Journal of affective disorders最新文献

{"title":"The D*Phase-study: Comparing short-term psychodynamic psychotherapy and cognitive behavioural therapy for major depressive disorder in a randomised controlled non-inferiority trial.","authors":"Maartje Miggiels, Peter Ten Klooster, Aartjan Beekman, Susanne Bremer, Jack Dekker, Colin Janssen, Maarten K van Dijk","doi":"10.1016/j.jad.2024.10.122","DOIUrl":"10.1016/j.jad.2024.10.122","url":null,"abstract":"<p><strong>Background: </strong>Given both the large volume and manifold preferences of patients with depression, the availability of various effective treatments is important. Psychodynamic psychotherapy (PDT) has received less research in comparison to cognitive behavioural therapy (CBT) for major depressive disorder (MDD). This study aimed to establish whether short-term psychodynamic supportive psychotherapy (SPSP) is non-inferior to CBT in the treatment of MDD.</p><p><strong>Methods: </strong>A non-inferiority trial was conducted in a Dutch mental health setting, with 290 patients randomised to receive 16 sessions of either CBT or SPSP, over eight weeks. Primary outcome was depressive symptom severity assessed using the self-rated Inventory of Depressive Symptomatology (IDS-SR). The non-inferiority margin was prespecified as a - 5 post-treatment difference on the IDS-SR. Secondary outcome measures were functional impairment caused by symptoms assessed using the Sheehan disability scale (SDS), and wellbeing measured by the Mental Health Continuum-Short Form (MHC-SF).</p><p><strong>Results: </strong>Both intention-to-treat (baseline-adjusted mean difference 1.62, 95 % CI -1.82 to 5.05) and per-protocol analyses (mean difference 2.54; 95 % CI -0.63 to 5.72) showed SPSP to be non-inferior to CBT in reducing depressive symptoms. SPSP showed slightly but significantly higher remission rates and wellbeing scores.</p><p><strong>Limitations: </strong>Patients opting for other therapies or medication did not take part in the trial. Follow-up measures or clinician-rated questionnaires were not included.</p><p><strong>Conclusions: </strong>The findings support SPSP as a viable treatment option for MDD, expanding the available choices for patients and broadening treatment options.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"344-351"},"PeriodicalIF":4.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms of depression, but not PTSD, influence cognitive performance in healthy Army National Guard Soldiers.","authors":"Caitlin Ridgewell, Ashley Donovan, Caitlin Haven, Susan P Proctor, Kristin J Heaton","doi":"10.1016/j.jad.2024.11.038","DOIUrl":"10.1016/j.jad.2024.11.038","url":null,"abstract":"<p><strong>Introduction: </strong>Research suggests that comorbid depression and PTSD may contribute to cognitive impairment. However, few studies have explored this dynamic in military personnel who report only subclinical symptoms of PTSD and depression.</p><p><strong>Methods: </strong>Army National Guard Soldiers (ARNG; N = 1415) completed the Automated Neuropsychological Assessment Metrics (ANAM), the PTSD Checklist (PCL), and the Center for Epidemiological Studies Depression Scale (CES-D). The effects of PTSD and depression symptoms on ANAM performance were examined using multiple linear regression analyses. Exploratory factor analysis and regression models examined the relationship between symptom clusters and ANAM performance.</p><p><strong>Results: </strong>Six factors were identified: avoidance/flashbacks, cognitive/social difficulty, depressed mood, positive mood, sleep difficulty, and hypervigilance. Elevated symptoms of depression (measured using factor scores) were associated with poorer attention (β range -0.19-0.18, p range < 0.01-0.04, f² effect size range 0.02-0.94).</p><p><strong>Conclusion: </strong>Depression symptoms were associated with diminished attentional performance in a large sample of ARNG Soldiers who reported no clinical diagnosis. This study was limited in that unmeasured factors other than depression, PTSD, or demographics may explain much of the variance in cognitive performance. These findings highlight the importance of careful mental health screening and strategies to heighten awareness of the potential detrimental effects of depression and PTSD on health and performance.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"352-360"},"PeriodicalIF":4.