Prevalence and psychosocial correlates of depressive symptoms among adolescents and adults with Klinefelter syndrome

PurposeTo determine the prevalence and psychosocial correlates of depressive symptoms among adolescents and adults with Klinefelter syndrome.MethodsIndividuals (n = 310) aged 14–75 years with self-reported Klinefelter syndrome were recruited from regional and national support networks to complete a web-based survey. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Perceived consequences (Illness Perceptions Questionnaire), perceived stigma (Perceived Social Stigmatization Scale), and coping (Ways of Coping Checklist-Revised) were also measured and evaluated as correlates of depressive symptoms.ResultsOverall, 68.8% of the study participants reported clinically significant levels of depressive symptoms as indicated by a Center for Epidemiologic Studies Depression Scale score ≥16. The use of emotion-focused coping strategies (P < 0.01), perceptions of stigmatization (P < 0.01), perceived negative consequences of Klinefelter syndrome (P < 0.01), and the importance of having children in the future (P < 0.05) were all significantly associated with depressive symptoms.ConclusionsIndividuals with Klinefelter syndrome may be at increased risk for depression. Routine screening for depressive symptoms and appropriate referral and evaluation may be warranted.     

Psychiatric treatment seeking and psychosocial impairment among young adults with depression

BACKGROUND: We report data on 1-year prevalence and comorbidity of depression, related impairment, treatment need, and psychiatric treatment among young adults. METHODS: A sample of young urban adults (n=245) mean age 21.8 years was screened from a baseline population of 706 high-school students and given a semistructured clinical interview to evaluate 12-month prevalence of depression, psychosocial functioning according to DSM-IV GAF scale, need for psychiatric treatment, and use of mental health services. RESULTS: One in 10 young adults suffered from depression with associated psychosocial impairment, the female-to-male-ratio being approximately 2:1. Most depressive disorders were comorbid with other DSM-IV disorders, depression usually occurring secondary to other disorders. Comorbidity was related to impairment, treatment need, and treatment contacts. Less than half of the depressed young adults had ever contacted mental health services, and less than one-third reported treatment contacts during the index episode. Males were less likely than females to report previous treatment contacts or intention to refer to mental health services for their problems, but treatment contacts during the index episode were reported equally often by both sexes. CONCLUSIONS: A minority of the severely depressed young adults with associated impairment had sought treatment. Except for subjects with dysthymia, no gender difference emerged in treatment contact rates during the 12-month depression episode. Comorbidity showed important clinical implications by its relation to severity of depression and treatment contacts.     

Tryptophan and depressive illness.

Plasma free tryptophan is significantly decreased in monopolar, depressed patients. No evidence was found to suggest that poor nutritional history prior to hospital admission was responsible for these low levels. Factors known to influence tryptophan-albumin binding in plasma, e.g. concentration of plasma proteins, albumin and non-esterified fatty acids, did not account for the low levels of free tryptophan in depressed patients. A significant decrease in plasma free tryptophan levels was found in perimenopausal but not in pre- or post-menopausal female controls. This mirrors the decrease in circulating oestrogens. Although exogenously administered oestrogens do not have any therapeutic efficacy in relieving mild residual depressive symptoms of lithium treated patients, they increased the levels of plasma free tryptophan. Clofibrate also displaces tryptophan from plasma protein binding sites in both depressed patients and controls. Utilization of the increased levels of plasma free tryptophan is reduced in depressed patients. A situation therefore exists in depressed patients where the plasma free tryptophan is not only reduced but also leaves the plasma less readily than in control subjects.     

Assessing the severity of depressive illness.

Twenty-five psychiatrists ranked a set of hypothetical patient scenarios, based on the three depression rating scales (Hamilton, Hospital Anxiety and Depression, and Montgomery Asberg), in terms of severity of illness. The results indicate some scope for comparing different condition-specific outcome measures. Although the patient scenarios were context free, the responses of the psychiatrists suggested that they might be used to assess severity of depressive illness.     

The relationship between perimenstrual depressive mood and depressive illness.

