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1.
Background
The nature of adolescent sub-syndromal depression has not been investigated in primary care.Aims
To document frequency, characteristics and 6 month outcome of sub-syndromal depression amongst adolescent primary care attenders.Method
Primary care attenders (13–18 years) completed depression screening questionnaires (Mood and Feelings Questionnaires) at consultation and at 6 month follow-up. Those screening positive were interviewed with the K-SADS. Sub-syndromal depression was defined as high levels of depressive symptoms in the absence of depressive disorder.Results
Two hundred and seventy four questionnaires were completed at consultation: the estimated rate of sub-syndromal depression was 25 %. These young people were clinically intermediary between those without depressive symptoms and those with depressive disorder; at 6-months follow-up 57 % had persistent depressive symptoms and 12 % had developed a depressive disorder. Negative life events during the follow-up period and a positive family history of depression were the strongest predictors of symptom persistence and the development of depressive disorder, respectively.Conclusion
Sub-syndromal depression is common and persistent, in adolescent primary care attenders and it deserves attention. 相似文献2.
Purpose
This study investigated changes in depressive symptoms after the implementation of a universal screening for depression and subsequent care support.Methods
A cluster-randomized study design used 10 subdistricts (2,400 inhabitants aged 40–64 years) in northern Japan randomly assigned in a 2:3 ratio to intervention and control conditions. All 900 residents aged 40–64 in the intervention districts were invited to participate in a 2-year depressive screening program, with a participation rate of 49.2 %. A 4-year ongoing education program occurred in both intervention and control districts. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptomatology. Repeated cross-sectional samples were surveyed before (n = 1,516, response rate 63.6 %) and after (n = 1,596, 66.4 %) intervention, and the data, clustered according to district, were analyzed at the individual level using a mixed-effects model.Results
Significant changes in mean scores between baseline and 5-year follow-up in the intervention group were observed in the Depressive Affect, Somatic Symptoms, and Interpersonal Problems subscales. The difference between the changes over time in the two groups was significant for the three subscales and marginally for the CES-D total scale, but not for the Positive Affect subscale.Conclusions
Universal depression screening and subsequent support can be effective in preventing general depressive symptoms, but may not influence psychological well-being, among middle-aged adults in a community setting. 相似文献3.
Bauke T. Stegenga Mirjam I. Geerlings Francisco Torres-González Miguel Xavier Igor Švab Brenda W. Penninx Irwin Nazareth Michael King 《Social psychiatry and psychiatric epidemiology》2013,48(7):1067-1075
Purpose
Major depressive disorder may vary according to number and duration of episodes. It is unclear whether risk factors for onset of multiple or long episodes of depression (MDE) differ from risk factors for the onset of single and short ones.Methods
Data were used from a cohort study of 5,256 GP attendees without major depressive disorder at baseline, who were followed up three times (predictD). The numbers and duration of MDE were noted and categorized into no episodes, single and short (≤3 months), and multiple or long (>3 months) episodes at follow-up. Log-binomial regression models were used to calculate relative risks between the groups for 18 risk factors examined at baseline.Results
165 persons (3 %) had a single and short MDE and 328 (6 %) had multiple or long MDE at follow-up. Lower education, anxiety, problems at work and financial strain significantly increased the risk of multiple or long MDE when compared to single and short MDE. Younger people were at reduced risk of multiple or long MDE.Conclusions
Our findings suggest that several risk factors can be identified that may help to predict onset of different types of MDE. These factors are easy to assess and may be used in the prevention of depression. 相似文献4.
Ada Ávila Assunção Carla Jorge Machado Hugo Alejandro Cano Prais Tânia Maria de Araújo 《Social psychiatry and psychiatric epidemiology》2014,49(8):1219-1229
Purpose
Prevalence of depressive disorders has been reported among physicians in a number of different settings. The aim of the present study is to assess the prevalence of self-reported depression and its associated factors among physicians working in the public healthcare system of Belo Horizonte, Minas Gerais state, Brazil.Methods
A cross-sectional survey was carried out in 2009 to investigate individual and occupational dimensions of depressive disorders in a group of physicians working at several municipal healthcare units. The percentage of physicians that self-reported a confirmed diagnosis of depression by another physician was used as the prevalence proportion; the Poisson regression univariate and multivariate models were applied to study factors associated with depression.Results
The response rate was 81.2 %, of which 12.0 % reported depression confirmed by another physician. Reports of RSI/WMSD (p < 0.001) and passive work (p < 0.05) were positively and independently associated with the outcome.Conclusions
Our data bring valuable information that may help guide interventions and health-promoting activities for physicians by indicating concrete measures to change working conditions that affect mental health. 相似文献5.
