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PubMed2004

Age, marital processes, and depressed affect.

PURPOSE: We examined age-cohort differences in the interrelationships among marital processes and depressed affect. DESIGN AND METHODS: We used data from individuals in first marriages that participated in the National Survey of Families and Households (NSFH). The NSFH interviewed one adult per household of a nationally representative sample. Participants were categorized into young (n = 2,289), middle-aged (n = 1,145), and older adult (n = 691) age cohorts. RESULTS: The three age cohorts did not differ on negative marital processes (NMP), but older adults scored significantly higher on marital satisfaction than young and middle-aged adults. Marital satisfaction mediated the link between NMP and depressed affect for young adults and older adults. NMP were more strongly related to depressed affect for young adults than middle-aged adults, whereas marital satisfaction was more strongly related to depressed affect for older adults than young adults. IMPLICATIONS: Our findings on age-cohort differences in the salience of marital processes to depressed affect are discussed in light of socioemotional selectivity theory.

Adult↗

PubMed1999

Recurrence in affective disorder: analyses with frailty models.

The risk of recurrence in affective disorder is influenced by the number of prior episodes and by a person's tendency toward recurrence. Newly developed frailty models were used to estimate the effect of the number of episodes on the rate of recurrence, taking into account individual frailty toward recurrence. The study base was the Danish psychiatric case register of all hospital admissions for primary affective disorder in Denmark during 1971-1993. A total of 20,350 first-admission patients were discharged with a diagnosis of major affective disorder. For women with unipolar disorder and for all kinds of patients with bipolar disorder, the rate of recurrence was affected by the number of prior episodes even when the effect was adjusted for individual frailty toward recurrence. No effect of episodes but a large effect of the frailty parameter was found for unipolar men. The authors concluded that the risk of recurrence seems to increase with the number of episodes of bipolar affective disorder in general and for women with unipolar disorder.

Age Distribution↗

PubMed1998

Stunting syndrome in broilers: effect of stunting syndrome inoculum obtained from stunting syndrome affected broilers, on broilers, leghorns and turkey poults.

Responses to stunting syndrome (SS) infective material obtained from affected broilers and administered per os were monitored for 3 wk in a fast-growing commercial broiler population, in slow-growing Leghorn chicks, and in turkey poults. At 2 and 3 wk, the size of the gastrointestinal tract (GIT) segments, the pH of the GIT contents, and the activities of digestive enzymes in the intestinal contents and of disaccharidases on the jejunum mucosae were determined. Inoculation affected the genetic stocks differently. In broiler chicks, growth and feed utilization were markedly reduced. In contrast, inoculation of Leghorns was accompanied by improved feed intake and growth rate. Performance of poults was affected only slightly, albeit significantly. The effect of inoculation on the pH of crop and intestinal contents in Leghorn chicks was opposite to that found in broiler chicks, i.e., a significant increase in the crop and small intestinal pH in the former vs a significant decrease in inoculated broilers. Although inoculation of the broiler chicks did not affect the pH in the proventriculus, in Leghorn chicks it was reduced by 25%. In poults, inoculation did not significantly affect GIT contents pH. The GIT segments were markedly enlarged in broiler chicks, whereas in Leghorn chicks the opposite trend was observed; namely, intestinal segment weights were significantly reduced. In poults, inoculation caused a reduction in the intestinal segments and gizzard weight at 3 wk. During this same period, the liver and pancreas relative weights were dramatically increased in broiler chicks. A higher relative heart weight at 2 wk was observed in broilers and poults; this trend persisted to Week 3 in poults but not in broiler chicks. In broiler chicks, a nonsignificant reduction was observed for all enzymes assayed at 3 wk and for chymotrypsin at 2 wk. In Leghorn chicks, inoculation was accompanied by a marked and significant increase in the activity of chymotrypsin during both periods. In poults, inoculation caused a marked increase in the activities of amylase during Week 2 and 3, and trypsin at 3 wk. Maltase and saccharase activities in the jejunum of broiler chicks were slightly depressed a t 2 and 3 wk, the depression being significant at 2 wk for maltase and at 3 wk for saccharase. In the Leghorn chicks, inoculation caused a twofold increase in the activities of both enzymes. As in Leghorns, inoculation of poults with SS infective material caused a marked increase in the activities of the disaccharidases. The different responses to SS inoculation in the different genetic stocks are discussed.

