The longitudinal effects of education on depression: Finding from the Indonesian national survey

Three Latent Factors in Major Depressive Disorder Base on Functional Connectivity Show Different Treatment Preferences

The heterogeneity of major depressive disorder (MDD) complicates the selection of effective treatments. While more studies have identified cluster-based MDD subtypes, they often overlook individual variability within subtypes. To address this, we applied latent dirichlet allocation to decompose resting-state functional connectivity (FC) into latent factors. It allows patients to express varying degrees of FC across multiple factors, retaining inter-individual variability. We enrolled 226 patients and 100 healthy controls to identify latent factors and examine their distinct patterns of hyper- and hypo-connectivity. We investigated the association between these connectivity patterns and treatment preferences. Additionally, we compared demographic characteristics, clinical symptoms, and longitudinal symptom improvements across the identified factors. We identified three factors. Factor 1, characterized by inter-network hyperconnectivity of the default mode network (DMN), was associated with treatment response to antidepressant monotherapy. Additionally, factor 1 was more frequently expressed by younger and highly educated patients, with significant improvements in cognitive symptoms. Conversely, factor 3, characterized by inter-networks and intra-networks hypoconnectivity of DMN, was associated with treatment response when combining antidepressants with stimulation therapy. Factor 2, characterized by global hypoconnectivity without DMN, was associated with higher baseline depression severity and anxiety symptoms. These three factors showed distinct treatment preferences and clinical characteristics. Importantly, our results suggested that patients with DMN hyperconnectivity benefited from monotherapy, while those with DMN hypoconnectivity benefited from combined treatments. Our approach allows for a unique composition of factors in each individual, potentially facilitating the development of more personalized treatment-related biomarkers.

The psychosocial impact of childhood constipation on the children and family: A scoping review

BACKGROUND

Constipation is a common and complex health issue among children that negatively affects multiple domains of children's and families' lives. Emotional, psychological, and behavioural problems in children, as well as anxiety, distress and frustration in parents, are some of the reported effects.

AIM

This manuscript presents a systematic scoping review synthesising current evidence on the psychosocial impact of childhood constipation on children and their families.

METHODS

This review was guided by Arksey and O'Malley's five-stage framework, updated by Levac, Colquhoun and O'Brien and the Joanna Briggs Institute. Five databases were systematically searched: PUBMED, CINAHL, ASSIA, PsycINFO and Google Scholar, which yielded 2836 records. Following a systematic screening process, 32 articles met the inclusion criteria. Results were analysed, discussed and presented using the PAGER framework.

RESULTS

The four key patterns that emerged were the psychosocial impact of childhood constipation on children, their parents, and school and academic life, and parental factors associated with childhood constipation.

CONCLUSION

Childhood constipation significantly impacts the quality of life for both children and their parents, as well as the school life and academic performance. Various parental factors are linked to a higher prevalence of constipation in children.

IMPLICATIONS

Neglecting to assess and address psychosocial issues in children with constipation can prolong the condition and significantly reduce their overall quality of life, contributing to multimorbidity. Adopting a holistic approach to managing constipation in children and their families is essential for promoting overall well-being.

Prediction of depressive disorder using machine learning approaches: findings from the NHANES

BACKGROUND

Depressive disorder, particularly major depressive disorder (MDD), significantly impact individuals and society. Traditional analysis methods often suffer from subjectivity and may not capture complex, non-linear relationships between risk factors. Machine learning (ML) offers a data-driven approach to predict and diagnose depression more accurately by analyzing large and complex datasets.

METHODS

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 to predict depression using six supervised ML models: Logistic Regression, Random Forest, Naive Bayes, Support Vector Machine (SVM), Extreme Gradient Boost (XGBoost), and Light Gradient Boosting Machine (LightGBM). Depression was assessed using the Patient Health Questionnaire (PHQ-9), with a score of 10 or higher indicating moderate to severe depression. The dataset was split into training and testing sets (80% and 20%, respectively), and model performance was evaluated using accuracy, sensitivity, specificity, precision, AUC, and F1 score. SHAP (SHapley Additive exPlanations) values were used to identify the critical risk factors and interpret the contributions of each feature to the prediction.

RESULTS

XGBoost was identified as the best-performing model, achieving the highest accuracy, sensitivity, specificity, precision, AUC, and F1 score. SHAP analysis highlighted the most significant predictors of depression: the ratio family income to poverty (PIR), sex, hypertension, serum cotinine and hydroxycotine, BMI, education level, glucose levels, age, marital status, and renal function (eGFR).

CONCLUSION

We developed ML models to predict depression and utilized SHAP for interpretation. This approach identifies key factors associated with depression, encompassing socioeconomic, demographic, and health-related aspects.

