Browsing by Subject "depression"
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Item A Comparative Analysis of Recruitment Methods used in Randomized Controlled Clinical Drug Trials(2019-05) Garud, Ashwini A.; Mathew, Stephen O.; Goulopoulou, Styliani; Anderson, Jessica; Maynard, BrianClinical trials are a crucial part of any drug development process. The reliability and validity of clinical trials depend on the successful recruitment of subjects. The overall goal of this project was to evaluate the effectiveness of subject recruitment methods used in Randomized Controlled Trials (RCTs) focusing on Major Depressive Disorder (MDD) and Postpartum Depression (PPD) studies. Recruitment methods (on-site and off-site) utilized in these trials were examined for their cost-effectiveness, recruitment return, including the number of subjects enrolled and the number of subjects randomized in the trial and subject demographics. Regarding cost effectiveness, on-site methods were found to be more effective in terms of recruitment return and less costly than off-site for both studies. There was a significant difference in race and gender when subjects were recruited from on-site versus off-site recruitment. For MDD study, a comparatively large number of enrolled and randomized participants were recruited from on-site recruitment methods as compared to off-site, this may be due to the number of physician referrals, indicating that physicians play a major role in subject recruitment. For the Postpartum Depression study, the number of enrolled and randomized subjects from off-site recruitment method was higher than those of on-site methods. Monitoring recruitment strategies implemented in the study and assessing their effectiveness would be helpful in employing strategies for future trials.Item A Novel Prodrug Approach for Central Nervous System-Selective Estrogen Therapy(MDPI, 2019-11-19) Prokai-Tatrai, Katalin; Prokai, LaszloBeneficial effects of estrogens in the central nervous system (CNS) results from the synergistic combination of their well-orchestrated genomic and non-genomic actions, making them potential broad-spectrum neurotherapeutic agents. However, owing to unwanted peripheral hormonal burdens by any currently known non-invasive drug administrations, the development of estrogens as safe pharmacotherapeutic modalities cannot be realized until they are confined specifically and selectively to the site of action. We have developed small-molecule bioprecursor prodrugs carrying the para-quinol scaffold on the steroidal A-ring that are preferentially metabolized in the CNS to the corresponding estrogens. Here, we give an overview of our discovery of these prodrugs. Selected examples are shown to illustrate that, independently of the route of administrations and duration of treatments, these agents produce high concentration of estrogens only in the CNS without peripheral hormonal liability. 10beta,17beta-Dihydroxyestra-1,4-dien-3-one (DHED) has been the best-studied representative of this novel type of prodrugs for brain and retina health. Specific applications in preclinical animal models of centrally-regulated and estrogen-responsive human diseases, including neurodegeneration, menopausal symptoms, cognitive decline and depression, are discussed to demonstrate the translational potential of our prodrug approach for CNS-selective and gender-independent estrogen therapy with inherent therapeutic safety.Item Acceleration of Anxiety, Depression, and Suicide: Secondary Effects of Economic Disruption Related to COVID-19(Frontiers Media S.A., 2020-12-15) Brenner, M. Harvey; Bhugra, DineshThe SARS-CoV-2 (COVID-19) pandemic has contributed to increasing levels of anxiety, depression and other symptoms of stress around the globe. Reasons for this increase are understandable in the context of individual level factors such as self-isolation, lockdown, grief, survivor guilt, and other factors but also broader social and economic factors such as unemployment, insecure employment and resulting poverty, especially as the impacts of 2008 recession are still being felt in many countries further accompanied by social isolation. For those who are actively employed a fear of job and income loss and those who have actually become ill and recovered or those who have lost family and friends to illness, it is not surprising that they are