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PubMed1997

Depression among Swedish adolescents measured by the self-rating scale Center for Epidemiology Studies-Depression Child (CES-DC).

The self-report questionnaire Center for Epidemiological Studies-Depression Child (CES-DC) was used for screening depression in Swedish 16-17 year olds during their first year in high school. Completed questionnaires were produced by 2272 students (92% of the population). The mean score was 13.2 (boys 9.9; girls 16.5). Factor analysis gave the same factors for boys and girls with a strong main factor for depressed mood. High scores of 30 or above were found in 240 cases (10.3%). Of those, 204 (85%) and the same number of controls with low scores were interviewed with the Diagnostic Interview for Children and Adolescents (DICA-R-A). Depressive diagnosis during the last year was confirmed in 71% of high scores and 15% of low scorers. Beck's depression inventory with cut off at score 16 was used in the same material with equal result. Used with high cut off scores the CES-DC was specific enough for discovering depressive disorder.

Adolescent↗
PubMed1988

Self-cognitions, stressful events, and the prediction of depression in children of depressed mothers.

In a preliminary effort to integrate cognitive, life stress, and interpersonal approaches to vulnerability to depression, children's cognitions about themselves, their stressful life events, and the interaction of self-cognitions and life events were tested as predictors of depression. Children of normal, medically ill, and bipolar and unipolar depressed mothers were assessed initially and 6 months later for diagnostic status using the Kiddie-SADS interview. As predicted, Piers-Harris self-concept scores and interview-assessed children's stressful life events significantly predicted changes in depression status over the 6-month follow-up. Stressors and the interaction of stressors and self-concept also predicted changes in diagnosis of nonaffective disorders. A self-schema measure of accessibility of negative self-cognitions, known to be mood-dependent, failed to add to the prediction of depression severity. The results are consistent with a model of depression vulnerability that emphasizes cognition about self-worth and self-efficacy as mediators of the impact of stressful events, and we speculate that such self-schemas are acquired in part in the context of parent-child relationships. Recommendations are given for further studies of the acquisition and the mechanisms of self-schemas.

Adolescent↗
PubMed2001

Methodological aspects in the assessment of severity of depression by the Hamilton Depression Scale.

Observer-rating scales are used for the evaluation of drug trials in depression. One of the most widely used depression rating scales is still the Hamilton Depression Scale (HAMD), which was developed at the time when the first antidepressants were becoming available. Due to its construction it seems to have a specific focus on drug effects of classical antidepressants. As a result of different methodological analyses such as principal component analysis, the Rasch model and facet analysis, a differentiation between core symptoms reflecting the severity of depression and additional symptoms describing other aspects of the symptomatology of depression seems meaningful. The use of the HAMD 6-item score, described primarily by Bech, as the main efficacy criterion in antidepressant drug trials gives a fair estimation of drug-induced changes of severity of depression and avoids bias such as the well-known bias of the HAMD total score in favour of tricyclic antidepressants. This is demonstrated by the evaluation of two sertraline-amitriptyline comparative studies.

Antidepressive Agents↗
PubMed2003

Deceased, disabled or depressed--a population-based 6-year follow-up study of elderly people with depression.

The prognosis of depression in elderly people is reported as poor, with high mortality and high rate of non-recovery. The aim of this study was to investigate the outcome after 6 years in a broader perspective. In addition to the risk of dying, we also estimated the risk of moving to long-term care, and having a depression in a re-screening event after 6 years. In 1993, a screening event for depressive symptoms using the Hopkins Symptom Checklist (HSCL-25) was carried out on 1215 subjects aged 65 years and older living in a health care district in Karlstad, Sweden. The study population was divided into a high score, a low score and a dropout group. A re-screening of the same population was carried out in 1999. Logistic regression analysis was used for calculating odds ratios for the selected end-points adjusted for age, gender, civil status and occurrence of physical illness. The adjusted odds ratios for dying for the high score group were 2.5 (95% CI 1.5-4.4) and for any of the end-points 6.1 (95% CI 3.5-10.8) compared with the low score group. Nearly three-quarters of the subjects in the high score group were deceased, depressed or had moved to long-term care after 6 years. The prognosis was poor for depressed elderly people despite not having more physical illness. It is believed that the poor outcome is due to an additive effect of depression on the total medical disease burden.

Aged↗
PubMed2003

Assessment and prevalence of depression in women 45-55 years of age visiting gynecological clinics in Poland: screening for depression among midlife gynecologic patients.

