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Background: Psychiatric comorbidities are frequent in patients admitted in general hospital and are associated with greater lengths of stay (LOS). Early consultation-liaison psychiatry (CLP) interventions may reduce the LOS but previous studies were underpowered to allow subgroup analyses and have generally not considered the severity of the condition for which patients were admitted ('disease severity'). Aims: To investigate the association between the timing of CLP interventions and LOS in a general hospital. Method: We retrospectively included 4500 consecutive patients admitted in non-psychiatric wards of a university hospital between 2008 and 2016 who had a first CLP intervention. We used general linear models to examine the association between the referral time, defined as log(days before the consultation)/log(LOS), and log(LOS), adjusting for age, gender, year of admission, place of residence, main psychiatric diagnosis, admission to the intensive care unit (ICU), main physical condition and disease severity. Results: Referral time was associated with log(LOS) (β = 0.31; P <0.001), notably for older patients (β = 0.43; P <0.001) and those admitted to the ICU (β = 0.50; P <0.001), but not for those with psychotic disorders (β = −0.20; P = 0.10). The association was confirmed when considering the expected LOS for each patient. For instance, for an expected LOS of 10 days, a CLP intervention on day 3 compared with day 6 was associated with a reduction of the actual LOS of 2.4 days. Conclusions: Earlier CLP interventions were associated with a clinically significant shorter LOS in a large population even after adjusting for disease severity. Early CLP interventions may have benefits for both patients and health-related costs. [ABSTRACT FROM AUTHOR]

Background: The expression of depressive symptoms in older people with cancer is heterogeneous because of specific features of age or cancer comorbidity. We aimed to identify depressive symptom profiles in this population and describe the associated features including survival. Materials and Methods: Patients ≥70 years who were referred to geriatric oncology clinics were prospectively included in the ELCAPA study. In this subanalysis, depressive symptoms were used as indicators in a latent class analysis. Multinomial multivariable logistic regression and Cox models examined the association of each class with baseline characteristics and mortality. Results: For the 847 complete‐case patients included (median age, 79 years; interquartile range, 76–84; women, 47.9%), we identified five depressive symptom classes: "no depression/somatic only" (38.8%), "no depression/pauci‐symptomatic" (26.4%), "severe depression" (20%), "mild depression" (11.8%), and "demoralization" (3%). Compared with the no depression/pauci‐symptomatic class, the no depression/somatic only and severe depression classes were characterized by more frequent comorbidities with poorer functional status and higher levels of inflammation. "Severe" and "mild" depression classes also featured poorer nutritional status, more medications, and more frequent falls. Severe depression was associated with poor social support, inpatient status, and increased risk of mortality at 1 year (adjusted hazard ratio, 1.62, 95% confidence interval, 1.06–2.48) and 3 years (adjusted hazard ratio, 1.49; 95% confidence interval, 1.06–2.10). Conclusion: A data‐driven approach based on depressive symptoms identified five different depressive symptom profiles, including demoralization, in older patients with cancer. Severe depression was independently and substantially associated with poor survival. Implications for Practice: Older patients with cancer present with distinct profiles of depressive symptomatology, including different severity levels of depression and the demoralization syndrome. Clinicians should use a systematic assessment of depressive symptoms to adequately highlight these distinct profiles. Geriatric and oncological features are differently associated with these profiles. For instance, severe depression was associated with more frequent comorbidities with poorer functional, poor nutritional status, polypharmacy, frequent falls, inpatient status and poor social support. Also, severe depression was independently and substantially associated with poor survival so that the identification and management of depression should be considered a high priority in this population. The expression of depressive symptoms in older patients with cancer is complex, with greater heterogeneity than in younger patients. This article identifies different homogeneous classes of depressive symptoms that can assist in analyzing outcomes to avoid inconsistent interpretation of study results. [ABSTRACT FROM AUTHOR]

