Depressive symptoms predispose females to metabolic syndrome: a 7‐year follow‐up study

Objective: To evaluate the risk for developing metabolic syndrome when having depressive symptoms. Method: The prevalence of depressive symptoms and metabolic syndrome at baseline, and after a 7‐year follow‐up as measured with Beck depression inventory (BDI), and using the modified National Cholesterol Education Program – Adult Treatment Panel III criteria for metabolic syndrome (MetS) were studied in a middle‐aged population‐based sample (n = 1294). Results: The logistic regression analysis showed a 2.5‐fold risk (95% CI: 1.2–5.2) for the females with depressive symptoms (BDI ≥10) at baseline to have MetS at the end of the follow‐up. The risk was highest in the subgroup with more melancholic symptoms evaluated with a summary score of the melancholic items in BDI (OR 6.81, 95% CI: 2.09–22.20). In men, there was no risk difference. Conclusion: The higher risks for MetS in females with depressive symptoms at baseline suggest that depression may be an important predisposing factor for the development of MetS.     

Prevalence of depression and correlates of depressive symptoms for residents in the urban part of Jeju Island, Korea

AIMS: This study examined the prevalence of depression and depressive symptoms, and the correlates of depressive symptoms, and proposes some methods for reducing risk of depression in residents of the urban part of Jeju Island in Korea. METHODS: In all, 1050 residents were selected using multiphasic cluster sampling to represent each district. Of the 981 respondents, 413 were men and 568 were women. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to evaluate depression (CES-D score over 25) and depressive symptoms (CES-D score over 21). Multiple logistic regression analysis was performed for comparisons. RESULTS: The prevalence of depression in males and females was comparable, at 9.47 and 11.36%, respectively. The prevalence of depressive symptoms in men was 15.01%, while in women the level rose to 18.37%. Those with high self-assessed level of stress scores were significantly more likely to have depressive symptoms than those with low self-assessed level of stress scores (odds ratio (OR) = 5.73 (95% confidence interval (95% CI), 1.29-25.36)). Residents at high risk of problem drinking (CAGE score over 3) were significantly more likely to have depressive symptoms than those with a CAGE score under 1 (OR = 3.43 95% CI, 1.77-6.66). Respondents who slept poorly had more depressive symptoms than respondents who slept well (OR = 2.11 95% CI, 1.37-3.23). Females were significantly more likely to have more depressive symptoms than males (OR = 1.70 95% CI, 1.08-2.68). CONCLUSIONS: The prevalence of depression and depressive symptoms in urban Jeju Island is similar to that in a nation-wide sample. By providing intensive mental health services to those who have high stress levels, problem drinking, and poor health behavior, early detection of depressive symptoms in the community will be important for improving general health status.     

未治疗抑郁障碍患者自杀风险与认知情绪调节策略的关系

目的探讨具有自杀风险的抑郁障碍患者在认知情绪调节策略方面的特征及其影响因素,以早期识别具有自杀风险的患者,有针对性地给予干预。方法选取117例来自北京回龙观医院门诊、经简明国际神经精神访谈(MINI)5. 0中文版筛查符合抑郁障碍诊断标准的未治疗抑郁障碍患者,根据MINI 5. 0中文版自杀模块的访谈结果,将患者分为自杀风险组(n=52)和无自杀风险组(n=65)。采用认知情绪调节问卷(CERQ-C)进行认知调节策略的测评,采用汉密尔顿抑郁量表17项版(HAMD-17)评定抑郁症状的严重程度。结果抑郁障碍患者自杀风险发生率为44. 4%(52/117)。与无自杀风险组相比,自杀风险组患者更多见于女性、未婚、平均年龄更小、发病年龄更早、HAMD-17总评分更高、伴精神病性症状率较高,自杀风险组自我责难、接受、沉思、灾难化4个认知调节策略维度及消极认知情绪调节评分均高于无自杀风险组(P均<0. 05)。Logistic回归分析显示,女性(OR=3. 539,95%CI:1. 383~9. 057)、发病年龄(OR=0. 931,95%CI:0. 895~0. 968)、HAMD-17总评分(OR=1. 207,95%CI:1. 063~1. 370)和灾难化(OR=1. 143,95%CI:1. 002~1. 305)与抑郁障碍患者自杀风险相关(P均<0. 05)。结论女性、发病年龄早、抑郁症状严重和灾难化可能为未治疗抑郁障碍患者自杀风险的危险因素。     

