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Gao YN, Olfson M. Associations of Patient Race and Ethnicity With Emergency Department Disposition for Mental Health Visits in the United States. J Clin Psychiatry 2023; 84:22m14661. [PMID: 37498648 DOI: 10.4088/jcp.22m14661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Objective: To describe associations between patient race and ethnicity with emergency department disposition for mental health visits in the United States. Methods: We identified 674,821 visits for mental health in the 2019 National Emergency Department Sample and classified them by ICD-10 diagnostic group: schizophrenia-spectrum, bipolar, major depressive, anxiety, or other disorders. Racial and ethnic categories were White, Black, Hispanic, or other. Logistic regression models, adjusted for age, sex, insurance status, and medical comorbidities, were used to describe differences in odds of inpatient admission by race/ethnicity and diagnosis. Results: After covariate adjustment, we did not find overall differences in the likelihood of admission between racial/ethnic groups. However, compared to White patients, admission rates were lower for visits by Black patients for bipolar disorder (OR = 0.71; 95% CI, 0.59-0.84) and major depressive disorder (OR = 0.70; 95% CI, 0.59-0.83) and lower for Hispanic patients (OR = 0.57; 95% CI, 0.47-0.68) for anxiety disorders. There were no significant racial/ethnic differences in admission rates for schizophrenia-spectrum disorders. Conclusions: Overall admission rates were comparable for Black and White patients. After covariate adjustment, there were no differences across racial/ethnic groups, though some racial/ethnic differences persisted within diagnostic subsets of mood and anxiety disorders.
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Affiliation(s)
- Y Nina Gao
- Department of Psychiatry, Vagelos College of Physicians & Surgeons Columbia University and New York State Psychiatric Institute, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Corresponding Author: Y. Nina Gao, MD, PhD, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032
| | - Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians & Surgeons Columbia University and New York State Psychiatric Institute, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Constante HM, Bastos JL, Ruiz MA. The more you need, the less you get: Intersectionality and the inverse care law in the Brazilian depression care cascade. Ethn Health 2023; 28:488-502. [PMID: 35608907 DOI: 10.1080/13557858.2022.2078483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Substantial research has shown that the population distribution of major depressive disorder (MDD) is strongly influenced by race, gender, and socioeconomic position. However, a deeper understanding of inequities in access to care for MDD according to these social markers is yet to be reached. We use data from the 2019 Brazilian National Health Survey, which includes 87,187 respondents aged 18 years and over, to test two hypotheses derived from the inverse care law: women, Black, and low-education respondents have higher frequencies of MDD, but lower access to each step of the depression care cascade, including diagnosis by a health professional, regular healthcare visits, and access to specialised treatment (H1); low-education Black women show the highest MDD frequency and the lowest access to care across the entire cascade (H2). Partially supporting H1 and H2, our results reveal a bottleneck in the first step of the depression care cascade. While no racial inequities were observed in the MDD prevalence, Black individuals were less likely than whites to be diagnosed by a health professional (OR 0.74). Women (OR 2.64) and low-education (OR 1.18) were more likely to have probable MDD in relation to men and high-education respondents, respectively, but only women (OR 1.58) were more likely to be diagnosed. Low-education Black women were equally more likely to have probable MDD (OR 3.11) than high-education white men. Conversely, high-education white women emerged as the most likely to be diagnosed with MDD (OR 1.63). Our findings suggest the inverse care law applies to the depression care cascade in Brazil through indication that its healthcare system perpetuates a multilayered system of oppression that overlooks multiply marginalised individuals. We also show that adequate screening by health care professionals should mitigate the complex patterns of inequity revealed by our study.
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Affiliation(s)
- Helena M Constante
- Graduate Program in Public Health, Federal University of Santa Catarina, Campus Universitário Trindade, Florianópolis, Brazil
| | - João L Bastos
- Graduate Program in Public Health, Federal University of Santa Catarina, Campus Universitário Trindade, Florianópolis, Brazil
| | - Milagros A Ruiz
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Flores MW, Moyer M, Rodgers CRR, Cook BL. Major Depressive Episode Severity Among Adults from Marginalized Racial and Ethnic Backgrounds in the US. JAMA Psychiatry 2021; 78:1279-1280. [PMID: 34495282 PMCID: PMC8427491 DOI: 10.1001/jamapsychiatry.2021.2485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/01/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Center for Health Equity, Albert Einstein College of Medicine, Bronx, New York
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Margo Moyer
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Caryn R. R. Rodgers
- Center for Health Equity, Albert Einstein College of Medicine, Bronx, New York
- Department of Psychiatry & Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York
| | - Benjamin Lê Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Center for Health Equity, Albert Einstein College of Medicine, Bronx, New York
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Ohi K, Nishizawa D, Shimada T, Kataoka Y, Hasegawa J, Shioiri T, Kawasaki Y, Hashimoto R, Ikeda K. Polygenetic Risk Scores for Major Psychiatric Disorders Among Schizophrenia Patients, Their First-Degree Relatives, and Healthy Participants. Int J Neuropsychopharmacol 2020; 23:157-164. [PMID: 31900488 PMCID: PMC7171929 DOI: 10.1093/ijnp/pyz073] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/17/2019] [Accepted: 01/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The genetic etiology of schizophrenia (SCZ) overlaps with that of other major psychiatric disorders in samples of European ancestry. The present study investigated transethnic polygenetic features shared between Japanese SCZ or their unaffected first-degree relatives and European patients with major psychiatric disorders by conducting polygenic risk score (PRS) analyses. METHODS To calculate PRSs for 5 psychiatric disorders (SCZ, bipolar disorder [BIP], major depressive disorder, autism spectrum disorder, and attention-deficit/hyperactivity disorder) and PRSs differentiating SCZ from BIP, we utilized large-scale European genome-wide association study (GWAS) datasets as discovery samples. PRSs derived from these GWASs were calculated for 335 Japanese target participants [SCZ patients, FRs, and healthy controls (HCs)]. We took these PRSs based on GWASs of European psychiatric disorders and investigated their effect on risk in Japanese SCZ patients and unaffected first-degree relatives. RESULTS The PRSs obtained from European SCZ and BIP patients were higher in Japanese SCZ patients than in HCs. Furthermore, PRSs differentiating SCZ patients from European BIP patients were higher in Japanese SCZ patients than in HCs. Interestingly, PRSs related to European autism spectrum disorder were lower in Japanese first-degree relatives than in HCs or SCZ patients. The PRSs of autism spectrum disorder were positively correlated with a young onset age of SCZ. CONCLUSIONS These findings suggest that polygenic factors related to European SCZ and BIP and the polygenic components differentiating SCZ from BIP can transethnically contribute to SCZ risk in Japanese people. Furthermore, we suggest that reduced levels of an ASD-related genetic factor in unaffected first-degree relatives may help protect against SCZ development.
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Affiliation(s)
- Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
- Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
- Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Takamitsu Shimada
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Yuzuru Kataoka
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Toshiki Shioiri
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasuhiro Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Nichter B, Haller M, Norman S, Pietrzak RH. Risk and protective factors associated with comorbid PTSD and depression in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. J Psychiatr Res 2020; 121:56-61. [PMID: 31765837 DOI: 10.1016/j.jpsychires.2019.11.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/30/2019] [Accepted: 11/13/2019] [Indexed: 12/17/2022]
Abstract
Converging evidence suggests that veterans with co-occurring PTSD/MDD represent a high-risk group for poor mental health compared to those with PTSD alone. To date, however, little is known about the specific factors that may increase vulnerability for and buffer risk for comorbid PTSD/MDD. The purpose of this study was to provide a population-based characterization of sociodemographic, risk, and protective variables associated with comorbid PTSD/MDD among U.S. military veterans. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative survey of U.S. military veterans (n = 2,732). Analyses (1) compared veterans with PTSD alone and co-occurring PTSD/MDD on sociodemographic, military, and psychosocial characteristics; and (2) examined variables independently associated with PTSD/MDD status. Multivariable logistic regression analyses revealed that racial/ethnic minority status (odds ratio [OR] = 12.5), number of lifetime traumas (OR = 1.3), and time spent engaged in private religious/spiritual activities (OR = 1.8) were associated with PTSD/MDD status, while higher scores on measures of community integration (OR = 0.6) and dispositional optimism (OR = 0.7) were negatively associated with comorbid PTSD/MDD status. Relative importance analyses revealed that dispositional optimism (34%) and community integration (24%) explained the largest proportions of variance in PTSD/MDD comorbidity. Taken together, results of this study suggest that racial/ethnic minority status, greater lifetime trauma burden, and engagement in private religious/spiritual activities are key distinguishing characteristics of U.S. military veterans with comorbid PTSD/MDD vs. PTSD alone. They further underscore the need to study whether targeting community integration and optimism in prevention and treatment efforts may enhance clinical outcomes in this population.
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Affiliation(s)
- Brandon Nichter
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
| | - Moira Haller
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sonya Norman
- Department of Psychiatry, University of California, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
| | - Robert H Pietrzak
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Lowe SR, Tineo P, Young MN. Perceived Discrimination and Major Depression and Generalized Anxiety Symptoms: In Muslim American College Students. J Relig Health 2019; 58:1136-1145. [PMID: 30094677 DOI: 10.1007/s10943-018-0684-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Prior research has found that Muslim Americans' discrimination experiences are associated with increased risk of mental health problems. However, few studies have included Muslim American college students or identified moderators of this relationship. Among a sample of Muslim American college students (N = 141), the current study found that perceived discrimination was positively associated with MD and GAD symptom severity. Having a strong Muslim American identity exacerbated the relationship between perceived discrimination and GAD symptoms. The findings support practices to reduce discrimination toward Muslim American college students and the need for outreach to students with a strong Muslim American identity.
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Affiliation(s)
- Sarah R Lowe
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, 07043, USA.
| | - Petty Tineo
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, 07043, USA
| | - Megan N Young
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, 07043, USA
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Abstract
OBJECTIVE This study examined the mental health status, need for services, and unmet need of community-dwelling Native Hawaiian and other Pacific Islanders (NHPI). METHODS Survey data were collected from 223 NHPI adults of Samoan or Marshallese heritage. Surveys were translated into Samoan and Marshallese by using back-translation, with feedback from cultural experts. Severity of depression, anxiety, and alcohol use were measured, as were perceived need for and avoidance of, or delay in, seeking mental health services. Logistic regressions calculated adjusted odds ratios for past-year perceived need for services and avoidance or delay of needed services, controlling for depression, anxiety, and alcohol use. RESULTS Participants' screened prevalence of major depression, generalized anxiety disorder, and alcohol use disorder was 21%, 12%, and 22%, respectively. In the past year, 35% and 26% of participants reported needing services and avoiding or delaying needed services, respectively. Urban Samoan and rural Marshallese participants did not differ significantly in measures of depression, anxiety, or alcohol use, even though the groups had significant demographic differences. Female gender and greater familiarity-contact with persons with mental illness were significant predictors of both reporting service need and reporting avoiding or delaying services. CONCLUSIONS Community-dwelling NHPIs reported a heavy burden of depression, anxiety, and alcohol use, and high perceived need for services, yet low levels of help-seeking. The large unmet need in the sample suggests that a gap may exist between service need and engagement in U.S. NHPI communities that could be targeted with culturally tailored approaches that promote engagement in care.
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Affiliation(s)
- Andrew M. Subica
- University of California, Riverside Center for Healthy Communities, School of Medicine
| | | | - Bruce G. Link
- University of California, Riverside School of Public Policy
| | - Ann Marie Yamada
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work
| | - Benjamin F. Henwood
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work
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8
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Das-Munshi J, Chang CK, Schofield P, Stewart R, Prince MJ. Depression and cause-specific mortality in an ethnically diverse cohort from the UK: 8-year prospective study. Psychol Med 2019; 49:1639-1651. [PMID: 30180917 PMCID: PMC6601358 DOI: 10.1017/s0033291718002210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 06/15/2018] [Accepted: 08/01/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression is associated with increased mortality, however, little is known about its variation by ethnicity. METHODS We conducted a cohort study of individuals with ICD-10 unipolar depression from secondary mental healthcare, from an ethnically diverse location in southeast London, followed for 8 years (2007-2014) linked to death certificates. Age- and sex- standardised mortality ratios (SMRs), with the population of England and Wales as a standard population were derived. Hazard ratios (HRs) for mortality were derived through multivariable regression procedures. RESULTS Data from 20 320 individuals contributing 91 635 person-years at risk with 2366 deaths were used for analyses. SMR for all-cause mortality in depression was 2.55(95% CI 2.45-2.65), with similar trends by ethnicity. Within the cohort with unipolar depression, adjusted HR (aHRs) for all-cause mortality in ethnic minority groups relative to the White British group were 0.62(95% CI 0.53-0.74) (Black Caribbean), 0.53(95% CI 0.39-0.72) (Black African) and 0.69(95% CI 0.52-0.90) (South Asian). Male sex and alcohol/substance misuse were associated with an increased all-cause mortality risk [aHR:1.94 (95% CI 1.68-2.24) and aHR:1.18 (95% CI 1.01-1.37) respectively], whereas comorbid anxiety was associated with a decreased risk [aHR: 0.72(95% CI 0.58-0.89)]. Similar associations were noted for natural-cause mortality. Alcohol/substance misuse and male sex were associated with a near-doubling in unnatural-cause mortality risk, whereas Black Caribbean individuals with depression had a reduced unnatural-cause mortality risk, relative to White British people with depression. CONCLUSIONS Although individuals with depression experience an increased mortality risk, marked heterogeneity exists by ethnicity. Research and practice should focus on addressing tractable causes underlying increased mortality in depression.
