Lahortiga, F. (Francisca)
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- Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I).(Biomed Central, 2008) Martinez-Gonzalez, M.A. (Miguel Ángel); Schlatter, J. (Javier); Pla-Vidal, J. (Jorge); Ortuño-Sanchez-Pedreño, F. (Felipe); Benito-Corchon, S. (Silvia); Lahortiga, F. (Francisca); Sanchez-Villegas, A. (Almudena)Abstract Background: Depression assessment in population studies is usually based on depressive symptoms scales. However, the use of scales could lead to the choice of an arbitrary cut-off point depending on the sample characteristics and on the patient diagnosis. Thus, the use of a medical diagnosis of depression could be a more appropriate approach. Objective: To validate a self-reported physician diagnosis of depression using the Structured Clinical Interview for DSM-IV (SCID-I) as Gold Standard and to assess the factors associated to a valid self-reported diagnosis. Methods: The SUN Project is a cohort study based on university graduates followed-up through postal questionnaires. The response to the question included in the questionnaire: Have you ever been diagnosed of depression by a physician? was compared to that obtained through the SCID-I applied by a psychiatrist or a clinical psychologist. The percentages of confirmed depression and non-depression were assessed for the overall sample and according to several characteristics. Logistic regression models were fitted to ascertain the association between different factors and a correct classification regarding depression status. Results: The percentage of confirmed depression was 74.2%; 95% confidence interval (95% CI) =63.3-85.1. Out of 42 participants who did not report a depression diagnosis in the questionnaire, 34 were free of the disease (%confirmed non-depression=81.1%; 95% CI=69.1- 92.9). The probability of being a true positive was higher among ex- smokers and non-smokers and among those overweight or obese but the differences were not statistically significant. Conclusion: The validity of a self-reported diagnosis of depression in the SUN cohort is adequate. Thus, this question about depression diagnosis could be used in further investigations regarding this disease in this graduate cohort study.
- Ultra‐processed food consumption and the incidence of depression in a Mediterranean cohort: the SUN Project(Springer, 2020) Martinez-Gonzalez, M.A. (Miguel Ángel); De-Deus-Mendonça, R. (Raquel); Bes-Rastrollo, M. (Maira); Lahortiga, F. (Francisca); Gómez-Donoso, C. (Clara); Gea, A. (Alfredo); Sanchez-Villegas, A. (Almudena)Purpose A growing body of evidence shows that consumption of ultra-processed foods (UPF) is associated with a higher risk of cardiometabolic diseases, which, in turn, have been linked to depression. This suggests that UPF might also be asso- ciated with depression, which is among the global leading causes of disability and disease. We prospectively evaluated the relationship between UPF consumption and the risk of depression in a Mediterranean cohort. Methods We included 14,907 Spanish university graduates [mean (SD) age: 36.7 year (11.7)] initially free of depression who were followed up for a median of 10.3 years. Consumption of UPF (industrial formulations made mostly or entirely from substances derived from foods and additives, with little, if any, intact food), as defned by the NOVA food classifcation system, was assessed at baseline through a validated semi-quantitative 136-item food-frequency questionnaire. Participants were classifed as incident cases of depression if they reported a medical diagnosis of depression or the habitual use of antidepressant medication in at least one of the follow-up assessments conducted after the frst 2 years of follow-up. Cox regression models were used to assess the relationship between UPF consumption and depression incidence. Results A total of 774 incident cases of depression were identifed during follow-up. Participants in the highest quartile of UPF consumption had a higher risk of developing depression [HR (95% CI) 1.33 (1.07–1.64); p trend=0.004] than those in the lowest quartile after adjusting for potential confounders. Conclusions In a prospective cohort of Spanish university graduates, we found a positive association between UPF consump- tion and the risk of depression that was strongest among participants with low levels of physical activity.
