University, DK-8000, Aarhus C, Denmark.,Centre for Integrative Sequencing, iSEQ, Aarhus University, DK-8000, Aarhus C, Denmark
| | - Archie Campbell
- Centre for Genomic & Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Ellen W Demerath
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Ilja Demuth
- Charité Research Group on Geriatrics, Charité, Universitätsmedizin Berlin, Berlin, 13347, Germany.,Lipid Clinic at the Interdisciplinary Metabolism Center, Charité, Universitätsmedizin Berlin, Berlin, 13353, Germany.,Institute for Medical and Human Genetics, Charité, Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Jessica D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48014, USA
| | - Ian Ford
- Robertson Center for biostatistics, University of Glasgow, Glasgow, G12 8QQ, UK
| | | | - Martin Gögele
- Center for Biomedicine, European Academy of Bozen/Bolzano (EURAC), (Affiliated Institute of the University of Lübeck, Lübeck, Germany), Bolzano, 39100, Italy
| | - MariaElisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27514, USA
| | - Aroon Hingorani
- Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam Public Health Institute (APH), Amsterdam, 1081BT, Netherlands
| | - David M Hougaard
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, DK-8000, Denmark.,Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, 2300, Denmark
| | - Mikko A Hurme
- Department of Microbiology and Immunology, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33014, Finland
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - Marja Jylhä
- Gerontology Research Center, Tampere, Finland, Faculty of Social Sciences, University of Tampere, Tampere, 33104, Finland
| | - Diana Kuh
- MRC Unit for Lifelong Health & Ageing at UCL, University College London, London, WC1B 5JU, UK
| | - Lannie Ligthart
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam Public Health Institute (APH), Amsterdam, 1081BT, Netherlands
| | - Christina M Lill
- Genetic and Molecular Epidemiology Group, Institute of Neurogenetics, University of Lübeck, 23562, Lübeck, Germany
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, 14195, Germany.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, 14195, Germany
| | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, 1010, New Zealand
| | - Reedik Mägi
- Estonian Genome Center, University of Tartu, University of Tartu, Tartu, 51010, Estonia
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, 1011, Switzerland
| | - Sarah E Medland
- QIMR Berghofer Institute of Medical Research, Brisbane, QLD, 4006, Australia
| | - Lili Milani
- Estonian Genome Center, University of Tartu, University of Tartu, Tartu, 51010, Estonia
| | - Reka Nagy
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - William E R Ollier
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, Greater Manchester, M13 9PL, UK
| | - Patricia A Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Peter P Pramstaller
- Center for Biomedicine, European Academy of Bozen/Bolzano (EURAC), (Affiliated Institute of the University of Lübeck, Lübeck, Germany), Bolzano, 39100, Italy
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, 02215, USA.,TH Chan School of Public Health, Harvard Medical School, Boston, MA, 02115, USA
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - Daniela Ruggiero
- Institute of Genetics and Biophysics "A. Buzzati-Traverso" - CNR, Naples, 80131, Italy
| | - Yasaman Saba
- Austrian Stroke Prevention Study, Institute of Molecular Biology and Biochemistry, Centre for Molecular Medicine, Medical University of Graz, Graz, 8010, Austria
| | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Helena Schmidt
- Austrian Stroke Prevention Study, Institute of Molecular Biology and Biochemistry, Centre for Molecular Medicine, Medical University of Graz, Graz, 8010, Austria
| | - P Eline Slagboom
- Section of Molecular Epidemiology, Department of medical statistics, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
| | - Blair H Smith
- Division of Population Health Sciences, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48014, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, University of Washington, Seattle, WA, 98101, USA
| | | | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - André L Verbeek
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, 6500 HB, The Netherlands
| | - Sita H Vermeulen
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, 6500 HB, The Netherlands
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, 1011, Switzerland
| | - Yunpeng Wang
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, DK-8000, Denmark.,NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, 0450, Norway
| | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Mental Health Services Copenhagen, Roskilde, DK-4000, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, DK-8000, Denmark
| | - John B Whitfield
- QIMR Berghofer Institute of Medical Research, Brisbane, QLD, 4006, Australia
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore City, MD, 21224, USA
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33014, Finland
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore City, MD, 21224, USA
| | - Mario Pirastu
- Institute of Genetic and Biomedical Research - Support Unity, National Research Council of Italy, Sassari, 07100, Italy
| | - Christian Fuchsberger