stressed and feeling the psychological impact. Furthermore, multiple uncertainties contribute to this sense of anxiety. These fears and losses are major immediate stresses and undoubtedly can have long-term implications on mental health. Economic uncertainty combined with a sense of feeling trapped and resulting lack of control can contribute to helplessness and hopelessness where people may see suicide as a way out. Taking a macro view, we present a statistical model of the impact of unemployment, and national income declines, on suicide, separately for males and females over the life cycle in developed countries. This impact may reflect a potent combination of social changes and economic factors resulting in anomie. The governments and policymakers have a moral and ethical obligation to ensure the physical health and well-being of their populations. While setting in place preventive measures to avoid infections and then subsequent mortality, the focus on economic and social recovery is crucial. A global pandemic requires a global response with a clear inter-linked strategy for health as well as economic solutions. The models we have constructed represent predictions of suicide rates among the 38 highly industrialized OECD countries over a period of 18 years (2000-2017). Unemployment has a major effect on increasing suicide, especially in middle-aged groups. However, the impact of economic decline through losses of national income (GDP per capita) are substantially greater than those of unemployment and influence suicide throughout the life course, especially at the oldest ages.Item COMORBID DIABETES AND DEPRESSION AND INCREASED RISK FOR COGNITIVE IMPAIRMENT IN MEXICAN AMERICANS(2014-03) Dickensheets, Tony; Johnson, Leigh; Hall, James; Obryant, SidBackground: By 2050, the percent of Hispanics in America age 65 and above will nearly triple compared to other ethnic groups. During this timeframe, the numbers of Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI, a prodromal stage to AD) cases among Hispanic elders is expected to grow exponentially. Given that 65% of the U.S. Hispanic population is Mexican American (MA), this ethnic group represent the fastest growing segment of the aging population, which will be disproportionately impacted by MCI and /AD in the near future. Recent work from our group suggest that depression is a significant risk factor for MCI and AD among Mexican Americans while many other “established” risk factors among non-Hispanic whites (i.e. education, gender, hypertension, diabetes, ApoEε4 genotype) are not. Another important risk factor among this population is diabetes (DM). Depression and DM have been shown to be pathologically linked several times in the past, however little research has examined the affect that comorbidity of depression and DM has on cognitive impairment in an ethnically diverse sample Purpose (a): To determine whether there is a connection between depression, diabetes and Alzheimer's disease in the Mexican American population. Methods (b): Methods: This study used data from three separate cohorts: HABLE, TARCC, and Project FRONTIER. In HABLE data was collected from 208 MA (AGE= 62years; EDU=7years); TARCC had 2080 Non- Hispanic white (AGE=75; EDU=15years) and 543 MA (AGE=70; EDU=11); Project FRONTIER had 330 non-Hispanic white (AGE=65; EDU=13) and 233 MA (AGE=55; EDU=7years). Logistic regression analyses were conducted to examine comorbid diagnosis of depression and diabetes on Alzheimer’s disease diagnosis or a diagnosis of Mild Cognitive Impairment. Covariates entered into the model were age, education, and gender. Results (c): Results: Comorbid diagnosis of diabetes and depression was significantly related to diagnosis of Mild Cognitive Impairment in Mexican Americans across all three cohorts: TARCC (odds ratio [OR]= 8.6, 95% CI=1.5 to 2.7); HABLE (odds ratio [OR]= 2.4, 95% CI= 1.3-3.2), and FRONTIER (odds ratio [OR]= 2.6, 95% CI=1.2 to 6.4). TARCC was the only cohort with a large enough sample of AD patients to run the analyses split by ethnicity. In TARCC, comorbidity was related to AD diagnosis in MA (odds ratio [OR]= 10.4, 95%=1.2-2.7), and narrowly related in Non-Hispanic Whites (odds ratio [OR]= 8.3, 95%=.14 to 1.4). Conclusions (d): Discussion: Comorbid diagnosis of depression and diabetes increases risk for diagnosis of cognitive impairment, and Mexican