Life events and the dexamethasone suppression test in affective illness

Forty patients with primary endogenous major depression were followed up during a 12-month period after recovery, on maintenance therapy. Neither the results of the DST, nor the life events reported could predict the occurrence of affective relapses although bereavement life events tended to be observed more frequently in patients relapsing, regardless of the type of antidepressant treatment.     

Life events and hemodynamic stress reactivity in the middle-aged and elderly

Recent versions of the reactivity hypothesis, which consider it to be the product of stress exposure and exaggerated hemodynamic reactions to stress that confers cardiovascular disease risk, assume that reactivity is independent of the experience of stressful life events. This assumption was tested in two substantial cohorts, one middle-aged and one elderly. Participants had to indicate from a list of major stressful life events up to six they had experienced in the previous 2 years. They were also asked to rate how disruptive and stressful they were, at the time of occurrence and now. Blood pressure and pulse rate were measured at rest and in response to acute mental stress. Those who rated the events as highly disruptive at the time of exposure and now exhibited blunted systolic blood pressure reactions to acute stress. The present results suggest that acute stress reactivity may not be independent of stressful life events experience.     

Life events and treatment outcomes among individuals with substance use disorders: A narrative review

Substance use disorders are characterized by a variable course, in which multiple treatment attempts and relapses are typical. Consistent with conceptualizations of substance use and relapse, life events have been implicated in contributing to poor substance use disorders treatment outcomes. However, inconsistencies in empirical findings regarding the life events-substance use disorders outcome literature have been previously observed. This review provides an updated critique of the literature since the previous review published in 1987 (O'Doherty & Davies, 1987), examining the relationship between life events and substance use disorders treatment outcome among clinical samples of individuals. Review of 18 peer-reviewed articles suggested that data on the life events-outcome relationship continue to be inconclusive. Inconsistencies across studies in the operationalization of life events and substance use treatment outcomes and lack of theoretically driven designs may be contributing to differences in findings. Recommendations for future research that will increase the clinical utility of the life events construct are provided.     

Life events in depression. Relationship to subtypes

Life events that had occurred in the 6 months before the onset of depression were recorded in 40 depressed patients and 41 normal controls. The depressed patients had experienced significantly more life events and significantly more undesirable life events than the controls. The 20 patients with a DSM-III diagnosed major depressive episode (MDE) without melancholia had experienced significantly more life events in the 6 months before the onset of depression than the 20 patients with a major depressive episode with melancholia. The patients with MDE without melancholia, but not the MDE with melancholia patients, had also experienced significantly more life events than a group of age- and sex-matched normal controls.     

青少年早期的抑郁与生活事件的交叉滞后分析

目的:探讨青少年早期生活事件与抑郁的因果关系以及因果关系的动态变化。方法:连续三年对来自南京市的598名初中生进行生活事件和抑郁的测量。运用交叉滞后回归分析考察了两个变量间的因果关系。结果:①在初一到初二年级时,生活事件总分以及人际关系和学习压力因子可以预测抑郁倾向。②在初二到初三年级时,抑郁倾向可以预测生活事件总分以及人际关系和学习压力因子。③在生活事件总分、人际关系和学习压力和抑郁的因果关系上存在显著的性别差异。结论:在青少年早期,抑郁与生活事件的因果关系发生动态变化,抑郁并不总是结果变量,也可能是原因变量。     

The longitudinal influence of peers on the development of alcohol use in late adolescence: a growth mixture analysis

This study examines heterogeneity in the developmental trajectories of alcohol use in adolescents and the accompanying trajectory-specific longitudinal influence of exposure to their deviant peers. Using a national data set on alcohol use (N = 188), a growth mixture model capturing growth trajectories in adolescent alcohol use from ages 14 to 18 years was first examined. This was followed by an investigation of age-varying influences of peers on adolescent alcohol use and the co-development of peer influence and adolescent alcohol use. Results of growth mixture modeling of repeated-measures data on adolescent alcohol use showed two distinct latent classes of developmental trajectory with significant differences in levels of use. Analyses of exposure to deviant peer and adolescent alcohol use variables indicated differential effects of peers across trajectory classes. Stronger prospective influences for the trajectory group having a low initial status of use were found. Findings from this study suggest the need to consider heterogeneity in the study of peer influence on alcohol use during adolescence to facilitate more refined targeting of prevention/intervention programs.     

