Brief report: “I can’t talk about it:” Sexuality and self-silencing as interactive predictors of depressive symptoms in adolescent dating couples

This longitudinal study examined sexual intercourse within adolescent romantic relationships as a couple-level moderator of the association between adolescent individual characteristics and depressive symptoms. Two hundred nine middle- and older-adolescent dating couples (aged 14-17 and 17-21, respectively) reported on their own self-silencing, depressive symptoms, and sexual behaviors. At Time 1, frequency of sexual intercourse significantly moderated the relationship between self-silencing and depressive symptoms, such that adolescents higher in self-silencing engaging in more frequent sex were at risk for clinically significant levels of depression. Adolescents who were low in self-silencing were not at increased risk for depression, regardless of frequency of sex. Self-silencing also significantly predicted increases in depressive symptoms from Time 1 to Time 2. Implications include the possibility that frequent sex in highly self-silencing adolescents exacerbates psychological depletion believed to link self-silencing to depressive symptoms, and that this depletion compounds over time.     

Persistent depressive symptomatology and inflammation: To what extent do health behaviours and weight control mediate this relationship?

We examined if persistent depressive symptoms are associated with markers of inflammation (C-Reactive Protein-CRP) and coagulation (fibrinogen), and if this association can be partly explained by weight control and behavioural risk factors (smoking, alcohol, physical activity). The study sample included 3609 men and women (aged 60.5 ± 9.2 years) from The English Longitudinal Study of Ageing, a prospective study of community dwelling older adults. Depressive symptoms (using the 8-item CES-D scale), health behaviours (smoking, alcohol, physical activity), body weight, and central adiposity were assessed at baseline and 2 years follow up. CRP and fibrinogen were assessed at follow up. At baseline 12.7% of the sample reported elevated depressive symptomatology, which persisted in 6.1% of participants at follow up. Baseline CES-D score was associated with CRP (β = .035, SE = .0066) and fibrinogen (β = .023, SE = .0060) measured 2 years later. Using simple mediation analysis we observed both a direct association of depressive symptoms on CRP (β = .013, SE = .0066) and indirect mediating effects through behavioural risk factors (β for total indirect effect β = .022, SE = .0023). For fibrinogen there were no direct effects of depression, and the association was entirely explained through indirect mediating effects of health behaviours. The presence of recurrent elevated depressive symptomatology at both time points was more strongly associated with CRP and fibrinogen. In summary, the association between depressive symptoms and low grade inflammation can be partly explained by behavioural risk factors. The presence of persistent depression appears to be associated with the greatest risk of elevated inflammation.     

Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology

Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and “at-risk” remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology.     

Brief report: Gender and ethnicity predict adolescent self-silencing above and beyond gender ideology

IntroductionFeminist scholars have proposed that adolescents experience a loss of voice termed “self-silencing” due to the internalization of gender norms. A growing literature shows that the content and strength of adolescents' gender norms is dependent on ethic socialization practices.MethodsWe examined the association among self-silencing behaviors and gender ideology, measured both explicitly and implicitly, in a racially/ethnically and socioeconomically diverse sample of 12–14 year old American adolescents (N = 119, 62 female).Results & conclusionMultiple regression analyses indicated that self-silencing was weakly associated with implicit gender ideology, but being White and female were larger risk factors for self-silencing. The internalization of implicit gender norms weakly predicted self-silencing when adjusting for ethnicity and gender, but we challenge past research by showing gender and ethnicity to be stronger predictors than gender ideology. Self-silencing occurred in both boys and girls, but was slightly more salient in girls. We report preliminary findings intended for replication due to limitations on statistical power and the introduction of an implicit measurement tool for assessing gender attitudes with adolescents. Implications include clarification of the widely debated association between self-silencing and gender ideology and the development of more culturally nuanced theories of interpersonal development as it relates to gender and ethnicity during adolescence     

Intellectual Ability,Self-perceived Social Competence,and Depressive Symptomatology in Children with High-functioning Autistic Spectrum Disorders

Although social competence deficits in children with high-functioning autistic spectrum disorders (HFASD) are well documented, there is little research investigating self-perceptions of social limitations. This study replicated research showing a negative association between self-perceived social competence and intellectual ability and investigated associations between self-perceived social competence and depressive symptomatology. Participants were 22 children with HFASD, aged 7–13 years with intelligence quotient (IQ) scores of 82–141. Parent- (N = 18) and teacher- (N = 17) rated social competence was lower for children with HFASD compared with a normative sample. Higher age and IQ predicted lower levels of self-perceived social competence, and low self-perceived social competence predicted higher levels of depressive symptomatology. Almost a third of children rated themselves for depression; parent ratings suggested even higher levels.

