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Background: Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic., Methods: This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates., Results: A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017)., Conclusions: This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics., Trial Registration: Clinicaltrials.gov, NCT04352634., (© 2024. The Author(s).)

Background: The aim of this study is to measure in two samples of Sardinian immigrants in Buenos Aires and representatives of the population in Sardinia the prevalence of depressive symptoms at the time of an economic crisis in Sardinia and to compare these results with those collected at the time of a similar crisis in Argentina more than 10 years before., Methods: Observational study. The associations of Sardinian immigrants in Buenos Aires provided the lists of families of Sardinian origin. A random sample of one fifth of registered families was selected. The sample of a study carried out in Sardinia was used as the control. The results were compared with those of the previous study performed in 2001-2002. The Patient Health Questionnaire (PHQ9) was used for the screening of depression., Results: The Sardinian immigrants show a lower rate of scoring positively on PHQ9 (i.e. less risk of being depressed) and reach statistical significance after standardization (8.7% vs. 13.1%, P = 0.046). Young women (≤40) are at higher risk. On the contrary, the risk of depression was higher in Sardinian immigrants in Argentina during the 2001-2002 crises., Conclusion: The study indicates a risk for depressive episodes linked to the fallout of the economic crisis (in Argentina in 2001-2002, in Sardinia in 2015) and specifically more in females than in males. Due to the associated socio-demographic risk factors, these results could be interpreted as due to an increase in non-bipolar depression.

Background: The purpose is to measure the worsening of the Quality of Life (QoL) in people with Multiple Sclerosis (MS) and the concomitant role of co-morbid Major Depressive Disorder (MDD) and Bipolar Disorder (BD), the latter not yet studied even though it was found strictly associated with MS., Cases: 201 consecutive-MS-patients., Controls: 804 sex-and-age-matched subjects without MS, randomly selected from an epidemiological database study. Psychiatric diagnoses according to DSM-IV were determined by physicians using structured interview tools (ANTAS-SCID). Bipolar Spectrum Disorders were identified by Mood Disorders Questionnaire (MDQ). QoL was measured by SF-12., Results: MS was the strongest determinant in worsening the QoL in the overall sample. Both MDD and BD type-II lifetime diagnoses were significantly associated with a poorer quality of life in the total sample as in cases of MS. In MS the impairment of the QoL attributable to BD type-II was even greater than that in MDD., Limitations: The MS diagnosis was made differently in cases and controls. Although this may have produced false negatives in controls, it would have reinforced the null hypothesis (no role of MS in worsening the QoL); therefore, it does not invalidate the study., Conclusions: MDD as well BD type-II are co-determinants in worsening QoL in MS. Clinicians should consider depressive symptoms as well as the hypomanic and mixed components in MS. Additional research is required to confirm our results and further clarify the manner in which BD and the mixed symptoms of BD type-II may affect awareness of both the underlying disease and psychiatric component and finally to what extent they impact treatment adherence with the available therapies for MS., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: With the exception of bereavement, the diagnosis of major depressive disorder in the DSM-IV does not take into account the context in which symptoms occur. Recent criticism has maintained that common sense suggests making a distinction between depression as mental disorder and sorrow as 'normal' reaction to social stress. Results of a study from Vienna support this view. This study sets out to examine whether these results can be replicated in a different cultural setting., Methods: In 2012, a population-based survey was conducted by phone in Sardinia (n = 1,200). A fully structured interview was carried out which began with the presentation of a vignette depicting a diagnostically unlabeled case of depression, with or without provision of information about preceding stressful life events., Results: In general, as compared to the people from Vienna, the Sardinian public was much less prone to define depressive symptoms as expression of mental illness and more reluctant to recommend professional help. However, similar to Vienna, respondents presented with vignettes containing information on loss events were less likely to define depressive symptoms as indication of a psychiatric illness. They were also less willing to recommend professional help and relied more on self-help and support by family members and close friends., Conclusions: We were able to replicate the result of the previous study that the public tends to perceive depressive symptoms differently depending on the context in which they occur. This lets us conclude that the divide between the public's view of what depression is and the view of DSM-IV is not limited to a particular culture but seems to represent a more general phenomenon. In consequence, one might rethink the diagnostic criteria for major depressive disorder in order to reconcile both views.

Background: Depressive syndromes, including recurrent brief depression (RBD), have frequently been observed in association with chronic diseases characterized by immune activation, such as autoimmune thyroiditis or celiac disease. However, the association of RBD with chronic hepatitis C (CHC), a disease with an increased incidence of major depressive disorders, is unknown., Cases: 135 (83 males, 52 females) consecutive treatment-naïve patients with CHC., Exclusion Criteria: previous treatment with IFN-alpha, co-infection with hepatitis C virus (HCV) and hepatitis B virus, infection with human immunodeficiency virus (HIV), drug or alcohol abuse, or malignancy., Controls: 540 (332 males, 208 females) subjects without evidence of hepatitis, randomly extracted from the database of a previous epidemiological study. The psychiatric diagnosis was based on the Composite International Diagnostic Interview Simplified (CIDI-S), containing a specific section on RBD., Results: A significantly higher rate of RBD was observed among both male and female patients with CHC (n=21, 15.5%) as compared to controls (n=34, 6.3%) (OR=2.6, CI 95% from 1.37 to 4.93)., Conclusion: The present study provides the first evidence of an association between CHC and RBD, independent of treatment with IFN-alpha and not influenced by substance or alcohol abuse. The results are similar to those found in other conditions with immune activation. RBD may be another expression of mood disorders in such conditions., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: The objective of the study was to determine if community surveys, conducted 3 times over a period of 20 years in a small district of Sardinia (Italy), confirm the increase in depressive disorders reported in the recent literature., Methods: Three community surveys were carried out on randomized samples of the same Sardinian mining area in 1988, 1998 and 2008. The surveys were conducted using the interview "Present State Examination" in 1988 (depression diagnosed with ICD-IX) and the CIDI-S in 1998 and 2008 (major depression diagnosed with ICD-X). The three surveys produced estimates of one-month prevalence and of lifetime prevalence in 1998 and 2008., Results: Our work found a substantial decrease in depressive disorders from the survey conducted in 1998 to the survey in 2008 using a similar methodology, except in the youngest age group, which showed an increase in the rate. A decrease in the frequency of depressive disorders compared to what was found 20 years ago was also observed. However, in this case the comparison is more problematic because of use of different diagnostic systems., Discussion: The research seems to show a decrease in depressive disorders over the past two decades. While the small population examined makes it difficult to generalize the overall findings, this study suggests that the hypothesis of an increase in the incidence of depressive disorders since the 1980s in western countries, should have exceptions. A complex interaction between socio-economic (mining closure and large migration) and biological factors (possible selective migration) is likely to influence changes in the prevalence of mood disorders. However, due to certain limitations of this study, this hypothesis may be considered from a heuristic perspective., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: To determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD., Study Design: community survey., Study Population: samples randomly drawn, after stratification from the adult population of municipal records., Sample Size: 4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE)., Results: SD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use., Conclusions: This study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.