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Intergroup contact theory suggests that developing a close relationship with outgroup members ameliorates the negative impact of prejudice that individuals perceive from outgroup members. This article specifically investigates the moderating role of cross-ethnic self-disclosure in the link between international students' perceived ethnic/racial prejudice and depression as well as loneliness. One hundred and forty-three international students in Japan were asked to rate their perceived prejudice, depression, and loneliness as well as their self-disclosure to host nationals. The results showed that self-disclosure buffers the negative effects of prejudice on depression and loneliness such that international students who were more likely to disclose themselves to host nationals were less likely to be influenced by prejudice. Theoretical and practical contributions are considered.

Five studies document the validity of a new 8-item scale designed to measure "positivity," defined as the tendency to view life and experiences with a positive outlook. In the first study (N = 372), the psychometric properties of Positivity Scale (P Scale) were examined in accordance with classical test theory using a large number of college participants. In Study 2, the unidimensionality of the P Scale was corroborated with confirmatory factor analysis in 2 independent samples (N[subscript 1] = 322; N[subscript 2] = 457). In Study 3, P Scale invariance across sexes and its relations with self-esteem, life satisfaction, optimism, positive negative affect, depression, and the Big Five provided further evidence of the internal and construct validity of the new measure in a large community sample (N = 3,589). In Study 4, test-retest reliability of the P Scale was found in a sample of college students (N = 262) who were readministered the scale after 5 weeks. In Study 5, measurement invariance and construct validity of P Scale were further supported across samples in different countries and cultures, including Italy (N = 689), the United States (N = 1,187), Japan (N = 281), and Spain (N = 302). Psychometric findings across diverse cultural context attest to the robustness of the P Scale and to positivity as a basic disposition. (Contains 6 tables and 5 footnotes.)

Summary: This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women. Purpose: A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation. Methods: From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40–74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture. Results: Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 – 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture. Conclusions: Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail. [ABSTRACT FROM AUTHOR]

Objective: We explored whether a patient’s psychosocial background before allogeneic hematopoietic stem cell transplantation (allo-HSCT) could predict the occurrence of psychiatric symptoms during treatment and after hospital discharge. Method: Logistic regression analysis was performed using INTERMED, a scale that comprehensively evaluates psychological factors such as psychiatric history, current mental status, and coping skills, and social factors such as social participation status, relationships with others, and living environment, which were used as independent variables. The Center for Epidemiologic Studies Depression Scale was used to measure depression, while the Profile of Mood States was used to measure anxiety and other symptoms. Both measures were used as dependent variables and were administered upon clean room admission, during clean room stay, at clean room discharge, and at 3, 6, and 12 months after hospital discharge. Results: Participants included 70 patients (45 males and 25 females, mean age 53.3 ± 12.3 years). Thirty-eight patients participated in the program for the entire period, up to 12 months after hospital discharge. The total score on the Japanese version of the INTERMED and psychological factor scores assessed at baseline were significant predictors of depressed mood on discharge; however, there were no significant predictors of scores on the Profile of Mood States. Conclusions: A comprehensive pretransplant evaluation of psychosocial background can help predict the appearance of psychiatric symptoms after allo-HSCT. In patients who are expected to develop psychiatric symptoms after allo-HSCT, it is important to consider early intervention by a specialist and close monitoring by a medical team. [ABSTRACT FROM AUTHOR]

