Displaying publications 121 - 140 of 803 in total

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  1. Ghawadra SF, Abdullah KL, Choo WY, Phang CK
    J Clin Nurs, 2019 Nov;28(21-22):3747-3758.
    PMID: 31267619 DOI: 10.1111/jocn.14987
    AIMS AND OBJECTIVES: To explore the studies that used interventions based on the Mindfulness-Based Stress Reduction (MBSR) for decreasing psychological distress among nurses.

    BACKGROUND: Because of the demanding nature of their work, nurses often have significantly high levels of stress, anxiety and depression. MBSR has been reported to be an effective intervention to decrease psychological distress.

    DESIGN: Systematic review.

    METHODS: The databases included were Science Direct, PubMed, EBSCO host, Springer Link and Web of Science from 2002 to 2018. Interventional studies published in English that used MBSR among nurses to reduce their psychological distress were retrieved for review. The PRISMA guideline was used in this systematic review. The included studies were assessed for quality using "The Quality Assessment Tool For Quantitative Studies (QATFQS)."

    RESULTS: Nine studies were found to be eligible and included in this review. Many benefits, including reduced stress, anxiety, depression, burnout and better job satisfaction, were reported in these studies.

    CONCLUSION: The adapted/brief versions of MBSR seem promising for reducing psychological distress in nurses. Future research should include randomised controlled trials with a larger sample size and follow-up studies. There should also be a focus on creative and effective ways of delivering MBSR to nurses.

    RELEVANCE TO CLINICAL PRACTICE: The results of this review are substantial for supporting the use of MBSR for nurses' psychological well-being.

    Matched MeSH terms: Depression/psychology
  2. Mesbah SF, Sulaiman N, Shariff ZM, Ibrahim Z
    PMID: 32365772 DOI: 10.3390/ijerph17093118
    With the aging of the population worldwide, there is an increasing concern for the mental health status as well as physical health. Depression is a common mental health problem among the elderly populations. Since the elderly are susceptible to food insecurity, this cross-sectional study is aimed to determine an association between food insecurity and depression among elderly people. A total of 220 elderly people- aged 60 years and above, residing in the Petaling district of Selangor, were included in this study. Face-to-face interviews were conducted to obtain the pertinent information on demographic background, food security status (six items USDA FSSM), functional status (IADL, EMS), psychosocial status (LSNS-6), and depression status (GDS-15). Binary logistic regression was used to assess the factors that were associated with depression. The median age of the elderly sample was 65.5 years. The prevalence of depression and food insecurity that was recorded were 13.2% and 19.5%, respectively. Social isolation (AOR = 5.882, 95% CI: 2.221, 15.576), food insecurity (AOR = 3.539, 95% CI: 1.350, 9.279), and unsafe mobility (AOR= 3.729, 95% CI: 1.302, 10.683) increased the odds of depression. In conclusion, social isolation, food insecurity, and unsafe mobility are factors associated with depression among the elderly people. Plans such as health interventions as well as grocery and financial aid among the qualifying elderly are suggested to improve this depression and food insecurity.
    Matched MeSH terms: Depression*
  3. Wan Mohd Yunus WMA, Musiat P, Brown JSL
    Occup Environ Med, 2018 01;75(1):66-75.
    PMID: 29074553 DOI: 10.1136/oemed-2017-104532
    Depression is increasingly being recognised as a significant mental health problem in the workplace contributing to productivity loss and economic burden to organisations. This paper reviews recently published randomised controlled trials (RCTs) of universal and targeted interventions to reduce depression in the workplace. Studies were identified through searches of EMBASE, MEDLINE/PubMed, PsycINFO, PsycARTICLES Full Text, and Global Health and Social Policy and Practice databases. Studies were included if they included an RCT of a workplace intervention for employees targeting depression as the primary outcome. Twenty-two published RCTs investigating interventions utilising various therapeutic approaches were identified. The cognitive behavioural therapy (CBT) approach is the most frequently used in the workplace, while interventions that combine different therapeutic approaches showed the most promising results. A universal intervention in the workplace that combines CBT and coping flexibility recorded the highest effect size (d=1.45 at 4 months' follow-up). Most interventions were delivered in group format and showed low attrition rates compared with other delivery formats. Although all studies reviewed were RCTs, the quality of reporting is low. Interventions using different therapeutic approaches with different modes of delivery have been used. Most of these interventions were shown to reduce depression levels among employees in the workplace, particularly those that combine more than one therapeutic approaches.
    Matched MeSH terms: Depression/therapy*
  4. Liao SJ, Tan MP, Chong MC, Chua YP
    Issues Ment Health Nurs, 2018 May;39(5):398-402.
    PMID: 29436896 DOI: 10.1080/01612840.2017.1417519
    BACKGROUND: The effectiveness of pharmacological treatment may be limited in older persons. Several studies using Tai Chi or music therapy separately confirmed positive effects in the reduction of depressive symptoms. We conducted a cluster randomized controlled trial to evaluate the possible synergistic effect of combined music and Tai Chi on depressive symptoms.

