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Yeung YL, Lee KL, Lau ESH, Yung TF, Yang A, Wu H, Wong KTC, Kong APS, Chow EYK, Ma RCW, Yeung T, Loo KM, Ozaki R, Luk AOY, Lui JNM, Chan JCN. Associations of comorbid depression with cardiovascular-renal events and all-cause mortality accounting for patient reported outcomes in individuals with type 2 diabetes: a 6-year prospective analysis of the Hong Kong Diabetes Register. Front Endocrinol (Lausanne) 2024; 15:1284799. [PMID: 38586459 PMCID: PMC10999250 DOI: 10.3389/fendo.2024.1284799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/29/2024] [Indexed: 04/09/2024] Open
Abstract
Background Psychosocial status and patient reported outcomes (PRO) [depression and health-related quality-of-life (HRQoL)] are major health determinants. We investigated the association between depression and clinical outcomes in Chinese patients with type 2 diabetes (T2D), adjusted for PRO. Methods Using prospective data from Hong Kong Diabetes Register (2013-2019), we estimated the hazard-ratio (HR, 95%CI) of depression (validated Patient Health Questionnaire 9 (PHQ-9) score≥7) with incident cardiovascular disease (CVD), ischemic heart disease (IHD), chronic kidney disease (CKD: eGFR<60 ml/min/1.73m2) and all-cause mortality in 4525 Chinese patients with T2D adjusted for patient characteristics, renal function, medications, self-care and HRQoL domains (mobility, self-care, usual activities, pain/discomfort, anxiety/depression measured by EQ-5D-3L) in linear-regression models. Results In this cohort without prior events [mean ± SD age:55.7 ± 10.6, 43.7% women, median (IQR) disease duration of 7.0 (2.0-13.0) years, HbA1c, 7.2% (6.6%-8.20%), 26.4% insulin-treated], 537(11.9%) patients had depressive symptoms and 1923 (42.5%) patients had some problems with HRQoL at baseline. After 5.6(IQR: 4.4-6.2) years, 141 patients (3.1%) died, 533(11.8%) developed CKD and 164(3.6%) developed CVD. In a fully-adjusted model (model 4) including self-care and HRQoL, the aHR of depression was 1.99 (95% confidence interval CI):1.25-3.18) for CVD, 2.29 (1.25-4.21) for IHD. Depression was associated with all-cause mortality in models 1-3 adjusted for demographics, clinical characteristics and self-care, but was attenuated after adjusting for HRQoL (model 4- 1.54; 95%CI: 0.91-2.60), though HR still indicated same direction with important magnitude. Patients who reported having regular exercise (3-4 times per week) had reduced aHR of CKD [0.61 (0.41-0.89)]. Item 4 of PHQ-9 (feeling tired, little energy) was independently associated with all-cause mortality with aHR of 1.66 (1.30-2.12). Conclusion Depression exhibits significant association with CVD, IHD, and all-cause mortality in patients with diabetes, adjusting for their HRQoL and health behaviors. Despite the association between depression and all-cause mortality attenuated after adjusting for HRQoL, the effect size remains substantial. The feeling of tiredness or having little energy, as assessed by item Q4 of the PHQ-9 questionnaire, was found to be significantly associated with an increased risk of all-cause mortality after covariate adjustments. Our findings emphasize the importance of incorporating psychiatric evaluations into holistic diabetes management.
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Affiliation(s)
- Yiu-Lam Yeung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Ka-Long Lee
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Eric SH. Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Tsun-Fung Yung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Kelly TC. Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Alice PS. Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Elaine YK. Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Ronald CW. Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Theresa Yeung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Kit-man Loo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Risa Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Andrea OY. Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Juliana NM. Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
| | - Juliana CN. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, China
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Velescu DR, Marc MS, Traila D, Pescaru CC, Hogea P, Suppini N, Crisan AF, Wellmann N, Oancea C. A Narrative Review of Self-Reported Scales to Evaluate Depression and Anxiety Symptoms in Adult Obstructive Sleep Apnea Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:261. [PMID: 38399548 PMCID: PMC10889932 DOI: 10.3390/medicina60020261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/14/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent chronic condition that has been associated with mental disorders like depression and anxiety. This study intends to provide a practical overview of the most relevant self-reported and self-rating scales that assess depression and anxiety in OSA patients. Materials and Methods: A search for articles was performed using PubMed, Google Scholar, and Semantic Scholar using a combination of words for obstructive sleep apnea, depression, anxiety, and scales. The tools were ordered by type (screening and rating) and arranged chronologically according to the year of publication. Results: Three scales were identified for assessing depression, which were the Center for Epidemiologic Studies Depression Scale (CES-D), the Hospital Anxiety and Depression Scale (HADS-D), and the Patient Health Questionnaire-9 (PHQ-9). For rating depression, two scales were discussed: the Zung Self-Rating Depression Scale (SDS) and the Beck Depression Inventory (BDI), which has three versions (the BDI, the BDI-II, and the Fast Screen (BDI-FS)). For assessing anxiety, the Generalized Anxiety Disorder-7 (GAD-7) scale was identified. Two scales were reviewed for rating anxiety: the State-Trait Anxiety Inventory (STAI) and the Beck Anxiety Inventory (BAI). Each scale is accompanied by a brief description of its practicality and psychometric qualities and an analysis of its strengths and limitations. Conclusions: The findings of this review will contribute to the understanding of the importance of assessing mental health comorbidities in the context of OSA, ultimately guiding clinical practice and future research in this area.
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Affiliation(s)
- Diana Raluca Velescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Monica Steluta Marc
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Daniel Traila
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Camelia Corina Pescaru
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Patricia Hogea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Noemi Suppini
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Alexandru Florian Crisan
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Research Center for the Assessment of Human Motion, Functionality and Disability (CEMFD), “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Norbert Wellmann
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Zwick L, Schmitz N, Shojaa M. Oral health-related quality of life and depressive symptoms in adults: longitudinal associations of the English Longitudinal Study of Ageing (ELSA). BMC Oral Health 2023; 23:1029. [PMID: 38124069 PMCID: PMC10734100 DOI: 10.1186/s12903-023-03722-4] [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: 06/09/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Little is known about the relationship between oral health status and depressive symptoms in adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in adults in England. METHODS Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline anticipated self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment. RESULTS Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioral, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38-2.07). Similarly, having oral impacts on daily performances were associated with the development of depressive symptoms: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62-2.96) after adjustment for all covariates. Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52-2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45-2.40) at follow-up than those without depressive symptoms at baseline, even after adjusting for confounders. CONCLUSIONS In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.
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Affiliation(s)
- Luisa Zwick
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Norbert Schmitz
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany
| | - Mahdieh Shojaa
- Department of Population-Based Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str. 9, Tuebingen, 72076, Germany.
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4
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Ma X, Bai W, Yu F, Yang F, Yin J, Shi H, Niu Y, Wang L. The effect of neighborhood social cohesion on life satisfaction in type 2 diabetes mellitus patients: the chain mediating role of depressive symptoms and sleep quality. Front Public Health 2023; 11:1257268. [PMID: 38162623 PMCID: PMC10757367 DOI: 10.3389/fpubh.2023.1257268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objective Although most studies have shown that neighborhood social cohesion (NSC) is associated with life satisfaction among patients with type 2 diabetes mellitus (T2DM), it remains unclear how NSC is linked to life satisfaction. The present study aims to examine the potential mediation effect of depressive symptoms and sleep quality on the relationship between NSC and life satisfaction among Chinese individuals with T2DM. Methods A cross-sectional survey was conducted from August 2019 to November 2020 involving 1747 T2DM patients. The main information was obtained using the Center for Epidemiological Survey Depression Scale (CES-D), self-report sleep quality and life satisfaction questionnaire and NSC scales. Mediation analyses were performed using the PROCESS macro in SPSS. Results The results manifested that the NSC was positively associated with sleep quality (r = 0.219) and life satisfaction (r = 0.214), while negatively correlated with depressive symptoms (r = -0.232). Depressive symptoms were found to be negatively associated with life satisfaction (r = -0.263). NSC influenced life satisfaction through three mediating pathways: (a) depressive symptoms (effect = 0.0081); (b) depressive symptoms and sleep quality (effect = 0.0019); and (c) sleep quality (effect = 0.0015). The total mediating effect accounted for 28.1% of the overall effect. Conclusion Our findings support the hypothesis that depressive symptoms and sleep quality mediated the relationship between NSC and life satisfaction in patients with T2DM. It is important to encourage T2DM patients to participate in social interactions and enhance their level of NSC. Additionally, efforts should be made to actively reduce depressive symptoms and improve sleep quality, so as to improve their life satisfaction.
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Affiliation(s)
- Xueping Ma
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Wei Bai
- Department of Pulmonary Disease, Zhongwei Hospital of Traditional Chinese Medicine, Zhongwei, China
| | - Fan Yu
- School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
| | - Fan Yang
- School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
| | - Jiaxin Yin
- School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
| | - Huilian Shi
- School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China
| | - Liqun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
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Kuo HJ, García AA, Huang YC, Zuñiga JA, Benner AD, Cuevas H, Fan KC, Hsu CY. Impact of Fatigue and Its Influencing Factors on Diabetes Self-Management in Adults With Type 2 Diabetes: A Structural Equation Modeling Analysis. Sci Diabetes Self Manag Care 2023; 49:438-448. [PMID: 37873569 DOI: 10.1177/26350106231205029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
PURPOSE The purposes of this study were to (1) examine the relationships between fatigue, its influencing factors, and diabetes self-management and (2) test the mediation effects of fatigue on the link between the influencing factors and diabetes self-management in adults with type 2 diabetes. METHODS This cross-sectional, correlational study was guided by the theory of unpleasant symptoms. Data were collected using structured questionnaires. Fatigue was measured by the Fatigue Symptom Inventory and the Multidimensional Fatigue Inventory. Diabetes self-management was measured by the Summary of Diabetes Self-Care Activities. From March to July 2021, a convenience sample of 150 participants was recruited from 2 diabetes outpatient clinics of a regional hospital in Taiwan. Data were analyzed using structural equation modeling. RESULTS A more recent diagnosis of diabetes, more depressive symptoms, and lower sleep quality were related to higher fatigue. Higher fatigue correlated with less performance in diabetes self-management. Fatigue mediated the relationship between depressive symptoms, sleep quality, and diabetes self-management. CONCLUSIONS Fatigue had a mediating effect on the link between psychological influencing factors and diabetes self-management. Future development of fatigue interventions integrating depressive symptoms and sleep management will likely increase the performance of diabetes self-management and improve the health outcomes in adults with type 2 diabetes. The study tested the theory of unpleasant symptoms using empirical data and will assist in building theory-guided fatigue interventions to improve diabetes self-management in people with type 2 diabetes.
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Affiliation(s)
- Hsuan-Ju Kuo
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | | | - Ya-Ching Huang
- School of Nursing, Texas A&M University, College Station, Texas
| | - Julie A Zuñiga
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Aprile D Benner
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas
| | - Heather Cuevas
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Kang-Chih Fan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan
| | - Chih-Yao Hsu
- Taipei City Hospital Renai Branch, Taipei City, Taiwan
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Linnenkamp U, Gontscharuk V, Ogurtsova K, Brüne M, Chernyak N, Kvitkina T, Arend W, Schmitz-Losem I, Kruse J, Hermanns N, Kulzer B, Evers SMAA, Hiligsmann M, Hoffmann B, Icks A, Andrich S. PHQ-9, CES-D, health insurance data-who is identified with depression? A Population-based study in persons with diabetes. Diabetol Metab Syndr 2023; 15:54. [PMID: 36945050 PMCID: PMC10031874 DOI: 10.1186/s13098-023-01028-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023] Open
Abstract
AIMS Several instruments are used to identify depression among patients with diabetes and have been compared for their test criteria, but, not for the overlaps and differences, for example, in the sociodemographic and clinical characteristics of the individuals identified with different instruments. METHODS We conducted a cross-sectional survey among a random sample of a statutory health insurance (SHI) (n = 1,579) with diabetes and linked it with longitudinal SHI data. Depression symptoms were identified using either the Centre for Epidemiological Studies Depression (CES-D) scale or the Patient Health Questionnaire-9 (PHQ-9), and a depressive disorder was identified with a diagnosis in SHI data, resulting in 8 possible groups. Groups were compared using a multinomial logistic model. RESULTS In total 33·0% of our analysis sample were identified with depression by at least one method. 5·0% were identified with depression by all methods. Multinomial logistic analysis showed that identification through SHI data only compared to the group with no depression was associated with gender (women). Identification through at least SHI data was associated with taking antidepressants and previous depression. Health related quality of life, especially the mental summary score was associated with depression but not when identified through SHI data only. CONCLUSION The methods overlapped less than expected. We did not find a clear pattern between methods used and characteristics of individuals identified. However, we found first indications that the choice of method is related to specific underlying characteristics in the identified population. These findings need to be confirmed by further studies with larger study samples.
