Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study
BackgroundDepression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected indivi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-05-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2022/5/e30907 |
| _version_ | 1797735048871411712 |
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| author | Huimin Zhang Yuhua Liao Xue Han Beifang Fan Yifeng Liu Leanna M W Lui Yena Lee Mehala Subramaniapillai Lingjiang Li Lan Guo Ciyong Lu Roger S McIntyre |
| author_facet | Huimin Zhang Yuhua Liao Xue Han Beifang Fan Yifeng Liu Leanna M W Lui Yena Lee Mehala Subramaniapillai Lingjiang Li Lan Guo Ciyong Lu Roger S McIntyre |
| author_sort | Huimin Zhang |
| collection | DOAJ |
| description |
BackgroundDepression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected individuals. China’s public and academic communities have reached a consensus on the need to improve access to early screening, diagnosis, and treatment of depression.
ObjectiveThis study aims to estimate the screening prevalence and associated factors of subthreshold depressive symptoms among Chinese residents enrolled in the cohort study using a mobile app–based integrated mental health care model and investigate the 12-month incidence rate and related factors of major depressive disorder (MDD) among those with subthreshold depressive symptoms.
MethodsData were drawn from the Depression Cohort in China (DCC) study. A total of 4243 community residents aged 18 to 64 years living in Nanshan district, Shenzhen city, in Guangdong province, China, were encouraged to participate in the DCC study when visiting the participating primary health care centers, and 4066 (95.83%) residents who met the DCC study criteria were screened for subthreshold depressive symptoms using the Patient Health Questionnaire-9 at baseline. Of the 4066 screened residents, 3168 (77.91%) with subthreshold depressive symptoms were referred to hospitals to receive a psychiatric diagnosis of MDD within 12 months. Sleep duration, anxiety symptoms, well-being, insomnia symptoms, and resilience were also investigated. The diagnosis of MDD was provided by trained psychiatrists using the Mini-International Neuropsychiatric Interview. Univariate and multivariate logistic regression models were performed to explore the potential factors related to subthreshold depressive symptoms at baseline, and Cox proportional hazards models were performed to explore the potential factors related to incident MDD.
ResultsAnxiety symptoms (adjusted odds ratio [AOR] 1.63, 95% CI 1.42-1.87) and insomnia symptoms (AOR 1.13, 95% CI 1.05-1.22) were associated with an increased risk of subthreshold depressive symptoms, whereas well-being (AOR 0.93, 95% CI 0.87-0.99) was negatively associated with depressive symptoms. During the follow-up period, the 12-month incidence rate of MDD among participants with subthreshold depressive symptoms was 5.97% (189/3168). After incorporating all significant variables from the univariate analyses, the multivariate Cox proportional hazards model reported that a history of comorbidities (adjusted hazard ratio [AHR] 1.49, 95% CI 1.04-2.14) and anxiety symptoms (AHR 1.13, 95% CI 1.09-1.17) were independently associated with an increased risk of incident MDD. The 5-item World Health Organization Well-Being Index was associated with a decreased risk of incident MDD (AHR 0.90, 95% CI 0.86-0.94).
