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Vissa sjukdomar för konsekvenser med sig utöver den somatiska bördan. Hepatit C är en av dessa. Detta virus påverkar den drabbades liv på ett sätt som står över den patologiska beskrivningen. Varje år anmäls 2000 fall av hepatit C i Sverige. Syftet med denna litteraturstudie var att få kunskap om omfattningen av psykosociala problem hos hepatit C-smittade. Litteraturstudien grundar sig på sju vetenskapliga artiklar. Forskningsprocessen inspirerades av Goodmans sju olika steg. Som teoretisk referensram har använts Carnevalis modell för ett funktionellt hälsotillstånd i dagligt liv. Resultatet presenteras genom fyra olika teman som identifierades under artikelgranskningen: (1) Stigmatisering av individer med hepatit C, (2) rädsla förknippad med hepatit C, (3) Depressiva symtom förknippade med hepatit C och (4) Bristande socialt stöd vid hepatit. Resultatet pekar på att hepatit C-smittade i stor omfattning upplever psykosociala problem. Detta medför att den smittades livssituation påverkas negativt och därmed minskar dennes möjlighet till att uppleva hälsa. / Certain diseases carry consequences beyond the somatic burden. Hepatitis C is one of them. This virus influences the infected beyond its pathological description. Every year 2000 cases of Hepatitis C are reported in Sweden. The aim of this study was to illuminate the extent and character of psychosocial problems in patients with the diagnosis hepatitis C. The study is based on seven scientific articles. The seven steps for a literature study presented by Goodman inspired the research process. As a theoretical frame of reference Carnevali´s model for a functional and healthy daily life has been used. The analysis resulted in four themes: (1) Stigmatization, (2) fear associated with hepatitis C, (3) depressive symptoms connected with the diagnosis and (4) lack of social support The results indicate that patients with the diagnosis hepatitis C experience psychosocial problems to a larger extent. This also means that these patients are negatively influenced leading to a decreased opportunity to experience health.

Background: To investigate the link between depressive symptoms and physical activity (PA) by examining their association across genders, age, and race/ethnicity. Methods: Data of the cross-sectional study were from the 2011 and 2015 Behavioral Risk Factor Surveillance System. The Patient Health Questionnaire-8, a well-validated instrument to measure depressive symptoms was used. PA was categorized as active, moderately active, and inactive. A generalized linear model specified with a Poisson distribution and log link was performed to investigate the association between depressive symptoms and PA across population characteristics. Results: No significant association between PA and depressive symptoms between genders and across racial/ethnic groups was found. Persons aged 65 years or older showed a significantly lower risk of depressive symptoms than those below 45 years when physically active (Adjusted Prevalence Ratio (APR) 0.36, 95% CI = 0.16–0.82) and moderately active (APR 0.39, 95% CI = 0.16–0.98). Limitations: The study included only leisure-time PA. Well-designed surveys that reflect a wider scope of PA are needed to strengthen the analysis. Conclusions: Compared to younger adults, older adults may gain further health benefits in reducing the risk of depressive symptoms by being physically active. Similar health benefits may be gained from PA between genders and between racial/ethnic groups. The different association between PA and depressive symptoms provides practical implications for the effective management of depressive symptoms in persons with diabetes.

Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age Hana Vaňková, MD Abstract Background: Given the population ageing in Europe and in the Czech Republic, strategies aiming to prevent functional decline in older age are of great importance. Depression in old age increases functional decline and is also associated with increased morbidity, mortality and deterioration of quality of life (Anstey et al., 2007; Karakaya et al., 2009). Therefore, there is a need for a comprehensive intervention addressing both functional status and depressive symptoms. Methods: Using comprehensive geriatric assessment, the relationship between functional status and depressive symptoms was examined in 308 residents of long-term care facilities (RCFs) in the Czech Republic. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. An additional randomized control trial (RCT) evaluated the effect of a dance-based therapy on depressive symptoms in 162 institutionalized older adults with average age over 80 years. Results: A multiple regression analyses adjusted for sociodemographic factors and for taking antidepressants found that cognitive function and functional limitation by pain were most strongly associated with depressive symptoms. The ability to...