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Affiliation(s)
- Ute Linnenkamp
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany.
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Katherine Ogurtsova
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Manuela Brüne
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nadezda Chernyak
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tatjana Kvitkina
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Werner Arend
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Johannes Kruse
- Clinic for Psychosomatic and Psychotherapy, University Clinic Gießen, Gießen, Germany
| | - Norbert Hermanns
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Bernd Kulzer
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Silvia M A A Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Silke Andrich
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Psychometric Properties of the Slovenian Version of the Cardiac Depression Scale. Zdr Varst 2022; 62:13-21. [PMID: 36694791 PMCID: PMC9837811 DOI: 10.2478/sjph-2023-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/17/2022] [Indexed: 12/30/2022] Open
Abstract
Introduction The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease. Methods A total of 272 patients with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed. Results Cronbach's alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations. Conclusions The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.
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Suh HN, Goergen J, Nelson B, Clinton L, Osborne A. The Role of Model Minority Stereotype on General Self-Efficacy and Depressive Symptoms. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221130016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The model minority stereotype (MMS) is a belief that Asian Americans’ comparative success comes from their hard-work and perseverance, coupled with a lack of barriers such as racism or discrimination against Asian Americans. In this study, we hypothesized that because the MMS demands cognitive energy, the use of self-efficacy as a regulator for depressive symptoms is then limited. Participants included 199 self-identified Asian American college students. A moderation effect of the MMS on the relationship between general self-efficacy and depressive symptoms was tested. Participants with low to above average Unrestricted Mobility (UM), a component of the MMS, displayed a regulating effect of self-efficacy on depressive symptoms, which was not found for individuals with higher UM. Although the variance of moderation effect was small (2%), this study is the first to suggest the effect of self-efficacy in lowering depressive symptoms may depend on the level of UM. Other findings and implications are further discussed.
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Affiliation(s)
- Han Na Suh
- Georgia State University, Atlanta, GA, USA
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9
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Langendoen-Gort M, Groeneveld L, Prinsen CAC, Beulens JW, Elders PJM, Halperin I, Mukerji G, Terwee CB, Rutters F. Patient-reported outcome measures for assessing health-related quality of life in people with type 2 diabetes: A systematic review. Rev Endocr Metab Disord 2022; 23:931-977. [PMID: 35779199 PMCID: PMC9515038 DOI: 10.1007/s11154-022-09734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
Patient-Reported Outcome Measures (PROMs) are important tools to assess outcomes relevant to patients, with Health-Related Quality Of Life (HRQOL) as an important construct to be measured. Many different HRQOL PROMs are used in the type 2 diabetes field, however a complete overview of these PROMs is currently lacking. We therefore aimed to systematically describe and classify the content of all PROMs that have specifically been developed or validated to measure (aspects of) HRQOL in people with type 2 diabetes. A literature search was performed in PubMed and EMBASE until 31 December 2021. Studies on the development or validation of a PROM measuring HRQOL, or aspects of HRQOL, in people with type 2 diabetes were included. Title and abstract and full-text screening were conducted by two independent researchers and data extraction was performed independently by one of the researchers. Data were extracted on language in which the PROM was developed, target population, construct(s) being measured, names of (sub)scales and number of items per (sub)scale. In addition, all PROMs and subscales were classified according to specific aspects of HRQOL based on the Wilson & Cleary model (symptom status, functional status, general health perceptions) to aid researchers in PROM selection. In total 220 studies were identified that developed or validated PROMs that measure (aspects of) HRQOL in people with type 2 diabetes. Of the 116 unique HRQOL PROMs, 91 (of the subscales) measured symptom status, 60 measured functional status and 26 measured general health perceptions. In addition, 16 of the PROMs (subscales) measured global quality of life. 61 of the 116 PROMs (subscales) also include characteristics of the individual (e.g. aspects of personality, coping) or environment (e.g. social or financial support) and patient-reported experience measures (PREMs, e.g. measure of a patient's perception of their personal experience of the healthcare they have received, e.g. treatment satisfaction), which are not part of the HRQOL construct. Only 9 of the 116 PROMs measure all aspects of HRQOL based on the Wilson & Cleary model. Finally, 8 of the 116 PROMs stating to measure HRQOL, measured no HRQOL construct. In conclusion, a large number of PROMs are available for people with type 2 diabetes, which intend to measure (aspects of) HRQOL. These PROMs measure a large variety of (sub)constructs, which are not all HRQOL constructs, with a small amount of PROMs not measuring HRQOL at all. There is a need for consensus on which aspects of HRQOL should be measured in people with type 2 diabetes and which PROMs to use in research and daily practice. PROSPERO: CRD42017071012. COMET database: http://www.comet-initiative.org/studies/details/956 .
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Affiliation(s)
- Marlous Langendoen-Gort
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Cecilia A C Prinsen
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Joline W Beulens
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Petra J M Elders
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Ilana Halperin
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Geetha Mukerji
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
- Women's College Hospital Institute for Health System Solutions and Virtual Care, 76 Grenville Street, Toronto, ON, Canada
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands.
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Li Q, Chen Y, Välimäki M, Long Q, Yang J, Guo J. The Association Between General Self-Efficacy and Depressive Symptoms in People with Type 2 Diabetes Mellitus: The Mediating Role of Coping Styles Preference. Psychol Res Behav Manag 2022; 15:2501-2511. [PMID: 36104998 PMCID: PMC9467442 DOI: 10.2147/prbm.s381742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Depressive symptoms are prevalent in persons with type 2 diabetes mellitus and related with poor disease outcomes. Both general self-efficacy and coping style are associated with depressive symptoms. A model about proactive coping indicates that coping style plays a mediation role between general self-efficacy and depressive symptoms. But, empirical evidence is missing about this potential mediation relationship which may be a barrier of taking precise strategies for relieving depressive symptoms. Objective This study aims to investigate the prevalence of elevated depressive symptoms in persons with type 2 diabetes mellitus and explore whether coping style preference mediates the association between general self-efficacy and depressive symptoms. Methods This was a secondary data analysis of a cross-sectional survey (June-July 2017) among 721 persons with type 2 diabetes mellitus (45.4% male and 54.6% female) aged from 22 to 96 years old. Data on general self-efficacy, coping style preference and depressive symptoms were collected using validated questionnaires in hospital setting. The mediation model was tested using the bootstrapping (K=5000) in the MPlus program version 7.4. The results were reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results The prevalence of elevated depressive symptoms was 58% (n = 418) among persons with type 2 diabetes mellitus at hospital setting. A higher level of general self-efficacy was related to less depressive symptoms via positive coping preference (p < 0.01). Discussion About two-thirds of persons with type 2 diabetes mellitus experienced elevated depressive symptoms during hospitalization. The intervention elements, including strengthening general self-efficacy and promoting positive coping, are promising to decrease their depressive symptoms.
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Affiliation(s)
- Qingting Li
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Yao Chen
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Maritta Välimäki
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
| | - Jundi Yang
- School of Nursing, the University of Hong Kong, Pokfulam, 999077, People's Republic of China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, 410013, People's Republic of China
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Wang Y, Yang S, Wang F, Liu Z. Long-term effects of left-behind experience on adult depression: Social trust as mediating factor. Front Public Health 2022; 10:957324. [PMID: 36159254 PMCID: PMC9500461 DOI: 10.3389/fpubh.2022.957324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background Despite much attention paid to the mental health of left-behind children, there has not been sufficient research on whether and how left-behind experiences have long-term effects on adults among the general population. This paper aims to evaluate the long-term effects of left-behind experience on adult psychological depression. Methods By using the China Labor-force Dynamics Survey in 2018 (CLDS 2018), we assessed depression by the Center for Epidemiological Studies, Depression Scale (CES-D) and used a cut-off score of 20 for detecting depression (Yes = 1, No = 0). The Binomial logistic regression was used to compare the odds ratio across groups. We used the KHB method in the mediation analysis, to measure the indirect effect of social trust on the relationship between left-behind experience and depression. Results The rate of depression (χ2 = 17.94, p < 0.001) for the children who have left-behind experience (LBE) (10.87%) was higher than the children who have non-left-behind experience (N-LBE) (6.37%). The rate of social trust (χ2 = 27.51, p < 0.001) of LBE (65.70%) was lower than N-LBE (75.05%). Compared with the other three groups, left-behind experience occurred in preschool (OR = 2.07, p < 0.001, 95% CI = [1.45, 2.97]) was more likely to suffer from depression. The indirect effect of social trust (OR = 1.06, p < 0.01, 95% CI = [1.02, 1.10]) is significantly on the relationship between LBE and psychological depression, with the total effect (OR = 1.71, p < 0.001, 95% CI = [1.27, 2.31]) and direct effect (OR = 1.62, p < 0.01, 95% CI = [1.20, 2.18]) are both significantly. The proportion of indirect effect in the total effect is 10.69%. Conclusion The left-behind experience that occurred in childhood has a significantly negative effect on adult psychological depression, in which preschool left-behind experience played the most critical role. Social trust is the mediating factor associated with left-behind experience and psychological depression. To mitigate the long-term effects of the left-behind experience on psychological depression, parents need to be prudent about the decision-making of migration in the preschool stage of their children. and subsequent policies should strengthen social work targeting vulnerable youth groups especially those with left-behind experience at an early age in terms of their psychological depression.
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Affiliation(s)
- Yan Wang
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Shuai Yang
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Feng Wang
- Department of Health Management and Policy, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhijun Liu
- Department of Sociology, Zhejiang University, Hangzhou, China,*Correspondence: Zhijun Liu
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Association between WeChat Use and Memory Performance among Older Adults in China: The Mediating Role of Depression. Behav Sci (Basel) 2022; 12:bs12090323. [PMID: 36135127 PMCID: PMC9495430 DOI: 10.3390/bs12090323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Changes to memory performance in the course of aging may be influenced by behavioral factors. The use of social media among elderly people is increasing, but studying its effect on cognitive functions such as memory remains at an early stage of development. Meanwhile, the linking mechanisms underlying the association between social media use and memory performance, if any exist, have not been revealed. This study attempted to examine the association between the use of WeChat, the most popular social media platform in China, and memory performance among older people, and to test the possible mediating role of depression underlying this association. Data were drawn from the five-wave survey of the China Family Panel Study (CFPS), and 4929 respondents aged 60 or older (mean age = 68.19, SD = 5.84, 48.2% females) were included. Based on the descriptive statistics, the chi-squared test, Student’s t-test, correlation analysis, and mediation analysis were conducted. The results indicated that the usage rate of WeChat among the sample was 20.1%. After controlling for demographic variables, the use of WeChat was related to higher levels of memory performance and lower levels of depression. Moreover, depression partially mediated the relationship between WeChat use and memory performance. To maintain memory performance and promote cognitive health in the course of aging, using social media and alleviating depression merit special attention.
