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Fulltext Prevalence of mental health problems among children with long COVID: A systematic review and meta-analysis

Mat Hassan N, Salim HS, Amaran S, Yunus NI, Yusof NA, Daud N, et al.

PLoS One, 2023;18(5):e0282538.
PMID: 37195978 DOI: 10.1371/journal.pone.0282538

INTRODUCTION: The number of children with mental health problems has more than doubled since the COVID-19 pandemic. However, the effect of long Covid on children's mental health is still debatable. Recognising long Covid as a risk factor for mental health problems in children will increase awareness and screening for mental health problems following COVID-19 infection, resulting in earlier intervention and lower morbidity. Therefore, this study aimed to determine the proportion of mental health problems post-COVID-19 infection in children and adolescents, and to compare them with the population with no previous COVID-19 infection.
METHODOLOGY: A systematic search was done in seven databases using pre-defined search terms. Cross-sectional, cohort and interventional studies reporting the proportion of mental health problems among children with long COVID in the English language from 2019 to May 2022 were included. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. Studies with satisfactory quality were included in meta-analysis using R and Revman software programmes.
RESULTS: The initial search retrieved 1848 studies. After screening, 13 studies were included in the quality assessments. Meta-analysis showed children who had previous COVID-19 infection had more than two times higher odds of having anxiety or depression, and 14% higher odds of having appetite problems, compared to children with no previous infection. The pooled prevalence of mental health problems among the population were as follows; anxiety: 9%(95% CI:1, 23), depression: 15%(95% CI:0.4, 47), concentration problems: 6%(95% CI: 3, 11), sleep problems: 9%(95% CI:5, 13), mood swings: 13% (95%CI:5, 23) and appetite loss: 5%(95% CI:1, 13). However, studies were heterogenous and lack data from low- and middle-income countries.
CONCLUSION: Anxiety, depression and appetite problems were significantly increased among post-COVID-19 infected children, compared to those without a previous infection, which may be attributed to long COVID. The findings underscore the importance of screening and early intervention of children post-COVID-19 infection at one month and between three to four months.

Matched MeSH terms: Depression/epidemiology
The prevalence and predictors of severe depression among the elderly in Malaysia

Rashid A, Tahir I

J Cross Cult Gerontol, 2015 Mar;30(1):69-85.
PMID: 25349019 DOI: 10.1007/s10823-014-9248-3

The population of Malaysia is relatively young, due to this there is a dearth in research conducted among the elderly especially relating to depression. The aim of this study is to determine the prevalence and the predictors of severe depression among the elderly in Malaysia. A sample of 2005 older adults randomly selected from the Penang State government's list of elderly receiving aid participated in the study. The Geriatric Depression Scale was used to screen for depression. Socio-demographic, social support, disease, functional and other factors were looked at as possible predictor variables. The prevalence of severe depression was 19.2 %. Indians (aOR = 2.0), being married (aOR = 10.5), widowed & divorced (aOR = 5.2), having poor (aOR = 2.7) or moderate social support (aOR = 2.7), having no one (aOR = 2.9), relatives (aOR = 2.3) or religious figures & others (aOR = 1.9) as compared to a spouse as a source of emotional support, feeling extremely lonely (aOR = 3.4), not socially active (aOR = 2.3), cognitively impaired (aOR 2.5), activities limited due to illness or disability (aOR = 1.6) and poor sleep quality (aOR = 3.6) were significant predictor variables. The prevalence of severe depression was high. It is pertinent that older adults, especially those with risk factors identified in this study be screened for depression at every opportunity.
Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-30)

Matched MeSH terms: Depression/epidemiology*
Fulltext Medical students' experience of and reaction to stress: the role of depression and anxiety

Saravanan C, Wilks R

ScientificWorldJournal, 2014;2014:737382.
PMID: 24688425 DOI: 10.1155/2014/737382

Medical school is recognized as a stressful environment that often has a negative effect on students' academic performance, physical health, and psychosocial well-being. Previous studies have not identified differences between depressed and nondepressed and anxious and nonanxious medical students' experiences of stress or their reactions to stressors. The present study aimed to identify the prevalence of depression and anxiety among a sample of 358 medical students attending a private university in Malaysia and to examine differences according to participants' gender, year of study, and stage of training (preclinical and clinical). Additionally, this study examined the extent to which stress predicts depression and anxiety, differences between depressed and nondepressed medical students' experiences of and reactions to stressors, and differences between anxious and nonanxious medical students' experiences of and reactions to stressors.