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Affiliation(s)
- Jayati Das-Munshi
- Department of Health Services and Population Research, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Chin-Kuo Chang
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Health and Welfare, University of Taipei, Taipei City, Taiwan
| | - Peter Schofield
- King's College London, Primary Care and Public Health Sciences, London, UK
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Martin J. Prince
- Department of Health Services and Population Research, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Hastings1 JF, Snowden LR. African Americans and Caribbean Blacks: Perceived neighborhood disadvantage and depression. J Community Psychol 2019; 47:227-237. [PMID: 30706518 PMCID: PMC6361541 DOI: 10.1002/jcop.22117] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 07/12/2018] [Indexed: 05/18/2023]
Abstract
The purpose of this study was to advance a theoretical understanding of the effects of impoverished neighborhoods on mental health and to inform policy measures encouraging residents to leave such neighborhoods. To do this, we investigated whether individuals' perceived neighborhood disadvantage served as a risk factor for clinical depression in a nationally representative sample of African Americans and Caribbean Blacks. We performed logistic regression analysis on stratified socioeconomic status (SES) subsamples from the National Survey of American Life sample of 5,019 African Americans and Caribbean Blacks. The association between perceived neighborhood social disorder and past-year depression was statistically significant for low-SES individuals (at or below the federal poverty line; odds ratio [OR] = 1.73, 95% confidence interval [CI] [1.07, 2.81], p = 0.026) and at the boundary of significance for middle-SES individuals (between 100% and 300% of the poverty line; OR = 1.74, 95% CI [1.00, 3.02], p = 0.052), but not for high-SES individuals (at or above 300% of the poverty line). Results suggest, at least for low- and middle-income African Americans, perceived neighborhood social disorder is a risk factor for depression. U.S. housing policies aimed at neighborhood improvement and poverty de-concentration may benefit the mental health of low-income African Americans and Caribbean Blacks.
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Pachter LM, Caldwell CH, Jackson JS, Bernstein BA. Discrimination and Mental Health in a Representative Sample of African-American and Afro-Caribbean Youth. J Racial Ethn Health Disparities 2018; 5:831-837. [PMID: 28916954 PMCID: PMC5854514 DOI: 10.1007/s40615-017-0428-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/10/2017] [Accepted: 08/14/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Racism and discrimination are psychosocial stressors that affect the health of minority populations. While discrimination has been associated with poor mental health, little is known about the relationship between discrimination and mental health outcomes in youth nationally. Furthermore, mental and behavioral health consequences of discrimination may differ in different minority groups. OBJECTIVE The goal of this study is to determine (1) how common perceptions of discrimination are in a nationally representative sample of African-American (AA) and Afro-Caribbean (AC) teens, (2) the relationship between discrimination and mental health conditions, and (3) whether discrimination has different associations with mental health in AA and AC youth. DESIGN Cross-sectional comparison study SETTING: National Survey of American Life-Adolescent Supplement, a nationwide sample of African-American and Afro-Caribbean youth drawn from a nationally representative household survey of AA and AC population PARTICIPANTS: One thousand, one hundred and seventy AA and AC youth between 13 and 17 years EXPOSURE: Experiences with discrimination (Everyday Discrimination Scale) MAIN OUTCOMES: Lifetime and past 12-month major depression and anxiety RESULTS: Ninety percent of AA and 87% of AC youth experienced discrimination. Discrimination was significantly associated with lifetime and 12-month major depression and lifetime and 12-month anxiety. There were no differences in the associations between discrimination and mental health between AA and AC youth except for lifetime anxiety: as discrimination increased, the likelihood of lifetime anxiety disorder increased at a higher rate among AC youth compared to AA. CONCLUSIONS Discrimination is a common psychosocial stressor in African-American and Afro-Caribbean youth. It is associated with poor mental health outcomes. There was no difference in the occurrence of discrimination between African-American and Afro-Caribbean youth or in its mental health consequences.
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Affiliation(s)
- Lee M Pachter
- Department of Pediatrics, Nemours/AI duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA.
| | | | - James S Jackson
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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11
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Assari S, Caldwell CH. High Risk of Depression in High-Income African American Boys. J Racial Ethn Health Disparities 2018; 5:808-819. [PMID: 28842841 PMCID: PMC6556394 DOI: 10.1007/s40615-017-0426-1] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/17/2017] [Accepted: 08/10/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Despite the well-established literature on the protective effect of socioeconomic status (SES) on physical and mental health, there are a few reports on poor mental health of blacks with high SES. Using a national sample, this study investigated the association between household income and risk of major depressive disorder (MDD) in black youth based on ethnicity, gender, and their intersection. METHODS One thousand one hundred seventeen black adolescents (810 African Americans and 360 Caribbean blacks) were included in the current study. Household income was the main predictor. MDD (lifetime, 12-month, and 30-day) was the main outcome. Age was the covariate. Ethnicity and gender were the focal moderators. Logistic regressions were used for data analysis. RESULTS In the pooled sample, household income was not associated with risk of MDD (lifetime, 12-month, or 30-day). We found significant interactions between income and gender on lifetime and 12-month MDD, suggesting a stronger protective effect of income on MDD for females than males. We also found significant interaction between income and ethnicity on 30-day MDD, suggesting stronger protective effect of income against MDD for Caribbean blacks than African Americans. In African American males, high household income was associated with higher risk of lifetime, 12-month, and 30-day MDD. For Caribbean black males and females, high household income was associated with lower odds of 30-day MDD. CONCLUSION Findings suggest that ethnicity and gender influence how socioeconomic resources such as income are associated with MDD risk among black youth. Higher household income may be associated with higher risk of MDD for African American males.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education (HBHE), School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Abstract
Current instruments used to aid in the diagnosis of psychological disorders have limited effectiveness with clients from Asian backgrounds. The Vietnamese Depression Interview (VDI) is a diagnostic instrument created to assess the presence of current and lifetime history of major depressive disorder specifically among Vietnamese refugees and immigrants. The purpose of the present study is to provide a description of the VDI, while also noting it as a reliable and valid means by which to assess depression in Vietnamese individuals. Using the Longitudinal, Expert, and All Data (LEAD; Spitzer in Compr Psychiatry 24:399-411, 1983) standard and the VDI, experienced clinicians conducted the diagnosis process with 127 Vietnamese refugees and immigrants. Assessment of the reliability and validity of the VDI yielded good to excellent AUC and kappa values, indicating the reliability of the VDI and the agreement between the LEAD procedure and the VDI. These study results imply that the VDI performs successfully as a diagnostic instrument specifically created for Vietnamese refugees and immigrants in their native language. Current and future contributions of the VDI with Vietnamese individuals are discussed.
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Affiliation(s)
- Katherine Ramos
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX, 77204, USA.
| | - Martinque K Jones
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX, 77204, USA
| | - Alison B Shellman
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX, 77204, USA
| | - Tam K Dao
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX, 77204, USA
| | - Kim Szeto
- Asian American Family Services, Houston, TX, USA
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13
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Kalyani RR, Ji N, Carnethon M, Bertoni AG, Selvin E, Gregg EW, Sims M, Golden SH. Diabetes, depressive symptoms, and functional disability in African Americans: the Jackson Heart Study. J Diabetes Complications 2017; 31:1259-1265. [PMID: 28433449 PMCID: PMC5676306 DOI: 10.1016/j.jdiacomp.2017.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/28/2017] [Accepted: 03/06/2017] [Indexed: 01/02/2023]
Abstract
AIMS To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African Americans (AAs), a population at high-risk for complications. METHODS We examined 2989 African Americans (AAs) in the Jackson Heart Study who had diabetes and depressive symptoms (CES-D) assessed at baseline. Overall functional disability was defined as the inability to perform at least one task of daily living. Multivariable logistic regression models explored the association of diabetes and depressive symptoms with functional disability. RESULTS Prevalence of overall functional disability was highest with both diabetes and depressive symptoms (54%), similar with diabetes alone (31%) or depressive symptoms alone (33%), and lowest with neither (15%). Adjusting for demographics, smoking, BMI, cardiovascular comorbidities, and hsCRP, the association of depressive symptoms alone (OR=2.30,95% CI 1.75-3.03) and both diabetes and depressive symptoms (OR=2.75,1.88-4.04) with overall functional disability was significant, but not for diabetes alone (OR=1.26,0.95-1.67), compared to neither. In regression analyses including any diabetes and any depressive symptoms together in models, the main effect of depressive symptoms but not diabetes was associated with overall functional disability, and the interaction term was not significant (p-value=0.84). CONCLUSIONS Functional disability was highest among AAs who have both diabetes and depressive symptoms; the latter was a stronger contributor. Future studies should explore mechanisms underlying functional disability in diabetes, particularly the role of depression.
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Affiliation(s)
- Rita Rastogi Kalyani
- Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 333, Baltimore, MD 21287, USA.
| | - Nan Ji
- Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA.
| | - Mercedes Carnethon
- Department of Preventive Medicine-Epidemiology, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA.
| | - Alain G Bertoni
- Department of Epidemiology and Prevention Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Elizabeth Selvin
- Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 333, Baltimore, MD 21287, USA.
| | - Edward W Gregg
- Centers for Disease Control, Division of Diabetes Translation, 4770 Buford Hwy., NE Mailstop K-10, Atlanta, GA 30341, USA.
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson Medical Mall Suite 701, 350 W. Woodrow Wilson Drive, Jackson, MS 39213, USA.
| | - Sherita Hill Golden
- Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 333, Baltimore, MD 21287, USA.
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Ho SC, Jacob SA, Tangiisuran B. Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study. PLoS One 2017; 12:e0179290. [PMID: 28614368 PMCID: PMC5470687 DOI: 10.1371/journal.pone.0179290] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 05/26/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND One of the major challenges in treating major depressive disorder (MDD) is patients' non-adherence to medication. This study aimed to explore the barriers and facilitators of patients' adherence to antidepressants among outpatients with MDD. METHODS Semi-structured and individual in-depth interviews were conducted among patients with MDD who were taking antidepressants, in the psychiatric clinic of a government-run hospital in Malaysia. Participants were purposively sampled from different genders and ethnicities. Interviews were conducted using a validated topic guide, and responses were audio-recorded, transcribed verbatim, checked, and analyzed using the grounded theory approach. RESULTS A total of 30 patients were interviewed. Forty different themes and sub-themes were identified which were conceptually divided into two distinct categories related to barriers and facilitators to adherence. The barriers were: patient-specific, medication-specific, healthcare provision and system, social-cultural, and logistics. The facilitators were: having insight, perceived health benefits, regular activities, patient-provider relationship, reminders, and social support networks. CONCLUSIONS Patient-specific barriers and medication side effects were the major challenges for adhering to treatment. Perceived health benefits and having insight on the need for treatment were the most frequently cited facilitators. Targeted interventions should be developed to address the key barriers, and promote measures to facilitate adherence in this group of patients.
