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Guidetti C, Serra G, Apicella M, Andracchio E, Iannoni ME, Trasolini M, Della Santa G, Maglio G, Vicari S. Childhood Clinical Features Preceding the Onset of Bipolar Versus Major Depressive Disorders During Adolescence. J Atten Disord 2024; 28:648-663. [PMID: 38327097 DOI: 10.1177/10870547231225819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To identify childhood psychopathological features that predict the onset of adolescent Bipolar (BD) versus Unipolar Major Depressive Disorder (UD) during adolescence. METHOD We analyzed clinical data from 495 juveniles diagnosed with DSM-5 UD (n = 359), and BD (n = 136), using bivariate analysis and multivariate logistic regression model. RESULTS BD subjects exhibited earlier onset of any psychiatric feature compared to UD. Antecedents associated with later BD were: oppositional defiant > specific phobias > ADHD > obsessive compulsive (OCD). Antecedents selectively associated with later UD were: social anxiety and separation anxiety. Factors significantly and independently associated with later BD diagnosis were: [a] emotional dysregulation at onset of the mood disorder; [b] first depressive episode with mixed features; [c] antecedent ADHD; [d] antecedent OCD, and [e] antecedent oppositional-defiance. CONCLUSION Identifying developmental differences in BD and UD symptoms can aid clinicians in early identification and treatment planning for bipolar disorder in youth.
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Affiliation(s)
- Clotilde Guidetti
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Giulia Serra
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Massimo Apicella
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elisa Andracchio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Elena Iannoni
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monia Trasolini
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giorgia Della Santa
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gino Maglio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
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2
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Sun K, Cao C. The effects of childhood maltreatment, recent interpersonal and noninterpersonal stress, and HPA-axis multilocus genetic variation on prospective changes in adolescent depressive symptoms: A multiwave longitudinal study. Dev Psychopathol 2024:1-12. [PMID: 38389485 DOI: 10.1017/s0954579424000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Based on a multiwave, two-year prospective design, this study is the first to examine the extent to which multilocus hypothalamic-pituitary-adrenal axis (HPA axis)-related genetic variants, childhood maltreatment, and recent stress jointly predicted prospective changes in adolescent depressive symptoms. A theory-driven multilocus genetic profile score (MGPS) was calculated to combine the effects of six common polymorphisms within HPA-axis related genes (CRHR1, NR3C1, NR3C2, FKBP5, COMT, and HTR1A) in a sample of Chinese Han adolescents (N = 827; 50.2% boys; Mage = 16.45 ± 1.36 years). The results showed that the three-way interaction of HPA-axis related MGPS, childhood maltreatment and recent interpersonal, but not noninterpersonal, stress significantly predicted prospective changes in adolescent depressive symptoms. For adolescents with high but not low HPA-axis related MGPS, exposure to severe childhood maltreatment predisposed individuals more vulnerable to recent interpersonal stress, exhibiting greater prospective changes in adolescent depressive symptoms. The findings provide preliminary evidence for the cumulative risk mechanism regarding gene-by-environment-by-environment (G × E1 × E2) interactions that underlie the longitudinal development of adolescent depressive symptoms and show effects specific to interpersonal stress.
