1
|
Pielage M, El Marroun H, Odendaal HJ, Willemsen SP, Hillegers MHJ, Steegers EAP, Rousian M. Alcohol exposure before and during pregnancy is associated with reduced fetal growth: the Safe Passage Study. BMC Med 2023; 21:318. [PMID: 37612658 PMCID: PMC10463675 DOI: 10.1186/s12916-023-03020-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) is a worldwide public health concern. While PAE is known to be associated with low birth weight, little is known about timing and quantity of PAE on fetal growth. This study investigated the association between periconceptional and prenatal alcohol exposure and longitudinal fetal growth, focusing on timing and quantity in a high exposure cohort. METHODS The Safe Passage Study was a prospective cohort study, including 1698 pregnant women. Two-dimensional transabdominal ultrasound examinations were performed to measure fetal femur length, abdominal and head circumference, and biparietal diameter, at three time points during pregnancy. Estimated fetal weight and Z-scores of all parameters were calculated. Trimester-specific alcohol exposure was assessed using the Timeline Followback method. To investigate the associations of specific timing of PAE and fetal growth, two models were built. One with alcohol exposure as accumulative parameter over the course of pregnancy and one trimester specific model, in which PAE was separately analyzed. Linear mixed models adjusted for potential confounders were applied with repeated assessments of both alcohol exposure and fetal growth outcomes. RESULTS This study demonstrated that periconceptional and prenatal alcohol exposure were associated with reduced fetal growth. Effect sizes are displayed as estimated differences (ED) in Z-score and corresponding 95% confidence intervals (95% CIs). When investigated as accumulative parameter, PAE was related to a smaller femur length (ED30; - 0.13 (95% CI; - 0.22; - 0.04), ED36; - 0.14 (95% CI; - 0.25; - 0.04)) and a smaller abdominal circumference (ED36; - 0.09 (95% CI; - 0.18; - 0.01)). Periconceptional alcohol exposure was associated with a smaller abdominal circumference (ED30; - 0.14 (95% CI; - 0.25; - 0.02), ED36; - 0.22 (95% CI; - 0.37; - 0.06)) and a smaller estimated fetal weight (ED36; - 0.22 (95% CI; - 0.38; - 0.05)). Second trimester alcohol exposure was associated with a smaller abdominal circumference (ED30; - 0.49 (95% CI; - 0.86; - 0.12), ED36; - 0.70 (95% CI; - 1.22; - 0.17)) and estimated fetal weight (ED30; - 0.54 (95% CI; - 0.94; - 0.14), ED36; - 0.69 (95% CI; - 1.25; - 0.14)). No additional association of binge drinking was found besides the already observed association of PAE and fetal growth. CONCLUSIONS This study demonstrated that PAE negatively affects fetal growth, in particular when exposed during the periconception period or in second trimester. Our results indicate that potential negative consequences of PAE are detectable already before birth. Therefore, healthcare providers should actively address and discourage alcohol use during pregnancy.
Collapse
Affiliation(s)
- Marin Pielage
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Sp-4469, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Sophia Children's Hospital, 3000 CB, Rotterdam, the Netherlands
- Department of Psychology, Education and Child Studies - Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Sten P Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Sp-4469, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Sophia Children's Hospital, 3000 CB, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Sp-4469, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Sp-4469, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| |
Collapse
|
2
|
Robinson MN, Erving CL, Thomas Tobin CS. Are Distressed Black Women Also Depressed? Implications for a Mental Health Paradox. J Racial Ethn Health Disparities 2023; 10:1280-1292. [PMID: 35556224 PMCID: PMC9652478 DOI: 10.1007/s40615-022-01313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/17/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Recent research suggests the determinants of and links between psychological distress and psychiatric disorder are distinct among Black Americans. Yet, these associations have not been explored among Black women, despite the unique social experiences, risks, and mental health patterns they face. The present study assessed the sociodemographic and psychosocial determinants of distress and disorder and evaluated the distress-disorder association, including whether it was conditional on sociodemographic and psychosocial characteristics among Black women. METHODS Data were from 328 Black women in the Nashville Stress and Health Study, a cross-sectional community epidemiologic survey of Blacks and Whites in Nashville, Tennessee, and was used to assess the correlates of distress (CES-D depressive symptoms scale) and major depressive disorder (MDD; based on the CIDI). Multinomial logistic regression models estimated the extent to which greater distress was associated with higher risk of "chronic" or "resolved MDD". RESULTS Stress exposure and marital status were associated with greater distress, while stress exposure and childhood SES were associated with elevated disorder risk. Although increased distress was associated with greater disorder risk, significant interactions indicated these associations depend on differences in age and adult socioeconomic status within this population. CONCLUSIONS This study identifies distinct correlates of distress and disorder and shows that the distress-disorder association varies among subgroups of Black women. Results have important implications for public health research and practice, as they highlight the factors that matter most for the mental health outcomes of Black women.
Collapse
Affiliation(s)
- Millicent N Robinson
- Department of Community Health Sciences (Office 21-245), Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA.
| | - Christy L Erving
- Department of Sociology, College of Arts and Science, Vanderbilt University, Nashville, TN, USA
| | - Courtney S Thomas Tobin
- Department of Community Health Sciences (Office 21-245), Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| |
Collapse
|
3
|
Giannelis A, Palmos A, Hagenaars SP, Breen G, Lewis CM, Mutz J. Examining the association between family status and depression in the UK Biobank. J Affect Disord 2021; 279:585-598. [PMID: 33189065 PMCID: PMC7780845 DOI: 10.1016/j.jad.2020.10.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND We examined associations between family status (living with a spouse or partner and number of children) and lifetime depression. METHODS We used data from the UK Biobank, a large prospective study of middle-aged and older adults. Lifetime depression was assessed as part of a follow-up mental health questionnaire. Logistic regression was used to estimate associations between family status and depression. We included extensive adjustment for social, demographic and other potential confounders, including depression polygenic risk scores. RESULTS 52,078 participants (mean age = 63.6, SD = 7.6; 52% female) were included in our analyses. Living with a spouse or partner was associated with substantially lower odds of lifetime depression (OR = 0.67, 95% CI 0.62-0.74). Compared to individuals without children, we found higher odds of lifetime depression for parents of one child (OR = 1.17, 95% CI 1.07-1.27) and parents of three (OR = 1.11, 95% CI 1.03-1.20) or four or more children (OR = 1.27, 95% CI 1.14-1.42). Amongst those not cohabiting, having any number of children was associated with higher odds of lifetime depression. Our results were consistent across age groups, the sexes, neighbourhood deprivation and genetic risk for depression. Exploratory Mendelian randomisation analyses suggested a causal effect of number of children on lifetime depression. LIMITATIONS Our data did not allow distinguishing between non-marital and marital cohabitation. Results may not generalise to all ages or populations. CONCLUSIONS Living with a spouse or partner was strongly associated with reduced odds of depression. Having one or three or more children was associated with increased odds of depression, especially in individuals not living with a spouse or partner.
Collapse
Affiliation(s)
- Alexandros Giannelis
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Alish Palmos
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Saskia P Hagenaars
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Cathryn M Lewis
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Department of Medical and Molecular Genetics, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Julian Mutz
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
| |
Collapse
|
4
|
Johnson-Lawrence V, Scott JB, James SA. Education, perceived discrimination and risk for depression in a southern black cohort. Aging Ment Health 2020; 24:1872-1878. [PMID: 31389255 PMCID: PMC7004854 DOI: 10.1080/13607863.2019.1647131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/28/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
Abstract
Objectives: Assess whether education moderates associations between discrimination and depression risk within a southern Black/African American cohort in a labor market shifting from manufacturing and farming to education-intensive industries, such as health care and technology.Methods: Data are from the Pitt County (NC) Study (n = 1154) collected in 2001. Depression risk was assessed with the Center for Epidemiologic Study-Depression (CES-D) scale. Discrimination was measured using a subset from the Everyday Discrimination Scale. Education was categorized as completion of less than high school (HS), HS/GED (General Educational Development), or any college.Results: Completing any college mitigated the association between discrimination and CES-D among men (b = -1.33, 95% CI = -2.56, -0.09) but not women (b = -0.19, 95% CI = -1.36, 0.98).Conclusions: Education is protective for depression risk related to discrimination for men but not women. Recent macroeconomic changes placed a premium on higher levels of education in 2018, as in the 1990s. Because racial discrimination remains a stressor in the everyday lives of African Americans regardless of education level, the health benefits of higher education for working-aged African Americans in shifting labor markets warrants further investigation.