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Genis-Mendoza AD, González-Castro TB, Tovilla-Vidal G, Juárez-Rojop IE, Castillo-Avila RG, López-Narváez ML, Tovilla-Zárate CA, Sánchez-de la Cruz JP, Fresán A, Nicolini H. Increased Levels of HbA1c in Individuals with Type 2 Diabetes and Depression: A Meta-Analysis of 34 Studies with 68,398 Participants. Biomedicines 2022; 10:biomedicines10081919. [PMID: 36009468 PMCID: PMC9405837 DOI: 10.3390/biomedicines10081919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 01/10/2023] Open
Abstract
Glycosylated hemoglobin is used to diagnose type 2 diabetes mellitus and assess metabolic control. Depression itself has been associated with high levels of HbA1c in individuals with T2DM. The association between diabetes and depression suggests the usefulness of determining HbA1c as a biological marker of depressive symptoms. The aim of this study was to determine HbA1c levels in individuals with T2DM with vs. without depression. Additionally, we analyzed the influence of pharmacological treatments, time of evolution, and complications of disease. We performed a literature search in different databases published up to January 2020. A total of 34 articles were included. Our results showed that individuals with T2DM with depression showed increased levels of HbA1c in comparison to individuals with T2DM without depression (d = 0.18, 95% CI: 0.12−0.29, p(Z) < 0.001; I2 = 85.00). We also found that HbA1c levels remained elevated in individuals with T2DM with depression who were taking hypoglycemic drugs (d = 0.20 95% CI: 0.11−0.30, p(Z) < 0.001; I2 = 86.80), in individuals with less than 10 years of evolution (d = 0.17 95% CI: 0.09−0.26, p(Z) = 0.001; I2 = 66.03) and in individuals with complications of the disease (d = 0.17, 95% CI: 0.07−0.26, p(Z) < 0.001; I2 = 58.41). Our results show that HbA1c levels in individuals with T2DM with depression are significantly increased compared to controls with T2DM without depression. Additionally, these levels remained elevated in individuals who were taking hypoglycemic drugs, those with less than 10 years of disease evolution, and those with complications related to diabetes. It is necessary to examine the existence of a diabetes−HbA1c−depression connection.
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Affiliation(s)
- Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86040, Tabasco, Mexico
| | - Gisselle Tovilla-Vidal
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico
| | - Rosa Giannina Castillo-Avila
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico
| | - María Lilia López-Narváez
- Hospital Chiapas Nos Une “Dr. Gilberto Gómez Maza”, Secretaría de Salud de Chiapas, Tuxtla Gutiérrez 29045, Chiapas, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Tabasco, Mexico
- Correspondence: (C.A.T.-Z.); (H.N.); Tel.: +52-993-358-1500 (ext. 6901) (C.A.T.-Z.); +52-5350-1900 (ext. 1197) (H.N.)
| | - Juan Pablo Sánchez-de la Cruz
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Tabasco, Mexico
| | - Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México 14370, Mexico
| | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico
- Correspondence: (C.A.T.-Z.); (H.N.); Tel.: +52-993-358-1500 (ext. 6901) (C.A.T.-Z.); +52-5350-1900 (ext. 1197) (H.N.)
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Huang S, Wischik DL, Whittemore R, Jeon S, Qing L, Guo J. Determinants of elevated depressive symptoms in Chinese women with gestational diabetes mellitus. Birth 2022; 49:289-297. [PMID: 34927281 DOI: 10.1111/birt.12605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/19/2021] [Accepted: 12/08/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Pregnant women with gestational diabetes mellitus (GDM) have a higher risk of developing elevated depressive symptoms than women without GDM. The aim of this study was to investigate the sociodemographic (eg, location), clinical (eg, health care-seeking behaviors), and psychological (eg, active coping skills) factors associated with elevated depressive symptoms in Chinese women with GDM. METHODS This was a secondary data analysis of a cross-sectional study among Chinese women with GDM. Data (n = 323) were collected in 2018 from two hospitals in Hunan Province in China. The Center for Epidemiological Survey Depression Scale was used, with a criterion score ≥20 indicative of clinically elevated depressive symptoms. Descriptive, bivariate, and multiple logistic regression analyses were completed. FINDINGS The women had a mean age of 32.71 (SD = 5.17), and the majority were married (84.2%), college-educated (65.6%), and with Han ethnicity (89.8%). About 68% of women had elevated depressive symptoms. Women with higher active coping scores were less likely (OR = 0.19, 95% CI: 0.10-0.38) to have elevated depressive symptoms. Women from one geographical location (Changde) who had more emergency room visits had higher odds (OR = 3.10, 95% CI: 1.88-5.10) of elevated depressive symptoms. DISCUSSION There was a high co-occurrence of GDM and elevated depressive symptoms among pregnant women in our sample. Assessment for depressive symptoms in women with GDM is warranted. More research about increasing active coping skills may improve health outcomes in women with GDM.
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Affiliation(s)
| | | | | | | | - Long Qing
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, China
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15
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Huang YC, Zuñiga J, García A. Illness perceptions as a mediator between emotional distress and management self-efficacy among Chinese Americans with type 2 diabetes. ETHNICITY & HEALTH 2022; 27:672-686. [PMID: 32894684 DOI: 10.1080/13557858.2020.1817339] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Emotional distress and illness perceptions have been linked to patients' self-efficacy for diabetes management. This study, guided by Leventhal's Self-Regulatory Model, explores the direct effects of emotional distress (diabetes distress and depressive symptoms) on diabetes management self-efficacy, and the indirect effects through illness perceptions among Chinese Americans with type 2 diabetes (T2DM).Design: Data were obtained from a cross-sectional study of Chinese Americans with T2DM recruited from health fairs and other community settings (N = 155, 47.1% male, mean age 69.07 years). Data analyses including descriptive statistics, correlation, and PROCESS mediation models were used to examine the mediation effects of illness perceptions.Results: Diabetes distress and depressive symptoms had direct negative effects on self-efficacy. Perceived treatment control mediated the association between diabetes distress and self-efficacy, while none of the illness perceptions dimensions impacted the relationship between depressive symptoms and self-efficacy.Conclusion: Improved perceptions of treatment control can ameliorate diabetes distress and improve diabetes management self-efficacy among Chinese Americans. Health providers should elicit patients' illness perceptions as a first step in evaluating their diabetes management self-efficacy and provide appropriate culturally-tailored interventions.
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Affiliation(s)
- Ya-Ching Huang
- Texas State University, St. David's School of Nursing, Round Rock, TX, USA
| | - Julie Zuñiga
- The University of Texas at Austin, School of Nursing
| | - Alexandra García
- The University of Texas at Austin, School of Nursing and Dell Medical School
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16
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Zheng K, Chu J, Zhang X, Ding Z, Song Q, Liu Z, Peng W, Cao W, Zou T, Yi J. Psychological resilience and daily stress mediate the effect of childhood trauma on depression. CHILD ABUSE & NEGLECT 2022; 125:105485. [PMID: 35026440 DOI: 10.1016/j.chiabu.2022.105485] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Childhood trauma (CT) is a well-recognized distal risk factor for depression. Previous studies suggested that the psychological mechanism of the impact of childhood trauma on depression may be attributed to some mediators such as daily stress and psychological resilience. This study aimed to assess how daily stress and resilience affect the relationship between childhood trauma and depression in adult clinical context. METHOD In this cross-section survey, a total of 569 clinical patients with psychological disorders completed a series of psychological scales such as the Childhood Trauma Questionnaire (CTQ), the Center for Epidemiologic Studies Depression Scale (CESD), the Perceived Stress Scale (PSS) and Connor-Davidson Resilience Scale (CD-RISC). To show the relationship among childhood trauma, psychological resilience, daily stress and depression, structural equation modeling (SEM) was performed. RESULTS The results indicated that psychological resilience and daily stress partially mediated the relationship between childhood trauma and depressive symptoms. Childhood trauma not only exerted direct effect on depressive symptoms, but also had indirect effect through the mediation pathway (resilience → daily stress) on depressive symptoms. The chain mediation pathway through resilience and daily stress was weighted 43.31%. CONCLUSIONS The study provides novel evidence on the underlying process between childhood trauma and depression. The distal factor childhood trauma can influence the latter depression by the chain effect of psychological resilience and daily stress. Therefore, some clinical interventions to improve psychological resilience to carry off daily stress are the way to reduce the impact of childhood trauma on depression.
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Affiliation(s)
- Kaili Zheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Jun Chu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Zixia Ding
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Qian Song
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Zhaoxia Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Wanrong Peng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Wanyi Cao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China
| | - Tao Zou
- Department of psychiatry, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou, China.
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China; Medical Psychology Institution, Central South University, Changsha 410011, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China.
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Zhang X, Gao F, Kang Z, Zhou H, Zhang J, Li J, Yan J, Wang J, Liu H, Wu Q, Liu B. Perceived Academic Stress and Depression: The Mediation Role of Mobile Phone Addiction and Sleep Quality. Front Public Health 2022; 10:760387. [PMID: 35145942 PMCID: PMC8821519 DOI: 10.3389/fpubh.2022.760387] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/07/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although academic stress is a well-known risk factor for students' depression, little is known about the possible psychological mechanisms underlying this association. In this study, we investigated the prevalence of depression and sleep disturbance among Chinese students, examined the relationship between perceived academic stress and depression, considered if mobile phone addiction and sleep quality is a mediator of this relationship, and tested if mobile phone addiction and sleep quality together play a serial mediating role in the influence of perceived academic stress on depression. METHOD A cross-sectional survey was conducted among students from September to December 2018 in Heilongjiang Province, China. The final analysis included 5,109 students. Mobile phone addiction, sleep quality, and depressive symptoms were assessed using the Mobile Phone Addiction Index, Pittsburgh Sleep Quality Index, and Center for Epidemiologic Studies-Depression scales, respectively. The serial mediation model was used to analyse the relationship between perceived academic stress, mobile phone addiction, sleep quality, and depression. RESULTS Among all participants, the prevalence of depressive symptoms and sleep disturbance was 28.69 and 27.95%, respectively. High school students showed the highest scores of perceived academic stress (2.68 ± 1.06), and the highest prevalence of depressive symptoms (33.14%) and sleep disturbance (36.47%). The serial mediation model indicated that perceived academic stress was a significant predictor of depression (B = 0.10, SE = 0.02, 95% CI = 0.06 - 0.13). Additionally, mobile phone addiction (B = 0.08, 95% boot CI = 0.06-0.11) and sleep quality (B = 0.27, 95% boot CI = 0.22-0.33) played a mediating role between perceived academic stress and depression. Mobile phone addiction and sleep quality together played a serial mediating role in the influence of perceived academic stress on depression (B = 0.11, 95% boot CI = 0.08-0.14). Furthermore, the indirect effect (i.e., the mediating effect of mobile phone addiction and sleep quality) was significant and accounted for 64.01% of the total effect. CONCLUSIONS Our research results underscore the need for stakeholders-including family members, educators, and policy makers-to take preventative intervention measures to address depression among Chinese students, especially high school students.
