Medicine and Health Sciences Commons^™

Stroke-Related Mental Health Challenges And Interventions: Strategies For Holistic Recovery, Christopher Walsh, Sam Lee

MOT Student Capstones

This capstone project examines the relationship between post-stroke and mental health. It presents the necessity for a holistic and client-centered approach in the recovery process. Through a mixed-methods approach combining a literature review and empirical research, including surveys of stroke survivors, caregivers, and practitioners, the study shows the prevalence of depression and anxiety post-stroke and the potential benefit of comprehensive mental health support. The findings emphasize the importance of community, spirituality, and proactive education in enhancing mental well-being. The effectiveness of specific interventions for this population was found to be variable, which warrants the use of personalized assessments and intervention …

New-Onset Depression Following Total Shoulder Arthroplasty: The Impact Of Preoperative Patient Factors And Postoperative Complications, Kevin X. Farley, Robert S. Dean, Eric R. Wagner, Michael B. Gottschalk, J Michael Wiater

Conference Presentation Abstracts

OBJECTIVE: Depression has been well studied as a risk factor for postoperative complications following total shoulder arthroplasty (TSA). However, little is known about new-onset depression (NOD) following TSA. The purpose of this study is to determine the incidence of NOD following TSA and identify risk factors for its occurrence. METHODS: This was a retrospective review of patients undergoing TSA in the Truven Health MarketScan database. NOD was identified. Patients with preoperative depression were excluded from analysis. Postoperative complications were identified, including the development of a prosthetic joint infection (PJI), need for revision surgery, and postoperative dislocation. If a complication occurred …

Effects Of Electrical Exercise On Self-Reported Depression And Quality Of Life In Those With Spinal Cord Injury, Aj Barber, Eric Heidorn, John Mcdaniel, Cody S. Dulaney

International Journal of Exercise Science: Conference Proceedings

One of the most common psychological disorders that occur as a result of spinal cord injury (SCI) is depression along with reductions in quality of life. Moreover, depression is correlated with quality of life. It is increasingly apparent that exercise offers an accessible and non-pharmacological intervention to ease depressive symptoms and improve quality of life. Unfortunately, access to meaningful exercise options remains challenging to those with mobility impairments such as those seen with SCI. PURPOSE: The purpose of this study was to assess the chronic engagement of home-based electrical stimulation exercise (ESE) on self-reported depression and quality of life …

Comparisons Of Using Alcohol, Coping Strategies, Anxiety, And Depression Between Usa And Taiwanese College Students, Pi-Ming Yeh Associate Professor, Cheng-Huei Chiao Professor, Jennchang Liou Professor

Epsilon Sigma at-Large Research Conference

Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression.

Research Questions:

1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students?

2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression?

3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies?

Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was …

Implementation Of Provider-Made Follow-Up Appointments For Depression In Primary Care, Rebecca Vaughn

Epsilon Sigma at-Large Research Conference

Implementation of provider-made follow-up appointments for depression in primary care

Rebecca Vaughn

College of Nursing, East Tennessee State University; Whitson Hester School of Nursing, Tennessee Technological University

Author Note

Rebecca Vaughn https://orcid.org/0009-0007-0731-3316 College of Nursing, East Tennessee State University

There are no conflicts of interest to disclose.

Corresponding concerning this manuscript should be addressed to Rebecca Vaughn

108 Reed Mill Lane Monroe TN 38573

[email protected]

Abstract

Depression is a common condition diagnosed and managed in primary care.

Follow-up is inconsistent and low in these settings, creating a gap in care that

impacts management, adherence to treatment, and patient outcomes. The …

Individual Differences In Cannabis Use Disorder With Implications For Endocannabinoid Modulation In Therapeutics Development, Erin L. Martin

MUSC Theses and Dissertations

Cannabis use disorder (CUD) is increasingly prevalent in the United States, but there is no effective pharmacological means to treat it. The endocannabinoid (eCB) system has emerged as a candidate therapeutic target demonstrating some evidence of efficacy in treating CUD. However, clinical trials evaluating eCB-modulating therapeutics have historically undervalued individual differences that could contribute to variation in treatment outcome (e.g. sex, comorbid psychiatric illness). To address this gap in the literature, the present set of studies (a) compared plasma eCB tone in groups underrepresented in treatment trials for CUD (females, individuals with comorbid major depressive disorder; MDD/CUD) with males or …