A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls

Background: This study evaluates the benefits of a self‐directed Internet intervention for depression (MoodGYM) delivered as a part of the high school curriculum. Method: One hundred and fifty‐seven girls, aged 15 and 16 years, were allocated to undertake either MoodGYM or their usual curriculum. MoodGYM's impact on depressive symptoms, risk of depression, attributional style, depression literacy and attitudes toward depression was examined using random effect regression. Results: MoodGYM produced a significantly faster rate of decline in depressive symptoms over the trial period than the control condition. The effect size for MoodGYM was not significant immediately after the intervention (Cohen's d=.19, 95% CI ?.18–.56) but was moderate and significant 20 weeks after the intervention (d=.46, 95% CI .10–.82). Girls with high depression scores before intervention showed the strongest benefits on self‐reported depression at follow‐up (d=.92, 95% CI .10–1.38). There were no significant intervention effects on depression status, attributional style, depression literacy, and attitudes. Approximately 70% of girls in the MoodGYM group completed less than three of its modules and completion of fewer modules was related to high depression score before intervention. Conclusions: The findings suggest that there are benefits from MoodGYM on self‐reported depressive symptoms but has low rates of completion highlight problems in ensuring adherence to Internet programs for depression. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Chernobyl exposure as stressor during pregnancy and behaviour in adolescent offspring

Objective: Research in animals has shown that exposure to stressors during pregnancy is associated with offspring behavioural disorders. We aimed to study the effect of in utero exposure to the Chernobyl disaster in 1986, and maternal anxiety presumably associated with that exposure, on behaviour disorder observed at age 14. Method: Exposed (n = 232) and non‐exposed Finnish twins (n = 572) were compared. A semi‐structured interview was used to assess lifetime symptoms of depression, generalized anxiety disorder, attention deficit hyperactivity disorder, conduct disorder and oppositional defiant disorder symptoms. Results: Adolescents who were exposed from the second trimester in pregnancy onwards, had a 2.32‐fold risk (95% CI: 1.13–4.72) of having lifetime depression symptoms, an increased risk of fulfilling DSM‐III‐R criteria of a major depressive disorder (OR = 2.48, 95% CI: 1.06–5.7), and a 2.01‐fold risk (95% CI: 1.14–3.52) of having attention deficit hyperactivity disorder symptoms. Conclusion: Perturbations in fetal brain development during the second trimester may be associated with the increased prevalence of depressive and attention deficit hyperactivity disorder symptoms.     

Neuroticism,introversion, and major depressive disorder—traits,states, or scars?

Background: The extent to which measures of the personality dimensions of neuroticism and introversion are influenced by symptoms of depression and anxiety or by episodes of depression, and whether neuroticism alone or both traits predispose one to depression remain unclear. Methods: Major depressive disorder patients (n=193) from the Vantaa Depression Study were interviewed at baseline and at 6 and 18 months, and a general population comparison group (n=388) was surveyed by mail. Patients' scores of neuroticism and extraversion‐introversion were compared between time points, and before and after a possible recurrence of depression between interviews. Patients' scores at an index interview, when the level of depression was lowest, were compared with scores of the general population, after controlling for anxiety and depression. Results: Among depressive patients, neuroticism scores declined (from 17.2, SD 3.7–13.7, SD 5.6, P<0.001) and extraversion scores increased (from 10.0, SD 4.7–11.2, SD 4.5, P<0.001) with recovery during follow‐up. The scores were not influenced by a recurrence of depression between measurements. In logistic regression, patients had higher neuroticism (odds ratio, OR 1.11, P=0.001) and lower extraversion (OR 0.92, P=0.003) than the general population. Conclusions: The overall level of neuroticism is markedly and introversion somewhat higher in depressive patients than in the general population. Anxiety symptoms have some, and depressive symptoms a strong influence on neuroticism scores, but only depression has an impact on introversion during a depressive episode. In medium‐term follow‐up, depressive episodes are unlikely to result in a personality scar persisting after recovery from an episode. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Foreløbige erfaringer med lobotomia frontalis