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Affiliation(s)
- Xin Zhang
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Fei Gao
- Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin, China
| | - Zheng Kang
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Hongguo Zhou
- Department of Educational Administration, Ningbo College of Health Sciences, Ningbo, China
| | - Jianfeng Zhang
- Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin, China
| | - Jingjing Li
- Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin, China
| | - Jun Yan
- Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin, China
| | - Jiahui Wang
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Huan Liu
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Baohua Liu
- Department of Elderly Healthcare and Management, School of Health Services and Management, Ningbo College of Health Sciences, Ningbo, China
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18
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Li Y, Guo Y, Hong YA, Zeng Y, Monroe-Wise A, Zeng C, Zhu M, Zhang H, Qiao J, Xu Z, Cai W, Li L, Liu C. Dose-Response Effects of Patient Engagement on Health Outcomes in an mHealth Intervention: Secondary Analysis of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e25586. [PMID: 34982724 PMCID: PMC8767469 DOI: 10.2196/25586] [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: 11/08/2020] [Revised: 05/04/2021] [Accepted: 11/12/2021] [Indexed: 12/16/2022] Open
Abstract
Background The dose–response relationship between patient engagement and long-term intervention effects in mobile health (mHealth) interventions are understudied. Studies exploring long-term and potentially changing relationships between patient engagement and health outcomes in mHealth interventions are needed. Objective This study aims to examine dose–response relationships between patient engagement and 3 psychosocial outcomes in an mHealth intervention, Run4Love, using repeated measurements of outcomes at baseline and 3, 6, and 9 months. Methods This study is a secondary analysis using longitudinal data from the Run4Love trial, a randomized controlled trial with 300 people living with HIV and elevated depressive symptoms to examine the effects of a 3-month mHealth intervention on reducing depressive symptoms and improving quality of life (QOL). We examined the relationships between patient engagement and depressive symptoms, QOL, and perceived stress in the intervention group (N=150) using 4–time-point outcome measurements. Patient engagement was assessed using the completion rate of course assignments and frequency of items completed. Cluster analysis was used to categorize patients into high- and low-engagement groups. Generalized linear mixed effects models were conducted to investigate the dose–response relationships between patient engagement and outcomes. Results The cluster analysis identified 2 clusters that were distinctively different from each other. The first cluster comprised 72 participants with good compliance to the intervention, completing an average of 74% (53/72) of intervention items (IQR 0.22). The second cluster comprised 78 participants with low compliance to the intervention, completing an average of 15% (11/72) of intervention items (IQR 0.23). Results of the generalized linear mixed effects models showed that, compared with the low-engagement group, the high-engagement group had a significant reduction in more depressive symptoms (β=−1.93; P=.008) and perceived stress (β=−1.72; P<.001) and an improved QOL (β=2.41; P=.01) over 9 months. From baseline to 3, 6, and 9 months, the differences in depressive symptoms between the 2 engagement groups were 0.8, 1.6, 2.3, and 3.7 points, respectively, indicating widening between-group differences over time. Similarly, between-group differences in QOL and perceived stress increased over time (group differences in QOL: 0.9, 1.9, 4.7, and 5.1 points, respectively; group differences in the Perceived Stress Scale: 0.9, 1.4, 2.3, and 3.0 points, respectively). Conclusions This study revealed a positive long-term dose–response relationship between patient engagement and 3 psychosocial outcomes among people living with HIV and elevated depressive symptoms in an mHealth intervention over 9 months using 4 time-point repeat measurement data. The high- and low-engagement groups showed significant and widening differences in depressive symptoms, QOL, and perceived stress at the 3-, 6-, and 9-month follow-ups. Future mHealth interventions should improve patient engagement to achieve long-term and sustained intervention effects. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
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Affiliation(s)
- Yiran Li
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Yan Guo
- Department of Medical Statistics, School of Public Health, Guangzhou, China.,Sun Yat-sen Center for Global Health, Guangzhou, China.,Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Yu Zeng
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Aliza Monroe-Wise
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaying Qiao
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Zhimeng Xu
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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19
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Sharif Nia H, Rahmatpour P, Sivarajan Froelicher E, Pahlevan Sharif S, Kaveh O, Rezazadeh Fazeli A, Sia CC. Psychometric Properties of the Persian Version of the Center for Epidemiological Studies Depression Scale Among the Iranian Public People During COVID-19 Pandemic. Front Public Health 2022; 9:728904. [PMID: 34970522 PMCID: PMC8712319 DOI: 10.3389/fpubh.2021.728904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/02/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Several studies indicate a high prevalence of depression around the world during the period of the COVID-19 pandemic. Using a valid instrument to capture the depression of an individual in this situation is both important and timely. The present study aims to evaluate the psychometric properties of the Persian version of the Center for Epidemiological Studies Depression Scale (CES-D) among the public during the COVID-19 pandemic in Iran. Method: This is a cross-sectional study that was conducted in the Iranian population (n = 600) from April to July 2020. A two-part online form was used: sociodemographic characteristics and depression items (CES-D). The construct validity and internal consistency reliability of the scale were evaluated. Result: The results of the exploratory factor analysis illustrated two factors with 43.35% of the total variance of the depression were explained. Confirmatory factor analysis indicated that this model fits well. Internal consistency reliability was evaluated, and it was acceptable. Conclusion: The findings demonstrated that, in the Iranian sample, this depression scale yielded two factors (somatic and positive affects) solutions with suitable psychometric properties.
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Affiliation(s)
- Hamid Sharif Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pardis Rahmatpour
- Department of Nursing, Alborz University of Medical Sciences, Karaj, Iran
| | | | | | - Omolhoda Kaveh
- Department of Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Chin Chin Sia
- Faculty of Business and Law, Taylor's University, Subang Jaya, Malaysia
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20
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Ding X, Rong S, Wang Y, Li D, Wen L, Zou B, Zang D, Feng K, Liang Y, Wang F, Zhai G. The Association of the Prevalence of Depression in Type 2 Diabetes Mellitus with Visual-Related Quality of Life and Social Support. Diabetes Metab Syndr Obes 2022; 15:535-544. [PMID: 35237054 PMCID: PMC8882658 DOI: 10.2147/dmso.s343926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/22/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To report the prevalence of depression and its association with vision-related quality of life and social support in a type 2 diabetes mellitus (T2DM) population. METHODS Patients were recruited from a community-based study, Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT), conducted between July 2012 and May 2013 in China. Depression was assessed using the Centre for Epidemiological Studies Depression Scale (CES-D). Vision-related quality of life was evaluated using the Visual Function Questionnaire-25 (VFQ-25). Social support was captured with the Social Support Rating Scale (SSRS). Generalized linear models were used to estimate the individual and joint association of VFQ-25 composite score (VFQCS) and SSRS score (SSRSS) with depression. RESULTS A total of 1618 subjects (60.9% female) aged 61.69 ± 8.72 years in an urban district of Jiangjun Street, Fushun City, Liaoning province, Northeast China from July 2012 to May 2013 were recruited, of which, 23.36% (95% CI: 21.30-25.42%) were identified with depression. Every 14.1 increase in VFQ-25 composite score decreased the risk of depression by half (OR = 0.5; 95% CI: 0.4-0.6); with the elevation of 10.0 SSRS score the risk of depression decreased by 40% (OR = 0.6; 95% CI: 0.5-0.7). Patients with the VFQCS less than 91.3 and SSRSS less than 38.0 had 5.9 times more risk of depression (OR = 5.9; 95% CI: 3.6-9.7). Age (over 60 years) (OR = 0.6; 95% CI: 0.4-0.9) and medical history of cardiovascular disease (OR = 1.7; 95% CI: 1.1-2.5) were independently correlated with depression symptom. CONCLUSION The prevalence of depression is high among patients with T2DM in urban district in northeast China. Vision-related quality of life and social support scores are significantly associated with depression. Measures should be taken to screen depressive symptoms in patients with type 2 diabetes patients. These patients need to be intervened with appropriate and effective treatment as early as possible. Meanwhile, behavioral health specialists should guide the patient to get and use social support sources effectively.
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Affiliation(s)
- Xiaoxia Ding
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Shisong Rong
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA, USA
| | - Yu Wang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Dong Li
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Liang Wen
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Bo Zou
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Dongxiao Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
| | - Kemi Feng
- Department of Ophthalmology, the Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Yuanbo Liang
- Department of Ophthalmology, the Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Fenghua Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, People’s Republic of China
| | - Gang Zhai
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, People’s Republic of China
- Correspondence: Gang Zhai, Fushun Eye Hospital, No. 1 Hupo Street, Xinfu District, Fushun, Liaoning, 113008, People’s Republic of China, Email
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21
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Zhu X, Shek DTL, Dou D. Factor structure of the Chinese CES-D and invariance analyses across gender and over time among Chinese adolescents. J Affect Disord 2021; 295:639-646. [PMID: 34509779 DOI: 10.1016/j.jad.2021.08.122] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 08/22/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Research findings on the factor structure and invariance of the Center for the Epidemiological Studies Depression Scale (CES-D) are inconclusive. Besides, very few studies have examined factorial invariance of the scale over time. Related studies based on Chinese adolescents are also sparse. This study attempted to examine the factor structure of the CES-D and its invariance across gender and time over a one-year period among adolescents in mainland China. METHOD A total of 3,010 adolescents (mean age = 13.16 years, 1,730 boys) completed a questionnaire including the CES-D at Wave 1 and 2,648 of them completed the same survey one year later. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure of the CES-D. Factorial invariance of the resultant factor structure was tested using cross-sectional multi-group CFA (girls vs. boys) at Wave 1 and Wave 2 and longitudinal CFA (Wave 1 vs. Wave 2). RESULTS EFA and CFA revealed a three-factor model of the CES-D, including "somatic complaints," "depressed affect," and "positive affect." Additionally, findings supported the factorial invariance across gender and over time for the three-factor model. LIMITATIONS Limitations of the present study included a lack of adolescents from different areas in mainland China (particularly rural areas) and only a one-year follow-up. CONCLUSIONS This pioneering study suggests that there are three stable dimensions of the CES-D in Chinese adolescents in mainland China which are invariant across gender and over time.
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Affiliation(s)
- Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
| | - Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China.
| | - Diya Dou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
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22
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Li Y, Guo Y, Hong YA, Zeng C, Zeng Y, Zhang H, Zhu M, Qiao J, Cai W, Li L, Liu C. Mediating Effects of Stigma and Depressive Symptoms in a Social Media-Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res 2021; 23:e27897. [PMID: 34751654 PMCID: PMC8663519 DOI: 10.2196/27897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/09/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions. OBJECTIVE This study aims to explore the intervention mechanisms of a social media-based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period. METHODS We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants' QOL. RESULTS About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. CONCLUSIONS These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media-based interventions that can address HIV-related stigma and alleviate depressive symptoms. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019.
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Affiliation(s)
- Yiran Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Guo
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Center for Global Health, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Yu Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiaying Qiao
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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23
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Chou WJ, Hsiao RC, Chang CC, Yen CF. Predictors of Depressive Symptoms in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: A One-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168835. [PMID: 34444584 PMCID: PMC8393252 DOI: 10.3390/ijerph18168835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/14/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
This 1-year follow-up study examined the predictive values of the demographics, depressive symptoms, stress-coping orientations, and perceived family support of caregivers as well as the internalizing, externalizing and ADHD symptoms of children with attention-deficit/hyperactivity disorder (ADHD) at baseline on the depressive symptoms of the caregivers after 1 year. A total of four hundred caregivers of children with ADHD were recruited. The baseline levels of the caregivers' depressive symptoms, stress-coping orientations, and perceived family support and the internalizing and externalizing problems of the children were assessed using the Center for Epidemiological Studies Depression Scale, the Coping Orientation to Problems Experienced, Family Adaptation, Partnership, Growth, Affection, Resolve Index, and the Child Behavior Checklist For Ages 6-18, respectively. Their predictions for the caregiver's depressive symptoms 1 year after the baseline were examined using linear regression analysis. In total, 382 caregivers of children with ADHD underwent the follow-up assessment 1 year from the baseline. A marital status of being separated or divorced, less effective coping and depressive symptoms orientation, and children with internalizing problems and ADHD symptoms at baseline were positively associated with the caregivers' depressive symptoms at follow-up, whereas the caregivers' perceived family support and an emotion-focused coping orientation at baseline were negatively associated with depressive symptoms at follow-up. Multiple characteristics of the caregivers and children with ADHD at baseline predicted the caregivers' depressive symptoms 1 year later.
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Affiliation(s)
- Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA;
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-6-2203702 (C.-C.C.); +886-7-3134761 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-6-2203702 (C.-C.C.); +886-7-3134761 (C.-F.Y.)