- Micronutrient intake adequacy and depression risk in the SUN cohort study(Springer Link, 2018) Perez-Cornago, A. (Aurora); Zazpe, I. (Itziar); Santiago, S. (Susana); Lahortiga, F. (Francisca); Sanchez-Villegas, A. (Almudena)Purpose The aim of the study was to prospectively assess the association between micronutrient intake adequacy and risk of depression. Methods This dynamic cohort study involves Spanish university graduates (SUN Project). Dietary intake was assessed at baseline and after 10 years of follow-up with a semi-quantitative food frequency questionnaire. Micronutrient intake adequacy for vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, zinc, iodine, selenium, iron, calcium, potassium, phosphorus, magnesium and chrome was estimated. Inadequate intake for each nutrient was defined when the intake of the nutrient was below the estimated average requirements (EAR) if available or the adequate intake levels, if EARs were not available. We compared participants with inadequate intake for ≥4 nutrients vs. those with one nutrient. Participants were classified as having incident depression if they had no previous history of depression or antidepressants use at baseline, but they reported during follow-up a new clinical diagnosis of depression by a physician, use of antidepressant drugs, or both. Time-dependent multivariable Cox regression models were fitted. Results After a median follow-up of 8.5 years, 953 new cases of depression were observed among 13,983 participants. Participants with inadequate intake for ≥4 nutrients showed a significantly higher risk of depression [multivariable hazard ratio (HR) = 1.37; 95% confidence interval (CI) 1.01–1.85]. When the analyses were updated with repeated assessments of intakes, the association was attenuated and it was no longer statistically significant (Multivariable HR = 1.11; 95% CI 0.82–1.51). Conclusions Micronutrient inadequacy in four or more micronutrients could exert a moderate role in the development of depression.
- Preventing the recurrence of depression with a Mediterranean diet supplemented with extra-virgin olive oil. The PREDI-DEP trial: study protocol(Springer Science and Business Media LLC, 2019) Hernández-Fleta, J. L. (J. L.); Pla-Vidal, J. (Jorge); Ortuño-Sanchez-Pedreño, F. (Felipe); Florido-Rodríguez, M. (M.); Navarro, S. (Silvia); Lahortiga, F. (Francisca); Chiclana-Actis, C. (Carlos); Cabrera, C. (Carmen); Calviño-Cabada, M. J. (M. J.); Gonzalez-Pinto, A. (Ana); Almeida, Y. (Y.); Sanchez-Villegas, A. (Almudena); Cabrera-Suárez, B. (B.); Vega-Pérez, R. (R.); Molero, P. (Patricio)Background: The role of dietary patterns in the prevention of unipolar depression has been analyzed in several epidemiological studies. The primary aims of this study are to determine the effectiveness of an extra-olive oil enriched Mediterranean diet in reducing the recurrence of depression and improving the symptoms of this condition. Methods: Multicenter, two-arm, parallel-group clinical trial. Arm 1, extra-virgin olive oil Mediterranean diet; Arm 2, control group without nutritional intervention. Dieticians are in charge of the nutritional intervention and regular contact with the participants. Contacts are made through our web platform (https://predidep.es/participantes/) or by phone. Recurrence of depression is assessed by psychiatrists and clinical psychologists through clinical evaluations (semi-structured clinical interviews: Spanish SCID-I). Depressive symptoms are assessed with the Beck Depression Inventory. Information on quality of life, level of physical activity, dietary habits, and blood, urine and stool samples are collected after the subject has agreed to participate in the study and once a year. Discussion: To the best of our knowledge, the PREDI-DEP trial is the first ongoing randomized clinical trial designed to assess the role of the Mediterranean diet in the prevention of recurrent depression. It could be a cost-effective approach to avoid recurrence and improve the quality of life of these patients.