Americans were found to be at greater risk than non- Hispanic whites for Mild Cognitive Impairment. These findings were validated across multiple cohorts, and could have significant clinical implications.Item Establishing the Effects of Exercise Schema and Self-Schema on Emotional Distress(2003-08-01) Rodriguez, Leslie R.; Claudia Coggin; Joseph Doster; Daisha CipherRodriguez, Leslie R., BSN, RN, Establishing the Effects of Exercise Schema and Self-Schema on Emotional Distress. Masters of Public Health (Health Behavior), August 2003, 78 pp., 4 tables, references, 81 titles. Chronic diseases’ resulting from anger and depression represents a significant problem. Vast amounts of resources and dollars are expended and utilized. Their link to the development of cardiovascular disease, hypertension, and diabetes is recognized. Physical activity produces improvements in self-esteem, increased alertness, and decreased anxiety. The purpose of this study was determining the effect exercise and exercise schema has on mood states. College age students (N=198) of a large North Texas University were recruited. Data collection included States of change, the Exerciser self-schema questionnaire, Clinical Analysis Questionnaire, and the State Trait Anger Expression Inventory. Significance in some mood states of those who were exercising and exercise schematic were found.Item Estrogen administration attenuates post-stroke depression by enhancing CREB/BDNF/TrkB signaling in the rat hippocampus(Spandidos Publications, 2021-02-26) Jiang, Huigang; Xiao, Li; Jin, Kunlin; Shao, BeiA previous study demonstrated that 17beta-estradiol (E2), which is an antidepressant, can ameliorate post-stroke depression (PSD); however, the underlying mechanisms governing this remain largely unknown. Therefore, the present study developed a PSD model in rats, which was induced by left middle cerebral artery occlusion followed by exposure to chronic mild stress for 2 weeks. The results revealed that the activity of the cAMP response element-binding protein (CREB), a cellular transcription factor, and the associated brain-derived neurotrophic factor (BDNF)/tyrosine kinase B (TrkB) signaling were all attenuated in the hippocampus in PSD rats. The depression-like behaviors were significantly improved after treatment with E2, along with increased CREB and the BDNF/TrkB signaling activity. These results provide novel insight into the molecular basis of PSD, and suggest the potential involvement of CREB/BDNF/TrkB signaling in E2-mediated improvement of PSD in rats.Item Factors associated with COVID-19-related mental health among Asian Indians in the United States(Elsevier B.V., 2023-01-11) Ikram, Mohammad; Shaikh, Nazneen F.; Siddiqui, Zasim A.; Dwibedi, Nilanjana; Misra, Ranjita; Vishwanatha, Jamboor K.; Sambamoorthi, UshaBACKGROUND: In the United States, the COVID-19 pandemic has caused increased mental health symptoms and mental illness. Specific subgroups such as Asian Indians in the US have also been subject to additional stressors due to unprecedented loss of lives in their home country and increased Asian hate due to the misperception that Asians are to be blamed for the spread of the SARS-CoV-2. OBJECTIVE: We examined the various factors including discrimination associated with COVID-19-related mental health symptoms among Asian Indians. METHODS: We administered an online survey between May 2021 and July 2021 using convenient and snowball sampling methods to recruit Asian Indian adults (age > 18 years, N = 289). The survey included questions on mental health and the experience with unfair treatment in day-to-day life. Descriptive analysis and logistic regressions were performed. RESULTS: Overall, 46.0% reported feeling down, depressed, or lonely and feeling nervous, tense, or worried due to the COVID-19 pandemic; 90.0% had received at least one dose of vaccination and 74.7% reported some form of discrimination. In the fully-adjusted logistic regression, age (AOR = 0.95; 95%CI- 0.92, 0.97;p < 0.01) and general health (AOR=0.84; 95%CI- 0.73, 0.97; p < 0.015) were negatively associated with mental health symptoms. Participants who experienced discrimination were more likely (AOR=1.26; 95%CI- 1.08, 1.46; p < 0.01) to report mental health symptoms. CONCLUSION: In this highly vaccinated group of Asian Indians discriminatory behaviors were associated with mental