Why is low educational attainment linked to worse pain and function in fibromyalgia?

Lower educational attainment has been linked to worse pain in individuals with chronic pain, but the mechanisms of this relationship are not fully elucidated. This observational study analyzed the relationship between educational attainment and pain in patients with fibromyalgia (FM) and the potential psychological mechanisms driving this relationship. We hypothesized that (1) lower educational attainment would be associated with greater pain intensity and interference, and that (2) concerns about pain (CAP), anxiety, and depression would mediate the relationship between educational attainment and pain. A total of 119 adults (93.3% female, 79.7% White, Mage=50.4) with FM completed questionnaires including demographics, Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scales (HADS). Pearson correlations and bootstrapped mediation analyses were conducted to examine the relationships among education, psychological variables, and pain variables. Education was inversely correlated with pain intensity and interference, CAP, anxiety, and depression (p<.05). CAP significantly mediated the relationship between education and pain intensity (95% CI [0.151, 0.026]), while both CAP and depression mediated the effects of education on pain interference (95% CI [0.195, -0.025]; 95% CI [-0.163, -0.004]). However, anxiety did not mediate either relationship. These findings suggest that greater CAP, and in part depression, may be possible mechanisms in the relationships between lower educational attainment and worse pain intensity and interference. This work has important implications in reducing pain disparities and provides direction for psychological treatment, suggesting that both depression and CAP may be critical targets especially for people with lower education attainment. PERSPECTIVES: This study examined the relationship between educational attainment, psychological variables, and pain. Results have implications for psychological intervention aimed at concerns about pain and depression, especially among individuals with low educational attainment.

Insight into potential long COVID effects: Antidepressant use in post SARS-CoV-2 Infection scenarios. A multiregional nested case-control study

This study aimed to investigate the impact of previous SARS-CoV-2 infection and the role of vaccination in the onset of neuropsychiatric conditions, evaluated through antidepressant prescriptions. This case-control study evaluated the risk of new antidepressant prescriptions in relation to previous exposure to SARS-CoV-2 infection and vaccination. It was conducted in three Italian Regions on adults who did not receive antidepressant prescriptions in the year preceding the study period. Individuals with newly prescribed antidepressants (cases) were matched by sex and age to non-users of antidepressants (controls). Pooled estimates of regional Odds Ratios (ORs) were obtained through a meta-analysis. Findings showed that individuals previously infected with SARS-CoV-2 had a higher risk of receiving a new prescription of antidepressants. Moreover, this association was stronger among subjects hospitalized due to infection, and SARS-CoV-2 vaccination may have acted as an effect modifier by reducing that risk. In fact, the pooled OR for receiving a new antidepressant prescription was higher for unvaccinated individuals than for those vaccinated. The results of this study confirm the role of SARS-CoV-2 infection as a risk factor for the onset of neuropsychiatric symptoms. Antidepressant treatment initiation was much more likely after severe COVID-19 infection but vaccination reduced such a risk.

Study on the changes and influencing factors of depression in Chinese women with cancer: an analysis based on CHARLS panel data

Background

The social problems caused by depressive disorders and psychological behaviors in women are increasingly prominent, with extreme incidents occurring from time to time. Therefore, the issue concerning "how to prevent and resolve the risk of depression in women" is gaining significant attention across various sectors. However, previous studies have largely focused on teenage girls, perimenopausal women, or women during pregnancy and the postpartum period, neglecting the adverse effects of major diseases, which is detrimental to enhancing the psychological well-being of women with cancer.

Objective

Based on cancer impacts, this study aims to clarify the depressive state, development trends, and influencing factors in Chinese women with cancer, a group particularly susceptible to depression, to provide decision-making references for improving their psychological well-being.

Methods

Using follow-up panel data from five waves of China Health and Retirement Longitudinal Study (CHARLS), Chinese women with cancer who had complete observed values were selected as research subjects. After data cleaning, a balanced short panel dataset containing 1,030 samples was obtained. The depression characteristics and development trends in women with cancer were analyzed using the panel statistical method, and the influence of socio-demographic factors was examined using a panel stochastic trend model.

Results

The overall depression of Chinese women with cancer has deteriorated, putting them at risk of moderate depressive disorder. The development trend shows an inverted "U" curve, with significant differences observed among various groups based on urban and rural residency, educational levels, and regional locations. Specifically, urban women with cancer show milder depressive symptoms than those in rural areas, and women in the eastern region, those with higher educational levels, and those with non-reproductive system cancers show milder depressive symptoms than those in the central and western regions, those with lower educational levels, and those with reproductive system cancers. Regression analysis indicates that socio-demographic factors significantly influence depression in women with cancer. Among these influencing factors, age, having a spouse, high educational level, good performance in the activity of daily living (ADL), frequent visits to neighbors, and regular exercise are protective factors against depression, while diabetes, dyslipidemia, frequent outpatient visits, frequent hospitalizations, smoking, and low life satisfaction are risk factors for depression.