Collapse
Affiliation(s)
- Vicki Johnson-Lawrence
- Department of Family Medicine, College of Human Medicine, Michigan State University, Flint, MI, US
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI, US
| | - J. B. Scott
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI, US
| | - S. A. James
- Sanford School of Public Policy, Duke University, Durham, NC US
| |
Collapse
|
5
|
Assari S. Combined Effects of Ethnicity and Education on Burden of Depressive Symptoms over 24 Years in Middle-Aged and Older Adults in the United States. Brain Sci 2020; 10:E209. [PMID: 32252391 PMCID: PMC7225993 DOI: 10.3390/brainsci10040209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 12/20/2022] Open
Abstract
Ethnicity and educational attainment are among the major social determinants of depression in the general population. While high education credentials protect individuals against depressive symptoms, this protection may be weaker for ethnic minority groups such as Hispanic Whites compared to the majority group (non-Hispanic Whites). Built on marginalization-related diminished returns (MDRs), the current study used 24-year follow-up data from a nationally representative sample of middle-aged and older adults to explore ethnic variation in the protective effect of education levels against the burden of depressive symptoms over time. Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study. HRS followed 8314 middle-aged and older adults (50+ years old) for up to 24 years. From this number, 763 (9.2%) were Hispanic White, and 7551 (90.8%) were non-Hispanic White Americans. Education level was the independent variable. We had two outcomes. Firstly, using cluster analysis, individuals were categorized to low- and high-risk groups (regarding the burden of depressive symptoms over 24 years); secondly, average depressive symptoms were observed over the 24 years of follow up. Age and gender were the covariates. Ethnicity was the moderator. Linear and logistic regression were used for analysis. Logistic regression showed that, overall, high educational credentials reduced the odds of chronic depressive symptoms over the 24 years of follow-up. Linear regression also showed that higher years of education were associated with lower average depressive symptoms over time. Both models showed statistically significant interactions between ethnicity and graduation, indicating a smaller protective effect of high education against depressive symptoms over the 24 years of follow-up time among Hispanic with respect to non-Hispanic White people. In line with the MDRs, highly educated Hispanic White Americans remain at high risk for depressive symptoms, a risk that is unexpected given their education. The burden of depressive symptoms, however, is lowest for highly educated non-Hispanic White Americans. Policies that exclusively focus on equalizing educational gaps across ethnic groups may fail to eliminate the ethnic gap in the burden of chronic depressive symptoms, given the diminished marginal health return of education for ethnic minorities. Public policies must equalize not only education but also educational quality across ethnic groups. This aim would require addressing structural and environmental barriers that are disproportionately more common in the lives of ethnic minorities across education levels. Future research should test how contextual factors, residential segregation, school segregation, labor market practices, childhood poverty, and education quality in urban schools reduce the health return of educational attainment for highly educated ethnic minorities such as Hispanics.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA
| |
Collapse
|
6
|
Park SC, Østergaard SD, Kim JM, Jun TY, Lee MS, Kim JB, Yim HW, Park YC. Gender Differences in the Clinical Characteristics of Psychotic Depression: Results from the CRESCEND Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2015; 13:256-62. [PMID: 26598583 PMCID: PMC4662171 DOI: 10.9758/cpn.2015.13.3.256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/22/2015] [Accepted: 04/22/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To test whether there are gender differences in the clinical characteristics of patients with psychotic depression (PD). METHODS Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, we tested for potential gender differences in clinical characteristics among 53 patients with PD. The Psychotic Depression Assessment Scale (PDAS) and other psychometric scales were used to evaluate various clinical features of the study subjects. Independent t-tests were performed for normally distributed variables, Mann-Whitney U-tests for non-normally distributed variables, and χ(2)tests for discrete variables. In addition, to exclude the effects of confounding variables, we carried out an analysis of covariance (ANCOVA) for the normally distributed variables and binary logistic regression analyses for discrete variables, after adjusting the effects of marital status. RESULTS We identified more prevalent suicidal ideation (adjusted odds ratio [aOR]=10.316, p=0.036) and hallucinatory behavior (aOR=8.332, p=0.016), as well as more severe anxiety symptoms (degrees of freedom [df]=1, F=6.123, p=0.017), and poorer social and occupational functioning (df=1, F=6.265, p=0.016) in the male patients compared to the female patients. CONCLUSION Our findings suggest that in South Korean patients with PD, suicidal ideation, hallucinatory behavior, and anxiety is more pronounced among males than females. This should be taken into consideration in clinical practice.
Collapse
Affiliation(s)
- Seon-Cheol Park
- Department of Psychiatry, Yong-In Mental Hospital, Yongin, Korea.,Institute of Mental Health, Hanyang University, Seoul, Korea
| | - Søren Dinesen Østergaard
- Department of Clinical Medicine, Aarhus University Hospital, Risskov, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPsych), Denmark
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University School of Medicine, Gwangju, Korea
| | - Tae-Youn Jun
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Jung-Bum Kim
- Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea
| | - Hyeon-Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Chon Park
- Department of Psychiatry, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| |
Collapse
|
7
|
Yoon JH, Jung PK, Roh J, Seok H, Won JU. Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey. PLoS One 2015; 10:e0129142. [PMID: 26080022 PMCID: PMC4469698 DOI: 10.1371/journal.pone.0129142] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 05/05/2015] [Indexed: 11/25/2022] Open
Abstract
Background Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Methods Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Results Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09–1.70) for males and 1.38 (1.11–1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks’ experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6–8 hours of nighttime sleep. Conclusion In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated.
Collapse
Affiliation(s)
- Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Incheon Workers’ Health Center, Incheon, Korea
| | - Pil Kyun Jung
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jaehoon Roh
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Incheon Workers’ Health Center, Incheon, Korea
| | - Hongdeok Seok
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Uk Won
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Incheon Workers’ Health Center, Incheon, Korea
- * E-mail:
| |
Collapse
|
8
|
Hudson DL, Purnell JQ, Duncan AE, Baker E. Subjective religiosity, church attendance, and depression in the National Survey of American Life. JOURNAL OF RELIGION AND HEALTH 2015; 54:584-597. [PMID: 24615302 DOI: 10.1007/s10943-014-9850-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Studies have consistently indicated that blacks report lower rates of depression than whites. This study examined the association between religion and depression and whether religion explained lower rates of depression among blacks compared to whites. Data were drawn from the National Survey of American Life, a multi-ethnic sample of African Americans, Caribbean Blacks, and non-Hispanic whites (n = 6,082). African Americans and Caribbean Blacks reported higher mean levels of subjective religiosity than whites, but there were no significant differences in levels of church attendance. African Americans (OR 0.54; CI 0.45-0.65) and Caribbean Blacks (OR 0.66; CI 0.48-0.91) reported significantly lower odds of depression than whites. Differences in subjective religiosity and church attendance did not account for the association between major depression and African American and Caribbean Black race/ethnicity relative to whites. More research is needed to examine whether there are other factors that could protect against the development of depression.
Collapse
Affiliation(s)
- Darrell L Hudson
- George Warren Brown School of Social Work and Institute for Public Health, Washington University in St. Louis, One Brookings Drive Campus, Box 1196, Saint Louis, MO, 63130, USA,
| | | | | | | |
Collapse
|
9
|
Race Attribution Modifies the Association Between Daily Discrimination and Major Depressive Disorder Among Blacks: the Role of Gender and Ethnicity. J Racial Ethn Health Disparities 2015; 2:200-10. [PMID: 26863338 DOI: 10.1007/s40615-014-0064-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 09/10/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Although the association between discrimination and depression among Blacks is well-known, we do not know if this effect is influenced by race attribution. In this current study, we investigated the effect modification of race attribution on the association between everyday discrimination and major depressive disorder (MDD) among Blacks in the United States, and whether this effect modification is influenced by the intersection of ethnicity and gender. METHODS With a cross-sectional design, this study used data from the National Survey of American Life (NSAL), 2001-2003. The study included a nationally representative sample of Blacks (n = 5,008), composed of 3,570 African Americans and 1,438 Caribbean Blacks. Everyday discrimination, two single-item measures of race attribution (race as the major barrier against upward social mobility, and race as the main cause for being discriminated against) and 12-month MDD were measured. In the first step, we fit logistic regressions to the pooled sample. In the next step, we ran regressions specific to the intersections of ethnicity and gender. Interaction between race attribution and discrimination were also entered into the models. RESULTS Among Caribbean Black men, the belief that race is a major barrier against one's own upward social mobility modified the association between exposure to daily discrimination and MDD. In this group, the association between discrimination and MDD was weaker among those who believed that race is a major barrier against one's own upward social mobility. Race attribution did not modify the association between discrimination and MDD among African American men, African American women, and Caribbean Black women. The other measure of race attribution (race as the main cause of being discriminated against) did not modify the association between discrimination and MDD in any ethnicity by gender subgroups. CONCLUSIONS Among Caribbean Black men, the link between everyday discrimination and depression may depend on seeing race as the main barrier against upward social mobility. Among African American men and women, however, the link between discrimination and MDD does not depend on race attribution. Our results suggest that ethnicity, gender, and race attribution may alter the association between discrimination and risk of MDD among Blacks.