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Affiliation(s)
- Siew Ching Ho
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Balamurugan Tangiisuran
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia, Penang, Malaysia
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Polanka BM, Vrany EA, Patel J, Stewart JC. Depressive Disorder Subtypes as Predictors of Incident Obesity in US Adults: Moderation by Race/Ethnicity. Am J Epidemiol 2017; 185:734-742. [PMID: 28369312 DOI: 10.1093/aje/kwx030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/12/2016] [Indexed: 02/05/2023] Open
Abstract
We compared the relative importance of atypical major depressive disorder (MDD), nonatypical MDD, and dysthymic disorder in predicting 3-year obesity incidence and change in body mass index and determined whether race/ethnicity moderated these relationships. We examined data from 17,787 initially nonobese adults in the National Epidemiologic Survey on Alcohol and Related Conditions waves 1 (2001-2002) and 2 (2004-2005) who were representative of the US population. Lifetime subtypes of depressive disorders were determined using a structured interview, and obesity outcomes were computed from self-reported height and weight. Atypical MDD (odds ratio (OR) = 1.68, 95% confidence interval (CI): 1.43, 1.97; P < 0.001) and dysthymic disorder (OR = 1.66, 95% CI: 1.29, 2.12; P < 0.001) were stronger predictors of incident obesity than were nonatypical MDD (OR = 1.11, 95% CI: 1.01, 1.22; P = 0.027) and no history of depressive disorder. Atypical MDD (B = 0.41 (standard error, 0.15); P = 0.007) was a stronger predictor of increases in body mass index than were dysthymic disorder (B = -0.31 (standard error, 0.21); P = 0.142), nonatypical MDD (B = 0.007 (standard error, 0.06); P = 0.911), and no history of depressive disorder. Race/ethnicity was a moderator; atypical MDD was a stronger predictor of incident obesity in Hispanics/Latinos (OR = 1.97, 95% CI: 1.73, 2.24; P < 0.001) than in non-Hispanic whites (OR = 1.54, 95% CI: 1.25, 1.91; P < 0.001) and blacks (OR = 1.72, 95% CI: 1.31, 2.26; P < 0.001). US adults with atypical MDD are at particularly high risk of weight gain and obesity, and Hispanics/Latinos may be especially vulnerable to the obesogenic consequences of depressions.
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Gutnick D, Siegel C, Laska E, Wanderling J, Wagner EC, Haugland G, Conlon MK. Making the cut: Depression screening in urban general hospital clinics for culturally diverse Latino populations. Gen Hosp Psychiatry 2017; 45:85-90. [PMID: 28274345 DOI: 10.1016/j.genhosppsych.2016.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/01/2016] [Accepted: 12/07/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We examined whether the cut-point 10 for the Patient Health Questionnaire-9 (PHQ9) depression screen used in primary care populations is equally valid for Mexicans (M), Ecuadorians (E), Puerto Ricans (PR) and non-Hispanic whites (W) from inner-city hospital-based primary care clinics; and whether stressful life events elevate scores and the probability of major depressive disorder (MDD). METHODS Over 18-months, a sample of persons from hospital clinics with a positive initial PHQ2 and a subsequent PHQ9 were administered a stressful life event questionnaire and a Structured Clinical Interview to establish an MDD diagnosis, with oversampling of those between 8 and 12: (n=261: 75 E, 71 M, 51 PR, 64 W). For analysis, the sample was weighted using chart review (n=368) to represent a typical clinic population. Receiver Operating Characteristics analysis selected cut-points maximizing sensitivity (Sn) plus specificity (Sp). RESULTS The optimal cut-point for all groups was 13 with the corresponding Sn and Sp estimates for E=(Sn 73%, Sp 71%), M=(76%, 81%), PR=(81%, 63%) and W=(80%, 74%). Stressful life events impacted screen scores and MDD diagnosis. CONCLUSIONS Elevating the PHQ9 cut-point for inner-city Latinos as well as whites is suggested to avoid high false positive rates leading to improper treatment with clinical and economic consequences.
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Affiliation(s)
- Damara Gutnick
- Montefiore Hudson Valley Collaborative, 3 Executive Boulevard, Yonkers, NY 10701, United States.
| | - Carole Siegel
- Langone School of Medicine, New York University Department of Psychiatry, One Park Avenue, New York, NY 10016, United States.
| | - Eugene Laska
- Langone School of Medicine, New York University Department of Psychiatry, One Park Avenue, New York, NY 10016, United States.
| | - Joseph Wanderling
- Nathan Kline Institute for Psychiatric Research, 140, Old Orangeburg Rd., Orangeburg, NY 10962, United States.
| | - Ellen Cogen Wagner
- Adolescent Health Initiative, University of Michigan, 2025 Traverwood Drive, Ann Arbor, MI 48105, United States.
| | - Gary Haugland
- Nathan Kline Institute for Psychiatric Research, 140, Old Orangeburg Rd., Orangeburg, NY 10962, United States.
| | - Mary K Conlon
- Langone School of Medicine, New York University Department of Child and Adolescent Psychiatry, One Park Avenue, New York, NY 10016, United States.
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Pignon B, Geoffroy PA, Thomas P, Roelandt JL, Rolland B, Morgan C, Vaiva G, Amad A. Prevalence and clinical severity of mood disorders among first-, second- and third-generation migrants. J Affect Disord 2017; 210:174-180. [PMID: 28049102 DOI: 10.1016/j.jad.2016.12.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/27/2016] [Accepted: 12/17/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The role of migration as a risk factor remains unknown for mood disorders because of poor data. We sought to examine the prevalence and severity of mood disorders (bipolar disorder (BD), unipolar depressive disorder (UDD) and dysthymia) in first, second, and third generation migrants in France. METHODS The Mental Health in the General Population survey interviewed 38,694 individuals. The prevalence of lifetime mood disorders, comorbidities, and clinical features was compared between migrants and non-migrants and by generation. All analyses were adjusted for age, sex and level of education. RESULTS The prevalence of any lifetime mood disorder was higher in migrants compared with non-migrants (OR = 1.36, 95% CI [1.27 - 1.45]). This increased prevalence was significant for UDD (OR = 1.44, 95% CI [1.34 - 1.54]), but not for BD (OR = 1.15, 95% CI [0.96 - 1.36]) or dysthymia (OR = 1.09, 95% CI [0.94 - 1.27]), although the prevalence of BD was increased in the third generation (OR = 1.27, 95% CI [1.01 - 1.60]). Migrants with BD or UDD were more likely to display a comorbid psychotic disorder compared to non-migrants with BD or UDD. Cannabis-use disorders were more common in migrant groups for the 3 mood disorders, whereas alcohol-use disorders were higher in migrants with UDD. Posttraumatic stress disorder was more frequent among migrants with UDD. LIMITATIONS The study used cross-sectional prevalence data and could be biased by differences in the course of disease according to migrant status. Moreover, this design does not allow causality conclusion or generalization of the main findings. CONCLUSION Mood disorders are more common among migrants, especially UDD. Moreover, migrants with mood disorders presented with a more severe profile, with increased rates of psychotic and substance-use disorders.
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Affiliation(s)
- Baptiste Pignon
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France.
| | - Pierre Alexis Geoffroy
- Inserm, U1144, Paris F-75006, France; Paris Descartes University, UMR-S 1144, Paris F-75006, France; Paris Diderot University, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Psychiatry and Addiction Medicine Department, 75475 Paris Cedex 10, France
| | - Pierre Thomas
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; Federation of Mental Health Research, Lille, France; INSERM 1123, Equipe ECEVE, Paris, France
| | - Jean-Luc Roelandt
- World Health Organization Collaborative Centre (WHO-CC), EPSM Lille-Metropole, Lille, France; INSERM 1123, Equipe ECEVE, Paris, France
| | - Benjamin Rolland
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; Univ. Lille, INSERM, CHU LILLE, U1171, Department of Addiction Medicine - Addiction Consultation Liaison Unit, Pôle de Psychiatrie, F-59000 Lille, France
| | - Craig Morgan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Guillaume Vaiva
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; Federation of Mental Health Research, Lille, France
| | - Ali Amad
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Amutah-Onukagha NN, Doamekpor LA, Gardner M. An Examination of the Sociodemographic and Health Determinants of Major Depressive Disorder Among Black Women. J Racial Ethn Health Disparities 2016; 4:1074-1082. [PMID: 27928770 DOI: 10.1007/s40615-016-0312-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/03/2016] [Accepted: 11/13/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Black women disproportionately share the distribution of risk factors for physical and mental illnesses. The goal of this study was to examine the sociodemographic and health correlates of major depressive disorder (MDD) symptoms among black women. METHODS Pooled data from the 2005-2010 National Health and Nutrition Examination Survey (NHANES) were used to assess the sociodemographic and health correlates of MDD symptoms among black women (n = 227). Multivariate logistic regression techniques assessed the association between MDD symptoms and age, socioeconomic status, health status, and health behaviors. RESULTS Poverty income ratio and smoking status were significantly associated with the likelihood of having MDD symptoms. Black women who were smokers were also more likely to have MDD symptoms compared to non-smokers [OR = 8.05, 95% CI = (4.56, 14.23)]. After controlling for all other socioeconomic and health variables, this association remained statistically significant. In addition, after controlling for all other variables, the multivariate analyses showed that black women below 299% federal poverty level (FPL) were nearly three times more likely to have MDD symptoms compared to women above 300% FPL [OR = 2.82, 95% CI = (1.02, 7.96)]. CONCLUSIONS These analyses suggest that poverty and smoking status are associated with MDD symptoms among black women. A deeper understanding of the underlying mechanisms and key factors which influence MDD symptoms are needed in order to develop and create mental health programs targeting women of color.
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Affiliation(s)
- Ndidiamaka N Amutah-Onukagha
- Department of Public Health, College of Education and Human Services, Montclair State University, 1 Normal Avenue, UN 4192, Montclair, NJ, 07043, USA.
| | - Lauren A Doamekpor
- The Lewin Group, 3130 Fairview Park Dr #500, Falls Church, VA, 22042, USA
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Loret de Mola C, Hartwig FP, Gonçalves H, Quevedo LDA, Pinheiro R, Gigante DP, Motta JVDS, Pereira AC, Barros FC, Horta BL. Genomic ancestry and the social pathways leading to major depression in adulthood: the mediating effect of socioeconomic position and discrimination. BMC Psychiatry 2016; 16:308. [PMID: 27596337 PMCID: PMC5011949 DOI: 10.1186/s12888-016-1015-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence suggests that there is an association between ethnicity/skin color and depression; however, many contextual and individual variables, like sense of discrimination and socioeconomic position (SEP), might influence the direction of this association. We assessed the association between African ancestry and major depression among young adults that have been followed-up since birth in a Southern Brazilian city, and the mediating effect of SEP and discrimination. METHODS In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified; liveborns were examined and their mothers interviewed (n = 5914). In 2012-13, at 30 years of age, we used the Mini International Neuropsychiatric Interview (MINI) for major depression diagnosis. In addition, DNA samples were genotyped for approximately 2.5 million single nucleotide polymorphisms (SNPs) using Illumina (CA, USA) HumanOmni2.5-8v1 array. Genomic ancestry estimation was based on approximately 370 000 single nucleotide polymorphisms (SNPs) mutually available for the Pelotas cohort and selected samples (used as reference panels) of the HapMap and Human Genome Diversity (HGDP). We estimated prevalence ratios (PR) using Poisson regression models and evaluated the association between percentage of African ancestry and major depression. We used G-computation for mediation analysis. RESULTS At 30 years, 3576 individuals were evaluated for major depression (prevalence = 7.9 %). Only individuals in the highest SEP, who had a percentage of African ancestry between >5-30 % and >30 % had a prevalence of major depression 2.16 (PR = 2.16 95 % CI [1.05-4.45]) and 2.74 (PR = 2.74 95 % CI [1.06-7.06]) times higher, than those with 5 % or less, respectively. Among these subjects, sense of discrimination by skin color, captured 84 % of the association between African ancestry and major depression. CONCLUSION SEP is an important effect modifier of the positive association between African ancestry and major depression. In addition, this association is predominantly mediated by the sense of feeling discriminated by skin color.
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Affiliation(s)
- Christian Loret de Mola
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Luciana de Avila Quevedo
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Ricardo Pinheiro
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Denise Petrucci Gigante
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
| | - Janaína Vieira dos Santos Motta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Alexandre C. Pereira
- Heart Institute, University of São Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César - CEP: 01246903, São Paulo, SP Brazil
| | - Fernando C. Barros
- Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Rua Gonçalves Chaves, 377 - sala 411, prédio C. CEP: 96015-560, Pelotas, RS Brazil
| | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro. Cep: 96020-220, Caixa Postal 464, Pelotas, RS Brazil
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Szaflarski M, Cubbins LA, Bauldry S, Meganathan K, Klepinger DH, Somoza E. Major Depressive Disorder and Dysthymia at the Intersection of Nativity and Racial-Ethnic Origins. J Immigr Minor Health 2016; 18:749-763. [PMID: 26438660 PMCID: PMC4821814 DOI: 10.1007/s10903-015-0293-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Immigrants often have lower rates of depression than US-natives, but longitudinal assessments across multiple racial-ethnic groups are limited. This study examined the rates of prevalent, acquired, and persisting major depression and dysthymia by nativity and racial-ethnic origin while considering levels of acculturation, stress, and social ties. Data from the National Epidemiologic Survey on Alcohol and Related Conditions were used to model prevalence and 3-year incidence/persistence of major depression and dysthymia (DSM-IV diagnoses) using logistic regression. Substantive factors were assessed using standardized measures. The rates of major depression were lower for most immigrants, but differences were noted by race-ethnicity and outcome. Furthermore, immigrants had higher prevalence but not incidence of dysthymia. The associations between substantive factors and outcomes were mixed. This study describes and begins to explain immigrant trajectories of major depression and dysthymia over a 3-year period. The continuing research challenges and future directions are discussed.
