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Urbanization remains an important factor affecting the mental health of people. Currently, there is insufficient research on depression among the offspring of women who have children at an advanced maternal age (AMA). The objective of this study is to investigate the urban and rural disparities in depressive symptoms among the offspring of AMA and related influencing factors. In this study, a total of 1273 offspring born to AMA were selected from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) database. The questionnaire used in the study included demographic information and the Center for Epidemiologic Studies Depression Scale (CES D). Chi-square tests and logistic regression analysis were employed to examine the urban-rural differences. The likelihood of developing depressive symptoms of the offspring of AMA in rural areas was 1.633 times higher (AOR = 1.633; 95%CI: 1.211–2.202) compared to their urban counterparts. Several factors including gender, education, marital status, disability, chronic diseases, and sleep duration showed a linkage with depression among rural based offspring of AMA. For the urban offspring of AMA, only disability and sleep duration exhibited a significant association with depressive symptoms. This study cannot establish a causal relationship between depressive symptoms and the influencing factors for the offspring of AMA. Age range and variables of the respondents needs further consideration. This study has brought to light the elevated risk of depressive symptoms among rural-based offspring of AMA. Thus, emphasizing the urgent need for targeted interventions and measures to address the negative impact. • The prevalence of depressive symptoms among offspring of AMA was found to be high; • The prevalence of depressive symptoms was significantly higher among offspring of AMA in rural areas than in urban areas; • There are more influencing factors for depressive symptoms among offspring of AMA in rural areas than in urban areas. [ABSTRACT FROM AUTHOR]

Rapid urbanization is a major trend in global population migration. There is growing debate about whether this urban-rural disparity exacerbate depression at the individual level. This study aims to investigate how urban living has a beneficial impact on individual mental health. Based on the data of 15,764 participants in the 2018 China Health and Retirement Longitudinal Study (CHARLS), we perform analysis of variance to identify the gap in depression levels between urban and rural areas. Extensive comparisons and detailed statistical analyses are carried out to demonstrate the differences in social participation between urban and rural residents. Finally, we conduct a series of mediation and moderation analyses to reveal the underlying mechanisms of depressive disorder benefits of cities. The results indicate that those who lived in urban areas were less likely to suffer from depression (β = −1.461, 95 % CI = [−1.691, −1.235], p < 0.001). Social engagement is found to mediate the relationship between residence type (β = 0.164, 95 % CI = [0.136, 0.193], p < 0.001) and individual depression (β = −0.462, 95 % CI = [−0.587, −0.337], p < 0.001). City size plays a moderating role in the association between urban living and social engagement. The mechanism is conducted through cross-sectional data. Self-reported depression status is accessed in this study, which could lead to measurement error. This study demonstrates the beneficial effects of urban living on individual depression, and reveals the mechanism by which urbanization at different scales affects the prevalence of depression. • This study fueled the debate about depressive disorder from growing cities with a nationwide empirical analysis. • We identified the underlying mechanism by which urban living could protect residents from the obnoxious depression. • Our observation also revealed the contingency of the protective effect of cities against depression. [ABSTRACT FROM AUTHOR]

Depression is a major challenge in the global healthy aging process, and exploring the key factors of depression in urban and rural older adults is essential for differentiated and precise interventions. To explore the urban-rural differences and key influencing factors of depressive symptoms among Chinese older adults. The data of 5267 older adults were obtained from the China Health and Retirement Longitudinal Survey (CHARLS2018). Random forest model and logistic regression were used to analyze the key factors influencing depressive symptoms 19 variables. The detection rate of depressive symptoms in older adults was 31.0 %, with 22.3 % and 34.8 % in urban and rural areas, respectively. Education, self-rated health, self-rated pain, and self-rated vision were common factors. Physical activity (OR = 0.716 for Moderate PA), social activity (OR = 0.671 for social activity), and self-rated hearing (OR = 0.602 for good) were key factors specific to urban older adults, and alcohol consumption (OR = 0.716 for drinking more than once a month) and marital status (OR = 0.689 for cohabitation) were key factors specific to depressive symptoms in rural older adults (all P < 0.05). Cross-sectional data cannot reflect dynamic processes among variables; The cultural background might affect the cross-cultural validity of the study. The key factors of depressive symptoms among older adults in urban and rural areas differed, which provides priority and references for differential prevention and precise intervention of depressive symptoms to promote the process of healthy aging. • Education, self-rated health, pain, and vision are common factors that influence depressive symptoms in older adults. • Physical activity, social activity, and self-rated hearing were key factors specific to urban older adults. • Alcohol consumption and marital status were key factors specific to rural older adults. • The combination of random forest and logistic regression achieves the importance measurement and analysis of factors. [ABSTRACT FROM AUTHOR]

