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Purpose: We explored factors predicting repeated or hazardous alcohol use among autistic and non-autistic U.S. youth ages 16 to 20 years. Methods: Autistic (n = 94) and non-autistic (n = 92) youth completed an online survey. By design, half of each group reported past-year alcohol use. We compared drinking patterns for autistic and non-autistic youth, and within each group between abstinent or infrequent drinkers (0–1 drinking episodes in past year) versus those who drank 2 + times in past year. Results: Autistic (vs. non-autistic) youth who drank did so less frequently and consumed fewer drinks per occasion. However, 15% of autistic youth who drank in the past year reported heavy episodic drinking and 9.3% screened positive for AUDIT-C hazardous drinking. For autistic youth only, a diagnosis of depression, bullying or exclusion histories were positively associated with drinking 2 + times in the past year. Autistic youth who put more effort into masking autistic traits were less likely to report drinking 2 + times in the past year. As compared to non-autistic youth, autistic participants were less likely to drink for social reasons, to conform, or to enhance experiences, but drank to cope at similar rates. Conclusion: Repeated and hazardous underage alcohol occur among autistic youth. Targeted prevention programs designed to address the specific drinking profiles of autistic youth are needed. [ABSTRACT FROM AUTHOR]

Background: Hip fracture and depression are important public health issues among older adults, but how pre‐fracture depression impacts recovery after hip fracture is unknown, especially among males who often experience greater depression severity. Days at home (DAH), or the days spent outside a hospital or healthcare facility, is a novel, patient‐centered outcome that can capture meaningful aspects of fracture recovery. How pre‐fracture depression impacts DAH after fracture, and related sex differences, remains unclear. Methods: Participants included 63,618 Medicare fee‐for‐service beneficiaries aged 65+ years, with a hospitalization claim for hip fracture surgery between 2010 and 2017. The primary exposure was a diagnosis of depression at hospital admission, and the primary outcome was total DAH over 12 months post‐discharge. Longitudinal associations between pre‐fracture depression and the count of DAH among beneficiaries were estimated using Poisson regression models after adjustment for covariates; sex‐by‐depression interactions were also assessed. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) reflecting relative differences were estimated from these models. Results: Overall, beneficiaries with depression were younger, White females, and spent 11 fewer average DAH compared to counterparts without depression when demographic factors (age and sex) (IRR = 0.91; 95% CI = 0.90, 0.92; p < 0.0001) and social determinants of health (race, Medicaid dual eligibility, and poverty) were adjusted for (IRR = 0.92; 95% CI = 0.91, 0.93; p < 0.0001), but this association attenuated after adjusting for medical complexities (IRR = 0.99; 95% CI = 0.98, 1.01; p = 0.41) and facility and geographical factors (IRR = 1.0037; 95% CI = 0.99, 1.02; p = 0.66). There was no evidence of effect modification by sex. Conclusions: The comorbidity burden of preexisting depression may impact DAH among both male and female Medicare beneficiaries with hip fracture. Results suggest a holistic health approach and secondary prevention of depressive symptoms after hip fracture. [ABSTRACT FROM AUTHOR]

This study examined primary care provider (PCP) alignment with guideline-based care for adolescent depression screening and identified factors associated with post-screening responses. A retrospective chart review was conducted across 17 primary care clinics. Logistical regressions were estimated across provider specialties, sociodemographic factors, and patient clinical histories. Significant differences in follow-up and identification of depression were found among patients with more severe depression presentation. Follow-up screening was also more likely to be completed among patients with private insurance and less likely to occur among Black patients. Patients with significant mental health history of a mood concern, history of being prescribed psychotropic medication, were currently on medications at the time of the screening, or had a history of an internal mental health referral had a higher predicted probability of being identified as depressed on the patient problem list. [ABSTRACT FROM AUTHOR]

Oncology nurses and nurse practitioners often provide initial (prior to transition of care to a psychiatric provider) or maintenance assessment of and treatment for patients with depressed mood. Research informing oncology nurses and nurse practitioners on the assessment, differential diagnoses development, and treatment of depressed mood is limited. This article discusses assessment and management of common causes of depressed mood in the oncology setting. Implications for oncology nurses and nurse practitioners include improved quality of care and empowered, evidence-based clinical decision-making. [ABSTRACT FROM AUTHOR]

The literature lacks a rigorous psychometric evaluation of the Arabic version of Hospital Anxiety and Depression Scale (HADS) in hemodialysis (HD) patients. This study aims to evaluate reliability, determine the underlying factor structure of the Arabic version of HADS and assess its suitability as screening tool for depression and anxiety among Arabic HD patients. A sample of 370 HD patients were recruited from all health districts in Kuwait. Reliability for HADS (all items) and its subscales HADS-A (anxiety) and HADS-D (depression) were estimated using Cronbach's alpha and item analysis was conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to extract and test the factor structure for the Arabic version of HADS. Eight models were tested using CFA to determine goodness-of-fit. The Cronbach α for the Arabic HADS (all items), HADS-A and HADS-D were 0.884, 0.852 and 0.764, respectively. Pearson correlation coefficient between HADS-A and HADS-D subscales indicated significant correlation (r = +0.69, PV < 0.001). EFA indicated two factors with eigenvalues >1, which accounted for 48.5% of the total variance. CFA revealed the one-factor model had the poorest fit, the two-factor models with acceptable fit, and three-factor models showed good fit. The Arabic HADS has good reliability and internal consistency, which warrants its use in screening for anxiety and depression among Arabic HD patients. Furthermore, the three-factor structure has shown a better fit which warrants further exploration in HD patients with the advancement in theory of psychological models for anxiety and depression. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the current study is to describe mental health among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people who work in agriculture in the U.S. Methods: This study uses a survey of LGBTQ+ adults who work in agriculture in the U.S. (N = 148), including questions about LGBTQ+ identity, farming background, depression symptoms (PHQ-8) and diagnosis, anxiety symptoms (GAD-7) and diagnosis, suicide risk, and stress. Data were analyzed using SPSS, including descriptive statistics, chi-square tests, and Mann-Whitney U tests. Results: Over one-third (36.1%) had probable depression (PHQ-8 ≥ 10), and 71.9% were experiencing mild to severe depression symptoms. Nearly half (46.2%) had probable anxiety disorder (GAD-7 ≥ 8), and 69.7% experienced mild to severe anxiety symptoms. Over half (51.7%) were at significant risk for suicide. Greater proportions of men had probable anxiety disorder, probable depression, and suicide risk compared to non-men. Greater proportions gay participants had probable depression, as did beef producers. Perceived stress was higher for men, lesbian and gay participants, transgender participants, and those in beef production. Resilient coping was highest among participants who were genderqueer or genderfluid, bisexual, and those in field crop production. Conclusion: LGBTQ+ farmers in the current sample experienced depression and anxiety at higher rates than general farming or general LGBTQ+ samples, although suicide risk was lower than for general LGBTQ+ samples. Future research should explore how working in agriculture may be protective against suicide risk for LGBTQ+ farmers, as well as how specific farm stressors are related to LGBTQ+ farmer mental health. [ABSTRACT FROM AUTHOR]