Conclusion

The depressive state among Chinese women with cancer is alarming. In view of this, there is an urgent need for introducing more supportive policies aimed at improving psychological health, developing tailored measures to address the specific needs of different groups, intensifying efforts to standardize the diagnosis and treatment of depression, particularly for those in rural areas, central and western regions, and among individuals with lower educational levels. Additionally, the role of social participation activities, such as visiting neighbors and exercising, should be given full play to alleviate depressive symptoms.

Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study

AIMS

The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDOH summary score and mental health disorders in the United States.

METHODS

We analyzed data from a diverse group of participants enrolled in the All of Us research programme, a research programme to gather data from one million people living in the United States, in a cross-sectional design. The primary exposure was SDOH based on Healthy People 2030: education access and quality, economic stability, healthcare access and quality, social and community context, and neighbourhood and built environment. A summary SDOH score was calculated by adding each adverse SDOH risk (any SDOH vs. no SDOH). Our primary outcomes were diagnoses of major depression (MD) (i.e., major depressive disorder, recurrent MD or MD in remission) and anxiety disorders (AD) (i.e., generalized AD and other anxiety-related disorders). Multiple logistic regression models were used to determine adjusted odd ratios (aORs) for MD and/or ADs after controlling for covariates.

RESULTS

A total of 63,162 participants with MD were identified (22,277 [35.3%] age 50-64 years old; 41,876 [66.3%] female). A total of 77,624 participants with AD were identified (25,268 [32.6%] age 50-64 years old; 52,224 [67.3%] female). Factors associated with greater odds of MD and AD included having less than a college degree, annual household income less than 200% of federal poverty level, housing concerns, lack of transportation, food insecurity, and unsafe neighbourhoods. Having no health insurance was associated with lower odds of both MD and AD (aOR, 0.48; 95% confidence interval [CI], 0.46-0.51 and aOR, 0.44; 95% CI, 0.42-0.47, respectively). SDOH summary score was strongly associated with the likelihood of having MD and AD (aOR, 1.97; 95% CI, 1.89-2.06 and aOR, 1.69; 95% CI, 1.63-1.75, respectively).

CONCLUSIONS

This study found associations between all five domains of SDOH and the higher odds of having MD and/or AD. The strong correlations between the SDOH summary score and mental health disorders indicate a possible use of the summary score as a measure of risk of developing mental health disorders.

The association between socioeconomic position and depression or suicidal ideation in low- and middle-income countries in Southeast Asia: a systematic review and meta-analysis

BACKGROUND

Mental illnesses contribute to a significant burden of disease in low- and middle- income countries (LMICs). Understanding risk factors for poor mental health is essential to reducing the burden, and for preventative measures to be implemented. The role of socioeconomic position (SEP) in poorer mental health is well established in high income countries, but less is known in LMICs. This study aimed to identify and synthesise epidemiological evidence for the associations between SEP and depression and suicidal ideation in LMICs in Southeast Asia, and to describe the strength and direction of any associations identified.

METHODS

This systematic review identified evidence by searching four databases in February 2023 (Medline, Embase, PsycInfo and Web of Science), grey literature and reference searching of included papers. Papers were included if they were based in a Southeast Asian LMIC general or hospital populations (= 16 years of age) and explored at least one measure of SEP in association with depression or suicidal ideation. Study quality was assessed using the Joanna Briggs Institute tool. A meta-analysis and narrative synthesis were performed.

RESULTS

Fifty-nine papers from six out of nine Southeast Asian LMICs were identified, with education the most commonly examined measure of SEP. Several papers explored more than one measure of SEP. Around half of the papers were rated as higher quality. Meta-analyses of education (OR: 1.87, 95% CI: 1.49-2.35) and working status (OR: 1.30, 95% CI: 0.99-1.71) provided evidence of lower levels of education and not being employed being associated with higher odds of depression. Consistent associations between lower SEP and higher odds of depression were also found for financial difficulty and subjective economic status. Three papers used suicidal ideation as their outcome, and there was some evidence of an association with lower SEP and higher ideation.

CONCLUSIONS

Evidence indicates that lower SEP is associated with higher likelihood of depression, whereas for suicidal ideation, the evidence available is insufficient to reach a conclusion. The lack of longitudinal studies prevents the temporal nature of these associations being established.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO: CRD42023410444.

Development and validation of a nomogram to predict depression in older adults with heart disease: a national survey in China

Background

Comorbid depression, frequently observed in heart disease patients, has detrimental effects on mental health and may exacerbate cardiac conditions. The objective of this study was to create and validate a risk prediction nomogram specifically for comorbid depression in older adult patients suffering from heart disease.