Collapse
|
10
|
Hicken MT, Lee H, Mezuk B, Kershaw KN, Rafferty J, Jackson JS. Racial and ethnic differences in the association between obesity and depression in women. J Womens Health (Larchmt) 2014; 22:445-52. [PMID: 23659483 DOI: 10.1089/jwh.2012.4111] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It is generally accepted that obesity and depression are positively related in women. Very little prior research, however, has examined potential variation in this relationship across different racial/ethnic groups. This paper examines the association between obesity and depression in non-Hispanic White, non-Hispanic Black, and Mexican American women. METHODS The sample included women aged 20 years and older in the 2005-2008 National Health and Nutrition Examination Surveys (n=3666). Logistic regression was used to assess the relationship between obesity and depression syndrome (assessed using the Patient Health Questionnaire-9), after adjusting for covariates. We then investigated whether this association varied by race/ethnicity. RESULTS Overall, obese women showed a 73% greater odds of depression (odds ratio [OR]=1.73; 95% confidence interval [CI]=1.19, 2.53) compared with normal weight women. This association varied significantly, however, by race/ethnicity. The obesity-depression associations for both Black and Mexican American women were different from the positive association found for White women (ORBlack*obese=0.24; 95% CI=0.10,0.54; ORMexican American*obese=0.42; 95% CI=1.04). Among White women, obesity was associated with significantly greater likelihood of depression (OR=2.37; 95% CI=1.41, 4.00) compared to normal weight. Among Black women, although not statistically significant, results are suggestive that obesity was inversely associated with depression (OR=0.56; 95% CI=0.28, 1.12) relative to normal weight. Among Mexican American women, obesity was not associated with depression (OR=1.01; 95% CI=0.59, 1.72). CONCLUSIONS The results reveal that the association between obesity and depression varies by racial/ethnic categorization. White, but not Black or Mexican American women showed a positive association. Next research steps could include examination of factors that vary by race/ethnicity that may link obesity to depression.
Collapse
Affiliation(s)
- Margaret T Hicken
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan 48109, USA.
| | | | | | | | | | | |
Collapse
|
11
|
Body image satisfaction and depression in midlife women: the Study of Women's Health Across the Nation (SWAN). Arch Womens Ment Health 2014; 17:177-87. [PMID: 24623160 PMCID: PMC4026204 DOI: 10.1007/s00737-014-0416-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 02/10/2014] [Indexed: 10/25/2022]
Abstract
With aging, women's bodies undergo changes that can affect body image perception, yet little is known about body image in midlife. The purpose of this study was to examine associations between body image and depressive symptoms in Caucasian and African-American midlife women from the Study of Women's Health Across the Nation (SWAN) Chicago site. Body image was measured using the Stunkard Adult Female Figure Rating Scale, and a clinically significant level of depressive symptoms was defined as Center for Epidemiologic Studies Depression Scale (CES-D) score of ≥16 (N=405; N=63 (15.6%) with clinically significant levels of depressive symptoms). Differences between perceived actual, perceived ideal, and actual body size and responses to questions concerning weight satisfaction and attractiveness were examined using logistic regression for associations with a CES-D score of ≥16. Women with body image dissatisfaction (odds ratio (OR)=1.91; p=0.04) or who perceived themselves as "unattractive" (OR=7.74; p<0.01) had higher odds of CES-D of ≥16. We found no significant difference by race. Our results were not confounded by BMI. These results suggest that midlife women with poor body image may be more likely to have clinically significant levels of depressive symptoms. Larger prospective studies are needed to better understand this association.
Collapse
|
12
|
Rogers CE, Kidokoro H, Wallendorf M, Inder TE. Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety before discharge. J Perinatol 2013; 33:171-6. [PMID: 22678144 PMCID: PMC3584234 DOI: 10.1038/jp.2012.75] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVE We investigated whether particular demographics, maternal psychosocial and infant factors identified mothers of very preterm infants at risk for postpartum depression or anxiety at the time of discharge from a level III urban Neonatal Intensive Care Unit (NICU). STUDY DESIGN A racially diverse cohort of mothers (N=73) of preterm infants (gestational age <30 weeks) completed a comprehensive questionnaire at discharge from the NICU assessing postpartum depression, anxiety and psychosocial and demographic factors. Additionally, infants underwent brain magnetic resonance imaging before discharge. RESULT Twenty percent of mothers had clinically significant levels of depression whereas 43% had moderate to severe anxiety. Being married (P<0.01), parental role alteration (P<0.01) and prolonged ventilation (P<0.05) were associated with increased depressive symptoms. No psychosocial, demographics or infant factors, including severity of brain injury, were associated with state anxiety levels. CONCLUSION Maternal factors, such as marital status, stress from parental role alteration and infant factors, such as prolonged ventilation, are associated with increased depression. However, clinically significant levels of anxiety are common in mothers of very preterm infants with few identifiable risk factors. These findings support the need for universal screening within the NICU.
Collapse
|
13
|
Schwarz AG, McVeigh KH, Hoven C, Kerker BD. Racial and Ethnic Differences in Depression by Partner Status and the Presence of Children in the Household. Womens Health Issues 2012; 22:e553-61. [DOI: 10.1016/j.whi.2012.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 07/18/2012] [Accepted: 07/19/2012] [Indexed: 11/30/2022]
|
14
|
Sclar DA, Robison LM, Skaer TL, Dickson WM, Kozma CM, Reeder CE. Antidepressant prescribing patterns: a comparison of blacks and whites in a medicaid population. Clin Drug Investig 2012; 16:135-40. [PMID: 18370531 DOI: 10.2165/00044011-199816020-00006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This paper reports results stemming from a retrospective inquiry designed to determine the prescribing pattern of tricyclic antidepressants (TCAs) relative to selective serotonin reuptake inhibitors (SSRIs), and the subsequent effect on regimen adherence among African American (Black) and White beneficiaries enrolled in the state of South Carolina Medicaid programme. PATIENTS AND METHODS Adjudicated patient-level paid-claims data for the time-frame 1 January 1990 to 31 December 1994 were abstracted resulting in a statewide cohort of 8596 ambulatory beneficiaries, 18 to 64 years of age, without receipt of antidepressant pharmacotherapy in the 1-year time-frame prior to initiating a regimen of either a TCA or SSRI, and remaining Medicaid-eligible for 1 year thereafter. RESULTS Black race [odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.43 to 1.70], age 40 to 64 years (OR = 1.15, 95% CI = 1.06 to 1.26), and male gender (OR = 1.27, 95% CI = 1.14 to 1.41) were significant predictors of initiating antidepressant pharmacotherapy with a TCA. Relative to Whites, Blacks were found to be less likely to have obtained at least a 3-month (>/=90 days) supply of a TCA (22.1 vs 31.7%) or an SSRI (30.7 vs 36.1%), or to have obtained a 6-month (>/=180 days) supply of a TCA (6.4 vs 10.9%) or an SSRI (8.1 vs 13.2%). CONCLUSION Further prospective research is required to discern the reasons for observed differences in prescribing and adherence patterns for antidepressant pharmacotherapy by age, gender and race, and to foster the development of educational programming designed to ensure clinically rational and equitable access to pharmacotherapeutic innovation.
Collapse
Affiliation(s)
- D A Sclar
- College of Pharmacy, Washington State University, Pullman, Washington, USA
| | | | | | | | | | | |
Collapse
|
15
|
Hudson DL, Bullard KM, Neighbors HW, Geronimus AT, Yang J, Jackson JS. Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men? JOURNAL OF MENS HEALTH 2012; 9:127-136. [PMID: 22707995 DOI: 10.1016/j.jomh.2012.03.006] [Citation(s) in RCA: 158] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: conventional wisdom suggests that increased socioeconomic resources should be related to better health. Considering the body of evidence demonstrating the significant association between racial discrimination and depression, we examined whether exposure to racial discrimination could attenuate the positive effects of increased levels of socioeconomic position (SEP) among African Americans. Specifically, this paper investigated the joint interactive effects of SEP and racial discrimination on the odds of depression among African Americans. METHODS: racial discrimination was measured using two measures, major and everyday discrimination. Study objectives were achieved using data from the National Survey of American Life, which included a nationally representative sample of African Americans (n =3570). Logistic regression models were used to estimate the effects of SEP and racial discrimination on the odds of depression. RESULTS: reports of racial discrimination were associated with increased risk of depression among American African men who possessed greater levels of education and income. Among African American men, significant, positive interactions were observed between education and experiences of major discrimination, which were associated with greater odds of depression (P = 0.02). Additionally, there were positive interactions between income and both measures of racial discrimination (income x everyday discrimination, P = 0.013; income x major discrimination, P = 0.02), which were associated with increased odds of depression (P = 0.02). CONCLUSIONS: it is possible that experiences of racial discrimination could, in part, diminish the effects of increased SEP among African American men.