Objective: To study the correlation of personality traits measured by the Temperament and Character Inventory (TCI) with the prognosis of major depressive disorder in patients treated with either fluoxetine or short-term psychodynamic psychotherapy in a randomized comparative study. Method: 35 patients with DSM IV-defined major depressive disorder of mild or moderate severity were randomized to receive either short-term psychodynamic psychotherapy or fluoxetine treatment for 16 weeks. Prior to beginning of the therapy, patients were assessed with TCI. The Hamilton Depression Rating Scale (HDRS) was used as the outcome measure completed at the baseline and follow-up at 4 months. Results: In the combined group (n=35), Harm Avoidance was associated with the severity of the depression measured by the HDRS at the baseline (P=0.01) and baseline Self-Directedness with the HDRS at 4 months follow-up (P=0.03). In the fluoxetine treatment group, Reward Dependence (P=0.03), Self-Directedness (P=0.01) and Cooperativeness (P=0.02) at the baseline associated with HDRS at 4 months follow-up. No statistically significant associations between personality traits and depression scores at the follow-up were found in the patients treated with psychotherapy. Conclusion: In this whole cohort of depressive patients, baseline high Self-Directedness predicted higher depression scores after 4 months of treatment. In the fluoxetine treatment group, subjects with high baseline Reward Dependence, Self-Directedness or Cooperativeness were likely more severely depressed at the 4 months follow-up. We suggest that associations between personality traits and remaining depressive symptoms after 4 months treatment with fluoxetine could be caused by the potential differences in the placebo effect.     

The prevalence of and factors associated with depressive symptoms in the Korean adults: the 2014 and 2016 Korea National Health and Nutrition Examination Survey

Purpose

This study was performed to investigate the prevalence of and factors associated with depressive symptoms in the Korean adult population.

Methods

10,710 participants in the 2014 and 2016 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed in this study. Assessment of depressive symptoms was performed using the self-administered nine-item Patient Health Questionnaire (PHQ–9).

Results

The weighted prevalence of clinically relevant depression (PHQ-9 score ≥ 10) in the Korean adult population was 6.1% [5.5–6.8%]. Female sex, adults aged 19–29 years, elementary school graduation, living alone were significantly associated with clinically relevant depression. Having a household income ≤ 24th percentile was associated with a 2.26 (CI 1.49–3.45, p < 0.001)-fold higher prevalence of clinically relevant depression compared to having a household income ≥ 75th percentile. Regarding occupation, treating managers and professionals as controls, we found that unemployed individuals (OR 2.36, 95% CI 1.52–3.65, p < 0.001) had an increased risk of clinically relevant depression. Alcohol consumption < 30 g/day was reversely associated with clinically relevant depression (OR 0.75, 95% CI 0.62–0.93, p = 0.007), when abstain from alcohol was treated as control. Current smokers (OR 3.42, 95% CI 2.54–4.60, p < 0.001) and ex-smokers (OR 1.73, 95% CI 1.24–2.42, p = 0.001) had a higher risk of clinically relevant depression than never-smokers.

Conclusions

The estimated prevalence of depressive symptoms in a representative sample of the Korean adult population was 6.1%. This study suggests that younger age, female sex, elementary school graduation, living alone, low household income, current smoking, and being unemployed are associated with depressive symptoms.