Methods

The 2018 data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was analyzed and 2,110 older adult patients with heart disease aged 60 and above were included in the study. They were randomly divided in a 7:3 ratio into a training set (n = 1,477) and a validation set (n = 633). Depression symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the participants were categorized into depressed (n = 687) and non-depressed (n = 1,423) groups. We collected information regarding general demographics, lifestyle habits, and medical history of the included patients. LASSO regression and binary logistic regression analyses were performed to identify independent risk factors and construct the depression prediction nomogram. Receiver operating characteristic curve analysis and the Hosmer-Lemeshow test were used to assess the model's discrimination and calibration. Decision curve analysis helped evaluate the clinical utility of the predictive nomogram.

Results

Based on the LASSO and multivariable regression analyses, education level, quality of life, sleep quality, frequency of watching TV, and history of arthritis were identified as independent risk factors for comorbid depression in the older adult heart disease patients. A nomogram model was constructed with these five independent risk factors. The nomogram showed good clinical performance with an area under the curve (AUC) value of 0.816 (95% CI: 0.793 to 0.839). The calibration curves and Hosmer-Lemeshow goodness-of-fit test (training setχ t 2 = 4.796, p = 0.760; validation setχ v 2 = 7.236, p = 0.511) showed its satisfactory. Clinical usefulness of the nomogram was confirmed by decision curve analysis.

Conclusions

A five-parameter nomogram for predicting depression in older adult heart disease patients was developed and validated. The nomogram demonstrated high accuracy, discrimination ability, and clinical utility in assessing the risk of depression in the older adult patients with heart disease.

Association and causal mediation between marital status and depression in seven countries

Depression represents a significant global public health challenge, and marital status has been recognized as a potential risk factor. However, previous investigations of this association have primarily focused on Western samples with substantial heterogeneity. Our study aimed to examine the association between marital status and depressive symptoms across countries with diverse cultural backgrounds using a large-scale, two-stage, cross-country analysis. We used nationally representative, de-identified individual-level data from seven countries, including the USA, the UK, Mexico, Ireland, Korea, China and Indonesia (106,556 cross-sectional and 20,865 longitudinal participants), representing approximately 541 million adults. The follow-up duration ranged from 4 to 18 years. Our analysis revealed that unmarried individuals had a higher risk of depressive symptoms than their married counterparts across all countries (pooled odds ratio, 1.86; 95% confidence interval (CI), 1.61-2.14). However, the magnitude of this risk was influenced by country, sex and education level, with greater risk in Western versus Eastern countries (β = 0.36; 95% CI, 0.16-0.56; P < 0.001), among males versus females (β = 0.25; 95% CI, 0.003-0.47; P = 0.047) and among those with higher versus lower educational attainment (β2 = 0.34; 95% CI, 0.11-0.56; P = 0.003). Furthermore, alcohol drinking causally mediated increased later depressive symptom risk among widowed, divorced/separated and single Chinese, Korean and Mexican participants (all P < 0.001). Similarly, smoking was as identified as a causal mediator among single individuals in China and Mexico, and the results remained unchanged in the bootstrap resampling validation and the sensitivity analyses. Our cross-country analysis suggests that unmarried individuals may be at greater risk of depression, and any efforts to mitigate this risk should consider the roles of cultural context, sex, educational attainment and substance use.

Effect of spiritual intelligence and employment status on the association between education and depressive symptoms among adults in rural Puducherry, India: A mediation analysis

BACKGROUND

Depression is a major global health concern, particularly in India, where it significantly impacts the population's well-being. The interplay of various factors, including education, employment status, and spiritual intelligence, contributes to the complex landscape of depressive symptoms among adults.

METHODOLOGY

A community-based cross-sectional study was conducted in the rural service areas of a tertiary care medical institution in rural India from March 2021 to September 2022. The study employed structured questionnaires and validated scales to assess depressive symptoms, spiritual intelligence, educational status, and occupational status among participants. Structural equation modelling was used for mediation analysis to evaluate the effect of spiritual intelligence and employment status on the association between education and depressive symptoms.

RESULTS

The study included 381 participants, with a prevalence of depressive symptoms at 14.4%. Higher educational attainment was associated with lower odds of depressive symptoms (aOR = 0.34, 95% CI [0.17, 0.67]). Employment status mediated the relationship between education and depression, with employed individuals exhibiting lower odds of depressive symptoms (aOR = 0.42, 95% CI [0.22, 0.82]). While spiritual intelligence was higher among those with formal education, its direct impact on depression was not statistically significant. The mediation analysis revealed that a significant portion (77.5%) of the total effect of education on depression was mediated through employment status and spiritual intelligence.

