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Revista Brasileira de Psiquiatria (Sao... 2020Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific...
OBJECTIVES
Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD.
METHODS
A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018.
RESULTS
Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies.
CONCLUSIONS
MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
Topics: Child; Comorbidity; Depressive Disorder, Major; Female; Humans; Marital Status; Prevalence
PubMed: 32756809
DOI: 10.1590/1516-4446-2020-0650 -
Respiratory Investigation Mar 2023Although studies have investigated the factors associated with psychological post-COVID-19 symptoms, the impact of marital status on symptom development has not been...
Although studies have investigated the factors associated with psychological post-COVID-19 symptoms, the impact of marital status on symptom development has not been fully determined. This study conducts a questionnaire survey to investigate the association between marital status and the proportion of patients with post-COVID-19 symptoms in 749 cases as valid responses. Depressive state and memory impairment were more frequently seen in the no-spouse group when each symptom was compared according to marital status. Particularly in individuals in the 40s who had minor COVID-19 illness, this trend was noted. Single patients with mild COVID-19 illness may need proactive psychological support.
Topics: Humans; COVID-19; Depression; Marital Status; Surveys and Questionnaires; Anxiety
PubMed: 36720183
DOI: 10.1016/j.resinv.2023.01.001 -
Indian Journal of Medical Ethics 2020The introduction of AETCOM (attitude, ethics and communication) (1) is seen as an effort at incorporating Medical Humanities (MH) within the medical curriculum. For the...
The introduction of AETCOM (attitude, ethics and communication) (1) is seen as an effort at incorporating Medical Humanities (MH) within the medical curriculum. For the first time, India's medical curriculum includes modules on the patient-doctor relationship, helping doctors to address ethical dilemmas that might arise during medical practice. Despite this progressive step, AETCOM has a number of drawbacks. Gayathri Prabhu (2) has analysed AETCOM as ossified, instrumental, lacking in a critical sensibility and failing to borrow from a humanities methodology. We would like to add to her excellent critique by examining other areas which have been overlooked within AETCOM. Our editorial addresses AETCOM's lack of sensibility towards the diversity of patients in India by focusing specifically on questions of gender, sexuality and marital status. While it is also important to understand how caste, religious, tribal and ethnic backgrounds of patients might be addressed within AETCOM, it is outside the scope of this editorial.
Topics: Curriculum; Education, Medical, Undergraduate; Female; Humanities; Humans; India; Marital Status; Sexuality
PubMed: 32393449
DOI: 10.20529/IJME.2020.039 -
Journal of Aging and Health Jan 2022To investigate whether the association between non-spousal support and mortality risk differs by marital status.
OBJECTIVE
To investigate whether the association between non-spousal support and mortality risk differs by marital status.
METHODS
Using data from the National Social Life, Health, and Aging Project (N = 2460), we estimate a series of logistic regression models to assess how non-spousal support moderates the relationship between marital status and mortality across a 5-year period.
RESULTS
Never married respondents who had minimal perceived access to non-spousal support had a greater probability of death compared to married respondents with similar levels of non-spousal support. The disparity in mortality risk between these two groups disappeared when non-spousal support was high.
DISCUSSION
Although family and friends play an important role in mortality risk in later life, these findings suggest that never married older adults exhibit a heightened dependence on support from non-spousal sources. Future research and policies should explore ways in which never married older adults can be integrated into a supportive social environment.
Topics: Aged; Aging; Humans; Marital Status; Marriage; Single Person; Social Support
PubMed: 34114491
DOI: 10.1177/08982643211025381 -
Cancer Medicine Jan 2023In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival.
METHODS
The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT).
RESULTS
Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis.
CONCLUSIONS
Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.
Topics: Humans; Male; Female; Marital Status; Neoplasms; Divorce; Single Person; Proportional Hazards Models
PubMed: 35789072
DOI: 10.1002/cam4.5003 -
Trends in Cardiovascular Medicine May 2020The national burden of cardiovascular disease (CVD) continues to impose significant risk of morbidity, mortality and increased costs. While traditional risk factors have... (Review)
Review
The national burden of cardiovascular disease (CVD) continues to impose significant risk of morbidity, mortality and increased costs. While traditional risk factors have been well-established, the evolving role of non-traditional risk factors, including socioeconomic and psychosocial factors, is increasingly being recognized. Several studies have acknowledged an association between marital status and the presence of CVD and its associated adverse outcomes. Across multiple U.S. and international cohorts, patients who are unmarried, including those who are divorced, separated, widowed, or never married, have an increased rate of adverse cardiovascular events when compared to their married counterparts. Some studies suggest that marriage may have a more protective role for men compared to women. Furthermore, dissatisfaction in a marriage and marriage quality have significant impact on cardiovascular risk. Psychosocial and socioeconomic factors, as well as other acute stressors, may contribute to the association between marital status and CVD outcomes, but the underlying mechanisms are not completely clear. Further investigation is required to identify potential targets for intervention and to determine whether more aggressive targeting of standard anti-atherosclerotic therapies can favorably impact CVD risk in unmarried patients.
Topics: Cardiovascular Diseases; Female; Humans; Male; Marital Status; Prognosis; Risk Assessment; Risk Factors; Sex Factors; Social Determinants of Health
PubMed: 31204239
DOI: 10.1016/j.tcm.2019.05.012 -
International Journal of Environmental... Jan 2022Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health...
Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.