Objective: This study compared female adolescents in institutional care (AICs) diagnosed with major depression (MD) or substance use disorder (SUD) with those who were not. In addition, we examined the protective effects of resilience, coping skills, and social support on SUD and MD. Methods: Participants included 49 female AICs (11–18 years) and a control group of 49 girls of similar age. Psychiatric diagnoses were made using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). In addition, participants completed self-report questionnaires: Screen for Child Anxiety Related Emotional Disorders Child Version (SCARED), The Child and Youth Psychological Resilience Scale, KIDCOPE, Social Support Appraisals Scale (SSAS), Children's Depression Inventory (CDI). Results: AICs were found to have more psychopathologies than the control group. Higher resilience, SSAS-friends scores, and more positive coping styles were associated with lower CDI scores in AICs with MD. CDI and SCARED scores were higher, and SSAS- family, friends, teacher scores, and positive coping styles were lower in the AICs with SUD. Conclusions: Resilience, increased social support from friends, and positive coping styles showed negative relationships with MD and SUD in AICs. Social support from teachers and family was negatively associated with SUD in AICs. [ABSTRACT FROM AUTHOR]

Introduction: Nociplastic pain (NP), classified as a third type of pain alongside nociceptive and neuropathic pain, is chronic pain arising from the amplification of nociceptive stimuli through central sensitization, despite the absence of tissue damage, sensory nerve damage, or disease. An important clinical feature of NP is that it is not only associated with pain but also with sensory hypersensitivity to sound and light and cognitive dysfunction, including mood and attention disorders. Recent studies have suggested that depression and developmental disorders, such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), coexist with NP at high frequency. Additionally, cognitive impairment in individuals with NP may be associated with these psychiatric comorbidities. However, to our knowledge, there are no reports on (1) multidimensional evaluation and diagnostic details of abdominal NP in adults with ADHD/ASD; (2) how ADHD drugs and antidepressants are administered when ADHD and depression coexist with NP; and (3) how central sensitization, brain function, and family relationship problems underlying NP are altered by treatments of ADHD and depression. Case presentation: Herein, we present the case of a 51-year-old woman with abdominal NP. She developed severe right lower abdominal pain and underwent a thorough medical examination; however, the physical, medical cause remained unknown, making treatment challenging. Additionally, she took time off work as she began to complain of insomnia and anxiety. She was referred to our pain center, where a diagnosis of depression, ADHD, and ASD was confirmed, and treatment with ADHD medication was initiated. While ADHD medications alone did not yield sufficient improvement, a combination of methylphenidate and the antidepressant venlafaxine eventually led to improvements in abdominal NP, depression, ADHD symptoms, central sensitization, and family relationship issues. During treatment, cerebral blood flow in the anterior cingulate, prefrontal, and parietal cortices also improved. Conclusion: The treatment of comorbid depression is important while treating NP, and venlafaxine may be effective, especially in cases of comorbid ADHD/ASD. Screening for developmental disorders and depression is required in patients with abdominal NP. [ABSTRACT FROM AUTHOR]

Objective: Shame is a powerful self‐conscious emotion that is often experienced by individuals with eating disorders (EDs). While the association between EDs and shame is well‐established, there is limited research investigating the contribution of pre‐treatment shame to clinical outcomes. Method: Participants (N = 273) received outpatient cognitive‐behavioral therapy for eating disorders (CBT‐ED). We investigated pre‐treatment shame as a predictor of dropout and as a moderator of change in ED psychopathology and clinical impairment from pre‐treatment to post‐treatment. We also explored the potentially moderating roles of body mass index, ED diagnostic category, and co‐occurring anxiety and depression diagnoses. Results: Shame improved substantially (d = 1.28) despite not being explicitly targeted in treatment. Pre‐treatment shame did not predict treatment dropout. Individuals high in shame started and ended treatment with higher ED symptoms and impairment than those with low shame. The contribution of pre‐treatment shame on the degree of change in symptoms/impairment depended critically on whether analyses controlled for pre‐treatment symptoms/impairment. When those were controlled, high pre‐treatment shame was associated with substantially less improvement in ED symptoms and impairment. There was some evidence that ED diagnosis and co‐occurring depressive diagnoses may moderate the relationship between shame and treatment outcome. Changes in shame were positively associated with changes in ED symptoms and clinical impairment. Discussion: A high level of shame at pre‐treatment is not a contraindication for CBT‐ED as good therapeutic outcomes can be achieved. However, outcomes may be enhanced among individuals high in shame by offering adjunctive interventions that explicitly target shame. [ABSTRACT FROM AUTHOR]

The Center for Epidemiologic Studies Depression Scale – Revised (CESD-R) is a popular self-report screening measure for depression. A 20-item questionnaire with scores ranging from 0 to 4 for each item, the CESD-R can produce total scores ranging from 0 to 80. However, the typical scoring protocol for the CESD-R restricts the range of possible scores to between 0 and 60 to retain the same range and clinical cutoff scores as the original CES-D. Despite the widespread adoption of this scoring approach, the psychometric impact has never been systematically examined. In an undergraduate and community adult sample (n = 869), item response theory analyses indicated that scoring the CESD-R with all 5 response options (CESD-R5opt) provided nearly twice as much information about a person's latent depression for individuals with high levels of depression than did scoring the CESD-R with 4 response options per item (CESD-R4opt). The CESD-R5opt retained the strong reliability and factor structure of the CESD-R4opt and was more sensitive to individual differences for participants at high levels of depression compared to the CESD-R4opt. Results provide preliminary evidence that researchers and clinicians should score the CESD-R using the full 0-to-80 scale and a clinical cutoff score of 29. [ABSTRACT FROM AUTHOR]

Beck Depression Inventory-II (BDI-II) is one of the most used instruments for depression assessment. Stepankova Georgi, H., Vlckova,H., Lukavsky, K., Kopecek, J., M., & Bares, M. (2019). Beck Depression Inventory-II: Self-report or interview-based administrations show different results in older persons. International Psychogeriatrics, 31(5), 735–742.) found that BDI-II yielded lower scores when administered to elderly participants in the interview form after previous questionnaire form. Stepankova Georgi et al. imply that some participants misunderstand the instructions, which inflates their score, and that the interview form of BDI-II has a potential to prevent such bias thanks to the interviewer's feedback. However, many studies have found a decrease in BDI-II scores simply due to the repeated administration. Our study aims to test whether the hypothesis of Stepankova Georgi, H., Vlckova, H., Lukavsky, K., Kopecek, J., M., & Bares, M. (2019). Beck Depression Inventory-II: Self-report or interview-based administrations show different results in older persons. International Psychogeriatrics, 31(5), 735–742.) is plausible by using a sample of young adults without cognitive impairment. We administered the Czech version of BDI-II in both the questionnaire and the interview form to a convenience sample of 125 young adults (Mage = 22.3, 60% women) and performed a Wilcoxon signed-rank test to within-subject compare mean scores. We show that both administration forms yield similar mean scores. The results imply that BDI-II can be administered to young adults without cognitive impairment in either form without the risk of substantial bias, but the interview form can still prevent misunderstanding of instructions in some respondents. [ABSTRACT FROM AUTHOR]

Purpose: A diagnosis of dysphagia and/or depression after stroke can impact the physical, psychological, and social welfare of stroke survivors. Although poststroke depression (PSD) and poststroke dysphagia are known to occur concurrently, there is a paucity of research that has specifically investigated their association. Therefore, we aimed to study the relationship between PSD and poststroke dysphagia during acute inpatient hospitalization and within 90 days after discharge. Furthermore, we aimed to evaluate the odds and hazard of being diagnosed with depression after stroke and estimate the time to depression diagnosis from the initial stroke diagnosis in patients with and without a diagnosis of dysphagia. Method: Using the acute inpatient hospital data set from our previous work, we pulled additional postdischarge administrative claims data from the 2017 Medicare 5% Limited Data Set and conducted a retrospective, cross-sectional study of patients diagnosed with poststroke dysphagia and PSD. Results: Patients diagnosed with poststroke dysphagia had 2.7 higher odds of being diagnosed with PSD and had an approximately 1.75-fold higher hazard for PSD diagnosis in the 90 days after discharge compared to patients not diagnosed with dysphagia. Risk factors for PSD included having dysphagia, being female, and having dual eligibility Conclusions: Our results demonstrated a significant association between PSD and poststroke dysphagia. Additional research should further explore the impact of PSD on poststroke dysphagia. [ABSTRACT FROM AUTHOR]