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Affiliation(s)
- Magdalena Szaflarski
- Department of Sociology, University of Alabama at Birmingham, HHB 460Q, 1720 2nd Ave S, Birmingham, AL, 35294-1152, USA.
| | | | - Shawn Bauldry
- Department of Sociology, University of Alabama at Birmingham, HHB 460Q, 1720 2nd Ave S, Birmingham, AL, 35294-1152, USA
| | - Karthikeyan Meganathan
- Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH, USA
| | | | - Eugene Somoza
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
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Park SC, Sakong JK, Koo BH, Kim JM, Jun TY, Lee MS, Kim JB, Yim HW, Park YC. Potential Relationship between Season of Birth and Clinical Characteristics in Major Depressive Disorder in Koreans: Results from the CRESCEND Study. Yonsei Med J 2016; 57:784-9. [PMID: 26996582 PMCID: PMC4800372 DOI: 10.3349/ymj.2016.57.3.784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/24/2015] [Accepted: 10/23/2015] [Indexed: 12/21/2022] Open
Abstract
We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ² tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ²=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.
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Affiliation(s)
- Seon-Cheol Park
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Jeong-Kyu Sakong
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Bon Hoon Koo
- Department of Psychiatry, Yeungnam University School of Medicine, Daegu, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University School of Medicine, Gwangju, Korea
| | - Tae-Youn Jun
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Min-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Jung-Bum Kim
- Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea
| | - Hyeon-Woo Yim
- Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yong Chon Park
- Department of Psychiatry, Hanyang University Guri Hospital, Guri, Korea.
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Lin CH, Huang CJ, Liu SK. Melancholic features in inpatients with major depressive disorder associate with differential clinical characteristics and treatment outcomes. Psychiatry Res 2016; 238:368-373. [PMID: 26899817 DOI: 10.1016/j.psychres.2015.11.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 11/01/2015] [Accepted: 11/07/2015] [Indexed: 11/17/2022]
Abstract
To determine whether the presence of melancholic features in hospitalized patients with major depressive disorder (MDD) was associated with specific clinical characteristics and treatment outcomes, supporting melancholic depression as a distinct subtype within MDD. 126 acutely ill inpatients with MDD were enrolled in an open, 6-week trial with fixed-dose fluoxetine 20mg daily. Symptom severity was assessed regularly, using the 17-item Hamilton Depression Rating Scale (HAMD-17) and Clinical Global Impression of Severity (CGI-S). Melancholic features were defined according to the DSM-IV criteria. Clinical variables were compared between patients with and without melancholic features. Generalized estimating equations method was used to explore the differences in HAMD-17 and CGI-S scores between the 2 groups over time. Clinical response was defined as having a 50% or greater reduction in HAMD-17 scores. 96 (76.2%) of the 126 patients with at least one post-baseline assessment met the criteria for melancholic depression. Melancholic depression differed from non-melancholic depression in clinical characteristics and predicted a better response to fluoxetine treatment. The differentiation between melancholic and non-melancholic depression within MDD hence is clinically significant and valid.
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Affiliation(s)
- Ching-Hua Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jen Huang
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan
| | - Shi-Kai Liu
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Baumel A, Wolmer L, Laor N, Toren P. Assessing the Use of the Child Attachment Interview in a Sample of Israeli Jewish Children. Isr J Psychiatry Relat Sci 2016; 53:56-61. [PMID: 28492382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND This manuscript assesses the use of the Child Attachment Interview (CAI) in a sample of Israeli Jewish children in middle childhood in order to add to empirical data on this measure. METHOD Forty-one children between the ages of 7 and 13 were consecutively recruited to the study. The clinical sample included 29 children diagnosed with anxiety disorder, major depression or ADHD. The Father Focused Referral (FFR) sample included 12 children whose father was unavailable to them. Participants were administered the CAI and coded by certified personnel. RESULTS 81.4% concordance was found between maternal and paternal secure-insecure attachment classifications in the clinical sample; 100% of the children in the FFR group were classified as insecurely attached to their fathers suggesting convergent validity for the classification of father attachment; 45.4% of the children in the FFR sample were also classified as insecurely attached to their mothers, pointing to the difference that can be found between the two parental attachment classifications in relevant cases, and therefore to sufficient discriminant validity between the two classifications. CONCLUSIONS The clinical sample concordance rate, which was lower than in previous studies, indicates that parental concordance rates should be further investigated using different samples and countries. The study's findings regarding the difference that can be found between parental attachment classifications show the instrument's relevance in cases which the parental representations may differ. In these cases, using an instrument that does not examine the attachment toward both parents might not suffice. Study limitations and further implications are discussed.
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Affiliation(s)
- Amit Baumel
- Tel Aviv Community Mental Health Center, Clalit Health Services, Tel Aviv, Israel The Feinstein Institute for Medical Research, Zucker Hillside Hospital, Glen Oaks, New York, U.S.A
| | - Leo Wolmer
- Donald J. Cohen & Irving B. Harris Resilience Center, Association for Children at Risk, Tel Aviv, Israel Ivcher School of Psychology, Herzliya Inter-Disciplinary Center, Herzliya, Israel
| | - Nathaniel Laor
- Tel Aviv Community Mental Health Center, Clalit Health Services, Tel Aviv, Israel Donald J. Cohen & Irving B. Harris Resilience Center, Association for Children at Risk, Tel Aviv, Israel The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Yale Child Study Center, Yale University, New Haven, Conn., U.S.A
| | - Paz Toren
- Tel Aviv Community Mental Health Center, Clalit Health Services, Tel Aviv, Israel The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Augsberger A, Yeung A, Dougher M, Hahm HC. Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide. BMC Health Serv Res 2015; 15:542. [PMID: 26645481 PMCID: PMC4673784 DOI: 10.1186/s12913-015-1191-7] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 11/19/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Despite the substantially high prevalence of depression, suicidal ideation and suicide attempts among Asian American women who are children of immigrants, little is known about the prevalence of mental health utilization and the perceived barriers to accessing care. METHODS The data were from the Asian American Women's Sexual Health Initiative Project (AWSHIP), a 5-year mixed methods study at Boston University. The quantitative analysis examined the differential proportion of mental health utilization among 701 survey participants based on their mental health risk profile determined by current moderate to severe depression symptoms and lifetime history of suicidality. Mental health risk groups were created based on participants' current depression symptoms and history of suicide behaviors: Group 1-low-risk; Group 2-medium-risk; Group 3-high-risk. Mental health care utilization outcomes were measured by any mental health care, minimally adequate mental health care, and intensive mental health care. The qualitative analysis explored the perceived barriers to mental health care among 17 participants from the medium and high-risk groups. RESULTS Among 701 participants, 43% of women (n = 299) reported that they either suffered from current moderate to severe depression symptoms or a lifetime history of suicidal ideation or suicide attempt. Although the high-risk group demonstrated statistically significant higher mental health utilization compared to the low and medium-risk groups, more than 60% of the high-risk group did not access any mental health care, and more than 80% did not receive minimally adequate care. The qualitative analysis identified three underutilization factors: Asian family contributions to mental health stigma, Asian community contributions to mental health stigma, and a mismatch between cultural needs and available services. CONCLUSIONS Despite the high prevalence of depression and suicidal behaviors among young Asian American women in the sample, the proportion of mental health care utilization was extremely low. The qualitative analysis underscores the influence of Asian family and community stigma on mental health utilization and the lack of culturally appropriate mental health interventions. Prevention and intervention efforts should focus on raising mental health awareness in the Asian American community and offering culturally sensitive services.
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Affiliation(s)
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Meaghan Dougher
- Boston University School of Social Work, Boston, MA, 02215, USA.
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Nguyen AL, Green J, Enguidanos S. The relationship between depressive symptoms, diabetes symptoms, and self-management among an urban, low-income Latino population. J Diabetes Complications 2015; 29:1003-8. [PMID: 26490755 DOI: 10.1016/j.jdiacomp.2015.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/24/2015] [Accepted: 09/06/2015] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the prevalence of depression symptoms among Latinos with diabetes following transition from hospital to home and the relationship of depressive symptoms to diabetes symptom severity and self-management activities. METHODS 203 Latino patients with diagnosed diabetes completed a survey assessing depressive symptoms (PHQ-9), diabetes symptom severity, and diabetes self-management activities (SDSCA). Characteristics and diabetes outcomes between patients with and without probable major depression were compared. Associations between PHQ-9 scores and diabetes outcomes were assessed. Multivariate regression models evaluated the relationship between depressive symptoms and diabetes outcomes and exercise after controlling for patient characteristics. RESULTS 31.5% of participants indicated probable major depression (PHQ-9≥10). More severe diabetes symptoms and less reported exercise were associated with higher PHQ-9 scores. Regression models showed no relationship between self-management and depression. More severe diabetes symptoms were significantly associated with being female, married, and having probable major depression. Odds of exercising were reduced by 6% for every one-unit increase in PHQ-9 score. CONCLUSIONS The prevalence of probable depressive symptoms is high in this population. Having depressive symptoms is an indicator of poorer diabetes symptoms. Screening for depressive symptoms may help identify individuals who need additional support with diabetes symptom and self-management.
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Affiliation(s)
- Annie L Nguyen
- Keck School of Medicine at the University of Southern California, Department of Family Medicine, Los Angeles, CA.
| | - Janelle Green
- University of Southern California, Davis School of Gerontology, Los Angeles, CA
| | - Susan Enguidanos
- University of Southern California, Davis School of Gerontology, Los Angeles, CA
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Assari S, Lankarani MM. Association Between Stressful Life Events and Depression; Intersection of Race and Gender. J Racial Ethn Health Disparities 2015; 3:349-56. [PMID: 27271076 DOI: 10.1007/s40615-015-0160-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 07/30/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although stressful life events (SLEs) and depression are associated, we do not know if the intersection of race and gender modifies the magnitude of this link. Using a nationally representative sample of adults in the USA, we tested if the association between SLE and major depressive episode (MDE) depends on the intersection of race and gender. METHODS Data came from the National Survey of American Life (NSAL), 2003, a cross-sectional survey that enrolled 5899 adults including 5008 Blacks (African-Americans or Caribbean Blacks), and 891 Non-Hispanic Whites. Logistic regression was used for data analysis. Stressful life events (past 30 days) was the independent variable, 12-month MDE was the dependent variable, and age, educational level, marital status, employment, and region of country were controls. RESULTS In the pooled sample, SLE was associated with MDE above and beyond all covariates, without the SLE × race interaction term being significant. Among men, the SLE × race interaction was significant, suggesting a stronger association between SLE and MDE among White men compared to Black men. Such interaction between SLE × race could not be found among women. CONCLUSIONS The association between SLE and depression may be stronger for White men than Black men; however, this link does not differ between White and Black women. More research is needed to better understand the mechanism behind race by gender variation in the stress-depression link.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Maryam Moghani Lankarani
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI, 48109-2700, USA
- Center for Research on Ethnicity, Culture and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Park S, Hatim Sulaiman A, Srisurapanont M, Chang SM, Liu CY, Bautista D, Ge L, Choon Chua H, Pyo Hong J. The association of suicide risk with negative life events and social support according to gender in Asian patients with major depressive disorder. Psychiatry Res 2015; 228:277-82. [PMID: 26160206 DOI: 10.1016/j.psychres.2015.06.032] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 02/25/2015] [Accepted: 06/07/2015] [Indexed: 11/18/2022]
Abstract
We investigated the associations between negative life events, social support, depressive and hostile symptoms, and suicide risk according to gender in multinational Asian patients with major depressive disorder (MDD). A total of 547 outpatients with MDD (352 women and 195 men, mean age of 39.58±13.21 years) were recruited in China, South Korea, Malaysia, Singapore, Thailand, and Taiwan. All patients were assessed with the Mini-International Neuropsychiatric Interview, the Montgomery-Asberg Depression Rating Scale, the Symptoms Checklist 90-Revised, the Multidimensional Scale of Perceived Social Support, and the List of Threatening Experiences. Negative life events, social support, depressive symptoms, and hostility were all significantly associated with suicidality in female MDD patients. However, only depressive symptoms and hostility were significantly associated with suicidality in male patients. Depression severity and hostility only partially mediated the association of negative life events and poor social support with suicidality in female patients. In contrast, hostility fully mediated the association of negative life events and poor social support with suicidality in male patients. Our results highlight the need of in-depth assessment of suicide risk for depressed female patients who report a number of negative life events and poor social supports, even if they do not show severe psychopathology.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Ahmad Hatim Sulaiman
- Department of Psychiatry, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | | | - Sung-man Chang
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taiwan
| | - Dianne Bautista
- Singapore Clinical Research Institute, Singapore; Duke-National University of Singapore, Singapore
| | - Lan Ge
- Lundbeck China, Beijing, China
| | - Hong Choon Chua
- Institute of Mental Health, Woodbridge Hospital, Hospital, Singapore
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, South Korea.
