Neuroticism in adolescence and psychotic symptoms in adulthood

BACKGROUND: The aims of this research were to examine the associations between the personality trait of neuroticism in adolescence and later psychotic symptoms, taking into account potential confounding factors. METHOD: Data were gathered over the course of a longitudinal study of a birth cohort of New Zealand born young people (N=1265). Over the course of the study, data were gathered on: (a) neuroticism at age 14; (b) psychotic symptoms predominantly subclinical, assessed on the Symptom Checklist (SCL-90), at ages 18 and 21; (c) a range of potential confounding factors including measures of childhood adversity and co-morbid mental disorders. RESULTS: Young people in the highest quartile of neuroticism at age 14 had rates of psychotic symptoms that were two to three times higher than those in the lowest quartile. After statistical adjustment for confounding factors, including childhood adversity and co-morbid mental disorders, the association between neuroticism and later psychotic symptoms reduced but remained statistically significant (P<0.05). After adjustment for confounding, young people with high levels of neuroticism had rates of psychotic symptoms that were between 1.5 to 1.8 times higher than those with low levels of neuroticism. CONCLUSIONS: Early neuroticism may be a precursor to the onset of psychotic symptoms. The mechanisms underlying this association are unclear, but may relate to overlapping features between prodromal phases of psychosis and items that measure neuroticism.     

Postpartum depressive symptoms and the BDNF Val66Met functional polymorphism: effect of season of delivery

Postpartum depression (PPD) is an often underdiagnosed and undertreated mood disorder, with negative impact on the mother’s and infant’s health. Seasonal variation has been discussed as a risk factor for PPD. Candidate genes, such as those encoding for the brain-derived neurotrophic factor (BDNF), serotonin transporter (5-HTT), and Period2 (PER2), have been associated with depression and seasonal disorders. The present study is aimed to examine whether functional polymorphic variants, BDNF Val66Met, 5-HTTLPR, or PER2 SNP 10870, are associated with PPD symptoms and whether these genetic polymorphisms interact with season in predicting PPD symptoms. This case–control study comprised of 275 women from a population-based cohort of delivering women in Sweden, who completed a questionnaire containing the Edinburgh postnatal depression scale (EPDS) at 6 weeks and 6 months postpartum. Stressful life events (SLEs) and maternity stressors were also assessed. The results did not reveal any statistically significant overall association between the studied genetic polymorphisms and PPD symptoms. However, a significant association between BDNF Met66 carrier status and development of PPD symptoms at 6 weeks postpartum, even when controlling for prepartum and postpartum environmental risk factors, was evident among mothers delivering during autumn/winter. No gene–gene interactions were found but a cumulative effect was detected with carriers of a greater number of 5-HTTLPR S and BDNFVal66Met Met alleles reporting higher EPDS scores, if delivered during autumn/winter. Our findings propose a role of the BDNF gene in the development of PPD symptoms, potentially mediated by season of delivery.     

Relations among menopausal symptoms,sleep disturbance and depressive symptoms in midlife

Objectives

To investigate the relations among hot flashes, other menopausal symptoms, sleep quality and depressive symptoms in midlife women.

Methods

A large population-based cross-sectional study of 639 women (ages 45–54 years) consisting of a questionnaire including the Center for Epidemiologic Studies-Depression (CES-D) Scale, demographics, health behaviors, menstrual history, and menopausal symptoms.

Results

After controlling for menopausal status, physical activity level, smoking status and current self-reported health status elevated CES-D score is associated with frequent nocturnal hot flashes, frequent trouble sleeping, experiencing hot flashes, nausea, headaches, weakness, visual problems, vaginal discharge, irritability, muscle stiffness, and incontinence.

Conclusions

The present study found significant links between depressive symptoms and several menopausal symptoms including hot flashes, sleep disturbance, irritability, muscle stiffness, and incontinence after controlling for covariates. These findings suggest that a potential mechanism in which bothersome menopausal symptoms may influence depressed mood during the midlife is through sleep disturbance.     