- Center for Biomedicine, European Academy of Bozen/Bolzano (EURAC), (Affiliated Institute of the University of Lübeck, Lübeck, Germany), Bolzano, 39100, Italy
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, Institutes of Neurogenetics & Cardiogenetics, University of Lübeck, Lübeck, 23562, Germany.,Neuroepidemiology and Ageing Research Group, School of Public Health, Imperial College, London, W6 8RP, UK
| | - Neil Pendleton
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, Greater Manchester, M13 9PL, UK
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Marina Ciullo
- Institute of Genetics and Biophysics "A. Buzzati-Traverso" - CNR, Naples, 80131, Italy.,IRCCS Neuromed, Pozzilli (IS), 86077, Italy
| | - Diane M Becker
- Department of Medicine, GeneSTAR Research Program, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Andrew Wong
- MRC Unit for Lifelong Health & Ageing at UCL, University College London, London, WC1B 5JU, UK
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Epidemiology, Medicine and Health Services, University of Washington, Seattle, WA, 98101, USA.,Kaiser Permanente Washington Health Research Institute, Seattle, WA, 98101, USA
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - James G Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, 2300RC, The Netherlands
| | - Lambertus Kiemeney
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, 6500 HB, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3015 CN, Netherlands
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27514, USA
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27514, USA
| | - David R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48014, USA
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, University of Tartu, Tartu, 51010, Estonia
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam Public Health Institute (APH), Amsterdam, 1081BT, Netherlands
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - Daniel Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, 02215, USA.,TH Chan School of Public Health, Harvard Medical School, Boston, MA, 02115, USA
| | - Nicholas G Martin
- QIMR Berghofer Institute of Medical Research, Brisbane, QLD, 4006, Australia
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TD, UK
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Tōnu Esko
- Estonian Genome Center, University of Tartu, University of Tartu, Tartu, 51010, Estonia.,Program in Medical and Population Genetics, Broad Institute, Broad Institute, Cambridge, MA, 02142, USA
| | - Zoltán Kutalik
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, 1010, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, 1015, Switzerland
| | - James F Wilson
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK.,MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
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36
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Merrick MT, Ports KA, Ford DC, Afifi TO, Gershoff ET, Grogan-Kaylor A. Unpacking the impact of adverse childhood experiences on adult mental health. CHILD ABUSE & NEGLECT 2017; 69:10-19. [PMID: 28419887 PMCID: PMC6007802 DOI: 10.1016/j.chiabu.2017.03.016] [Citation(s) in RCA: 409] [Impact Index Per Article: 51.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/10/2017] [Accepted: 03/23/2017] [Indexed: 05/05/2023]
Abstract
Exposure to childhood adversity has an impact on adult mental health, increasing the risk for depression and suicide. Associations between Adverse Childhood Experiences (ACEs) and several adult mental and behavioral health outcomes are well documented in the literature, establishing the need for prevention. The current study analyzes the relationship between an expanded ACE score that includes being spanked as a child and adult mental health outcomes by examining each ACE separately to determine the contribution of each ACE. Data were drawn from Wave II of the CDC-Kaiser ACE Study, consisting of 7465 adult members of Kaiser Permanente in southern California. Dichotomous variables corresponding to each of the 11 ACE categories were created, with ACE score ranging from 0 to 11 corresponding to the total number of ACEs experienced. Multiple logistic regression modeling was used to examine the relationship between ACEs and adult mental health outcomes adjusting for sociodemographic covariates. Results indicated a graded dose-response relationship between the expanded ACE score and the likelihood of moderate to heavy drinking, drug use, depressed affect, and suicide attempts in adulthood. In the adjusted models, being spanked as a child was significantly associated with all self-reported mental health outcomes. Over 80% of the sample reported exposure to at least one ACE, signifying the potential to capture experiences not previously considered by traditional ACE indices. The findings highlight the importance of examining both cumulative ACE scores and individual ACEs on adult health outcomes to better understand key risk and protective factors for future prevention efforts.
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Affiliation(s)
- Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Derek C Ford
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Canada.
| | - Elizabeth T Gershoff
- Department of Human Development and Family Sciences, University of Texas at Austin, United States.