Background: The association of psychological variables with cardiovascular health might depend on socioeconomic status. We examined the moderating effect of occupational grade on the association between depression and incident cardiac events among middle-aged workers from the GAZEL cohort.Methods and Results: A total of 10 541 participants (7855 men, mean age: 47.8±3.5 years) free of cardiovascular diseases completed the Center of Epidemiologic Studies Depression scale in 1993. Age, sex, and occupational grade (low, medium, and high) were obtained from company records. Classical cardiovascular risk factors were self-reported. All participants were followed-up for medically certified cardiac events from January 1994 to December 2014. Associations between baseline variables and incident cardiac events were estimated with hazard ratios and 95% confidence intervals computed in Cox regressions. After a median follow-up of 21 years, 592 (5.6%) participants had a cardiac event. There was a significant interaction between depression and occupational grade in both age- and sex-adjusted (P=0.008) and multiadjusted (P=0.009) models. This interaction was mainly explained by an association between depression and incident cardiac events that prevailed among participants of low occupational grade (3.71 versus 1.96 events per 1000 person-years among those depressed versus nondepressed, multiadjusted hazard ratios [95% confidence intervals], 1.99 [1.12-3.48]).Conclusions: From a research perspective, these results may account for previous conflicting results and constitute an impetus for reanalyzing previous data sets, taking into account the moderating role of socioeconomic status. From a clinical perspective, they urge clinicians and policy makers to consider depressive symptoms and low socioeconomic status as synergistic cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Objective: Evidence for an association between hostility and peptic ulcer mainly relies on cross-sectional studies. Prospective studies are rare and have not used a validated measure of hostility. This prospective study aimed to examine the association between hostility and peptic ulcer in the large-scale French GAZEL cohort. Method: In 1993, 14,674 participants completed the Buss and Durkee Hostility Inventory. Participants were annually followed-up from 1994 to 2011. Diagnosis of peptic ulcer was self-reported. The association between hostility scores and ulcer incidence was measured by hazard ratios (HR) and 95% confidence intervals computed through Cox regression. Results: Among 13,539 participants free of peptic ulcer history at baseline, 816 reported a peptic ulcer during a mean follow-up of 16.8 years. Adjusting for potential confounders, including smoking, occupational grade, and a proxy for nonsteroidal anti-inflammatory drug exposure, ulcer incidence was positively associated with total hostility (HR per SD: 1.23, confidence interval: 1.14-1.31), behavioral hostility (HR per SD: 1.13, confidence interval: 1.05-1.21), cognitive hostility (HR per SD: 1.26, confidence interval: 1.18-1.35), and irritability (HR per SD: 1.20, confidence interval: 1.12-1.29). The risk of peptic ulcer increased from the lowest to the highest quartile for all hostility measures ip for linear trend < .05). Conclusions: Hostility might be associated with an increased risk of peptic ulcer. Should these results be replicated, further studies would be needed to explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background Whether there are systematic differences in depression symptom expression during pregnancy, the postpartum period and outside these periods (i.e., outside the peripartum period) remains debated. The aim of this study was to use methods based on item response theory (IRT) to examine, after equating for depression severity, differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) in women of childbearing age (i.e., aged 18-50) during pregnancy, the postpartum period and outside the peripartum period. Methods We conducted these analyses using a large, nationally representative sample of women of childbearing age from the United States ( n = 11,256) who participated in the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Results The overall 12-month prevalence of all depressive criteria (except for worthlessness/guilt) was significantly lower in pregnant women than in women of childbearing age outside the peripartum period, whereas the prevalence of all symptoms (except for 'psychomotor symptoms') was not significantly different between the postpartum and the nonperipartum group. There were no clinically significant differences in the endorsement rates of symptoms of MDE by pregnancy status when equating for levels of depression severity. Conclusions This study suggests that the clinical presentation of depressive symptoms in women of childbearing age does not differ during pregnancy, the postpartum period and outside the peripartum period. These findings do not provide psychometric support for the inclusion of the peripartum onset specifier for major depressive disorder in the DSM-5. [ABSTRACT FROM AUTHOR]

The article presents a study aimed at identifying the clinical and sociodemographic correlates and the treatment-seeking rate of major depressive disorder (MDD), diagnosed according to the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition," and its link to co-morbid psychiatric disorders and sensed health status. Findings discussed include the clinical features of the older and younger groups, the health status of the participants, and their mental health service use.