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24
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Wee PJL, Kwan YH, Loh DHF, Phang JK, Puar TH, Østbye T, Thumboo J, Yoon S, Low LL. Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review. J Med Internet Res 2021; 23:e25002. [PMID: 34397387 PMCID: PMC8398743 DOI: 10.2196/25002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/18/2020] [Accepted: 06/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The management of diabetes is complex. There is growing recognition of the use of patient-reported outcome measures (PROMs) as a standardized method of obtaining an outlook on patients' functional status and well-being. However, no systematic reviews have summarized the studies that investigate the measurement properties of diabetes PROMs. OBJECTIVE Our aims were to conduct a systematic review of studies investigating the measurement properties of diabetes PROMs by evaluating the methodological quality and overall level of evidence of these PROMs and to categorize them based on the outcome measures assessed. METHODS This study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the Embase, PubMed, and PsychINFO databases. The PROMs were evaluated with the COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) guidelines. RESULTS A total of 363 articles evaluating the measurement properties of PROMs for diabetes in the adult population were identified, of which 238 unique PROMs from 248 studies reported in 209 articles were validated in the type 2 diabetes population. PROMs with at least a moderate level of evidence for ≥5 of 9 measurement properties include the Chinese version of the Personal Diabetes Questionnaire (C-PDQ), Diabetes Self-Management Instrument Short Form (DSMI-20), and Insulin Treatment Appraisal Scale in Hong Kong primary care patients (C-ITAS-HK), of which the C-PDQ has a "sufficient (+)" rating for >4 measurement properties. A total of 43 PROMs meet the COSMIN guidelines for recommendation for use. CONCLUSIONS This study identified and synthesized evidence for the measurement properties of 238 unique PROMs for patients with type 2 diabetes and categorized the PROMs according to their outcome measures. These findings may assist clinicians and researchers in selecting appropriate high-quality PROMs for clinical practice and research. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020180978; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020180978.
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Affiliation(s)
| | - Yu Heng Kwan
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Troy H Puar
- Department of Endocrinology, Changi General Hospital, Singapore, Singapore
| | - Truls Østbye
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Julian Thumboo
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sungwon Yoon
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Lian Leng Low
- SingHealth Office of Regional Health, Singapore, Singapore
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore
- Post Acute and Continuing Care, Outram Community Hospital, SingHealth Community Hospitals, Singapore, Singapore
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Park SH, Yu HY. How useful is the center for epidemiologic studies depression scale in screening for depression in adults? An updated systematic review and meta-analysis ✰. Psychiatry Res 2021; 302:114037. [PMID: 34098160 DOI: 10.1016/j.psychres.2021.114037] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/22/2021] [Indexed: 10/21/2022]
Abstract
This study analyzes the performance of the Center for Epidemiologic Studies Depression Scale (CES-D) to screen for major depressive disorder (MDD) in adults. We divided adults into three groups such as community-indwelling adults, patients with chronic diseases, and psychiatric patients. Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO database using the following keywords: depression, depressive disorder, major, and CES-D scale. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias in diagnostic studies. We reviewed 33 studies, including 18,271 adults that met the selection criteria. In meta-analysis, the pooled sensitivity was 0.86 on community-indwelling adults, 0.85 on patients with chronic diseases and 0.85 on psychiatric patients. The pooled specificity was 0.74, 0.84, and 0.88, respectively, and the summary receiver-operating characteristic curves were 0.88, 0.91, and 0.93, respectively. The RE correlation was a negative value (-0.394) only in patients with chronic diseases, showing no heterogeneity between studies. The CES-D, which has shown high diagnostic accuracy in adults, can be recommended for use as a first-stage screener for MDD. As a result, the early application of the CES-D can lead to disease prevention in adults at risk for depression.
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Affiliation(s)
| | - Hye Yon Yu
- School of Nursing, Soonchunhyang University, Korea
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Liu Y, Han Y, Wang X, Chen Y, Mo Q, Li L, Wang Y, Fan J, Yang Y, Soondrum T, Zhu X. Psychometric properties of the Chinese version of the Courtauld Emotional Control Scale in women newly diagnosed with breast cancer. Qual Life Res 2021; 31:865-876. [PMID: 34328583 DOI: 10.1007/s11136-021-02953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Emotional control, the attempt to suppress the expression of negative effects, is an essential factor in the prevalence of psychological distress in women with breast cancer. The Courtauld Emotional Control Scale (CECS) is a commonly used self-report tool for assessing emotional suppression in both clinical and general groups. This study aimed to validate the Chinese version of the Courtauld Emotional Control Scale (CECS) in women newly diagnosed with breast cancer. METHODS The study involved 680 women newly diagnosed with breast cancer aged 25 to 76 (mean age = 48.19, standard deviation (SD) = 8.57) from Changsha (China). Data analysis included Cronbach's alpha coefficients, the intraclass correlation coefficient (ICC), Pearson's correlations, Independent-Samples T test, confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted to determine the optimal model. For the best fitting model stability was assessed with tests for invariance across age, educational level, and employment status. RESULTS Internal consistency (α = 0.987) and test-retest reliability (ICC = 0.715) of the CECS were presented. Results confirm the structure of the Chinese version of the CECS with 21 items divided into three dimensions, anger suppression (CECS_AG), depression suppression (CECS_MD), and anxiety suppression (CECS_AX). Convergent and known-groups validity were acceptable. Additionally, this model remained invariant across age, educational levels, and employment status. CONCLUSIONS The Chinese version of the CECS has good psychometric properties in terms of reliability and validity, remaining invariant across age, educational levels, and employment status in women newly diagnosed with breast cancer.
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Affiliation(s)
- Yao Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
- Medical Psychological Institute of Central South University, Changsha, China
| | - Yan Han
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Yaoxin Chen
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Qingqian Mo
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingyan Li
- School of Nursing, Nanchang University, Nanchang, China
| | - Yuping Wang
- School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Yanjie Yang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Tamini Soondrum
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China.
- Medical Psychological Institute of Central South University, Changsha, China.
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Zhao M, Xiao D, Wang W, Wu R, Zhang W, Guo L, Lu C. Association Among Maltreatment, Bullying and Mental Health, Risk Behavior and Sexual Attraction in Chinese Students. Acad Pediatr 2021; 21:849-857. [PMID: 33279736 DOI: 10.1016/j.acap.2020.11.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To identify the association between sexual attraction, childhood maltreatment and bullying victimization, and mental and behavioral health problems among Chinese adolescents. METHODS A cross-sectional study among Chinese high school students by multistage stratified cluster sampling was conducted using a self-reported questionnaire. Participants who were same- or both-sex attracted were identified as sexual minorities, and those who were opposite-sex attracted were identified as heterosexuals. Childhood maltreatment was assessed as physical, emotional, and sexual abuse, and bullying was assessed as traditional and cyberbullying. Psychological distress was assessed as depressive and anxiety symptoms, and self-destructive behavior was assessed as suicidal behavior and nonsuicidal self-injury. Logistic regression and path analysis were conducted to analyze the data. RESULTS There were 1360 sexual minority and 15,020 heterosexual respondents. Sexual minority status was associated with increased risk of maltreatment (adjusted odds ratio [AOR] range: 1.25-2.46) and bullying (AOR range: 1.38-1.77) victimization, and a series of health problems (AOR range: 1.85-3.69). Furthermore, childhood maltreatment could partially explain the association of sexual minority status with psychological distress (indirect effect: β = 0.026 for boys; β = 0.086 for girls) and self-destructive behavior (β = 0.056 for boys; β = 0.125 for girls), and bullying could partially explain the association between sexual minority status and psychological distress (β = 0.040 for boys; β = 0.031 for girls). CONCLUSIONS Sexual minority adolescents were more likely than heterosexuals to experience different forms of childhood victimization, which may put them at higher risk for mental and behavioral health problems. Interventions based on both family and school are essential.
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Affiliation(s)
- Meijun Zhao
- Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Di Xiao
- Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Weihong Zhang
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology (W Zhang), Ghent University, Ghent, Belgium
| | - Lan Guo
- Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Kato T. Measurement Invariance in the Center for Epidemiologic Studies-Depression (CES-D) Scale among English-Speaking Whites and Asians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105298. [PMID: 34065748 PMCID: PMC8156289 DOI: 10.3390/ijerph18105298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022]
Abstract
The Center for Epidemiologic Studies Depression (CES-D) Scale has been widely used to measure depressive symptoms. This study compared the measurement invariances for one-, two-, three-, and four-factor models of the CES-D across English-speaking Whites and Asians: White Americans, White Australians, Indians, Filipinos, and Singaporeans. White Americans and Australians, Indians, Filipinos, and Singaporeans English speakers (782 men and 824 women) whose ages ranged from 20 to 79 years, completed the CES-D. They were recruited from the data pool of the 2013 and 2014 Coping and Health Survey. Confirmatory factor analyses indicated that the original four-factor model showed the best fit, compared to the other models. Mean and covariance structure analyses showed that the factor means of the CES-D subscales among Whites were significantly lower than were those among Asians; the score gap was particularly high between Whites and Indians. Additionally, Indians scored the highest on all subscales of the CES-D compared to all other countries. Overall, CES-D scores among Whites were lower than those among Asians.
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Affiliation(s)
- Tsukasa Kato
- Department of Social Psychology, Toyo University, 5-28-20 Hakusan, Bunkyo-ku, Tokyo 112-8606, Japan
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Heo S, Sung Y, Lee SW. Effects of subclinical depression on prefrontal-striatal model-based and model-free learning. PLoS Comput Biol 2021; 17:e1009003. [PMID: 33989284 PMCID: PMC8153417 DOI: 10.1371/journal.pcbi.1009003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 05/26/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Depression is characterized by deficits in the reinforcement learning (RL) process. Although many computational and neural studies have extended our knowledge of the impact of depression on RL, most focus on habitual control (model-free RL), yielding a relatively poor understanding of goal-directed control (model-based RL) and arbitration control to find a balance between the two. We investigated the effects of subclinical depression on model-based and model-free learning in the prefrontal-striatal circuitry. First, we found that subclinical depression is associated with the attenuated state and reward prediction error representation in the insula and caudate. Critically, we found that it accompanies the disrupted arbitration control between model-based and model-free learning in the predominantly inferior lateral prefrontal cortex and frontopolar cortex. We also found that depression undermines the ability to exploit viable options, called exploitation sensitivity. These findings characterize how subclinical depression influences different levels of the decision-making hierarchy, advancing previous conflicting views that depression simply influences either habitual or goal-directed control. Our study creates possibilities for various clinical applications, such as early diagnosis and behavioral therapy design.
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Affiliation(s)
- Suyeon Heo
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Brain and Cognitive Engineering Program, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Yoondo Sung
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Sang Wan Lee
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Brain and Cognitive Engineering Program, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- KAIST Institute for Health Science Technology, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- KAIST Institute for Artificial Intelligence, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- KAIST Center for Neuroscience-inspired AI, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
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He SJ, Fang YW, Huang ZX, Yu Y. Validation of an 8-item Recovery Assessment Scale (RAS-8) for people with schizophrenia in China. Health Qual Life Outcomes 2021; 19:119. [PMID: 33849558 PMCID: PMC8045355 DOI: 10.1186/s12955-021-01763-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 04/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background The 24-item Recovery Assessment Scale (RAS) is the most widely-used and well-validated tool for measuring recovery for people with mental illness. The current study aims to assess the reliability and validity of an 8-item short form of RAS (RAS-8) among a Chinese sample of people living with schizophrenia. Methods A sample of 400 people living with schizophrenia were recruited for scale validation. Internal consistency was tested by calculating Cronbach's α. Test–retest reliability was calculated using the intraclass correlation coefficient (ICC) for the total score and weighted kappa for each item. Factor structure was tested with confirmatory factor analysis, and concurrent validity was examined by investigating the correlation of the RAS-8 with patient symptoms, disability, depression, anxiety, patient functioning, quality of life and general health. Results The RAS-8 full scale and subscales showed good internal consistency with Cronbach’s alpha ranging from 0.87 to 0.92. ICC of 0.99 and weighted kappa ranged from 0.62 to 0.88, which generally indicates good test–retest reliability. The findings supported an a priori two-factor structure, χ2/df = 2.93, CFI = 0.98, TLI = 0.98, RMSEA = 0.07, SRMR = 0.035. Concurrent validity of the RAS-8 was further supported by its significant negative correlations with patient symptoms (r = −0.24, p < 0.01), disability (r = −0.30, p < 0.01), depression (r = −0.16, p < 0.05), and anxiety (r = −0.14, p < 0.05), and its significant positive relationships with patient functioning (r = 0.26, p < 0.01), quality of life (r = 0.39, p < 0.01) and general health (r = 0.34, p < 0.01). Conclusions This study confirmed the reliability and validity of an 8-item short-form RAS for people living with schizophrenia in Chinese communities. The validation of the RAS-8 allows for its use as an alternative for the full RAS as a rapid assessment tool in clinical and research settings. The findings are discussed for their implications for application and validation with other populations and in other countries.
