辽宁省城乡居民情感性精神障碍流行病学调查

目的了解辽宁省18岁以上人群各类情感障碍的患病率和分布特点。方法采用多阶段分层随机抽样方法,以复合性国际诊断交谈检查量表1.0（CIDI1.0）对全省6个市县13358名18～65岁居民进行了入户面访调查。结果重性抑郁、心境恶劣、双相情感障碍及情感障碍合计的年标化率为1.54%,0.91%,0.09%和1.96%;终生标化率为2.22%,1.57%,0.14%和2.93%。重性抑郁和心境恶劣患病率女性（3.35%,2.45%）高于男性（1.80%,1.26%,RR=1.76,95%CI：1.40～2.23;RR=1.81,95%CI：1.37～2.38）;城市（3.14%,2.28%）高于农村（2.19%,1.56%,RR=1.62,95%CI：1.24～2.13;RR=1.50,95%CI：1.10～2.05）。情感障碍与焦虑和酒精使用障碍的终生共病率分别为41.96%和10.87%。结论辽宁省居民重性抑郁、心境恶劣和双相情感障碍的患病率接近GBD2000对我国估计的水平。情感障碍与焦虑和酒精使用障碍的共病普遍存在,抑郁等情感障碍已经成为常见病和主要公共卫生问题。     

Cross-sectional and prospective study of exercise and depressed mood in the elderly : the Rancho Bernardo study

This study examined cross-sectional and prospective associations of exercise with depressed mood in a community-based sample of older men and women (aged 50--89 years in 1984--1987) in southern California. Regular strenuous exercise and exercise > or =3 times per week were reported; depressed mood was assessed by using the Beck Depression Inventory (BDI). After exclusion of persons with categorical depression and those rating themselves largely or extremely physically limited during the previous month, data on 932 men and 1,097 women were available for cross-sectional analysis. Exercise and depressed mood were reassessed for 404 men and 540 women in 1992--1995; these data were the focus of prospective analyses. In 1984--1987, exercise rates were high (>80%), and average BDI scores were low. Cross-sectional analyses indicated that before and after adjustment for covariates, exercise was significantly associated with less depressed mood. However, prospective analyses of the 944 persons who attended both clinic visits indicated no association between baseline exercise and either follow-up BDI score (p > 0.10) or change in BDI score between baseline and follow-up (p > 0.10). Results confirm that exercisers have less depressed mood. However, exercise does not protect against future depressed mood for those not clinically depressed at baseline.     

阜新市城市居民精神疾病流行病学调查

目的掌握阜新市城市18—65岁人群各类精神疾病患病率和分布特点。方法采用多阶段分层随机整群抽样方法．以复合性国际诊断交谈检查量表（CIDI1．0）对阜新市2724名18-65岁城市居民进行了入户面对面调查。结果调查的应答率为80．14％。各类精神疾病总的2周、12个月和终生患病率分别为6．39％，9．06％和13．71％。情感障碍、焦虑障碍和酒精使用障碍的终身患病率分别为4．36％，7．86％和4．80％，终身患病率居前3位的依次是场所恐怖（3．81％）、特殊恐怖（3．70％）和重性抑郁（3．67％）。男性的焦虑障碍患病率低于女性（OR=0．63，95％CI为0．45—0．88），酒精使用障碍高于女性（OR=12．33。95％CI为6．17．24．63）。离婚者情感障碍、焦虑障碍和酒精使用障碍的患病率均升高。结论精神疾病已成为阜新市居民迫切需要解决的重大公共卫生问题。     

Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study

BACKGROUND: It has been hypothesized that n-3 polyunsaturated fatty acids (PUFAs) are involved in mood regulation, but epidemiologic evidence for such a link in the general population is lacking. OBJECTIVE: This study examined whether community-dwelling elderly persons with depression have a fatty acid composition that is different from that of nondepressed persons. DESIGN: We screened 3884 adults aged > or = 60 y for depressive symptoms as part of the Rotterdam Study. Subjects who screened positive had a psychiatric interview to diagnose depressive disorders. All eligible subjects had their blood drawn for measurement of plasma phospholipid concentrations. We compared percentages of n-3 and n-6 PUFAs and their ratios between 264 subjects with depressive symptoms, including 106 subjects with depressive disorders, and 461 randomly selected reference subjects. We also investigated whether atherosclerosis or the inflammatory response as measured by C-reactive protein underlies the relation between fatty acid composition and depression. RESULTS: Subjects with depressive disorders had a higher ratio of n-6 to n-3 PUFAs, but differences in individual PUFAs were mostly small. However, depressed subjects with normal CRP concentrations (< 1.5 mg/L) had a substantially altered fatty acid composition; percentages of n-3 PUFAs and ratios of n-6 to n-3 PUFAs were significantly lower and higher, respectively, in subjects with depressive disorders than in control subjects [5.2% compared with 5.9% (P = 0.02) and 7.2 compared with 6.6 (P = 0.01), respectively]. This relation was not due to atherosclerosis. CONCLUSIONS: In community-dwelling persons, fatty acid composition is related to depression. Because this relation was not secondary to inflammation, atherosclerosis, or possible confounders, it suggests a direct effect of fatty acid composition on mood.     

The relationship between quality of life and posttraumatic stress disorder or major depression for firefighters in Kaohsiung,Taiwan

Objective The work of firefighters involves the risk of exposure to the harmful effects of toxic substances as well as the possibility of enormous emotional shock from disasters, which may result in psychiatric impairments and a lower quality of life. Therefore, we examined quality of life, prevalence of posttraumatic stress disorder (PTSD) and major depression, and the related risk factors for firefighters in Kaohsiung, Taiwan. Methods This is a two-stage survey study. During the first stage, we used the 36-item Short-Form Health Survey (SF-36) and the Disaster-Related Psychological Screening Test (DRPST) to assess quality of life, probable PTSD, probable major depression, and the related risk factors for 410 firefighters. During the second stage, psychiatrists categorized these probable cases according to self-reported questionnaires against DSM-IV into PTSD or major depression group, subclinical group, and health group. All the data were analyzed with SPSS 10.0 Chinese version. Results The estimated current prevalence rates for major depression and PTSD were 5.4% (22/410) and 10.5% (43/410), respectively. The firefighters with estimated PTSD or major depression scored significantly lower on quality of life measures than subclinical PTSD/major depression and mentally healthy groups, which was evident in eight concepts and two domains of the SF-36. The major predictors of poor quality of life and PTSD/major depression were mental status, psychosocial stressors, or perceived physical condition. Conclusion Firefighters have a higher estimated rate of PTSD, and the risk factors that affect quality of life and PTSD/major depression should encourage intervention from mental health professionals.     

社会支持对部队离退休老年人心理健康状况影响的问卷分析

目的了解社会支持与老年人心理健康水平的关系。方法随机抽取总后离退休老干部及部分家属291人，进行社会支持度评定量表（SSRS）、老年幸福度量表（MLINSH）、症状自评量表（SCL-90）、老年抑郁量表（GDS）的问卷调查，将SSRS量表结果分别与其余3个量表进行相关分析。结果受测者的SSRS总分与MLINSH总分、正性情感、正性体验呈显著的正相关．与负性情感和负性体验呈显著的负相关；与SCL-90的强迫、人际关系敏感、抑郁、阳性项目均分呈显著的负相关；与GDS总分呈显著的负相关。结论社会支持是老年心理健康的重要因素，提高社会支持度，可以提高老年人的幸福度，对于改善老年人的抑郁倾向尤为重要。     

唐山市老人院老年人抑郁现状及影响因素调查

[目的]调查唐山市老人院老年人抑郁现状及其影响因素,从而获取相应的干预方法。[方法]按整群随机抽样法,应用一般人口资料量表,老年抑郁量表(GDS),社会支持量表和日常生活能力量表(ADL)对唐山市老人院60岁及以上老年人进行调查。[结果]唐山市老人院老年抑郁情绪的发生率为27.85%,其中文化程度低,社会支持水平低,经济支持水平低,健康状况和睡眠状况差,日常生活能力有障碍,不经常读书看报和进行体育锻炼的老年人抑郁发生率高,差异有统计学意义(P﹤0.05或P﹤0.01)。[结论]唐山市老人院老年人抑郁症发生率较高,与多种因素相关。     

