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Background: It is unclear if certain post-stroke somatic symptoms load onto items of the Patient Health Questionnaire-9 (PHQ-9), a self-report depression questionnaire. We investigated these concerns in a stroke sample using factor analysis, benchmarked against a non-stroke comparison group., Methods: The secondary dataset constituted 787 stroke and 12,016 non-stroke participants. A subsample of 1574 comparison participants was selected via propensity score matching. Dimensionality was assessed by comparing fit statistics of one-factor, two-factor, and bi-factor models. Between-group differences in factor structure were explored using measurement invariance., Results: A two-factor model, consisting of somatic and cognitive-affective factors, showed better fit than the unidimensional model (CFI = 0.984 versus CFI = 0.974, p < .001), but the high correlation between the factors indicated unidimensionality (r = 0.866). Configural invariance between stroke and non-stroke was supported (CFI = 0.983, RMSEA = 0.080), as were invariant thresholds (p = .092) and loadings (p = .103). Strong invariance was violated (p < .001, ΔCFI = -0.003), stemming from differences in the tiredness and appetite intercepts. These differences resulted in a moderate overestimation of depression in stroke when using a summed score approach, relative to the comparison sample (Cohen's d = 0.434)., Conclusions: The findings suggest that the PHQ-9 measures a single factor in stroke. Because stroke patients may report higher tiredness on item 4, caution is advisable when classifying patients as depressed if they are near the cut-off and have significant post-stroke fatigue. Caution is also advised when comparing total scores between stroke and other populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Previous research into the phenomenological differences of post-stroke depression (PSD) has typically focused on comparisons of symptom profiles between stroke and non-stroke population controls. This systematic review aimed to synthesize these findings with results from other methodological approaches that contribute to an understanding of phenomenological differences. Articles were identified via a systematic search of seven databases and additional manual searching. A narrative synthesis approach was adopted because of the high methodological heterogeneity. Twelve articles comparing the symptomatology of depression between stroke and non-stroke controls were included. Three distinct methodological approaches, relevant to the aim, were identified: comparisons of profiles among groups with similar overall depression severity, comparisons of the strengths of correlations between a symptom and depression, and comparisons of latent symptom severity. The symptomatology of depression was generally similar between the groups, including somatic symptoms, despite the hypothesized interference of comorbid physical stroke effects. Despite high heterogeneity, there was a tentative indication that post-stroke depression manifests with comparatively less severe/prevalent anhedonia. Possible mechanisms for the observed similarities and differences are explored, including suggestions for future research., (© 2023. The Author(s).)

Asian Indians were the first South Asians to immigrate to the United States in the late 1800s and are currently the largest ethnic group of South Asians living in the United States. Despite this the literature on perceived ethnic and racial discrimination experiences among this group is relatively understudied. The documented experiences of Asian Indians who either recently immigrated from India or were born and raised in America pose an important question: what are the experiences of perceived discrimination among Asian Indians living in America, particularly among younger populations who are continuing to develop their racial and ethnic identities? The current study utilized phenomenological methodology to explore the experiences of nine Asian Indian American adolescents' (ages 12-17 years). Data were collected via semi-structured interviews to assess participants' experiences of ethnic and racial discrimination and identity development. Thematic analysis was used to identify themes and subthemes among the participants' responses. Asian Indian adolescents living in the United States report experiencing discrimination at a young age. It is also evident that Asian Indian youth experience significant challenges when developing their sense of ethnic and racial identity while living within the United States. Findings document the racial and ethnic discrimination that Asian Indian adolescents living in the United States may experience from a young age. Importantly, these discrimination experiences are occurring as Asian Indian adolescents are developing their racial and ethnic identities. This study provides insight for future research, which is necessary to fully understand the experiences of Asian Indian adolescents., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Unni, Blake, Salter, Luo and Liew.)