A Nation's response to attack: Israelis' depressive reactions to the Gulf War

We examined Israelis' reactions to the Gulf War and SCUD missile attacks. Four national samples of Israelis (n=3,204) were interviewed as to depressive mood on four occasions—prior to the Gulf Crisis, as the war approached, during the SCUD missile attacks, and after cessation of hostilities. There was an expected increase in depressive mood during the period of SCUD missile attacks and a quick return to base-line levels following the hostilities. Less educated and older individuals reported higher base-line levels of depressive mood and were at higher risk for clinical depression. Women and men did not differ in depressive mood before or after the SCUD missile attacks. However, women experienced a marked increase in depressive mood when the SCUD missile attacks occurred.     

普通外科手术患者伴发抑郁障碍的现况调查

目的：了解准备接受手术治疗的外科患者伴发抑郁障碍的情况,并分析其可能的影响因素。方法：运用ZUNG抑郁自评量表对104例手术患者伴发抑郁障碍的情况进行调查,依据患者的年龄、性别、文化程度、罹患疾病的性质、接受手术的规模大小等因素进行分组研究,应用SPSS10．0统计软件进行数据的统计学检验。结果：40．4％的普通外科手术患者合并有不同程度的抑郁障碍。其中伴发中、重度抑郁障碍者占14．42％;女性患者、大学或大学以上文化程度的患者、小学文化程度和文盲患者、罹患肿瘤性疾病的患者伴发抑郁障碍的比例较高;而手术规模大小、患者是否明确进一步治疗方案则不影响合并抑郁障碍的情况。结论：普通外科手术患者伴发抑郁障碍的比例较高,性别、文化程度、疾病性质是其主要影响因素。     

Depression and Chronic Kidney Disease

Depression is the most common mental health disorder in patients with renal failure including those with pre-dialysis chronic kidney disease (CKD). The estimated prevalence of depression among patients with CKD is higher than in the general population and varies between 15 to 50% depending on the characteristics of the study sample and the instrument used to screen for depressive symptoms or diagnose a major depressive episode. In this patient population, depression has been associated with higher risk for hospitalization and shorter time to dialysis initiation. The role of screening, diagnosis and treatment for depression in patients with pre-dialysis CKD needs to be critically evaluated in prospective studies.     

The prevalence of post-traumatic stress disorder in the Vietnam generation: A multimethod,multisource assessment of psychiatric disorder

Findings from the Congressionally mandated National Vietnam Veterans Readjustment Study indicate that nearly one-half million Vietnam veterans—15.2% of the men and 8.5% of the women who served in Vietnam—suffer from post-traumatic stress disorder (PTSD) fifteen or more years after their military service. Current PTSD prevalence rates for Vietnam veterans are significantly and substantially higher than the rates for their comparable Vietnam generation peers, which range from 0.3% to 2.5%. Additionally, the current prevalence rate among male Vietnam veterans was found to differ significantly among race/ethnicity subgroups: 27.9% among Hispanic men, 20.6% among black men, 13.7% among white/other men. Multivariate analyses indicated that although background factors are significantly related to the current prevalence of PTSD, the current prevalence is much higher among Vietnam veterans than among era veteran and civilian counterpart comparison groups even after background differences are taken into account. These analyses also demonstrated the important role of exposure to combat and other types of war zone stress in the current prevalence of the disorder.     

