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OBJETIVE: To investigate the relationship between the masticatory function and the frailty of older people. METHODS: Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health. RESULTS: 2,341 older people (164 f rail older a dults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41). CONCLUSION: This study found an association between masticatory function and a greater chance of frailty among the studied population. [ABSTRACT FROM AUTHOR]

Introduction: The current pandemic due to a new coronavirus (SARS-Cov-2) has claimed the health and lives of many people worldwide. This has a negative impact on the mental health of health personnel, which includes medical students. Objective: To determine the degree of anxiety present in first-year medical students from a private university, Lima-Peru. Methods: The sample consisted of 57 students from private university in Lima Perú. The scale was applied to measure Generalized Anxiety Disorder-7 (GAD-7). The data were analyzed using frequency and contingency tables, in addition bivariate analysis was performed applying the statistical tests X2 and Student's t. Results: 75.4% of the medical students manifested some degree of anxiety. A statistically significant association was found between female sex and anxiety (p = 0.045). Likewise, there was no association between the variables age and anxiety (p = 0.058). Conclusion: First-year medical students showed high levels of anxiety during the current pandemic, with women being among those who anxiety occurs more frequently. The development of intervention strategies in university centers for the care of mental health of health sciences students is timely.

Abstract Background Legal access to medical cannabis is increasing world-wide. Despite this, there is a lack of evidence surrounding its efficacy on mental health outcomes, particularly, on depression. This study assesses the effect of medical cannabis on Patient Health Questionnaire (PHQ-9) scores in adult patients between 2014 and 2019 in Ontario and Alberta, Canada. Methods An observational cohort study of medically authorized cannabis patients in Ontario and Alberta. Overall change in PHQ-9 scores from baseline to follow-up were evaluated (mean change) over a time period of up to 3.2 years. Results 37,338 patients from the cohort had an initial PHQ-9 score recorded with 5103 (13.7%) patients having follow-up PHQ-9 scores. The average age was 54 yrs. (SD 15.7), 46% male, 50% noted depression at baseline. The average PHQ-9 score at baseline was 10.5 (SD 6.9), following a median follow-up time of 196 days (IQR: 77–451) the average final PHQ-9 score was 10.3 (SD 6.8) with a mean change of − 0.20 (95% CI: − 0.26, − 0.14, p-value

Background: Medically unexplained symptoms are frequently encountered by physicians at the primary care level. The complexity lies in the ill-defined nature of the multiple physical symptoms and the similarity to several organic disorders. Objective: To determine the prevalence of medically unexplained symptoms and relate this to physicians detection rate in a primary care setting in South-west, Nigeria. Methods: The study was a cross-sectional, descriptive study of consecutive patients of the General Out-patient Department of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State. Interviews were conducted on 472 participants using a purposely designed socio-demographic questionnaire and the self-administered Patient Health Questionnaire -15 to screen for somatic symptoms. Results: The ages of the participants ranged from 18 years to 90 years with the mean of 52.7±20.9 years. Out of the 472 participants, 225 (47.7%) met the criteria for medically unexplained symptoms using the Patient Health Questionnaire (PHQ). Across ages, medically unexplained symptoms were more often diagnosed among younger age groups especially those close to the age of 35 years (59.2%) [χ2 = 12.34, p = 0.02]. There were significant differences in the prevalence of somatisation across different levels of education [χ2= 9.78, p = 0.03]. Physicians were able to diagnose psychological disorders in 12.4% of participants (n = 28) with somatisation disorders. Conclusion: There was a moderately high prevalence of medically unexplained symptoms in primary health care settings and physicians’ detection rate of somatisation was also low. Physicians in primary health care should have a high index of suspicion for somatisation.

Abstract Purpose Rheumatoid arthritis (RA) is a disease with a high disability rate, resulting in severe family and social burden. The aim of treatment is to improve the health-related quality of life (QoL) of patients. The purpose of this study was to evaluate the QoL of patients with RA in Northeast China and analyze its influencing factors. Methods The study group consisted of 200 patients diagnosed with RA. The control group consisted of 200 healthy subjects. All subjects were residents in Northeast China. The investigation was conducted by questionnaire survey and electronic medical record. The WHOQOL-BREF, The Short-Form 36 Health Survey (SF-36) and Quality of Life Instruments for Chronic Diseases-RA (QLICD-RA) were used as questionnaires. Results The QoL scores acquired by SF-36, WHOQOL-BREF and QLICD-RA scales showed significant differences between RA and control groups (P

Background Postoperative pain is affected by preoperative depression. If the risk of postoperative pain associated with depression can be predicted preoperatively, anesthesiologists and/or surgeons can better manage it with personalized care. The objective of this study was to determine the efficacy of Patient Health Questionnaire-2 (PHQ-2) depression screening tool as a predictor of postoperative pain. Methods A total of 50 patients scheduled for elective laparoscopic cholecystectomy with an American Society of Anesthesiologists physical status 1 or 2 were enrolled. They answered the PHQ-2, which consists of two questions, under the supervision of a researcher on the day before the surgery. The numerical rating scale (NRS) scores were assessed at post-anesthesia care unit (PACU), at 24, and 48 postoperative hours, and the amount of intravenous patient-controlled analgesia (IV-PCA) administered was documented at 24, 48, and 72 postoperative hours. At 72 h, the IV-PCA device was removed and the final dosage was recorded. Results The NRS score in PACU was not significantly associated with the PHQ-2 score (correlation coefficients: 0.13 [P = 0.367]). However, the use of analgesics after surgery was higher in patients with PHQ-2 score of 3 or more (correlation coefficients: 0.33 [P = 0.018]). Conclusions We observed a correlation between the PHQ-2 score and postoperative pain. Therefore, PHQ-2 could be useful as a screening test for preoperative depression. Particularly, when 3 points were used as the cut-off score, the PHQ-2 score was associated with the dosage of analgesics, and the analgesic demand could be expected to be high with higher PHQ-2 scores.

Abstract Background Remote monitoring of cardiac implantable electronic devices (CIEDs) has demonstrated substantial benefits. Treatment guidelines have therefore endorsed its use and is being increasingly adopted in the clinical setting, but the level of satisfaction they convey remains still unknown. We developed and validated a questionnaire to measure patient satisfaction with remote monitoring using Medtronic CareLink® Network and assessed its internal reliability and dimensional validity. Methods After a thorough literature review, cognitive debriefing of 18 patients, and an expert panel discussion, a 30-item instrument was proposed and grouped into 5 dimensions (items): 1- Information on cardiac condition (3), 2- Device convenience (3), 3- Transmission process (6), 4- Satisfaction with medical monitoring (8), and 5- General opinions (10). Correlation with the visual analog scale (VAS), overall health related quality of life (HRQoL) measured by the EuroQoL-5D accompanied by the VAS as well as with the Medical Outcomes Study (MOS) SF-36 were assessed. Psychometric properties, exploratory factor analysis and a second order confirmatory factor analysis (a hierarchical CFA with a general common factor explaining the relations between the first order common factors, See Figure 1) were estimated. Models were assessed based on item loading size, sign and statistical significance, and goodness-of-fit statistics. Results A total of 186 patients (77% male) with a mean age of 66.03 (SD = 13.94) years were assessed. 48% had implantable cardioverter-defibrillators, 24% had pacemakers, and 29% had cardiac resynchronization therapy devices. An overall Cronbach’s α = 0.893 was achieved, with acceptable reliabilities for isolated dimensions. Correlations with corresponding VAS scales were meaningful and significant (p

Objective: The aim of this study was to translate the Chronic Otitis Media Benefit Inventory (COMBI) into Turkish and evaluate the questionnaire’s reliability in assessing benefit outcomes in patients after ear surgery.Methods: A total of 30 patients with chronic otitis media who underwent ear surgery were asked to fill out the translated Turkish version of the COMBI questionnaire six months after their surgery twice, 10 days apart. The patients were divided into two groups in two different ways based on surgical and audiological outcomes. These were surgical success (SS), surgical failure (SF), audiological success (AS), audiological failure (AF) groups. Student's -t test was performed to show the differences in the COMBI scores of the groups. Cronbach’s alpha value was calculated to test internal consistency, Pearson’s correlation coefficient was measured to demonstrate test-retest reliability and factor analysis was run.Results: The average score of the SS group was 51.08 and significantly higher than the score of the SF group (42.40) (p=0.012). There was, however, no statistically significant difference between the average scores of the AS and the AF groups (p=0.330). A Cronbach’s alpha value of 0.862 was found. Pearson’s r value was calculated 0.810. Factor analysis showed that a three-factor solution explained the 70.2% of the variance.Conclusion: The Turkish version of the COMBI is a valid test with high test-retest reliability. It should be used with objective assessment tools for better understanding how patients benefit from the surgery.

