ResearchPad - depression https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Exploring burnout and depression of Thai medical students: the psychometric properties of the Maslach Burnout Inventory]]> https://www.researchpad.co/article/elastic_article_13138 To examine the psychometric properties of the Maslach Burnout Inventory-Student Survey (MBI-SS) Thai version and to determine the frequency of burnout and correlation between burnout and associated factors.MethodsA cross-sectional study was conducted among undergraduate medical students using convenience sampling (n=545, 76.1% response rate, female 52.1%). Data were collected by a self-report survey. The MBI-SS was translated in Thai and tested for internal consistency using Cronbach’s coefficient alpha. A confirmatory factor analysis was performed using as fit indices of the chi-square and degree of freedom ratio (χ2/df), Comparative Fit Index (CFI), the Goodness of Fit Index (GFI), the Non-normed Fit Index (NNFI), Akaike information criterion (AIC) and the Root Mean Square Error of Approximation (RMSEA). Spearman and Kendall’s tau-b were used to identify correlations between burnout, depression and other factors.ResultsInterrater reliability was acceptable with Kappa of 0.83. Confirmatory factor analysis demonstrated good fit indices (χ2/df=197.62/83, CFI=0.97, GFI=0.95, NNFI=0.96, AIC=271.62 and RMSEA=0.06). Burnout had a weak, positive association with the PHQ-9 (r=0.294, df=2, p< 0.001). The screening depression score had a significant, modest positive association with emotional exhaustion (r=0.469, df=4, p<0.001) and cynicism (r=0.411, df=4, p< 0.001), and a weak inverse association with professional efficacy (r=−0.273, df=4, p< 0.001). ConclusionsThe Thai version of the MBI-SS had adequate psychometric properties among Thai medical students and can be used to assess burnout among undergraduate medical students in Thailand. Burnout was associated with risk for depression. Further studies on other associated factors contributing to depression are suggested. ]]> <![CDATA[Pooling individual participant data from randomized controlled trials: Exploring potential loss of information]]> https://www.researchpad.co/article/elastic_article_7838 Pooling individual participant data to enable pooled analyses is often complicated by diversity in variables across available datasets. Therefore, recoding original variables is often necessary to build a pooled dataset. We aimed to quantify how much information is lost in this process and to what extent this jeopardizes validity of analyses results.MethodsData were derived from a platform that was developed to pool data from three randomized controlled trials on the effect of treatment of cardiovascular risk factors on cognitive decline or dementia. We quantified loss of information using the R-squared of linear regression models with pooled variables as a function of their original variable(s). In case the R-squared was below 0.8, we additionally explored the potential impact of loss of information for future analyses. We did this second step by comparing whether the Beta coefficient of the predictor differed more than 10% when adding original or recoded variables as a confounder in a linear regression model. In a simulation we randomly sampled numbers, recoded those < = 1000 to 0 and those >1000 to 1 and varied the range of the continuous variable, the ratio of recoded zeroes to recoded ones, or both, and again extracted the R-squared from linear models to quantify information loss.ResultsThe R-squared was below 0.8 for 8 out of 91 recoded variables. In 4 cases this had a substantial impact on the regression models, particularly when a continuous variable was recoded into a discrete variable. Our simulation showed that the least information is lost when the ratio of recoded zeroes to ones is 1:1.ConclusionsLarge, pooled datasets provide great opportunities, justifying the efforts for data harmonization. Still, caution is warranted when using recoded variables which variance is explained limitedly by their original variables as this may jeopardize the validity of study results. ]]> <![CDATA[Life within a limited radius: Investigating activity space in women with a history of child abuse using global positioning system tracking]]> https://www.researchpad.co/article/elastic_article_7709 Early experiences of childhood sexual or physical abuse are often associated with functional impairments, reduced well-being and interpersonal problems in adulthood. Prior studies have addressed whether the traumatic experience itself or adult psychopathology is linked to these limitations. To approach this question, individuals with posttraumatic stress disorder (PTSD) and healthy individuals with and without a history of child abuse were investigated. We used global positioning system (GPS) tracking to study temporal and spatial limitations in the participants’ real-life activity space over the course of one week. The sample consisted of 228 female participants: 150 women with PTSD and emotional instability with a history of child abuse, 35 mentally healthy women with a history of child abuse (healthy trauma controls, HTC) and 43 mentally healthy women without any traumatic experiences in their past (healthy controls, HC). Both traumatized groups—i.e. the PTSD and the HTC group—had smaller movement radii than the HC group on the weekends, but neither spent significantly less time away from home than HC. Some differences between PTSD and HC in movement radius seem to be related to correlates of PTSD psychopathology, like depression and physical health. Yet group differences between HTC and HC in movement radius remained even when contextual and individual health variables were included in the model, indicating specific effects of traumatic experiences on activity space. Experiences of child abuse could limit activity space later in life, regardless of whether PTSD develops.

