Specific Types of Screen-Based Sedentary Time and Depressive Symptoms in Adolescents

Purpose: Screen-based sedentary behavior (SSB) has been identified as risk factor for mental disorders in most of adolescents. However, there is little literature pertaining to the specific kinds of SSB and its connections with depressive symptoms in most of adolescents. In the present study, we are going to find out the connections between specific types of SSB and depressive symptoms in Chinese adolescents. Methods: A cross-sectional data based on 996 study participants of middle school students in Guangdong Province. SSB was evaluated by distributing the questionnaire of Health Behavior in School-aged Children, while depressive symptoms were evaluated using Chinese version of Children’s Depressive symptoms Inventory (CDI). SSB was categorized into TV/movie time, video games time and other electronic devices-based time (e.g., mobile phone, computer use). Generalized linear models was used to explore the connections between specific kinds of SSB and depressive symptoms. Results: After controlling for variables of sex, ethnicity, grade, residence, siblings, perceived family affluence, father educational level, mother educational background, body mass index (BMI), physical exercise, duration of sleep, other electronic devices-based time was positively correlated with depressive symptoms in Chinese adolescents (B = 0.557%, 95%CI: 0.187–0.926, p = 0.003). This significant connection was also found in girls (B = 0.728%, 95%CI: 0.230–1.225, p = 0.004) instead of boys (p > 0.05). The other types of SSB were not significantly in relation to depressive symptoms in adolescents regardless of sex. Conclusion: This study suggested that it might be effective in reducing or preventing depressive symptoms through limiting electronic devices-based time, like computer use or mobile phone use time. This strategy would be particularly useful in girls. Future studies should negate or replicate the research results by introducing more improved study design, which is beneficial to better understand the connections between SSB and depressive symptoms as well as then design more efficient interventions in adolescents.     

Cross-Sectional Associations of Lifestyle Behaviors with Depressive Symptoms in Adolescents

This study aimed to examine the associations between lifestyle behaviors and depressive symptoms in adolescents. Self-reported data from the 2019 Youth Risk Behavior Survey (YRBS) was analyzed. Depressive symptoms were set as the outcome variable. Movement variables (physical activity, muscle-strengthening exercise, physical education attendance, sports team participation, television watching, video or computer games, and sleep), eating behaviors (fruit intake, vegetable intake, milk intake, and eating breakfast or not), and substance use (alcohol use and cigarette use) were included as explanatory variables. Binary logistic regression was used to explore the associations between lifestyle behaviors and depressive symptoms after adjusting for sex, age, grade, race, and weight status. Of 13,677 participants who completed the investigation, girls were more than boys (50.3% vs. 48.6%). The proportion of participants in grades 9, 10, 11, and 12 was 26.6, 27.2, 24.3, and 20.8, respectively. Of them, the prevalence of depressive symptoms was 36.0% (weighted%: 36.7% [35.1%, 38.3%]). Among all the lifestyle behaviors included, participating in no sports teams (OR = 1.53 [1.32, 1.77]), spending more than 2 h in video or computer games (OR = 1.64 [1.40, 1.92]), sleeping less than 8 h nightly (OR = 1.79 [1.45, 2.20]), not eating breakfast (OR = 1.56 [1.37, 1.78]), alcohol use (OR = 1.74 [1.49, 2.02]), and cigarette use (OR = 1.83 [1.42, 2.37]) were associated with higher odds of depressive symptoms. To reduce depressive symptoms in adolescents, interventions can consider encouraging adolescents to engage in team sports activity, limit time for video or computer games, sleep enough, regularly eat breakfast, and avoid using alcohol and cigarette. Future studies are encouraged to verify our research findings by using a more improved study design.     

Depressive Symptoms and Perceived Burdensomeness Mediate the Association between Anxiety and Suicidal Ideation in Adolescents

A relationship between anxiety disorders and suicide-related behaviors has been demonstrated in adolescents, with a paucity of research examining mediators of this association. The present study hypothesized that anxiety would be associated with suicidal ideation via a serial mediation pathway through depressive symptoms and perceived burdensomeness and/or thwarted belongingness. A sample of 80 adolescents (68.8% female, 65.8% Hispanic), 13–19 years of age (mean?=?16.93, SD?=?1.66), completed 3 interviews as part of a randomized controlled trial. Results indicated a significant serial mediation from anxiety to suicidal ideation via depressive symptoms and perceived burdensomeness, but not thwarted belongingness. Clinicians and mental health service providers working with adolescents experiencing elevated anxiety should regularly assess for perceived burdensomeness and suicidal ideation.     

