Biomedical subjects

H Perris

Publications and source records attributed to H Perris.

At least 37 records · Page 2Linked to original sources

PubMed1984

Life events and depression. Part 2. Results in diagnostic subgroups, and in relation to the recurrence of depression.

Although there is evidence that the occurrence of stressful life events might be important for the onset and development of depression, it is still unclear whether differences occur in diagnostic subgroups of depressed patients, or in relation to type of episode, i.e., whether the first event or a relapse in a depression with a recurrent course. The present study has been carried out to investigate these issues more closely. Two hundred and six depressed patients have been classified into bipolar, unipolar, neurotic-reactive, and unspecified subgroups according to given definitions. The patients have also been classified into those suffering from a first episode and those suffering from recurrent depression. Each patient, when sufficiently improved, was given a semistructured interview, based on a specially constructed 56-item life events inventory. Unipolar and bipolar patients proved to have experienced significantly fewer events, even of the 'fateful' type (i.e., independent of depression) than the neurotic-reactive patients. However, this difference appeared to be due to difference in age among the groups and not to diagnosis. No difference occurred between uni- and bipolar patients. Patients with recurrent depression showed only small differences compared with patients in their first episode. These differences were consistently in the direction of fewer events in patients with recurrent depression. The implications of these results are discussed in relation to findings published by other authors.

Adjustment Disorders↗

PubMed1984

Life events and depression. Part 3. Relation to severity of the depressive syndrome.

Two hundred and six depressed patients, consecutively treated at the Department of Psychiatry, Umeå University were investigated both concerning the occurrence of life events within defined time limits and the severity of their depressive syndrome. Three different criteria were used to divide the patients according to severity: whether they were in- or out-patients, whether or not they were psychotic according to a classification model (MACM) used at Umeå and, finally, according to the clinical ratings received by those admitted to the hospital. The average number of events experienced by the patients within the time limits set by the study was similar in each of the subgroups taken into account. A weak, but still statistically significant, relation was found between a negative experience of the events and the total score obtained at the ratings. The occurrence of events 'independent' of depression did not distinguish between the groups. Thus, the results of this study do not support the opinion maintained by some authors that there is a sizeable positive relation between magnitude of life events and seriousness of illness.

Adult↗

PubMed1984

Life events and biological vulnerability: a study of life events and platelet MAO activity in depressed patients.

The present study investigated the possible relationship between platelet monoamine oxidase (MAO) activity and life events. From the general hypothesis that the impact of life events should be seen against the background of an individual's vulnerability, it was assumed that low platelet MAO patients would need fewer life events to develop a psychopathological condition and that they would experience more negatively those events that occurred. Patients (n = 127) of both sexes suffering from various kinds of depressive disorders participated in the study. There were 39 unipolar patients, 11 bipolar patients, 43 patients suffering from neurotic-reactive disorder, and 34 patients suffering from an unspecified depressive disorder. No statistically significant differences in MAO activity were found in this series among the diagnostic subgroups. Younger patients predominated among those with the lowest MAO values. As expected, low MAO patients reported a lower number of life events than patients in the highest MAO quartile, and had experienced those events more negatively.

Adjustment Disorders↗

PubMed1984

Presentation of a subscale for the rating of depression and some additional items to the Comprehensive Psychopathological Rating Scale.

From the Comprehensive Psychopathological Rating Scale (CPRS) a subscale for depression has been derived in the course of a study of depression in which 209 patients took part. The subscale presented in this article comprises 28 items from the original pool and two additional items constructed later. The scale has a high degree of internal consistency and is satisfactorily reliable also among previously unskilled raters who have undergone a minimum of training. It is able to significantly differentiate between ill and recovered patients and among patients with syndromes of different severity according to various classification principles. Reported symptoms rated by the subscale correlated significantly with self-ratings of depression. Since the original CPRS pool also comprises items for the rating of manic manifestations, the scale is particularly suitable for the study of patients suffering from affective disorders, also when a switch from depression to mania could occur in the course of treatment.

Adjustment Disorders↗

PubMed1984

Perceived parental rearing practices in depressed patients in relation to social class.

The occurrence of possible differences in rearing practices related to social class has been investigated in a series of 125 depressed patients by means of a special inventory - the EMBU - constructed by our group. Three factors derived from the EMBU in the course of previous studies: "rejection", "emotional warmth", "overprotection" have been taken into account. The rearing practices experienced by subjects belonging to different social classes did not differ concerning "emotional warmth". On the other hand, subjects belonging to the higher social classes scored their parents higher on the variables "rejection" and "overprotection". Since "emotional warmth" proved in an earlier study to discriminate between depressives and healthy controls, it is concluded that the difference cannot have been biased by possible differences in social class.

Adult↗

PubMed1984

Life events and personality characteristics in depression.

