Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital

Whittier, Anjalene; Gelaye, Bizu; Deyessa, Negussie; Bahretibeb, Yonas; Kelkile, Teshome Shibre; Berhane, Yemane; Williams, Michelle A.

doi:10.1016/j.jad.2016.02.052

Cited by 23 publications

(28 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our report of significant risk factors for suicidality was in line with many other cross-national studies in China: being female, unmarried, living alone, being younger, not attaining college education [ 4 , 35 , 36 ]. A most recent Ethiopian study showed that women had 63% higher odds of endorsing suicidal risk than men at general hospital (OR = 1.63 95%CI: 1.13–2.36) [ 9 ]. The Hong Kong survey also showed that female gender was associated with a higher risk of suicidal ideation [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population

Li¹,

Luo²,

Ke³

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

BackgroundSomatic complaints are often the presenting symptoms of major depressive disorder (MDD) in the outpatient context, because this may go unrecognized. It is well understood that MDD carries an increased risk of suicide. This study aimed to identify the risk factors and association with both MDD and suicidality among Han Chinese outpatients.MethodsA multicenter study was carried out in 5189 outpatient adults (≥18 years old) in four general hospitals in Guangzhou, China. The 1392 patients who had the Patient Health Questionnaire-9 (PHQ-9) score ≥ 5, indicating depressive symptoms were offered an interview with a psychiatrist by the Mini International Neuropsychiatric Interview (MINI); 819 patients consented and completed the MINI interview. MINI module B was used to assess suicidality. Stepwise binary logistic models were used to estimate the relationship between a significant risk factor and suicide or MDD. According to with or without MDD, the secondary analysis was performed using the logistic regression model for the risk of suicidility.ResultsThe current prevalence of MDD and the one month prevalence of suicidality were 3.7% and 2.3% respectively. The odds ratio of suicidality in women was more than twice that in men (OR = 2.62; 95% CI 1.45–4.76). Other risk factors which were significantly associated with suicidality were: living alone, higher education, self-reported depression, getting psychiatric diagnoses (MDD, anxiety disorders, and bipolar disorders). Significant risk factors for MDD were also noticed, such as comorbid anxiety disorders, self-reported anxiety, insomnia, suicidal ideation.LimitationIt’s a cross-sectional study in outpatient clinics using self-report questionnaires.ConclusionThis study provides valuable data about the risk factors and association of MDD and suicide risk in adult outpatients in Han Chinese. Those factors allow better the employment of preventative measures.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Psychiatric disorders are a well-established risk factor for suicidility [ 9 ]. Affective disorders possess the greatest risk; it has been estimated that half of all individuals who complete suicide meet criteria for MDD.…”

Section: Introductionmentioning

confidence: 99%

Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population

Li¹,

Luo²,

Ke³

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…The magnitude of CHD risk is also related to the severity of MDD, ranging from a 2-fold increase to up to 5-fold with more severe depression [7]. Depression thus appears as powerful a determinant of CHD risk and outcomes as more traditional risk factors, and its occurrence is significant: recent analyses indicate a lifetime prevalence of ~16% in the US [19], with varying estimates from other populations (and diagnostic criteria), for example ~11% in Canada [20], 4-7% in Singapore [21], 12% in a Scottish cohort [22], 18% in urban Ethiopians [23], and 5% in rural-to-urban Chinese workers [24]. Whether overall incidence is on the rise is questionable, with a perceived growing epidemic of MDD and anxiety disorders potentially reflecting population growth, among other factors [25].…”