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypomanic symptoms in major depressive disorder: Prognostic impact and treatment issues.","authors":"Paolo Olgiati, Siegfried Kasper, Joseph Zohar, Daniel Souery, Stuart Montgomery, Panagiotis Ferentinos, Dan Rujescu, Raffaella Zanardi, Gernot Fugger, Raffaele Ferri, Mariangela Tripodi, Bernhard T Baune, Chiara Fabbri, Julien Mendlewicz, Alessandro Serretti","doi":"10.1016/j.jad.2024.10.104","DOIUrl":"10.1016/j.jad.2024.10.104","url":null,"abstract":"<p><strong>Background: </strong>Mixed depression (MXD), defined as (hypo)manic symptoms occurring within major depressive episodes, is common in both bipolar and unipolar disorders, but its prognostic and treatment implications remain unclear. This study aimed to examine the relationship between hypomanic symptoms, treatment response and remission of suicidal thoughts.</p><p><strong>Methods: </strong>We analyzed 1243 adults with major depressive disorder (MDD), recruited for a naturalistic study on treatment-resistant depression. Data were gathered cross-sectionally and retrospectively through structured interviews and clinical rating scales including the Young Mania Rating Scale (YMRS) and Montgomery-Asberg Depression Rating Scale (MADRS); statistical analyses were performed using univariate and multivariate methods.</p><p><strong>Results: </strong>Hypomanic symptoms were present in 651 patients (45 %), while 307 patients (25 %) responded to treatment. Both treatment responders (p < 0.0001) and those who achieved remission from suicide ideation (p = 0.0085) showed lower hypomanic (YMRS) scores. Multivariate analysis showed that hypomanic symptoms were negatively linked to treatment response (O.R. 0.71-0.87), while bipolar spectrum markers such as age at illness onset (O.R. 1.00-1.03) and MDD recurrence (O.R. 0.47-0.89) predicted remission from suicidal thoughts. Medications commonly used to treat bipolar disorder showed some benefits, with dopamine/serotonin antagonists improving suicide ideation (p < 0.0001) and mood stabilizers being associated with reduced hypomanic symptoms (p = 0.0003).</p><p><strong>Limitations: </strong>The study lacked prospective clinical assessments and treatment randomization.</p><p><strong>Conclusion: </strong>Hypomanic symptoms are common in unipolar depression; their assessment is essential to identify challenging-to-treat cases and select the best pharmacological options.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1021-1030"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered electroencephalography-based source functional connectivity in drug-free patients with major depressive disorder.","authors":"Che-Sheng Chu, Yen-Yue Lin, Cathy Chia-Yu Huang, Yong-An Chung, Sonya Youngju Park, Wei-Chou Chang, Chuan-Chia Chang, Hsin-An Chang","doi":"10.1016/j.jad.2024.10.087","DOIUrl":"10.1016/j.jad.2024.10.087","url":null,"abstract":"<p><strong>Background: </strong>Compared to functional magnetic resonance imaging (fMRI), source localization of a scalp-recorded electroencephalogram (EEG) provides higher temporal resolution and frequency synchronization to better understand the potential neurophysiological origins of disrupted functional connectivity (FC) in major depressive disorder (MDD). The present study aimed to investigate EEG-sourced measures to examine the FC in drug-free patients with MDD.</p><p><strong>Method: </strong>Resting-state 32-channel EEG were recorded in 84 drug-free patients with MDD and 143 healthy controls, and the cortical source signals were estimated. Exact low-resolution brain electromagnetic tomography (eLORETA) was used to compute the intracortical activity from regions within the default mode network (DMN) and frontoparietal network (PFN). Lagged phase synchronization was used as a measure of functional connectivity.</p><p><strong>Results: </strong>Compared with control subjects, the MDD group showed greater within-DMN alpha 1 and 2 bands and within-FPN alpha 1, 2, and beta 3 bands. Furthermore, the MDD group showed hyperconnectivity between the DMN and the FPN in the alpha 1 and 2 bands. Finally, higher levels of anhedonia were associated with higher between-network DMN and FPN connectivity in the alpha-1 band.</p><p><strong>Limitations: </strong>Due to the inherent limitations of eLORETA with predefined seeds, we could not exclude connectivity between regions of interest (ROIs), which may be related to the activity from regions adjacent to the ROIs.</p><p><strong>Conclusions: </strong>The present findings support the importance of phase-lagged functional dysconnectivity in the neurophysiological mechanisms underlying MDD. Exploring the potential of these patterns as surrogates for treatment responses may advance targeted interventions for depression.