     

Depression during pegylated interferon-alpha plus ribavirin therapy: prevalence and prediction

BACKGROUND: Interferon-alpha (IFN-alpha) plus ribavirin is used to treat hepatitis C virus (HCV) infection and is associated with a high rate of depression. Newer, pegylated preparations of IFN-alpha have a longer half-life, require once-per-week dosing, and may be associated with reduced neuropsychiatric burden. Limited data exist on depression during pegylated IFN-alpha therapy. METHOD: Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) in 162 HCV-infected patients at baseline and after 4, 8, 12, and 24 weeks of treatment with pegylated IFN alpha-2b (PEG IFN) plus weight-based (N = 86) versus standard dose (N = 76) ribavirin. Data were collected from March 2001 to April 2003. RESULTS: Compared with baseline, mean SDS index scores were significantly increased by week 4 and remained elevated throughout the study. Thirty-nine percent of the sample experienced moderate to severe depressive symptoms (SDS index score > or = 60) at some point during PEG IFN/ribavirin therapy. Baseline depression scores significantly predicted severity of depressive symptoms during PEG IFN/ribavirin treatment (simple regression analysis: Y = 0.55X + 32.7, p < .0001). In addition, assignment to weight-based ribavirin treatment and history of depression were associated with increased likelihood of developing moderate to severe depressive symptoms (odds ratio [OR] = 2.7, 95% CI = 1.3 to 5.6, p < .01, and OR = 3.3, 95% CI = 1.3 to 8.1, p < .01, respectively). CONCLUSIONS: Development of moderate to severe depressive symptoms occurred frequently during PEG IFN/ribavirin treatment and was predicted by baseline depression scores and higher doses of ribavirin. History of major depressive disorder was also a significant predictive factor, but only through association with elevated baseline depression status. All of these factors can be evaluated and addressed to limit neuropsychiatric morbidity during HCV treatment.     

Is improvement in impaired cognition and depressive symptoms in post‐stroke patients associated with recovery in activities of daily living?

Background and purpose – Depression and cognitive impairment after stroke are associated with physical functional outcomes, but there are limited data on whether depressive symptoms and cognitive status and improvements independently influence functional status and recovery. Methods – In a 6‐month prospective cohort study of 141 post‐acute stroke patients, demographic and clinical data on admission, and neurological, cognitive, depressive symptoms and functional variables on admission and at 6 months after stroke were measured using the National Institute of Health Stroke Scale (NIHSS), Abbreviated Mental Test (AMT), Geriatric Depression Scale (GDS) and Barthel Index (BI). Results – On multivariate analysis, severe activities of daily living (ADL) dependence at 6 months was significantly less likely associated with higher baseline AMT score denoting better cognitive status (OR = 0.68, 95% CI 0.48–0.97 per score point) and with greater AMT change score denoting greater cognitive improvement (OR = 0.61, 95% CI 0.41–0.91 per change score point); it was also more likely with higher baseline NIHSS scores denoting severe neurological impairment, (OR = 1.74, 95% CI 1.13–2.63 per point score), NIHSS change score [denoting lesser neurological improvement (OR = 1.83, 95% CI 1.13–2.93 per unit change score)], but was not associated with baseline or change scores of GDS. Greater magnitudes of functional recovery [BI change score (standardized beta)] were associated with better baseline depressive symptoms (?0.21) and improvement (?0.31), but not with cognitive status or improvement, in the presence of other significant variables, neurological status (?0.89) and improvement (?0.65), lower baseline physical functional status (?0.85) and younger age (?0.23). Conclusions – These data suggest that improving depressive symptoms in stroke patients may accelerate functional recovery, but the level of physical functioning achieved post‐stroke is determined by neurological and cognitive factors, consistent with the evidence that improvement of depressive symptoms through therapeutic intervention is limited by cognitive impairment.     

