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Objective: To address the impact of the COVID-19 pandemic and its relevant political climate on college-level international students in the United States. Participants: International students aged 18 years and older in the San Francisco Bay Area. Methods: A descriptive cross-sectional survey using PHQ-9 and the GAD-7. Results: The prevalence of depression and anxiety significantly decreased during the last two weeks from the survey completion in April or May in 2021 (Time 2) as compared to the two weeks after the July 6th policy directive in 2020 (Time 1). However, both depression severity, 2.172 (95% CI: 1.900, 2.445), and anxiety severity, 1.897 (95% CI: 1.655, 2.138), during Time 2 were still mild, indicating the ongoing COVID-19 pandemic had still negatively impacted their mental health status. Conclusions: Future research can expand the target population and analyze the long-term effects of policy changes and disease outbreaks on international students in the United States. [ABSTRACT FROM AUTHOR]

Background: The global health burden has surged due to a significant rise in anxiety and depression cases. In India, pandemic-related factors caused an increase in depression and anxiety levels. Various studies highlight the lifetime prevalence of these mental health disorders. It is essential to identify and monitor depression and anxiety symptoms in individuals across age groups. This study aims to gain insight into anxiety and depression prevalence by utilizing Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) to assess symptoms and their correlation with age and gender. Methods: A total of 136 individuals, both male and female, completed PHQ-9 and GAD-7 in a self-report format. Informed consent was obtained from each participant prior to their participation in the research. Data was collected and analyzed using Microsoft Excel. Charts and graphs aided data interpretation. Conclusion: Results revealed correlations between age and anxiety or depression severity. Younger age groups consistently reported higher symptom levels than older individuals. Tailored mental health interventions considering age and gender dynamics are crucial, like severe symptom intervention for ages ‘18-24,’ addressing severe anxiety and depression in the ‘25-44’ group, and implementing prevention initiatives for the ‘45 and above’ group [ABSTRACT FROM AUTHOR]

Objective: Depression is the most commonly observed psychological manifestation experienced by individuals diagnosed with cancer. The purpose of the study was to investigate the association between levels of IL-4, BDNF, neopterin, and depressive symptoms in lymphoma patients receiving consecutive cycles of chemotherapy. Methods: Newly diagnosed lymphoma patients scheduled to receive R-CHOP chemotherapy were enrolled. Effects of R-CHOP on circulatory biomarkers and depressive symptoms were assessed at three-time points [baseline assessment 7 days before the first dose of chemotherapy (TP1), interim assessment after the third cycle of chemotherapy (TP2), and follow-up assessment after the 6th cycle of chemotherapy (TP3)]. Results: Seventy lymphoma patients, with a mean age of 44.17 ± 13.67 years, were enrolled. Patients receiving R-CHOP were found significantly increased neopterin levels between given time points TP1 vs. TP2, TP1 vs. TP3, and TP2 vs. TP3 (p < 0.001). However, IL-4 and BDNF levels significantly decreased with consecutive cycles of chemotherapy (p < 0.001). On Patient Health Questionnaire assessment (PHQ-9), scores of items like loss of interest, feeling depressed, sleep problems, loss of energy, and appetite problems were found significantly affected with consecutive cycles of chemotherapy (p < 0.001). The study found weak negative correlations between IL-4, BDNF, and neopterin levels and changes in PHQ-9 scores at both TP2 and TP3, suggesting a potential inverse relationship between these markers and depression symptoms. Conclusion: In conclusion, the present study suggests a potential link between elevated neopterin levels, decreased IL-4, and BDNF levels, and the presence of depression in lymphoma patients receiving R-CHOP chemotherapy. This study provides valuable insights into understanding the emotional challenges faced by cancer patients, offering information for more personalized interventions and comprehensive support approaches within the oncology setting. [ABSTRACT FROM AUTHOR]

Background: Patients with type 2 diabetes mellitus (T2DM) face an increased risk of developing depression and metabolic dysregulation, which can lead to a higher risk of cardiovascular disease (CVD). However, the relationship between the severity of depression and metabolic dysregulation in patients with T2DM remains unclear. This study aimed to investigate this association using data from the ACCORD‐health‐related quality of life study. Methods and Results: Patient Health Questionnaire‐9 (PHQ‐9) scores and medication regimens were assessed at baseline, 1, 3, and 4 years, and HbA1c, blood pressure, and lipid levels were monitored every 4 months over a 4‐year period. The severity of depressive symptoms was categorized as none (0–4 points), mild (5–9 points), or moderate–severe (10–24 points) based on PHQ‐9 scores. Among the participants, 62% developed depressive symptoms at some point during the 4‐year follow‐up period, with 21% experiencing persistent depressive symptoms. Participants with moderate‐to‐severe depression exhibited 0.18% (0.12, 0.24) higher levels of HbA1c, 1.11 mmHg (95% CI, 0.04, 2.15) of SBP, 0.90 mmHg (95% CI, 0.22,1.58) of DBP, and 2.12(95% CI, −0.03, 4.27) mg/dL of LDL, and 0.97 (95% CI, 0.38, 1.56) mg/dL lower levels of HDL compared to their counterparts without depressive symptoms. Moreover, as the severity of depressive symptoms increased, variability in HbA1c and blood pressure levels also increased. Furthermore, patients with more severe depressive symptoms demonstrated suboptimal adherence to medication regimens. Conclusion: Our study found a significant association between depressive symptoms severity and metabolic control in T2DM patients. Greater depressive severity correlated with poorer glycemic, blood pressure, and lipid control, alongside increased variability in these parameters. Additionally, patients with severe depressive symptoms showed suboptimal medication adherence. Addressing mental health in T2DM management is crucial to improve metabolic control and reduce CVD risks. Trial Registration: ClinicalTrials.gov identifier: NCT00000620 [ABSTRACT FROM AUTHOR]

The Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) are commonly used scales to measure depression severity in older adults. We utilized data from the Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM) clinical trial to produce conversion tables relating PHQ-9 and MADRS total scores. We split the sample into training (N = 555) and validation samples (N = 187). Equipercentile linking was performed on the training sample to produce conversion tables for PHQ-9 and MADRS. We compared the original and estimated scores in the validation sample with Bland-Altman analysis. We compared the depression severity level using the original and estimated scores with Chi-square tests. The Bland-Altman analysis confirmed that differences between the original and estimated scores for at least 95 % of the sample fit within 1.96 standard deviations of the mean difference. Chi-square tests showed a significant difference in the proportion of participants at each depression severity category determined using the original and estimated scores. The conversion tables should be used with caution when comparing depression severity at the individual level. Our conversion tables relating PHQ-9 and MADRS scores can be used to compare treatment outcomes using aggregate data in studies that only used one of these scales. • Equipercentile linking was used to produce conversion tables for PHQ-9 and MADRS. • Total scores can be compared using the conversion table for aggregate data. • Comparing total scores between individuals should be done with caution. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence indicated that depression is currently one of the most burdensome diseases worldwide, and it can lead to a variety of functional physical impairments. However, the studies estimated the association between depression and thyroid function remain sparse. We aimed to investigate the association between depression and thyroid function in the American population. Methods: A cross-sectional analysis was performed using the data from the National Health and Nutrition Examination Survey conducted from 2007 to 2012. In the 12,502 adults aged 20-80 years, weighted linear regression models and multiple logistic regression models were applied to evaluate the association between depression and thyroid function indicators. The thyroid indicators investigated were mainly free thyroxine (FT4), total T4 (TT4), free triiodothyronine (FT3), total T3 (TT3), thyroid-stimulating hormone (TSH), and antithyroperoxidase antibody (TPOAb), thyroglobulin (Tg) and antithyroglobulin antibody (TgAb). Results: The final results were reached after adjusting for various confounding factors. In the stratification analysis of subgroups divided by age, depression was significantly negatively correlated with FT4, FT3, and TT3 in both younger adults (p = 0.00122, p < 0.00001, and p = 0.00003) and older adults (p = 0.00001, p = 0.00004, and p < 0.00001). In contrast, depression was significantly negatively correlated with TT4 and Tg in older adults (p = 0.00054, p = 0.00695) and positively correlated in younger adults (p = 0.01352, p < 0.00001). The subgroup analysis by gender revealed that depression was significantly negatively correlated with FT4, FT3, and TT3 in both adult males (p = 0.0164, p = 0.0204, and p = 0.0050) and adult females (p = 0.0001, p < 0.0001, and p < 0.0001), which was more prominent in females. The positive correlation between depression symptoms and TPOAb was only found in adult females (p = 0.0282) and younger adults (p = 0.00488). Conclusion: This study confirmed a significant correlation between depressive and thyroid function and it varied among different genders or age. In the future, more prospective studies are needed to reveal these findings and confirm a causal relationship between them. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the prevalence of anxiety and depression among patients with glaucoma compared to the average Brazilian prevalence (9.8% of anxiety and 5.8% of depression, according to the World Health Organization) and its correlation with the severity of the disease. Methods: This was a transversal, single-arm trial of patients from four glaucoma centers in São Paulo and Curitiba--Brazil. Patients comprised adults at least 18 years of age with glaucoma diagnosis under treatment for at least 6 months. All subjects of the study answered two questionnaires (PHQ-9 and GAD-7) to evaluate the presence of anxiety and depression, and the results were analyzed accordingly to clinical and demographic characteristics. Results: The protocol included a total of 210 patients. The average age was 61.6 ± 15.3 years, and the female gender was more common (68.86%). Primary open-angle glaucoma was the most common diagnosis (59.90%). The average IOP was 18.5 mmHg, and 1.5 anti-glaucoma drops were the mean treatment. The prevalence of depression and anxiety was 26.90 and 25.71%, respectively. Most patients with anxiety were classified as early glaucoma, while those with depression had severe glaucoma. Conclusion: This study found that the prevalence of anxiety and depression among patients with glaucoma is higher than in the general population in our country. [ABSTRACT FROM AUTHOR]