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Affiliation(s)
- Kexin Sun
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Cong Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
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3
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Li C, Liu J, Ju Y, Liu B, Zhang Y. Multiple trajectories of depressive symptoms among Chinese in middle and late life: Characterization and risk factors. Int J Soc Psychiatry 2023; 69:1462-1471. [PMID: 37081758 DOI: 10.1177/00207640231164020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Depressive symptoms, which are continuously changing, are an essential manifestation of depression and can increase the risk of mental disorders and other diseases. Because the causes and cures for depression have not yet been identified, finding the characteristics, and risk factors of depressive symptom trajectories can help us identify at-risk populations early and reduce the related public disease burden. AIMS Herein we aimed to figure out the specific manifestations of depressive symptom trajectories among Chinese adults, explore the risk profiles of trajectory groups with higher depression burdens, and test the longitudinal associations between blood biomarkers with depressive symptoms. METHODS Trajectories of participants' depressive symptoms measured by the Center for Epidemiologic Studies Depression scores were modeled with growth mixture models from 2011 to 2018. Multinomial logistic models tested associations of baseline covariates with trajectories. Generalized estimating equations were used to explore the longitudinal associations between blood data and depressive symptoms in two waves from 2011 to 2015. RESULTS Among the sample of 5,641 individuals aged 40 or over, four heterogeneous depressive symptom trajectories were defined: stable-low, high-decrease, stable-high, and low-increase. At baseline, demographic factors and health statuses such as gender, education, income, and self-reported health status were associated with trajectories. A significant association was found between high-density lipoprotein and depressive symptoms. CONCLUSIONS These findings provide clues for predicting and identifying adults with elevated depression burdens in middle and late life and may facilitate the development of targeted preventive strategies for this population.
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Affiliation(s)
- Chao Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
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4
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Zhang R, Peng X, Song X, Long J, Wang C, Zhang C, Huang R, Lee TMC. The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population. Psychol Med 2023; 53:3611-3620. [PMID: 35156595 PMCID: PMC10277767 DOI: 10.1017/s0033291722000241] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established. METHODS By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals). RESULTS No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96). CONCLUSIONS Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.
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Affiliation(s)
- Ruibin Zhang
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | | | - Xiaoqi Song
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jixin Long
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chanyu Wang
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Management, Southern Medical University, Guangzhou, China
| | - Ruiwang Huang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Tatia M. C. Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, SAR China
- Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
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Battista K, Diao L, Patte KA, Dubin JA, Leatherdale ST. Examining the use of decision trees in population health surveillance research: an application to youth mental health survey data in the COMPASS study. Health Promot Chronic Dis Prev Can 2023; 43:73-86. [PMID: 36794824 PMCID: PMC10026612 DOI: 10.24095/hpcdp.43.2.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION In population health surveillance research, survey data are commonly analyzed using regression methods; however, these methods have limited ability to examine complex relationships. In contrast, decision tree models are ideally suited for segmenting populations and examining complex interactions among factors, and their use within health research is growing. This article provides a methodological overview of decision trees and their application to youth mental health survey data. METHODS The performance of two popular decision tree techniques, the classification and regression tree (CART) and conditional inference tree (CTREE) techniques, is compared to traditional linear and logistic regression models through an application to youth mental health outcomes in the COMPASS study. Data were collected from 74 501 students across 136 schools in Canada. Anxiety, depression and psychosocial well-being outcomes were measured along with 23 sociodemographic and health behaviour predictors. Model performance was assessed using measures of prediction accuracy, parsimony and relative variable importance. RESULTS Decision tree and regression models consistently identified the same sets of most important predictors for each outcome, indicating a general level of agreement between methods. Tree models had lower prediction accuracy but were more parsimonious and placed greater relative importance on key differentiating factors. CONCLUSION Decision trees provide a means of identifying high-risk subgroups to whom prevention and intervention efforts can be targeted, making them a useful tool to address research questions that cannot be answered by traditional regression methods.
