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Millender EF, Radey M, Sabuncu BC, Wu Q, McWey L. Exploring the Interplay of Social Safety Nets, Race, Ethnicity, and Nativity on Psychological Distress Among Low-Income Mothers. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01744-9. [PMID: 39126482 DOI: 10.1007/s10578-024-01744-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
Low-income mothers face numerous challenges that increase their vulnerability to psychological distress. Their perceived or actual difficulty in accessing vital support networks, whether public or private, can significantly amplify this distress. Socially assigned identities, such as nativity, ethnicity, and race, intersect with socioeconomic factors, influencing mental health outcomes. Using data from the Future of Families and Child Wellbeing Study, our research investigated the impact of public and private safety nets on maternal psychological health. We found that, even after accounting for socioeconomic factors, non-Hispanic, US-born White mothers experienced higher levels of psychological distress compared to minoritized mothers. The role of safety nets varied by race and ethnicity, with private safety nets providing unique protection to Black and Hispanic mothers, while support was associated with increased distress only among White mothers. These findings highlight the need to consider sociocultural history when assessing safety net impacts on mental health.
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Affiliation(s)
- Eugenia Flores Millender
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA.
- College of Nursing, Florida State University, Tallahassee, FL, USA.
- College of Social Work, Florida State University, Tallahassee, FL, USA.
| | - Melissa Radey
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | | | - Qiong Wu
- Department of Human Development & Family Science, Florida State University, Tallahassee, FL, USA
| | - Lenore McWey
- Department of Human Development & Family Science, Florida State University, Tallahassee, FL, USA
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Jimenez MP, Gause EL, Sims KD, Hayes‐Larson E, Morris EP, Fletcher E, Manly J, Gilsanz P, Soh Y, Corrada M, Whitmer RA, Glymour MM. Racial and ethnic differences in the association between depressive symptoms and cognitive outcomes in older adults: Findings from KHANDLE and STAR. Alzheimers Dement 2024; 20:3147-3156. [PMID: 38477489 PMCID: PMC11095484 DOI: 10.1002/alz.13768] [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: 10/18/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Depressive symptoms are associated with higher risk of dementia, but how they impact cognition in diverse populations is unclear. METHODS Asian, Black, Latino, or White participants (n = 2227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over 4 years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity. RESULTS Higher depressive symptoms were associated with lower baseline verbal episodic memory scores (-0.06, 95% CI: -0.12, -0.01; -0.15, 95% CI: -0.25, -0.04), and faster decline annually in semantic memory (-0.04, 95% CI: -0.07, -0.01; -0.10, 95% CI: -0.15, -0.05) for Black and Latino participants. Depressive symptoms were associated with lower baseline but not decline in executive function. DISCUSSION Depressive symptoms were associated with worse cognitive outcomes, with some evidence of heterogeneity across racial/ethnic groups. HIGHLIGHTS We examined whether baseline depressive symptoms were differentially associated with domain-specific cognition or cognitive decline by race/ethnicity. Depressive symptoms were associated with worse cognitive scores for all racial/ethnic groups across different domains examined. Higher depressive symptoms were associated with faster cognitive decline for semantic memory for Black and Latino participants. The results suggest a particularly harmful association between depressive symptoms and cognition in certain racial/ethnic groups.
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Affiliation(s)
- Marcia P. Jimenez
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Emma L. Gause
- Center for Climate and HealthBoston University School of Public HealthBostonMassachusettsUSA
| | - Kendra D. Sims
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Eleanor Hayes‐Larson
- Department of EpidemiologyUCLA Fielding School of Public HealthLos AngelesCaliforniaUSA
| | - Emily P. Morris
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Evan Fletcher
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Jennifer Manly
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
| | - Paola Gilsanz
- Division of ResearchKaiser PermanenteOaklandCaliforniaUSA
| | - Yenee Soh
- Division of ResearchKaiser PermanenteOaklandCaliforniaUSA
| | - Maria Corrada
- Department of EpidemiologyUniversity of California Irvine School of MedicineIrvineCaliforniaUSA
| | - Rachel A. Whitmer
- Department of Public Health Sciences and NeurologyUniversity of California Davis School of MedicineDavisCaliforniaUSA
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Meza E, Hebert J, Garcia ME, Torres JM, Glymour MM, Vable AM. First-generation college graduates have similar depressive symptoms in midlife as multi-generational college graduates. SSM Popul Health 2024; 25:101633. [PMID: 38434443 PMCID: PMC10905036 DOI: 10.1016/j.ssmph.2024.101633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Higher education may protect an individual against depressive symptoms, yet, disadvantaged socioeconomic status (SES) during childhood, often measured by lower parental education, may put them at higher risk for depressive symptoms later in life. This study evaluates if midlife depression is similar for first-generation and multi-generation college graduates. Methods For US Health and Retirement Study (HRS) participants ages 55-63 (N = 16,752), we defined a 4-category exposure from parents' (highest of mother or father's) and participant's own years of education, with 16 years indicating college completion: multi-gen (both ≥ 16 years: reference); first-gen (parents <16; own ≥ 16); only parent(s) (parents ≥ 16; own <16); and neither (both <16) college graduates across three birth cohorts. We used linear regressions to evaluate relationships between college completion and depressive symptoms measured by an 8-item Center for Epidemiologic Studies - Depression (CES-D) scale. Models pooled over time evaluated differences by sex, race/ethnicity, and birthplace. Results First-gen and multi-gen college graduates averaged similar depressive symptoms in midlife (β : 0.01; 95% CI: 0.15, 0.13). Results were similar by sex and race/ethnicity. Conclusion Consistent with resource substitution theory, college completion may offset the deleterious effects of lower parental education on midlife depressive symptoms for first-generation graduates.
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Affiliation(s)
- Erika Meza
- Department of Epidemiology and Biostatistics University of California, San Francisco, 550 16th St 2nd Floor, San Francisco, CA, 94158, USA
- Center for Population and Development Studies Harvard University, 9 Bow St. Cambridge, MA 02138, USA
| | - Jillian Hebert
- Department of Family and Community Medicine University of California, San Francisco, 995 Potrero Ave, San Francisco, CA, 94110, USA
| | - Maria E. Garcia
- Department of Epidemiology and Biostatistics University of California, San Francisco, 550 16th St 2nd Floor, San Francisco, CA, 94158, USA
- Division of General Internal Medicine, University of California, San Francisco, 1701 Divisadero St, San Francisco, CA, 94115, USA
| | - Jacqueline M. Torres
- Department of Epidemiology and Biostatistics University of California, San Francisco, 550 16th St 2nd Floor, San Francisco, CA, 94158, USA
| | - M. Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA, USA
| | - Anusha M. Vable
- Department of Family and Community Medicine University of California, San Francisco, 995 Potrero Ave, San Francisco, CA, 94110, USA
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Jimenez MP, Gause EL, Hayes-Larson E, Morris EP, Fletcher E, Manly J, Gilsanz P, Soh Y, Corrada M, Whitmer RA, Glymour MM. Racial and Ethnic Differences in the Association between Depressive Symptoms and Cognitive Outcomes in Older Adults: Findings from KHANDLE and STAR. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.07.23295205. [PMID: 37732261 PMCID: PMC10508807 DOI: 10.1101/2023.09.07.23295205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Depressive symptoms are associated with higher risk of dementia but how they impact cognition in diverse populations is unclear. METHODS Asian, Black, LatinX, or White participants (n=2,227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over four years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity. RESULTS Higher depressive symptoms were associated with lower baseline verbal episodic memory scores (-0.06, 95%CI: -0.12, -0.01; -0.15, 95%CI: -0.25, -0.04), and faster decline annually in semantic memory (-0.04, 95%CI: -0.07, -0.01; -0.10, 95%CI: -0.15, -0.05) for Black and LatinX participants. Depressive symptoms were associated with lower baseline but not decline in executive function. DISCUSSION Depressive symptoms were associated with worse cognitive domains, with some evidence of heterogeneity across racial/ethnic groups.
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Affiliation(s)
- Marcia P Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Emma L Gause
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Evan Fletcher
- Department of Neurology, University of California, Davis, CA, USA
| | - Jennifer Manly
- Department of Neurology, Columbia University, New York, NY, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Yenee Soh
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Maria Corrada
- Department of Epidemiology, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Rachel A Whitmer
- Department of Public Health Sciences and Neurology, University of California Davis School of Medicine, Davis, CA, USA
| | - M Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Zöllinger I, Bauer A, Blotenberg I, Brettschneider C, Buchholz M, Czock D, Döhring J, Escales C, Fankhaenel T, Frese T, Hoffmann W, Kaduszkiewicz H, König HH, Luppa M, Oey A, Pabst A, Sanftenberg L, Thyrian JR, Weiss J, Wendel F, Wiese B, Riedel-Heller SG, Gensichen J. Associations of Depressive Symptoms with Subjective Cognitive Decline in Elderly People-A Cross-Sectional Analysis from the AgeWell.de-Study. J Clin Med 2023; 12:5205. [PMID: 37629244 PMCID: PMC10455560 DOI: 10.3390/jcm12165205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
To develop effective dementia prevention strategies, it is necessary to understand risk factors, associated factors and early signs of dementia. Subjective cognitive decline (SCD) is the earliest form of dementia. The aim of this study is to assess depression as a factor that is significantly associated with SCD. The data of 1030 general practitioner patients from the AgeWell.de-study (60-77 years; CAIDE dementia risk score ≥ 9) were analysed. A descriptive analysis was conducted using validated instruments like the Geriatric depression scale (GDS), Lubben social network scale (LSNS-6) and education classes according to CASMIN (Comparative Analysis of Social Mobility in Industrial Nations). A multivariate regression model with the dependent variable SCD was calculated. Of the 1030 participants, 5.9% had depressive symptoms and 31.3% SCD. The group with depressive symptoms showed significantly higher body-mass-index (p = 0.005), lower education class (p = 0.022), lower LSNS-6 score (p < 0.001), higher sports activity (p < 0.001), and more sleeping problems (p = 0.026). In the regression model a higher GDS-score [Odds ratio (OR): 1.219 (p < 0.001)], more sleeping problems [OR: 1.550 (p = 0.017)] and higher education class [middle/high: OR: 1.474/1.875 (p = 0.037/0.004)] were significantly associated with SCD. This study identified depressive symptoms, sleeping problems, and higher education classes as factors associated with SCD, which can represent an early form of dementia.
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Affiliation(s)
- Isabel Zöllinger
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (A.B.); (T.F.); (T.F.)
| | - Iris Blotenberg
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.B.); (H.-H.K.)
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany; (J.D.); (C.E.); (H.K.)
| | - Catharina Escales
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany; (J.D.); (C.E.); (H.K.)
| | - Thomas Fankhaenel
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (A.B.); (T.F.); (T.F.)
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (A.B.); (T.F.); (T.F.)
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
- Institute for Community Medicine, University Medicine Greifswald, 17487 Greifswald, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany; (J.D.); (C.E.); (H.K.)
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.B.); (H.-H.K.)
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Anke Oey
- State Health Department of Lower Saxony, 30449 Hannover, Germany;
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany; (I.B.); (M.B.); (W.H.); (J.R.T.)