Scores on the Patient Health Questionnaire–9 (PHQ-9) are frequently used to assess depression both in research and in clinical practice. The aim was to examine the validity of the PHQ-9 sum score by using Mokken scale analysis (Study I) and cognitive interviews (Study II) on the Icelandic version of PHQ-9. A primary care sample of 618 individuals was used in Study I. The results indicate that the PHQ-9 items are not close enough to perfectly unidimensional for their sum score to accurately order people on the depression severity dimension. In Study II, the sample consisted of 53 individuals, with 28 having a history of depression and 25 not. The findings reveal a number of issues concerning respondents' use of the PHQ-9. No systematic differences were found in the results of the two groups. The PHQ-9 sum score should thus be interpreted and used with great care. We provide scale revision recommendations to improve the quality of PHQ-9. [ABSTRACT FROM AUTHOR]

Objective: Vortioxetine has demonstrated safety and efficacy in improving symptoms of major depressive disorder (MDD), including overall functioning in real-world settings. This is the first study in a real-life clinical setting in India to evaluate effectiveness and safety of vortioxetine in patients with MDD. Methods: This interventional, open-label study consisted of a 12-week treatment period with flexible doses of vortioxetine (5–20 mg/day) in adult patients (aged 18–65 years) with a confirmed MDD diagnosis. Effectiveness outcomes included change from baseline to week 12 in Patient Health Questionnaire-9 (PHQ-9) and Clinical Global Impression–Severity (CGI-S) scores, along with CGI-Improvement (CGI-I) scores at week 12, using a mixed model for repeated measures. Adverse events (AEs) were recorded for safety outcome assessments. Results: Of 395 patients who received vortioxetine, 42.3% were women mean age 38.9 years; 322 patients completed the study. Significant improvement in depressive symptoms was observed in change from baseline to week 12 least squares (LS) mean (SE) PHQ-9 total score (−9.36 [0.276]; p<.0001) and CGI-S score (−2.14 [0.065]; p<.0001). LS mean (SE) CGI-I score showed significant improvement at week 12 (1.93 [0.067]; p<.0001). Subgroup analysis across age, sex, disease severity, and body mass index showed significant improvements in depression symptoms and severity. A total of 35.4% (n = 140) of patients experienced treatment-emergent AEs (mostly mild-moderate); nausea and pruritus were the most frequent (6.6%, n = 26 each). Conclusion: Safety and effectiveness of vortioxetine in improving symptoms of MDD over a 12-week period was demonstrated in a real-life clinical setting in India. Clinical trial registration information: Open-label, flexible-dose study of vortioxetine in patients with major depressive disorder in India; Clinical Trials.gov ID: NCT04288895; [ABSTRACT FROM AUTHOR]

Background: Young adults report increased rates of anxiety and depression than other age groups. Furthermore, young adult athletes experience additional stressors that may negatively impact their mental health. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among Division I collegiate athletes and the influences of sex, sport type, and distance from home. Hypothesis: It was hypothesized that self-reported levels of anxiety and depression would increase among this population during this timeframe. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Participants included 792 incoming Division I collegiate athletes. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores were completed by all incoming student athletes at a single institution as part of their preparticipation examination over 5 years. Both survey scores were categorized into different levels of severity and separately compared with chi-square tests. Continuous scores were modeled separately using negative binomial regression models including year, sex, sport type, and home location as covariates. Results: Results showed consistent levels of anxiety and depression over time. Female athletes reported higher levels of both anxiety and depression than male athletes, and individual sport athletes reported higher levels of depression than team sport athletes. Distance from home was not associated with anxiety or depression levels. Conclusion: Overall, levels of anxiety and depression did not change in this population over this time period. However, differences in anxiety and depression were seen between sexes and depression between sport types. Clinical Relevance: Understanding anxiety and depression risk factors among collegiate athletes can enhance early identification and intervention to improve mental health and allow for better allocation of resources to at-risk groups among Division I collegiate athletes. [ABSTRACT FROM AUTHOR]

Mobile sensing-based depression severity assessment could complement the subjective questionnaires-based assessment currently used in practice. However, previous studies on mobile sensing for depression severity assessment were conducted on homogeneous mental health condition participants; evaluation of possible generalization across heterogeneous groups has been limited. Similarly, previous studies have not investigated the potential of free-living audio data for depression severity assessment. Audio recordings from free-living could provide rich sociability features to characterize depressive states. We conducted a study with 11 healthy individuals, 13 individuals with major depressive disorder, and eight individuals with schizoaffective disorders. Communication logs and location data from the participants' smartphones and continuous audio recordings of free-living from a wearable audioband were obtained over a week for each participant. The depression severity prediction model trained using communication log and location data features had a root mean squared error (rmse) of 6.80. Audio-based sociability features further reduced the rmse to 6.07 (normalized rmse of 0.22). Audio-based sociability features also improved the F1 score in the five-class depression category classification model from 0.34 to 0.46. Thus, free-living audio-based sociability features complement the commonly used mobile sensing features to improve depression severity assessment. The prediction results obtained with mobile sensing-based features are better than the rmse of 9.83 (normalized rmse of 0.36) and the F1 score of 0.25 obtained with a baseline model. Additionally, the predicted depression severity had a significant correlation with reported depression severity (correlation coefficient of 0.76, p < 0.001). Thus, our work shows that mobile sensing could model depression severity across participants with heterogeneous mental health conditions, potentially offering a screening tool for depressive symptoms monitoring in the broader population. [ABSTRACT FROM AUTHOR]

Objectives: The study examined the impact of long term COVID-19 infection on the patients' erectile function and anxiety and depression in the same patients as well as the impact of daily tadalafil 5 mg supplementation on their erectile function. Methods: Recovered 114 men were evaluated by the validated Arabic version of the international index of erectile function (ArIIEF-5) and the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at time of presentation, at 3 months and at 6 months, respectively. Forty recovered patients who still complained of ED received tadalafil 5 mg daily for 2 months then were evaluated again at 3 and 6 months by penile duplex, the Arabic versions of the patient health questionnaire-9 (PHQ-9) and the generalized anxiety disorder-7 (GAD-7) at the same periods, respectively. Results: At the time of presentation, there was a positive correlation between the severity of COVID-19 infection, ArIIEF-5 and PHQ-9 (r = 0.249, p = 0.008; r = 0.241, p = 0.010, respectively). Most of the patients showed normal penile duplex parameters. There were 40 ED patients at presentation, 5 ED patients at 3 months and 3 ED patients at 6 months, respectively. Conclusions: ED in COVID-19 patients who were not suffering from chronic illnesses before the affection, is primarily psychological and completely responsive to tadalafil. [ABSTRACT FROM AUTHOR]

