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Journal of the American Geriatrics... Jun 2024Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and...
BACKGROUND
Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults.
METHODS
We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self-rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function.
RESULTS
We analyzed data from 3940 respondents over 10 years of follow-up. A greater number of sensory disabilities was associated with greater hazard of low self-rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self-rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self-rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01).
CONCLUSIONS
Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults.
PubMed: 38944677
DOI: 10.1111/jgs.19056 -
Radiography (London, England : 1995) Jun 2024Radiotherapy treatment for gynaecological cancer has significant negative effects on sexual wellness and pleasure (1-3). Patients undergoing radiotherapy for...
INTRODUCTION
Radiotherapy treatment for gynaecological cancer has significant negative effects on sexual wellness and pleasure (1-3). Patients undergoing radiotherapy for gynaecological cancers have more sexual dysfunction and experience more sexual and depressive symptoms than those who undergo surgery alone (4). The World Health Organization defines sexual health as a crucial part of health and wellbeing and recognizes the importance of positive and respectful approaches to sexuality, alongside safe and pleasurable sexual experiences free from violence and coercion (5).
METHODS
Taking a sex critical approach to sexual wellness and pleasure, this project aimed to support practitioners to have improved and impactful conversations with people receiving radiotherapy treatment for gynaecological cancers. A series of three professional development workshops were held to explore language, unpack assumptions and develop key competencies for practitioners. A fourth workshop involved co-development of resources for use by other practitioners.
RESULTS
The group united, sharing insights, learning, and developing practices through reflection developing critical awareness about damaging silences around sexual wellness and pleasure. Co-created resources included conversation cards and a poster.
CONCLUSION
The project aimed to build and extend research findings to develop practitioner skills in supporting sexual wellness and pleasure for people receiving gynae-radiotherapy. The study shows the benefits of discussing norms and harms associated with biomedically focused conversations in gynae-radiotherapy to acknowledge diversity and validate concerns about sexual wellbeing and pleasure.
IMPLICATIONS FOR PRACTICE
A sex critical approach to sexual wellness and pleasure should be considered a core principle of care for patients during their treatment for gynaecological cancers. Conversations are a key (free) resource within the practitioner-patient relationship that can address and improve patients' psychosocial wellbeing.
PubMed: 38944580
DOI: 10.1016/j.radi.2024.06.012 -
Maternal Postpartum Depression Screening and Early Intervention in the Neonatal Intensive Care Unit.Advances in Pediatrics Aug 2024Families with infants admitted to the neonatal intensive care unit (NICU) are at a markedly increased risk of developing postpartum depression (PPD) because of the... (Review)
Review
Families with infants admitted to the neonatal intensive care unit (NICU) are at a markedly increased risk of developing postpartum depression (PPD) because of the stressors they experience by having an infant in this intensive setting. Routine screening for PPD is not regularly performed for these families because many NICUs do not offer it and well-child visits are missed while the infant is hospitalized. Because the identification and treatment of PPD is often missed in these families, screening needs to be administered in the NICU to ensure improved outcomes.
Topics: Humans; Depression, Postpartum; Female; Intensive Care Units, Neonatal; Infant, Newborn; Mass Screening; Risk Factors
PubMed: 38944489
DOI: 10.1016/j.yapd.2024.01.004 -
Journal of Epidemiology and Community... Jun 2024While there is a large body of evidence indicating that sexual minority youth experience inequitably high rates of mental health problems (eg, depression, suicidality),...
While there is a large body of evidence indicating that sexual minority youth experience inequitably high rates of mental health problems (eg, depression, suicidality), we know little about how temporal changes in sexual attractions, identities and behaviour may impact mental health (and other) outcomes. In this essay, we review existing research regarding sexual fluidity and mental health among young adults in order to identify critical knowledge gaps with respect to an epidemiological understanding of the relationship between these factors. We describe three gaps that in turn inform a larger public health research agenda on this topic. First, there are a number of methodological challenges given that fluidity can occur over short or long periods of time and across multiple dimensions of sexual orientation (eg, attractions, identities and behaviour) with various patterns (eg, directionality of change). Tailored measures that accurately and inclusively reflect diversities of sexual fluidity trajectories are needed. Second, causal relationships between sexual fluidity and mental health remain uncertain and unquantified. Third, little is known about how features of context (eg, gender norms and political climate) influence youth experiences with sexual fluidity and mental health. Finally, we propose a set of recommendations to address these knowledge gaps to improve the quality of epidemiological research involving young people.
PubMed: 38944417
DOI: 10.1136/jech-2023-221844 -
Biological Psychiatry. Cognitive... Jun 2024'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH...