Stigmatization involves the application of labels to individuals in social contexts, leading to impaired access to social, economic, and political power. Although actual stigmatizing beliefs that society holds about particular groups are important, the extent to which individuals themselves perceive stigma from others and internalize stigmatizing beliefs is being increasingly recognized as a cause of psychological and physical distress. Little research has been done on explanatory mechanisms of the relations between perceived stigma and health outcomes, particularly in the area of stigma related to finances. Two important dimensions of overall health include depressive symptoms and health-related quality of life. According to Self-Determination Theory feeling controlled by external forces decreases subjective vitality, a measure of energy that is available to self for engaging in life pursuits. Changes in subjective vitality may, in turn, affect health outcomes. Interpersonal variables including how connected one feels with others and whether or not one feels like a burden may affect the manner in which stigma relates to subjective vitality and health. In the current study a sample of 100 individuals receiving medical treatment from a primary clinic that targets the working uninsured population in a region of Appalachia completed questionnaires assessing for perceived stigma of finances, depressive symptoms, health-related quality of life, subjective vitality, thwarted belongingness, and perceived burdensomeness. Results confirmed that experienced and internalized perceived stigma were moderately associated with poorer health outcomes and lower subjective vitality. Thwarted belongingness and perceived burdensomeness were, likewise, associated with worse health outcomes. In mediation analyses subjective vitality significantly explained the relations between each dimension of stigma and each outcome. Subsequent conditional indirect effect analyses found that thwarted belongingness moderated the mediation effect for some of the models by impacting the relation between stigma and subjective vitality or by moderating the relation between subjective vitality and the dependent variable. The findings suggest the importance of subjective vitality and feelings of belongingness in understanding how perceived stigma negatively affects health. Results and implications are discussed along with considerations for future research and interventions.

Objective: Social support and religious commitment were examined in relation to antenatal and postpartum depressive symptoms in a prospective, longitudinal study to determine whether religious commitment explained variance in depression scores beyond that accounted for by social support. Background: Social support and religiosity are positively related to good mental/physical health, and depression is related to poor health outcomes in pregnancy and postpartum. It was hypothesised that social support and religious commitment would be inversely related to depressive symptoms, and that religious commitment would predict variance in depression scores over and above social support. Methods: In 106 mostly low SES Appalachian pregnant women, social support and religious commitment were measured during the first trimester. First and third trimester (Center for Epidemiological Studies Depression Scale – 10 item version), and 6 weeks and 6 months postpartum (Edinburgh Postnatal Depression Scale) depression symptoms were measured. Hierarchical regression examined relative contributions of social support (Prenatal Psychosocial Profile) and religious commitment (Religious Surrender and Attendance Scale – 3 Item Version) to depressive symptoms at each time point while controlling for education and marital status. Results: Regression results indicated that social support and religious commitment explained 10–18% and 0–3% of the variability in depression scores, respectively. Conclusion: Both social support (all time points) and religious commitment (only at 6 months postpartum) were inversely related to depression. Pregnant women low in social support and postpartum women low in social support or religious commitment may be at increased risk for depression.

Background: As the majority of studies examining mental health during the pandemic are cross-sectional, little is known about the changes in mental health during the pandemic, especially in university students. Most studies indicate a worsening of mental health conditions. This study aimed to evaluate the mental health status of German university students during the third wave of the pandemic in 2021 and to compare the results to a sample of a congruent cross-sectional study from 2020. Methods: Two cross-sectional and anonymous online surveys among university students were conducted (first survey: July-August 2020, N = 3,382; second survey: March-April 2021, N = 5,642). Mental health status was assessed with standardized measures (depressive symptoms, alcohol and drug consumption, and eating disorder symptoms), and social and emotional aspects of the COVID-19 pandemic were assessed. In addition to descriptive statistics and group comparisons of the two survey samples from 2020 and 2021, respectively, risk and protective factors related to mental health were analyzed. Results: There were significant differences in severities of depressive symptoms and alcohol and drug consumption between the two online surveys from 2020 and 2021. Findings suggest an increase in the severity of depressive symptoms as well as alcohol and drug consumption. Significantly more respondents reported suicidal ideation in the survey from 2021. Lower self-efficacy, less social support and lower resilience as well as higher perceived stress and more loneliness were reported by the participants of the survey from 2021 compared to 2020. Regarding factors predicting mental health symptoms, being female was a positive predictor for hazardous alcohol use and anorexia nervosa in comparison to men. Further, younger age, being diverse, higher perceived stress and loneliness were positive predictors for all mental health outcomes. Conclusion: This study reveals an increase in severities of depressive symptoms, including suicidal ideation, drug and alcohol consumption among students. Being diverse, younger age, higher perceived stress and loneliness were mutual risk factors for higher depressive and eating disorder symptoms as well as alcohol consumption. Universities and health care policy should recognize and address mental health issues of young adults during ongoing times of crisis and invest in easy-to-access interventions.

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Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.