Bidirectional relationship between depression and erectile dysfunction

PURPOSE: We specified the interrelationship between depressive mood and erectile dysfunction. MATERIALS AND METHODS: The target population consisted of men who were 50, 60 or 70 years old and residing in the study area in Finland in 1994. Questionnaires were mailed to 3,143 men in 1994 and to 2,837 men 5 years later. The followup sample consisted of 1,683 men who responded to the baseline and followup questionnaires. RESULTS: Erectile dysfunction was strongly associated with untreated and treated depressive symptoms. The prevalence OR adjusted for potential confounders was 2.6 (95% CI 1.8-3.8) for untreated and 3.3 (95% CI 1.6-7.1) for treated depressive symptoms at the beginning of followup. The incidence of erectile dysfunction was 59/1,000 person-years (95% CI 39-90) in men with depressive mood and 37/1,000 person-years (95% CI 32-43) in those free of the disorder. Compared with men free of depressive symptoms who did not use medication for psychological disorders at study entry the adjusted incidence density ratio of erectile dysfunction was 4.5 (95% CI 2.2-9.2) in men with treated depressive symptoms and 1.2 (0.7-2.1) in those with untreated depressive symptoms. The incidence of depressive mood was 20/1,000 person-years in men with erectile dysfunction and 11/1,000 person-years in those free of erectile dysfunction. The adjusted incidence density ratio of depressive mood was 1.9 (95% CI 1.1-3.3) in men with erectile dysfunction compared with those free of it at entry. CONCLUSIONS: Moderate or severe depressive mood or antidepressant medication use may cause erectile dysfunction and erectile dysfunction independently may cause or exacerbate depressive mood.     

Long‐term course of probable PTSD after the 9/11 attacks: A study in urban primary care

Although the short‐ and midterm psychological effects of the attacks on September 11, 2001 (9/11) have been well described, less is known about the long‐term effects. This study examines the course of probable posttraumatic stress disorder (PTSD), its predictors and clinical consequences in a cohort of 455 primary care patients in New York City, interviewed approximately 1 and 4 years after 9/11. The rate of PTSD decreased from 9.6% to 4.1%. Pre‐9/11 major depressive disorder emerged as the strongest predictor of PTSD, particularly late‐PTSD. At follow‐up, late‐PTSD was associated with major depressive and anxiety disorders, and PTSD regardless of timing was associated with impaired functioning. Findings highlight the importance of ongoing evaluation of mental health needs in primary care settings in the aftermath of disasters.     

Brain injury and violent crime

Primary objective: To test the hypothesis that TBI is associated with violent crime, the prevalence and characteristics of traumatic brain injury (TBI) were compared between men convicted of domestic violence and a matched comparison group.

Methods and procedures: Participants were 20 African American men convicted of domestic violence and 20 African American men without criminal convictions matched for age and socioeconomic status. Participants completed a questionnaire regarding health and behaviour history.

Main outcomes and results: More than half of the participants in both groups had sustained a TBI, although injuries in the offender group were significantly more severe. There were significantly more reports of problems with anger management in the offender group.

Conclusions: Published epidemiological data regarding TBI may underestimate the prevalence in urban populations, which may have confounded earlier studies of TBI and domestic violence. The reported prevalence in this sample of defendants suggests implications for the justice system.     

The Role of Gender in the Associations Among Posttraumatic Stress Symptoms,Anger, and Aggression in Russian Adolescents

Symptoms of posttraumatic stress disorder (PTSD) have been linked to anger and aggressive behavior in adult and veteran populations. However, research on the associations among anger, aggression, and PTSD in adolescents is lacking, particularly regarding differences between the sexes. To address this research gap, we used self-report data from Russian adolescents (N = 2,810; age range: 13–17 years) to perform a full path analysis examining the associations between PTSD symptoms and the emotional (anger traits) and cognitive (rumination) components of anger as well as physical/verbal and social aggression, after adjusting for depressive symptoms. We also examined the interaction effects between PTSD symptoms and sex on anger and aggression. The results indicated that girls scored higher on measures of anger and PTSD symptoms, ds = 0.20–0.32, whereas boys scored higher on measures of physical and verbal aggression, d = 0.54. Clinical levels of PTSD symptoms were associated with anger rumination, β = .16, and trait anger, β = .06, and an interaction effect for PTSD symptoms and sex was found for aggression, whereby boys with clinical levels of PTSD symptoms reported more physical/verbal and social aggression, βs = .05 and .20, respectively. Our findings suggest that PTSD symptoms may have an important impact on anger, anger rumination, and aggression during adolescence. In particular, boys seem to have an increased risk for aggressive behavior in the presence of PTSD symptoms. The present results highlight the importance of taking anger and aggression into account when evaluating PTSD.     