No study has shown the relationship between alanine-glyoxylate aminotransferase 2 (AGXT2) single nucleotide polymorphisms (SNPs) and depressive symptoms. The present case–control study examined this relationship in Japanese adults. Cases and control participants were selected from those who participated in the baseline survey of the Aidai Cohort Study, which is an ongoing cohort study. Cases comprised 280 participants with depressive symptoms based on a Center for Epidemiologic Studies Depression Scale (CES-D) score ≥ 16. Control participants comprised 2034 participants without depressive symptoms based on the CES-D who had not been diagnosed by a physician as having depression or who had not been currently taking medication for depression. Adjustment was made for age, sex, smoking status, alcohol consumption, leisure time physical activity, education, body mass index, hypertension, dyslipidemia, and diabetes mellitus. Compared with the GG genotype of rs180749, both the GA and AA genotypes were significantly positively associated with the risk of depressive symptoms assessed by the CES-D: the adjusted odds ratios for the GA and AA genotypes were 2.83 (95% confidence interval [CI] 1.23–8.24) and 3.10 (95% CI 1.37–8.92), respectively. The TGC haplotype of rs37370, rs180749, and rs16899974 was significantly inversely related to depressive symptoms (crude OR 0.67; 95% CI 0.49–0.90), whereas the TAC haplotype was significantly positively associated with depressive symptoms (crude OR 1.24; 95% CI 1.01–1.52). This is the first study to show significant associations between AGXT2 SNP rs180749, the TGC haplotype, and the TAC haplotype and depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: We aimed to examine the relationship between food group-specific intake and depression among workers in Japan. Methods: A questionnaire survey was administered to 568 workers in 2020; 503 workers responded and 423 were included in the study. Information on sex, age, body mass index, overtime hours, sleep duration, marital status, employment position, exercise habits, smoking status, incidence of depression, and intake of energy, proteins, lipids, carbohydrates, alcohol, and specific food groups were collected. The Center for Epidemiologic Studies Depression Scale was used to assess the presence and severity of depression. Food group-specific intake was adjusted for energy intake using the residual method and classified into low, moderate, and high by sex. Logistic regression was used to examine the odds ratios (ORs) and trends according to sex, with the presence/absence of depression as the dependent variable and food group-specific intake as the independent variable. Results: Men in the eggs low-intake, and women in the other vegetables low- and moderate-intake and eggs moderate-intake groups had significantly higher adjusted ORs (aORs) for depression. Additionally, a dose-response relationship was observed, where the OR for depression was significantly higher in men when the intake of eggs was low (p for trend = 0.024) and in women when the intakes of other vegetables (p for trend = 0.011) and eggs (p for trend = 0.032) were low. Conclusions: The intake of eggs in men and eggs and vegetables in women may be related to depression. [ABSTRACT FROM AUTHOR]

We examined the association between depression symptoms and job stress based on the Demand–Control–Support model among workers employed in Japanese eldercare institutions. We randomly selected 197 eldercare institutions and invited workers to participate in a questionnaire survey. Depression symptom prevalence and severity were evaluated using the Center for Epidemiologic Studies Depression (CES-D) Scale (≥ 16 = high score). Job stress was assessed using the Job Content Questionnaire based on job Demand–Control–Support. A total of 2,727 workers agreed to participate. In total, 1,740 valid responses were obtained from 434 males and 1,306 females. Approximately 44.9% had high CES-D scores. Workers with long working hours had high and low scores of psychological job demand and social support, respectively. Those who exhibited high CES-D scores had significantly higher psychological job demand scores and lower decision latitude and social support scores. A positive correlation was found between psychological job demand and CES-D scores. By contrast, a negative correlation was found between decision latitude and CES-D scores and between the social support scores and CES-D scores. Employers and employees should be mindful of the risks associated with prolonged work hours to prevent depression. Moreover, special attention should be paid to workers with substantial psychological job demands, low decision latitude, and low social support, as these workers constitute a high-risk group. [ABSTRACT FROM AUTHOR]

