Nicole Beaulieu Perez

Abstract

Depression is frequently assessed in science, as it is known to contribute to, exacerbate, and result from other health declines, but selecting among numerous depression instruments can be challenging for researchers. Here, we critically examine and compare self-report depression measures, describing theoretical foundations, psychometric features, and performance across diverse populations of adults-salient considerations for selection in research. Five commonly used depression measures were evaluated: the Beck Depression Inventory (BDI), the Center for Epidemiological Studies Depression (CES-D), the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ-9), and The Patient Reported Outcome Measures Information System Depression (PROMIS-D). Each measure was critically evaluated according to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) properties. Variations in theoretical basis and COSMIN quality were evident across the measures. Only the PROMIS-D received COSMIN ratings of 'very good' or 'acceptable' across all properties. Content and structural validity were deemed 'inadequate' or 'doubtful' for the BDI, PHQ-9, and HADS. Adequacy of criterion and construct validity varied across measures. HADS received 'doubtful' or 'inadequate' ratings across all properties. All but the PROMIS-D received 'doubtful' ratings for internal consistency. The CES-D and PROMIS-D received the highest cross-cultural validity ratings. Continued use of depression measures that lack theoretical grounding, robust psychometrics, or equivalence across diverse populations should be reconsidered. The PROMIS-D scale demonstrates sound theoretical foundations, superior COSMIN ratings, and robust scoring. Research to test cross-cultural validity of measures across race and ethnicity is needed to advance health for all.

Abstract

Sleep health disparities are well documented, whereas racial differences in treatment response to sleep interventions, are not. This single arm sleep intervention study explored treatment-response differences in sleep behaviors, quality of life, well-being, depressive symptoms, and daytime sleepiness between White and Underrepresented racial groups, as well as racial differences in pre-treatment sleep-relevant characteristics. Middle-aged adults at risk for the metabolic syndrome with short sleep duration (N???=???41; 49% Underrepresented racial group [n???=???20], 51% White [n???=???21]) participated in a virtually-delivered, 12-week personalized systematic sleep time extension informed by cognitive behavioral therapy for insomnia. Sleep behaviors were estimated using wrist actigraphy. Quality of life, emotional well-being, daytime sleepiness, chronotype preference, daytime sleepiness, depressive symptoms, quality of life, and well-being were assessed using validated surveys. Sleep environment, race, and socio-demographic characteristics were self-reported. Underrepresented participants had a greater increase in fragmentation indexes and a greater improvement in emotional well-being from pre to post-intervention compared to their White counterparts of medium and medium-to-large magnitude, respectively. Within each racial group, statistically and clinically significant improvements in sleep duration and daytime sleepiness were found. Within the Underrepresented group, the sleep regularity index increased and sleep onset times advanced significantly. These exploratory findings suggest that future studies with larger samples should investigate the modulating effects of chronotype on sleep intervention treatment response for Underrepresented racial groups and the upstream contextual and systemic factors impacting sleep.

Abstract

(1) The prevalence of depression is two times higher in women than men. Black women have an increased risk of depression due to stressors such as low socioeconomic status and perceived discrimination. Depression is likely influenced by both genetic and environmental factors. Psychosocial stressors can influence DNA methylation (DNAm), leading to changes in gene expression and ultimately, depression. The objective of this study was to examine associations between DNAm and depressive symptoms in Black women. (2) This study was a secondary analysis of data from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure (InterGEN) Study. Perceived discrimination was assessed using Krieger???s Experiences of Discrimination and Waelde???s Race-Related Events Scale, and participants were screened for depressive symptoms with the Beck Depression Inventory. Raw data from saliva samples were analyzed using the Illumina Infinium Epic (850 K) BeadChip and then preprocessed in RStudio. (3) Differential methylation analysis identified DNAm sites and regions associated with depressive symptoms. Six DNAm sites had a q-value less than 0.05. Additionally, of the 25 regions identified, 12 were associated with neurological diseases or disorders. (4) These findings suggest that there is a neurological component to depression, which should be considered during treatment.

Abstract

Depression affects 33% of women with type 2 diabetes (T2D) and leads to increased risks of premature mortality. Fluctuation and variation of depressive presentations can hinder clinical identification.