Collapse
|
16
|
Watson KT, Roberts NM, Saunders MR. Factors Associated with Anxiety and Depression among African American and White Women. ISRN PSYCHIATRY 2012; 2012:432321. [PMID: 23738202 PMCID: PMC3658591 DOI: 10.5402/2012/432321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 10/25/2011] [Indexed: 01/27/2023]
Abstract
Background. We examined factors associated with depression and anxiety in a cohort of low-income Baltimore women. Methods. We used Pathways to Adulthood data, a cohort of adults aged 27 to 33 who were born in Baltimore between 1960 and 1965. Our outcomes were a score of >4 on the General Health Questionnaire (GHQ-28) across the depression or anxiety domains. Linear regression clustered on census tract was used for multivariate analysis. Results. In multivariable analyses, unmarried women, White women, those with lower self-rated health, and younger mothers had higher depression scores. Only lower self-rated health and White race were associated with a higher anxiety score. Neither neighborhood poverty nor racial composition was a predictor for anxiety or depression; however, the significant risk factors cluster in disadvantaged neighborhoods. Conclusion. Our work highlights the importance of universal screening for depression or anxiety with more in-depth surveillance based on risk factors rather than on race.
Collapse
Affiliation(s)
- Kalycia Trishana Watson
- Department of Urban Planning and Policy, University of Illinois at Chicago, 412 S. Peoria, Room 215, MC 348, Chicago, IL 60607, USA
| | | | | |
Collapse
|
17
|
Spence NJ, Adkins DE, Dupre ME. Racial differences in depression trajectories among older women: socioeconomic, family, and health influences. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2011; 52:444-59. [PMID: 22021654 PMCID: PMC3973726 DOI: 10.1177/0022146511410432] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Despite recent increases in life course research on mental illness, important questions remain about the social patterning of, and explanations for, depression trajectories among women in later life. The authors investigate competing theoretical frameworks for the age patterning of depressive symptoms and the physical health, socioeconomic, and family mechanisms differentiating black and white women. Using data from the National Longitudinal Survey of Mature Women, the authors use linear mixed (growth curve) models to estimate trajectories of distress for women aged 52 to 81 years (N = 3,182). The results demonstrate that: (1) there are persistently higher levels of depressive symptoms among black women relative to white women throughout later life; (2) physical health and socioeconomic status account for much of the racial gap in depressive symptoms; and (3) marital status moderates race differences in distress. The findings highlight the importance of physical health, family, and socioeconomic status in racial disparities in mental health.
Collapse
Affiliation(s)
- Naomi J Spence
- Department of Sociology, Lehman College, City University of New York, Bronx, NY 10468, USA.
| | | | | |
Collapse
|
18
|
Association between median family income and self-reported mood symptoms in bipolar disorder. Compr Psychiatry 2011; 52:17-25. [PMID: 21220061 DOI: 10.1016/j.comppsych.2010.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 03/26/2010] [Accepted: 04/15/2010] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE There is broad consensus from epidemiologic research that lower socioeconomic status is related to poorer health. This study investigated the relation between median family income and self-reported mood symptoms in patients with bipolar disorder who reside in the United States. METHODS Two hundred eighty-four patients with bipolar disorder provided daily self-reported mood ratings for 6 months (50,054 days of data). Regardless of income, all patients were treated by a psychiatrist, took psychotropic medications, and participated in computerized self-monitoring throughout the study. Median family income was obtained from US census tract data. The association between income and mood was analyzed using income as both a continuous and categorical variable. Demographic characteristics were compared by income group. Education level was included in the analysis a priori. RESULTS Both the continuous and categorical approaches found a positive association between income and euthymia, a negative association between income and manic/hypomanic symptoms including those due to mixed states, and no association between income and depressive symptoms. Patients in the lower-income group spent 12.4% fewer days euthymic than those in the upper-income group and 9.7% fewer days euthymic than those in the middle-income group. Patients in the lower-income group spent 7.1% more days with manic/hypomanic symptoms than those in the upper-income group. There was no association between education and income. CONCLUSION Median family income is associated with mood symptoms in patients with bipolar disorder. Inclusion of income as a measure of socioeconomic status is recommended for future studies of outcome in bipolar disorder.
Collapse
|
19
|
Prepregnancy depressive symptoms and preterm birth in the Black Women's Health Study. Ann Epidemiol 2010; 20:8-15. [PMID: 20006271 DOI: 10.1016/j.annepidem.2009.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 08/19/2009] [Accepted: 09/12/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the association between prepregnancy depressive symptoms and preterm birth. METHODS The present study is a prospective investigation of prepregnancy depressive symptoms-measured by the Center for Epidemiologic Studies Depression Scale (CES-D)-and risk of preterm birth reported in the Black Women's Health Study. With data on 2,627 singleton births (175 spontaneous and 163 medically indicated preterm births and 2,289 term births), we used generalized estimating equation models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for potential confounders. RESULTS Relative to mothers with CES-D scores less than 16, the multivariable ORs of spontaneous preterm birth for mothers with CES-D scores of 16-22, 23-32, and > or =33 were 1.17 (95% CI = 0.78-1.80), 1.20 (95% CI = 0.69-2.10), and 2.00 (95% CI = 0.94-4.25), respectively (p for trend = 0.09). There was little evidence of an association between prepregnancy depressive symptoms and medically indicated preterm birth. CONCLUSIONS Our data provide some evidence of an increased risk of spontaneous preterm birth among women with high prepregnancy depressive symptoms.
Collapse
|
20
|
Keith VM, Lincoln KD, Taylor RJ, Jackson JS. Discriminatory Experiences and Depressive Symptoms among African American Women: Do Skin Tone and Mastery Matter? SEX ROLES 2009; 62:48-59. [PMID: 21151821 DOI: 10.1007/s11199-009-9706-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We apply structural equation modeling techniques to data from the National Survey of American Life to investigate the relationship between perceived discrimination and depressive symptoms among African American women ages 18-98 years (N=2,299). In addition, we evaluate whether or not personal mastery accounts for the intensity of African American women's psychological response to discrimination and whether or not exposure to discrimination varies by skin complexion. Findings reveal that discrimination is a major threat to African American women's mental health. They are vulnerable to discrimination, in part, because discrimination undermines their beliefs in mastery making them less psychologically resilient. Experiences of discrimination do not differ by complexion. We conclude that complexion does not matter, but mastery does.
Collapse
Affiliation(s)
- Verna M Keith
- Department of Sociology and Center for Demography and Population Health, Florida State University, Room 526 BEL, P.O. Box 3062270, Tallahassee, FL 32306-2270, USA
| | | | | | | |
Collapse
|
21
|
Bloch JR, Webb DA, Mathews L, Dennis EF, Bennett IM, Culhane JF. Beyond marital status: the quality of the mother-father relationship and its influence on reproductive health behaviors and outcomes among unmarried low income pregnant women. Matern Child Health J 2009; 14:726-734. [PMID: 19649696 DOI: 10.1007/s10995-009-0509-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Accepted: 07/16/2009] [Indexed: 10/20/2022]
Abstract
In populations where the majority of pregnancies occur to unmarried women, exploring the quality of partner relationships and reproductive health is warranted. This study assesses differences in psychosocial characteristics, health behaviors, and birth outcomes between unmarried pregnant women who reported having a 'good' relationship with their baby's father, compared to those who reported having a 'fair' or 'poor' relationship with their baby's father. This research was part of a prospective study of low-income urban women. All unmarried women (n = 3,633) enrolled during their first prenatal visit were asked questions designed to differentiate between being in a good, fair or poor relationship with the baby's father. The worse the quality of the relationship, the worse the outcome, with dose-response associations between the quality of the relationship, emotional health, health behaviors, and birthweight. Compared to women in good relationships, those in poor relationships were more likely to have depressive symptoms (aPR 1.93; 95% CI: 1.65, 2.25), stress (aPR 1.24; 95% CI: 1.14, 1.35), use drugs (aPR 1.34; 95% CI: 1.11, 1.61) and smoke (aPR 1.28; 95% CI: 1.10, 1.49). Although infants born to mothers in poor relationships had the highest rate of low birth weight, the differences were not significant. Delving beyond marital status to assess the quality of partner relationships among unmarried mothers is important. Further research is needed to understand the complex interplay of individual, social and environmental factors promoting or hindering stable and supportive partner relationships among socially disadvantaged populations of pregnant women.
