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Shen G, Chen YH, Zou Y, Wu S, Zheng Y, Chen L. The social-ecological model of depressive symptoms in middle aged in China: a network analysis. BMC Public Health 2025; 25:1451. [PMID: 40247288 PMCID: PMC12004623 DOI: 10.1186/s12889-025-22699-z] [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: 03/10/2024] [Accepted: 04/08/2025] [Indexed: 04/19/2025] Open
Abstract
BACKGROUND Depression in middle-aged individuals is influenced by multiple factors; however, research focusing on this demographic remains limited. The social-ecological system framework explores how interactions among individual characteristics, social relationships, and environmental contexts contribute to health outcomes. This study aimed to assess the prevalence, core manifestations, and influencing factors of depression through a comprehensive model grounded in the social-ecological system. METHODS Using data from the 2018 Chinese Labor Dynamic Survey, a total of 3,799 middle-aged individuals (mean age: 52.35 years; 53.75% female) were included. Depression was assessed using the Center for Epidemiological Studies Depression Scale, with a cut-off score of 36. We used a graphical gaussian model to identify the measurement network and core symptoms of midlife depression, and logistic regression to identify influencing factors. A social-ecological model of middle-aged depression was constructed through a Mixed Graphical Model. RESULTS 23.74% of participants exhibited clinically significant depression. Feelings of disgust (Strength = 2.18, Expected Influence = 1.30) and incapacity (Strength = 1.29, Expected Influence = 1.57) emerged as the most central symptoms. Higher global strength (GS = 8.89, p < 0.001) of the network suggested stronger associations and mutual exacerbation of symptoms. Logistic regression showed that education, exercise, and subjective feeling were associated with depression risk (p < 0.05). The social-ecological system emphasized the importance of education (Strength = 2.50, Expected Influence = 2.50) and complex interaction between subjective and objective influencing factors. CONCLUSION This study found middle-aged individuals had a high prevalence of depression, characterized by feelings of disgust and incapacity. Influencing factors spanned individual, social and environmental levels. These results emphasize the role of education in depressive individuals, providing guidance for potential future interventions.
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Affiliation(s)
- Guanghui Shen
- Wenzhou Seventh People's Hospital, Wenzhou, 325006, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yu-Hsin Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yang Zou
- Sichuan Tourism University, Chengdu, 610100, China
| | - Shaochang Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yawen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- Zhejiang Provincial Clinical Research Center for Mental Health, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, 325035, China.
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Hoffman CM, Versluis A, Chirila S, Kirenga BJ, Khan A, Saeed S, Sooronbaev T, Tsiligianni I, Arvind DK, Bauld LC, van den Brand FA, Chavannes NH, Pinnock H, Powell PD, van der Schans J, Siddiqi K, Williams S, van der Kleij MJJR. The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations. NPJ Prim Care Respir Med 2024; 34:14. [PMID: 38834570 PMCID: PMC11150571 DOI: 10.1038/s41533-024-00367-w] [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: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 06/06/2024] Open
Abstract
The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents' exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.
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Affiliation(s)
- Charlotte M Hoffman
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Sergiu Chirila
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Bruce J Kirenga
- Lung Institute & Department of Medicine, Makerere University, Kampala, Uganda
| | | | - Saima Saeed
- Indus Hospital and Health Network, Karachi, Pakistan
| | - Talant Sooronbaev
- National Center of Cardiology and Internal Medicine named after academician Mirrakhimov, Bishkek, Kyrgyzstan
| | | | - D K Arvind
- School of Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Linda C Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, UK
| | - Floor A van den Brand
- Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| | - Siân Williams
- International Primary Care Respiratory Group, London, UK
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Yakovlev V, Lapato DM, Rana P, Ghosh P, Frye R, Roberson-Nay R. Neuron enriched extracellular vesicles' MicroRNA expression profiles as a marker of early life alcohol consumption. Transl Psychiatry 2024; 14:176. [PMID: 38575599 PMCID: PMC10994930 DOI: 10.1038/s41398-024-02874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
Alcohol consumption may impact and shape brain development through perturbed biological pathways and impaired molecular functions. We investigated the relationship between alcohol consumption rates and neuron-enriched extracellular vesicles' (EVs') microRNA (miRNA) expression to better understand the impact of alcohol use on early life brain biology. Neuron-enriched EVs' miRNA expression was measured from plasma samples collected from young people using a commercially available microarray platform while alcohol consumption was measured using the Alcohol Use Disorders Identification Test. Linear regression and network analyses were used to identify significantly differentially expressed miRNAs and to characterize the implicated biological pathways, respectively. Compared to alcohol naïve controls, young people reporting high alcohol consumption exhibited significantly higher expression of three neuron-enriched EVs' miRNAs including miR-30a-5p, miR-194-5p, and miR-339-3p, although only miR-30a-5p and miR-194-5p survived multiple test correction. The miRNA-miRNA interaction network inferred by a network inference algorithm did not detect any differentially expressed miRNAs with a high cutoff on edge scores. However, when the cutoff of the algorithm was reduced, five miRNAs were identified as interacting with miR-194-5p and miR-30a-5p. These seven miRNAs were associated with 25 biological functions; miR-194-5p was the most highly connected node and was highly correlated with the other miRNAs in this cluster. Our observed association between neuron-enriched EVs' miRNAs and alcohol consumption concurs with results from experimental animal models of alcohol use and suggests that high rates of alcohol consumption during the adolescent/young adult years may impact brain functioning and development by modulating miRNA expression.