Aims: The main purpose of this study is to develop an indirect screening system for paternal perinatal depression based on the female partner's assessment in the Japanese population. The Japanese version of the Edinburgh Postnatal Depression Scale‐Partner (EPDS‐P) will be used as the indirect screening tool, and its accuracy will be studied in this longitudinal prospective observational study. Methods: Public health nurses and midwives at the participating community health center are currently inviting couples to participate, and are distributing self‐rating scales to the participants. The primary evaluation scales being used in this study are the Japanese versions of the Center for Epidemiologic Studies Depression Scale (CES‐D) and the Japanese version of the EPDS‐P which evaluates paternal perinatal depression by women. We will evaluate EPDS‐P performance against CES‐D, including accuracy, sensitivity, specificity, and correlations. Results and Conclusions: Perinatal depression is a mental illness that occurs between pregnancy and postpartum within the 12 months, and it is known to increase the risk of adversely impacting on child development. Men may also experience a psychosocial crisis during their partners' perinatal period. Although it was recently reported that the EPDS‐P can indirectly detect paternal perinatal depression, there is, as yet, insufficient evidence of this because the previous studies had relatively small sample sizes and were limited to cross‐sectional studies in the postpartum period. The development of a screening system for paternal perinatal depression using the EPDS‐P will lead to increased awareness of the disease and provide an opportunity to establish a family‐based support system in Japan. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to: (1) clarify the traumatic stress experienced by Japanese midwives using the Traumatic Stress Scale for Midwives (TSSM); (2) identify the traumatic stress experience with the highest frequency and greatest impact; and (3) clarify the relationship of the frequency and impact of the traumatic stress experience with burnout and work engagement. Methods: A quantitative exploratory study was conducted using a self‐administered questionnaire. The target midwives were those employed in hospitals, clinics, and midwifery centers throughout Japan. Results: TSSM item 7 "Disregarded oneself when providing care" showed the highest average frequency score (1.70, SD = 0.8). TSSM item 2 "Experience of intrauterine fetal death" showed the highest average impact score (2.84, SD = 1.2). There was a significant difference in the average scores of frequency and impact of traumatic stress by current workplace, marital status, and living with family members. There was no significant difference in the average scores of frequency and impact of traumatic stress by midwife educational background. The frequency and impact of traumatic stress showed a positive correlation with burnout, but a negative correlation with work engagement. Conclusions: TSSM is a valid measure to determine traumatic stress. It correlated with burnout and work engagement. TSSM may be used to prevent turnover. Additional research to understand traumatic stress is needed. [ABSTRACT FROM AUTHOR]

Objective: Tryptophan is an essential amino acid wholly derived from diet. While the majority of tryptophan is degraded through the kynurenine pathway into neuroactive metabolites like quinolinic acid and kynurenic acid, a small proportion of ingested tryptophan is metabolized into the neurotransmitter serotonin. The current cross-sectional study in Japan examined the association between tryptophan intake and depressive symptoms during pregnancy. Methods: Study subjects were 1744 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined as a score ≥ 16 on the Center for Epidemiologic Studies Depression Scale. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, education, body mass index, and intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, calcium, vitamin D, and isoflavones. Results: The prevalence of depressive symptoms during pregnancy was 19.2%. After adjustment for confounding factors, higher tryptophan intake was independently inversely associated with the prevalence of depressive symptoms during pregnancy: the adjusted prevalence ratios (95% confidence intervals) for depressive symptoms during pregnancy in the first, second, third, and fourth quartiles of tryptophan intake were 1 (reference), 0.99 (0.76−1.28), 0.94 (0.71−1.25), and 0.64 (0.44−0.93), respectively (p for trend = 0.04). Conclusions: Higher estimated tryptophan intake was cross-sectionally independently associated with a lower prevalence of depressive symptoms during pregnancy in Japanese women. [ABSTRACT FROM AUTHOR]

This study investigated whether dual tasks comprising cognitive tasks and occupations related to daily living can improve the mental and cognitive function of Japanese community-dwelling older adults. Participants included 30 older adults, equally divided into intervention and control groups. The outcome measures were memory, attention, depression, and health-related quality of life. No adverse effects of the intervention were observed in any participant in the intervention group. Logical memory I, logical memory II, and Center for Epidemiologic Studies Depression Scale scores showed a significant interaction. Dual tasks combining cognitive tasks and occupations may help improve delayed recall and alleviate depression. A novel attempt to integrate cognitive stimulation and activities valued by individuals may help mediate age-related cognitive function decline and reduce depressive symptoms in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Background: Precarious employment has affected mental health, and limited data are available on the association of low stress tolerance with depressive symptoms among Japanese workers. Aims: This study aimed to examine the relationship between stress tolerance and depressive symptoms among Japanese workers, including company employees, civil servants and self-employed persons in various industries. Methods: We conducted a nationwide cross-sectional study. From March 26 to April 6, 2020, we performed a web-based survey of Japanese workers. The questionnaire included questions on socioeconomic factors, the SOC scale that assesses stress tolerance, the CES-D, and the EQ-5D-5L. Multivariate regression analyses were performed to determine the factors associated with depressive symptoms. Results: We included 3,001 participants in the analysis. A high SOC score, adequate sleeping time and frequency of exercise were associated with higher depressive symptoms. Employment status and long working hours were not associated with depressive symptoms. Younger workers had lower SOC scores than older workers. An inverse correlation between the SOC score and CES-D score was found among Japanese workers. Conclusions: Improving stress tolerance among younger workers is needed to prevent worsening mental health regardless of employment status for Japanese workers. [ABSTRACT FROM AUTHOR]