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Alcántara C, Chen CN, Alegría M. Transnational ties and past-year major depressive episodes among Latino immigrants. Cultur Divers Ethnic Minor Psychol 2015; 21:486-495. [PMID: 25090146 PMCID: PMC4317386 DOI: 10.1037/a0037540] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Latino immigrants live in an increasingly global world in which maintaining contact with kin in the home country is easier than ever. We examined (a) the annual distribution of remittances burden (percentage of remittances/household income) and visits to the home country, (b) the association of these transnational ties with a past-year major depressive episode (MDE), and (c) moderation by Latino subethnicity or gender. We conducted weighted logistic regression analyses with the Latino immigrant subsample (N = 1,614) of the National Latino and Asian American Study. Mexican and Other Latino immigrants had greater remittances burden than Puerto Rican migrants. Cuban immigrants made the fewest visits back home. After adjustment for sociodemographics and premigration psychiatric history, remittances burden decreased odds of MDE (odds ratio [OR] = 0.80, 95% confidence interval [CI] [0.67, .0.98]), whereas visits back home increased odds of MDE (OR = 1.04, 95% CI [1.01, 1.06]). Latino subethnicity was not a significant moderator. Visits back home were more strongly linked to depression among women than men. The distribution of transnational ties differs by Latino subgroup, although its association with depression is similar across groups. Monetary giving through remittances might promote a greater sense of self-efficacy, and caregiving for relatives back home that positively affect mental health. Visits back home, especially for women, might signal social stress from strained relationships with kin, spouses, or children left behind, or increased caregiving demands that negatively affect mental health. Clinical practice with immigrants should routinely assess the social resources and strains that fall outside national borders.
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Affiliation(s)
- Carmela Alcántara
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY
| | - Chih-Nan Chen
- Department of Economics, National Taipei University, Taipei, Taiwan
| | - Margarita Alegría
- Center for Multicultural Mental Health Research at Cambridge Health Alliance, Harvard Medical School, Somerville, MA
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Kendler KS, Aggen SH, Li Y, Lewis CM, Breen G, Boomsma DI, Bot M, Penninx BWJH, Flint J. The similarity of the structure of DSM-IV criteria for major depression in depressed women from China, the United States and Europe. Psychol Med 2015; 45:1945-1954. [PMID: 25781917 PMCID: PMC4446696 DOI: 10.1017/s0033291714003067] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/11/2014] [Accepted: 11/29/2014] [Indexed: 01/23/2023]
Abstract
BACKGROUND Do DSM-IV diagnostic criteria for major depression (MD) in Chinese and Western women perform in a similar manner? METHOD The CONVERGE study included interview-based assessments of women of Han Chinese descent with treated recurrent MD. Using Mplus software, we investigated the overall degree of between-sample measurement invariance (MI) for DSM-IV diagnostic criteria for MD in the CONVERGE sample and samples selected from four major Western studies from the USA and Europe matched to the inclusion criteria of CONVERGE. These analyses were performed one pair at a time. We then compared the results from CONVERGE paired with Western samples to those obtained when examining levels of MI between pairs of the Western samples. RESULTS Assuming a single factor model for the nine diagnostic criteria for MD, the level of MI based on global fit indexes observed between the CONVERGE and the four Western samples was very similar to that seen between the Western samples. Comparable results were obtained when using a two-factor structure for MI testing when applied to the 14 diagnostic criteria for MD disaggregated for weight, appetite, sleep, and psychomotor changes. CONCLUSIONS Despite differences in language, ethnicity and culture, DSM criteria for MD perform similarly in Chinese women with recurrent MD and comparable subjects from the USA and Europe. The DSM criteria for MD may assess depressive symptoms that are relatively insensitive to cultural and ethnic differences. These results support efforts to compare findings from depressed patients in China and Western countries.
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Affiliation(s)
- K. S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - S. H. Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Y. Li
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - C. M. Lewis
- MRC SGDP Centre, Institute of Psychiatry, King's College London, London, UK
| | - G. Breen
- MRC SGDP Centre, Institute of Psychiatry, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre for Mental Health at the Maudsley and Institute of Psychiatry, King's College London, London, UK
| | - D. I. Boomsma
- Department of Biological Psychology and EMGO Institute of Health and Care Research, VU University, Amsterdam, The Netherlands
| | - M. Bot
- Department of Psychiatry and EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - B. W. J. H. Penninx
- Department of Psychiatry and EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J. Flint
- Wellcome Trust Centre for Human Genetics, Oxford, UK
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Tan TX. Major depression in China-to-US immigrants and US-born Chinese Americans: testing a hypothesis from culture-gene co-evolutionary theory of mental disorders. J Affect Disord 2015; 167:30-6. [PMID: 25082111 DOI: 10.1016/j.jad.2014.05.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 05/23/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND In this study, the culture-gene co-evolutionary theory of mental disorders was used to test the hypothesis that major depression was less prevalent in China-to-US immigrants who migrated to the US as adults than in US-born adult Chinese Americans. METHODS Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) were extracted for secondary data analyses on the rates of major depression disorder (MDD) and major depressive episode (MDE) in the two groups. RESULTS Findings showed that for life time MDD, the rates for China-to-US immigrant and US-born Chinese were 5.3% and 7.9% for men and 8.5% and 33.1% for women. For 12-month MDD, the corresponding rates were 2.2% and 3.4% for men, and 4.7% and 12.6% for women. For life time MDE, the corresponding rates were 6.8% and 8.8% for men; for women the rates were 8.5% and 33.1%. For 12-month MDE, the rates were 2.2% and 4.4% for men; the rates were 4.7% and 12.6% for women. Controlling for age, education level, income, BMI, marital status, and income-to-needs ratio, China-to-US immigrant women remained less likely to have life time major depression than US-born Chinese American women. LIMITATIONS While the study has the strength of utilizing nationally representative datasets, the approach is limited as the data sources lack the capacity to investigate how the strength of connection with the collectivist culture might be related to major depression in the immigrant group.
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Affiliation(s)
- Tony Xing Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Edu 105, Tampa, FL 33620, United States.
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Cao S, Li H, Lou L, Xie Z, Zhao X, Pang J, Sui J, Xie G. Association study between 5-HT2A and NET gene polymorphisms and recurrent major depression disorder in Chinese Han population. Pak J Pharm Sci 2015; 28:1101-1108. [PMID: 26051731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A functional NET T-182C polymorphism (rs2242446) in the promoter region, a synonymous polymorphisms G1287A in the exon 9(rs5569) and a functional serotonin 2A (5-HT2A) receptor (rs6311) genes in the promoter region were associated with MDD in different populations. However, few studies have focused on the relationship between these three polymorphisms and recurrent MDD patients in Chinese Han population. Three hundred MDD patients (112 males, 188 females) and three hundre unrelated healthy controls were enrolled in the study. POST-PCR ligase detection reaction genotype assay method was used for the genotypic analyses. There existed significant differences both in the frequencies of alleles and genotypes between patients and controls for the 5-HT2A receptor gene polymorphism (χ2=9.267, p=0.01 for genotype; χ2=7.615,p=0.006 for allele). No difference in genotype and allele distribution of G1287A, T182C were found in MDD patients and controls. Our results suggest that the rs6311 polymorphism seems to be the susceptibility factor in etiology of recurrent MDD. In conclusion, 5-HT2A receptor gene variants may be involved in the etiology of MDD, although the results must be verified in larger samples and different ethnicities.
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Affiliation(s)
- Suxia Cao
- ental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan Province, P.R. China
| | - Hengfen Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Lihong Lou
- Prevention and Health Department, Zhengzhou Ninth People's Hospital, Zhengzhou, Henan Province, P. R. China
| | - Zheng Xie
- Department of Psychiatry, The First Affiliated Hospital, He Nan University of Traditional Chinese medicine, Zhengzhou, Henan Province, P. R. China
| | - Xiaofeng Zhao
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Jianyue Pang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Jingjing Sui
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Guangrong Xie
- Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan Province, P.R. China
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Wilusz MJ, Peters RM, Cassidy-Bushrow AE. Course of depressive symptoms across pregnancy in African American women. J Midwifery Womens Health 2015; 59:411-6. [PMID: 25215349 DOI: 10.1111/jmwh.12057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although African American women are at increased risk for antenatal depression, less is known regarding the course of antenatal depression symptoms among African American women. Because pregnancy is a state of rapid physical and mental changes, we examined if depression symptoms changed between the second and third trimesters in a sample of pregnant African American women. METHODS A nonprobability sample of women was recruited from obstetrics clinics within a large Midwestern health system. African American women in their second trimester (N = 189) completed an initial study visit; a convenience sample of 37 women (19.6%) completed a second identical study visit during their third trimester. The 20-item Center for Epidemiological Studies Depression Scale (CES-D) was used to measure depressive symptoms; a CES-D score of 16 or higher equates with clinical depression and a CES-D score of 23 or higher indicates major depression. Paired t tests and correlation coefficients were used to estimate change in depression symptoms. RESULTS Mean (SD) second- and third-trimester CES-D scores were not statistically significantly different (15.3 [10.6] and 15.1 [10.3], respectively; P = .87) and were moderately and significantly correlated (r = 0.65; P .001). Prevalence of CES-D scores of 16 or higher was 43.2% (n = 16) in the second trimester and 37.8% (n=14) in the third trimester, which was not significantly different (P =.77). Between the 2 visits, 67.6% (n=25) were classified identically with a CES-D scores of 16 or higher with only fair agreement between the 2 measures (kappa = 0.33). Prevalence of CES-D scores of 23 or higher was 27.0% (n = 10) and 21.6% (n = 8) in the second and third trimesters, respectively, and was not significantly different (P = .69). Between the 2 visits, 83.8% (n = 31) were classified identically with CES-D scores of 23 or higher, with moderate agreement between the 2 measures (kappa = 0.56). DISCUSSION Depression symptoms were relatively constant across the latter 2 trimesters of pregnancy. The second trimester may be an appropriate time to screen women for antenatal depression, as it is less likely to be affected by early-pregnancy somatic events yet is early enough that intervention may impart positive health benefits for mother and child.
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Srisurapanont M, Bautista D, Chen CH, Wang G, Udomratn P, Eurviriyanukul K. Subjective memory and concentration deficits in medication-free, non-elderly Asians with major depressive disorder: prevalence and their correlates. J Affect Disord 2015; 171:105-10. [PMID: 25303026 DOI: 10.1016/j.jad.2014.09.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Subjective cognitive impairment (SCI) in major depressive disorder (MDD) is prevalent and correlated with disability. This study aimed to examine the prevalence rates and correlates of subjective memory deficit (SMD) and subjective concentration deficit (SCD) in medication-free, non-elderly Asians with MDD. METHODS The SMD and SCD were assessed by using two items of the Symptom Checklist-90-Revised (SCL-90-R). Other measurements of interest included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the Sheehan Disability Scale (SDS), and the Short Form Health Survey (SF-36). Adjusted odds ratios with 95% confidence intervals were calculated. RESULTS Of 515 participants from China, Korea, Malaysia, Singapore, Taiwan, and Thailand, 347 (67.4%) and 377 (73.2%) had SMD and SCD, respectively. In total, 420 participants (81.6%) had SMD alone, SCD alone, and both deficits. Severe depression and poor mental health were significant correlates of SMD. Severe depression, clinically significant disability, poor physical health, and poor mental health were significantly independent correlates of SCD. Compared with young adults (18-34 years), older adults aged 50-65 years had a significantly lower risk of SCD (OR=.33, 95% CI: .19-.57). LIMITATIONS Only two SCL-90-R items were used to assess the SMD and SCD. The exclusion of MDD patients treated with psychotropic medications eliminated many patients commonly seen in typical clinic settings. CONCLUSION SMD and SCD are prevalent in medication-free, non-elderly Asians with MDD. Both deficits are correlated with depression and mental health status. The independent correlation between SCD and disability underscores the crucial role of SCI in MDD.