Background: The intricate pathophysiological mechanisms of major depressive disorder (MDD) necessitate the development of comprehensive early indicators that reflect the complex interplay of emotional, physical, and cognitive factors. Despite its potential to fulfill these criteria, interoception remains underexplored in MDD. This study aimed to evaluate the potential of interoception in transforming MDD's clinical practices by examining interoception deficits across various MDD stages and analyzing their complex associations with the spectrum of depressive symptoms. Methods: This study included 431 healthy individuals, 206 subclinical depression individuals, and 483 MDD patients. Depressive symptoms and interoception function were assessed using the PHQ‐9 and MAIA‐2, respectively. Results: Interoception dysfunction occurred in the preclinical phase of MDD and further impaired in the clinical stage. Antidepressant therapies showed limited efficacy in improving interoception and might damage some dimensions. Interoceptive dimensions might predict depressive symptoms, primarily enhancing negative thinking patterns. The predictive model based on interoception was built with random split verification and demonstrated good discrimination and predictive performance in identifying MDD. Conclusions: Early alterations in the preclinical stage, multivariate associations with depressive symptoms, and good discrimination and predictive performance highlight the importance of interoception in MDD management, pointing to a paradigm shift in diagnostic and therapeutic approaches. [ABSTRACT FROM AUTHOR]

Background: The main objective of this study was to provide Spanish normative data for the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Assessment-7 (GAD-7) in a community-derived sample of adolescents. Method: A total of 2,235 adolescents (M = 14.68 years, SD = 1.76 years), selected through stratified cluster sampling, participated in the study. Results: Self-reported symptoms of depression and anxiety were common. Statistically significant differences were found when comparing the means scores of PHQ-9 and GAD-7 across sex and age. Percentile scores were computed for both total scores and were stratified by sex and age. Conclusions: Both the PHQ-9 and the GAD-7 are brief, simple, and useful measurement instruments with adequate psychometric properties for the assessment of self-reported depressive and anxious symptomatology among Spanish adolescents. A reliable and valid assessment of mental health is essential, as it allows for early detection and identification, which in turn can help in guiding psychological preventive interventions in a critical human developmental stage such as adolescence. [ABSTRACT FROM AUTHOR]

Exposure and damage caused by noise have been reported in many countries around the world. However, few nationwide studies explored the association of residential environmental noise with depressive symptoms, this study aims to examine this association. The Korean Community Health Survey at the individual-level and the Korean Environmental Noise Measurement Database at the regional-level were used. A total of 30,630 individuals were eligible for the analysis. Multilevel model framework was applied to account for the clustered structure of the regional-level data in which individual-level data containing demographic characteristics and health information were nested. As a result of the analysis, Individuals living in the highest environmental noise area had a 1.55 times higher likelihood of experiencing depressive symptoms than those living in the lowest environmental noise area (95% CI, 1.04–2.31). After stratified analysis according to depressive symptom severity, individuals residing in areas with the highest environmental noise exposure had significantly higher odds of mild (aOR, 1.46; 95% CI, 1.02–2.07) and moderate symptoms (aOR, 1.70; 95% CI, 1.00–2.91). In conclusion, the higher the residential environmental noise, the higher the possibility of mild-to-moderate depressive symptoms. Our findings suggest the need for continued attention to and management of noise pollution, which has the potential to adversely affect individual's mental health. [ABSTRACT FROM AUTHOR]

The association between diabetes and depressive symptoms is well recognized. However, the impact of depressive symptoms on prediabetes remains unclear. This study aims to explore the specific correlation between depressive symptoms and prediabetes. A total of 7467 participants from the National Health and Nutrition Examination Survey (NHANES) were included in this study, spanning five rounds of surveys conducted between 2007 and 2016. Weighted logistic regression was utilized to assess the relationship between depressive symptoms and prediabetes. Compared with the normoglycemic population, individuals with prediabetes had a significantly higher probability of experiencing trouble sleeping (P = 0.020). After adjusting for non-glucose factors, there was no significant correlation between PHQ-9 and prediabetes; however, severe depressive symptoms were positively associated with abnormal fasting plasma glucose (FPG) levels (OR = 1.093 [95 % CI 1.002, 1.192]). There was a positive correlation between trouble concentrating and FPG abnormalities (OR = 1.065 [95 % CI 1.004, 1.129]). The cross-sectional design limits causal inference. Individuals with depressive symptoms, especially severe cases, should be targeted for prediabetes prevention and management efforts. The diverse symptom presentations may have distinct impacts on glucose, necessitating personalized prevention and management strategies. • Depressive symptoms may be positively associated with prediabetes. • Severe depressive symptoms and trouble concentrating are specifically linked to elevated fasting plasma glucose (FPG) levels. • It appears that depressive symptoms have minimal impact on hemoglobin A1c (HbA1c) levels. [ABSTRACT FROM AUTHOR]

Previous studies suggest an association between Post-concussion syndrome (PCS) and depression, both highly prevalent after mTBI. To assess the prevalence and risk-factors of depression among patients with PCS 1 month after mTBI. We prospectively screened 372 mTBI patients admitted in two academic Emergency Departments between 2017 and 2019. One month after mTBI, we administered the Rivermead Post-concussion symptoms Questionnaire (RPQ) and the Patient Health Questionnaire (PHQ-9) questionnaires over the telephone. PCS and depression were defined by RPQ ≥ 12 and PHQ-9 ≥ 10. Multivariate multinomial regression identified baseline factors associated with PCS and depression. Two hundred and eight completed RPQ and PHQ-9. Forty-seven patients (22.5%) met criteria for PCS, among which 22 (46.8%) met criteria for depression (PCS+D+). Patients with PCS but without depression were less likely to present with an associated injury (Coefficient = −1.6, p = 0.047) and to report initial sadness (Coefficient = −2.5, p = 0.03). Initial sadness (Coefficient = −1.3, p = 0.047), associated injury (Coefficient = −1.9, p = 0.008), as well as initial nausea (Coefficient = −1.8, p = 0.002), and male sex (Coefficient = 1.8, p = 0.002), were associated with the absence of depression and PCS in comparison with PCS+D+ patients. Among patients with PCS 1 month after mTBI, those with depression are more likely to present with initial sadness and with an associated injury. [ABSTRACT FROM AUTHOR]

Perinatal depression has attracted increasing attention. However, a detailed investigation of the network structure of depression is still lacking. We aim to examine the similarities and differences between the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) from a network perspective. A cross-sectional study was conducted from August 2020 to March 2022. We followed the STROBE checklist to report our research. Pregnant women (n = 2484) were recruited. All participants completed the EPDS and PHQ-9. We mainly used network analyses for statistical analysis and constructed two network models: the EPDS and PHQ-9 models. The detection rates of prenatal depression measured by the EPDS and PHQ-9 were 30.2 % and 28.2 %, respectively. In the EPDS network, the EPDS8 'sad or miserable' node (strength = 1.2161) was the most central node, and the EPDS10 'self-harming' node (strength = 0.4360) was the least central node. In the PHQ-9 network, the PHQ4 'fatigue' node (strength = 0.9815) was the most central node, and PHQ9 'suicide' was the least central symptom (strength = 0.5667). For both models, 'sad' acted as an important central symptom. Psychological symptoms may be more important in assessing depression using the EPDS, while physical symptoms may be more influential in assessing depression using the PHQ-9. For both the EPDS and PHQ-9, "sad" was an important central symptom, suggesting that it may be the most important target for further maternal depression interventions in the future. • We can focus on pregnant women with prominent psychological or physical symptoms according to the results of the EPDS and develop targeted treatment and nursing measures to better help pregnant women maintain positive attitudes through the perinatal period. The implications of this study are: • Psychological symptoms may be more important when assessing maternal depression using the EPDS, while physical symptoms may be more influential when assessing depression with the PHQ-9. • Attention should be paid to pregnant women with not only psychological symptoms of depression but also physical symptoms, such as fatigue, sleep and appetite changes, as they may suffer from prenatal depression. • In addition to those for cognitive-affective symptoms, the treatment and nursing measures for physical symptoms such as fatigue may also contribute to the treatment of prenatal depression. [ABSTRACT FROM AUTHOR]