- Daily time spent on screens and psychological well-being: Cross-sectional association within the SUN cohort(Elsevier, 2024) Martinez-Gonzalez, M.A. (Miguel Ángel); Fuente-Arrillaga, C. (Carmen) de la; Bes-Rastrollo, M. (Maira); Basterra-Gortari, V. (Virginia); Lahortiga, F. (Francisca); Sayon-Orea, C. (Carmen); Gil-Conesa, M. (Mario)Background: The impact of various lifestyles on psychological well-being (PWB) remains under-studied. We aimed to explore the cross-sectional association between daily screen use (television, tablet and mobile phone) and PWB within the SUN cohort. Methods: PWB was assessed using the 29-item Ryff scale (ranging from 29 to 174), and participants with scores >75th percentile were considered as having optimal PWB. Participants were categorized based on their self-reported weekly screen usage hours. Postestimation logistic regression models assessing the prevalence likelihood of not achieving optimal PWB were adjusted for sociodemographic, psychological, personality and lifestyles factors. Isotemporal substitution models explored the potential impact on PWB resulting from replacing 1 h/day of screen time with 1 h/day of exercise. Results: The study included 3051 participants (55.8% women, mean age 57.3 ± 11.1 years, mean Ryff's score: 139.1 ± 17.4 points). Daily screen use for ≥2 h was associated with a higher prevalence likelihood of not achieving an optimal PWB (Prevalence Ratio [PR]:1.09; 95% CI:1.01-1.18). Among PWB dimensions, screen use ≥2 h/day was linked to an increased likelihood of not achieving optimal scores in environmental mastery (PR:1.11; 95% CI:1.02-1.20), life purpose (PR:1.10; 95% CI:1.02-1.18), and personal growth (PR:1.09; 95% CI:1.01-1.18). Replacing 1 h of daily screens time with 1 h of exercise may lead to potential improvements in environmental mastery (Odds Ratio [OR]:0.87; 95% CI:0.76-0.99), purpose in life (OR:0.86; 95% CI: 0.76-0.98), personal growth (OR:0.84; 95% CI:0.73-0.96) and positive interpersonal relationships (OR:0.86; 95% CI:0.75-0.99). Conclusions: These findings highlight the importance of reducing screen use activities and increasing physical exercise for achieving optimal PWB.
- Tobacco and alcohol co-use: Lifestyle and sociodemographic factors, and personality aspects as potential predictors in the Seguimiento Universidad de Navarra cohort(2024) Martinez-Gonzalez, M.A. (Miguel Ángel); Fuente-Arrillaga, C. (Carmen) de la; Neddermann, S. (Sofía); Bes-Rastrollo, M. (Maira); Lahortiga, F. (Francisca); Pardavila-Belio, M.I. (Miren Idoia); Ruiz-Canela, M. (Miguel); Gea-Sánchez, A. (Alfredo); Latifa, A. (Abidi)Tobacco and alcohol co-use are two major lifestyle modifiable risk factors. Understanding the determinants of both behaviors helps to develop interventions to prevent these exposures. However, previous studies have focused on predictors of individual tobacco or alcohol use. This study aims to explore the potential predictors of tobacco and alcohol co-use among Spanish university graduates from the "Seguimiento Universidad de Navarra" (SUN) cohort study. A total of 7175 participants who were co-users of tobacco and alcohol were selected for this cross-sectional analysis. Their mean age was 39.1 years (12.04 SD) and 57.3% were women. Univariate regression models were used to select the potential predictors of tobacco and alcohol co-use, and the areas under the ROC curves (AUC) were calculated. Multivariable logistic regression models were used to create a predictive model. Baseline potential predictors included sociodemographic factors, lifestyle habits, and perceived personality aspects. In the multivariable model, the main significant potential predictors of tobacco and alcohol co-use were driving under the influence of alcohol (odds ratio [OR] = 1.65 [1.43-1.90]), drinking 1-2 cups of coffee daily (OR = 1.50 [1.24-1.84]), and drinking three or more cups of coffee daily (OR = 1.61 [1.35-1.91]) when compared with the reference group. Conversely, those who were married (OR = 0.87 [0.75-0.99], ate at home 7 days a week (OR = 0.69 [0.60-0.80]), did more physical activity than recommended (OR = 1.18 [1.02-1.34]), or had a high perceived level of competitiveness (OR = 0.83 [0.72-0.95]) had a lower risk of co-use (AUC 0.61 [confidence interval 95% 0.59-0.63]), compared to the reference group. These results could be used by healthcare professionals, especially nurses, to effectively assess patients at higher risk of tobacco and alcohol co-use.