Depressive symptoms and 10-year risk for cardiovascular morbidity and mortality

Abstract

Objectives. Depression is associated with increased physical morbidity and overall mortality. As less is known about how much depression increases the 10-year risk for fatal and nonfatal cardiovascular (CV) events, we evaluated the cross-sectional risk with two well-characterized risk functions measuring CV mortality and total CV event risk. Methods. The prevalence of increased depressive symptoms was measured with the Beck Depression Inventory (BDI), and the SCORE and Framingham risk functions were calculated in a middle-aged population-based sample (N=923). For metabolic syndrome (MetS), the modified National Cholesterol Education Program – Adult Treatment Panel III criteria were employed. Results. Depressive symptoms were associated with increased CV mortality and morbidity risk in men: OR for SCORE 2.9; 95%CI 1.4–5.7 and OR for Framingham function 2.2 (95%CI 1.1–4.2). In women, the corresponding figures were 1.4 (95%CI 0.3–6.9) and 1.3 (95%CI 0.7–2.6). The BDI scores showed significant correlations with SCORE (r=0.18 for men, P < 0.001; and r=0.14 for women, P=0.002), and Framingham function (for men r=0.16, P < 0.001; and for women r=0.13, P=0.005). Conclusions. Our results suggest that screening and effective treatment of depression are important in the primary and secondary prevention of cardiovascular events, especially in males.     

Topiramate versus bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single-blind study

Objective: Antiepileptic drugs (AEDs) are commonly employed in the treatment of bipolar disorder. The efficacy and tolerability of topiramate, a novel anticonvulsant, and bupropion SR when added to mood stabilizer therapy were compared under single‐blind conditions (rater‐blinded) in patients meeting DSM‐IV criteria for bipolar I/II depression. Methods: A total of 36 out‐patients with Hamilton Depression Rating Scale (HDRS‐17) scores ≥16 were randomized to receive escalating doses of either topiramate (50–300 mg/day) or bupropion SR (100–400 mg/day) for 8 weeks. Data were analyzed on an intent‐to‐treat basis using the last observation carried forward method. Results: The percentage of patients meeting a priori response criteria (≥50% decrease from baseline in mean HDRS‐17 total score) was significant for both topiramate (56%) and bupropion SR (59%) [t(17)=2.542, p=0.04 and t(17)=2.661, p=0.03, respectively]. Baseline demographic and clinical parameters were comparable between the two treatment groups. The mean doses of study medication were 176 mg/day (SD=102 mg/day) for the topiramate‐treated group and 250 mg/day (SD=133 mg/day) for the bupropion SR‐treated group. A significant and comparable reduction in depressive symptoms was observed from baseline to endpoint following topiramate and bupropion SR treatment, according to a ≥ 50% reduction in the HDRS‐17. Total mean HDRS‐17 scores significantly decreased from baseline to endpoint in both groups (p=0.001), however, differences between the topiramate‐treated group and the bupropion SR‐treated group were not significant [t(36)=1.754, p=0.097]. Both topiramate and bupropion SR were generally well tolerated. Thirteen patients discontinued the study: 2 because of lack of efficacy, 1 due to withdrawal of consent and 10 following side‐effects (six in the topiramate and four in the bupropion SR‐treated group). There were no cases of affective switch in either arm. Weight loss was experienced by patients in both groups (mean weight loss at endpoint was 1.2 kg in bupropion SR and 5.8 kg in topiramate) [t(17)=2.325, p=0.061 and t(17)=2.481, p=0.043, respectively]. Conclusions: These preliminary data suggest that adjunctive topiramate may reduce depressive symptom severity in acute bipolar depression. The antidepressant efficacy of this compound requires confirmation via double‐blind placebo controlled investigation.     

