Genetic association of daytime sleepiness and depressive symptoms in elderly men

STUDY OBJECTIVES: Clinical rating scales, self-reports, and diagnostic instruments measuring depression often inquire about daytime fatigue and tiredness. Excessive daytime sleepiness refers specifically to the tendency to feel drowsy or fall asleep during waking hours and is considered conceptually and operationally independent from the fatigue, tiredness, and sleeping difficulties that characterize depression. The objective of this study was to examine whether daytime sleepiness assessed using the Epworth Sleepiness Scale and depressive symptoms assessed using the Geriatric Depression Scale are genetically related. DESIGN/SETTING: Cross-sectional data were collected via questionnaire in 1998-2000. PARTICIPANTS: Population-based sample of more than 5,000 male elderly twins aged 69-82 years old at the time of survey. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: There was evidence for moderate heritability for daytime sleepiness (36.9%) and depressive symptoms (30.7%). There was evidence for a significant genetic correlation (0.40) between the 2 measures, suggesting that both daytime sleepiness and depressive symptoms have some genes in common. The genetic correlation was reduced to 0.21 after adjustment for several covariates. CONCLUSIONS: The results showed that the often reported phenotypic correlation between daytime sleepiness and depressive symptoms is due, in part, to modest overlap in genetic factors, at least in elderly men. However, the majority of individual variation in daytime sleepiness and depressive symptoms, in particular after covariate adjustment, was attributable to individual-specific environmental factors.     

Higher prevalence of depressive symptoms in middle-aged men with low serum cholesterol levels

OBJECTIVE: Investigators from several studies have reported a positive relationship between low cholesterol levels and death due to violent causes (eg, suicide and accidents), possibly mediated by depressive symptoms, aggression or hostility, or impulsivity. We set out to establish whether middle-aged men with chronically low cholesterol levels (< or =4.5 mmol/liter) have a higher risk of having depressive symptoms, according to scores on the Beck Depression Inventory, compared with a reference group of men with cholesterol levels between 6 and 7 mmol/liter. A similar comparison was also made for measures of anger, hostility, and impulsivity. METHODS: Cholesterol measurements were obtained as part of a population-based cholesterol screening study in 1990-1991. These levels were remeasured in 1993-1994. Only those whose cholesterol level remained in the same range were included in the study. Depressive symptoms were assessed by using the Beck Depression Inventory; anger, by questionnaires based on the Spielberger Anger Expression Scale and State-Trait Anger Scale; hostility, by the Buss-Durkee Hostility Inventory; and impulsivity, by the Eysenck and Eysenck Impulsivity Questionnaire. RESULTS: Men with chronically low cholesterol levels showed a consistently higher risk of having depressive symptoms (Beck Depression Inventory score > or =15 or > or =17) than the reference group, even after adjusting for age, energy intake, alcohol use, and presence of chronic diseases. No differences in anger, hostility, and impulsivity were observed between the two groups. CONCLUSIONS: Men with a lower cholesterol level (< or =4.5 mmol/liter) have a higher prevalence of depressive symptoms than those with a cholesterol level between 6 and 7 mmol/liter. These data may be important in the ongoing debate on the putative association between low cholesterol levels and violent death.     

A population study of the association between sexual function, sexual satisfaction and depressive symptoms in men

