Browsing by Author "Wang, JianLi"

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    A randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol
    (2019-09-18) Wang, JianLi; MacQueen, Glenda; Patten, Scott; Manuel, Douglas; Lashewicz, Bonnie; Schmitz, Norbert
    Abstract Background Major depressive disorder is one of the most prevalent and disabling forms of mental illness in the general population. One public health strategy that may reduce the disease burden is early identification and prevention - identifying people who are at high risk and intervening to prevent symptoms from progressing into a major depressive episode (MDE). Multivariable risk predictive algorithms (MVRP) have been developed to estimate personalized risk (probability) of an MDE. The purpose of this trial is to answer the questions: (1) Does disclosure of personalized depression risk information promote high-risk individuals to take preventive actions? (2) Will disclosure of personalized depression risk information negatively affect the mental health of those at high risk? Methods We are recruiting 350 high-risk men and 350 high-risk women across the country. Individuals are eligible, if they: (1) are 18 years or older, (2) have not had a depressive episode in the past two months, (3) are at high risk of MDE based on the MVRPs (predicted risk of 6.5% + for men and of 11.2% + for women), (4) can communicate in either English or French, and (5) agree to be contacted for follow-up interviews. The MVRPs were developed and validated using longitudinal data from over 10,000 Canadians across the country. Eligible participants are randomized into (1) the control group, and (2) the group receiving personalized depression risk information. The participants are assessed at baseline, 6 and 12 months regarding accuracy of risk perception, use of self-help strategies and changes in psychological distress and functioning. Qualitative interviews are conducted in sub-samples of the intervention groups to explore how the personalized information affects risk perception, self-help behaviors and mental health. Discussion MVRPs can be used for risk stratification and planning preventive actions. The personalized risk information produced by MVRPs may also empower users to actively engage in self-management. This trial will contribute to the knowledge base about the potential health benefits and psychological harms associated with the provision of personalized depression risk information that will inform future implementation and patient-physician communication in the clinical settings. Trial registration NCT02943876 . Date of trial registration: October 21st, 2016.
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    An Epidemiological Study on Risk Factors for the Development of Serious Mental Illness In At-Risk Youth
    (2023-08) Jalali, Sara; Addington, Jean; Patten, Scott B.; Wang, JianLi
    Usually, mental illnesses begin in adolescence and early adulthood, and for many, persist over time. Consequently, mental illnesses lead to significant personal and societal burden. In response, there has been increasing effort in early intervention strategies that may help with delaying or stopping the progression of a mental illness to a more serious state. Aside from finding early intervention strategies best suited for young people, it is imperative to understand the psychosocial, biological and environmental factors that may lead to the development of a mental illness. Research on these early factors in youth mental illness development is limited. The aim of this study was to determine which clinical factors might be related to the development of a serious mental illness (SMI) in at-risk youth. A total of 162 participants aged 12-26 years and at various stages of risk for SMI were included in the study. Out of these participants, 31 developed a SMI. Comparisons were made on a range of baseline clinical and functional measures between two groups; those that made a transition to a SMI (n=31) and those that did not (n=131). A cox regression analysis was used to assess the relationship between measures and SMI development. Female sex, attenuated psychotic symptoms as assessed with the Scale of Psychosis-risk Symptoms (SOPS), and higher ratings on the K-10 Distress Scale were found to be significantly related to later transition to a SMI. Female participants were 2.77 times more likely to transition to SMI compared to the males. There was a 14% increased risk of transition with each one-point increase in the SOPS, and a 7% increase with a one-point increase in the K-10 scale. Results from this longitudinal study may help improve understanding of illness trajectory and aid with early detection in mental illnesses.