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Affiliation(s)
- Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intavarorod Road, Si Poom, Muang, Chiang Mai 50200, Thailand.
| | - Dianne Bautista
- Duke-NUS Graduate Medical School, Singapore; Singapore Clinical Research Institute, Singapore
| | - Chia-Hui Chen
- National Health Research Institute, Department of Psychiatry, Taipei Medical University Shuang-Ho Hospital, Taiwan
| | - Gang Wang
- Depression Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kanokkwan Eurviriyanukul
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intavarorod Road, Si Poom, Muang, Chiang Mai 50200, Thailand
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Abstract
Filipino Americans have lower suicide rates than other Asian ethnic groups. The present study examined risk factors for suicide ideation and attempt among Filipino Americans with random forest. The data were from the Filipino American Community Epidemiological Study (Takeuchi, 2011). The results showed that the important predictors for suicide ideation were depressive disorder, substance use disorder, and years in the United States. The important predictors for suicide attempt were the number of family relatives and family conflict. Clinicians are advised to investigate familial and cultural factors among Filipino Americans. How family and cultural factors may affect suicidal behaviors were further discussed.
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Ward EC, Brown RL. A culturally adapted depression intervention for African American adults experiencing depression: Oh Happy Day. Am J Orthopsychiatry 2015; 85:11-22. [PMID: 25420141 DOI: 10.1037/ort0000027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The purpose of this article is to describe development of a culturally adapted depression intervention (Oh Happy Day Class, OHDC) designed for African American adults experiencing major depressive disorder (MDD). This project included 2 pilot studies testing the feasibility and acceptability of the OHDC and examining short-term effects of the OHDC in reducing symptoms of MDD. The OHDC is a 2.5-hr weekly, culturally specific, cognitive behavioral, group counseling intervention for 12 weeks. Cultural adaptations of the OHDC are based on the ecological validity and culturally sensitive framework, along with an Afrocentric paradigm. Fifty African American participants with MDD were enrolled (15 in Pilot I and 35 in Pilot II). All participants in Pilots I and II received the 12-week intervention and completed assessments at baseline, mid-intervention, end-intervention, and 3 months postintervention. General linear mixed modeling for assessment of pre-post longitudinal data analysis was conducted. Results for Pilot I showed 73% of participants completed the full OHDC, a statistically significant decline in depression symptoms from pre- to postintervention, and a 0.38 effect size. Participants were very satisfied with the OHDC. In Pilot II, 66% of participants completed the full OHDC, and there was a significant pre-post intervention decrease in depression symptoms. For men, the OHDC showed a 1.01 effect size and for women, a 0.41 effect size. Both men and women were very satisfied with the OHDC based on the satisfaction measure. These promising findings are discussed with a focus on future plans for examining efficacy of the OHDC in a large-scale, randomized, control trial.
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Affiliation(s)
| | - Roger L Brown
- School of Nursing, Medicine and Public Health, University of Wisconsin
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Virtue SM, Manne SL, Mee L, Bartell A, Sands S, Gajda TM, Darabos K. Psychological distress and psychiatric diagnoses among primary caregivers of children undergoing hematopoietic stem cell transplant: an examination of prevalence, correlates, and racial/ethnic differences. Gen Hosp Psychiatry 2014; 36:620-6. [PMID: 25246347 PMCID: PMC4329245 DOI: 10.1016/j.genhosppsych.2014.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/08/2014] [Accepted: 08/27/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aims of the study were to examine the prevalence of self-reported psychological distress, examine the prevalence of interview-rated psychiatric diagnoses, identify correlates of psychological distress and psychiatric diagnosis and examine racial/ethnic group differences on measures of psychological distress among primary caregivers of children preparing to undergo hematopoietic stem cell transplant (HSCT). METHODS Caregivers (N = 215) completed the Beck Anxiety Inventory, Beck Depression Inventory (BDI), Impact of Events Scale, and a psychiatric interview assessing major depressive disorder, generalized anxiety disorder and panic disorder. Regression analyses examined correlates of distress and psychiatric diagnosis. Comparisons were made between racial/ethnic groups. RESULTS Posttraumatic stress symptoms were reported by 54% of caregivers during the time preparing for the child's HSCT. Twenty-seven percent of caregivers met diagnostic criteria for at least one of the psychiatric diagnoses during this time. Few factors were associated with distress or psychiatric diagnosis, except the child scheduled for allogeneic transplant, being married and prior psychological/psychiatric care. Sociodemographic factors accounted for racial/ethnic group differences, except that Hispanic/Latino caregivers reported higher BDI scores than non-Hispanic white caregivers. CONCLUSION Caregivers may be at greater risk of posttraumatic stress symptoms than anxiety or depression. Prior psychological/psychiatric treatment is a risk factor for greater psychological distress and psychiatric diagnosis during this time. Racial differences are mostly due to sociodemographic factors.
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MESH Headings
- Adolescent
- Adult
- Black or African American/psychology
- Black or African American/statistics & numerical data
- Anxiety Disorders/epidemiology
- Anxiety Disorders/ethnology
- Anxiety Disorders/psychology
- Caregivers/psychology
- Caregivers/statistics & numerical data
- Child
- Child, Preschool
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/ethnology
- Depressive Disorder, Major/psychology
- Female
- Hematopoietic Stem Cell Transplantation
- Hispanic or Latino/psychology
- Hispanic or Latino/statistics & numerical data
- Humans
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Panic Disorder/epidemiology
- Panic Disorder/ethnology
- Panic Disorder/psychology
- Parents/psychology
- Prevalence
- Stress Disorders, Post-Traumatic/epidemiology
- Stress Disorders, Post-Traumatic/ethnology
- Stress Disorders, Post-Traumatic/psychology
- Stress, Psychological/epidemiology
- Stress, Psychological/ethnology
- Stress, Psychological/psychology
- White People/psychology
- White People/statistics & numerical data
- Young Adult
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Affiliation(s)
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Laura Mee
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Stephen Sands
- Columbia University Medical Center, New York, NY, USA
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Abstract
BACKGROUND Pregnant women with depression face complicated treatment decisions, either because of the risk associated with not treating depression or because of the risks associated with antidepressant use. Approximately 1 in 5 women experience depressive symptoms during pregnancy. This information suggests that many women may take an antidepressant at some time during pregnancy. Once pregnant women initiate antidepressant prescription pharmacotherapy, medication treatment persistence plays an important role in managing depression, yet little is known regarding antidepressant use behavior in pregnant women. OBJECTIVE To determine antenatal antidepressant treatment nonpersistence and associated factors in low-income, insured pregnant women. METHODS We identified eligible pregnant women (≥ 18 years) diagnosed with major depression who initiated antidepressant medications during pregnancy from South Carolina Medicaid claims data (2004-2009). Our main outcome measure was treatment nonpersistence to antidepressant therapy during pregnancy. We defined treatment nonpersistence to antidepressant pharmacotherapy as having a gap between 2 consecutive prescriptions lasting at least 15 days during pregnancy. We applied a proportional hazards model to identify predictors associated with the risk for antidepressant nonpersistence during pregnancy. RESULTS Of 804 pregnant women meeting study criteria, nearly 45% of this cohort did not continue to use antidepressant pharmacotherapy, showing a gap ≥ 15 days between 2 prescriptions, after initiating antidepressant therapy during pregnancy. Women reporting nonwhite race were 36% more likely to show a gap in antidepressant medication use during pregnancy than white women. Women with a history of antidepressant use before pregnancy were 44% more likely to discontinue the antidepressant therapy during pregnancy. CONCLUSIONS Treatment persistence to antidepressant medications was poor during pregnancy in low-income, insured pregnant women. Individualized treatment might be considered to reduce the risks of untreated depression and antenatal antidepressant use in vulnerable women.
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Affiliation(s)
- Jun Wu
- University of South Carolina, 701 Grove Rd., Health Sciences Administration Bldg. (MIPH), Greenville, SC 29605.
| | - Mary Lynn Davis-Ajami
- University of South Carolina, 701 Grove Rd., Health Sciences Administration Bldg. (MIPH), Greenville, SC 29605.
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Horn AB, Cañizares C, Gómez Y. Prevention of adolescent depression in the Spanish-speaking world. Int J Environ Res Public Health 2014; 11:5665-83. [PMID: 24871258 PMCID: PMC4078541 DOI: 10.3390/ijerph110605665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 11/26/2022]
Abstract
This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency.
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Affiliation(s)
- Andrea B Horn
- Department of Psychopathology and Clinical Intervention, University of Zürich, Binzmuehlestr. 14/17, 8150 Zürich, Switzerland.
| | - Catalina Cañizares
- Department of Psychology, University of Los Andes, Carrera 1 Este Nr. 18 A-12, Bogotá, 11001, Colombia.
| | - Yvonne Gómez
- Department of Psychology, University of Los Andes, Carrera 1 Este Nr. 18 A-12, Bogotá, 11001, Colombia.
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Li Y, Aggen S, Shi S, Gao J, Li Y, Tao M, Zhang K, Wang X, Gao C, Yang L, Liu Y, Li K, Shi J, Wang G, Liu L, Zhang J, Du B, Jiang G, Shen J, Zhang Z, Liang W, Sun J, Hu J, Liu T, Wang X, Miao G, Meng H, Li Y, Hu C, Li Y, Huang G, Li G, Ha B, Deng H, Mei Q, Zhong H, Gao S, Sang H, Zhang Y, Fang X, Yu F, Yang D, Liu T, Chen Y, Hong X, Wu W, Chen G, Cai M, Song Y, Pan J, Dong J, Pan R, Zhang W, Shen Z, Liu Z, Gu D, Wang X, Liu X, Zhang Q, Flint J, Kendler KS. The structure of the symptoms of major depression: exploratory and confirmatory factor analysis in depressed Han Chinese women. Psychol Med 2014; 44:1391-1401. [PMID: 23920138 PMCID: PMC3967839 DOI: 10.1017/s003329171300192x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 06/20/2013] [Accepted: 07/02/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome? METHOD Symptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples. RESULTS The preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety. CONCLUSIONS MD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.