Collapse
Affiliation(s)
- Joan Rosen Bloch
- College of Nursing and Health Professions, Drexel University, 245 N 15th St, MS 1030, Philadelphia, PA, 19102, USA.
| | - David A Webb
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, 3535 Market Street, Suite 880, Philadelphia, PA, 19104, USA
| | - Leny Mathews
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, 3535 Market Street, Suite 880, Philadelphia, PA, 19104, USA
| | | | - Ian M Bennett
- Department of Family Medicine and Community Health, School of Medicine of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jennifer F Culhane
- Department of Adolescent Medicine, Children's Hospital of Philadelphia, 3535 Market Street, Suite 880, Philadelphia, PA, 19104, USA.,Department of Obstetrics and Gynecology, College of Medicine, Drexel University, Philadelphia, PA, USA
| |
Collapse
|
22
|
Gavin AR, Chae DH, Mustillo S, Kiefe CI. Prepregnancy depressive mood and preterm birth in black and white women: findings from the CARDIA Study. J Womens Health (Larchmt) 2009; 18:803-11. [PMID: 19445645 PMCID: PMC2851123 DOI: 10.1089/jwh.2008.0984] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We examine associations among race, prepregnancy depressive mood, and preterm birth (<37 weeks gestation) in a cohort study of black and white women. METHODS We tested for mediation of the association between race and preterm birth by prepregnancy depressive mood among 555 women enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. RESULTS Black women had significantly higher levels of prepregnancy depressive mood (modified CES-D score 13.0 vs. 9.5, t = -4.64, p < 0.001). After adjustment for covariates, black women had 2.70 times the odds of preterm birth as white women (95% confidence interval [CI] 1.41, 5.17). When adding prepregnancy depressive mood to this model, higher depressive mood was associated with greater odds of preterm birth (odds ratio [OR] 1.04; 95% CI 1.01, 1.07), and the effect of black race was attenuated (OR 2.47, 95% CI 1.28, 4.77). CONCLUSIONS Our data suggest that prepregnancy depressive mood may be a risk factor for preterm birth among black and white women.
Collapse
Affiliation(s)
- Amelia R Gavin
- University of Washington, School of Social Work, 4101 15th Avenue NE, Seattle, WA 98105, USA.
| | | | | | | |
Collapse
|
23
|
Social Support and the Association of Type 2 Diabetes and Depressive and Anxiety Disorders Among Low-income Adults Seen in Primary Care Clinics. J Clin Psychol Med Settings 2007. [DOI: 10.1007/s10880-007-9089-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
24
|
Lara-Cinisomo S, Griffin BA. Factors associated with major depression among mothers in Los Angeles. Womens Health Issues 2007; 17:316-24. [PMID: 17707124 PMCID: PMC2108528 DOI: 10.1016/j.whi.2007.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Revised: 07/03/2007] [Accepted: 07/03/2007] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to identify factors associated with major depression among a sample of diverse mothers in Los Angeles while paying special attention to racial and ethnic as well as immigration status differences. METHODS Using logistic regression models, we examined the association between major depression and race and ethnicity, immigration status, and other key covariates. Major depression was measured using the Comprehensive International Diagnostic Interview Short Form. This study was based on 1,856 racially and ethnically diverse mothers who participated in Wave 1 of the Los Angeles Family and Neighborhood Survey, which was fielded in 65 census tracts. MAIN FINDINGS After controlling for key covariates, we found that non-Hispanic white mothers had 1.67 times the odds of having major depression than Hispanic mothers (95% confidence interval [CI], 0.99-2.80). In addition, single mothers had elevated rates of major depression compared with married mothers (odds ratio [OR], 1.54; 95% CI, 1.00-2.37). Mothers with a college degree or higher had significantly lower odds of being depressed compared with mothers without a college degree (OR, 0.50; 95% CI, 0.29-0.86); mothers with only adolescents in the home had significantly higher odds of major depression than mothers with at least one preadolescent child in the home (OR, 1.73; 95% CI, 1.11-2.70). CONCLUSION Given the links between depressed mothers and child outcomes, our results have important implication for mothers with adolescent children, particularly those who are white, single, or less educated.
Collapse
|
25
|
Etowa J, Keddy B, Egbeyemi J, Eghan F. Depression: the 'invisible grey fog' influencing the midlife health of African Canadian women. Int J Ment Health Nurs 2007; 16:203-13. [PMID: 17535166 DOI: 10.1111/j.1447-0349.2007.00469.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Depression is a topic that is often avoided in discussions among Black women for a myriad of reasons. The purpose of this study was to investigate the midlife health of Black women living in the province of Nova Scotia, Canada. This paper will present one of the key findings of this research; midlife depression. It will examine the factors associated with depression among mid-life African Canadian women and how these women deal with depression. A triangulation of qualitative and quantitative methods guided by the principles of participatory action research (PAR) was used in the study. Data collection methods included 50 in-depth interviews of mid-life African Canadian women aged 40-65, focus groups, and workshops as well as the CES-D structured instrument. Purposive sampling method was the primary recruitment strategy and 113 people participated in the study. Although the women rarely openly discussed depression, they described depression as emotional feelings that range from "feeling blue" to being clinically depressed. Women viewed midlife depression as the consequence of a complex set of circumstances and stressors that they face. At midlife, Black women frequently recognize the importance of greater self-care and the need to pay more attention to their health, but they are reluctant to do so because they have to be "strong" in order to deal with their daily experiences of racism. Racism, among other things, leads to accumulated stress and undermines Black women's ability to cope and make healthy life choices. This signifies the implications of these research findings for clinical practice.
Collapse
Affiliation(s)
- Josephine Etowa
- Dalhousie University, School of Nursing, Halifax, Nova Scotia, Canada.
| | | | | | | |
Collapse
|
26
|
Sharghi A, Karbakhsh M, Nabaei B, Meysamie A, Farrokhi A. Depression in mothers of children with thalassemia or blood malignancies: a study from Iran. Clin Pract Epidemiol Ment Health 2006; 2:27. [PMID: 17020622 PMCID: PMC1599717 DOI: 10.1186/1745-0179-2-27] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Accepted: 10/04/2006] [Indexed: 11/22/2022]
Abstract
Background Several studies have found that parents of children with chronic diseases or disabilities have higher depression scores than control parents. Mothers usually take on the considerable part of the extra care and support that these children need and thus are at markedly increased risks of suffering from psychological distress and depression. The main aim of the present study was to investigate if mothers of children with thalassemia or blood malignancies have higher scores of depression compared with a group of control mothers. Methods and materials In this cross – sectional study, 294 mothers were recruited in three groups and assessed using the Beck Depression Inventory (BDI): mothers of children with thalassemia, mothers of children with blood malignancies and a control group. SPSS version 11.5 with chi square, ANOVA, linear and logistic regression were used for statistical analysis. Results The only variable bearing a statistically significant relationship with the depression score of mothers was the child's disease: for thalassemia with OR of 2.17 (95% CI = 1.16–4.0, P = 0.015), for blood malignancies with OR of 2.71 (95% CI = 1.48–4.99, P = 0.001). Discussion and conclusion The results of this study can contribute to the development of a screening program for decreasing depression burden and promoting quality of life for mothers of children with thalassemia or blood malignancies.
Collapse
Affiliation(s)
- Afshan Sharghi
- Department of Community Medicine, Ardebil University of Medical Sciences, Daneshgah Ave, Ardebil, Iran
| | - Mojgan Karbakhsh
- Department of Community Medicine, Tehran University of Medical Sciences, Poursina st, Qods st, Enqelab st, Tehran, Iran
| | - Behrooz Nabaei
- Department of Community Medicine, Tehran University of Medical Sciences, Poursina st, Qods st, Enqelab st, Tehran, Iran
| | - Alipasha Meysamie
- Department of Community Medicine, Tehran University of Medical Sciences, Poursina st, Qods st, Enqelab st, Tehran, Iran
| | - AliReza Farrokhi
- Legal Medicine Center of Ardebil Province, Panzdah Khordad Square, Ardebil, Iran
| |
Collapse
|
27
|
Pascoe JM, Stolfi A, Ormond MB. Correlates of mothers' persistent depressive symptoms: a national study. J Pediatr Health Care 2006; 20:261-9. [PMID: 16831634 DOI: 10.1016/j.pedhc.2006.01.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2006] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to examine the prevalence, persistence, and correlates of mothers' depressive symptoms over a 5-year period in a nationally representative sample of the United States population. METHOD Data from 2235 mothers in the National Survey of Families and Households, Wave I, 1987-1988, and Wave II, 1992-1994, were analyzed. Outcome measures were scores on the Center for Epidemiological Studies Depression Scale (CES-D, 12-item version) and a validated three-item depression screen. RESULTS One fifth of study mothers had positive CES-D scores and almost half (48%) had negative CES-D scores in both waves. Wave I risk factors for persistent "positive" CES-D scores were maternal age less than 30 years (24%), African-American (33%), never married (26%) or divorced (32%), education less than high school (35%), and indigent (32%). Adjusted odds ratios (AOR) and 95% confidence intervals for persistent "positive" versus persistent "negative" CES-D scores were: age less than 30 years (Wave I), AOR = 1.64, (1.22-2.21); unmarried (Wave II), AOR = 2.60, (1.89-3.56); education less than high school (Wave II), AOR = 2.18, (1.41-3.38); and indigent (Wave II), AOR = 2.09 (1.36-3.21). DISCUSSION About one fifth of the study sample reported high depressive symptoms twice over a 5-year period. Depression in women, especially mothers, is an urgent public health problem.