Depression inhibits the anti-inflammatory effects of leisure time physical activity and light to moderate alcohol consumption

Light to moderate alcohol consumption and leisure time physical activity (LTPA) are independently associated with lower levels of high sensitivity C-reactive protein (CRP), a predictor of cardiometabolic risk. In contrast, depression, ranging from low mood disturbance to major depressive disorder, has been associated with elevated CRP. To test the hypothesis that depression attenuates the anti-inflammatory effects of LTPA and alcohol consumption, the current study tested the moderating effect of severity of depressive symptomatology on the relation of alcohol consumption and LTPA to CRP in 222 healthy adult men and women (18–65 years of age). Given the known effects of gender on inflammation, we also examined the effects of gender on the tested interactions. Depression was assessed using the Beck Depression Inventory. Frequency of alcohol consumption, hours of LTPA per week and other coronary risk/protective factors were assessed via self-report and structured interview. Fasting blood samples were used to measure CRP and lipids. As predicted, the interaction between LTPA and depressive symptomatology was significant (F = 5.29, p < .03) such that lower CRP was associated with the combination of decreased depressive symptomatology and increased LTPA. Among those with increased depressive symptoms, increased LTPA was not associated with higher CRP. Similarly, depression interacted with alcohol consumption in predicting CRP in men but not women (F = 5.03, p < .008) such that for men light to moderate alcohol consumption was associated with lower CRP but only among those with decreased depressive symptoms. Light to moderate alcohol consumption was not associated with lower CRP in those with increased depressive symptom severity. The pattern of the interactions between anti-inflammatory activities such as light to moderate alcohol consumption and LTPA and psychological distress as indexed by severity of depressive symptomatology suggests an important new avenue for future research.     

Rejection sensitivity and depressive symptoms: Longitudinal actor-partner effects in adolescent romantic relationships

The present study utilizes the actor-partner interdependence model to examine the longitudinal relationship between rejection sensitivity and one's own and one's partner's depressive symptoms. The sample included adolescent romantic couples from the U.S. (N = 198 adolescents; 50% girls; 90.2% Caucasian) whose rejection sensitivity at Time 1 and depressive symptoms approximately one year later (Time 2) were assessed. Additionally, aggressive behaviors and maintenance behaviors that commonly associated with rejection sensitivity (e.g., self-silencing) are explored as mediators. Results indicate that boyfriends' rejection sensitivity at Time 1 predicted girlfriends' depressive symptoms at Time 2. Additionally, girls' rejection sensitivity predicted their own and their boyfriends' self-silencing. Developmental and clinical implications are discussed.     

Major depression,borderline personality disorder,and visceral fat content in women

Major depressive disorder (MDD) is associated with increased volumes of visceral fat and a high prevalence of the metabolic syndrome. In turn, affective disorders are frequently found in patients with borderline personality disorder (BPD). It is therefore unclear whether BPD per se may influence body composition. In order to clarify a potential relationship between BPD and body composition, we measured visceral fat content (VFC) in young depressed women with and without comorbid BPD and related this parameter to various features of the metabolic syndrome. Visceral fat content was measured by magnetic resonance imaging in 22 premenopausal women with MDD only, in 44 women with comorbid MDD and BPD, in 12 female BPD patients without MDD, and in 34 healthy women (CG). Data showed that depressed women without comorbid BPD had a 335% higher VFC and women with comorbid BPD had a 250% higher VFC than the CG women. When controlling for age, data showed significant effects of MDD on VFC (F = 8.4; P = 0.005). However, BPD, with or without MDD, was not related to VFC. Young depressed women with and without comorbid BPD display increased visceral fat content when compared to control subjects and may therefore constitute a risk group for the development of the metabolic syndrome. BPD per se is not an additive risk factor in this context.     