Measurement tools from which valid interpretations can be made are critical for assessing early emerging depressive symptoms, as depressive symptoms in childhood are associated with increased risk for early-onset depressive disorder, recurrence, suicidality, and other psychopathology. The Depression Self-Rating Scale for Children (DSRS) is a widely used self-report scale assessing youth depressive symptoms. The relatively few studies investigating the DSRS' latent structure have yielded mixed results, and measurement invariance (MI) based on sex and age has not been examined. We examined the factor structure and MI of the DSRS across sex and age in a community sample of 6–9-year-olds (N = 352; Mage = 7.57 years, SD =.70). Consistent with the largest prior structural study of the DSRS, a two-factor structure, with factors reflecting elevated negative affect (NA) and low positive affect (PA), showed strong model fit. Although this structure was consistent across sex and age (i.e., configural invariance), loadings of DSRS items varied across sex and age (i.e., metric noninvariance). Allowing the loadings of items contributing to noninvariance to vary across groups improved model fit. Implications for the clinical and research utility of the DSRS and suggestions for future research are discussed. Public Significance Statement: We examined factors underlying children's responses on the Depression Self-Rating Scale for Children (DSRS) and the structure of scores across sex and age. DSRS items reflect low positive affect and high negative affect. Although this was consistent across sex and age, how much individual items related to these factors differed across sex and age. As a result, we may not be able to meaningfully compare scores across sex and age. [ABSTRACT FROM AUTHOR]

Face culture is a crucial facet of East Asia. The most common self‐report measure for face concern is the unidimensional Loss of Face Scale. In this study, we examined the dimensionality, factor structure, and validity of the Loss of Face Scale in two samples. Sample 1 (N = 602) consisted of 303 Taiwanese mothers and 299 U.S. mothers. Sample 2 (N = 602) was an independent sample from Sample 1, consisting of 294 Taiwanese mothers and 308 U.S. mothers. We proposed a modified 15‐item four‐dimensional factor structure to better capture the complexity of face. Four sub‐domains emerged from the results of exploratory structural equation modelling: Low‐Profile, Over‐Preparation, Harmony Seeking, and Non‐Aggression. Multigroup confirmatory factor analysis indicated configural and metric invariance but failed to establish full scalar invariance across countries. Convergent validity was supported by positive correlations with other Asian cultural values. While all four domains of face showed small to moderate correlations with depression in the U.S., only Low‐Profile was associated with depression in Taiwan, suggesting that not all aspects of face concern are non‐adaptive in East Asian contexts. Future studies should consider the multidimensional nature of face as well as how different dimensions affect mental and social well‐being across cultures. [ABSTRACT FROM AUTHOR]

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

Background: Depression is present in individuals with type 2 diabetes mellitus. Objective : We evaluated the sociodemographic, anthropometric, and clinical features of Mexican individuals with clinical depressive symptoms in order to identify predictors for depression symptoms; finally, we evaluated if HbA1c levels could be used as a probable diagnostic of depressive symptoms in individuals with type 2 diabetes mellitus. Methods: The population studied consisted of 376 Mexicans with diabetes who were interviewed to collect information about comorbidities and habits. The evaluation of depressive symptoms was performed using the Hamilton scale. For a possible clinical association between HbA1c levels and depressive symptoms, we performed chi-square tests (χ2)/ t tests. A multivariate logistic regression model with the backward conditional method was used to identify predictors of depressive symptoms. An ROC curve was plotted to assess the possible role of HbA1c as a diagnostic predictive test of depression symptoms. Results: A total of 42.8% (n = 161) individuals showed clinical depressive symptoms. When comparing individuals with and without depression symptoms, those with depression symptoms showed higher levels of glucose and HbA1c; additionally, gender (p = 0.04), age (p = 0.006), HbA1c (p < 0.01), and complications related to diabetes were predictive factors for clinical depressive symptoms (p < 0.01). However, HbA1c showed a low diagnostic accuracy for depressive symptoms, with an area under the ROC curve of 0.59. Conclusions: Our findings provided evidence of the sex, age, HbA1c levels, and medical complications as predictors of clinical depressive symptoms in individuals with diabetes mellitus. Nevertheless, HbA1c levels are not useful as a diagnostic instrument for depressive symptom severity in these Mexican individuals. [ABSTRACT FROM AUTHOR]

Although there are studies showing the effects of physical exercises on depression, there are not many studies that clearly demonstrate the effect of aerobic exercise in geriatric depression with a clear protocol. To examine the effect of aerobic exercises on depression in geriatric individuals. 38 sedentary individuals diagnosed with geriatric depression participated in this prospective cohort study. Vital signs, depression levels and quality of life were evaluated before and after the program. Statistical significance was accepted as p < 0.05 in the analyzes. The respiratory frequency, Clinically Useful Depression Outcome Scale scores (p < 0.05), blood pressure and heart rate values (p < 0.001) decreased, and the change in median quality of life values increased (p < 0.001) after the aerobic exercise program. Aerobic exercises have positive effects on geriatric depression. The effectiveness of treatments can be increased by adding aerobic exercises to geriatric depression treatment protocols. [ABSTRACT FROM AUTHOR]

Pediatric overweight and obesity is a complex chronic medical condition with a multitude of contributing factors. Rates are now nearly double what they were before the COVID-19 pandemic and if the current trajectory holds it is anticipated that by 2050 one in every two US children will experience obesity before the age of thirty-five. Pediatric obesity guidelines emphasize referral to intensive health behavior and lifestyle therapy programs, but these are difficult to access. Front line providers caring for children can use a lifestyle medicine approach within the medical home to make lifestyle changes easier. Lifestyle Medicine can promote a family-oriented, weight-neutral approach by (1) Educating and equipping providers to assess readiness to change and providing high-quality motivational interviewing and lifestyle counseling, (2) Equipping patients and their families with tools involving the six lifestyle interventions to optimize health starting an early age, and (3) Offering a longitudinal uniform office approach to effectively prevent, manage and often reverse obesity and related comorbidities through healthy habit change. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether the same health state results in the same distribution of responses on the EQ-5D youth and adult descriptive systems. Methods: Adolescents aged 13–18 years with a range of health conditions and from the general school going population were recruited in South Africa (ZA) and Ethiopia (ET). In ZA participants completed the English EQ-5D-3L, EQ-5D-Y-3L and EQ-5D-5L in parallel. Whereas in ET participants completed the Amharic EQ-5D-5L and EQ-5D-Y-5L in parallel. Analysis aimed to describe the transition between youth and adult instruments and not differences between countries. Results: Data from 592 adolescents completing the EQ-5D-3L, EQ-5D-Y-3L and EQ-5D-5L (ZA) and 693 completing the EQ-5D-5L and EQ-5D-Y-5L (ET) were analysed. Adolescents reported more problems on the youth versions compared to the adult version for the dimension of mental health. 13% and 4% of adolescents who reported no problems on the EQ-5D-3L and EQ-5D-5L reported some problems on the EQ-5D-Y-3L respectively. This was less notable with transition between the five level versions with 4% of adolescents reporting more problems on the EQ-5D-Y-5L than the EQ-5D-5L. Very few adolescents reported severe problems (level 3 on the EQ-5D-3L or EQ-5D-Y-3L and level 4 and level 5 on the EQ-5D-5L or EQ-5D-5L) thus there was little variation between responses between the versions. In ZA, discriminatory power, measured on the Shannon's Index, was higher for Y-3L compared to 3L for pain/discomfort (ΔH′=0.11) and anxiety/depression (ΔH′=0.04) and across all dimensions for Y-3L compared to 5L. Similarly, in ET discriminatory power was higher for Y-5L than 5L (ΔH′ range 0.05–0.09). Gwet's AC showed good to very good agreement across all paired (ZA) 3L and (ET) 5L dimensions. The summary score of all EQ-5D versions were able to differentiate between known disease groups. Conclusion: Despite the overall high levels of agreement between EQ-5D instruments for youth and for adults, they do not provide identical results in terms of health state, from the same respondent. The differences were most notable for anxiety/depression. These differences in the way individuals respond to the various descriptive systems need to be taken into consideration for descriptive analysis, when transitioning between instruments, and when comparing preference-weighted scores. [ABSTRACT FROM AUTHOR]

