Personality differences in patients with depressive illness and anxiety neurosis

This study explores personality in subgroups of affective illness. Self-assessment scores on Cattell's 16 Personality Factor (16 PF) Questionnaire were obtained from 87 patients comprising five groups, namely ill and recovered unipolar and bipolar depressives and chronic anxiety (CA) neurotics. It was predicted that the anxiety group would have more abnormal scores than both actively depressed groups, but the three groups had markedly similar traits. The prediction that three different types of personality profiles would be obtained from the two recovered depressive groups and the anxiety group was partly confirmed. However, the scores of the anxious patients were more similar to those of recovered unipolar depressives than either was to recovered bipolar depressives. It is suggested that the similar personalities of unipolar depressives and anxiety neurotics may be aetiologically important. Furthermore, the differences between the two recovered depressive groups supports the idea of distinguishing between sub-populations in studies of affective illness.     

Identifying anxiety and depressive disorders among primary care patients: a pilot study

One stage case-identification method, using the Arabic Version of the Hospital Anxiety and Depression Scale (HAD) was applied in a pilot study for estimating the prevalence of depressive and anxiety disorders among a group of Saudi primary care attenders. The validity of the Arabic Version of the HAD scale was previously tested and found valid with high sensitivity and specificity. The total prevalence rate of depression was 17% and that of anxiety was 16%. Seven percent of the sample suffered both depression and anxiety i.e. the total percentage of patients with depression, anxiety or both was 26%. Higher morbidity of depression was recorded among females and a higher morbidity of anxiety among male patients.     

Sex differences in the use of coping strategies: predictors of anxiety and depressive symptoms

This study examined sex differences in the use of coping strategies and their relationship to depression and anxiety-related psychopathology. Responses on measures of coping strategies, depression, and anxiety were obtained from a carefully screened nonclinical sample (N = 107). The results demonstrated that women who used less positive reframing had higher levels of depressive symptoms compared with women who used more positive reframing and to men irrespective of their use of more or less positive reframing. In addition, women who reported the use of more self-blame had elevated levels of trait anxiety, although a similar effect was not found for men. The observed sex differences in the use of coping strategies and their association with depression and anxiety-related problems underscores differences in the clinical presentation of anxiety and depression between women and men.     

Anxious and depressive symptoms in Parkinson's disease: The French cross‐sectionnal DoPaMiP study

Anxiety has been less extensively studied than depression in Parkinson's disease (PD). The DoPaMiP survey allowed assessing simultaneously anxiety and depressive symptoms in PD and comparing correlations of both symptoms with clinical and therapeutic features of the disease. Cross sectional survey conducted prospectively in 450 ambulatory nondemented PD patients and 98 patients with other disorders than PD. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), parkinsonism using the Unified Parkinson's Disease Rating Scale (UPDRS). Other clinical factors were measured using a structured standardized examination/questionnaire. The mean HADS‐A (anxiety) subscore was higher in PD patients than in the others (8.2 ± 3.9 vs. 6.5 ± 3.2, P < 10^?4) as was the HADS‐D (depressive) subscore (6.6 ± 3.8 vs. 3.9 ± 3.2, P < 10^?4). Patients with possible/probable anxious signs (HADS‐A ≥ 8) were more prevalent in PD (51% vs. 29%, P < 10^?4) as were those with depressive symptoms (40% vs. 10%, P < 10^?4). Conversely, anxiolytic and antidepressant medications consumption was not different between the 2 groups. Patients with anxious symptoms were more frequently female and younger than those without such symptoms, while those with depressive symptoms had more severe indices of parkinsonism, more comorbidities and lower cognitive function (Mini Mental State Exam). The logistic regression model revealed that patients with depressive symptoms received more frequently levodopa and less frequently a dopamine agonist. Anxiety and depressive symptoms were more frequent in PD patients than in medical control group. Both symptoms were commonly associated in the same PD patients, but were correlated with different clinical/therapeutic features, suggesting different underlying pathophysiological mechanisms. © 2009 Movement Disorder Society     