Excessive alcohol consumption has been consistently linked to depression. This study, utilizing nationwide samples from the Korea National Health and Nutrition Examination Survey (n = 21,440) examined the association between drinking behaviors and depressive symptoms while also exploring the influence of sleep duration on this relationship. Demographic, socioeconomic, and health-related factors were included as covariates in the multivariable logistic regression analysis to assess their relationships with depressive symptoms. Based on their sleep duration, the participants were divided into subgroups to explore how sleep duration affects the relationship between drinking behaviors and depressive symptoms. Moderate alcohol consumption (1–4 times a month) was associated with reduced likelihood of experiencing depressive symptoms in women (p = 0.024), with a similar trend observed among men (p = 0.001). Men who started consuming alcohol before the age of 19 had a higher likelihood of experiencing depressive symptoms (p = 0.048). Only women who consumed more alcohol per occasion (≥ 7 drinks) had higher odds of depressive symptoms (p = 0.001). This study revealed complex factors that influence depressive symptoms, including alcohol consumption and sleep duration. This highlights the importance of tailored interventions based on sleep duration and sociodemographic characteristics for preventing and treating depression. [ABSTRACT FROM AUTHOR]

Background: Depression has a negative impact on the health outcomes of hemodialysis (HD) patients, including decreased quality of life and increased morbidity and mortality rates. Therefore, this study aimed to determine the prevalence of depression and its associated factors among HD patients in Hodeida city, Yemen. Methods: A cross-sectional study involving 200 HD patients at the Dialysis Center in Hodeida was conducted from February to May 2022. Data on depression were collected using the 9-item Patient Health Questionnaire (PHQ-9). Association of sociodemographic characteristics of patients with depression were assessed using chi-square, subsequently by multivariable logistic regression. Statistical significance was set at P-values < 0.05. Results: The response rate was 98% (200/204). Depression was prevalent among 63% of HD patients at the Dialysis Center in Hodeida city. Sex was significantly associated with depression, where female patients were more frequently depressed than males (82.4% vs 56.4%, P < 0.001). In addition, employment status and medical insurance were significantly associated with depression, where unemployed patients were more frequently depressed than employed patients (67.6% vs 52.5%, P = 0.041) and patients with medical insurance were less frequently depressed than their counterparts (47.1% vs 66.3%, P = 0.035). Conclusion: Depression is highly prevalent among HD patients in Hodeida city. Female sex, unemployment and lack of medical insurance are predictors of depression among HD patients. These findings emphasize the urgent need for targeted interventions. Implications for practice: Depression is common among HD patients, so that, psychiatric physicians and nurses are increasingly needed in HD centers to implement mental health assessment of patients for depression signs and symptoms to help in early diagnosis and management of depression in order to improve patients' quality of life and preventing negative outcomes. [ABSTRACT FROM AUTHOR]

Background: People are more likely to fall victim to depression during adolescence since it is a period of rapid biopsychosocial transformation. Despite this, most depression research has concentrated on clinical issues, and evaluating depressive symptoms in teenagers is not as widespread. This study used item response theory (IRT) to examine the psychometric properties of the Patient Health Report scale (PHQ-9) in Chinese adolescents. Meanwhile, item function difference tests were used to check whether there were differences in depression symptoms in this group based on education and gender. Methods: In this research, the PHQ-9 was employed as a measurement tool, and 5958 valid data points were obtained from 12 secondary schools in China (Mage = 13.484; SDage = 1.627; range 11–19 years; 52.17% boys). Results: IRT shows that all items of the PHQ-9 satisfy monotonicity, unidimensionality and local independence and that they have good psychometric properties. Furthermore, DIF analysis revealed gender and educational disparities in adolescent depressive symptoms. Conclusion: The study indicates that the PHQ-9 possesses favourable psychometric properties for use in Chinese adolescents. As a result, it serves as a valuable tool for effectively screening depressive symptoms in adolescents. It provides a foundation for prioritizing the development of secondary school students' physical and mental health. [ABSTRACT FROM AUTHOR]

Objective: Depressive symptoms can be assessed with self-reported questionnaires, such as the Patient Health Questionary-9 (PHQ-9). Previous studies have suggested that the PHQ-9 items can be grouped into somatic and nonsomatic clusters. However, the classification of the PHQ-9 item "concentration difficulties" into somatic or non-somatic is still controversial. This controversy may be explained by difficulties experienced by subjects in accurately evaluating their attention problems. The primary objective of this study was to determine the correlation between objective attentional performance and the two clusters of depressive symptoms in hospital employees working in stressful conditions. Methods: The participants filled out the PHQ-9 to identify their depressive symptoms. Based on the PHQ-9, the somatic or non-somatic symptoms were measured without considering the question about subjective concentration difficulties. Then, a brief version of the Continuous Visual Attention Test (CVAT) was applied to assess four attentional subdomains. The CVAT is a Go/No-go task that measures number of correct responses (focused attention), number of incorrect responses (behavior-inhibition), average reaction time of correct responses (RT-alertness), and variability of reaction time (VRT-sustained attention). The entire task lasted 90 s. Correlation analyses assessed the relationships between attentional performance and the two dimensions of depressive symptoms. Results: After applying the inclusion/exclusion criteria, 359 individuals were selected. Their age ranged from 20 to 70 years (mean = 40.5, SD = 10.37), and the majority was female (67.6%). A predominance in somatic depressive symptoms was present in 231 (64%) participants, whereas 59 (16%) showed a predominance of non-somatic symptoms. Sixty-nine participants (20%) did not show any predominance. Higher somatic scores were associated with higher RTs, whereas higher non-somatic scores were related to an increase in the number of incorrect responses. Conclusion: The predominance of the somatic cluster was related to lower alertness, whereas the predominance of non-somatic cluster was associated with impulsivity/hyperactivity. This result may explain the difficulties associated with correctly classifying the item concentration difficulties. A brief attentional task can be used as an auxiliary tool to correctly identify the different dimensions of attention that are associated with different clusters of depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of depression and anxiety in COVID-19-positive people. Study Design: Cross Sectional study. Setting: Qateef Hospital Kingdom of Saudia Arabia. Period: 25th April, 2021 to 18th May, 2021. Material & Methods: 450 participants were enrolled in this study. Both genders were included who had COVID positive but suffering from depression and anxiety were included in this study. In this study all participants were completed questionnaires describing their social and demographic status, as well as PHQ-9 for depression and GAD-7 for anxiety. To analyze the continuous and categorical data the SPSS version 20 was used. Results: Over four hundred and fifty subjects participated in this cross-sectional study with the age of 49.91±12.2 years. In addition, according to the findings when the PHQ-9 scoring is significant in old age people whereas the GAD-7 is significantly found in young age. Conclusion: The study found the evidence about the probable psychologic difficulties associated with this pandemic and underline the necessity for PHQ-9 and GAD-7 for assessing mental health. The findings of this research provide light on the emotional condition of post-COVID-19 patients and indicate the necessity for depression and anxiety treatment by a psychiatrist. This research will focus in the future on how strongly depression and anxiety in the participants predict mental disorders following COVID-19. [ABSTRACT FROM AUTHOR]

This research compares the capability of data classification models to predict consistent results for a subject's depression potentiality, track the subject behaviour and recognise facial expressions during PHQ-9 assessments. This research is motivated by the necessity for depression screening and diagnosis, which traditionally relies on observations by experienced physicians or clinical psychologists of symptoms in conjunction with data from questionnaires. However, the field still requires a suitable technological approach that gives more accurate and consistent results. All data used in the present research were collected by combining technologies and compared by using classification models, the goal being to find the machine-learning model that most accurately predicts consistent results for the subjects' PHQ-9 assessment, behaviours and emotions. The subjects were screened by clinical psychologists and divided into three groups: (i) subjects suffering from depression but not receiving treatment (undertreated subjects), (ii) subjects undergoing depression treatment (subjects undergoing treatment) and (iii) subjects without depression disorder (normal subjects). Related studies have compared the accuracy of classification models to one another. The four most frequently applied classification models in depressionrelated studies are (i) decision tree (ii) support vector machine, (iii) naïve Bayes and (iv) neural network. All models were analysed, designed and developed before being tested experimentally. The accuracy of the experimental results was tested by using the data analysis tool RapidMiner Studio. The results show that the decision tree model is not only the most accurate for predicting depression potentiality, tracking behaviour and recognising facial expressions during PHQ-9 assessments but also the most suitable. [ABSTRACT FROM AUTHOR]