    METHODS: One hundred and seven older adults with mild to moderate depressive symptoms were recruited from Ya'an city. Fifty-five participants were cluster randomized to combined music and Tai Chi group for three months, while the other fifty-two individuals were randomized to the control group that entailed routine health education delivered monthly by community nurses. The primary outcome of depressive symptoms was measured with the Geriatric Depression Scale (GDS) at baseline and monthly for three months.

    RESULTS: At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.661, P < 0.001). Following adjustments for socio-demographic data, the true effect of intervention on depressive symptoms was significant (F = 41.725, P < 0.01, ηp2 = 0.574).

    CONCLUSIONS: Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons. This represents an economically viable solution to the management of depression in highly populous developing nations.

    Matched MeSH terms: Depression/therapy*
  5. Abdollahi A, Hosseinian S, Asmundson GJG
    J Gen Psychol, 2018 01 18;145(1):93-105.
    PMID: 29345535 DOI: 10.1080/00221309.2017.1421137
    To better understand depression among adolescent university students, this study was designed to examine coping style as a potential mediator between perfectionism and depression. Participants comprised 510 undergraduate students from Malaysia. Structural Equation Modelling demonstrated that personal standards perfectionism and task-focused coping style were negatively associated with depression, while emotion-focused coping style, avoidant coping style, and evaluative concerns perfectionism were positively associated with depression. Multiple mediator modelling provided evidence that coping styles partially mediated the relationship between perfectionism and depression. These findings advance current knowledge by suggesting how perfectionism may contribute to depression and may inform the development of more effective prevention and intervention programs for depression.
    Matched MeSH terms: Depression/psychology*
  6. Davenport CJ, Swami V
    J Psychiatr Ment Health Nurs, 2023 Feb;30(1):1-7.
    PMID: 35757849 DOI: 10.1111/jpm.12854
    WHAT IS KNOWN ABOUT THE SUBJECT?: A significant proportion of fathers report experiencing depression after their baby is born Fathers are not offered regular support for their psychological well-being in the transition to parenthood despite an acknowledged need for such support WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Lived experience provides new insight into how one father experienced postnatal depression, including the role of his partner in help-seeking It explains the delayed presentation in help-seeking as resulting from healthcare practitioner language and attitudes, and gendered expectations around mental health and help-seeking in the context of fatherhood WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING?: Mental health nurses should be aware that postnatal depression can affect fathers as well as mothers, and that it is necessary to support fathers in safe spaces and with appropriate language Planning care for depression in men should consider the recent birth of a child in order to provide effective care Clearer guidance is needed for supporting new fathers with postnatal depression ABSTRACT: Introduction Fathers are not universally supported with their perinatal mental health, but evidence shows that they suffer at a similar level to mothers. Aim This paper examines the journey of one father through his PND experience, his help seeking, and encounters in healthcare, in order to highlight the needs of a depressed father. Method The method is a father's lived experience narrative which has been written alongside a health visitor who highlights the relevance of the condition to healthcare practice. Results & Discussion The needs of fathers are unmet. They require support which considers their gender role expectations. Partners are key to their help seeking. Implications for practice The language and sensitivity used by nurses is key to encouraging fathers to share their depression and reduce stigma around the condition.
    Matched MeSH terms: Depression/psychology
  7. Dasor MM, Jafridin AA, Azhar AA, Asma AAA, Manivannan PC, Bilal S, et al.
    Int J Public Health, 2023;68:1604383.
    PMID: 36846156 DOI: 10.3389/ijph.2023.1604383
    Objectives: This study aimed to measure depression, anxiety and stress (DAS) among undergraduate dental students during the COVID-19 pandemic, identify key contributing factors of stress and explore the association of emotional intelligence to DAS. Methods: A multi-centre, cross-sectional study was conducted across four universities in Malaysia. The study administered a questionnaire consisting of the validated Depression Anxiety Stress Scale (DASS), Dental Environment Stress (DES), Emotional Intelligence Scale (EI) and 10 statements assessing COVID-19 specific potential stressor factors. Results: Participants included 791 students across four universities. Abnormal levels of DAS were identified in 60.6%, 66.8% and 42.6% of the study participants, respectively. "Pressure of performance," "Faculty administration" and "Self-efficacy belief" were the highest rated stressors. On-time graduation was the main COVID-19 specific stressor factor. EI was negatively correlated with DAS scores (p < 0.001). Conclusion: The levels of DAS during COVID-19 pandemic in this population is high. However, participants with higher EI presented with lower DAS suggesting that EI may be a form of coping resource and should be enhanced in this population.
    Matched MeSH terms: Depression/epidemiology
  8. Li ZB, Lv JJ, Lu W, Yin MY, Li XY, Yang CH
    Psychiatry Res, 2024 Jun;336:115889.
    PMID: 38621309 DOI: 10.1016/j.psychres.2024.115889
    BACKGROUND: Depression is a highly prevalent and disabling mental health condition among adolescents. The epidemiology of depression in adolescents has been changing over time, reflecting changes in risk factors as well as disease concepts and diagnosis. However, few studies have characterized the longitudinal epidemiology of depression in adolescents. Understanding trends of disease burden provides key insights to improve resource allocation and design targeted interventions for this vulnerable population. The Western Pacific Region (WPR) is home to over 1.3 billion people with tremendous diversity in culture and socioeconomic development. The epidemiology of adolescent depression in WPR remains largely unknown. In this study, we aimed to estimate trends of disease burden attributable to depressive disorders among adolescents aged 10-24 years in WPR countries between 1990 and 2019, and to investigate period and cohort effects using the Global Burden of Disease (GBD) study database.

