O papel mediador da dependência de mídia social e da qualidade do sono na associação entre tempo de uso de mídia social e sintomas depressivos em universitários / The mediating role of social media addiction and sleep quality in the association between social media usage and depressive symptoms in university students / El papel mediador de la adicción a las redes sociales y la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios

Resumo: O aumento do uso de mídias sociais e sua associação com sintomas depressivos, especialmente em jovens adultos, tem gerado a necessidade do entendimento de como ocorre tal associação para subsidiar políticas de redução de danos e agravos. Nesse sentido, este estudo objetivou verificar o efeito mediador da dependência de mídias sociais e da qualidade do sono na associação entre o tempo de uso de mídias sociais e sintomas depressivos em universitários brasileiros. Trata-se de um estudo transversal, realizado com 2.823 universitários, que forneceram informações referentes ao tempo de uso de mídias sociais, à dependência de mídias sociais, aos sintomas depressivos e à qualidade do sono. A análise de mediação, ajustada por fatores de confusão, foi realizada por meio do software PROCESS para SPSS, para obtenção do efeito total (c), direto (c') e indiretos (EI1, EI2 e EI3). Os resultados identificaram associação entre o tempo de uso de mídias sociais e os sintomas depressivos, mediada pela dependência de mídias sociais (EI1 = 20%) e pela qualidade do sono (EI1 = 40%). Os resultados permitem ampliar o conhecimento acerca dos mecanismos que influenciam mutuamente a relação entre o tempo de uso de mídias sociais e os sintomas depressivos, auxiliando na adoção de estratégias de redução de danos decorrentes do uso excessivo de mídias sociais.

Abstract: Increase in time spent on social media and its association with depressive symptoms, especially among young adults, has generated the need to understand how this association occurs in order to support the development of policies to reduce harm and complications. In view of this fact, this study aimed to assess the mediating effect of social media addiction and sleep quality on the association between time spent on social media and depressive symptoms in Brazilian university students. This is a cross-sectional study conducted with 2,823 university students, who provided information regarding time spent on social media, social media addiction, depressive symptoms and sleep quality. The mediation analysis, adjusted for confounding factors, was performed using the PROCESS macro for SPSS to obtain the total (c), direct (c'), and indirect effects (EI1, EI2, and EI3). The results identified an association between time spent on social media and depressive symptoms, mediated by social media addiction (EI1 = 20%) and sleep quality (EI1 = 40%). These findings help expand knowledge about the mechanisms that mutually influence the relationship between time spent on social media and depressive symptoms, supporting the adoption of strategies to reduce harm resulting from excessive social media use.

Resumen: El aumento del uso de las redes sociales y su asociación con síntomas depresivos, especialmente en adultos jóvenes, ha generado la necesidad de comprender cómo se produce esta asociación como una forma de apoyar las políticas de reducción de daños y afecciones. En ese sentido, el presente estudio tuvo como objetivo verificar el efecto mediador de la adicción a las redes sociales y de la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios brasileños. Se trata de un estudio transversal, realizado con 2.823 estudiantes universitarios, quienes brindaron información respecto al tiempo de uso de las redes sociales, adicción a las redes sociales, síntomas depresivos y calidad del sueño. El análisis de mediación, ajustado por factores de confusión, se realizó por medio del software PROCESS para SPSS, para obtener el efecto total (c), directo (c') e indirectos (EI1, EI2 y EI3). Los resultados identificaron una asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos, mediada por adicción a las redes sociales (EI1 = 20%) y la calidad del sueño (EI1 = 40%). Los resultados permiten ampliar el conocimiento acerca de los mecanismos que influyen mutuamente en la relación entre tiempo de uso de las redes sociales y los síntomas depresivos, ayudando a adoptar estrategias para reducir los daños resultantes del uso excesivo de las redes sociales.

Inseguridad alimentaria y síntomas depresivos: análisis antes y durante la pandemia por COVID-19 en México / Food insecurity and depressive symptoms: analysis before and during the COVID-19 pandemic in Mexico

Resumen Objetivo: Analizar la relación entre la inseguridad alimentaria y los síntomas depresivos entre hombres y mujeres de México antes y durante la pandemia por COVID-19. Materiales y método: Estudio transversal con datos de la Encuesta Nacional de Salud y Nutrición 2018-19 y de la Encuesta Nacional de Salud y Nutrición 2021 sobre COVID-19. Utilizando modelos de regresiones logísticas binomiales, se estiman las razones de momios entre hombres y mujeres de presentar síntomas depresivos según la inseguridad alimentaria del hogar ajustando por diversas variables socioeconómicas y de la salud. Resultados: Existe una diferencia significativa de la prevalencia de síntomas depresivos, pero no de la inseguridad alimentaria entre sexos y entre periodos. Los síntomas depresivos y la inseguridad alimentaria se relacionaron antes de y durante la pandemia por COVID-19 entre hombres y mujeres, incluso ajustando por las variables de control sociodemográficas y de la salud. Conclusión: Los síntomas depresivos y la inseguridad alimentaria se relacionan de forman consistente. Es importante estudiar esta asociación en etapas posteriores a la pandemia para determinar si es consistente o se relaciona con las condiciones sociales y económicas impuestas.

Abstract Objective: To analyze the relationship between food insecurity and depressive symptoms among men and women in Mexico before and during the COVID-19 pandemic. Methods and materials: Cross-sectional study with data from the Encuesta Nacional de Salud y Nutrición 2018-19 and the Encuesta Nacional de Salud y Nutrición 2021 sobre COVID-19. Using binomial logistic regression models, the odds ratios between men and women of presenting depressive symptoms according to household food insecurity are estimated, adjusting for various socioeconomic and health variables. Results: There is a significant difference in the prevalence of depressive symptoms, but not in food insecurity between sexes and between periods. Depressive symptoms and food insecurity were associated before and during the COVID-19 pandemic among men and women, even adjusting for health and sociodemographic control variables. Conclusion: Depressive symptoms and food insecurity are consistently related. It is important to study this association in post-pandemic stages to determine if it is consistent or related to imposed social and economic conditions.