A validation study of depressive syndromes in Parkinson's disease

The validity, sensitivity, and specificity of depressive symptoms for the diagnosis of major depression, minor depression, dysthymic disorder, and subsyndromal depression in Parkinson's disease (PD) were examined. A consecutive series of 173 patients with PD attending a Movement Disorders Clinic underwent a comprehensive psychiatric and neurological assessment. The symptoms of loss of interest/pleasure, changes in appetite or weight, changes in sleep, low energy, worthlessness or inappropriate guilt, psychomotor retardation/agitation, concentration deficits, and suicide ideation were all significantly associated with the presence of the DSM‐IV depressed mood criterion for major depression. The symptoms of changes in appetite, changes in sleep, low energy, low self‐esteem, poor concentration, and hopelessness were all significantly associated with the presence of the DSM‐IV criterion of sad mood for dysthymic disorder. Thirty percent of our sample met DSM‐IV diagnostic criteria for major depression, 20% met diagnostic criteria for dysthymic disorder, 10% met diagnostic criteria for minor depression, and 8% met clinical criteria for subsyndromal depression. Patients with either major or minor depression had significantly more severe deficits in activities of daily living, more severe cognitive impairments, and more severe Parkinsonism than patients with either dysthymic disorder or no depression. This study provides validation to the DSM‐IV diagnostic criteria for major depression and dysthymic disorder for use in PD. The categories of minor and subsyndromal depression may need further validation. © 2007 Movement Disorder Society     

高危孕妇焦虑抑郁症状发生率及相关危险因素

背景：高危孕妇与普通孕妇相比在妊娠期会出现更多的并发症,高危因素作为一种应激因素更易诱发孕妇产生焦虑、抑郁等负面情绪症状。目前国内外对高危孕妇焦虑、抑郁症状的研究相对较少。
　　目标：调查产科高危妊娠孕妇焦虑、抑郁症状发生率及其相关危险因素。
　　方法：对197例孕中期（16-20周）的高危孕妇在妊娠最后4月每月进行综合性医院焦虑/抑郁量表（HAD）评估和风险因素调查。产后3-7天、42天及3月进行爱丁堡产后抑郁量表（EPDS）评估和风险因素调查。
　　结果：入组时高危孕妇HAD焦虑均分：3.69(2.76),抑郁均分：3.42(2.53)。焦虑症状14例(7.18%),抑郁症状10例(5.13%)。多因素分析显示,怀孕有无保胎（OR：8.162,95%CI：1.213-54.914）和乙肝阳性（OR：8.912,95%CI：1.052-75.498）与焦虑症状相关。尿糖阳性（OR：30.529,95%CI：1.312-710.610）和既往出血史（OR：7.122,95%CI：1.015-49.984）与抑郁症状相关。孕期影响高危孕妇焦虑、抑郁症状的因素有：近3月孕妇健康状况、担心胎儿健康、夫妻关系、婆媳关系等。
　　结论：高危妊娠孕妇焦虑、抑郁症状较常见。近3月孕妇健康状况、婆媳关系、夫妻关系、担心胎儿健康是高危孕妇孕期焦虑、抑郁症状的风险因素。     

Psychiatric diagnosis in primary care patients with increased depressive symptoms

Background: Screening of depression has been recommended in primary care and Beck’s 21-item Depression Inventory (BDI-21) is a commonly used tool for screening. Depression has been shown to be frequently accompanied by comorbidities.

Aims: This study aimed to analyze the characteristics, psychiatric diagnoses, and psychiatric comorbidity of primary care patients who have been screened for depression and referred to a depression nurse.

Methods: The study subjects were primary care patients aged ≥ 35 years with depressive symptoms (BDI-21?>?9). Their psychiatric diagnosis were based on a diagnostic interview (Mini-International Neuropsychiatric Interview; M.I.N.I.) conducted by a trained study nurse.

