scholarly journals Depressive Symptom Screening in Youth – Using a Community Diabetes Prevention Clinic

2020 ◽  
Vol 3 ◽  
Author(s):  
Alexander Wright ◽  
Lisa Yazel-Smith ◽  
Tamara Hannon
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Diabetes Prevention ◽  
Diabetes Management ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Risk Category ◽  
Symptom Screening ◽  
Increased Risk ◽  
Prevention Clinic

Background: Rates of youth diagnosed with diabetes and prediabetes are increasing and comorbidities like depression warrant strict monitoring to improve patient outcomes.  Objective: The aim was to determine if increased depressive symptoms are associated with worse clinical findings, including BMI, obesity, diabetes, prediabetes, hemoglobin A1c (HbA1c), and demographic variables including age, gender, and race.  Methods: The study is a retrospective chart review of patients referred to the Youth Diabetes Prevention Clinic (YDPC) based on increased risk for type 2 diabetes (T2D). The Patient Health Questionnaire (PHQ-9), a 9-question depressive symptom screening tool, was utilized to screen for depressive symptoms using a cut point of >=10 which indicates possible depression and a need for further evaluation. All available data were evaluated for clinic visits occurring between 2013 and 2020.  Results: 178 patients filled out PHQ-9 screening forms and returned them to clinic. Age (p <0.01), sex (p <0.01), BMI (p <0.01), HbA1c (p <0.01), and obesity diagnosis (p = 0.01) were associated with increased depressive symptoms based on screening score cutoff. Race (p > 0.05), BMI z-score (p = 0.18), prediabetes diagnosis (p = 0.92), and diabetes diagnoses (p = 0.05) were not. Middle adolescent (ages 14-17) youth were 3.5 times more likely than early adolescents to fall into the moderate/high risk category for depression. Females were 2.6 times more likely and those with higher HbA1c or an obesity diagnosis were ~3 times more likely. A modest portion (36.5%) in this sample met criteria for possible clinical depression.  Conclusion and Impact: Patients at risk for prediabetes and diabetes should be screened for depressive symptoms in order to intervene to decrease its adverse effects on diabetes management. Older youth, females, and those with obesity and higher HbA1c values are at particularly higher risk of having increased depressive symptoms. 

scholarly journals Depressive symptom dimensions and cardiac prognosis following myocardial infarction: results from the ENRICHD clinical trial

2011 ◽  
Vol 42 (1) ◽  
pp. 51-60 ◽  
Author(s):  
S. Bekke-Hansen ◽  
M. Trockel ◽  
M. M. Burg ◽  
C. Barr Taylor
Keyword(s):  
Myocardial Infarction ◽  
Clinical Trial ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Cardiovascular Mortality ◽  
Bonferroni Correction ◽  
Symptom Dimensions ◽  
Symptom Dimension ◽  
Increased Risk ◽  
Co Morbidity

BackgroundDepression following myocardial infarction (MI) independently increases risk for early cardiac morbidity and mortality. Studies suggest that somatic, but not cognitive, depressive symptoms are responsible for the increased risk. However, the effects of somatic depressive symptoms at follow-up, after sufficient time has elapsed to allow for physical recovery from the initial infarction, are not known. Our aim was to examine the relationship between cognitive and somatic depressive symptom dimensions at baseline and 12 months post-MI and subsequent mortality and cardiovascular morbidity.MethodPatients were 2442 depressed and/or socially isolated men and women with acute MI included in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. We used principal components analysis (PCA) of the Beck Depression Inventory (BDI) items to derive subscales measuring cognitive and somatic depressive symptom dimensions, and Cox regression with Bonferroni correction for multiple testing to examine the contribution of these dimensions to all-cause mortality, cardiovascular mortality, and first recurrent non-fatal MI.ResultsAfter adjusting for medical co-morbidity and Bonferroni correction, the somatic depressive symptom dimension assessed proximately following MI did not significantly predict any endpoints. At 12 months post-MI, however, this dimension independently predicted subsequent all-cause [hazard ratio (HR) 1.43, 95% confidence interval (CI) 1.13–1.81] and cardiovascular mortality (HR 1.60, 95% CI 1.17–2.18). No significant associations were found between the cognitive depressive symptom dimension and any endpoints after Bonferroni correction.ConclusionsSomatic symptoms of depression at 12 months post-MI in patients at increased psychosocial risk predicted subsequent mortality. Psychosocial interventions aimed at improving cardiac prognosis may be enhanced by targeting somatic depressive symptoms, with particular attention to somatic symptom severity at 12 months post-MI.

scholarly journals Exploring the causal role of intimate partner violence and abuse on depressive symptoms in young adults: a population-based cohort study