Depressive symptoms and risk for malnutrition among hospitalized elderly people

Objectives: To explore the association between depressive symptoms and risk for malnutrition in hospitalized elderly people.Methods: 195 hospitalized medical patients older than 65 years of age were studied in a cross-sectional design. Depression was assessed by 30-item Geriatric Depression Scale (GDS), nutritional status was evaluated by the Mini-Nutritional Assessment (MNA). Eating and digestive problems were assessed using selected items of Nutrition Risk Index (NRI), cognitive and functional status by Folstein and Barthel indices respectively; demographic data, diagnoses and medications were obtained from medical records.Results: The prevalence of depression in the studied population was 28%. MNA scores were significantly lower among depressed patients as compared with non-depressed (22.86 vs. 24.96, p < 0.001), indicating a higher risk for undernutrition among depressed persons. After controlling for age, cognitive status, functional ability, and number of illnesses, undernutrition was significantly associated with depression (OR = 2.23; 95% CI: 1.04–4.8).Conclusions: Nutritional risk is associated with depression in aged inpatients. Close case management of the elderly hospitalized patients that include assessment and treatment for both disorders may be beneficial.     

Improved detection of depression in primary care through severity evaluation

OBJECTIVES: To determine whether the use of a symptom severity measure to augment an existing Diagnostic and Statistical Manual of Mental Disorders-Third Edition, Revised (DSM-III-R) criteria-based depression screener (PRIME-MD) would decrease the difficulties associated with depression screening in primary care by filtering out patients with minimal impairment. STUDY DESIGN: The study design was secondary data analysis. POPULATION: The study sample comprised 1317 patients, with intentional oversampling by ethnicity and sex, presenting for routine care at a university family practice center in Galveston, Texas. OUTCOMES MEASURED: The primary outcomes were cross-sectional, health-related quality-of-life outcomes of subjects who met symptom severity criteria as well as criteria for a DSM-III-R mood disorder. Health care utilization outcomes were examined as secondary outcomes. RESULTS: The combination of a 6-item depression severity instrument and the PRIME-MD resulted in 71% of depressed subjects being categorized as severely symptomatic and 29% as minimally symptomatic. Severely symptomatic subjects had significantly worse SF-36 Mental Health Component Summary scale (MCS) scores than did minimally symptomatic subjects (32.8 vs 43.5, P <.05). Minimally symptomatic subjects had MCS scores similar to those of a third group of subjects who did not meet DSM-III-R "threshold" criteria for mood disorder but who were severely symptomatic. Adjusted health care utilization was higher for the initial 3-month charge period in the severely symptomatic depressed subjects compared with minimally symptomatic depressed subjects ($679.20 vs $462.38, P <.05). CONCLUSIONS: The 6-item depression severity measure effectively separated patients meeting DSM-III-R "threshold" depression criteria into 2 groups: one presenting with severe symptoms and impairment and the other presenting with mild symptoms and significantly less impairment. A strategy of initial screening using a brief depression severity instrument, followed with a DSM criteria-based instrument, could decrease the immediate clinician workload by one third and focus treatment on those most likely to benefit.     

Environmental exposure to natural sour gas containing sulfur compounds results in elevated depression and hopelessness scores