In a study of 144 women, mainly self-designated PMS sufferers, the premenstrual depression experienced was, apart from its shorter duration, quantitatively and qualitatively similar to major depressive disorder for a substantial proportion of subjects. The associations with previous history of depression were complex: the severity of premenstrual depression was related to previous history of postnatal depression, whereas its duration (i.e., whether it persisted through longer) was related to a history of treatment with antidepressants. Two independent dimensions are proposed. (i) A menstrual cycle-related factor which in vulnerable women can results in severe and disabling premenstrual dysphoria, and which may be aetiologically related to a subgroup of postnatal depression. (ii) In a minority of women a more general propensity for depressive illness evidence as a tendency for any premenstrual depression to be prolonged.     

Predictors of psychopathology among Nigerian adolescents: the role of psychosocial, demographics, personality and medical condition reports domains

Background

Psychopathology among adolescents has become a global concern in the last decade.

Objective

The aim of this study was to identify the predictors of psychopathology among adolescents in Ibadan region using a multi-theoretical approach.

Methods

Eight hundred and eighty-nine (889) male and female adolescents drawn from different parts of Ibadan region of the South-West Nigeria, participated in the study. The study is a cross-sectional survey and adopted an ex-post facto design. A questionnaire divided into six sections, with two versions was used for data collection. Analysis of data involved multiple/stepwise regressions, F-test & T-test. SPSS 10.0 computer programme was utilized for all analyses.

Results

Data showed that all the predictors jointly contributed 37% (P<0.0001) to the prediction of reported psychopathology. The domains of psychosocial, personality, demographic and medical condition reports all independently and significantly predicted psychopathology among the adolescents but psychosocial domain had the highest contribution of 16% (P<0.0001). Prevalence rate for psychopathology among the sampled adolescents was 0.152 (15.2%) at the criteria of one standard deviation above the mean.

Conclusion

It is concluded that a multi-theoretical approach to the understanding of psychopathology among adolescents will be more appropriate in the Nigerian community. Results have implication for further assessment and treatments. Parents are advised to report any behavioural dysfunction observed in their wards to experts early enough to avoid degeneration to greater psychopathology in the later years.     

Observations on the haemopoietic response to critical illness.

Peripheral blood cytopenias are common in patients receiving intensive care, particularly in those with multiple organ failure. To assess the contribution of bone marrow hypoplasia in such patients 44 bone marrow samples from 24 patients under intensive care were studied by standard morphological techniques and by the granulocyte-macrophage colony forming cell (GM-CFC) assay. Frequently observed morphological abnormalities in the bone marrow included the following: (i) a reduction in overall cellularity in seven patients, with a progressive decrease in most patients studied sequentially; (ii) an increase in the number of actively phagocytic macrophages; and (iii) a disruption of normal bone marrow architecture with the accumulation of intercellular hyaluronic acid glycosaminoglycan. Mean GM-CFC growth was significantly reduced when compared with that in a group of normal controls. In four of five patients studied sequentially GM-CFC growth became subnormal in association with a reduction in bone marrow cellularity. Inhibitory serum factors were not identified. These morphological abnormalities are similar to the changes observed in gelatinous degeneration of the bone marrow. In both situations disruption of the haemopoietic microenvironment, with the accumulation of hyaluronic acid proteoglycan, may be an important factor in the inhibition of haemopoietic progenitor cell growth. The proliferation of macrophages, by the release of a variety of cytokines or reactive oxygen intermediates, may also be implicated in impaired haemopoiesis and the development of disordered erythropoiesis.     

Major depressive episode among Brazilian adults: A cross-sectional population-based study

Background

Despite the fact that there is extensive scientific research on depression very few population-based studies have been conducted in Brazilian cities.

Methods

A sampling design of two-stage conglomerates with probability proportional to size. All adults aged 20 or more living in the selected households were invited to participate in the study. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) with a cutoff ≥9.

