10 research outputs found
Impact of a Depression-Specific Pharmaceutical Care Counseling and Smartphone App in Medication Adherence among Patients with Major Depressive Disorders: A pilot study
No full textIntroduction: Medication nonadherence has a number of clinical consequences, including an increased risk of relapse and recurrence. By offering individualized in-person pharmaceutical care counseling, pharmacists play a significant part in encouraging medication adherence. One of the most popular forms of communication in nowadays is the smartphone. As a result, one of the measures for enhancing patients’ outcomes should be a smartphone app specifically designed for depression. Objectives: To investigate whether depression-specific counseling and smartphone app could improve medication adherence in newly diagnosed MDD patients. Methods: A prospective, randomized, pilot study was conducted in newly diagnosed major depressive disorder patients. They were randomly assigned to either the intervention or usual care groups (1:1). The intervention included in-person pharmaceutical care counseling along with the introduction use of a depression-specific smartphone app, whereas the usual care group received traditional pharmaceutical care counseling and simple chatbot. The primary outcome, medication adherence was measured using the Medication Adherence Rating Scale (MARS) and the percentage of pills counted (PC) at the one-month follow-up. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms as a secondary outcome. Results: The study was completed by 36 participants (18 intervention and 18 usual care). The average age was 29.81 years, and 65.38% of the participants were female. The two groups had similar baseline characteristics, including baseline PHQ-9 scores. The intervention group had a mean MARS score of 7.0 (IQR=5) higher than the usual group, which had a mean score of 4.5 (IQR=7; p-value=0.04). The intervention group had a higher PC percentage of 81.75 (IQR=33.33) more than the usual care group, which had a mean percentage of 69.95 (IQR=78.57; p-value=0.10). The mean difference of PHQ-9 scores between two visits for the intervention and usual groups was -1.44 [-2.61 - -0.28]. (p-value=0.02). Discussion and Conclusions: This study discovered that new patients with major depression who received depression-specific pharmaceutical care counseling along with smartphone app improved their medication adherence. In addition, improvement in overall depression symptoms was discovered
Biopsychosocial determinants of anxiety and depression among working mothers in China: A public mental health perspective
No full textWorking mothers often face dual demands from work and parenting, increasing their risk for anxiety and depression. However, the prevalence and contributing factors among Chinese working mothers remain underexplored. The aim of this study was to examine the prevalence and biopsychosocial determinants of anxiety and depression in this population. A cross-sectional survey was conducted between October 17 and November 21, 2024 through WeChat online among 330 working mothers aged 30–45 years old using validated instruments, including the Outcome Inventory-21 (OI-21), Parental Stress Scale (PSS), Experiences in Close Relationships-revised (ECR-R-10), Inner Strength-based Inventory (I-SBI), and the Multidimensional Scale of Perceived Social Support (MSPSS). Sociodemographic, socioeconomic and biological factors, including age, marital status, annual income, and physical disease, were also collected through a self-administered general information questionnaire. Data were analyzed using t-test, analysis of variance, Pearson’s correlation, and hierarchical linear regression. This study found the prevalence was 26.1% for anxiety symptoms and 38.2% for depression symptoms in this group based on the screening tools. Anxiety was significantly associated with both biological (e.g., hormonal changes, family psychiatric history) and psychological factors (e.g., attachment anxiety, parental stress). At the same time, depressive symptoms were primarily predicted by psychological and lifestyle-related factors (e.g., smoking, alcohol use). Notably, inner strength was a protective factor across both conditions. The findings highlight the importance of early detection and integrative care strategies for addressing mental health concerns in working mothers. Incorporating psychological screening, lifestyle assessment, and resilience-building interventions into workplace and community-based healthcare services may improve work-family balance outcomes in this population
Predictors of polypharmacy among elderly Thais with depressive and anxiety disorders: findings from the DAS study