外科住院患者抑郁状况及相关因素分析

目的 探讨外科住院患者抑郁障碍的发生情况及其可能的影响因素.方法 首先采用抑郁自评量表(SDS)对符合人组条件的266例外科住院患者进行调查,然后对筛选有抑郁者和20%的无抑郁者采用美国<精神障碍诊断与统计手册第四版>DSM-Ⅳ轴Ⅰ障碍定式临床检查(SCID)作为金标准进行抑郁症的诊断,并对影响抑郁发生的因素进行分析.结果 外科住院患者SDS标准均显著高于国内正常人群,抑郁障碍检出率为37.2%.单因素分析发现:性别、文化程度、经济状况、病种、住院时间、治疗方法与抑郁的发生有关.多因素Logistic回归分析显示:性别、经济状况、治疗方法、躯体疾病既往史是影响抑郁发生的主要因素.结论 外科住院患者抑郁障碍发生率较高,其中性别、经济状况、治疗方法、躯体疾病既往史是主要的影响因素.     

Trauma symptoms and PTSD-like profiles in perpetrators of intimate abuse

The presence of chronic trauma symptoms and similarity to a specific profile for post-traumatic stress disorder (PTSD) were assessed in a group 132 wife assaultive men and 44 demographically matched controls. Men who committed intimate abuse experienced more chronic trauma symptoms than nonabusive controls. A composite profile on the MCMI-II for wife assaulters demonstrated peaks on 82C (negative/avoidant/borderline), as have two independent studies of the profile of men diagnosed with PTSD. However, the assaultive population had higher scores on the antisocial personality scale and lower scores on anxiety and dysthymia. This PTSD-like profile on the MCMI-II was associated significantly with more frequent anger and emotional abuse of the subject's partner. The trauma origin for these men may have been parental treatment: experiencing frequent trauma symptoms as an adult was significantly related to negative recollections of parental treatment, specifically parental coldness/rejection and physical abuse.     

Depression and anxiety in multisomatoform disorder: prevalence and clinical predictors in primary care

OBJECTIVE: Multisomatoform disorder (MSD) is characterised by > or = 3 medically inexplicable, troublesome physical symptoms, together with a > or = 2-year history of somatisation. The aim of this study was to evaluate the prevalence of depressive and anxiety disorders in a South African sample MSD, and to compare demographic and clinical outcomes in those patients with and without co-morbidity. METHODS: Fifty-one adult outpatients with MSD were recruited from primary care clinics in the Cape Town metropolitan area. Participants were assessed for the presence of co-morbid depressive and anxiety disorders using the Mini Neuropsychiatric Interview-Plus (MINI-Plus). Outcomes included somatic symptom severity, disability, reported sick days and health care visits, pain experience, patient satisfaction with health services, and clinician-experienced difficulty. RESULTS: A current co-morbid depressive disorder was present in 29.4% (N = 15) of patients, and a current co-morbid anxiety disorder in 52.9% (N = 27). MSD patients with a co-morbid depressive disorder (current or lifetime) had significantly higher physical symptom counts, greater functional impairment, higher unemployment rates, more clinician-reported difficulties, and more dissatisfaction with health care services than those without the disorder. A larger number of co-morbid disorders was associated with greater overall disability. CONCLUSION: High rates of co-morbid depressive and anxiety disorders were present in a South African sample of primary care patients with MSD. Not all patients had co-morbidity, which is consistent with the view that MSD should be viewed as an independent disorder. However, co-morbid depressive disorders were associated with increased symptom severity and functional impairment, consistent with previous reports from developing countries, emphasising the importance of comorbidity in MSD.     

Posttraumatic Stress Disorder,Gender, and Risk Factors: World Trade Center Tower Survivors 10 to 11 Years After the September 11, 2001 Attacks