Collapse
Affiliation(s)
- John M Pascoe
- Department of Pediatrics, Wright State University School of Medicine, Children's Medical Center, One Children's Plaza, Dayton, OH 45404, USA.
| | | | | |
Collapse
|
28
|
Orr ST, Blazer DG, James SA. Racial disparities in elevated prenatal depressive symptoms among black and white women in eastern north Carolina. Ann Epidemiol 2005; 16:463-8. [PMID: 16257228 DOI: 10.1016/j.annepidem.2005.08.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Revised: 08/02/2005] [Accepted: 08/13/2005] [Indexed: 11/21/2022]
Abstract
PURPOSE Black women have an increased risk for preterm birth compared with white women, and prior research indicated that maternal prenatal depressive symptoms are associated with increased risk for preterm outcomes among black women. Race-related differences in prenatal depression could be of etiologic significance in understanding racial disparities in preterm birth. Our study focused on Center for Epidemiologic Studies' Depression Scale (CES-D) scores of pregnant black and white women. METHODS Women were administered the CES-D at the time of their first visit to hospital-based prenatal clinics. Two cutoff scores for the CES-D were used: 16 or higher, which indicates "significant" depressive symptoms, and 23 or higher, which indicates major depressive disorder. RESULTS For the sample of 1163 women, mean CES-D scores were significantly higher among black (17.4) than white (13.7) women. Of black women, 49% had CES-D scores higher than 15 compared with 33.5% of white women. Also, 27.5% of black women had scores higher than 22 compared with 16% of white women. After adjustment for maternal age, marital status, and education, odds ratios for race for both CES-D cutoff scores were approximately 1.5. CONCLUSIONS Results of this study indicate that black women have greater rates of prenatal depression than white women.
Collapse
Affiliation(s)
- Suezanne T Orr
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA.
| | | | | |
Collapse
|
29
|
Miller DK, Malmstrom TK, Joshi S, Andresen EM, Morley JE, Wolinsky FD. Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans. J Am Geriatr Soc 2004; 52:741-8. [PMID: 15086655 DOI: 10.1111/j.1532-5415.2004.52211.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To identify the prevalence of and potentially modifiable risk factors for clinically relevant levels of depressive symptoms in a population-based sample of community-dwelling African Americans and the prevalence of treatment by prescription and alternative medications. DESIGN Cross-sectional survey, 2000-01. SETTING Community-based. PARTICIPANTS Nine hundred ninety-eight noninstitutionalized African Americans in St. Louis, Missouri, born between 1936 and 1950. MEASUREMENTS Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression scale (CES-D). Clinically relevant levels of depressive symptoms were defined as nine or more (equivalent to >/=16 on the 20-item CES-D). A comprehensive set of risk factors was considered that included three demographic variables, eight socioeconomic-access measures, four environmental factors, seven measures of functional status, 15 biomedical markers, one service utilization indicator, and three psychosocial measures. All analyses were weighted to the represented population. Treatment with an antidepressant was determined by examining subjects' medications compiled in their homes. RESULTS Two hundred ten subjects (21.1%) had clinically relevant levels of depressive symptoms. Several multivariate logistic regression approaches were used for model building, which identified a consistent set of nine predictive factors: female sex (odds ratio adjusted (AOR) for all factors in the final model=1.52; 95% confidence interval (CI)=1.01-2.27), lower objective income (AOR=1.62, 95% CI=1.08-2.43), perceived income inadequacy (AOR=2.33, 95% CI=1.49-3.65), lower assessment of home environment (AOR=1.07 per scale point, 95% CI=1.01-1.12), limitations in visual acuity (AOR=1.12 per scale point, 95% CI=1.04-1.21), being severely underweight (AOR=2.52, 95% CI=1.02-6.20), being obese (AOR=1.72, 95% CI=1.16-2.54), being hospitalized in the previous year (AOR=2.25, 95% CI=1.45-3.49), and lower social support (AOR=1.20 per scale point, 95% CI=1.16-1.26). Of these, social support was the most important (adjusted standardized odds ratio =2.41). Forty-one (19.5%) of the subjects with clinically relevant levels of depressive symptoms were taking prescription antidepressants. CONCLUSION The prevalence of clinically relevant levels of depressive symptoms in middle-aged African Americans was greater than that for the general U.S. population. Community-based health programs that screen for depression and refer individuals to clinical care sites with appropriately designed systems of care for depression management should be developed. For optimal effect, these programs should concentrate their efforts in socioeconomically disadvantaged areas and address socioeconomic factors such as income inadequacy and social support in addition to the biomedical risk factors. Given the pervasive adverse effects of depression, such interventions have the potential for significantly enhancing the health of African Americans in their later years and reducing current health disparities.
Collapse
Affiliation(s)
- Douglas K Miller
- Division of Geriatric Medicine, School of Medicine, Saint Louis University, St Louis, Missouri, USA.
| | | | | | | | | | | |
Collapse
|
30
|
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 2004; 103:698-709. [PMID: 15051562 DOI: 10.1097/01.aog.0000116689.75396.5f] [Citation(s) in RCA: 1056] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Current estimates of the prevalence of depression during pregnancy vary widely. A more precise estimate is required to identify the level of disease burden and develop strategies for managing depressive disorders. The objective of this study was to estimate the prevalence of depression during pregnancy by trimester, as detected by validated screening instruments (ie, Beck Depression Inventory, Edinburgh Postnatal Depression Score) and structured interviews, and to compare the rates among instruments. DATA SOURCES Observational studies and surveys were searched in MEDLINE from 1966, CINAHL from 1982, EMBASE from 1980, and HealthSTAR from 1975. METHODS OF STUDY SELECTION A validated study selection/data extraction form detailed acceptance criteria. Numbers and percentages of depressed patients, by weeks of gestation or trimester, were reported. TABULATION, INTEGRATION, AND RESULTS Two reviewers independently extracted data; a third party resolved disagreement. Two raters assessed quality by using a 12-point checklist. A random effects meta-analytic model produced point estimates and 95% confidence intervals (CIs). Heterogeneity was examined with the chi(2) test (no systematic bias detected). Funnel plots and Begg-Mazumdar test were used to assess publication bias (none found). Of 714 articles identified, 21 (19,284 patients) met the study criteria. Quality scores averaged 62%. Prevalence rates (95% CIs) were 7.4% (2.2, 12.6), 12.8% (10.7, 14.8), and 12.0% (7.4, 16.7) for the first, second, and third trimesters, respectively. Structured interviews found lower rates than the Beck Depression Inventory but not the Edinburgh Postnatal Depression Scale. CONCLUSION Rates of depression, especially during the second and third trimesters of pregnancy, are substantial. Clinical and economic studies to estimate maternal and fetal consequences are needed.
Collapse
Affiliation(s)
- Heather A Bennett
- Faculty of Pharmacy and Department of Medicine, University of Toronto, Ontario, Canada.
| | | | | | | | | |
Collapse
|
31
|
Thomas J, Jones G, Scarinci I, Brantley P. A descriptive and comparative study of the prevalence of depressive and anxiety disorders in low-income adults with type 2 diabetes and other chronic illnesses. Diabetes Care 2003; 26:2311-7. [PMID: 12882854 DOI: 10.2337/diacare.26.8.2311] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether type 2 diabetes contributes to the presence of depressive and anxiety disorder diagnoses in low-income adults with hypertension, asthma, and/or arthritis. RESEARCH DESIGN AND METHODS Using a cross-sectional design, this study administered a structured diagnostic interview to low-income primary care patients diagnosed with type 2 diabetes, hypertension, arthritis, and asthma, as well as to those with no chronic illness (n = 326), to determine the 12-month prevalence of depressive and anxiety disorders. A logistic regression (LR) model was used to assess whether a diagnosis of depression and/or anxiety was associated with type 2 diabetes after adjusting for known risk factors. RESULTS A high prevalence rate of depressive and/or anxiety disorders was found in the total sample (29%) and in all three illness groups: type 2 diabetes (36%), other chronic illnesses (24%), and no chronic illness (31%). Using LR, a main effect was detected for illness group when age and education were controlled (chi(2) = 22.66, df 4, P = 0.000). Specifically, the odds of occurrence of a depressive and/or anxiety disorder in those with comorbid type 2 diabetes were twice that in the nondiabetic, chronically ill comparison group (odds ratio 2.26, 95% CI 1.28-4.01, P = 0.005). CONCLUSIONS These results suggest a positive contribution of type 2 diabetes to increased rates of depressive and/or anxiety disorders in patients with hypertension, asthma, and/or arthritis and support prior research that type 2 diabetes may serve as an indicator of depression and anxiety in low-income adults treated in primary care clinics.