Previous meta-analyses have revealed that in adult and older adult populations of developed countries, depression is more prevalent in urban than rural areas. No meta-analyses have identified the effects of urbanicity on the general age demographic for developing countries. We conducted a meta-analysis of urban-rural differences in depression across all age demographics for developed and developing countries. PubMed and PsycINFO databases were searched for studies published between 1980 and 2020. Studies were included if they reported prevalences of urban and rural depression, or odds ratios comparing urban-rural depression prevalence. Studies were excluded for: nonrepresentative samples, non-standard measures of depression, and reporting continuous outcomes only. Meta-analytic models of urban-rural differences in the odds of depression were conducted across country development levels and age demographics. From 1597 records screened and 302 full texts assessed for eligibility, 80 studies (N = 539,557) were included for meta-analysis. Urban residence was significantly associated with a higher prevalence of depression in developed countries (OR = 1.30, 95 % CI [1.17, 1.46], z = 4.75, p <.001), which was primarily driven by urban-rural differences in the general population age demographic (OR = 1.37, 95 % CI [1.22, 1.54], z = 5.38, p <.001). Studies reporting urban-rural differences in depression in terms of continuous symptom severity scores were not included. Urbanicity appears to uniquely be associated with a higher prevalence of depression in developed countries, but not in developing countries. • In developed countries, depression is more prevalent in urban than rural areas. • This urbanicity effect is most observable in the general age demographic. • In developing countries, there is no effect of urbanicity on depression. • The impact of urbanicity on depression may be growing for developing countries. [ABSTRACT FROM AUTHOR]

This study aimed to examine urban-rural disparities in the prevalence and trends of depressive symptoms (DS) among Chinese elderly and associated factors. A total of 8025, 7808, and 4887 respondents aged 60 years and above were selected from the China Family Panel Studies (CFPS) in 2016, 2018, and 2020, respectively. DS was assessed using a short version of Center for Epidemiologic Studies Depression Scale (CES-D). Twenty-two associated factors from six categories were included in random forest (RF) models. All urban-rural comparisons were conducted based on good model performance. The DS prevalence among all rural elderly was significantly higher than corresponding urban elderly. This disparity continued to widen among younger elderly, while it continued to narrow among older elderly. The top 10 common leading factors were sleep quality, self-rated health, life satisfaction, memory ability, child relationship, IADL disability, marital status, educational level, and gender. Urban-rural disparities in sleep quality, interpersonal trust, and child relationship continued to widen, while disparities in multimorbidity, hospitalization status, and frequency of family dinner continued to narrow. This study may exist recall bias and lacks causal explanation. Significant and continuing disparities in the DS prevalence were observed between urban and rural elderly in China, showing opposite trends in younger and older elderly. The top 10 leading associated factors for DS were nearly consistent across urban and rural elderly, with sleep quality having strongest contribution. Urban-rural disparities in associated factors also showed different trends. This study provides a reference for mental health promotion among Chinese elderly. • Depression prevalence rates are continuously higher in rural than urban elderly in China. • Reveal different trends of urban-rural gap in depression prevalence among Chinese elderly across age groups. • Use machine learning to identify factors' contributions to late-life depression in China. • First explore different urban-rural trends of factors associated with late-life depression. • Provide a reference for mental health promotion among Chinese elderly. [ABSTRACT FROM AUTHOR]