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Affiliation(s)
- Si-Jia He
- Department of Sociology, School of Public Management, Central South University, Lushan South Road 932, Changsha, 410083, Hunan, China
| | - Yan-Wen Fang
- Department of Public Health, Faculty of Medicine, University of Queensland, 20 Weightman St, Herston, QLD, 4006, Australia
| | - Zi-Xin Huang
- Department of Public Health, Faculty of Medicine, University of Queensland, 20 Weightman St, Herston, QLD, 4006, Australia
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China. .,Division of Prevention and Community Research, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
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Sun W, Mei J, Wang Y, Zhao X, Zhu Z, Zhang C, Pan C, Li G, Chen Y, Miao J, Lan Y, Qiu X, Xu Y. Psycho-social factors associated with high depressive symptomatology in female adolescents and gender difference in adolescent depression: an epidemiological survey in China's Hubei Province. BMC Psychiatry 2021; 21:168. [PMID: 33771118 PMCID: PMC7995784 DOI: 10.1186/s12888-021-03165-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exploring etiological clues to adolescent depression, especially in female adolescents, might be helpful to improve the social environment of female adolescents. The aim at this study is to explore psycho-social factors of female adolescents with high depressive symptomatology and gender differences in depressive symptoms among Chinese adolescents. METHOD We examined 4100 adolescents from Wuhan city and Jianli county via a cross-sectional study. Depressive symptomatology was screened through the Chinese version of Center for Epidemiology Studies Depression Scale. Multivariate logistic regression was performed to explore the factors related to high depressive symptomatology in female and male adolescents, respectively. RESULTS The prevalence of high depressive symptomatology in female and male were 38.9 and 30.2% respectively. The psycho-social factors of high depressive symptomatology in female adolescents were age (Adjusted odds ratio [aOR] = 1.201, 95% confidence interval [CI], 1.076 ~ 1.341), single parent family (aOR = 2.004, 95%CI, 1.448 ~ 2.772) and fathers' education level (compared to primary school and below, [Junior middle school, aOR = 0.641, 95%CI, 0.439 ~ 0.934; Senior middle school, aOR = 0.603, 95%CI, 0.410 ~ 0.888; College degree and above, aOR = 0.639, 95%CI, 0.437 ~ 0.936]). CONCLUSION Fathers' education level was associated with high depressive symptomatology in female adolescents. Female adolescents whose father with primary school education or below deserves more attention. Further epidemiologic researches need to be conducted to explore the different risk factors between female and male adolescents in China.
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Affiliation(s)
- Wenzhe Sun
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Junhua Mei
- grid.410609.aDepartment of Neurology, Wuhan First Hospital, No.215 Zhongshan Avenue, Wuhan, 430030 Hubei China
| | - Yanyan Wang
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Xin Zhao
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Zhou Zhu
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Chenyan Zhang
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Chensheng Pan
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Guo Li
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Yuxi Chen
- grid.21107.350000 0001 2171 9311The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Jinfeng Miao
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Yan Lan
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Xiuli Qiu
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Yi Xu
- Department of Plastic surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030, China.
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Schmalbach B, Zenger M, Michaelides MP, Schermelleh-Engel K, Hinz A, Körner A, Beutel ME, Decker O, Kliem S, Brähler E. From Bi-Dimensionality to Uni-Dimensionality in Self-Report Questionnaires. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2021. [DOI: 10.1027/1015-5759/a000583] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract. The common factor model – by far the most widely used model for factor analysis – assumes equal item intercepts across respondents. Due to idiosyncratic ways of understanding and answering items of a questionnaire, this assumption is often violated, leading to an underestimation of model fit. Maydeu-Olivares and Coffman (2006) suggested the introduction of a random intercept into the model to address this concern. The present study applies this method to six established instruments (measuring depression, procrastination, optimism, self-esteem, core self-evaluations, and self-regulation) with ambiguous factor structures, using data from representative general population samples. In testing and comparing three alternative factor models (one-factor model, two-factor model, and one-factor model with a random intercept) and analyzing differential correlational patterns with an external criterion, we empirically demonstrate the random intercept model’s merit, and clarify the factor structure for the above-mentioned questionnaires. In sum, we recommend the random intercept model for cases in which acquiescence is suspected to affect response behavior.
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Affiliation(s)
- Bjarne Schmalbach
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Markus Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Germany
- Integrated Research and Treatment Center AdiposityDiseases – Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Germany
| | | | | | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Annett Körner
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Oliver Decker
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - Sören Kliem
- Ernst-Abbe-Hochschule Jena – University of Applied Sciences, Jena, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
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Zhao X, Sun M, Yang Y. Effects of social support, hope and resilience on depressive symptoms within 18 months after diagnosis of prostate cancer. Health Qual Life Outcomes 2021; 19:15. [PMID: 33413485 PMCID: PMC7792299 DOI: 10.1186/s12955-020-01660-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022] Open
Abstract
Background The prevalence of depression symptoms and related modifiable factors in prostate cancer (PCa) are not well evaluated. We aimed to assess the effects of perceived social support, hope and resilience on depressive symptoms within 18 months after diagnosis of PCa, and to evaluate the role of hope and resilience as mediators of that relationship. Method A cross-sectional study was analyzed in consecutive inpatients with PCa during the months of January 2018 and August 2019. A total of 667 patients eligible for this study completed questionnaires on demographic and clinic variables, Center for Epidemiologic Studies Depression Scale, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Resilience Scale (14 items). All registered patients were all volunteers and anonymous. Depressive symptoms, perceived social support, hope and resilience were measured anonymously. Out of 667 patients, a total of 564 effective respondents (< 30% missing data) became our subjects. Hierarchical linear regression was used to identify the factors associated with depressive symptoms. Asymptotic and resampling strategies were used to conduct the mediating effects of hope and resilience. Results The prevalence of depressive symptoms was 65.9% in PCa patients. Hierarchical regression analyses indicated that perceived social support, hope, and resilience together accounted for 27.5% variance of depressive symptoms. Support from family, hope, and resilience significantly associated with depressive symptoms, respectively. Hope (a*b = − 0.0783, BCa95% CI: − 0.134 to − 0.0319, p < 0.05), and resilience (a*b = − 0.1315, BCa95% CI: − 0.1894 to − 0.0783, p < 0.05) significantly mediated the association between perceived social support and depressive symptoms. Conclusions The high prevalence of depressive symptoms among PCa patients should receive more attention. Perceived social support, hope and resilience could be positive resources for combating depressive symptoms, and hope and resilience mediated the association between perceived social support and depressive symptoms. Enhancing social support, particularly the support form family, and improving patients’ outlook and resilience may be potential targets for future psychosocial interventions aimed at reducing depressive symptoms.
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Affiliation(s)
- Xinxin Zhao
- Department of Hospice, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Ming Sun
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ye Yang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
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Zhao M, Xiao D, Wang W, Wu R, Dewaele A, Zhang W, Buysse A, Song C, Guo L, Lu C. Association of sexual minority status, gender nonconformity with childhood victimization and adulthood depressive symptoms: A path analysis. CHILD ABUSE & NEGLECT 2021; 111:104822. [PMID: 33291012 DOI: 10.1016/j.chiabu.2020.104822] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/04/2020] [Accepted: 11/08/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Sexual minority status and childhood gender nonconformity have been associated with elevated risks of childhood adversities and poorer mental health. OBJECTIVE To explore how abuse and bullying explain the disparities in the associations of sexual minority status and childhood gender nonconformity with adulthood depressive symptoms in men. PARTICIPANTS AND SETTING We conducted a cross-sectional study using a self-report questionnaire among Chinese adult men (18-35 years) who were identified as heterosexual (n = 873) and sexual minority (n = 858) in Guangzhou from 2017 to 2019. METHODS Structural equation modeling (SEM) were conducted for path analysis. RESULTS The levels of exposure to childhood maltreatment were higher in sexual minorities than in straight men, and sexual minority status predicted an increased risk of depressive symptoms via childhood maltreatment (indirect effect: β = 0.026, p = 0.004). Meanwhile, childhood gender nonconformity predicted higher depressive symptoms via both family (indirect effect: β = 0.042, p < 0.001) and school (indirect effect: β = 0.028, p < 0.001) victimization, and there was a direct effect (β = 0.154, p < 0.001) of gender nonconformity on depressive symptoms. CONCLUSION Sexual minority status and gender nonconformity are indicators of men's increased risk of childhood victimization and adulthood depressive symptoms. As a result, intervention based on both family and school dimensions needs to be developed.
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Affiliation(s)
- Meijun Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Di Xiao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Alexis Dewaele
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Weihong Zhang
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ann Buysse
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Chao Song
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Bhattarai D, Shrestha N, Paudel S. Prevalence and factors associated with depression among higher secondary school adolescents of Pokhara Metropolitan, Nepal: a cross-sectional study. BMJ Open 2020; 10:e044042. [PMID: 33384401 PMCID: PMC7780534 DOI: 10.1136/bmjopen-2020-044042] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study examined the prevalence and factors associated with depression among adolescents attending higher secondary schools in the Pokhara Metropolitan City of Nepal. DESIGN A cross-sectional study design was adopted. SETTING Four randomly selected higher secondary schools of Pokhara Metropolitan, Nepal. PARTICIPANTS 312 randomly sampled higher secondary school students. METHODS The Center for Epidemiologic Studies Depression Scale was used to assess the level of depression among students. The data collected through a self-administered questionnaire were analysed using descriptive statistical methods such as frequency and percentage. χ2 test and unadjusted OR (UOR) were calculated to assess the statistical relationship between depression and various variables at 95% CI, with level of significance at p<0.05. RESULTS The study found a high prevalence of depression among high school students, with more than two-fifths (44.2%) of students having depression. Furthermore, almost a quarter (25.3%) of the students were noted to have mild depression and 18.9% of the students expressed major depression. Students who had low perceived social support (UOR: 3.604; 95% CI 2.088 to 6.220), did not share their problems with anyone (UOR: 1.931; 95% CI 1.228 to 3.038) and had low self-esteem (UOR: 5.282; 95% CI 2.994 to 9.319) were at higher odds of being depressed. CONCLUSION A high prevalence of depression was observed among high school students. It was also observed that students' level of perceived social support, self-esteem and help-seeking behaviour are somehow related to their mental well-being. Hence, improving social support and self-esteem may alleviate depression and mental distress among these adolescents.
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Affiliation(s)
- Deepa Bhattarai
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Lekhnath, Kaski, Nepal
| | - Nisha Shrestha
- Pokhara Nursing Campus, Institute of Medicine, Tribhuvan University, Pokhara, Kaski, Nepal
| | - Shishir Paudel
- Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
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Smarr KL, Keefer AL. Measures of Depression and Depressive Symptoms. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:608-629. [PMID: 33091258 DOI: 10.1002/acr.24191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 03/17/2020] [Indexed: 01/27/2023]
Affiliation(s)
- Karen L Smarr
- Harry S. Truman Memorial Veterans' Hospital and University of Missouri School of Medicine, Columbia
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Song X, Fu W, Liu X, Luo Z, Wang R, Zhou N, Yan S, Lv C. Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China. Brain Behav Immun 2020; 88:60-65. [PMID: 32512134 PMCID: PMC7273140 DOI: 10.1016/j.bbi.2020.06.002] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 05/30/2020] [Accepted: 06/02/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China. METHODS Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020. OUTCOMES A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD. INTERPRETATION The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.
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Affiliation(s)
- Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoran Liu
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China; Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zhiqian Luo
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Ning Zhou
- Central People's Hospital of Zhanjiang, Guangdong, China.
| | - Shijiao Yan
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China; School of Public Health, Hainan Medical University, Haikou, Hainan, China.
| | - Chuanzhu Lv
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China; Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China; Emergency and Trauma College, Hainan Medical University, Haikou, Hainan, China.