Abnormal Neural Sensitivity To Rewards As A Candidate Process Of High Depression Risk In The Fmr1 Premutation: A Pilot Study, Roslyn Harold, Bridgette Kelleher, Keisha Novak, Wei Siong Neo, Teagan Stump, Taylor Lee, Tessa Garwood, Elizabeth Berry-Kravis, Dan Foti

Purdue University Libraries Open Access Publishing Fund

The etiological heterogeneity of depression poses a challenge for prevention and intervention efforts. One solution is to map unique etiological pathways for subgroups defined by a singular risk factor. A relevant population for this approach is women who carry the premutation of the fragile X messenger ribonucleoprotein 1 (FMR1) gene, who are at high risk for adult-onset depression. This study explores a candidate neurophysiological marker of depression risk: reduced reward sensitivity, indexed by the reward positivity (RewP). The RewP has been linked to depression risk in the general population, but is unexplored within FMR1 premutation carriers. 16 women with the …

Perioperative Mental Health Intervention For Depression And Anxiety Symptoms In Older Adults Study Protocol: Design And Methods For Three Linked Randomised Controlled Trials, Katherine J Holzer, Kimberly A Bartosiak, Ryan P Calfee, Chet W Hammill, Simon Haroutounian, Benjamin D Kozower, Theresa A Cordner, Emily M Lenard, Kenneth E Freedland, Bethany R Tellor Pennington, J Philip Miller, Mary C Politi, Yi Zhang, Michael D Yingling, Ana A Baumann, Thomas Kannampallil, Julia A Schweiger, Sherry L Mckinnon, Michael S Avidan, Eric J Lenze, Joanna Abraham, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Preoperative anxiety and depression symptoms among older surgical patients are associated with poor postoperative outcomes, yet evidence-based interventions for anxiety and depression have not been applied within this setting. We present a protocol for randomised controlled trials (RCTs) in three surgical cohorts: cardiac, oncological and orthopaedic, investigating whether a perioperative mental health intervention, with psychological and pharmacological components, reduces perioperative symptoms of depression and anxiety in older surgical patients.

METHODS AND ANALYSIS: Adults ≥60 years undergoing cardiac, orthopaedic or oncological surgery will be enrolled in one of three-linked type 1 hybrid effectiveness/implementation RCTs that will be conducted in tandem …

Is A Patient Navigation Program More Helpful Than A Referral Program For Reducing Depression And Improving Quality Of Life Among Women Living In Neighborhoods With Few Resources?, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The research team compared two programs designed to help women with feelings of depression who live in neighborhoods with few resources. Both programs lasted four months.

Comparing Long-Term Outcomes Of Two Collaborative Care Approaches For People With Depression, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

People with depression usually get treatment in healthcare settings, such as clinics. In communities with few resources, people may also get help in community settings such as social services agencies or churches. Collaborative care brings together healthcare and community programs to help people with depression.

Comparing Two Ways To Treat Serious Worry Among Older Adults From Underserved, Racial Or Ethnic Minority Communities, Reach Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Compared with other older adults, those with serious worry are more likely to have poor physical health, and often have depression, sleep problems, and trouble thinking clearly.

Acute Post-Surgery Education And Occupational Therapy For Improved Outcomes In Rural Below Knee Amputation Patients, Spencer Mauk

MOT Student Capstones

Below knee amputation (BKA) patients who live in a rural setting see poorer functional outcomes, face systemic healthcare barriers, and have limited access to necessary healthcare resources. To improve this population's outcomes a project aimed to improve acute occupational therapy (OT) approaches for BKA patients in rural areas was developed. This project started with a literature review to identify existing best practices and gaps in post-operative care. The study also analyzed current educational materials, therapy protocols, and practices. The project's main goal was to develop educational and intervention materials catered to the health literacy levels of rural BKA patients. These …

Occupational Therapy For People With Dementia Who Have Occupational Performance Challenges Due To Depression, Ally Frazier, Steven M. Gerardi

Spring 2024 Virtual OTD Capstone Symposium

Individuals with dementia experience a multitude of barriers and challenges that impact their daily engagement throughout the environment. In addition, although the pandemic has concluded, noxious effects are still influencing people's lives. Residential care facilities have noticed continual acts of isolation that are presenting as barriers in mental health. Depression has known to be a common comorbidity in the ailment of dementia. Occupational therapy (OT) practitioners have the unique and valuable role in working with this population to target beyond the biomechanical aspects of a resident. Identifying barriers for mastery in leisure pursuits throughout someone’s day is crucial. When residents …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Differential Effects Of Type 2 Diabetes Treatment Regimens On Diabetes Distress And Depressive Symptoms In The Glycemia Reduction Approaches In Diabetes: A Comparative Effectiveness Study (Grade), Jeffrey S Gonzalez, Ionut Bebu, Heidi Krause-Steinrauf, Claire J Hoogendoorn, Gladys Crespo-Ramos, Caroline Presley, Aanand D Naik, Shihchen Kuo, Mary L Johnson, Deborah Wexler, Jill P Crandall, Anne E Bantle, Valerie Arends, Andrea L Cherrington

Faculty, Staff and Student Publications

Objective: We evaluated whether adding basal insulin to metformin in adults with early type 2 diabetes mellitus (T2DM) would increase emotional distress relative to other treatments.