- Does the number of children take a role in marital dysfunction?(2011-06-03T08:17:28Z) Beunza-Nuin, M.I. (Mª Isabel); Lahortiga, F. (Francisca); Aubá-Guedea, E. (Enrique); Tricas-Sauras, S. (Sandra); Cano-Prous, A. (Adrián); RaquelINTRODUCTION The number of separations and divorces has dramatically increased in Europe in the last few years. In Spain, according to the last report of the Institute for Family Policies entitled “Evolution on the Family in Europe 2009”, the rate represents a 268% increase. Furthermore, birth rates have also decreased, with only 4% of families having three or more children. OBJECTIVES To analyse differences in marital and family functioning depending on the number of children. METHOD We studied a sample of 168 married couples who on their own initiative turned to the Diagnosis and Family Therapy Unit (UDITEF) at the University of Navarra Hospital (Spain) referring marital dysfunction. Sociodemographic data were gathered from all couples. They were asked to fill in the Dyadic Adjustment Scale (DAS) in order to assess marital dynamics and the Family Assessment Device (FAD) to assess family functioning. Statistic analysis was done with the SPSS (v. 15.0) program. RESULTS Out of the couples studied (N=168), 78 had three or more children, and 90 had less than three. Couples in large families had been married for a mean of 19.6+10.6 years, and nearly had four children (3.94+1.2) of ages in a range of 10 to 17 years. Couples in families with less than three children had been married for a mean of 13.7+10.3 and had a mean of one child (1.23+0.28) within an age range of 9 to 12 years. Statistic analysis of marital dynamics as measured with the DAS shows that there are statistically meaningful differences in the “Affective expression” subscale (p<0.05) both in husbands and wives. Concerning family functioning as measured by the FAD, we can find statistically meaningful differences in the subscale “communication” (p<0.05) measured in wives. CONCLUSIONS In our sample, marital dysfunction does not seem to be influenced by the number of children in the family. However, further research is necessary to study other variables that could also take a role, in order to get more accurate data.
- A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN project(BioMed Central, 2015) Martinez-Gonzalez, M.A. (Miguel Ángel); Toledo, E. (Estefanía); Lahortiga, F. (Francisca); Ruiz-Canela, M. (Miguel); Henriquez-Sanchez, P. (Patricia); Sanchez-Villegas, A. (Almudena); Molero, P. (Patricio)Background: Some studies have pointed out that several dietary patterns could be associated with a reduced risk of depression among adults. This association seems to be consistent across countries, cultures and populations. The objective of the study was to compare and to establish the type of relationship between three diet quality scores and depression in the SUN (Seguimiento Universidad de Navarra) Cohort study. Methods: We performed a dynamic cohort study based on Spanish university graduates free of depression at baseline. Dietary intake was repeatedly assessed at baseline and after 10 years of follow-up with a validated semi-quantitative foodfrequency questionnaire. Three previously described diet quality scores: Mediterranean Diet Score (MDS), Pro-vegetarian Dietary Pattern (PDP) and Alternative Healthy Eating Index-2010 (AHEI-2010) were built. Participants were classified as having depression if they reported a new clinical diagnosis of depression by a physician or initiated the use of an antidepressant drug during follow-up. Time-dependent Cox regression models with cumulative averages of diet and restricted cubic splines were used to estimate hazard ratios of depression according to quintiles of adherence to the MDS, PDP and AHEI-2010. Results: One thousand and fifty one incident cases of depression were observed among 15,093 participants from the SUN Cohort after a median follow-up of 8.5 years. Inverse and significant associations were observed between the three diet quality scores and depression risk. The hazard ratios and 95 % confidence intervals for extreme quintiles (fifth versus first) of updated adherence to MDS, PDP and AHEI-2010 were 0.84 (0.69–1.02), 0.74 (0.61–0.89) and 0.60 (0.49–0.72), respectively. The dose–response analyses showed non-linear associations, suggesting that suboptimal adherence to these dietary patterns may partially be responsible for increased depression risk. Conclusions: Better adherence to the MDS, PDP and AHEI-2010 was associated with a reduced risk of depression among Spanish adults. However, our data suggested a threshold effect so that although the risk of depression was reduced when comparing moderate versus lower adherence, there was not much extra benefit for the comparison between moderate and high or very high adherence.