This cross-sectional study aims to clarify the relationship between the number of behavioral and psychological symptoms in long-term care recipients and family caregivers' depressive states. Participants were 38 family caregivers who had provided care for their relatives for 6 years or more; they were recruited from in-home care settings in Aichi, Gifu, and Shiga Prefectures, Japan. Participants answered a self-administered questionnaire assessing their depressive state using the Japanese version of the Center for Epidemiologic Studies for Depression Scale (CES-D). They also answered questions inquiring about behavioral and psychological symptoms of care recipients, including resistance to care, irritability, and feelings of persecution. Using CES-D scores, 11 participants were categorized as depressed and 27 as non-depressed. Depressive symptoms were significantly greater in those with more behavioral and psychological symptoms, following adjustment for confounding factors. The odds ratio of being in a depressive state was 9.43 higher for those with more than 4 behavioral and psychological symptoms compared to those with none, showing a distinct threshold for the influence of behavioral and psychological symptoms on depressive state. Knowing the number of behavioral and psychological symptoms of care recipients may help quickly identify depressed caregivers and alleviate depressive symptoms. [ABSTRACT FROM AUTHOR]

High intake of sweet foods such as cakes, cookies, chocolate and ice cream has been reported to be associated with depressive symptoms. However, prospective studies are scarce and no study has been conducted in Asian populations. We prospectively investigated the association between confectionery intake and depressive symptoms in a Japanese working population. Participants were 911 workers (812 men and 99 women; aged 19–68 years) without depressive symptoms at baseline who completed a 3-year follow-up survey. Dietary intake was assessed using a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Multiple logistic regression was used to estimate the OR of depressive symptoms according to tertile of confectionery intake with adjustment for covariates. At the time of the 3-year follow-up survey, 153 (16·8 %) workers were newly identified as having depressive symptoms (CES-D score ≥ 16). Confectionery intake was significantly associated with increased odds of developing depressive symptoms. The multivariable-adjusted OR of depressive symptoms for the highest v. lowest tertile of confectionery intake was 1·72 (95 % CI 1·03, 2·86) after adjustment for covariates including dietary factors such as folate, vitamin B6, vitamin B12, n-3 PUFA, Mg, Zn and soft drink (Pfor trend = 0·012). Our results suggest that confectionery intake is associated with a higher risk of depressive symptoms in a Japanese working population predominantly comprised of men. [ABSTRACT FROM AUTHOR]

Background: Depression is an illness with biological, psychological, and social underpinnings, which may include the interplay of inflammation, psychological traits, stress, social relationships, and cultural background. Aims: This work examines the prospective associations between social relationship quality and depressive symptoms, and between social relationship quality and inflammatory outcomes in two distinct cultures. Methods: Data were obtained from two longitudinal, prospective cohort studies: Midlife in the United States (MIDUS), and Midlife Development in Japan (MIDJA) between 2004 and 2010. One thousand three hundred and twenty-seven community-based adults were included in analyses, 1,054 from the United States and 273 from Tokyo, Japan. Depressive symptoms (measured by the CES-D Depression Scale) and inflammation (measured by blood sample concentrations of the inflammatory biomarkers interleukin-6 and C-reactive protein) were the outcomes. Social relationship quality was the predictor. Culture, trait independence and interdependence, and psychosocial stressors were examined as moderators of the link between social relationship quality and depressive symptoms. Results: Higher social relationship quality was associated with lower depressive symptoms in the United States (β = −6.15, p <.001), but not in Japan (β = −1.25, p =.390). Social relationship quality had no association with inflammation. Psychosocial stressors moderated the link between social relationship quality and depressive symptoms in both the United States (β = −0.39, p =.001) and Tokyo (β = −0.55, p =.001), such that social relationship quality acted as a buffer against depressive symptoms as psychosocial stress increased. Conclusion: Improving the perceived quality of social relationships appears to be a stronger target for depression interventions in the United States than in Tokyo, Japan. [ABSTRACT FROM AUTHOR]