Animals↗

PubMed2004

Quantification of fetal microchimeric cells in clinically affected and unaffected skin of patients with systemic sclerosis.

OBJECTIVE: Fetal microchimerism has been hypothesized as a potential pathogenic mechanism for systemic sclerosis (SSc). This hypothesis was based on the clinical similarities between SSc and graft-vs-host disease and the identification of microchimeric cells in affected SSc tissues. The aim of this study was to compare the quantity of microchimeric cells in clinically affected and non-affected skin of female patients with SSc. METHODS: Fluorescence in situ hybridization (FISH) and real-time PCR were employed in paired skin biopsies obtained from clinically affected and unaffected areas from five female SSc patients with diffuse cutaneous SSc (dcSSC) and 10 healthy women. All women in the study had delivered a male fetus. RESULTS: FISH analysis revealed the presence of male fetal cells in 1/5 SSc patients (20.0%) compared with 0/10 healthy women (P = 0.0037), whereas quantification by real-time PCR revealed that all SSc samples were positive for male DNA compared with none of the controls. In the five patients with dcSSc, there were similar numbers of microchimeric cells in both affected and unaffected skin (P = 0.4) CONCLUSION: The presence of higher numbers of microchimeric cells in clinically unaffected SSc skin, before any clinically detectable evidence of sclerotic changes, suggests that an influx of microchimeric cells may precede the development of tissue fibrosis. This provides additional support to the hypothesis that fetal microchimerism may play a role in the pathogenesis of SSc.

Aged↗

PubMed1995

Vulnerability to delusions over time in schizophrenia and affective disorders.

This research used a prospective longitudinal design to study differences in vulnerability to delusions over time in 234 subjects with schizophrenia, schizoaffective disorder, or bipolar or unipolar affective disorder. Patients were assessed at three successive followups over a 7- to 8-year period. Over 60 percent of the schizophrenia and schizoaffective patients assessed experienced delusional activity at one of the three followups. Over 60 percent of the patients who initially had psychotic affective disorders also showed posthospital delusional activity. Significantly more schizophrenia patients than psychotic affective-disordered patients experienced consistent posthospital delusional activity at three successive followups. Unlike the schizophrenia subjects, affective patients showed a significant reduction in delusions after the first followup. After the initial acute psychotic episode that led to hospitalization, psychotic bipolar and unipolar affective patients showed a traitlike vulnerability to episodic delusional activity over time, but schizophrenia patients were vulnerable to more severe delusional activity and to more frequently recurring or sustained delusions. The study results question the views of several major theorists on the importance, persistance, and prognostic significance of delusions in schizophrenia.

Adult↗

PubMed1994

Norepinephrine and epinephrine levels in affected versus unaffected limbs in sympathetically maintained pain.

OBJECTIVE: To test the hypothesis that there is relative sympathetic hyperactivity in the affected limb in patients with sympathetically maintained pain syndromes by measuring serum norepinephrine and epinephrine in the affected versus the unaffected sides. DESIGN: Venous pool samples were drawn just proximal to the affected area and from an identical site on the unaffected side. Serum norepinephrine and epinephrine were measured by high-pressure liquid chromatography with electrochemical detection. SUBJECTS: Sixteen women and seven men with a mean age of 44.4 years diagnosed as having sympathetically maintained pain on the basis of a positive response to paravertebral block and a criteria-based diagnostic scheme. RESULTS: The serum norepinephrine level was significantly lower in the affected limbs than the unaffected limbs (p = 0.024). The serum epinephrine level was not significantly different. CONCLUSIONS: These results are not consistent with the hypothesis of segmental sympathetic hyperactivity in the affected limb in sympathetically maintained pain and support a hypothesis of peripheral receptor upregulation with pathologic response to circulating catecholamines. Other possible explanations are discussed.