Abstract

OBJECTIVE: Inflammation is implicated in the pathophysiology of depression and type 2 diabetes (T2D) and is linked to social determinants of health (SDoH) associated with socioeconomic disadvantage. The objective of this review is to identify and map the range of SDoHs associated with inflammation in depression, T2D, or their co-occurrence among women. METHODS: PubMed, CINAHL, PsychINFO, and Web of Science were searched March-July 2023 to identify studies where 1) an SDoH was a predictor or independent variable, 2) depression or T2D was a clinical focus, 3) inflammatory markers were collected, and 4) analysis was specific to women. We used the National Institute on Minority Health and Health Disparities research framework to guide searching SDoHs, organize findings, and identify gaps. RESULTS: Of the 1135 studies retrieved, 46 met criteria. Within the reviewed studies, the most used inflammatory measures were C-reactive protein, interleukin-6, and tumor necrosis factor-??, and the most studied SDoHs were early life stress and socioeconomic status. Individual and interpersonal-level variables comprised the bulk of SDoHs in the included studies, while few to no studies examined built environment (n??=??6) or health system level (n??=??0) factors. Disadvantageous SDoHs were associated with higher levels of inflammation across the included studies. CONCLUSION: The scope and intersection of depression and T2D represent a syndemic that contributes to and results from socioeconomic inequities and disproportionately affects women. Simultaneous inclusion of social and inflammatory measures, particularly understudied SDoHs, is needed to clarify potent targets aimed at advancing health and equity.

Abstract

Depression is a growing global problem with significant individual and societal costs. Despite their consequences, depressive symptoms are poorly recognized and undertreated because wide variation in symptom presentation limits clinical identification-particularly among African American (AA) women-an understudied population at an increased risk of health inequity.

Abstract

Depression affects one in three women with Type 2 diabetes, and this concurrence significantly increases the risks of diabetes complications, disability, and early mortality. Depression is underrecognized because of wide variation in presentation and the lack of diagnostic biomarkers. Converging evidence suggests inflammation is a shared biological pathway in diabetes and depression. Overlapping epigenetic associations and social determinants of diabetes and depression implicate inflammatory pathways as a common thread.

Abstract

The authors recommend a more proactive approach.

Abstract

African American women (AAW) have a high risk of both cardiometabolic (CM) illness and depressive symptoms. Depressive symptoms co-occur in individuals with CM illness at higher rates than the general population, and accelerated aging may explain this. In this secondary analysis, we examined associations between age acceleration; depressive symptoms; and CM traits (hypertension, diabetes mellitus [DM], and obesity) in a cohort of AAW.

Abstract

IMPACT: This study deepens knowledge with respect to the associations between depression, cardiometabolic conditions, and accelerated aging with a clinically accessible marker in a population with disproportionate risk for comorbidity. OBJECTIVES/GOALS: The aim of this secondary analysis is to examine associations between DNA methylation age acceleration (DNAm AA) and depressive symptoms in African American women (AAW) considering the presence of cardiometabolic conditions (CMCs) including hypertension, diabetes, obesity. METHODS/STUDY POPULATION: Genomic and longitudinal clinical data (collected 2015-2020) from the Intergenerational Impact of Genetic and Psychosocial Factors on Blood Pressure Study (InterGEN) cohort (n=227) were utilized for this analysis. DNA methylation age (estimated by the Horvath method) incorporates DNA methylation status at 353 CpG sites. DNAm AA is the residual of DNA methylation age regressed on chronological age in a linear model. Spearman???s correlations and linear regression examine the relationship between DNAm AA and depressive symptoms (Beck Depression Inventory) and cardiometabolic status. The potential association and impact of SES, trauma, substance use, and stress were also considered. RESULTS/ANTICIPATED RESULTS: Contrary to our hypothesis, DNAm AA did not associate with the severity of depressive symptoms. Correlation between DNAm AA and affective symptom subscore (BDI) approached significance (p = 0.06). We observed significant correlations between DNAm AA and specific depressive symptoms including participants??? reported disappointment, disgust, or hatred toward themselves (p < 0.05), difficulty with making decisions (p < 0.05), and worry about their physical health (p < 0.05). DNAm AA was also significantly correlated with BMI (p > 0.001). Significant relationships were not evident in the subsequent regression analysis examining potential relationships between DNAm AA and depression. To our knowledge, this is the first study to examine associations between DNAm AA and depressive symptoms in AAW. DISCUSSION/SIGNIFICANCE OF FINDINGS: Depression limits life quality and quantity and is highly comorbid in CMCs. AAW have a high risk of comorbidity. This study deepens knowledge with respect to the associations between depression, CMCs, and aging with a clinically accessible marker in a population with disproportionate risk.