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37
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Quality of life independently predicts long-term mortality but not vascular events: the Northern Manhattan Study. Qual Life Res 2017; 26:2219-2228. [PMID: 28357682 DOI: 10.1007/s11136-017-1567-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Cardiovascular disease is a major contributor to morbidity and mortality, and prevention relies on accurate identification of those at risk. Studies of the association between quality of life (QOL) and mortality and vascular events incompletely accounted for depression, cognitive status, social support, and functional status, all of which have an impact on vascular outcomes. We hypothesized that baseline QOL is independently associated with long-term mortality in a large, multi-ethnic urban cohort. METHODS In the prospective, population-based Northern Manhattan Study, Spitzer QOL index (SQI, range 0-10, with ten signifying the highest QOL) was assessed at baseline. Participants were followed over a median 11 years for stroke, myocardial infarction (MI), and vascular and non-vascular death. Multivariable Cox proportional hazards regression estimated hazard ratio and 95% confidence interval (HR, 95% CI) for each outcome, with SQI as the main predictor, dichotomized at 10, adjusting for baseline demographics, vascular risk factors, history of cancer, social support, cognitive status, depression, and functional status. RESULTS Among 3298 participants, mean age was 69.7 + 10.3 years; 1795 (54.5%) had SQI of 10. In fully adjusted models, SQI of 10 (compared to SQI <10) was associated with reduced risk of all-cause mortality (HR 0.80, 95% CI 0.72-0.90), vascular death (0.81, 0.69-0.97), non-vascular death (0.78, 0.67-0.91), and stroke or MI or death (0.82, 0.74-0.91). In fully adjusted competing risk models, there was no association with stroke (0.93, 0.74-1.17), MI (0.98, 0.75-1.28), and stroke or MI (1.03, 0.86-1.24). Results were consistent when SQI was analyzed continuously. CONCLUSION In this large population-based cohort, highest QOL was inversely associated with long-term mortality, vascular and non-vascular, independently of baseline primary vascular risk factors, social support, cognition, depression, and functional status. QOL was not associated with non-fatal vascular events.
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Jia H, Lubetkin EI. Incremental decreases in quality-adjusted life years (QALY) associated with higher levels of depressive symptoms for U.S. Adults aged 65 years and older. Health Qual Life Outcomes 2017; 15:9. [PMID: 28077154 PMCID: PMC5225616 DOI: 10.1186/s12955-016-0582-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 12/19/2016] [Indexed: 01/22/2023] Open
Abstract
Background Quality-adjusted life years (QALY) is a single value index that quantifies the overall burden of disease. It reflects all aspects of heath, including nonfatal illness and mortality outcomes by weighting life-years lived with health-related quality of life (HRQOL) scores. This study examine the burden of disease due to increasing levels of depressive symptoms by examining the association between the 9-item Patient Health Questionnaire (PHQ-9) scores and QALY for U.S. adults aged 65 years and older. Methods We ascertained respondents’ HRQOL scores and mortality status from the 2005–2006, 2007–2008, and 2009–2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up data through December 31, 2011. This analysis included respondents aged 65 years and older (n = 3,680). We estimated the mean QALY throughout the remaining lifetime according to participants’ depression severity categories: none or minimal (PHQ-9 score 0–4), mild (5–9), moderate (10–14), and moderately severs and severe (15 or higher). We estimated QALY loss due to major depressive disorder (PHQ-9 score 10 or higher) and to mild depression (5–9). Results The QALY for persons with none/minimal, mild, moderate, and moderately severe/severe depression were 14.0, 7.8, 4.7, and 3.3 years, respectively. Compared to persons without major depressive disorder, persons with major depressive disorder had 8.3 fewer QALY (12.7 vs. 4.4), or a 65% loss. Compared to persons who reported “none” or minimal depressive symptoms, persons who reported mild depressive symptoms had 6.2 fewer QALY (14.0 vs. 7.8), or a 44% loss. The same patterns were noted in demographic and socioeconomic subgroups and according to number of comorbidities. Conclusions This study not only confirmed the significant burden of disease for major depressive disorder among the U.S. elderly, but also showed an incremental decrease in QALY with an increasing severity of depressive symptoms as well as significant QALY loss due to mild depression. Specifically, individuals with higher (or more impaired) PHQ-9 scores had significantly fewer QALYs and our findings of fewer years of QALY for persons with major depressive disorder and mild depression were not only statistically significant but also clinically important.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10032, USA.