The article looks at the prevalence of personality disorders in older patients from data from the 2001-2002 U.S. National Epidemiologic Survey on Alcohol and Related Conditions, also noting factors such as sociodemographics, mental and physical comorbidities, and disability. The results found personality disorders in 8.07 percent of subjects over 65 years old, with obsessive-compulsive disorders the most common occurrences. Other topics include quality of life, prevention, and treatment.

Background: Growing evidence supports the validity of distinguishing major depressive disorder (MDD) plus a lifetime history of subthreshold hypomania (D(m)) from pure MDD in psychiatric classifications. The present study sought to estimate the proportion of individuals with D(m) that would have been included in RCTs for MDD using typical eligibility criteria, and examine the potential impact of including these participants on internal validity. Methods: Data were derived from the 2001–2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a national representative sample of 43,093 adults of the United States population. We examined the proportion of participants with a current diagnosis of pure MDD and D(m) that would have been eligible in clinical trials for MDD with a traditional set of eligibility criteria, and compared it with that of participants with bipolar 2 disorder if the same set of eligibility criteria was applied. We considered 4 models including different definitions of subthreshold hypomania. Results: We found that more than 7 out of ten participants with pure MDD and with D(m) would have been excluded by at least one classical eligibility criterion. Prevalence rate of individuals with D(m) in RCTs for MDD with traditional eligibility criteria would have ranged from 7.98% to 22.59%. Overall exclusion rate of individuals with MDD plus at least 4 lifetime concomitant hypomanic probes significantly differ from those with pure MDD, whereas it was not significantly different in those with at least 2 lifetime concomitant hypomanic probes compared to those with bipolar 2 disorder. Conclusions: The current design of clinical trials for MDD may suffer from impaired external validity and potential impaired internal validity, due to the inclusion of a substantial proportion of individuals with subthreshold hypomania presenting with similar pattern of exclusion rates to those with bipolar 2 disorder, possibly resulting in a selection bias. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have shown that person under train (PUT) accidents cause psychological distress to drivers during the first year following the incident. Our aims were to assess the psychological consequences of PUT accidents on drivers prospectively, and to identify risk factors for psychological effects. In this prospective, one-year, follow-up study, a consecutive series of PUT drivers (n =202) were compared with a group of matched control drivers (n =186). Psychological state was assessed 15 days, 3 months and 1 year after the event, using the GHQ-28 questionnaire and a standardised diagnostic interview (the v4.4 MINI). Fifteen days after the event, PUT drivers had significantly higher GHQ-28 scores (p <0.0001) and more acute stress disorder (p =0.008) than control drivers. No significant differences were found 3 months and 1 year after the accident. Significant explicative variables were the presence of acute and chronic psychosocial stressors (OR=3.30 and 3.68) and the availability of immediate help (OR=0.46). We thus confirm previous findings that train drivers who have experienced a PUT accident experience acute psychological disturbances. Our results also highlight the utility of the systematic prevention programme provided. [Copyright &y& Elsevier]

Objective: Prior studies support that younger age of onset would be associated with poorer psychiatric and mental health outcomes for many psychiatric disorders. However, such relationship has never been examined for social anxiety disorder (SAD) in a nationally representative sample.Methods: Using data from the second Wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we have identified four groups of participants with a lifetime DSM-IV diagnosis of SAD based on the self-reported age of onset (childhood onset (<12 years, N = 658), adolescence onset (12-17 years, N = 663), early-adulthood onset (18-39 years, N = 663), and late-adulthood onset (>39 years, N = 415)), and a control group without a lifetime history of SAD (N = 32,205). We performed multinomial logistic regression models to compare lifetime DSM-IV psychiatric disorders and current mental health-related quality of life (assessed with the mental component summary score (MSC) of the SF-12) across these groups.Results: The lifetime prevalence rates of panic disorder, agoraphobia and post-traumatic stress disorder were significantly higher in the adulthood onset groups than in groups with an onset during childhood or adolescence (p < 0.01 for most models). MCS score was significantly higher in the childhood (46.0 (SE = 0.5)) or adolescence (46.5 (SE = 0.5)) onset groups than in the groups with an onset during adulthood (early-adulthood onset: 43.5 (SE = 0.6), and late-adulthood onset: 43.0 (SE = 0.8)).Limitations: Our results relied on retrospective self-reported data.Conclusion: Among individuals with SAD, a later age of onset was significantly associated with greater lifetime rates of psychiatric disorders and diminished quality of life. [ABSTRACT FROM AUTHOR]