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1161-1167"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral cortex changes in FD, IBS, and GERD: A Mendelian randomization study.","authors":"Kai-Yue Huang, Jia-Yan Hu, Mi Lv, Feng-Yun Wang, Xiang-Xue Ma, Xu-Dong Tang, Lin Lv","doi":"10.1016/j.jad.2024.10.057","DOIUrl":"10.1016/j.jad.2024.10.057","url":null,"abstract":"<p><strong>Background: </strong>Prospective and cross-sectional studies have reported an association between functional gastrointestinal disorders and anxiety and depression. However, the causal relationship remains uncertain. To clarify this, we utilized Mendelian randomization (MR) to assess the causal effects of common gastrointestinal disorders on cortical structures.</p><p><strong>Methods: </strong>Genome-wide association study (GWAS) data was gathered for functional dyspepsia (FD), irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD) from European populations numbering 329,262, 16,792, and 602,604, respectively. GWAS cerebral cortical architecture data for cortical thickness (TH) and surface area (SA) were obtained from 51,665 MRI scans. MR was used to analyze the casual relationship between FD, IBS, GERD, and cortical structures. Inverse-variance weighted, weighted median, and MR-Egger tests were performed as assessment indicators. We also evaluated heterogeneity and pleiotropy.</p><p><strong>Results: </strong>FD significantly decreases the TH in the rostral anterior cingulate cortex (β_TH = -0.022 mm; 95%CI: -0.035 mm to -0.009 mm²; P_TH = 6.89 × 10^-4), and IBS significantly decreases the SA of the pars triangularis (β_SA = -21.91 mm²; 95%CI: -32.99 mm to -10.83 mm²; P_SA = 1.06 × 10^-4), precuneus (β_SA = -47.53 mm²; 95%CI: -73.57 mm to-21.48 mm²; P_SA = 3.48 × 10^-4) and superior frontal regions (β_SA = -78.70 mm²; 95%CI: -122.61 mm to -34.78 mm²; P_SA = 4.4 × 10^-4). At the local functional level, GERD significantly increases the SA of the inferior temporal region (β_SA = -113.58 mm², 95%CI: -113.58 mm to -39.01 mm², P_SA = 6.05 × 10^-5).</p><p><strong>Conclusions: </strong>FD, IBS and GERD can affect the cerebral cortex architecture through the brain-gut axis, potentially increasing the risks of mental illness and cognitive impairment.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1153-1160"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Separate and joint associations of adverse childhood experiences and childhood socioeconomic status with depressive symptoms: The mediating role of unhealthy lifestyle factors.","authors":"Yifang Liu, Zhikang Wang, Ziyi Cheng, Yilin Li, Qi Wang, Junan Liu","doi":"10.1016/j.jad.2024.10.117","DOIUrl":"10.1016/j.jad.2024.10.117","url":null,"abstract":"<p><strong>Background: </strong>The associations between adverse childhood experiences (ACEs), childhood socioeconomic status (SES), and depressive symptoms (DS) remain unclear. This study aimed to assess the separate and joint associations of ACEs and childhood SES with DS and explore the potential mediating role of lifestyles.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study, which included 6879 participants. Cox proportional hazard models were used to evaluate the associations of ACEs and childhood SES with DS. Additive and multiplicative interactions between ACEs and childhood SES on DS were also examined. Causal mediation analyses were then conducted to quantify the mediating role of lifestyle factors in these associations.</p><p><strong>Results: </strong>During a median follow-up of 3.0 years, 1283 (18.7 %) participants were identified with DS. ACEs and low childhood SES were significantly associated with an increased risk of DS (ACEs [3 or more vs 0]: HR = 1.68, 95 % CI: 1.43-1.99; childhood SES [low vs high]: HR = 1.48, 95 % CI: 1.22-1.79). Compared to the no ACEs-moderate/high childhood SES group, the group with 1 or more ACEs-low childhood SES had the highest risk of DS (HR = 1.76, 95 % CI: 1.47-2.10). Significant additive interaction of ACEs with low childhood SES on DS was observed with relative excess risk due to an interaction of 1.21 (95 % CI: 0.27, 2.15). Sleep duration and smoking were identified as the potentially modifiable mediators.</p><p><strong>Conclusions: </strong>The findings highlight the importance of promoting initiatives to address ACEs, low childhood SES, and unhealthy lifestyles as part of DS prevention strategies.