To facilitate sustainable dairy farming, it is essential to assess and support the mental health of dairy farm workers, which is affected more than that of workers in other industries, as indicated by the relatively few studies to date. In addition, the limited investigations on mental health in dairy workers minimize the opportunities to suggest practical approaches of improvement of their mental health. Therefore, further data acquisition and analysis is required. In the present study, we undertook quantitative surveys on 17 management factors and administered a mental health questionnaire to 81 dairy farm managers (80 male, 1 female) in Hokkaido, northern Japan. The management factors were categorized into 3 groups: production input, production output, and facility indicator; mental health was evaluated based on the Center for Epidemiologic Studies Depression Scale (CES-D). Principal component analysis assigned the factors into 2 groups: intensiveness factors of dairy production systems (PC1: livestock care cost, fat- and protein-corrected milk, stocking density, medical consultation fee per unit time per animal unit, nonfamily wages, fertilizer and pesticide expenses, and net agricultural income ratio) and basic dairy management factors (PC2: net agricultural income ratio, quantity of concentrate feed, and milk quality variable). The depression symptoms of dairy farm managers were not significantly associated with PC1 and milking methods; however, they were significantly negatively associated with PC2, which integrated 3 management factors, including factors related to finances, feeding, and milk quality. According to the findings of the present study, the efforts needed for stable economic farm management, adequate feed supply, and milk quality maintenance may increase the depression levels of dairy farm managers and negatively affect their mental health. These findings could be the basis for future studies on the relationship between the mental health of farm managers and sustainable dairy farm management and production. [ABSTRACT FROM AUTHOR]

Aim: Depression is a frequent outcome of long‐term stress, but no studies have examined depression rates among Japanese healthcare workers fighting the COVID‐19 pandemic. Therefore, we conducted a web‐based interview of hospital employees to assess depression prevalence and factors. Methods: This observational cohort study was conducted from July to August, 2020, as part of a mandatory health checkup of Juntendo University Hospital employees (Tokyo, Japan). A total of 4239 participants completed a web‐based questionnaire on medical history and current health status. The Center for Epidemiologic Studies Depression Scale (CES‐D) was used for self‐assessment, with a score of ≥16 considered to indicate depression. Results: Among all employees, the proportion of depression was 31.3% in 2020, the highest measured in the last 10 years and substantially greater than the pre‐pandemic value in 2019 (27.5%). The proportion of depression for 2020 was significantly higher in new recruits than in employees with more than 2 years of experience (47.0% vs 29.9%, respectively, P <.0001) and in new recruits in 2019 (26.4%, P <.0001). When subdivided by occupation, nurses demonstrated the highest depression rate (43.2%), followed by paramedics (35.1%) and clerks (31.6%), whereas residents (22.9%), doctors (20.4%), teaching staff (18.0%), and part‐time staff (15.3%) reported lower depression rates. The positive CES‐D score significantly correlated with age (P <.0001). Conclusions: Younger and newer employees demonstrated the highest rates of depression independent of occupation. Therefore, mental healthcare programs focusing on these vulnerable groups need to be established. [ABSTRACT FROM AUTHOR]