Objective: In this study, we aimed to translate the Glasgow-Edinburgh Throat Scale (GETS) into Turkish and test its reliability and validity.Methods: A total of 69 patients with globus sensation and no signs of otolaryngologic or gastroenterological disease in etiology were included in the study. The patients were asked to complete the translated Turkish version (GETS-T) of GETS and the Hospital Anxiety and Depression Scale (HADS).Results: The Cronbach’s alpha coefficient of the patients in the study group was calculated based on the 12 questions in the GETS-T scale and found as 0.868. The correlation between the GETS-T total score and the total HADS score in the study group was found to be very low and statistically insignificant. As a result of factor analysis, it was found that the first 10 problems in GETS-T were divided into two sub-groups, unlike GETS.Conclusion: Translation of GETS into Turkish (GETS-T) showed high reliability and validity, suggesting that translation and cross-cultural adaptation was appropriate. The GETS-T can be used in studies about globus pharyngeus in future.

Children with high dental anxiety display uncooperative behavior during dental procedures. Different self-assessment questionnaires are in use to estimate the prevalence of dental fear and anxiety (DFA) in children but they need to be tested for reliability and validity in different populations. Objectives: The aim of this study was to test the reliability and validity of two scales for the assessment of child dental fear and anxiety in a sample of Croatian children. Material and Methods: The sample comprised 202 pairs consisting of children and their mothers (97 boys and 105 girls) aged 5 - 12 years. Two scales were used to assess children’s DFA: the Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS) and the Modified Child Dental Anxiety Scale - face version (MCDAS-f). The Corah’s Dental Anxiety Scale (CDAS) was used in the sample of children’s mothers. The average scores of cooperative children and children with behavior management problem (BMP) were compared. Results: Cooperative children displayed significantly lower CFSS-DS scores than children with BMP (M = 28. 46 vs. M = 39. 36; P < 0.001). The average MCDAS-f score was significantly higher in children with BMP than in cooperative children (M = 28. 07 vs. 20. 01; P < 0.001). The CFSS-DS showed high internal consistency (Cronbach’s α = 0. 90), while internal consistency of MCDAS-f was good (α = 0.73). The maternal CDAS showed good internal consistency (α = 0, 89). The correlations with other self-report measurements of DFS show good validity of all scales. The correlations between CFSS-DS and MCDAS-f were highly significant (r = 0.482; P < 0. 01) as well as the correlations of CFSS-DS and MCDAS-f with CDAS scores (r = 0.223; P < 0. 01 and r = 0.198; P < 0. 01, respectively. Conclusion: The obtained results suggest that both the CFSS-DS scale and the MCDAS-f scale are reliable and valid scales for measuring dental fear and anxiety in children in a sample of Croatian children. The MCDAS-f scale has shown slightly lower internal consistency but it is suitable for use in young children. In addition, the MCDAS-f scale is simple to administer.

Abstract Background Although a variety of patient-reported outcome measures (PROMs) for children have been developed, there is no pediatric PROM specific to Korean medicine (KM) that is validated by experts in the field. The aim of this study was to collate the opinions of specialists in KM pediatrics on the development of a generic PROM that can be used by Korean medical doctors to assess the health status of children. Methods A three-round Delphi survey was conducted to determine the level of consensus on the development of a new PROM. Delphi questionnaires were sent by e-mail to 91 KM pediatricians on January 24, 2018. The Delphi questionnaire was composed of four sections: conceptualization, construction, items, and sources of content for a PROM. A nine-point Likert scale was used, and if more than two-thirds of the panels agreed or disagreed with a given sentence, they were considered to have reached a consensus. A draft of a PROM for the pediatric field of KM was developed in accordance with the preliminary conceptual framework. Results Out of 91 experts, 18 finished three rounds of the Delphi survey. The experts reached a consensus on the necessity of a KM pediatric PROM for measuring various areas including child health, and using Likert scales with a recall period of 3 months. They also agreed on specific items and sources of content. A new draft of a health questionnaire for KM pediatrics was developed based on the Delphi consensus. It contains 44 items covering 7 domains: i) functions of the digestive system, ii) functions of the respiratory system, iii) mental functions, iv) skin functions, v) pain, vi) functions of the metabolic and endocrine systems, and vii) demographic details. Conclusions This research represents the first step in developing a health questionnaire for the pediatric field of KM. The questionnaire can be used in clinical and research settings after verifying several types of validity and reliability.

Objective: To estimate frequency of preoperative anxiety (PA) and associated factors in pregnant women scheduled for elective cesarean section. Methods: Cross sectional study in full term pregnant women without uterine activity and without medical, surgical or obstetric complications. Was carried out before elective cesarean section in Cartagena, Colombia. Anonymous and voluntary participation with informed consent. A sociodemographic characteristic form and the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) were applied. Unadjusted logistic regression was performed to observe the association of the qualitative variables with PA and the correlation coefficient between the scores of the two subscales of the APAIS and the quantitative variables was estimated. Results: 326 pregnant women were studied. Age 28,5±6,4 years; 7,9 % teenagers; 24,2 % primigravid, 81,9 % with previous cesarean section and 70,8 % without other previous surgery. 45,0 % reported not being in any way worried about surgery/anesthesia and 7,8 % wanted to know much more about the procedure. The frequency of PA and the need of much more information about surgery/anesthesia was 9,2 %. The number of relatives in the waiting room was negatively correlated with PA, rho: -0,127[CI 95 %: -0,232 to -0,019]. The need of much more information about surgery/anesthesia was associated with increased frequency of PA, OR:10,9 [CI 95 %: 4,54-26,36]. Also, civil status was associated: free union and separate respect to married, OR: 3,7[CI 95 %: 1,5-9,2] and OR: 4,4[CI 95 %: 1,0-19,3], respectively. Conclusion: The frequency of PA before cesarean section was 9,2 %. The need of much more information about surgery/anesthesia, was associated ten times greater presence of PA and the number of relatives in the waiting room was negatively correlated with AP, but the size of the correlation coefficient was interpreted as negligible.

Introduction: Globally, around 264 million people suffer from depression according to World Health Organization (WHO). As per the National Mental Health Survey (NMHS), in the year 2015-2016, one in 20 people over the age of 18 years have ever had depression in India amounting to 45 million persons with depression in the year 2015. This study aimed to find out the self-perceived reasons of depression among married working women residing in an urban area of Kancheepuram district, Tamil Nadu. Methodology: This is a qualitative study done on married working urban women above 18 years of age visiting an UHTC of a private medical college at Anakaputhur. Patient Health Questionnaire (PHQ-9) was used to assess whether they have depression. Data was collected by in-depth interviews, and it was recorded and transcribed verbatim. Results: Based on the responses obtained from the participants the following themes and subthemes are formed like Workplace factors, Factors related to family, social factors and Mental Health seeking behaviour. Among the workplace factors job satisfaction, long working hours and relationship with peers were common reasons elicited. Conclusion: Most of these problems could be overcome only if the society changes their mentality about women and practice gender equality and social justice.