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Affiliation(s)
- Y. Li
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - S. Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - S. Shi
- Shanghai Mental Health Center, Shanghai, P.R. China (PRC)
- Huashan Hospital of Fudan University, Shanghai, PRC
| | - J. Gao
- Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, PRC
| | - Y. Li
- No. 1 Hospital of Zhengzhou University, Zhengzhou, Henan, PRC
| | - M. Tao
- Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, PRC
| | - K. Zhang
- No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, PRC
| | - X. Wang
- ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, PRC
| | - C. Gao
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, PRC
| | - L. Yang
- Jilin Brain Hospital, Siping, Jilin, PRC
| | - Y. Liu
- The First Hospital of China Medical University, Heping District, Shenyang, Liaoning, PRC
| | - K. Li
- Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, PRC
| | - J. Shi
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, PRC
| | - G. Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Deshengmen wai, Xicheng District, Beijing, PRC
| | - L. Liu
- Shandong Mental Health Center, Jinan, Shandong, PRC
| | - J. Zhang
- No. 3 Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, PRC
| | - B. Du
- Hebei Mental Health Center, Baoding, Hebei, PRC
| | - G. Jiang
- Chongqing Mental Health Center, Jiangbei District, Chongqing, PRC
| | - J. Shen
- Tianjin Anding Hospital, Hexi District, Tianjin, PRC
| | - Z. Zhang
- No. 4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, PRC
| | - W. Liang
- Psychiatric Hospital of Henan Province, Xinxiang, Henan, PRC
| | - J. Sun
- Nanjing Brain Hospital, Nanjing, Jiangsu, PRC
| | - J. Hu
- Harbin Medical University, Nangang District, Haerbin, Heilongjiang, PRC
| | - T. Liu
- Shenzhen Kang Ning Hospital, Luohu District, Shenzhen, Guangdong, PRC
| | - X. Wang
- First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PRC
| | - G. Miao
- Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Liwan District, Guangzhou, Guangdong, PRC
| | - H. Meng
- No. 1 Hospital of Chongqing Medical University, Yuzhong District, Chongqing, PRC
| | - Y. Li
- Dalian No. 7 Hospital, Ganjingzi District, Dalian, Liaoning, PRC
| | - C. Hu
- No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, PRC
| | - Y. Li
- Wuhan Mental Health Center, Wuhan, Hubei, PRC
| | - G. Huang
- Sichuan Mental Health Center, Mianyang, Sichuan, PRC
| | - G. Li
- Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, PRC
| | - B. Ha
- Liaocheng No. 4 Hospital, Liaocheng, Shandong, PRC
| | - H. Deng
- Mental Health Center of West China Hospital of Sichuan University, Wuhou District, Chengdu, Sichuan, PRC
| | - Q. Mei
- Suzhou Guangji Hospital, Suzhou, Jiangsu, PRC
| | - H. Zhong
- Anhui Mental Health Center, Hefei, Anhui, PRC
| | - S. Gao
- Ningbo Kang Ning Hospital, Zhenhai District, Ningbo, Zhejiang, PRC
| | - H. Sang
- Changchun Mental Hospital, Changchun, Jilin, PRC
| | - Y. Zhang
- No. 2 Hospital of Lanzhou University, Lanzhou, Gansu, PRC
| | - X. Fang
- Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, PRC
| | - F. Yu
- Harbin No. 1 Special Hospital, Haerbin, Heilongjiang, PRC
| | - D. Yang
- Jining Psychiatric Hospital, North Dai Zhuang, Rencheng District, Jining, Shandong, PRC
| | - T. Liu
- No. 2 Xiangya Hospital of Zhongnan University, Furong District, Changsha, Hunan, PRC
| | - Y. Chen
- Xijing Hospital of No. 4 Military Medical University, Xian, Shaanxi, PRC
| | - X. Hong
- Mental Health Center of Shantou University, Shantou, Guangdong, PRC
| | - W. Wu
- Tongji University Hospital, Shanghai, PRC
| | - G. Chen
- Huaian No. 3 Hospital, Huaian, Jiangsu, PRC
| | - M. Cai
- Huzhou No. 3 Hospital, Huzhou, Zhejiang, PRC
| | - Y. Song
- Mudanjiang Psychiatric Hospital of Heilongjiang Province, Xinglong, Mudanjiang, Heilongjiang, PRC
| | - J. Pan
- No. 1 Hospital of Jinan University, Guangzhou, Guangdong, PRC
| | - J. Dong
- Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, PRC
| | - R. Pan
- Guangxi Longquanshan Hospital, Yufeng District, Liuzhou, PRC
| | - W. Zhang
- Daqing No. 3 Hospital of Heilongjiang Province, Ranghulu District, Daqing, Heilongjiang, PRC
| | - Z. Shen
- Tangshan No. 5 Hospital, Lunan District, Tangshan, Hebei, PRC
| | - Z. Liu
- Anshan Psychiatric Rehabilitation Hospital, Lishan District, Anshan, Liaoning, PRC
| | - D. Gu
- Weihai Mental Health Center, ETDZ, Weihai, Shandong, PRC
| | - X. Wang
- Renmin Hospital of Wuhan University, Wuchang District, Wuhan, Hubei, PRC
| | - X. Liu
- Tianjin First Center Hospital, Hedong District, Tianjin, PRC
| | - Q. Zhang
- Hainan Anning Hospital, Haikou, Hainan, PRC
| | - J. Flint
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - K. S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
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40
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Shi J, Zhang Y, Liu F, Li Y, Wang J, Flint J, Gao J, Li Y, Tao M, Zhang K, Wang X, Gao C, Yang L, Li K, Shi S, Wang G, Liu L, Zhang J, Du B, Jiang G, Shen J, Zhang Z, Liang W, Sun J, Hu J, Liu T, Wang X, Miao G, Meng H, Li Y, Hu C, Li Y, Huang G, Li G, Ha B, Deng H, Mei Q, Zhong H, Gao S, Sang H, Zhang Y, Fang X, Yu F, Yang D, Liu T, Chen Y, Hong X, Wu W, Chen G, Cai M, Song Y, Pan J, Dong J, Pan R, Zhang W, Shen Z, Liu Z, Gu D, Wang X, Liu X, Zhang Q, Li Y, Chen Y, Kendler KS. Associations of educational attainment, occupation, social class and major depressive disorder among Han Chinese women. PLoS One 2014; 9:e86674. [PMID: 24497966 PMCID: PMC3909008 DOI: 10.1371/journal.pone.0086674] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 12/11/2013] [Indexed: 02/05/2023] Open
Abstract
Background The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years. Principal findings We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25–0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77–0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86–0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders. Conclusions In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype.
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Affiliation(s)
- Jianguo Shi
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, People’s Republic of China
- The Affiliated Mental Health Institute of Xi’an School of Medicine, Xian, Shaanxi, People’s Republic of China
- * E-mail:
| | - Yan Zhang
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, People’s Republic of China
- The Affiliated Mental Health Institute of Xi’an School of Medicine, Xian, Shaanxi, People’s Republic of China
| | - Feihu Liu
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, People’s Republic of China
- The Affiliated Mental Health Institute of Xi’an School of Medicine, Xian, Shaanxi, People’s Republic of China
| | - Yajuan Li
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, People’s Republic of China
- The Affiliated Mental Health Institute of Xi’an School of Medicine, Xian, Shaanxi, People’s Republic of China
| | - Junhui Wang
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, People’s Republic of China
- The Affiliated Mental Health Institute of Xi’an School of Medicine, Xian, Shaanxi, People’s Republic of China
| | - Jonathan Flint
- Wellcome Trust Centre for Human Genetics, Oxford, United Kindgom
| | - Jingfang Gao
- Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, People’s Republic of China
| | - Youhui Li
- No.1 Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Ming Tao
- Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, People’s Republic of China
| | - Kerang Zhang
- No.1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Xumei Wang
- ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Chengge Gao
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, People’s Republic of China
| | - Lijun Yang
- Jilin Brain Hospital, Siping, Jilin, People’s Republic of China
| | - Kan Li
- Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, People’s Republic of China
| | - Shenxun Shi
- Shanghai Mental Health Center, Shanghai, People’s Republic of China
| | - Gang Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Deshengmen wai, Xicheng District, Beijing, People’s Republic of China
| | - Lanfen Liu
- Shandong Mental Health Center, Jinan, Shandong, People’s Republic of China
| | - Jinbei Zhang
- No. 3 Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, People’s Republic of China
| | - Bo Du
- Hebei Mental Health Center, Baoding, Hebei, People’s Republic of China
| | - Guoqing Jiang
- Chongqing Mental Health Center, Jiangbei District, Chongqing, People’s Republic of China
| | - Jianhua Shen
- Tianjin Anding Hospital, Hexi District, Tianjin, People’s Republic of China
| | - Zhen Zhang
- No.4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, People’s Republic of China
| | - Wei Liang
- Psychiatric Hospital of Henan Province, Xinxiang, Henan, People’s Republic of China
| | - Jing Sun
- Nanjing Brain Hospital, Nanjing, Jiangsu, People’s Republic of China
| | - Jian Hu
- Harbin Medical University, Nangang District, Haerbin, Heilongjiang, People’s Republic of China
| | - Tiebang Liu
- Shenzhen Kang Ning Hospital, Luohu District, Shenzhen, Guangdong, People’s Republic of China
| | - Xueyi Wang
- First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Guodong Miao
- Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Liwan District, Guangzhou, Guangdong, People’s Republic of China
| | - Huaqing Meng
- No.1 Hospital of Chongqing Medical University, Yuzhong District, Chongqing, People’s Republic of China
| | - Yi Li
- Dalian No.7 Hospital, Ganjingzi District, Dalian, Liaoning, People’s Republic of China
| | - Chunmei Hu
- No.3 Hospital of Heilongjiang Province, Beian, Heilongjiang, People’s Republic of China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan, Hubei, People’s Republic of China
| | - Guoping Huang
- Sichuan Mental Health Center, Mianyang, Sichuan, People’s Republic of China
| | - Gongying Li
- Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, People’s Republic of China
| | - Baowei Ha
- Liaocheng No.4 Hospital, Liaocheng, Shandong, People’s Republic of China
| | - Hong Deng
- Mental Health Center of West China Hospital of Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China
| | - Qiyi Mei
- Suzhou Guangji Hospital, Suzhou, Jiangsu, People’s Republic of China
| | - Hui Zhong
- Anhui Mental Health Center, Hefei, Anhui, People’s Republic of China
| | - Shugui Gao
- Ningbo Kang Ning Hospital, Zhenhai District, Ningbo, Zhejiang, People’s Republic of China
| | - Hong Sang
- Changchun Mental Hospital, Changchun, Jilin, People’s Republic of China
| | - Yutang Zhang
- No.2 Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Xiang Fang
- Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, People’s Republic of China
| | - Fengyu Yu
- Harbin No.1 Special Hospital, Haerbin, Heilongjiang, People’s Republic of China
| | - Donglin Yang
- Jining Psychiatric Hospital, North Dai Zhuang,Rencheng District, Jining, Shandong, People’s Republic of China
| | - Tieqiao Liu
- No.2 Xiangya Hospital of Zhongnan University, Furong District, Changsha, Hunan, People’s Republic of China
| | - Yunchun Chen
- Xijing Hospital of No.4 Military Medical University, Xian, Shaanxi, People’s Republic of China
| | - Xiaohong Hong
- Mental Health Center of Shantou University, Shantou, Guangdong, People’s Republic of China
| | - Wenyuan Wu
- Tongji University Hospital, Shanghai, People’s Republic of China
| | - Guibing Chen
- Huaian No.3 Hospital, Huaian, Jiangsu, People’s Republic of China
| | - Min Cai
- Huzhou No.3 Hospital, Huzhou, Zhejiang, People’s Republic of China
| | - Yan Song
- Mudanjiang Psychiatric Hospital of Heilongjiang Province, Xinglong, Mudanjiang, Heilongjiang, People’s Republic of China
| | - Jiyang Pan
- No.1 Hospital of Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Jicheng Dong
- Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, People’s Republic of China
| | - Runde Pan
- Guangxi Longquanshan Hospital, Yufeng District, Liuzhou, People’s Republic of China
| | - Wei Zhang
- Daqing No.3 Hospital of Heilongjiang Province, Ranghulu district, Daqing, Heilongjiang, People’s Republic of China
| | - Zhenming Shen
- Tangshan No.5 Hospital, Lunan District, Tangshan, Hebei, People’s Republic of China
| | - Zhengrong Liu
- Anshan Psychiatric Rehabilitation Hospital, Lishan District, Anshan, Liaoning, People’s Republic of China
| | - Danhua Gu
- Weihai Mental Health Center, ETDZ, Weihai, Shandong, People’s Republic of China
| | - Xiaoping Wang
- Renmin Hospital of Wuhan University, Wuchang District, Wuhan, Hubei, People’s Republic of China
| | - Xiaojuan Liu
- Tianjin First Center Hospital, Hedong District, Tianjin, People’s Republic of China
| | - Qiwen Zhang
- Hainan Anning Hospital, Haikou, Hainan, People’s Republic of China
| | - Yihan Li
- Wellcome Trust Centre for Human Genetics, Oxford, United Kindgom
| | - Yiping Chen
- Clinical Trial Service Unit, Richard Doll Building, Oxford, United Kingdom
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
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Williams L, Gorman R, Hankerson S. Implementing a mental health ministry committee in faith-based organizations: the promoting emotional wellness and spirituality program. Soc Work Health Care 2014; 53:414-34. [PMID: 24717187 PMCID: PMC4000587 DOI: 10.1080/00981389.2014.880391] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Social workers have successfully collaborated with African-American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African-American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a preexisting relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation.
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Affiliation(s)
- Laverne Williams
- a Mental Health Association in New Jersey , Verona , New Jersey , USA
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42
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Alcántara C, Chen CN, Alegría M. Do post-migration perceptions of social mobility matter for Latino immigrant health? Soc Sci Med 2014; 101:94-106. [PMID: 24560229 PMCID: PMC4041158 DOI: 10.1016/j.socscimed.2013.11.024] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 09/06/2013] [Accepted: 11/12/2013] [Indexed: 11/27/2022]
Abstract
Latino immigrants exhibit health declines with increasing duration in the United States, which some attribute to a loss in social status after migration or downward social mobility. Yet, research into the distribution of perceived social mobility and patterned associations to Latino health is sparse, despite extensive research to show that economic and social advancement is a key driver of voluntary migration. We investigated Latino immigrant sub-ethnic group variation in the distribution of perceived social mobility, defined as the difference between respondents' perceived social status of origin had they remained in their country of origin and their current social status in the U.S. We also examined the association between perceived social mobility and past-year major depressive episode (MDE) and self-rated fair/poor physical health, and whether Latino sub-ethnicity moderated these associations. We computed weighted logistic regression analyses using the Latino immigrant subsample (N=1561) of the National Latino and Asian American Study. Puerto Rican migrants were more likely to perceive downward social mobility relative to Mexican and Cuban immigrants who were more likely to perceive upward social mobility. Perceived downward social mobility was associated with increased odds of fair/poor physical health and MDE. Latino sub-ethnicity was a statistically significant moderator, such that perceived downward social mobility was associated with higher odds of MDE only among Puerto Rican and Other Latino immigrants. In contrast, perceived upward social mobility was not associated with self-rated fair/poor physical health. Our findings suggest that perceived downward social mobility might be an independent correlate of health among Latino immigrants, and might help explain Latino sub-ethnic group differences in mental health status. Future studies on Latino immigrant health should use prospective designs to examine the physiological and psychological costs associated with perceived changes in social status with integration into the U.S. mainland.