- Institute for Community Medicine, University Medicine Greifswald, 17487 Greifswald, Germany
| | - Julian Weiss
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Flora Wendel
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, 30625 Hannover, Germany;
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany; (L.S.); (J.W.); (F.W.); (J.G.)
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Vajpeyi Misra A, Mamdouh HM, Dani A, Mitchell V, Hussain HY, Ibrahim GM, Alnakhi WK. Impact of COVID-19 pandemic on the mental health of university students in the United Arab Emirates: a cross-sectional study. BMC Psychol 2022; 10:312. [PMID: 36527101 PMCID: PMC9756732 DOI: 10.1186/s40359-022-00986-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic had a significant impact on the mental well-being of students worldwide. There is a scarcity of information on the mental health impact of the COVID-19 pandemic on university students in the United Arab Emirates (UAE). This study aimed to investigate the mental health impact of the COVID-19, including depression, anxiety and resilience among a sample of university students in the UAE. METHODS A cross-sectional study using an online survey was conducted from September to November 2021. The patient health questionnaire (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess depression, anxiety, and resilience. The COVID-19 impact was assessed using a list of questions. RESULTS Only, 798 students completed the survey and were analyzed for this study. Overall, 74.8% of the students were females, 91.2% were never married, and 66.3% were UAE-nationals. Based on PHQ-9 and GAD-7 cut-off scores (≥ 10), four out of ten of the students self-reported moderate to severe depression (40.9%) and anxiety (39.1%). Significantly higher mean PHQ-9 and GAD-7 scores were found among students who were impacted by COVID-19 than those non-impacted (mean PHQ-9 = 9.51 ± 6.39 and 6.80 ± 6.34; p = 0.001, respectively) and (mean GAD-7 = 9.03 ± 6.00 and 8.54 ± 6.02; respectively, p < 0.001). Female students who were impacted by COVID-19 had statistically significant higher depression and anxiety scores (mean PHQ-9 of 9.14 ± 5.86 vs. 6.83 ± 6.25, respectively; p < 0.001) than the non-impacted females (mean GAD-7 of 9.57 ± 6.32 vs. 5.15 ± 3.88, respectively; p = 0.005). Never married students had significantly higher PHQ-9 and GAD-7 scores than ever-married (9.31 ± 6.37 vs. 6.93 ± 5.47, P = 0.003) and (8.89 ± 6.11 vs. 7.13 ± 5.49, respectively; p = 0.017). CONCLUSIONS The results of this study demonstrate that the COVID-19 pandemic has negatively impacted the mental health of this sample of university students in terms of depression and anxiety. The results highlight the need to adopt culturally appropriate interventions for university students and focus on vulnerable groups.
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Affiliation(s)
- Anamika Vajpeyi Misra
- grid.444463.50000 0004 1796 4519Department of Health Sciences- Social Work Program, Higher Colleges of Technology, Abu Dhabi, UAE
| | - Heba M. Mamdouh
- grid.414167.10000 0004 1757 0894Department of Data Analysis, Research and Studies, Dubai Health Authority, Dubai, UAE ,grid.7155.60000 0001 2260 6941Department of Family Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Anita Dani
- grid.444463.50000 0004 1796 4519General Academic Requirement (General Studies), Higher Colleges of Technology, Abu Dhabi, UAE
| | - Vivienne Mitchell
- grid.444463.50000 0004 1796 4519Department of Health Sciences- Social Work Program, Higher Colleges of Technology, Abu Dhabi, UAE
| | - Hamid Y. Hussain
- grid.414167.10000 0004 1757 0894Department of Data Analysis, Research and Studies, Dubai Health Authority, Dubai, UAE
| | - Gamal M. Ibrahim
- grid.414167.10000 0004 1757 0894Department of Data Analysis, Research and Studies, Dubai Health Authority, Dubai, UAE
| | - Wafa K. Alnakhi
- grid.414167.10000 0004 1757 0894Department of Data Analysis, Research and Studies, Dubai Health Authority, Dubai, UAE ,grid.510259.a0000 0004 5950 6858Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
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Yan SS, Xu Q, Han BX, Ni JJ, Wei XT, Feng GJ, Zhang H, Zhang YJ, Zhang L, Yu WY, Pei YF. Mendelian randomization analysis identified causal Association of Childhood Obesity with adult major depressive disorder. Pediatr Obes 2022; 17:e12960. [PMID: 35869568 DOI: 10.1111/ijpo.12960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood obesity is associated with adult major depressive disorder (MDD), but their causality is not clear. METHODS We performed a two-sample Mendelian randomization (MR) analysis to explore the causality of childhood body mass index (BMI) and childhood obesity on MDD, followed by a multivariable MR (MVMR) analysis to investigate the potential role of adult BMI in mediating such effect. We accessed genome-wide association summary statistics of childhood BMI, childhood obesity, adult BMI and adult MDD from the Early Growth Genetics consortium (nBMI = 47 541, nobesity = 24 160), the Genetic Investigation of Anthropometric Traits consortium (nadult_BMI = ∼700 000) and the Psychiatric Genomics consortium (nMDD = 500 199), respectively. The MR-PRESSO test was performed to remove SNPs with potential pleiotropic effect. The MR analysis was performed by inverse-variance weighted test. Further sensitivity analyses, including the MR-Egger intercept test and leave-one-out analysis, were performed to evaluate the reliability of the results. RESULTS Our study found that childhood obesity might increase the odds of developing MDD in adults (OR = 1.03, 95% CI: 1.01-1.06, p = 2.6 × 10-3 ). Children with higher BMI were more likely to develop MDD in adulthood, with an OR of 1.12 per standard deviation score (SDS) increase in BMI (95% CI: 1.07-1.17, p = 4.4 × 10-7 ). Sensitivity analyses verified the reliability of the causality between childhood BMI/obesity and MDD. Further MVMR results revealed that the impact of childhood BMI on MDD risk was predominantly mediated by adult BMI. CONCLUSION Our findings provided evidence of a causal relationship between childhood BMI/obesity and adult MDD, thus providing new insights into the prevention of MDD.
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Affiliation(s)
- Shan-Shan Yan
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Department of Epidemiology and Health Statistics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Qian Xu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Department of Epidemiology and Health Statistics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Bai-Xue Han
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Department of Epidemiology and Health Statistics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Jing-Jing Ni
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Center for Genetic Epidemiology and Genomics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Xin-Tong Wei
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Department of Epidemiology and Health Statistics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Gui-Juan Feng
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Department of Epidemiology and Health Statistics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Hong Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Center for Genetic Epidemiology and Genomics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - You-Jie Zhang
- Department of Child Health Care and Social Medicine, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Lei Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Center for Genetic Epidemiology and Genomics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
| | - Wen-Yuan Yu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,The Second Affiliated Hospital of Soochow University, SuZhou City, China
| | - Yu-Fang Pei
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou City, China.,Department of Epidemiology and Health Statistics, School of Public Health, Suzhou Medical College of Soochow University, SuZhou City, China
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Depression, aging, and immunity: implications for COVID-19 vaccine immunogenicity. Immun Ageing 2022; 19:32. [PMID: 35836263 PMCID: PMC9281075 DOI: 10.1186/s12979-022-00288-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
The aging process can have detrimental effects on the immune system rendering the elderly more susceptible to infectious disease and less responsive to vaccination. Major depressive disorder (MDD) has been hypothesized to show characteristics of accelerated biological aging. This raises the possibility that depressed individuals will show some overlap with elderly populations with respect to their immune response to infection and vaccination. Here we provide an umbrella review of this literature in the context of the SARS CoV-2 pandemic. On balance, the available data do indeed suggest that depression is a risk factor for both adverse outcomes following COVID-19 infection and for reduced COVID-19 vaccine immunogenicity. We conclude that MDD (and other major psychiatric disorders) should be recognized as vulnerable populations that receive priority for vaccination along with other at-risk groups.
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9
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Tran S, Wormley AS, Louie P, Sheehan C. Increasing psychological distress among Californians from 2013 to 2020: Race/ethnic differences. SSM - MENTAL HEALTH 2022; 2:100101. [PMID: 36590986 PMCID: PMC9792130 DOI: 10.1016/j.ssmmh.2022.100101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/24/2022] [Accepted: 04/19/2022] [Indexed: 01/13/2023] Open
Abstract
The influence of the COVID-19 pandemic on mental health is of mounting concern to population-health researchers. While early reports indicated increases in mental health problems, noticeably absent from these studies is how mental health has changed in 2020 compared to previous years (2013-2019) and whether such trends vary by race/ethnicity. The present study used repeated cross-sectional data from the California Health Interview Survey (n = 168,216) to systematically document trends in psychological distress scores (Kessler-6 scale; K6) and severe psychological distress scores (K6; 13+) from 2013 to 2020 and by race/ethnicity over the same period. Among all Californians we find that the reported average psychological distress scores increased by 22% between 2013 and 2020. Reported severe psychological distress scores increased 61% from 2013 to 2020. These increases were largely concentrated in the years 2017-2020. Increases in psychological distress were also especially pronounced among non-Latino/a White Californians (29% increase in K6 from 2013 to 2020), Latino/a Californians (14% increase in K6 from 2013 to 2020), and Asian Californians (35% increase in K6 from 2013 to 2020). Multiple and logistic regression models that accounted for sociodemographic and behavioral health covariates echoed these findings. Future research should continue to investigate secular trends in mental health that coincided with the COVID-19 pandemic and carefully situate the shifts into broader temporal perspective.
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Affiliation(s)
- Sydney Tran
- Department of Psychology, Arizona State University, USA
| | | | | | - Connor Sheehan
- School of Social and Family Dynamics, Arizona State University, USA
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10
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O'Shields J, Mowbray O, Patel D. Allostatic load as a mediator of childhood maltreatment and adulthood depressive symptoms: A longitudinal analysis. Psychoneuroendocrinology 2022; 143:105839. [PMID: 35728362 DOI: 10.1016/j.psyneuen.2022.105839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
Childhood maltreatment (CM) is associated with several negative outcomes in adulthood, including major depression. People who experience CM that go on to develop symptoms of major depression in adulthood tend to have earlier depressive symptom onset and greater symptom severity than those who do not experience CM. Studies have utilized allostatic load (AL) to understand how CM "gets under the skin" to contribute to depressive symptoms. However, studies largely utilize cross-sectional designs and limited biomarkers. The present study uses data from Wave 2 and Wave 3 of the Midlife Development in the United States study in regression-based analyses, examining if AL mediates the relationship between CM and the number of depressive symptoms in adulthood. AL was measured at Wave 2 using the system risk method with 27 biomarkers across seven different systems. CM was measured using the Childhood Trauma Questionnaire at Wave 2. Number of depressive symptoms were measured using the Composite International Diagnostic Interview-Short Form at Wave 3. Past month perceived stress, age, household income, education, sex, racial/ethnic identity, and current prescription medication use at Wave 2 were included as controls. Analyses identified that CM was associated with AL cross-sectionally, and that both CM and AL at were associated with the number of depressive symptoms prospectively. AL partially mediated the effects of CM on the number of depressive symptoms. The present study is the first to identify the mediating role of AL in the relationship between CM and adulthood depressive symptoms in a longitudinal design.