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Sebera F, Vissoci JRN, Umwiringirwa J, Teuwen DE, Boon PE, Dedeken P. Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda. PLoS One 2020; 15:e0234095. [PMID: 32530968 PMCID: PMC7292570 DOI: 10.1371/journal.pone.0234095] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with epilepsy (PwE) have an increased risk of active and lifetime depression. Two in 10 patients experience depression. Lack of trained psychiatric staff in low- and middle-income countries (LMIC) creates a need for screening tools that enable detection of depression in PwE. We describe the translation, validity and reliability assessment of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for depression among PwE in Rwanda. METHOD PHQ-9 was translated to Kinyarwanda using translation-back translation and validated by a discussion group. For validation, PwE of ≥15 years of age were administered the PHQ-9 and Hamilton Depression Rating Scale (HDRS) by trained psychiatry staff at Visit 1. A random sample of 20% repeated PHQ-9 and HDRS after 14 days to assess temporal stability and intra-rater reliability. Internal structure, reliability and external validity were assessed using confirmatory factor analysis, reliability coefficients and HDRS-correlation, respectively. Maximal Youden's index was considered for cut-offs. RESULTS Four hundred and thirty-four PwE, mean age 30.5 years (SD ±13.3), were included of whom 33.6%, 37.9%, 13.4%, and 15.1% had no, mild, moderate and severe depression, respectively. PHQ-9 performed well on a one-factor model (unidimensional model), with factor loadings of 0.63-0.86. Reliability coefficients above 0.80 indicated strong internal consistency. Good temporal stability was observed (0.79 [95% CI: 0.68-0.87]). A strong correlation (R = 0.66, p = 0.01) between PHQ-9 and HDRS summed scores demonstrated robust external validity. The optimal cut-off for the PHQ-9 was similar (≥5) for mild and moderate depression and ≥7 for severe depression. CONCLUSION PHQ-9 validation in Kinyarwanda creates the capacity to screen PwE in Rwanda at scores of ≥5 for mild or moderate and ≥7 for severe depression. The availability of validated tools for screening and diagnosis for depression is a forward step for holistic care in a resource-limited environment.
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Affiliation(s)
- Fidèle Sebera
- CARAES Neuropsychiatric Hospital, Ndera, Kigali, Rwanda
- Centre Hospitalier Universitaire Kigali (CHUK), Kigali, Rwanda
| | - Joao Ricardo Nickenig Vissoci
- Department of Surgery, Duke University Medical School, Durham, NC, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | | | | | | | - Peter Dedeken
- UCB Pharma, Brussels, Belgium
- Ghent University Hospital, Ghent, Belgium
- Heilig Hart Hospitaal, Lier, Belgium
- * E-mail:
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Yu Y, Liu ZW, Li TX, Zhou W, Xi SJ, Xiao SY, Tebes JK. A comparison of psychometric properties of two common measures of caregiving burden: the family burden interview schedule (FBIS-24) and the Zarit caregiver burden interview (ZBI-22). Health Qual Life Outcomes 2020; 18:94. [PMID: 32252766 PMCID: PMC7137330 DOI: 10.1186/s12955-020-01335-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/19/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The Family Burden Interview Schedule (FBIS-24) and the Zarit Caregiver Burden Interview (ZBI-22) are among the most widely used measures for assessing caregiving burden, but their psychometric performances have not been compared in the same study of caregivers of people living with schizophrenia (PLS). This is important because the measures assess overlapping constructs- the FBIS-24 assesses objective burden (e.g., completion of manual tasks) and the ZBI-22 assesses subjective burden (e.g., perceived distress, stigma). This study seeks to fill this gap by comparing the reliability and validity of the FBIS-24 and the ZBI-22 in a Chinese community sample of caregivers of PLS. Methods A Cross-sectional stud was conducted in a community-based mental health service program in Central South part of China. A total of 327 primary family caregivers of PLS completed face-to-face interviews of the FBIS-24, the ZBI-22, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Family Adaptation, Partnership, Growth, Affection and Resolve Index scale (APGAR), and PLS were assessed using the Global Assessment of Function scale (GAF). Results Our findings show that both the FBIS-24 and ZBI-22 have comparable psychometric performance in terms of the internal consistency, convergent validity and known group’s validity. Conclusion Both the FBIS-24 and the ZBI-22 are psychometrically sound measures of caregiving burden but the choice of which measure to use will depend on the research question.
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Affiliation(s)
- Yu Yu
- Hospital Evaluation Office, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.,Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
| | - Zi-Wei Liu
- School of Medicine, Hunan Normal University, 371 Tongzhi Road, Changsha, Hunan, 410013, China
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Wei Zhou
- Hospital Administration Institute, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China
| | - Shi-Jun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Shui-Yuan Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
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Kuo HJ, Huang YC, García AA. Fatigue, Pain, Sleep Difficulties, and Depressive Symptoms in Mexican Americans and Chinese Americans with Type 2 Diabetes. J Immigr Minor Health 2020; 22:895-902. [DOI: 10.1007/s10903-020-01001-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Two-Year Incidence and Associated Factors of Dry Eye Among Residents in Shanghai Communities With Type 2 Diabetes Mellitus. Eye Contact Lens 2020; 46 Suppl 1:S42-S49. [DOI: 10.1097/icl.0000000000000626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Li Y, Guo Y, Hong YA, Zhu M, Zeng C, Qiao J, Xu Z, Zhang H, Zeng Y, Cai W, Li L, Liu C. Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial. J Med Internet Res 2019; 21:e14729. [PMID: 31774411 PMCID: PMC6906623 DOI: 10.2196/14729] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 08/25/2019] [Accepted: 08/31/2019] [Indexed: 01/03/2023] Open
Abstract
Background People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide. Objective This study was designed to examine the mechanisms and effects of a WeChat-based intervention, Run4Love, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators. Methods A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the Run4Love group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses. Results The Run4Love mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=−.18, P=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=−.09, P=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33% (–0.09/–0.27) of the total effect. Conclusions Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019
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Affiliation(s)
- Yiran Li
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Center for Migrant Health Policy, Guangzhou, China.,Sun Yat-sen Center for Global Health, Institute of State Governance, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Mengting Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Jiaying Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhimeng Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiping Cai
- Department of Infectious Diseases, Eight People's Hospital, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Eight People's Hospital, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Eight People's Hospital, Guangzhou, China
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Ying J, Yap P, Gandhi M, Liew TM. Validity and Utility of the Center for Epidemiological Studies Depression Scale for Detecting Depression in Family Caregivers of Persons with Dementia. Dement Geriatr Cogn Disord 2019; 47:323-334. [PMID: 31307034 PMCID: PMC6878745 DOI: 10.1159/000500940] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/13/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/AIMS The psychometric properties of Center for Epidemiological Studies Depression Scale (CES-D) have never been substantively investigated in caregivers of persons with dementia (PwD). We evaluated the validity and reliability of CES-D for detecting caregiver depression in dementia, and assessed whether CES-D could provide added utility beyond Zarit Burden Interview (ZBI). METHOD Family caregivers of community-dwelling PwD (n = 394) completed self-administered questionnaires containing CES-D. Factorial validity was evaluated with confirmatory factor analysis; convergent and discriminant validity with Pearson's correlation coefficient; known-group validity by comparing across key variables; and internal consistency reliability with Cronbach's α. Cohen's κ was used to compare the agreement between those with depression (CES-D ≥16) and those with high caregiver burden (ZBI >60). RESULTS CES-D demonstrated convergent, discriminant and known-group validity, consistent with a priori hypotheses. The original four-factor model of CES-D produced the best model-fit indices. Internal consistency reliability was good for the CES-D total scale (α = 0.92), but lower for the Positive affect and Interpersonal problems subscales (α = 0.70-0.74). Forty-five percent of the caregivers had depression as identified by CES-D (95% CI 40-50%), but most of them were not identified by high ZBI scores (κ = 0.16). CONCLUSIONS CES-D is a valid and reliable scale for detecting caregiver depression in dementia. It has added utility, beyond that of a caregiver burden scale, in identifying a subgroup of caregivers with depression but not burden. However, two subscales (Positive affect and Interpersonal problems) may require caution in interpretation among non-Caucasian caregivers.
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Affiliation(s)
- Jiangbo Ying
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore,Geriatric Education and Research Institute, Singapore, Singapore
| | - Mihir Gandhi
- Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Tau Ming Liew
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore, .,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore,
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Liu Y, Fu R, Roberto KA, Savla J. Depressive symptoms among adult children caregivers in China: moderating effects of working status and gender. Aging Ment Health 2019; 23:1391-1399. [PMID: 30621438 DOI: 10.1080/13607863.2018.1488943] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: With over one-fifth of the world's older population, shrinking family size and increasing number of women in the workforce, elder care is a growing challenge for families in mainland China. This study explored the moderating effect of working status and gender on caregiving time and depressive symptoms among adult children caregivers in mainland China. Method: Participants were 660 adult children caregivers from a nationally representative sample of individuals aged 45 + (N = 13,204) who participated in the China Health and Retirement Longitudinal Study (CHARLS) Wave 2 (2013). Multiple linear regression was used to analyze the direct effect of caregiving time and the moderating effects of working status and gender on symptoms of depression among caregivers. Results: Significant main effect between caregiving time and depressive symptoms was found controlling for demographic covariates. The three-way interaction between working status, gender and caregiving time was also significant. Working status and gender moderate the effect of caregiving time on depressive symptoms: among employed men and women caregivers, spending more hours providing care predicted fewer depression symptoms. Unemployed men caregivers who spent more hours providing care showed highest level of depressive symptoms. Conclusion: The relationship between caregiving time and depressive symptoms was moderated by working status and gender. Future research is needed to explore factors that influence changes in caregivers' health and well-being over time.
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Affiliation(s)
- Yujun Liu
- a Department of Psychology, Brandeis University , Waltham , MA , USA.,b Department of Human Development and Family Science, Center for Gerontology , Waltham , MA , USA
| | - Rong Fu
- c Department of Sociology, Siena College , Loudonville , NY , USA
| | - Karen A Roberto
- d Center for Gerontology and the Institute for Society, Culture and Environment, Virginia Tech , Blacksburg , VA , USA
| | - Jyoti Savla
- e Department of Human Development and Family Science, Center for Gerontology, Virginia Tech , Blacksburg , VA , USA
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Sharif Nia H, Rezapour M, Allen KA, Pahlevan Sharif S, Jafari A, Torkmandi H, Goudarzian AH. The Psychometric Properties of the Center for Epidemiological Studies Depression Scale (CES-D) for Iranian Cancer Patients. Asian Pac J Cancer Prev 2019; 20:2803-2809. [PMID: 31554380 PMCID: PMC6976839 DOI: 10.31557/apjcp.2019.20.9.2803] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Indexed: 12/25/2022] Open
Abstract
Objectives: The Center for Epidemiologic Studies Depression Scale (CES-D) was specifically created to assess depression in cancer patients. However, to date, the CES-D has not been validated in Farsi. Therefore, this study aimed to assess the psychometric properties of the CES-D in Iranian cancer patients. Methods: During a three-month period (October to December, 2015), a total of 380 cancer patients completed a Farsi version of the CES-D. The construct validity of the scale was evaluated by exploratory factor analysis. Reliability was assessed using Cronbach’s alpha and McDonald Omega. All of the statistical procedure were run by SPSS 22 (SPSS Inc., Chicago, IL, USA). Results: The construct validity of the CES-D determined three factors (somatic affect, negative affect, and positive affect), which explained 65.60% of the total variance. The internal consistency was greater than 0.70. Conclusion: Findings revealed that the Farsi version of the CES-D has acceptable validity and reliability, which can be used to measure depression in Iranian cancer patients.