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<![CDATA[Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis]]> https://www.researchpad.co/article/Nc2795b82-f9e4-46cc-9fc3-23c3f213e7d4

Introduction

Post-stroke fatigue (PSF) is a common symptom affecting 23–75% of stroke survivors. It is associated with increased risk of institutionalization and death, and it is of many patients considered among the worst symptoms to cope with after stroke. Longitudinal studies focusing on trajectories of fatigue may contribute to understanding patients’ experience of fatigue over time and its associated factors, yet only a few have been conducted to date.

Objectives

To explore whether subgroups of stroke survivors with distinct trajectories of fatigue in the first 18 months post stroke could be identified and whether these subgroups differ regarding sociodemographic, medical and/or symptom-related characteristics.

Materials and methods

115 patients with first-ever stroke admitted to Oslo University Hospital or Buskerud Hospital were recruited and data was collected prospectively during the acute phase and at 6, 12 and 18 months post stroke. Data on fatigue (both pre- and post-stroke), sociodemographic, medical and symptom-related characteristics were collected through structured interviews, standardized questionnaires and from the patients’ medical records.

Growth mixture modeling (GMM) was used to identify latent classes, i.e., subgroups of patients, based on their Fatigue Severity Scales (FSS) scores at the four time points. Differences in sociodemographic, medical, and symptom-related characteristics between the latent classes were evaluated using univariate and multivariable ordinal regression analyses.

Results and their significance

Using GMM, three latent classes of fatigue trajectories over 18 months were identified, characterized by differing levels of fatigue: low, moderate and high. The mean FSS score for each class remained relatively stable across all four time points. In the univariate analyses, age <75, pre-stroke fatigue, multiple comorbidities, current depression, disturbed sleep and some ADL impairment were associated with higher fatigue trajectories. In the multivariable analyses, pre-stroke fatigue (OR 4.92, 95% CI 1.84–13.2), multiple comorbidities (OR 4,52,95% CI 1.85–11.1) and not working (OR 4.61, 95% CI 1.36–15,7) were the strongest predictor of higher fatigue trajectories The findings of this study may be helpful for clinicians in identifying patients at risk of developing chronic fatigue after stroke.

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<![CDATA[Understanding ambivalence in help-seeking for suicidal people with comorbid depression and alcohol misuse]]> https://www.researchpad.co/article/N5bd48253-819c-499c-aeec-83c12fc90159

Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.

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<![CDATA[Clinical impact of melatonin on breast cancer patients undergoing chemotherapy; effects on cognition, sleep and depressive symptoms: A randomized, double-blind, placebo-controlled trial]]> https://www.researchpad.co/article/Nf52b3d22-02a5-4e7e-bb1d-9e73ca6c7e6b