Factors related to academic performance in medical students / Factores relacionados con el desempeño académico en estudiantes de medicina

Abstract Introduction Academic performance in medical students can be influenced by several factors, including those related to mental health and family relationships. Objective To examine the factors affecting academic performance in medical students, specifically considering potential diagnoses of depression. Method A survey was conducted among 747 fourth-year medical students. The survey included questions on sociodemographic variables, mental health, and well-being. The Patient Health Questionnaire (PHQ) was utilized, encompassing sections on depression, anxiety, panic, eating habits, alcohol consumption, and the Stress Perception Scale. Academic performance was assessed based on students' Grade Point Average (GPA). Descriptive statistics, Pearson correlation coefficients, and a linear regression model were employed for data analysis. Results The study revealed several variables significantly associated with GPA. Age (r = -.388), financial situation (r = .241), relationships with cohabitants (r = .165), and relationships with peers (r = .217) were found to have a correlation with academic performance. Additionally, repeating a course was found to be significantly associated with a person's GPA (r = .518) even after controlling for depression. Discussion and conclusion The findings indicate that robust mental health, a favorable financial situation, and positive interpersonal relationships are crucial for achieving optimal academic performance in medical students. These results emphasize the need to address mental health concerns, promote a supportive social environment, and provide financial assistance to enhance the educational outcomes of medical students.

Resumen Introducción El desempeño académico de los estudiantes de medicina puede verse influenciado por varios factores, entre ellos los relacionados con la salud mental y las relaciones familiares. Objetivo Examinar los factores que afectan el desempeño académico en estudiantes de medicina, considerando específicamente los posibles diagnósticos de depresión. Método Se realizó una encuesta entre 747 estudiantes de cuarto año de la carrera de medicina. La encuesta incluyó preguntas sobre variables sociodemográficas, salud mental y bienestar. Se utilizó el Cuestionario de Salud del Paciente (PHQ), que comprende secciones sobre depresión, ansiedad, pánico, hábitos alimentarios, consumo de alcohol y la Escala de Percepción del Estrés. El desempeño académico se evaluó con base en el promedio de calificaciones (GPA) de los estudiantes. Se emplearon estadísticas descriptivas, coeficientes de correlación de Pearson y un modelo de regresión lineal para el análisis de datos. Resultados El estudio reveló varias variables significativamente asociadas con el GPA. Se encontró que la edad (r = -.388), la situación financiera (r = .241), las relaciones con los convivientes (r = .165) y las relaciones con los compañeros (r = .217) tenían correlación con el rendimiento académico. Además, se encontró que repetir un curso estaba significativamente asociado con el GPA de una persona (r = .518) incluso después de controlar la depresión. Discusión y conclusión Los hallazgos indican que una salud mental sólida, una situación financiera favorable y relaciones interpersonales positivas son cruciales para lograr un desempeño académico óptimo en los estudiantes de medicina. Estos resultados enfatizan la necesidad de abordar los problemas de salud mental, promover un entorno social de apoyo y brindar asistencia financiera para mejorar los resultados educativos de los estudiantes de medicina.

Sintomatología Depresiva y Bienestar en Personas Mayores de Concepción, Chile: Rol moderador del apoyo social

Antecedentes: La población sobre 60 años va en aumento y es relevante tener más conocimiento sobre los factores que inciden en su bienestar y salud mental. Objetivo: Este estudio busca comprender la relación entre bienestar, apoyo social y sintomatología depresiva en personas mayores de la provincia de Concepción. Método: 538 adultos mayores fueron seleccionados aleatoriamente de 15 Centros de Salud Primaria de la provincia de Concepción, Chile. Se midieron sus niveles de bienestar (con el Pemberton Happiness Index), de apoyo Social (con la Escala Multidimensional de Percepción de Apoyo Social de Zimet) y de sintomatología depresiva (mediante el Patient Health Questionnaire-9). Resultados: Los adultos mayores mostraron un puntaje elevado (M=8,54; DE = 1,34) en bienestar, sin diferencias por sexo (t(536) = −1,065, p = 0,288 > 0,05). En los análisis de regresión lineal, el apoyo social (β =0,463, p<0,001) y la sintomatología depresiva (β =-1,585, p<0,001) aparecen como influyentes en el bienestar de las personas mayores; y el apoyo social actúa como un factor moderador (β=0,049, p=0,007, IC =0,021; 0,077) en la relación entre sintomatología depresiva y bienestar. Conclusiones: Las personas mayores muestran elevado bienestar. Los resultados refuerzan la relevancia del apoyo social como un factor protector en las personas mayores. Ello corrobora la importancia del fomento de este aspecto en los programas promocionales y preventivos destinados al bienestar y salud mental de adultos mayores.

Background: The population over 60 years of age is increasing. Aim: This research aims to understand the relationship between well-being, social support, and depressive symptoms in older Chilean people. Method: 538 older adults were randomly selected from 15 Primary Health Centers in the province of Concepción, Chile, 341 women and 197 men. Well-being was measured with the Pemberton Happiness Index, Social Support with the Zimet Multidimensional Scale of Perceived Social Support, and Depressive Symptomatology using the Patient Health Questionnaire-9. Results: Older adults showed a high mean score (M=8.54; SD=1.34) in well-being, with no differences by sex (t(536) = −1.065, p = .288 > .05.) In linear regression analyses, social support (β =0,463, p<0,001) and depressive symptomatology (β =-1,585, p<0,001) influence the well-being of the elderly, and social support acts as a moderating factor (β=0.049, p=0.007, CI =0.021; 0.077) in the relationship between social support and well-being. Conclusions: Older people show high well-being. The results reinforce the relevance of social support as a protective factor for the positive mental health of older adults. This corroborates the importance of including this aspect in promotional and preventive mental health programs for older adults.

Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais / Interrelationships between dissatisfaction with teaching work and depressive symptoms: Structural equation modelling

Resumo O objetivo deste artigo é avaliar inter-relações de fatores associados a sintomas depressivos (SD) em professores, considerando a insatisfação com o trabalho docente como possível mediador. Estudo transversal utilizando dados de 700 professores da rede pública de ensino de um município brasileiro. O desfecho de interesse foi SD aferido pelo Inventário de Depressão de Beck (BDI). Foram testadas inter-relações diretas e indiretas entre o desfecho e insatisfação com o trabalho, idade, renda, estilo de vida e adiposidade. Essas variáveis compuseram modelo operacional testado por meio de modelagem de equações estruturais. A maior idade (β=0,12) e a maior insatisfação com o trabalho (β=0,12) associaram-se diretamente aos SD. Já o estilo de vida mais favorável (β=-0,60) e a adiposidade (β=-0,10), associaram-se a menor ocorrência de SD. As variáveis estilo de vida (β=-0,06) e adiposidade (β=-0,02) também apresentaram efeitos indiretos negativos nos SD, mediados pela insatisfação com o trabalho. O modelo de equação estrutural testado identificou inter-relações que influenciaram os SD. A insatisfação com o trabalho docente associou-se aos SD e mediou a relação de outros fatores sobre tais sintomas.

Abstract The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (β=0.12) and greater dissatisfaction with work (β=0.12) were directly associated with DS. A more favourable lifestyle (β=-0.60) and adiposity (β=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (β=-0.06) and adiposity (β=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

Social connections and depressive symptoms among older adults during the initial lockdown period for COVID-19 / Conexiones sociales y síntomas depresivos entre adultos mayores durante el primer período de confinamiento por COVID-19

Abstract Introduction Little information from developing countries during the first lockdown for COVID-19 is available. We hypothesized that the use of communication tools, and not living alone would provide a protective effect against DS. Objective To determine the association between social connections and depressive symptoms (DS) during the first lockdown period among Mexican community-dwelling older adults. Method Cross-sectional phone survey including 269 participants aged 65 years or older. Participants were asked about their social connections and the presence of DS during the first lockdown for COVID-19. Results Mean age was 83.2 (SD = 6.7). Compared with those without DS, those with DS reported a greater number of phone calls or videocalls although this was not statistically significant. However, when stratifying by housing situation, only the participants who lived alone and that received less calls from friends had more DS (p = .04). Discussion and conclusion Living alone allowed the participants not to have much contact with family and this caused friends to represent the most important social relationship outside the home. We hypothesize that the means to stay socially active for older adults in Latin America are different and have a different impact. Because, DS only were present among the participants who reported living alone and having fewer calls from friends during the confinement period.

Resumen Introducción Hay poca información disponible sobre los países en desarrollo durante el primer período de confinamiento por COVID-19. Planteamos la hipótesis de que el uso de herramientas de telecomunicación y vivir acompañado proporciona un efecto protector frente a la presencia de síntomas depresivos (SD). Objetivo Determinar la asociación entre las conexiones sociales y los SD durante el primer período de confinamiento en adultos mayores mexicanos que viven en la comunidad. Método A través de un estudio transversal, 269 participantes de 65 años o más completaron una encuesta telefónica sobre sus conexiones sociales y la presencia de SD durante el primer período de confinamiento por COVID-19. Resultados La edad media fue de 83.2 (DE = 6.7). En comparación con los que no tenían SD, los que tenían SD reportaron un mayor número de llamadas telefónicas o videollamadas, pero esto no fue estadísticamente significativo. Sin embargo, al estratificar por situación de vivienda, los participantes que vivían solos y que recibían menos llamadas de amigos tenían más SD (p = .04). Discusión y conclusión Vivir solo permitió a los participantes no tener mucho contacto con la familia y esto provocó que los amigos representaran la relación social más importante fuera del hogar. Creemos que los medios para mantenerse socialmente activos de los adultos mayores en América Latina son diferentes y tienen un impacto diferente. Debido a que los SD solo estuvieron presentes entre los participantes que reportaron vivir solos y tener menos llamadas de amigos durante período de confinamiento.

Suporte Familiar, Traço/Estado Depressivo e Motivos para Viver em Usuários da Atenção Primária/Secundária / Family Support, Depressive Traits/Conditions and Reasons For Living in Primary/Secondary Care Users / Lo Apoyo Familiar, Rasgos/Condiciones Depresivos y Razones Para Vivir en Usuarios de la Atención Primaria/Secundaria

A depressão pode ser desenvolvida, agravada e/ou prevenida em função de alguns fatores como suporte familiar e motivos para viver, além da possibilidade de ser concebida como traço e estado depressivo. O objetivo principal desta pesquisa foi testar um modelo teórico preditivo (path analysis) do suporte familiar sobre traço/estado depressivo e sobre os motivos para viver, em uma amostra de 123 participantes, composta por dois grupos: pacientes do CAPS-AD e da ESF e, posteriormente, verificar as diferenças desses aspectos na amostra estudada. Foram aplicados uma ficha sociodemográfica, a Escala Baptista de Depressão - Adulto (EBADEP-A), Inventário de Percepção de Suporte Familiar (IPSF), Escala de Traço e Estado Depressivo (ETED) e Escala Brasileira de Motivos para Viver (BEMVIVER). O resultado da path analysis indicou que os motivos para viver são explicados pelo estado e traço depressivo e pelo suporte familiar. Os pacientes do CAPS-AD, tinham maiores níveis de sintomatologia depressiva e estado depressivo do que o grupo do ESF. Pacientes do ESF apresentaram médias maiores de suporte familiar e motivos para viver. Conclui-se que investir em estratégias que potencializem os motivos para viver e o suporte familiar podem reduzir os riscos de sintomatologia depressiva.