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Affiliation(s)
- Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Rezapour
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Department of Psychiatry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kelly A Allen
- The Melbourne Graduate School of Education, the University of Melbourne, Melbourne, Australia
| | | | - Azar Jafari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Hojjat Torkmandi
- Operating Room Group, Department of Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
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Gao X, Leng Y, Guo Y, Yang J, Cui Q, Geng B, Hu H, Zhou Y. Association between earthquake experience and depression 37 years after the Tangshan earthquake: a cross-sectional study. BMJ Open 2019; 9:e026110. [PMID: 31434762 PMCID: PMC6707697 DOI: 10.1136/bmjopen-2018-026110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate the association between the Tangshan earthquake and depression after 37 years. DESIGN AND SETTING A cross-sectional study conducted in Tangshan from 2013 to 2014. PARTICIPANTS The sample included 5024 participants born before 28 July 1976 the date of the Tangshan earthquake, with available data on their earthquake experiences and depression 37 years post-earthquake. OUTCOMES AND VARIABLES The outcome was depression measured using the Center for Epidemiological Study and Depression Scale. The independent variable was earthquake experience, which was classified into three groups: no earthquake experience, earthquake experience without bereavement and earthquake experience with bereavement. Multivariable logistic regression analysis was used to evaluate the association between earthquake experience and depression after adjusting for gender, age at the time of the earthquake, smoking status, drinking status, education, income, residence in Tangshan 1 to 2 years post-earthquake, hypertension, diabetes and dyslipidaemia. RESULTS Of the 5024 participants, 641 experienced the Tangshan earthquake, and 98 experienced bereavement due to the earthquake. 37 years after the earthquake, survivors who had lost relatives during the earthquake were nearly three times (OR 2.82, 95% CI 1.24 to 6.39) as likely to have depression as those who had not experienced the earthquake, while those who had not lost relatives were 1.69 times as likely (OR 1.69, 95% CI 0.93 to 3.08). Stratified analyses showed that earthquake was significantly associated with depression in women with (OR 3.51, 95% CI 1.21 to 10.16) or without bereavement (OR 3.07, 95% CI 1.44 to 6.56) but not in men; this association was also significant in individuals over 18 years old at the time of the earthquake with (OR 13.16, 95% CI 3.08 to 56.3) or without bereavement (OR 3.39, 95% CI 1.31 to 8.87) but not in individuals less than 18 years old. CONCLUSIONS 37 years after the Tangshan earthquake, earthquake experience was associated with depression among bereaved survivors, women and individuals over 18 years old at the time of the earthquake.
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Affiliation(s)
- Xing Gao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Leng
- Global Brain Health Institute, Department of Psychiatry, University of California, San Francisco, California, USA
| | - Yuchen Guo
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jichun Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Qinghua Cui
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Hongpu Hu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Comparing the Impact of Cancer and Treatment-Related Effects on Psychological Well-being and Quality of Life Between Hong Kong Survivors of Childhood Solid Tumors and Leukemia. Cancer Nurs 2019; 43:446-454. [PMID: 31361673 DOI: 10.1097/ncc.0000000000000736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Evidence shows that survivors of solid tumors have a lower survival rate and shorter disease-free survival time than survivors of leukemia. However, the psychological well-being and health-related quality of life (HRQOL) of these 2 groups of cancer survivors have not been compared. OBJECTIVE To examine and compare the impact of cancer and treatment-related effects on psychological well-being and HRQOL between survivors of childhood solid tumors and leukemia. METHODS We conducted a cross-sectional study involving 65 Hong Kong survivors of solid tumors and 70 survivors of leukemia aged 8 to 18 years who had their medical follow-up in a pediatric outpatient clinic. Participants' depressive symptoms, self-esteem, and HRQOL were assessed. Twenty-two survivors of childhood solid tumors and 15 survivors of childhood leukemia were then selected for semistructured interviews. RESULTS Survivors of childhood solid tumors reported significantly higher mean scores for depressive symptoms, and lower mean self-esteem and HRQOL scores than survivors of childhood leukemia. Qualitative data revealed that survivors of childhood solid tumors faced more challenges in their daily life than survivors of childhood leukemia. CONCLUSIONS Survivors of childhood solid tumors reported poorer psychological well-being and HRQOL than survivors of childhood leukemia. This vulnerable group warrants more attention and support. IMPLICATIONS FOR PRACTICE It is vital for healthcare professionals to understand the impact of cancer and treatment-related effects in the context of different types of cancer. This will facilitate development and evaluation of appropriate psychological interventions to promote psychological well-being and HRQOL among childhood cancer survivors.
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de Joode JW, van Dijk SE, Walburg FS, Bosmans JE, van Marwijk HW, de Boer MR, van Tulder MW, Adriaanse MC. Diagnostic accuracy of depression questionnaires in adult patients with diabetes: A systematic review and meta-analysis. PLoS One 2019; 14:e0218512. [PMID: 31220131 PMCID: PMC6586329 DOI: 10.1371/journal.pone.0218512] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/04/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Comorbid depression is common among patients with diabetes and has severe health consequences, but often remains unrecognized. Several questionnaires are used to screen for depression. A systematic review and meta-analysis regarding the diagnostic accuracy of depression questionnaires in adults with diabetes is unavailable. Our aim was to conduct a systematic review and meta-analysis to evaluate the diagnostic accuracy of depression questionnaires in adults with type 1 or type 2 diabetes. METHODS PubMed, Embase and PsycINFO were searched from inception to 28 February 2018. Studies were included when the diagnostic accuracy of depression questionnaires was assessed in a diabetes population and the reference standard was a clinical interview. Data extraction was performed by one reviewer and checked by another. Two reviewers independently conducted the quality assessment (QUADAS-2). Diagnostic accuracy was pooled in bivariate random effects models. The main outcome was diagnostic accuracy, expressed as sensitivity and specificity, of depression questionnaires in an adult diabetes population. This study is reported according to PRISMA-DTA and is registered with PROSPERO (CRD42018092950). RESULTS A total 6,097 peer-reviewed articles were screened. Twenty-one studies (N = 5,703 patients) met the inclusion criteria for the systematic review. Twelve different depression questionnaires were identified, of which the CES-D (n = 6 studies) and PHQ-9 (n = 7 studies) were the most frequently evaluated. Risk of bias was unclear for multiple domains in the majority of studies. In the meta-analyses, five (N = 1,228) studies of the CES-D (≥16), five (N = 1,642) of the PHQ-9 (≥10) and four (N = 822) of the algorithm of the PHQ-9 were included in the pooled analysis. The CES-D (≥16) had a pooled sensitivity of 85.0% (95%CI, 71.3-92.8%) and a specificity of 71.6% (95%CI, 62.5-79.2%); the PHQ-9 (≥10) had a sensitivity of 81.5% (95%CI, 57.1-93.5%) and a specificity of 79.7% (95%CI, 62.1-90.4%). The algorithm for the PHQ-9 had a sensitivity of 60.9% (95%CI, 52.3-90.8%) and a specificity of 64.0% (95%CI, 53.0-93.9%). CONCLUSIONS This review indicates that the CES-D had the highest sensitivity, whereas the PHQ-9 had the highest specificity, although confidence intervals were wide and overlapping. The algorithm for the PHQ-9 had the lowest sensitivity and specificity. Given the variance in results and suboptimal reporting of studies, further high quality studies are needed to confirm the diagnostic accuracy of these depression questionnaires in patients with diabetes.
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Affiliation(s)
- Johanna W. de Joode
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Susan E.M. van Dijk
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Knowledge Institute of Medical Specialists, Utrecht, The Netherlands
| | - Florine S. Walburg
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Judith E. Bosmans
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Harm W.J. van Marwijk
- Department of Primary Care and Public Health, University of Brighton, Brighton, United Kingdom
- Brighton and Sussex Medical School, Watson Building House, University of Brighton, Brighton, United Kingdom
| | - Michiel R. de Boer
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maurits W. van Tulder
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marcel C. Adriaanse
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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49
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Cheung K, Tse MMY, Wong CK, Mui KW, Lee SK, Ma KY, Tung KTS, Lau EPW. The Effectiveness of a Multidisciplinary Exercise Program in Managing Work-Related Musculoskeletal Symptoms for Low-Skilled Workers in the Low-Income Community: A Pre-Post-Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091548. [PMID: 31052483 PMCID: PMC6540287 DOI: 10.3390/ijerph16091548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/22/2019] [Accepted: 04/28/2019] [Indexed: 02/07/2023]
Abstract
Studies on work-related musculoskeletal symptoms (WRMSs) have been conducted mainly on different types of workforce but not many on low-skilled workers. The purpose of this study was to evaluate the effectiveness of a multidisciplinary exercise program in decreasing the number of body parts with WRMSs for low-skilled workers. This study used a repeated-measures, single-group design. One hundred and five (105) workers participated in eight weekly 90-min sessions (including 45-min workshops and 45-min exercises) in low-income community settings. The exercise program involved a 21-movement stretching exercise and a 10-movement muscle-strengthening exercise. Questionnaire and health-assessment data were collected at the baseline (N = 105) and immediately after the 8-week program (n = 86). The average age of the 105 participants was 50.5 ± 8.7 years (ranging from 31 to 67). Over 80% (n = 87) of them were female, 68.6% (n = 72) were married, and 68.6% (n = 72) had completed secondary school. They reported an average of three body parts with WRMSs at baseline (T0). By the end of the eight weeks (T1), the participants had reduced the number of WRMS-affected body parts, job stress, and incidences of working through pain, and had improved spine flexibility and handgrip strength. The factors significantly affecting the reduction in the number of body parts with WRMSs were change in the workstyle of working through pain, and self-rated health status. Our study has demonstrated that a community-based multidisciplinary program can reduce the number of body parts affected by WRMSs in low-skilled workers in low-income communities.
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Affiliation(s)
- Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Mimi M Y Tse
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Chi Kan Wong
- Caritas Community Development Service, Hong Kong, China.
| | - Kwan Wai Mui
- Caritas Community Development Service, Hong Kong, China.
| | - Siu Kan Lee
- Caritas Community Development Service, Hong Kong, China.
| | - Ka Yan Ma
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Keith T S Tung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Echo Ping Woi Lau
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
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50
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Yokota J, Fukutani N, Nin K, Yamanaka H, Yasuda M, Tashiro Y, Matsushita T, Suzuki Y, Yokota I, Teramukai S, Aoyama T. Association of low back pain with presenteeism in hospital nursing staff. J Occup Health 2019; 61:219-226. [PMID: 30953383 PMCID: PMC6499356 DOI: 10.1002/1348-9585.12030] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/28/2018] [Accepted: 09/10/2018] [Indexed: 01/03/2023] Open
Abstract
Objectives Chronic low back pain (LBP) is known to cause various disorders compared with acute LBP. However, there was no study evaluating presenteeism due to LBP divided into subcategories by the duration of LBP. Therefore, this study aims to investigate the relationship between acute or chronic LBP and presenteeism in hospital nursing staff. Methods Overall, 1100 nurses filled in a questionnaire on basic attributes, LBP symptoms, depression symptoms, and work productivity. The subjects were divided into three groups based on the period of LBP and the compared work productivity. Work Limitation Questionnaire Japanese version (WLQ‐J) was used for the assessment of work productivity. The effects of acute and chronic LBP on presenteeism were evaluated through multiple regression analysis models. Results In total, 765 subjects, without missing values, were included. The overall prevalence of LBP was 64.6% (acute LBP 47.5%, chronic LBP 17.1%). On multiple regression analysis, acute pain and presenteeism were not associated. Conversely, chronic LBP was associated with time management (adjusted β = −2.3, 95% CI: −4.5 to −1.1), mental‐interpersonal relationship (adjusted β = −2.8, 95% CI: −5.1 to −0.6), and output (adjusted β = −2.7, 95% CI: −5.4 to 0.0) after adjustment for sex and career years. When depression was included in the adjustment factors, chronic LBP and WLQ subscales were not associated. Conclusions It became obvious that Chronic LBP in nurses was significantly related to time management, mental‐interpersonal relationship, and output. The importance of preventing a decline in work productivity by taking precautions to prevent chronic LBP and depression was suggested.
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Affiliation(s)
- Junpei Yokota
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoto Fukutani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuko Nin
- Department of Nursing, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroe Yamanaka
- Nursing Department, Kyoto University Hospital, Kyoto, Japan
| | - Makoto Yasuda
- Department of Nursing, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuto Tashiro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomofumi Matsushita
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Suzuki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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