Melissa Spears Alan A. Montgomery David Gunnell Ricardo Araya 《Social psychiatry and psychiatric epidemiology》2014,49(4):629-637
Purpose
Studies carried out in the West indicate that the incidence of self-harm (SH) is particularly high amongst adolescents, but few studies have investigated its incidence and aetiology in low-income countries. The purpose of this study was to investigate risk factors associated with new onset episodes of SH, amongst Chilean adolescents from low socio-economic backgrounds.Methods
Prospective cohort study nested within a cluster randomised controlled trial. A 6-month follow-up for 2,042 adolescents, median age 14 years, from socio-economically deprived areas of Santiago, Chile.Results
The lifetime prevalence of SH was 23 %. The incidence rate of SH at 6 months was 14 % amongst those reporting no SH at baseline. In multivariable analyses, risk factors for incident SH include depressive symptoms, suicidal thoughts, poor problem-solving skills and cannabis misuse.Conclusions
The prevalence and incidence of SH in this socio-economically deprived sample differed highly according to gender. Poor problem-solving skills, suicidal thoughts, and cannabis misuse were associated with onset of SH. 相似文献6.
7.
A. Alexander Beaujean Sonia Parker Xiao Qiu 《Social psychiatry and psychiatric epidemiology》2013,48(12):1983-1992
Purpose
There is literature indicating cognitive ability and depression are related, but few studies have examined the direction of the relationship. This study examined the relationship between depression levels and cognitive abilities from adolescence to early adulthood.Methods
Using the National Longitudinal Study of Adolescent Health (n = 14,322), this study used path modeling to investigate the relationship between depression and cognitive ability at baseline and again 8 years later.Results
After controlling for initial levels of depression, cognitive ability, and other covariates, depressive symptoms in adolescence are related to cognitive ability in early adulthood, but adolescent cognitive ability is not related to adult depression levels. Moreover, after controlling for adolescent levels of depression and cognitive ability, the cognitive ability–depression relationship disappears in adulthood.Conclusions
The cognitive ability–depression relationship appears early in life, and it is likely that the presence of depressive symptoms leads to lower cognitive ability. Thus, intervening at early signs of depression not only can help alleviate depression, but will likely have an effect of cognitive ability as well. 相似文献8.
Lisa A. Uebelacker Charles B. Eaton Risa Weisberg Megan Sands Carla Williams Darren Calhoun JoAnn E. Manson Natalie L. Denburg Teletia Taylor 《Social psychiatry and psychiatric epidemiology》2013,48(12):1971-1982
Purpose
To determine whether social support and/or physical activity buffer the association between stressors and increasing risk of depression symptoms at baseline and at 3-year follow-up.Methods
This is a secondary analysis of data from the Women’s Health Initiative Observational Study. 91,912 community-dwelling post-menopausal women participated in this prospective cohort study. Depression symptoms were measured at baseline and 3 years later; social support, physical activity, and stressors were measured at baseline.Results
Stressors at baseline, including verbal abuse, physical abuse, caregiving, social strain, negative life events, financial stress, low income, acute pain, and a greater number of chronic medical conditions, were all associated with higher levels of depression symptoms at baseline and new onset elevated symptoms at 3-year follow-up. Social support and physical activity were associated with lower levels of depressive symptoms. Contrary to expectation, more social support at baseline strengthened the association between concurrent depression and physical abuse, social strain, caregiving, and low income. Similarly, more social support at baseline increased the association between financial stress, income, and pain on new onset depression 3 years later. Physical activity similarly moderated the effect of caregiving, income, and pain on depression symptoms at baseline.Conclusion
Stressors, social support, and physical activity showed predicted main effect associations with depression. Multiplicative interactions were small in magnitude and in the opposite direction of what was expected. 相似文献9.