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Affiliation(s)
| | | | - Dipali Patel
- University of Georgia, School of Social Work, USA
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11
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Associations Between Implementation of the Collaborative Care Model and Disparities in Perinatal Depression Care. Obstet Gynecol 2022; 140:204-211. [PMID: 35852270 PMCID: PMC9307131 DOI: 10.1097/aog.0000000000004859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/28/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate whether perinatal collaborative care model implementation was associated with a reduction in racial disparities in depression care. METHODS This retrospective cohort study included pregnant and postpartum people who self-identified as either Black or White, and received prenatal care at academic faculty offices affiliated with an urban quaternary medical center. Individuals were divided into two cohorts to reflect the epochs of implementation. The primary outcome was the frequency of depression screening. The secondary outcome was the frequency of provision of a treatment recommendation for those with a positive depression screen. Antenatal and postpartum care were analyzed separately. A propensity score was used in multivariable models to control for confounders chosen a priori across implementation epoch. Interaction terms were created between race and implementation epoch to identify whether effect modification was present. Subgroup analyses were performed for outcomes with significant race-by-epoch interaction terms. RESULTS Of the 4,710 individuals included in these analyses, 4,135 (87.8%) self-identified as White and 575 (12.2%) self-identified as Black. Before implementation, Black individuals were more likely to receive screening (adjusted odds ratio [aOR] 2.44) but less likely to have a treatment recommended when a positive screen was identified (aOR 0.05). In multivariable models, race-by-epoch interaction terms were significant for both antenatal screening (P<.001) and antenatal treatment recommendation (P=.045), demonstrating that implementation of the perinatal collaborative care model was associated with reductions in extant racial disparities. After implementation, there were no significant differences by race (referent=White) in screening for antenatal depression (aOR 1.22, 95% CI 0.89-1.68) or treatment recommendations for those who screened positive (aOR 0.64, 95% CI 0.27-1.53). Race-by-epoch interaction terms were not significant in multivariable models for either postpartum screening or treatment recommendation. CONCLUSION Implementation of the perinatal collaborative care model is associated with a mitigation of racial disparities in antenatal depression care and may be an equity-promoting intervention for maternal health.
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12
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Gao T, Mei S, Li M, Arcy CD, Meng X. Roles of Psychological Distress and Social Support in the Relationship Between Childhood Maltreatment and Perceived Needs for Mental Health Care. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14089-NP14116. [PMID: 33858262 DOI: 10.1177/08862605211006368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.
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Affiliation(s)
- Tingting Gao
- Jilin University, Changchun, China
- McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
- Shandong University, Jinan, China
| | | | - Muzi Li
- McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
| | | | - Xiangfei Meng
- McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
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13
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Mindlis I, Wisnivesky JP, Wolf MS, O’Conor R, Federman AD. Comorbidities and depressive symptoms among older adults with asthma. J Asthma 2022; 59:910-916. [PMID: 33556292 PMCID: PMC11009969 DOI: 10.1080/02770903.2021.1887890] [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: 10/08/2020] [Revised: 01/25/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Depression is associated with poor outcomes among older adults with asthma, and the presence of multiple comorbidities may magnify this relationship. We sought to determine the association of comorbidities with depressive symptoms among older adults with asthma. METHODS Secondary analysis of data from a randomized controlled trial of older adults with poorly controlled asthma and comorbidities. Comorbidities were measured in two ways: (1) as a count of all the patient's chronic diseases, and (2) as a count of chronic illnesses with self-management intensive needs (diabetes, hypertension, congestive heart failure). Depressive symptoms were measured using the PROMIS SF8a scale. Multiple regression analyses tested the relationship between comorbidities and depressive symptoms, adjusting for sociodemographic factors. RESULTS Overall, 25% of participants had moderate-severe levels of depressive symptoms, 87% had ≥ two comorbidities, and 41% had ≥ one comorbidity with self-management intensive needs. The count of all comorbidities was significantly associated with depressive symptoms (F (8, 330) = 7.7, p < 0.0001, R2 = 0.158) in adjusted models, whereas the count of self-management intensive conditions was not significantly associated with depressive symptoms in adjusted analyses. CONCLUSIONS In older adults with asthma and multiple comorbidities, depressive symptoms increased with the overall count of comorbidities but not with the count of comorbidities with self-management intensive needs. Given the impact of depression on asthma outcomes for older adults, the mechanisms by which comorbid illness contributes to depressive symptoms in older asthmatics warrants further evaluation.
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Affiliation(s)
- Irina Mindlis
- The Graduate Center, City University of New York, NY, USA
| | - Juan P. Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael S. Wolf
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Rachel O’Conor
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alex D. Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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14
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Aman AM, García-Marín LM, Thorp JG, Campos AI, Cuellar-Partida G, Martin NG, Rentería ME. Phenome-wide screening of the putative causal determinants of depression using genetic data. Hum Mol Genet 2022; 31:2887-2898. [PMID: 35394011 DOI: 10.1093/hmg/ddac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Depression is one of the most common mental health disorders and one of the top causes of disability throughout the world. The present study sought to identify putative causal associations between depression and hundreds of complex human traits through a genome-wide screening of genetic data and a hypothesis-free approach. We leveraged genome-wide association studies (GWAS) summary statistics for depression and 1504 complex traits and investigated potential causal relationships using the latent causal variable method. We identified 559 traits genetically correlated with depression risk at FDR < 5%. Of these, 46 were putative causal genetic determinants of depression, including lifestyle factors, diseases of the nervous system, respiratory disorders, diseases of the musculoskeletal system, traits related to the health of the gastrointestinal system, obesity, vitamin D levels, and the use of prescription medications, among others. No phenotypes were identified as potential outcomes of depression. Our results suggest that genetic liability to multiple complex traits may contribute to a higher risk for depression. In particular, we show a putative causal genetic effect of pain, obesity, and inflammation on depression. These findings provide novel insights into the potential causal determinants of depression and should be interpreted as testable hypotheses for future studies to confirm, which may facilitate the design of new prevention strategies to reduce depression's burden.
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Affiliation(s)
- Asma M Aman
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Luis M García-Marín
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane QLD Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane QLD Australia
| | - Jackson G Thorp
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane QLD Australia.,Translational Neurogenomics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Adrian I Campos
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD Australia
| | - Gabriel Cuellar-Partida
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, Australia
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane QLD Australia
| | - Miguel E Rentería
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane QLD Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane QLD Australia
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15
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Awan S, Hashmi AN, Taj R, Munir S, Habib R, Batool S, Azam M, Qamar R, Nurulain SM. Genetic Association of Butyrylcholinesterase with Major Depressive Disorder. Biochem Genet 2021; 60:720-737. [PMID: 34414522 DOI: 10.1007/s10528-021-10125-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
Major depressive disorder (MDD) is characterized as clinical depression, which primarily affects the mood and behaviour of an individual. In the present study butyrylcholinesterase (BChE), a co-regulatory cholinergic neurotransmitter enzyme implicated in several putative neuronal and non-neuronal physiological roles was investigated for its role in MDD. Eighty MDD patients and sixty-one healthy controls were recruited for the study. BChE activity was measured by Ellman's method using serum while DNA samples of the patients were genotyped for BCHE polymorphisms rs3495 (c.*189G > A) and rs1803274 (c.1699G > A) by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and tetra-primer Amplification Refractory Mutation System- polymerase chain reaction (ARMS-PCR). The genotyping was further validated by Sanger Sequencing. Biochemical estimation of serum BChE levels revealed a statistically significant decrease of enzyme activity in MDD patients (69.96) as compared to healthy controls (90.97), which was independent of age and gender. BCHE single nucleotide polymorphism rs1803274 genotype GA was found to be associated with the disease under a dominant model (OR 2.32; 95% CI 1.09-4.96; p value = 0.025). Furthermore, risk allele-A frequency was higher in cases (p value = 0.013) than control. Carriers of rs1803274 GA genotype showed reduced mean BChE activity than wild-type allele GG homozygotes (p value = 0.040). Gender-based analysis revealed a protective role of rs3495 in females (χ2 = 6.87, p value = 0.032, RM: OR 0.173, CI = 0.043-0.699 (p value = 0.017). In addition, rs1803274 risk allele-A was observed to be significantly higher in males (χ2 = 4.258, p value = 0.039). In conclusion, the present study is indicative of a role of BChE in the pathophysiology of MDD where genetic polymorphisms were observed to effect BChE activity. Further replication studies in different ethnicities are recommended to validate the current observations.
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Affiliation(s)
- Sliha Awan
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan
| | - Aisha N Hashmi
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan
| | - Rizwan Taj
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Sadaf Munir
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan
| | - Rabia Habib
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan
| | - Sajida Batool
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan
| | - Maleeha Azam
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan. .,Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45550, Pakistan.
| | - Raheel Qamar
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan.,Pakistan Academy of Sciences, Islamabad, Pakistan.,Science and Technology Sector, ICESCO, Rabat, Morocco
| | - Syed M Nurulain
- Department of Biosciences, COMSATS University Islamabad, Islamabad, 45550, Pakistan.
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16
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Fettes DL, Sklar M, Green AE, Sandhu A, Hurlburt MS, Aarons GA. Racial and Ethnic Differences in Depressive Profiles of Child Welfare-Involved Families Receiving Home Visitation Services. Psychiatr Serv 2021; 72:539-545. [PMID: 33691489 DOI: 10.1176/appi.ps.201900256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Profiles of depressive symptoms were identified among Hispanic, Black, and White parents involved in the child welfare service system, including changes in symptoms over time. METHODS Participants (N=2,109) were parents receiving SafeCare, a home visitation intervention provided in a large, diverse child welfare system. Depressive symptoms were assessed with the Centers for Epidemiological Studies Depression Scale at baseline and at approximately every sixth home visit, up to a total of four times. Univariate tests examined the relationship between baseline symptoms, race-ethnicity, and service participation. Latent class growth analyses identified trajectories of depressive symptoms during participation in child welfare services. RESULTS Participation in services was affected by depressive symptoms. Forty percent of parents did not remain long enough in the program to complete a second CES-D assessment, and those who reported more symptoms at baseline were significantly less likely to do so. Among parents who engaged in services, distinct profiles of depressive symptoms emerged that differed by race-ethnicity. For non-Hispanic Black parents, no changes in depressive symptoms over time were noted, regardless of level of severity at baseline. Parents with the highest levels of symptoms did not improve over time. CONCLUSIONS Despite receipt of supportive and recovery-oriented services specifically focused on empowering child welfare-involved parents, many experienced elevated depressive symptoms. Integration of child welfare and community mental health systems may improve both service engagement and mental health among child welfare-involved families.