- Self-perceived level of competitiveness, tension and dependency and depression risk in the SUN cohort(BMC, 2018) Martinez-Gonzalez, M.A. (Miguel Ángel); Raquel; Zazpe, I. (Itziar); Santiago, S. (Susana); Lahortiga, F. (Francisca); Sanchez-Villegas, A. (Almudena); Molero, P. (Patricio)Background: Emerging evidence suggests a possible etiologic role of certain personality traits (not necessary dysfunctional) in the risk of depression, but the longitudinal long-term available evidence is currently scarce. We longitudinally assessed whether 3 common personality traits (competitiveness, tension and dependency) were associated with the risk of depression after a maximum follow-up of 15 years. Methods: We assessed 15,604 university graduates free of depression at baseline through a self-administered questionnaire including personality traits. Simple, Likert-type, questions with 11 possible answers ranging from 0 to 10 were used at baseline to assess the 3 personality traits. We compared participants with high scores (7–10) versus those with low scores (0–4). New medical diagnoses of depression during follow-up were used as the outcome. Results: During a median follow-up of 10.1 y, we prospectively identified 902 new medical diagnoses of depression. The multivariable-adjusted hazard ratios (95% confidence intervals) for depression were 1.85 (1.52–2.24) for participants with higher baseline tension (7–10 versus 0 to 4), P-trend < 0.001; and 1.23 (1.06–1.44) for high versus low baseline dependence levels, P-trend = 0.004. Higher levels of competitiveness were marginally associated with lower risk of depression, with hazard ratio = 0.78 (0.61–1.01), P-trend = 0.105. Conclusion: A simple scoring system of personality traits shows an independent association with the future occurrence of depression. This finding underscores, with now prospective evidence, the importance of personality traits in the aetiology of depression and can provide a clinically useful tool for gathering valid information about depression-related personality traits.
- A structural equation model of achievement emotions, coping strategies and engagement-burnout in undergraduate students: a possible underlying mechanism in facets of perfectionism(2020) Fuente-Arias, J. (Jesús) de la; Laspra-Solís, C. (Carmen); Lahortiga, F. (Francisca); Alustiza-Quintana, I. (Irene); Maestro-Martín, C. (Cristina); Aubá-Guedea, E. (Enrique); RaquelAchievement emotions that the university student experiences in the learning process can be significant in facilitating or interfering with learning. The present research looked for linear and predictive relations between university students¿ achievement emotions, coping strategies, and engagement-burnout, in three dierent learning situations (classroom, study time, and testing). Hypotheses were identified for a possible model that would analyze the two facets of perfectionism based on these relations. In the case of perfectionistic strivings, the test hypothesis was that positive emotions would predispose the use of problem-focused coping strategies and an emotional state of engagement; in the case of perfectionistic concerns, however, negative emotions would predispose the use of emotion-focused strategies and a state of burnout. A total of 654 university students participated in the study, using an online tool to complete validated questionnaires on the three study variables. All students provided informed consent and corresponding permissions. Given the ex-post facto linear design, the predictions could be verified for each situation by means of logistic regression analyses and Structural Equations Models (SEM). Empirical results lent support, in varying degree, to the proposed theoretical relations. The testing situation was of particular interest. We discuss implications for perfectionism research and for the practice of prevention, education and health care in the university setting.