This randomized, double-blinded, placebo-controlled trial tested the hypothesis that 20mg of melatonin before and during the first cycle of adjuvant chemotherapy for breast cancer (ACBC) reduced the side effects associated with cognitive impairment. We evaluated the effects of melatonin on cognition, depressive symptoms and sleep quality, and whether these effects were related to serum levels of Brain Derived Neurotrophic Factor (BDNF) and its receptor, tropomyosin kinase B (TrkB). Thirty-six women were randomly assigned to receive melatonin or placebo for 10 days. To evaluate cognitive performance, we used the Trail-Making-Test Parts A and B (A-B), Rey Auditory-Verbal Learning Test (RAVLT), Controlled Oral Word Association Test (COWAT) and an inhibitory task type Go / No-Go. Our results revealed that melatonin improved executive function on TMT scores, enhanced episodic memory (immediate and delayed) and recognition on RAVLT, and increased verbal fluency in the orthographic COWAT. The TMT-A-B(A-B) were negatively correlated with baseline levels of TrkB and BDNF, respectively. At the end of treatment, changes in TrkB and BDNF were inversely associated with depressive symptoms and sleep quality, but not with the TMT scores. These results suggest a neuroprotective effect of melatonin to counteract the adverse effects of ACBC on cognitive function, sleep quality and depressive symptoms.

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<![CDATA[Prevalence of depressive symptoms among Italian medical students: The multicentre cross-sectional “PRIMES” study]]> https://www.researchpad.co/article/N89095419-220d-4d38-944c-d00bb778cf6f

Background

Four percent of the world’s population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors.

Methods

The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value<0.05 considered significant.

Results

The number of collected questionnaires was 2,513 (117 BDI-II incomplete). Females accounted for 61.3% of the respondents, and the median age was 22 years (IQR = 4). The prevalence of DS was 29.5%. Specifically, 14.0% had mild depression, 11.1% had moderate depression, and 4.5% had severe depression. The main risk factors for DS were age, being female, bisexual/asexual orientation, living with partner/housemates, poor economic status (worsened by living far from home), less than 90 min of weekly exercise, relatives with psychiatric disorders, personal chronic disease, judging medical school choice negatively, unsatisfying friendships with classmates, competitive and hostile climate among classmates, thinking that medical school hinders specific activities and being worried about not measuring up to the profession. Protective factors included family cohesion, hobbies, intellectual curiosity as a career motivation and no worries about the future.

Conclusion

Italian medical students are at high risk of reporting DS, similar to the global population of medical students’. Medical schools must make efforts to implement preventive and treatment interventions by offering counselling and working on modifiable factors, such as lifestyle and learning climate.

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<![CDATA[Mental health problems and social media exposure during COVID-19 outbreak]]> https://www.researchpad.co/article/Nb7fad802-34c4-4007-a6dc-8e780c86cbf8

Huge citizens expose to social media during a novel coronavirus disease (COVID-19) outbroke in Wuhan, China. We assess the prevalence of mental health problems and examine their association with social media exposure. A cross-sectional study among Chinese citizens aged≥18 years old was conducted during Jan 31 to Feb 2, 2020. Online survey was used to do rapid assessment. Total of 4872 participants from 31 provinces and autonomous regions were involved in the current study. Besides demographics and social media exposure (SME), depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5) and anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7). multivariable logistic regressions were used to identify associations between social media exposure with mental health problems after controlling for covariates. The prevalence of depression, anxiety and combination of depression and anxiety (CDA) was 48.3% (95%CI: 46.9%-49.7%), 22.6% (95%CI: 21.4%-23.8%) and 19.4% (95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. More than 80% (95%CI:80.9%-83.1%) of participants reported frequently exposed to social media. After controlling for covariates, frequently SME was positively associated with high odds of anxiety (OR = 1.72, 95%CI: 1.31–2.26) and CDA (OR = 1.91, 95%CI: 1.52–2.41) compared with less SME. Our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health problems, especially depression and anxiety among general population and combating with “infodemic” while combating during public health emergency.

