Confirmatory factor analysis of the 12-item center for epidemiologic studies depression scale among blacks and whites

Background: The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used tools to measure depressive symptoms in epidemiological studies. Given the importance of cross-racial measurement equivalence of the CES-D scale for research, we performed confirmatory factor analysis (CFA) of the 12-item CES-D in a nationally representative sample of Black and White adults in the United States. Methods: We used data from the National Survey of American Life (NSAL), 2001-2003. A total number of 3570 Blacks (African-Americans) and 891 non-Hispanic Whites were included in the present study. CFA was carried out on the 12-item CES-D scale using multi-group structural equation modeling. Results: For both Blacks and Whites, the best fitting model was found to be the 3-factor model, indicating invariance of factor structure between Blacks and Whites. A statistically different fit of the models with and without constraints indicated lack of invariance of factor loadings between Blacks and Whites. Some of the positive (i.e., "as good" and "hopeful") and interpersonal (i.e., "people were unfriendly") items showed poor loadings, even in the 3-factor solution that allowed separate domains for positive affect, negative affect, and interpersonal problems. Despite the good fit of our final model, more items (i.e., "as good," "hopeful," "keeping mind," and "everything effort") had poorer loadings in Blacks than Whites (i.e., "as good"). Conclusion: There is invariance in factor structure but lack of invariance in factor/item loadings between Blacks and Whites. These findings have implications for cross-racial studies of depressive symptoms using CES-D scale among Blacks and Whites. Further research is warranted to scrutinize the role of socioeconomics and culture in explaining the lack of invariance of the CES-D scale between Blacks and Whites. � 2016 Assari and Moazen-Zadeh

Ethnic variation in the cross-sectional association between domains of depressive symptoms and clinical depression

Background: The degree by which depressive symptoms and clinical depression reflect each other may vary across populations. The present study compared Blacks and Whites for the magnitude of the cross-sectional associations between various domains of depressive symptoms and endorsement of clinical disorders of depression. Methods: Data came from the National Survey of American Life, 2001-2003. We included 3570 Black (African-Americans) and 891 Non-Hispanic Whites. Predictors were positive affect, negative affect, and interpersonal problems measured using the 12-item Center for Epidemiologic Studies Depression Scale (CES-D). Outcomes were lifetime major depressive disorder (MDD), lifetime major depressive episode (MDE), 12-month MDE, 30-day MDE, and 30-day major depressive disorder with hierarchy (MDDH) based on the Composite International Diagnostic Interview (CIDI). Logistic regression models were applied in the pooled sample as well as Blacks and Whites. Results: Regarding CES-D, Blacks had lower total scores, positive affect, negative affect, and interpersonal problems compared to Whites (p < 0.05 for all comparisons). Blacks also had lower odds of meeting criteria for lifetime MDD and MDE, 12-month MDE, and 30-day MDE and MDDH (p < 0.05 for all comparisons). For most depressive diagnoses, ethnicity showed a positive and significant interaction with the negative affect and interpersonal problems domains, suggesting stronger associations for Blacks compared to Whites. The CES-D total score and CES-D positive affect domain did not interact with ethnicity on CIDI-based depressive diagnoses. Conclusion: Stronger associations between multiple domains of depressive symptoms and clinical depression may be due to higher severity of depression among Blacks, when they endorse the CIDI criteria for the disorder. This finding may explain some of previously observed ethnic differences in social, psychological, and medical correlates of depressive symptoms and clinical depression in the general population as well as clinical settings. � 2016 Assari and Moazen-Zadeh

Comparing duloxetine and pregabalin for treatment of pain and depression in women with fibromyalgia: an open-label randomized clinical trial