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1248-1255"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal beta bursts of depression in the orbitofrontal cortex and its relationship with clinical symptoms.","authors":"Li Xue, Xiaowen Hu, Siqi Zhang, Zhongpeng Dai, Hongliang Zhou, Zhilu Chen, Zhijian Yao, Qing Lu","doi":"10.1016/j.jad.2024.10.092","DOIUrl":"10.1016/j.jad.2024.10.092","url":null,"abstract":"<p><strong>Background: </strong>Recent researches have reported that frequency-specific patterns of neural activity contain not only rhythmically sustained oscillations but also transient-bursts of isolated events. The aim of this study was to investigated the correlation between beta burst and depression in order to explore depressive disease and the neurological underpinnings of disease-related symptoms.</p><p><strong>Methods: </strong>We collected resting-state MEG recordings from 30 depressive patients and a matched 40 healthy controls. A Hidden Markov Model (HMM) was applied on source-space time courses for 78 cortical regions of the AAL atlas and the temporal characteristics of beta burst from the matched HMM states were captured. Group differences were evaluated on these beta burst characteristics after permutation tests and, for the depressive group, associations between burst characteristics and clinical symptom severity were determined using Spearman correlation coefficients.</p><p><strong>Results: </strong>At a threshold of p=0.05corrected, burst characteristics revealed significant differences between depression patients and controls at the group level, including increased burst amplitude in frontal lobe, decreased burst duration in occipital regions, increased burst rate and decreased burst interval time in some brain regions. Furthermore, burst amplitude in the orbitofrontal cortex (OFC) was positively related to the severity of sleep disturbance and burst rate in the OFC was negatively related to the severity of anxiety in depression patients.</p><p><strong>Conclusions: </strong>The findings highlight OFC may be a targeted area responsible for the anxiety and sleep disturbance symptom by abnormal beta burst in depressive patients and beta burst characteristics of OFC might serve as a neuro-marker for the depression.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1168-1177"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topography of depressive experiences. A dialectic approach.","authors":"Guilherme Messas, Francesca Brencio","doi":"10.1016/j.jad.2024.10.064","DOIUrl":"10.1016/j.jad.2024.10.064","url":null,"abstract":"<p><p>This article aims to offer clinical descriptions and philosophical interpretations of the ontological nature of depressive experiences trying to address issues related to the contemporary diagnostic paradigm and values-based practices which shape clinical decisions. At the core of this contribution there is the idea that the variety of depressive experiences might be understood acknowledging the qualitative difference in the ontology underlying each form of depression. We argue that there is a fundamental difference between melancholia as a disease and those melancholic traits which characterizes human existence as such: while the former indicates a qualitative alteration of the global human experience, constituting psychopathological experience, the latter describes a style of disproportion of existence not pathological per se at all. Moreover, we defend the hypothesis that melancholia (in a medical sense) is a distinct unity of mental alteration, and should not be conflated with the multivarious kind of experiences merged under the name of depression, the variety of which may be understood as disorders of the personal development. It is in this context that the leading element of anthropological disproportions impact the role of pre-reflective and transcendental structures, polarizing the self and the world in a three-way topography: 1. depression as an excessive symmetric proportion between self and world; 2. depression as a disproportion between the self and the world (detriment of the self); 3. depressions as impoverishment of the transcendental value of the world.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"986-994"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination and manic symptoms in early adolescence: A prospective cohort study.","authors":"Jason M Nagata, Jennifer Wong, Gabriel Zamora, Abubakr A A Al-Shoaibi, Patrick Low, Kyle T Ganson, Alexander Testa, Jinbo He, Jason M Lavender, Fiona C Baker","doi":"10.1016/j.jad.2024.10.078","DOIUrl":"10.1016/j.jad.2024.10.078","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the prospective associations between four types of perceived discrimination (country of origin, race and ethnicity, sexual orientation, and weight) and the development of manic symptoms in a diverse, nationwide sample of adolescents aged 9-14 years in the U.S.