Search PubMed⌕ Search

Biomedical subjects

M L Bruce

Publications and source records attributed to M L Bruce.

53 records · Page 3Linked to original sources
PubMed1992

Differences in the effects of divorce on major depression in men and women.

OBJECTIVE: The authors examined the relationship between marital disruption and major depressive episodes. METHOD: The analyses were based on longitudinal, community-based data from the New Haven Epidemiologic Catchment Area (ECA) program on respondents 18-60 years old. The presence and history of major depression was assessed by using the National Institute of Mental Health Diagnostic Interview Schedule. RESULTS: Martial disruption was associated with higher prevalence rates of major depression in both men and women, but only men had a greater risk of a first-onset major depression. Differences between men and women in rates of major depression were observed only among married subjects. CONCLUSIONS: These findings suggest that the relationship between marital disruption and major depressive episode differs for men and women. They also provide further evidence that differences between men and women in rates of depression vary by marital status.

Adolescent↗
PubMed1991

Poverty and psychiatric status. Longitudinal evidence from the New Haven Epidemiologic Catchment Area study.

We assessed the effect of poverty on psychiatric status using two waves of New Haven (Conn) Epidemiologic Catchment Area data. Poverty was defined using federal poverty guidelines; psychiatric status was assessed by the Diagnostic Interview Schedule (DIS). When examining the course of healthy respondents at the first interview, respondents in poverty had a twofold-increased risk (controlling for demographic factors) for an episode of at least one DIS/DSM-III Axis I psychiatric disorder. Rates of most specific psychiatric disorders were comparably higher for respondents meeting poverty criteria compared with those not in poverty, although these differences were not always statistically significant. The effects of poverty did not differ by sex, age, race, or history of psychiatric episodes.

Adolescent↗
PubMed1990

Factors associated with 1-year outcome of major depression in the community.

Evidence from outcome studies of major depression indicates a high rate of relapse and chronicity, and that prior chronicity, recurrent episodes, and the presence of psychosocial stressors are associated with a poor outcome. However, the generalizability of these findings is limited because most studies have focused on treated samples; thus, these studies may have been biased toward more chronic or severe illnesses. In prospectively surveying a large probability sample of the general population, the Epidemiologic Catchment Area program offers the opportunity to investigate prognosis without selection bias. In this study, the Epidemiologic Catchment Area subjects with a diagnosis of Major Depressive Disorder at first interview (n = 423) were categorized according to their diagnostic status 1 year later. The results confirmed a high rate of nonrecovery, with clinical features associated with a poor outcome that resembled those identified in previous clinical studies. Overall, clinical factors were more important prognostically than were sociodemographic characteristics. However, there was some evidence that a poorer outcome in older women may partially explain the greater female prevalence of depression in the community.

Adolescent↗
PubMed1990

Birth-cohort changes in the rates of mania.

Secular changes in the rates of mania have been reported in the relatives of affectively ill patients, and the present study is an independent replication of these findings in a large probability sample of a community. Data from the five U.S. sites of the National Institute of Mental Health's Epidemiologic Catchment Area study (ECA), a community survey of adults, are presented. A total of 17,827 respondents were divided into eight birth cohorts, each spanning a 10-year interval. Actuarial life-table analyses showed a greater cumulative risk of mania for white men and women from the three most recently born cohorts (i.e., those born after 1935). The Wilcoxon test for homogeneity indicated an overall significant difference by birth cohort. These findings in a community sample are consistent with those previously reported in relatives of affectively ill patients. The results support the hypothesis that birth cohort changes have occurred in the risk of mania and that the risk was greatest in the post-1935 cohorts.

Adult↗
PubMed1990

Depressive episodes and dysphoria resulting from conjugal bereavement in a prospective community sample.

Using three waves of interviews from the New Haven Epidemiologic Catchment Area Program, the authors contrast the extent and nature of depressive episodes and dysphoria between newly bereaved (N = 39) and married (N = 1,047) respondents age 45 and older. Bereavement greatly increased the risk of both conditions. This observation did not appear to be an artifact because psychosocial risk factors were similar for the bereaved and married groups. Bereavement increased the risk for a depressive episode more among respondents who reported no prior dysphoria than among those who did. Among those meeting criteria for depression, the bereaved reported symptoms similar to those of the married group except for significantly fewer reports of guilt.

Adult↗
PubMed1989

Reliability of self-reported age at onset of major depression.

Reliability of self-reported age at onset of major depressive disorder was studied in a sample of 335 subjects who were ascertained from a large epidemiologic survey conducted in several U.S. communities and who were interviewed blindly at two different times. Reliability was generally good for these subjects who met DSM-III criteria for depression at two interviews. A large proportion of the variability in the difference of test-retest values can be accounted for by recency of last episode of depression and interactions of age with duration of illness, having been treated for a mental health problem, and comorbidity of other mental disorders. Interactions between duration and comorbidity and between geographic region and treatment were also significant. Contrary to previous studies which do not consider the interval between current age and age at onset and which suggest that reliability diminishes with age, our findings show that older respondents tend to systematically decrease and not increase age at onset across the two interviews. These findings do not support the hypothesis that recently reported secular changes in major depression, including a decreased age at onset and higher rates in younger as compared to older cohorts, can be explained by a differential reporting effect. Furthermore, the findings suggest that factors which contribute to variability in an individual's age at onset should be incorporated in genetic and clinical studies of major depression.