BACKGROUND
'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH remain largely unexplored. While auditory perceptual dysfunction is among the abnormalities implicated in schizophrenia VH, whether VH in trauma-D also involves auditory perceptual alterations is unknown.
METHODS
We investigated auditory cortex (AC)-related functional connectivity (FC) in n=65 women with trauma-D related to childhood abuse with varying severities of VH. Using a novel, computationally-driven and individual-specific method of functionally parcellating the brain, we calculated the FC of two distinct AC subregions-Heschl's gyrus (HG, corresponding to primary AC) and lateral superior temporal gyrus (lSTG, in non-primary AC)- with both the cerebrum and cerebellum. We then measured the association between VH severity and FC using leave-one-out cross validation within the cerebrum, and voxel-wise multiple regression analyses in the cerebellum.
RESULTS
We found that VH severity positively correlated with left lSTG-frontoparietal network FC, while it negatively correlated with FC between left lSTG and both cerebral and cerebellar representations of the default mode network. VH severity was not predicted by FC of left HG or right AC subregions.
CONCLUSIONS
Our findings point to altered interactions between auditory perceptual processing and higher-level processes related to self-reference and executive functioning. This is the first study to show alterations in auditory cortical connectivity in trauma-related VH. While VH in trauma-D appears to be mediated by brain networks that are also implicated in schizophrenia VH, the results suggest a unique mechanism that could distinguish VH in trauma-D.
PubMed: 38944384
DOI: 10.1016/j.bpsc.2024.06.009 -
Journal of Affective Disorders Jun 2024Trying to better define Bipolar Disorder (BD) progression, different staging models have been conceptualized, each one emphasizing different aspects of illness. In a...
BACKGROUND
Trying to better define Bipolar Disorder (BD) progression, different staging models have been conceptualized, each one emphasizing different aspects of illness. In a previous article we retrospectively applied the main staging models to a sample of 100 bipolar patients at four time points over a ten-year observation. In the present study, focusing on Kupka & Hillegers's model, we aimed to assess the transition of the same sample through the different stages of illness and to explore the potential role of clinical variables on the risk of progression.
METHODS
Multistate Model using the mstate package in R and Markov model with stratified hazards were used for statistical analysis.
RESULTS
A high hazard of transition from stage 2 to 3 emerged, with a probability of staying in stage 2 decreasing to 14 % after 3 years. BD II and depressive predominant polarity were significantly associated with transition from stage 1 to 2, whereas the number of lifetime episodes >3 and the elevated predominant polarity with transition from stage 3 to 4.
CONCLUSION
Our results corroborated the evidence on BD progression and contributed to outline its trajectory over time. Further effort may help to define a standardized staging approach towards ever increasing tailored interventions.
PubMed: 38944295
DOI: 10.1016/j.jad.2024.06.094 -
Journal of Affective Disorders Jun 2024Immune-inflammatory mediators influence numerous immune and inflammatory pathways, elevating the likelihood of depression. The systemic immune-inflammation index (SII)...
BACKGROUND
Immune-inflammatory mediators influence numerous immune and inflammatory pathways, elevating the likelihood of depression. The systemic immune-inflammation index (SII) emerges as an innovative prognostic indicator, integrating various peripheral blood immune cell subpopulations, specifically neutrophils, platelets, and lymphocytes. This exploratory study aims to examine the correlation between SII and depression.
METHODS
Data from the 2005-2020 National Health and Nutrition Examination Survey (NHANES) were utilized. Depression was diagnosed with a Patient Health Questionnaire score of 10 or higher. The relationship between log2-SII and depression incidence was analyzed using a restricted cubic spline (RCS). Logistic regression was employed to calculate the odds ratio of depression concerning log2-SII. In cases of non-linearity, piecewise linear models with change points were applied to assess the associations in both the overall population and specific subgroups. Additionally, subgroup analyses were conducted to determine the applicability of the findings to particular populations.
RESULTS
A total of 42,133 participants were included in the study, comprising 49.32 % men and 50.68 % women, with an average age of 47.02 ± 17.45 years. RCS analysis demonstrated a J-shaped non-linear relationship between log2-SII and depression incidence. When log2-SII was ≥8.50, SII showed a positive association with depression incidence, even after adjusting for covariates. Additionally, each unit increase in log2-SII corresponded to an 18 % rise in depression incidence (OR = 1.18, 95 % CI: 1.10-1.27). Subgroup analysis further revealed that the association between SII and depression incidence varied across different populations.