The aims of the Polish survey were to assess efficacy of screening for depression in gynecological practice and to estimate prevalence of depressive disorders in midlife women visiting gynecologists. The study included 2262 female outpatients aged 45-55, who were screened by 120 gynecologists throughout Poland. Patients completed the Beck's Depression Inventory (BDI) and were assessed by gynecologists to verify the presence of symptoms of a current Depressive Episode according to ICD-10 diagnostic criteria. Patients who obtained a score of 12 points or more on the BDI were referred for psychiatric evaluation, including the modified version of Mini International Neuropsychiatric Interview (MINI). The study showed that gynecologists in Poland are able to perform screenings for depression effectively in outpatient settings. Results also suggested that about 19% of women aged 45 to 55 years visiting gynecologists may suffer from depressive disorders.

Ambulatory Care Facilities↗
PubMed2005

Individual, family, school, and community risk and protective factors for depressive symptoms in adolescents: a comparison of risk profiles for substance use and depressive symptoms.

This study examines the relationship between adolescent depressive symptoms and risk and protective factors identified for substance use. A questionnaire, developed to measure these factors in a young person's community, family, school, peer group, and individual characteristics for substance use, was used to assess associations with self-reported depressive symptoms. Data were provided by a representative sample of 8984 secondary school students in Victoria, Australia. The prevalence of depressive symptoms was 10.5% (95% CI 9.2,12.0) for males and 21.7% (95% CI 20.3,23.7) for females. Depressive symptoms were associated with factors in all domains, with the strongest associations in the family domain. Strong relationships were found between the number of elevated risk and protective factors and depressive symptoms, maintained after adjusting for substance use. Patterns of associations were similar for users and nonsubstance users. The findings indicate that prevention programs targeting factors for substance use have the potential to impact on depression.

Adolescent↗
PubMed2005

Comparative efficacy of cognitive behavioral therapy, fluoxetine, and their combination in depressed adolescents: initial lessons from the treatment for adolescents with depression study.

Adolescents with major depressive disorder (MDD), their families and clinicians experience significant challenges when weighing the potential risks versus benefits of available choices in the treatment of MDD. Although MDD is highly prevalent in adolescents and is associated with marked suffering, impairment and risk of suicide, the scientific data regarding the safety and efficacy of treatments for pediatric depression are limited. Controlled clinical trials have provided support for the use of psychotherapy and fluoxetine for the treatment of pediatric depression, but until recently no information on the comparative efficacy of these recommended interventions alone or in combination was available. The Treatment for Adolescents with Depression Study provides a very important therapeutic advance in the field by convincingly showing that combination treatment with cognitive behavioral therapy and fluoxetine has the best benefit to risk ratio for adolescents with moderate to severe depression, and is superior to monotherapy. Moreover, the study results confirm that fluoxetine alone is effective in the treatment of depressed adolescents.

Adolescent↗
PubMed1990

Sleep, gender, and depression: an analysis of gender effects on the electroencephalographic sleep of 302 depressed outpatients.

Gender-related differences in electroencephalographic (EEG) sleep were examined in 151 pairs of men and women with major depression, all outpatients, matched for age and severity of depression. Across five decades (age 21-69), depressed men had less slow-wave sleep than did depressed women. Gender differences were small with respect to visually scored measures of slow-wave sleep time and percent, but moderate for gender differences in automated measures of slow-wave density. The time constant of the polygraph preamplifier significantly affected both visually scored and automatically scored slow-wave sleep. Other measures such as REM sleep latency, first REM period duration, sleep efficiency, and early morning awakening, showed robust age effects, but no main effects for gender or gender-by-age interactions. Gender effects on slow-wave sleep and delta-wave counts in depression parallel gender effects seen in healthy aging. The possibility of occult alcohol use by depressed male outpatients cannot be definitely excluded as a partial explanation of the current findings. However, covarying for past alcohol abuse did not negate the statistical significance of the observed gender effects on slow-wave sleep and delta-wave density. The possibility of gender differences in slow-wave regulatory mechanisms is suggested, but similarity in temporal distribution of delta-wave density between the first and second non-rapid-eye-movement (NREM) periods does not support gender differences in slow-wave sleep regulation.

Adult↗
PubMed1995

Electroencephalographic sleep profiles in single-episode and recurrent unipolar forms of major depression: I. Comparison during acute depressive states.

