BACKGROUND: Depression is associated with lower quality of life and increased risk of mortality. The prevalence of depression in chronic dialysis patients. as well as in patients with diabetes, is... Show moreBACKGROUND: Depression is associated with lower quality of life and increased risk of mortality. The prevalence of depression in chronic dialysis patients. as well as in patients with diabetes, is more than 20%. It is debated whether use of beta-blockers increases the risk of depression. Therefore. we examined in chronic dialysis patients with and without diabetes. the association between beta-blockers and depressive symptoms.METHODS: Data were collected from the DIVERS-I study. a multicentre prospective cohort among chronic dialysis patients in the Netherlands Depressive symptoms were assessed with the Beck Depression Inventory (BDI-II). We defined depressive symptoms as a BDI-II score >= 16. The cross-sectional association at baseline between depressive symptoms and beta-blocker use in chronic dialysis patients. was studied by multivariable logistic regression adjusted for potential confounders.RESULTS: We included 684 chronic dialysis patients, of whom 43% had diabetes mellitus, and 57% used a beta-blocker of which 97% were lipophilic. After multivariable adjustment, the OR (95% CI) for depressive symptoms in patients with compared to without diabetes was 1.41 (1.00-1.98), and in beta-blocker users compared to non-users 1.12 (0.80-1.56), respectively. Dialysis patients with diabetes and beta-blocker use compared to those without diabetes and not using beta-blockers had an OR of 1.73 (1.12-2.69) for depressive symptoms. The association was stronger in dialysis patients with diabetes and lipophilic beta-blocker use with an OR of 1.77 (1.14-2.74).CONCLUSIONS: We found a possible association between lipophilic beta-blocker use and depressive symptoms in chronic dialysis patients with diabetes. Show less
COVID-19 posed enormous challenges for nursing home staff, which may have caused stress and mental health problems. This study aimed to measure the prevalence of mental health problems among... Show moreCOVID-19 posed enormous challenges for nursing home staff, which may have caused stress and mental health problems. This study aimed to measure the prevalence of mental health problems among nursing home staff and investigate the differences in job demands, work functioning and mental health between staff with and without COVID contact or COVID infection and across different levels of COVID worries. In this cross-sectional study, 1669 employees from 10 nursing home organizations filled in an online questionnaire between June and September 2020. The questionnaire measured the participants' characteristics, COVID contact, infection and worries, job demands, work functioning, depressive symptoms and burnout. Differences were investigated with multilevel models to account for clustering at the organization level. Of the participants, 19.1% had high levels of depressive symptoms and 22.2% burnout. Job demands, work functioning, depressive symptoms and burnout differed between participants who never worried and participants who often or always worried about the COVID crisis. Differences were smaller for participants with and without COVID contact or infection. Most models improved when clustering was accounted for. Nursing homes should be aware of the impact of COVID worries on job demands, work functioning and mental health, both at the individual and organizational level. Show less
Maarse, B.C.E.; Chesnaye, N.C.; Schouten, R.; Michels, W.M.; Bos, W.J.W.; Szymczak, M.; ... ; EQUAL Study Investigators 2022
Background: Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with... Show moreBackground: Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods: CKD patients (>= 65 years; estimated glomerular filtration rate <= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off <= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results: Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions: There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men. Show less
OBJECTIVE: Combined oral contraceptives are often considered a treatment option for women with premenstrual syndrome or premenstrual dysphoric disorder also seeking contraception, but evidence for... Show moreOBJECTIVE: Combined oral contraceptives are often considered a treatment option for women with premenstrual syndrome or premenstrual dysphoric disorder also seeking contraception, but evidence for this treatment is scarce. We aimed to determine (1) the level of evidence for the efficacy of combined oral contraceptives in managing premenstrual depressive symptoms and overall premenstrual symptomatology and (2) the comparative efficacy of combined oral contraceptives (the International Prospective Register of Systematic Reviews registration number CRD42020205510). DATA SOURCES: We searched Cochrane Central Register of Controlled Trials, PubMed, Web of Science, PsycINFO, EMCare, and Embase from inception to June 3, 2021. STUDY ELIGIBILITY CRITERIA: All randomized clinical trials that evaluated the efficacy of combined oral contraceptives in women with premenstrual syndrome or premenstrual dysphoric disorder were considered eligible for inclusion in this meta-analysis. STUDY APPRAISAL AND SYNTHESIS METHODS: A random effect Bayesian pairwise and network meta-analysis was conducted with change in premenstrual depressive symptoms and overall premenstrual symptomatology between baseline and 3 cycles as outcome. Certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: Of 3664 records, 9 eligible trials were included that studied 1205 women with premenstrual syndrome or premenstrual dysphoric disorder (mean age per study range, 24.6-36.5 years). The pairwise meta-analysis revealed that combined oral contraceptives were more efficacious than placebo in treating overall premenstrual symptomatology (standardized mean difference, 0.41; 95% credible interval, 0.17-0.67), but not premenstrual depressive symptoms specifically (standardized mean difference, 0.22; 95% credible interval,-0.06 to 0.47). However, none of the combined oral contraceptives were more effective than each other in reducing premenstrual depressive symptoms and overall premenstrual symptomatology. CONCLUSION: Combined oral contraceptives may improve overall premenstrual symptomatology in women with premenstrual syndrome or premenstrual dysphoric disorder, but not premenstrual depressive symptoms. There is no evidence for one combined oral contraceptive being more efficacious than any other. Show less