The link between negative affect,vagal tone,and visceral sensitivity in quiescent Crohn's disease

Autonomic dysfunction and mood disorders are frequently described in Crohn's disease (CD) and are known to influence visceral sensitivity. We addressed the link between vagal tone, negative affect, and visceral sensitivity in CD patients without concomitant features of irritable bowel syndrome (IBS). Rectal distensions to a discomfort threshold of 70% and onset of pain were performed in nine CD patients in remission and eight healthy controls. Autonomic parameters were evaluated with heart rate variability and electrodermal reactivity. We showed that CD patients had (i) higher scores of depressive symptomatology (12 ± 3 in patients vs 4 ± 1 in controls on the Center for Epidemiologic Studies‐Depression Scale; p = 0.038), (ii) reduced vagal tone (HF 257 ± 84 ms² vs 1607 ± 1032 ms², p = 0.043; LF 455 ± 153 ms² vs 1629 ± 585 ms², p = 0.047), (iii) decreased sympathetic reactivity during an aversive stimulus, and (iv) higher tolerance to rectal distension pressures (43 ± 3 mmHg vs 30 ± 2 mmHg, p = 0.002) and low sensitivity index scores. In conclusion, our results provide preliminary evidence that patients with quiescent CD, in the absence of IBS, are hyposensate to experimental rectal distension. These data provide further evidence that anxiety and depressive symptomatology in addition to autonomic dysfunction modulate visceral pain perception in quiescent CD patients in the absence of IBS.     

NACP-Rep1 relates to Beck Depression Inventory Scores in Healthy Humans

Alpha-synuclein (SNCA) is associated with a range of psychiatric diseases including neurodegeneration, alcohol craving, and depression. It regulates cellular homeostasis by virtue of its ability to interfere in dopaminergic, serotonergic, and noradrenergic pathways. To date, it is unclear whether the previously described association between SNCA and depressive symptomatology is limited to females with eating disorders or whether it could be extended to include healthy individuals. We included 105 women and 108 men. Genetic data and mRNA expression analyses were drawn from peripheral blood and the severity of depressive symptoms was quantified by the Beck’s Depression Inventory (BDI). We found a significant association between the NACP-Rep1 length polymorphism and the BDI score (p = 0.004). Moreover, there was a significant gender dimorphism regarding mRNA expression of SNCA (p = 0.011). Our analysis revealed no further association between the In4 polymorphism or between the mRNA expression of SNCA and the BDI score. Since this investigation was limited to healthy individuals, conclusions concerning depression according to ICD-10 or DSM-IV cannot be drawn. The reported results may contribute to a better understanding of the molecular mechanisms linked to depressive symptoms.     

Polymorphisms in the CRP gene moderate an association between depressive symptoms and circulating levels of C-reactive protein

Although many studies have found psychological depression associated with higher circulating levels of C-reactive protein (CRP), not all findings are consistent. Since DNA sequence variation in the CRP gene has also been shown to predict plasma CRP levels, we hypothesized that plasma CRP may covary with depressive symptomatology as a function of allelic variation in the CRP gene. We tested this hypothesis in 868 healthy community volunteers of European ancestry. Depressive symptomatology was measured using the Center for Epidemiological Studies-Depression (CESD) scale, and plasma CRP was assayed from whole blood. Three polymorphisms [rs1417938 (A/T), rs1800947 (C/G) and rs1205 (C/T)] were genotyped and three-locus haplotypes were generated. Regression models adjusting for demographic and lifestyle-related covariates showed no direct association of CESD depression scores with CRP. In regression models adjusting for age, gender, education, smoking status and statin use, one CRP haplotype (T-G-C) was associated with CRP level (p = 0.014) and a second haplotype (A-G-T) showed marginal association (p = 0.064, respectively). Neither haplotype was related to depressive symptoms. However, plasma CRP was predicted by the interaction of A-G-T haplotype with depressive symptomatology (p = 0.009). Higher CESD scores were associated positively with CRP levels among individuals with the A-G-T haplotype (p = 0.004). In secondary analyses, body mass index was found to partially account for the moderating effects of the A-G-T haplotype on the association of depression with circulating CRP. In conclusion, we found that haplotypic variation in the CRP locus moderates an association of depressive symptoms with circulating CRP, which is partially mediated by BMI.     

Cerebrovascular burden and depressive symptomatology interrelate over 18 years: support for the vascular depression hypothesis

Objective

Potentially incongruent research literatures suggest three divergent hypotheses about depressive symptomatology: (1) symptoms are recurrent; (2) later‐life depression results from high cerebrovascular burden (CVB); and (3) depressive symptoms contribute to comorbidities causing vascular burden. Past vascular depression research assumes that later‐life depressive symptoms relate uniquely to high CVB and not to prior, recurrent depression. This study examines these divergent hypotheses.