Community-based psychological counselling services (CPCS) is crucial for the oldest-old who often faces challenges or are reluctant to seek care at the healthcare settings. This study aims to examine trends in availability of CPCS over time and rural-urban disparities in service availability among nationwide oldest-old in China. Multiple cross-sectional data were derived from the 2005–2018 Chinese Longitudinal Health Longevity Survey. Service availability was reported by each oldest-old participant or their next-of-kins as having CPCS in one's neighborhood. We used Cochran-Armitage tests to estimate service availability trends and applied sample-weighted logistic regression models to examine its rural-urban disparities. Of 38,032 oldest-old, CPCS availability decreased from 6.7 % in 2005 to 4.8 % in 2008/2009, followed by continual increases to 13.6 % in 2017/2018. In 2017/2018, rural oldest-old's neighborhoods had no greater service availability. Oldest-old residing in the Central (6.7 %), Western (13.4 %) and Northeast China (8.1 %) were less likely to report having services locally than their Eastern counterparts (17.8 %). Oldest-old having any disability or living in the nursing homes reported having greater service availability than those without disability or living at home. Service availability might have been disrupted during the COVID-19 pandemic. Despite the increasing service availability, as of 2017/2018, only 13.6 % oldest-old in China had reported CPCS availability. It raises concerns on the disproportionate access to and continuity of mental health care, especially for those living the Central, Western China and those living at home. Policy efforts are needed to incentivize service expansion and eliminate disparities in the service availability. • Community-based psychological counselling services (CPCS) are increasingly available in China. • Only 13.6 % of oldest-old in China reported having access to CPCS in 2017/2018. • Geographic disparities in CPCS availability are substantial and persistent. [ABSTRACT FROM AUTHOR]

Background: Suicidal ideation (SI) is severe comorbidity of depression that has been extensively studied in the past. Residence differences between SI have rarely been systematically studied, especially in parental rearing behavior. This large-scale explored the residence differences in the prevalence and correlation of SI adolescent patients with depression.Methods: A total of 1417 patients with depression were recruited, and their demographic data and clinical data were collected. The Children's Depression Inventory (CDI) and the Egna Minnen Beträffande Uppfostran (EMBU) scale were used to assess depression, and parental rearing behavior, respectively.Results: The prevalence of suicidal ideation was higher in urban patients than in rural patients (43.7 % vs.37.7 %, P < 0.05). Patients with SI scored higher on total CDI scores, parental punishment, parental rejection, and paternal overprotection compared to their respective patients without SI. In the urban group, patients with SI had lower parental emotional warmth scores and higher parental intervention scores compared to patients without SI. Logistic regression analysis showed that total CDI score, gender, alcohol consumption, father's emotional warmth, father's rejection, and mother's intervention were significantly associated with SI in urban patients (P < 0.05); total CDI score and mother's rejection were significantly associated with SI in rural patients (P < 0.05).Limitations: No causal relationship could be drawn due to the cross-sectional design.Conclusions: The results of this study showed significant residential differences in risk and associated factors for SI among adolescents with depression. Focusing on the parenting styles of adolescent patients can help with the early identification and intervention of SI. [ABSTRACT FROM AUTHOR]

• Mental health worsened from 2005 to 2019 among Chinese college students. • College students from rural areas had worse mental health than those from urban and town areas. • Some aspects of mental health deteriorated more rapidly among college students from urban areas than those from towns or rural areas. • This research has implications for public health and school mental health applications. [ABSTRACT FROM AUTHOR]

Background: The specific impacts of attitudes toward aging on depressive symptoms have not been widely reported in previous studies in China.Objectives: The aim is to examine the associations between attitudes toward aging, perceived social support, and depressive symptoms among older adults stratified by rural and urban dwelling.Methods: This study used a cross-sectional data including 7209 participants, among which 64.6% were urban adults and 35.4% were rural adults. Several multiple liner regression models were used to analysis the data. Three social support types were analyzed as moderators of the relationship between the attitudes toward aging and depressive symptoms.Results: Positive attitudes toward aging (β=-0.139, P<0.001), negative attitudes toward aging (β=0.284, P<0.001) were significantly associated with lower depressive symptoms among older Chinese adults. Support from family (β=-0.087, P<0.001), friends (β=-0.047, P<0.01) and the government (β=-0.035, P<0.01) were all significantly associated with urban older adults' levels of depressive symptoms. Only family support (β=-0.109, P<0.001) was associated with lower depressive symptoms among rural older adults'. In addition, family support buffered the effect of negative attitudes toward aging on depressive symptoms for all the older adults, while the moderation effects of support from friends and government only worked for urban elderly.Limitations: A cross-sectional design is limited to establish causal associations.Conclusions: Addressing depression among older adults should focus on improving attitudes toward aging and expanding the availability of social support. Moreover, deeper reforms are needed to address inequalities between urban and rural areas in China. [ABSTRACT FROM AUTHOR]