Results: Of the 705 study subjects, 617 (87.5%) had at least one and 66.1% had at least two psychiatric diagnoses. The most common diagnosis was depression (63.4%). The next most common diagnoses were generalized anxiety disorder (GAD) (48.1%) and panic disorder (22.8%). Only 8.8% of the study subjects had depression without other psychiatric disorders. Ten percent of the subjects had both depression and a generalized anxiety disorder (GAD). Also other psychiatric comorbidities were common. Age was inversely associated with the psychiatric diagnosis in the M.I.N.I.

Conclusions: This study suggests that most of the primary care patients with increased depressive symptoms have a psychiatric disorder. Although depression is the most common diagnosis, there are several other concurrent psychiatric comorbidities. Therefore, diagnostic assessment of primary care patients with a screening score over 9 in the BDI-21 should be reconsidered.     

A factor analytical study of the Comprehensive Psychopathological Rating Scale among patients with anxiety and depressive disorders

A sample of 136 inpatients, meeting the DSM-III-R criteria for anxiety and/or unipolar depressive disorders, were rated on the 37 CPRS items designed for nonpsychotic disorders. By factor analysis we identified 2 indices: a 12-item depression index and a 7-item anxiety index. The indices proved to have good internal consistency and interrater reliability. They differentiated well between patients with anxiety and those with depressive disorders, and among subgroups of anxiety and depression. Our depression index may represent a slight improvement in specificity compared with previously suggested depression indices. Our main finding is the identification of an anxiety index with good psychometric properties.     

Social anxiety and insomnia: the mediating role of depressive symptoms

Anxiety is commonly associated with insomnia. Given that social anxiety disorder is one of the most prevalent anxiety disorders, socially anxious individuals may be particularly vulnerable to insomnia. However, there is currently very little empirical work on this relationship. This study used bivariate correlations to examine whether social anxiety was related to insomnia in an undergraduate sample (n=176) using the Social Interaction Anxiety Scale and the Insomnia Severity Index. Further, we utilized responses from the Beck Depression Inventory to investigate the role of depressive symptoms in the association between social anxiety and insomnia. Hierarchical linear regressions were used to examine the moderational and mediational role of depressive symptoms in the link between social anxiety and insomnia. To increase generalizability to clinical samples, analyses were repeated on a subset of the sample with clinically significant social anxiety symptoms (n=23) compared to a matched control group (n=23). Consistent with expectation, social anxiety was associated with increased insomnia symptoms. Specifically, social anxiety was correlated with sleep dissatisfaction, sleep-related functional impairment, perception of a sleep problem to others, and distress about sleep problems. Importantly, depressive symptoms mediated the relationship between social anxiety and insomnia, thereby at least partially accounting for insomnia among socially anxious individuals. Our data support the contention that social anxiety is associated with insomnia and suggest that depression may play a vital role in this co-occurrence.     

Shattered Shangri-la: differences in depressive and anxiety symptoms in students born in Tibet compared to Tibetan students born in exile

OBJECTIVE: As a result of ongoing political tensions within Tibetan regions of the People's Republic of China, several thousand Tibetans escape across the Himalayas every year to seek refuge in India and Nepal. Prior studies have found a high prevalence of depressive and anxiety symptoms in these refugees, many of whom are young and have been exposed to significant trauma. However, it is not known whether depressive and anxiety symptoms are more prevalent in these refugees than in ethnic Tibetans born and raised in the relative political and social stability of exile communities in North India and Nepal. METHODS: We conducted a cross-sectional survey of a convenience sample of 319 students attending school at the Tibetan Children's Villages in Northern India to test the a priori hypothesis that adolescents and young adults who escaped from Tibet to India would demonstrate increased depressive and anxiety symptoms when compared to ethnic Tibetans born and raised in exile. The Hopkins Symptom Checklist-25 (HSCL-25) was used to measure depressive and anxiety symptoms. In addition, demographic information on age, sex, country of birth and frequency of family contact was collected. RESULTS: Students born in Tibet had higher mean HSCL-25 depressive and anxiety symptom scores than did ethnic Tibetans born in exile. Female students demonstrated higher depressive and anxiety scores, as did those with limited contact with immediate family. After adjusting for sex, age and frequency of family contact, being born in Tibet was associated with increased HSCL-25 depressive and anxiety symptom scores (depression: F[2, 316] = 29.96, P < 0.0001; anxiety: F[4, 316] = 43.57, P < 0.0001). CONCLUSIONS: The experience of being raised in Tibet and escaping to India appears to be a risk factor for increased depressive and anxiety symptoms when compared to being born and raised within an exile community in India or Nepal.     

Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study

Background: Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses.

Aims: To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes.

Methods: A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression).

Results: In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis.

Conclusions: Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.     

Mothers of primary school children with Down's syndrome

The occurrence of anxiety or depression, experience of social support and feelings about the family situation were evaluated in 13 mothers of children of primary school age with Down's syndrome (DS). The results were compared with those obtained in a group of 13 females engaged in taking care of these children and assisting their families. Questionnaires were used to assess feelings of depression or anxiety (Hospital Anxiety and Depression Scale), to evaluate social support (Interview Schedule for Social Interaction) and the family situation (Family Adaptability and Cohesion Evaluation Scale). A semi-structured interview with the mothers was also conducted. The results indicated that negative feelings at the birth of a child with DS had almost invariably changed in a positive direction. Experience of depression or anxiety was uncommon. Social and emotional contacts were quantitatively normal, although more empathy was often desired. The families were relatively often described as enmeshed and controlled, but the experience of the family situation was generally positive.     

Gender differences of depressive symptoms in depressed and nondepressed elderly persons.

OBJECTIVES: Women suffer more frequently from major depression and depressive symptoms than men. The somatic and the atypical subtype of depression seem to be more prevalent in women. However, few studies investigated gender differences of depressive symptoms in the elderly. These gender differences in the elderly will be investigated in the present study. METHODS: In the course of a family study 236 subjects with a lifetime diagnosis of major depression aged > 50 years and 357 control subjects from the general population matched for age and gender were questioned using the Composite International Diagnostic Interview (CIDI). Chi-square tests were used to compare the individual depressive symptoms between men and women and logistic regression analyses were performed to account for the subjects' age, cognitive performance, family and employment status. RESULTS: Women in the general population suffered from more depressive symptoms than men and had more appetite disturbance and joylessness. These gender differences could be entirely explained by gender differences in the family and the employment status. Men and women with a major depressive disorder presented with a distinct profile of symptoms that could not be explained by psychosocial factors: elderly depressed women presented with more appetite disturbances and elderly depressed men with more agitation. CONCLUSION: Major depression in the elderly presents with partially different symptoms in men and women. The results suggest that the gender differences in the symptoms of major depression in the elderly reflect gender differences in the perception and the expression of depressive syndromes.     

A blinded,controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia,as measured by standardized psychometric interview scales

The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. Fibromyalgia patients scored significantly higher than the controls on the Bech-Rafaelsen Melancholia Scale, the Atypical Depression Scale and the Hamilton Anxiety Rating Scale. On the Newcastle Depression Scale there was no difference. In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression.     

氟伏沙明治疗伴有焦虑的抑郁症对照研究

目的：比较氟伏沙明与氟西汀治疗伴有焦虑的抑郁症疗效和不良反应。方法：71例伴有焦虑的抑郁症患者随机分为氟伏沙明组36例和氟西汀组35例,分别给予氟伏沙明和氟西汀治疗。疗程8周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、治疗中出现的症状量表（TESS）评定疗效和不良反应。结果：两组HAMD和HAMA评分治疗后均较治疗前显著下降（P均〈0.01）;以氟伏沙明组在治疗1周起即显著下降（P〈0.01）,而氟西汀组在治疗2周起显著下降（P〈0.01）;两组间比较差异有显著性（P〈0.05或P〈0.01）。两组不良反应相仿。结论：氟伏沙明与氟西汀治疗伴有焦虑的抑郁症均安全有效,但氟伏沙明起效更快。