Evidence from many sources supports the view that stressful life events might be relevant for the onset and development of depression, but their pathogenic role is still only poorly understood. One approach in trying to elucidate the role of life events in depression, might be to study them from a multi-factorial point of view, taking into account the vulnerability of the individual experiencing them. As part of such an investigation, 138 depressed patients with a mean age of 45 years have participated in a study of life events and personality traits. In particular, it was tested whether aspects of aggression might interact with the occurrence and perception of external stressful events. Patients who scored high on outward aggression had experienced more stressful events, and patients who scored high on inhibition of aggression had experienced fewer, but more negatively. It is concluded that a combined study of the occurrence of life events and the personality characteristics of the patients experiencing them might enhance our understanding of the pathogenic role of life events in depression.

Adjustment Disorders↗

PubMed1984

Personality traits and monoamine oxidase activity in platelets in depressed patients.

Personality characteristics and platelet monoamine oxidase (MAO) activity have been assessed in 143 depressed patients of both sexes (60 males and 83 females) in the age range 21-65 years (mean age 44.8 +/- 12.8, SD), the personality inventory being completed by the patients when recovered, or at least markedly improved from the depressive disorder. In line with previous studies, a significant negative correlation between MAO activity and the variables, impulsivity and monotony avoidance, was found in the whole series. A significant negative correlation between MAO activities and the traits reflecting verbal aggression and irritability was also found. A separate analysis showed that those correlations hold true for female but not for male patients.

Adult↗

PubMed1984

Personality traits in former depressed patients and in healthy subjects without past history of depression.

208 patients (81 male and 127 female) in the age range 21-67 years completed a Swedish personality inventory (Karolinska Sjukhusets Personlighetsinventorium; KSP) aimed at measuring stable personality traits after recovering from the depressive syndrome. Diagnostically, the series comprised 62 unipolars, 31 bipolars, 58 neurotic-reactive depressives, and 57 patients with an 'unspecified' depressive disorder, i.e., those patients who did not meet the criteria for inclusion in any of the aforementioned groups. As a contrast group, a series of 75 mentally healthy individuals (27 men and 48 women with a mean age of 39.5 +/- 12.1 years) without any past history of depression was also investigated. The former patients scored differently from the healthy controls in almost all the personality variables covered by the KSP, with the exception of the variable 'social desirability', on which all groups scored alike. A factor analysis of the results yielded three principal factors: factor 1 covering such variables which reflect anxiety proneness, psychasthenia, suspicion, and guilt; factor 2 (bipolar) covering different aspects of aggression; and factor 3 comprising the variables 'impulsiveness' and 'monotony avoidance'. From the present study it is concluded that although inter-group differences do occur, the main characteristics of the personality of the depression-prone individual seem to be anxiety, psychasthenia (covering such traits as orderly, conscientious, bound to routine), suspicion, and guilt. Such characteristics are shared by all diagnostic subgroups. Depression-prone individuals also show a higher level of inhibited aggression and a lower level of manifest aggression than healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjustment Disorders↗

PubMed1983

Deprivation in childhood and life events in depression.

The study reported in this article is part of a larger investigation of life events and depression approached from a multifactorial point of view. In total 83 patients, participating in a larger study of depression, have also participated in a study of parental rearing practices and of life events in relation to the onset of depression. From these patients information has also been obtained concerning the loss of a parent before the age of 15. In the present study patients (n = 33) who had been reared by rejecting mothers have been compared for the report of life events with patients (n = 28) reared by fewer stressful events than stimulated patients before becoming depressed. The results supported this hypothesis to some extent. In fact, the rejected patients reported that they experienced fewer events, however categorized than the stimulated ones. In this series 11 patients had lost one parent before the age of 15. No significant or otherwise consistent differences were found compared with those patients who had not lost parents during childhood. The results related to rearing practice are discussed in terms of individual vulnerability. Alternative explanations are also mentioned.

Adult↗

PubMed1983

Parental rearing behaviour and personality characteristics of depressed patients.

Within the framework of a large and ongoing study of depression in its biological, clinical, psychological and social aspects, 141 patients of both sexes in the age range 21 to 65 years participated in a study of parental rearing practices and personality characteristics. The perceived parental rearing behaviour was assessed by means of a specially constructed inventory (EMBU), and the personality characteristics by means of a Swedish personality inventory, the KSP, which had previously been shown to measure relatively stable personality characteristics. Several important correlations emerged between parental rearing practices and personality traits. In particular, power assertive practices and psychological types of discipline (shaming, guilt-engendering) showed significant correlations with aspects of aggression and significant negative correlations with socialization. There was a good agreement between male and female patients in the judgement of the rearing behaviour of their fathers. However, female patients scored their mother as more abusive, whereas male patients scored them as more over-protective. On the whole, the rearing practices of the mothers were judged more negatively than those of the fathers. The findings of this study appear to be consistent with earlier results reported by other authors.