People with panic disorder are at increased risk of suicide. Multiple factors influence their risk suggesting a need to combine them into an integrative model to develop more effective suicide prevention strategies for this population. In this report, we sought to build a comprehensive model of the 3-year risk of suicide attempt in individuals with panic disorder using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001–2002; wave 2, 2004–2005). We used structural equation modeling to simultaneously examine effects of six broad groups of clinical factors previously identified as potential predictors of suicide attempt in adults with panic disorder: 1) severity of panic disorder, 2) severity of comorbidity, 3) prior history of suicide attempt, 4) family history of psychiatric disorders, 5) sociodemographic characteristics and 6) treatment-seeking behavior. The 3-year prevalence rate of suicide attempt was 4.6%. A general psychopathology factor, lower physical health-related quality of life, prior suicide attempt and a greater number of stressful life events at baseline significantly and independently predicted suicide attempt between the two waves (p <.05). R-square of the models ranged from 0.47 to 0.50. This model may help inform future research and identify high-risk individuals among adults with panic disorder. Unlabelled Image • Individuals with panic disorder are at high risk of suicide (1.2%–8.0%). • Previous studies identified many potential predictors of suicide attempt. • General psychopathology factor, low quality of life, prior suicide attempt and stressful events, predicted suicide attempt. • More research is needed to better identify individuals with panic disorder at high-risk of suicide. [ABSTRACT FROM AUTHOR]

Background Recent evidence suggests that the association of psychological variables with the risk of coronary heart disease (CHD) might depend upon socioeconomic status (SES). However, it is unclear whether the association between depressive symptoms and CHD risk might differ according to three SES indicators (education, occupational status and household monthly income). Methods Among 34,836 working participants of the French CONSTANCES cohort (16,221 men, mean age [SD]: 44.0 [10.4] years) without history of cardiovascular disease, depressive symptoms were assessed with the Center of Epidemiologic Studies Depression scale (CES-D). The Framingham risk equation calibrated to the French population estimated the participant's 10-year risk of CHD. Associations between depressive symptoms and CHD risk were estimated using linear regression models in SES strata. Results The estimated 10-year risk of CHD was 16.9% in men and 1.8% in women. In men, the increased CHD risk in those with (versus without) depressive symptoms was more pronounced as occupational status decreased, being 0.65% (−0.57; 1.88), 1.58% (0.50; 2.66) and 3.19% (1.30; 5.07) higher in individuals of high, medium and low occupational status, respectively (p for interaction: 0.01). In contrast, effect modification by education or household income was less evident, despite similar trends. In women, no effect modification was found whatever the SES indicator. Conclusions Depressive symptoms and 10-year estimated CHD risk were more tightly linked in individuals of lower SES, at least in men. Occupational status was the SES indicator that displays the most obvious effect modification on this association. [ABSTRACT FROM AUTHOR]