Background: For people experiencing homelessness and problem substance use, access to appropriate services can be challenging. There is evidence that development of trusting relationships with non-judgemental staff can facilitate service engagement. Peer-delivered approaches show particular promise, but the evidence base is still developing. This study tested the feasibility and acceptability of a peer-delivered intervention, through ‘Peer Navigators’, to support people who are homeless with problem substance use to address a range of health and social issues. Objectives: The study objectives were to design and implement a peer-delivered, relational intervention to reduce harms and improve health/well-being, quality of life and social functioning for people experiencing homelessness and problem substance use, and to conduct a concurrent process evaluation to inform a future randomised controlled trial. Design: A mixed-methods feasibility study with concurrent process evaluation was conducted, involving qualitative interviews [staff interviews (one time point), n = 12; Peer Navigator interviews (three or four time points), n = 15; intervention participant interviews: first time point, n = 24, and second time point, n = 10], observations and quantitative outcome measures. Setting: The intervention was delivered in three outreach services for people who are homeless in Scotland, and three Salvation Army hostels in England; there were two standard care settings: an outreach service in Scotland and a hostel in England. Participants: Participants were people experiencing homelessness and problem substance use (n = 68) (intervention). Intervention: This was a peer-delivered, relational intervention drawing on principles of psychologically informed environments, with Peer Navigators providing practical and emotional support. Main outcome measures: Outcomes relating to participants’ substance use, participants’ physical and mental health needs, and the quality of Peer Navigator relationships were measured via a ‘holistic health check’, with six questionnaires completed at two time points: a specially created sociodemographic, health and housing status questionnaire; the Patient Health Questionnaire-9 items plus the Generalised Anxiety Disorder-7; the Maudsley Addiction Profile; the Substance Use Recovery Evaluator; the RAND Corporation Short Form survey-36 items; and the Consultation and Relational Empathy Measure. Results: The Supporting Harm Reduction through Peer Support (SHARPS) study was found to be acceptable to, and feasible for, intervention participants, staff and Peer Navigators. Among participants, there was reduced drug use and an increase in the number of prescriptions for opioid substitution therapy. There were reductions in risky injecting practice and risky sexual behaviour. Participants reported improvements to service engagement and felt more equipped to access services on their own. The lived experience of the Peer Navigators was highlighted as particularly helpful, enabling the development of trusting, authentic and meaningful relationships. The relationship with the Peer Navigator was measured as excellent at baseline and follow-up. Some challenges were experienced in relation to the ‘fit’ of the intervention within some settings and will inform future studies. Limitations: Some participants did not complete the outcome measures, or did not complete both sets, meaning that we do not have baseline and/or follow-up data for all. The standard care data sample sizes make comparison between settings limited. Conclusions: A randomised controlled trial is recommended to assess the effectiveness of the Peer Navigator intervention. Future work: A definitive cluster randomised controlled trial should particularly consider setting selection, outcomes and quantitative data collection instruments. Trial registration: This trial is registered as ISRCTN15900054. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 14. See the NIHR Journals Library website for further project information.

Background: We sought to assess the anxiety and depression scores of pregnant women in Hong Kong during the COVID-19 pandemic and to evaluate the impact of demographic, economic and social factors on these scores. Methods: This was part of an ongoing worldwide cross-sectional study conducted from 22 May 2020 to 28 February 2021. Data were collected through an anonymous web-based survey. The severity of depression and anxiety was assessed using the Patient Health Questionnaire-9 (PHQ-9) score and the General Anxiety Disorder-7 (GAD-7) score, respectively. Results: A total of 361 participants completed both the GAD-7 and PHQ-9 questionnaires. Participants with psychiatric illness reported a significant higher median GAD-7 score (6.00, interquartile range [IQR] 3.00–7.75 vs. 2.00, IQR 0.00–6.00, p = 0.001), while the median PHQ-9 score was also higher but was not statistically significant (6.50, IQR 3.00–11.00 vs. 5.00, IQR 3.00–8.00, p = 0.066). A higher proportion of participants with psychiatric illness reported moderate-severe depression and anxiety (35.7% vs. 16.5%, p = 0.002, 17.8% vs. 3.6%, p < 0.001 respectively). Multivariate regression analysis demonstrated that financial difficulty, in education and pregnancy by in-vitro fertilization were associated with a higher PHQ-9 score in pregnant women during the COVID-19 pandemic, while underlying psychiatric illness was associated with a higher GAD-7 score. Support from a partner was demonstrated to be associated with a reduced level of depression and anxiety in pregnancy. Conclusions: Pregnant women with underlying psychiatric illness were more vulnerable during the COVID-19 pandemics than the non-psychiatric counterparts. Partner support is important for alleviating depression and anxiety in pregnancy during the COVID-19 pandemic. Clinical Trial Registration: The study was registered at http://www.clinicaltrials.gov, registration number NCT04377412.

Background: Socioeconomic status (SES) has consistently been associated with depressive symptoms, however, it remains unclear which subset of SES variables is most relevant to the development of depressive symptoms. This study determined a standardized SES-Index to test the relationship of its sub-dimensions with depressive symptoms., Methods: HCHS data ( N  = 10,000; analysis sample n = 8,400), comprising participants 45+ years of age, was used. A standardized approach to quantify SES was employed. Depressive symptoms were quantified using the Patient Health Questionnaire-9 (PHQ-9). Using multiple linear regression models, PHQ-9-scores were modeled as a function of age and sex, and (1a) total SES-Index score versus (1b) its three sub-dimension scores (education, occupational status, income). Models were compared on explained variance and goodness of fit. We determined risk ratios (RR, concerning a PHQ-9 sum score ≥ 10) based on (low, middle, high; 2a) SES-Index scores and (2b) the sub-dimension scores, with groups further differentiated by sex and age (45-64 versus 65+). We distinguished between the total SES-Index score and its three sub-dimension scores to identify relevant SES sub-dimensions in explaining PHQ-9-variability or risk of depression., Results: Among all regression models (total explained variance 4-6%), income explained most variance, but performance of the SES-Index was comparable. Low versus high income groups showed the strongest differences in depressive trends in middle-aged females and males (RRs 3.57 and 4.91). In older age, this result was restricted to females (RR ≈ 2). Middle-aged males (versus females) showed stronger discrepancies in depressive trends pertaining to low versus high SES groups. In older age, the effect of SES was absent. Education was related to depressive trends only in middle-aged females and males. In an exploratory analysis, marital status and housing slightly increased model fit and explained variance while including somatic symptoms lead to substantial increases (R 2 adj  = 0.485)., Conclusion: In line with previous research, the study provides evidence for SES playing a significant role in depressive symptoms in mid to old age, with income being robustly linked to depressive trends. Overall, the relationship between SES and depressive trends appears to be stronger in males than females and stronger in mid compared to old age., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Klimesch, Ascone, Schmager, Petersen, Hoven, von dem Knesebeck, Gallinat and Kühn.)

Comparing self-reported symptom scores across time requires longitudinal measurement invariance (LMI), a psychometric property that means the measure is functioning identically across all time points. Despite its prominence as a measure of depression symptom severity in both research and health care, LMI has yet to be firmly established for the Patient Health Questionnaire-9 depression module (PHQ-9), particularly over the course of antidepressant pharmacotherapy. Accordingly, the objective of this study was to assess for LMI of the PHQ-9 during pharmacotherapy for major depressive disorder. This was a secondary analysis of data collected during a randomized controlled trial. A total of 1,944 veterans began antidepressant monotherapy and completed the PHQ-9 six times over 24 weeks of treatment. LMI was assessed using a series of four confirmatory factor analysis models that included all six time points, with estimated parameters increasingly constrained across models to test for different aspects of invariance. Root-mean-square error of approximation of the chi-square difference test values below 0.06 indicated the presence of LMI. Exploratory LMI analyses were also performed for separate sex, age, and race subgroups. Root-mean-square error of approximation of the chi-square difference test showed minimal change in model fits during invariance testing (≤ 0.06 for all steps), supporting full LMI for the PHQ-9. LMI was also supported for all tested veteran subgroups. As such, PHQ-9 sum scores can be compared across extended pharmacotherapy treatment durations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Obesity impacts mental health greatly. Psychological factors may influence the effectiveness of its treatment. This study aimed to compare symptoms of generalised anxiety disorder and depression among adult women across different weight categories. The study sample comprised 1105 adult women. The computer-assisted web interview (CAWI) utilising the seven-item Generalised Anxiety Disorders Scale (GAD-7) and the nine-item Patient Health Questionnaire (PHQ-9) was used. Both GAD-7 and PHQ-9 scores correlated positively with BMI (r = 0.121, p < 0.001 and r = 0.173, p < 0.001, respectively) and negatively with age (r = -0.106, p < 0.001 and r = -0.103, p < 0.001, respectively). Patients undergoing treatment with semaglutide scored lower for both anxiety symptoms (8.71 ± 6.16, p = 0.013) and depression symptoms (9.76 ± 6.37, p = 0.013). Women who underwent bariatric surgery screened less frequently for anxiety (8.03 ± 6.27, p = 0.002) but not for depression. An interdisciplinary approach involving mental health professionals within the therapeutic team can comprehensively address factors contributing to obesity development and treatment outcomes. Further investigation of semaglutide's use is needed due to the promising evidence suggesting a positive effect on decreasing the severity of depression and anxiety symptoms to assess the direct or indirect character of this influence.