ConclusionsElevated anxiety symptoms and unfavorable general well-being were significantly associated with subthreshold depressive symptoms and incident MDD among Chinese residents in Shenzhen. Early screening for subthreshold depressive symptoms and related factors may be helpful for identifying populations at high risk of incident MDD. |
| first_indexed | 2024-03-12T12:52:22Z |
| format | Article |
| id | doaj.art-435b9ea90f8343bb881feb2d6e63e0f3 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:52:22Z |
| publishDate | 2022-05-01 |
| publisher | JMIR Publications |
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| series | Journal of Medical Internet Research |
| spelling | doaj.art-435b9ea90f8343bb881feb2d6e63e0f32023-08-28T21:49:11ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-05-01245e3090710.2196/30907Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort StudyHuimin Zhanghttps://orcid.org/0000-0001-5944-400XYuhua Liaohttps://orcid.org/0000-0002-5006-6644Xue Hanhttps://orcid.org/0000-0001-5801-4788Beifang Fanhttps://orcid.org/0000-0003-4241-2997Yifeng Liuhttps://orcid.org/0000-0002-8096-1885Leanna M W Luihttps://orcid.org/0000-0002-0148-5455Yena Leehttps://orcid.org/0000-0003-0629-9456Mehala Subramaniapillaihttps://orcid.org/0000-0002-6917-3984Lingjiang Lihttps://orcid.org/0000-0002-8775-7852Lan Guohttps://orcid.org/0000-0002-5213-2158Ciyong Luhttps://orcid.org/0000-0003-4266-4967Roger S McIntyrehttps://orcid.org/0000-0003-4733-2523 BackgroundDepression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected individuals. China’s public and academic communities have reached a consensus on the need to improve access to early screening, diagnosis, and treatment of depression. ObjectiveThis study aims to estimate the screening prevalence and associated factors of subthreshold depressive symptoms among Chinese residents enrolled in the cohort study using a mobile app–based integrated mental health care model and investigate the 12-month incidence rate and related factors of major depressive disorder (MDD) among those with subthreshold depressive symptoms. MethodsData were drawn from the Depression Cohort in China (DCC) study. A total of 4243 community residents aged 18 to 64 years living in Nanshan district, Shenzhen city, in Guangdong province, China, were encouraged to participate in the DCC study when visiting the participating primary health care centers, and 4066 (95.83%) residents who met the DCC study criteria were screened for subthreshold depressive symptoms using the Patient Health Questionnaire-9 at baseline. Of the 4066 screened residents, 3168 (77.91%) with subthreshold depressive symptoms were referred to hospitals to receive a psychiatric diagnosis of MDD within 12 months. Sleep duration, anxiety symptoms, well-being, insomnia symptoms, and resilience were also investigated. The diagnosis of MDD was provided by trained psychiatrists using the Mini-International Neuropsychiatric Interview. Univariate and multivariate logistic regression models were performed to explore the potential factors related to subthreshold depressive symptoms at baseline, and Cox proportional hazards models were performed to explore the potential factors related to incident MDD. ResultsAnxiety symptoms (adjusted odds ratio [AOR] 1.63, 95% CI 1.42-1.87) and insomnia symptoms (AOR 1.13, 95% CI 1.05-1.22) were associated with an increased risk of subthreshold depressive symptoms, whereas well-being (AOR 0.93, 95% CI 0.87-0.99) was negatively associated with depressive symptoms. During the follow-up period, the 12-month incidence rate of MDD among participants with subthreshold depressive symptoms was 5.97% (189/3168). After incorporating all significant variables from the univariate analyses, the multivariate Cox proportional hazards model reported that a history of comorbidities (adjusted hazard ratio [AHR] 1.49, 95% CI 1.04-2.14) and anxiety symptoms (AHR 1.13, 95% CI 1.09-1.17) were independently associated with an increased risk of incident MDD. The 5-item World Health Organization Well-Being Index was associated with a decreased risk of incident MDD (AHR 0.90, 95% CI 0.86-0.94). ConclusionsElevated anxiety symptoms and unfavorable general well-being were significantly associated with subthreshold depressive symptoms and incident MDD among Chinese residents in Shenzhen. Early screening for subthreshold depressive symptoms and related factors may be helpful for identifying populations at high risk of incident MDD.https://www.jmir.org/2022/5/e30907 |
| spellingShingle | Huimin Zhang Yuhua Liao Xue Han Beifang Fan Yifeng Liu Leanna M W Lui Yena Lee Mehala Subramaniapillai Lingjiang Li Lan Guo Ciyong Lu Roger S McIntyre Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study Journal of Medical Internet Research |
| title | Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study |
| title_full | Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study |
| title_fullStr | Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study |
| title_full_unstemmed | Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study |
| title_short | Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App–Based Integrated Mental Health Care Model: Cohort Study |
| title_sort | screening depressive symptoms and incident major depressive disorder among chinese community residents using a mobile app based integrated mental health care model cohort study |
| url | https://www.jmir.org/2022/5/e30907 |
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