Matched MeSH terms: Depression/epidemiology
Loneliness and depression among the elderly in an agricultural settlement: mediating effects of social support

Wan Mohd Azam WM, Din NC, Ahmad M, Ghazali SE, Ibrahim N, Said Z, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:134-9.
PMID: 23857850 DOI: 10.1111/appy.12061

INTRODUCTION: Loneliness has long been known to have strong association with depression. The relationship between loneliness and depression, however, has been associated with other risk factors including social support. The aim of this paper is to describe the role of social support in the association between loneliness and depression.
METHODS: This cross-sectional study examined the mediating effects of social support among 161 community-based elderly in agricultural settlement of a rural area in Sungai Tengi, Malaysia. Subjects were investigated with De Jong Gierveld Loneliness Scale, Geriatric Depression Scale and Medical Outcome Survey Social Support Survey. Data were analyzed using Pearson correlation, linear and hierarchical regression.
RESULTS: Results indicated that social support partially mediated the relationship between loneliness and depression.
DISCUSSION: This suggests that social support affects the linear association between loneliness and depression in the elderly.
KEYWORDS: depression; elderly; loneliness; rural community; social support
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: De Jong Gierveld Loneliness Scale; Geriatric Depression Scale (GDS-15): Medical Outcome Survey Social Support Survey

Matched MeSH terms: Depression/epidemiology*
Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Fadzil A, Balakrishnan K, Razali R, Sidi H, Malapan T, Japaraj RP, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:7-13.
PMID: 23857831 DOI: 10.1111/appy.12036

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.

Matched MeSH terms: Depression/epidemiology
Chronic diseases, depressive symptoms and functional limitation amongst older people in rural Malaysia, a middle income developing country

Hairi NN, Bulgiba A, Mudla I, Said MA

Prev Med, 2011 Oct;53(4-5):343-6.
PMID: 21864564 DOI: 10.1016/j.ypmed.2011.07.020

To determine prevalence and prevalence ratio of functional limitation amongst older people with combined chronic diseases and co-morbid depressive symptoms compared with older people with either chronic disease or depressive symptoms alone.

Matched MeSH terms: Depression/epidemiology*
Depressive symptoms, visual impairment, and its influence on physical disability and functional limitation

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I

J Am Geriatr Soc, 2011 Mar;59(3):557-9.
PMID: 21391950 DOI: 10.1111/j.1532-5415.2010.03301.x
Matched MeSH terms: Depression/epidemiology*
Anxiety and depression in hyperemesis gravidarum: prevalence, risk factors and correlation with clinical severity

Tan PC, Vani S, Lim BK, Omar SZ

Eur J Obstet Gynecol Reprod Biol, 2010 Apr;149(2):153-8.
PMID: 20097465 DOI: 10.1016/j.ejogrb.2009.12.031

To evaluate prevalence, risk factors and clinical severity correlates of anxiety and depression caseness in hyperemesis gravidarum (HG).

Matched MeSH terms: Depression/epidemiology*
Fulltext Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital

Imran A, Azidah AK, Asrenee AR, Rosediani M

Med J Malaysia, 2009 Jun;64(2):134-9.
PMID: 20058573 MyJurnal

Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.

Study site: Outpatient clinics, Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Depression/epidemiology*
Fulltext A case control study on factors that influence depression among the elderly in Kuala Lumpur Hospital and Universiti Kebangsaan Malaysia Hospital

Salimah O, Rahmah MA, Rosdinom R, Azhar SS

Med J Malaysia, 2008 Dec;63(5):395-400.
PMID: 19803299 MyJurnal

Depressive illness is common among the aged population. A case control study was conducted, focusing on risk factors influencing depression among the elderly. This study involved 130 elderly patients diagnosed to have depressive illness from the psychiatric clinics of Kuala Lumpur Hospital (HKL) and Universiti Kebangsaan Malaysia Hospital (HUKM). Another group of 130 elderly patients with no history of depressive illness were recruited from the medical specialist clinics. The majority of cases were female (75.4%), aged 60-74 years (92.3%) and from Chinese ethnic group (59.2%). Non-Malay elderly has three times risk (AOR 2.537, 95% CI 1.439-4.471) of suffering the depressive illness compared to the Malay elderly, the elderly with chronic health problems are more likely to be depressed compared to those who do not suffer from any chronic illness (p trend <0.001). Other risk factors identified were family history of depression with four times risk (AOR 4.225, 95% CI 2.017-8.848) and lower social support with eight times risk (AOR 7.949, 95% CI 2.588-24.417). Social support is not only important in encouraging the elderly to practice healthy life style but proven to influence the risk of getting depression among them. Hence, it is very crucial that the elderly is given total attention, respect and love from all parties to ensure prosperity and meaningfulness in life.