Background: Although studies conducted in developed countries have reported a negative relationship between social participation and depressive symptoms, few studies have examined rural-urban differences in the relationship between participation in various types of social activities and depressive symptoms among Chinese older adults.Objectives: This study examined the association between participation in paid work, political, and voluntary activities and depressive symptoms among Chinese older adults in urban and rural areas.Methods: Data were obtained from the China Longitudinal Ageing Social Survey conducted in 2014, and bivariate linear regression and multivariable linear regression analyses were conducted.Results: The prevalence of depressive symptoms was significantly higher among older adults residing in rural areas than among older adults in urban areas. Participation in paid work activities was significantly associated with fewer depressive symptoms among older adults in urban and rural areas, whereas participation in political or voluntary activities was negatively associated with depressive symptoms only among older adults in urban areas. Older adults who participated in two or three types of activities (paid work, political, and voluntary activities) tended to have fewer depressive symptoms both in urban and rural areas.Limitations: Because this study comprised a cross-sectional design, causality could not be established between social participation and depressive symptoms.Conclusions: Social participation plays a protective role against depressive symptoms among Chinese older adults, especially among those in urban areas. Urban-rural differences exist between participation in different types of social activities and depression symptoms. [ABSTRACT FROM AUTHOR]

Background Studies have shown that the prevalence of mental illness can vary between urban and rural locations. This study extended research to the countries of the former Soviet Union (fSU) by assessing the association between settlement type and psychological distress and whether factors associated with psychological distress vary by settlement type. Methods Data on 18,000 adults aged ≥18 years from the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010/11 were analyzed. Settlement types were country capitals, regional capitals, cities/other urban settlements, and villages. Psychological distress was defined as the country-specific highest quintile of a composite score based on 11 questions. Logistic regression analysis with random effects was used to examine associations. Results In a pooled country analysis, living in a smaller urban settlement or village was associated with significantly higher odds for psychological distress compared to living in the country capital. Lower social support was a strong correlate of psychological distress in all locations except capital cities. Limitations The psychological distress measure has not been formally validated in the study countries. Conclusions Lower levels of urbanicity are associated with greater psychological distress in the fSU countries. As many Western studies have linked greater urbanization to poorer mental health, this highlights the need for caution in extrapolating findings from one part of the world to others and the importance of undertaking research on the geographical correlates of mental health in different world regions. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To determine if levels of personal stigma towards depression and agreement with health professionals about treatment differ between rural–urban populations. Methods: Data from a telephone survey conducted in Alberta (n=3047, response rate=75.2%) was analyzed. Participants responded to a case vignette describing a depressed individual and questionnaires assessing attitudes towards treatments, and personal stigma against depression. The relation between rural–urban status and agreement with health professionals about treatment was assessed using logistic regression. Stigma scores in relation to rural–urban status were analyzed using multivariate linear regression. Results: Urban respondents were more likely than rural participants to agree with health professionals about depression treatments. This was found overall, and in women. After adjustment for income and education, rural–urban status was no longer significant. Urban participants had lower stigma scores in overall analysis. After adjustment for income and education, stigma scores remained higher among rural men. Education was associated with lower stigma scores among both men and women in fully adjusted models. The ability to recognize depression was associated with lower stigma scores. Conclusions: Differences exist in rural–urban population about treatments for depression and stigma towards depression. The rural–urban differences in stigma and agreement with health professionals about treatment may be largely explained by educational levels. [Copyright &y& Elsevier]