Adult↗

PubMed2003

Identification of novel mutations of the CHST6 gene in Vietnamese families affected with macular corneal dystrophy in two generations.

PURPOSE: To report the clinical and genetic findings of Vietnamese families affected with macular corneal dystrophy (MCD) in 2 generations. METHODS: Two families, including 7 patients and 3 unaffected members, were examined clinically. Blood samples were collected. Fifty normal Vietnamese individuals were used as controls. Genomic DNA was extracted from leukocytes. Analysis of the carbohydrate sulfotransferase (CHST6) gene was performed using polymerase chain reaction and direct sequencing. RESULTS: The typical form of MCD was recognized in family B, in which sequencing of CHST6 gene revealed an nt 1067-1068ins(GGCCGTG) mutation (frameshift after 125V) homozygously in MCD patients and heterozygously in the unaffected members. Family N also showed clinical features of MCD, moderate in the mother but severe in the affected son. Sequencing revealed a single heterozygous Arg211Gln in the mother, compound heterozygous Arg211Gln+ Gln82Stop in the affected son, and heterozygous Arg211Gln mutation in the unaffected members. The identified mutations in these pedigrees were excluded from normal controls. CONCLUSIONS: The novel frameshift and compound heterozygous mutations might be responsible for MCD in the families studied. The phenotypic variation between affected parents and offspring was unclear. In family N, severe MCD phenotype seen in the affected son may be due the fact that he had an early stop codon mutation (Gln82Stop).

Adolescent↗

PubMed1993

The impact of parental affective disorder on depression in offspring: a longitudinal follow-up in a nonreferred sample.

OBJECTIVE: This study explored the effects of parental affective disorder on offspring in a nonreferred health maintenance organization 4 years after initial examination. METHOD: The sample, average age 18.5 years, included 91% of the 153 youngsters initially studied. The main instruments were structured diagnostic interviews scored according to criterion systems for both parents and children; assessment of the youngsters was blind to the previous assessment. RESULTS: Rates of major depressive disorder were higher in the children of parents with affective disorder (26%) compared with those whose parents had no disorder (10%). CONCLUSION: Depression and other parental affective disorders, as they occur in the community in parents who often are neither recognized nor treated, are associated with serious affective disorder in offspring. Clinical and preventive approaches for these offspring are needed and should be targeted to all families in which there is serious parental affective disorder, not just those who present for psychiatric treatment.

Adolescent↗

PubMed1993

A psychoeducational program for families of affectively ill children and adolescents.

OBJECTIVE: The objective of this study was to evaluate the acceptability, feasibility, and efficacy of a family psychoeducational program for the parents of affectively ill adolescents. METHODS: Sixty-two parents of 34 affectively ill adolescents received one 2-hour psychoeducational session that covered information about the diagnosis, course, and treatment of affective illness. Methods of coping with an affectively ill family member also were discussed. The view of depression as a chronic and recurrent illness was strongly emphasized. RESULTS: Participants showed improvement in knowledge about depression and in modification of dysfunctional beliefs about depression and its treatment. Almost all participants found the program both useful and interesting. CONCLUSIONS: These findings support the feasibility, acceptability, and to a modest degree, the efficacy of a family psychoeducational program for parents of affectively ill adolescents. Additional studies should address the impact of such programs on compliance with treatment, clinical outcome, and family life.

Adolescent↗

PubMed1996

Negative affect and cognitive biases in suicidal and nonsuicidal hospitalized adolescents.