health symptoms suggesting the need for novel institutional level policy responses to reduce anti-Asian racism.Item Nutrition, Dementia and Depression in an Ambulatory Geriatric Care Center(2005-05-01) Birmingham, John F.; Daisha Cipher; Douglas A. Mains; Thomas J. FairchildBirmingham, John F., Nutritional Risk, Dementia Factors and Depression in an Ambulatory Geriatric Care Center. Master’s of Public Health (Clinical Research), May 2005, 60pp., 7 tables, 2 figures, reference list, 56 titles. Dementia is a major public health problem in the aging population. Depression, nutritional risk and declining self-efficacy are broadly listed risk factors for dementia. Cross-sectional patient data was obtained by chart review of ambulatory community-dwelling elderly patients screened for depression, dementia factors, levels of independence in activities associated with daily living and nutritional risk. The statistical coefficients of the correlational relationships between nutritional risks, dementia factors, depression levels and levels of functional capacity were examined using path analysis. Two models depicted the composite of instrumental activities of daily living items (IADLs), as they related to the dependent variables models, nutritional risk, dementia factors, and depression levels. The model which regressed the IADLs composite variable against depression and dementia factors indicated a good fit (X2=0.00, p=0.01). Attempts to match screening data with diagnostic follow-up data were unsuccessful. Only 12 matches occurred between the GAP and CARE databases (N=256, N=1470).Item Prescription Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Incidence of Depression Among Older Cancer Survivors With Osteoarthritis: A Machine Learning Analysis(Sage Publications, 2023-04-27) Shaikh, Nazneen F.; Shen, Chan; LeMasters, Traci; Dwibedi, Nilanjana; Ladani, Amit; Sambamoorthi, UshaOBJECTIVES: This study examined prescription NSAIDs as one of the leading predictors of incident depression and assessed the direction of the association among older cancer survivors with osteoarthritis. METHODS: This study used a retrospective cohort (N = 14, 992) of older adults with incident cancer (breast, prostate, colorectal cancers, or non-Hodgkin's lymphoma) and osteoarthritis. We used the longitudinal data from the linked Surveillance, Epidemiology, and End Results -Medicare data for the study period from 2006 through 2016, with a 12-month baseline and 12-month follow-up period. Cumulative NSAIDs days was assessed during the baseline period and incident depression was assessed during the follow-up period. An eXtreme Gradient Boosting (XGBoost) model was built with 10-fold repeated stratified cross-validation and hyperparameter tuning using the training dataset. The final model selected from the training data demonstrated high performance (Accuracy: 0.82, Recall: 0.75, Precision: 0.75) when applied to the test data. SHapley Additive exPlanations (SHAP) was used to interpret the output from the XGBoost model. RESULTS: Over 50% of the study cohort had at least one prescption of NSAIDs. Nearly 13% of the cohort were diagnosed with incident depression, with the rates ranging between 7.4% for prostate cancer and 17.0% for colorectal cancer. The highest incident depression rate of 25% was observed at 90 and 120 cumulative NSAIDs days thresholds. Cumulative NSAIDs days was the sixth leading predictor of incident depression among older adults with OA and cancer. Age, education, care fragmentation, polypharmacy, and zip code level poverty were the top 5 predictors of incident depression. CONCLUSION: Overall, 1 in 8 older adults with cancer and OA were diagnosed with incident depression. Cumulative NSAIDs days was the sixth leading predictor with an overall positive association with incident depression. However, the association was complex and varied by the cumulative NSAIDs days.Item The association of COVID-19 vaccine availability with mental health among adults in the United States(Frontiers Media S.A., 2022-08-09) Shen, Chen; Rashiwala, Lucy; Wiener, R. Constance; Findley, Patricia A.; Wang, Hao; Sambamoorthi, UshaObjective: To assess whether COVID-19 vaccine approval and availability was associated with reduction in the prevalence of depression and anxiety among adults in the United States. Methods: We adopted cross sectional and quasi-experimental