Life events and depression. Part 1. Effect of sex, age and civil status

This is the first of three articles dealing with some basic aspects of the relationship between life events and depression, and is also one part of a larger study in which the possible impact of stressful events has been studied from a multifactorial point of view. Two-hundred and four patients suffering from a depressive disorder, consecutively admitted to the Department of Psychiatry of the Umeå University have participated in a study of life events carried out by means of a specially constructed life events inventory that was used as a guideline for a semistructured interview.The results of this part of the study show that there are no pronounced differences in the occurrence, or appraisal of life events between male and female patients. The more vulnerable, older patients have experienced significantly fewer life events, even of the fateful type, prior to the onset of depression. No difference was found between patients who were married or lived together with a partner and patients who were unmarried, separated, divorced or widowed except in the categories of events (e.g. ‘conflict’ events) which might have been the very reason for a separation or a divorce. The results are discussed in relation to other findings in the literature.     

城市和农村产后抑郁症者生活事件及社会支持的对照研究

目的 探讨城市、农村产后抑郁症生活事件和社会支持的差别.方法 随机抽取城市和农村产妇261例,经艾氏产后抑郁症量表(EPDS)筛选出城市组21例,农村组19例.将两组被试进行生活事件量表和社会支持量表的对比测评.结果 城市组和农村组生活事件总分、正性分和负性分差异不明显,但两组中高危生活事件的种类和相关系数并不相同;社会支持总分、主观支持分和客观支持分差异不显著,在社会支持利用度上差异显著.结论 对产后抑郁症的防治工作宜有针对性、有重点地进行.     

唐山市大学生自杀态度与生活事件相关研究

目的为预防大学生因生活事件自杀提供数据与依据。方法运用问卷调查法对唐山市4所高校453名大学生进行问卷调查。结果①大学生自杀态度总体保持中立或矛盾态度 性别、城乡比较无显著差异 专业、是否独生子女比较在安乐死态度上有显著差异。②对大学生产生较大影响的生活事件是学习压力、健康适应及人际关系等。③大学生对自杀行为性质的态度与人际关系呈非常显著相关,与生活事件总分、学习压力、受惩罚、健康适应、其它事件呈显著相关 对自杀者家属的态度与受惩罚呈显著相关。结论大学生自杀态度与生活事件相关。     

Life events and suicidal ideation and behavior: A systematic review

Despite the sustained theoretical and empirical interest over the past 40 years in the association between life events and suicidal ideation and behavior, the literature in this area has yet to be systematically reviewed. The current article provides a comprehensive review of the empirical literature pertaining to life events in relation to at least one aspect of suicidal ideation and behavior (i.e., suicidal ideation, plans, attempts, degree of suicidal intent, medical severity of attempt, repeat versus first lifetime attempt status, and death by suicide). A total of 95 articles meeting inclusion criteria were identified by a literature search using Medline and PsycINFO. Evidence for an association between negative life events and suicidal ideation and behavior was generally consistent, with strongest support found for more severe than with less severe forms of suicidal ideation and behavior. Support for an inverse relation between positive events and suicidal ideation and behavior was generally lacking. Although there is general support for life stressors as a risk factor for suicidal ideation and behavior, interpretation of these findings is constrained by methodological limitations prevalent in much of the literature, particularly in the case of suicidal ideation and suicide plans. Recommendations for future research are provided.     

Changes in adiposity status from childhood to adolescence: A 6-year longitudinal study in Portuguese boys and girls

Background: Cross-sectional data show high prevalence of overweight in Portuguese children, but there are few longitudinal studies describing the patterns of obesity development in the young.