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Affiliation(s)
- Katelyn Battista
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Liqun Diao
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Joel A Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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6
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Battista K, Patte KA, Diao L, Dubin JA, Leatherdale ST. Using Decision Trees to Examine Environmental and Behavioural Factors Associated with Youth Anxiety, Depression, and Flourishing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10873. [PMID: 36078594 PMCID: PMC9518212 DOI: 10.3390/ijerph191710873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/18/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Modifiable environmental and behavioural factors influence youth mental health; however, past studies have primarily used regression models that quantify population average effects. Decision trees are an analytic technique that examine complex relationships between factors and identify high-risk subgroups to whom intervention measures can be targeted. This study used decision trees to examine associations of various risk factors with youth anxiety, depression, and flourishing. Data were collected from 74,501 students across Canadian high schools participating in the 2018-2019 COMPASS Study. Students completed a questionnaire including validated mental health scales and 23 covariates. Decision trees were grown to identify key factors and subgroups for anxiety, depression, and flourishing outcomes. Females lacking both happy home life and sense of connection to school were at greatest risk for higher anxiety and depression levels. In contrast with previous literature, behavioural factors such as diet, movement and substance use did not emerge as differentiators. This study highlights the influence of home and school environments on youth mental health using a novel decision tree analysis. While having a happy home life is most important in protecting against youth anxiety and depression, a sense of connection to school may mitigate the negative influence of a poor home environment.
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Affiliation(s)
- Katelyn Battista
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Karen A. Patte
- Department of Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - Liqun Diao
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Joel A. Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Scott T. Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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7
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Noyes BK, Munoz DP, Khalid-Khan S, Brietzke E, Booij L. Is subthreshold depression in adolescence clinically relevant? J Affect Disord 2022; 309:123-130. [PMID: 35429521 DOI: 10.1016/j.jad.2022.04.067] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/29/2022] [Accepted: 04/10/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Subthreshold depression is highly prevalent in adolescence, but compared to major depressive disorder, the clinical impact is under-researched. The aim of this review was to compare subthreshold depression and major depressive disorder in adolescents by reviewing available literature on epidemiology, risk factors, illness trajectories, brain anatomy and function, genetics, and treatment response. METHODS We conducted a scoping review of papers on subthreshold depression and major depressive disorder in adolescence published in English. Studies in adults were included when research in adolescence was not available. RESULTS We found that individuals with subthreshold depression were similar to individuals with major depressive disorder in several regards, including female/male ratio, onset, functional impairment, comorbidity, health care utilization, suicidal ideation, genetic predisposition, brain alterations, and treatment response. Further, subthreshold depression was about two times more common than major depressive disorder. LIMITATIONS The definition of subthreshold depression is highly variable across studies. Adolescent-specific data are limited in the areas of neurobiology and treatment. CONCLUSIONS The findings of the current review support the idea that subthreshold depression is of clinical importance and provide evidence for a spectrum, versus categorical model, for depressive symptomatology. Given the frequency of subthreshold depression escalating to major depressive disorder, a greater recognition and awareness of the significance of subthreshold depression in research, clinical practice and policy-making may facilitate the development and application of early prevention and intervention.
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Affiliation(s)
- Blake K Noyes
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Medicine, Queen's University, Kingston, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada
| | - Sarosh Khalid-Khan
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Elisa Brietzke
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Medicine, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Linda Booij
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychology, Concordia University, Montréal, Canada; CHU Sainte-Justine Hospital Research Centre, University of Montréal, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada.
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8
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Sampson L, Cabral HJ, Rosellini AJ, Gradus JL, Cohen GH, Fink DS, King AP, Liberzon I, Galea S. Stressful life events and trajectories of depression symptoms in a U.S. military cohort. Sci Rep 2022; 12:11026. [PMID: 35773360 PMCID: PMC9246834 DOI: 10.1038/s41598-022-14496-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/08/2022] [Indexed: 02/08/2023] Open
Abstract
Depression is a common mental disorder that may comprise distinct, underlying symptom patterns over time. Associations between stressful life events throughout the civilian lifecourse-including during childhood-and adult depression have been documented in many populations, but are less commonly assessed in military samples. We identified different trajectories of depression symptoms across four years in a military cohort using latent class growth analysis, and investigated the relationship between these trajectories and two domains of civilian life experiences: childhood adversity (e.g., being mistreated during childhood) and more proximal stressful experiences (e.g., divorce). A four-group depression model was identified, including a symptom-free group (62%), an increasing symptom group (13%), a decreasing symptom group (16%), and a "chronic" symptom group (9%). Compared to the symptom-free group, soldiers with childhood adversity were more likely to be in the chronic depression, decreasing, and increasing symptom groups. Time-varying adult stressors had the largest effect on depression symptoms for the increasing symptom group compared to other groups, particularly in the last two years of follow-up. This study indicates the importance of considering events from throughout the lifecourse-not only those from deployment-when studying the mental health of servicemembers.