Ten to eleven years after the September 11, 2001 terrorist attacks, probable posttraumatic stress disorder (PTSD) was evaluated in 1,755 World Trade Center (WTC) evacuees based on data from the WTC Health Registry. Characteristics of men and women were compared and factors associated with PTSD symptom severity were examined using the PTSD Checklist (PCL). Compared with men (n = 1,015, 57.8%), women (n = 740, 42.2%) were younger and of lower socioeconomic status. Ten to eleven years after September 11, 2001, 13.7% of men and 24.1% of women met criteria for PTSD. Results indicated that when considered with all other variables (i.e., demographic, socioeconomic and social resources, exposure to the attacks, life events), gender was not a significant predictor of PTSD symptom severity. Being younger on September 11, 2001, unemployed, less educated, and/or having higher exposure to the attacks, unmet mental health care needs, and less social support predicted higher PCL scores for both genders (βs = .077 to .239). Demographic characteristics and socioeconomic resources (ΔR ² = .113) accounted for the largest amount of variance in PCL scores over and above exposure/evacuation, mental healthcare needs, and social support variables (ΔR ² = .093 to .102). When trends of unmet mental healthcare needs were analyzed, the most prevalent response for men was that they preferred to manage their own symptoms (15.1%), whereas the most prevalent response for women was that they could not afford to pay for mental health care (14.7%). Although the prevalence of probable PTSD in women tower survivors was approximately twice as high as it was for men, this is attributable largely to demographic and socioeconomic resource factors and not gender alone. Implications for treatment and interventions are discussed.     

Neurostimulatory and ablative treatment options in major depressive disorder: a systematic review

Introduction  

Major depressive disorder is one of the most disabling and common diagnoses amongst psychiatric disorders, with a current worldwide prevalence of 5–10% of the general population and up to 20–25% for the lifetime period.     

Association between comorbidity and erectile dysfunction in patients with diabetes

The aims of this study were to determine the prevalence of erectile dysfunction (ED) and its relationship with comorbidity in patients with diabetes. The study population comprised of 312 consecutive patients aged 20 years or over residing in the city of Hamadan in Iran in 2005. Depression was assessed by the modified version of the Beck Depression Inventory (BDI-II) and ED by the short form of the International Index of Erectile Function (IIEF-5) questionnaire. Potential confounding was controlled by stratification and by a logistic regression model. The prevalence of moderate or complete ED (IIEF score 相似文献   

The prevalence of depressive symptoms and other variables among frail aging men in New York City's Personal Care Services program

Background

New York City's Personal Care Service Program provides service-rich assistance to the frail elderly who would not be able to live at home without such support. However, gender-specific health care delivery has not been introduced. Depressive symptoms are common among elderly people. We conducted a cross-sectional study in order to investigate the prevalence of depressive symptoms and other variables among frail elderly men receiving personal care services.

Methods

Data were collected from administrative data available in the Human Resources Administration's computer system. Two hundred men aged 65 or older were randomly selected. We defined depressive symptoms by tracking the recording of depressed mood in the data system. We examined statistical differences in a variety of indicators between elderly men with and without depressive symptoms. Multiple logistic regression analysis was performed to determine which independent variables were associated with depressive symptoms.

Results

Of all cases, 10.5% had depressive symptoms. In multiple logistic regression models, the duration of services provision and hearing impairment were independently associated with depressive symptoms in frail elderly men.

Conclusion

The results of this study indicate the low prevalence of depressive symptoms among frail elderly men compared with previous studies. The duration of services provision was a protective factor for depressive symptoms, i.e. personal care services provided high quality Activities of Daily Living (ADL) support, which keeps frail elderly men living at home for as long as possible. The significance of hearing impairment, which can induce social isolation, also needs to be stressed as an indicator of depressive symptoms, even though there was no discrete measurement of social isolation included in the data.     

The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th

This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.     

The prevalence of prostate cancer in Brazil is higher in Black men than in White men: systematic review and meta-analysis