Some parts of Masjid-i-Sulaiman (MIS) (Khozestan provinces, southwest of Iran) are contaminated with subsurface leakage of natural sour gas containing H(2)S. It is reported that the incidence of suicide by self-burning in MIS is very high. High endogenous H2S levels have been found in the brain and it is involved in the brain functions. Because there is no report about the effect(s) of natural sour gas containing sulfur compounds on the function(s) of human brain, the present study was done. The study was performed on 128 individuals exposed or unexposed to natural sour gas. The exposed group consisted of 64 persons (39 males, 25 females). Unexposed subjects were matched by sex, age, and educational levels. Depression and hopelessness were determined using Beck's depression inventory (BDI) and Beck's hopelessness (BHS) questionnaires. Using multiple linear regression models, the averages of BDI (t=2.637, P=0.009) and BHS (t=3.344, P=0.001) were significantly higher among the exposed subjects than among the control group. In Lali 57.8% and 14.1% of subjects had no depressed mood and moderate to severe depressed mood, respectively, while in MIS 31.3% and 35.9% of subjects had no depressed mood and moderate to severe depressed mood, respectively; the difference was significant (chi2=12.88, df=3, P=0.005). In Lali 35.9% and 12.5% of subjects had no hopelessness at all and moderate to severe hopelessness, respectively, while in MIS 17.2% and 32.8% of subjects had no hopelessness at all and moderate to severe hopelessness, respectively, the difference was significant (chi2=11.49, df=3, P=0.009). Replication is necessary and health implications are discussed.     

A systematic review of depressed mood and anxiety by SES in youth aged 10-15 years

OBJECTIVES: A majority of population-based studies suggest prevalence of depressed mood and anxiety is most common during late adolescence to early adulthood. Mental health status has been linked previously to socio-economic status in adults. The purpose of this systematic literature review is to clarify if socio-economic status (SES) is a risk indicator of depressed mood or anxiety in youth between the ages of 10 to 15 years old. METHODS: We performed a systematic literature review to identify published or unpublished papers between January 1, 1980 and October 31, 2006 that reviewed depressed mood or anxiety by SES in youth aged 10-15 years. SYNTHESIS: We found nine studies that fulfilled our inclusion criteria and passed the methodological quality review. The prevalence of depressed mood or anxiety was 2.49 times higher (95% CI 2.33-2.67) in youth with low SES in comparison to youth with higher SES. DISCUSSION: The evidence suggests that low SES has an inverse association with the prevalence of depressed mood and anxiety in youth between the ages of 10 to 15 years old. Higher rates of depressed mood and anxiety among lower socio-economic status youth may impact emotional development and limit future educational and occupational achievement. CONCLUSION: Lower socio-economic status is associated with higher rates of depressed mood and anxiety in youth.     

Are eating disorders associated with borderline personality disorder? a critical review

Seven studies using structured diagnostic interviews have assessed the prevalence of borderline personality disorder among patients with eating disorders, yielding rates from 0% to 42% in different samples. However, many patients with eating disorders suffer from depression, and there is substantial overlap between the symptoms of depression and those of borderline personality disorder. Thus, structured interviews for borderline personality disorder–most of which are of untested or uncertain specificity–may perhaps frequently produce false-positive diagnoses of borderline personality disorder in patients with eating disorders and hence yield exaggerated estimates of the true prevalence of borderline personality disorder in this population. Considering the grave implications of the borderline diagnosis, one must remain critical of studies in this area until further data, using instruments of documented specificity, blind ratings, and suitable control groups, become available.     

Physical activity and depressed mood in primary and secondary school-children

ObjectivePhysical activity appears effective in reducing the risk of depression in adults however associations between physical activity and depression in youth remain unclear. We have previously demonstrated physical activity domain specificity in associations between physical activity and depression in young adults participating in the Childhood Determinants of Adult Health study. The current analysis examined associations between physical activity in different domains (active commuting, school physical education, discretionary sport) and depressed mood when cohort participants were children and adolescents.MethodParticipants were 6070 school-children (aged 9–15 years) participating in a national health and fitness survey in 1985. Physical activity and depressed mood were assessed via self-report. Analyses were conducted separately by gender and school-level, and prevalence ratios adjusted for scholastic level, health status, smoking, alcohol consumption, residential arrangements and familial language.ResultsAssociations between physical activity and depressed mood were mixed however dose–response relationships were observed whereby increasing durations of total physical activity and discretionary sport in secondary boys were associated with decreasing prevalence of depressed mood (both Ptrend < 0.001). Further, increasing durations of physical education were associated with decreasing prevalence of depressed mood in primary girls (Ptrend = 0.02). No significant associations were observed for total physical activity or discretionary sport in primary and secondary girls. Associations were not mediated by overweight/obesity in girls.ConclusionsAssociations between physical activity and depressed mood varied by gender, school-level and the domain in which activity was assessed. Further research utilizing more accurate assessment of childhood physical activity and depression is required to clarify potential associations.     

