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Tuesday, December 15, 2020 Youth Depression Associated With Somatic Diseases, Mortality Children and adolescents with depression are at higher risk for a host of somatic diseases and premature death in early adulthood, according to a study published in JAMA Psychiatry . These findings support the hypothesis that youth depression is linked to more than other psychiatric and neurologic disorders, impacting their quality of life and posing public health challenges, according to corresponding author Sarah E. Bergen, Ph.D., of the Karolinska Institutet in Sweden and colleagues. “Consequentially, clinical efforts to comprehensively manage both psychiatric and somatic diagnoses are needed.” Bergen and colleagues conducted a cohort study of nearly 1.5 million Swedish individuals born between 1982 and 1996, with follow-up through 2013. Using data on clinical diagnoses from the National Patient Register and deaths noted in the Cause of Death Register, they compared outcomes in people who were diagnosed with depression between the ages of 5 and 19 (defined by authors as youth depression) with those who were not diagnosed with depression as youth. (The observation period began when patients were aged 5 because pediatric depression is rarely diagnosed during the first years of life, the authors wrote.) The patients’ age at the end of the follow-up period was between 17 and 31 years. The authors specifically focused on causes of death and the diagnoses of 69 somatic diseases, including gastrointestinal, respiratory, and genitourinary diseases; autoimmune diseases; and endocrine and metabolic disorders. In total, 360 patients (1.0%) with youth depression died during follow-up compared with 6,254 individuals (0.4%) in the group without history of depression. Intentional self-harm was the leading cause of death among those with youth depression. Those participants also had a significantly higher risk of being diagnosed with 66 of the 69 somatic diseases included in the study at any time after their first inpatient or outpatient recorded depressive episode. The strongest risk for an injury was among females with youth depression, who were 14 times more likely to experience an injury from self-harm than females not diagnosed with youth depression. Females with youth depression also had a higher risk of genitourinary infections, while males had a higher risk for obesity, thyroid disease, and other endocrine gland disorders. Both sexes, however, had an increased risk for type 2 diabetes, viral hepatitis, kidney disease, and liver disease. When adjusted for psychiatric comorbidity, all the associations that the authors identified were weaker, but persisted. “More research is needed to identify whether depression at a young age leads to adverse health outcomes or common causes underlie both,” the authors concluded. “Discovery of disease mechanisms that may serve as intervention targets in early life should be prioritized in light of the substantial disease burden associated with youth depression diagnoses.” (Image: iStock/Nadezhda1906) Join Former AMA President, Psychiatrist in New Campaign on Black Women’s Health The AMA has launched a new campaign with other medical organizations to support Black women in a movement for healthy blood pressure. A two-part interview with radio talk show host Tom Joyner is being aired to spread the word. Part one is posted here ; the second part will be available tomorrow (Wednesday, December 16) at 8 p.m. ET. In this episode, Joyner will interview the AMA’s first Black president, psychiatrist Patrice A. Harris, M.D., M.A. The AMA has also posted a toolkit for physicians as part of the campaign. Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here . Follow Psychiatric News on Twitter! Posted by Psychiatric News Alert at 4:02 PM Email This BlogThis! Share to Twitter Share to Facebook Share to Pinterest Labels: depression , endocrine disorders , genitourinary infections , JAMA Psychiatry , obesity , premature death , self-harm , somatic disorders , Swedish registries , thyroid disease Monday, December 14, 2020 Depression, Not Burnout, Associated With Greater Suicidal Ideation in Physicians Depression, but not burnout, appears to be associated with greater suicidal ideation in U.S. physicians, according to a study in JAMA Network Open . In contrast, burnout, but not depression, was associated with self-reported medical errors. “Approximately 1 in 10 medical students, 1 in 4 interns, and 1 in 16 practicing physicians report some degree of suicidal ideation,” wrote senior author Mickey T. Trockel, M.D., Ph.D., of Stanford University School of Medicine and colleagues. “Addressing physician well-being and reducing suicide risk require understanding the associations between physician distress, including burnout and depression, and personal and professional outcomes.” Previous studies have suggested burnout is a risk factor for depression and suicide in physicians and physicians in training. Few, however, have examined the association between burnout and suicidal ideation after adjusting for depression, according to Trockel and colleagues. To examine this association after accounting for concurrent symptoms of depression, the authors invited a random sample of U.S. attending and postgraduate trainee physicians to complete a survey assessing burnout, depression, and suicidal ideation. This cross-sectional study was conducted from November 12, 2018, to February 15, 2019. The participants were evaluated using subscales of the Stanford Professional Fulfillment Index (PFI), Maslach Burnout Inventory–Human Services Survey for Medical Personnel, Mini-Z burnout survey, and the Patient-Reported Outcomes Measurement Information System (PROMIS) depression Short Form. In addition, the participants were asked about suicidal ideation, as well as any history of making medical errors and the types of errors made. The authors analyzed the responses of 1,354 survey participants, 75 (5.5%) of whom reported having thoughts of taking their own life in the previous 12 months. Burnout was significantly associated with increased odds of suicidal ideation before but not after the data were adjusted for depression. In contrast, after the data were adjusted for overall burnout (PFI), sex, race/ethnicity, training status, and age category, each increase of one standardized point on the PROMIS depression scale was associated with 202% greater odds of suicidal ideation. The authors found the opposite was true when examining the relationship between burnout, depression, and medical errors: Burnout, not depression, was associated with self-reported medical errors. Trockel and colleagues noted several limitations to the study, including their inability to assess causality. “Future investigations are warranted to evaluate causal relationships between burnout, depression, suicidal ideation, and medical error,” they concluded. For related information, see the Psychiatric News article “ New Findings and Controversies in Physician Well-Being and Burnout ” and the American Journal of Psychiatry article “ The Elephant in the Room: What Burnout Is and What It Is Not .” (Image: iStock/rclassenlayouts) Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here . Follow Psychiatric News on Twitter! Posted by Psychiatric News Alert at 2:28 PM Email This BlogThis! Share to Twitter Share to Facebook Share to Pinterest Labels: burnout , depression , JAMA Network Open , medical errors , suicidal ideation , suicide , trainees Friday, December 11, 2020 Anxiety, Depression May Increase Risk of Acute Exacerbation in COPD Patients with chronic obstructive pulmonary disease (COPD) may experience an acute exacerbation of their illness if they have depression and/or anxiety, suggests a study in the Journal of Affective Disorders . Guangxi Li, M.D., Ph.D., of Guang'anmen Hospital at the China Academy of Chinese Medical Sciences i...
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