Background: While social disparities in depression are well-documented, the symptom experience across social positions remains less studied. Aims: This study examines the connections between depressive symptoms and self-recognizing a depressive episode, on the one hand, and clinical diagnosis, on the other hand, by three social position indicators. Methods: We analyzed baseline data from a population-based cohort of adults living in France, grouping participants by three indicators: education, financial difficulties, and occupation, and stratifying by sex. Utilizing a psychometric network approach, we estimated 24 networks. Nodes corresponded to the 20 CES-D items and 1 external variable, either 'Limitations due to depression' or 'Clinical depression'. Comparisons between socially disadvantaged and advantaged groups across the three social indicators were made in terms of network structures, global strength, and edge weights involving symptoms and both external nodes. Results: The study included data from 201,952 participants. Individuals in lower social positions exhibited higher rates of depressive-related variables. Four depressive symptoms emerged as crucial, being linked both to 'Clinical depression' and 'Limitations' across all social positions. Socially disadvantaged groups had denser networks. Some of the tests comparing network structures according to social position were significant, suggesting differences in the symptom activation chains. Connections between each external node and 'Felt depressed' and 'Could not get going' were non-invariant in educational and financial-based networks. Conclusions: Findings highlight four depressive symptoms, likely to play a key role in the experience of depression across all social positions. Other insights from specific symptoms could be used for improving depression care among disadvantaged populations. [ABSTRACT FROM AUTHOR]

Purpose: To assess the knowledge, clinical experience, and attitudes of Italian midwives toward perinatal depression (PND) and to explore how these factors impact the quality of care. Methods: We conducted a cross-sectional online survey among 152 midwives employed in public hospitals across Italy. The questionnaire covered a range of topics, including demographic data, professional experience, knowledge of PND symptoms, risk factors, and clinical management, as well as communication skills and personal experiences with PND cases. Results: A concerning 76.3% of midwives displayed inadequate knowledge of PND based on current scientific literature. Those with a more comprehensive understanding were notably more confident in their practice, expressing significantly fewer apprehensions about communicating with mothers (25.8% vs 74.2%) and lesser concerns about the mothers' future well-being (38.9% vs 62.95%). The survey results also emphasised the midwives' call for specialised guidelines and formal training in PND management and underscored the value of communication skills, continuity of care, and family engagement in supporting affected mothers. Conclusion: This inaugural study sheds light on the current state of knowledge and attitudes among Italian midwives regarding PND. It pinpoints crucial areas for educational enhancement and practice improvement, suggesting that elevated levels of midwife expertise in PND could significantly elevate the standard of care and expedite early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective: People with mental health conditions have high rates of chronic physical diseases, partially attributable to lifestyle risks factors. This study examined risk prevalence among community mental health service clients, their readiness and confidence to change, and associations with participant characteristics. Methods: Cross-sectional survey of adult clients from 12 community mental health services across 3 local health districts in New South Wales, Australia, collected from 2021 to 2022. Participants (n = 486) completed a telephone interview determining five risk factors, and readiness and confidence to change these. Multiple binary logistic regression models determined associations between readiness and confidence (for each risk), and participant characteristics (demographics and diagnosis). Results: Participants most commonly reported a diagnosis of schizophrenia (36.7%) or depression (21.1%). Risk factors were prevalent: ranging from 26% (harmful alcohol use) to 97% (poor nutrition). High readiness was greatest for smoking (68%), weight (66%) and physical inactivity (63%), while confidence was highest for changing alcohol use (67%). Two significant associations were identified; females were more likely than males to have high readiness to change nutrition (odds ratio = 1.14, confidence interval = [1.13, 2.34], p = 0.0092), with males more likely to have high confidence to change physical activity (odds ratio = 0.91, confidence interval = [0.45, 0.99], p = 0.0109). Conclusions: Many participants were ready and confident to change risk factors. Gender influenced readiness to change nutrition and physical activity confidence. Training to upskill mental health clinicians in provision of preventive care that builds confidence and readiness levels may aid in supporting positive behaviour change. [ABSTRACT FROM AUTHOR]

This study documents the need for wider use of treatment monitoring in the mental health field and presents clinicians with a valuable, brief tool for monitoring progress regarding depression, anxiety and anger, all on one page. Strong concurrent validation was established between the five-item Depression Scale of David Burns' Brief Mood Survey (BMS) and the widely used but longer, 21-item Beck Depression Inventory–II (BDI-II). Strong validation was also found regarding the classification of depression severity (minimal, mild, moderate, and severe) between the two scales. Additionally, the sensitivity (using standard formulas) of the BMS Depression Scale in detecting "clinically significant" scores as defined by the BDI-II is 96% (i.e., the percentage of accurate detection by the BMS); its specificity is 83% (i.e., its freedom from incorrectly labeling a BDI-II "minimal depression" score as "clinically significant"), and its overall combined accuracy in differentiating "minimal" and "clinical classifications" is 92%. This research also shows that the BMS Anxiety Scale and BMS Anger Scale (both five items) correlate significantly with the respective subscales of Anxiety and Hostility on the Symptom Checklist–90–Revised (SCL-90-R), providing further valuable client information for clinicians. This means the BMS offers psychotherapists a much needed quick, efficient, valid, standardized instrument for identifying and assessing depression, and for monitoring treatment progress regarding depression, anxiety, and anger. Additionally, the five-item BMS Depression Scale by itself offers physicians and other health care professionals a valid, quick screening tool for detecting depression and assessing its severity. Public Significance Statement: More brief, validated, and easy-to-use clinical measures are needed to increase practitioner monitoring of mental health treatment. The Brief Mood Survey (Burns, 1997) has five-item scales each for depression, anxiety, and anger, all on one page, and correlate well with two longer, well-established clinical scales indicating its usefulness as a brief, valid tool for identifying and assessing depression, monitoring treatment progress, and serving as an efficient screening tool in other settings. [ABSTRACT FROM AUTHOR]