BMC Medicine ◽  
2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Annie Herbert ◽  
Jon Heron ◽  
Maria Barnes ◽  
Christine Barter ◽  
Gene Feder ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Linear Regression ◽  
Partner Violence ◽  
Adult Population ◽  
Intimate Partner ◽  
Geometric Means ◽  
Increased Risk ◽  
Symptom Scores

Abstract Background Previous studies have shown an association between experience of intimate partner violence and abuse (IPVA) and depression. Whether this is a causal relationship or explained by prior vulnerability that influences the risk of both IPVA and depression is not known. Methods We analysed data from the Avon Longitudinal Study of Parents and Children prospective cohort (N = 1764 women, 1028 men). To assess the causal association between IPVA at 18–21 years old and logged depressive symptom scores at age 23, we used (i) multivariable linear regression, (ii) inverse probability of treatment weighting (IPTW), and (iii) difference-in-difference (DiD) analysis, which compared the mean change in logged depressive symptom scores between ages 16 and 23 between those who experienced IPVA and those who did not. Results Women who experienced IPVA had on average 26% higher depressive symptom scores after adjustment for measured confounders (ratio of geometric means 1.26, 95% CI 1.13 to 1.40). In men, the difference was 5% (ratio of geometric means 1.05, 95% CI 0.92 to 1.21). Results from IPTW analysis were similar. In the DiD analysis, there was no evidence that being exposed to IPVA affected the change in depressive symptom scores over time compared to being in the non-exposed group for either women (difference-in-differences 1%, −12 to 16%) or men (−1%, −19 to 20%). Conclusions Multivariable linear regression and IPTW suggested an association between IPVA and higher depressive symptom score in women but not men, but DiD analysis indicated a null effect in both women and men. This suggests the causal origins of higher depressive symptoms in this young adult population are likely to reflect prior vulnerability that leads to both higher depressive symptoms and increased risk of IPVA exposure.

Clinical experience with exemestane in postmenopausal women at increased risk of breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1565-1565
Author(s):  
Mia Sorkin ◽  
Donna Lapolt ◽  
Lajos Pusztai ◽  
Erin Wysong Hofstatter
Keyword(s):  
Breast Cancer ◽  
Cancer Prevention ◽  
Postmenopausal Women ◽  
Uterine Cancer ◽  
Retrospective Chart Review ◽  
Cancer Chemoprevention ◽  
Breast Cancer Prevention ◽  
Patient Acceptance ◽  
Increased Risk ◽  
Prevention Clinic

1565 Background: Exemestane has recently been identified as an effective breast cancer chemoprevention agent. This drug may be more appealing to patients than tamoxifen or raloxifene, since it does not increase the risks of thrombosis, cataracts and uterine cancer. Poor patient acceptance of tamoxifen and raloxifene as chemoprevention is well-documented but patient acceptance rates for exemestane have not been reported. The goal of this study was to assess exemestane use in a breast cancer prevention clinic. Methods: A retrospective chart review was conducted to capture patient characteristics, medical history and chemoprevention uptake of all postmenopausal women presenting to the Yale Breast Cancer Prevention Clinic from November 2011-November 2012. Descriptive statistics are presented. Results: Fifty-six postmenopausal women deemed eligible for initiation of chemoprevention were seen during the study timeframe, with a mean age of 58 (range 42-79). Risk categories included: 22 women (39%) diagnosed with breast atypia, 7 with LCIS (12%), 4 with prior DCIS (7%), 41 with family history of breast cancer (73%), and 8 women with a deleterious BRCA 1 or 2 mutation (14%). 22 (39%) of these women had osteopenia or osteoporosis. Of all eligible women, 13 opted to start a chemoprevention medication (23%); 8 of whom opted for raloxifene, 1 for tamoxifen and 4 for exemestane. While exemestane comprised 30.7% (4/13) of chemoprevention medication uptake, only 4 of 56 women eligible for chemoprevention decided to take exemestane (7%). Conclusions: Chemoprevention uptake rates of postmenopausal women in the setting of a breast cancer prevention clinic are higher (23%) than those reported in the general population, but remain low overall. Uptake of exemestane appears lower than that of raloxifene but higher than tamoxifen. A large proportion of postmenopausal women (39%) have osteopenia or osteoporosis which limits exemestane uptake in a breast cancer prevention setting.

scholarly journals Establishing the causal role of intimate partner violence and abuse on depressive symptoms in young adults: a population-based cohort study

2021 ◽  
Author(s):  
Annie Herbert ◽  
Jon Heron ◽  
Maria Barnes ◽  
Christine Barter ◽  
Gene Feder ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Linear Regression ◽  
Symptom Score ◽  
Partner Violence ◽  
Intimate Partner ◽  
Geometric Means ◽  
Increased Risk ◽  
Symptom Scores