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    Brain connectomes in youth at risk for serious mental illness: an exploratory analysis
    (2022-09-15) Metzak, Paul D.; Shakeel, Mohammed K.; Long, Xiangyu; Lasby, Mike; Souza, Roberto; Bray, Signe; Goldstein, Benjamin I.; MacQueen, Glenda; Wang, JianLi; Kennedy, Sidney H.; Addington, Jean; Lebel, Catherine
    Abstract Background Identifying early biomarkers of serious mental illness (SMI)—such as changes in brain structure and function—can aid in early diagnosis and treatment. Whole brain structural and functional connectomes were investigated in youth at risk for SMI. Methods Participants were classified as healthy controls (HC; n = 33), familial risk for serious mental illness (stage 0; n = 31), mild symptoms (stage 1a; n = 37), attenuated syndromes (stage 1b; n = 61), or discrete disorder (transition; n = 9) based on clinical assessments. Imaging data was collected from two sites. Graph-theory based analysis was performed on the connectivity matrix constructed from whole-brain white matter fibers derived from constrained spherical deconvolution of the diffusion tensor imaging (DTI) scans, and from the correlations between brain regions measured with resting state functional magnetic resonance imaging (fMRI) data. Results Linear mixed effects analysis and analysis of covariance revealed no significant differences between groups in global or nodal metrics after correction for multiple comparisons. A follow up machine learning analysis broadly supported the findings. Several non-overlapping frontal and temporal network differences were identified in the structural and functional connectomes before corrections. Conclusions Results suggest significant brain connectome changes in youth at transdiagnostic risk may not be evident before illness onset.
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    Descriptive epidemiology of stigma against depression in a general population sample in Alberta
    (BioMed Central, 2010-04-19) Cook, Trevor M.; Wang, JianLi
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    High Work Stress as a Risk Factor for Problematic Alcohol Use in the Canadian Working Population
    (2013-09-24) Birney, Arden; Wang, JianLi
    Objective: To investigate the longitudinal relationship between work stress and problematic drinking in the Canadian working population using data from the National Population Health Survey. Methods: Participants (n=4,326) were classified by work stress based on the Job Content Questionnaire. Problematic drinking was defined in three ways: 5+ drinks on one occasion at least once per month during the past 12 months, 10+ drinks/week for women and 15+ drinks/week for men, and a proxy of the AUDIT-C. Results: Men with high work stress at baseline were at lower risk of problematic drinking, regardless of the way in which work stress or problematic drinking were defined. Problematic drinking was not consistently associated with work stress among women. Conclusions: Among men, high work stress was associated with a decreased risk of problematic drinking. Future research is necessary to further clarify the relationship between work stress and problematic drinking among working Canadians.
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    Low Social Support as a Risk Factor for a Major Depressive Episode in Canadian Community Dwelling Seniors
    (2015-03-24) Cook, Trevor; Wang, JianLi
    Background: The proportion of Canadians aged 65 years of age and older is rapidly growing. While major depression has consistently been identified in the literature as a major health concern, little research exists on geriatric depression in Canada. Current research on risk factors for depression in seniors has been generated almost exclusively through cross-sectional studies. A small number of longitudinal studies have been conducted, though their applicability is limited by short study periods, strictly defined study populations, and focus on only one or two potential risk factors. No longitudinal studies on seniors’ depression have been conducted in Canada at the population level despite the availability of data to do so (the National Population Health Survey, or NPHS). Using the NPHS, this thesis explored the relationship between social support and major depression in Canadian community-dwelling seniors. Methods: I assessed types and levels of social support using the Medical Outcomes Study Social Support Survey. Major depressive episode (MDE) in the past 12-months was assessed using the Composite International Diagnostic Interview – Short Form for Major Depression (CIDI-SFMD) and Anatomic Therapeutic Classification (ATC) Drug codes for anti-depressant usage. Demographic characteristics and health characteristics of respondents and non-respondents were examined and compared. The 12-month prevalence and 2- and 8-year incidence proportions of MDE were estimated. Multivariate logistic regression modeling was used to examine the association between social support and the 8-year risk of MDE Results: In participants aged 65 years of age and older, the 12-month prevalence of MDE was 6.50% (95% CI 5.28%-7.63%). The 2-year and 8-year incidence of MDE was estimated to be 4.54% (95% CI 3.38%-5.60%), and 13.09% (95% CI 11.27%-14.90%), respectively. Incidence was higher among women, those with a chronic condition, those with a restriction to activity, a pain problem or a