BACKGROUND: Depression and erectile dysfunction (ED) have a complex and bi-directional relationship. We examined the relationships between erectile dysfunction and depressive symptoms or diagnosed depression, sexual activity and sexual satisfaction. METHODS: A population survey of men aged 40-70 years was carried out in Brazil, Italy, Japan and Malaysia in 1997-1998. A questionnaire was used to collect life style, sexual behaviors and medical data. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. ED was classified as moderate or complete if the men reported they were "sometimes" or "never" able to achieve and maintain an erection satisfactory for sexual intercourse. Only men with a sexual partner and not taking psychoactive drugs were considered. RESULTS: Diagnosed depression was reported by 2.0% of the men, depressive symptoms by 21.0%. The prevalence of moderate or complete ED was 17.8%. Sexual satisfaction related to the frequency of sexual intercourse and inversely related to depressive symptoms. Depressive symptoms were positively associated with being single (odds ratio [OR] 1.7), widowed, separated or divorced (OR 2.2), moderate or complete ED (1.8), heart disease (1.6) and smoking (1.6), and negatively associated with age, physical activity and frequency of sexual intercourse. LIMITATIONS: Cross-sectional studies cannot establish a temporal cause-effect relationship. However, the confirmation of known associations reassures about the validity of the original findings. CONCLUSIONS: The findings suggest that depressive symptoms are linked to ED by the mediation of decreased sexual activity and the dissatisfaction generated by the inability to have a healthy sexual life.     

Poor sleep and emotion dysregulation mediate the association between depressive and premenstrual symptoms in young adult women

Archives of Women's Mental Health - A large portion of reproductive-aged women report experiencing distressing premenstrual symptoms. These symptoms can be exacerbated by concurrent mood...     

Prevalence of menopause symptoms and their association with lifestyle among Finnish middle-aged women

Background and aim of the study

The aim of this study is to report the prevalence of menopausal symptoms by severity among the Finnish female population and the association of their symptoms with lifestyle (smoking, use of alcohol, physical activity) and body mass index (BMI).

Material and methods

Health 2000 is a nationally representative population-based study of Finnish adults. Data were collected by home interview, three self-administered questionnaires and a clinical examination by a physician. This study included women aged 45–64 years (n = 1427). All symptoms included menopause-specific symptoms. Both univariate analysis and a factor analysis based on symptom factors were performed by menopausal group. Multiple regression analysis included each symptom factor as a dependent variable and confounding and lifestyle factors (age, education, smoking, alcohol use, physical activity, BMI, use of hormonal replacement therapy (HRT) and chronic disease status).

Results

Over one-third (38%) of the premenopausal, half of the perimenopausal, and 54% of both postmenopausal and hysterectomized women reported bothersome symptoms. The difference between pre- and perimenopausal women was largest and statistically most significant in the case of back pain and hot flushes. Physically active women reported fewer somatic symptoms than did women with a sedentary lifestyle. Smoking was not related to vasomotor symptoms.

Conclusion

Bothersome symptoms are common in midlife, regardless of menopausal status. Inverse association between physical activity and menopausal symptoms needs to be confirmed in randomized trials.     

Lower urinary tract symptoms and depressive symptoms in elderly men

BACKGROUND: To evaluate the impact of moderate to severe lower urinary tract symptoms (LUTS) on clinically significant depressive symptoms in elderly Chinese men aged 65 and above. METHODS: In a large prospective cohort of 2000 Chinese men aged 65 to 92 years of age in Hong Kong, the association between moderate to severe lower urinary tract symptoms and clinically relevant depressive symptoms was studied. After excluding men with prostate or bladder cancer or surgery, 1980 subjects provided response to a structured interviewer-administered questionnaire and physical examination. A case-control analysis was performed, comparing subjects with clinically relevant depressive symptoms (cases) to those without depressive symptoms (controls). RESULTS: In multiple analyses adjusting for all factors that were shown to be significantly associated with having clinically relevant depressive symptoms in the initial bivariate analyses, being widowed, divorced or single were associated with increased risk of having clinically relevant depressive symptoms. Having a history of cardiac disease, being a current smoker and the use of corticosteroid were also associated with increased risk. Having moderate to severe LUTS was significantly associated with increased odds of having clinically relevant depressive symptoms (OR: 2.40; CI: 1.68-3.43) even after adjustment. LIMITATION: This study was cross-sectional and there were no clinician-based diagnostic interviews that were conducted to diagnose clinical depression and thus only clinically relevant depressive symptoms were assessed. CONCLUSIONS: In elderly men, moderate to severe LUTS are important public health problems that are associated with increased risk of having clinically relevant depressive symptoms. These findings suggest that physicians who deal with patients with moderate to severe LUTS should consider the psychological health of their patients as this population is at risk of having clinically relevant depressive symptoms.     