Decreased plasma BDNF level in depressive patients

BACKGROUND: Recent reports have suggested a pathophysiological role for brain-derived neurotrophic factor (BDNF) in major depressive disorder (MDD). We evaluated plasma levels of BDNF in patients with MDD. METHODS: Plasma BDNF levels were measured in 77 MDD patients and 95 normal controls. The severity of psychiatric symptoms was measured with the Hamilton Depression Rating Scale and the Brief Psychiatric Rating Scale. RESULTS: Plasma BDNF levels were significantly lower in MDD patients than in normal control subjects (p<0.001). Plasma BDNF levels were significantly lower in MDD patients with recurrent episodes than in MDD patients with the first episode or normal controls (p<0.001). Plasma BDNF levels were significantly lower in non-psychotic MDD patients than in psychotic MDD patients or normal controls (p<0.001). Plasma BDNF in suicidal MDD patients were significantly lower than those in non-suicidal MDD patients (p<0.001). LIMITATIONS: We measured only plasma levels of BDNF. However, the cellular sources of BDNF in human plasma are not yet clearly defined. CONCLUSIONS: Our study suggests that there is a decrease in plasma BDNF levels in untreated MDD patients. However, relapsed or recurrent episodes, suicidal behavior, and psychotic features could also affect the plasma levels of BDNF. Further studies are required to understand the source and role of the circulating BDNF in depression.     

BDNF promoter methylation and suicidal behavior in depressive patients

Introduction

Suicide is a major health problem, and depression is a major psychiatric cause of suicide. Suicide is influenced by the multifactorial interaction of many risk factors. Therefore, epigenetic research may lead to understandings that are applicable to suicide. This study investigated whether epigenetic changes are associated with suicidal behavior and evaluated the treatment outcome of suicidal ideation in depressive patients.

Methods

In 108 patients with major depression, the promoter methylation of the gene encoding brain-derived neurotrophic factor (BDNF) was measured. Sociodemographic and clinical characteristics including a history of previous depressive episodes, age at onset, duration of illnesses, family history of depression, and number of stressful life events as well as subjective perception of stress and assessment scales for depression (HAMD), anxiety (HAMA), function (SOFAS), disability (WHODAS-12), and quality of life (WHOQOL-BREF) were evaluated at baseline. Suicidal behavior was ascertained using a semistructured clinical interview with questions about severity and intent. Beck Scale for Suicide Ideation (BSS) was administered during 12 weeks of treatment with antidepressants.

Results

A higher BDNF promoter methylation status was significantly associated with a previous suicidal attempt history, suicidal ideation during treatment, and suicidal ideation at last evaluation as well as with higher BSS scores and poor treatment outcomes for suicidal ideation.

Limitations

Methylation status was investigated with limited area of the BDNF gene and sample size was relatively small.

Conclusions

BDNF methylation status could be a proxy marker for previous suicidal attempts and a clinical biomarker for poor treatment outcomes of suicidal ideation in depression.     

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.     

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.     

Heritability of individual depressive symptoms

Background: In attempting to understand the familial basis of depression, most studies have focused on broad indices of depression and mood change. Broad indices may not adequately reflect the heritable basis of depression because of an unexplored possibility that not all symptoms are heritable. Methods: The heritability of individual depressive symptoms was estimated from a sample of 343 general population volunteer twin pairs who completed the Beck Depression Inventory, the Centre for Epidemiologic Studies Depression Scale and items from the Symptom Checklist assessing depressive symptoms. Principal component analysis of the items extracted 14 factors that represented a wide range of depressive symptomatology. Results: The factors were differentially heritable (h² range: 0.0–35.0%). The factors that have a heritable basis described endogenous or physiological functions (e.g. loss of appetite, libido/pleasure). Symptoms such as negative affect or tearfulness did not have a heritable basis, suggesting that these symptoms are responses to negative life events/experiences or a learned association to changes in physiologic function. Limitations: Relatively small size of the sample. Conclusions: Depressive symptoms are differentially heritable and the results suggest that future research, such as genotyping studies, separates heritable and non-heritable symptom clusters prior to analysis. This will help identify which genes are involved and what their function in depression may be, leading to the development of more targeted and effective therapies.     

Coping strategies,hostility, and depressive symptoms: A path model

Previous studies of coping, hostility, and depressive symptoms have highlighted the significant relations between all possible pairs of these 3 variables. To more completely explore the nature of depressive symptoms, we link them all together in this study by testing a coping→hostility→depressive symptoms path model. One hundred forty participants completed psychological questionnaires measuring coping strategies, hostility, and depressive symptoms. While controlling age and social class as covariates, SPSS stepwise regression analyses were used to examine relations among these 3 constructs. Results suggest that coping has a direct relation with depressive symptoms as well as an indirect relation mediated by hostility. Passive coping may lead to increased hostility, resulting in depressive symptoms. Active coping may have the opposite effect. These findings suggest that the inclusion of measures of both coping strategies and hostility yields a more thorough understanding of concomitants of depressive symptoms. From a clinical perspective, knowing what coping strategies a person uses and how much anger they experience and express may be useful in guiding the management of depressive symptoms.     