Prevalence of psychiatric disorders and suicidality among children and adolescents with thalassemia major—A Turkish sample

The current study examined psychiatric diagnoses and suicidality in children with transfusion-dependent thalassemia major via a semi-structured interview (K-SADS). Although 4 subjects were diagnosed with major depressive disorder, 24 subjects (40.7%) had depressed mood and irritability, whereas anhedonia and boredom were detected in 23 (39.0%) subjects. Suicidal thoughts were expectedly more prevalent (28.8%) than suicidal intention (5.1%) and suicide attempts (1.7%). Children with thalassemia major may be an under-risk population for subclinical forms of depression and suicidality. Offering routine screening for mental health problems can lead to early identification and treatment.     

Gulf War veterans with anxiety: prevalence, comorbidity, and risk factors

BACKGROUND: Veterans of the first Gulf War have higher rates of medical and psychiatric symptoms than nondeployed military personnel. METHODS: To assess the prevalence of and risk factors for current anxiety disorders in Gulf War veterans, we administered a structured telephone interview to a population-based sample of 4886 military personnel from Iowa at enlistment. Participants were randomly drawn from Gulf War regular military, Gulf War National Guard/ Reserve, non-Gulf War regular military, and non-Gulf War National Guard/Reserve. Medical and psychiatric conditions were assessed through standardized interviews and questionnaires in 3695 subjects (76% participation). Risk factors were assessed using multivariate logistic regression models. RESULTS: Veterans of the first Gulf War reported a markedly higher prevalence of current anxiety disorders than nondeployed military personnel (5.9% vs. 2.8%; odds ratio = 2.1; 95% confidence interval = 1.3-3.1), and their anxiety disorders are associated with co-occurring psychiatric disorders. Posttraumatic stress disorder, panic disorder, and generalized anxiety disorder were each present at rates nearly twice expected. In our multivariate model, predeployment psychiatric treatment and predeployment diagnoses (posttraumatic stress disorder, depression, or anxiety) were independently associated with current anxiety disorder. Participation in Gulf War combat was independently associated with current posttraumatic stress disorder, panic disorder, and generalized anxiety disorder. CONCLUSIONS: Current anxiety disorders are relatively frequent in a military population and are more common among Gulf War veterans than nondeployed military personnel. Predeployment psychiatric difficulties are robustly associated with the development of anxiety. Healthcare providers and policymakers need to consider panic disorder and generalized anxiety disorder, in addition to posttraumatic stress disorder, to ensure their proper assessment, treatment, and prevention in veteran populations.     

Bulimic symptoms, cognitions, and body dissatisfaction in women with major depressive disorder

OBJECTIVE: The goals of this study were to assess eating disorder symptoms in depressed women with no history of eating disturbance and to evaluate the clinical significance of these symptoms relative to those reported by women with bulimia spectrum disorder. METHOD: Participants were 63 women with major depressive disorder (MDD) (n = 19), bulimia spectrum disorder (n = 20), or no history of MDD or eating disorder (n = 24). Measures included diagnostic interviews and self-report questionnaires designed to assess diagnostic criteria for bulimia nervosa, subthreshold eating disorder symptoms, dysfunctional attitudes about appearance, and body dissatisfaction. RESULTS: There were no significant differences between depressed and bulimic women on shape concerns, appearance overvaluation, or body dissatisfaction. Depressed women endorsed significantly more subthreshold eating disorder symptoms, dysfunctional attitudes about appearance, and body dissatisfaction than did control subjects. DISCUSSION: Eating disorder symptoms may be associated with depression in women in the absence of comorbid eating disorder diagnoses.     