Post-traumatic Stress and Depressive Symptoms Among Adolescents After the 2015 Earthquake in Nepal: A Longitudinal Study

Few longitudinal studies have focused on mental health problems among adolescents after earthquakes. We investigated changes in post-traumatic stress symptoms (PTSS) and depressive symptoms from 18 to 31 months after the 2015 earthquake in Nepal and explored potential risk factors associated with the change in psychiatric symptoms. This study comprised of 515 adolescents, aged 11–17 years from two earthquake-affected areas, one severely affected than the other. The psychiatric symptoms were assessed using the standardized Child Post-traumatic Stress Disorder Scale and the Depression Self-Rating Scale. No significant change was observed in the prevalence of PTSS and depressive symptoms from 18 to 31 months after the earthquake. Living in severely affected area and exposure to trauma after the earthquake were associated with adolescents who developed chronic or delayed PTSS and depressive symptoms. The study findings highlight the need for disaster preparedness and early interventions that strengthen support at various levels.

     

Paternal childcare at 6 months and risk of maternal psychological distress at 1 year after delivery: The Japan Environment and Children’s Study (JECS)

BackgroundPaternal childcare is reported to benefit maternal mental health, but specific childcare behaviors have not been comprehensively determined. This study sought to identify paternal childcare behaviors associated with maternal mental health by adjusting for other covariates associated with maternal mental health and examining childcare behaviors.MethodsThis study investigated whether seven types of paternal childcare behaviors at 6 months after delivery were associated with maternal psychological distress at 1 year after delivery, which was assessed using the Kessler Psychological Distress Scale (K6). After exclusions from a dataset of 103,062 pregnancies obtained in the Japan Environment and Children’s Study, we evaluated data from 75,607 mothers.ResultsMore than 70% of fathers were always or sometimes involved in “playing at home,” “playing outdoors,” “changing diapers,” and “bathing,” 60%–70% in “helping with feeding” and “dressing,” and 45.9% in “putting the child to bed.” All paternal childcare behaviors showed some beneficial association with less maternal psychological distress, both moderate (K6 score 5–12) and severe (K6 score ≥ 13) distress. Playing at home was the most beneficial association identified (adjusted odds ratio [aOR] 0.66, 95% confidence interval [CI] 0.56–0.76 for moderate psychological distress; aOR 0.36, 95% CI 0.28–0.48 for severe psychological distress).ConclusionsThese seven types of paternal childcare behaviors may help lessen maternal psychological distress. Emphasis should be given to building education systems and working environments that promote paternal childcare.     

Association of Physical Activity,Screen Time and Sleep with Depressive Symptoms in Adolescents

Little is known on the association between movement behaviors including physical activity (PA), screen time (ST) and sleep (SLP) with depression in adolescents. This study aimed to explore the associations of PA, ST and SLP with depressive symptoms in adolescents. A total of 1,331 middle school students participated in this survey and provided valid data pertaining to the study variables. Self-reported questionnaires were used to collect information on participants’ sociodemographic parameters. The Health Behavior in School-aged Children Questionnaire was used to assess the PA (days for moderate to vigorous PA), ST (daily hours of ST) and SLP (daily hours of SLP). Study participants’ depressive symptoms were assessed using the Children’s Depression Inventory. Generalized linear models were used to estimate the associations of PA, ST and SLP with depressive symptoms. Of all the 1331 study participants, boys accounted for 51.31% and percentage of 7^th, 8^th and 9^th graders were 52.44%, 23.22% and 24.34%, respectively. After controlling for sex, body mass index, grade, ethnicity, residence, siblings, perceived family affluence, father and mother educational level, only ST was positively associated with depressive symptoms (beta = 0.17, p = 0.005). This study suggests that excessive ST would be detrimental to depressive symptoms in adolescents. It may be effective to reduce ST for depression intervention or prevention. Future studies are encouraged to use an improved study design to confirm or negate this study’s research findings.     

