围绝经期女性抑郁症状及其影响因素的探讨

目的调查广州市社区围绝经期女性抑郁症状发生情况,并探讨其影响因素,为制定针对性的社区干预策略和措施提供依据。方法采用随机与整群抽样相结合的方法,以广州某城区和市郊两社区为流调现场,抽取40～55岁721例围绝经期女性为研究对象,其中市区368人,郊区各353人,采用自评抑郁量表（SDS）、生活事件量表（LES）、社会支持评定量表（SSRS）、应对方式问卷（CSQ）和一般社会人口学调查表（SDQ）进行调查和评价,运用多元逐步回归分析的方法,探讨影响其抑郁水平的保护因素和危险因素。结果抑郁症状发生率为8．04％,46～50岁组发生率（12．35％）显著高于40～45岁组（6．22％）和51～55岁组（5．49％,χ2=9．2552,P〈0．01）;城市社区抑郁症状发生率（10．33％）显著高于郊区社区（5．67％,χ2=5．2902,P〈0．05）;负性事件刺激量和自责是抑郁症状发生的危险因素,对支持利用度则是其保护因素;生活事件、社会支持和应对方式均与自评抑郁量表评分存在正性或负性显著性相关,各因子间也存在一些显著性相关。结论围绝经期抑郁的发生受多因素影响,应采取多层次和有针对性的干预措施。     

Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities

The aim of this was to examine rates and determinants of depressive symptomatology in the immediate postpartum period among Hispanic women in the United States. A total of 3952 Hispanic women who had delivered infants (parturients) were interviewed in postpartum wards in Miami, New York City and San Francisco. Symptoms of depression were regressed onto a series of social, psychological, and socioeconomic variables. Results showed that 42.6% of participants were probable cases of depression (CES-D > or = 16). Depression was negatively associated with perceived level of social support (adjusted OR = 0.59, 95% CI: 0.53-0.67) and health insurance coverage (adjusted OR = 0.68, 95% CI: 0.49-0.95), but not with the degree of acculturation or immigration status. It was found that depressive symptoms are common among Hispanic parturients. Pregnant Hispanic women should be carefully monitored for signs of depression and appropriate preventive measures are needed.     

Two-three-year stability and interrelations of bulimotypic indicators and depressive and anxious symptoms in middle-aged women

OBJECTIVE: There is a paucity of research examining eating disorder symptoms among middle-aged women. METHOD: This prospective study assessed the stability of bulimic symptoms and 5 associated variables (perfectionism, depressive symptoms, self-esteem, anxiety symptoms, and perceived weight status) in a sample of 150 middle-aged women (mean age = 45.19 years) over a 2.5-year time period. In addition, interrelations among bulimic, anxiety, and depressive symptoms were assessed. RESULTS: Results suggested that all 6 bulimia-related variables remained significantly stable over 2.5 years. In addition, notable relations between Time 1 and Time 2 variables emerged (e.g., anxious symptoms at Time 1 predicted bulimic symptoms at Time 2). CONCLUSION: Thus, the results indicate that bulimic symptoms exist in middle-aged women, and that they remain relatively stable over a 2.5-year time period. Clinical implications for middle-aged women with eating disorder symptoms are discussed.     

Depressive symptoms in farm women: effects of health status and farming lifestyle characteristics,behaviors, and beliefs

A multitude of responsibilities, environmental and social influences, and stressors place farm women at high risk for depressive symptoms. This cross sectional survey design study examines demographic, health status, and farm lifestyle characteristics, behaviors and beliefs as risk factors contributing to depressive symptoms among farm women in southeast Louisiana. The study was conducted in a stratified, random sample of 657 women 18 years and older. Factors predictive of depressive symptoms in adjusted logistic regression included those who experience poor health, perceive hazards associated with farming, experience recent farm-related injuries and engage in farming over longer periods of time. These findings help target interventions toward women at risk for depressive symptoms.     

Locus of control and HIV risk among a sample of Mexican and Puerto Rican women

The disproportionate impact of HIV/AIDS on Hispanic women in the United States has been variously attributed to a failure to utilize protective measures due to low levels of HIV knowledge, a denial or minimization of risk, and conflicts with cultural norms. It has been hypothesized that women's relative lack of power in relationships may be associated with higher risk sexual behavior. We examined the relationship between higher risk sexual behavior and perceived locus of control in sexual relationships among a sample of Puerto Rican and Mexican women. We interviewed 71 women of self-reported Mexican ethnicity in San Diego, California, and 79 women of self-reported Puerto Rican ethnicity in Cleveland, Ohio, to examine the relationship between HIV risk, HIV knowledge, and locus of control. Univariate logistic regression indicates that among Puerto Rican women, the perception that locus of control in a sexual relationship resides in the male partner was significantly associated with increased HIV risk, while younger age was significantly associated with increased risk among Mexican women only. In a combined sample of both Puerto Rican and Mexican women, multiple logistic regression analysis indicates that younger age, increased length of residence in the United States, and an other-focused locus of control are significantly associated with increased HIV risk. Women who have been in the United States for relatively longer periods of time may be more likely to integrate U.S. sexual norms into their own behavior and may, as a consequence, be at higher risk of HIV infection. Increased HIV prevention efforts must be made available to Mexican and Puerto Rican women born outside of the United States. These prevention efforts must necessarily focus not only on HIV prevention strategies, but also on the dynamics within male-female intimate relations. Increased attention to younger Puerto Rican and Mexican women is also needed.     

Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors

Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships of adverse childhood experiences (ACE), perceived health status, resilience, and social support with depressive symptoms in Northern Plains AI women cancer survivors. We used a cross-sectional design with purposive sampling of 73 female cancer survivors (aged 18 years or older) between June 2014 and February 2015. Hierarchical multiple regression was used to test three sets of variables in relation to depressive symptoms: (1) sociodemographics, (2) risk factors (ACE and perceived health), and (3) protective factors (psychological resilience and social support). Approximately 47 percent of participants had probable depressive symptoms. Depressive symptoms were inversely associated with perceived health, psychological resilience, and social support. These results support bolstering existing social support among AI cancer patients and survivors as well as prevention and intervention efforts that strengthen resilience.     

Bulimic symptoms, cognitions, and body dissatisfaction in women with major depressive disorder

OBJECTIVE: The goals of this study were to assess eating disorder symptoms in depressed women with no history of eating disturbance and to evaluate the clinical significance of these symptoms relative to those reported by women with bulimia spectrum disorder. METHOD: Participants were 63 women with major depressive disorder (MDD) (n = 19), bulimia spectrum disorder (n = 20), or no history of MDD or eating disorder (n = 24). Measures included diagnostic interviews and self-report questionnaires designed to assess diagnostic criteria for bulimia nervosa, subthreshold eating disorder symptoms, dysfunctional attitudes about appearance, and body dissatisfaction. RESULTS: There were no significant differences between depressed and bulimic women on shape concerns, appearance overvaluation, or body dissatisfaction. Depressed women endorsed significantly more subthreshold eating disorder symptoms, dysfunctional attitudes about appearance, and body dissatisfaction than did control subjects. DISCUSSION: Eating disorder symptoms may be associated with depression in women in the absence of comorbid eating disorder diagnoses.     

孕晚期静坐行为与抑郁和妊娠相关焦虑的关系

目的 探究北京地区孕晚期妇女总静坐行为和不同类型静坐行为与抑郁和妊娠相关焦虑的关系.方法 以中国孕产妇队列研究(CPWCS)·协和项目中的576例孕晚期妇女为研究对象.CPWCS项目自2018年5月起,在北京市通州区妇幼保健院采用方便抽样的方法纳入年龄≥16岁,孕5～12周的孕早期妇女,并进行基线调查.于研究对象孕晚期...     

HIV knowledge among a sample of Puerto Rican and Mexican men and women

This study assessed levels of HIV knowledge and identified factors associated with HIV knowledge among a sample of heterosexual Puerto Rican and Mexican men and women, ages 18 to 45. The sample consisted of 144 men and women living in San Diego County, California, who self-identified as being of Mexican ethnicity and 209 men and women living in Cuyahoga County, Ohio, who self-identified as Puerto Rican. Interviews were conducted by trained, bilingual interviewers. Data were collected on demographic variables, attitudes towards decision-making in relationships, and HIV knowledge and risk behaviors. Puerto Rican individuals were significantly more likely than Mexican individuals to respond correctly to almost one-half of the 12 HIV knowledge items. Multiple logistic regression analysis indicated that higher levels of education, greater U.S. acculturation, legal status and birth in the United States, a self-focused locus of control in relationships, and being male were predictors of higher knowledge.     

Perceived discrimination and depressive symptoms among US Latinos: the modifying role of educational attainment

Objective: Despite growing evidence that discrimination may contribute to poor mental health, few studies have assessed this association among US Latinos. Furthermore, the interaction between discrimination and educational attainment in shaping Latino mental health is virtually unexplored. This study aims to examine the association between perceived discrimination and depressive symptoms and the modifying role of education among a population of Mexican-origin adults.