Age Factors↗
PubMed1989

The prevalence of major depression in black and white adults in five United States communities.

There have been inconsistent findings on race differences in the rates and nature of depression, which are probably due to methodological differences between studies. Data are presented on the prevalence of major depression in white and black adults from the Epidemiologic Catchment Area Study, which examined a large community sample of five United States sites using diagnostic criteria based on the American Psychiatric Association Diagnostic and Statistical Manual, Third Edition. A total of 16,436 adults living in New Haven (Connecticut), Baltimore (Maryland), St. Louis (Missouri), the Piedmont area of North Carolina, and Los Angeles (California) were surveyed in 1980-1983. In the five sites, age-adjusted analyses by site and sex did not show any consistent black excess in lifetime prevalence or six-month prevalence; white men as compared with black men in particular tended to have slightly higher prevalence of major depression. At all sites, in the 18-24 years age group, black women as compared with white women showed a trend for higher six-month prevalence. White men in the 18-24 years age group showed a trend for higher six-month prevalence than black men. In New Haven, Baltimore, and the Piedmont area of North Carolina, logistic regression analyses of lifetime prevalence (by site and sex) showed no significant or consistent interaction of race with household income or age. Controlling for age and household income, whites tended to have higher lifetime prevalence than black at each of these three sites, regardless of sex.

Adult↗
PubMed1989

Psychiatric disorders and 15-month mortality in a community sample of older adults.

The relation between psychiatric disorders, defined by the Diagnostic Interview Schedule (DIS), and mortality over 15 months is compared in 3007 adults age 55 and over in the New Haven Epidemiologic Catchment Area (ECA) project. Our results indicate that the odds of dying are more than four times greater for individuals with affective disorders than for others in the sample, controlling for age, sex, and physical health. Cause of death is also examined. There were no suicides or deaths from external causes.

Aged↗
PubMed1988

Affective disorders in five United States communities.

Results on the age/sex specific prevalence of DSM-III affective disorders from the NIMH Epidemiologic Catchment Area Study (ECA), a probability sample of over 18,000 adults from five United States communities, are presented. The cross-site means for bipolar disorder ranged from 0.7/100 (2 weeks) to 1.2/100 (lifetime), with a mean age of onset of 21 years and no sex difference in rates. The cross-site means for major depression ranged from 1.5/100 (2 weeks) to 4.4/100 (lifetime), with a mean age onset of 27 years and higher rates in women. The cross-site means for dysthymia, a chronic condition, was 3.1/100 with a higher rate in women. There was reasonable consistency in prevalence rates among sites. The implications of these findings for understanding psychopathology are discussed.

Adolescent↗
PubMed1988

Factors affecting the utilization of specialty and general medical mental health services.

This study compares the extent to which need, predisposing, and enabling factors affect the use of mental health services in the specialty and general medical health sectors during a 6-month period. Data are drawn from the first wave of interviews of the Epidemiological Catchment Area (ECA) project at the Yale University site. The results indicate that 1) in the general population, factors affecting use of the two sectors differ; 2) among those using any mental health services, factors affecting use of the two sectors differ; 3) indicators of need have the strongest relationships with utilization; and 4) the effects of predisposing and enabling factors are contingent upon the presence of need.

Adult↗
PubMed1988

The epidemiology of dysthymia in five communities: rates, risks, comorbidity, and treatment.

Data from a survey of five U.S. communities showed that dysthymia affected approximately 3% of the adult population. It was more common in women under age 65, unmarried persons, and young persons with low income and was associated with greater use of general health and psychiatric services and psychotropic drugs. Dysthymia had a high comorbidity with other psychiatric disorders, particularly major depression; only about 25%-30% of cases occur over a lifetime in the absence of other psychiatric disorders. The findings suggest that although the onset and highest risk periods of major depression and bipolar disorder are in young adulthood, a residual state of dysthymia occurs in middle and old age.

Adult↗
PubMed1987

The relationship between demographic factors and attitudes toward mental health services.

Considerable effort has been exerted in recent years toward educating the public concerning mental illness and the efficacy of various treatment modalities. Most previous studies of attitudes have focused solely on attitudes toward the mentally ill. In this study we investigated attitudes toward mental health services and found that most people are positively disposed toward the use of these services. Attitudes toward the use of mental health services were affected by the age, sex, race, education, and income of the subjects. In general, differences of attitude lie in the direction that would tend to inhibit utilization among those most at risk.

Adolescent↗
PubMedDate not supplied

Social functioning in community residents with depression and other psychiatric disorders: results of the New Haven Epidemiologic Catchment Area Study.

Social functioning was compared among 4913 community participants with current depression, past depression, other psychiatric disorders and no psychiatric history, from the New Haven Epidemiologic Catchment Area Wave I survey. Respondents with current major depressive disorder (1.5%) (based on the Diagnostic Interview Schedule) reported significantly poorer intimate relationships and less satisfying social interactions than respondents with past depression or other current disorders. Respondents with no psychiatric history (77%) reported significantly more active and satisfying social interactions than persons with any psychiatric disorder. These social functioning and depression associations were similar among males and females, and corroborated results from patient samples.

Adolescent↗