Background: Duloxetine and pregabalin are among the most widely used medications in the treatment of patients with fibromyalgia syndrome (FM). Objectives: To add to the very few lines of evidence that exist on the comparative safety and efficacy of these two medications. Methods: In this open-label randomized clinical trial, outpatient women, who were diagnosed with FM based on American College of Rheumatology 2010 criteria, and had an age range of 18�65 years old were assigned to either duloxetine 30-60 mg or pregabalin 75-150 mg per day for 4 weeks. Patients were excluded in cases of having used duloxetine, pregabalin, gabapentin, or antidepressants within 12 weeks prior to the study, having had a history of comorbid medical conditions that could provoke chronic pain, or having had comorbid neuropsychiatric disorders, except for major depressive/anxiety disorders. Primary outcomes were between-group differences in mean score changes from baseline to end point for Widespread Pain Index (WPI) and Beck Depression Inventory-II. Secondary outcomes were the same statistical estimates, but for Fibromyalgia Impact Questionnaire-Revised and 12-Item Short Form Survey. Descriptive statistics and independent samples t-test were the main methods of analysis. (www.irct.ir; IRCT2016030626935N1). Results: Among all the scales, only WPI scores improved with a statistically significant difference between the two treatment arms, favoring duloxetine (Mean difference in score change � 2.32, 95 CI, �4.46 to � 0.18; p = 0.034; Cohen�s d 0.53 95 CI, 0.04 to 1.02). Drop out rate and cumulative incidence of nausea was significantly higher in the duloxetine arm compared to the pregabalin arm. Conclusion: This study provides further evidence on higher efficacy of duloxetine compared to pregabalin for the treatment of pain in patients with fibromyalgia. Future comprehensive pragmatic clinical trials are warranted. © 2019, Springer Nature Switzerland AG

Increased blood pressures in veterans with post traumatic stress disorder: A case-control study

Objective Veterans of war affected by posttraumatic stress disorder (PTSD) are at increased risk for cardiovascular diseases. We aimed to compare brachial and central blood pressures between veterans with PTSD and controls. Method In this case-control study on veterans of Iran-Iraq war, 50 veterans with PTSD and 50 veterans as controls were selected from an outpatient clinic and matched for age ±3 years. Exclusion criteria were malignancies, severe anatomical defects such as amputated extremities, history of PTSD before serving in war, comorbid psychiatric disorders other than anxiety or depressive disorders. Detailed history was taken concerning medical and social aspects. Beck Depression Inventory was used for depressive symptoms. Brachial blood pressures were measured using both auscultatory and oscillometric devices. Measures of central hemodynamics were estimated accordingly. Data on lipid profile were collected either through medical records or newly required lab tests. Results Brachial systolic, diastolic, and pulse pressures as well as estimated central systolic and diastolic pressures were significantly higher in the PTSD group. Beck Depression Inventory scores, frequency of diabetes mellitus, and hypertension were significantly higher in the PTSD group. PTSD status was an independent predictor of both brachial and central systolic and diastolic pressures. Conclusions We demonstrated increased measures of blood pressure in veterans with PTSD independent of depression and other risk factors. Further research is warranted to confirm our results. © The Author(s) 2017

Association involving serotonin transporter gene linked polymorphic region and bipolar disorder type 1 in Iranian population

Introduction: Serotonin transporter gene linked polymorphic region, also called 5HTTLPR, is a candidate in the genetics of bipolar disorder; however, the results of previous association studies are inconsistent. Several explanations have been proposed for that inconsistency; among them are the existing differences both in the genetic basis of bipolar disorder subtypes and the genetic backgrounds of the studied populations. We aimed to investigate the association of 5HTTLPR with bipolar disorder type I (BP-1) in Iranian population. Methods: In this case-control study, 146 patients with BP-1 and 165 controls were recruited. The patients were selected through the Structured Clinical Interview for Diagnostic andStatisticalManual ofMentalDisorders, 4th edition. It was required that the patients do not have any present history of general medical conditions, substance abuse, and concurrent major psychiatric disorders. The polymorphism was evaluated by blood sampling and subsequent DNA extraction, polymerase chain reaction, and agarose gel electrophoresis. Chi-square test was used for analyzing allelic and genotype frequencies and two-tailed P values were obtained. Results: The S allele was significantly more frequent in the BP-1 patients compared with the controls (P=0.02, S allele odds ratio=1.5, confidence interval 95=1.06-2.11). Discussion: Our statistically significant results suggest that the role of 5HTTLPR in the pathogenesis of BP-1 needs to be clarified by further scrutiny in Iranian population and other populations of Near East. © 2016 John Wiley & Sons Australia, Ltd

Long-Term Effects of Chemical Warfare on Post-traumatic Stress Disorder, Depression, and Chronic Medical Conditions in Veterans