Research design and methods: The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) of adults with T2DM of < 10 years' duration, HbA1c 6.8-8.5%, and taking metformin monotherapy randomly assigned participants to add insulin glargine U-100, sulfonylurea glimepiride, the glucagon-like peptide-1 receptor agonist liraglutide, or the dipeptidyl peptidase 4 inhibitor sitagliptin. The Emotional Distress Substudy enrolled 1,739 GRADE participants (mean [SD] age 58.0 [10.2] years, 32% female, 56% non-Hispanic White, 18% non-Hispanic Black, 17% Hispanic) and assessed diabetes distress and depressive symptoms every 6 months. Analyses examined differences at 1 year and over the 3-year follow-up.

Results: Across treatments, diabetes distress (-0.24, P < 0.0001) and depressive symptoms (-0.67, P < 0.0001) decreased over 1 year. Diabetes distress was lower at 1 year for the glargine group than for the other groups combined (-0.10, P = 0.002). Diabetes distress was also lower for liraglutide than for glimepiride or sitagliptin (-0.10, P = 0.008). Over the 3-year follow-up, there were no significant group differences in total diabetes distress; interpersonal diabetes distress remained lower for those assigned to liraglutide. No significant differences were observed for depressive symptoms.

Conclusions: Contrary to expectations, this randomized trial found no evidence for a deleterious effect of basal insulin on emotional distress. Glargine lowered diabetes distress modestly at 1 year rather than increasing it. Liraglutide also reduced diabetes distress at 1 year. Results can inform treatment decisions for adults …

Cross-Cultural Equivalence Of The Kessler Psychological Distress Scale (K10) Across Four African Countries In A Multi-National Study Of Adults, Amantia Ametaj, Christy Denckla, Anne Stevenson, Rocky Stroud, Jasmine Hall, Linnet Ongeri, Barkot Milkias, Jacob Hoffman, Lukoye Atwoli, Stella Gichuru

Internal Medicine, East Africa

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional …

Reciprocal Relationships Between Stress And Depressive Symptoms: The Essential Role Of The Nucleus Accumbens, Yizhou Ma, Peter Kochunov, Mark D Kvarta, Tara Legates, Bhim M Adhikari, Joshua Chiappelli, Andrew Van Der Vaart, Eric L Goldwaser, Heather Bruce, Kathryn S Hatch, Si Gao, Shuo Chen, Ann Summerfelt, Thomas E Nichols, L Elliot Hong

Faculty, Staff and Student Publications

BACKGROUND: Stress and depression have a reciprocal relationship, but the neural underpinnings of this reciprocity are unclear. We investigated neuroimaging phenotypes that facilitate the reciprocity between stress and depressive symptoms.

METHODS: In total, 22 195 participants (52.0% females) from the population-based UK Biobank study completed two visits (initial visit: 2006-2010, age = 55.0 ± 7.5 [40-70] years; second visit: 2014-2019; age = 62.7 ± 7.5 [44-80] years). Structural equation modeling was used to examine the longitudinal relationship between self-report stressful life events (SLEs) and depressive symptoms. Cross-sectional data were used to examine the overlap between neuroimaging correlates of SLEs and …

Hubungan Tingkat Stres, Kecemasan, Dan Depresi Dengan Konstipasi Fungsional Pada Mahasiswa Kedokteran, Khafifah Z, Wilson Wilson, Agustina Arundina Triharja Tejoyuwono

Jurnal Penyakit Dalam Indonesia

Introduction. Stress, anxiety, and depression are factors associated with functional constipation that affect students’ quality of life. Stress, anxiety, and depression are often experienced by first-year medical students, but studies assessing these three variables with functional constipation are still limited.

Methods. This study used a cross-sectional analytical design. Study was carried out in July 2023 involving 88 first-year medical students from the Tanjungpura University Medical Study Program. Analysis of relationship tests was carried out using Kendall’s Tau-B tests.