Work and family roles and the association with depressive and anxiety disorders: differences between men and women

BACKGROUND: This study examined the associations of (combinations of) social roles (employee, partner and parent) with the prevalence of anxiety and depressive disorders and whether social roles contribute to the explanation of the female preponderance in these disorders. METHOD: This was a cross-sectional study using data from 3857 respondents aged 25-55 of NEMESIS (Netherlands Mental Health Survey and Incidence Study). Depression and anxiety disorders were measured using the CIDI 1.1. RESULTS: The OR of depressive disorders and anxiety disorders among women compared to men was 1.71 (95% CI: 1.40-2.10). Among both genders, the partner role was associated with decreased risks of depression and anxiety and the parent role was not. The work role was a significant protective factor of depression and anxiety for men (OR=0.40; 95% CI: 0.24-0.69) but not for women (OR=0.86; 95% CI: 0.66-1.12). The effect of the work role was positive among women without children (OR=0.28; 95% CI: 0.14-0.54), but not among those with children (OR=1.01; 95% CI: 0.75-1.35). The gender risk for depression and anxiety decreased significantly by adding the work role variables into the model. LIMITATIONS: This was a cross-sectional study. This study did not give insight into the quality of social roles. CONCLUSION: The work role contributed to the explanation of the female preponderance in depression and anxiety disorders. Considering depression and anxiety among women, a focus upon quality and meaning of the work role, and barriers in combining the work role and parent role may be essential.     

Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe

OBJECTIVE: Research into social inequalities in depression has studied western populations but data from non-western countries are sparse. In this paper, we investigate the extent of social inequalities in depression in Eastern Europe, the relative importance of social position at different points of the life-course, and whether social patterning of depression differs between men and women. METHOD: A cross-sectional study examined 12,053 men and 13,582 women in Russia, Poland and the Czech Republic. Depressive symptoms (16 or above on the CESD-20) were examined in relation to socio-economic circumstances at three phases of the life-course: childhood (household amenities and father's education); own education; current circumstances (financial difficulties and possession of household items). RESULTS: Pronounced social differences in depression exist in men and women throughout Eastern Europe. Depression was largely influenced by current circumstances rather than by early life or education, with effects stronger in Poland and Russia. Odds ratios in men for current disadvantage were 3.16 [95% CI: 2.57-3.89], 3.16 [2.74-3.64] and 2.17 [1.80-2.63] in Russia, Poland and the Czech Republic respectively. Social variables did not explain the female excess in depression, which varied from 2.91 [2.58-3.27] in Russia to 1.90 [1.74-2.08] in Poland. Men were more affected by adult disadvantage than women, leading to narrower sex differentials in the presence of disadvantage. LIMITATIONS: Cross-sectional data with recall of childhood conditions were used. CONCLUSION: Current social circumstances are the strongest influence on increased depressive symptoms in countries which have recently experienced social changes.     

Lack of association between cytomegalovirus infection of heart and rejection-like inflammation.

Serial myocardial biopsy specimens, taken up to the time of serological evidence of primary cytomegalovirus (CMV) infection in 22 heart transplant patients, were examined and compared with those taken over similar times after transplantation in 21 patients who did not develop CMV infection. None of these 43 patients had serological evidence of CMV infection before their heart transplantation. There was no evidence of an increased cellular infiltrate in the myocardium at the time of the active CMV infection, even though the donor heart is the likeliest source of infection, nor was there any change in myocyte, interstitial cell, or vascular endothelial cell nuclei to identify active CMV infection.     

