Allergies and major depression: a longitudinal community study

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Major Depression Is a Risk Factor for Shorter Time to First Cigarette Irrespective of the Number of Cigarettes Smoked Per Day: Evidence From a National Population Health Survey

Article deposited according to Oxford Open Self-Archiving policy: http://www.oxfordjournals.org/oxfordopen/policies.html, January 12, 2012.YesFunding provided by the Open Access Authors Fund

The effect of major depression on participation in preventive health care activities

<p>Abstract</p> <p>Background</p> <p>The objective of this study was to determine whether major depressive episodes (MDE) contribute to a lower rate of participation in three prevention activities: blood pressure checks, mammograms and Pap tests.</p> <p>Methods</p> <p>The data source for this study was the Canadian National Population Health Survey (NPHS), a longitudinal study that started in 1994 and has subsequently re-interviewed its participants every two years. The NPHS included a short form version of the Composite International Diagnostic Interview (CIDI-SF) to assess past year MDE and also collected data on participation in preventive activities. Initially, we examined whether respondents with MDE in a particular year were less likely to participate in screening during that same year. In order to assess whether MDE negatively altered the pattern of participation, those successfully screened at the baseline interview in 1994 were identified and divided into cohorts depending on their MDE status. Proportional hazard models were used to quantify the effect of MDE on subsequent participation in screening.</p> <p>Results</p> <p>No effect of MDE on participation in the three preventive activities was identified either in the cross-sectional or longitudinal analysis. Adjustment for a set of relevant covariates did not alter this result.</p> <p>Conclusion</p> <p>Whereas MDE might be expected to reduce the frequency of participation in screening activities, no evidence for this was found in the current analysis. Since people with MDE may contact the health system more frequently, this may offset any tendency of the illness itself to reduce participation in screening.</p

A Longitudinal Community Study of Major Depression and Physical Activity

This pre-publication proof is posted here in keeping with the requirements of the funding agency.Background: The objective of this study was to determine whether major depressive episodes (MDE) are associated transitions between active and inactive recreational activity patterns. Methods: The data source was the Canadian National Population Health Survey (NPHS). The NPHS included a brief instrument to assess major depressive episodes and collected data on participation in recreational activities. In order to meaningfully categorize participation in recreational activities, the participation data was translated into overall estimated metabolic energy expenditure. A threshold of 1.5 kcal/kg/day was used to distinguish between active and inactive activity patterns. Proportional hazards models were used to compare the incidence of inactivity in initially active respondents with and without MDE and to compare the frequency of becoming active among initially inactive respondents with and without MDE. Results: For active respondents with MDE an elevated risk of transition into an inactive pattern was observed, adjusted Hazard Ratio (HR) = 1.6 (95% CI 1.2 – 1.9). However, MDE did not affect the probability of moving from an inactive to an active lifestyle, adjusted HR = 1.0 (95% CI 0.78-1.19). Conclusions: Major depressive episodes are associated with an increased risk of transition from an active to inactive pattern of activity.CIHRYesCanadian Institutes of Health Researc

Major Depression, Antidepressant Medication and the Risk of Obesity

This late revision is archived here in order to comply with the requirements of the funding agency.Background: Cross-sectional studies have reported an association between episodes of major depression (MDE) and obesity. The objective of this longitudinal analysis was to determine whether MDE increases the risk of becoming obese over a 10 year period. Method: We used data from the Canadian National Population Health Survey (NPHS), a longitudinal study of a representative cohort of household residents in Canada. The incidence of obesity, defined as a body mass index (BMI) of ≥ 30 kg/m2 was evaluated in respondents who were 18 years or older at the time of a baseline interview in 1994. MDE was assessed using a brief diagnostic instrument. Results: The risk of obesity was not elevated in association with MDE, either in unadjusted or covariate-adjusted analyses. The strongest predictor of obesity was a BMI in the overweight (but not obese) range. Effects were also seen for (younger) age, (female) sex, a sedentary activity pattern, low income and exposure to antidepressant medications. Unexpectedly, significant effects were seen for serotonin reuptake inhibiting antidepressants and venlafaxine, but not for tricyclic antidepressants nor antipsychotic medications. Conclusions: MDE does not appear to increase the risk of obesity. The cross-sectional associations that have been reported, albeit inconsistently, in the literature probably represent an effect of obesity on MDE risk. Pharmacologic treatment with antidepressants may be associated with an increased risk of obesity, and strategies to offset this risk may be useful in clinical practice.CIHRYesCanadian Institutes of Health Researc