Matched MeSH terms: Depression/epidemiology*
Fulltext Psychosocial impact of mothers with perinatal loss and its contributing factors: an insight

Sutan R, Amin RM, Ariffin KB, Teng TZ, Kamal MF, Rusli RZ

J Zhejiang Univ Sci B, 2010 Mar;11(3):209-17.
PMID: 20205307 DOI: 10.1631/jzus.B0900245

To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.

Matched MeSH terms: Depression/epidemiology*
Fulltext Pilot study on depression among secondary school students in Selangor

Adlina S, Suthahar A, Ramli M, Edariah AB, Soe SA, Mohd Ariff F, et al.

Med J Malaysia, 2007 Aug;62(3):218-22.
PMID: 18246911 MyJurnal

A cross sectional descriptive study of 2048 subjects was conducted to determine the prevalence of depression and factors influencing depression among students in secondary school from urban and rural areas in the state of Selangor, Malaysia. The children's depression inventory (CDI) developed by Maria Kovacs was used in this study. Students who participated in this study come from two urban schools and three rural schools. It was found that in the yield for scores for five factors were 9.2% have negative mood, 5% have interpersonal problems, 8.3% have ineffectiveness, 9.8% have anhedonia and 10.6% have negative self esteem. Following the interpretive guidelines for the T-scores, it was found that 10.3% of the students were much above average in the depression scale. This study also found that: 1% of students were smoking, 1.6% of students were gum sniffling, 0.9% took drugs, 4.1% took alcohol and 9.9% took things from other people. Females were more depressed than males. The Chinese students were more depressed compared to Indian students. Students whose parents had no formal education or had only primary education were more depressed than students whose parents had secondary, college or university education. Depression increased with increasing number of siblings. Depression contributed to the habit of drug abuse, gum sniffing and stealing but not to smoking and alcohol abuse. Suicidal tendencies were more likely among the depressed students. It is imperative that not only caregivers but also teachers have to be equipped with the knowledge, attitude and skills to assist secondary school children cope with their emotions, handle conflicts and manage stress early so that a more productive society will develop in the future.

Matched MeSH terms: Depression/epidemiology*
Fulltext Prevalence of undetected cognitive impairment and depression in residents of an elderly care home

Al-Jawad M, Rashid AK, Narayan KA

Med J Malaysia, 2007 Dec;62(5):375-9.
PMID: 18705469 MyJurnal

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.

Matched MeSH terms: Depression/epidemiology*
Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms

Halbreich U, Karkun S

J Affect Disord, 2006 Apr;91(2-3):97-111.
PMID: 16466664 DOI: 10.1016/j.jad.2005.12.051

BACKGROUND:
The prevalence of postpartum depression (PPD) is currently considered to be 10-15%. Most studies were performed with a brief unidimensional instruments (mostly the Edinburgh Postnatal Depression Scale-EPDS) with focus on depression and not on other symptoms and disorders. Most cited studies were conducted in Western economically developed countries.

METHODS:
We reviewed the literature on prevalence of postpartum depression and depressive symptoms in a wide range of countries.

RESULTS:
143 studies were identified reporting prevalence in 40 countries. It is demonstrated that there is a wide range of reported prevalence of PPD ranging from almost 0% to almost 60%. In some countries like Singapore, Malta, Malaysia, Austria and Denmark there are very few reports of PPD or postpartum depressive symptoms, whereas in other countries (e.g. Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea) reported postpartum depressive symptoms are very prevalent.

CONCLUSIONS:
We believe that the widely cited mean prevalence of PPD-10-15% is not representative of the actual global prevalence and magnitude of the problem, due to the wide range of reports. The variability in reported PPD might be due to cross-cultural variables, reporting style, differences in perception of mental health and its stigma, differences in socio-economic environments (e.g. poverty, levels of social support or its perception, nutrition, stress), and biological vulnerability factors. The elucidation of the underlying processes of this variability as well as the diversity of postpartum normal versus abnormal expressions of symptoms may contribute to better understanding of the diversified ante, peri- and postpartum phenomena.