Methods

Data include 5175 participants across 18 years from the Wisconsin Longitudinal Study (mean age at 1993 baseline was 53 years; follow‐ups in 2004 and 2011). Depressive symptomatology was measured using the Center for Epidemiological Studies Depression. CVB was operationalized as hypertension, high blood sugar, diabetes, and other heart problems. Hypotheses were examined via a cross‐lagged structural equation model and logistic regression.

Results

Model fit was acceptable (root mean square error of approximation (RMSEA) = 0.047; comparative fit index = 0.963). Hypotheses 1 and 2 were supported. Depressive symptomatology at 2004 and 2011 follow‐ups was predicted by earlier depressive symptomatology and prior CVB. Hypothesis 3 was partially supported; depressive symptomatology in 2004 predicted subsequent CVB. Logistic regression results were that CVB predicted clinically significant depressive symptoms based on the Center for Epidemiological Studies Depression clinical cutoff.

Conclusions

Cerebrovascular burden in midlife predicts depressive symptomatology in later‐life, even after accounting for prior depressive symptomatology, supporting a fundamental assumption of the vascular depression hypothesis. Midlife depressive symptomatology also predicted escalation of CVB in later‐life. Results suggest a process model of later‐life depressive symptom development that interrelates CVB and depressive symptoms throughout the life span and have clinical implications for the interruption of this process through the integration of primary care and behavioral health specialists. Copyright © 2017 John Wiley & Sons, Ltd.     

Prevalence of postpartum depression among immigrant women: A systematic review and meta-analysis

The aims of this systematic review and meta-analysis were threefold: to estimate the prevalence of postpartum depressive symptoms in immigrant women, compare this prevalence to non-immigrant women, and determine risk factors for postpartum depressive symptoms in immigrant women. Literature searches were conducted in PubMed, Embase, PsycINFO, Web of Science, Scopus, ResearchGate and Google Scholar databases from 1950 until October 2014. Twenty-four studies met the inclusion criteria of which 22 (12 cross-sectional and 10 prospective cohort) contributed data for meta-analyses. Heterogeneity and publication bias were assessed. The prevalence of postpartum depressive symptoms in immigrant women was 20% (95% confidence interval [CI] 17–23%, 18 studies, N = 13,749 women). Immigrant women were twice more likely to experience depressive symptoms in the postpartum period than non-immigrant women (pooled unadjusted odds ratio [OR] = 2.10 [95% CI 1.62–2.73, 15 studies, N = 50,519 women] and adjusted OR = 2.18 [95% CI 1.60–2.96, 7 studies, N = 35,557 women]). There was, however, evidence of publication bias with the pooled adjusted OR reduced to 1.63 (95% CI 1.22–2.17) after adjustment for bias. Risk factors associated with postpartum depressive symptoms among immigrant women included shorter length of residence in the destination country, lower levels of social support, poorer marital adjustment, and perceived insufficient household income. This study suggests that postpartum depression is a common condition among immigrant women. Moreover, immigrant women are at higher risk of postpartum depression than non-immigrant women. Further prospective studies on the risk factors of postpartum depression among immigrant women verified by a clinical diagnosis are needed.     

What makes a difference? Understanding the role of protective factors in Hungarian adolescents’ depressive symptomatology

Depressive symptomatology contributes to morbidity and mortality across the life course. Among factors predicting adolescent depressive symptomatology, it has become increasingly important to identify factors that prevent or minimize it, i.e., protective factors. This study examines protective factors operating in three contextual domains (parental, school-related and individual) that hold promise for explicating their role in the prevention of depressive symptomatology among a non-clinical adolescent population in Hungary. Data from this cross-sectional survey were gathered using self-administered questionnaires from adolescents (N = 881; aged between 14 and 20 years; 44.6% females) from five randomly selected high schools in Szeged, Hungary. Multiple regression analyses revealed that individual level variables (i.e., life satisfaction and optimism) were important predictors of adolescent depressive symptomatology. Among parental variables, social support from the same-sex parents lowered depressive symptoms. In addition, having dinner together with one’s family was a significant protective factor for boys, whereas talking about problems with parents was significant for girls. In our study, school-related factors played only a limited role in reducing depressive symptoms; being happy with school was a protective factor only for boys. As a consequence, our findings draw attention to important gender differences in the structuring of protective factors and their role in reducing depressive symptoms, which will likely continue to be an important part of the prevention conversation.     