Depression as a predictor for coronary heart disease. a review and meta-analysis

OBJECTIVE: To review and quantify the impact of depression on the development of coronary heart disease (CHD) in initially healthy subjects. DATA SOURCES: Cohort studies on depression and CHD were searched in MEDLINE (1966-2000) and PSYCHINFO (1887-2000), bibliographies, expert consultation, and personal reference files. DATA SELECTION: Cohort studies with clinical depression or depressive mood as the exposure, and myocardial infarction or coronary death as the outcome. DATA EXTRACTION: Information on study design, sample size and characteristics, assessment of depression, outcome, number of cases, crude and most-adjusted relative risks, and variables used in multivariate adjustments were abstracted. DATA SYNTHESIS: Eleven studies met the inclusion criteria. The overall relative risk [RR] for the development of CHD in depressed subjects was 1.64 (95% confidence interval [CI]=1.29-2.08, p<0.001). A sensitivity analysis showed that clinical depression (RR=2.69, 95% CI=1.63-4.43, p<0.001) was a stronger predictor than depressive mood (RR=1.49, 95% CI=1.16-1.92, p=0.02). CONCLUSION: It is concluded that depression predicts the development of CHD in initially healthy people. The stronger effect size for clinical depression compared to depressive mood points out that there might be a dose-response relationship between depression and CHD. Implications of the findings for a broader bio-psycho-social framework are discussed.     

Association Between Depressed Mood and Perceived Weight in Middle and High School Age Students: Texas 2004–2005

Research exploring the relationship between weight perception and depressed mood among adolescents is limited in the United States. The purpose of this study is to examine the association of perceived versus actual body weight and depressed mood in a representative sample of 8th and 11th grade public school students in Texas. Using data from the 2004–2005 School Physical Activity and Nutrition (SPAN) study, logistic regression analyses were conducted to assess the association of weight perception with depressed mood. Healthy weight students who perceived themselves to be a healthy weight were the reference group for all analyses. A high prevalence of misperception of body weight was observed. Overweight and obese 8th grade girls and boys who perceived themselves to be overweight had increased odds of depressed mood [Girls: OR 1.70 (95% CI: 1.07–2.69), Boys: OR 2.05 (95% CI: 1.16–3.62)]. Healthy weight 8th grade girls who perceived themselves to be overweight had 2.5 times greater odds of depressed mood (OR 2.63, 95% CI: 1.54–4.50). Healthy weight boys who perceived themselves to be underweight had more than twice the odds (OR 2.18, 95% CI: 1.23–3.89) of depressed mood. No weight category was significantly associated with depressed mood in boys or girls in 11th grade. The present study suggests that weight misperceptions are associated with depressed mood in young adolescents. Education about healthy body size is necessary to correct the common weight misperceptions observed. The high prevalence rates of depressed mood suggest a greater need for research into understanding factors that may contribute to depressed mood in adolescents.     

Diagnoses, requests and timing of 503 psychiatric consultations in two general hospitals

The high comorbidity of medical and psychiatric diagnoses in the general hospital population requires collaboration between various medical fields to provide comprehensive health care. This study aims to find the rate of psychiatric consultations, their timing and overall diagnostic trend in comparison to previous studies. Tehran University of Medical Sciences has got an active psychiatric consultation-liaison service which includes services provided by four faculty psychiatrists (two full-time and two part-time). This study was done in two general hospitals by simple sampling in available cases. For each consultation, a board-certified faculty psychiatrist conducted a clinical evaluation based on DSM-IV-TR. Other than psychiatric diagnoses, socio-demographic variables, relative consultation rates, reasons for referral, medical diagnoses and the time stay after admission were assessed. Among 503 patients who were visited by the consultation-liaison service, there were 54.3% female with mean age of 39.8 years. In 90.1% of consultations, at least one DSM-IV-TR diagnosis was made. The most frequent diagnosis groups were mood disorder (43.5%), adjustment disorder (10.9%) and cognitive disorder (7.6%). In about 10.9% of the consultations, multiple psychiatric diagnoses were made. The mean length of hospital stay before the consultation was 12.56 days (range=1-90, SD=13). Based on our findings, the mood and cognitive disorders still remain major foci of consultation-liaison practice in general hospitals; however our findings showed high rate of adjustment disorders diagnosis and ambiguous request for psychiatric consultation which need more interdisciplinary interaction.