Section: Introductionmentioning

confidence: 99%

The heartbreak of depression: ‘Psycho-cardiac’ coupling in myocardial infarction

Headrick

Peart

Budiono

et al. 2017

Journal of Molecular and Cellular Cardiology

View full text Add to dashboard Cite

Ample evidence identifies strong links between major depressive disorder (MDD) and both risk of ischemic or coronary heart disease (CHD) and resultant morbidity and mortality. The molecular mechanistic bases of these linkages are poorly defined. Systemic factors linked to MDD, including vascular dysfunction, atherosclerosis, obesity and diabetes, together with associated behavioral changes, all elevate CHD risk. Nonetheless, experimental evidence indicates the myocardium is also directly modified in depression, independently of these factors, impairing infarct tolerance and cardioprotection. It may be that MDD effectively breaks the heart's intrinsic defense mechanisms. Four extrinsic processes are implicated in this psycho-cardiac coupling, presenting potential targets for therapeutic intervention if causally involved: sympathetic over-activity vs. vagal under-activity, together with hypothalamic-pituitary-adrenal (HPA) axis and immuno-inflammatory dysfunctions. However, direct evidence of their involvement remains limited, and whether targeting these upstream mediators is effective (or practical) in limiting the cardiac consequences of MDD is unknown. Detailing myocardial phenotype in MDD can also inform approaches to cardioprotection, yet cardiac molecular changes are similarly ill defined. Studies support myocardial sensitization to ischemic insult in models of MDD, including worsened oxidative and nitrosative damage, apoptosis (with altered Bcl-2 family expression) and infarction. Moreover, depression may de-sensitize hearts to protective conditioning stimuli. The mechanistic underpinnings of these changes await delineation. Such information not only advances our fundamental understanding of psychological determinants of health, but also better informs management of the cardiac consequences of MDD and implementing cardioprotection in this cohort.

show abstract

“…To be able to target such interventions, we need to understand which men are most at risk for anxiety and depression. More population-based research is needed in sub-Saharan Africa, but the few available studies from this context indicate that depression may be associated with age [67,68], marital status [67,69,70], education [69,71], employment and income [68,69,71], and gender [67,69]. Though studies have observed a higher risk of depression among women, the substantial levels of clinically significant symptoms of anxiety and depression among men in this study should not be discounted.…”

Section: Discussionmentioning

confidence: 99%

“…Though studies have observed a higher risk of depression among women, the substantial levels of clinically significant symptoms of anxiety and depression among men in this study should not be discounted. Research specific to men will be needed as the determinants of anxiety and depression are likely to be different among men than among women [67,69]. …”

Section: Discussionmentioning

confidence: 99%

Changes in Anxiety and Depression Symptoms Predict Sexual Risk Behaviors Among Young Men Living in Dar es Salaam, Tanzania

et al. 2017

View full text Add to dashboard Cite

Young men are important targets in HIV prevention in Tanzania and throughout sub-Saharan Africa. Anxiety and depression are common among youth and may be important predictors of HIV risk behaviors; evidence of these relationships in high-risk populations is needed. Using baseline and 1 year follow-up assessments from an HIV prevention trial we assessed the association between changes in symptoms of anxiety and depression and follow-up sexual risk behaviors (condom use and sexual partner concurrency) controlling for baseline sexual risk behaviors among 1113 male members of social groups known as "camps" in Dar es Salaam, Tanzania. Anxiety and depression were measured using the HSCL-25 and condom use and sexual partner concurrency were assessed through self-report. In separate models, increases in anxiety and depression were associated with sexual partner concurrency and with lower levels of condom use. In a combined model, both anxiety and depression appeared to independently affect concurrency but only depression was independently associated with condom use, with the association between anxiety and condom use being likely attributable to covariance with depression symptoms. The results of this study indicate the importance of screening and providing treatment for depression and anxiety disorders in high HIV-prevalence contexts, and the need to develop effective HIV prevention interventions targeting young men living with anxiety and depression.

show abstract

Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital

Cited by 23 publications

References 45 publications

Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population

Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population

The heartbreak of depression: ‘Psycho-cardiac’ coupling in myocardial infarction

Changes in Anxiety and Depression Symptoms Predict Sexual Risk Behaviors Among Young Men Living in Dar es Salaam, Tanzania

Contact Info

Product

Resources

About