QUITE apart from the academic consideration that vital and medical statistics now form an obligatory part of the education of students seeking the University of London's diploma in public health, the demand for information about the methods of vital and medical statistics is increasing. The most casual reader of the newspapers is now aware that population problems are of serious practical importance and that the publications of the General Register Office cannot be ignored. It is scarcely an exaggeration to say that the recently issued preliminary report on the census of 1931 is one of the most sensational documents which has appeared for years, and that he who reads it intelligently will understand what is meant by saying that civilisation is in the melting pot. An Introduction to Medical Statistics. By Hilda M. Woods William T. Russell. Pp. x + 125. (London: P. S. King and Son, Ltd., 1931.) 7s. 6d.

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An Introduction to Medical Statistics

In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record

Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms.

Background The Center for Epidemiological Studies Depression Scale (CES-D) has been widely used in studies of late-life depression. While the CES-D is convenient to use in most settings, it can present problems for elderly respondents who may find the response format confusing, the questions emotionally stressful, and the time to complete burdensome. A briefer 10-item version has been proposed, but there are few data on its properties as a screening instrument. Methods The 10-item CES-D was administered in 2 studies. In study 1, a stratified sample of middle-aged depressed patients (n=40) and comparison controls (n=43) were administered the CES-D to determine an optimal cutoff score. In study 2, the accuracy of the CES-D optimal cutoff score was tested in a sample of adults older than 60 years (n=68). Major depression diagnoses were derived from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition , with consensus diagnoses using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Results Reliability statistics with the 10-item CES-D were found to be comparable to those reported for the original CES-D. Using an optimal cutoff score of 4 in study 1, the sensitivity of the 10-item CES-D was 97%; specificity, 84%; and positive predictive value, 85%. In the study 2 sample of older adults, the sensitivity of the CES-D was 100%; specificity, 93%; and positive predictive value, 38%. Conclusion The 10-item CES-D has excellent properties for use as a screening instrument for the identification of major depression in older adults.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/1105625/ioi80719.pdf

Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D)

Background Depression may be a potential risk factor for subsequent cardiac death. The impact of depression on cardiac mortality has been suggested to depend on cardiac disease status, and to be stronger among cardiac patients. This study examined and compared the effect of depression on cardiac mortality in community-dwelling persons with and without cardiac disease. Methods A cohort of 2847 men and women aged 55 to 85 years was evaluated for 4 years. Major depression was defined according to psychiatric DSM-III criteria. Minor depression was defined by Center for Epidemiologic Studies-Depression Scale scores of 16 or higher. Effects of minor and major depression on cardiac mortality were examined separately in 450 subjects with a diagnosis of cardiac disease and in 2397 subjects without cardiac disease after adjusting for demographics, smoking, alcohol use, blood pressure, body mass index, and comorbidity. Results Compared with nondepressed cardiac patients, the relative risk of subsequent cardiac mortality was 1.6 (95% confidence interval [CI], 1.0-2.7) for cardiac patients with minor depression and 3.0 (95% CI, 1.1-7.8) for cardiac patients with major depression, after adjustment for confounding variables. Among subjects without cardiac disease at baseline, similar increased cardiac mortality risks were found for minor depression (1.5 [95% CI, 0.9-2.6]) and major depression (3.9 [95% CI, 1.4-10.9]). Conclusion Depression increases the risk for cardiac mortality in subjects with and without cardiac disease at baseline. The excess cardiac mortality risk was more than twice as high for major depression as for minor depression.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/481731/yoa20038.pdf

Depression and cardiac mortality: results from a community-based longitudinal study.

Objective. Cross-sectional research has suggested that television viewing may be associated with decreased attention spans in children. However, longitu- dinal data of early television exposure and subsequent attentional problems have been lacking. The objective of this study was to test the hypothesis that early television exposure (at ages 1 and 3) is associated with attentional problems at age 7. Methods. We used the National Longitudinal Survey of Youth, a representative longitudinal data set. Our main outcome was the hyperactivity subscale of the Be- havioral Problems Index determined on all participants at age 7. Children who were >1.2 standard deviations above the mean were classified as having attentional problems. Our main predictor was hours of television watched daily at ages 1 and 3 years. Results. Data were available for 1278 children at age 1 and 1345 children at age 3. Ten percent of children had attentional problems at age 7. In a logistic regression model, hours of television viewed per day at both ages 1 and 3 was associated with attentional problems at age 7 (1.09 (1.03-1.15) and 1.09 (1.02-1.16)), respectively. Conclusions. Early television exposure is associated with attentional problems at age 7. Efforts to limit tele- vision viewing in early childhood may be warranted, and additional research is needed. Pediatrics 2004;113:708 - 713; ADHD, television, attentional problems, prevention. ABBREVIATIONS. ADHD, attention-deficit/hyperactivity disor- der; NLSY, National Longitudinal Survey of Youth; BPI, Behav- ioral Problems Index; SD, standard deviation; CES-D, Center for Epidemiologic Studies Depression scale.

https://people.cas.sc.edu/dubinsk/Ling300/Early.television.exposure.Pediatrics.2004.pdf

Early Television Exposure and Subsequent Attentional Problems in Children

The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in studies of late-life depression. Psychometric properties are generally favourable, but data on the criterion validity of the CES-D in elderly community-based samples are lacking. In a sample of older (55-85 years) inhabitants of the Netherlands, 487 subjects were selected to study criterion validity of the CES-D. Using the 1-month prevalence of major depression derived from the Diagnostic Interview Schedule (DIS) as criterion, the weighted sensitivity of the CES-D was 100%; specificity 88%; and positive predictive value 13.2%. False positives were not more likely among elderly with physical illness, cognitive decline or anxiety. We conclude that the criterion validity of the CES-D for major depression was very satisfactory in this sample of older adults.

/pdf/criterion-validity-of-the-center-for-epidemiologic-studies-fi1gjhq8jn.pdf

Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands.

In community-based studies the CES-D is the most widely used screening instrument for depression in the elderly. In the Netherlands it is relatively unknown. Results of a literature-survey and empirical data of three groups of older respondents in the Netherlands are presented (n1 = 224, n2 = 116, n3 = 190). To determine whether the CES-D can be used as a screening instrument for depression in the elderly in the Netherlands six criteria are formulated. The results of the literature-survey are favourable on most criteria. Because the overlap with symptoms of physical diseases is very limited, the CES-D can be used in physically ill populations. In our three groups of respondents the psychometric properties and practical use of the CES-D proved satisfactory (Cronbach's alfa 0.80-0.90 in three groups of respondents). Shortening the scale's answering-format has been advocated by others, but is discouraged. Being a screening instrument, the scale cannot be used as a substitute for psychiatric diagnosis. Recognising this limitation we conclude that the Dutch translation of the CES-D provides a useful instrument for measuring depressive symptoms in the elderly.

Een screeningsinstrument voor depressie bij ouderen in de algemene bevolking: de bruikbaarheid van de center for epidemiologic studies depression scale (ces-d)

J. van Limbeek

Papers

Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands.

Een screeningsinstrument voor depressie bij ouderen in de algemene bevolking: de bruikbaarheid van de center for epidemiologic studies depression scale (ces-d)

Psychopathologie bij geditineerden