Background: Black men have a higher incidence of prostate cancer compared with White men in several countries. In Brazil, most studies reported a similar prevalence of prostate cancer between Blacks and Whites as a result of the high race mixture of the population. Objective: To perform a systematic review with meta-analysis of the prevalence of prostate cancer in Black versus White, Brown versus White, and Black versus Brown Brazilian men. Design, Setting, and Participants: This systematic review included cohort, cross sectional and case-control studies comparing the prevalence of prostate cancer between races in Brazil. It was performed using an electronic search of references in bibliographic databases, and dissertations and theses databases from several Brazilian hospitals, universities, and schools of medicine. Meta-analysis was conducted using the RevMan software from the Cochrane Collaboration. To control for potential confounding variables, sensitivity analyses excluding case-control and cross sectional studies were performed. Measurements: The outcomes of interest included the number of participants, prevalence of prostate cancer, and odds ratio of cancer between Black and White men, Brown and White men, and Black and Brown men. Results and Limitations: Twelve studies approaching the prevalence of prostate cancer in Black or Brown vs. White men in Brazil were identifi ed, totalizing 41388 participants. The prevalence of prostate cancer was 9.6% in Black vs. 5.6% in White men (OR 1.58), 10.1% in Black vs. 6.7% in Brown men (OR 1.43), and 6.7% in Brown vs. 6.6% in White men (OR 1.14). Limitations of this review reflect the complexity and ambiguity in the defi nition of who is Black and who is not in such an heterogeneous population like the Brazilian people. Conclusions: This systematic review with meta-analysis demonstrates a higher prevalence of prostate cancer in Black men compared to White or Brown Brazilian men. The prevalence of prostate cancer is similar in Brown versus White men.     

Anger and its association to distress and social/occupational functioning in symptomatic disaster relief workers responding to the September 11, 2001, World Trade Center disaster

Empirical evidence suggests that anger plays a significant role in posttraumatic stress disorder (PTSD) and may impede recovery from traumatic events. The purpose of this study was to assess the role of anger and its relationship to distress and social/occupational functioning in disaster relief workers (DRWs) who had PTSD symptoms who were deployed to the World Trade Center after September 11, 2001. Six hundred twenty-six utility workers (96% male) completed measures of anger, distress, PTSD severity, and social/occupational functioning. Results indicated that anger was significantly higher in DRWs who had PTSD symptoms than in those who did not, and statistically significant associations were found among anger, distress, PTSD severity, and social/occupational functioning in workers who had PTSD symptoms. Careful assessment of anger in DRWs exposed to traumatic events is warranted as well as longitudinal studies to further understand the relationship between anger and PTSD.     

Hodenhochstand und Infertilit?t unter besonderer Ber��cksichtigung der interdisziplin?ren Leitlinie

Cryptorchidism is the most common genital disorder in boys. Early-born boys are affected in up to one third of the cases, while about 2-5% of full-term newborns suffer from at least one undescended testicle. As a result of short-term endogenous testosterone secretion after birth the prevalence decreases to 1-2% after 3 months. According to most studies, watchful waiting after 6 months is not justified because after this time spontaneous testicular descent only very rarely occurs. Even though the effects of testicular development and fertility in undescended testis have been extensively examined, the only fact that remains certain is that approximately 90% of untreated men with bilateral cryptorchidism develop azoospermia. The remaining scenarios of cryptorchidism (unilateral, ectopic, inguinal, treated or not treated) exhibit unpredictable fertility and likelihood of fatherhood.     

Anger: Cause or Consequence of Posttraumatic Stress? A Prospective Study of Dutch Soldiers

Many studies have shown that individuals with posttraumatic stress disorder (PTSD) experience more anger over time and across situations (i.e., trait anger) than trauma‐exposed individuals without PTSD. There is a lack of prospective research, however, that considers anger levels before trauma exposure. The aim of this study was to prospectively assess the relationship between trait anger and PTSD symptoms, with several known risk factors, including baseline symptoms, neuroticism, and stressor severity in the model. Participants were 249 Dutch soldiers tested approximately 2 months before and approximately 2 months and 9 months after their deployment to Afghanistan. Trait anger and PTSD symptom severity were measured at all assessments. Structural equation modeling including cross‐lagged effects showed that higher trait anger before deployment predicted higher PTSD symptoms 2 months after deployment (β = .36), with stressor severity and baseline symptoms in the model, but not with neuroticism in the model. Trait anger at 2 months postdeployment did not predict PTSD symptom severity at 9 months, and PTSD symptom severity 2 months postdeployment did not predict subsequent trait anger scores. Findings suggest that trait anger may be a pretrauma vulnerability factor for PTSD symptoms, but does not add variance beyond the effect of neuroticism.