Prevalence of Depressive Symptoms and Related Risk Factors for Depressive Symptoms among Elderly Persons Living in a Rural Japanese Community: a Cross-Sectional Study

To clarify the prevalence of depression in a rural community in Japan and to evaluate the social and familial risk factors for depression, with the goal of suicide prevention, a questionnaire survey was conducted on a total of 2,763 elderly persons. The determined prevalence of depressive symptoms (Zung’s self-rated depression scale score of 50 points or more) was 10.4%. Logistic regression analysis showed associations between depressive symptoms and age, absence of a friendly companion, irritation with one’s family, frequent loneliness, the opinion that stress has a large impact on one’s life, suicide ideation, and poor subjective physical and mental health. Y. Kaneko, Y. Motohashi and H. Sasaki are affiliated with the Department of Public Health, Akita, Japan. M. Yamaji is an Assistant Professor in the Faculty of Health and Medical Care, Saitama, Japan.     

Depressive symptoms and the risk of long-term sickness absence

Background The aim of this paper is to examine the impact of depressive symptoms on long-term sickness absence in a representative sample of the Danish workforce. Methods This prospective study is based on 4,747 male and female employees, participating in the Danish Work Environment Cohort Study. Depressive symptoms were measured at baseline. Data on sickness absence were obtained from a national register on social transfer payments. Onset of long-term sickness absence was followed up for 78 weeks. Results The cumulative 78 weeks incidence for the onset of long-term sickness absence was 6.5% in men and 8.9% in women. Both men and women with severe depressive symptoms (≤52 points) were at increased risk of long-term sickness absence during follow-up (men: HR = 2.69; 95% CI: 1.18, 6.12; women: HR = 2.27; 95% CI: 1.25, 4.11), after adjustment for demographic, health related, and lifestyle factors. When we divided the depressive symptom scores into quartiles, we found no significant effects with regard to long-term sickness absence. Conclusions Severe depressive symptoms, as measured with the MHI-5, increased the risk of future long-term sickness absence in the general Danish working population. However, effects were not linear, but occurred mostly only in those employees with high levels of depressive symptoms.     

Hypothalamic‐Pituitary‐Adrenal Axis Functioning in Huntington's Disease and its Association with Depressive Symptoms and Suicidality

Hyperactivity of the hypothalamic‐pituitary‐adrenal (HPA) axis has been reported in Huntington's disease (HD). In non‐HD populations, alterations in HPA axis activity have been associated with depression and suicidality. The present study aims to compare HPA axis activity between HD mutation carriers and controls, and examine its association with depressive symptoms and suicidality. To this end, salivary cortisol concentrations at seven time points, as well as depressive symptoms and suicidality, were assessed in 49 pre‐motor, 102 motor symptomatic mutation carriers and 55 controls, at baseline and follow‐up combined. Differences in parameters of HPA axis activity between these three groups, and their associations with depressive symptoms and suicidality in HD mutation carriers, were analysed using multilevel regression analyses. There were no differences in parameters of HPA axis activity between mutation carriers and controls, whereas pre‐motor symptomatic mutation carriers had a significantly higher area under the curve to the increase (AUC_i) compared to motor symptomatic mutation carriers. In the entire HD cohort, HPA axis activity was not associated with depressive symptoms or suicidality. After stratifying mutation carriers into pre‐motor, early and advanced disease stages, β values differed between these groups. Remarkably, a higher AUC_i was significantly associated with depressive symptoms in pre‐motor and early disease stage mutation carriers, with a reverse nonsignificant association in advanced disease stage mutation carriers. The lower AUC_i in motor symptomatic mutation carriers and the varying associations with depressive symptoms and suicidality in pre‐motor, early and advanced disease stages could possibly be explained by exhaustion of the HPA axis after prolonged stress‐induced HPA axis hyperactivity and deserves further longitudinal study.     

Ethnic Norwegian and ethnic minority adolescents in Oslo,Norway

Background Little is known about ethnic disparities in mental health during late teens. The aim of this study was to compare changes in self reported mental health between adolescents with ethnic Norwegian and ethnic minority background aged 15-16 years followed for three years. Methods The youth part of the Oslo Health Study constituted the baseline of this self-reported longitudinal study, carried out in schools in 2001 (n = 3811). The follow-up in 2004 was conducted partly in school and partly through mail. A total of 2489 (1112 boys and 1377 girls) participated in the follow-up. Twenty percent of the participants had an ethnic minority background. Mental health was measured by the Strengths and Difficulties Questionnaire (SDQ) and The Hopkins Symptom Checklist (HSCL-10). Results Ethnic minority boys and girls reported poorer mental health than ethnic Norwegians of the same sex, both at baseline and follow-up. Exceptions were hyperactivity-inattention problems and prosocial behaviours where no differences were found. Consistent changes from baseline to follow-up were; an increase in mental distress and prosocial behaviour. No ethnic disparities were found for changes in mental health from ages 15 to 18 between the two groups. There was no different effect of perceived family economy, parents’ marital status and socioeconomic region of residence in Oslo on change in mental health between ethnic Norwegian and ethnic minority boys and girls from age 15 to 18 years. Conclusions Ethnic disparities in mental health remained the same from age 15-16 and throughout teenage years. Demographic factors adjusted for had no different impact on changes in mental health between host and immigrant adolescents.     