Background: In communities affected by a disaster, walking can be a feasible form of physical exercise to improve physical and mental health conditions. However, there is limited evidence to support relationships between walking habits and mental health conditions in post-disaster settings. Cross-sectional epidemiological data obtained from a questionnaire survey (conducted in October 2017) of a community affected by the 2011 Great East Japan Earthquake (GEJE) was analyzed to evaluate the relationships. Methods: Participants included individuals over 20 years of age (N = 718) from Shichigahama town in Miyagi prefecture, whose houses were significantly damaged by the GEJE. Their mental health conditions were assessed by the Kessler Psychological Distress Scale (K6), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Impact of Event Scale-Revised (IES-R). Additionally, the questionnaire asked the participants spent duration walking on average and their walking purpose by the following items: (1) longer than 60 min per day, (2) between 30 and 60 min per day, or (3) less than 30 min per day, and whether they walked to maintain healthy living habits (health-conscious walkers) or merely for transportation without considering health consequences (non-health-conscious walkers). These information and mental health indicators were analyzed using analysis of covariance (ANCOVA). Results: Among the three walking duration groups of health-conscious walkers, there were significant differences in CES-D and K6 scores (p = 0.01 and p = 0.04), but not in IES-R scores, considering age, gender, and alcohol drinking habits as covariates. CES-D score was significantly higher among short walkers (p = 0.004). Among the three walking duration groups of non-health-conscious walkers, there were significant differences in avoidance symptoms, the subdomain of IES-R (p = 0.01), but not in CES-D, K6, and total IES-R scores, considering the variants. Conclusion: Our study suggests that walking durations may positively affect mood, but not PTSR, only when walking is performed with the purpose of maintaining healthy living habits. Walking durations were negatively associated with avoidance symptoms among non-health-conscious walkers in the community affected by the GEJE, indicating that the disaster may have had a long-lasting impact on walking habits. [ABSTRACT FROM AUTHOR]

This 20-year prospective cohort study aimed to longitudinally explore the relationship between the number of teeth and the incidence of depressive symptoms among community-dwelling middle-aged and older adults. Data were collected from the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) database from 2002 to 2022 (3rd–9th waves). Data of adults aged ≥40 years were analyzed and those who had depressive symptoms at baseline (3rd wave), had missing data, or did not participate in follow-up, were excluded. We collected data on the number of teeth at baseline. Depressive symptoms were defined as a score of ≥16 on the Center for Epidemiologic Studies Depression Scale. The generalized estimating equation (GEE) model was used to examine the longitudinal relationships between the number of teeth at baseline and the subsequent incidence of depressive symptoms. The final analysis included 1668 participants, with a mean (standard deviation) age of 58.8 (11.1) years and a mean follow-up time of 12.9 years. After GEE analysis with adjustment for multiple covariates, compared to participants with ≥20 teeth, participants with 10–19 teeth and < 10 teeth at baseline were associated with a higher risk of depressive symptoms. The subgroup analysis showed that the effect was stronger in men than in women. Among middle-aged and older community dwellers, particularly men, a small number of teeth after the age of 40 was associated with the future incidence of depressive symptoms. • The causal relationship between number of teeth and depression is not clear. • This 20-year cohort study aimed to longitudinally explore the relationship. • Middle-aged and older adults with fewer than 10 teeth had more risk of depression. • Men have a higher risk of developing depression when having fewer than 10 teeth. • Proper care has to be taken to ensure that no tooth is lost among this population. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study are to confirm whether the excess mortality caused by depressive symptoms is independent of severe hypoglycemia in patients with type 2 diabetes mellitus (T2DM) and to evaluate the association between all-cause mortality and degrees of severity of depressive symptoms in Japanese patients with T2DM.Methods: A total of 1160 Japanese patients with T2DM were eligible for this analysis. Participants were followed prospectively for 3years and their depressive states were evaluated at baseline by the Center for Epidemiologic Studies Depression Scale (CES-D). Cox proportional hazards model was used to evaluate the relative risk of all-cause mortality and was adjusted by possible confounding factors, including severe hypoglycemia, all of which are known as risk factors for both depression and mortality.Results: After adjustment for severe hypoglycemia, each 5-point increase in the CES-D score was significantly associated with excess all-cause mortality (hazard ratio 1.69 [95% CI 1.26-2.17]). The spline curve of HRs for mortality according to total CES-D scores showed that mortality risk was slightly increased at lower scores but was sharply elevated at higher scores.Conclusion: A high score on the CES-D at baseline was significantly associated with all-cause mortality in patients with T2DM after adjusting for confounders including severe hypoglycemia. However, only a small effect on mortality risk was found at relatively lower levels of depressive symptoms in this population. Further research is needed to confirm this relationship between the severity of depressive symptoms and mortality in patients with T2DM. [ABSTRACT FROM AUTHOR]