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Affiliation(s)
- Vasily Yakovlev
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - Dana M Lapato
- Department of Human and Molecular Genetics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Pratip Rana
- Department of Computer Science, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Preetam Ghosh
- Department of Computer Science, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Rebekah Frye
- Neuroscience Program, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Roxann Roberson-Nay
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Rajkumar JL, Viggeswarapu S, Kurian S, Nandyal MB, Gowri M. Addressing the mental health needs of India's aging population: Understanding depression prevalence and social risk factors in tertiary care outpatients. Indian J Psychiatry 2023; 65:949-954. [PMID: 37841541 PMCID: PMC10569333 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_352_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/07/2023] [Accepted: 08/09/2023] [Indexed: 10/17/2023] Open
Abstract
Background Depression is a major public health problem among older persons. Identifying the prevalence and recognizing modifiable risk factors of depression in older persons is essential for early diagnosis and appropriate management. Apart from traditional risk factors, medical comorbidities, chronic illness, and social factors can contribute to depression in the older person. This study aimed to estimate the prevalence of depression and identify the medical and social risk factors associated with depression in older persons attending a geriatric outpatient clinic. Methods Consecutive patients aged over 60 years presented to the geriatric outpatient clinic of the Christian Medical College (CMC) and Hospital, Vellore, were screened using the Physical Health Questionnaire-2 (PHQ-2) and Geriatric Depression Scale (GDS). Medical, social, and financial information were collected. Following a detailed clinical interview, the Clinical Interview Schedule-Revised (CIS-R) was administered and the ICD-10 diagnosis of depression was derived. Results A total of 171 participants were recruited. The prevalence of depression was found to be 53.2% with PHQ-2 and 35.6% with GDS. Using CIS-R, 41.5% had an ICD-10 diagnosis of depression. The risk factors associated with depression in older persons were female gender, financial insecurity, lack of pension, and financial dependence. Conclusion This study revealed a high prevalence of depression among older persons attending a geriatric outpatient clinic. Financial insecurities, particularly lack of pension or financial dependence, were identified as significant social risk factors for depression. Addressing these risk factors may help prevent the onset or progression of depression, thus improving their quality of life.
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Affiliation(s)
| | | | - Suja Kurian
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Munaf B. Nandyal
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Suryaputri IY, Mubasyiroh R, Idaiani S, Indrawati L. Determinants of Depression in Indonesian Youth: Findings From a Community-based Survey. J Prev Med Public Health 2022; 55:88-97. [PMID: 35135052 PMCID: PMC8841193 DOI: 10.3961/jpmph.21.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/16/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives This study investigated the determinants of depression in adolescents and young adults. Methods The present study analyzed data from the 2018 Indonesia Basic Health Survey (Riset Kesehatan Dasar; RISKESDAS). The study subjects were adolescents (15-17 years old) and young adults (18-24 years old). In total, 64 179 subjects were included. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between youths’ characteristics, risky behavior, chronic disease, parents’ health, and youths’ depression. Results The prevalence of depression was 5.1% in adolescents and 5.6% in young adults. The risk factors for depression in adolescents were being women (adjusted odds ratio [aOR], 3.53; 95% confidence interval [CI], 2.89 to 4.30; p<0.001), an ex-smoker (aOR, 2.99; 95% CI, 2.10 to 4.25; p<0.001), or a current smoker (aOR, 2.60; 95% CI, 1.97 to 3.44; p<0.001); consuming alcohol (aOR, 2.00; 95% CI, 1.33 to 3.01; p=0.001), having a chronic disease (aOR, 2.64; 95% CI, 1.41 to 4.96; p=0.002); maternal depression (aOR, 2.47; 95% CI, 1.97 to 3.09; p<0.001); and paternal depression (aOR, 2.63; 95% CI, 1.98 to 3.50; p<0.001). In young adults, the risk factors were being women (aOR, 2.23; 95% CI, 1.82 to 2.75; p<0.001) or an ex-smoker (aOR, 2.47; 95% CI, 1.67 to 3.67; p<0.001), consuming alcohol (aOR, 2.42; 95% CI, 1.89 to 3.09; p<0.001), maternal depression (aOR, 3.12; 95% CI, 2.54 to 3.84; p<0.001), and paternal depression (aOR, 2.80; 95% CI, 2.17 to 3.63; p<0.001). Conclusions Being women, smoking, drinking alcohol, having a chronic disease, and having a parent with depression were crucial factors associated with youth depression. Mental health screening, prevention, and treatment should involve collaboration among primary healthcare, schools, universities, professionals, and families.
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Affiliation(s)
- Indri Yunita Suryaputri
- Center for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
- Corresponding author: Indri Yunita Suryaputri Center for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta 10560, Indonesia E-mail:
| | - Rofingatul Mubasyiroh
- Center for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
| | - Sri Idaiani
- Center for Research and Development of Health Resources and Services, National Institute of Health Research and Development, Ministry of Health, Republic Indonesia, Jakarta, Indonesia
| | - Lely Indrawati
- Center for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
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