Aim: To examine the trajectories of obesity from late childhood to adolescence.

Subjects and methods: Triceps and subscapular skinfold thickness measurements were carried out in 288 children at age 9 (baseline) and later at age 15 (follow-up). Percentage body fat (%BF) was estimated according to Slaughter equations and the health-related definition of obesity ( ≥ 25%BF in boys and ≥ 30%BF in girls) was used.

Results: In boys, the prevalence of obesity decreased from 21.9% to 14.8% (p < 0.05) while in girls it increased from 14.3% to 19.5%. The incidence of obesity in the 6-year study period was 2.6% and 8.3% for boys and girls, respectively (p < 0.05). In comparison with girls, the percentage of boys that reversed obesity was more than 3-fold higher (3% vs 9.7%, p < 0.05). Obesity tracked moderately in both sexes (Kappa = 0.6, p < 0.001).

Conclusion: The results indicate a marked sex difference in the incidence and reversal of obesity from late childhood to adolescence that is unfavourable to girls. Consideration of this difference might be important when designing programmes for the prevention and treatment of obesity focusing on this period.     

Insomnia symptoms and non‐suicidal self‐injury in adolescence: understanding temporal relations and mechanisms

We propose a theoretical model of insomnia symptoms and non‐suicidal self‐injury (NSSI) that posits bidirectional linkages. We hypothesised that heightened depressive symptoms and impulsivity that result from insomnia increase NSSI. We also posit that the shame associated with NSSI triggers repetitive negative thinking, in turn increasing insomnia. Using three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1,457; M_age = 13.2, SD = 0.43; 52.7% boys), we assessed the mediating role of depressive symptoms, impulsivity, rumination, and worry on the link between insomnia and NSSI. After controlling for depressive symptoms, we found that insomnia was related to increases in NSSI from the second to the third time point (ß₂₃ = 0.09, p = .01). NSSI was consistently related to increased insomnia (ß₁₂ = 0.09, p = .01; ß₂₃ = 0.11, p < .001). In addition, depressive symptoms (ß_ind = 0.01, p = .02), but not impulsivity (ß_ind = 0.01, p = .09), mediated the path from insomnia to increased NSSI. Neither worry (ß_ind = 0.00, p = .59) nor rumination (ß_ind = 0.00, p = .96) mediated the link between NSSI and increased insomnia. We conclude that NSSI and insomnia maintain each other over time. Thus, screening adolescents for insomnia symptoms may help identify those at risk of NSSI. Although depression seems to explain why insomnia is a risk factor for NSSI, further studies should investigate why NSSI plays a role in the maintenance of insomnia. This understanding will lay the foundation for intervention.     

Psychiatry: life events and social support in late life depression

OBJECTIVES:

To examine the association of life events and social support in the broadly defined category of depression in late life.

INTRODUCTION:

Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil.

METHODS:

We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. “Old age symptomatic depression” was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed “late subthreshold depression”. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE) inventory.

RESULTS:

“Old age symptomatic depression” occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, “old age symptomatic depression” was associated with a perceived lack of social support in men and life events in women.

DISCUSSION:

Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance.

CONCLUSIONS:

We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.     

Life events and depression. Part 3. Relation to severity of the depressive syndrome

Two hundred and six depressed patients, consecutively treated at the Department of Psychiatry, Umeå University were investigated both concerning the occurrence of life events within defined time limits and the severity of their depressive syndrome. Three different criteria were used to divide the patients according to severity: whether they were in- or out-patients, whether or not they were psychotic according to a classification model (MACM) used at Umeå and, finally, according to the clinical ratings received by those admitted to the hospital. The average number of events experienced by the patients within the time limits set by the study was similar in each of the subgroups taken into account. A weak, but still statistically significant, relation was found between a negative experience of the events and the total score obtained at the ratings. The occurrence of events ‘independent’ of depression did not distinguish between the groups. Thus, the results of this study do not support the opinion maintained by some authors that there is a sizeable positive relation between magnitude of life events and seriousness of illness.