Background: A thorough psychosocial assessment is time-consuming, often requiring multiple sessions to uncover the psychological factors contributing to mental illness, such as depression. The duration varies depending on the severity of the patient's condition and how effectively the psychotherapist can establish rapport. However, prolonged assessment periods pose a significant risk of patient deterioration. Methods: The comprehensive psychosocial intervention, led by the Multi-Criteria Decision-Making (MCDM) approach utilizing the Multi-Objective Optimization by Ratio Analysis (MOORA) method, played a pivotal role in identifying the key psychological factors contributing to the depression of the client among the 21 factors specified by BDI-II analysis. Results: The integration of the MOORA strategy compared to traditional psychotherapy on 254 samples demonstrates a Jaccard similarity coefficient of 0.8, with a minimum error margin of 7% (vulnerability index = 0.57), indicating a significant agreement between the two approaches, both converging towards a similar solution. For patients with extreme depression, the number of sessions reduced from 18 ± 2 to 11 ± 2, showing a 33–35% reduction (χ2 = 6.94, p = 0.008). Severe depression patients experienced a reduction from 14 ± 2 to 8 ± 1 sessions i.e., 34–39% reduction (χ2 = 8.32, p = 0.004). Moderate depression patients saw sessions drop from 9 ± 1 to 5 ± 1, i.e., 37–43% reduction (χ2 = 0.29, p = 0.001). The accuracy for detecting dominant psychological factors improved to 82.88% for extreme, 86.74% for severe, and 90.34% for moderate depression, respectively. Conclusion: The implementation of MOORA facilitated the identification and prioritization of key psychosocial intervention strategies, making the process significantly faster compared to traditional methods. This acceleration greatly enhanced the precision and efficacy of the work. Additionally, critical vulnerable factors were identified through ordered statistics and correlation analysis [Pearson (r) = 0.8929 and Spearman's rank (ρ) = 0.7551] on the Beck Depression Inventory-II model. These findings were supported by other MCDM schemes such as EDAS and TOPSIS, demonstrating high stability and robustness in dynamic decision-making environments, maintaining consistency across scenarios adapted by different psychotherapists. Overall, the combined application of MCDM (MOORA) and targeted psychological interventions yielded substantial positive outcomes in enhancing the well-being of individuals with psychological illnesses, such as depression, cognitive, affective, and somatic syndromes. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a common mental health disorder with a lifetime prevalence of 20.6% among United States (US) adults. Multiple US surveys have shown a consistently higher burden of mental health struggles among lesbian, gay, bisexual, trans, and questioning (LGBTQ+) adults compared to non-LGBTQ+ adults. However, it is not known whether diagnosis and treatment for those adults who do report symptoms of MDD differ based on sexual orientation. We test for differences in prevalence, diagnosis, and treatment of MDD in sexual minorities using appropriate multivariable logistic regression using the New York City Health and Nutrition Examination Survey (NYC HANES). About 10% of NYC adults (≥ 20 years old) self-identify as a sexual minority and 8.5% of adults in NYC have MDD based on the Patient Health Questionnaire (PHQ-9) score. Significantly higher proportion of sexual minorities in NYC have depression compared to non-sexual minorities (17.7% vs. 7.6%, p = 0.01). In the multivariable model, sexual minorities were 2.33 (CI = [1.24–4.39], p = 0.009) times more likely to have depression compared to non-sexual minorities. Additionally, people with multimorbidity were more likely to be diagnosed for depression (OR = 3.78, CI = [1.33, 10.75], p = 0.013). Disparities exist in the prevalence, diagnosis, and treatment of MDD in NYC adults. Targeted outreach toward the LGBTQ + community should be considered by public health officials when designing primary and secondary prevention programs for depression. [ABSTRACT FROM AUTHOR]

Objectives: A life interference measure specifically designed for young adults with anxiety and depressive symptoms does not currently exist. This paper describes the development and psychometric evaluation of a brief self‐report measure of life interference associated with young adult anxiety and depression, the Child Anxiety and Depression Life Interference Scale – Young Adult version (CADLIS‐YA). Design: Cross‐sectional, correlational and exploratory factor analysis (EFA). Methods: Five‐hundred and thirty‐two participants aged 18–24 years recruited from an undergraduate and community sample completed the CADLIS‐YA. Results: An EFA supported a three‐factor model describing the impact of young adult anxiety and depression on social life, family and daily life interference. Test–retest reliability and internal consistency were good to excellent. Convergent validity was demonstrated, and the scale differentiated between young adults with and without elevated anxiety and depressive symptoms. Support for divergent validity was limited. Conclusions: The CADLIS‐YA is a reliable and valid life interference measure for young adults with symptoms of anxiety and depression. It is potentially suitable for administration in low‐resource research settings and it has promise for use in clinical settings; however, it needs validation in a clinical sample. [ABSTRACT FROM AUTHOR]

Background: The association between depression and dementia is still unclear, particularly regarding depression as a potential risk factor preceding dementia. Therefore, we aimed to verify if the presence of depression at baseline may increase the risk of dementia and cognitive impairment during 15 years of follow‐up in the SHARE (Survey of Health, Aging and Retirement in Europe) study. Methods: Depressive symptoms were defined using the EURO‐D, with a score ≥4 indicative of depression. Incident dementia was ascertained using self‐reported data and caregivers' information, cognitive impairment using objective cognitive tests. Cox regression analysis, adjusted for 10 baseline confounders, was run and hazard ratios (HRs), with their 95% confidence intervals, were estimated. Results: In total 22,789 participants were included in the present analysis (mean age 64.2 years) and were predominantly female. The prevalence of depression at baseline was 24.9%. Over 15 years of follow‐up, the onset of dementia occurred a median 2 years earlier in people with depression compared to those without. Depression at the baseline significantly increased the risk of dementia in the overall sample (HR = 1.74; 95% CI: 1.54–1.95) and the risk of cognitive impairment (HR = 1.15; 95% CI: 1.06–1.25). For dementia, the association was stronger in people less than 60 years (HR = 2.07; 95% CI: 1.42–3.02) than in participants aged ≥80 years (HR = 1.47; 95% CI: 1.14–1.91). A similar trend was observed for cognitive impairment. Among the single items of the EURO‐D, loss of concentration was the strongest individual variable predicting the onset of dementia. Conclusions: Depression increased the risk of dementia and cognitive impairment, particularly in younger adults, whereas loss of concentration was the strongest individual predicting variable of dementia. These findings demonstrate the need for early detection of depression for preventing future cognitive worsening. Key points: Depression is a common condition. Its role as a potential risk factor for dementia has been explored in several studies, but these have limitations, for example, differences in study population, insufficient numbers of younger patients, limited follow‐up duration, and differences in the assessment of depression and dementia.Our study, carried out using data from the SHARE project, showed that the presence of depression at baseline increased the risk of dementia by 74% and of cognitive impairment of 15%. The effect was stronger when considering young‐age depression. Among the single items of the questionnaire proposed for assessing depression, loss of concentration showed the strongest association.Our study indicates that depression may be associated with dementia and cognitive impairment in later life. Therefore, in the early recognition of depression we should remember that cognitive aspects are of critical importance for better individualizing pharmacological and non‐pharmacological approaches. [ABSTRACT FROM AUTHOR]

Background: Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High‐Risk [HR]) and without (Low‐Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). Method: Study 1 included LR (n = 65) and HR (n = 22) 12‐ to 14‐year‐olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid‐to‐late adolescents (64 females; 73.56%), including 57 MDD youth from a short‐term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. Results: We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β =.22, CI95 = 0.01–0.42, p =.041), independent (β =.34, CI95 = 0.12–0.56, p =.003), and interpersonal (β =.23, CI95 = 0.004–0.45, p =.047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β =.62, CI95 = 0.45–0.79, p <.001) and dependent (β =.41, CI95 = 0.21–0.61, p <.001) stress than the HC group, but not independent (p =.083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17–10.70, p =.026). Conclusions: Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course. [ABSTRACT FROM AUTHOR]