    METHODS: The study utilized data from the Global Burden of Disease, Injuries, and Risk Factors Study 2019, concentrating on adolescents aged 10 to 24 years with depression. We conducted an in-depth analysis of depression, including its age-standardized prevalence, incidence, and Disability-Adjusted Life Years (DALYs), across diverse demographics such as regions, ages, genders, and socio-demographic indexes, spanning from 1990 to 2019.

    RESULTS: The analysis found decreasing trends in the prevalence, incidence, and DALYs of adolescent depression in the WPR between 1990-2019, although some countries like Australia and Malaysia showed increases. Specifically, the prevalence of adolescent depression in the region decreased from 9,347,861.6 cases in 1990 to 5,551,341.1 cases in 2019. The incidence rate declined from 2,508.6 per 100,000 adolescents in 1990 to 1,947.9 per 100,000 in 2019. DALYs decreased from 371.9 per 100,000 in 1990 to ASR 299.7 per 100,000 in 2019.

    CONCLUSION: This study found an overall decreasing trend in adolescent depression burden in the Western Pacific Region between 1990 and 2019, with heterogeneity across countries. For 30 years, the 20-24 age group accounted for the majority of depression among adolescents Widening inequality in depression burden requires policy attention. Further analysis of risk factors contributing to epidemiological trends is warranted to inform prevention strategies targeting adolescent mental health in the region.

    Matched MeSH terms: Depression/epidemiology
  9. Ibrahim N, Amit N, Suen MW
    PLoS One, 2014;9(10):e110670.
    PMID: 25340331 DOI: 10.1371/journal.pone.0110670
    BACKGROUND: There has been a drastic increase in the rate of suicides over the past 45 years in Malaysia. The statistics show that adolescents aged between 16 and 19 years old are at high risk of committing suicide. This could be attributed to issues relating to the developmental stage of adolescents. During this stage, adolescents face challenges and are exposed to various stressful experiences and risk factors relating to suicide.