Background. Depression stands as a significant mood disorder on a global scale. It is known that some physical symptoms show significant positive predictive values (PPV) for depression, such as sleep disturbances (PPV – 61%), fatigue (PPV – 60%), experiencing three or more complaints (PPV – 56%), nonspecific musculoskeletal complaints (PPV – 43%), back pain (PPV – 39%), amplified complaints (PPV 39%), and vaguely expressed complaints (PPV – 37%). The aim of this study. This study aims to evaluate the correlations of subjective expressions of somatic, cognitive, and depressive symptoms severity among individuals at risk of depressive disorder. Methods. The survey consisted of a questionnaire designed by the authors regarding sociodemographic information and two standard questionnaires: PHQ-9 and PHQ-15. Results. 189 individuals had significant severity of depressive symptoms. Multivariable regression analysis indicated that PHQ-9 factor 2 (somatic symptoms) was associated with higher rates of back pain (β = 0.250, p < 0.001), pain in arms, legs, or joints (β = 0.488, p < 0.001), menstrual cramps (β = 0.640, p < 0.001), pain or problems during sexual intercourse (β= 0.270, p < 0.001), headaches (β = 0.304, p < 0.001), chest pain (β = 0.304, p < 0.001), dizziness (β = 0.594, p < 0.001), heart palpitations (feeling heart pound or race) (β = 0.266, p < 0.001), nausea, gas or indigestion (β = 0.281, p < 0.001) and feeling tired or having low energy (β = 0.223, p < 0.001), after adjusting each regression model for the potential confounders. Conclusions. It can be emphasized that individuals who are at risk of developing depression may experience various somatic symptoms that are conditioned by their depressive state. The obtained results indicate that the following research is required to identify other factors affecting the severity of the disease and to determine more sufficient treatment plans. [ABSTRACT FROM AUTHOR]

Objectives: The present study introduces the assessment of depression and depressive symptoms in the German National Cohort (NAKO), a population-based mega cohort. Distribution of core measures, and associations with sociodemographic factors are examined. Methods: The current analysis includes data from the first 101,667 participants (NAKO data freeze 100,000). Depression and depressive symptoms were assessed using a modified version of the depression section of the Mini-International Neuropsychiatric Interview (MINI), selfreported physician's diagnosis of depression, and the depression scale of the Patient Health Questionnaire (PHQ-9). Results: A lifetime physician's diagnosis of depression was reported by 15.0% of participants. Of those, 47.6% reported having received treatment for depression within the last 12months. Of the subset of 26,342 participants undergoing the full depression section of the modified MINI, 15.9% were classified by the MINI with a lifetime depressive episode. Based on the PHQ-9, 5.8% of the participants were classified as currently having a major or other depression by the diagnostic algorithm, and 7.8% according to the dimensional assessment (score ≥ 10). Increased frequency of depression measures and higher depression scores were observed in women and participants with lower education level or a family history of depression. Conclusions: The observed distributions of all depression measures and their associations with sociodemographic variables are consistent with the literature on depression. The NAKO represents a valuable epidemiologic resource to investigate depression, and the range of measures for lifetime and current depression allows users to select the most suitable instrument for their specific research question. [ABSTRACT FROM AUTHOR]

The purpose of this study is to report the utility of a universal depression screening in a student-run free clinic (SRFC) to improve bridging to psychiatric care. Patients (n = 224) seen by an SRFC between April 2017 and November 2022 were screened for depression in the patient's primary language using the standardized Patient Health Questionnaire (PHQ-9). A PHQ-9 score greater or equal to 5 prompted psychiatry referral. Retrospective chart review was conducted to determine clinical characteristics and length of psychiatry follow-up. Out of 224 patients screened, 77 patients had positive depression screens and were referred to the SRFC's adjacent psychiatry clinic. Of these 77 patients, 56 patients (73%) were female, the average age was 43.7 (SD = 14.5), and the mean PHQ score was 10 (SD = 5.13). Thirty-seven patients (48%) accepted referral, while 40 (52%) declined or were lost to follow-up. There were no statistical differences in age or number of medical comorbidities between the two groups. Patients who accepted referrals were more likely to be female, as well as to have psychiatric histories, higher PHQ-9 scores, and a history of trauma. Reasons for declining and being lost to follow-up included transition to insurance, geographic relocation and deferral due to hesitancy in seeking psychiatric care. Implementation of a standardized depression screening reveals a significant rate of depressive symptoms among an urban uninsured primary care population. Universal screening may serve as a tool to improve the delivery of psychiatric care to underserved patients. [ABSTRACT FROM AUTHOR]

Purpose: Many studies have shown conflicting results regarding mental health among transmasculine adults or transgender men (TM). This study aimed to identify the prevalence of depression among Thai TM receiving gender-affirming hormone therapy (GAHT). Methods: All TM, over 18 years of age, who received GAHT for at least three consecutive months were invited to complete a self-report questionnaire that covered participants' demographic and clinical data. Mental health, including depression, anxiety, and quality of life (QoL), was assessed. We reported the prevalence of mental illnesses and examined the correlations between mental health scores and other associated data. Results: A total of 84 TM were included in the analysis. Major depression and generalized anxiety disorder were detected in 14.3% and 3.6%, respectively. Depression severity was negatively associated with age and QoL. Depression and anxiety severity were found to be positively associated. Conclusions: Compared with the general Thai population, the prevalence of mental health problems among Thai TM receiving GAHT was higher. Age of maturity may be a potential mental health protective factor, and assessment in younger individuals may benefit mental health. [ABSTRACT FROM AUTHOR]

Background: Depression with diverse etiologies is exacerbated by chronic diseases, such as chronic kidney disease (CKD), coronary artery disease (CAD), cancer, diabetes mellitus, and hypertension. This study aimed to analyse depression, its associations, and predictors among patients attending the kidney clinic of a teaching hospital. Methods: Data were collected from 01 August 2017 to 30 September 2017 via face-to-face interviews and examination of the medical records of a convenience sample of 314 patients. The patients were categorised broadly as stages I and II with an estimated glomerular filtration rate (eGFR) > 60 mls/min/1.73 m2, and with stages III, IV, and V or GFR ≤ 60 mls/ min/1.73 m2 (or CKD). The Patient Health Questionnaire (PHQ)-9 was the data collection instrument for depression-related data. Results: Participants were predominantly male (n = 179; 57.0%), aged over 60 years (n = 211; 67.2%), Indo-Trinbagonian (n = 237; 75.5%), and with stages III, IV, and V CKD. The two leading comorbid conditions were hypertension (83.4%) and diabetes mellitus (56.1%). Of the 261 (83.1%) patients with recorded eGFR, 113 (43.3%) had Stage III CKD. The mean depression (PHQ-9) score was 13.0/27 ( 9.15), with 306 (97.5%) patients diagnosed as having depression with the following severities: mild (n = 116; 37.9%), moderate (n = 138, 45.1%), moderately severe (n = 38; 12.4%), and severe (n = 14; 4.6%). Depression was independent of sex. Nine sociodemographic variables were associated with depression; however, 'level of education', was the only predictor of depression with greater severity associated with lower levels of education. eGFR was negatively correlated with the PHQ-9 scores (Pearson's correlation, r = -0.144, p = 0.022). At least 78.3% of the patients who self-reported no depression had clinical depression (moderate, moderately severe, or severe) PHQ-9 scores ≥ 10. Conclusion: Depression was a significant comorbidity among patients with CKD, with the majority displaying clinical depression. "Level of education" was the only predictor of depression. Self-reported depression is an unreliable method for evaluating clinical depression. [ABSTRACT FROM AUTHOR]

Depression and sleep disturbances are highly prevalent health problems that have been suggested to be associated with vitamin D deficiency. This study investigated whether sleep disturbances affect the association between vitamin D and depressive symptoms. A total of 425 patients with depression were included in this study. Spearman correlation coefficients were chosen to assess the relation between vitamin D concentrations and depressive symptomatology (according to the PHQ-9 and HAMD-17 scores). The GLM Mediation Model in the Medmod module for data analysis in Jamovi 2.2.5 was used to analyze the mediation models for sleep disturbances. Vitamin D concentrations were significantly correlated with PHQ-9 and HAMD-17 scale scores. In addition, item 3 was suggested to have a mediating effect between vitamin D and depressive symptoms in the mediating model of PHQ-9, and item 4 was suggested to have a mediating effect between vitamin D and depressive symptoms in the mediating model of HAMD-17. Sleep disturbances (especially difficulty falling asleep) are mediators between vitamin D and depressive symptoms, suggesting that increasing vitamin D levels at the right time to regulate sleep disturbances may improve depression symptoms, yet further research is necessary. [ABSTRACT FROM AUTHOR]