OBJECTIVE: To examine the main and interactive effects of suicidal behavior and gender on negative affect and cognitive biases in hospitalized adolescents (N = 228) aged 13 to 18 years, identified as suicide ideators (n = 68), attempters (n = 90), and nonsuicidal (n = 70). METHOD: Standardized measures of negative affect (depression, anxiety, anger) and cognitive biases (hopelessness, self-concept) were administered upon admission. RESULTS: Suicide ideators reported significantly greater hopelessness and poorer self-concept than did nonsuicidal controls; suicide attempters did not differ from either group. Regression analysis indicated that negative affect and cognitive bias variables accounted for 48% of the variability in suicidal ideation; however, only anxiety and depression were uniquely related to suicidal ideation. Females reported greater depression severity and anxiety than did males; no interaction effects were evident. CONCLUSIONS: Suicide ideators and attempters may have different psychological profiles, with the former reporting greater cognitive biases than nonsuicidal adolescents. The findings regarding suicidal ideation support a mediational model in which negative views of the self and the future contribute to negative affect, and ultimately, suicidal ideation. An integrated assessment of suicidal ideation and affective and cognitive variables is recommended for early risk detection and treatment.

Adolescent↗

PubMed1998

Children of affectively ill parents: a review of the past 10 years.

OBJECTIVE: To review the literature investigating the effects of parental affective illness on children over the past decade. METHOD: A computerized search of articles published over the past 10 years was completed. Articles were reviewed and relevant studies are presented. RESULTS: Over the course of the past 10 years a number of longitudinal studies have confirmed that children of affectively ill parents are at a greater risk for psychiatric disorders than children from homes with non-ill parents. Life table estimates indicate that by the age of 20 a child with an affectively ill parent has a 40% chance of experiencing an episode of major depression. Children from homes with affectively ill parents are more likely to exhibit general difficulties in functioning, increased guilt, and interpersonal difficulties as well as problems with attachment. Marital difficulties, parenting problems, and chronicity and severity of parental affective illness have been associated with the increased rates of disorder observed in these children. CONCLUSION: The presence of depression in parents should alert clinicians to the fact that their children also may be depressed and therefore in need of services. J. Am. Acad. Child Adolesc.

Child↗

PubMed1981

Cholinergic challenges in affective illness: behavioral and neuroendocrine correlates.

The cholinergic-adrenergic balance hypothesis of affective disorders suggests that, in the areas of the brain that regulate mood, depression may represent a relative predominance of central cholinergic tone over adrenergic tone and that mania may represent the converse. Currently, converging lines of investigation from a number of independent groups suggest that affective disorder patients may have a central cholinergic receptor hypersensitivity that induces a vulnerability to affective and neuroendocrine disturbances. This article reviews the evidence for cholinergic mechanisms in the regulation of affective state and describes current research strategies using centrally active cholinomimetic agents to explore disturbances in affective disorder subjects.

Clinical Trials as Topic↗

PubMed1999

Mitchell B. Balter Award--1998. Pindolol and major affective disorders: a three-year follow-up study of 30,485 patients.

The role of serotonin autoreceptor antagonism in major depression has been a matter of intense debate in recent years. On the basis of animal experiments, it has been suggested that the blockade of this autoreceptor with pindolol during concomitant treatment with selective serotonin reuptake inhibitors (SSRIs) would result in a rapid and augmented antidepressant effect, but it has also been argued that the possible augmenting effect of pindolol is due to the beta-blocking properties of this drug. Results from the first human studies have also been controversial. We used a national computer-based central register to study the cumulative incidence of the use of beta-adrenergic receptor antagonists and antidepressant drugs, as well as the point prevalence of disability pensions as a result of major affective disorders (296, DSM-III-R; F30-F34, ICD-10) at the end of a 3-year follow-up period. Our results from a very large database (total N = 30,485) indicate that the use of pindolol is associated with a marked reduction (from 29% to 52%) in the prevalence of disability pensions resulting from major affective disorders when compared with the use of other beta-adrenergic receptor antagonists. The use of pindolol was associated with a slightly lower rate of antidepressant use when compared with other beta-adrenergic receptor antagonists and especially when compared with propranolol. The results suggest that long-term therapy with pindolol treatment augments the pharmacologic effect of antidepressant drugs (especially SSRIs) among patients with major affective disorders. The finding that patients receiving pindolol have a lower prevalence of disability pensions resulting from major affective disorders indicates that the prevalence of severe treatment-resistant major affective disorders could be decreased markedly by using pindolol as the first-choice beta-adrenergic receptor antagonist in the treatment of cardiovascular diseases whenever possible among those patients who have experienced at least one depressive episode and are receiving antidepressant treatment.

