ABSTRACT
Background: Although the association between major depressive disorder [MDD] and low self-esteem is well established, we do not know if race and ethnicity modify the magnitude of this link
Objectives: Using a nationally representative sample of adults in the United States, we explored whether or not race alters the association between MDD and self-esteem
Materials and Methods: Data came from the National Survey of American Life [NSAL], a nationally representative household survey with 3,570 African Americans [Blacks] and 891 Non-Hispanic Whites. Low self-esteem [Rosenberg Self-Esteem Scale] was the dependent variable, MDD [Composite International Diagnostic Interview] was the independent variables, gender, age and educational level were controls, and race was the focal moderator. Logistic regressions were used for data analysis
Results: In the pooled sample, MDD and low self-esteem showed reciprocal associations, above and beyond all covariates. Our model showed significant interaction between race and MDD, suggesting a stronger association between MDD and self-esteem among Blacks compared to Whites. We could find such interactions among men but not women
Conclusion: Depression and low self-esteem are more strongly linked among Blacks than Whites, particularly among men. It is not clear whether depression leaves a larger scar on self-esteem for Blacks or that Blacks are more vulnerable to the effect of low self-esteem on depression
ABSTRACT
Background: For psychiatric disorders, comorbidity is a rule rather than exception. Thus it is particularly important to study additive and multiplicative effects of multiple mental disorders on suicidal behaviors
Objectives: The aim of this study was to investigate the ethnic differences in multiplicative effects of mental disorders on suicidal ideation among Black adults in the United States
Materials and Methods: Data came from the National Survey of American Life, 2001-2003. For this study, we used data of 5,181 Black adults [3,570 African Americans and 1,621 Caribbean Blacks]. Lifetime depression, anxiety, and drug abuse as well as suicidal ideation were measured, using the World Mental Health Composite International Diagnostic Interview [WMH-CIDI]. Ethnic specific logistic regressions were used to determine multiplicative effects of anxiety, depression and drug abuse on suicidal thoughts among African Americans and Caribbean Blacks
Results: Depression showed multiplicative effects with anxiety and drug abuse for African Americans, but not Caribbean Blacks. Drug abuse and anxiety showed multiplicative effects among Caribbean Blacks but not African Americans
Conclusion: Based on our study, ethnicity modifies how anxiety, depression and drug abuse contribute to suicidality among Blacks. As suicide risk is differently influenced by multiple psychiatric disorders for African Americans and Caribbean Blacks, ethnic-specific programs for screening and prevention of suicide is suggested
ABSTRACT
OBJECTIVE: Although psychological problems, such as anxiety and depression, can affect the quality of sleep, there is scant research on the link between decreased sleep quality and mental health in coronary artery disease (CAD) patients. This study aimed to explore the quality of sleep in CAD patients with and without abnormal anxiety and depressive complaints. METHODS AND RESULTS: In a cross-sectional setting, 163 CAD patients were consecutively selected. Using Hospital Anxiety Depression Scale (HADS), patients were divided into the following 4 groups: I(anx) (subjects with abnormal anxiety symptoms, n = 34), II(anx) (subjects without abnormal anxiety symptoms, n = 129), I(dep) (subjects with abnormal depressive symptoms, n = 34), and II(dep) (subjects without abnormal depressive symptoms, n = 129). Subsequently, sleep quality was compared between the study groups by means of Pittsburgh Sleep Quality Index were significantly (PSQI). Mean values of total PSQI score, subjective sleep quality, sleep latency and sleep disturbances in group I(anx) were significantly poorer than those in group II(anx). Also, mean values of total PSQI score and daytime dysfunction in group I(dep) were significantly poorer than those in group II(dep). CONCLUSIONS: This study shows that there is a significant association between decreased quality of sleep and abnormal anxiety and depressive symptoms in CAD patients. Thus, we recommend that physicians check for the presence of the other related symptom when encountering patients with one of these complaints.
Subject(s)
Adaptation, Psychological , Adult , Aged , Aged, 80 and over , Anxiety , Coronary Artery Disease/physiopathology , Cross-Sectional Studies , Depression , Female , Humans , Male , Middle Aged , Psychometrics , Surveys and Questionnaires , Sleep , Sleep Wake DisordersABSTRACT
Having enjoyed considerable success in kidney transplantation in recent years, Iran has been named the most active country in the Middle East Society for Organ Transplantation region in providing equitable quick, and intermediary-free access to affordable kidney transplantation for everyone regardless of gender and economic circumstances. We are, however, of the opinion that the Iranian model can benefit further from improving deceased-donor kidney transplantation, especially after a fatwa (Islamic edict) in the early 1980s lifted many religious and legal barriers. Deceased-donor kidney transplantation in Iran should be bolstered by establishing a transplantation model, increasing government funds, and encouraging participation of the general public in the Iranian Network for Transplant Organ Procurement. We recommend that an intensive media campaign be launched to heighten public awareness and more transplantation centres be involved in cadaveric transplantation with streamlined systems of cadaveric donations registration so as to facilitate the process of finding and relating the donors with potential recipients.