Maciejewski, D.; Sprang, E. van; Spinhoven, P.; Penninx, B. 2021
Research has shown that negative life events contribute to the development of depression. Moreover, it has been suggested that individuals with a family history of depression experience more... Show moreResearch has shown that negative life events contribute to the development of depression. Moreover, it has been suggested that individuals with a family history of depression experience more negative life events and are more susceptible to the effect of negative life events. However, previous studies did not differentiate stable between-person effects (interindividual differences) and temporal within-person effects (intraindividual differences). This study aims to examine the bidirectional relation between negative life events and depressive symptoms using a novel statistical method (i.e., a random intercept cross-lagged panel model) that allows to separate within-person from between-person processes. Second, we examined the role of family history in that relation. Data came from 1,771 adults (1,320 with a depressive and/or anxiety disorder, 451 controls) that were followed over 9 years (baseline, 2-, 4-, 6-, and 9-year follow-up). Questionnaires were used to measure depressive symptoms and the number of independent (i.e., events independent of someone's symptoms) and dependent negative life events (i.e., events more likely to be influenced by a person). Results showed that individuals with more negative life events experienced more depressive symptoms on a between-person level. Additionally, although the effects were considerably smaller, results suggested within-person increases in dependent and independent negative life events were correlated with within-person increases in depressive symptoms. Overall, our results suggest that negative life events and depressive symptoms are more consistently associated on a between-person than on a within-person level. Thus, negative life events may rather explain differences in depressive symptoms between persons than within persons. Show less
Executive functions play an important role in mediating self-control and self-regulation. It has been suggested that the inability to control eating in Binge Eating Disorder (BED) may indicate... Show moreExecutive functions play an important role in mediating self-control and self-regulation. It has been suggested that the inability to control eating in Binge Eating Disorder (BED) may indicate inefficiencies in executive functioning. This study investigated whether executive functioning predicted cognitive behavioural therapy outcome in BED while accounting for other possible predictors: depressive symptoms, interpersonal factors, eating disorder psychopathology, and self-esteem. Executive functioning and other predictors were assessed in 91 patients with BED by means of neuropsychological tests and questionnaires at baseline. Eating disorder (ED) symptoms were assessed during treatment at variable time points. Potential predictor variables were investigated using multivariate Cox regression models. Recovery was defined by means of two different indicators based on the Eating Disorder Examination-Questionnaire: (a) showing a 50% reduction in baseline symptom ED severity and/or reaching the clinical significance cut-off; and (b) achieving abstinence of objective binge eating. Severity of depressive symptoms was a significant predictor for outcome on both indicators. Patients with no or mild depressive symptoms recovered faster (i.e., 50% reduction in ED symptoms and abstinence of objective binge eating) than those with severe depressive symptoms, which is in line with previous studies. Executive functioning was not related to treatment outcome in this study. Show less
Background Chronotype is an individual's preferred timing of sleep and activity, and is often referred to as a later chronotype (or evening-type) or an earlier chronotype (or morning-type). Having... Show moreBackground Chronotype is an individual's preferred timing of sleep and activity, and is often referred to as a later chronotype (or evening-type) or an earlier chronotype (or morning-type). Having an evening chronotype is associated with more severe depressive and anxiety symptoms. Based on these findings it is has been suggested that chronotype is a stable construct associated with vulnerability to develop depressive or anxiety disorders. To examine this, we test the stability of chronotype over 7 years, and its longitudinal association with the change in severity of depressive and anxiety symptoms.Methods Data of 1,417 participants with a depressive and/or anxiety disorder diagnosis and healthy controls assessed at the 2 and 9-year follow-up waves of the Netherlands Study of depression and anxiety were used. Chronotype was assessed with the Munich chronotype questionnaire. Severity of depressive and anxiety symptoms were assessed with the inventory of depressive symptomatology and Beck anxiety inventory.Results Chronotype was found to be moderately stable (r = 0.53) and on average advanced (i.e., became earlier) with 10.8 min over 7 years (p < .001). Controlling for possible confounders, a decrease in severity of depressive symptoms was associated with an advance in chronotype (B = 0.008, p = .003). A change in severity of anxiety symptoms was not associated with a change in chronotype.Conclusion Chronotype was found to be a stable, trait-like construct with only a minor level advance over a period of 7 years. The change in chronotype was associated with a change in severity of depressive, but not anxiety, symptoms. Show less