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY, USA
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Steensma C, Loukine L, Orpana H, McRae L, Vachon J, Mo F, Boileau-Falardeau M, Reid C, Choi BC. Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada. Health Promot Chronic Dis Prev Can 2016; 36:205-213. [PMID: 27768557 PMCID: PMC5158123 DOI: 10.24095/hpcdp.36.10.01] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Few studies have evaluated the impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQOL) on the overall population. Health-adjusted life expectancy (HALE) is a summary measure of population health that combines both morbidity and mortality into a single summary statistic that describes the current health status of a population. METHODS We estimated HALE for the Canadian adult population according to depression status. National Population Health Survey (NPHS) participants 20 years and older (n = 12 373) were followed for mortality outcomes from 1994 to 2009, based on depression status. Depression was defined as having likely experienced a major depressive episode in the previous year as measured by the Composite International Diagnostic Interview Short Form. Life expectancy was estimated by building period abridged life tables by sex and depression status using the relative risks of mortality from the NPHS and mortality data from the Canadian Chronic Disease Surveillance System (2007-2009). The Canadian Community Health Survey (2009/10) provided estimates of depression prevalence and Health Utilities Index as a measure of HRQOL. Using the combined mortality, depression prevalence and HRQOL estimates, HALE was estimated for the adult population according to depression status and by sex. RESULTS For the population of women with a recent major depressive episode, HALE at 20 years of age was 42.0 years (95% CI: 40.2-43.8) compared to 57.0 years (95% CI: 56.8-57.2) for women without a recent major depressive episode. For the population of Canadian men, HALE at 20 was 39.0 years (95% CI: 36.5-41.5) for those with a recent major depressive episode compared to 53.8 years (95% CI: 53.6-54.0) for those without. For the 15.0-year difference in HALE between women with and without depression, 12.3 years can be attributed to the HRQOL gap and the remaining 2.7 years to the mortality gap. The 14.8 fewer years of HALE observed for men with depression equated to a 13.0-year HRQOL gap and a 1.8-year mortality gap. CONCLUSION The population of adult men and women with depression in Canada had substantially lower healthy life expectancy than those without depression. Much of this gap is explained by lower levels of HRQOL, but premature mortality also plays a role.
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Affiliation(s)
- C Steensma
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - L Loukine
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
| | - H Orpana
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - L McRae
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
| | - J Vachon
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
| | - F Mo
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
| | - M Boileau-Falardeau
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - C Reid
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
| | - B C Choi
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Bossard C, Santin G, Guseva Canu I. Suicide Among Farmers in France: Occupational Factors and Recent Trends. J Agromedicine 2016; 21:310-5. [DOI: 10.1080/1059924x.2016.1211052] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tracking search engine queries for suicide in the United Kingdom, 2004-2013. Public Health 2016; 137:147-53. [PMID: 26976489 DOI: 10.1016/j.puhe.2015.10.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 09/20/2015] [Accepted: 10/29/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVES First, to determine if a cyclical trend is observed for search activity of suicide and three common suicide risk factors in the United Kingdom: depression, unemployment, and marital strain. Second, to test the validity of suicide search data as a potential marker of suicide risk by evaluating whether web searches for suicide associate with suicide rates among those of different ages and genders in the United Kingdom. STUDY DESIGN Cross-sectional. METHODS Search engine data was obtained from Google Trends, a publicly available repository of information of trends and patterns of user searches on Google. The following phrases were entered into Google Trends to analyse relative search volume for suicide, depression, job loss, and divorce, respectively: 'suicide'; 'depression + depressed + hopeless'; 'unemployed + lost job'; 'divorce'. Spearman's rank correlation coefficient was employed to test bivariate associations between suicide search activity and official suicide rates from the Office of National Statistics (ONS). RESULTS Cyclical trends were observed in search activity for suicide and depression-related search activity, with peaks in autumn and winter months, and a trough in summer months. A positive, non-significant association was found between suicide-related search activity and suicide rates in the general working-age population (15-64 years) (ρ = 0.164; P = 0.652). This association is stronger in younger age groups, particularly for those 25-34 years of age (ρ = 0.848; P = 0.002). CONCLUSIONS We give credence to a link between search activity for suicide and suicide rates in the United Kingdom from 2004 to 2013 for high risk sub-populations (i.e. male youth and young professionals). There remains a need for further research on how Google Trends can be used in other areas of disease surveillance and for work to provide greater geographical precision, as well as research on ways of mitigating the risk of internet use leading to suicide ideation in youth.