design with mental health measurements before vaccine availability (June 2020, N = 68,009) and after vaccine availability (March 2021, N = 63,932) using data from Census Pulse Survey. Depression and anxiety were derived from PHQ-2 and GAD-2 questionnaires. We compared rates of depression and anxiety between June 2020 and March 2021. Unadjusted and adjusted analysis with replicate weights were conducted. Results: Depression prevalence was 25.0% in June 2020 and 24.6% in March 2021; anxiety prevalence was 31.7% in June 2020 and 30.0% in March 2021 in the sample. In adjusted analysis, there were no significant differences in likelihood of depression and anxiety between June 2020 and March 2021. Conclusion: Depression and anxiety were not significantly different between June 2020 and March 2021, which suggests that the pandemic effect continues to persist even with widespread availability of vaccines.Item THE ROLE OF LIFETIME TRAUMA IN EXECUTIVE FUNCTIONING IN PATIENTS WITH A DIAGNOSED DEPRESSIVE DISORDER(2013-04-12) Gandhy, ShreyaPurpose: Exposure to trauma has been associated with depression, hostility, self-harm and other problems of daily life. Trauma is defined based on previous studies which suggest that events of direct or indirect exposure to interpersonal violence and other traumatic experiences may place individuals at risk for several dysfunctional psychological orientations. The aim of this study was to explore the relationship between lifetime trauma and behavioral and psychological factors such as symptoms of depression and problems with aggression. Methods: We used an exploratory approach in a cross-sectional, correlation study designed to assess the potential relationship of life trauma with symptoms of depression and indicators of aggression. The subjects for this study were 14 women between the ages of 25-40 recruited from JPS Psychiatry Clinic System. Outcome measures included the Social and Health History Questionnaire (SHHQ Part 1), the Patient Health Questionnaire (PHQ-9), and the Buss-Perry Aggression Questionnaire. Results: This project was designed to describe a small group of psychiatric outpatients diagnosed with Major Depressive Disorder (MDD) with respect to the impact of lifetime trauma on their psychosocial behavior We hypothesized there was a relationship between trauma, depression and aggression. In this study sample however, there was no linear relationship between an individual's history of trauma and their recent self-reported aggression or depression ratings. Conclusions: The clinical significance of our findings indicates that trauma exposure may or may not be associated with co-occurring depression and hostility. Thus, physicians should evaluate all of these dimensions of the whole person in order to determine the next steps in treatment.Item The SPADE symptom cluster and physical disability in chronic low back pain patients(2019-12) Hendrix, Zachary N.; Cross, Deanna S.; Licciardone, John C.; Kearns, Cathleen; Mathew, Stephen O.Introduction: Chronic pain is a major healthcare issue. It is debilitating and often occurs simultaneously with other health issues (Murray et al., 2013; Shmagel et al., 2016). The SPADE symptom cluster (sleep disturbance, pain interference, anxiety, depression, and low energy/fatigue) is common in chronic low back pain (cLBP) patients and may interact with their disability (Alamam et al., 2019; Davis et al., 2016; Tavares et al., 2019). Methods: This cross-sectional study utilized data from the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION). The PROMIS-29 v2.0 was used to assess SPADE symptoms, and the Roland-Morris Disability Questionnaire was used to measure disability. The Spearman-Rho correlation between each SPADE symptom and disability was calculated. The correlations were then tested for significant differences and ranked in order of strongest to weakest correlation. Lastly, groups were assigned based on the number of presenting symptoms and tested for between-groups differences in mean disability. Results: Each of the five SPADE symptoms and the composite SPADE score were all positively and significantly correlated with disability. Pain Interference was most strongly correlated with disability. SPADE comorbidity was related to disability. Conclusion: SPADE symptoms greatly increase disability in chronic low back pain patients.