Adrenergic beta-Antagonists↗

PubMed1992

Bipolar II affective disorder in eating disorder inpatients.

We examined the association between affective disorders and eating disorders in 22 eating disorder inpatients who were interviewed using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version. The first series of 11 were interviewed as part of an interrater reliability study; the second series, done as follow-up to the first, consisted of 11 consecutive admissions. Overall, there were 15 bulimics and seven anorexics. Nineteen patients had a major affective disorder, and 13 (59%) had bipolar II affective disorder. Bipolar II affective disorder appears to be a common finding in hospitalized patients with severe persistent eating disorders.

Adult↗

PubMed1998

Progression of cerebral amyloid angiopathy: accumulation of amyloid-beta40 in affected vessels.

Cerebrovascular deposits of amyloid (cerebral amyloid angiopathy, or CAA) are generally asymptomatic, but in advanced cases, they can lead to vessel rupture and hemorrhage. The process of progression in CAA was studied by comparison of postmortem brains with asymptomatic ("mild") CAA to brains with the form of the disease associated with hemorrhage ("severe CAA"). Cortical and meningeal vessels were immunostained for beta-amyloid and examined by confocal microscopy and by systematic quantitative sampling. We focused on 2 quantitative parameters: the proportion of vessels affected by amyloid (a measure of amyloid seeding of vessels) and the amount of amyloid per affected vessel (a measure of growth of existing lesions). Surprisingly, there was no difference between the proportion of affected cortical vessels in mild and severe CAA (0.29 vs 0.32, p = 0.65), but rather an increase in the area of the 40 amino acid form of beta-amyloid per affected cortical vessel (198.5 +/- 38.7 vs 455.8 +/- 100.9 microm2/vessel, p < 0.007). Increasing doses (from 0 to 1 to 2 copies) of the apolipoprotein E epsilon4 allele were also associated with greater amyloid per vessel without change in the proportion of affected vessels within each class of CAA severity. These findings suggest that progression from asymptomatic to advanced CAA reflects progressive accumulation of amyloid in vessels previously seeded with amyloid, and that this process is selectively enhanced by apolipoprotein E epsilon4.

Aging↗

PubMed2004

The risk of celiac disease in 107 families with at least two affected siblings.

OBJECTIVES: Screening for celiac disease (CD) in the apparently healthy members of 107 nuclear families with two affected siblings (sib pair) and estimating the risk of CD in siblings and parents. METHODS: One hundred seven families from Sweden and southern Norway with at least two affected children were investigated. Frozen sera from 187 of the 192 healthy parents and from 94 of 95 siblings without diagnosed CD were examined for total immunoglobulin A (IgA) and anti-endomysial antibodies (EMA). Individuals with positive antibody titers underwent small intestinal biopsy. RESULTS: Positive test for EMA was found in 6 of 94 (6.3%) siblings without previously diagnosed CD and in 8 of 189 (4.2%) parents. CD was confirmed by small intestinal biopsy in all siblings and seven parents. The estimated risk for CD in multiply affected families was 26.3% for siblings and 12.9% for parents. An unexpected male preponderance was found among the new CD cases (10 males, 3 females). CONCLUSION: The risk of CD in the members of nuclear families with two affected children is approximately three times higher than that when only one child is affected. The high male preponderance of new cases is unexpected and could not be explained fully by more silent disease in males as compared with females. Considering the high level of knowledge about CD in these families, the number of undiagnosed cases is surprisingly high. The authors suggest that serologic screening should be offered to all first-degree relatives of patients with CD.