Design: We utilized population-based data from 629 Mexican-origin adults (mean age?=?52.8 years) participating the Niños Lifestyle and Diabetes Study (2013–2014). Perceived discrimination was defined as responding ‘sometimes’ or ‘often’ to at least one item on the 9-item Everyday Discrimination Scale. High depressive symptoms were defined as scoring ≥10 on the CESD-10. We used log-binomial and linear-binomial models to estimate prevalence ratios (PR) and prevalence differences (PD), respectively, of high depressive symptoms for levels of perceived discrimination. Final models were adjusted for age, sex, education, cultural orientation, and nativity. General estimating equations were employed to account for within-family clustering.

Results: Prevalence of perceived discrimination and high depressive symptoms were 49.5% and 29.2%, respectively. Participants experiencing discrimination had higher depressive symptom prevalence than those never or rarely experiencing discrimination [PR?=?1.94, 95% confidence interval (CI): 1.46–2.58; PD?=?0.19, 95% CI: 0.12–0.27]. The strength of this association varied by education level. The association between discrimination and depressive symptoms was stronger among those with >12 years of education (PR?=?2.69; PD?=?0.24) compared to those with ≤12 years of education (PR?=?1.36; PD?=?0.09).

Conclusion: US Latinos suffer a high burden of depressive symptoms, and discrimination may be an important driver of this burden. Our results suggest that effortful coping strategies, such as achieving high education despite high perceived discrimination, may magnify discrimination’s adverse effect on Latino mental health.     

HIV prevention risks for Black women in Canada

The future availability of HIV vaccines can increase options available to Canadian Black women for risk reduction. However, current conceptual frameworks do not adequately address barriers to HIV prevention for this population, and may be inadequate to address challenges with vaccines. This study explored knowledge and attitudes regarding HIV vaccines and associated prevention methods to inform appropriate conceptual frameworks for their dissemination to Canadian Black women. We completed four 90-min focus groups with women (n=26) of African or Caribbean origins, and six interviews with key informants providing health and social services in the Black communities of Toronto. The participants suggested that there were significant risks associated with seeking prevention information and attempting to reduce exposure to HIV infection. They described individual, familial, community and institutional domains of risk and predicted the same spectrum of risk for HIV vaccines. Participants advocated for education, empowerment and institutional change to create a supportive environment for vaccines and other HIV prevention methods. They further indicated that preparation for vaccine dissemination will need to prioritize building trust between women of the Black communities and institutions in the research, health and government sectors.     

首次住院伴抑郁症状的精神分裂症临床研究

[目的]了解首次住院伴抑郁症状的精神分裂症患者的临床特征。[方法]对94例伴抑郁症状的精神分裂症患者与94例不伴抑郁症状的精神分裂症状患者进行临床对照研究。[结果]伴抑郁症状的精神分裂症患者占首次住院精神分裂症患者的30．13％。抑郁症状以焦虑、疑虑、绝望、兴趣下降多见,自杀行为也较突出,精神症状以幻觉、被害、关系、被洞悉、罪恶、疑病为主,治疗上是否使用抗抑郁剂对疗效关系不大。[结论]抑郁症状是精神分裂症的组成部分,随着精神症状的好转,抑郁症状也有所改善,对首次住院伴抑郁症状的精神分裂症患者需防自杀。     

Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: a systematic review and meta-analysis

To date, few systematic reviews of observational studies have been conducted to comprehensively evaluate the co-morbidity of intimate partner violence (IPV) and specific depression outcomes in women. In this systematic review and meta-analysis, we summarize the extant literature and estimate the magnitude of the association between IPV and key depressive outcomes (elevated depressive symptoms, diagnosed major depressive disorder and postpartum depression). PubMed (January 1, 1980-December 31, 2010) searches of English-language observational studies were conducted. Most of the selected 37 studies had cross-sectional population-based designs, focused on elevated depressive symptoms and were conducted in the United States. Most studies suggested moderate or strong positive associations between IPV and depression. Our meta-analysis suggested two to three-fold increased risk of major depressive disorder and 1.5-2-fold increased risk of elevated depressive symptoms and postpartum depression among women exposed to intimate partner violence relative to non-exposed women. A sizable proportion (9%-28%) of major depressive disorder, elevated depressive symptoms, and postpartum depression can be attributed to lifetime exposure to IPV. In an effort to reduce the burden of depression, continued research is recommended for evaluating IPV preventive strategies.     

