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Comparing sense of coherence, depressive symptoms and anxiety, and their relationships with health in a population-based study
- Authors:
- KONTINEN Hanna, HAUKKALA Ari, UUTELA Anitta
- Journal article citation:
- Social Science and Medicine, 66(12), June 2008, pp.2401-2412.
- Publisher:
- Elsevier
The strong negative correlations observed between the sense of coherence (SOC) scale and measures of depression and anxiety raise the question of whether the SOC scale inversely measures the other constructs. The main aim of the present study was to examine the discriminant validity of the three measures by comparing their associations with health indicators and behaviours. The participants were 25 to 74-year-old Finnish men (n = 2351) and women (n = 2291) from the National Cardiovascular Risk Factor Survey conducted in 1997. The SOC scale had high inverse correlations with both depression (r = −0.62 among both men and women) and anxiety measures (r = −0.57 among the men and r = −0.54 among the women). Although confirmatory factor analyses suggested that it was possible to differentiate between SOC, cognitive depressive symptoms and anxiety, the estimated correlations were even higher than those mentioned above. Education was related only to SOC, but the associations of SOC, cognitive depressive symptoms and anxiety with self-reported and clinically measured health indicators (body mass index, blood pressure, cholesterol) and health behaviours were almost identical. The variation in the lowest SOC tertile was more strongly associated with health variables than in the highest tertile. To conclude, the size of the overlap between the SOC and depression scales was the same as between depression and anxiety measures. This indicates that future studies should examine the discriminant validity of different psychosocial scales more closely, and should compare them in health research in order to bring parallel concepts into the same scientific discussion.
The criterion validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a sample of self-referred elders with depressive symptomatology
- Authors:
- HARINGSMA R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(6), June 2004, pp.558-563.
- Publisher:
- Wiley
The criterion validity of the Center for Epidemiological Studies Depression scale (CES-D) was assessed in a group of elderly Dutch community-residents who were self-referred to a prevention programme for depression. Paper-and-pencil administration of the CES-D to 318 elders (55-85 years). Criterion validity was evaluated with the Mini International Neuropsychiatric Interview (MINI), a clinical diagnostic interview based on DSM-IV. Sensitivity and specificity for various cut-off scores of CES-D were compared with the DSM-IV major depressive disorder (MDD) and with clinically relevant depression (CRD), a composite diagnosis of MDD, subthreshold depression or dysthymia. Furthermore the characteristics of true versus false positives were analyzed. For MDD, the optimal cut-off score was 25, (sensitivity 85%, specificity 64%, and positive predicted value of 63%). For CRD, the optimal cut-off was 22 (sensitivity 84%, specificity 60%, and positive predicted value 77%). True positives, MDD and CRD, reported significantly more anxiety symptomatology and more co-morbid anxiety disorders, false positives reported more previous depressive episodes. The criterion validity of the CES-D for MDD and CRD was satisfactory in this semi-clinical sample of elders. Subjects scoring 25 constitute a target group for further diagnostic assessment in order to determine appropriate treatment.
Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects
- Authors:
- SCHREINER Andrea S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.498-505.
- Publisher:
- Wiley
Proper screening of depression among older adults depends on accurate cut-off scores. Recent articles have recommended the Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD) for this screening. However, there has been no investigation of the sensitivity and specificity of either scale using Japanese subjects. The purpose of the present study was to identify appropriate GDS and CSDD cut-offs for Japanese older adults. The GDS and the CSDD were interview-administered to nondepressed Japanese older adults (n = 74) and to Japanese older adults with a SCID-IV diagnosis of major or minor depression (n = 37). Depressed subjects were also administered the Hamilton Depression Rating Scale (HDRS). Data were also collected on demographic variables, mental status, health status, and medication use. ROC curve analysis identified a cut-off score of 6 for the GDS which had a sensitivity of 0.973, a specificity of 0.959, a False Positive Rate (FPR) of 0.894, and a False Negative Rate (FNR) of 0. A cutoff score of 5 for the CSDD yielded a sensitivity of 1, a specificity of 0.919, a FPR of 0.942, and a FNR of 0. Comparisons indicate current HDRS cut-offs may overlook subthreshold depression. The GDS cut-off score identified among Japanese subjects was the same as that reported for Western subjects. Due to the substantial prevalence of psychiatric disorders found in false-negative subjects, the above cut-off scores were chosen to optimize the potential for true positives. These scores are recommended for alerting physicians and other caregivers as to when more intensive depression evaluation is needed.
Depression and dementia: coexistence and differentiation
- Author:
- WARRINGTON Jill
- Publisher:
- University of Stirling. Dementia Services Development Centre
- Publication year:
- 1996
- Pagination:
- 37p.,bibliog.
- Place of publication:
- Stirling
This report reviews the complex relationship between these two conditions and gives guidance on the recognition and management of depression in older people. Contents include: defining depression and dementia; how common are depression and dementia in the elderly?; what causes depression; how do depression and dementia relate to each other?; depressive dementia (pseudodementia); depression as a secondary condition to dementia.
Depressive disorders and alcohol dependence in a community population
- Authors:
- KIRCHNER JoAnn, et al
- Journal article citation:
- Community Mental Health Journal, 38(5), October 2002, pp.361-373.