Topics: Adult; Divorce; Exercise; Female; Humans; Male; Marital Status; Marriage; Obesity
PubMed: 35010761
DOI: 10.3390/ijerph19010502 -
International Journal of Environmental... Oct 2022The risk of mortality in old age is associated with marital status and living arrangements. There is still little knowledge about this in Latin America. Our objectives...
The risk of mortality in old age is associated with marital status and living arrangements. There is still little knowledge about this in Latin America. Our objectives are to examine the association between marital status, living arrangements and mortality of older adults (>60 years) in Chile, and to test whether this association varies when demographic, socioeconomic and health factors are included. We used data from the Social Protection Survey, and mortality data were linked to the Civil Registry. We estimate a series of Poisson regression models. Our results show a clear association between marriage and longevity, since even controlling for demographic, socioeconomic and health factors, we found that separated or divorced, widowed, and unmarried people showed higher relative mortality compared to married people (IRR1.24, IRR1.33, IRR1.35, respectively). Considering only living arrangements, the results show that living alone, alone with children, with children and other relatives or in other arrangements is associated with higher mortality (IRR1.22, IRR1.27, IRR1.35, IRR1.35, respectively) compared to those living with their partners and children. However, considering marital status and living arrangements together, we find that survival among older adults was strongly associated with marital status. Marital status continues to be a direct measure of living arrangements among older adults in Chile.
Topics: Child; Humans; Aged; Middle Aged; Chile; Marital Status; Marriage; Residence Characteristics; Divorce
PubMed: 36360612
DOI: 10.3390/ijerph192113733 -
Scientific Reports Apr 2023To investigate whether marital status is associated to long-term major fatal and non-fatal cardiovascular events in men and women from the Gubbio Population Study. The...
To investigate whether marital status is associated to long-term major fatal and non-fatal cardiovascular events in men and women from the Gubbio Population Study. The incidence of cardiovascular disease (CVD), including stroke and coronary heart disease (CHD) and CVD death together with all-cause mortality were analyzed. The analysis included 2832 persons (44% men, 54 ± 11 years old). Marital status was defined at entry as married (married or living conjugally) versus unmarried subjects (widowed, separated, divorced or single). Married and unmarried subjects did not differ concerning socio-demographic, anthropometric and biological variables at baseline. Over 191 months median follow-up, the incidence of CHD was lower among married versus unmarried women [HR: 0.63 (95% CI 0.41-0.96)] only; the same was true for CHD mortality [HR: 0.43 (95% CI 0.22-0.84)] and all-cause mortality [HR: 0.75 (95% CI 0.59-0.96)] independently of traditional risk factors (age, SBP, total and HDL cholesterol, cigarette smoke and BMI). In men, marital status was not associated to any of the investigated outcomes. In primary care, marital status should be investigated as it can be associated with long-term CHD and all-cause incidence and mortality risks among women.
Topics: Male; Humans; Female; Adult; Middle Aged; Aged; Cardiovascular Diseases; Risk Factors; Marital Status; Heart Disease Risk Factors; Coronary Disease; Italy
PubMed: 37185571
DOI: 10.1038/s41598-023-33943-0 -
JAMA Network Open May 2022Marital status has been shown to be associated with mortality, but evidence in Asian populations is limited. (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Marital status has been shown to be associated with mortality, but evidence in Asian populations is limited.
OBJECTIVE
To examine the association of marital status with total and cause-specific mortality.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study included individual participant data from 16 prospective studies in the Asia Cohort Consortium conducted between 1963 and 2015. Asian participants with complete information on marital and vital status were included. Study-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards model and then pooled using a random-effects meta-analysis. The analysis began in February 2021 and ended in August 2021.
EXPOSURES
Marital status.
MAIN OUTCOMES AND MEASURES
All-cause and cause-specific mortality.
RESULTS
Of 623 140 participants (326 397 women [52.4%] and 296 743 men [47.6%]; mean [SD] age, 53.7 [10.2] years; mean [SD] follow-up time, 15.5 [6.1] years), 123 264 deaths were ascertained. Compared with married individuals, those who were unmarried had pooled HRs of 1.15 (95% CI, 1.07-1.24) for total mortality, 1.12 (95% CI, 1.03-1.22) for cerebrovascular disease mortality, 1.20 (95% CI, 1.09-1.31) for coronary heart disease mortality, 1.17 (95% CI, 1.07-1.28) for circulatory system diseases mortality, 1.06 (95% CI, 1.01-1.11) for cancer mortality, 1.14 (95% CI, 1.05-1.23) for respiratory diseases mortality, and 1.19 (95% CI, 1.05-1.34) for external causes of death. Positive associations with total mortality were also observed for those who were single (HR, 1.62; 95% CI, 1.41-1.86), separated (HR, 1.35; 95% CI, 1.13-1.61), divorced (HR, 1.38; 95% CI, 1.13-1.69), and widowed (HR, 1.09; 95% CI, 1.04-1.13). In subgroup analyses, the positive association persisted across baseline health conditions, and the risk of death was more pronounced among men or people younger than 65 years.
CONCLUSIONS AND RELEVANCE
This large pooled cohort study of individual participant data provides strong evidence that being unmarried, as well as belonging to the unmarried subcategories, was positively associated with total and cause-specific mortality. Investment of targeted social support services might need to be considered in light of the mortality differences between married and unmarried individuals.
Topics: Asia; Cause of Death; Cohort Studies; Female; Humans; Male; Marital Status; Middle Aged; Prospective Studies
PubMed: 35639382
DOI: 10.1001/jamanetworkopen.2022.14181