Results. Most students were in the normal category of stress, anxiety and depression levels, however 21 students were in …

The Psychological Burden Of Nmosd - A Mixed Method Study Of Patients And Caregivers, Darcy C. Esiason, Nicole Ciesinski, Chelsi N. Nurse, Wendy Erler, Tom Hattrich, Ankita Deshpande, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved …

Russians Fleeing Putin’S Country: Trauma, Daily Stressors, Anxiety, Depression, Post Traumatic Stress Disorder, Maria Mccready, David Witherington, Steven Verney, Dmitry Boltyanskiy

Brain & Behavioral Health Research Day

The turmoil unleashed by the Russian invasion of Ukraine in February 2022 triggered a mass migration of individuals from Russia to nearby countries like Armenia and Georgia. Amidst this upheaval, concerns have arisen regarding the mental well-being of Russian emigrants and their experiences during this turbulent period. To bridge this gap in knowledge, our study aims to examine the mental health status of adult Russian emigrants who departed from their homeland after the beginning of the conflict.

Drawing from a sample of 67 participants, comprising 30 females and 3 non-binary individuals, our research focuses on communities in Armenia and Georgia, …

Bipolar Symptoms, Somatic Burden And Functioning In Older-Age Bipolar Disorder: A Replication Study From The Global Aging & Geriatric Experiments In Bipolar Disorder Database (Gage-Bd) Project, Martha Sajatovic, Farren B.S Briggs, Kaylee Sarna, Joy Yala

Faculty Scholarship

Objectives: The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset. Design/Methods: Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the …

Effects Of Core Stabilization Exercises In Patients With Non-Specific Low Back Pain: Huber Motion Lab Versus Conventional, Ebru Koyuncu, Nur Tunali, Seda Saka, Ertuğrul Ural, Melek Güneş Yavuzer

Baltic Journal of Health and Physical Activity

Introduction: This study aimed to determine the effects of core stabilization exercises with Huber® Motion Lab on pain, depression, and activity levels in patients with non-specific low back pain (LBP).

Materials and methods: In this study, 30 patients with non-specific LBP were allocated either to an experimental or to a control group. Both groups received a conventional physiotherapy program for 15 sessions. In addition, the control group performed 30 minutes of core stabilization exercises on the floor, whereas the experimental group used the Huber® Motion Lab device. The main outcome measures were pain severity (Visual Analogue Scale VAS), depression (Beck …

Reliability And Validity Of The Patient Health Questionnaire-4 Scale And Its Subscales Of Depression And Anxiety Among Us Adults Based On Nativity, David Adzrago, Timothy J Walker, Faustine Williams

Faculty, Staff and Student Publications

BACKGROUND: The burdens of anxiety and depression symptoms have significantly increased in the general US population, especially during this COVID-19 epidemiological crisis. The first step in an effective treatment for anxiety and depression disorders is screening. The Patient Health Questionnaire-4 (PHQ-4, a 4-item measure of anxiety/depression) and its subscales (PHQ-2 [a 2-item measure of depression] and Generalized Anxiety Disorder [GAD-2, a 2-item measure of anxiety]) are brief but effective mass screening instruments for anxiety and depression symptoms in general populations. However, little to no study examined the psychometric properties (i.e., reliability and validity) of the PHQ-4 and its subscales (PHQ-2 …

Prevalence Of Small T Trauma In Depressed Adolescent And Early Adulthood Patient In King Chulalongkorn Memorial Hospital, Krittapast Thongrakyoo, Puchong Laurujisawat, Parichawan Chandarasiri

Chulalongkorn Medical Journal

Background: Trauma and depression are known to be related, especially in adolescents and early adulthood patients in which depression usually starts, then deteriorates, and causes decreased function and worse quality of life.

Objective: To study prevalence of small t trauma level in depressed adolescents and early adulthood patients and to study whether small t trauma level and severity of depression are related.

Methods: This cross-sectional descriptive study recruited depressive patients aged 15 – 25 years to complete a questionnaire consisted of 3 parts: demographic data and Big T trauma, BDI-IA scale Thai version, and the Small t trauma Level of …

Depression, Smartphone Addiction And Association Factors Among Preclinical Medical Students, Aticha Wattanaudomchai

Chulalongkorn Medical Journal

Background: There were few studies of smartphone addiction behavior has been found in preclinical medical students.

Objective: To determine the prevalence and associated factors of depression of smartphone addiction behavior among preclinical medical students of Chulalongkorn University.