CONCLUSION

The study underscores the importance of education and employment opportunities in mitigating depressive symptoms among rural adults. It suggests targeted interventions that promote education and employment support to enhance mental health resilience. While spiritual intelligence may influence mental health outcomes, its exact role requires further investigation.

Investigating the Impact of the Number of Medication Use on Depression Among Hypertensive Patients: Results from the National Health and Nutrition Examination Survey Database

Background and Objective: Hypertension is a prevalent chronic condition often treated with multiple medications, leading to polypharmacy, which can heighten the risk of adverse drug reactions and contribute to psychological issues like depression. This study aimed to investigate the relationship between polypharmacy and depressive symptoms in hypertensive patients using data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Materials and Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2017 and March 2020. Results: Among 2543 hypertensive participants, 12.3% met the criteria for depression. The findings revealed that patients using 11 or more medications were ten times more likely to experience depressive symptoms compared to those taking 1 to 2 medications (OR = 10.06, p < 0.001). Additionally, younger age (18 to 45 years), female gender, and lower educational attainment were significantly associated with higher rates of depressive symptoms. Specifically, females were 1.47 times more likely to experience depression compared to males (p = 0.032). Conclusions: This research highlights the substantial impact of medication burden on mental health among hypertensive patients, emphasizing the need for tailored clinical interventions for this vulnerable population.

Validity and reliability of the Depression Information Needs Scale among the Iranian general population

Introduction

The prevalence of depression in the community is high. Therefore, it is necessary to examine the information needs on depression in the community. This cross-sectional study aimed to translate and evaluate the psychometric properties of the Depression Information Needs Scale (DINS) among the general population.

Methods

The translation and assessment of the validity and reliability of the DINS were conducted from February 2022 to May 2023 in Gonabad, Iran. The inclusion criteria in this study were individuals 18 years or older, those living in Gonabad for 1 year or more, and participants who provided written informed consent. Sample sizes of 546 and 629 were used for the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. The reliability of the DINS was examined using three methods: McDonald's omega coefficient, test-retest reliability, and Cronbach's alpha coefficient.

Results

Most participants were women, had a bachelor's degree, and were married. The values of 0.959 for scale content validity index averaging (S-CVI/Ave) and 0.817 for content validity ratio (CVR) were calculated. In the EFA section, four factors with eigenvalues greater than 1 were extracted and explained 63.861% of the variance. Only two items were not placed in related or acceptable factors and were deleted. Finally, based on the results of the goodness-of-fit indexes (e.g., RMSEA = 0.074, CFI = 0.944, NFI = 0.930, and GFI = 0.911), the scale was approved with 18 items and 4 factors: lived experience (4 items), general (facts about depression) (6 items), research and policies (4 items), and specific treatments (4 items). For all the DINS items, the McDonald's omega coefficient, Cronbach's alpha coefficient, and Intraclass Correlation Coefficient (ICC) were 0.953, 0.950, and 0.957, respectively.

Conclusion

The Persian version of the DINS was validated with 18 items and 4 factors, and this scale can be used to assess depression information needs in the general public and specific groups.

Depression among general outpatient department attendees in selected hospitals in Somalia: magnitude and associated factors

BACKGROUND

Depressive disorders are among the common mental health conditions in the general outpatient setting and affect patients' load and treatment outcomes. People who suffer from depression frequently consult general practitioners and prefer to attribute their symptoms to physical illness rather than mental illness. Little is known about the magnitude and associated factors of depression among patients attending general outpatient services in Somalia. The study aimed at determining the prevalence and associated factors of depression among them.

METHODS

This is an institution-based cross-sectional study among randomly selected 422 patients who attended general outpatient services of two hospitals in Mogadishu. We applied three standardized instruments, such as the Somali version of the Patient Health Questionnaire (PHQ-9), the Oslo Social Support Scale (OSSS-3), and the Perceived Stress Scale-10 (PSS-10). We analyzed data using the statistical software SPSS version 29. We calculated prevalence and its 95% Confidence Interval (CI) and identified associated factors by bivariate and Multivariate analysis. We considered the association significant when p value is < 0.05.

RESULTS

The prevalence of depression symptoms was found to be 55% (95% CI 50-60%). The result also showed that 55.0% were females, 50.7% were aged between 26 and 44 years, 44.3% were single, 29.9% achieved tertiary education, and 44.3% were unemployed. Multivariate analysis established that age of between 26 and 44 years (aOR = 2.86, 95%CI:1.30-6.29, p = 0.009), being separated/divorced (aOR = 2.37, 95%CI: 1.16-4.82, p = 0.018), income level of ≤$100 (aOR = 3.71, 95% CI:1.36-10.09, p = 0.010), and high stress levels (aOR = 20.06, 95%CI:7.33-54.94, p < 0.001) were independent factors that significantly associated with depressive symptoms.