Depression can be developed, worsened and/or prevented depending on some factors such as: family support and reasons for living, in addition to the possibility of being conceived with a depressive trait and state. The main objective of this research was to test a predictive theoretical model (path analysis) of family support on the depressive trait/state and reasons for living, in a sample of 123 participants, composed of two groups: patients from the Psychosocial Care Center- Alcohol and Drugs (CAPS-AD) and the Family Health Strategy (ESF) and verify the differences of these aspects in the studied sample. A sociodemographic form, the Baptista Depression Scale -Adult (EBADEP-A), the Perceived Family Support Inventory (IPSF), Trait and Depressive State Scale (DTS) and the Brazilian Scale of Reasons to Live (BEMVIVER) were applied. The result of the path analysis indicated that the reasons for living are explained by the depressive state and trait and family support. CAPS-AD patients had higher levels of depressive symptoms and depressive state than the ESF group. ESF patients presented higher means of family support and reasons to live. It is concluded that investing in strategies that enhance the reasons to live and family support can reduce the risks of depressive symptoms.

La Depresión puede desarrollarse, agravarse y prevenirse dependiendo de factores como: apoyo familiar y razones para vivir, además puede de ser concebido con un rasgo y estado depresivo. El objetivo de esta investigación fue probar un modelo teórico predictivo del apoyo familiar sobre el rasgo/estado depresivo y las razones de vivir y verificar las diferencias de esos aspectos en la muestra estudiada, de 123 participantes compuesta por dos grupos: pacientes del Centro de Atención Psicosocial - Alcohol y Drogas (CAPS-AD) y la Estrategia de Salud de la Familia (ESF). Se aplicó un formulario sociodemográfico, Escala de Depresión de Baptista - Adulto (EBADEP-A), Inventario de Apoyo Familiar Percibido (IPSF), Escala de Rasgo y Estado Depresivo (DTS), Escala Brasileña de Razones para Vivir (BEMVIVER). El resultado del análisis indicó que las razones para vivir a ser explicadas por el estado y rasgo depresivo y por el apoyo familiar. Los pacientes CAPS-AD tenían niveles más altos de síntomas y estado depresivo que el grupo ESF. Los pacientes ESF presentaron mayores medios de apoyo familiar y razones para vivir. Se concluye que invertir en estrategias que potencien estas razones y apoyo familiar puede en la reducción de los riesgos de síntomas depresivos.

Psychotropic drug use and suggestive depression symptoms associated with NR3C1 DNA methylation / Uso de drogas psicotrópicas e sintomas sugestivos de depressão associados à metilação do DNA do NR3C1

Introduction: Psychiatric disorders have become a global problem that leads millions of people to use psychotropic medications, especially benzodiazepines. The effects of these substances are widely known regarding tolerance and chemical dependence, however, from epigenetics perspective, there are still little known.Objective: To evaluate the association between psychotropic drug use, NR3C1 gene methylation and its relation with symptoms suggestive of depression in adult individuals assisted in the public health system.Methods: 385 adult volunteers (20-59 years) users of the Brazilian Unified Health System were recruited to evaluate socioeconomic, health, lifestyle conditions in a cross sectional study. BDI-II evaluated symptoms suggestive of depression and pyrosequencing evaluated NR3C1 DNA methylation. Bivariate and multivariate Poisson regression model with robust variance (p < 0.05) evaluated the association between psychotropic drug use and NR3C1 gene methylation.Results: Specific depressive symptoms such as irritability, insomnia and fatigability were associated with psychotropic drug use. Symptoms of past failure, indecision and loss of appetite were associated with hypermethylation patterns in CpGs 40 to 47 of NR3C1 gene. Moreover, psychotropic drug use is associated with 50% reduction in NR3C1 gene methylation, through model adjusted with socioeconomic, health and lifestyle confounding variables.Conclusions: Psychotropic drug use and depressive symptoms was associated with changes in NR3C1 DNA methylation. In this context, epigenetic modification resulting from psychotropic drug use and depressive symptoms could be considered, mainly in population studies with epigenetic evaluation, where these factors may be influencing the findings of future studies.

Introdução: os distúrbios psiquiátricos tornaram-se um problema global que leva milhões de pessoas ao uso de medicamentos psicotrópicos. Os efeitos dessas substâncias são amplamente conhecidos quanto à tolerância e dependência química, porém, do ponto de vista epigenético, ainda são pouco conhecidos.Objetivos: avaliar a associação entre o uso de drogas psicotrópicas, metilação do gene NR3C1 e sua relação com sintomas sugestivos de depressão em indivíduos entre 20 a 59 anos usuários da rede pública de saúde.Método: 385 voluntários de 20-59 anos, usuários do Sistema Único de Saúde brasileiro foram recrutados para avaliação das condições socioeconômicas, de saúde e de estilo de vida em estudo transversal. O BDI-II avaliou sintomas sugestivos de depressão e o pirosequenciamento avaliou a metilação do DNA de NR3C1. Modelo de regressão de Poisson bivariado e multivariado com variância robusta (p < 0,05) avaliou a associação entre o uso de drogas psicotrópicas e metilação do gene NR3C1.Resultados: sintomas depressivos específicos como irritabilidade, insônia e fadiga foram associados ao uso de medicamentos psicotrópicos. Sintomas de fracasso passado, indecisão e perda de apetite foram associados a padrões de hipermetilação nos CpGs 40 a 47 do gene NR3C1. Além disso, o uso de psicofármacos está associado à redução de 50% na metilação do gene NR3C1, por meio de modelo ajustado com variáveis de confusão socioeconômicas, de saúde e estilo de vida.Conclusão: o uso de drogas psicotrópicas e sintomas específicos depressivos foram associados a alterações na metilação do DNA de NR3C1.

