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PurposeTo examine the relationship between depressive symptoms, subjective cognitive function, and quality of life in Japanese adults using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA).Patients and methodsWe evaluated 585 adult community volunteers using the Patient Health Questionnaire-9 (PHQ-9) for evaluation of depressive symptoms and the COBRA for evaluation of subjective cognitive function. We additionally used the 8-item Short-Form Health Survey and the Sheehan Disability Scale to evaluate the quality of life (QoL).ResultsMeasures of subjective cognitive function were significantly correlated with depressive symptoms and QoL. Structural equation modeling demonstrated that depressive symptoms directly and indirectly decreased QoL via their effects on subjective cognitive dysfunction. Measures of depressive symptoms were more closely related to QoL than were measures of subjective cognitive function.LimitationsStudy participants were general adult population community volunteers and included healthy people; thus, these results may not be generalizable to patients with depression or bipolar disorder. In addition, the cross-sectional design of this study prevented the identification of causal relationships among the parameters.ConclusionChanges in subjective cognitive function may affect QoL via depressive symptoms. Evaluations of subjective cognitive function may help identify factors that reduce QoL.

Background Presenteeism has attracted much attention in the research into mental health. However, how cognitive complaints and depressive symptoms affect presenteeism remains unknown. Therefore, this study examined the correlation between subjective cognitive impairment, depressive symptoms, and work limitations. Methods We collected data from 477 adult workers in Japan. We evaluated subjective cognitive function using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9), and work limitations with the Work Limitations Questionnaire 8 (WLQ-8). The relations between depressive symptoms, cognitive complaints, and work limitations were examined using Spearman’s rank correlations and multiple regression analysis. It was hypothesized that cognitive complaints would mediate the effects of depressive symptoms on work productivity loss, which was tested using path analysis. Results The results indicated that cognitive complaints were significantly correlated with work limitations and depressive symptoms. Multiple regression analysis, using the WLQ-8 productivity loss score as the dependent variable, revealed that COBRA and PHQ-9 scores were significant predictors of work productivity loss. We performed path analysis using PHQ-9, COBRA, and WLQ-8 productivity loss scores and created a path diagram, which revealed that the direct effects of both depressive symptoms and cognitive dysfunction on work productivity loss were statistically significant. Moreover, depressive symptoms indirectly affected work productivity loss through subjective cognitive impairment. There was no significant interaction effect between depressive symptoms and cognitive complaints. Conclusions Our results suggest that work limitations may be predicted by not only depressive symptoms but also cognitive complaints. Moreover, subjective cognitive impairment may mediate the effect of depressive symptoms on presenteeism among adult workers.

Background: Adverse experiences, such as low care, overprotection, or abuse in childhood increase the likelihood of depression via their effects on personality traits. Similarly, being victimized in childhood may affect the likelihood of depression via personality traits. In this case-control study, we hypothesized that being victimized in childhood is associated with depression in adulthood via its effect on neuroticism, and verified this hypothesis using path analysis. Subjects and methods: Eighty-two major depressive disorder (MDD) patients and 350 age-and-sex matched healthy controls completed self-administered questionnaires of demographic data, Patient Health Questionnaire-9, neuroticism, and victimization. The association between victimization, neuroticism, and depressive symptoms or having major depression was investigated by path analysis. Results: Multiple group path analysis, in which depressive symptoms were considered as dependent variables, showed that the direct effect of victimization in childhood on depressive symptoms was not statistically significant in either healthy controls or MDD patients (standardized path coefficient: 0.079 and 0.084, respectively), but their indirect effects via neuroticism were statistically significant (standardized path coefficient: 0.059 and 0.141, respectively). Path analysis, in which the distinction between healthy controls and MDD patients was a dependent variable, showed that both direct effects and indirect effects of victimization in childhood via neuroticism on the distinction between healthy controls and MDD patients were statistically significant (standardized path coefficient: 0.186 and 0.164, respectively). Limitations: Recall bias and the relatively small number of MDD patients are limitations of this study. Because it was a case-control survey, this study could not make any conclusions regarding causal associations. Conclusion: This study suggests the possibility of causal associations between victimization in childhood and depressive symptoms or MDD in adulthood, and the mediation of this association by neuroticism.