CONCLUSION

This study found high levels of depression among patients attending outpatient clinics, with age, marital status, education level, income level, family history of psychiatry disorder, and stress level being key predictors. Regular screening among patients in outpatient clinics and proper referral are crucial in ensuring that those at high risk of depression are managed effectively.

Depression, anxiety, and stress among private shopkeepers after COVID-19 pandemic: A cross-sectional study from Mohali, India

Background

The COVID-19 pandemic affected almost all sections of society. The economy of the country collapsed and it affected the economic situation of the common man. Private shopkeepers also suffered as they could not open their shops. The current study was an effort to assess the psychological status of these people.

Aim

To assess depression, anxiety, and stress levels among private shopkeepers in Mohali after the COVID-19 pandemic who were previously mentally healthy.

Materials and Methods

This observational, cross-sectional study was conducted on 500 consenting private shopkeepers from 10 different topographically scattered markets of Mohali. Written informed consent was obtained. Ethical clearance was sorted by the institutional ethics committee. Sociodemographic data were recorded on sociodemographic proforma. Depression Anxiety Stress Scale -21 (DASS-21) was employed to assess depression, anxiety, and stress. The data obtained was statistically analyzed.

Results

A total of 34.2% of shopkeepers had depression, 31.4% had anxiety, and 44.80% had stress. Out of which street vendors had more depression (6.60%), anxiety (6.80%), and stress (7.40%) compared to other shopkeepers. Depression (36.07%), anxiety (32.61%), and stress (46.87%) were comparatively more among shopkeepers who had incurred financial loss compared to those who had received gain. Shopkeepers who had their shops closed were suffering from depression (35.42%), anxiety (33.26%), and stress (46.65%) comparatively more than individuals who had their shops open. A total of 59.75%, 51.57%, and 72.96% of shopkeepers whose products expired during the pandemic were suffering from depression, anxiety, and stress respectively.

Conclusion

Depression, anxiety, and stress are high in private shopkeepers after the pandemic. Mental health services should be more accessible, affordable, and available during a pandemic and its aftermath. The economy of the country should be strengthened after the pandemic keeping in interest the economic needs of the common man.

Low Vitamin D Concentration Is Associated with Increased Depression Risk in Adults 20-44 Years Old, an NHANES 2007-2018 Data Analysis with a Focus on Perinatal and Breastfeeding Status

The objective was to investigate associations of serum vitamin D concentration with depressive symptoms and assess the impact that vitamin D concentration has on the occurrence of depressive symptoms in 20-44-year-old pregnant women, postpartum women, non-pp women (non-pregnant/postpartum women), and men, including a separate subgroup analysis of postpartum breastfeeding and non-breastfeeding women. The study populations were selected from the 2007-2018 NHANES public data. Subjective interview data and objective laboratory data including depressive symptoms, serum vitamin D concentration, nutrient intake, and demographic information were utilized. Two diet patterns were created using principal component analysis, and a Bayesian multinomial model was fit to predict the depression outcomes for each subpopulation. The estimates for the log vitamin D slope parameter were negative for all cohorts; as vitamin D increased, the probability of having no depression increased, while the probability of depression decreased. The pregnant cohort had the steepest vitamin D slope, followed by postpartum women, then non-pp women and men. Higher vitamin D concentration had more impact on decreasing depression risk in pregnant and postpartum women compared to non-pp women and men. Among postpartum women, higher vitamin D concentration had a greater influence on decreasing breastfeeding women's depression risk than non-breastfeeding women.

Influence of cognitive reserve on risk of depression and subsequent dementia: A large community-based longitudinal study

BACKGROUND

Cognitive reserve (CR) has been linked to dementia, yet its influence on the risk of depression and related outcomes remains unknown. We aimed to examine the association of CR with depression and subsequent dementia or death, and to assess the extent to which CR is related to depression-free survival.

METHODS

Within the UK Biobank, 436,232 participants free of depression and dementia were followed. A comprehensive CR indicator (low, moderate, and high) was created using latent class analysis based on information on education, occupation, mentally passive sedentary behavior, social connection, confiding with others, and leisure activities. Depression, dementia, and survival status were ascertained through self-reported medical history and/or linkages to medical records. Data were analyzed using multi-state Markov model and Laplace regression.

RESULTS

Over a median follow-up of 12.96 years, 16,560 individuals developed depression (including 617 with subsequent dementia) and 28,655 died. In multivariable multi-state models, compared with low CR, high CR was associated with lower risk of depression (hazard ratio 0.53 [95% confidence interval 0.51-0.56]) and lower risk of post-depression dementia (0.55 [0.34-0.88]) or death (0.69 [0.55-0.88]) in middle-aged adults (aged <60 years). In Laplace regression, the depression-free survival time was prolonged by 2.77 (2.58-2.96) years in participants with high compared to low CR.