Matched MeSH terms: Depression/epidemiology*
Fulltext Psychological stress among undergraduate medical students

Sherina MS, Rampal L, Kaneson N

Med J Malaysia, 2004 Jun;59(2):207-11.
PMID: 15559171 MyJurnal

The aim of this study was to determine the prevalence of psychological stress among medical students and to identify its symptoms and association with depression. A cross-sectional study design was used. Three-hundred and ninety-six medical students at a university in Malaysia were included in the study. Tools similar to the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI) were used to screen for psychological stress and depression, respectively. 41.9% of the medical students were found to have psychological stress, which was significantly associated with depression (chi2=4.636, df=1, p<0.05). Psychological stress is common among medical students and is associated with depression.

Matched MeSH terms: Depression/epidemiology*
Fulltext The prevalence of depression among the elderly in Sepang, Selangor

Sherina MS, Rampal L, Mustaqim A

Med J Malaysia, 2004 Mar;59(1):45-9.
PMID: 15535335 MyJurnal

Objective: To determine the prevalence of depression among the elderly and to identify its associated factors.
Methods: A cross sectional study design was used. Stratified proportionate cluster sampling method was used to select the respondents. A 30 item Geriatric Depression Scale questionnaire was used as a screening instrument.
Results: 7.6% of the elderly were found to have depression. Only employment status was found to be significantly associated with depression.
Discussion: The prevalence of depression in the elderly was 7.6%. Primary Care providers need to be vigilant when treating elderly patients as depression is commonly found in this age group .
Study site: Nine villages in Mukim Sepang, Sepang District, Selangor, Malaysia
Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-30)

Matched MeSH terms: Depression/epidemiology*
The mediating role of Internet addiction in depression, social anxiety, and psychosocial well-being among adolescents in six Asian countries: a structural equation modelling approach

Lai CM, Mak KK, Watanabe H, Jeong J, Kim D, Bahar N, et al.

Public Health, 2015 Sep;129(9):1224-36.
PMID: 26343546 DOI: 10.1016/j.puhe.2015.07.031

OBJECTIVES: This study examines the associations of Internet addiction with social anxiety, depression, and psychosocial well-being among Asian adolescents. A self-medication model conceptualizing Internet addiction as a mediating role in relating depression and social anxiety to negative psychosocial well-being was tested.
STUDY DESIGN: A cross-sectional survey.
METHODS: In the Asian Adolescent Risk Behavior Survey (AARBS), 5366 adolescents aged 12-18 years from six Asian countries (China, Hong Kong, Japan, South Korea, Malaysia, and Philippines) completed a questionnaire with items of the Internet Addiction Test (IAT), Social Anxiety Scale for Adolescents (SAS-A), Center for Epidemiological Studies Depression Scale (CESD), Self-Rated Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA-SR) in the 2012-2013 school year. Structural equation modelling was used to examine the mediating role of Internet addiction in depression, social anxiety, and subjective psychosocial well-being.
RESULTS: Significant differences on the scores of IAT, SAS-A, CESD, and HoNOSCA-SR across the six countries were found. The proposed self-medication model of Internet addiction received satisfactory goodness-of-fit with data of all countries. After the path from social anxiety to Internet addiction had been discarded in the revised model, there was a significant improvement of the goodness-of-fit in the models for Japan, South Korea, and the Philippines.
CONCLUSIONS: Depression and social anxiety reciprocally influenced, whereas depression associated with poorer psychosocial well-being directly and indirectly through Internet addiction in all six countries. Internet addiction mediated the association between social anxiety and poor psychosocial well-being in China, Hong Kong, and Malaysia.
KEYWORDS: Adolescents; Asian; Depression; Internet addiction; Social anxiety; Structural equation modelling

Matched MeSH terms: Depression/epidemiology*
Increased levels of depressive symptoms among pregnant women in The Netherlands after the crash of flight MH17

Truijens SE, Boerekamp CA, Spek V, van Son MJ, Oei SG, Pop VJ

Am J Epidemiol, 2015 Sep 1;182(5):426-30.
PMID: 26173773 DOI: 10.1093/aje/kwv161

On July 17, 2014, Malaysia Airlines flight MH17 was shot down, a tragedy that shocked the Dutch population. As part of a large longitudinal survey on mental health in pregnant women that had a study inclusion period of 19 months, we were able to evaluate the possible association of that incident with mood changes using pre- and postdisaster data. We compared mean Edinburgh Depression Scale (EDS) scores from a group of women (n = 126 cases) at 32 weeks' gestation during the first month after the crash with mean scores from a control group (n = 102) with similar characteristics who completed the EDS at 32 weeks' gestation during the same summer period in 2013. The mean EDS scores of the 126 case women in the first month after the crash were significantly higher than the scores of 102 control women. There were no differences in mean EDS scores between the 2 groups at the first and second trimesters. The present study is among the first in which perinatal mental health before and after the occurrence of a disaster has been investigated, and the results suggest that national disasters might lead to emotional responses.