Association between C-reactive protein and depressive symptoms in women with rheumatoid arthritis

Converging lines of evidence support an association between systemic inflammation and depressive symptoms. Neuroimmune pathways may account for the high prevalence of depression in individuals with inflammatory conditions such as rheumatoid arthritis (RA). However, this relationship is complicated by factors linked to both inflammatory disease activity and mood, such as pain and physical disability. The goal of this cross-sectional study was to examine the relationship between C-reactive protein (CRP) and depressive symptoms among 173 women with RA. Somatic symptoms of depression and circulating CRP were significantly associated in regression analyses adjusted for body mass index (β = .19, p < .05), but this relationship was attenuated when pain and disability were included as covariates (β = .09, p = .24). CRP was not significantly associated with negative mood symptoms of depression. Findings suggest that depression in the context of RA may result from the overlap of somatic depressive and RA symptoms rather than neuroimmune pathways.     

Lack of association between Y chromosome haplogroups and male infertility in Japanese men

The Y chromosome carries several genes involved in spermatogenesis, which are distributed in three regions in the euchromatic part of the long arm, called AZFa (azoospermia factor a), AZFb, and AZFc. Microdeletions in these regions have been seen in 10-15% of sterile males with azoospermia or severe oligozoospermia. The relatively high de novo occurrence of these microdeletion events might be due to particular chromosome arrangements associated with certain Y chromosome haplogroups. To test whether there is any association between Y chromosome types and male infertility, we studied a sample of 84 Japanese oligozoospermic or azoospermic males. The patients were analyzed for the presence of Yq microdeletions and also typed with a battery of unique event polymorphisms (UEPs) to define their Y haplogroups. Six of the infertile patients presented likely pathological microdeletions detectable with the sequence tagged sites (STS) markers used. There was no significant association between Y chromosome haplogroups and the microdeletions. We also compared the Y haplogroup frequencies in our subset sample of 51 idiopathic azoospermia patients with 57 fertile control Japanese males, and did not observe any significant differences. Contrary to previous reports, our data suggest that Y microdeletions and other molecular events causally associated with male infertility in Japan occur independently of the Y chromosome background.     

Lack of association between smoking and DNA fragmentation in the spermatozoa of normal men

Male factor infertility patients can have anomalies in their sperm nuclei, displaying high levels of loosely packaged chromatin and damaged DNA. The primary objectives of this study were to compare the extent of DNA fragmentation in the spermatozoa of healthy light and heavy smokers versus non-smokers, and to investigate its correlation with concentrations of the smoking markers cotinine and cadmium. A secondary objective was to compare the concentrations of blood cadmium and serum cotinine with corresponding concentrations in seminal plasma. Ninety-seven healthy male volunteers were divided into three groups: non-smokers, light and heavy smokers. There was no difference between the three groups with respect to age, number of ejaculations per week, serum testosterone concentration, and parameters of semen analysis. The percentages of DNA fragmentation in spermatozoa were not statistically different in the heavy smokers (12.11%), light smokers (11.66%) and non-smokers (20.41%). Serum and seminal plasma concentrations of cotinine were significantly higher in heavy smokers compared with the other groups (P < 0.0001). Median values for blood cadmium concentration were higher in heavy smokers (4.50 microg/l) than in light smokers (0.20 microg/l) and non-smokers (0.20 microg/l) (P < 0.001). Cadmium concentration in seminal plasma was significantly higher in heavy smokers (0.20 microg/l) than in light smokers (0.10 microg/l) and non-smokers (0. 10 microg/l) (P < 0.05). In summary, our results indicate no association between smoking and DNA fragmentation in the spermatozoa of healthy men.     

Predictors of postpartum depressive symptoms in Icelandic women

Summary Objective: The aim of the survey was to investigate the prevalence of postpartum depressive symptoms among Icelandic women and the predictive capacity of parental stress and infant difficulty. Method: A sample of women (n = 734), 2–3 months after giving birth was studied by mailed questionnaires that included the Edinburgh Postnatal Depression Scale (EPDS); Parent Stress Index/Short Form (PSI/SF) and the Infant Difficulty Index (IDI). Demographic questions were also included. Results: The mean for depressive symptoms was 6.5, with 14% of the women experiencing frequent symptoms. Maternal stress and worries about health of the infant predicted depressive symptoms best. These variables explained 34% of the variance and social variables did not add to prediction. Conclusion: Maternal stress and worries about infant health are suggested as powerful predictors of postpartum depressive symptoms and are useful indicators for planning health care of mothers with young infants.     