CONCLUSIONS

High CR is associated with lower risks of depression and subsequent transitions to dementia and death, particularly in middle age. High CR may prolong depression-free survival. Our findings highlight the importance of enhancing CR in the prevention and prognosis of depression.

Sleep quality and mental health differences following Syria-Turkey earthquakes: A cross-sectional study

BACKGROUND

This study explores the lasting mental health impact of the Syria-Turkey earthquakes in 2023 on a population affected by conflict and trauma. It analyzes pre- and post-event mental health and sleep quality differences, identifying predictors of outcomes.

AIMS

Studying the 2023 Syria-Turkey earthquakes' enduring mental health impact on conflict-affected individuals, this research informs better support and interventions for disaster survivors.

METHODS

This longitudinal, cross-sectional study examined the enduring mental health impact of the Syria-Turkey earthquakes. The present study involved N = 1,413 Syrian survivors, aged 18 years or older, who actively participated by contributing both pre- and post-earthquake data. A meticulously designed digital questionnaire with established metrics assessed sleep disturbances, depressive symptoms, and anxiety levels. Stratification variables (age, gender, education, marital status) were used for subgroup analysis. Arabic versions of PHQ-9, PSQI, and GAD-2 proved reliable for measuring depression, sleep quality, and anxiety.

RESULTS

The majority of participants were female (73.6%) with tertiary education (83.3%). Post-earthquake, a higher percentage reported poor sleep quality (67.7% vs. 59.7%, p < .001) and increased prevalence of MDE (66.1% vs. 56%, p < .001). GAD did not differ significantly. Post-earthquake, women had a higher likelihood of poor sleep quality (OR: 1.58, 95% CI [1.19, 2.10], p < .001) and MDE (OR: 1.55, 95% CI [1.18 to 2.04], p = .003). Predictors varied before and after earthquakes; age and education were significant predictors of poor sleep quality, MDE, and GAD.

CONCLUSION

This study reveals higher rates of poor sleep quality and major depressive episodes among earthquake-affected individuals, especially women. Age, education, and gender contribute to these outcomes. Targeted interventions and comprehensive mental health support are crucial for post-earthquake recovery.

Independent associations of education, intelligence, and cognition with gastrointestinal diseases and the mediating effects of risk factors: a Mendelian randomization study

Background

Education, intelligence and cognition affect occupational performance and socioeconomic status and may influence virous diseases development. However, the impact of these factors on gastrointestinal diseases and their mediating risk factors remains unclear.

Methods

We utilized genome-wide association studies from European ancestry populations to perform two-sample Mendelian randomization analyses, aiming to estimate genetic instruments associated with education, intelligence, or cognition in relation to 24 gastrointestinal diseases Subsequently, we evaluated 14 potential mediators of this association and calculated the corresponding mediated proportions through two-step Mendelian randomization analyses.

Result

As the dominant factor in gastrointestinal diseases, education had a statistically significant association with 2 gastrointestinal diseases (acute pancreatitis, gastroesophageal reflux) and a suggestive association with 6 diseases (cirrhosis, alcoholic liver disease, cholecystitis, cholelithiasis, chronic gastritis and gastric ulcer). Of the 14 mediators, smoking and adiposity traits played a major role in mediating the effects.

Conclusion

The study demonstrated the causal, independent impact of education on specific gastrointestinal diseases. Smoking and adiposity traits emerged as primary mediators, illuminating potential avenues for targeted interventions for prevention of them.

Screening for negative emotions and analysis of related factors among general surgery inpatients: a retrospective cross-sectional study

Background

Adverse psychological states in surgical patients can impact outcomes. This study aimed to evaluate mood disorders and associated factors in general surgery inpatients using the Huaxi Emotional Distress Index (HEI).

Methods

This retrospective cross-sectional study analyzed HEI scores of 20,398 adult patients hospitalized for elective surgery at a tertiary hospital in China (2018-2021). Univariable and multivariable logistic regression identified factors linked to moderate/severe mood disturbances.