No full textAbstract Background Polypharmacy is a geriatric syndrome defined variously as the use of potentially inappropriate drugs and/or the concurrent use of multiple medications including prescription and over-the-counter drugs. An association has been shown between polypharmacy and physical health, increased morbidity and increased mortality. However, there is little information regarding the association between polypharmacy and physical disease, personality trait and mental health problems in elderly. The aim of this study was to investigate potential predictive psychosocial factors related to polypharmacy in elderly Thai people. Methods The study analysed the secondary data from the Depressive Disorders, Anxiety Disorders, Suicide Risk and Associated Factors Among Elderly Thai People Program (DAS Study) which was funded by National Research Council of Thailand and conducted between January 2012 and April 2013. Demographic and baseline clinical characteristics including sex, age, education, living alone or with others, access to health care privilege and monthly income were described. The number of medication, physical diseases and mental health problems (i.e. depression, anxiety, and personality trait of neuroticism) were analyzed using descriptive statistics, chi-square and proportional odds logistic regression. Results The 803 participants consumed an average of 2.13 prescribed medicines daily (SD 1.46, median = 2). The largest group used 3 medications (18.6%). Predictors found to be associated with polypharmacy in the logistic regression model included hypertension (OR = 1.985, 95% CI = 1.420–2.775), anxiety disorder (OR = 4.402, 95% CI = 2.630–7.367), number of diseases (OR = 2.140, 95% CI = 1.874–2.445), depressive disorder (OR = 1.470, 95% CI = 1.080–2.001), diabetes mellitus (OR = 1.864, 95% CI = 1.122–3.098) and dyslipidemia (OR = 0.511, 95%CI = 0.325–0.803). Conclusions The prevalence of polypharmacy among Thai elderly was relatively high compared to other related studies. Several aspects should be taken into consideration before starting an additional medication in elderly patients. In addition to the number of physical disease that leads to polypharmacy, general practitioners should be aware of anxiety, depression, and personality trait of neuroticism that may be related to polypharmacy. Early detection for such condition as well as non-pharmacological intervention could be one way to help reduce polypharmacy in the elderly
Optimal GRID-HAM-D7 cut-off scores for defining remission in older Thai adults with depression
No full textObjectivesThe 7-item Hamilton Depression Rating Scale (HAM-D7) is commonly used to assess depression severity and remission; however, its standard cut-off scores may not be optimal for elderly populations. This study aimed to establish GRID-HAM-D7 remission thresholds among elderly Thai patients diagnosed with depressive disorders, including both any depressive disorder and major depressive disorder (MDD).MethodsA total of 803 elderly participants were recruited from four tertiary care hospitals across Thailand as part of a larger psychiatric study. Diagnoses were determined using the Mini International Neuropsychiatric Interview, and depression severity was assessed via the GRID-HAM-D7. Statistical analyses, including sensitivity, specificity, predictive values, and Receiver Operating Characteristic curves, were performed to determine optimal remission cut-off scores.ResultsFor any depressive disorder, a GRID-HAM-D7 score of ≤ 4 yielded sensitivities of 88.86% and specificity of 77.66%. In major depressive disorder, the optimal threshold was ≤ 6, resulting in 91.68% sensitivity and 79.73% specificity. Both values surpassed the diagnostic accuracy of conventional lower thresholds. These results suggest that higher GRID-HAM-D7 remission cut-offs better reflect depressive symptomatology in older adults.ConclusionsThe study underscores the necessity of tailoring standardized assessment tools for specific populations to enhance clinical management and decision-making in geriatric psychiatry
Psychological Well-Being Among Older Chinese Migrants in Chiang Mai, Thailand: A Cross-Sectional Study on Structural and Psychosocial Resources