Background Previous studies have shown an association between experience of intimate partner violence and abuse (IPVA) and depression. Whether this is a causal relationship or explained by prior vulnerability that influences the risk of both depression and IPVA is not known. Methods and Findings We analysed data from the Avon Longitudinal Study of Parents and Children prospective cohort (N=1,764 women, 1,028 men). To assess the causal association between IPVA at 18-21 years old and logged depressive symptom scores at age 23, we used: i) multivariable linear regression, ii) inverse probability of treatment weighting (IPTW), and iii) difference-in-difference (DID) analysis, which compared the mean change in logged depressive symptom scores between ages 16 and 23 between those who experienced IPVA and those who did not. Women who experienced IPVA had on average 26% higher depressive symptom score after adjustment for measured confounders (ratio of geometric means 1.26, 95% CI 1.13 to 1.40). In men, the difference was 5% (ratio of geometric means 1.05, 95% CI 0.92 to 1.21). Results from IPTW analysis were similar. In the DID analysis, there was no evidence that being exposed to IPVA affected the change in depressive symptom scores over time compared to being in the non-exposed group for either women (difference-in-differences: 1%, -12% to 16%) or men (-1%, -19% to 20%). Conclusions Multivariable linear regression and IPTW suggested an association between IPVA and higher depressive symptom score in women but not men, but DID analysis indicated a null effect in both women and men. This suggests the causal origins of higher depressive symptoms in this young adult population are likely to reflect prior vulnerability that leads to both higher depressive symptoms and increased risk of IPVA exposure.

The Role of Disordered Eating in Type 2 Diabetes: A Pilot Study

2021 ◽  
pp. 155982762110024
Author(s):  
Alyssa M. Vela ◽  
Brooke Palmer ◽  
Virginia Gil-Rivas ◽  
Fary Cachelin
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Disordered Eating ◽  
Lifestyle Intervention ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Behavioral Therapy ◽  
Exercise Stress ◽  
Increased Risk

Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.

scholarly journals The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Joshua E. J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Phoebe Barnett ◽  
Katherine Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Panic Disorder ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Antidepressant Treatment ◽  
Patient Data ◽  
History Of ◽  
Depressive Symptom Severity

Abstract Background This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care. Methods We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Results Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions. Conclusions When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.

756 The Moderating Influence of Depression on Insomnia and Suicidal Ideation in a Military Sample

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A295
Author(s):  
Emma Palermo ◽  
Jennifer Goldschmied ◽  
Elaine Boland ◽  
Elizabeth A Klingaman ◽  
Philip Gehrman ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Research University ◽  
Negative Binomial ◽  
Suicide Attempts ◽  
Risk And Resilience ◽  
Depression Severity ◽  
Significant Interaction Effect ◽  
Increased Risk ◽  
The Impact

Abstract Introduction Military personnel are at an increased risk for suicide compared to the general population, making it important to develop a deeper understanding of which factors contribute to this elevated risk. Given that suicidal ideation (SI) is one of the strongest predictors of suicide attempts, understanding factors that underlie SI may improve prevention efforts. Insomnia and depression both serve as independent risk factors for SI, and therefore the aim of this study was to examine the extent to which depressive symptoms moderate the association between insomnia and SI. Methods Data were obtained from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS). Soldiers (n=21,450) completed questions related to suicidal ideation (5 items), depressive symptoms (9 items), and insomnia (5 items) based on symptom presence in the past 30 days. Items in each domain were summed to create a total severity score. GEE models using a negative binomial linking function were conducted to examine the impact of depression, insomnia, and their interaction on SI. Results Both depression (χ2 =117.56, p&lt;0.001) and insomnia (χ2=11.79, p=0.0006) were found to have significant main effects on SI, and there was a significant interaction effect (χ2=4.52, p=0.0335). Follow up simple effects revealed that insomnia was no longer significantly associated with SI when depression severity was low, but was associated with SI in the presence of greater depression severity (χ2=2.91, p=0.0882). Conclusion In a large sample of Army soldiers, depression significantly moderated the association between SI and insomnia, such that insomnia seems to amplify the effects of depression on SI. These findings highlight the importance of addressing insomnia severity as a mean of reducing SI in those with depression, potentially allowing for intervention prior to a suicide attempt. Support (if any) Perlis: K24AG055602 & R01AG041783. This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan- http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981.

scholarly journals 1110. Very Late Onset Infections Amongst Long Term Survivors of Kidney Transplantation

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S585-S585
Author(s):  
Harry Cheung ◽  
Marwan M Azar ◽  
Geliang Gan ◽  
Yanhong Deng ◽  
Elizabeth A Cohen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Data ◽  
Opportunistic Infections ◽  
Late Onset ◽  
Retrospective Chart Review ◽  
Kidney Transplant Recipients ◽  
Increased Risk ◽  
Simple Logistic ◽  
Long Term Survivors