Background: Cross sectional studies have identified linguistic correlates of major depressive disorder (MDD) in smartphone communication. However, it is unclear whether monitoring these linguistic characteristics can detect when an individual is experiencing MDD, which would facilitate timely intervention. Methods: Approximately 1.2 million messages typed into smartphone social communication apps (e.g. texting, social media) were passively collected from 90 adolescents with a range of depression severity over a 12‐month period. Sentiment (i.e. positive vs. negative valence of text), proportions of first‐person singular pronouns (e.g. 'I'), and proportions of absolutist words (e.g. 'all') were computed for each message and converted to weekly aggregates temporally aligned with weekly MDD statuses obtained from retrospective interviews. Idiographic, multilevel logistic regression models tested whether within‐person deviations in these linguistic features were associated with the probability of concurrently meeting threshold for MDD. Results: Using more first‐person singular pronouns in smartphone communication relative to one's own average was associated with higher odds of meeting threshold for MDD in the concurrent week (OR = 1.29; p =.007). Sentiment (OR = 1.07; p =.54) and use of absolutist words (OR = 0.99; p =.90) were not related to weekly MDD. Conclusions: Passively monitoring use of first‐person singular pronouns in adolescents' smartphone communication may help detect MDD, providing novel opportunities for early intervention. [ABSTRACT FROM AUTHOR]

Background: Older adults with major depression are at risk of frailty and long‐term care needs. Consequently, screening for major depression is imperative to prevent such risks. In Japan, the Late‐Stage Elderly Questionnaire was developed to evaluate older adults' holistic health, including mental well‐being. It comprises one specific question to gauge life satisfaction, but the effectiveness of this question to screen for major depression remains unclear. Therefore, we aimed to assess the usability of this question to screen for major depression. Methods: This retrospective cohort study used a large, commercially available claims database in Japan. Participants were older adults aged ≥75 years who completed the Late‐Stage Elderly Questionnaire and were classified with and without new major depression within 1 year. We evaluated the questionnaire's ability to screen for major depression using C‐statistics, developing three models to assess the cut‐off value based on responses to the life satisfaction question ('Satisfied', 'Somewhat satisfied', 'Somewhat unsatisfied', or 'Unsatisfied'), estimating the sensitivity and specificity of each model. Results: Among 11 117 older adults, 77 newly experienced major depression within 1 year. The C‐statistic for screening major depression was 0.587. The model setting the cut‐off between 'Somewhat unsatisfied' and 'Unsatisfied' the demonstrated lowest sensitivity and highest specificity, while the model setting the cut‐off between 'Satisfied' and 'Somewhat satisfied' demonstrated highest sensitivity and lowest specificity. Conclusions: Our results suggest that due to its poor screening ability and high rate of false negatives, the question assessing life satisfaction in the Late‐Stage Elderly Questionnaire may not be useful for screening major depression in older adults and may require modification. [ABSTRACT FROM AUTHOR]

Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management. [ABSTRACT FROM AUTHOR]

Interests in including mindfulness techniques in medical and psychological fields have been increasing recently. Accordingly, it is important to validate the short form of the Freiburg Mindfulness Inventory (FMI-14) to help professionals living in Arabic speaking countries. Thus, we aimed to validate the FMI-14 in the Arabic language (FMI-Ar) in Arabic-speaking university students from Lebanon. We carried-out a cross-sectional study between July and September 2021; 363 university students (mean age 22.65 ± 3.48 years, 61.7% females) were enrolled. The McDonald's omega and Cronbach's alpha values for the total score were excellent (0.92 for both). Confirmatory factor analysis of the one-factor model of the FMI-Ar showed satisfactory fit indices: χ2/df = 218.33/77 = 2.83, RMSEA = 0.071 [0.060–0.082], CFI = 0.92, and TLI = 0.90. Additionally, the FMI score was negatively associated with depression (r = –0.51; p = 0.001) and anxiety (r = –0.48; p < 0.001). All hypotheses (factor, convergent, and divergent validity) related to the FMI-Ar were verified in our study. Therefore, professionals can now benefit from the FMI-Ar, a suitable scale to measure mindfulness among Lebanese University students. [ABSTRACT FROM AUTHOR]

Mental health is a complex, multidimensional concept that goes beyond clinical diagnoses, including psychological distress, life stress, and well-being. In this study, we aimed to use unsupervised clustering approaches to identify multidimensional mental health profiles that exist in the population, and their associated service-use patterns. The data source was the 2012 Canadian Community Health Survey–Mental Health, linked to administrative health-care data; all Ontario, Canada, adult respondents were included. We used a partitioning around medoids clustering algorithm with Gower's proximity to identify groups with distinct combinations of mental health indicators and described them according to their sociodemographic and service-use characteristics. We identified 4 groups with distinct mental health profiles, including 1 group that met the clinical threshold for a depressive diagnosis, with the remaining 3 groups expressing differences in positive mental health, life stress, and self-rated mental health. The 4 groups had different age, employment, and income profiles and exhibited differential access to mental health-care services. This study represents the first step in identifying complex profiles of mental health at the population level in Ontario. Further research is required to better understand the potential causes and consequences of belonging to each of the mental health profiles identified. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

Aims: To explore the association between a depression diagnosis in young adulthood and risk of marginalisation at age 29 years, among those who had completed upper secondary school and those who had not completed at age 21. Methods: In a longitudinal cohort study based on nationwide registers we followed 111,558 people from age 22–29 years. Outcomes were risk of marginalisation and educational achievement at age 29. Exposure was a diagnosed depression at ages 22–26 years. Comorbid mental and somatic health conditions, gender and country of origin were covariates. Relative risks were estimated with Poisson regression models, stratified by educational level at age 21. Results: For people who had not completed upper secondary school at age 21 years, a depression diagnosis at age 22–26 increased the risk of low income (relative risk = 1.33; 95% confidence interval = 1.25–1.40), prolonged unemployment benefit (1.46; 1.38–1.55) and social security benefit (1.56; 1.41–1.74) at age 29 compared with those with no depression. Among those who had completed upper secondary school at age 21 years, depression increased the risk of low income (1.71; 1.60–1.83), prolonged unemployment benefit (2.17; 2.03–2.31), social security benefit (3.62; 2.91–4.51) and disability pension (4.43; 3.26–6.01) compared with those with no depression. Mental comorbidity had a significant impact on risk of marginalisation in both groups. Conclusions: Depression in one's mid-20s significantly increases the risk of marginalisation at age 29 years, and comorbid mental health conditions reinforce this association. Functional ability should be given priority in depression care in early adulthood to counteract marginalisation. [ABSTRACT FROM AUTHOR]

Aaron T. Beck's cognitive model of depression became the basis for the analysis of cognitive factors as significant correlates and predictors of depression. Psychological mechanisms of depression related to the depressive cognitive triad, the specificity of cognitive schemas and errors in cognitive processing determined the directions of further research on depression. The presented analysis of selected studies confirms and extends Beck's assumptions about the role of cognitive factors in the development and maintenance of depressive symptoms. The analysis of psychological, neuroimaging and biochemical studies provides a broader perspective of understanding both the etiology and mechanisms that sustain the symptoms of depression. The development of neuroimaging research has broadened the knowledge about the brain mechanisms of depression - the presented research combine the theoretical constructs of the cognitive concept of depression with the characteristics of the activity of brain structures and their functional connections. The following conclusions seem to be particularly important for clinical practice: (1) impairment of the cognitive inhibition function in depression reduces the control of negative automatic thoughts - strengthening working memory is important; (2) different brain mechanisms for processing rewards and punishments in people suffering from depression and in healthy people explain the formation of self-esteem - this knowledge can be an important element of psychoeducation in therapeutic work; (3) neuroimaging studies indicate neuronal correlates of cognitive distortions observed in depression - for further research on depression, it would be particularly important to monitor changes in brain activity in the course of its treatment. [ABSTRACT FROM AUTHOR]