Background: Over the past decade, nationally representative research elucidating the association between depression and infertility has been notably lacking. Our study aimed to investigate the association between depression and infertility among women of childbearing age., Methods: Our study encompassed 3,654 women aged 18 to 45 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Infertility was defined as a positive response to the query: "Have you attempted to conceive for a minimum of one year without achieving pregnancy?" Depression was evaluated by the Patient Health Questionnaire (PHQ-9) score (range, 0-27). Multiple logistic regression analyses and subgroup analyses stratified by age and race/ethnicity were conducted to investigate the association between depression and infertility. Furthermore, fitted smoothing curves and threshold effect analysis were utilized to depict the nonlinear relationship., Results: Total PHQ-9 score was associated with infertility in the fully adjusted model (OR 1.04, 95% CI 1.01-1.07, P = 0.010), and this relationship exhibited a non-linear pattern, reaching a saturation point at 13, as substantiated by the fitting of smoothed curves. Additionally, the association remained robust when stratified by age but not by race/ethnicity., Limitations: Cross-sectional design and recall biases., Conclusions: In this cross-sectional study, depression was associated with infertility among women of childbearing age in the fully adjusted models. This observed association holds potential relevance for clinicians tasked with enhancing psychological well-being during infertility management strategies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wan, He. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Depression and anxiety symptoms among medical students are often a concern. The Patient Health Questionnaire-Four (PHQ-4), an important tool for depression and anxiety screening, is commonly used and easy to administer. This study aimed to assess and update the longitudinal measurement invariance and psychometric properties of the simplified Chinese version., Methods: A three-wave longitudinal survey was conducted among healthcare students using the PHQ-4. Structural validity was based on one-factor, two-factor, and second-order factor models, construct validity was based on the Self-Rated Health Questionnaire (SRHQ), Sleep Quality Questionnaire (SQQ), and Rosenberg Self-Esteem Scale (RSES), and longitudinal measurement invariance (LMI), internal consistency, and test-retest reliability were based on structural consistency across three time points., Results: The results of the confirmatory factor analysis indicated that two-factor model was the best fit, and LMI was supported at three time points. Inter-factor, factor-total, and construct validity correlations of the PHQ-4 were acceptable. Additionally, Cronbach's alpha, McDonald's omega, and the intraclass correlation coefficient demonstrated acceptable/moderate to excellent reliability of the PHQ-4., Conclusions: This study adds new longitudinal evidence that the Chinese version of the PHQ-4 has promising LMI and psychometric properties. Such data lends confidence to the routine and the expanded use of the PHQ-4 for routine screening of depression and anxiety in Chinese healthcare students., (© 2024. The Author(s).)

Background: Depression and anxiety co-occur frequently and there is heterogeneity in the co-occurrence of such symptoms; however, few previous studies investigated the heterogeneity based on person-centered perspectives in adolescents. The primary aim of our study was to explore it using latent profile analysis (LPA), a person-centered statistical approach., Method: The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to examine depression and anxiety symptoms in 7422 Chinese adolescents from 23 primary and secondary schools. To investigate latent profiles and assess profile validity, we employed Latent Profile Analysis (LPA), multinomial logistic regression, and analysis of variance., Results: A three-profile model was suggested as the optimum: low (69.9 %), moderate (21.6 %), and high depression/anxiety (8.5 %). Female with higher negative cognitive bias and higher emotional regulation difficulty are more likely to be categorized in the high depression/anxiety group. Internet addiction, academic "Lying flat" and involution are significantly and positively linked with the severity of anxiety and depression., Limitations: Reliance on self-reported measures may lead to response bias; the cross-sectional design limits our ability to study how symptom profiles and category membership change over time., Conclusions: Three latent profiles of the co-occurrence of depression and anxiety presented a parallel pattern, which serves as a poignant reminder of the imperative need to identify Chinese adolescents who may be at elevated risk for depression and/or anxiety, and promoting intervention that are meticulously tailored to address the unique symptom presentations of each individual., Competing Interests: Declaration of competing interest Author DYL, Author ZY, Author HKS, Author CJY, Author LQ, Author LS and Author XJ and declare that they have no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Participants in research trials often disclose severe depression symptoms, including thoughts of self-harm and suicidal ideation, in validated self-administered questionnaires such as the Patient Health Questionnaire (PHQ-9). However, there is no standard protocol for responding to such disclosure, and the opportunity to support people at risk is potentially missed. We developed and evaluated a risk assessment protocol for the IBD-BOOST randomised controlled trial (ISRCTN71618461 09/09/2019)., Methods: Participants completed the PHQ-9 at baseline and 6-month and 12-month follow-ups. The trial database automatically alerted the research team to risk assess participants. Trial researchers, trained in the protocol, contacted participants by telephone, completed the risk assessment, and signposted participants to appropriate professional services., Results: Seven hundred eighty participants were randomised in the trial; 41 required risk assessment. One participant declined assessment, so 40 risk assessments were completed. Twenty-four participants were assessed as low-risk and 16 participants as medium-risk, with 12 declaring previous suicide attempts. None were rated as high-risk. Trial participants expressed appreciation for being contacted, and all except two wished to receive information about professional support services. Trial risk assessors reported positive experiences of conducting the risk assessment with suggestions for improvement, which resulted in minor modifications to the protocol., Discussion: Our evaluation demonstrated that it was viable for a research trial team to successfully conduct a risk-assessment protocol for trial participants reporting thoughts of self-harm, with training and support from senior colleagues. Resources are required for training and delivery, but it is not unduly onerous. Trial participants appeared to find completing the assessment acceptable., (© 2024. The Author(s).)

Importance: Given that the Patient Health Questionnaire (PHQ) item 9 is commonly used to screen for risk of self-harm and suicide, it is important that clinicians recognize circumstances when at-risk adolescents may go undetected., Objective: To understand characteristics of adolescents with a history of depression who do not endorse the PHQ item 9 before a near-term intentional self-harm event or suicide., Design, Setting, and Participants: This was a retrospective cohort study design using electronic health record and claims data from January 2009 through September 2017. Settings included primary care and mental health specialty clinics across 7 integrated US health care systems. Included in the study were adolescents aged 13 to 17 years with history of depression who completed the PHQ item 9 within 30 or 90 days before self-harm or suicide. Study data were analyzed September 2022 to April 2023., Exposures: Demographic, diagnostic, treatment, and health care utilization characteristics., Main Outcome(s) and Measure(s): Responded "not at all" (score = 0) to PHQ item 9 regarding thoughts of death or self-harm within 30 or 90 days before self-harm or suicide., Results: The study included 691 adolescents (mean [SD] age, 15.3 [1.3] years; 541 female [78.3%]) in the 30-day cohort and 1024 adolescents (mean [SD] age, 15.3 [1.3] years; 791 female [77.2%]) in the 90-day cohort. A total of 197 of 691 adolescents (29%) and 330 of 1024 adolescents (32%), respectively, scored 0 before self-harm or suicide on the PHQ item 9 in the 30- and 90-day cohorts. Adolescents seen in primary care (odds ratio [OR], 1.5; 95% CI, 1.0-2.1; P = .03) and older adolescents (OR, 1.2; 95% CI, 1.0-1.3; P = .02) had increased odds of scoring 0 within 90 days of a self-harm event or suicide, and adolescents with a history of inpatient hospitalization and a mental health diagnosis had twice the odds (OR, 2.0; 95% CI, 1.3-3.0; P = .001) of scoring 0 within 30 days. Conversely, adolescents with diagnoses of eating disorders were significantly less likely to score 0 on item 9 (OR, 0.4; 95% CI, 0.2-0.8; P = .007) within 90 days., Conclusions and Relevance: Study results suggest that older age, history of an inpatient mental health encounter, or being screened in primary care were associated with at-risk adolescents being less likely to endorse having thoughts of death and self-harm on the PHQ item 9 before a self-harm event or suicide death. As use of the PHQ becomes more widespread in practice, additional research is needed for understanding reasons why many at-risk adolescents do not endorse thoughts of death and self-harm.