Monica L. Wang Sc.D. M.S. Stephenie C. Lemon Ph.D. Matthew C. Whited Ph.D. Milagros C. Rosal Ph.D. 《Annals of behavioral medicine》2014,48(2):256-264
Background
Depressive symptoms are common among adults with diabetes. Depression and social support may influence diabetes self-management.Purpose
This study aimed to examine change in depressive symptoms and the role of depression and support on clinical and dietary outcomes among Latinos with type 2 diabetes participating in a diabetes self-management intervention.Methods
Participants (N?=?252) were randomized to the intervention or usual care. Mixed effects models were used to examine interaction effects between intervention status and depressive symptoms (Centers for Epidemiologic Studies Depression (CES-D) score) and support for diabetes self-management behaviors at baseline. Outcomes were measured at baseline and 4 and 12 months and included dietary quality, physical activity, depressive symptoms, and hemoglobin A1c levels.Results
Intervention participants had lower CES-D scores at follow-up than control participants. An interaction effect between intervention status and CES-D scores predicted diet quality.Conclusion
Latinos with depressive symptoms may derive the greatest benefits from diabetes self-management interventions. Additional research on support during diabetes self-management interventions is warranted. 相似文献10.
Norbert Schmitz Ph.D. Geneviève Gariépy M.Sc. Kimberley J. Smith Ph.D. Ashok Malla M.D. Richard Boyer Ph.D. Irene Strychar E.D.D. Alain Lesage M.D. JianLi Wang Ph.D. 《Annals of behavioral medicine》2014,47(2):172-179
Background
The reciprocal relationship between depression and functioning in people with chronic conditions is poorly understood.Purpose
The aim of the present study was to analyze the dynamic relationship between depression and functioning in a community sample of people with diabetes.Methods
Participants with diabetes were assessed at baseline and three yearly follow-up assessments (n?=?1,403). Depression was assessed using the Patient Health Questionnaire. Global functioning was assessed using the World Health Organization Disability Assessment Schedule II.Results
Path analysis suggested a reciprocal relationship between depression and functioning. Baseline depression was associated with functioning at 3 years follow-up through depression and functioning at 1 and 2 years follow-up assessments.Conclusions
Depression and functioning might interact with each other in a dynamic way: depression at one assessment point might predict poor functioning at the next assessment point, which in turn might predict depression at the next assessment point. This should be taken into account in both treatment and research programs. 相似文献11.
Sylaja PN Dong W Grotta JC Miller MK Tomita K Hamilton S Semba C Hill MD 《Neurocritical care》2007,6(3):181-185
Background
Although tissue plasminogen activator (tPA) has been approved for use in acute ischemic stroke, concerns linger regarding its safety. We analyzed whether patients in special subgroups (i.e., age >70 years, baseline National Institute of Health Stroke Scale (NIHSS) score >20, diabetes, congestive heart failure (CHF), and of Hispanic origin) have a higher risk of symptomatic intracerebral hemorrhage (SICH) than patients without these characteristics.Methods
Four prospective observational studies of acute ischemic stroke patients treated within 3 h with Alteplase were identified and individual patient data were pooled for this analysis. These included the Standard Treatment with Alteplase to Reverse Stroke Study [STARS, N = 389], Epidemiology Study of Ischemic Stroke [ESIS, N = 236], University Of Texas Houston Stroke Study [UT, N = 241], and Canadian Activase For Stroke Effectiveness Study [CASES, N = 1100]. The risk of SICH was calculated for all patients and for each of five subgroups.Results
A total of 1966 patients were studied. Overall the risk of symptomatic ICH was 4.7% (95%CI, 3.8–5.8%) and the risk was similar among patients with and without each of the five characteristics. Patients with advanced age, baseline NIHSS score >20, CHF or diabetes had increased mortality and significantly lower rate of functional recovery.Conclusions
The present study suggests that these specified subgroups of patients are not at increased risk of SICH after stroke thrombolysis compared to those without these characteristics. 相似文献12.