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Affiliation(s)
- Danielle L Fettes
- Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt)
| | - Marisa Sklar
- Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt)
| | - Amy E Green
- Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt)
| | - Amanpreet Sandhu
- Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt)
| | - Michael S Hurlburt
- Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt)
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt)
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17
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Keeping hope alive: Racial-ethnic disparities in distress tolerance are mitigated by religious/spiritual hope among Black Americans. J Psychosom Res 2021; 144:110403. [PMID: 33730637 PMCID: PMC8919343 DOI: 10.1016/j.jpsychores.2021.110403] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/08/2020] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
Racial and ethnic minorities, including Blacks/African-Americans and Hispanics/Latinos,indicate lower tolerance to psychological distress (DT) and secular hope yet endorse more religious and spiritual hope than their non-Hispanic White (NHW) counterparts. Whether racial-ethnic minorities derive greater benefit from non-secular hope on the tolerance of psychological distress remains unclear. Self-reported endorsement of religious/spiritual (R/S) hope, secular hope, DT, and a number of other psychosocial, R/S and sociodemographic variables were analyzed from a nationwide survey of persons aged over 18 years (N = 2875) identifying as Black (14.2%), Hispanic (15.4%), or NHW (67.3%) using multiple regression. Overall, higher levels of both R/S and secular hope predicted greater DT. In turn, greater DT was associated with lower psychosomatic distress. Compared to NHW, the ethnic-minority groups reported lower overall levels of DT. An interaction for race-ethnicity further revealed that compared to distress intolerant NHW, Blacks/African-Americans at lower levels of DT report higher R/S and secular hope. Hispanics/Latinos were also higher on R/S and secular hope, but endorsed lower hope at higher levels of DT than the reference group. Although hope is considered a more passive form of coping, it is more frequently endorsed in marginalized ethnic-minority groups. However, compared to NHW, differences do exist in the extent to which R/S hope mitigates DT in Blacks/African-Americans compared to Hispanics/Latinos.
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18
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Dennis AC. THOSE LEFT BEHIND: Socioeconomic Predictors and Social Mediators of Psychological Distress among Working-age African Americans in a Post-industrial City. DU BOIS REVIEW : SOCIAL SCIENCE RESEARCH ON RACE 2021; 18:119-151. [PMID: 34712354 PMCID: PMC8550544 DOI: 10.1017/s1742058x21000011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
While the socioeconomic status (SES)-psychological distress gradient is well-documented in the social science literature, less attention has been devoted to how this relationship varies within sociodemographic subgroups. I contribute to this small but growing literature by first examining the relationship between multiple dimensions of SES and two measures of psychological distress (depression and anxiety) among working-aged African Americans. I then test whether three social mediators explain the SES-psychological distress relationship, and whether gender modifies these associations and/or the social mediators that shape them. To address these aims, I analyze two waves of population-representative data from the Detroit Neighborhood Health Study (N=685). Data were collected between 2008 and 2010 in the wake of the Great Recession. I utilize structural equation modeling with latent variables to assess these relationships, and test indirect and conditional effects to detect the presence of mediation and/or moderation, respectively. Findings revealed associations between higher total household income and lower levels of depression/anxiety, as well as unemployment and increased depression/anxiety among working age African Americans. Furthermore, higher educational attainment was associated with reduced anxiety, but not depression, in this population. Gender moderated these findings such that unemployment was associated with higher levels of depression/anxiety among women but not men. I also found that trauma mediated the relationship between unemployment and depression/anxiety as well as educational attainment and anxiety. Gender, however, moderated the association between unemployment and depression/anxiety via traumatic events such that the relationship was stronger among women than men. Collectively, these findings contribute to our limited understanding of African Americans' mental health and underscore the importance of how both socioeconomic forces and life course experiences with traumatic events contribute to poor mental health among this population.
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Affiliation(s)
- Alexis C Dennis
- Department of Sociology and Carolina Population Center, The University of North Carolina at Chapel Hill
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19
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Ettman CK, Cohen GH, Abdalla SM, Galea S. Do assets explain the relation between race/ethnicity and probable depression in U.S. adults? PLoS One 2020; 15:e0239618. [PMID: 33006988 PMCID: PMC7531850 DOI: 10.1371/journal.pone.0239618] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/09/2020] [Indexed: 11/19/2022] Open
Abstract
Depression is a leading cause of disability in the U.S. across all race/ethnicity groups. While non-Hispanic Black and Hispanic persons have worse physical health on most indicators than non-Hispanic White persons, the literature on the association between race/ethnicity and rates of depression is mixed. Given unequal distribution of assets across racial/ethnic groups, it is possible that social and economic differences may explain differential rates of depression across race/ethnicity groups. Using National Health and Nutrition Examination Survey (NHANES) data from 2007–2016, we constructed a nationally representative sample of 26,382 adults over 18 years old (11,072 non-Hispanic White, 5,610 non-Hispanic Black, 6,981 Hispanic, and 2,719 Other race). We measured symptoms of depression using the Patient Health Questionnaire-9 (PHQ-9), with a score of 10 or more indicating probable depression. We identified three kinds of assets: financial assets (income), physical assets (home ownership), and social assets (marital status and education). We estimated the weighted prevalence of probable depression across race/ethnicity groups, odds ratios controlling for assets, and predicted probabilities of probable depression across race/ethnicity and asset groups. Three results contribute to our understanding of the differences in probable depression rates between race/ethnicity groups: 1) Non-Hispanic Black and Hispanic persons had a higher weighted prevalence of probable depression in the U.S. than non-Hispanic White persons. In models unadjusted for assets, non-Hispanic Black and Hispanic persons had 1.3 greater odds of probable depression than non-Hispanic White persons (p<0.01). 2) We found an inverse relation between assets and probable depression across all race-ethnicity groups. Also, non-Hispanic Black and Hispanic persons had fewer assets than non-Hispanic Whites. 3) When we controlled for assets, non-Hispanic Black and Hispanic persons had 0.8 times lower odds of probable depression than non-Hispanic White persons (p<0.05). Thus, when holding assets constant, minorities had better mental health than non-Hispanic White persons in the U.S. These three findings help to reconcile findings in the literature on race/ethnicity and depression. Given vastly unequal distribution of wealth in the U.S., it is not surprising that racial minorities, who hold fewer assets, would have an overall larger prevalence of mental illness, as seen in unadjusted estimates. Once assets are taken into account, Black and Hispanic persons appear to have better mental health than non-Hispanic White persons. Assets may explain much of the relation between race/ethnicity group and depression in the U.S. Future research should consider the role of assets in protecting against mental illness.
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Affiliation(s)
- Catherine K. Ettman
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, United States of America
- * E-mail:
| | - Gregory H. Cohen
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Columbia Mailman School of Public Health, NYC, New York, United States of America
| | - Salma M. Abdalla
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Sandro Galea
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
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20
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Radey M, McWey L, Cui M. Psychological distress among low-income mothers: the role of public and private safety nets. Women Health 2020; 60:692-706. [PMID: 31814538 PMCID: PMC7266719 DOI: 10.1080/03630242.2019.1700586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
Poverty is linked with a host of negative outcomes. Approximately one-third of unmarried mothers and their children live in poverty in the United States. Public and private supports have the potential to mitigate the adverse effects of poverty; however, these supports may be unstable over time. The purpose of this study was to determine public and private safety net configurations of low-income mothers longitudinally and test linkages between safety net configurations and maternal psychological distress. Using longitudinal data from the Welfare, Children, Families project conducted in 1999, 2001, and 2005 (n = 1,987), results of multilevel models of change indicated that less than one-half of low-income mothers used public assistance and had private support at any one point. Safety net configurations and psychological distress levels changed over time with deterioration occurring more than improvement, and private safety net availability offered protection from psychological distress. These findings can be used to inform family support services and highlight the need to augment public assistance programs with services aimed to also address maternal psychological well-being and social support. Doing so can be a means of improving the public and private safety nets and outcomes of vulnerable families.
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Affiliation(s)
- Melissa Radey
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Lenore McWey
- College of Human Sciences, Florida State University, Tallahassee, Florida, USA
| | - Ming Cui
- College of Human Sciences, Florida State University, Tallahassee, Florida, USA
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21
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Peñalver Bernabé B, Maki PM, Dowty SM, Salas M, Cralle L, Shah Z, Gilbert JA. Precision medicine in perinatal depression in light of the human microbiome. Psychopharmacology (Berl) 2020; 237:915-941. [PMID: 32065252 DOI: 10.1007/s00213-019-05436-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/11/2019] [Indexed: 12/17/2022]
Abstract
Perinatal depression is the most common complication of pregnancy and affects the mother, fetus, and infant. Recent preclinical studies and a limited number of clinical studies have suggested an influence of the gut microbiome on the onset and course of mental health disorders. In this review, we examine the current state of knowledge regarding genetics, epigenetics, heritability, and neuro-immuno-endocrine systems biology in perinatal mood disorders, with a particular focus on the interaction between these factors and the gut microbiome, which is mediated via the gut-brain axis. We also provide an overview of experimental and analytical methods that are currently available to researchers interested in elucidating the influence of the gut microbiome on mental health disorders during pregnancy and postpartum.
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Affiliation(s)
- Beatriz Peñalver Bernabé
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States.
| | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA
| | - Shannon M Dowty
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mariana Salas
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Lauren Cralle
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Zainab Shah
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Jack A Gilbert
- Scripts Oceanographic Institute, University of California San Diego, La Jolla, CA, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
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22
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Lindberg L, Hagman E, Danielsson P, Marcus C, Persson M. Anxiety and depression in children and adolescents with obesity: a nationwide study in Sweden. BMC Med 2020; 18:30. [PMID: 32079538 PMCID: PMC7033939 DOI: 10.1186/s12916-020-1498-z] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 01/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anxiety and depression are more common in children with obesity than in children of normal weight, but it is unclear whether this association is independent of other known risk factors. Interpretation of results from previous studies is hampered by methodological limitations, including self-reported assessment of anxiety, depression, and anthropometry. The aim of this study was to investigate whether obesity increases the risk of anxiety or depression independently of other risk factors in a large cohort of children and adolescents, using robust measures with regard to exposure and outcome. METHODS Children aged 6-17 years in the Swedish Childhood Obesity Treatment Register (BORIS, 2005-2015) were included (n = 12,507) and compared with a matched group (sex, year of birth, and area of residence) from the general population (n = 60,063). The main outcome was a diagnosis of anxiety or depression identified through ICD codes or dispensed prescribed medication within 3 years after the end of obesity treatment. Hazard ratios (HRs) with 95% confidence intervals (CIs) from Cox proportional models were adjusted for several known confounders. RESULTS Obesity remained a significant risk factor for anxiety and depression in children and adolescents after adjusting for Nordic background, neuropsychiatric disorders, family history of anxiety/depression, and socioeconomic status. Girls in the obesity cohort had a 43% higher risk of anxiety and depression compared to girls in the general population (adjusted HR 1.43, 95% CI 1.31-1.57; p < 0.0001). The risk in boys with obesity was similar (adjusted HR 1.33, 95% CI 1.20-1.48; p < 0.0001). In sensitivity analyses, excluding subjects with neuropsychiatric disorders and a family history of anxiety/depression, the estimated risks in individuals with obesity were even higher compared with results from the main analyses (adjusted HR [95% CI]: girls = 1.56 [1.31-1.87], boys = 2.04 [1.64-2.54]). CONCLUSIONS Results from this study support the hypothesis that obesity per se is associated with risk of both anxiety and depression in children and adolescents.
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Affiliation(s)
- Louise Lindberg
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden.