Preexisting mental health disorders and risk of opioid use disorder in young people: A case-control study

Aim

Opioid use disorder (OUD) is a leading cause of preventable mortality amongst young people worldwide. Early identification and intervention of modifiable risk factors may reduce future OUD risk. The aim of this study was to explore whether the onset of OUD is associated with preexisting mental health conditions such as anxiety and depressive disorders in young people.

Methods

A retrospective, population-based case-control study was conducted from 31 March 2018 until 01 January 2002. Provincial administrative health data were collected from Alberta, Canada. Cases: Individuals 18–25 years on 01 April 2018, with a previous record of OUD. Controls: Individuals without OUD were matched to cases, on age/sex/index date. Conditional logistic regression analysis was used to control for additional covariates (e.g., alcohol-related disorders, psychotropic medications, opioid analgesics, and social/material deprivation).

Results

We identified N = 1848 cases and N = 7392 matched controls. After adjustment, OUD was associated with the following preexisting mental health conditions: Anxiety disorders, aOR = 2.53 (95% CI = 2.16–2.96); depressive disorders, aOR = 2.20 (95% CI = 1.80–2.70); alcohol-related disorders, aOR = 6.08 (95% CI, 4.86–7.61); anxiety and depressive disorders, aOR = 1.94 (95% CI = 1.56–2.40); anxiety and alcohol-related disorders, aOR = 5.22 (95% CI = 4.03–6.77); depressive and alcohol-related disorders, aOR = 6.47 (95% CI = 4.73–8.84); anxiety, depressive and alcohol-related disorders, aOR = 6.09 (95% CI = 4.41–8.42).

Discussion

Preexisting mental health conditions such as anxiety and depressive disorders are risk factors for future OUD in young people. Preexisting alcohol-related disorders showed the strongest association with future OUD and demonstrated an additive risk when concurrent with anxiety/depression. As not all plausible risk factors could be examined, more research is still needed.     

Romantic and sexual activities, parent–adolescent stress, and depressive symptoms among early adolescent girls

Building on evidence that romantic experiences are associated with depressive symptoms in adolescence, we examined their bidirectional association, as well as the role of sexual activity and parent–adolescent stress in their association. Data were collected from 71 early adolescent girls (M age 13.45 years; SD = 0.68) and their primary caregiver initially and one year later. Results indicated that adolescents who engaged in more romantic activities experienced increases in depressive symptoms over time. Second, greater depressive symptoms predicted romantic involvement and sexual activities, including intercourse, one year later. Third, dysphoric adolescents who were experiencing higher parent–adolescent stress were the most likely to engage in subsequent sexual intercourse. Implications for understanding how the association between depressive symptoms and romantic and sexual experiences develops and the course of this association are discussed.     

Life stress,negative mood states,and antibodies to heat shock protein 70 in endometrial cancer

Heat shock protein 70 (HSP70), an intracellular chaperone “stress protein,” has been identified in the extracellular milieu, where it may exert regulatory effects upon monocytes. HSPs are overexpressed in many cancers and implicated in tumorigenesis. Few studies have examined the relationship between psychosocial factors and HSP levels, particularly in cancer. The purpose of the present study was to examine the relationship between negative psychosocial states (life events stress and negative mood states) and serum concentration of HSP70 antibodies among women with endometrial cancer, the fourth most common cancer among women in the United States. Thirty-six women scheduled to undergo surgery for suspected endometrial adenocarcinoma underwent a psychosocial assessment and peripheral venous blood draw. Life events stress was assessed using an abbreviated version of the Life Experiences Survey; negative mood states were assessed using abbreviated versions of the Structured Interview Guide for the Hamilton Anxiety and Depression Scales and the Profile of Mood States. HSP70 antibody levels were regressed sequentially on life events stress and negative mood variables while controlling for body mass index (BMI) and cancer stage. Results revealed that greater HSP70 antibody concentrations were associated with greater impact of recent negative life events (p = .04), anxious symptomatology (p = .007), depressive symptomatology (p = .03), and total mood disturbance (p = .001) after controlling for BMI and cancer stage. While based on a modest sample size, these preliminary results suggest that larger-scale research exploring the relationships among psychosocial factors and HSP70 in cancer patients may be warranted.     