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<![CDATA[HIGH ON SMI: QUALITY CONCERNS ABOUT NURSING HOMES SERVING HIGH PROPORTIONS OF SERIOUSLY MENTALLY ILL RESIDENTS]]> https://www.researchpad.co/article/Nb2caf4c5-d4df-40f7-acf9-2ec721fb6693

Abstract

The proportion of nursing home (NH) residents that have serious mental illness (SMI) has increased over the least two decades. Residents with SMI tend be younger and have different medical needs than traditional residents. To better understand this population, our study examined the facility, staffing, and resident characteristics of NHs that were more likely to specialize in SMI. Utilizing the Certification and Survey Provider Enhanced Reports, low-SMI (N = 3,616) and high-SMI (N = 3,615) NHs were defined as the first and fourth quartile of the distribution of the proportion of SMI residents, respectively. We performed bivariate tests and multivariate logistic regression to compare facility, staffing, resident, and star-ratings characteristics between NHs. High-SMI NHs were less likely to be Not-For-Profit, have fewer beds, have more Medicaid-paying residents, lower registered nurse staffing, and lower certified nurse aide staffing levels (p’s<.001). Residents in high-SMI NHs were more likely to require behavioral healthcare (p<.001) and be treated with psychoactive medications (any psychoactive, antidepressants, antipsychotics, anxiolytics (p’s<.001), hypnotics (p<.01)). Finally, high-SMI facilities had lower overall quality, health inspection, quality measure, staffing, and registered nurse staffing star-ratings (p’s<.001). High-SMI NHs have characteristics that are associated with lower quality-of-care (e.g., For-Profit, more Medicaid), lower staffing, prescribe more psychoactive medications, and have lower star-ratings. As the SMI population grows, large numbers of SMI residents will concentrate in a few NHs. While further research is needed to understand the implications of these trends, policy-makers must be aware of this population when affecting the resources and staffing of NHs.

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<![CDATA[INTRA-INDIVIDUAL PHYSICAL AND PSYCHOLOGICAL SYMPTOM VARIABILITY AND STRESS INFLUENCE ACTIVITIES OF DAILY LIVING]]> https://www.researchpad.co/article/Nec8bf4bd-cff2-48fc-8daa-39bd10e35489

Abstract

Stress and symptomatology have been shown to have strong relationships to health outcomes in older adults. More specifically, perceived social stressors (PSS), whether related to disease, disability or demographics, is a contributor to health. Recently it was reported that intra-individual symptom variability (ISV) may predict poor health outcomes better than symptom severity in some chronic illnesses. Individual and combined influences of ISV and PSS on health behaviors are not fully described. Using a subset (n = 518, 46.5% men; mean age = 48.7) of MIDUS Refresher participants’ 8 day daily diary data, we sought to determine the influences of physical and psychological ISV and PSS on independent and basic activities of daily living (iADLs, bADLs). The ISVs represent an average of day-to-day variation across each of the 22 physical and 27 psychological symptoms for each participant. Psychological ISV, physical ISV, PSS, and total number of chronic conditions were entered into two structural equation models as predictors for each ADL outcome (p<.01). The models depicted both direct and indirect influences of psychological ISV on ADLs (iADLs: B=-.43, P < .001; B = .51, P < .001 [through PSS]; bADLs: B=-.45, P < .001; B = .51, P < .001 [through PSS]). However, the influence of physical ISV on ADLs was indirect (B = .22, P = .001 [through PSS]). Individual-level influences of ISV and PSS on ADLs may better aide healthcare providers’ identifying and intervening to disrupt poor health outcomes for those at risk.

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<![CDATA[Cutaneous leishmaniasis and co-morbid major depressive disorder: A systematic review with burden estimates]]> https://www.researchpad.co/article/5c7d95d9d5eed0c484734dd0

Background

Major depressive disorder (MDD) associated with chronic neglected tropical diseases (NTDs) has been identified as a significant and overlooked contributor to overall disease burden. Cutaneous leishmaniasis (CL) is one of the most prevalent and stigmatising NTDs, with an incidence of around 1 million new cases of active CL infection annually. However, the characteristic residual scarring (inactive CL) following almost all cases of active CL has only recently been recognised as part of the CL disease spectrum due to its lasting psychosocial impact.