We investigated the association between exposure to chemical warfare and chronic mental/physical conditions. This was a secondary analysis of data from a case�control study on Iranian male veterans. Participants with neuropsychiatric disorders other than depressive/anxiety disorders, anatomical defects, or malignancies were excluded. Compared to non-exposed veterans, exposed veterans demonstrated significantly higher odds of PTSD OR (95% CI) = 5.23 (1.98�13.85), hypertension OR (95% CI) = 5.57 (1.68�18.48), coronary heart disease OR (95% CI) = 6.8 (1.62�28.49), and diabetes OR (95% CI) = 3.88 (1.35�11.16), and marginally higher odds of moderate to severe depressive symptoms OR (95% CI) = 2.21 (0.93�5.28). This study provides preliminary evidence on association of exposure to chemical warfare with long-term mental disorders as well as chronic medical conditions. © 2018, Springer Science+Business Media, LLC, part of Springer Nature

Long-Term Effects of Chemical Warfare on Post-traumatic Stress Disorder, Depression, and Chronic Medical Conditions in Veterans

We investigated the association between exposure to chemical warfare and chronic mental/physical conditions. This was a secondary analysis of data from a case�control study on Iranian male veterans. Participants with neuropsychiatric disorders other than depressive/anxiety disorders, anatomical defects, or malignancies were excluded. Compared to non-exposed veterans, exposed veterans demonstrated significantly higher odds of PTSD OR (95% CI) = 5.23 (1.98�13.85), hypertension OR (95% CI) = 5.57 (1.68�18.48), coronary heart disease OR (95% CI) = 6.8 (1.62�28.49), and diabetes OR (95% CI) = 3.88 (1.35�11.16), and marginally higher odds of moderate to severe depressive symptoms OR (95% CI) = 2.21 (0.93�5.28). This study provides preliminary evidence on association of exposure to chemical warfare with long-term mental disorders as well as chronic medical conditions. © 2018 Springer Science+Business Media, LLC, part of Springer Natur

Long-Term Effects of Chemical Warfare on Post-traumatic Stress Disorder, Depression, and Chronic Medical Conditions in Veterans

We investigated the association between exposure to chemical warfare and chronic mental/physical conditions. This was a secondary analysis of data from a case�control study on Iranian male veterans. Participants with neuropsychiatric disorders other than depressive/anxiety disorders, anatomical defects, or malignancies were excluded. Compared to non-exposed veterans, exposed veterans demonstrated significantly higher odds of PTSD OR (95% CI) = 5.23 (1.98�13.85), hypertension OR (95% CI) = 5.57 (1.68�18.48), coronary heart disease OR (95% CI) = 6.8 (1.62�28.49), and diabetes OR (95% CI) = 3.88 (1.35�11.16), and marginally higher odds of moderate to severe depressive symptoms OR (95% CI) = 2.21 (0.93�5.28). This study provides preliminary evidence on association of exposure to chemical warfare with long-term mental disorders as well as chronic medical conditions. © 2018 Springer Science+Business Media, LLC, part of Springer Natur

Red yeast rice as an adjunct to sertraline for treatment of depression in patients with percutaneous coronary intervention: Placebo-controlled trial

Objectives: Red yeast rice (RYR) has demonstrated neuroprotective effects in animal studies. The aim of this study was to access the efficacy of RYR for treatment of depression in patients with recent history of percutaneous coronary intervention. Design: This was a 6-week double-blind placebo-controlled randomized clinical trial. Setting: Participants included outpatient men and women aged 18 to 60 years old with history of coronary angioplasty, diagnosis of major depressive disorder based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), and Hamilton Depression Rating Scale (HDRS) score of �20. Candidates were excluded in case of any other DSM-V disorders, use of lipid lowering agents in the last two weeks, elevated serum aminotransferases or serum LDL � 80 mg/dL. Interventions: Patients received sertraline (200 mg/day) plus either red yeast rice commercially available capsules (2400 mg/day) containing 10.05 mg/day lovastatin or placebo. Main outcome measures: The primary outcome was the difference in mean change of the HDRS score from baseline to endpoint between the two treatment arms. Results: The primary outcome approached significance (Mean difference in score change(CI95) = �1.24 (�2.51 to 0.03), p =.056) and was accompanied by a significant time � treatment interaction effect Two-way ANOVA: F (df, mean square) = 4.42 (2, 13.687), p =.015. There was no significant difference between the two treatment arms in terms of lipid profile, liver function tests, or incidence of adverse events. Conclusions: This is the first report on the benefits of RYR in treatment of depression. Future studies are warranted to confirm our findings and scrutinize the mechanisms of action. © 2018 Elsevier Lt