    METHOD: The present study examined psychological factors (i.e., depression, anxiety and stress) as predictors for suicidal ideation among adolescents. A cross-sectional study was conducted on 190 students (103 males and 87 females), aged 15 to 19 years old from two different schools in Kuala Lumpur. The Depression Anxiety Stress Scale 21-item version (DASS-21) was used to measure depression, anxiety and stress among the students, and the Beck Scale for Suicide Ideation (BSS) to measure suicidal ideation. The data were analysed using Pearson's correlation and multiple regression analysis.

    RESULTS: The results show that 11.10%, 10.00%, and 9.50% of the students reported that they were experiencing severe depression, anxiety and stress, respectively. There were significant correlations between depression, anxiety, and stress with suicidal ideation. However, only depression was identified as a predictor for suicidal ideation.

    CONCLUSION: Hence, this study extends the role of depression in predicting suicidal ideation among adolescents in the Malaysian context. The findings imply that teenagers should be assisted in strengthening their positive coping strategies in managing distress to reduce depression and suicidal ideation.

    Matched MeSH terms: Depression/psychology
  10. Tan YQ, Wang Z, Yap QV, Chan YH, Ho RC, Hamid ARAH, et al.
    Ann Surg, 2023 Jan 01;277(1):50-56.
    PMID: 33491983 DOI: 10.1097/SLA.0000000000004775
    OBJECTIVE: To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic.

    SUMMARY OF BACKGROUND DATA: The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19.

    METHODS: We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the depression anxiety stress scale-21 and Impact of Event Scale-Revised scores.

    RESULTS: A total of 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9%, and 24.0% screened positive for depression, anxiety, stress, and PTSD respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress, and PTSD (OR 1.3, 1.6, 1.4, 1.7 respectively, all P < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress, and PTSD (OR 1.2, 1.2, and 1.3 respectively, all P < 0.05). Surgical specialties that operated in the head and neck region had higher psychological distress among its surgeons. Deployment for COVID- 19-related work was not associated with increased psychological distress.

    CONCLUSIONS: The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.

    Matched MeSH terms: Depression/psychology
  11. Butt MD, Ong SC, Butt FZ, Sajjad A, Rasool MF, Imran I, et al.
    Int J Environ Res Public Health, 2022 Nov 18;19(22).
    PMID: 36429988 DOI: 10.3390/ijerph192215266
    BACKGROUND: Kidney failure is a global health problem with a worldwide mean prevalence rate of 13.4%. Kidney failure remains symptomless during most of the early stages until symptoms appear in the advanced stages. Kidney failure is associated with a decrease in health-related quality of life (HRQOL), deterioration in physical and mental health, and an increased risk of cardiovascular morbidity and mortality. This study aimed to evaluate the factors associated with decreased HRQOL and other factors affecting the overall health of patients. Another objective was to measure how medication adherence and depression could affect the overall HRQOL in patients with kidney failure.

    METHODOLOGY: The study used a prospective follow-up mix methodology approach with six-month follow-ups of patients. The participants included in the study population were those with chronic kidney disease grade 4 and kidney failure. Pre-validated and translated questionnaires (Kidney Disease Quality of Life-Short Form, Hamilton Depression Rating Scale Urdu Version, and Morisky Lewis Greens Adherence Scale) and assessment tools were used to collect data.

    RESULTS: This study recruited 314 patients after an initial assessment based on inclusion criteria. The mean age of the study population was 54.64 ± 15.33 years. There was a 47.6% male and a 52.4% female population. Hypertension and diabetes mellitus remained the most predominant comorbid condition, affecting 64.2% and 74.6% of the population, respectively. The study suggested a significant (p < 0.05) deterioration in the mental health composite score with worsening laboratory variables, particularly hematological and iron studies. Demographic variables significantly impact medication adherence. HRQOL was found to be deteriorating with a significant impact on mental health compared to physical health.

    CONCLUSIONS: Patients on maintenance dialysis for kidney failure have a significant burden of physical and mental symptoms, depression, and low HRQOL. Given the substantial and well-known declines in physical and psychological well-being among kidney failure patients receiving hemodialysis, the findings of this research imply that these areas related to health should receive special attention in the growing and expanding population of kidney failure patients.