- Publisher:
- Springer
This cross-sectional study examines sociodemographic, clinical and functional correlates of comorbid depression in a community sample of 268 individuals with alcohol dependence. Results of analyses comparing drinkers with either current or past depression to never-depressed drinkers showed that respondents in the former two groups were more likely to be female and report more comorbid drug use disorders. In addition to marked functional impairment for currently depressed drinkers, we also found that respondents with past depression were significantly less likely to have health insurance coverage. This lack of insurance for previously depressed persons calls for future work examining the potential influence of this barrier to access care on both clinical and functional outcomes.
Loop analysis of causal feedback in epidemiology: An illustration relating to urban neighborhoods and resident depressive experiences
- Author:
- DINNO Alexis
- Journal article citation:
- Social Science and Medicine, 65(10), November 2007, pp.2043-2057.
- Publisher:
- Elsevier
The causal feedback implied by urban neighbourhood conditions that shape human health experiences, that in turn shape neighbourhood conditions through a complex causal web, raises a challenge for traditional epidemiological causal analyses. This article introduces the loop analysis method, and builds off of a core loop model linking neighbourhood property vacancy rate, resident depressive symptoms, rate of neighbourhood death, and rate of neighbourhood exit in a feedback network. External interventions and models including resident social isolation and neighbourhood greenspace programs are hypothesized to predict different effects upon depressive symptoms and neighbourhood conditions. The author justifies and applies loop analysis to the specific example of depressive symptoms and abandoned urban residential property to show how inquiries into the behaviour of causal systems can answer different kinds of hypotheses, and thereby compliment those of causal modelling using statistical models. Neighbourhood physical conditions that are only indirectly influenced by depressive symptoms may nevertheless manifest the mental health experiences of their residents; conversely, neighbourhood physical conditions may be a significant mental health risk for the population of neighbourhood residents. It was found that participatory greenspace programs are likely to produce adaptive responses in depressive symptoms and different neighbourhood conditions, which are different in character to non-participatory greenspace interventions.
Reducing the global burden of depression: population-level analysis of intervention cost-effectiveness in 14 world regions
- Authors:
- CHISHOLM Dan, et al
- Journal article citation:
- British Journal of Psychiatry, 184(5), May 2004, pp.393-403.
- Publisher:
- Cambridge University Press
International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. The aim was to estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Evaluated interventions have the potential to reduce the current burden of depression by 10–30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantly if there is a substantial increase in treatment coverage.
Global burden of depressive disorders in the year 2000
- Authors:
- USTUN T. B., et al
- Journal article citation:
- British Journal of Psychiatry, 184(5), May 2004, pp.386-392.
- Publisher:
- Cambridge University Press
The initial Global Burden of Disease study found that depression was the fourth leading cause of disease burden, accounting for 3.7% of total disability adjusted life years (DALYs) in the world in 1990. These are new estimates of depression burden for the year 2000. DALYs for depressive disorders in each world region were calculated, based on new estimates of mortality, prevalence, incidence, average age at onset, duration and disability severity. Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, accounting for almost 12% of all total years lived with disability worldwide. These data on the burden of depression worldwide represent a major public health problem that affects patients and society.
Population prevalence of psychiatric disorders in Chile: 6-month and 1-month rates
- Authors:
- VINCENTE Benjamin, et al
- Journal article citation:
- British Journal of Psychiatry, 184(4), April 2004, pp.299-305.
- Publisher:
- Cambridge University Press
The Composite International Diagnostic Interview was administered to a stratified random sample of 2978 individuals from four provinces representative of the country’s population. Six-month and 1-month prevalence rates were estimated. Demographic correlates, comorbidity and service use were examined. Nearly a fifth of the Chilean population had had a psychiatric disorder during the preceding 6 months. The 6-month and 1-month prevalence rates were 19.7% and 16.7% respectively. For the 6-month prevalence the five most common disorders were simple phobia, social phobia, agoraphobia, major depressive disorder and alcohol dependence. Less than 30% of those with any psychiatric diagnosis had a comorbid psychiatric disorder and the majority of them had sought treatment from mental health services. Current prevalence studies are useful indicators of service needs. People with comorbid psychiatric conditions have high rates of service use. The low rate of comorbidity in Chile merits further study.
Mental health survey of the adult population in Iran
- Authors:
- NOORBALA A. A., et al
- Journal article citation:
- British Journal of Psychiatry, 184(1), January 2004, pp.70-73.
- Publisher:
- Cambridge University Press
No national data on the prevalence of mental disorders are available in Iran. Such information may be a prerequisite for efficient national mental health intervention. Through random cluster sampling, 35 014 individuals were selected and evaluated using the 28-item version of the General Health Questionnaire. A complementary semi-structured clinical interview was also undertaken to detect learning disability ('mental retardation'), epilepsy and psychosis. About a fifth of the people in the study (25.9% of the women and 14.9% of the men) were detected as likely cases. The prevalence of mental disorders was 21.3% in rural areas and 20.9% in urban areas. Depression and anxiety symptoms were more prevalent than somatisation and social dysfunction. The interview of families by general practitioners revealed that the rates of learning disability, epilepsy and psychosis were 1.4%, 1.2% and 0.6%, respectively. Prevalence increased with age and was higher in the married, widowed, divorced, unemployed and retired people. Prevalence rates are comparable with international studies. There is a wide regional difference in the country, and women are at greater risk.