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      The Prevalence and Risk Factors for Depression Symptoms in a Rural Chinese Sample Population

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          Abstract

          Background

          It is essential to understand how we can prevent and treat the epidemic of depression. Several studies have reported the prevalence of depressive symptoms in the urban population in China, but there is a lack of information regarding the prevalence of depression in rural populations.

          Objective

          To understand the prevalence of depression in a rural Chinese population and to analyze the risk factors for depression.

          Methods

          This study used a cross-sectional approach. A total of 11,473 subjects were surveyed and completed the Patient Health Questionnaire-9 (PHQ-9) and the World Health Organization Quality of Life Brief scales. Living conditions, per capita income, marital status, and information about dietary health and chronic disease status were assessed.

          Results

          The prevalence of depressive symptoms in the population was 5.9%. The prevalence in women (8.1%) was higher compared with men (3.5%) and also increased with age. The per capita income level, amount of sleep obtained per day, education level, weekly consumption of meat and beans or bean products, salt intake, and chronic disease status were associated with depressive symptoms. The quality of life of individuals with a score less than 10 points on the PHQ-9 was significantly better compared with individuals with a score greater than 10.

          Conclusion

          The prevalence of depressive symptoms among rural population is higher than some southern cities in China. Dietary patterns may be an important risk factor linked to this disorder in the Chinese rural population.

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          Most cited references19

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          The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.

          Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable. Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales. The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15. The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. Copyright 2010. Published by Elsevier Inc.
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            Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.

            This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.
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              Exercise treatment for depression: efficacy and dose response.

              This study, conducted between 1998 and 2001 and analyzed in 2002 and 2003, was designed to test (1) whether exercise is an efficacious treatment for mild to moderate major depressive disorder (MDD), and (2) the dose-response relation of exercise and reduction in depressive symptoms. The study was a randomized 2x2 factorial design, plus placebo control. All exercise was performed in a supervised laboratory setting with adults (n =80) aged 20 to 45 years diagnosed with mild to moderate MDD. Participants were randomized to one of four aerobic exercise treatment groups that varied total energy expenditure (7.0 kcal/kg/week or 17.5 kcal/kg/week) and frequency (3 days/week or 5 days/week) or to exercise placebo control (3 days/week flexibility exercise). The 17.5-kcal/kg/week dose is consistent with public health recommendations for physical activity and was termed "public health dose" (PHD). The 7.0-kcal/kg/week dose was termed "low dose" (LD). The primary outcome was the score on the 17-item Hamilton Rating Scale for Depression (HRSD(17)). The main effect of energy expenditure in reducing HRSD(17) scores at 12 weeks was significant. Adjusted mean HRSD(17) scores at 12 weeks were reduced 47% from baseline for PHD, compared with 30% for LD and 29% for control. There was no main effect of exercise frequency at 12 weeks. Aerobic exercise at a dose consistent with public health recommendations is an effective treatment for MDD of mild to moderate severity. A lower dose is comparable to placebo effect.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                11 June 2014
                : 9
                : 6
                : e99692
                Affiliations
                [1 ]Department of Cardiology, The First Hospital of China Medical University, Shenyang city, Liaoning province, China
                [2 ]Department of Psychology, The First Hospital of China Medical University, Shenyang city, Liaoning province, China
                [3 ]Department of Clinical Epidemiology, Shenjing Hospital of China Medical University, Shenyang city, Liaoning province, China
                Old Dominion University, United States of America
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: YS. Performed the experiments: XZ BB. Analyzed the data: LZ. Contributed reagents/materials/analysis tools: ZL. Wrote the paper: XZ. Data collection: HY. Supervision: HS.

                Article
                PONE-D-14-01548
                10.1371/journal.pone.0099692
                4053343
                24919087
                955e23e9-c461-4831-9bf3-0376c1d75f3e
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 January 2014
                : 15 May 2014
                Page count
                Pages: 8
                Funding
                This study was supported by grants from the “Twelfth Five-Year” project funds (National Science and Technology Support Program of China, grant #2012BAJ18B02) that Pro Yingxian Sun responsible for enable the project completion. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Cardiology
                Clinical Genetics
                Epidemiology
                Public and Occupational Health

                Uncategorized
                Uncategorized

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