LIMITATIONS
Due to the cross-sectional nature of NHANES, causality or long-term implications cannot be inferred. Further research is needed to ascertain if a longitudinal relationship exists between SII and depression.
CONCLUSION
Our findings suggest a significant and complex non-linear association between SII and depression. However, further basic and prospective studies are necessary to explore SII's impact on depression and clarify its underlying mechanisms. Additionally, these studies will provide a foundation for personalized interventions targeting the immune-inflammatory processes in patients with depression and elevated SII.
PubMed: 38944294
DOI: 10.1016/j.jad.2024.06.103 -
Journal of Affective Disorders Jun 2024
PubMed: 38944293
DOI: 10.1016/j.jad.2024.06.107 -
Journal of Affective Disorders Jun 2024In the United States, the lifetime prevalence of depression in the US population is 20.6 %. We aimed to understand the temporal trends in the prevalence of depression...
BACKGROUND
In the United States, the lifetime prevalence of depression in the US population is 20.6 %. We aimed to understand the temporal trends in the prevalence of depression among adults in the United States during the period 2013-2022 as well as the effects of age, period, and cohort effects on the prevalence of depression.
METHODS
Data from 3,139,488 participants in the U.S. Behavioral Risk Factor Surveillance System (BRFSS) from 2013 to 2022 were used in this study. The joinpoint regression model was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to learn about the time trends in the prevalence of depression. Age-period-cohort models were used to estimate the effects of age, period, and birth cohort effects on the prevalence of depression.
RESULTS
The prevalence of depression among adults in the United States showed an overall increasing trend from 2013 to 2022. The rate of increase was greater in males than females, with AAPC values of 1.44 % (95 % CI: 0.32-2.18), and 1.23 % (95 % CI: 0.32-2.25), respectively. Regarding the age effect, the risk of depression among adults in the United States generally showed an increasing and then decreasing trend with age. The risk of developing the condition reached its maximum at 50-54 years (RR = 1.28, 95 % CI = 1.26-1.30). Regarding the period effect, the risk of depression among US adults was higher during 2018-2022 than during 2013-2017. The overall cohort effect for depression prevalence was a higher risk for those born later, with a maximum RR of 1.51 (95 % CI: 1.47-1.54).
CONCLUSION
The prevalence of adult depression in the United States is showing an increasing trend. Middle-aged people and those born later in life deserve more attention as high-risk groups. It is recommended that the condition burden of depression be reduced with the promotion of healthy lifestyles, the promotion of interpersonal communication, as well as enhanced mental health education and mental health literacy.
PubMed: 38944291
DOI: 10.1016/j.jad.2024.06.090 -
Journal of Affective Disorders Jun 2024Growing evidence highlights the role of the spleen-brain axis in inflammation-associated depression. The α7-subtype of nicotinic acetylcholine receptor (α7 nAChR,...
BACKGROUND
Growing evidence highlights the role of the spleen-brain axis in inflammation-associated depression. The α7-subtype of nicotinic acetylcholine receptor (α7 nAChR, encoded by the Chrna7 gene) is implicated in systemic inflammation, with Chrna7 knock-out (KO) mice displaying depression-like behaviors. Yet, the influence of spleen nerve on depression-like behaviors in these KO mice remains to be elucidated.
METHODS
We investigated the effects of the splenic nerve denervation (SND) on depression-like behaviors, the protein expression in the prefrontal cortex (PFC), and the gut microbiota composition in Chrna7 KO mice.
RESULTS
SND markedly alleviated depression-like behaviors and the reduced expression of GluA1 and postsynaptic density protein-95 (PSD-95) in the PFC of Chrna7 KO mice. No changes in α-diversity of gut microbiota were noted among the control, KO + sham, and KO + SND groups. However, significant differences in β-diversity of gut microbiota were noted among the groups. Notable alterations in various microbiota (e.g., Fluviimonas_pallidilutea, Maribacter_arcticus, Parvibacter_caecicola) and plasma metabolites (e.g., helicide, N-acetyl-L-aspartic acid, α-D-galactose 1-phosphate, choline, creatine) were observed between KO + sham and KO + SND groups. Interestingly, correlations were found between the relative abundance of specific microbiota and other outcomes, including synaptic proteins, metabolites and behavioral data.
LIMITATIONS
The underlying mechanisms remain to be fully understood.
CONCLUSIONS
Our findings indicate that the splenic nerve contributes to depression-like phenotypes in Chrna7 KO mice via the spleen-gut-brain axis.
PubMed: 38944290
DOI: 10.1016/j.jad.2024.06.091