Objetives: Obtain a version to validate it in a population of adults with AD., Materials and Methods: 1) Translation into Spanish and cross-cultural adaptation of the questionnaire from the original version in English, through a seven-step process. 2) Evaluation of the unidimensionality of the resulting scale by means of an exploratory factor analysis (EFA), of its reliability by means of Cronbach's alpha coefficient, and of its validity by evaluating the correlation of its score with those of the POEM and DLQI questionnaires. (external reference criteria)., Results: The version resulting from the translation and cross-cultural adaptation process was well understood by the target population. The AFE of the 66 questionnaires documented the unidimensionality of the scale based on compliance with all the criteria used for its verification. Its reliability was excellent (Cronbach's Alpha: 0.917) and its score had a very high correlation with the external reference criteria (POEM: Spearman's Rho 0.85; p < 0.0001; DLQI Spearman's Rho = 0.81; p < 0 .0001)., Conclusions: The version translated into Spanish and adapted for transculturation of the ADCT questionnaire has appropriate psychometric characteristics, which will contribute to optimizing the care processes of Spanish-speaking patients., (UNIVERSIDAD NACIONAL DE CORDOBA)

Background: Outcome monitoring of depression treatment is recommended but there is a lack of evidence on patient benefit in primary care., Aim: To test monitoring depression using the Patient Health Questionnaire (PHQ-9) with patient feedback., Design and Setting: An open cluster-randomised controlled trial was undertaken in 141 group practices., Method: Adults with new depressive episodes were recruited through record searches and opportunistically. The exclusion criteria were as follows: dementia; psychosis; substance misuse; and suicide risk. The PHQ-9 was administered soon after diagnosis, and 10-35 days later. The primary outcome was the Beck Depression Inventory (BDI-II) score at 12 weeks. The secondary outcomes were as follows: BDI-II at 26 weeks; Work and Social Adjustment Scale (WSAS) and EuroQol EQ-5D-5L quality of life at 12 and 26 weeks; antidepressant treatment; mental health and social service contacts; adverse events, and Medical Interview Satisfaction Scale (MISS) over 26 weeks., Results: In total, 302 patients were recruited to the intervention arm and 227 to the controls. At 12 weeks, 254 (84.1%) and 199 (87.7%) were followed-up, respectively. Only 40.9% of patients in the intervention had a GP follow-up PHQ-9 recorded. There was no significant difference in BDI-II score at 12 weeks (mean difference -0.46; 95% confidence interval [CI] = -2.16 to 1.26; adjusted for baseline depression, baseline anxiety, sociodemographic factors, and clustering by practice). EQ-5D-5L quality-of-life scores were higher in the intervention arm at 26 weeks (adjusted mean difference 0.053; 95% CI = 0.013 to 0.093. A clinically significant difference in depression at 26 weeks could not be ruled out. No significant differences were found in social functioning, adverse events, or satisfaction. In a per-protocol analysis, antidepressant use and mental health contacts were significantly greater in patients in the intervention arm with a recorded follow-up PHQ-9 ( P = 0.025 and P = 0.010, respectively)., Conclusion: No evidence was found of improved depression outcome at 12 weeks from monitoring. The findings of possible benefits over 26 weeks warrant replication, investigating possible mechanisms, preferably with automated delivery of monitoring and more instructive feedback., (© The Authors.)

Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief episodes of vertigo triggered by specific head movements. Despite its short duration, BPPV significantly impacts the quality of life. A comprehensive search of electronic databases, including PubMed, Scopus, and Web of Science, was performed to gather peer-reviewed articles, clinical trials, and review articles published between 2014 and 2024. Keywords used in the search included "benign paroxysmal positional vertigo," "BPPV," "vestibular disorders," "quality of life," "diagnosis," and "treatment." Eleven articles were included in the systematic review. Tools such as the Dizziness Handicap Inventory (DHI) and the 36-Item Short Form Health Survey (SF-36) are reported to assess the impact of BPPV on quality of life. This review includes 11 articles focusing on quality of life outcomes in BPPV patients. This systematic review explores the various dimensions of quality of life affected by BPPV and the tools used to evaluate these effects. BPPV can lead to physical limitations, such as difficulty in performing daily activities, and psychological effects, including anxiety, depression, and emotional distress. Socially, BPPV can cause social withdrawal and isolation due to the fear of experiencing vertigo in public. Occupationally, BPPV can interfere with job-related tasks. Future research should focus on developing personalized treatment approaches and patient-reported outcome measures specific to BPPV. A comprehensive approach to BPPV management is essential for improving the quality of life of affected individuals., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Madrigal et al.)

Background: Symptoms of major depressive disorder (MDD) are commonly assessed using self-rating instruments like the Patient Health Questionnaire-9 (PHQ-9) (current symptoms) and the Composite International Diagnostic Interview Short-Form (CIDI-SF) (worst-episode symptoms). We performed a systematic comparison between them for their genetic architecture and utility in investigating MDD heterogeneity., Methods: Using data from the UK Biobank (n = 41,948-109,417), we assessed the single nucleotide polymorphism heritability and genetic correlation (r g ) of both sets of MDD symptoms. We further compared their r g with non-MDD traits and used Mendelian randomization to assess whether either set of symptoms has more genetic sharing with non-MDD traits. We also assessed how specific each set of symptoms is to MDD using the metric polygenic risk score pleiotropy. Finally, we used genomic structural equation modeling to identify factors that explain the genetic covariance between each set of symptoms., Results: Corresponding symptoms reported through the PHQ-9 and CIDI-SF have low to moderate genetic correlations (r g  = 0.43-0.87), and this cannot be fully attributed to different severity thresholds or the use of a skip structure in the CIDI-SF. Both Mendelian randomization and polygenic risk score pleiotropy analyses showed that PHQ-9 symptoms are more associated with traits that reflect general dysphoria, whereas the skip structure in the CIDI-SF allows for the identification of heterogeneity among likely MDD cases. Finally, the 2 sets of symptoms showed different factor structures in genomic structural equation modeling, reflective of their genetic differences., Conclusions: MDD symptoms assessed using the PHQ-9 and CIDI-SF are not interchangeable; the former better indexes general dysphoria, while the latter is more informative about within-MDD heterogeneity., (Copyright © 2023 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Objectives: To evaluate the external validity of the FINDRISC, DESIR and ADA risk scores for the prediction of diabetes in a Spanish population aged >45 years and to test the possible improvement of FINDRISC by adding a new variable of high risk of depression when Patient Health Questionnaire-9 (PHQ-9) questionnaire score ≥10 (FINDRISC-MOOD)., Design: Prospective population-based cohort study., Setting: 10 primary healthcare centres in the north of the city of Madrid (Spain)., Participants: A total of 1242 participants without a history of diabetes and with 2-hour oral glucose tolerance test (OGTT) plasma glucose <200 mg/dL (<11.1 mmol/L) were followed up for 7.3 years (median) using their electronic health records (EHRs) and telephone contact., Primary and Secondary Outcome Measures: Diabetes risk scores (FINDRISC, DESIR, ADA), PHQ-9 questionnaire and 2-hour-OGTT were measured at baseline. Incident diabetes was defined as treatment for diabetes, fasting plasma glucose ≥126 mg/dL (≥7.0 mmol/L), new EHR diagnosis or self-reported diagnosis. External validation was performed according to optimal cut-off, sensitivity, specificity and Youden Index. Comparison between diabetes risk scores, including FINDRISC-MOOD (original FINDRISC score plus five points if PHQ-9 ≥10), was measured by area under the receiver operating characteristic curve (AUROC)., Results: During follow-up, 104 (8.4%; 95% CI, 6.8 to 9.9) participants developed diabetes and 185 had a PHQ-9 score ≥10. The AUROC values were 0.70 (95% CI, 0.67 to 0.72) for FINDRISC-MOOD and 0.68 (95% CI, 0.65 to 0.71) for the original FINDRISC. The AUROCs for DESIR and ADA were 0.66 (95% CI, 0.63 to 0.68) and 0.66 (95% CI, 0.63 to 0.69), respectively. There were no significant differences in AUROC between FINDRISC-MOOD and the other scores., Conclusions: The results of FINDRISC-MOOD were like those of the other risk scores and do not allow it to be recommended for clinical use., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Depression is recognized as a significant public health issue in the United States. The National Survey on Drug Use and Health reports that 21.0 million adults aged 18 or older had major depressive disorder in 2020, including 14.8 million experiencing a major depressive episode with severe impairment. The aim is to predict the positivity of Patient Health Questionnaire-2 (PHQ-2) outcomes among patients in primary care settings by analyzing a range of variables, including socioeconomic status, demographic characteristics, and health behaviors, thereby identifying those at increased risk for depression. Employing a machine learning approach, the study utilizes retrospective data from electronic health records across 15 primary care clinics in South Florida to explore the relationship between social determinants of health (SDoH), including area of deprivation index (ADI) and PHQ-2 positivity. The study encompasses 15 primary care clinics located in South Florida, where a diverse patient population receives care. Analysis included 94,572 patient visits; 74,636 records were included in the study. If a zip+4 was not available or an ADI score did not exist, the visit was not included in the final analysis. Screening involved the PHQ-2, assessing depressed mood and anhedonia, with a cutoff >2 indicating positive screening. ADI was used to assess SDoH by matching patients' residential postal codes to ADI national percentiles. Demographics, sexual history, tobacco use, caffeine intake, and community involvement were also evaluated in the study. Over 40 machine learning algorithms were explored for their accuracy in predicting PHQ-2 outcomes, using software tools including Scikit-learn and stats models in Python. Variables were normalized, scored, and then subjected to predictive regression models, with Random Forest showing outstanding performance. Feature engineering and correlation analysis identified ADI, age, education, visit type, coffee intake, and marital status as significant predictors of PHQ-2 positivity. The area under the curve and model accuracies varied across clinics, with specific clinics showing higher predictive accuracy and others ( p  > .05). The study concludes that the ADI, as a proxy for SDoH, alongside other individual factors, can predict PHQ-2 positivity. Health organizations can use this information to anticipate health needs and resource allocation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective To assess the influences of self-and interviewer-administered methods on the scores of anxiety and depression questionnaires among the patients with sports injuries.Methods A total of 532 participants with sports injuries treated in the Sports Medicine Center of West China Hospital,Sichuan University from November 2022 to May 2023 were included.They were randomly assigned to either the interviewer-administered group ( n =270) or the self-administered group ( n =262) to complete the generalized anxiety disorder (GAD-7) and the patient health questionnaire (PHQ-9) scales.The total scores and prevalence rates of anxiety and depression were compared between the two groups.Results There was no statistically significant difference in gender,occupation,or surgical site between the two groups (all P >0.05).The self-administered group had higher scores of GAD-7 and PHQ-9 scales than the interviewer-administered group ( P <0.001, P <0.001).A greater proportion of participants in the self-administered group than in the interview-administered group met the criteria for mild to moderate anxiety and depression ( P <0.001, P =0.002).The prevalence rates of moderate to severe anxiety (GAD-7≥10) and depression (PHQ-9≥10) showed no statistically significant difference between the two groups ( P =0.761, P =0.086).Conclusion This study demonstrates that the participants in the self-administered group are more likely to report mild to moderate symptoms of anxiety and depression than those in the interviewer-administered group.