Background: Occupational mental health, work environment, sleep health, presenteeism, and loss of work productivity caused by health problems are all public health concerns. Although sleep affects mental health and presenteeism, the associations between sleep disturbance, job stressors, stress responses, and presenteeism have remained unclear. We hypothesized that job stressors affect the presenteeism of office workers through sleep disturbance and analyzed the association among these factors. Subjects and Methods: In 2017, a cross-sectional survey of adult office workers was performed. A total of 2899 subjects who provided written consent were included in the analysis. The survey collected demographic information, as well as the Work Limitation Questionnaire (WLQ), Pittsburgh Sleep Quality Index (PSQI), and Brief Job Stress Questionnaire (BJSQ). Associations between each of the variables were analyzed by path analysis (covariance structure analysis). This study was approved by the Ethics Committee of Tokyo Medical University. Results: The path analysis demonstrated that job stressors, psychological and physical stress response (PPSR) in the BJSQ, and sleep disturbance in the PSQI had direct effects on presenteeism in the WLQ. Both job stressors and social support in the BJSQ indirectly affected presenteeism through effects on sleep disturbance and PPSR. Sleep disturbance indirectly affected presenteeism via PPSR. This model accounted for the variation of presenteeism (R 2 = 0.322). Conclusion: In the workplace, job stressors and low social support increase presenteeism through psychological and physical stress responses, as well as sleep disturbance. Evaluating and resolving work problems and sleep disturbance would hence be beneficial from the aspects of public health and socioeconomics.

BackgroundVarious personality traits mediate the association between childhood stress and depressive symptoms in adulthood. The aim of this study was to clarify the indirect effects of the experience of child maltreatment on depressive symptoms and appraisal of life events in adulthood through trait anxiety.Subjects and methodsA total of 404 participants who were volunteer subjects from the community were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9, which measures depressive symptoms; State-Trait Anxiety Inventory Form Y, which measures trait anxiety; the Child Abuse and Trauma Scale, which measures child maltreatment; and Life Experiences Survey, which measures negative and positive appraisal of adulthood life events.ResultsStructural equation modeling demonstrated that the experience of child maltreatment increased depressive symptoms in adulthood as well as the negative appraisal of life events in adulthood through an increase in trait anxiety. Furthermore, trait anxiety affected depressive symptoms in adulthood through its influence on the negative appraisal of adulthood life events. The following indirect effect was also significant: the experience of child maltreatment increased the negative appraisal of adulthood life events via trait anxiety and subsequently influenced adult depressive symptoms.LimitationsThe subjects of this study are volunteer subjects from the community including healthy people, and hence the results may not be generalizable to major depressive patients. Recall bias should be considered when interpreting the results. Because this study is a cross-sectional study, the causality between the experience of child maltreatment and depression is not clear.ConclusionThis study suggests that trait anxiety may play a mediating role in the influence of the experience of child maltreatment on depressive symptoms in adulthood and negative appraisal of adulthood life events.

BackgroundRecent studies have suggested that multiple factors interact with the onset and prognosis of major depressive disorders. In this study, we investigated how child abuse, affective temperaments, and interpersonal sensitivity are interrelated, and how they affect depressive symptoms in the general adult population.Subjects and methodsA total of 415 volunteers from the general adult population completed the Patient Health Questionnaire-9, the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire version, the Child Abuse and Trauma Scale, and the Interpersonal Sensitivity Measure, which are all self-administered questionnaires. Data were subjected to structural equation modeling (Mplus), and single and multiple regression analyses.ResultsThe effect of child abuse on depressive symptoms was mediated by interpersonal sensitivity and 4 affective temperaments, including depressive, cyclothymic, anxious, and irritable temperaments. In addition, the effect of these temperaments on depressive symptoms was mediated by interpersonal sensitivity, indicating the indirect enhancement of depressive symptoms. In contrast to these 4 temperaments, the hyperthymic temperament did not mediate the effect of child abuse on depressive symptoms; its effect was not mediated by interpersonal sensitivity. However, a greater hyperthymic temperament predicted decreased depressive symptoms and interpersonal sensitivity, independent of any mediation effect.LimitationsBecause this is a cross-sectional study, long-term prospective studies are necessary to confirm its findings. Therefore, recall bias should be considered when interpreting the results. As the subjects were adults from the general population, the results may not be generalizable towards all patients with major depression.ConclusionThis study suggests that child abuse and affective temperaments affect depressive symptoms partly through interpersonal sensitivity. Interpersonal sensitivity may have a major role in forming the link between abuse, affective temperament, and depression.

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