Lack of association between Rh status, Rh immune globulin in pregnancy and autism

Though causes of autism are considered largely genetic, considerable concern remains that exposure to Rh immune globulin (RhIg), which until 2001 in the United States contained the preservative thimerosal, can cause autism. To determine whether mothers of children with autism are more likely to be Rh negative (Rh(-)) or to have received RhIg preserved with thimerosal, which is 49.6% ethyl mercury, we surveyed families of children with an autism spectrum disorder (ASD) ascertained through a University-based autism clinic considered free of ascertainment biases related to type of autism or severity. Between 2004 and 2006, 305 mothers of 321 children with an ASD agreed to participate in a telephone interview. Analysis of complete records including the blood group status and RhIg exposure of 214 families showed that Rh(-) status is no higher in mothers of children with autism than in the general population, exposure to antepartum RhIg, preserved with thimerosal is no higher for children with autism and pregnancies are no more likely to be Rh incompatible. This was also true for autism subgroups defined by behavioral phenotype, gender, IQ, regressive onset, head circumference, dysmorphology, birth status, essential, or complex phenotype. These findings support the consensus that exposure to ethylmercury in thimerosal is not the cause of the increased prevalence of autism. These data are important not only for parents in this country but also for the international health community where thimerosal continues to be used to preserve multi-dose vials which in turn makes vaccines affordable.     

Exploring the relationship between diabetes self-efficacy,depressive symptoms,and glycemic control among men and women with type 2 diabetes

Depression and low self-efficacy are both associated with worse glycemic control in adults with diabetes, but the relationship between these variables is poorly understood. We conducted a cross-sectional study examining associations between depressive symptoms, self-efficacy, and glycemic control among men (n = 64) and women (n = 98) with type 2 diabetes to see if self-efficacy mediates the relationship between depression and glycemic control. Correlational and mediational analyses examined the relationship between these three variables for the sample as a whole and separately by sex. A significant association between depressive symptoms and glycemic control was found for men (0.34, P < 0.01) but not for women (0.05, P = 0.59). Path analysis suggested that, among men, self-efficacy mediates the relationship between depressive symptoms and glycemic control. We conclude that men with depressive symptoms and type 2 diabetes may need tailored interventions that improve their self-efficacy in order to achieve glycemic control.     

Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China

BACKGROUND: To evaluate the prevalence of and risk factors for depressive symptoms among middle-aged and elderly Chinese in northern and southern China. METHODS: A population-based cross-sectional survey was performed in Beijing and Shanghai. Participants included 3289 community residents aged 50-70. Socio-demographic, lifestyle and health-related information were obtained by a standardized questionnaire. Clinically relevant depressive symptoms were assessed by the Center for Epidemiological Studies of Depression Scale (CES-D). RESULTS: The prevalence of depressive symptoms in the total study population was 9.5% (6.7% for men and 11.7% for women), and it was significantly higher in participants from Beijing than those from Shanghai (14.9% vs. 4.1%, P < 0.001). Multivariate logistic regression analyses indicated that this geographic disparity was independent of gender, age, marital status, living status, education level, health status, mobility, social activities and medical insurance (odds ratio, 3.94; 95% confidence interval, 2.86-5.40). LIMITATIONS: No clinical diagnostic validation was performed and the prevalence might be underestimated due to our exclusion criteria. CONCLUSIONS: Approximately one in ten middle-aged and elderly Chinese might suffer from depressive symptoms. Furthermore, the prevalence is substantially higher among residents in the north of China compared to the south. Prospective studies are required to confirm the results and identify the major risk factors contributing to this geographic disparity.