Effect of aerobic training on depression and thyroid function in treated hypothyroid women / Efeito do treinamento aeróbico na depressão e função tireoidiana em mulheres com hipotireoidismo tratado

INTRODUCTION: Hypothyroidism is commonly associated with depression and a slowing in mental activity. OBJECTIVES: The current investigation aimed to investigate the effect of aerobic training on depression and thyroid function in treated hypothyroid females. METHODS AND MATERIALS: Thirty women diagnosed with primary hypothyroidism that was regulated and accompanied by mild to moderate levels of depression completed a 12-week randomized controlled exercise trial involving two equal groups: aerobic (n = 15) and control (n = 15) groups. The exercising group performed three sessions of aerobic exercise per week at low to moderate intensity for 12 consecutive weeks while the control group performed no exercise intervention during the same duration. At baseline and post-intervention, Beck Depression Inventory score (BDIS), thyroid stimulating hormone (TSH) and free thyroxin (T4) were assessed. RESULTS: The exercising group showed significant improvements in BDIS, TSH and free T4 compared to baseline (p < 0.05) with negligible change in the control group (p > 0.05). As compared to the control, all measured items differed significantly in favor to the aerobic training group. CONCLUSION: In women with treated hypothyroidism, aerobic training can minimize depressive symptoms and enhance thyroid function.

INTRODUÇÃO: O hipotireoidismo é comumente associado à depressão e à lentidão da atividade mental. OBJETIVOS: A presente investigação teve como objetivo investigar o efeito do treinamento aeróbico na depressão e na função tireoidiana em mulheres com hipotireoidismo tratado. MÉTODOS E MATERIAIS: Trinta mulheres diagnosticadas com hipotireoidismo primário que foi regulado e acompanhado por níveis leves a moderados de depressão completaram um teste de exercício controlado randomizado de 12 semanas envolvendo dois grupos iguais: aeróbico (n = 15) e controle (n = 15). O grupo de exercício realizou três sessões de exercício aeróbico por semana em intensidade baixa a moderada por 12 semanas consecutivas, enquanto o grupo de controle não realizou nenhuma intervenção de exercício durante a mesma duração. No início e pós-intervenção, o escore do Inventário de Depressão de Beck (BDIS), hormônio estimulante da tireoide (TSH) e tiroxina livre (T4) foram avaliados. RESULTADOS: O grupo de exercícios apresentou melhorias significativas em BDIS, TSH e T4 livre em comparação com a linha de base (p < 0,05) com alteração insignificante no grupo de controle (p > 0,05). Em comparação com o controle, todos os itens medidos diferiram significativamente em favor do grupo de treinamento aeróbico. CONCLUSÃO: Em mulheres com hipotireoidismo tratado, o treinamento aeróbico pode minimizar os sintomas depressivos e melhorar a função da tireoide.

Association between sleep duration and depressive symptoms inthe elderly / 四川精神卫生

BackgroundDepression presents a significant risk to the physical and mental health of the elderly. The relationship between sleep and depressive symptoms has become a major research focus. However， previous research findings on this relationship have yielded inconsistent conclusions. ObjectiveTo explore the relationship between sleep duration and depressive symptoms in the elderly， in order to provide insights into the prevention of depressive symptoms and delaying their progression in the elderly. MethodsData analysis involved 8 210 adults aged 60 years or older， utilizing data from the 2018 China Health and Retirement Longitudinal Study （CHARLS） survey. Participants were categorized into two groups those with depressive symptoms and those without- based on the Center for Epidemiologic Studies Depression-10 Scale （CESD-10） criteria. Logistic regression and restricted cubic spline models were used to analyze the association between sleep duration and depressive symptoms. ResultsThe 318 people with depressive symptoms were detected among the 8 210 elderly participants， with an average sleep duration of （6.14±2.05） hours per night. Restricted cubic spline models showed a non-linear association between sleep duration and depressive symptoms （χ2=412.670，P<0.01）. After adjusting for confounding factors， compared to the elderly with a sleep duration 7~7.9 hours， the risk of depressive symptoms in the elderly was 2.971 times higher （95% CI： 2.560~3.449， P<0.01） in those with a sleep duration <6 hours， 1.372 times higher （95% CI： 1.161~1.621， P<0.01） in those with 6~6.9 hours， and 1 185 times higher （95% CI： 1.009~1.393， P<0.05） in those with ≥8 hours. Subgroup analysis showed no correlation between sleep duration ≥8 hours and the risk of depressive symptoms across genders and the 60~69 age group （P>0.05）. ConclusionThere was an approximately nonlinear association between sleep duration and depressive symptoms， with differences by gender and age.［Funded by Sichuan Applied Psychology Research Center， Chengdu Medical College （number， CSXL-22226）］

Relationship between family intergenerational contact, depressive symptoms and self-reported health status in the elderly / 预防医学

Objective@#To explore the relationship between family intergenerational contact, depressive symptoms and self-rated health status in the elderly, so as to provide insights into promoting health of the elderly and actively coping with population aging. @*Methods@#Demographic information, intergenerational contact frequency, self-rated health status and depressive symptoms in the elderly at ages of 65 years and older were collected through the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Structural equation model was established to analyze the effects of intergenerational contact on self-rated health and the mediating role of depressive symptoms between family intergenerational contact and self-rated health in the elderly. @*Results@#Totally 15 497 elderly participants were enrolled, with 6 727 males (43.41%) and 8 770 females (56.59%), and there 12 583 individuals lived with family members (81.19%). The median age was 85.00 (interquartile range, 16.00) years. The scores of self-rated health and depressive symptoms were (3.39±0.87) and (2.22±0.56), respectively. The results of structural equation model analysis showed that after adjusting for age, gender and residence, frequent intergenerational contact had a direct positive effect on self-rated health (effect size=0.038, P<0.001), and could improve the depressive symptoms (effect size=0.089, P<0.001) in the elderly. In addition, depressive symptoms had a negative effect on self-rated health in the elderly (effect size=-0.422, P<0.001).@* Conclusions @#Frequent intergenerational contact can improve the self-rated health status in the elderly, and indirectly improve the self-rated health level by alleviating depressive symptoms.