    Matched MeSH terms: Depression/epidemiology
  12. Abdul Rashid MR, Syed Mohamad SN, Tajjudin AIA, Roslan N, Jaffar A, Mohideen FBS, et al.
    PMID: 36901486 DOI: 10.3390/ijerph20054476
    This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.
    Matched MeSH terms: Depression/epidemiology
  13. Masiran R, Hussin NS
    BMJ Case Rep, 2018 Jan 17;2018.
    PMID: 29348292 DOI: 10.1136/bcr-2017-223430
    A middle-aged man who has been enduring financial constraint experienced a period of irritability, increased goal-directed activities and insomnia occurring along with extreme jealousy with his current wife. The episode was followed by depressed mood and non-prominent auditory hallucination. His previous history revealed a forensic psychiatry case of a murder he committed 20 years ago.
    Matched MeSH terms: Depression/psychology*
  14. Mohamad Fisal ZA, Abdul Manaf R, Fattah Azman AZ, Karpal Singh GK
    PLoS One, 2023;18(6):e0286816.
    PMID: 37267403 DOI: 10.1371/journal.pone.0286816
    BACKGROUND: Depression is the most common psychiatric disorder reported among patients living with Human Immunodeficiency Virus (HIV), resulting from the intricate combination of biological, psychological, and social factors. Biopsychosocial factors can significantly impact the psychological well-being of men who have sex with men (MSM) living with HIV through social stigma, access and compliance to care, economic insecurity, relationship difficulties, and risky behavior. Compared to MSM without HIV, MSM living with HIV were more likely to be depressed. Despite specific vulnerabilities and health needs, MSM living with HIV remain understudied and underserved in Malaysia owing to legal, ethical, and social challenges.

    OBJECTIVE: This is merely a published protocol, not the findings of a future study. This study aims to determine and explain the predictors of depressive symptoms among MSM living with HIV. Specifically, this study wants to determine the association between depressive symptoms among MSM living with HIV and biological, psychosocial, and social factors. Finally, the mixed methods will answer to what extent the qualitative results confirm the quantitative results of the predictors of depressive symptoms among MSM living with HIV.

    METHODS: The study has ethical approval from the Medical Research Ethics Committee (MREC) of the Ministry of Health (MOH) NMRR ID-21-02210-MIT. This study will apply an explanatory sequential mixed methods study design. It comprised two distinct phases: quantitative and qualitative study design for answering the research questions and hypothesis. This study will randomly recruit 941 MSM living with HIV in the quantitative phase, and at least 20 MSM living with HIV purposively will be selected in the qualitative phase. The study will be conducted in ten public Primary Care Clinics in Selangor, Malaysia. A self-administered questionnaire will gather the MSM's background and social, psychological, and biological factors that could be associated with depressive symptoms. For the quantitative study, descriptive analysis and simple logistic regression will be used for data analysis. Then, variables with a P value < 0.25 will be included in multiple logistic regression to measure the predictors of depressive symptoms. In the qualitative data collection, in-depth interviews will be conducted among those with moderate to severe depressive symptoms from the quantitative phase. The thematic analysis will be used for data analysis in the qualitative phase. Integration occurs at study design, method level, and later during interpretation and report writing.

    RESULT: The quantitative phase was conducted between March 2022 to February 2023, while qualitative data collection is from March 2023 to April 2023, with baseline results anticipated in June 2023.

    CONCLUSION: In combination, qualitative and quantitative research provides a better understanding of depressive symptoms among MSM living with HIV. The result could guide us to provide a comprehensive mental healthcare program toward Ending the AIDS epidemic by 2030.

    Matched MeSH terms: Depression/epidemiology
  15. Tan ESS, Chin SAFX, Sathapan MSP, Dewi AD, Amini F, Bustami NA, et al.
    PMID: 36901057 DOI: 10.3390/ijerph20054046
    The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.
    Matched MeSH terms: Depression/epidemiology
  16. Ma Q, Shi Y, Zhao W, Zhang H, Tan D, Ji C, et al.
    BMC Psychiatry, 2024 Sep 06;24(1):604.
    PMID: 39243081 DOI: 10.1186/s12888-024-06046-x
    OBJECTIVE: To assess the effectiveness of Internet-based self-help interventions in treating depression in adolescents and young adults.