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43
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Barnes DM, Keyes KM, Bates LM. Racial differences in depression in the United States: how do subgroup analyses inform a paradox? Soc Psychiatry Psychiatr Epidemiol 2013; 48:1941-9. [PMID: 23732705 PMCID: PMC3834079 DOI: 10.1007/s00127-013-0718-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 05/20/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE Non-Hispanic Blacks in the US have lower rates of major depression than non-Hispanic Whites, in national household samples. This has been termed a "paradox," as Blacks suffer greater exposure to social stressors, a risk factor for depression. Subgroup analyses can inform hypotheses to explain this paradox. For example, it has been suggested that selection bias in household samples undercounts depression in Blacks; if selection is driving the paradox, Black-White differences should be most pronounced among young men with low education. METHODS We examined Black-White differences in lifetime major depression in subgroups defined simultaneously by sex, age, and education using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the Collaborative Psychiatric Epidemiology Surveys (CPES). RESULTS In NESARC and CPES, Blacks had lower odds than Whites of lifetime major depression in 21 and 23 subgroups, respectively, of 24. All statistically significant differences were in subgroups favoring Blacks, and lower odds in Blacks were more pronounced among those with more education. CONCLUSIONS These results suggest that hypotheses to explain the paradox must posit global mechanisms that pertain to all subgroups defined by sex, age, and education. Results do not lend support for the selection bias hypothesis.
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Affiliation(s)
- David M Barnes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 720D, New York, NY, 10032, USA,
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Abstract
OBJECTIVE Depression is a major debilitating disease. For American Indians living in tribal reservations, who endure disproportionately high levels of stress and poverty often associated with depression, determining the patterns and correlates is key to appropriate clinical assessment and intervention development. Yet little attention has been given to the cultural context of correlates for depression, including the influence of family, cultural traditions or practices, or community conditions. METHOD We used data from a large representative psychiatric epidemiological study among American Indians in 2 reservation communities to estimate nested individual and multilevel models of past-year major depressive episode (MDE) accounting for family, cultural, and community conditions. RESULTS We found that models including culturally informed individual-level measures significantly improved the model fit over demographics alone. We found significant community-level variation in the probability of past-year MDE diagnosis in 1 tribe even after accounting for individual-level characteristics. CONCLUSIONS Accounting for culture, family, and community context will facilitate research, clinician assessment, and treatment of depression in diverse settings.
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45
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Leurent B, Nazareth I, Bellón-Saameño J, Geerlings MI, Maaroos H, Saldivia S, Svab I, Torres-González F, Xavier M, King M. Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study. Psychol Med 2013; 43:2109-2120. [PMID: 23360581 DOI: 10.1017/s0033291712003066] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the U.S.A., limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further. METHOD Data were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data. RESULTS The analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p<0.001). However, the findings varied significantly across countries, with the difference being significant only in the U.K., where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59–4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event. CONCLUSIONS These results do not support the notion that religious and spiritual life views enhance psychological well-being.
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Affiliation(s)
- B Leurent
- Mental Health Sciences Unit, Faculty of Brain Sciences, University College London Medical School, UK
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46
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Himelhoch S, Medoff D, Maxfield J, Dihmes S, Dixon L, Robinson C, Potts W, Mohr DC. Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS: results of a randomized controlled trial. AIDS Behav 2013; 17:2756-64. [PMID: 23644816 PMCID: PMC10839944 DOI: 10.1007/s10461-013-0465-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED This pilot randomized controlled trial evaluated a previously developed manualized telephone based cognitive behavioral therapy (T-CBT) intervention compared to face-to-face (f2f) therapy among low-income, urban dwelling HIV infected depressed individuals. The primary outcome was the reduction of depressive symptoms as measured by the Hamliton rating scale for depression scale. The secondary outcome was adherence to HAART as measured by random telephone based pill counts. Outcome measures were collected by trained research assistants masked to treatment allocation. Analysis was based on intention-to-treat. Thirty-four participants met eligibility criteria and were randomly assigned to receive T-CBT (n = 16) or f2f (n = 18). There was no statistically significant difference in depression treatment outcomes comparing f2f to T-CBT. Within group evaluation demonstrated that both the T-CBT and the f2f psychotherapy groups resulted in significant reductions in depressive symptoms. Those who received the T-CBT were significantly more likely to maintain their adherence to antiretroviral medication compared to the f2f treatment. None of the participants discontinued treatment due to adverse events. T-CBT can be delivered to low-income, urban dwelling HIV infected depressed individuals resulting in significant reductions in depression symptoms and improved adherence to antiretroviral medication. TRIAL REGISTRY Clinical Trial.gov identifier: NCT01055158.
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Affiliation(s)
- Seth Himelhoch
- Department of Psychiatry, Division of Services Research, University of Maryland School of Medicine, 737 West Lombard St., Room 516, Baltimore, MD, 21212, USA,
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47
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Cassano P, Chang T, Trinh NH, Baer L, Fava M, Mischoulon D. Differential impact of isolated psychotic symptoms on treatment outcome of major depressive disorder in the STAR*D cohort of Whites, Blacks and Latinos. J Affect Disord 2013; 150:578-84. [PMID: 23489398 PMCID: PMC3749257 DOI: 10.1016/j.jad.2013.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 02/01/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether isolated psychotic symptoms are more likely to be endorsed by depressed Latinos as opposed to other ethnic-racial groups; whether these symptoms affect Latinos similarly to other ethnic-racial groups in terms of treatment response; and whether they are more likely to be associated with anxiety disorders in depressed Latinos. METHODS We analyzed data from STAR*D subjects who self identified as White, Black, or Latino. Rates of isolated psychotic symptoms were assessed by the self-rated Psychiatric Diagnostic Screening Questionnaire (PDSQ) and compared between ethnic-racial groups. Depressive remission outcomes were compared within each ethnic-racial group between subjects who endorsed psychotic symptoms versus no psychotic symptoms. Associations between isolated psychotic symptoms and anxiety disorders were also examined. RESULTS Among 2597 eligible subjects with at least one post-baseline assessment and available PDSQ data excluding first-rank symptoms, the prevalence of auditory-visual hallucination was 2.5% in Whites (n=49/1928), 11.3% in Blacks (n=45/398) 6.3% in Latinos (n=17/270) (χ(2)=64.9; df=2; p<0.001). Prevalence of paranoid ideation was 15.5% in Whites (n=299/1927), 31.5% in Blacks (n=126/400), and 21.1% in Latinos (n=57/270) (χ(2)=57.3; df=2; p<0.001). Among Whites and Blacks but not Latinos, depressive remission rates were worse in subjects with auditory-visual hallucinations compared to those without them. Paranoid ideation had a significant negative impact on remission in Whites only. In all ethnic-racial groups, a significant association was found between auditory-visual hallucinations and PTSD and panic disorder. LIMITATIONS The STAR*D study did not include any structured clinician-based assessment of psychotic symptoms. CONCLUSION Latinos do not appear to have worse outcomes when treated for MDD with auditory-visual hallucinations, differently from Whites and Blacks.
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Affiliation(s)
- Paolo Cassano
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, United States.
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48
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Lorenzo-Blanco EI, Cortina LM. Latino/a depression and smoking: an analysis through the lenses of culture, gender, and ethnicity. Am J Community Psychol 2013; 51:332-46. [PMID: 22956250 DOI: 10.1007/s10464-012-9553-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Rates of major depressive disorder (MDD) and cigarette smoking increase with Latino/a acculturation, but this varies by gender and ethnic subgroup. We investigated how lived experiences (i.e., discrimination, family conflict, family cohesion, familismo) clustered together in the everyday lives of Latina/os. We further examined associations of cluster profile and Latino/a subgroup with MDD and smoking, and tested whether gender moderated these associations. Data came from the National Latino Asian American Study, which included 2,554 Latino/as (48 % female; mean age = 38.02 years). K-means cluster analysis revealed six profiles of experience, which varied by gender and socio-cultural characteristics. Proportionately more women than men were in groups with problematic family lives. Acculturated Latino/as were disproportionately represented in profiles reporting frequent discrimination, family conflict, and a lack of shared family values and cohesion. Profiles characterized by high discrimination and family problems also predicted elevated risk for MDD and smoking. Findings suggest that Latino/a acculturation comes jointly with increased discrimination, increased family conflict, and reduced family cohesion and shared family values, exacerbating risk for MDD and smoking. This research on pathways to depression and smoking can inform the development of targeted assessment, prevention, and intervention strategies, tailored to the needs of Latino/as.
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49
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Abstract
The authors used a population-based database to investigate antidepressant use among children and adolescents in Taiwan. The National Health Research Institutes provided a database of 1 000 000 random subjects for study. The authors adopted this sample of subjects who were younger than 18 years during 1997 to 2005. Subjects with at least 1 antidepressant prescription were identified. Trends, prevalence, associated factors, and disease patterns of antidepressant use were detected. The 1-year prevalence of pediatric antidepressant use increased from 0.27% in 1997 to 0.47% in 2005. The 1-year prevalence of tricyclic antidepressant, selective serotonin reuptake inhibitor, and other antidepressant use among pediatric population was 0.23%, 0.20%, and 0.08%, respectively, in 2005. The prevalence of pediatric antidepressant use increased from 1997 to 2005. Among pediatric subjects with antidepressant use, selective serotonin reuptake inhibitors, and other antidepressants were used the most for psychiatric disorders, whereas tricyclic antidepressant was used the most for nonpsychiatric disorders.
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Affiliation(s)
- I-Chia Chien
- Department of Health, Taoyuan Mental Hospital, 71 Longshow Street, Taoyuan, Taiwan.
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50
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He M, Yan H, Duan ZX, Qu W, Gong HY, Fan ZL, Kang JY, Li BC, Wang JM. Genetic distribution and association analysis of DRD2 gene polymorphisms with major depressive disorder in the Chinese Han population. Int J Clin Exp Pathol 2013; 6:1142-1149. [PMID: 23696934 PMCID: PMC3657369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 04/11/2013] [Indexed: 06/02/2023]
Abstract
Dopamine D2 receptor is involved in reward-mediating mesocorticolimbic pathways. It plays an important role in major depressive disorder (MDD). Three gene polymorphisms Taq1A, C957T and -141C ins/del, were identified in the DRD2 gene among the Western population. These variants in the DRD2 gene might be associated with the susceptibility of MDD patients through affecting the bioeffects of endogenous dopamine neurotransmission. However, little is known about their occurrence in Chinese population and their association with the susceptibility of patients with major depressive disorder. In this study, a total of 338 unrelated adult Chinese Han population, including 224 healthy volunteers and 114 patients with major depressive disorder, were recruited. DRD2 polymorphisms (Taq1A and -141C ins/del) were detected using restriction fragment length polymorphism (RFLP) analysis and the C957T were detected by sequencing directly. As a result, three polymorphisms were identified in Chinese Han population and all were common SNP. However, we could detect no evidence of genetic association between 3 markers in DRD2 and major depressive disorder in the Chinese Han population. To conclude, this result suggests that Taq1A, C957T and -141C ins/del of DRD2 gene may not be associated with major depressive disorder, also may be the sample sizes too small to allow a meaningful test.
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Affiliation(s)
- Mei He
- Clinical Psychology Department of Southwest Hospital, Third Military Medical UniversityChongqing 400038, China
| | - Hong Yan
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Third Military Medical UniversityChongqing 400038, China
| | - Zhao-Xia Duan
- Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, State Key Laboratory of Trauma, Burns and Combined InjuryChongqing 400042, China
| | - Wei Qu
- Clinical Psychology Department of Southwest Hospital, Third Military Medical UniversityChongqing 400038, China
| | - Hai-Yan Gong
- Prevention and Health Maintenance Department of Southwest Hospital, Third Military Medical UniversityChongqing 400038, China
| | - Zheng-Li Fan
- Mental Health Center of ChongqingChongqing 400036, China
| | - Jian-Yi Kang
- Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, State Key Laboratory of Trauma, Burns and Combined InjuryChongqing 400042, China
| | - Bing-Cang Li
- Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, State Key Laboratory of Trauma, Burns and Combined InjuryChongqing 400042, China
| | - Jian-Min Wang
- Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, State Key Laboratory of Trauma, Burns and Combined InjuryChongqing 400042, China
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