Effort-reward-imbalance and overcommitment are associated with hypothalamus-pituitary-adrenal (HPA) axis responses to acute psychosocial stress in healthy working schoolteachers

In this study, we examined HPA axis responses to acute psychosocial stress in relation to effort-reward-imbalance (ERI) and overcommitment (OC) to test whether chronic stress at work is accompanied by altered HPA axis stress responses in teachers. According to Siegrist's work stress model, ERI reflects stress due to a lack of reciprocity between personal costs and gains at work, whereas OC is conceptualized as a personality trait mainly characterized by the inability to withdraw from work obligations. Fifty-three medication-free, non-smoking, healthy teachers (33 women, 20 men, 29–63 years, mean age 49.9 ± 8.58 years) were confronted with the Trier Social Stress Test (TSST), a widely used standardized stress protocol to induce acute psychosocial stress in the laboratory. ACTH (five samples), total plasma (six samples) and free salivary cortisol (eight samples) were repeatedly measured before and after challenge. In the total group, ERI and OC were only marginally associated with HPA axis responses to acute stress. However, in the subgroup of responders (N = 30) high levels of OC were significantly associated with lower ACTH (p = 0.03) as well as plasma (p = 0.02) and salivary cortisol (p < 0.001) responses and results remained significant controlling for depressive symptoms. When additionally controlling for acute perceived stressfulness of the TSST, significant associations between OC and HPA axis responses emerged in responders as well as the total study sample. In respect to ERI, higher stress levels were solely related to significantly stronger plasma cortisol increases after TSST exposure, but this effect became non-significant controlling for depressive symptomatology. In sum, our findings support the notion of HPA axis hyporeactivity in highly overcommitted schoolteachers.     

Loneliness and cardiovascular disease and the role of late‐life depression

Objective

Loneliness and depression have a strong reciprocal influence, and both predict adverse health outcomes at old age. Therefore, this study examines whether loneliness is associated with the presence of cardiovascular diseases taking into account the role of late‐life depression.

Methods

Cross‐sectional data of 477 older adults in the Netherlands Study of Depressed Older Persons were used. Logistic regression analysis was performed to examine the relation between loneliness and cardiovascular disease. Depression was added to the regression model to examine whether depression is an explanatory factor in the association between loneliness and cardiovascular disease. Interaction terms between loneliness and depression and between loneliness and sex were introduced in the regression model to investigate whether depressed and non‐depressed participants, and men and women differed in their association between loneliness and cardiovascular disease.

Results

Of the overall group, 61% were lonely, 28% had a history of cardiovascular disease and 74% were depressed. Loneliness and cardiovascular disease were not associated in the overall group after adjustment for confounders (continuous: odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.98–1.10), p = 0.25; dichotomous: OR = 1.27, 95% CI = 0.80–2.03, p = 0.32). For women, there was an association between loneliness and cardiovascular diseases (continuous: OR = 1.13, 95% CI = 1.06–1.21, p < 0.001; dichotomous: OR = 2.64, 95% CI = 1.50–4.65, p = 0.001), but this association was not present in men (OR = 0.96, 95% CI = 0.88–1.05, p = 0.38). This association remained significant after adjustment for confounders, but it lost significance after adding depression to the model.

Conclusion

For women only, there was an association between loneliness and cardiovascular disease. However, this association was explained by depression, indicating that loneliness in its own right seems not related with cardiovascular disease. Copyright © 2017 John Wiley & Sons, Ltd.     

Differences in self-reported depressive symptoms between patients with epileptic and psychogenic nonepileptic seizures

Depression is a multidimensional condition encompassing affective, physiological, and cognitive symptoms. Although depression's high comorbidity with both epileptic and psychogenic nonepileptic seizures (ES and PNES) has been established, few studies have addressed whether the types of depressive symptoms experienced differ by seizure type (ES and PNES). This study compared the self-reported depressive symptomatology of patients (n = 60 ES and 59 PNES) who underwent video-EEG monitoring and completed self-reported objective measures of psychopathology (PAI and BDI-II). Differences in depressive symptoms were also compared by gender and among several subgroups with ES. Results revealed the PNES group, particularly PNES females, endorsed a significantly higher level of physiological symptoms of depression as measured by the PAI DEP-P subscale than the ES group; the BDI-II did not differ between groups. These findings have potential clinical implications for the identification and management of depressive symptoms among these patient groups.