Relationship between affective temperament and the severity of depressive symptoms on medical college students / 中华行为医学与脑科学杂志

Objective:To explore the relationship between affective temperament and the severity of depressive symptoms in medical college students.Methods:From October to November 2021, a questionnaire survey was conducted among 1 780 medical undergraduates from two medical colleges in Anhui Province.The Chinese version of temperament scale of Memphis, Pisa, Paris and San Diego autoquestionnaire (TEMPS-A) and the Chinese version of the Beck depression inventory (BDI-Ⅱ) were used to evaluate the affective temperament and depressive symptoms of medical college students, respectively.SPSS 23.0 software was used for statistical analysis of the data.Ordinal Logistic regression model was used to analyze the impact of affective temperament characteristics on the severity of depressive symptoms.Results:The detection of depressive symptoms among medical college students was 6.4% with mild depression, 7.4% with moderate and severe depression and 86.2% without depression.The scores of cyclothymic, depressive, irritable, hyperthymia and anxious temperaments in TEMPS-A were significantly different among medical college students with different levels of depressive symptoms (all P<0.05). There were statistically significant differences in the detection rates of depression symptoms among medical college students with different typical affective temperament characteristics(all P<0.05). Ordinal Logistic regression model analysis showed that typical cyclothymic temperament ( OR=5.05, 95% CI: 3.68-6.94), typical depressive temperament ( OR=7.69, 95% CI: 4.64-12.86), typical hyperthymia temperament ( OR=0.30, 95% CI: 0.15-0.58), and typical anxious temperament ( OR=2.41, 95% CI: 1.75-3.32) were influencing factors for the severity of depressive symptoms in medical college students. Conclusion:Affective temperament, especially typical depressive temperament, typical cyclothymic temperament and typical anxious temperament can affect the severity of depressive symptoms in medical college students.

Effects of long working hours on the health of food-delivery workers / 中国职业医学

{L-End}Objective To investigate the current status of long working hours of food-delivery workers from food-delivery platform, and analyze its impact on their health such as occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and life satisfaction. {L-End}Methods A total of 2 145 food-delivery workers from two food-delivery platforms in Guangzhou City were selected as the research subjects using convenience sampling method. The occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and life satisfaction were investigated using the Core Occupational Stress Scale, Patient Health Questionnaire-9 items, Self-sleep Management Questionnaire, Self-diagnosis Questionnaire of Fatigue Accumulation of Workers, and World Health Organization Five-item Well Being Index. {L-End}Results The median and the 25th and 75th percentiles of weekly working hours were 63 (49,77) hours. And 92.2% (1 978/2 145) of workers, who worked more than 40 hours per week, were long working hours workers. While 70.1% (1 504/2 145) workers, who worked 55 hours or more per week, were ultra-long working hours workers. The detection rate of occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and low life satisfaction was 30.1%, 27.5%, 34.7%, 40.8%, and 75.1%, respectively. The longer the weekly working hours of the research subjects, the higher the detection rate of occupational stress and fatigue accumulation (all P<0.01). The results of multivariate logistic regression analysis showed that ultra-long working hours (weekly working hours ≥55 hours) was the influencing factor of occupational stress and fatigue accumulation after excluding the influence of confounding factors among workers (all P<0.05). {L-End}Conclusion The food-delivery workers of food-delivery platforms generally work long hours. Ultra-long working hours is a risk factor for occupational stress and fatigue accumulation among these workers.

Status of depressive symptoms of senile cataract patients and the influence of self-perceived burden / 四川精神卫生

BackgroundElderly cataract patients with depressive symptoms have heavier self-perceived burden， and worse vision-related quality of life compared to patients without depressive symptoms， resulting in the increase of family burden. Most previous studies showed that family relationship and vision were the main factors leading to depression in elderly cataract patients， and ignored the effects of self-feeling and complicated diseases on the psychological state of elderly cataract patients. ObjectiveTo explore the relationship between depressive symptoms， self-perceived burden and postoperative vision-related quality of life in elderly cataract patients， and to analyze the risk factors of depressive symptoms. So as to provide references for targeted psychological intervention in this population. MethodsA total of 104 elderly cataract patients admitted to Jiangsu Province Hospital （The First Affiliated Hospital with Nanjing Medical University） from July 1， 2020 to December 31， 2022 were included. General information， self-perceived burden and postoperative vision-related quality of life were investigated by self-designed questionnaire， Patients' Health Questionnaire depressive Scale-9 item （PHQ-9）， Self-Perceived Burden Scale （SPBS） and National Eye Institute Visual Function Questionnaire-25 （NEI-VFQ-25）. Pearson correlation analysis was performed to analyze the correlation among PHQ-9， SPBS and NEI-VFQ-25 scores. Logistic regression analysis was used to analyze the influencing factors of depressive symptoms in eldery cataract patients. ResultsA total of 100 elderly cataract patients completed an effective questionnaire survey. Among the participants， 31 cases （31.00%） were found to have depressive symptoms. The depressive group exhibited significantly higher SPBS score （t=11.062， P<0.01） and significantly lower NEI-VFQ-25 score （t=-5.235， P<0.01） than those of the non-depressive group. Pearson correlation analysis showed a positive correlation between PHQ-9 and SPBS score （r=0.485， P<0.01）， and a negative correlation between PHQ-9 and NEI-VFQ-25 score （r=-0.440， P<0.01）. Complicated with diabetes （OR=1.441， P<0.01）， osteoarthritis （OR=1.324， P<0.05） and high SPBS score （OR=1.340， P<0.05） were risk factors of depressive sympptoms in elderly cataract patients. ConclusionThe detection rate of depressive symptoms in elderly cataract patients is higher， and postoperative vision-related quality of life in elderly cataract patients complicated with depressive symptoms is poor. Risk factors include diabetes， osteoarthritis and high self-perceived burden. ［Funded by 2022 Jiangsu Province Elderly Health Scientific Research Project （number， LKM2022019）］