Stephen E. Gilman Martha L. Bruce Thomas Ten Have George S. Alexopoulos Benoit H. Mulsant Charles F. Reynolds III Alex Cohen 《Social psychiatry and psychiatric epidemiology》2013,48(1):59-69
Purpose
Depression and suicide are major public health concerns, and are often unrecognized among the elderly. This study investigated social inequalities in depressive symptoms and suicidal ideation among older adults.Methods
Data come from 1,226 participants in PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial), a large primary care-based intervention trial for late-life depression. Linear and logistic regressions were used to analyze depressive symptoms and suicidal ideation over the 2-year follow-up period.Results
Mean Hamilton Depression Rating Scale (HDRS) scores were significantly higher among participants in financial strain [regression coefficient (b) = 1.78, 95 % confidence interval (CI) = 0.67–2.89] and with annual incomes below $20,000 (b = 1.67, CI = 0.34–3.00). Financial strain was also associated with a higher risk of suicidal ideation (odds ratio = 2.35, CI = 1.38–3.98).Conclusions
There exist marked social inequalities in depressive symptoms and suicidal ideation among older adults attending primary care practices, the setting in which depression is most commonly treated. Our results justify continued efforts to understand the mechanisms generating such inequalities and to recognize and provide effective treatments for depression among high-risk populations. 相似文献13.
Eva Asselmann Hans-Ulrich Wittchen Roselind Lieb Katja Beesdo-Baum 《Social psychiatry and psychiatric epidemiology》2017,52(11):1353-1362
Purpose
To prospectively examine whether higher daily hassles predict a variety of incident mental disorders and respective associations vary by gender, age, perceived coping efficacy and number of negative life events.Methods
Data comes from the Early Developmental Stages of Psychopathology Study (EDSP), a prospective-longitudinal study among adolescents and young adults from the community (n = 2797, aged 14–24 at baseline) followed up in up to 3 assessment waves over 10 years. Mental disorders were assessed at each wave using the DSM-IV/M-CIDI. Daily hassles, perceived coping efficacy, and negative life events were assessed at baseline using the Daily Hassles Scale, Scale for Self-Control and Coping Skills, and Munich Life Event List.Results
In logistic regressions adjusted for gender, age, other mental disorders, perceived coping efficacy and number of negative life events at baseline, higher daily hassles at baseline predicted the incidence of any anxiety disorder, specific phobia, obsessive–compulsive disorder, any affective disorder, and major depressive episodes at follow-up (OR 1.2–1.9 per standard deviation). Daily hassles interacted with perceived coping efficacy at baseline in predicting incident panic attacks (OR 1.3) and panic disorder (OR 1.3) at follow-up, i.e., higher daily hassles only predicted incident panic pathology among individuals with low perceived coping efficacy (OR 1.6–2.0) but not high perceived coping efficacy. Moreover, the associations between daily hassles and incident mental disorders partially varied by gender and age but not by negative life events at baseline.Conclusions
Targeted stress management interventions among individuals with increased daily hassles might be useful to prevent the onset of anxiety and affective disorders.14.
Neil Laufer Nelly Zilber Pablo Jecsmien Binyamin Maoz Daniel Grupper Haggai Hermesh Royi Gilad Abraham Weizman Hanan Munitz 《Social psychiatry and psychiatric epidemiology》2013,48(10):1539-1554
Objective
Psychiatric morbidity is common among patients in primary care services and leads to disability and increased use of medical services. Comparison of primary care and community prevalence data is of interest in relation to the health services planning for mental disorders. The aim of the present study was to measure prevalence of mental disorders in six primary care clinics in Israel and to assess risk factors for these disorders.Method
Prevalence of mental disorders was measured in a sample of 2,948 primary care consecutive attendees, using two-stage stratified sampling with the General Health Questionnaire 12 (GHQ-12) and the Composite International Diagnostic Interview (CIDI).Results
A high rate (46.3 %) of current mental disorders was found, with rates of current depressive episode, generalized anxiety disorder, somatization disorder, and neurasthenia being relatively high in comparison with rates in other countries. Low education was a risk factor for all categories of disorders, unemployment a risk factor for depressive disorders, and parenthood was protective for most categories of disorders.Conclusions
High rates of mental disorders were found in this Israeli primary care sample as compared to other countries, while in the community the rates were midrange as compared to other countries, pointing to a relatively higher use of primary care services by patients with mental disorders in Israel than in other countries. 相似文献15.