• Hearing impairment was independently positively related to depressive symptom. • The positive association was stronger among middle-aged participants. • The positive association was not significant in the elderly. Epidemiological evidence on the relationship between hearing loss (HL) and depressive symptoms, especially in the middle aged, is limited. The present cross-sectional study investigated this issue in middle-aged and older Japanese individuals separately. Study subjects were 1018 Japanese adults aged 36−84 years. We used the audiometric definition of HL, which identifies the speech-frequency pure tone average (PTA) hearing thresholds at 0.5, 1, 2, and 4 kHz as an average of four frequencies. HL was defined as present when PTA was > 25 dB HL in the better-hearing ear. Presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression Scale score ≥ 16. Adjustment was made for age, sex, smoking status, alcohol consumption, leisure time physical activity, hypertension, dyslipidemia, diabetes mellitus, body mass index, waist circumference, employment, education, and household income. The prevalence values of HL and depressive symptoms were 11.5% and 15.0%, respectively, among the 575 subjects aged < 65 years and 42.2% and 10.4%, respectively, among the 443 subjects aged ≥ 65 years. Among the 1018 participants, HL was independently related to a higher prevalence of depressive symptoms: the multivariate-adjusted OR was 1.92 (95% CI: 1.19−3.08). This positive association was stronger among middle-aged participants, with a multivariate-adjusted OR of 2.70 (95% CI: 1.34−5.27), but was not significant in the elderly, with a multivariate-adjusted OR of 1.71 (95% CI: 0.83−3.54). HL may be positively associated with depressive symptoms in middle-aged, but not older, individuals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study is to develop a Japanese version of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales Young Adult Version (PedsQL-YA-J) and determine the feasibility, reliability, and validity of the scales. Methods: Translation equivalence and content validity were verified using back-translation and cognitive debriefing tests. A total of 428 young adults recruited from one university, two vocational schools, or five companies completed questionnaires. We determined questionnaire feasibility, internal consistency, and test-retest reliability; checked concurrent validity against the Center for Epidemiologic Studies Depression Scale (CES-D); determined convergent and discriminant validity with the Medical Outcome Study 36-item Short Form Health Survey (SF-36); described known-groups validity with regard to subjective symptoms, illness or injury requiring regular medical visits, and depression; and verified factorial validity. Results: All scales were internally consistent (Cronbach's coefficient alpha = 0.77-0.86); test-retest reliability was acceptable (intraclass correlation coefficient = 0.57-0.69); and all scales were concurrently valid with depression (Pearson's correlation coefficient = 0.43-0.57). The scales convergent and discriminant validity with the SF-36 and CES-D were acceptable. Evaluation of known-groups validity confirmed that the Physical Functioning scale was sensitive for subjective symptoms, the Emotional Functioning scale for depression, and the Work/School Functioning scale for illness or injury requiring regular medical visits. Exploratory factor analysis found a six-factor structure consistent with the assumed structure (cumulative proportion = 57.0 %). Conclusions: The PedsQL-YA-J is suitable for assessing health-related quality of life in young adults in education, employment, or training, and for clinical trials and epidemiological research. [ABSTRACT FROM AUTHOR]

Aims In the Japanese education system, students who fail university entrance exam often go to special preparatory schools to prepare for the following year's exam. These students are called ronin-sei. The purpose of this study was to clarify: (i) depression and somatic complaints in ronin-sei; and (ii) the association between depression, examination-related stressors, and sense of coherence ( SOC). Methods A total of 914 ronin-sei from two preparatory schools were asked to answer a self-rating questionnaire. Depression was measured using the Center for Epidemiologic Studies Depression Scale ( CES-D) and SOC was measured using the SOC-13 Scale. Results Overall, 57.9% of subjects were considered to have depression ( CES-D ≥ 16) and 19.8% had severe depression ( CES-D ≥ 26). Higher CES-D scores were associated with a higher rate of somatic complaints. In hierarchical logistic regression analysis, having no one to talk to about his/her worries and having parents who disagree about the first-choice of university and faculty were independent risk factors for depression and severe depression, respectively, even after controlling for SOC. Conclusions Preparatory school students have various somatic complaints, and their depression is in part related to examination-related stressors. To maintain mental health, it is important to enhance SOC, to understand their examination-related stressors and to provide adequate support for these students. [ABSTRACT FROM AUTHOR]