Methods and findings

We performed a multi-language systematic review of the psychosocial impact of active and inactive CL. We estimated inactive CL (iCL) prevalence for the first time using reported WHO active CL (aCL) incidence data that were adjusted for life expectancy and underreporting. We then quantified the disability (YLD) burden of co-morbid MDD in CL using MDD disability weights at three severity levels. Overall, we identified 29 studies of CL psychological impact from 5 WHO regions, representing 11 of the 50 highest burden countries for CL. We conservatively calculated the disability burden of co-morbid MDD in CL to be 1.9 million YLDs, which equalled the overall (DALY) disease burden (assuming no excess mortality in depressed CL patients). Thus, upon inclusion of co-morbid MDD alone in both active and inactive CL, the DALY burden was seven times higher than the latest 2016 Global Burden of Disease study estimates, which notably omitted both psychological impact and inactive CL.

Conclusions

Failure to include co-morbid MDD and the lasting sequelae of chronic NTDs, as exemplified by CL, leads to large underestimates of overall disease burden.

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<![CDATA[An experimental examination of cognitive processes and response inhibition in patients seeking treatment for buying-shopping disorder]]> https://www.researchpad.co/article/5c8977a6d5eed0c4847d3276

There is an ongoing debate about whether buying-shopping disorder (BSD) should be acknowledged as a behavioral addiction. The current study investigated if mechanisms that play a prominent role in disorders due to substance use or addictive behaviors are relevant in BSD, particularly cue reactivity, craving, cognitive bias and reduced inhibitory control regarding addiction-relevant cues. The study included 39 treatment-seeking patients with BSD and 39 healthy control (HC) participants (29 women and 10 men in each group). Subjective responses toward buying/shopping-relevant visual cues were compared in patients vs. control participants. Experimental paradigms with neutral and semi-individualized buying/shopping-related pictures were administered to assess attentional bias, implicit associations and response inhibition with respect to different visual cues: Dot-probe paradigm (DPP), Implicit Association Task (IAT), Go/nogo-task (GNG). The severity of BSD, craving for buying/shopping, and symptoms of comorbid mental disorders (anxiety, depressive and hoarding disorders) were measured using standardized questionnaires. The BSD-group showed more general craving for buying/shopping, stronger subjective craving reactions towards buying/shopping-related visual cues, and more symptoms of anxiety, depression and hoarding disorder than control participants. Task performance in the DPP, IAT and GNG paradigm did not differ between the two groups. The present findings confirm previous research concerning the crucial role of craving in BSD. The assumption that attentional bias, implicit associations and deficient inhibitory control with respect to buying/shopping-related cues are relevant in BSD could not be proven. Future research should address methodological shortcomings and investigate the impact of acute psychosocial stress and present mood on craving responses, cognitive processing, and response inhibition in patients with BSD.

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<![CDATA[Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the U.S.]]> https://www.researchpad.co/article/5c89779fd5eed0c4847d31be

Background

Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women’s Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV.

Methods

Study participants completed six assessments from 2013–16 on food insecurity (operationalized as marginal, low, and very low food security) and violence (sexual or physical, and psychological). We used multi-level logistic regression, controlling for visits (level 1) nested within individuals (level 2), to estimate the association of experiencing violence.

Results

Among 2,343 women (8,528 visits), we found that victims of sexual or physical violence (odds ratio = 3.10; 95% confidence interval: 1.88, 5.19) and psychological violence (odds ratio = 3.00; 95% confidence interval: 1.67, 5.50) were more likely to report very low food security. The odds of experiencing violence were higher for women with very low food security at both the current and previous visit as compared to only the current visit. HIV status did not modify these associations.

Conclusions

Food insecurity was strongly associated with violence, and women exposed to persistent food insecurity were even more likely to experience violence. Food programs and policy must consider persistent exposure to food insecurity, and interpersonal harms faced by food insecure women, such as violence.