The current study was conducted to examine if recurrent depression is associated with more severe disturbances of all-night EEG sleep profiles than single-episode depressions. Unmedicated sex- and age-matched groups of 22 single-episode (SE) and 44 recurrent unipolar (RU) outpatients with DSM-III-R/SADS/RDC major depression underwent 2 consecutive nights of EEG sleep recording. Multivariate analyses of covariance (MANCOVAs) and/or analyses of covariance (ANCOVAs) were performed on six sets of sleep measures. Recurrent unipolar depression was associated with significantly increased phasic REM sleep, as well as increased REM counts on the second night of study. Recurrent depression also was associated with significantly poorer sleep efficiency, although the groups did not show consistent differences in sleep architecture or slow-wave sleep. Our findings generally support the hypothesis that recurrent depression is associated with a more severe neurophysiologic substrate than phenotypically similar SE cases. Results are, for the most part, compatible with Post's (1992) model of illness progression, particularly with respect to greater disturbances of state-dependent sleep abnormalities in the RU cases. Longitudinal studies are needed to confirm the evolution of such changes prospectively.

Acute Disease↗
PubMedDate not supplied

Depression and depressive symptoms in smoking cessation.

Previous findings from a smoking cessation trial showed that smokers with a history of major depression had lower success rates than smokers without a depression history. In an attempt to explain the worse outcome observed for smokers with a history of depression, postcessation data obtained from subjects randomly assigned to the placebo condition were examined further. It was observed that in the first week of a behaviorally oriented treatment program, the frequency and intensity of psychological symptoms, particularly depressive mood, were higher among smokers with past depression, and that this discomfort was related to treatment outcome. Interventions designed to prevent dysphoric symptoms during the acute withdrawal period may improve smoking cessation outcome for smokers with a history of major depression.

Adult↗
PubMed1984

Plasma prolactin changes following fenfluramine in depressed patients compared to controls: an evaluation of central serotonergic responsivity in depression.

In an attempt to evaluate the responsiveness of the serotonergic neurotransmitter system in depression, fenfluramine, a serotonin releasing agent, was administered to 18 depressed patients and 10 controls, and placebo was administered to 16 of the depressed patients in a double-blind paradigm. Plasma prolactin levels were measured prior to and for five hours following fenfluramine. Fenfluramine produced a significant increase in prolactin in both patients and controls. However, the prolactin response to fenfluramine whether measured as an absolute increase or percent increase from baseline was significantly less in depressed patients than controls. This difference remained equally statistically significant when age-and-sex-matched pairs of depressed patients and controls were compared. These results suggest that the central serotonergic system is less responsive in depressed patients than controls.

Adult↗
PubMed1990

Differentiating major depression from adjustment disorder with depressed mood in the medical setting.

Although the psychiatric consultant in the general hospital setting is frequently called on to distinguish major depression from adjustment disorder, no studies to date have examined whether the two diagnoses are in fact distinguishable. Analysis of computerized data base records from 944 cases seen by psychiatric consultants from 1981-1987 revealed 59 cases of major depression and 130 cases of adjustment disorder with depressed mood. Patients with major depression were more likely to be older (p less than 0.001), widowed (p less than 0.001), and living alone (p less than 0.005). Patients with adjustment disorder with depressed mood received higher ratings on Axis IV (p less than 0.01), and lower severity of illness ratings (p less than 0.001) were seen later in the hospital stay (p less than 0.05), and they were more likely to be rated by the consultant as improved by the time the case was terminated (p less than 0.001). The results suggest that the two disorders may be distinguished in the consultation population and that adjustment disorder with depressed mood may have descriptive validity in the medical inpatient setting.

Adaptation, Psychological↗
PubMed1984

Anxious depressions. Clinical, family history, and naturalistic outcome--comparisons with panic and major depressive disorders.

Patients with anxiety and depressive states were divided into 4 groups: those with panic attacks only, those with panic disorder and secondary depression, those with depression and secondary panic attacks, and those with depression only. Clinical and familial differences between the groups are described. Patients with both depression and panic attacks had the poorest outcome, and were most likely to be chronically depressed.

Adult↗
PubMedDate not supplied

Depressive symptoms in bulimic, depressed, and non-psychiatric control subjects.