Association between Active School Travel and Depressive Symptoms among 51,702 Adolescents in 26 Low- and Middle-Income Countries

Little is known about the role of active school travel (AST) on mental health among adolescents. Thus, this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low- and middleincome countries (LMICs). Data from the Global School-based Student Health Survey were analyzed in 51,702 adolescents [mean (SD) age 13.8 (1.0) years; 49.3% boys). Both depressive symptoms and AST were assessed by a single question self-reported measure, respectively. Participants who reported having 5 days or above were considered as AST. Multivariable logistic regression analysis (accounting for sampling weights) was performed while controlling for gender, age, physical activity, sedentary behavior, and food insecurity, and a countrywide meta-analysis was undertaken. The prevalence of depressive symptoms and AST were 30.1% and 37.0%, respectively. Compared with those not having AST, adolescents with AST were less likely to have self-reported depressive symptoms (OR = 0.88, 95%CI: 0.85-0.93) regardless of gender. Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12% lower odds for depressive symptoms (OR = 0.88; 95%CI: 0.82-0.94) but with a moderate between-country heterogeneity (I² = 59.0%). Based on large samples of adolescents from LMICs, it would be expected that AST may play a critical role in preventing adolescent depression worldwide. However, it is necessary to consider more country-specific factors when implementing AST-related mental health interventions. Future studies should adopt the solid study design to confirm or negate our research findings.     

Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior.

BACKGROUND: Preclinical studies demonstrate that the neonatal environment can permanently alter an individual's responses to stress. To demonstrate a similar phenomenon in humans, we prospectively examined the relationships of maternal stress beginning in infancy and concurrent stress on preschoolers' hypothalamic-pituitary-adrenal activity and later mental health symptoms. METHODS: Salivary cortisol levels were assessed in 282 4.5-year-old children and 154 of their siblings. Maternal reports of stress were obtained when the children were ages 1, 4, and 12 months, and again at 4.5 years. Children's mental health symptoms were assessed in first grade. RESULTS: A cross-sectional analysis revealed that preschoolers exposed to high levels of concurrent maternal stress had elevated cortisol levels; however, a longitudinal analysis revealed that concurrently stressed children with elevated cortisol also had a history of high maternal stress exposure in infancy. Importantly, children exposed only to high levels of concurrent or early stress had cortisol levels that did not significantly differ from those never exposed to stress. Further analysis of the components of stress indicated that maternal depression beginning in infancy was the most potent predictor of children's cortisol. We also found that preschoolers with high cortisol levels exhibited greater mental health symptoms in first grade. CONCLUSIONS: These results link the findings of preclinical studies to humans by showing that exposure to early maternal stress may sensitize children's pituitary-adrenal responses to subsequent stress exposure.     

From community mental health services to specialized psychiatry: the effects of a change in policy on patient accessibility and care utilization

In 1975, a community mental health (CMH) centre with most of its resources channelled to outpatient services was set up in a defined catchment area of 75,000 inhabitants near Stockholm. In 1981, the CMH centre was allocated 3 inpatient wards of its own. An outpatient unit to treat long-term psychotic patients was also built up from existing resources. Emergency cases were directed to the primary health care services or to the emergency department of a hospital. During the same period, the number of doctors in the area's primary health care services increased fourfold. The social, demographic and diagnostic composition of the patient population and its utilization of in- and outpatient care in connection with these organizational changes are described. The population of the cathment area increased by 12.5% and the patient population decreased by 40%. The decrease was particularly great among first-time visitors (-54%), patients from lower social groups (-53%) and those with crisis diagnosis (-71%). The number of patients with psychoses increased (+26%). Outpatient visits and hospital utilization increased by one third. The number of compulsory admissions increased by 20% (still being far below the mean number in Stockholm). The decrease in the patient population is attributed to the reduction in accessibility to the CMH centre at a time when primary care services in the area were undergoing a sizeable expansion. The increased care utilization is the result of an internal redistribution of resources in favour of resource-demanding, long-term psychotic patients.