A 68-year-old woman presented with fatigue, dry mouth, dry eyes, photophobia, numbness in the feet, and 'brain fog' 7 months after acute COVID-19 infection. She also suffered from a need to frequently stop for breath while speaking. Pre-existing depression was exacerbated by long COVID. Ten visits for chiropractic adjustments and home care advice were administered over a 7-week period. Partial improvement was noted in the patient's eye comfort, and fatigue was somewhat reduced. The attention deficit component of 'brain fog' was greatly improved as evidenced by the return of the patient's ability to read novels with comprehension and enjoyment. The need to frequently stop for breath while speaking no longer was present by the end of the study. Possible confounding factors are a complex constellation of pre-existing conditions and polypharmacy. An additional confounding factor may have been hypoglycaemia. This was a problem in the patient's early adulthood and may have been reactivated by long COVID. During the course of care, pragmatic innovations in clinical assessment ('forced inspiration shrug') and adjusting technique ('gluteal assist' for coccyx adjustment) were developed. [ABSTRACT FROM AUTHOR]

Background: Poor quality of sleep is a widespread issue in modern society, and even children are being diagnosed with sleep disorders nowadays. Sleep disruption in children can lead to poor mental health in the long term. The present study aimed to evaluate the association between sleep disorders and subsequent depression in children and adolescents. Methods: This retrospective cohort study used electronic medical records from the IQVIATM Disease Analyzer database. It included children and adolescents aged 6–16 with an initial diagnosis of a sleep disorder and age- and gender-matched patients without sleep disorders treated by one of 274 office-based pediatricians in Germany between January 2010 and December 2022. The five-year cumulative incidence of depression in the cohorts with and without sleep disorders was studied with Kaplan–Meier curves using the log-rank test. Multivariable Cox regression analyses were used to assess the association between sleep disorders and depression. Results: The present study included 10,466 children and adolescents with and 52,330 without sleep disorder diagnosis (mean age 10 ± 3 years, 48% female). Within five years after the index date, 5% of sleep disorder patients and 2% of the matched non-sleep disorder cohort had been diagnosed with depression. A strong and significant association was observed between sleep disorders and subsequent depression (HR: 2.34; 95% CI: 2.09–2.63). This association was stronger in adolescents (HR: 3.78; 95% CI: 3.13–4.56) than in children. Upon the exclusion of depression diagnoses in the first year after the index date, the association between sleep disorders and depression remained strong and significant (HR: 1.92; 95% CI: 1.68–2.19). Conclusions: This study indicates a strong and significant association between sleep disorders and depression. [ABSTRACT FROM AUTHOR]

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Aim: Inbreeding is thought to affect the morphometric parameters leading to lower health status among the progeny. The present study was aimed to investigate the repercussions of inbreeding on anthropometric traits, namely height, weight and body mass index (BMI). Subjects and methods: The survey was conducted in two North Indian cities and total 813 individuals were randomly recruited from inbred and outbred families. The morphometric parameters of the subjects were measured using standard methods, BMI was calculated and categorized into underweight, normal weight and overweight. Family pedigrees were drawn and degree of inbreeding in terms of the inbreeding coefficient (F) was calculated. Results: A significant decline in morphometric measures was observed among inbred individuals as compared to outbred ones. The mean differences (95% CI) were found significant for various inbred and first cousin categories as compared to outbred subjects (p < 0.05). We found the increased frequency of underweight individuals corresponding to the degree of inbreeding for different types of inbred categories (p = 2.086 × 10−9) and also for different subtypes of first cousin unions corresponding to their sex-linked inbreeding coefficients (p = 5.2 × 10−5). The regression slope and correlation coefficient revealed a fitness decline and depression in anthropometric measures (p < 0.05) with the increase in 'F' for all inbred groups and first cousin categories. Conclusions: The present research confirms the adverse effects of inbreeding on morphometric parameters among inbred subjects. It has novelty in shedding light on the hitherto unreported differences in the consequences of inbreeding among different types of first cousin unions. Highlights: Consanguinity acts as a risk factor among humans resulting in poor health status. This empirical study deals with the effect of inbreeding on anthropometric measures. Significant decrease in morphometric traits was observed among inbred individuals. The risk for poor health status was found proportional to the degree of inbreeding. We also reported the differences in inbreeding effects for various first cousin unions for the very first time. [ABSTRACT FROM AUTHOR]

Aim. This study examined the mental health of nurse managers in the Kingdom of Saudi Arabia. Background. The COVID‐19 pandemic has affected the physical and mental health of senior nurses, including effects of shortages of staff and medical supplies. However, no study has examined this topic among nurse managers in the Kingdom of Saudi Arabia despite their exposure to mental stress during the pandemic. Methods. A cross‐sectional design was used to investigate the levels of depression, anxiety, stress, and general psychological distress among nurse managers in Saudi Arabia. Data were collected August 2023 to February 2024. The main tool was the reliable and validated Arabic translation of the Depression, Anxiety, and Stress Scale (DASS‐21). Data collection was performed using an online platform. IBM SPSS software was used for data analysis. The data was analysed using multiple regression to examine the relationship between the dependent (outcome) and independent (predictor) variables. A significant p‐value was set at 0.05. Results. Stress and general psychological distress were the most common problems among nurse managers in the post‐COVID‐19 era. Individual educational attainment was the only significant predictor of anxiety, stress, and general psychological distress. Moreover, the nationalities of nurse managers were correlated with stress outcomes. Conclusions. Nursing managers are very likely to suffer from stress and general mental health problems in cases of exposure to crises. They may find the results of this study useful in understanding the factors that may play a role in the development of mental health problems during clinical work. Different strategies can be considered to alleviate depression, anxiety, and stress among managers, including the proper delegation of tasks. Top‐level management and healthcare stakeholders should give special considerations to the nationality and education level upon selecting nurse mangers at different levels. Implications in Nursing Management. Policy makers involved in planning care for healthcare professionals may find this study valuable in planning for future pandemics by developing a strategy that could reduce stress and psychological distress. [ABSTRACT FROM AUTHOR]

Objective: Understanding the relevance of religion or spirituality (R/S) in the treatment of mental disorders is central to clinical and academic psychiatry. In this secondary analysis, associations of R/S with depression were investigated with respect to a new second-generation mindfulness-based intervention, the Meditation-Based Lifestyle Modification (MBLM) program. Methods: Different aspects of spirituality, spiritual coping, and spiritual engagement were assessed in 81 patients with a diagnosis of mild-to-moderate depression. Treatment effects on R/S postscores and predictor and moderation effects of depression severity and stress change-scores were evaluated at 8 weeks (MBLM vs. CONTROL [drug continuation therapy] vs. TAU [inpatient treatment as usual]) and 6 months (TAU+MBLM vs. TAU). Results: At both time points, significant differences between MBLM versus TAU and CONTROL were found in a range of spiritual outcomes, most of them with a medium-to-large effect size and in favor of MBLM. Baseline interest in spirituality (p = 0.001) and baseline spiritual mind–body practice (p = 0.017) were identified as independent predictors of change in depression severity at 6 months. Moreover, moderation analyses found that patients reporting often/regular spiritual mind–body practice at 6 months did not benefit differently from TAU+MBLM versus TAU (p = 0.437) regarding their change in depression severity and stress, while those reporting no/seldom spiritual mind–body practice at 6 months benefited significantly worse from TAU than from TAU+MBLM (p = 0.002). Conclusions: Participation in the MBLM program resulted in significantly greater increases in spirituality in depressed patients than standard therapy. Interest in spirituality and engagement in spiritual mind–body practices at baseline were positive predictors of clinical outcome in both groups. Patients of any group who regularly performed spiritual mind–body practices benefited equally in terms of antidepressant outcomes, underlining the benefit of these practices within a general therapeutic framework. ClinicalTrials.gov Identifier: NCT03652220 [ABSTRACT FROM AUTHOR]