Adult↗

PubMed1983

Patterns of aggression in the personality structure of depressed patients.

The personality characteristics of 208 depressed patients of both sexes were studied by means of a Swedish personality inventory--the KSP--when the patients had recovered from the depressive syndrome. The patients in the study were divided into unipolars, bipolars, neurotic-reactive and "unspecified", i.e. those patients who did not meet the criteria for inclusion in any of the aforementioned groups. Female patients scored higher on variables of anxiety and psychasthenia and male patients scored higher on variables indicating distance preference and hostility. Several traits, in particular those reflecting aggression-out and hostility-out, appeared to be negatively correlated with age, whereas inhibition of aggression appeared to be positively related with age. Bipolar patients scored slightly differently from unipolars in many variables but none of the differences was significant. Neurotic-reactive patients distinguished themselves from the other in variables of aggression-out. Several interrelations between different personality characteristics and aspects of aggression have been investigated. Significant correlation could be shown between aspects of aggression and socialization, impulsiveness and aspects of anxiety. A positive correlation was shown between inhibition of aggression and social desirability, and both variables were shown to correlate with age. It is concluded that the difference in inhibition of aggression between "endogenous" and "non-endogenous" patients found in earlier studies might be due to a difference in age, and to the influence of social desirability.

Adult↗

PubMed1983

Pain as a symptom in depressive disorders. II. Relationship to personality traits as assessed by means of KSP.

The series included 140 hospitalized patients with depressive disorders, who were rated by means of the Comprehensive Psychopathological Rating Scale (CPRS). Furthermore, a personality inventory, KSP, was completed when the patients had improved markedly. Forty-six per cent of the patients were found to have pain as a symptom. The patients with pain were found to have more somatic anxiety, more muscular tension, more psychasthenia and more inhibition of aggression but no significant differences were found in guilt. Thus pain as a symptom in depressive disorders seems to be linked to muscular tension and the patients seem to have more introjected aggression while no evidence emerges indicating that pain could serve to relieve the feelings of guilt.

Adult↗

PubMed1983

Personality characteristics of depressed patients classified according to family history.

Personality traits were assessed in a series of 148 patients classified according to Winokur into depression pure disease (DPD), depression spectrum disease (DSD) and sporadic depression (SD) with the addition of a fourth group: family history positive-others (FH + .O) comprised of patients with psychiatric disorders among first-degree relatives other than those taken into account by Winokur. Personality was assessed by means of a Swedish inventory, the KSP, comprised of 15 subscales assumed to measure relatively stable traits. DSD patients appeared to be most deviant from the other groups in most variables. Statistically significant differences were obtained for the variable socialization, which measures the internalization of social rules on which the DSD patients scored lowest, and variables of aggression on which the DSD patients scored higher than all the others.

Adult↗

PubMed1983

Attempts to validate a classification of unipolar depression based on family data. Symptomatological aspects.

162 depressed patients, consecutively admitted to the Department of Psychiatry, Umeå University, were rated by means of the comprehensive psychopathological rating scale (CPRS) within a few days after their admission, and before any antidepressive treatment had been implemented. The same patients were later subdivided into groups according to the presence or absence of psychiatric illness among their first-degree relatives. Four groups were thus formed: depression pure disease (DPD), i.e., comprised of patients with only secondary cases of depression; depression spectrum disease (DSD), comprised of patients with secondary cases of both depression and alcoholism and antisocial personality among their first-degree relatives; positive family history-others (FH+.O), included those patients with first-degree relatives affected by other psychiatric disorders than those required for inclusion among the DSD; and finally, sporadic depression (SD), comprised of those patients who had no family loading at all. The results showed that the severity of illness was similar in all four groups. Only a few symptomatological differences emerged, and these related consistently to a higher frequency of symptoms of retardation (inability to feel, lassitude, and concentration difficulties) in the DSD group as compared to the SD group. No significant symptomatological differences occurred between patients in the DPD and DSD groups. It is concluded that a classification of unipolar patients based on family data does not predict the occurrence of various symptomatological patterns.

Adult↗

PubMed1983

Serum dopamine-beta-hydroxylase in diagnostic subgroups of depressed patients and in relation to their personality characteristics.