Abstract Background Kidney transplant recipients (KTR) are at increased risk for infections immediately post-transplant due to intense immunosuppression. However, this risk decreases over time as immunosuppression is tapered. The incidence of infection in KTR many years after transplant is not well characterized. The aim of this study was to describe these “very-late onset infections” (VLIs) ≥ 10 years after KT. Methods We performed a retrospective chart review of patients age ≥ 18 years who underwent KT between 2003 and 2009 and who survived ≥ 10 years post-KT. VLIs included opportunistic infections (OIs) and non-OIs. Demographics, comorbidities, immunosuppression, and clinical data for VLIs ≥ 10 years from KT were collected. Simple logistic regression was performed to determine characteristics associated with risk for VLIs. Results Of 332 KTR that met the inclusion criteria, the majority were male (62.0%), white (59.6%), and the largest proportion was transplanted between the ages of 50-59 (28.3%); 220 (67.9%) were on mycophenolate-based regimens. The mean Charlson Comorbidity Index (CCI) was 4.7 (S.D. 2.0). Of 332, 103 (31.0%) KTR experienced ≥ 1 VLI amounting to 187 episodes. Compared to those without VLI, KTR with VLI were more likely to have diabetes (p=0.005), cardiovascular disease (p=0.004), low ALC (p &lt; 0.001) and require dialysis (p=0.002). Of 103 KTR with VLI, 16 (15.5%) had OIs, while 87 KTR (84.5%) had non-OIs, most commonly urinary tract infection (n=85, 45.5%), pneumonia (n=35, 18.7%) and gastrointestinal infection (n=18, 9.6%). The most commonly isolated pathogens were E. coli (n=30, 16%), K. pneumoniae (n=16, 8.6%), MSSA (n=7, 3.7%), and P. aeruginosa (n=7, 3.7%). Higher CCI, diabetes, dialysis, cerebrovascular, cardiovascular disease and lower ALC were associated with increased risk for VLI (p &lt; 0.05), while living donor KTR was protective (p=0.04). Additionally, every 1 year after transplant was associated with an increased risk of VLI (OR=1.31, p &lt; 0.001). Table 1: Demographics, comorbidities, immunosuppression, and clinical data for all patients Conclusion VLIs were common in long-term survivors of KT and included both conventional and opportunistic pathogens. Every additional year from transplant incurred additional risk for VLI, particularly for those with multiple co-morbidities and lower ALC. Disclosures All Authors: No reported disclosures

scholarly journals Role of depressive symptoms in cardiometabolic diseases and subsequent transitions to all-cause mortality: an application of multistate models in a prospective cohort study

2021 ◽  
pp. svn-2020-000693
Author(s):  
Yanan Qiao ◽  
Siyuan Liu ◽  
Guochen Li ◽  
Yanqiang Lu ◽  
Ying Wu ◽  
...  
Keyword(s):  
Heart Disease ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
European Population ◽  
Multistate Models ◽  
Cardiometabolic Diseases ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Patients With Diabetes

Background and purposeThe role of depression in the development and outcome of cardiometabolic diseases remains to be clarified. We aimed to examine the extent to which depressive symptoms affect the transitions from healthy to diabetes, stroke, heart disease and subsequent all-cause mortality in a middle-aged and elderly European population.MethodsA total of 78 212 individuals aged ≥50 years from the Survey of Health Ageing and Retirement in Europe were included. Participants with any baseline cardiometabolic diseases including diabetes, stroke and heart disease were excluded. Depressive symptoms were measured by the Euro-Depression scale at baseline. Participants were followed up to determine the occurrence of cardiometabolic diseases and all-cause mortality. We used multistate models to estimate the transition-specific HRs and 95% CIs after adjustment of confounders.ResultsDuring 500 711 person-years of follow-up, 4742 participants developed diabetes, 2173 had stroke, 5487 developed heart disease and 7182 died. Depressive symptoms were significantly associated with transitions from healthy to diabetes (HR: 1.12, 95% CI: 1.05 to 1.20), stroke (HR: 1.31, 95% CI: 1.18 to 1.44), heart disease (HR: 1.26, 95% CI: 1.18 to 1.34) and all-cause mortality (HR: 1.41, 95% CI: 1.34 to 1.49). After cardiometabolic diseases, depressive symptoms were associated with the increased risk of all-cause mortality in patients with diabetes (HR: 1.54, 95% CI: 1.25 to 1.89), patients who had stroke (HR: 1.29, 95% CI: 1.03 to 1.61) and patients with heart disease (HR: 1.21, 95% CI: 1.02 to 1.44).ConclusionsDepressive symptoms increase the risk of diabetes, stroke and heart disease, and affect the risk of mortality after the onset of these cardiometabolic conditions. Screening and treatment of depressive symptoms may have profound implications for the prevention and prognosis of cardiometabolic diseases.

Sign in / Sign up

Export Citation Format

Share Document