Abstract: Background: The rate of suicides markedly increased in 1998 and leveled off at approximately 30,000 per year thereafter. The aim of the current study was to evaluate the link between the different dimensions of depressive symptoms and suicidal ideation among the middle-aged population in Japan. Method: A sample of 6848 middle-aged (40–60years of age) working individuals completed the Center for Epidemiological Studies Depression Scale (CES-D) and a questionnaire measuring suicidal ideation. The responses on the four dimensions of depressive symptoms on the CES-D (depressed affect, lack of positive affect, somatic symptoms, and interpersonal problems) were entered into regression analyses that predicted the presence of suicidal ideation among the participants with probable depression (n=1704). Results: The factor score of depressed affect was significantly higher in females than in males, whereas that of interpersonal problems was significantly higher in males than in females. Among both males and females, depressed affect was a significant predictor of suicidal ideation. Among males, interpersonal problems also significantly predicted suicidal ideation. Contrary to the results of a previous study among adolescents, we did not find a relationship between lack of positive affect and suicidal ideation. Conclusions: These findings indicate that the dimensions of depressive symptoms measured with the CES-D make different contributions to suicidal ideation. Although our results could not be generalizable to a clinical setting due to lacking clinical samples, the depressed affect dimension of CES-D might be useful for screening of suicide risk among community population. Furthermore, gender differences in the relationships between the dimensions of depressive symptoms in a middle-aged population were identified. Additional studies are needed to examine gender-specific relationships between the dimensions of depressive symptoms and suicidal ideation. [Copyright &y& Elsevier]

Aim: The purpose of the present study was to clarify the relationship between late-life depression and daily life stress in a representative sample of 10 969 Japanese subjects. Methods: Data on 10 969 adults aged ≥50 who participated in the Active Survey of Health and Welfare in 2000, were analyzed. The self-administered questionnaire included items on 21 reasons for life stressors and the magnitude of stress, as well as the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). The relationship between the incidence of life stressors and mild–moderate (D16) and severe (D26) depressive symptoms was examined using logistic regression analysis. Results: A total of 21.9% of subjects had D16 symptoms, and 9.3% had D26 symptoms. Further, increased age and being female were associated with more severe depressive state. Logistic regression analysis indicated that the strongest relationship between both the incidence of D16 and D26 symptoms and life stressors stemmed from ‘having no one to talk to’ (odds ratio = 3.3 and 5.0, respectively). Late-life depression was also associated with ‘loss of purpose in life’, ‘separation/divorce’, ‘having nothing to do’, ‘health/illness/care of self’, and ‘debt’. Conclusion: There is a relationship between late-life depression and diminished social relationships, experiences involving loss of purpose in life or human relationships, and health problems in the Japanese general population. [ABSTRACT FROM AUTHOR]

This study aimed to investigate factors related to presenteeism among Chinese workers residing in Japan by assessing their mental state and health-promoting lifestyles. An anonymous, self-reported questionnaire was administered to 450 Chinese workers living in Hiroshima Prefecture, of whom, 313 completed it in its entirety. Results showed that 40.6% reported suffering from depression (Center for Epidemiologic Studies Depression Scale, CES-D). Sociodemographic characteristics such as being female, having a lower educational background, being widowed/divorced, having fewer years of residence, fluency in basic-level Japanese, being employed part-time, being an engineer, and workplace environment (having no health education in the workplace) increased the likelihood of depression. Path analysis indicated that marital status (being married) was negatively associated with presenteeism on the Work Limitations Questionnaire-Chinese version via work-related stress. There was a positive correlation between work-related stress and presenteeism through mental health (CES-D). Health-promoting lifestyles (Health-Promoting Lifestyle Profile II) showed a negative correlation with presenteeism, via work-related stress and mental health. Furthermore, health-promoting lifestyles showed a direct negative association with presenteeism. Thus, health education that emphasizes mental health was a significant factor for improving presenteeism. Furthermore, the provision of health education shortly after Chinese workers had arrived in Japan is important.