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden
| | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Blickagången 6A Novum, 141 57, Stockholm, Sweden
| | - Martina Persson
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.,Department of Diabetes and Endocrinology, Sachsska Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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23
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Marees AT, Smit DJA, Ong JS, MacGregor S, An J, Denys D, Vorspan F, van den Brink W, Derks EM. Potential influence of socioeconomic status on genetic correlations between alcohol consumption measures and mental health. Psychol Med 2020; 50:484-498. [PMID: 30874500 PMCID: PMC7083578 DOI: 10.1017/s0033291719000357] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 02/01/2019] [Accepted: 02/12/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Frequency and quantity of alcohol consumption are metrics commonly used to measure alcohol consumption behaviors. Epidemiological studies indicate that these alcohol consumption measures are differentially associated with (mental) health outcomes and socioeconomic status (SES). The current study aims to elucidate to what extent genetic risk factors are shared between frequency and quantity of alcohol consumption, and how these alcohol consumption measures are genetically associated with four broad phenotypic categories: (i) SES; (ii) substance use disorders; (iii) other psychiatric disorders; and (iv) psychological/personality traits. METHODS Genome-Wide Association analyses were conducted to test genetic associations with alcohol consumption frequency (N = 438 308) and alcohol consumption quantity (N = 307 098 regular alcohol drinkers) within UK Biobank. For the other phenotypes, we used genome-wide association studies summary statistics. Genetic correlations (rg) between the alcohol measures and other phenotypes were estimated using LD score regression. RESULTS We found a substantial genetic correlation between the frequency and quantity of alcohol consumption (rg = 0.52). Nevertheless, both measures consistently showed opposite genetic correlations with SES traits, and many substance use, psychiatric, and psychological/personality traits. High alcohol consumption frequency was genetically associated with high SES and low risk of substance use disorders and other psychiatric disorders, whereas the opposite applies for high alcohol consumption quantity. CONCLUSIONS Although the frequency and quantity of alcohol consumption show substantial genetic overlap, they consistently show opposite patterns of genetic associations with SES-related phenotypes. Future studies should carefully consider the potential influence of SES on the shared genetic etiology between alcohol and adverse (mental) health outcomes.
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Affiliation(s)
- Andries T. Marees
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Translational Neurogenomics Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Dirk J. A. Smit
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jue-Sheng Ong
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Jiyuan An
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Florence Vorspan
- Assistance Publique – Hôpitaux de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, 200 rue du Faubourg Saint Denis, 75010Paris, France
- Inserm umr-s 1144, Université Paris Descartes, Université Paris Diderot, 4 avenue de l'Observatoire, 75006Paris, France
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Eske M. Derks
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Translational Neurogenomics Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Chen R, Kessler RC, Sadikova E, NeMoyer A, Sampson NA, Alvarez K, Vilsaint CL, Green JG, McLaughlin KA, Jackson JS, Alegría M, Williams DR. Racial and ethnic differences in individual-level and area-based socioeconomic status and 12-month DSM-IV mental disorders. J Psychiatr Res 2019; 119:48-59. [PMID: 31563857 PMCID: PMC7255491 DOI: 10.1016/j.jpsychires.2019.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to: (1) examine the associations of individual-level objective socioeconomic status (OSS), subjective socioeconomic status (SSS), and area-based indicators of socioeconomic status, with 12-month DSM-IV mood, anxiety, alcohol use, and drug use disorders; and, (2) determine the extent of racial/ethnic differences in these associations across non-Latino White, non-Latino Black, Latino, and Asian participants. Data are from the Collaborative Psychiatric Epidemiology Studies dataset, a collection of three population-based surveys of mental disorders among U.S. residents aged 18 and older (n = 13,775). Among all indicators of socioeconomic status, SSS was most consistently associated with 12-month mental disorders. Income was negatively associated with mood and anxiety disorders; education was negatively associated with alcohol use and drug use disorders. Significant interactions with race/ethnicity were found for the associations of socioeconomic indicators with anxiety, alcohol use, and drug use disorders but not with mood disorders. SSS was not associated with any of the 12-month mental disorders among Blacks. Education had stronger associations with 12-month anxiety and alcohol use disorders among Whites than among other racial/ethnic groups. Among Asians, low income compared to high income was associated with a lower risk of anxiety disorders and less than high school completion compared to college or more was associated with a lower risk of alcohol use disorders. Finally, tract-level income inequality was associated with a greater risk of drug use disorders only among Blacks. The patterns and magnitudes of the associations of individual-level and area-based socioeconomic indicators differed by type of disorder and race/ethnicity.
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Affiliation(s)
- Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States.
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Amanda NeMoyer
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States.
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, United States.
| | - Corrie L Vilsaint
- Recovery Research Institute, Massachusetts General Hospital Center for Addiction Medicine, 151 Merrimac Street, Boston, MA, 02114, United States.
| | - Jennifer Greif Green
- Wheelock College of Education & Human Development, Boston University, 2 Silber Way, Boston, MA, 02215, United States.
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, United States.
| | - James S Jackson
- Institute for Social Research, 5057 ISR, 426 Thompson St., Ann Arbor, MI, 48104, United States.
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, United States.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States.
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25
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Assari S. Ethnicity, educational attainment, and physical health of older adults in the United States. Aging Med (Milton) 2019; 2:104-111. [PMID: 31608316 PMCID: PMC6788632 DOI: 10.1002/agm2.12050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 12/29/2018] [Accepted: 01/01/2019] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Minorities' diminished returns theory suggests that socioeconomic status (SES) resources generate fewer health benefits for racial and ethnic minority groups, compared to the majority group. The current study aimed to compare Hispanic and non-Hispanic white older adults for the association between educational attainment and poor physical self-rated health (SRH). METHODS The first wave of the University of Michigan National Poll on Healthy Aging (UM-NPHA) included 1820 older adults who were 50-80 years old and were either non-Hispanic white (n = 1618) or Hispanic white (n = 202). The main independent variable of interest was educational attainment. The main dependent variable of interest was poor physical SRH. Gender, age, marital status, and employment status were covariates. Ethnicity was the focal effect modifier. RESULTS Overall, higher level of educational attainment was associated with better physical SRH. A significant interaction was found between ethnicity and level of educational attainment, which was indicative of a smaller physical SRH gain due to high educational attainment for Hispanic white compared to non-Hispanic white older adults. In ethnic-specific models, we found evidence suggesting that high educational attainment reduced the odds of poor physical SRH for non-Hispanic whites but not for Hispanic whites. CONCLUSION Compared to non-Hispanic whites, Hispanic whites gain less physical SRH benefits from their educational attainment.
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Affiliation(s)
- Shervin Assari
- Department of PsychologyUniversity of California Los Angeles (UCLA)Los AngelesCalifornia
- Center for Research on Ethnicity, Culture, and Health (CRECH)School of Public HealthUniversity of MichiganAnn ArborMichigan
- Department of PsychiatryUniversity of MichiganAnn ArborMichigan
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26
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Abstract
Depression is a common and heterogeneous condition with a chronic and recurrent natural course that is frequently seen in the primary care setting. Primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition. In this two part series, we review the evidence available to help to guide primary care providers and practices to recognize and manage depression. In this first of two reviews, we outline an approach to screening and diagnosing depression in primary care that evaluates current evidence based guidelines and applies the recommendations to clinical practice. The second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level. It also highlights strategies that are being adopted at an organizational level to manage depression more effectively in primary care.
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Affiliation(s)
- Erin K Ferenchick
- Center for Family and Community Medicine, Columbia University Medical Center, New York, NY, USA
| | | | - Harold Alan Pincus
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
- Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
- RAND Corporation, Pittsburgh, PA, USA
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27
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Wortzel JR, Norden JG, Turner BE, Haynor DR, Kent ST, Al-Hamdan MZ, Avery DH, Norden MJ. Ambient temperature and solar insolation are associated with decreased prevalence of SSRI-treated psychiatric disorders. J Psychiatr Res 2019; 110:57-63. [PMID: 30594025 DOI: 10.1016/j.jpsychires.2018.12.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/02/2018] [Accepted: 12/12/2018] [Indexed: 12/31/2022]
Abstract
Serotonergic function is known to fluctuate in association with light and temperature. Serotonin-related behaviors and disorders similarly vary with climatic exposure, but the associations are complex. This complexity may reflect the importance of dose and timing of exposure, as well as acclimation. This cross-sectional study tests how average climate exposures (ambient temperature and solar insolation) vary with the prevalence of a group of SSRI-treated disorders. For comparison, we similarly studied a group of disorders not treated by SSRIs (i.e substance use disorders). Psychiatric prevalence data were obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES). Average yearly solar insolation was obtained from NASA's NLDAS-2 Forcing Dataset Information. Average yearly temperature was obtained from NOAA's US Climate Normals. Logistic regression models were generated to assess the relationship between these two climatic factors and the prevalence of SSRI-treated and substance use disorders. Age, gender, race, income, and education were included in the models to control for possible confounding. Temperature and insolation were significantly associated with the SSRI-responsive group. For an average 1 GJ/m2/year increase, OR was 0.90 (95% CI 0.85-0.96, p = 0.001), and for an average 10 °F increase, OR was 0.93 (95% CI 0.88-0.97, p = 0.001). This relationship was not seen with substance use disorders (insolation OR: 0.97, p = 0.682; temperature OR: 0.96, p = 0.481). These results warrant further investigation, but they support the hypothesis that chronic exposure to increased temperature and light positively impact serotonin function, and are associated with reduced prevalence of some psychiatric disorders. They also support further investigation of light and hyperthermia treatments.
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Affiliation(s)
- J R Wortzel
- School of Medicine, Stanford University, Stanford, CA, 94305, USA.
| | - J G Norden
- School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - B E Turner
- School of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - D R Haynor
- University of Washington, Seattle, WA, 98195, USA
| | - S T Kent
- School of Public Health, University of Alabama at Birmingham Universities, AL, 35294, USA
| | - M Z Al-Hamdan
- Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL, 35812, USA
| | - D H Avery
- University of Washington, Seattle, WA, 98195, USA
| | - M J Norden
- University of Washington, Retired Associate Professor on the Axillary Faculty, USA
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28
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Bostwick WB, Hughes TL, Steffen A, Veldhuis CB, Wilsnack SC. Depression and Victimization in a Community Sample of Bisexual and Lesbian Women: An Intersectional Approach. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:131-141. [PMID: 29968037 PMCID: PMC6314920 DOI: 10.1007/s10508-018-1247-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/02/2018] [Accepted: 05/26/2018] [Indexed: 05/06/2023]
Abstract
Mental health inequities among bisexual and lesbian women are well-documented. Compared to heterosexual women, both bisexual and lesbian women are more likely to report lifetime depressive disorders, with bisexual women often faring the worst on mental health outcomes. Risk factors for depression, such as victimization in childhood and adulthood, are also more prevalent among bisexual women. Less is known about the intersection of racial/ethnic and sexual minority identities, and how depression and victimization may differ across these multiple, co-occurring identities. Data were from Wave 3 of the Chicago Health and Life Experiences of Women study, an 18-year, community-based longitudinal study of sexual minority women's health. We constructed a six-category "intersection" variable based on sexual identity and race/ethnicity to examine group differences in lifetime depression and victimization. We tested childhood and adult victimization as moderators of lifetime depression (n = 600). A majority (58.2%) of the total sample met criteria for lifetime depression. When considering the intersection of race/ethnicity and sexual identity, Black bisexual and Black lesbian women had significantly lower odds of depression than White lesbian women, despite their higher reports of victimization. Latina bisexual and lesbian women did not differ from White lesbians on depression. Victimization did not moderate the association between the intersection variable and depression. More research is needed to better understand risk and protective factors for depression among racially/ethnically diverse sexual minority women (SWM). We highlight the need to deliberately oversample SWM of color to accomplish this goal.