Serum dopamine-beta-hydroxylase (DBH) levels were assessed in 150 depressed patients of both sexes, with a mean age of 44.0 +/- 12.3 (SD) years. Patients were divided into unipolars (n = 46), bipolars (n = 25), neurotic-reactive (n = 46) and unspecified (n = 38) i.e., those who did not fit into any of the previous categories. According to their status 38 patients were psychotic and 104 clearly nonpsychotic at the time of the DBH assessment. Personality characteristics were assessed for the same patients when they had markedly improved from their depression. In line with previous findings bipolar patients were found to have slightly lower serum DBH values than unipolars, and psychotic patients slightly lower values than nonpsychotic. However, none of the differences among diagnostic groups or between psychotic and nonpsychotic patients was statistically significant. Weak negative correlations were found between serum DBH and the personality variables social desirability and indirect aggression, but an earlier finding of a positive correlation with the personality trait monotony avoidance, could not be confirmed. Owing to the large interindividual variations in serum DBH it is concluded that correlations between serum DBH and personality characteristics might be spurious and due to chance. This study does not support the assumption that significant differences in serum DBH might occur among subgroups of depressed patients.

Adjustment Disorders↗

PubMed1982

The genetics of depression. A family study of unipolar and neurotic-reactive depressed patients.

Sixty unipolar (23 male and 37 female) patients and 67 patients (25 male and 42 female) suffering from a neurotic-reactive depressive disorder, consecutively admitted to the Department of Psychiatry of Umeå University have participated in a family study aimed at identifying morbidity risks for psychiatric illnesses among first degree relatives (n = 437). Besides the classification of affective disorders used in Umeå for research purposes the patients have been classified, according to the ICD-9, DSM-III, age at onset (below or above 40 years), and the Winokur's classification of primary affective disorders. However, only the findings regarding the Umeå classification and the Winokur's classification are given in the present article. Of the patients 90% fulfilled Kendell's criteria for depression at the time of the investigation whereas the others were in a phase of remission when studied. The diagnosis of secondary cases were made without knowledge of the diagnoses of the probands. Among relatives of unipolar probands only two secondary cases of bipolar affective disorder were found--one among parents, and one among siblings (MR% 1.1 and 0.6 respectively). The overall morbidity risk for affective disorders (MR% 22.8 among parents and 15.5 among siblings) proved to be higher than in previous studies. In the families of neurotic-reactive patients the morbidity risk for bipolar affective disorders was also very low (MR% 1.0 among parents and 0.7 among siblings), whereas the overall MR% for affective disorders proved to be surprisingly high (12.1 among parents and 6.7 among siblings). No increased risk for schizophrenia or alcoholism was found among the relatives of either group. When the relatives were divided according to their sex no clear-cut difference in morbidity risk emerged when fathers and brothers were compared with mothers and sisters but alcoholisms occurred more frequently in male relatives. Preliminary findings in second degree relatives suggest that secondary cases of affective disorders might occur among second degree relatives of patients classified as suffering from "sporadic depression" according to Winokur's classification.

Adjustment Disorders↗

PubMed1982

Genetic vulnerability for depression and life events.

In the last decades there has been an increased interest in studies of life events and depression. Although evidence has accumulated suggesting that life events might be relevant for the occurrence and development of depression, their pathogenic role is still poorly understood. In the present study, we have investigated whether a possible interaction exists between external events and biological vulnerability for depression. On the basis of an intensive family study, 128 depressed patients, consecutively admitted to the department of psychiatry of Umeå University Hospital have been divided into 2 groups, those suffering from 'depression pure disease' (i.e. those with a family loading for affective disorders, n = 48) and, those suffering from 'depression sporadic disease' (i.e. those without any heredity for affective disorders, n = 80) according to Winokur's classification. The occurrence of life events has been assessed in each patient by means of a semistructured interview. The mean number of events experienced by the patients in the two groups proved to be similar during the different time periods taken into account, and the mean number of events per patient was similar to that found by other authors who studied life events and depression. None of the categorizations used to group the life events discriminated between the groups. It is concluded from this study that genetic vulnerability for depression does not enhance an individual's vulnerability for stressful events.

Adult↗

PubMed1981

Transcultural aspects of depressive symptomatology.

The following is a presentation of the first results of a cross-cultural study of depressive symptomatology, within the framework of a larger research project which is still in progress. Southern Italian and northern Swedish depressed patients completed a self-rating scale for depression and were rated by the doctors using a subscale of the Comprehensive Psychological Rating Scale. In the doctors' ratings Italian patients scored higher for variables referring to motor retardation and hypochondriasis, and Swedish patients for variables referring to inability to feel and agitation. These findings were in line with expectations. In contrast, in the self-ratings Swedish patients scored higher for the variables weight loss, tachycardia and agitation and Italian patients for hopelessness and loss of interest and dissatisfaction. This discrepancy between results in self-ratings and doctors' ratings might reflect cultural differences either in the way patients in the two countries are able to express verbally their symptoms or in the way doctors from the two countries give weight to different symptoms. Taking the results of the two ratings together as a general measure of the severity of the depressive disorder, patients in the two places appeared to be quite alike. Since the two centers are engaged in comprehensive investigations of depressed patients, the last-mentioned finding suggests that the populations in the two centers are comparable as concerns severity.

Adult↗