Background
In a sample of ex-political prisoners in the GDR examined in the middle of the 1990s, a follow-up examination carried out 15 years later investigated alterations in the diagnosis and symptom prevalence of post-traumatic stress syndrome PTSS) as well as other psychiatric disorders. The diagnosis course given by the clinicians was compared with the retrospective subjective estimations by participants.Methods
A total of 93 ex-political prisoners participated in the follow-up study (85 %) with an average age of 64 years. Diagnoses and symptoms were collated using structured clinical interviews and questionnaires. The retrospective subjective estimation of progression of the participants was calculated using a PTSS symptom index based on four symptom groups (intrusions, avoidance, numbing and hyperarousal).Results
At the time of follow-up PTSS was present in 33 % of participants (in 1997 it was 29 %). In 1994 this was present in only approximately 50 % of cases and in the other 50 % it concerned newly incident or remission cases. The next most common diagnoses were major depression episodes (26 %), panic (with or without agoraphobia 24 %) and somatoform disorders (19 %). In the PTSS symptom profile intrusions, flashbacks and alienation feelings decreased with time but in contrast irritability and shock reactions increased. The subjective self-estimation of the course of PTSS symptoms by the participants often gave a resilient (never PTSS) or delayed and rarely a remission course pattern in comparison to the diagnosing clinicians.Conclusions
The results indicate a trauma-related long-term morbidity which is, however less stable than previously assumed. 相似文献16.
Patricia Manzolli Maria Angélica Antunes Nunes Maria Inês Schmidt Andrea Poyastro Pinheiro Rafael Marques Soares Andressa Giacomello Michele Drehmer Caroline Buss Juliana Feliciati Hoffmann Silvia Ozcariz Cristiane Melere Carlo Nunes Manenti Suzi Camey Cleusa P. Ferri 《Social psychiatry and psychiatric epidemiology》2010,45(10):983-988
Aim
To estimate the prevalence of violence, depressive symptoms, and associated factors during pregnancy in women attending antenatal care in Brazil.Methods
Violence was assessed using a modified version of the abuse assessment screen (ASS), and depressive symptoms were evaluated using the primary care evaluation of mental disorders (PRIME-MD). Participants were pregnant women attending 18 primary care units in Rio Grande do Sul, Brazil, between June 2006 and April 2007. A total of 712 pregnant women participated, but only 627 of them responded the ASS.Results
Experience of any lifetime violence was reported by 273 (43.4%) women and 114 (18.2%) reported violence during the current pregnancy. One-third of them (n = 211) reported lifetime domestic violence and 100 (15.9%) women reported this type of violence during the current pregnancy. Experience of domestic violence during pregnancy was more common in unemployed women, among those with two or more children, with a higher consumption of alcohol, and who had not planned their current pregnancy. Of the total of sample (n = 712), 198 (27.8%) women reported six or more depressive symptoms. The presence of depressive symptoms during pregnancy was associated with low educational levels, living in a household with five or more people, and with higher consumption of alcohol during pregnancy.Conclusion
Pregnant women attending primary care are exposed to high rates of domestic violence, and many have clinically relevant depressive symptoms. Appropriate interventions to avoid or minimize the effects of violence and mental disorders to the well-being of the mothers and their babies are urgently required. Primary care services play an important role in identifying and supporting women at risk. 相似文献17.