Maternal depressive symptoms,maternal asthma,and asthma in school-aged children

Background

Little is known about the joint effects of maternal asthma and maternal depression on childhood asthma.

Somatoform symptoms in depressive and panic syndromes

Somatoform symptoms are common features of psychological and psychosomatic disorders. This study addresses the question of whether somatoform symptoms differ in patients with panic syndromes. with depressive syndromes, or with somatization syndromes without depression or panic syndromes. We therefore investigated 135 inpatients o f a psychosomatic clinic and identified 64 patients for the depression group, 31 for the panic subgroup, and 18 for the somatization syndrome group. Neither the number of somatization symptoms nor the pattern of somatoform symptoms differed substantially among the 3 groups, except for higher frequencies of palpitations in the panic group and more abdominal pain symptoms in the depressive group. The 3 groups showed nearly identical frequency distributions of the individual somatoform symptoms. All 3 groups showed elevated hypochondriasis scores. In personality dimensions, depressive patients showed the lowest scores for extraversion. The improvements during inpatient treatment on the somatization variables, as well as general psychopathology, were also comparable. We favor the interpretation that the somatization syndrome is a fairly uniform syndrome whether or not it occurs alone or in combination with depressive syndromes or panic syndromes.     

Physical symptoms and depressive symptoms among individuals with HIV infection.

The authors investigate the importance of physical symptoms as a correlate of depressive symptoms and suicidal thoughts in a large (N = 881) community-based sample of persons infected with human immunodeficiency virus. The study overcomes limitations of prior research by minimizing overlap in measures of affective and physical symptoms, studying a more diverse population, and including correlates such as measures of social support, function, employment, insurance coverage, and cognitive impairment in the analysis. The authors' data support the notion that in diagnosing depression in the medically ill, concern over isolating physical symptoms as either "affective" or "physical" may be exaggerated.     

The familial aggregation of depressive symptoms,antisocial behavior,and alcohol abuse

This study describes results from an ongoing family study of adolescent boys and their families designed to investigate potential risk factors for substance abuse. The adolescent treatment probands have severe drug and alcohol related problems and were recruited through a residential rehabilitation program. To date, the sample includes 251 individuals: 39 male probands and their families and 34 control families matched for age and geographic location (zip code). Probands and participating family members are given a structured interview which assesses alcohol and drug problems, and various psychiatric symptoms. The purpose of the present study was to examine the coaggregation of depressive symptoms, antisocial behavior, and alcohol misuse. Multivariate pedigree analyses were performed using a model that allowed for the estimation of vertical familial transmission, residual sibling resemblance, and assortative mating. Spouse correlations were estimated at .57, .21, and .31 for antisocial behavior, depressive symptoms, and alcohol abuse, respectively. Residual sibling environment (i.e., sibling resemblance unaccounted for by parent-offspring transmission) was not found for alcohol problem symptoms, but did contribute to resemblance for antisocial behavior and depressive symptoms. The proportion of variance accounted for by vertical familial transmission was estimated at approximately 30 to 40%. More important, correlations among the transmissible family factors for these psychiatric syndromes ranged from .58 to .73, suggesting substantial overlap among the underlying familial antecedents for these disorders. Am. J. Med Genet. 74:183–191, 1997 © 1997. Wiley-Liss, Inc.     

老年抑郁症状与日常烦心事和应对方式的关系

目的:探讨日常烦心事的累积、应对方式和与老年人抑郁症状的关系。方法:四川省绵竹市农村老年人303例(男性164例,女性139例),采用老年人日常烦心事量表(HS)、老年特质应对问卷(WCC)、流调中心用抑郁量表(CES-D)评估日常烦心事、应对方式和抑郁症状。结果:通径分析表明,HS总分在WCC淡化维度得分与CES-D总分间起部分中介作用,间接效应(偏差校正后的95%CI:-0.48～-0.20)占总效应的57.9%。HS总分在WCC幻想维度得分与CES-D总分、WCC逃避维度得分与CES-D总分之间起完全中介作用。结论:日常烦心事在淡化式应对与农村老年人抑郁症状的负相关关系中起部分中介作用,在消极应对方式与其抑郁症状的正相关关系中起完全中介作用。     