Depressive symptoms and syndromes occur commonly in bulimia--an observation which has prompted some investigators to hypothesize an association between bulimia and major affective disorder. However, it has also been suggested that the character of the depressive symptoms in bulimic patients differs from that found in patients with major depression--arguing against an association between the two disorders. To test this possibility, we compared item scores on the Hamilton Rating Scale for Depression among 45 bulimic patients, 21 patients in treatment for major depression, and 27 non-psychiatric control subjects. The bulimic and depressed patients proved indistinguishable on virtually all items, whereas both groups were readily distinguishable from non-psychiatric control subjects.

Adult↗
PubMed1995

Do differences in sleep architecture exist between depressives with comorbid simple phobia as compared with pure depressives?

Sleep records from 19 subjects with major depression and comorbid simple phobia were compared retrospectively with 25 patients with major depression alone and 25 normal controls. Groups were matched for age and gender; depressed subjects were matched for severity of depression. All subjects had been free of psychotropic medications at least 2 weeks when recorded. Sleep variables were analysed using one-way ANOVA. Both depressed groups had significantly longer sleep latency than normal controls. Depressed patients with and without simple phobia showed no differences in sleep architecture.

Depressive Disorder↗
PubMed1983

Brain purinergic activity linked with depressive symptomatology: hypoxanthine and xanthine in CSF of patients with major depressive disorders.

The purine metabolites hypoxanthine and xanthine were analyzed in cerebrospinal fluid (CSF) of 70 patients with major depressive disorders (diagnosed according to Research Diagnostic Criteria) and, for reference, in 26 nonpsychiatric individuals. In the patient group, levels adjusted by analysis of covariance to same sex, age, height, and weight were univariately and multivariately correlated with both depressive subdiagnoses and individual depressive symptoms. Results indicate that raw CSF levels in depressed patients are significantly correlated with the four variables used in adjustment (for hypoxanthine mainly negatively with height; for xanthine mainly positively with age). Hypoxanthine and xanthine both appear to be linked with the expression of depressive symptomatology: lower levels of hypoxanthine are associated with anger and suicidal tendencies, and higher levels are related to memory disturbance; lower xanthine levels characterize patients with subjective feelings of depression, and in patients with higher levels appetite is poor.

Adult↗
PubMed1991

Relationship of depression and cognitive impairment to self-injury in borderline personality disorder, major depression, and schizophrenia.

Self-injury was studied in 64 adults with borderline personality disorder, major depression, or chronic paranoid schizophrenia. Subjects were rated according to acute depression, chronic depression, self-injurious behaviors, and neurocognitive deficits, as measured by cognitive function examination. Borderline patients showed more self-injurious behaviors and more chronic depressive symptoms than the major depression or schizophrenia groups. Self-injury was not significantly correlated with acute or chronic depression in any group, but self-injury was correlated with neurocognitive deficits in borderline and schizophrenic groups. The results are explained in the context of a neurocognitive model of psychotic thought process in borderline disorder and schizophrenia.

Adaptation, Psychological↗
PubMedDate not supplied

Prolactin response to thyrotropin-releasing hormone in schizoaffective depressed compared to depressed and schizophrenic men and healthy controls.

Biological tests may help clarify the relationship of schizoaffective disorder to major depressive disorder (MDD) and schizophrenia (SCZ). Thyrotropin-releasing hormone (TRH), 500 micrograms, was administered intravenously to eight schizoaffective depressed (SD), ten SCZ, 23 MDD patients and 43 healthy controls (HC), all males, ages 20-66 years and drug-free. Research Diagnostic Criteria (RDC) were utilized for establishing diagnoses, Hamilton Rating Scale for Depression (HRSD) total scores were used for assessing depressive symptoms. There were no differences in dmax PRL (post-TRH prolactin peak minus baseline, mean +/- SD) amongst SD, SCZ and HC groups (27.3 +/- 5.2, 28.8 +/- 5.4 and 31.5 +/- 5.6 ng/ml respectively). Mean dmax PRL in MDD was significantly lower than each of the other three groups (17.1 +/- 2.2 ng/ml, P less than 0.05 for all). The essentially normal PRL response to TRH in SD, significantly different from MDD but similar to SCZ parallels our previous observations on the pattern of thyrotropin (TSH) response to TRH in the same diagnostic groups. These biological findings may be taken to indicate that schizoaffective disorder, depressed subtype, is closer to schizophrenia than to major depressive disorder. However, they cannot be considered definitive evidence to that effect since schizoaffective disorders are known to be quite heterogeneous, and since the utilized biological tests lack specificity.

Adult↗