Serum cholesterol and depressive symptoms in elderly Finnish men

OBJECTIVE: Evidence from previous studies suggests that alterations in lipid levels may be associated with depression in old age. The objective of this study was to investigate the association between serum lipids and depressive symptoms in a population of elderly men. SUBJECTS AND METHODS: Altogether 470 men born between 1900 and 1919 were examined in the 30-year follow-up of the Seven Countries Study in 1989. Zung Self-Rating Depression Scale was used to determine the depressive status of the subjects. The depressive status was dichotomised and used as the dependent variable in the present study. RESULTS: The depressive status was available for 421 men aged 70 to 89 years in 1989. The prevalence of depression, defined as the Zung sum score equal to or greater than 48, was 15.2% (n = 64). A low serum total cholesterol (odds ratio (OR) 0.67, 95% confidence intervals (CI) 0.48-0.94, p = 0.022) and low low density lipoprotein cholesterol (OR 0.67, 95% CI: 0.46-0.98, p = 0.041) were independently associated with depression. No association with depression was found for high density lipoprotein (HDL) concentration or HDL/total cholesterol ratio after the adjustment for other putative correlates for depression. CONCLUSIONS: Our study of a well-documented population of elderly Finnish men confirms that low total serum cholesterol is associated with a high amount of depressive symptoms independently of weight change or chronic disease. Our study is the first to show an independent association of low LDL-cholesterol concentration with a high amount of depressive symptoms in the old-old.     

Decreased Health-Seeking Behaviors in People With Depressive Symptoms: The Korea National Health and Nutrition Examination Survey 2014, 2016, and 2018

ObjectiveThe purpose of this study was to investigate the effects of depressive symptoms on health-seeking behaviors using the large epidemiological study data of the Korea National Health and Nutrition Examination (KNHANES). MethodsData from the Korea National Health and Nutrition Examination Survey (KNHANES), which is a large-scale national survey, were used in this study. The Patient Health Questionnaire-9 (PHQ-9) was used to assess the depressive state of the participants. Specialized self-reported questionnaires that included questions about health-seeking behaviors were also performed. To examine the relationships between depression and health-seeking behaviors, complex sample logistic regression models with control for covariates were used. ResultsThere was a significant association between decreased health-seeking behaviors and depressive symptoms in adults (odds ratio [OR]: 3.11, 95% confidence interval [CI]: 2.44–3.96). The association was found to be especially strong in males (OR: 2.63, 95% CI: 1.69–4.10) versus in females (OR: 2.49, 95% CI: 1.90–3.27). With regard to age group, younger adults (19–44 years of age) showed the highest OR (OR: 3.07, 95% CI: 2.12–4.45). ConclusionOur findings support the idea that there is a significant association between health-seeking behaviors and depressive symptoms in the Korean population. These results suggest that individuals with decreased health-seeking behaviors could be evaluated for depressive symptoms.     

APOE ε4 allele is associated with an increased risk of bulbar‐onset amyotrophic lateral sclerosis in men

Objective: Several association studies have identified possible susceptibility factors for sporadic amyotrophic lateral sclerosis (SALS). Studies on the APOE gene provided conflicting results, especially about the effect on bulbar onset. We assessed the possible role of APOE gene in a large cohort of patients with ALS and matched controls. Methods: The APOE alleles were determined in 1482 patients with SALS and 955 controls and analysed by univariate and multivariate statistics, taking into account gender, site‐of‐onset and age‐at‐onset. Results: Patients with bulbar onset were more likely to be women [odds ratio (OR) = 2.17; 95% CI: 1.74–2.72] and to be older (OR = 3.47; 95% CI: 2.58–4.67). The ε4‐carriers were more frequent in the bulbar‐onset group than in the limb‐onset group (OR = 1.39 bulbar onset versus limb onset; 95% CI: 1.08–1.80) but this association was observed amongst men (OR = 1.78; 95% CI: 1.25–2.53) and not women (OR = 1.09; 95% CI: 0.75–1.59). Conclusion: Our study provides evidence for a contribution of the ε4 allele in the occurrence of bulbar‐onset ALS amongst men. We propose that men are normally protected by androgens against bulbar onset and that the ε4 allele inhibits this protection, perhaps by interfering with the androgen pathway.     