Collapse
Affiliation(s)
- Janet Thomas
- Mayo Clinic, Nicotine Dependence Center, Rochester, Minnesota 55905, USA.
| | | | | | | |
Collapse
|
32
|
Zauszniewski JA, Picot SJF, Debanne SM, Roberts BL, Wykle ML. Psychometric characteristics of the Depressive Cognition Scale in African American women. J Nurs Meas 2003; 10:83-95. [PMID: 12619530 DOI: 10.1891/jnum.10.2.83.52557] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Depression in African-American women frequently goes unnoticed and untreated since commonly used depression scales fail to focus on early symptom recognition, do not address contextual factors, and lack adequate psychometric testing in African-American women. This analysis of the Depressive Cognition Scale was conducted with 213 African-American female caregivers and noncaregivers. Alpha coefficients for both groups (alpha 's = .75 and .87) showed internal consistency. Correlations with resourcefulness, depression, and daily hassles scales in the expected directions demonstrated construct validity (R's = -.36, .26, and .31, respectively). Factor structures for caregivers and noncaregivers differed, suggesting certain depressive cognitions were strongly integrated into the caregiver role. As a reliable and valid measure of depressive cognitions, the DCS would be useful for early detection of depression in African-American women.
Collapse
|
33
|
Coleman W. Family-focused pediatrics: a primary care family systems approach to psychosocial problems. Curr Probl Pediatr Adolesc Health Care 2002; 32:260-305. [PMID: 12202853 DOI: 10.1067/mps.2002.125468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- William Coleman
- Center for Development and Learning, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
34
|
Scarinci IC, Thomas J, Brantley PJ, Jones GN. Examination of the temporal relationship between smoking and major depressive disorder among low-income women in public primary care clinics. Am J Health Promot 2002; 16:323-30. [PMID: 12192743 DOI: 10.4278/0890-1171-16.6.323] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To determine the prevalence of major depressive disorder (MDD) by smoking status, and the temporal relationship between smoking and MDD, and explore other smoking-related variables that may be associated with MDD. DESIGN Cross-sectional study. SETTING Public primary care clinics. SUBJECTS Researchers studied 338 women (76% African-Americans) who were randomly selected while attending appointments in two public primary care clinics. MEASURES Data pertaining to smoking-related variables and MDD diagnosis were obtained using the Diagnostic Interview Schedule for the Diagnostic Statistical Manual of Mental Disorder IV (DSM-IV). RESULTS The prevalence of a lifetime history of MDD was significantly higher for current smokers (56.6%) than among former smokers (37.5%) or never-smokers (30.3%; p < .001). Most ever-smokers (81.3%) began smoking and were nicotine-dependent (63.6%) prior to their first episode of MDD. Using logistic regression, after controlling for demographic and smoking-related variables, age of smoking onset was the strongest variable associated with MDD among ever-smokers. Specifically, the odds of having an MDD decreased by 8.2% for each year delay in smoking initiation. CONCLUSION These results suggest that smoking initiation precedes MDD and that smoking is associated with a high prevalence of MDD among low-income women attending primary care clinics. Further, the younger women start smoking the more likely they are to have MDD.
Collapse
Affiliation(s)
- Isabel C Scarinci
- University of Memphis Center for Community Health, Memphis, Tennessee, USA
| | | | | | | |
Collapse
|
35
|
Abstract
BACKGROUND Long-term management of hypertension and diabetes, which are more prevalent in minority and socioeconomically disadvantaged populations, presents challenges for healthcare providers in community health centers. OBJECTIVES The purpose of the study was twofold: to examine health outcomes for persons with hypertension and diabetes and to compare these outcomes for disparities in patients who were Black, Hispanic, or White. METHODS Medical records (N = 280) from an urban community health center that serves predominantly uninsured adults were reviewed for selected clinical outcomes of primary care. Measures included outcomes of hypertension and diabetes control, lifestyle behaviors, preventive care, and patient status. Chi-square tests, t tests, and one-way analysis of covariance were used to analyze racial/ethnic group differences. RESULTS Data revealed significant differences in smoking status, influenza immunization, and blood pressure. Racial/ethnic group differences were minimal compared with the overall high prevalence of risk factors such as smoking and obesity. Regular access to primary care did not result in improved clinical outcomes. CONCLUSION The findings support the need for more effective interventions that promote healthy lifestyle if health disparities in low-income populations with chronic conditions are to be reduced.
Collapse
Affiliation(s)
- Linda Ciofu Baumann
- Academic Nursing Practice, University of Wisconsin-Madison School of Nursing, 53792-2455, USA.
| | | | | |
Collapse
|
36
|
McLennan JD, Kotelchuck M, Cho H. Prevalence, persistence, and correlates of depressive symptoms in a national sample of mothers of toddlers. J Am Acad Child Adolesc Psychiatry 2001; 40:1316-23. [PMID: 11699806 DOI: 10.1097/00004583-200111000-00012] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the prevalence, persistence, and correlates of depressive symptoms in mothers of toddlers in a nationally representative sample. METHOD The self-report components of two linked databases were used for this study, the 1988 National Maternal and Infant Health Survey and the 1991 Longitudinal Followup. Depressive symptoms of 7,537 mothers were measured by the Center for Epidemiologic Studies-Depression Scale (CES-D) at both time points. Weighted bivariate and multivariate analyses were used to assess the stability of maternal depressive symptoms across two time points and maternal and child predictors of elevated depressive symptoms. RESULTS Twenty-four percent of mothers at time 1 (mean child age 17 months) and 17% at time 2 (mean child age 35 months) had elevated depressive symptoms (CES-D score > or =16). Thirty-six percent of those with elevated scores at time 1 also had elevated scores at time 2. Not having breast-fed, a mistimed or unwanted pregnancy, and poor child health status were related to elevated depressive symptoms but not persistence. CONCLUSIONS Elevated depressive symptoms are common in mothers of toddlers. Given the potential magnitude of need, a systematic clinical and public health approach may be required.
Collapse
Affiliation(s)
- J D McLennan
- Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
| | | | | |
Collapse
|
37
|
Parker EA, Lichtenstein RL, Schulz AJ, Israel BA, Schork MA, Steinman KJ, James SA. Disentangling measures of individual perceptions of community social dynamics: results of a community survey. HEALTH EDUCATION & BEHAVIOR 2001; 28:462-86. [PMID: 11465157 DOI: 10.1177/109019810102800407] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined how different measures of individual perceptions of community social dynamics relate to each other and how these measures relate to self-reported general health and depressive symptoms. Results of a principal components analysis conducted to investigate the interrelationships between these individual measures suggest that these measures measure separate phenomena. In addition, in results of multiple-regression analyses conducted to examine associations between the various measures of individual perceptions of community social dynamics and the dependent variables of self-reported general health and depressive symptoms, sense of community, perceived neighborhood control, and neighborhood participation were all associated with the outcome variables in separate regression models. In a regression model with these three variables added to control variables, only sense of community was significantly, albeit modestly, associated with depressive symptoms and self-reported general health.
Collapse
Affiliation(s)
- E A Parker
- University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor 48109-2029, USA.
| | | | | | | | | | | | | |
Collapse
|
38
|
Petersen R, Gazmararian J, Andersen Clark K. Partner violence: implications for health and community settings. Womens Health Issues 2001; 11:116-25. [PMID: 11275515 DOI: 10.1016/s1049-3867(00)00093-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assist in the design and implementation of strategies to address partner violence, the objective of this study was to evaluate differences in mental health, health behaviors, and use of health care and specific community services between women who do or do not report experiences of partner violence as an adult. METHODS During interviews with 392 women enrolled in a Medicaid managed care organization, measures of mental health status, health behaviors, use of health care and community services, and experiences of partner violence were collected. Using bivariate statistical analyses, characteristics between women reporting or not reporting partner violence were compared. Chi-square tests were used to assess significant differences between the groups. The relationships between outcomes of interest and violence were estimated with logistic regression models adjusting for significant demographic and health characteristics. RESULTS Overall, 28% of women reported experiences of partner violence. Women reporting partner violence had twice the adjusted odds of depression and three times the adjusted odds of negative self-esteem compared with women not reporting experiences of partner violence. Women reporting partner violence, compared with those who did not, indicated higher use of specific types of health and community services such as mental health services [odds ratio (OR) 2.9; confidence interval (CI) 1.5-5.6] and individual counseling (OR 3.6; CI 2.2-6.1). CONCLUSIONS A communitywide effort that establishes linkages between health care settings and community services may be important in addressing the needs of women who are experiencing partner violence.
Collapse
Affiliation(s)
- R Petersen
- Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina, USA
| | | | | |
Collapse
|
39
|
Robbins JM, Vaccarino V, Zhang H, Kasl SV. Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the Third National Health and Nutrition Examination Survey. Am J Public Health 2001; 91:76-83. [PMID: 11189829 PMCID: PMC1446485 DOI: 10.2105/ajph.91.1.76] [Citation(s) in RCA: 242] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined the associations of poverty income ratio (PIR), education, and occupational status with type 2 diabetes prevalence among African American and non-Hispanic White (White) women and men aged 40 to 74 years. METHODS We analyzed cross-sectional data from the Third National Health and Nutrition Examination Survey, controlling for age and examination-related variables. RESULTS Among African American women, there was a strong, graded association between PIR and diabetes, which remained significant after other risk factors were adjusted for. All 3 variables were significantly associated with diabetes among White women. Among White men, only PIR was significantly associated with diabetes. Controlling for risk factors substantially attenuated these associations among White women. There were no significant associations for African American men. CONCLUSIONS Socioeconomic status is associated with type 2 diabetes prevalence among women, but not consistently among men. Diabetes prevalence is more strongly associated with PIR than with education or occupational status. These associations are largely independent of other risk factors, especially among African American women. Economic resources should be addressed in efforts to explain and reverse the increasing prevalence of diabetes in the United States.