Methods: This is a cross-sectional descriptive study. The data were collected from preclinical medical students at Chulalongkorn University in 2020 academic year, prior to COVID-19 pandemic in Thailand. The instruments included the Smartphone Addiction Scale Thai version (SAS-SV-TH), Patient Health Questionnaire-9 Thai version (PHQ-9-T), Pittsburgh Sleep Quality Index Thai version (PSQI-T), and Thai Interpersonal questionnaire. The data were analyzed using SPSS version 25. …

Impostor Phenomenon, Mental Health Status And Coping Strategies Among Medical Students In Southern Thailand, Napakhawarat Buathong

Chulalongkorn Medical Journal

Background: Impostor phenomenon is an internal experience in successful individuals who realize that their achievements are unintended, although their successes can be proven by objective evidence. The study of impostor phenomenon among medical students remains largely unexplored in Thailand, especially during the transitional period from traditional medical training to online training due to the COVID-19 pandemic.

Objectives: To determine the prevalence of impostor phenomenon, mental health and the coping strategies as well as to examine the factors related to impostor phenomenon among Thai medical students.

Methods: Two hundred and seventy-two subjects completed online questionnaires enquiring about sociodemographic characteristics and perception …

Caffeine Addiction And Mental Health Of Employees In An Organization In Bangkok, Rasmon Kalayasiri

Chulalongkorn Medical Journal

Background: Heavy caffeine consumption is the cause of caffeine addiction that might affect sleep quality and mental health. However, people, especially employees in various companies, may want to gain daily energy for efficient work and productivity by drinking high number of caffeinated beverages such as coffee.

Objectives: To explore coffee consumption, mental health, sleep quality, and factors related to caffeine addiction among employees.

Methods: A total of 321 employees at a company in Bangkok were asked about their demographics, coffee consumption and caffeine addiction by using newly developed instruments, namely Caffeine Addiction Questionnaire. Depression and sleep quality were assessed by …

Alcohol And Cannabis Use Among Women With Infertility: Associations With Psychological Distress, Attempts To Conceive, And Engagement In Fertility Treatment, Genevieve E. M. Joseph-Mofford Ms, Leah M. Hecht Phd, Rory Iacobelli Bs, Amy M. Loree Phd, Lisa R. Miller-Matero Phd

Medical Student Research Symposium

Objective: An infertility diagnosis can lead to distress. Although substance use is common and can also lead to distress, little is known about use among those with an infertility diagnosis. This is important since substance use can have implications for fertility. The purpose of this study was to estimate the rate of alcohol and cannabis use among women with infertility and examine whether substance use had associations with psychiatric symptoms, attempts to conceive, and engagement in fertility treatments.

Materials and Methods: Patients from one healthcare system were eligible if they received a female infertility diagnosis within the past 2 years. …

Cognitive, Emotional, And Other Non-Motor Symptoms Of Spinocerebellar Ataxias, Chi-Ying R Lin, Sheng-Han Kuo, Puneet Opal

Faculty, Staff and Students Publications

Purpose of review: Spinocerebellar ataxias (SCAs) are autosomal dominant degenerative syndromes that present with ataxia and brain stem abnormalities. This review describes the cognitive and behavioral symptoms of SCAs in the context of recent knowledge of the role of the cerebellum in higher intellectual function.

Recent findings: Recent studies suggest that patients with spinocerebellar ataxia can display cognitive deficits even early in the disease. These have been given the term cerebellar cognitive affective syndrome (CCAS). CCAS can be tracked using newly developed rating scales. In addition, patients with spinocerebellar ataxia also display impulsive and compulsive behavior, depression, anxiety, fatigue, and …

Identifying A Stable And Generalizable Factor Structure Of Major Depressive Disorder Across Three Large Longitudinal Cohorts, Vincent W S Tseng, Jordan A Tharp, Jacob E Reiter, Weston Ferrer, David S Hong, P Murali Doraiswamy, Stefanie Nickels

Faculty, Staff and Student Publications

The Patient Health Questionnaire 9 (PHQ-9) is the current standard outpatient screening tool for measuring and tracking the nine symptoms of major depressive disorder (MDD). While the PHQ-9 was originally conceptualized as a unidimensional measure, it has become clear that MDD is not a monolithic construct, as evidenced by high comorbidities with other theoretically distinct diagnoses and common symptom overlap between depression and other diagnoses. Therefore, identifying reliable and temporally stable subfactors of depressive symptoms could allow research and care to be tailored to different depression phenotypes. This study improved on previous factor analysis studies of the PHQ-9 by leveraging …