We introduced methods for solving causal direction of dependence between variables observed in pre- and post-psychotherapy assessments, showing how to apply them and investigate their properties via simulations. In addition, we investigated whether changes in depressive symptoms drive changes in social and occupational functioning as suggested by the phase model of psychotherapy or vice versa, or neither. As a Gaussian (normal-distribution) model is unidentifiable here, we used an identifiable linear non-Gaussian structural vector autoregression model, conceptualizing instantaneous effects as during-psychotherapy causation and lagged effects as pre-treatment predictors of change. We tested six alternative estimators in six simulation settings that captured different real-world scenarios, and used real psychotherapy data from 1428 adult patients (Finnish Psychotherapy Quality Registry; assessments on Patient Health Questionnaire-9 and Social and Occupational Functioning Assessment Schedule). The methodology was successful in identifying causal directions in simulated data. The real-data results provided no evidence for single direction of dependence, suggesting shared or reciprocal causation. A powerful new tool was presented to investigate the process of psychotherapy using observational data. Application to patient data suggested that depression symptoms and functioning may reciprocate or reflect third variables instead of one predominantly driving the other during psychotherapy. [ABSTRACT FROM AUTHOR]

Subclinical depression (SD) is a mental health disorder characterized by minor depressive symptoms. Most SD patients are treated in the primary practice, but many respond poorly to treatment at the expense of provider resources. Stepped care approaches are appealing for tiering SD care to efficiently allocate scarce resources while jointly optimizing patient outcomes. However, stepped care can be time inefficient, as some persons may respond poorly and be forced to suffer with their symptoms for prolonged periods. Machine learning can offer insight into optimal treatment paths and inform clinical recommendations for incident patients. As part of the Step-Dep trial, participants with SD were randomized to receive stepped care (N =96) or usual care (N =140). Machine learning was used to predict changes in depressive symptoms every three months over a year for each treatment group. Tree-based models were effective in predicting PHQ-9 changes among patients who received stepped care (r =0.35–0.46, MAE =0.14–0.17) and usual care (r =0.34–0.49, MAE =0.15–0.18). Patients who received stepped care were more likely to reduce PHQ-9 scores if they had high PHQ-9 but low HADS-A scores at baseline, a low number of chronic illnesses, and an internal locus of control. Models may suffer from potential overfitting due to sample size limitations. Our findings demonstrate the promise of machine learning for predicting changes in depressive symptoms for SD patients receiving different treatments. Trained models can intake incident patient information and predict outcomes to inform personalized care. • Stepped care is appealing for optimizing patient outcomes and provider resources. • Not all patients with depressive symptoms may respond well to stepped care. • Machine learning predicted PHQ-9 changes in patients receiving stepped care and usual care. • HADS-A, chronic illness, and locus of control were the most important predictors. • Trained models can intake incident patient information and generate predictions to inform personalized care. [ABSTRACT FROM AUTHOR]

To evaluate and compare the factor structure and reliability of EPDS and PHQ in antepartum and postpartum samples. Parallel analysis and exploratory factor analysis were conducted to determine the structure of both scales in the entire sample as well as in the antepartum and postpartum groups. McDonald's omega statistics examined the utility of treating items as a single scale versus multiple factors. Multigroup confirmatory factor analysis (MCFA) was utilized to test the measurement invariance between the antepartum and postpartum groups. Two-factor models fit best for the EPDS in both the antepartum and postpartum groups; however, the most reliable score variance was attributable to a general factor for each scale. MCFA provided evidence of weak invariance across groups regarding factor loadings and partial invariance regarding item thresholds. PHQ-9 showed a two-factor model in the antepartum group; however, the same model did not fit well in the postpartum group. EPDS should be preferred to PHQ-9 for measuring depressive symptoms in peripartum populations. Both scales should be used as a single-factor scale. Caution is required when comparing the antepartum and postpartum scores. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and risk factors for depression and anxiety in patients with nasolacrimal duct obstruction (NLDO). Methods: We conducted a telephone-based survey of patients with NLDO who underwent dacryocystorhinostomy (DCR) at the Department of Ophthalmology of Peking University Third Hospital in China between January 2016 and January 2021. Depression and anxiety were assessed with the PHQ-9 (range 0-25) and STAI (range 20-80) scales. PHQ-9 ≥ 5 and STAI ≥ 55 were considered clinically significant. Logistic regression and linear regression were performed to determine the factors related to depression and anxiety. Results: Of 565 patients approached, 344 (60.9%) completed the survey. A total of 13.1% of patients had mild-severe depression and 63.4% had severe anxiety. Univariate logistic regression revealed that hypertension, dry eye, and cataract were associated with mild to severe depression (P = 0.018, 0.045, 0.035, respectively). Dry eye was associated with severe anxiety (P = 0.007). Univariate linear regression revealed that male and income levels were significantly negatively correlated with PHQ-9 scores (P = 0.011, 0.010, respectively). Hypertension and dry eye were significantly positively correlated with PHQ-9 scores (P = 0.030, P < 0.001, respectively). Male, income levels, and educational levels were significantly negatively correlated with STAI scores (P = 0.022, P < 0.001, P = 0.005, respectively). Dry eye was significantly positively correlated with STAI scores (P < 0.001). Conclusion: Prevalence of depression and anxiety disorders was relatively high among NLDO patients. Our results demonstrate the importance of depression and anxiety screening and psychosocial support for patients with NLDO, which can improve their quality of life and compliance with medical appointments. [ABSTRACT FROM AUTHOR]

Depression is a heterogeneous disease. Identification of latent depression subgroups and differential associations across these putative groups and sociodemographic and health-related factors might pave the way toward targeted treatment of individuals. We used model-based clustering to identify relevant subgroups of 2900 individuals with moderate to severe depression (defined as scores ≥10 on the PHQ-9 instrument) from the NHANES cross-sectional survey. We used ANOVA and chi-squared tests to assess associations between cluster membership and sociodemographics, health-related variables, and prescription medication use. We identified six latent clusters of individuals, three based on depression severity and three differentially loaded by somatic and mental components of the PHQ-9. The Severe mental depression cluster had the most individuals with low education and income (P < 0.05). We observed differences in the prevalence of numerous health conditions, with the Severe mental depression cluster showing the worst overall physical health. We observed marked differences between the clusters regarding prescription medication use: the Severe mental depression cluster had the highest use of cardiovascular and metabolic agents, while the Uniform severe depression cluster showed the highest use of central nervous system and psychotherapeutic agents. Due to the cross-sectional design we cannot make conclusions about causal relationships. We used self-reported data. We did not have access to a replication cohort. We show that socioeconomic factors, somatic diseases, and prescription medication use are differentially associated with distinct and clinically relevant clusters of individuals with moderate to severe depression. • Depression is a heterogeneous disease. • We identified six clusters of individuals with moderate to severe depression based on responses to the PHQ-9 instrument. • Three clusters were defined based on depression severity, while the three others were defined based on symptom combinations. • Those with severe mental depression have the worst overall socioeconomic status and physical health. • Identification of latent depression subgroups might help identify individuals for targeted treatment. [ABSTRACT FROM AUTHOR]

The Patient Health Questionnaire (PHQ-9) and the Major Depression Inventory (MDI) are psychometric instruments frequently used for depression diagnosis and monitoring in primary care settings. The goal of this study was to assess and compare the construct validity of the PHQ-9 and the MDI using Rasch analysis. The PHQ-9 and the MDI were distributed in random ordering (first or last) to a waiting room sample of Danish primary care patients. Analysis of fit to the Rasch model, ordering of response categories, dimensionality-testing, test for differential item functioning, test for local dependency, and calculation of reliability indices were used to evaluate the psychometric characteristics of the instruments. A sample of 281 persons (18–87 years, 72 % females) responded to both instruments. Reliability was acceptable for PHQ-9 (PSI 0.80) and excellent for MDI (PSI 0.88). Both instruments demonstrated fit to the Rasch model after rescoring of all items. Dimensionality testing supports that both instruments are unidimensional. Indication of local dependency was observed for PHQ-9 item 2&6 and MDI item 1&4. No indication of differential item functioning regarding age, gender or ordering of instruments was found. The PHQ-9 and the MDI both demonstrate measurement problems. Modifying individual items and reducing the number of response categories in both instruments could potentially improve their measurement capabilities. Study findings do not provide a conclusive indication of which instrument has superior operating characteristics. • The PHQ-9 and the MDI are psychometric instruments frequently used for depression diagnosis and monitoring. • The construct validity of the PHQ-9 and MDI was compared head to head using Rasch analysis. • Reliability was excellent for MDI and acceptable for PHQ. • Both instruments demonstrated measurement problems in terms of local dependency of item pairs. • Both instruments may improve by reducing the number of response categories. [ABSTRACT FROM AUTHOR]