Purpose: Suicidality is rarely assessed in patients treated in German rehabilitation centers, although individuals with physical and mental impairments have an increased risk for suicidality. The item 9 of the 9-item depression module of the Patient Health Questionnaire (PHQ-9) asks about the desire to be dead or to harm oneself and could be used as a possible screening for suicidality. The Columbia Suicide Severity Rating Scale (C-SSRS) is a standardized interview to assess suicidality. We assessed the prevalence of suicidality in orthopedic and cardiac rehabilitation using the C-SSRS and the PHQ-9, examined the diagnostic accuracy of the item 9 of the PHQ-9 and of the PHQ-9 total score for identifying suicidality and surveyed the acceptance of the suicidality assessment by the rehabilitants., Methods: Study participants were screened with the PHQ-9 and subsequently interviewed using C-SSRS. Sensitivity and specificity of the item 9 of the PHQ-9 and the PHQ-9 total score were tested for the presence of suicidality assessed with the C-SSRS and in a sensitivity analysis for the presence of nonspecific active suicidal ideation (item 2 of the C-SSRS). We calculated the area under the curve (AUC) to predict the ability of the PHQ-9 to discriminate between individuals with and without acute suicidality. Screening and interview were evaluated by the rehabilitants., Results: Among 405 study participants, the prevalence of acute suicidality measured by the C-SSRS was 0.5%. 4% reported nonspecific active suicidal ideation on the C-SSRS. 10.4% reported suicidal ideation on item 9 of the PHQ-9. The sensitivity of item 9 and the PHQ-9 total score for identifying acute suicidality was only 50.0% (95% CI: 1.3% to 98.7%). However, item 9 was sensitive (81.3%, 95% CI: 54.4% to 96.0%) and specific (92.5%, 95% CI: 89.5% to 95.0%) for identifying nonspecific active suicidal ideation. Estimators for sensitivity were highly uncertain because of the low prevalence of acute suicidality. Addressing suicidality was rated as useful and helpful by study participants., Conclusion: If the response to item 9 is positive, the immediate risk of suicide is low. However, PHQ-9 is suitable for identifying patients with non-specific suicidal thoughts. A conspicuous score on the item 9 of the PHQ-9 should be further clarified by a psychotherapist., Competing Interests: Jona Ober, Lisa Weier und Dieter Benninghoven sind bzw. waren Mitarbeiter*innen der Mühlenbergklinik Holsteinische Schweiz. Die anderen Autor*innen geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: To examine the effect of esketamine nasal spray (ESK) plus newly initiated oral antidepressant (OAD) versus OAD plus placebo nasal spray (PBO) on the association between Montgomery-Åsberg Depression Rating Scale (MADRS) and 9-item Patient Health Questionnaire (PHQ-9) scores in adults with treatment-resistant depression (TRD)., Methods: Data from TRANSFORM-1 and TRANSFORM-2 (two similarly designed, randomized, active-controlled TRD studies) and SUSTAIN-1 (relapse prevention study) were analyzed. Group differences for mean changes in PHQ-9 total score from baseline were compared using analysis of covariance. Associations between MADRS and PHQ-9 total scores from TRANSFORM-1/TRANSFORM-2 were assessed using simple parametric, nonparametric, and multiple regression models., Results: In TRANSFORM-1/TRANSFORM-2 (ESK + OAD, n  = 343; OAD + PBO, n  = 222), baseline PHQ-9 mean scores were 20.4 for ESK + OAD and 20.6 for OAD + PBO (severe depression). At day 28, significant group differences were observed in least squares mean change (SE) in PHQ-9 scores from baseline (-12.8 [0.46] vs -10.3 [0.53], P  < .001) and in clinically substantial change in PHQ-9 scores (≥6 points; 77.1% vs 64%, P  < .001) in ESK + OAD and OAD + PBO groups, respectively. A nonlinear relationship between MADRS and PHQ-9 was observed; total scores demonstrated increased correlation over time. In SUSTAIN-1, 57.3% of patients receiving ESK + OAD ( n  = 89) versus 44.2% receiving OAD + PBO ( n  = 86) retained remission status (PHQ-9 score ≤4) at maintenance treatment end point ( P =  .044)., Conclusions: In adults with TRD, ESK + OAD significantly improved severity of depressive symptoms, and more patients achieved clinically meaningful changes in depressive symptoms based on PHQ-9, versus OAD + PBO. PHQ-9 outcomes were consistent with those of clinician-rated MADRS., Trial Registration: ClinicalTrials.gov: NCT02417064, NCT02418585, NCT02493868.

Background: The Affective Symptoms Scale (ASRS) is a unique instrument designed to separately measure depressive and manic symptoms in mood disorders. We validated the ASRS against the Patient Health Questionnaire (PHQ-9) and the Quick Inventory of Depressive Symptomatology (QIDS-16).Methods: A retrospective study of 258 patients who completed the PHQ-9, QIDS-16 and ASRS as part of routine clinical care. To establish meaningful clinical thresholds for the depression subscale of the ASRS, it was equated with the QIDS and the PHQ-9.Results: The depression subscale of the ASRS had significant positive correlations with the QIDS-16 and the PHQ-9 (respectively, r= 0.8, t[253] = 19.8, p < 0.001, and r= 0.8, t[245] = 28.2, p < 0.001). The equipercentile equating method with the PHQ-9 indicated that the thresholds corresponded to ASRS depression subscale scores of 5.4, 10.6, 16.1, and 23. Equating with the QIDS indicated that thresholds corresponded to ASRS depression subscale scores of 5.1, 11, 18.4, and 27.5.Limitations: Limitations include a small sample size that did not allow more detailed statistical analysis, such as Item Response Theory. The population is a heterogenous population at a university outpatient setting.Conclusions: The ASRS depression subscale significantly correlated with the PHQ-9 and QIDS-16. Our proposed threshold scores for the ASRS are 5, 11, 16 and 23 to indicated mild, moderate, severe and very severe depression respectively. [ABSTRACT FROM AUTHOR]