Depressive symptoms are not associated with risks of rapid renal function decline or chronic kidney disease in middle-aged and elderly with normal kidney function: a longitudinal investigation / 南方医科大学学报

OBJECTIVE@#To explore the association between depressive symptoms and the risks of rapid decline in renal function and chronic kidney disease (CKD) in middle-aged and elderly with normal kidney function.@*METHODS@#The residents aged 40- 75 years with eGFR≥60 mL·min-1·1.73 m-2 without proteinuria in Lanzhou region, who participated in the "REACTION" study carried out in 2011, were selected and followed up in 2014. A total of 4961 individuals with complete and qualified data from the two surveys were included in the subsequent analysis. Based on PHQ-9 questionnaire scores, the baseline population was divided into two groups with and without depressive symptoms. Cox proportional hazard analysis was used to compare the incidences of rapid renal function decline and CKD between the two groups and study the association of depressive symptoms with the risk of these renal conditions.@*RESULTS@#PHQ-9 questionnaire scores were not found to correlate with baseline SCr, ALB, UACR or eGFR levels among the participarts (P>0.05). After a mean follow-up time of 3.4±0.6 years, 33.9% of the participants with depressive symptoms at baseline experienced a rapid decline in renal function and 3.6% progressed to CKD. During the follow-up, the incidence of rapid decline in renal function and the risk of developing CKD were not found to correlate with depressive symptoms in these participants (P>0.05) regardless of the type of the depressive syndromes.@*CONCLUSION@#Depressive symptoms are not associated with the risks of rapid renal function decline or progression to CKD in middle-aged and elderly with normal kidney function.

Trends in prevalence of depression symptoms among middle-aged and elderly residents in China from 2011 to 2018 / 预防医学

Objective@#To investigate the trends in prevalence of depression symptoms among middle-aged and elderly residents at ages of 45 years and older in China from 2011 to 2018, so as to provide insights into depression prevention and control among middle-aged and elderly residents. @*Methods@#Demographic features and evaluation data of depressive symptoms were collected from middle-aged and elderly residents at ages of 45 years and older recorded during four follow-ups in the China Health and Retirement Longitudinal Study (CHARLS), and the depressive symptoms were screened using the Center for Epidemiological Studies Depression Scale (CES-D). Following sampling weights, non-response weights, and post-stratification weighting, the detection of depressive symptoms was analyzed among the middle-aged and elderly residents with different demographics, and the trends in prevalence of depressive symptoms were identified using annual percent change (APC). @*Results@#A total of 48 223 middle-aged and elderly residents were enrolled, including 12 624, 10 427, 12 144, and 13 028 residents in 2011, 2013, 2015 and 2018, with mean ages of (58.8±9.4), (58.9±9.2), (59.0±9.2), and (61.1±9.2) years, respectively. The prevalence of depressive symptoms was 34.5% (95%CI: 33.3%-35.8%), 29.6% (95%CI: 28.5%- 30.8%), 30.6% (95%CI: 29.4%-31.8%), and 35.0% (95%CI: 33.6%-36.4%) among middle-aged and elderly residents in 2011, 2013, 2015 and 2018, respectively, with no remarkable changing trends seen (APC=0.4%, t=0.188, P=0.868). Higher detection was seen among residents at advanced ages, among women than among men, among rural residents than among urban residents, among residents with lower educational levels, among widowed and unmarried residents than among married residents, among unemployed residents than among employees, and among residents that had lower per capita personal consumption expenditures than mean expenditures than among residents that had higher per capita personal consumption expenditures than mean expenditures (all P<0.05). @*Conclusions@#There were no obvious trends in prevalence of depressive symptoms among middle-aged and elderly residents in China from 2011 to 2018, and individuals with advanced ages, women, urban residents and those with low educational and economic levels should be given a high priority for depression control.

Joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with the cardiovascular disease in middle-aged and elderly people in China / 北京大学学报(医学版)

OBJECTIVE@#To explore joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease (CVD) in middle-aged and elderly people in China.@*METHODS@#Based on China Health and Retirement Longitudinal Study(CHARLS)database using 2011 baseline data and the follow-up cohort data of 2013, 2015 and 2018, describe the distribution characteristics of baseline depressive symptoms and 10-year risk of ischemic cardiovascular disease in 2011. Cox survival analysis model was used to analyze the individual, independent and joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with cardiovascular disease.@*RESULTS@#A total of 9 412 subjects were enrolled. The detection rate of depressive symptoms at baseline was 44.7%, and the 10-year middle and high risk of ischemic cardiovascular disease was 13.62%. During an average follow-up of 6.19 (6.19±1.66) years, 1 401 cases of cardiovascular disease were diagnosed in 58 258 person-years, revealing an overall incidence density of 24.048/1 000 person-years. After adjusting the factors, in terms of individual impact, the participants with depressive symptoms had a higher risk of developing CVD (HR=1.263, 95%CI: 1.133-1.408), while medium to high risk of ischemic cardiovascular disease had a higher risk of developing CVD (HR=1.892, 95%CI: 1.662-2.154). Among independent influences, participants with depressive symptoms had a higher risk of developing CVD (HR=1.269, 95% CI: 1.138-1.415), while medium to high risk of 10-year risk of ischemic cardiovascular disease had a higher risk of developing CVD (HR=1.898, 95%CI: 1.668-2.160). Joint impact result showed the incidence of cardiovascular disease in the low risk of 10-year risk of ischemic cardiovascular disease with depressive symptoms group, middle and high risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms group, and 10-year middle and high risk of ischemic cardiovascular disease with depressive symptoms group were 1.390, 2.149, and 2.339 times higher than that of low risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms (P < 0.001).@*CONCLUSION@#The superimposed depression symptoms of the middle and high-risk population at the 10-year risk of ischemic cardiovascular disease will aggravate the risk of cardiovascular disease in middle-aged and elderly people. In combination with the actual lifestyle intervention and physical index health management, attention should be paid to mental health intervention.

