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The mediating role of health behaviors in the association between depression, anxiety and cancer incidence: an individual participant data meta-analysis
- Kuan-Yu Pan, Lonneke van Tuijl, Maartje Basten, Judith J. M. Rijnhart, Alexander de Graeff, Joost Dekker, Mirjam I. Geerlings, Adriaan Hoogendoorn, Adelita V. Ranchor, Roel Vermeulen, Lützen Portengen, Adri C. Voogd, Jessica Abell, Philip Awadalla, Aartjan T. F. Beekman, Ottar Bjerkeset, Andy Boyd, Yunsong Cui, Philipp Frank, Henrike Galenkamp, Bert Garssen, Sean Hellingman, Monika Hollander, Martijn Huisman, Anke Huss, Melanie R. Keats, Almar A. L. Kok, Steinar Krokstad, Flora E. van Leeuwen, Annemarie I. Luik, Nolwenn Noisel, Yves Payette, Brenda W. J. H. Penninx, Susan Picavet, Ina Rissanen, Annelieke M. Roest, Judith G. M. Rosmalen, Rikje Ruiter, Robert A. Schoevers, David Soave, Mandy Spaan, Andrew Steptoe, Karien Stronks, Erik R. Sund, Ellen Sweeney, Alison Teyhan, Emma L. Twait, Kimberly D. van der Willik, Femke Lamers
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- Journal:
- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 29 April 2024, pp. 1-14
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Background
Although behavioral mechanisms in the association among depression, anxiety, and cancer are plausible, few studies have empirically studied mediation by health behaviors. We aimed to examine the mediating role of several health behaviors in the associations among depression, anxiety, and the incidence of various cancer types (overall, breast, prostate, lung, colorectal, smoking-related, and alcohol-related cancers).
MethodsTwo-stage individual participant data meta-analyses were performed based on 18 cohorts within the Psychosocial Factors and Cancer Incidence consortium that had a measure of depression or anxiety (N = 319 613, cancer incidence = 25 803). Health behaviors included smoking, physical inactivity, alcohol use, body mass index (BMI), sedentary behavior, and sleep duration and quality. In stage one, path-specific regression estimates were obtained in each cohort. In stage two, cohort-specific estimates were pooled using random-effects multivariate meta-analysis, and natural indirect effects (i.e. mediating effects) were calculated as hazard ratios (HRs).
ResultsSmoking (HRs range 1.04–1.10) and physical inactivity (HRs range 1.01–1.02) significantly mediated the associations among depression, anxiety, and lung cancer. Smoking was also a mediator for smoking-related cancers (HRs range 1.03–1.06). There was mediation by health behaviors, especially smoking, physical inactivity, alcohol use, and a higher BMI, in the associations among depression, anxiety, and overall cancer or other types of cancer, but effects were small (HRs generally below 1.01).
ConclusionsSmoking constitutes a mediating pathway linking depression and anxiety to lung cancer and smoking-related cancers. Our findings underline the importance of smoking cessation interventions for persons with depression or anxiety.
Characterising Dutch forests, wetlands and cultivated lands on the basis of phytolith assemblages
- Iris K. de Wolf, Crystal N.H. McMichael, Annemarie L. Philip, William D. Gosling
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- Journal:
- Netherlands Journal of Geosciences / Volume 101 / 2022
- Published online by Cambridge University Press:
- 12 September 2022, e17
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Palaeoecological reconstructions in the Netherlands are commonly based on pollen and macrofossil analysis, but can be limited if the preservation of organic material is poor. Phytoliths, biogenic silica, do not have this limitation and preserve in settings where other macro- and microfossils do not. Little is known about how phytolith assemblages preserved in soils and sediments reflect the parent vegetation in north-western European systems, so it is currently difficult to contextualise past environments. Here, we characterise phytolith assemblages for soil samples recovered from three major vegetation types in the Netherlands to provide reference data for future reconstructions of past vegetation change. We collected 42 soil surface samples from forests, wetlands and agricultural fields across the Netherlands and characterised the phytolith assemblages they contained. We identified the different phytolith morphotypes and quantified the percentages and concentrations (#phytoliths/cm3 soil) in each sample. We used non-metric multidimensional scaling to assess the variation in phytolith assemblage composition within, and between, the three vegetation types. The phytolith assemblages analysed from the forests, wetlands and agricultural fields were clearly distinguishable from each other. Agricultural fields were dominated by four phytolith morphotypes of grass silica short cells (GSSCs): rondel (tabular), cross type 1 (>15 µm), rondel (elongated) and disturbance or crop phytoliths. Forests settings had significantly higher amounts of different arboreal phytoliths (large and small spheroid rugose) compared with other vegetation types. Wetlands could be identified by significantly higher amounts of Cyperaceae phytoliths (papillate) and other GSSCs (saddle and bilobates with thick castula). Phytolith assemblages could distinguish different subtypes of vegetation within forest and wetland areas, while differences between agricultural systems could not be identified. Our study demonstrates that phytoliths preserved in soils or sediments can be used to separate major vegetation types across the Netherlands. Thus, these results support the hypothesis that phytoliths can be used to infer past environmental conditions in palaeoecological reconstructions. We suggest that future work should: (1) focus on characterising which phytolith types are produced by the commonest tree, wetland, shrub and herb species in the Netherlands and (2) characterise phytolith assemblages across a wider array of vegetation types in north-western European systems to increase the capability for quantitative reconstructions using phytolith assemblages.
Efficacy of digital CBT for insomnia to reduce depression across demographic groups: a randomized trial
- Philip Cheng, Annemarie I. Luik, Cynthia Fellman-Couture, Edward Peterson, Christine L.M. Joseph, Gabriel Tallent, Kieulinh Michelle Tran, Brian K. Ahmedani, Timothy Roehrs, Thomas Roth, Christopher L. Drake
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- Journal:
- Psychological Medicine / Volume 49 / Issue 3 / February 2019
- Published online by Cambridge University Press:
- 24 May 2018, pp. 491-500
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Background
Insomnia and depression are highly comorbid and mutually exacerbate clinical trajectories and outcomes. Cognitive behavioral therapy for insomnia (CBT-I) effectively reduces both insomnia and depression severity, and can be delivered digitally. This could substantially increase the accessibility to CBT-I, which could reduce the health disparities related to insomnia; however, the efficacy of digital CBT-I (dCBT-I) across a range of demographic groups has not yet been adequately examined. This randomized placebo-controlled trial examined the efficacy of dCBT-I in reducing both insomnia and depression across a wide range of demographic groups.
MethodsOf 1358 individuals with insomnia randomized, a final sample of 358 were retained in the dCBT-I condition and 300 in the online sleep education condition. Severity of insomnia and depression was examined as a dependent variable. Race, socioeconomic status (SES; household income and education), gender, and age were also tested as independent moderators of treatment effects.
ResultsThe dCBT-I condition yielded greater reductions in both insomnia and depression severity than sleep education, with significantly higher rates of remission following treatment. Demographic variables (i.e. income, race, sex, age, education) were not significant moderators of the treatment effects, suggesting that dCBT-I is comparably efficacious across a wide range of demographic groups. Furthermore, while differences in attrition were found based on SES, attrition did not differ between white and black participants.
ConclusionsResults provide evidence that the wide dissemination of dCBT-I may effectively target both insomnia and comorbid depression across a wide spectrum of the population.