    METHODS: A systematic search was conducted across six databases, including PubMed, to identify randomized controlled trials (RCTs) that satisfied the specified inclusion and exclusion criteria. The intervention measure consisted of Internet-based self-help interventions.

    RESULTS: A total of 23 randomized controlled trials (RCTs) were included in this analysis. Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults. (OR = -0.68, 95%CI [-0.88, -0.47], P 

    Matched MeSH terms: Depression/therapy
  17. Levis B, Bhandari PM, Neupane D, Fan S, Sun Y, He C, et al.
    JAMA Netw Open, 2024 Nov 04;7(11):e2429630.
    PMID: 39576645 DOI: 10.1001/jamanetworkopen.2024.29630
    IMPORTANCE: Test accuracy studies often use small datasets to simultaneously select an optimal cutoff score that maximizes test accuracy and generate accuracy estimates.

    OBJECTIVE: To evaluate the degree to which using data-driven methods to simultaneously select an optimal Patient Health Questionnaire-9 (PHQ-9) cutoff score and estimate accuracy yields (1) optimal cutoff scores that differ from the population-level optimal cutoff score and (2) biased accuracy estimates.

    DESIGN, SETTING, AND PARTICIPANTS: This study used cross-sectional data from an existing individual participant data meta-analysis (IPDMA) database on PHQ-9 screening accuracy to represent a hypothetical population. Studies in the IPDMA database compared participant PHQ-9 scores with a major depression classification. From the IPDMA population, 1000 studies of 100, 200, 500, and 1000 participants each were resampled.

    MAIN OUTCOMES AND MEASURES: For the full IPDMA population and each simulated study, an optimal cutoff score was selected by maximizing the Youden index. Accuracy estimates for optimal cutoff scores in simulated studies were compared with accuracy in the full population.

    RESULTS: The IPDMA database included 100 primary studies with 44 503 participants (4541 [10%] cases of major depression). The population-level optimal cutoff score was 8 or higher. Optimal cutoff scores in simulated studies ranged from 2 or higher to 21 or higher in samples of 100 participants and 5 or higher to 11 or higher in samples of 1000 participants. The percentage of simulated studies that identified the true optimal cutoff score of 8 or higher was 17% for samples of 100 participants and 33% for samples of 1000 participants. Compared with estimates for a cutoff score of 8 or higher in the population, sensitivity was overestimated by 6.4 (95% CI, 5.7-7.1) percentage points in samples of 100 participants, 4.9 (95% CI, 4.3-5.5) percentage points in samples of 200 participants, 2.2 (95% CI, 1.8-2.6) percentage points in samples of 500 participants, and 1.8 (95% CI, 1.5-2.1) percentage points in samples of 1000 participants. Specificity was within 1 percentage point across sample sizes.

    CONCLUSIONS AND RELEVANCE: This study of cross-sectional data found that optimal cutoff scores and accuracy estimates differed substantially from population values when data-driven methods were used to simultaneously identify an optimal cutoff score and estimate accuracy. Users of diagnostic accuracy evidence should evaluate studies of accuracy with caution and ensure that cutoff score recommendations are based on adequately powered research or well-conducted meta-analyses.

    Matched MeSH terms: Depression/diagnosis
  18. Shetty S, Maiya GA, Rao Kg M, Vijayan S, George BM
    J Bodyw Mov Ther, 2024 Oct;40:1588-1604.
    PMID: 39593495 DOI: 10.1016/j.jbmt.2024.08.013
    OBJECTIVE: To systematically review, summarize and appraise evidence on the factors determining quality of life (QoL) after total knee arthroplasty (TKA) in individuals with knee osteoarthritis.

    METHODS: We searched six databases (PubMed, Scopus, Web of Science, CINAHL, EMBASE, and ProQuest) using appropriate search terms to identify the relevant literature published on the factors determining QoL following TKA. Two reviewers independently performed the study screening and study selection. A third reviewer was consulted in case of any disagreement. The methodological quality of the included studies was assessed using the Modified Downs and Black Index checklist. This review was registered in PROSPERO (CRD42022352887) and reported according to the PRISMA checklist.