</p><p><strong>Methods: </strong>We analyzed prospective cohort data from the Adolescent Brain Cognitive Development Study (N = 7466; ages 9-14 years at Year 1 or 2 in 2017-2020; 48.5 % female; 39.4 % racial/ethnic minority). Multiple zero-inflated negative binomial analyses were conducted to examine the associations between Year 1 or 2 discrimination (by country of origin, race and ethnicity, sexual orientation, weight, sum score), and Year 3 manic symptoms (7 Up Mania scale), adjusting for covariates (age, sex, race and ethnicity, household income, parental education, sipping alcohol, puffing tobacco, anxiety symptoms, depressive symptoms, Year 1 manic symptoms, and study site).</p><p><strong>Results: </strong>After adjusting for covariates, perceived discrimination based on country of origin (incidence rate ratio [IRR] = 1.46; 95 % confidence interval [CI] 1.15-1.86), sexual orientation (IRR = 1.36; 95 % CI 1.21-1.53), race and ethnicity (IRR = 1.28; 95 % CI 1.13-1.46), weight (IRR = 1.21 95 % CI 1.09-1.34), and sum scores (IRR = 1.18 5 % CI 1.12-1.24), were significantly associated with higher manic symptoms.</p><p><strong>Conclusion: </strong>Perceived discrimination based on country of origin, race and ethnicity, sexual orientation, weight, and sum scores, are prospectively associated with greater manic symptoms in adolescents. These findings underscore the need for targeted interventions to address discrimination and associated psychological impacts. Efforts to reduce discrimination and to support affected adolescents are important components of comprehensive mental health care and public health strategies.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1233-1237"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between age and functional disability in US adults with lifetime exposure to the criminal legal system, 2015-2019.","authors":"Laura C Hawks, Sandra Iregbu, Rebekah J Walker, Leonard E Egede","doi":"10.1016/j.jad.2024.10.111","DOIUrl":"10.1016/j.jad.2024.10.111","url":null,"abstract":"<p><strong>Importance: </strong>As the global population ages, the proportion of individuals living with functional disability is increasing. Evidence suggests that functional disability is associated with worse health outcomes and is concentrated in populations with high rates of concurrent social risk factors such as criminal legal involvement (CLI), making it an increasingly important issue for advocates of health equity.</p><p><strong>Objective: </strong>To determine whether age is associated with functional disability in a nationally representative sample of United States adults with lifetime exposure to the criminal legal system.</p><p><strong>Design: </strong>Cross-sectional survey data from the National Survey of Drug Use and Health, 2015-2019.</p><p><strong>Setting: </strong>Nationally representative survey data.</p><p><strong>Participants: </strong>US adults who reported lifetime history of arrest (N = 37,279).</p><p><strong>Exposure: </strong>Respondents were categorized into age groups: younger adults (age 18-49); middle-aged adults (age 50-64); and older adults (age ≥ 65).</p><p><strong>Main outcome measure: </strong>Functional disability as measure by the World Health Organization Disability Assessment Score 2.0 (WHO-DAS 2.0). A higher score indicates a greater degree of functional disability.</p><p><strong>Results: </strong>The sample included 37,279 US adults with lifetime CLI of whom 60.0 % were younger adults, 28.5 % were middle-aged adults, and 11.5 % were older adults. The mean, unadjusted functional disability score for younger adults was 5.0 (95 % CI, 4.9, 5.1); for middle-aged adults it was 4.2 (95 % CI, 4.0, 4.4); and for older adults it was 3.2 (95 % CI, 2.9, 3.5). In models adjusted for sociodemographic and clinical confounders, differences were attenuated but remained statistically significant, indicating increased functional disability in the younger age groups.</p><p><strong>Conclusion and relevance: </strong>Our findings suggest that among adults with CLI, functional disability is distributed by age in a pattern distinct from the general population. A large number of young adults have CLI, and the findings suggest that prevalence of functional disability is exceedingly high in this marginalized group. Future studies should examine if substance use and mental health conditions contribute to these findings, and policy makers should examine if flexible interventions tailored to the needs of those with disability improve reentry outcomes for young adults with CLI.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"1178-1182"},"PeriodicalIF":4.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}