Depression as a predictor of occupational transition in a multiple sclerosis cohort

In MS, transitions between working and not-working status may occur in association with depression. This can complicate patients’ ability to promptly obtain disability support due to an expectation that their functioning will improve after the depression resolves, a viewpoint that sees depression assuming a role as a causal determinant of disability. In this study, prospective data were used to model the relationship between depressive symptoms and the transition out of employment. In unadjusted analyses, depression increased the risk of transition to non-working status, HR = 1.7 (95%CI 1.3-2.3). Adjustments for ambulation status, physical and mental quality of life composite scores and fatigue impact attenuated or eliminated the association. While depression commonly occurs around the time of occupational transitions in MS, it does not appear to be an independent or direct cause of such transitions

A comparison of recommendations and received treatment for mood and anxiety disorders in a representative national sample

Abstract Background The exact nature of treatment and management recommendations made, and received, for mood and anxiety disorders in a community population is unclear. In addition, there is limited evidence on the impact of recommendations on actual receipt of treatment or implementation of management strategies. We aim to describe the frequency with which specific recommendations were made and implemented; and thus assess the size of any gap between the recommendation and implementation of treatments and management strategies. Methods We used the Survey ‘Living with a Chronic Condition in Canada - Mood and Anxiety Disorders (SLCDC-MA), a unique crossectional survey of a large (N = 3358) and representative sample of Canadians with a diagnosed mood or anxiety disorder, which was conducted by Statistics Canada. The survey collected information on recommendations for medication, counselling, exercise, reduction of alcohol consumption, smoking cessation and reduction of street drug use. We also estimate the frequency that recommendations are made and followed, as well the impact of the prior on the latter. We consulted people with lived experience of the disorders to help interpret our results. Results The results generally showed that most people would receive recommendations, almost all for antidepressant medications (94.6%), with lower proportions for the other treatment and management strategies (e.g. 62.1 and 66% for counselling and exercise). Most recommendations were implemented and had an impact on behaviour. The exception to this was smoking reduction/cessation, which was often not recommended or followed through. Other than with medication, at least 20% of the population, for each recommendation, would not have their recommendation implemented. A substantive group also exists who access treatments, and employ various management strategies, without a recommendation. Conclusions The results indicate that there is a gap between recommendations made and the implementation of treatments. However, its size varies substantially across treatments

Recreational Physical Activity Ameliorates Some of the Negative Impact of Major Depression on Health-Related Quality of Life

Background: Major depressive episodes (MDEs) have a negative effect on health-related quality of life (HRQoL). The objective of this study was to determine whether recreational physical activity can ameliorate some of this negative impact. Methods: The data source for the study was the Canadian National Population Health Survey (NPHS). The NPHS is a longitudinal study that has collected data from a representative cohort of 15,254 community residents. Sixteen years of follow-up data are available. The NPHS included: an instrument to assess MDE (the Composite International Diagnostic Interview Short Form for Major Depression), an inventory of recreational activities (each associated with hours of participation and estimated metabolic expenditures) and a HRQoL instrument (the Health Utility Index, Mark 3 or HUI3). Proportional hazard and linear regression models were used in this study to determine whether MDE-related declines in HRQoL were lessened by participation in an active recreational lifestyle. Results: Consistent with expectation, major depression was associated with a significant decline in HRQoL over time. While no statistical interactions were observed, the risk of diminished HRQoL in association with MDE was reduced by physical activity. In a proportional hazards model, the hazard ratio for transition to poor HRQoL was 0.7 (95% CI: 0.6 – 0.8, p &lt; 0.0001). In linear regression models, physical activity was significantly associated with more positive HRQoL (β = 0.019, 95% CI 0.004 to – 0.034, p =0.02).Conclusions: Recreational physical activity appears to ameliorate some of the decline in HRQoL seen in association with MDE. Physical activity may be an effective tertiary preventive strategy for this condition