The association of weaning with depression has long been recognized. However, interest in the study of post-weaning depression has waned over the last few decades partly due to changes in the nosology of perinatal psychiatric disorders. In this paper, we review the relevant literature and conclude that post-weaning depression is a rare but severe complication of breastfeeding cessation. Given that post-weaning depression is an understudied and often undiagnosed clinical condition, research is needed to address this important unmet need. [ABSTRACT FROM AUTHOR]

Background: Very few studies have compared different diagnostic approaches to diagnose depression in patients with cancers. Aim: To compare the different diagnostic approaches used for diagnosing depression in patients with cancers. Methodology: This cross-sectional study included 200 patients (diagnosed with cancer at least 3 months prior to recruitment) attending the outpatient services who were assessed on diagnostic and statistical manual, fifth edition (DSM-5) criteria for depression. Additionally, these patients were also assessed using the inclusive, exclusive, and substitutive criteria for depression using a semistructured interview. Patients completed Patient Health Questionnaire-9 (PHQ-9). Results: The mean age of the patients was 50.28 years (S.D. M14.11). Females outnumbered males. The mean age of onset of malignancy was 47 years (S.D 14.03), and the mean time since diagnosis of cancer was 35.45 years (S.D 36.87). The prevalence of depression was the highest (38.5%) when estimated using the PHQ-9 and was the lowest (21.5%) when assessed using exclusive criteria for depression. All approaches had high degree of concordance with the DSM-5 criteria for depression. Conclusion: A significant proportion of patients with cancer suffer from depression, and the prevalence is influenced by the diagnostic method. [ABSTRACT FROM AUTHOR]

Depression is considered a leading cause of illness and disability worldwide. Early identification of depressive symptomatology is urgent to prevent its negative consequences in the lives of children and adolescents. The Mood and Feelings Questionnaire (MFQ) stands out as one of the most useful measures for screening depression in youth. The parent version of the Short Mood and Feelings Questionnaire (SMFQ-P) consists of a 13-item scale for screening depression in children and adolescents. This study aimed to analyze the psychometric properties of the SMFQ-P in a sample of Spanish children aged 8–12. The sample comprised 374 children whose parents completed the Spanish version of the SMFQ-P. Results showed excellent internal consistency of the SMFQ-P (α =.92), and excellent test–retest reliability (intraclass correlation coefficient [ICC] =.76). The original one-factor model of the SMFQ-P was confirmed in this sample of Spanish children, and all 13 items displayed adequate corrected item-factor correlation values. These findings reveal the SMFQ-P as a brief and reliable measure to assess depression in children and adolescents through their parents. [ABSTRACT FROM AUTHOR]

Depression has serious impacts on health and is a common condition seen in clinical practice. The initial therapy for depression may include both psychotherapy and medication, with selective serotonin reuptake inhibitors considered first-line treatment. For those with a partial or incomplete response to treatment, additional medications may also be utilized. In some individuals with treatment-resistant depression, there may be a need for adjuvant therapies in addition to such medications. This article reviews the adjuvant use of natural substances in people with depression. Evidence for the use of curcumin, methylfolate, omega-3 fatty acids, zinc, probiotics, and vitamin D in this context is discussed. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of recognising postnatal depression in fathers • To identify fathers’ barriers to, and motivators for, seeking support for postnatal depression • To consider how healthcare services could better support fathers experiencing postnatal depression. Background: Many men tend to avoid seeking support for mental health issues and little is known about help-seeking among fathers who experience postnatal depression. Aim: To explore fathers’ help-seeking for postnatal depression, including barriers and motivators, and their experiences of informal support from partners and formal support from healthcare professionals. Method: Data were obtained through individual semi-structured interviews with eight fathers who self-identified as having experienced postnatal depression. Data were analysed using interpretative phenomenological analysis. Findings: Five themes emerged from the data analysis: not recognising postnatal depression; fatherhood expectations restricting postnatal depression disclosure; disappointment at the medicalised response to help-seeking; health visitors as a feared profession which excludes fathers; needing communication, validation and a safe space to talk. Conclusion: Some fathers need professional support for their mental health after the birth of their child. Nurses and health visitors should routinely ask fathers about their mental well-being, validate their feelings and encourage them to discuss their mental health issues with a healthcare professional. [ABSTRACT FROM AUTHOR]

After decades of controversy, the concept of childhood depression now seems to be part of standard medical knowledge. Yet the form and content of this nosological entity, like many psychiatric diseases, is continuously shaped by the scientific, clinical, and political communities involved in child psychiatry. In this qualitative study, we explored how the concept of childhood depression is constructed in early twenty-first century child psychiatry. We conducted a series of 18 interviews with practising child psychiatrists, international experts in the field, and interpreted them with thematic analysis informed by discourse analysis. We identified five overarching discourse themes across interviews, relating to the definition of depression, the diagnostic process, the causes of this condition, the therapeutic strategy, and the scientific role of child psychiatry. Most participants agreed that childhood depression was a mental disorder where irritability prevailed, heavily influenced by psychosocial factors, and for which psychotherapy was the ideal treatment. However, subtle points of dissent also surfaced: whether depression is primarily a mood state or psychological suffering, whether categories or dimensions are more suitable to make the diagnosis, and whether there is a genetic predisposition were some of the most controversial topics. Theoretical considerations regarding childhood depression may have significant scientific, moral, and socio-political implications beyond child psychiatry and should be addressed appropriately. [ABSTRACT FROM AUTHOR]

Chronic subdural hematomas (CSDH) with isolated psychiatric presentation are rare. In this paper, we report a case of 77-year-oldfemale patient who had psychotic depression after repetitive head trauma without any neurological symptoms. The brain magnetic resonance imaging revealed an 20 mm subdural hematoma in the right frontoparietal region and a 7 mm subdural hematoma in the left frontal region. The psychiatric symptoms improved within the first week after evacuation but relapsed with the occurrence of right sided pneumocephalus. In the follow up, with the disappearance of the pneumocephalus, the psychiatric symptoms improved. It should be kept in mind that isolated psychiatric symptoms can be seen due to subdural hematoma and evacuation of the hematoma has an important role in improving the psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression.SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services.Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. What the paper adds to existing knowledge?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression.MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression.The positive preferences for providing information and family involvement in treatment decision‐making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. What are the implications for practice?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision‐making actively.A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression.SDM‐related training should be encouraged for MHPs to promote widespread SDM. Introduction: Shared decision‐making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well‐documented. Aim: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. Method: In this cross‐sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision‐Making Questionnaire—Physician Version (SDM‐Q‐Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. Results: The mean SDM‐Q‐Doc was 80.47 (±16.31). Within the six specific decision‐making situations, most MHPs selected non‐SDM (52.7%–71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision‐making, working in an outpatient clinic and receiving SDM training (F = 23.582; p =.000; R2 =.198; adjusted R2 =.189). Discussion: Although the MHPs' self‐rated score of SDM‐Q‐Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM‐related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer‐practitioner relationship. Implications for Practice: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high‐quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families. [ABSTRACT FROM AUTHOR]

Objectives "SuperAgers" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. Methods We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]). SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55–64, and (3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. Results Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p  < .001; HRS: OR = 1.14, p  = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p  = .019; HRS: OR = 0.58, p  = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p  = .031; HRS: OR = 0.67, p  = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p  = .015; HRS: OR = 0.69, p  = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g. chronic conditions and self-rated health) did not relate to SuperAging. Discussion Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults. [ABSTRACT FROM AUTHOR]