Collapse
Affiliation(s)
- J M Robbins
- Department of Epidemiology and Public Health, Yale University, New Haven, Conn., USA.
| | | | | | | |
Collapse
|
40
|
Skaer TL, Sclar DA, Robison LM, Galin RS. Trends in the rate of depressive illness and use of antidepressant pharmacotherapy by ethnicity/race: an assessment of office-based visits in the United States, 1992-1997. Clin Ther 2000; 22:1575-89. [PMID: 11192148 DOI: 10.1016/s0149-2918(00)83055-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study was undertaken to determine ethnicity/race-specific (white, black, and Hispanic) population-adjusted rates of US office-based physician visits in which a diagnosis of a depressive disorder was recorded or in which a diagnosis of a depressive disorder was recorded and antidepressant pharmacotherapy was prescribed. METHODS Data from the National Ambulatory Medical Care Survey for 1992 through 1997 were partitioned into three 2-year periods: 1992-1993, 1994-1995, and 1996-1997. For each 2-year period, data from office-based physician visits for patients aged 20 to 79 years were extracted to assess, by ethnicity/race, (1) the number of visits in which a diagnosis of a depressive illness was recorded (International Classification of Diseases, Ninth Revision, Clinical Modification codes 296.2-296.36, 300.4, or 311) and (2) the number of visits in which a diagnosis of a depressive illness was recorded and antidepressant pharmacotherapy was prescribed. We calculated ethnicity/race-specific rates (per 100 US population aged 20 to 79 years) of office-based visits in which a diagnosis of a depressive disorder was recorded and in which a diagnosis of a depressive disorder was recorded and antidepressant pharmacotherapy was prescribed. The specialty of the reporting physician and the proportion of patients receiving a selective serotonin reuptake inhibitor (SSRI) were also discerned. RESULTS From 1992-1993 to 1996-1997, the rate of office-based visits (per 100 US population aged 20 to 79 years) in which a diagnosis of a depressive disorder was recorded increased 3.7% for whites (from 10.9 to 11.3; P = 0.001), 31.0% for blacks (from 4.2 to 5.5; P = 0.001), and 72.9% for Hispanics (from 4.8 to 8.3; P = 0.001). The rate of office-based visits in which a diagnosis of a depressive disorder was recorded and antidepressant pharmacotherapy was prescribed increased 18.5% for whites (from 6.5 to 7.7 per 100; P = 0.001), 38.5% for blacks (from 2.6 to 3.6 per 100; P = 0.001). and 106.7% for Hispanics (from 3.0 to 6.2 per 100; P = 0.001). Between 1992-1993 and 1996-1997, use of an SSRI increased among whites and blacks (from 50.0% to 65.8% and from 40.5% to 58.2%, respectively), but declined among Hispanics (from 51.4% to 48.6%; all comparisons P = 0.001). CONCLUSION By 1996-1997, the population-adjusted rates for Hispanics were within a quartile of those observed for whites, whereas the rates for blacks remained at less than half those observed in whites. The observed divergence in population-adjusted rates by ethnicity/race may reflect the nature of the patient-physician relationship, sensitivity and specificity of diagnostic techniques and instruments, and the wider social context in which an office-based visit occurs, including access to and type of health insurance and coverage for mental health services.
Collapse
Affiliation(s)
- T L Skaer
- Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, Pullman 99164-6510, USA.
| | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND In a national survey, a correlation between overweight and depression was explained by dieting and poor health. This study examines overweight and depressive symptoms among urban African-American women, taking into account demographic factors, health status and practices, and psychosocial constructs. METHODS Respondents are 429 participants in a pilot for a culturally tailored intervention promoting healthful eating and exercising. Anthropomorphic and self-administered questionnaire data were collected at a community health club site. RESULTS Controlling for demographic factors, overweight is associated with symptoms of depression, a relationship that is partially explained by health status, but not by dietary restraint. Using multiple regression, poor health status, alcohol intake, hostility, and low levels of ethnic identity (connectedness with the African-American community) are independent predictors of depressed mood. In this study, dietary restraint reflects healthful eating and is inversely related to depression. The overweight/depression association is stronger among women with high levels of education and high levels of ethnic identity (statistical interactions). CONCLUSION Poor health likely contributes over time to both overweight and depressed mood. Ethnic identity enhancement strategies should be studied for their effectiveness in strengthening identity and for their potential in attracting individuals especially likely to benefit from lifestyle change programs.
Collapse
Affiliation(s)
- J M Siegel
- Department of Community Health Sciences, School of Public Health, University of California at Los Angeles, Los Angeles, CA 90095-1772, USA.
| | | | | |
Collapse
|
42
|
Abstract
Life's complexity is a haunting melody of continuously interacting variables .... Professional practice in nursing seeks to promote symphonic interaction between man [sic] and environment. . . (Rogers, 1970, pp. 41, 122). The purpose of this phenomenological study was to explore the lived experience of clinical depression for women in the context of their social relations and environment. Twelve ethnically diverse female friend dyads were interviewed and completed the Beck Depression Inventory (BDI). Seventeen of these women had experienced a major depression in the past or were in treatment for clinical depression at the time of the study. This depression was characterized by dissonance experienced in childhood abuse and incest, uncontrollable moods despite self-medication, abusive or negligent therapy, failed social relationships in adulthood, and a lack of resources in the environment. In contrast, seven healthy women described their social environment as generally resonant and connected. Prevention of childhood abuse and racism, relief from economic hardships, early diagnosis, and safe, effective treatment are essential in helping women to survive clinical depression. Nurses in the community are in a unique position to affect this public health problem.
Collapse
Affiliation(s)
- S M Poslusny
- DePaul University Department of Nursing, Chicago, Illinois 60614, USA.
| |
Collapse
|
43
|
Kramer MS, Séguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000; 14:194-210. [PMID: 10949211 DOI: 10.1046/j.1365-3016.2000.00266.x] [Citation(s) in RCA: 538] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this paper, we review the evidence bearing on socio-economic disparities in pregnancy outcome, focusing on aetiological factors mediating the disparities in intrauterine growth restriction (IUGR) and preterm birth. We first summarise what is known about the attributable determinants of IUGR and preterm birth, emphasising their quantitative contributions (aetiological fractions) from a public health perspective. We then review studies relating these determinants to socio-economic status and, combined with the evidence about their aetiological fractions, reach some tentative conclusions about their roles as mediators of the socio-economic disparities. Cigarette smoking during pregnancy appears to be the most important mediating factor for IUGR, with low gestational weight gain and short stature also playing substantial roles. For preterm birth, socio-economic gradients in bacterial vaginosis and cigarette smoking appear to explain some of the socio-economic disparities; psychosocial factors may prove even more important, but their aetiological links with preterm birth require further clarification. Research that identifies and quantifies the causal pathways and mechanisms whereby social disadvantage leads to higher risks of IUGR and preterm birth may eventually help to reduce current disparities and improve pregnancy outcome across the entire socio-economic spectrum.
Collapse
Affiliation(s)
- M S Kramer
- Department of Pediatrics, McGill University, Canada.
| | | | | | | |
Collapse
|
44
|
Vogeltanz ND, Wilsnack SC, Vickers KS, Kristjanson AP. Sociodemographic characteristics and drinking status as predictors of older women's health. THE JOURNAL OF GENERAL PSYCHOLOGY 1999; 126:135-47. [PMID: 10368940 DOI: 10.1080/00221309909595357] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
As part of a U.S. national survey of women's drinking and life experiences, the authors used responses from a subsample (n = 245) of women aged 55-90 years (M = 65.8 years) to examine the relationship of sociodemographic characteristics (income, marital status, and occupational status) and drinking status to several health outcomes (self-perceived general health, depression, sexual satisfaction, and sexual dysfunction). In all analyses, the authors controlled for respondent age. Results indicated that higher household income predicted greater lifetime and current sexual satisfaction with a partner as well as higher general health ratings. Women drinkers also reported better general health than did abstainers. An interaction between marital status (married or cohabitating vs. nonmarried) and employment status (employed vs. nonemployed) was a predictor of general health ratings. The authors found significant contrasts among the 4 groups when they controlled for age, income, and drinking status: (a) Among the employed respondents, the nonmarried women reported better general health than did the married women; and (b) among nonmarried respondents, the employed women reported better general health than did the nonemployed women.
Collapse
Affiliation(s)
- N D Vogeltanz
- Department of Psychology, University of North Dakota, Grand Forks 58202-8380, USA.
| | | | | | | |
Collapse
|