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<![CDATA[Effects of frontal-executive dysfunction on self-perceived hearing handicap in the elderly with mild cognitive impairment]]> https://www.researchpad.co/article/5c897757d5eed0c4847d2a69

It is increasingly agreed upon that cognitive and audiological factors are associated with self-perceived hearing handicap in old adults. This study aimed to compare self-perceived hearing handicap among mild cognitive impairment (MCI) subgroups and a cognitively normal elderly (CNE) group and determine which factors (i.e., demographic, audiometric, or neuropsychological factors) are correlated with self-perceived hearing handicap in each group. A total of 46 MCI patients and 39 hearing threshold-matched CNE subjects participated in this study, and their age ranged from 55 to 80 years. The MCI patients were reclassified into two groups: 16 with frontal-executive dysfunction (FED) and 30 without FED. All subjects underwent audiometric, neuropsychological, and self-perceived hearing handicap assessments. The Korean version of the Hearing Handicap Inventory for the Elderly (K-HHIE) was administered to obtain the hearing handicap scores for each subject. After controlling for age, years of education, and depression levels, we found no significant differences in the K-HHIE scores between the MCI and the CNE groups. However, after we classified the MCI patients into the MCI with FED and MCI without FED groups, the MCI with FED group scored significantly higher than did both the MCI without FED and the CNE groups. In addition, after controlling for depression levels, significant partial correlations of hearing handicap scores with frontal-executive function scores and speech-in-noise perception performance were found in the MCI groups. In the CNE group, the hearing handicap scores were related to peripheral hearing sensitivity and years of education. In summary, MCI patients with FED are more likely to experience everyday hearing handicap than those without FED and cognitively normal old adults. Although educational level and peripheral hearing function are related to self-perceived hearing handicap in cognitively normal old adults, speech-in-noise perception and frontal-executive function are mainly associated with hearing handicap in patients with MCI.

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<![CDATA[Linking childhood emotional abuse and depressive symptoms: The role of emotion dysregulation and interpersonal problems]]> https://www.researchpad.co/article/5c6f149dd5eed0c48467a3fc

Childhood abuse is a major public health problem that has been linked to depression in adulthood. Although different types of childhood abuse often co-occur, few studies have examined their unique impact on negative mental health outcomes. Most studies have focused solely on the consequences of childhood physical or sexual abuse; however, it has been suggested that childhood emotional abuse is more strongly related to depression. It remains unclear which underlying psychological processes mediate the effect of childhood emotional abuse on depressive symptoms. In a cross-sectional study in 276 female college students, multiple linear regression analyses were used to determine whether childhood emotional abuse, physical abuse, and sexual abuse were independently associated with depressive symptoms, emotion dysregulation, and interpersonal problems. Subsequently, OLS regression analyses were used to determine whether emotion dysregulation and interpersonal problems mediate the relationship between childhood emotional abuse and depressive symptoms. Of all types of abuse, only emotional abuse was independently associated with depressive symptoms, emotion dysregulation, and interpersonal problems. The effect of childhood emotional abuse on depressive symptoms was mediated by emotion dysregulation and the following domains of interpersonal problems: cold/distant and domineering/controlling. The results of the current study indicate that detection and prevention of childhood emotional abuse deserves attention from Child Protective Services. Finally, interventions that target emotion regulation skills and interpersonal skills may be beneficial in prevention of depression.

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<![CDATA[The Sport Concussion Assessment Tool (SCAT2) for evaluating civilian mild traumatic brain injury. A pilot normative study]]> https://www.researchpad.co/article/5c76fe2cd5eed0c484e5b651

Self-report measures, particularly symptom inventories, are critical tools for identifying patients with persistent post-concussion symptoms and their follow-up. Unlike in military or sports-related assessment, in general civilian settings pre-injury levels of concussion-like symptoms are lacking. Normative data are available in adolescent and college populations, but no reference data exist to guide clinical adult explorations. The purpose of this study was to use the second edition of the Sport Concussion Assessment Tool (SCAT2) to profile a cohort of 60 healthy community volunteers who had not sustained a head injury. Participating volunteers underwent MRI scanning and were evaluated with the Hospital Anxiety and Depression Scale (HADS). Participants reported a median of 3 concussion-like symptoms and the 97.5 percentile score was found at 10.5 symptoms, out of a total of 22. The median severity score was 4.9 points, and 28.9 was the upper limit of the reference interval. Only 10 participants (16.7%) did not endorse any symptom. The most frequently endorsed symptom was feeling difficulty in concentrating, with 41.7% of the sample reporting it. Age, sex and general distress, anxiety and depressive symptoms were not associated with concussion-like symptoms. Our data yielded elevated cut-offs scores for both the number of symptoms and the symptom severity. In conclusion, postconcussive-like symptoms are frequent in the general non-concussed adult population and it should be taken into account in any future models developed for screening patients at risk of developing physical, cognitive, and psychological complaints following mild traumatic injury.