mobility problem. In multivariate modeling low positive social interaction (OR 1.59, 95% CI 1.12-2.25, p=0.009) and low emotional social support (OR 1.53, 95% CI 1.09-2.14, p=0.013) were significantly associated with the risk of MDE. The association between tangible social support and MDE was modified by income (OR 0.2.70, p=0.019), with those of low income and low tangible support at higher risk of MDE (OR 2.66, 95% CI 1.02-6.89, p=0.044). The relationship between both tangible support (OR 0.43, p=0.025) and affection support (OR 0.35, p=0.008) with MDE was modified by the presence of a pain problem. In both cases, social support was not related to MDE if a pain problem was present. Among those without a pain problem, low tangible social support (OR 2.63, 95% CI 1.03-6.75, p=0.044) and low affection social support (OR 2.09, 95% CI 1.33-3.28, p=0.001) was associated with higher risk of MDE. Conclusion: Social support is an important risk factor for MDE in seniors, even after adjustment for a number of health and demographic variables. The relationship between some types of social support (tangible and affection social support) and MDE may be modified by the presence of a pain problem. It is therefore important that chronic pain issues be adequately controlled in seniors, as these may counter the positive effects of high levels of social support. Living arrangement was not found associated with depression in our study, suggesting that seniors aging in the community versus a long-term care facility are not at increased risk of depression, provided they have high levels of social support. Efforts such as community programs may therefore be important in helping ensure high levels of positive social interaction and social support in community-dwelling seniors.
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    Mental disorders in a population sample with musculoskeletal disorders
    (BioMed Central Ltd., 2006-04-25) Patten, Scott B.; Williams, Jeanne V.A.; Wang, JianLi
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    Users’ perceptions about receiving personalized depression risk information: findings from a qualitative study
    (2021-11-18) Eccles, Heidi; Nadouri, Doaa; Nannarone, Molly; Lashewicz, Bonnie; Schmitz, Norbert; Patten, Scott B.; Manuel, Douglas G.; Wang, JianLi
    Abstract Objectives To understand users’ perceptions about receiving their personalized depression risk score and to gain an understanding about how to improve the efficiency of risk communication from the user perspective. Methods A qualitative study embedded in a randomized controlled trial (RCT) on evaluating the impact of providing personalized depression risk information on psychological harms and benefits. The participants (20 males and 20 females) were randomly selected from the intervention arm of the RCT after the 12-month assessment. The qualitative interviews were conducted through telephone, audio recorded and transcribed verbatim. We conducted a content analysis to describe the content and contextual meaning of data collected from participants. Results The first theme explained the motivation for receiving a risk score. Most participants chose to receive their personalised depression risk score with the goal of improving their self-awareness. The results revealed three sub-themes surrounding perceptions and implication of receiving their risk score: positive, negative, and neutral. Most participants found that receiving their score was positive because it improved their awareness of their mental health, but some participants could see that some people would have negative feelings when getting the score causing them to be more likely to get depression. The final theme focussed on improvements including: the best delivery methods, having resources and strategies, and targeting younger people. Conclusion The most significant motivation for, and benefit of receiving one’s personalized depression risk score was improved awareness of one’s mental health. A comprehensive risk communication program may improve the uptake and maximize the impact on behavior changes and risk reduction.
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    Workplace factors and the transition to major depression in a representative sample of Alberta employees
    (2014-12-24) Bolo, Carmelle Angelie; Wang, JianLi
    Subthreshold depression is prevalent and increases risk of Major Depressive Disorder (MDD), though psychosocial workplace factors associated with the transition have not been explored. Using data from the Population-based Longitudinal Study on Work and Health, participants with no depression (n=2840) and subthreshold depression (n=305) were followed prospectively for two years. Subthreshold depression was measured with the Patient Health Questionnaire-9, while MDD was measured with the Composite International Diagnostic Interview-Auto 2.1. Using binomial regression modelling, those with high work to family conflict had an increased risk of 2-year transition to subthreshold depression (RRadj 1.47; 95% CI: 1.05-2.05; p=0.02) and 1-year transition to MDD (RRadj 2.88; 95% CI: 1.08-7.62; p=0.03) compared to those with low work to family conflict. Similar risk factors appear to exist for subthreshold depression and MDD. Future studies with larger sample sizes should consider multinomial transitions including outcomes of more severe depression, less severe depression, and no change.