No full textDespite the growing number of older adults engaging in voluntary migration, there is a lack of knowledge about their psychological well-being in cross-cultural contexts. This cross-sectional study investigated factors associated with psychological well-being among older Chinese migrants residing in Chiang Mai, Thailand. Between December 2024 and February 2025, 204 Chinese migrants aged 60 and above who had resided in Chiang Mai for at least six months participated in a survey in Chinese. The survey measured sociodemographic and psychosocial factors including perceived health, income, marital status, number of co-residing family members, social support, acculturative stress, sense of mastery, and loneliness. Multiple regression analysis showed that gender (female) (p = 0.006), better perceived health status (p = 0.021), higher income (p = 0.007), more co-residing family members (p = 0.037), a greater sense of mastery (p = 0.009), and lower levels of loneliness (p < 0.001) were each independently associated with better psychological well-being. In contrast, neither general family support nor acculturative stress was a statistically significant predictor. These findings highlight the significant roles of financial security, family co-residence, personal empowerment, and social connectedness in shaping overall well-being. Strategies to improve psychological well-being in this population should focus on strengthening emotional connectedness, supporting the development of meaningful family and social relationships, and supporting economic stability
Factors Associated with Depression in Infertile Couples: A Study in Thailand
No full textBackground: Infertility can affect a couple’s mental health and marital and social relationships. The study aimed to investigate the prevalence of depression among infertile couples and their relationships with other factors. Methods: This study employed a cross-sectional survey. Validated tools were used to assess anxiety and depression, marital satisfaction, personality traits and sufficiency economy. The actor–partner interdependence model (APIM) was used for dyadic analysis. Results: The prevalence of depression in infertile couples was 6.7%. Aggression, extraversion and neuroticism were significantly correlated with depression, whereas the expectation of having children, marital satisfaction and sufficiency economy were negatively correlated with depression. The APIM model suggested that neuroticism and marital satisfaction were significant predictors of depression. Partner effect between the expectation of having children and depression was observed (p = 0.039). Conclusions: Like other populations, depression in infertile couples seems to be associated with aggression, extraversion and neuroticism. However, there are specific variables related to infertility that impact the depression levels of these couples. For instance, the expectation of having children can affect the partners of infertile couples, while the role of the sufficiency economy is a new factor that has been examined for depression in this sample and requires further exploration
The Mediating Role of Inner Strength in the Relationship Between Biological Factors and Depressive Symptoms
No full textBackground: Depression is a significant public health concern, with working mothers at greater risk due to combined biological and psychosocial stressors. Recent evidence suggests that inner strength may play a mediating role in the link between biological risks and depression. Objectives: The primary objective was to determine whether inner strength mediates the relationship between biological risk factors (hormonal fluctuations, smoking, alcohol use, family psychiatric history, and physical diseases) and depressive symptoms among Chinese working mothers. A secondary objective was to assess the prevalence of depressive symptoms in this population, measured with the OI-Depression subscale (Outcome Inventory-21). Methods: A cross-sectional online survey was conducted with 330 Chinese working mothers aged 30–45 years, using validated instruments to measure depression, inner strength, and parental stress. Mediation analysis evaluated the indirect effect of inner strength, while covariate-adjusted regression analyses explored associated factors. Results: Biological risk factors showed a significant direct effect (β = 0.584, p < 0.001) and an indirect effect through inner strength (indirect effect = 0.623, 95% CI [0.294, 0.962]. The Sobel test indicated that the indirect effect of biological risk factors on depressive symptoms through inner strength was statistically significant (z = 3.67, p < 0.001). The prevalence of clinically significant depressive symptoms was 38.2%. Conclusions: Biological factors significantly contribute to depressive symptoms, but inner strength partially mediates this relationship, suggesting that interventions to enhance inner strength may help reduce depression risk in working mothers. Further research should investigate strategies to build inner resilience in this population
Factors Associated with Anxiety and Depression in Infertile Couples—Study Protocol
No full text(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions
MOESM1 of Anticholinergics and benzodiazepines on cognitive impairment among elderly with Alzheimer’s disease: a 1 year follow-up study
No full textAdditional file 1: Table S1. AChEIs and BZDs