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<![CDATA[The costs of negative affect attributable to alcohol consumption in later life: A within-between random longitudinal econometric model using UK Biobank]]> https://www.researchpad.co/article/5c6dca2fd5eed0c48452a89b

Aims

Research demonstrates a negative relationship between alcohol use and affect, but the value of deprecation is unknown and thus cannot be included in estimates of the cost of alcohol to society. This paper aims to examine this relationship and develop econometric techniques to value the loss in affect attributable to alcohol consumption.

Methods

Cross-sectional (n = 129,437) and longitudinal (n = 11,352) analyses of alcohol consumers in UK Biobank data were undertaken, with depression and neuroticism as proxies of negative affect. The cross-sectional relationship between household income, negative affect and alcohol consumption were analysed using regression models, controlling for confounding variables, and using within-between random models that are robust to unobserved heterogeneity. The differential in household income required to offset alcohol’s detriment to affect was derived.

Results

A consistent relationship between depression and alcohol consumption (β = 0.001, z = 7.64) and neuroticism and alcohol consumption (β = 0.001, z = 9.24) was observed in cross-sectional analyses, replicated in within-between models (depression β = 0.001, z = 2.32; neuroticism β = 0.001, z = 2.33). Significant associations were found between household income and depression (cross sectional β = -0.157, z = -23.86, within-between β = -0.146, z = -9.51) and household income and neuroticism (cross sectional β = -0.166, z = -32.02, within-between β = -0.158, z = -7.44). The value of reducing alcohol consumption by one gram/day was pooled and estimated to be £209.06 (95% CI £171.84 to £246.27).

Conclusions

There was a robust relationship between alcohol consumption and negative affect. Econometric methods can value the intangible effects of alcohol use and may, therefore, facilitate the fiscal determination of benefit.

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<![CDATA[Noninvasive vagus nerve stimulation alters neural response and physiological autonomic tone to noxious thermal challenge]]> https://www.researchpad.co/article/5c6dca21d5eed0c48452a80d

The mechanisms by which noninvasive vagal nerve stimulation (nVNS) affect central and peripheral neural circuits that subserve pain and autonomic physiology are not clear, and thus remain an area of intense investigation. Effects of nVNS vs sham stimulation on subject responses to five noxious thermal stimuli (applied to left lower extremity), were measured in 30 healthy subjects (n = 15 sham and n = 15 nVNS), with fMRI and physiological galvanic skin response (GSR). With repeated noxious thermal stimuli a group × time analysis showed a significantly (p < .001) decreased response with nVNS in bilateral primary and secondary somatosensory cortices (SI and SII), left dorsoposterior insular cortex, bilateral paracentral lobule, bilateral medial dorsal thalamus, right anterior cingulate cortex, and right orbitofrontal cortex. A group × time × GSR analysis showed a significantly decreased response in the nVNS group (p < .0005) bilaterally in SI, lower and mid medullary brainstem, and inferior occipital cortex. Finally, nVNS treatment showed decreased activity in pronociceptive brainstem nuclei (e.g. the reticular nucleus and rostral ventromedial medulla) and key autonomic integration nuclei (e.g. the rostroventrolateral medulla, nucleus ambiguous, and dorsal motor nucleus of the vagus nerve). In aggregate, noninvasive vagal nerve stimulation reduced the physiological response to noxious thermal stimuli and impacted neural circuits important for pain processing and autonomic output.