Adolescent↗

PubMed1995

Degeneration and aging affect the tensile behavior of human lumbar anulus fibrosus.

STUDY DESIGN: Samples of human lumbar (L3-L4) anulus fibrosus from four different anatomic sites (anterior outer, posterolateral inner), ranging from normal to severely degenerate, were studied in uniaxial tension and measured for water content. OBJECTIVES: To evaluate the effects of aging and degeneration on the tensile properties and hydration of the anulus fibrosus in a site-specific manner. The relationship between hydration and parameters of the tensile behavior were investigated. SUMMARY OF BACKGROUND DATA: Degeneration and aging have been shown to be related to dramatic changes in the composition and structure of the anulus fibrosus. The associated changes in the tensile, compressive, and shear properties of the anulus fibrosus have not been documented. Numerical studies using finite element models have attempted to simulate the degenerative process by incorporating estimated mechanical properties meant to represent the degenerate anulus fibrosus. Their results present findings that suggest that altered material properties of the anulus fibrosus affect the mechanics of the entire intervertebral disc. METHODS: Samples of human lumbar anulus fibrosus were classified by grade of degeneration based on a morphologic grading scheme. Multiple layer anulus specimens from four sites in the disc were tested in uniaxial tension under quasistatic conditions in a physiologic saline bath. The tensile modules, Poisson's ratio, failure stress and strain, the strain energy density to failure, and the corresponding hydration were determined for each sample. RESULTS: The Poisson's ratio, failure stress, and strain energy density of the anulus fibrosus were found to be affected significantly by degeneration, with some evidence of a sensitivity of the tensile modulus to grade of degeneration. All material properties were found to exhibit a significant and greater dependence on site within the disc than on degenerative grade. Weak correlations between aging and the Poisson's ratio and strain energy density were observed. Water content of anulus fibrosus tissue was not affected by degeneration or aging, although correlations with tensile properties were observed. CONCLUSIONS: The dramatic changes in morphology, composition, and structure that occur in anulus fibrosus with aging and degeneration are accompanied by specific variations in the tensile properties, which were generally small in magnitude. Position of the anulus fibrosus within the intervertebral disc, particularly in the radial direction, appeared to be the most important variable affecting anulus fibrosus tensile properties. This dependence on position did not change with either aging or degeneration. Results from the present study may be useful in future finite element models to assess how altered material properties of the anulus fibrosus during degeneration and aging may affect the mechanics of the entire intervertebral disc.

Adolescent↗

PubMed2003

Genetic association between the phospholipase A2 gene and unipolar affective disorder: a multicentre case-control study.

The co-segregation in one pedigree of bipolar affective disorder with Darier's disease whose gene is on chromosome 12q23-q24.1, and findings from linkage and association studies with the neighbouring gene of phospholipase A2 (PLA2) indicate that PLA2 may be considered as a candidate gene for affective disorders. All relevant genetic association studies, however, were conducted on bipolar patients. In the present study, the possible association between the PLA2 gene and unipolar affective disorder was examined on 321 unipolar patients and 604 controls (all personally interviewed), recruited from six countries (Belgium, Bulgaria, Croatia, Germany, Greece, and Italy) participating in the European Collaborative Project on Affective Disorders. After controlling for population group and gender, one of the eight alleles of the investigated marker (allele 7) was found to be more frequent among unipolar patients with more than three major depressive episodes than among controls (P<0.01); genotypic association was also observed, under the dominant model of genetic transmission (P<0.02). In addition, presence of allele 7 was correlated with a higher frequency of depressive episodes (P<0.02). These findings suggest that structural variations at the PLA2 gene or the chromosomal region around it may confer susceptibility for unipolar affective disorder.

Case-Control Studies↗