Results

Factors linked to moderate/severe mood disturbances were identified through univariable and multivariable logistic regression. The results showed that 3.7% of the patients had HEI ≥ 13, indicating significant emotional issues. The mean age was 52.67 (16.14) years in the group with no/mild distress and 59.65 (16.34) years in the group with moderate/severe distress. Among all the cases included, there were 2,689 cases (13.18%) of gastric and esophageal diseases, 1,437 cases (7.04%) of hepatic diseases, 913 cases (4.47%) of periampullary and pancreatic tumors, 9,150 cases (44.85%) of gallbladder diseases, 2,777 cases (13.61%) of colorectal diseases, and 3,432 cases (16.83%) of other diseases. The male percentage was 45.5 and 54.9% in the two groups, respectively. Older age, male gender, unstable occupations, lower education, and unmarried status were associated with higher risks of mood disturbances (all p < 0.05). A significant downward trend in adverse emotions was observed with increasing education levels (p < 0.001). Furthermore, the study found that the inpatients had higher HEI scores prior to the COVID-19 pandemic compared to during the pandemic (p < 0.001). However, the occurrence of adverse mood states in these patients was not exacerbated by the COVID-19 pandemic. The trend test remained highly significant in the none-adjusted, age-sex adjusted, and fully adjusted models (all p for trend <0.001).

Conclusion

The implementation of routine screening in higher education institutions (HEIs) allows for the early identification of surgical inpatients who require psychological intervention. It is recommended that counseling services focus on individuals with lower levels of education and income instability in order to address negative mood states. Furthermore, the potential application of this screening system in other clinical settings could enable earlier psychological interventions for a larger number of patients.

Depressive Symptoms among People Living with HIV Attending ART Centers of Lumbini Province, Nepal: A Cross-Sectional Study

Background

Depression is a common mental disorder and is a leading cause of disability globally. Depressive symptoms among people living with HIV can be a significant barrier to ART initiation and thus lead to poor ART adherence. Global studies have found the prevalence of depressive symptoms among people living with HIV ranges from 12 to 63%. The real scenario of Nepal still needs to be explored. Thus, this study aimed to identify the prevalence and predictors of depression in individuals with HIV.

Methods

An institutional-based cross-sectional study was carried out from August to December 2020 among 406 people living with HIV attending ART centers in Lumbini province. Participants were selected using a systematic random sampling technique and surveyed with a structured questionnaire consisting of sociodemographic variables, HIV AIDS-related variables, and 21 items Beck Depression Inventory tool. The odds ratio was used as the ultimate measure of association, with a 95% confidence interval computed to establish statistical significance. A multivariate regression analysis was carried out to identify the final predictors of depressive symptoms.

Results

The study found that 26.8% of the respondents had depressive symptoms. Those who were literate (AOR = 0.24, 95% CI: 0.10-0.61), in the poorest wealth quintile (AOR = 7.28, 95% CI: 2.22-23.87), initiated ART within 12 months (AOR = 1.88, 95% CI: 1.03-3.42), had CD4 cell counts below 200 (AOR = 2.50, 95% CI: 1.54-4.06), and had a time difference of 3 months or less between HIV diagnosis and ART initiation (AOR = 0.50, 95% CI: 0.29-0.86) were independently associated with depressive symptoms.

Conclusion

Routine screening for depressive symptoms should be integrated into national HIV prevention and control programs for people living with HIV. An enabling environment should be created to facilitate the rapid enrollment of individuals newly diagnosed with HIV in ART services, thereby reducing the time gap between HIV diagnosis and ART initiation.

Depression and Pseudodementia: Decoding the Intricate Bonds in an Italian Outpatient Setting

In spite of the uncertainties of its diagnostic framework, pseudodementia may be conceptualized as a condition characterized by depressive symptoms and cognitive impairment in the absence of dementia. Given the controversies on this topic, the aim of the present study was to assess neurological and cognitive dysfunctions in a sample of elderly depressed subjects, and the eventual relationship between cognitive impairment and depressive symptoms. Fifty-seven elderly depressed outpatients of both sexes were included in the study. A series of rating scales were used to assess diagnoses, depressive and cognitive impairment. Comparisons for continuous variables were performed with the independent-sample Student's t-test. Comparisons for categorical variables were conducted by the χ2 test (or Fisher's exact test when appropriate). The correlations between between socio-demographic characteristics and clinical features, as well as between cognitive impairment and depressive symptoms were explored by Pearson's correlation coefficient or Spearman's rank correlation. Our data showed the presence of a mild-moderate depression and of a mild cognitive impairment that was only partially related to the severity of depression. These dysfunctions became more evident when analyzing behavioral responses, besides cognitive functions. A high educational qualification seemed to protect against cognitive decline, but not against depression. Single individuals were more prone to cognitive disturbance but were similar to married subjects in terms of the severity of depressive symptoms. Previous depressive episodes had no impact on the severity of depression or cognitive functioning. Although data are needed to draw firm conclusions, our findings strengthen the notion that pseudodementia represents a borderline condition between depression and cognitive decline that should be rapidly identified and adequately treated.

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

PURPOSE

Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association.

MATERIALS AND METHODS

A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity.

RESULTS

Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI.

CONCLUSION

This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.