Background: Physical activity is often associated with better mental health. However, there is evidence that the domain of physical activity influences the strength and direction of this association. Therefore, this study aimed to examine the associations between different domains of physical activity and depression among a large sample of adults living in the European Union. Methods: Cross‐sectional analyses were conducted on 261,121 adults, recruited in the European Health Interview Survey (wave 2). Validated items were used to assess physical activity domains (i.e., work‐related, transport‐related, leisure‐time aerobic, and muscle‐strengthening) and depression symptom severity (8‐item personal health questionnaire). Generalized linear models with Poisson regressions provided adjusted prevalence ratios (APR) of depressive symptom severity categories across the physical activity domains. Results: Compared to doing no physical activity, any physical effort at work (APR: 0.82–0.86), moderate, high, and very high levels of transport‐related (APR: 0.69–0.83) and aerobic leisure‐time activity (APR: 0.78–0.87), and 3 days/week of muscle‐strengthening (APR: 0.93) were associated with a lower prevalence of mild depressive symptom severity. Moreover, doing any level of physical activity in any domain was mostly associated with a lower prevalence of moderate (APR: 0.43–0.80), moderate–severe (APR: 0.34–0.82), and severe (APR: 0.26–0.56) depressive symptoms. Conclusion: Favorable associations were seen between any domain (leisure‐time, transport‐ and work‐related) of physical activity and depressive symptom severity. The more severe the symptoms, the stronger the associations. Both modalities of leisure‐time physical activity (aerobic and muscle‐strengthening) demonstrated beneficial associations with depression, but slightly more so for aerobic physical activity. [ABSTRACT FROM AUTHOR]

Objectives: The Coronavirus Disease 2019 (COVID-19) outbreak is a global pandemic and has caught the attention of the rheumatology fraternity, where patients are thought to be at higher risk of infection. We aimed to study the incidence of COVID-19 infection and depression and anxiety symptoms among patients with rheumatic disease (RD) in Hospital Selayang, Malaysia, during the COVID-19 pandemic. Methods: A crosssectional study was conducted via phone interview using a structured questionnaire in patients with RD aged > 18 years old scheduled for clinic appointments from 4 to 28 May 2020, which coincided with the second wave of COVID-19 cases in Malaysia. The questionnaire included demographics, COVID-19 screening questions, depression and anxiety symptoms screening using questions derived from the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2). Results: Among the 361 patients enrolled, the majority were females (83.1%), and over half (54.3%) were ethnic Malays, 41.6% had rheumatoid arthritis, 34.6% had systemic lupus erythematosus, 12.2% had spondyloarthropathy, and only one (0.3%) patient had COVID-19 infection. The mean age of patients was 48.2 years (range: 16-80 years). The frequency of patients with depression and anxiety symptoms was 8.6% and 6.9%, respectively. Married patients reported feeling more anxious (p = 0.013), while patients with tertiary education levels reported feeling more depressed (p = 0.012). Conclusions: The incidence of COVID-19 infection is low, probably due to the low rate of testing. Depression and anxiety symptoms reported by patients in our cohort were modest. Our findings suggest that the COVID-19 pandemic has a greater impact on married patients with RD and those with a higher education level. [ABSTRACT FROM AUTHOR]

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Introduction: The Coronavirus disease 2019 (COVID-19) pandemic and its consequences have created anxiety in various segments of society. In particular, the transition to online education brought by this process has made the education process of university students difficult. Therefore, in the COVID-19 pandemic, it is important to examine the anxiety levels of university students and their relationship with somatic symptoms. Objective: To examine the level of generalised anxiety disorder and to reveal the relationship between somatic symptoms and the generalised anxiety disorder level of Turkish university students. Methods: Empirical research. Participants in the research constituted a total of 605 students studying at a private university in İstanbul. The Generalised Anxiety Disorder Scale (GAD-7) was used to collect data. Data were analysed using the chi-square test and Pearson correlation analysis. Results: It was found that, among the participants, 193 (31.90%) of the students had mild anxiety, 149 (24.63%) had moderate anxiety and 121 (20.00%) had severe anxiety. The study revealed that there is a significant positive relationship between the number of somatic symptoms and generalised anxiety disorder scores of university students. Conclusion: Most of the university students are affected by anxiety during the COVID-19 pandemic and this effect is correlated with the frequency of somatic symptoms. In this context, it would be beneficial for universities to plan for acute and long-term psychological services and to cooperate with the government to provide timely crisis-oriented psychological services.

Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals.In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25.The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P

Background: The Patient Health Questionnaire-8 (PHQ-8) is a screening questionnaire of depressive symptoms. However, it is unknown whether it is equivalent across time and between groups of individuals. The aim of our paper was to test whether the PHQ-8 has the same meaning in two groups of individuals over time. Methods: Primary care patients were proactively recruited from three German cities. PHQ-8 data from a baseline assessment (n = 588), two assessments during the intervention (n = 246/225), and a six (n = 437) and 12 months (n = 447) follow-up assessment were first used to examine the factor structure of the PHQ-8 by confirmatory factor analysis (CFA). The best fitting factor solution was then used to test longitudinal invariance across time and between intervention and control group by Multiple Group CFA. Results: A two-factor structure consistently showed the best model fit. Only configural longitudinal invariance was evidenced when the baseline assessment was included in the analysis. Without the baseline assessment, strict longitudinal invariance was shown across the intervention and the follow-up assessments. Scalar invariance was established between the intervention and control group for the baseline assessment and strict invariance between groups and across the 6- and 12-month follow-up assessments. Conclusions: The lack of longitudinal invariance might be attributed to various differences between the baseline assessments and all following assessments, e.g., assessment mode (iPad vs telephone), potential changes in symptom perception, and setting. Trial registration: DRKS00011635, date of trial registration: 20.01.2017; DRKS00011637, date of trial registration: 25.01.2017. [ABSTRACT FROM AUTHOR]

Objective: To describe depressive symptoms among people undergoing tuberculosis treatment in basic health units. Methods: Descriptive, cross-sectional study conducted between August 2019 and March 2020 in metropolitan municipalities in the state of Espírito Santo. Socioeconomic, behavioral and clinical data were collected in an interview, and depressive symptoms were tracked using the patient's health questionnaire. Results: From the sample of 92 patients, male (67%), black / brown (85%), average age 41.5 years, (50%) were single, without completing elementary school (43%), unemployed (63%), from socioeconomic classes C, D and E (89%), abandoned by the cash transfer program (86%). 48% (44) of the sample were screened with depressive symptoms, 81% (74) with mild to severe severity, predominance of the fatigue symptom (84%), presence of depressed mood and anhedonia in 58% (53). Conclusion: Depressive symptoms in the studied population showed a relevant and potential frequency to harm the personal, social and health status of people undergoing tuberculosis treatment. Thus, in the perspective of the National Plan for the End of Tuberculosis, the screening of depression and its manifestations can expand the care and prevention actions focused on the patient with tuberculosis and reduce the combined effects of tuberculosis and depression. [ABSTRACT FROM AUTHOR]

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Introduction: Chronic pain remains a public health issue as patients endure this condition while it affects the patients’ life either physically or mentally. Evidence has demonstrated that depression coexist with chronic pain; yet depression is often insufficiently acknowledged, indirectly causing this mental health problem to be undertreated. In this paper we aim to determine the local prevalence of depression among patients with chronic pain in a tertiary hospital in Sabah, East Malaysia. Methods: This is a retrospective cross-sectional study. Past patient consultation records of adult patients who attended a tertiary pain clinic in Sabah for the first time are included. Socio-demographic data were collected, as well as scores from painDetect Questionnaire (PD-Q) and 9-item Patient Health Questionnaire (PHQ-9). Results: From the 222 individual data collected, more than half (64.9%) were female. 79 (35.6%) were between the age of 18 to 40. The types of pain presented were almost equally distributed between nociceptive pain (38.3%), mixed pain (33.3%) and neuropathic pain (28.4%). Prevalence of depression among chronic pain patients was 15%. Patients with neuropathic pain are significantly associated with signs of depression (p<0.001). Female patients are significantly more prone to depression as compared to male (p = 0.024). Conclusion: The high prevalence of depression among chronic pain patients warrants the attention of physicians. Physicians should be vigilant and actively screen for depression in patients with chronic pain. [ABSTRACT FROM AUTHOR]