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Brown DS, Trogdon JG, Ekwueme DU, Chamiec-Case L, Guy GP, Tangka FK, Li C, Trivers KF, Rodriguez JL. Health State Utility Impact of Breast Cancer in U.S. Women Aged 18-44 Years. Am J Prev Med 2016; 50:255-61. [PMID: 26775904 DOI: 10.1016/j.amepre.2015.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/08/2015] [Accepted: 07/18/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Breast cancer affects women's health-related quality of life negatively, but little is known about how breast cancer affects this in younger women aged 18-44 years. This study measures preference-based health state utility (HSU) values, a scaled index of health-related quality of life for economic evaluation, for younger women with breast cancer and compares these values with same-age women with other cancers and older women (aged ≥45 years) with breast cancer. METHODS Data from the 2009 and 2010 Behavioral Risk Factor Surveillance System were analyzed in 2014. The sample included 218,852 women; 7,433 and 18,577 had histories of breast and other cancers. HSU values were estimated using Healthy Days survey questions and a published mapping algorithm. Linear regression models for HSU were estimated by age group (18-44 and ≥45 years). RESULTS The adjusted breast cancer HSU impact was four times larger for younger women than for older women (-0.097 vs -0.024, p<0.001). For younger women, the effect of breast cancer on HSU was 70% larger than that of other cancers (-0.097 vs -0.057, p=0.024). CONCLUSIONS Younger breast cancer survivors reported lower HSU values than older survivors, highlighting the impact of breast cancer on the physical and mental health of younger women. The estimates may be used to evaluate quality-adjusted life-years or expectancy for prevention or treatment of breast cancer. This study also indicates that separate quality of life adjustments for women by age group are important for economic analysis of public health breast cancer interventions.
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Affiliation(s)
- Derek S Brown
- Brown School, Washington University in St. Louis, St. Louis, Missouri.
| | - Justin G Trogdon
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | - Gery P Guy
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | | | - Chunyu Li
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | | | - Juan L Rodriguez
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
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Jia H, Lubetkin EI. Impact of nine chronic conditions for US adults aged 65 years and older: an application of a hybrid estimator of quality-adjusted life years throughout remainder of lifetime. Qual Life Res 2016; 25:1921-9. [PMID: 26781442 DOI: 10.1007/s11136-016-1226-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE To estimate quality-adjusted life years (QALY) loss due to each of the following nine chronic conditions-depression, diabetes mellitus, hypertension, heart disease, stroke, emphysema, asthma, arthritis, and cancer. METHODS We ascertained respondents' health-related quality of life scores and mortality status from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES) with mortality follow-up data through December 31, 2011. We included respondents aged 65 years and older (n = 2380). A hybrid estimator was used to calculate QALY from two parts: QALY during the follow-up period and QALY beyond the follow-up period. We calculated QALY by each of the nine chronic conditions. RESULTS For persons aged 65 and older, QALY throughout the reminder of lifetime was 12.3 years. After adjusting for age- and sex-related differences, depression had an associated 8.2 years of QALY loss; diabetes, 5.6 years; hypertension, 2.5 years; heart disease, 5.4 years; stroke, 6.4 years; emphysema, 8.0 years; asthma, 4.8 years; arthritis, 0.3 years; and cancer, 2.5 years. Compared to persons without any chronic conditions, persons with one condition had an associated 4.7 years of QALY loss; persons with two conditions, 7.9 years; and persons with three or more conditions, 10.8 years. CONCLUSIONS This study presents a QALY estimator for respondents in the NHANES-Linked Mortality File and demonstrates the utility of this method to other follow-up data. Continued application of our method would enable the burden of disease to be compared for a range of health conditions and risk factors in the ongoing effort to improve population health.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10032, USA.
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education/CUNY Medical School, New York, NY, 10031, USA
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