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      Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP)

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          Abstract

          Objective

          To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly.

          Methods

          We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support.

          Results

          Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women.

          Conclusion

          Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women.

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          Most cited references54

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          Stress, social support, and the buffering hypothesis.

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            Social disconnectedness, perceived isolation, and health among older adults.

            Previous research has identified a wide range of indicators of social isolation that pose health risks, including living alone, having a small social network, infrequent participation in social activities, and feelings of loneliness. However multiple forms of isolation are rarely studied together making it difficult to determine which aspects of isolation are most deleterious for health. Using population-based data from the National Social Life, Health, and Aging Project, we combine multiple indicators of social isolation into scales assessing social disconnectedness (e.g., small social network, infrequent participation in social activities) and perceived isolation (e.g., loneliness, perceived lack of social support). We examine the extent to which social disconnectedness and perceived isolation have distinct associations with physical and mental health among older adults. Results indicate that social disconnectedness and perceived isolation are independently associated with lower levels of self-rated physical health. However, the association between disconnectedness and mental health may operate through the strong relationship between perceived isolation and mental health. We conclude that health researchers need to consider social disconnectedness and perceived isolation simultaneously.
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              Use of the Center for Epidemiologic Studies Depression (CES-D) Scale in Korea.

              We translated the Center for Epidemiologic Studies Depression (CES-D) Scale into Korean, paying careful attention to culturally different modes of expression of depressive feelings and thoughts. The final translated version (CES-D-K) was administered to 164 psychiatric patients and 464 normal subjects residing in the community. Reliability, validity, and the optimal cutoff point of this scale were estimated, including ROC analysis. The CES-D-K was reliable and valid for the Korean population. Two optimal cutoff points were suggested: 24/25, the point which best corresponded to the clinical diagnosis of depression, and 20/21, which most effectively detects and covers depressive symptoms during screening. The higher cutoff points than those in Western countries may be due to different ways of expression affect, especially the suppression of positive affect, in cultures based on Confucian ethics.
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                Author and article information

                Journal
                Psychiatry Investig
                Psychiatry Investig
                PI
                Psychiatry Investigation
                Korean Neuropsychiatric Association
                1738-3684
                1976-3026
                January 2018
                16 January 2018
                : 15
                : 1
                : 24-33
                Affiliations
                [1 ]Department of Sociology, Yonsei University, Seoul, Republic of Korea.
                [2 ]Department of Preventive Medicine, Yonsei University, Seoul, Republic of Korea.
                [3 ]Department of Sociology, The University of Chicago, Chicago, IL, USA.
                Author notes
                Correspondence: Yoosik Youm, PhD. Department of Sociology, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Tel: +82-2-2123-2431, Fax: +82-2-2123-2420, yoosik@ 123456yonsei.ac.kr
                Article
                10.4306/pi.2018.15.1.24
                5795026
                7338a7bc-a6fa-4b14-bae1-621aacc51e91
                Copyright © 2018 Korean Neuropsychiatric Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 November 2016
                : 23 February 2017
                : 06 March 2017
                Funding
                Funded by: National Research Foundation of Korea, CrossRef http://dx.doi.org/10.13039/501100003725;
                Award ID: NRF-2017S1A3A2067165
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                c-reactive protein,social support,aged
                Clinical Psychology & Psychiatry
                c-reactive protein, social support, aged

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