Results

The study sample comprised 2925 respondents. The prevalence of depression in the sample studied was 20.4% (95% CI 18.9;21.8). After adjustment for confounding factors according to a conceptual analysis model the following variables were associated with a higher prevalence of depression: female gender; younger age; white skin color; lower socioeconomic condition; lower education; smoking; being single or separated; being unemployed; and reporting a heart condition. Alcohol use, arterial hypertension, and diabetes mellitus were not found to be associated with depression.

Limitations

The difference in the proportion of males among losses and refusals compared to that in the sample analyzed. Another limitation is reverse causality bias that is a problem inherent to cross-sectional studies.

Conclusions

Our findings support the relevance of depression as a prevalent condition among adults. It also provided evidence of the factors associated with depression, and that some are potentially modifiable risk factors may have implications for policy and health service planning.     

Types of exercise and training duration on depressive symptoms among older adults in long-term care facilities

BackgroundDepression is associated with a greater risk of disability, cognitive impairment, and suicide. Older adults in long-term care facilities (LTCFs) are more likely to develop depression due to changes in family roles and separation from family members. The aim of this study was to synthesize and analyze the effects of different types of exercise and training duration on depressive symptoms of older adults in LTCFs.MethodsRelevant peer-reviewed journal articles published in English were identified through a search of six electronic databases up to June 2021.ResultsA total of 25 studies were included in the systematic review and 22 in the meta-analysis. The results of meta-analysis showed that exercise interventions reduced depression in cognitively intact older adults and in cognitively impaired older adults. Both exercising less than 150 min per week or more than 150 min per week, reduced depressive symptoms of older adults. In terms of exercise types, mind-body exercises, exergames, and strength training reduced depressive symptoms.ConclusionExercise has a positive effect on reducing depressive symptoms with mind-body exercises, exergames, and strength training producing the best effect. Regardless of cognitive impairment, older adults in LTCFs benefited from exercise in reducing depressive symptoms.     

Religious involvement and depressive symptoms among Mexican‐origin adults in California

A burgeoning literature has documented generally salutary relationships between various aspects of religious involvement and mental health outcomes, including depressive symptoms. However, few of these studies have focused on Latinos (Hispanics), who now constitute the largest ethnic minority population in the United States. Our work addresses this gap in the literature. A number of hypotheses concerning main and contingent effects of religious attendance, salience, and consolation‐seeking are developed and tested, using data on a large (N=3,012) sample of Mexican‐origin adults drawn in the Fresno, CA area in 1995–1996. An initial inverse association between religious attendance and depressive symptoms disappears with controls for supportive social ties. However, an apparently salutary association between religious salience and depression persists despite all statistical controls; this relationship is present among both men and women, but it is significantly stronger for women. Contrary to expectations, there are signs that religious involvement may exacerbate the deleterious effects of discrimination and acculturation stress on depressive symptoms. A number of study implications, limitations, and directions for future research is discussed. © 2009 Wiley Periodicals, Inc.     

Observations on the epidemiology of post partum mental illness.

This study is based on a sample of 35,486 consecutive confinements in Cardiff (1965-72) which gave rise to 67 cases of post partum mental illness. No difference was found between these cases and all resident Cardiff maternities for the same period in respect of social class, maternal parity, weight gain in pregnancy, length of gestation, birth weight, and sex of infant. A statistically significant cyclic variation in month of conception and date of birth was found with a peak frequency among conceptions in the first quarter of the year. The bearing this finding may have on the prevention of post partum mental illness and the implications of the observation that post partum mental illness and the functional psychoses have a remarkably similar temporal behaviour are discussed.     

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。     

Reactive and endogenous depressive illness and five-year outcome

Data on severe life events and major difficulties, collected by the Bedford College method from a consecutive series of 71 in-patients, diagnosed as suffering from depression using the Present State Examination, was used in order to divide the sample into those having endogenous and reactive illnesses. There was no distinctive clinical picture associated with either diagnosis and there were no important differences on any of the measures of outcome obtained from a postal and case note follow-up 5 years later. A similar comparison of reactive depressive psychosis and non-reactive depressive psychosis likewise produced no outstanding differences in clinical picture nor outcome.