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Affiliation(s)
- Wendy B. Bostwick
- Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612;
| | | | - Alana Steffen
- Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612;
| | | | - Sharon C. Wilsnack
- Department of Psychiatry and Behavioral Science, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND
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29
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Assari S. Blacks' Diminished Return of Education Attainment on Subjective Health; Mediating Effect of Income. Brain Sci 2018; 8:E176. [PMID: 30213135 PMCID: PMC6162786 DOI: 10.3390/brainsci8090176] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/05/2018] [Accepted: 08/10/2018] [Indexed: 01/28/2023] Open
Abstract
Background: Minorities' Diminished Return (MDR) can be defined as smaller health gains from socioeconomic status (SES) indicators, such as education attainment among ethnic minorities compared to the majority group. The current study tested whether income explains why Black and White adults differ in the association between education attainment and self-rated health (SRH). Methods: With a cross-sectional design, this study used data from Cycle 5 of the Health Information National Trends Survey (HINTS), 2017. With a nationally representative sample, the HINTS study generates results that are generalizable to US adults. This study included 2277 adults who were either non-Hispanic White (n = 1868; 82%) or non-Hispanic Black (n = 409; 18%). The independent variable was education attainment. The dependent variable was SRH, measured using a standard single item. Age, gender, and health insurance status were covariates. Ethnicity was the focal moderator. Income was the mediator. A structural equation model (SEM) was applied for data analysis. Results: Overall, higher education attainment was associated with better SRH, net of covariates. However, a significant interaction between ethnicity and education attainment suggested a smaller SRH gain from education for Blacks compared to Whites. This interaction could be explained by Black⁻White differences in income. Conclusion: Our study results suggests that labor market preferences may explain smaller effects of education attainment on SRH for Blacks relative to Whites. Given this finding and other studies documenting MDR, policies should reduce labor market discrimination, increasing job opportunities and reducing the racial pay gap for Blacks. Programs should help Blacks compete for prestigious and high-paying jobs.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd.; Ann Arbor, MI 48109-2700, USA.
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30
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Ward JB, Robinson WR, Pence BW, Maselko J, Albrecht SS, Haan MN, Aiello AE. Educational Mobility Across Generations and Depressive Symptoms Over 10 Years Among US Latinos. Am J Epidemiol 2018; 187:1686-1695. [PMID: 29762643 DOI: 10.1093/aje/kwy056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 03/09/2018] [Indexed: 01/19/2023] Open
Abstract
Few studies have collected intergenerational data to assess the association between educational mobility across multiple generations and offspring depression. Using data from the Sacramento Area Latino Study on Aging (1998-2008), we assessed the influence of intergenerational education on depressive symptoms over 10 years among 1,786 Latino individuals (mean age = 70.6 years). Educational mobility was classified as stable-low (low parental/low offspring education), upwardly mobile (low parental/high offspring education), stable-high (high parental/high offspring education), or downwardly mobile (high parental/low offspring education). Depressive symptoms were measured with the Center for Epidemiological Studies-Depression Scale (CES-D); higher scores indicated more depressive symptoms. To quantify the association between educational mobility and CES-D scores over follow-up, we used generalized estimating equations to account for repeated CES-D measurements and adjusted for identified confounders. Within individuals, depressive symptoms remained relatively stable over follow-up. Compared with stable-low education, stable-high education and upward mobility were associated with significantly lower CES-D scores (β = -2.75 and -2.18, respectively). Downwardly mobile participants had slightly lower CES-D scores than stable-low participants (β = -0.77). Our results suggest that sustained, low educational attainment across generations may have adverse mental health consequences, and improved educational opportunities in underresourced communities may counteract the adverse influence of low parental education on Latino depression.
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Affiliation(s)
- Julia B Ward
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Sandra S Albrecht
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
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Assari S. Ethnic Groups Differ in How Poor Self-Rated Mental Health Reflects Psychiatric Disorders. J Racial Ethn Health Disparities 2018; 5:728-736. [PMID: 28913713 PMCID: PMC6378222 DOI: 10.1007/s40615-017-0417-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 07/23/2017] [Accepted: 07/25/2017] [Indexed: 01/07/2023]
Abstract
AIM This study aimed to explore cross-ethnic variation in the pattern of the associations between psychiatric disorders and self-rated mental health (SRMH) in the USA. METHODS This cross-sectional study used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, a national household probability sample. The study enrolled 18,237 individuals who were either Non-Hispanic White (n = 7587), African American (n = 4746), Mexican (n = 1442), Cuban (n = 577), Puerto Rican (n = 495), Other Hispanic (n = 1106), Vietnamese (n = 520), Filipino (n = 508), Chinese (n = 600) or Other Asian (n = 656). SRMH was the outcome. Independent variables were psychiatric disorders including major depressive disorder [MDD], general anxiety disorder [GAD], social phobia, alcohol abuse, binge eating disorders, panic disorder, and post-traumatic stress disorder [PTSD], measured by the Composite International Diagnostic Interview (CIDI). Demographic (age and gender) and socioeconomic (education and income) factors were covariates. RESULTS The only psychiatric disorder which was universally associated with SRMH across all ethnic groups was MDD. More psychiatric disorders were associated with poor SRMH in Non-Hispanic Whites than any other ethnic groups. Among African Americans, demographic and socioeconomic factors could fully explain the associations between psychiatric disorders and SRMH. Among Mexican and Other Hispanics, demographic and socioeconomic factors could only explain the association between some but not all psychiatric disorders and SRMH. In all other ethnic groups, demographic and socioeconomic factors did not explain the link between psychiatric disorders and SRMH. CONCLUSION Although SRMH is a useful tool for estimation of mental health needs of populations, poor SRMH may not have universal meanings across ethnically diverse populations. Ethnic groups differ in how their poor SRMH reflects psychiatric conditions and the role of demographic and socioeconomic factors in explaining such links. These ethnic differences may be a source of measurement bias in cross-ethnic health comparisons.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
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Peplinski B, McClelland R, Szklo M. Associations between socioeconomic status markers and depressive symptoms by race and gender: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Ann Epidemiol 2018; 28:535-542.e1. [PMID: 29934242 DOI: 10.1016/j.annepidem.2018.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/07/2018] [Accepted: 05/16/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Depression poses a significant public health burden, with varying prevalence by race/ethnicity, gender, and socioeconomic status (SES). It is unclear whether race/ethnicity and gender modify relationships between SES and depression. The purpose of this study was to investigate such effect modification. METHODS A cross-sectional analysis was performed on Multi-Ethnic Study of Atherosclerosis participants at the baseline (n = 5559). Multivariable logistic regression models stratified by race/ethnicity and gender were performed to evaluate associations between income, education, occupation, and neighborhood SES with depressive symptoms, defined by Center for Epidemiologic Studies Depression Scale values of 16 or greater. RESULTS Depressive symptom odds were lower with increasing income, and this was pronounced in white women, black men, and Hispanic women. Lower odds of depressive symptoms were seen in management/professional occupations for Hispanic men, and in blacks as neighborhood SES increased. Education was not associated with odds of depressive symptoms. Multiplicative interaction terms were significant for gender-income (P = .028) and race/ethnicity-neighborhood (P = .010). Race/ethnicity-neighborhood interaction was also observed on the additive scale. CONCLUSIONS Associations varied across races/ethnicities and gender, and evidence for effect modification was seen by gender with income, and by race/ethnicity with neighborhood SES. These findings provide a nuanced understanding of race/ethnicity and gender differences in SES related to depressive symptoms.
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Affiliation(s)
| | | | - Moyses Szklo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Assari S, Lapeyrouse LM, Neighbors HW. Income and Self-Rated Mental Health: Diminished Returns for High Income Black Americans. Behav Sci (Basel) 2018; 8:E50. [PMID: 29772799 PMCID: PMC5981244 DOI: 10.3390/bs8050050] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/11/2018] [Accepted: 05/13/2018] [Indexed: 01/16/2023] Open
Abstract
Background: The minorities' diminished return theory suggests that socioeconomic position (SEP) generates smaller health gains for racial/ethnic minorities compared to Whites. The current study was a Black⁻White comparison of the association between household income and self-rated mental health (SRMH). Methods: This cross-sectional study used data from the 2017 State of the State Survey (SOSS). With representative sampling, the SOSS generates results that are generalizable to the state of Michigan. This study included 881 adults, (n = 92) Black and (n = 782) White. The independent variable was household income. The dependent variable was SRMH, measured using a single item. Age, gender, and participation in the labor force were covariates. Race/ethnicity was the focal moderator. Logistic regression models were used for data analysis. Results: Overall, higher household income was associated with better SRMH, net of covariates. An interaction was found between race/ethnicity and household income on SRMH, suggesting a smaller, or nonexistent, protective effect for Blacks compared to Whites. In race/ethnicity-stratified models, higher household income was associated with better SRMH for Whites but not Blacks. Conclusion: Supporting the minorities' diminished return theory, our study documents differential effects for income on SRHM for Blacks and Whites, where Whites but not Blacks appear to benefit from their income. Given this, researchers and policy makers are cautioned against making assumptions that racial groups benefit equally from similar economic resources.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd.; Ann Arbor, MI 48109-2700, USA.
| | - Lisa M Lapeyrouse
- Department of Public Health and Health Sciences, University of Michigan, Flint, MI 48502, USA.
| | - Harold W Neighbors
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI 48502, USA.