To evaluate the effect of early depressive burden on PROMs in the setting of cervical disc replacement (CDR). Patients who had undergone primary elective CDR with recorded preoperative and 6-week postoperative 9-item Patient Health Questionnaire (PHQ-9) scores were identified. Early depressive burden was calculated via addition of the preoperative and 6-week PHQ-9 scores. Patients were divided into 2 cohorts, those with summative PHQ-9 scores beneath one-half standard deviation less than the mean (Lesser Burden; LB) and those with summative PHQ-9 scores above one-half standard deviation greater than the mean (Greater Burden; GB). Magnitude of improvement in PROMs (ΔPROM) was compared within and between cohorts at 6-weeks (ΔPROM-6W) and final follow-up (ΔPROM-FF). PROMs evaluated included PROMIS-PF/NDI/VAS-Neck (VAS-N)/VAS-Arm (VAS-A)/PHQ-9. Fifty-five patients were included with 34 in the LB cohort. The LB cohort demonstrated improvements from the preoperative baseline in 6-week PROMIS-PF/NDI/VAS-N/VAS-A (P ≤ 0.012, all). The GB cohort demonstrated improvements from the preoperative baseline in 6-week NDI/VAS-N/VAS-A/PHQ-9 (P ≤ 0.038, all). The GB cohort demonstrated greater ΔPROM-6W and ΔPROM-FF in PHQ-9 (P ≤ 0.047, both). The LB cohort demonstrated a greater ΔPROM-FF in PROMIS-PF (P = 0.023). Patients with a greater depressive burden were more likely to experience greater magnitudes of improvements in PHQ-9 at both 6-week and final follow-up and experience clinically meaningful improvement in depressive symptoms. Patients with a lesser depressive burden were more likely to experience a greater magnitude of improvement in PROMIS-PF at final follow-up and experience clinically meaningful improvement in physical function. [ABSTRACT FROM AUTHOR]

Psoriasis is a common, chronic T cell–mediated disease characterised by erythematous, scaly plaques. Psoriasis is associated with depression, anxiety, poor quality of life, harmful use of alcohol and suicidal ideation. We performed this study to find out prevalence of psychological morbidity in our patients with severe psoriasis and to know clinical variables associated with higher risk of psychological morbidity. This study is a cross-sectional, observational study conducted in a dermatology outpatient department (OPD) of a tertiary care centre. Study population included patients with severe psoriasis area severity index (PASI>10). Clinical and epidemiological data, Patient health questionnaire-9, Generalised anxiety disorder-7, Dermatology life quality index (DLQI) and Alcohol Use Disorders Identification Test questionnaires were recorded. Data were analysed using SPSS, version 24. Chi-square test and Spearman's rank correlation test (ρ) were performed, and p value of <0.05 was considered statistically significant. A total of 140 patients were included in the study and consisted of 67 men and 73 women. The median age was 44 years, median duration of disease was 10 years and median PASI was 13.6. Scoring revealed moderate-to-severe depression in 69 (49.3%) patients, moderate-to-severe anxiety in 40 (28.6%), severe impairment in quality of life in 98 (70%), harmful use of alcohol in 23 (16.4%) and suicidal ideation in 11 (7.8%) patients. Young age, recent onset, higher PASI and facial involvement show significant association with depression, anxiety and poor quality of life. Screening for psychological morbidity should be performed in patients with severe psoriasis especially younger patients with recent onset disease. Higher DLQI points to concomitant psychological morbidity and it should be performed in all the patients. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to examine the association between Obstructive Sleep Apnea (OSA) risk, health behaviors, and depressive symptoms in a representative Korean sample. Methods: Cross-sectional data from the 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. The sample included 4,352 adults aged 40 years and older. Multiple linear regression analysis was performed to examine the association between OSA risk, health behaviors, and depressive symptoms. Results: In total, 23.1% of the participants reported a high risk of OSA. Of the respondents, 39.8%, 19.0%, 27.2%, and 8.7% reported hypertension, snoring, tiredness, and observed apnea, respectively. The prevalence of moderate-severe depressive symptoms among adults with high-risk OSA was 7.5%. The significant associations between OSA risk and sex with PHQ-9 were shown in univariate linear regression. In the multiple linear regression analysis, the association between high risk of OSA and PHQ-9 showed in total (B = 1.58; P < 0.001), male (B = 1.21; P < 0.001), and female (B = 1.93; P < 0.001). Conclusions: A high risk of OSA was associated with an increased prevalence of depressive symptoms. Monitoring the risk factors of depressive symptoms, including OSA, or unhealthy behaviors may decrease the mental health issues of middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Background Systematic screening for depressive symptoms may identify patients who may benefit from clinical assessment and psychosocial support. Here we assess a two-step screening using ultrabrief pre-screeners [Edmonton Symptom Assessment Survey–revised Depression item (ESASr-D) or Patient Health Questionnaire-2 (PHQ-2)] followed by the Patient-Reported Outcomes Measurement Information System Depression questionnaire (PROMIS-D) to identify depressive symptoms in patients on kidney replacement therapies. Methods We conducted a cross-sectional study of adults (kidney transplant recipients or treated with dialysis) in Toronto, ON, Canada. We simulated various two-step screening scenarios where only patients above a pre-screening cut-off score on the ESASr-D or PHQ-2 would move to step 2 (PROMIS-D). Screening performance was evaluated by sensitivity, specificity and positive and negative predictive values using the Patient Health Questionnaire-9 (PHQ-9) as the referent. The average number of items completed by patients in different scenarios was reported. Results Of 480 participants, 60% were male with a mean age of 55 years. Based on PHQ-9, 19% of patients had moderate or severe depressive symptoms. Pre-screening with a PHQ-2 score ≥1 combined with a PROMIS-D score of ≥53 provided the best two-step results (sensitivity 0.81, specificity 0.84, NPV 0.95). Two-step screening also reduces question burden. Conclusions A two-step screening using a PHQ-2 score ≥1 followed by a PROMIS-D score ≥53 has good sensitivity and specificity for identifying potentially significant depressive symptoms among patients on kidney replacement therapies. This approach has lower question burden. Screened-in patients will need further clinical assessment to establish a diagnosis. [ABSTRACT FROM AUTHOR]

The Centers for Medicare and Medicaid Services covers the cost of collaborative care for Medicare beneficiaries. However, only 24 states cover the costs of collaborative care in their Medicaid programs despite evidence indicating the cost-effectiveness of delivering behavioral health services in primary care. This study examines benchmark data from a behavioral health medical group embedded within primary care practices across the United States using a large dataset of patients treated in collaborative care. The study explores the effectiveness of collaborative care in reducing depression and anxiety symptoms by comparing Medicare, Medicaid, and privately insured populations, seeking to inform the importance of supporting advocacy for continued Medicaid fee adoption for collaborative care. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of depression in patients with vitamin B12 deficiency. Methodology: This cross-sectional study was carried out from January 2020 to March 2021 on a total sample size of n=100 patients (age 49.84 ± 0.91 years) using a simple random sampling technique, visiting the medical department of the federal government polyclinic hospital, in Islamabad. Patients presenting with macrocytic anaemia secondary to vitamin B12 deficiency were included while the patients with previously diagnosed depression were excluded from the study. Serum vitamin B12 levels were measured through the ELISA technique. Patient Healthcare Questionnaire-9 (PHQ-9) was designed and presented to patients with vitamin B12 deficiency for depression assessment. Patients with PHQ-9 score ≤5 were rated as having no depression and the patients with score ≥5 were rated as having depression. Data were analyzed using GraphPad Prism and the correlation coefficient was measured through non-linear fit and linear regression curves while ordinary ANOVA (non-parametric) was applied for study variables. Results: The average level of vitamin B12 in the serum and PHQ-9 score were recorded as 158 ± 4.94 (pg/uL) and 5.85 ± 0.30, respectively. Vitamin B12 levels and PHQ-9 score depicted an inverse correlation, however, no association was found between gender and PHQ-9 score. Conclusion: Data depicted that the patients presenting low levels of vitamin B12 in their serum have shown corresponding high PHQ-9 scores which is an indicator of depression. However, depression prevails in all age groups without any discrimination of gender. [ABSTRACT FROM AUTHOR]

