Journal Article Annotations
2024, 1st Quarter

Hispanoamerican Psychiatry

Annotations by Felipe León, MD
April, 2024

Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer.
Prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the COVID‐19 pandemic.
Pain and incident cognitive impairment in very old Mexican American adults.

PUBLICATION #1 — Hispanoamerican Psychiatry

Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer.

Normarie Torres-Blasco, Cristina Peña-Vargas, Rosario Costas-Muñiz, Lianel Rosario-Ramos, Megan J Shen, Eida Castro.

Abstract: Support Care Cancer. 2024 Feb 27;32(3):195. doi: 10.1007/s00520-024-08360-2.

Purpose:
The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers.

Methods:
A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression.

Results:
Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B = – 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B = – 0.099, p = 0.054) and patients (B = – .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001).

Conclusion:
Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.

Keywords:
Advanced cancer; Dyads; Latino; Psychosocial symptoms; Spiritual well-being.

Annotation

The finding:
This is a cross-sectional survey administrated to advanced cancer patients (n=57) and their caregivers (n=57) from an oncology clinic in Puerto Rico that measured many psychosocial factors: spiritual well-being, depression, hopelessness, quality of life, family relationship, fatalism, burden, religiosity, and distress. This study showed the impact of spiritual well-being on mental health outcomes in cancer patients and their caregivers in Latino culture, indicating that the treatment target of spiritual well-being could help lower hopelessness among this population, how a higher spiritual well-being is a predictor of depression in caregivers, and how severity of symptoms of hopelessness had a relationship with depression and anxiety among caregivers.

Strength and weaknesses:
This study was not randomized, which may be a source of bias. It included many social factors (e.g. social level, marital status, among others); it lacks psychiatric evaluation of patients and their caregivers.

Relevance:
This study reflects the importance of cultural and religious aspects of Latino culture patients and their caregivers in advanced cancer, and perhaps shows the impact of psychosocial factors in the medically ill.

PUBLICATION #2 — Hispanoamerican Psychiatry

Prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the COVID‐19 pandemic.

Maryam Elhabashy, Jolyna Chiangong, Kevin Villalobos, Francisco A Montiel Ishino, David Adzrago, Faustine Williams.

Abstract: Sci Rep. 2024 Mar 20;14(1):6727. doi: 10.1038/s41598-024-57064-4.

Hispanic/Latino populations experienced disproportionate exposure to depression risk factors during the COVID-19 pandemic. While aggregated data confirm the risks of depressive symptoms among Hispanic/Latino individuals, little research uses disaggregated data to investigate these risks based on ethnic subgroups. Using the “Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases” survey, which was distributed nationally between May 13, 2021, and January 9, 2022 (N = 5413), we estimated the prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the pandemic. We performed descriptive analysis on a 116-item survey, which collected disaggregated data from Hispanic/Latino individuals aged ≥ 18 years (n = 1181). About one-third of the participants reported depressive symptoms (31.3%), with those who self-identified as other Hispanic/Latino/Spanish origin (40.2%) reporting the highest depressive symptom prevalence. Among participants who reported depression treatment before the pandemic, the highest reports of treatment were among Puerto Rican (81.8%) participants. More than one-third of participants receiving prior depression treatment (38.7%) reported treatment interference by the pandemic, mostly among Central American individuals (50.0%). This study highlights the need for integrating more disaggregated data into public health approaches which seek to target population subgroups and reduce racial/ethnic mental health disparities.

Annotation

The finding:
This survey was distributed to both US-born and foreign-born participants in the USA between May 13, 2021, and January 9, 2022. The Hispanic/Latino subsample of 1181 participants was used for this cross-sectional study. This study shows a higher prevalence of depressive symptoms among Latino/Hispano ethnic subgroups during the COVID-19 pandemic. Mental health treatment received by this population was interfered as they reported higher prevalence of depressive symptoms and poor general mental health.

Strength and weaknesses:
This study included a large group of participants, with many Latino/Hispano ethnic subgroups. They performed a statistical analysis of depressive symptoms experienced by this population during the pandemic, perhaps regarding its effects on social and economics factors rather than the effects of the disease in organic terms (e.g. depressive symptoms due to Sars-CoV-2 infection).

Relevance:
This study may show the need to improve culturally protective health strategies for vulnerable populations as Latino/Hispano and others, and the relevance of mental health in a global health crisis as a pandemic.

PUBLICATION #3 — Hispanoamerican Psychiatry

Pain and incident cognitive impairment in very old Mexican American adults

Sadaf Arefi Milani, Claudia Sanchez, Yong-Fang Kuo, Brian Downer, Soham Al Snih, Kyriakos S Markides, Mukaila Raji.

Abstract: J Am Geriatr Soc. 2024 Jan;72(1):226-235. doi: 10.1111/jgs.18618. Epub 2023 Oct 5.

Background:
Studies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity-limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80.

Methods:
Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010-2016). Pain interference, or pain that limited daily activities in the last 12 months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring <21 on the Mini-Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6-year period (n = 313).

Results:
Participants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09-4.36; treated aOR: 1.99; 95% CI: 1.15-3.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain.

Conclusions:
Among very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non-pharmacological treatments in these pathways.

Keywords:
aging; dementia; ethnicity; pain.

Annotation

The finding:
This study assessed the relationship of pain with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults older than 80. Data were taken from Wave 7 (2010/2011), Wave 8 (2012/2013), and Wave 9 (2016) of the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE), a longitudinal study of Mexican American older adults residing in the Southwestern US. They found both untreated pain and treated pain interference were associated with incident cognitive impairment, and depressive symptoms partially mediated this relationship.

Strength and weaknesses:
To the author’s knowledge, this is the first study to investigate the relationship between pain and incident cognitive impairment, considering depressive symptoms, among this population. There is risk of bias, with participants older than 80 years old and exclusion of cognitive impairment at baseline.

Relevance:
This study shows the relationship between many factors of cognitive impairment in older patients from a particular cultural/ethnic subgroup, namely pain and depressive symptoms.