Urban-rural differentials in the relationship between personality traits and changes in depressive symptoms / 北京大学学报(医学版)

OBJECTIVE@#The prevalence of depressive symptoms has become a significant public health issue in China. Research on the relationship between personality traits and changes in depressive symptoms, as well as further exploration of urban-rural differences, not only benefits for the understanding of the prevalence trend of depression in China, but also provides a useful reference for the government to develop personalized mental health prevention strategies.@*METHODS@#Based on the data from the China Family Panel Studies in 2018 and 2020, a univariate analysis was conducted on 16 198 Chinese residents aged 18 years and above. Five dimensions of personality traits were conscientiousness, extraversion, agreeableness, neuroticism and openness. In the study, 16 198 residents were divided into "keep good group", "better group", "worse group" and "keep bad group" according to the changes in depressive symptoms in 2018 and 2020. After controlling for factors, such as gender and education, multinomial Logistic regression analysis was used to examine whether personality traits were associated with changes in depressive symptoms. In addition, we evaluated whether urban-rural and personality traits interacted to influence depressive symptoms.@*RESULTS@#The five dimensions of personality traits were significantly correlated with changes in depressive symptoms. Conscientiousness, extroversion, and agreeableness were negatively associated with depressive symptoms, while neuroticism and openness were positively related. Urban and rural differences moderated the relationship between personality traits and depressive symptoms. Compared with urban residents, rural residents showed stronger correlations between neuroticism (OR=1.14; 95%CI: 1.00-1.30) and the group of depression-recovery, as well as conscientiousness (OR=0.79;95%CI: 0.68-0.93) and the group of persistent-depression.@*CONCLUSION@#The study finds that personality traits have a significant correlation with changes in depressive symptoms, with certain traits showing a negative or positive relationship. Specifically, higher levels of conscientiousness, extraversion, and agreeableness are associated with lower levels of depressive symptoms, while higher levels of neuroticism and openness are associated with higher levels of depressive symptoms. In addition, the study finds that rural residents have a stronger association between their personality traits and persistent or improved depressive symptoms, which highlights the need for tailoring mental health intervention and prevention programs that should take into account personality traits and urban-rural differences in China. By developing targeted strategies that are sensitive to personality differences and geographic disparities, policymakers and mental health professionals can help prevent and reduce the incidence of depressive symptoms, ultimately improving the overall well-being of Chinese adults. Meanwhile, additional studies in independent populations are needed to corroborate the findings of this study.

Effect of the enhanced external counterpulsation combined with drug on social function and efficacy in patients with depressive episodes / 四川精神卫生

ObjectiveTo observe the effect of the enhanced external counterpulsation （EECP） combined with drug on social function and efficacy in patients with depressive episodes， so as to provide references for the treatment of depressive episodes. MethodsA total of 66 hospitalized patients who was in hospital at department of psychiatry of the Second Xiangya Hospital of Central South University， met the criteria of Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5） diagnosis of depressive episode or bipolar disorder depressive episode from May 2019 to March 2020 were included by simple random sampling. The participants were divided into study group （n=36） and control group （n=30） according to the random number table method. Both groups received conventional drug treatment， and the study group recieved the EECP intervention at same time. The Depression symptoms and social function were assessed before and after treatment by using Hamilton Depression Scale-24 item （HAMD-24） and Sheehan Disability Scale （SDS）. Treatment efficacy of the two groups was compared. ResultsAfter the intervention， the HAMD-24 and SDS scores in both groups were lower than those before treatment， the differences were statistically significant （t=8.149， 5.791， 8.016， 3.488， P˂0.01）. And the SDS score of the study group was siginficantly lower than that of the control group （t=-3.008， P<0.05）. The total effective rate of treatment in the study group was higher than that of the control group， and the difference was statistically significant （90.63% vs. 63.33%， χ²=8.725， P˂0.05）. ConclusionEECP therapy combined with drug has better efficacy on the patients with depressive episodes， and it can improve social function effectively.

Frailty is associated with sociodemographic and health factors and related to the care context of older caregivers: a Brazilian cross-sectional study

Abstract BACKGROUND: The task of caring can arise suddenly without guidance or support, resulting in psychological tension and health impairment, which can culminate in the development of frailty. OBJECTIVE: To analyze the relationship between frailty and sociodemographic and health aspects related to the care context of older caregivers. DESIGN AND SETTING: A cross-sectional study was conducted on 65 older caregivers registered in family health units in the interior of the state of São Paulo. METHODS: The participants were interviewed individually using the following instruments: a characterization questionnaire, Fried's frailty phenotype, Zarit Burden's Interview, Mini-Mental State Examination, Geriatric Depression Scale, Katz Index, and Lawton Scale. In addition, the following statistical tests were applied: Pearson's chi-squared test, Fisher's exact test, and Mann-Whitney test. A significance level of 5% was considered to be statistically significant. RESULTS: Women who took care of their spouses predominated without prior training or the help of other people. Most of the patients were pre-frail (72.3%). Frailty was significantly related to marital status (P = 0.016), depressive symptoms (P = 0.029), cognitive decline (P = 0.029), the degree of kinship (P = 0.015), and burden (P = 0.004). CONCLUSION: Older caregivers without a partner, with severe depressive symptoms and cognitive changes, who cared for their parents, and had higher levels of burden, presented a higher proportion of frailty.