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Assari S. Socioeconomic Status and Self-Rated Oral Health; Diminished Return among Hispanic Whites. Dent J (Basel) 2018; 6:E11. [PMID: 29695074 PMCID: PMC6023433 DOI: 10.3390/dj6020011] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/20/2018] [Accepted: 04/20/2018] [Indexed: 12/12/2022] Open
Abstract
Background. An extensive body of knowledge has documented weaker health effects of socio-economic status (SES) for Blacks compared to Whites, a phenomenon also known as Blacks’ diminished return. It is, however, unknown whether the same diminished return also holds for other ethnic minorities such as Hispanics or not. Aim. Using a nationally representative sample, the current study aimed to compare Non-Hispanic and Hispanic Whites for the effects of SES on self-rated oral health. Methods. For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001⁻2003. With a nationally representative sampling, CPES included 11,207 adults who were either non-Hispanic Whites (n = 7587) or Hispanic Whites (n = 3620. The dependent variable was self-rated oral health, treated as dichotomous measure. Independent variables were education, income, employment, and marital status. Ethnicity was the focal moderator. Age and gender were covariates. Logistic regressions were used for data analysis. Results. Education, income, employment, and marital status were associated with oral health in the pooled sample. Although education, income, employment, and marital status were associated with oral health in non-Hispanic Whites, none of these associations were found for Hispanic Whites. Conclusion. In a similar pattern to Blacks’ diminished return, differential gain of SES indicators exists between Hispanic and non-Hispanic Whites, with a disadvantage for Hispanic Whites. Diminished return of SES should be regarded as a systemically neglected contributing mechanism behind ethnic oral health disparities in the United States. Replication of Blacks’ diminished return for Hispanics suggests that these processes are not specific to ethnic minority groups, and non-White groups gain less because they are not enjoying the privilege and advantage of Whites.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor 48109-2700, MI, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor 48109-2700, MI, USA 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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Assari S. High Income Protects Whites but Not African Americans against Risk of Depression. Healthcare (Basel) 2018; 6:healthcare6020037. [PMID: 29690595 PMCID: PMC6023547 DOI: 10.3390/healthcare6020037] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 01/08/2023] Open
Abstract
Background: Built on the Blacks’ diminished return theory, defined as smaller effects of socioeconomic status (SES) on a wide range of health outcomes for African Americans compared to Whites, the current study compared African Americans and Whites for the association between household income and risk of lifetime, 12-month, and 30-day major depressive disorder (MDD). Methods: For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001–2003. With a nationally representative sampling, CPES included 4746 non-Hispanic African Americans and 7587 non-Hispanic Whites. The dependent variables were lifetime, 12-month, and 30-day MDD, measured using Composite International Diagnostic Interview (CIDI). The independent variable was household income. Age, gender, education, chronic medical conditions, and obesity were covariates. Race was the focal moderator. Logistic regression models were used to test the protective effects of household income against MDD in the overall sample and also by race. Results: In the overall sample, household income was inversely associated with the risk of 12-month and 30-day MDD. We found a significant interaction between race and household income on 12-month and 30-day MDD, suggesting a smaller protective effect of household income against MDD for African Americans compared to Whites. Conclusion: In line with the Blacks’ diminished return theory, household income better protects Whites than African Americans against MDD. The contribution of diminished return of SES as an underlying mechanism behind racial disparities in health in the United States is often overlooked. Additional research is needed on why and how SES resources generate smaller health gain among minority groups.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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Müller MJ, Koch E. Gender Differences in Stressors Related to Migration and Acculturation in Patients with Psychiatric Disorders and Turkish Migration Background. J Immigr Minor Health 2018; 19:623-630. [PMID: 27026345 DOI: 10.1007/s10903-016-0408-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Migration, acculturation, and psychiatric disorders may cause stress and adaptation processes differently in men and women, but empirical research is scarce. In a retrospective study n = 62 Turkish migrants and n = 62 native German inpatients with depressive or anxiety disorders, matched for age, gender, and diagnoses, were compared using a 10-item instrument for the assessment of migration- and acculturation related stressors (MIGSTR10). Gender differences in the prevalence of stressors and in the total sum of stressors were calculated and compared between migrants and indigenous patients. Results showed a higher global stress level in migrants and in women than in men with migration background. Regarding single stressors, the perceived loss of status was significantly more prevalent and more pronounced in men than in women (P < 0.05) whereas guilt feelings were more severe in women with Turkish migration background compared to men (P < 0.05). Gender differences of perceived stress should be taken into account in migration and acculturation research.
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Affiliation(s)
- Matthias Johannes Müller
- Faculty of Medicine, University of Giessen, Giessen, Germany.
- Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Strasse 106, 35394, Giessen, Germany.
| | - Eckhardt Koch
- Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Strasse 106, 35394, Giessen, Germany
- Institute of European Ethnology and Cultural Studies, University of Marburg, Marburg, Germany
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Vaeth PAC, Caetano R, Mills BA. Factors Associated with Depression Among Mexican Americans Living in U.S.-Mexico Border and Non-Border Areas. J Immigr Minor Health 2017; 18:718-727. [PMID: 26137982 DOI: 10.1007/s10903-015-0236-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Factors associated with CES-D depression among Mexican Americans living on and off the U.S.-Mexico border are examined. Data are from two studies of Mexican American adults. The Border Survey conducted face-to-face interviews in urban U.S.-Mexico border counties of California, Arizona, New Mexico, and Texas (N = 1307). The non-border HABLAS survey conducted face-to-face interviews in Houston, Los Angeles, New York, Philadelphia, and Miami (N = 1288). Both surveys used a multistage cluster sample design with response rates of 67 and 76 %, respectively. The multivariate analysis showed that border residence and higher perceived neighborhood collective efficacy were protective for depression among men. Among men, lower education, unemployment, increased weekly drinking, and poor health status were associated with depression. Among women, alcohol-related problems and poorer health status were also associated with depression. Further examinations of how neighborhood perceptions vary by gender and how these perceptions influence the likelihood of depression are warranted.
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Affiliation(s)
- Patrice A C Vaeth
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612-3749, USA.
| | - Raul Caetano
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612-3749, USA
| | - Britain A Mills
- University of Texas School of Public Health, Dallas Regional Campus, Dallas, TX, USA
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Ncube CN, Enquobahrie DA, Gavin AR. Racial Differences in the Association Between Maternal Antenatal Depression and Preterm Birth Risk: A Prospective Cohort Study. J Womens Health (Larchmt) 2017; 26:1312-1318. [PMID: 28622475 PMCID: PMC5733649 DOI: 10.1089/jwh.2016.6198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In the United States, racial/ethnic disparities in preterm birth (PTB) are well documented, but explanations for why the disparity persists remain to be fully explored. We examined racial/ethnic differences in the association of maternal antenatal depression with PTB (<37 completed weeks of gestation) risk. METHODS In a prospective cohort study, participants (n = 2073) included non-Hispanic (NH) black, NH white, Asian, and Hispanic women who received prenatal care at a university obstetric clinic January 2004-March 2010, and delivered at the university's hospital. We obtained data from self-reported questionnaires and electronic medical records. We assessed antenatal depression using the Patient Health Questionnaire-9 and self-reported antenatal antidepressant medication use. Poisson regression models were used to estimate the association between antenatal depression and PTB risk, within strata of race/ethnicity. RESULTS NH black (risk ratio [RR] = 1.89; 95% confidence interval [CI]: 0.94, 3.80), NH white (RR = 1.58, 95% CI: 1.04, 2.39), and Asian (RR = 2.06; 95% CI: 0.69, 6.13) women with antenatal depression were at increased risk for delivering preterm infants, compared with women without antenatal depression, although the associations were statistically significant only among NH white women. There was no evidence of an association between antenatal depression and risk of PTB among Hispanic women (RR = 0.96; 95% CI: 0.28, 3.25); p-value for interaction = 0.81. CONCLUSION Our findings suggest race-specific associations of antenatal depression with an increased risk of delivering a preterm infant, supporting the importance of considering race/ethnicity when examining risk factors for health outcomes.
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Affiliation(s)
- Collette N. Ncube
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Daniel A. Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Amelia R. Gavin
- School of Social Work, University of Washington, Seattle, Washington
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Sutter M, Perrin PB, Trujillo MA. Understanding the association between discrimination and depression among sexual minority people of color: Evidence for diminishing returns of socioeconomic advantage. J Clin Psychol 2017; 74:940-952. [PMID: 29139126 DOI: 10.1002/jclp.22558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 09/02/2017] [Accepted: 09/05/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To examine the differential association of heterosexism and racism on depression as moderated by socioeconomic status (SES) among sexual minority people of color. METHOD A cross-sectional sample of sexual minority people of color (n = 170) was surveyed on their experiences of heterosexism, racism, depression, and SES in a national online study based in the United States. RESULTS Bivariately, SES was inversely associated with depression, racism, and heterosexism. Moderation analyses found that for individuals with less socioeconomic advantage, the associations between heterosexism and depression were not as strong. However, at higher socioeconomic advantage, heterosexism was more strongly positively associated with depression. CONCLUSION These results suggest that the effects of discrimination on depression in sexual minority individuals of color may be accentuated at higher socioeconomic levels. Implications suggest helping sexual minority clients of color from higher SES backgrounds explore the effects of discrimination on their mental health.
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Assari S. Psychiatric Disorders Differently Correlate with Physical Self-Rated Health across Ethnic Groups. J Pers Med 2017; 7:E6. [PMID: 29137173 PMCID: PMC5748622 DOI: 10.3390/jpm7040006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 11/16/2022] Open
Abstract
In this study, we compared 10 ethnic groups for associations between psychiatric disorders and physical self-rated health (SRH) in the United States. Data came from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. The study included 7587 non-Latino White, 4746 African American, 1442 Mexican, 1106 other Hispanic, 656 other Asian, 600 Chinese, 577 Cuban, 520 Vietnamese, 508 Filipino, and 495 Puerto Rican individuals. The Composite International Diagnostic Interview (CIDI) was used to measure psychiatric disorders, including major depressive disorder (MDD), general anxiety disorder (GAD), social phobia, panic disorder, post-traumatic stress disorder (PTSD), alcohol abuse, and binge eating disorders. A single-item measure was used to estimate physical SRH. Demographic (age and gender) and socioeconomic (education and income) factors were also measured. Unadjusted and adjusted correlations between psychiatric disorders and physical SRH were calculated. Major ethnic variations were found in the correlation between psychiatric disorders and physical SRH; as well as the role of demographic and socioeconomic status (SES) factors in explaining these associations. non-Hispanic Whites, Cubans, and African Americans showed more correlations between psychiatric disorders and physical SRH than other ethnic groups. In non-Hispanic Whites, the associations between psychiatric disorders and physical SRH were explained by demographic factors. In African Americans, the link between psychiatric disorders and poor physical SRH were explained by SES indicators. In conclusion, although single-item physical SRH measures are traditionally assumed to reflect the physical health needs of populations, they may also indicate psychiatric disorders in some ethnic groups, such as non-Hispanic Whites, Cubans, and African Americans. Demographic and socioeconomic factors also have differential roles in explaining the link between psychiatric disorders and physical SRH. Physical SRH does not exclusively reflect physical health, and it may be more biased by mental health across some ethnic groups.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
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Lee S, Park Y. Variation in Major Depressive Disorder Onset by Place of Origin Among U.S. Latinos. Psychiatr Q 2017; 88:653-663. [PMID: 27957656 DOI: 10.1007/s11126-016-9484-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Using a nationally representative sample of 2514 U.S. Latinos, this study examined the extent to which major depressive disorder (MDD) onset differs by place of origin and the factors associated with it. The Kaplan-Meier method estimated the survival and hazard functions for MDD onset by place of origin, and Cox proportional hazards models identified its associative factors. Approximately 13% of the sample had experienced MDD in their lifetimes. Cuban respondents showed the highest survival function, while Puerto Ricans showed the lowest. With the entire sample, the smoothed hazard function showed that the risk of MDD onset peaked in the late 20s and early 80s. Puerto Rican respondents showed the highest risk of MDD during their 20s and 30s, whereas Cuban respondents showed a relatively stable pattern over time. The results from the Cox proportional hazards model indicated that age, sex, and marital status were significantly related to MDD onset (p < .05). In addition, the effect of U.S.-born status on MDD onset was greater among Mexican respondents than among Puerto Ricans. Findings from the present study demonstrate that different Latino subgroups experience different and unique patterns of MDD onset over time. Future research should account for the role of immigration status in examining MDD onset.