A validation study of the Beck Anxiety Questionnaire was carried out in October 2019, then in May 2020 it was applied to analyse the relationship of anxiety risk with demographic, communicative, socio-economic and social cohesion factors. Objectives: to reveal the non-causal association between the risk of anxiety and post-quarantine stressors, such as a social one in the university population of Cochabamba. Method: in a pilot group of 144 subjects sampled by convenience, Cronbach's alpha was assessed for the BAI. In the second stage it was applied to 85 students, assessed with ordinal logistic regression. The sociological interpretation was carried out from Norbert Elias' perspectives on power and social marking. Results: Cronbach's Alpha was 0.925, which shows its consistency within similar groups, possession of savings was shown as sole statistically significant protective factor. Conclusions: BAI was validated for Cochabamba's university student's context, possession of savings was identified as a protective factor on May 2020 for anxiety risk, and it's sociological analysis pointed to the vulnerability/negotiations relation. [ABSTRACT FROM AUTHOR]

Background: A limited number of studies have evaluated the psychometric properties of rating scales used to assess depression in the older adults. The present study aimed to assess the validity of the Hindi Geriatric Depression Scale (GDS, 30, 15, 10, 5, 4, and 1 item version) and Hindi Patient Health Questionnaire (nine and two items version) in a group of older adults residing in a rural community. Methods: The psychometric properties of these scales were assessed against the diagnosis of depression a qualified psychiatrist made by using a semistructured interview. Results: Total 125 older adults were recruited from a rural community, with a mean age of 65.5 (SD: 6.4) years. The prevalence of depression was 36.8% as per the evaluation by the psychiatrist. When the agreement of different scales with the clinicians' diagnosis was evaluated, it was seen that sensitivity, specificity, and Cohen Kappa value of GDS-30 and 15 were better than the other scales used to assess depression. When the sensitivity and specificity were evaluated using newer cutoffs, the specificity and sensitivity of GDS-30 were more than that of other scales. Conclusion: Hindi version of GDS-30 with a cutoff of 13 has excellent psychometric properties. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has created global crisis & drastic change in living conditions, social life, professional life and economic activity. There is lack of study done yet which examined the presence of work related depression among the physiotherapist due to COVID 19. So the aim of the study is to evaluate the presence or absence of the work relate related depression among physiotherapist due to COVID 19. Purpose of the Study: To evaluate the level of work related depression and categirize it into mild, moderte, severe levels among physiotherapist due to COVID 19. Material and Methodology: Between 10/10/2020 to 26/10/2020, 94 Physiotherapist were recruited by online survey through a Google form.88 Participants completed measures of depression (PHQ9) Questionnaire. Settings and Design: Pravara Institute of Medical Sciences, Dr. APJ Abdul Kalam College of Physiotherapy, Loni. Type of study- Observational Study with Survey Approach. Sampling method- A web-based cross-sectional survey Result: The present study had a targeted sample size of 88 Physiotherapist in which 24 were having no depression, 40 were having mild depression, 18 were having moderate depression and 6 were having moderately severe and no one had severe depression. Meeting the criteria for depression was predicted by clinical practitioners. Work related depression symptoms were also predicted by low income, loss of income, and pre-existing health conditions in self and other. Conclusion: 88 Physiotherapist responded to the survey based study from all parts of Maharashtra. However, specific COVID-related variables which is associated with psychological distress due to loss of income because of the pandemic& exposure to the virus and high estimates of personal risk, most of physiotherapist from responses were mildly depressed. [ABSTRACT FROM AUTHOR]

Purpose: The Knee Injury Osteoarthritis Outcome Score (KOOS)-Child questionnaire is one of the frequently child-friendly measures used in pediatric studies. The aim of this study was to transculturally adapt the Greek version of KOOS-Child and evaluate its clinimetric properties in children with knee disorders. Methods: Children visiting the Outpatients Orthopaedic Clinic of a Greek Paediatric General Hospital were considered eligible if they were aged 8–14 years, had a knee soft tissue injury and associated physical limitations. The transcultural adaptation was based on a multistage backward translation approach. Participants completed the KOOS-Child at their first visit to the orthopedic specialist (baseline), 2 weeks and 3 months after baseline. Content validity of the KOOS-Child was evaluated using general QoL measures (KIDSCREEN and Kid-KINDL) and construct validity was explored by correlating relevant items. Responsiveness was evaluated according to the children's response on the given orthopeadic treatment. Results: Sample consisted of 59 children (30 males), aged: 11 ± 1.8 years. The KOOS-Child showed high internal consistency (Cronbach's a: 0.80–0.96). Adequate convergent validity with > 75% relevant a priori hypotheses was confirmed. Construct validity was moderate to strong (Pearson's r correlations between related KOOS and Kid-KINDL subdimensions: 0.54–0.62). KOOS and KIDSCREEN subdimensions correlations were fair (Pearson's r correlations: 0.32–0.65). KOOS-Child's diagnostic accuracy was high. Factor analysis extracted height factors accounting for 76.15% of the total variance, confirmed by the scree plot. Responsiveness was moderate to high with Cohen's d from 0.6 to 1.4. Conclusion: The Greek version of the KOOS-Child demonstrated excellent internal consistency, good construct validity, diagnostic accuracy and interpretability as well as good responsiveness. The measure could be used across Greek children with orthopaedic knee problems. Generalisability of findings is limited due to the relatively limited cohort. Level of evidence: II. [ABSTRACT FROM AUTHOR]

As the implementation of Patient-Reported Outcomes Measurement Information System (PROMIS) scales has increased, so has the number of studies linking legacy scale scores to PROMIS scale scores. Variability in linked scores for a given PROMIS score can be considerable, leading to potential bias. An alternative method is imputation using a bridge study. We sought to compare linking to this alternative novel method in group-level analyses using linked legacy scores. Adult patients who completed PROMIS Depression and Patient Health Questionnaire (PHQ-9) were included. We randomly allocated data samples to be missing either PROMIS Depression or PHQ-9. We estimated PROMIS T scores using six methods: Linking methods by Choi et al. (2014), linking in our internal data, imputation using bridge study data from external data and from our internal data, each with and without patient demographics. Estimated mean PROMIS T scores using the linking and imputation methods were compared to actual PROMIS T scores across varying proportions of missingness and sample size. We also compared regression coefficients for the six estimation methods to a model using actual PROMIS T scores. Mean estimated versus actual PROMIS T scores varied between 1 and 4 points for the linking methods and within 0.4 points for the imputation method using internal data with patient demographics. The imputation methods had estimated regression coefficients closer to that of the model using actual scores as compared to the linking methods. For group-level analyses, imputation using a bridge study may be a feasible alternative to using linked scores or can be used as a sensitivity analysis. Public Significance Statement: Many legacy scales have been linked to associated PROMIS scales using item response theory and other linking strategies. Group-level analyses involving such linked scores sometimes result in biased parameter estimates. We propose an alternative analysis approach: Imputation using a bridge study. The study findings indicate that imputation using a bridge study may be a feasible alternative to analyzing legacy scale data scored on a PROMIS metric. [ABSTRACT FROM AUTHOR]

Psoriasis has a strong impact on patients' lives and is closely linked to psychiatric disorders such as depression, anxiety and substance‐related disorders, especially dependence on alcohol and nicotine. The aim of our study was to systematically assess the psychiatric comorbidity and possible associations between psychological factors, disease severity and dermatology‐related quality of life in psoriatic patients from a high‐need university hospital dermatology department. Consecutive psoriatic patients (new and permanent patients) at the Department of Dermatology, University Hospital Essen, Germany, were asked to fill out a paper‐based questionnaire. In the first part of the questionnaire, baseline demographics, pre‐existing mental disorders and data on substance abuse were collected. In the second part of the questionnaire, mental and physical health was explored using different validated self‐rating tests. The current Psoriasis Area and Severity Index (PASI) was documented by a dermatologist. Patients with signs of mental disorders were offered an appointment with a board‐certified psychiatrist. Between August 2016 and February 2019, 228 consecutive psoriatic patients (138 men [60.5%], 90 women [39.5%]; mean age, 48.3 years [standard deviation, 13.6; range, 18–80]) participated in the study. Approximately 50% of the patients had evidence of suffering from mental health problems, mostly depression and anxiety, as well as alcohol dependence. Patients with a PASI of 3 or more showed a statistically significant reduced Dermatology Life Quality Index (DLQI) and a significantly impaired psychological as well as physical quality of life. DLQI correlated with all psychological test results. The data indicate a significant psychological burden in a tertiary psoriatic population. Our findings underscore the importance of screening psoriatic patients for psychiatric disorders, with a focus on depression, anxiety as well as alcohol and nicotine dependence, in a multidimensional approach involving psychiatrists and psychologists. [ABSTRACT FROM AUTHOR]