Charlotte McKercher Kristy Sanderson Michael D. Schmidt Petr Otahal George C. Patton Terence Dwyer Alison J. Venn 《Social psychiatry and psychiatric epidemiology》2014,49(11):1823-1834
Purpose
Little is known about how physical activity patterns during childhood and adolescence are associated with risk of subsequent depression. We examined prospective and retrospective associations between leisure physical activity patterns from childhood to adulthood and risk of clinical depression in young adulthood.Methods
Participants (759 males, 871 females) in a national survey, aged 9–15 years, were re-interviewed approximately 20 years later. Leisure physical activity was self-reported at baseline (1985) and follow-up (2004–2006). To bridge the interval between the two time-points, historical leisure activity from age 15 years to adulthood was self-reported retrospectively at follow-up. Physical activity was categorized into groups that, from a public health perspective, compared patterns that were least beneficial (persistently inactive) with those increasingly beneficial (decreasing, increasing and persistently active). Depression (major depressive or dysthymic disorder) was assessed using the Composite International Diagnostic Interview.Results
Compared with those persistently inactive, males who were increasingly and persistently active had a 69 and 65 % reduced risk of depression in adulthood, respectively (all p < 0.05). In retrospective analyses, females who were persistently active had a 51 % reduced risk of depression in adulthood (p = 0.01). Similar but non-significant trends were observed for leisure physical activity in females and historical leisure activity in males. Results excluded those with childhood onset of depression and were adjusted for various sociodemographic and health covariates.Conclusions
Findings from both prospective and retrospective analyses indicate a beneficial effect of habitual discretionary physical activity since childhood on risk of depression in young adulthood. 相似文献18.
Justin J. Lacasse Marie J. C. Forgeard Nuwan Jayawickreme Eranda Jayawickreme 《Social psychiatry and psychiatric epidemiology》2014,49(3):459-465
Background
Past research suggests that culture shapes the way psychopathology is experienced and expressed. Standard psychiatric assessment instruments may therefore not capture the same underlying constructs in different contexts. The present study investigated the factor structure of a standard depression scale in a sample of Rwandan genocide survivors.Methods
One hundred ninety six Rwandan adults provided socio-demographic information and completed the Center for Epidemiological Studies-Depression scale (CES-D), one of the most widely used self-report instruments assessing depressive symptoms, as part of a larger study on well-being and mental health in Rwanda.Results
A two-factor solution provided the best fit for these CES-D data. The first factor corresponded to general depressive symptoms (including depressed affect, somatic symptoms, and interpersonal concerns) and explained 37.20 % of the variance. The second factor included items assessing positive affect and explained 8.68 % of the variance.Conclusions
The two-factor solution found in the present study deviates from the commonly reported four-factor structure, but is consistent with studies showing that depressed affect and somatic symptoms may not be experienced as distinct in certain non-Western and minority cultural groups. 相似文献19.
Ondine Pez Fabien Gilbert Adina Bitfoi Mauro Giovanni Carta Vesna Jordanova Carmen Garcia-Mahia Raimundo Mateos-Alvarez Martin Prince Bogdana Tudorache Catherine Blatier Viviane Kovess-Masfety 《Social psychiatry and psychiatric epidemiology》2010,45(12):1149-1159
Objectives
The aims of the study are: first, to compare two short diagnostic instruments, CIDI-SF and CIS-R, with respect to the structured clinical interview for non-patient (SCID-I/NP) for anxiety and depressive disorders; and second, to evaluate the influence of four languages, Italian, Romanian, Spanish and French, on the concordance tests.Methods
A total of 120 participants from Italy and Romania, 119 from Spain and 141 from France (N = 500) were recruited randomly in a local primary care research centre (GPs or medical centres). The instruments were administered during a unique session: the lay instruments by students in psychology and the SCID by experienced psychiatrists. Kappa, sensitivity/specificity/negative (NPV) and positive predictive values (PPV), ROC curve (AUC) and the Youden Index (Y) were calculated.Results
Results were better for the CIDI-SF than the CIS-R for anxious disorders, depressive disorders and any of them. The results were identical to that obtained by the CIDI 3.0 for the three categories and constant across the languages except for depressive disorders in Romania and France.Conclusions
CIDI-SF is a cost-effective instrument and could be easily integrated into health surveys; its performance values are better across languages than values proposed by the CIS-R and could be increased by inclusion of few additional information. 相似文献20.
Yanxia Lu Liang Feng Leslie Lim Tze Pin Ng 《Social psychiatry and psychiatric epidemiology》2013,48(8):1273-1282