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Affiliation(s)
- Sungkyu Lee
- School of Social Welfare, Soongsil University, 369 Sangdo-Ro, Dongjak-Gu, Seoul, 06978, South Korea.
| | - Yangjin Park
- Graduate School of Social Welfare, Soongsil University, Seoul, South Korea
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Hessol NA, Schwarcz SK, Hsu LC, Shumway M, Machtinger EL. Gender differences in causes of death among persons with HIV/AIDS in San Francisco, California, 1996-2013. Int J STD AIDS 2017; 29:135-146. [PMID: 28728525 DOI: 10.1177/0956462417720370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective was to examine gender differences in causes of death using the San Francisco HIV/AIDS and death registries. Data from San Francisco residents diagnosed with HIV/AIDS who died from 1996 to 2013 were analyzed. Age, race/ethnicity, year, and gender-adjusted standardized mortality ratios and Poisson 95% confidence intervals were calculated for underlying causes of death. Among the 6268 deaths, deaths attributed to drug use, mental disorders due to substance use, cerebrovascular disease, chronic obstructive pulmonary disease, renal disease, and septicemia were more likely among women than among men. Compared to the California population, women had elevated standardized mortality ratios for drug overdose (25.37), mental disorders due to substance abuse (27.21), cerebrovascular disease (2.83), chronic obstructive pulmonary disease (7.37), heart disease (2.37), and liver disease (5.54), and these were higher than the standardized mortality ratios for the men in our study. Men, but not women, had elevated standardized mortality ratios for suicide (2.70), undetermined intent (3.88), renal disease (2.29), and non-AIDS cancer (1.68) compared to population rates. Continued efforts to reduce HIV-related illnesses and an increased emphasis on diagnosing and treating preventable causes of death, including substance use, heart disease, and mental health disorders, are needed as part of comprehensive HIV care.
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Affiliation(s)
- Nancy A Hessol
- 1 Department of Clinical Pharmacy, University of California, San Francisco, CA, USA.,2 Department of Medicine, University of California, San Francisco, CA, USA
| | - Sandra K Schwarcz
- 3 San Francisco Department of Public Health, San Francisco, CA, USA.,4 Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Ling Chin Hsu
- 3 San Francisco Department of Public Health, San Francisco, CA, USA
| | - Martha Shumway
- 5 Department of Psychiatry, University of California, San Francisco, CA, USA
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Fujita K, Kuwano Y, Saijo S, Nishikawa T, Nishida K, Rokutan K. Negative perception of socioeconomic status with depressive mood down-regulates expression of PPBP and SLC1A7 genes in peripheral blood leukocytes. COGENT PSYCHOLOGY 2017. [DOI: 10.1080/23311908.2017.1338825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Kinuyo Fujita
- Department of Pathophysiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Yuki Kuwano
- Department of Pathophysiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Saki Saijo
- Department of Pathophysiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Tatsuya Nishikawa
- Department of Pathophysiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Kensei Nishida
- Department of Pathophysiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Kazuhito Rokutan
- Department of Pathophysiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
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Choi Y, Kim TY, Pekelnicky DD, Kim K, Kim YS. Impact of youth cultural orientation on perception of family process and development among Korean Americans. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:244-257. [PMID: 27429061 PMCID: PMC5243931 DOI: 10.1037/cdp0000093] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES This study examined how cultural orientations influence youth perception of family processes in Korean American families and how these family processes, in turn, predict depressive symptoms and antisocial behaviors among youth. Family processes were examined separately for maternal and paternal variables. METHOD This study used survey data from Korean American families living in the Midwest (256 youth and their parents) across 2 time periods, spanned over a year. At the time of the first interview, the average age of youth was 13 (SD = 1.00). Using structural equation modeling, this study tested the hypothesized associations concurrently, longitudinally, and accounting for earlier outcomes. RESULTS AND CONCLUSION Results show that identity and behavioral enculturation in one's heritage culture are predictors of bonding with parents, which is notably protective for youth. The results highlight the critical effect of enculturation in enhancing youth perception of the parent-child relationship. Behavioral acculturation to mainstream culture, in contrast, predicts youth problems, although the effect may not necessarily always be via family processes. Similarly, Korean and English language proficiencies predict fewer youth problems, but not always by way of family processes. A few differences emerged across maternal and paternal variables, although there was much commonality in the hypothesized relationships. (PsycINFO Database Record
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Affiliation(s)
- Yoonsun Choi
- School of Social Service Administration, University of Chicago, Chicago, IL
| | - Tae Yeun Kim
- School of Social Service Administration, University of Chicago, Chicago, IL
| | | | - Kihyun Kim
- Sungkyunkwan University, Seoul, South Korea
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Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040370. [PMID: 28368314 PMCID: PMC5409571 DOI: 10.3390/ijerph14040370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 03/12/2017] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Abstract
The study aims to estimate the relationship between the individual/local socioeconomic status and the health of internal elderly migrants in China. A multilevel logistic model was used to estimate this association. The estimations were undertaken for 11,111 migrants aged over 60 years, using nationally representative data: the 2015 Migrant Dynamics Monitoring Survey (MDMS), which was carried out in China. Odds ratios with 95% confidence intervals were reported. Both the household income per capita and the area-level average wage were positively associated with migrants’ self-reported health; however, public service supply was not significantly related to their health. In addition, given the household income, migrants living in communities with a higher average wage were more likely to report poor health. Migrants’ health benefited from individual socioeconomic status, but not from the local socioeconomic status, which the migrants cannot enjoy. This study highlights the importance of multilevel and non-discriminatory policies between migrants and local residents.
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Turner RJ, Brown TN, Hale WB. Race, Socioeconomic Position, and Physical Health: A Descriptive Analysis. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2017; 58:23-36. [PMID: 28661769 DOI: 10.1177/0022146516687008] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A substantial and long-standing body of research supports the widely held conclusion that socioeconomic position (SEP) is a primary determinant of physical health risk. However, supporting evidence derives almost entirely from studies of dominantly white populations, and more recent research suggests that this relationship may vary across race-ethnicity. This article considers the extent to which such evidence applies to African Americans. It does so by examining the within-race relationships between SEP and physical health utilizing alternative research definitions of health and a nearly exhaustive array of measures of SEP. The results offer minimal support for SEP as a fundamental cause of disease among African Americans. They do not challenge the widely held view that health differences are rooted in the fundamental conditions of social context and experience. Rather, they indicate that these conditions tend to be defined more by being black than by being of lower SEP.
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Luking KR, Pagliaccio D, Luby JL, Barch DM. Reward Processing and Risk for Depression Across Development. Trends Cogn Sci 2016; 20:456-468. [PMID: 27131776 PMCID: PMC4875800 DOI: 10.1016/j.tics.2016.04.002] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/11/2016] [Accepted: 04/11/2016] [Indexed: 11/25/2022]
Abstract
Striatal response to reward has been of great interest in the typical development and psychopathology literatures. These parallel lines of inquiry demonstrate that although typically developing adolescents show robust striatal response to reward, adolescents with major depressive disorder (MDD) and those at high risk for MDD show a blunted response to reward. Understanding how these findings intersect is crucial for the development and application of early preventative interventions in at-risk children, ideally before the sharp increase in the rate of MDD onset that occurs in adolescence. Robust findings relating blunted striatal response to reward and MDD risk are reviewed and situated within a normative developmental context. We highlight the need for future studies investigating longitudinal development, specificity to MDD, and roles of potential moderators and mediators.
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Affiliation(s)
- Katherine R Luking
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, USA.
| | - David Pagliaccio
- Emotion and Development Branch, National Institute of Mental Health (NIMH), Bethesda, MD 20892, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63130, USA; Department of Psychology, Washington University in St. Louis, St. Louis, MO 63130, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO 63130, USA; Neuroscience Program, Washington University in St. Louis, St. Louis, MO 63130, USA
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When Words are not Enough: Psychotherapy with Clients Who are Living Below the Poverty Level. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2016. [DOI: 10.1007/s10879-015-9313-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ward JB, Haan MN, Garcia ME, Lee A, To TM, Aiello AE. Intergenerational education mobility and depressive symptoms in a population of Mexican origin. Ann Epidemiol 2016; 26:461-466. [PMID: 27346705 DOI: 10.1016/j.annepidem.2016.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/14/2016] [Accepted: 05/23/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE Low educational attainment has been associated with depression among Latinos. However, few studies have collected intergenerational data to assess mental health effects of educational mobility across generations. METHODS Using data from the Niños Lifestyle and Diabetes Study, we assessed the influence of intergenerational education on depressive symptoms among 603 Mexican-origin individuals. Intergenerational educational mobility was classified: stable-low (low parent and/or low offspring education), upwardly mobile (low parent and/or high offspring education), stable-high (high parent and/or high offspring education), or downwardly mobile (high parent and/or low offspring education). High depressive symptoms were defined as scoring ≥10 on the Center for Epidemiological Studies Depression Scale-10 (CESD-10). We examined prevalence ratios (PRs) for depressive symptoms with levels of educational mobility. We used general estimating equations with log-binomial models to account for within-family clustering, adjusting for age, gender, and offspring and parent nativity. RESULTS Compared with stable-low participants, the lowest prevalence of CESD-10 score ≥10 occurred in upwardly mobile (PR = 0.55; 95% confidence interval [CI] = 0.39-0.78) and stable-high (PR = 0.62; 95% CI = 0.44-0.87) participants. Downwardly mobile participants were also less likely to have a CESD-10 score ≥10 compared with stable-low participants (PR = 0.65; 95% CI = 0.38-1.11), although the estimate was not statistically significant. CONCLUSIONS Sustained stress from low intergenerational education may adversely affect depression. Latinos with stable-low or downwardly mobile intergenerational educational attainment may need closer monitoring for depressive symptoms.
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Affiliation(s)
- Julia B Ward
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Maria E Garcia
- UCSF Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco
| | - Anne Lee
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Tu My To
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill.
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Assari S, Lankarani MM. Race and Urbanity Alter the Protective Effect of Education but not Income on Mortality. Front Public Health 2016; 4:100. [PMID: 27242992 PMCID: PMC4873510 DOI: 10.3389/fpubh.2016.00100] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/02/2016] [Indexed: 12/27/2022] Open
Abstract
Background Although the effects of socioeconomic status (SES) on mortality are well established, these effects may vary based on contextual factors such as race and place. Using 25-year follow-up data of a nationally representative sample of adults in the U.S., this study had two aims: (1) to explore separate, additive, and multiplicative effects of race and place (urbanity) on mortality and (2) to test the effects of education and income on all-cause mortality based on race and place. Methods The Americans’ Changing Lives (ACL) Study followed Whites and Blacks 25 years and older from 1986 until 2011. The focal predictors were baseline SES (education and income) collected in 1986. The main outcome was time until death due to all causes from 1986 until 2011. Age, gender, behaviors (smoking and exercise), and health (chronic medical conditions, self-rated health, and depressive symptoms) at baseline were potential confounders. A series of survey Cox proportional hazard models were used to test protective effects of education and income on mortality based on race and urbanity. Results Race and place had separate but not additive or multiplicative effects on mortality. Higher education and income were protective against all-cause mortality in the pooled sample. Race and urbanity significantly interacted with baseline education but not income on all-cause mortality, suggesting that the protective effect of education but not income depend on race and place. While the protective effect of education were fully explained by baseline health status, the effect of income remained significant beyond health. Conclusion In the U.S., the health return associated with education depends on race and place. This finding suggests that populations differently benefit from SES resources, particularly education. Differential effect of education on employment and health care may explain the different protective effect of education based on race and place. Findings support the “diminishing returns” hypothesis for Blacks.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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