Age-related change in personality disorder trait levels between early adolescence and adulthood: a community-based longitudinal investigation

OBJECTIVE: To investigate change in personality disorder (PD) traits between early adolescence and early adulthood among individuals in the community. METHOD: PD traits were assessed in 1983 (mean age = 14), 1985-86 (mean age = 16) and 1992 (mean age = 22) in a representative community sample of 816 youths. RESULTS: Overall, PD traits declined 28% during both adolescence and early adulthood. PD traits were moderately stable during the first 2-year interval, and were as stable as they have been reported to be among adults over similar intervals. PD trait stability declined slightly as the inter-assessment interval increased. Adolescents with PDs tended to have elevated PD traits during early adulthood. CONCLUSION: PD traits tend to decline steadily in prevalence during adolescence and early adulthood. However, adolescents with PDs often have elevated PD traits as young adults, and the stability of PD traits appears to be similar during adolescence and early adulthood.     

Clinical characteristics of patients with cryptogenic liver cirrhosis in Okinawa, Japan

BACKGROUND/AIMS: The aims of the present study were to determine the prevalence of patients with cryptogenic liver cirrhosis, and to clarify the clinical characteristics of these patients, with special focus on obesity and type 2 diabetes mellitus. METHODOLOGY: For the case-control study, we selected age- and sex-matched control patients with cirrhosis of known etiology. RESULTS: Of 404 patients with liver cirrhosis, 40 (9.9%) were diagnosed as having cryptogenic cirrhosis. Of these 40 patients, 29 (73%) were female. The mean age was 66.1 +/- 8.9 (range 40-87 years old), and was significantly higher than that of either virus, or alcohol-related liver cirrhosis patients. Both obesity and type 2 diabetes mellitus were more common in patients with cryptogenic cirrhosis (53% and 40%, respectively) compared with the case-controls (20%, 18%, respectively). CONCLUSIONS: Cryptogenic liver cirrhosis accounted for approximately 10% of liver cirrhosis, and was associated with both obesity and type 2 diabetes mellitus. Nonalcoholic steatohepatitis sequelae may be the most important etiological factor in patients with cryptogenic liver cirrhosis in Okinawa, Japan, where virus-etiology is more predominant in liver cirrhosis compared with Western countries.     

Influence of child and adolescent psychiatric disorders on young adult personality disorder.

OBJECTIVE: This study examines associations between childhood psychopathology and young adult personality disorder in a random sample of 551 youths, who were 9 to 16 years old at first assessment. METHOD: Subjects were evaluated for DSM-III-R psychiatric disorders. Information was obtained prospectively from youths and their mothers at three points over 10 years. The predictive effects of prior axis I disorders and adolescent axis II personality disorder clusters A, B, and C on young adult personality disorder were examined in logistic regression analyses. RESULTS: The odds of young adult personality disorder increased given an adolescent personality disorder in the same cluster. Prior disruptive disorders, anxiety disorders, and major depression all significantly increased the odds of young adult personality disorder independent of an adolescent personality disorder. In addition, comorbidity of axis I and axis II disorders heightened the odds of young adult personality disorder relative to the odds of a disorder on a single axis. CONCLUSIONS: Assessment of personality pathology before late adolescence may be warranted. Childhood or adolescent axis I disorders may set in motion a chain of maladaptive behaviors and environmental responses that foster more persistent psychopathology over time. Identification and treatment of childhood disorder may help to reduce that risk.     

Metabolic syndrome is directly associated with gamma glutamyl transpeptidase elevation in Japanese women

AIM: This study aimed to determine whether metabolic syndrome is directly or indirectly, through fatty liver, associated with elevated gamma-glutamyl transpeptidase (GGT) levels in Japanese women. METHODS: From 4 366 women who received their annual health check-up, 4211 women were selected for analysis. All 4211 women were negative for both hepatitis B surface antigen and antibody to hepatitis C virus. Clinical and biochemical variables were examined by using univariate and multivariate analysis. RESULTS: A raised GGT level (>68 IU/L) was seen in 258 (6.1%) of the 4 211 women. In univariate analysis, all variables examined (age, body mass index, blood pressure, hemoglobin concentration, fasting blood glucose, glycosylated hemoglobin A1c, cholesterol, triglyceride, and uric acid) were associated with the elevated GGT level, whereas in multivariate analysis, four variables (age ≥ 50 yr, hemoglobin ≥14 g/dL, triglyceride ≥150 mg/dL, and presence of diabetes) were significantly and independently associated with raised GGT level. Clinical variables predicting the presence of ultrasonographic evidence of fatty liver were also examined by multivariate analysis; four variables were associated with the presence of fatty liver: BMI = 25 kg/m^2, hemoglobin ≥14 g/dL, triglyceride ≥150 mg/dL, and uric add ≥7 mg/dL. There was no significant association between the raised GGT level and the presence of fatty liver. Hypertriglyceridemia was significantly and independently associated with both the raised GGT level and the presence of fatty liver. CONCLUSION: Metabolic syndrome seemed to be directly, not indirectly through fatty liver, associated with the raised GGT level in ]apanese women.     

Depression in adult women: age changes and cohort effects

OBJECTIVES: We sought to separate age and cohort associations with depression, assessed 3 times within a 10-year period in 701 women born between 1928 and 1958. METHODS: We used regression analysis to examine age differences in women with depression in 2 birth cohorts, pre-1945 and post-1944, who were assessed at comparable ages. Multilevel modeling was used to estimate changes with age in successive birth year cohorts. RESULTS: An age by cohort interaction indicated more depression among younger than older women in the post-1944 cohort but a flat age profile in the pre-1945 cohort. Longitudinal analyses indicated declines in depression with age in more recent cohorts but increases in earlier ones. CONCLUSIONS: Increases in depression in younger women in successive cohorts may be offset by decreases in middle age.     