Freshmen adaptation to university life: depressive symptoms, stress, and coping

Attending a university for the first time can be a stressful experience for many new college students. This study examines the relationships among femininity and masculinity, depressive symptomatology, levels of stress, and the types of coping strategies used by college freshmen. Results of this study suggest that these variables were related uniquely for first-year college students. Masculinity and femininity significantly predicted problem-focused coping, and femininity significantly predicted emotion-focused coping. Further, the levels of family and college stress reported by college students, as well as their endorsement of avoidant coping, significantly predicted their levels of depressive symptoms. Overall, the results of this study suggest that understanding the relationships among the gender role, the levels of depressive symptomatology, and the levels of stress exhibited by college freshmen may be important in facilitating their transition and adjustment to university life.     

Possible connections among job stress, depressive symptoms, lipid modulation and antioxidants

BACKGROUND: Oxidative/antioxidative status may be related to psychological stress or pathogenesis of depression. SUBJECTS AND METHODS: Participants were selected from 381 female nurses working in a university hospital, and the Brief Job Stress Questionnaire was utilized to assess them. Nurses with high job stress (JS) (n = 18) and with low JS (n = 15) consented to participate in this study. Depressive symptoms were assessed by the Centre for Epidemiologic Studies Depression scale (CES-D). Cholesterols, lipid peroxidation (malondialdehyde, MDA) and antioxidants in the plasma were measured. RESULTS: High JS participants exhibited significantly higher CES-D scores (t = 3.34, p < 0.005), and significantly lower concentrations of total cholesterol (TC), low density+very low density lipoprotein cholesterols (LDL+VLDL), alpha-tocopherol, and beta-carotene compared with low JS participants (t = 2.69, p < 0.05; t = 3.46, p < 0.005; t = 2.96, p < 0.05; t = 2.98, p < 0.05, respectively). However, the reductions in plasma indicators were substantially weakened after controlling for lifestyle factors with the exception of LDL+VLDL and alpha-tocopherol. In addition, the significance of alpha-tocopherol concentrations appeared to depend on cholesterol levels. CES-D scores correlated positively with plasma MDA levels, the MDA/TC ratio and the MDA/LDL+VLDL ratio among the low JS group (r = 0.69, p < 0.001; r = 0.79, p < 0.001; r = 0.75, p < 0.005, respectively), whereas there were no correlations among the high JS group. After controlling for lifestyle covariates, the relationship between CES-D scores and the MDA/LDL+VLDL ratio remained significant (beta = 0.95, p < 0.05) using a multiple linear regression model (F = 3.61, p < 0.05). LIMITATIONS: Sample numbers in each JS group were relatively small. CONCLUSIONS: Psychological stress may reduce the plasma levels of LDL+VLDL accompanying an alpha-tocopherol decrease. There appeared to be a correlation between elevated MDA and depressive symptoms in low JS participants.     

Implicit loneliness,emotion regulation,and depressive symptoms in breast cancer survivors

Among individuals coping with cancer, emotional approach coping—expressing and processing emotions following negative events—has been identified as a potentially adaptive form of emotion regulation. However, its mental health benefits may depend on social-cognitive factors and on how it is implemented. This study examined loneliness as a determinant of emotion regulation associations with depressive symptoms in women with breast cancer. Loneliness was examined as an implicit social-cognitive phenomenon (i.e., automatic views of oneself as lonely), and emotional expression and processing were examined as both explicit and implicit processes. Approximately 11 months after diagnosis, 390 women completed explicit measures of coping through cancer-related emotional expression and processing; an implicit measure of expression and processing (an essay-writing task submitted to linguistic analysis); and an implicit association test measuring loneliness. Depressive symptoms were assessed 3 months later. Regardless of implicit loneliness, self-reported emotional expression (but not emotional processing) predicted fewer depressive symptoms, whereas implicit expression of negative emotion during essay-writing predicted more symptoms. Only among women high in implicit loneliness, less positive emotional expression and more causal processing during the writing task predicted more depressive symptoms. Results suggest that explicit and implicit breast cancer-related emotion regulation have distinct relations with depressive symptoms, and implicit loneliness moderates effects of implicit emotional approach. Findings support implicit processes as influential mechanisms of emotion regulation and suggest targets for intervention among breast cancer survivors.