Sub‐threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcome

Objective: A small but significant proportion of patients with major depressive disorder (MDD) report mild manic symptoms which are below the diagnostic threshold for a hypomanic episode. Method: We tested for an association between sub‐threshold manic symptoms and clinical outcome in almost 600 patients with recurrent MDD who also had no known family history of bipolar disorder. Results: 9.6% of this large sample had a life‐time history of sub‐threshold manic symptoms. These patients were significantly more likely to have a history of poor response to antidepressants (OR 2.84; 95% CI 1.23–6.56; P < 0.02) and more likely to have experienced psychosis (OR 2.07; 95% CI 1.05–4.09; P < 0.04). They had also experienced more depressive episodes on average (P = 0.006) and were more likely to have been admitted to hospital (P < 0.03). Conclusion: Sub‐threshold manic symptoms in patients with recurrent MDD may be a useful clinical marker for poor response to antidepressants and a more morbid long‐term clinical course.     

Antenatal Depression Strongly Predicts Postnatal Depression in Primary Health Care

Objective: To estimate the association between antenatal and postnatal depression and to examine the role of socioeconomic conditions in the risk of postnatal depression. Methods: A prospective cohort study, conducted between May 2005 and January 2006, with 831 pregnant women recruited from primary care clinics in the public sector in the city of São Paulo, Brazil. The presence of antenatal and postnatal depression was measured with the Self Report Questionnaire (SRQ-20). Sociodemographic and socioeconomic characteristics and obstetric information were obtained through a questionnaire. Crude and adjusted risk ratios (RR), with 95% CI, were calculated using a Poisson regression. Results: The prevalence of postnatal depressive symptoms was 31.2% (95%CI: 27.8-34.8%). Among the 219 mothers who had depressive symptoms, nearly 50% had already shown depressive symptoms during pregnancy. Women who had antenatal depression were 2.4 times more likely to present with postnatal depression than were women who did not have such symptoms during pregnancy. In the multivariate analysis, higher scores for assets (RR: 0.76, 95% CI 0.61-0.96), higher education (RR: 0.75 95%CI 0.59-0.96), daily contact with neighbors (RR: 0.68, 95%CI 0.51-0.90) and antenatal depression (RR: 2.44, 95%CI 1.93-3.08) remained independently associated with postnatal depression. Conclusions: Antenatal and postnatal depression are highly prevalent in the primary care setting.     

A longitudinal typology of symptoms of depression and anxiety over the life course.

BACKGROUND: Little is known about long-term profiles of depressive and anxious symptomatology over the life course and about the developmental determinants of different trajectories. The objective of this study was to identify a novel typology of symptoms of depression and anxiety over the life course and examine its neurodevelopmental antecedents in an epidemiological sample. METHODS: A longitudinal latent variable analysis was conducted on measures of anxious and depressive symptoms at ages 13, 15, 36, 43, and 53 years among 4627 members of the Medical Research Council National Survey of Health & Development (the British 1946 birth cohort). Early life predictors of class membership were studied with ordinal logistic regression. RESULTS: We identified six distinct profiles up to age 53: absence of symptoms (44.8% of sample); repeated moderate symptoms (33.6%); adult-onset moderate symptoms (11.3%); adolescent symptoms with good adult outcome (5.8%); adult-onset severe symptoms (2.9%); and repeated severe symptoms over the life course (1.7%). Heavier babies had lower likelihood of depressive and anxious symptoms (odds ratio [OR] = .92; 95% confidence interval [CI] .85-.99), whereas delay in first standing (OR = 1.19; 95% CI 1.11-1.28) and walking (OR = 1.22; 95% CI 1.14-1.31) was associated with subsequent higher likelihood of symptoms, controlling for social circumstances and stressful life events during childhood. CONCLUSIONS: There was evidence of distinct profiles of depressive and anxious symptomatology over the life course and associations with markers of neurodevelopment. This suggests very early factors are associated with long-term experience of symptoms of depression and anxiety.