Impact of adolescent mental disorders and physical illnesses on quality of life 17 years later

OBJECTIVE: To investigate associations of mental disorders and physical illnesses during adolescence with quality of life (QOL) 17 years later. DESIGN: The Children in the Community Study, a prospective longitudinal investigation. SETTING: Upstate New York. PARTICIPANTS: A community-based sample of mothers and their offspring were interviewed. MAIN OUTCOME MEASURES: Axis I disorders and Axis II personality disorders and physical illnesses were assessed by self-report and mother report in 1985-1986. Outcome indicators of QOL were assessed in 2001-2004. RESULTS: Compared with participants without adolescent illness or disorder, those with a history of physical illness reported poorer physical health (mean difference [MD], -4.8); those with a history of an Axis I disorder reported poorer physical health (MD, -8.0) and more problematic social relationships (MD, -4.5); and those with a history of personality disorder reported poorer physical health (MD, -8.2), more problematic social relationships (MD, -5.0), lower psychological well-being (MD, -3.6), and more adversity within their environmental context (MD, -4.6) in adulthood. Comorbid physical illness and mental disorder were associated with all 5 QOL domains (MD, -3.1 to -11.9). After adjusting for all demographic variables and comorbidity, associations remained between physical illness and poor physical health (effect size [ES], -0.33); an Axis I disorder and problematic social relationships (ES, -0.37); and personality disorder and problematic social relationships (ES, -0.36), low psychological well-being (ES, -0.23), impaired role function (ES, -0.24), and an adverse environmental context (ES, -0.50). CONCLUSIONS: Mental disorders may have more adverse long-term associations with QOL than do physical illnesses. Adolescent personality disorders may have a more adverse impact on adult QOL than do adolescent Axis I disorders.     

Adherence to childhood religious affiliation and suicide intentions in women exposed to the violence of the 1994 Genocide against the Tutsi in Rwanda

Purpose

To examine the association between adherence to childhood religious affiliations and serious suicide intentions in 371 women exposed to the 1994 Genocide against the Tutsi in Rwanda.

Methods

Participants were randomly sampled in 2011 from households in the Southern Province of Rwanda. Trained interviewers gathered information on socio-economic background, genocide-related trauma exposure, Major Depressive Episode (MDE) and suicide intentions (assessed with the Mini International Neuropsychiatric Interview), and Posttraumatic Stress Disorder (PTSD) (assessed with the PTSD Checklist-Civilian version).

Results

In this predominantly Christian sample, 62.8% (233/371) had adhered to their childhood religious affiliation. Adherence was associated with lower odds of serious suicide intentions (OR 0.321, 95% CI 0.13–0.78, P < 0.01) independent of socio-economic factors, court-designated victim status, trauma exposure, MDE, and PTSD; that association held following consideration of specific denomination.

Conclusion

Women who adhere to their childhood religious affiliation may be less likely to have serious suicide intentions following major catastrophes. Whether that association is attributable to stronger connections with lost and remaining family and friends, or greater faith in the church as a facilitator of reconciliation and coping, requires further study.

     

Cohort differences in self-rated health: evidence from a three-decade, community-based, longitudinal study of women

Despite the fact that life expectancy has nearly doubled over the past century, the US public has become increasingly preoccupied with issues of health and illness. In this study, the authors investigated cohort differences in self-rated health between women born in 1935-1944 (preboomers) and women born in 1945-1954 (baby boomers). A randomly selected, community-based sample of 618 mothers, 314 preboomers, and 304 baby boomers was interviewed. Over three decades, self-rated health was assessed in 1975, 1983, 1985-1986, 1991-1994, and 2001-2004. An individual growth model showed a linear decline (-0.61 per year, p<0.001) in self-rated health from mean ages 31-59 years combined, with a quadratic age effect (-0.03, p<0.001). Baby boomers reported lower self-rated health (mean difference, -5.30; p<0.001) and more rapid decline per year (slope difference, -0.52; p<0.001) than did preboomers of overlapping ages; those differences remained after adjusting for demographics, socioeconomic variables, personality factors, health behaviors, chronic illness, and depression symptoms. Study findings have important implications with regard to the potential growing burden on the nation's health care system, suggesting that generational changes in health evaluations and expectations may continue to increase demand for medical care.     

Cumulative prevalence of personality disorders between adolescence and adulthood

Objective: To investigate the cumulative prevalence of personality disorder (PD) among adults in the community, based on prospective longitudinal data from a series of psychiatric interviews. Method: Psychiatric interviews were administered to a regionally representative community‐based sample of 568 individuals in 1983 (mean age = 14), 1985–1986 (mean age = 16), 1991–1993 (mean age = 22), and 2001–2004 (mean age 33). Results: The point prevalence of any current DSM‐IV PD, including depressive PD and passive‐aggressive PD, varied between 12.7% and 14.6% across the four diagnostic assessments. The cumulative prevalence of PD increased at each of the follow‐up assessments. At mean age 33, the estimated lifetime prevalence of PD was 28.2%. Conclusion: The cumulative prevalence of PD, based on a series of interviews conducted during adolescence and adulthood, may be substantially higher than the point prevalence of current PD based on a single assessment interview.