Background: Heavy drinkers are at high risk for suicide attempt and suicide. Multiple factors, when examined in isolation, have been implicated in the risk of suicide attempt in this population. In this report, we present a comprehensive model of the 3-year risk of suicide attempt in heavy drinkers using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005).Methods: We used structural equation modeling to simultaneously examine effects of four broad groups of clinical factors previously identified as potential predictors of attempted suicides: 1) alcohol use disorder severity, 2) severity of comorbidity, 3) sociodemographic characteristics and 4) help-seeking for alcohol problems. Heavy drinking was defined as drinking 5 or more drinks in a day more than once a week in the month prior to Wave 1.Results: About 1.5% of the 1573 heavy drinker participants (i.e., 5.1% of the NESARC sample) attempted suicide during the 3-year follow-up period. After adjusting for all other factors, several factors independently predicted attempted suicides: the alcohol use disorder liability factor measured by DSM-IV-TR criteria for alcohol abuse and dependence and two dimensions of psychopathology, the general psychopathology factor accounting for the shared effects of all comorbid psychiatric disorders and the externalizing dimension accounting for the shared effects of comorbid substance use disorders. No other factor predicted this risk in addition.Conclusion: This model may help identify individuals with heavy drinking at high risk of suicide and develop more effective suicide prevention strategies. [ABSTRACT FROM AUTHOR]

Objective Prior research indicates that different types of childhood maltreatment frequently co-occur and confer risk for adulthood intimate partner violence (IPV). However, it is unknown whether the risk of IPV is due to specific type(s) of maltreatment or to their shared association or both. Although these competing explanations have different implications for intervention, they have never been evaluated empirically. Method Data were drawn from a nationally representative survey of 34,653 US adults, the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Structural equation modeling was used to simultaneously examine the shared and specific effects of five types of childhood maltreatment (i.e., sexual abuse, physical and emotional abuse and neglect) on the risk of different IPV behaviors (i.e., perpetration, victimization and reciprocal violence). Analyses were stratified by sex and adjusted for sociodemographic characteristics (i.e., age, personal income, educational background and race/ethnicity). Results Most types of childhood maltreatment increased the risk of victimization, perpetration and reciprocal violence. Effects of maltreatment types on each IPV behavior were exerted mostly through a latent factor representing the shared effect across all different types of maltreatment in both sexes (CFI = 0.990, TLI = 0.990, RMSEA = 0.023), although sexual abuse had an additional effect on victimization. Conclusions Because childhood maltreatment types increase the risk of each intimate partner violence behavior mainly through a general maltreatment dimension, underlying biological and developmental-ecological mechanisms should be considered important targets of prevention for both victimization and perpetration of abuse in adult relationships. [ABSTRACT FROM AUTHOR]

Recent theories have proposed a metastructure that organizes related mental disorders into broad dimensions of psychopathology (i.e., internalizing and externalizing dimensions). Prevalence rates of most mental disorders, when examined independently, are substantially lower in older than in younger adults, which may affect this metastructure. Within a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093), we developed a dimensional liability model of common psychiatric disorders to clarify whether aging affects specific disorders or general dimensions of psychopathology. Significant age differences existed across age groups (18-24, 25-34, 35-44, 45-54, 55-64, 65-75 and 75+), such that older adults showed lower prevalence rates of most disorders compared to younger adults. We next investigated patterns of disorder comorbidity for past-year psychiatric disorders and found that a distress-fear-externalizing liability model fit the data well. This model was age-group invariant and indicated that the observed lower prevalence of mental disorders with advancing age originates from lower average means on externalizing and internalizing liability dimensions. This unifying dimensional liability model of age and mental disorder comorbidity can help inform the role of aging on mental disorder prevalence for research and intervention efforts, and service planning for the impending crisis in geriatric mental health. [ABSTRACT FROM AUTHOR]

Limited literature suggests that there may be differences in how women and men experience borderline personality disorder (BPD) symptoms. The aim of the current study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of BPD symptom severity, there are sex differences in the likelihood of reporting DSM-IV BPD symptoms. We conducted these analyses using a large, nationally representative sample from the USA (n = 34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Data from women and men were compared. There were statistically and clinically significant sex differences for 3 out of the 9 DSM-IV BPD symptoms. We found that women were more likely to experience suicidal/self-mutilation behavior, affective instability and chronic feelings of emptiness and tended to be less likely to endorse impulsivity at lower levels of borderline personality disorder severity than men, while affective instability and chronic feelings of emptiness appeared to be significantly less discriminant in terms of severity in men than in women. There were no significant differences between women and men on the remaining DSM-IV symptoms. Overall, our findings indicate substantial sex differences in borderline personality disorder symptom expression. Although our results may reflect sex-bias in diagnostic criteria, they are in keeping with recent arguments suggesting that BPD could be understood as a clinical phenomenon that may partially differ in men and women. [ABSTRACT FROM AUTHOR]