    RESULTS: We identified a total of 8517 studies, 29 of which were included. Advanced age; female sex; increased body mass index (BMI); the presence of comorbidities such as diabetes; contralateral knee pain; poor preoperative status; psychological and pain-related factors such as the presence of pain catastrophizing; central sensitization; kinesiophobia; anxiety; depression; chronic pain; psychological distress; low level of optimism; and reduced patient satisfaction were used to determine post-TKA QoL scores. High BMI and depression were the most common factors evaluated in these studies. Overall, the methodological quality of the included studies varied from high to low.

    CONCLUSION: After TKA, the overall QoL score improved. However, there are a few physical, behavioral, and psychological factors that influence QoL. Identifying these factors could aid clinicians and health professionals in treating and rehabilitating patients by helping them improve patient prognosis after TKA.

    Matched MeSH terms: Depression/psychology
  19. N Fountoulakis K, N Karakatsoulis G, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, et al.
    Soc Psychiatry Psychiatr Epidemiol, 2023 Sep;58(9):1387-1410.
    PMID: 36867224 DOI: 10.1007/s00127-023-02438-8
    INTRODUCTION: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak.

    MATERIALS AND METHODS: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively.

    STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables.

    RESULTS: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p 

    Matched MeSH terms: Depression/epidemiology
  20. Aravindhan K, Morgan K, Mat S, Hamid TA, Ibrahim R, Saedon NI, et al.
    Psychogeriatrics, 2023 Nov;23(6):1071-1082.
    PMID: 37752079 DOI: 10.1111/psyg.13031
    BACKGROUND: Cognitive frailty describes the co-occurrence of cognitive impairment and physical frailty and is classified into reversible and irreversible phenotypes. Data on the impact of COVID-19 pandemic imposed lockdowns, locally known as the Movement Control Order (MCO), on the psychological status of cognitively frail older adults remain scarce. Therefore, this study aimed to determine the relationship between depression, anxiety, stress and cognitive frailty among older adults during the MCO.

    METHOD: Participants aged above 60 years from three ageing cohorts in Malaysia were interviewed virtually. The Fatigue, Resistance, Ambulation, Illness and Loss of Weight scale, blind Montreal Cognitive Assessment, 15-item Geriatric Depression Scale, anxiety subscale of Depression, Anxiety and Stress Scale and four-item Perceived Stress Scale measured frailty, mild cognitive impairment (MCI), depression, anxiety and stress, respectively.

    RESULTS: Cognitive frailty data were available for 870 participants, age (mean ± SD) = 73.44 ± 6.32 years and 55.6% were women. Fifty-seven (6.6%) were robust, 24 (2.8%) had MCI, 451 (51.8%) were pre-frail, 164 (18.9%) were pre-frail+MCI, 119 (13.7%) were frail and 55 (6.3%) were frail+MCI. There were significant differences in depression and anxiety scores between the controlled MCO and recovery MCO. Using multinomial logistic regression, pre-frail (mean difference (95% confidence interval, CI) = 1.16 (0.932, 1.337), frail (1.49 (1.235, 1.803) and frail+MCI (1.49 (1.225, 1.822)) groups had significantly higher depression scores, frail (1.19 (1.030, 1.373)) and frail+MCI (1.24 (1.065, 1.439)) had significantly higher anxiety scores and pre-frail (1.50 (1.285, 1.761)), frail (1.74 (1.469, 2.062)) and frail+MCI (1.81 (1.508, 2.165)) had significantly higher stress scores upon adjustments for the potential confounders. The MCO was a potential confounder in the relationship between depression and prefrail+MCI (1.08 (0.898, 1.340)).

    CONCLUSION: Frail individuals with or without MCI had significantly higher depression, anxiety and stress than those who were robust. Increased depression and stress were also observed in the pre-frail group. Interventions to address psychological issues in older adults during the COVID-19 pandemic could target prefrail and frail individuals and need further evaluation.

    Matched MeSH terms: Depression/epidemiology
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