Spiritual Well-Being,Depressive Symptoms,and Immune Status Among Women Living with HIV/AIDS

Spirituality is a resource some HIV-positive women use to cope with HIV, and it also may have positive impact on physical health. This cross-sectional study examined associations of spiritual well-being, with depressive symptoms, and CD4 cell count and percentages among a non-random sample of 129 predominantly African-American HIV-positive women. Significant inverse associations were observed between depressive symptoms and spiritual well-being (r = ?.55, p = .0001), and its components, existential well-being (r = ?.62, p = .0001) and religious well-being (r = ?.36, p = .0001). Significant positive associations were observed between existential well-being and CD4 cell count (r = .19, p < .05) and also between spiritual well-being (r = .24, p < .05), religious well-being (r = .21, p < .05), and existential well-being (r = .22, p < .05) and CD4 cell percentages. In this sample of HIV-positive women, spiritual well-being, existential well-being, and religious well-being accounted for a significant amount of variance in depressive symptoms and CD4 cell percentages, above and beyond that explained by demographic variables, HIV medication adherence, and HIV viral load (log). Depressive symptoms were not significantly associated with CD4 cell counts or percentages. A significant relationship was observed between spiritual/religious practices (prayer/meditation and reading spiritual/religious material) and depressive symptoms. Further research is needed to examine relationships between spirituality and mental and physical health among HIV-positive women.     

Social and psychological correlates of unprotected anal intercourse among Hispanic-American women: implications for STI/HIV prevention

Heterosexual anal intercourse is associated with increased risk for HIV and other sexually transmitted infections. Research on the social and psychological risk factors associated with heterosexual unprotected anal intercourse among Hispanic women in the USA is limited. We examined demographic, mental health, relationship power, sexual self-efficacy, self-esteem, acculturation and HIV knowledge as correlates of unprotected anal intercourse among 514 HIV-negative Hispanic women, 18 to 59 years of age, residing in one urban county in southern Florida. In both unadjusted and adjusted results, the likelihood of engaging in unprotected anal intercourse was associated with food insecurity in the past 30 days (adjusted odds ratio [AOR] = 1.57, 95% confidence interval [CI] 1.03, 2.40) and more interpersonal power attributed to the male partner (AOR = 1.63, 95%CI 1.08, 2.45). Not significant, yet of possible importance, were ever having engaged in exchange sex (AOR = 1.96, 95%CI = 0.97, 3.98) and lower HIV knowledge (AOR = 0.80, 95%CI = 0.63, 1.01). Interventions aimed at reducing heterosexual unprotected anal intercourse risk for HIV infection among Hispanic women may benefit by addressing socioeconomic and interpersonal issues, and assessing HIV knowledge and comprehension.     

武汉市中小学生人格特质及心理弹性与抑郁症状的关系

目的探讨武汉市中小学生人格特质、心理弹性与抑郁症状的关系。方法2015年9月至2016年1月,采取整群抽样法抽取武汉市5所小学(5~6年级)、3所初中(7~9年级)以及2所高中(高一年级)共10所学校的10~17岁中小学生共6019人。其中男生3071,女生2948人;小学生2420人,初中生2912人,高中生687人。采用自编一般情况调查表、流调中心用抑郁量表(the center for epidemiological studies depression scale,CES-D)、心理弹性量表(connor-davidson resilience scale,CD-RISC)和大五人格量表简版(the NEO-five factor inventory,NEO-FFI)进行自评式问卷调查,运用多因素Logistic回归模型分析影响中小学生抑郁症状的因素。结果被调查中小学生抑郁症状检出率为10.5%(635/6019)。多因素Logistic回归分析显示,调整年级和家族抑郁史后,中小学生神经质水平越高(OR=4.53,95%CI 3.88~5.28)、开放性水平越高(OR=1.33,95%CI 1.18~1.50),抑郁症状发生风险可能越大;而外向性水平越高(OR=0.70,95%CI 0.62~0.79)、严谨性水平越高(OR=0.77,95%CI 0.67~0.90)、心理弹性水平越高(OR=0.77,95%CI 0.67~0.88),中小学生抑郁症状发生风险可能性越小。结论神经质和开放性水平与武汉市中小学生抑郁症状的发生成正相关;外向性和严谨性以及心理弹性水平与中小学生抑郁症状的发生成负相关,提示培养中小学生良好人格特质、提升心理弹性水平,有助于预防中小学生抑郁症的发生。     

Association between workplace discrimination and depressive symptoms among firefighters in South Korea

Background

Workplace discrimination is associated with poor mental health. However, there is a lack of studies examining the effects of discrimination on depressive symptoms among firefighters.

Methods

We analyzed a national cross‐sectional survey of 6369 firefighters in South Korea. Workplace discrimination during the past year was measured and main reasons for the discriminatory experience (gender, birth region, age, education, field/office work, job division) were identified separately by gender and job division. Depressive symptoms during the previous week were measured by the CES‐D11.

Results

Overall, 30.3% of firefighters experienced workplace discrimination and the main reasons for discrimination differed by gender and job division. Firefighters who experienced workplace discrimination had a higher likelihood of depressive symptoms than those who did not after adjusting for potential confounders (PR: 1.73; 95%CI: 1.55, 1.92).

Conclusions

This finding suggests that experience of workplace discrimination could aggravate the mental health of firefighters who provide an important public service.