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Background: The prevalence of mental health disorders is known to be high among university students globally. Currently there are only a few studies on depression among university students in Sri Lanka. The aim of this study was to screen for the prevalence of Major Depressive Disorder (MDD) and other forms of depression, and to evaluate the factors associated with MDD. Methods: A cross sectional survey using the Patient Health Questionnaire (PHQ-9) was conducted among 637, second-year students from the faculties of Management Studies & Commerce, Science and Medicine at the University of Jaffna, during the Coronavirus (COVID-19) pandemic. Bivariate associations were assessed using chi-squared tests. Logistic regression was used to evaluate factors associated with any type of ragging. Results: MDD was considered to have been experienced by 31% of the students. From all three faculties, 70% of the students claimed to have experienced some form of depression ranging from mild to severe. The factor associated with MDD was the students' ethnicity. Conclusion: Due to the high MDD risk among university students, it is imperative to develop psychosocial interventions to ensure early detection of mental health disorders and provide adequate support to safeguard this vulnerable population. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the relationship between spiritual health and aging perception with depression in older adults in Bushehr city, 2019. The present cross-sectional study designed based on the STROBE statement on 430 elderly people. Systematic multi-stage sampling was performed with the informed consent of participants. The mean age of participants was 66.83 ± 7.91 years. The mean scores of spiritual health, physical health and aging perception were obtained 96.75 ± 10.02, 43.07 ± 4.86 and 58.65 ± 6.69, respectively. The results of the interaction between the variables of spiritual health and perception of aging on depression showed a significant relationship between these variables and depression. The results showed that spiritual health and perception of aging have a significant effect on depression. In other words, older adults who were more aware of their aging process and had higher spiritual health reported less depression. [ABSTRACT FROM AUTHOR]

(1) Objectives: To investigate the difference in prevalence of depression between patients with CL/P (cleft lip and/or palate) and analyze the possible demographic factors that affect the prevalence of depression in Chinese patients with CL/P. (2) Methods: Patients with CL (cleft lip only), CP (cleft palate), and CLP (cleft lip and palate) were included in the study group. Non-CL/P individuals were included in the control group. The Patient Health Questionnaire (PHQ-9) was used to screen the depression of Chinese patients with CL/P. The different proportions of different depression groups between the CL/P group and the control groups were tested by the Fisher–Freeman–Halton test and Bonferroni correction. The scores between the study groups and the control group were analyzed by one-way ANOVA. In the study groups, demographic and clinical data of the patients, including diagnosis (CL, CP, CLP), gender, age, the only child or not, and region were collected to analyze whether they were the possible factors affecting depression through one-way independent-samples t-test. Pearson correlation analysis was used to analyze the correlation between monthly family income and depression. (3) Results: 111 and 80 valid questionnaires were collected from the study and control groups, respectively. The mean PHQ-9 score of the study group (5.459 ± 6.082) was relatively higher than the control group (4.362 ± 3.384), and the difference in proportions of depression groups was statistically significant between the CL/P group and the control group (p = 0.01), especially in the mild depression (p < 0.05) and moderately severe depression groups (p < 0.05). Statistically significant differences in PHQ-9 scores were observed between the individuals of different genders (p = 0.036) and ages (p = 0.007) in patients with CL/P, the individuals who were the only child or not in patients with CL (p = 0.007), and the individuals of different ages in patients with CP (p = 0.016). (4) Conclusions: The prevalence of depression in Chinese patients with CL/P was different compared with those without CL/P, while gender, age, the only child or not, and region played significant roles in affecting depression psychology. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) and depression are the leading causes of disability in the U.S. Using five cycles (2009–2018) of the U.S. National Health and Nutrition Examination Survey, we examined the cross-sectional association between CVD risk factor burden and depression severity in nonpregnant adults with no history of CVD events. With at least 3000 participants per cycle, the overall N was 18,175. CVD risk factors were ascertained through self-report, lab tests, or medications. The sum of hypertension, diabetes, dyslipidemia, and current smoking represented a CVD risk score variable (range: 0–4). Depression severity was assessed using scores on the 9-item patient health questionnaire: 0–9 (none-mild) and 10–27 (moderate-to-severe). Logistic regression models were performed to investigate the association between CVD risk score categories and moderate-to-severe depression. Cycle-specific odds ratios (OR) were meta-analyzed to obtain a pooled OR (95 % CI) (Q-statistic p > 0.05). Compared to participants with no CVD risk factors, participants with risk scores of 1, 2, 3, and 4, had 1.28 (0.92–1.77), 2.18 (1.62–2.94), 2.53 (1.86–3.49), 2.97 (1.67–5.31) times higher odds of moderate-to-severe depression, respectively, after adjusting for socio-demographics and antidepressant use (linear trend p < 0.0001). This relationship persisted after additionally adjusting for lifestyle variables. NHANES data is cross-sectional and self-reported, thus preventing causal assessments and leading to potential recall bias. Among U.S. adults, CVD risk factor burden was associated with worsened depression symptoms. Integrated mental and physical healthcare services could improve risk stratification among persons with CVD and depression, possibly reducing long-term disability and healthcare costs. • In persons with ≥1 heart disease risk factors, depression severity was worsened. • Routine depression screening could allow timely diagnosis/treatment. • Importance of healthy diet and exercise should be discussed during clinical visits. • Dedicated attention to mental illness in cardiovascular health improvement programs. [ABSTRACT FROM AUTHOR]

Purpose: Poor self-care behavior and depression are associated with worse glycemic control, but the relationship between these variables is poorly reported. The present study aimed to describe self-care behaviors and explore the association between depression, self-care and glycemic control in people with type 2 diabetes in an Arab population. Patients and Methods: This study recruited 446 patients with type-2 diabetes from an outpatient clinic in Kuwait and completed assessments of diabetes self-care using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire and depression using the Patients Health Questionnaire-9 (PHQ-9) scales. Multiple linear regression models were used to determine the associations between depression, self-care behaviors and glycemic control. Results: Self-care behaviors were highest for medication taking (92.9%), an average for foot care (61.4%), blood glucose testing (60%) and healthy diet (55.7%), and lowest for exercise (27.1%). Depression, poor self-care activities and poor HbA1c levels were inter-correlated in univariate analysis (p< 0.03). In regression analysis, following healthful eating (B= − 0.27, p< 0.001), general eating plan (B= − 0.21, p= 0.01), more space carbohydrates evenly throughout the day (B= - 0.17, p= 0.03) and exercise at least 30 minutes (B= − 0.17, p= 0.02) behaviors were associated with better HbA1c levels. However, depression was associated with poor scores of following a general eating plan (B= − 0.20, p= 0.03), space carbohydrates evenly throughout the day (B= − 0.21, p= 0.05), and exercising at least 30 minutes (B= − 0.24, p= 0.03) behaviors. Depression scores were also associated with poor HbA1c levels (B= 0.32, p= 0.03). However, this association no longer persists after mutual adjustment with following a healthy diet (B= 0.14, p= 0.38) and exercise (B = 0.26, p = 0.08) behaviors. Conclusion: Self-care activity was less than fifty percent in people with type 2 diabetes and higher activity was associated with better glycemic control. However, depression adversely affects self-care behaviors. To maintain and achieve glycemic control, diabetes educators might motivate people with type 2 diabetes to enhance their self-care activities, particularly those with depression symptoms and poor compliance with self-care activities. [ABSTRACT FROM AUTHOR]

Depression is serious and common disorder among human being that affects mental health. Large scale research is carried out to identify the risk of depression. Using technology to identify individuals with depression could connect patients with the help they need more quickly and easily while reducing healthcare costs and burden on physicians. In this paper Convolution Neural Network (CNN) is implemented using Patient Health Questionnaire (PHQ-9) screened NHANES (National Health and Nutrition Examination Survey) dataset from 1999 to 2014. The proposed framework for automatic depression prediction shows accuracy starting from 92.37 to 1.0. Continuing the research, dropout layer is used in visible and hidden layers to avoid overfitting. After the use of dropout layer the training and validation accuracy is synchronized and validation loss is less than training loss. Hence generalized model is obtained by using regularized CNN with 100% accuracy. When the implemented model is compared with existing work in the same area then it is observed that till date using CNN this is the first attempt to achieve 100% accuracy on NHANES dataset for identifying the risk of depression using PHQ-9 questionnaire. [ABSTRACT FROM AUTHOR]