Matched MeSH terms: Depression/epidemiology*
Fulltext Relationship between trusting behaviors and psychometrics associated with social network and depression among young generation: a pilot study

Watabe M, Kato TA, Teo AR, Horikawa H, Tateno M, Hayakawa K, et al.

PLoS One, 2015;10(3):e0120183.
PMID: 25836972 DOI: 10.1371/journal.pone.0120183

Maladaptive social interaction and its related psychopathology have been highlighted in psychiatry especially among younger generations. In Japan, novel expressive forms of psychiatric phenomena such as "modern-type depression" and "hikikomori" (a syndrome of severe social withdrawal lasting for at least six months) have been reported especially among young people. Economic games such as the trust game have been utilized to evaluate real-world interpersonal relationships as a novel candidate for psychiatric evaluations. To investigate the relationship between trusting behaviors and various psychometric scales, we conducted a trust game experiment with eighty-one Japanese university students as a pilot study. Participants made a risky financial decision about whether to trust each of 40 photographed partners. Participants then answered a set of questionnaires with seven scales including the Lubben Social Network Scale (LSNS)-6 and the Patient Health Questionnaire (PHQ)-9. Consistent with previous research, male participants trusted partners more than female participants. Regression analysis revealed that LSNS-family (perceived support from family) for male participants, and item 8 of PHQ-9 (subjective agitation and/or retardation) for female participants were associated with participants' trusting behaviors. Consistent with claims by social scientists, our data suggest that, for males, support from family was negatively associated with cooperative behavior toward non-family members. Females with higher subjective agitation (and/or retardation) gave less money toward males and high attractive females, but not toward low attractive females in interpersonal relationships. We believe that our data indicate the possible impact of economic games in psychiatric research and clinical practice, and validation in clinical samples including modern-type depression and hikikomori should be investigated.

Matched MeSH terms: Depression/epidemiology*
Depressive symptoms in adolescents in Kuching, Malaysia: Prevalence and associated factors

Ang AL, Wahab S, Abd Rahman FN, Hazmi H, Md Yusoff R

Pediatr Int, 2019 Apr;61(4):404-410.
PMID: 30597707 DOI: 10.1111/ped.13778

BACKGROUND: The trend of depression is rising worldwide. There are limited studies on depression in adolescents. The aim of this study was to estimate the prevalence of and identify the factors associated with depressive symptoms in adolescents in Kuching, Malaysia, and to analyze the relationship between depressive symptoms and suicidal ideation.
METHODS: A cross-sectional study was conducted in 320 students from urban and rural secondary schools. The participants were randomly selected via multi-stage sampling. They completed the Malay versions of the Children's Depression Inventory (CDI) and Beck Scale for Suicide Ideation (BSS).
RESULTS: The prevalence of depressive symptoms was 26.2%. On binary logistic regression analysis, variables with significant association with depressive symptoms were race (P = 0.028), type of class (P < 0.001), mother's education level (P = 0.036), type of housing (P = 0.036), parents' marital status (P = 0.012), alcohol intake (P = 0.005), stealing (P < 0.001) and history of disciplinary record (P = 0.005). Variables that remained significant on multivariable logistic regression were type of class (P = 0.004), parents' marital status (P = 0.017) and stealing (P < 0.001). Students from the Arts stream (OR, 2.43) with parents who were separated, divorced or widowed (OR, 3.13) and who had experience of stealing (OR, 3.27) were predicted to be at risk of developing depressive symptoms. There was a significant correlation between total CDI score and total BSS score (P < 0.001).
CONCLUSIONS: The prevalence of depressive symptoms in adolescents was high. Depressive symptoms are significantly correlated with suicidal ideation. Greater collaboration between the education and health agencies is essential for mental health promotion in schools and early detection of depression, especially in at-risk adolescents.

Matched MeSH terms: Depression/epidemiology*

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