Abstract: Background: The explanation of the lower lifetime prevalence rate of major depressive disorder (MDD) in older adults compared to younger people in community surveys is debated. This study examines the hypothesis that the decrease of the lifetime prevalence of MDD in older adults may be due to an age-related difference in the lifetime prevalence of subthreshold hypomania and, to a lesser extent, to the increased rate of medical induced-depression. Methods: Data were derived from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a national representative sample of 43,093 adults of the United States population. We examined lifetime prevalence rates of pure MDD and MDD plus subthreshold hypomania (D(m)) by age, assuming that the lifetime prevalence of pure MDD in older adults would be similar to that in the youngest cohort, consequent to an inverse age-D(m) relationship. We further considered non-hierarchical MDD (i.e., general medical condition depressive disorders were not ruled out) with the same method. Results: The lifetime prevalence of D(m) among depressed adults aged 65 years and over was substantially lower compared to the youngest group. When considering non-hierarchical MDD, the odds ratio of the lifetime prevalence estimates of non-hierarchical pure MDD in older adults compared to the youngest group appeared not significantly different from 1. Conclusions: Findings indicate that the decrease of lifetime prevalence of MDD in older adults may be due to an age-related difference in the lifetime prevalence of subthreshold hypomania and, to a lesser extent, to the increased rate of medical induced-depression. [Copyright &y& Elsevier]

Abstract: Background: Research on the generalizability of clinical trials in panic disorder is limited. The present study sought to quantify the generalizability of clinical trials'' results of individuals with DSM-IV panic disorder (PD) to a large community sample. Methods: Data were derived from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a large national representative sample of 43,093 adults of the United States population. We applied a standard set of eligibility criteria representative of PD clinical trials to all adults with past 12 months PD (n=907), and then to a subgroup of participants seeking treatment (n=105). Our aim was to determine the proportion of participants with PD who would have been excluded by typical eligibility criteria. Results: We found that more than 8 out of ten participants (80.52%; 95% CI=77.13–83.52%) with PD were excluded by at least one criterion. In the subgroup of participants who sought treatment, the exclusion rate by at least one criterion was higher (92.40%; 95% CI=84.60–96.42%). For the full sample and the treatment-seeking subsample, having currently a depression and a diagnosis of alcohol or drug abuse/dependence were the criteria excluding the highest percentage of participants. Having a lifetime history of bipolar disorder and a current significant medical condition also excluded a substantial proportion of individuals in both samples. Exclusion rates were similar when considering panic disorder with and without agoraphobia. Conclusions: Clinical trials, that exclude a majority of adults with panic disorder, should carefully consider the impact of eligibility criteria on the generalizability of their results. As required by CONSORT guidelines, reporting exclusion rate estimate and reasons of eligibility should be mandatory in both clinical trials and meta-analyses. [Copyright &y& Elsevier]

Abstract: This study presents gender effects in sociodemographics and psychiatric correlates of bullying in the United States. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of U.S. adults. Face-to-face interviews of more than 43,000 adults were conducted during the 2001–2002 period. The present study compared 2460 respondents who ever bullied with 39,501 respondents who did not, stratified by gender. The prevalence of this behavior in the U.S. was significantly higher in men (8.5%) than in women (4.2%). Multivariate logistic regression analyses indicated strong associations in both genders with numerous psychiatric and addictive disorders with significant gender effects. Following adjustments for sociodemographic characteristics and other antisocial behaviors, women who ever bullied were significantly more likely to have any lifetime externalizing, including conduct disorder, as well as any lifetime internalizing spectrum disorder compared to men with such behavior. Bullying in women may be a symptom of a broader syndrome than in men, including more prevalent impairment of impulse control and more frequent affective disorders. [Copyright &y& Elsevier]

Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia. [ABSTRACT FROM AUTHOR]