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<![CDATA[Depression and anxiety in patients with different rare chronic diseases: A cross-sectional study]]> https://www.researchpad.co/article/5c76fe74d5eed0c484e5bab4

Objective

Empirical evidence on depression and anxiety in patients with rare diseases is scarce but can help improve comprehensive treatment. The objectives of this study were to investigate the frequency of depression and anxiety in this heterogeneous population and to examine aspects associated with increased psychopathology.

Methods

N = 300 patients with 79 different rare diseases (female:80%, age:M = 44.3(12.8), range:16–74 years) participated in a cross-sectional online study. We determined the percentages of patients reporting elevated depression (PHQ-9) and anxiety (GAD-7) scores. We calculated two linear regressions with depression and anxiety as outcomes. Predictor variables were diagnosis-related aspects (diagnosis assigned to ICD-10 chapter, visibility of symptoms, time since diagnosis, comorbid diseases), perceived somatic-symptom-severity (PHQ-15), illness-perceptions (consequences, control, identity, concern, understanding and treatment control; B-IPQ-R), coping mechanisms (constructive attitudes, active engagement in life) and social support (heiQ). We controlled for gender, age and depression or anxiety depending on the outcome.

Results

42% of the patients (95%CI [36.41%,47.59%]) reported depression scores indicating moderately or severely elevated symptom levels. Regarding anxiety, this applies to 23% (95%CI [18.54%,28.06%]). Variables significantly associated with depression were higher perceived somatic-symptom-severity (B = 0.41,p < .001), less control (B = .17,p < .05), lower levels of concern (B = -0.32,p < .01) and less constructive attitudes (B = -1.40,p < .001). No diagnosis-related variables were associated with depression. Variables significantly associated with anxiety were diseases of the circulatory system compared to congenital malformations (B = 1.88,p < .05), less consequences (B = -0.32,p < .05) and more concern (B = -0.32,p < .01).

Conclusion

The data reveal first insights into depression and anxiety in patients with different rare diseases. High percentages of patients showed clinically relevant symptom burden. No diagnosis-related differences were found in depression while anxiety seems to be particularly frequent in patients with rare diseases of the circulatory system. Besides perceived somatic symptom severity, cognitive appraisal seems to be linked to depression. Supporting patients in coping with their disease may help reduce psychopathology and therefore improve overall health.

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<![CDATA[Mental health in individuals with spinal cord injury: The role of socioeconomic conditions and social relationships]]> https://www.researchpad.co/article/5c76fe0dd5eed0c484e5b386

Objectives

To evaluate socioeconomic inequalities in social relationships, and to assess whether socioeconomic conditions and social relationships are independently related to mental health problems in individuals with a physical disability due to spinal cord injury (SCI).

Methods

We analyzed cross-sectional data from 511 individuals with SCI aged over 16 years who participated in the community survey of the Swiss SCI Cohort Study (SwiSCI). Indicators for socioeconomic conditions included years of formal education, household income, and financial strain. Social relationships were operationalized by three structural (partner status; social contact frequency; number of supportive relationships) and four functional aspects (satisfaction with: overall social support; family relationships; contacts to friends; partner relationship). General mental health was assessed by the Mental Health Inventory (MHI-5) of SF-36 and depressive symptoms were measured by the Hospital Anxiety and Depression Scale (depression subscale, HADS-D). Established cut-offs for general mental health problems (MHI-5 ≤56) and depressive symptomatology (HADS-D ≥8) were used to dichotomize outcomes. Associations were assessed using logistic regressions.

Results

Lower household income was predominantly associated with poor structural social relationships, whereas financial strain was robustly linked to poor functional social relationships. Financial strain was associated with general mental health problems and depressive symptomatology, even after controlling for social relationships. Education and household income were not linked to mental health. Poor structural and functional social relationships were related to general mental health problems and depressive symptomatology. Notably, trends remained stable after accounting for socioeconomic conditions.

Conclusion

This study provides evidence for socioeconomic inequalities in social relationships as well as for independent associations of financial strain and poor social relationships with mental health problems in individuals with SCI. Further research may develop strategies to improve mental health in SCI by strengthening social relationships. Such interventions may be especially beneficial for individuals with low income and financial strain.

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