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Affiliation(s)
- Laura Sampson
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Howard J. Cabral
- grid.189504.10000 0004 1936 7558Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Anthony J. Rosellini
- grid.189504.10000 0004 1936 7558Center for Anxiety and Related Disorders, Department of Psychological and Brain Science, Boston University, Boston, MA USA
| | - Jaimie L. Gradus
- grid.189504.10000 0004 1936 7558Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
| | - Gregory H. Cohen
- grid.189504.10000 0004 1936 7558Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
| | - David S. Fink
- grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA
| | - Anthony P. King
- grid.214458.e0000000086837370Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI USA
| | - Israel Liberzon
- grid.264756.40000 0004 4687 2082Department of Psychiatry, College of Medicine, Texas A&M University, College Station, TX USA
| | - Sandro Galea
- grid.189504.10000 0004 1936 7558Department of Epidemiology, Boston University School of Public Health, Boston, MA USA ,grid.189504.10000 0004 1936 7558Boston University School of Public Health, 715 Albany Street, Boston, MA 02118 USA
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9
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Volz HP, Stirnweiß J, Kasper S, Möller HJ, Seifritz E. Subthreshold depression - concept, operationalisation and epidemiological data. A scoping review. Int J Psychiatry Clin Pract 2022; 27:92-106. [PMID: 35736807 DOI: 10.1080/13651501.2022.2087530] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020.Materials and methods: Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods.Results: The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data.Conclusions: Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria.
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Affiliation(s)
- Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy und Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Johanna Stirnweiß
- Hospital for Psychiatry, Psychotherapy und Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Siegfried Kasper
- Center of Brain Research, Medical University of Vienna, Vienna, Austria
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics. Psychiatric Hospital, University of Zürich, Zürich, Switzerland
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10
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Xie X, Song J, Zhu J, Han M, He Y, Huang J, Tao J, Wu J. The effectiveness of Tai Chi on the depressive symptom of young adults with subthreshold depression: a study protocol for a randomized controlled trial. Trials 2021; 22:106. [PMID: 33516240 PMCID: PMC7847042 DOI: 10.1186/s13063-021-05054-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/20/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Depression is seriously affecting the physical and mental health of young people worldwide. Subthreshold depression, as an early stage of depression, is essential for early prevention and treatment of depression. Tai Chi, as a traditional Chinese mind-body therapy, may become an alternative intervention. However, the neurophysiological mechanism of Tai Chi for young people with subthreshold depression remains unclear, restricting its further promotion and application. Therefore, rigorous randomized clinical trials are needed to further observe the intervention effect of Tai Chi on young adults with subthreshold depression and explore the neurophysiological mechanism. METHOD/DESIGN This report describes a two-arm, randomized, parallel controlled trial with allocation concealment and assessor blinding. A total of 64 eligible participants are randomly allocated to the Tai Chi group and the waiting list group in a 1:1 ratio. Participants in the Tai Chi group receive 12 weeks of Tai Chi training, with a total of 36 times and each for 60 min. Specifically, the participants in the waiting list group are requested to maintain their routine lifestyle. In this study, the primary outcome measure is the mean change in scores on the PHQ-9 and HAMD-17 between baseline and 12 weeks; the secondary outcomes are the mean change in the scores on CES-D, CPSS, GAD-7, and PSQI. Besides, the saliva cortisol levels and fMRI are monitored to explore the mechanism of action of Tai Chi on subthreshold depression. DISCUSSION The protocol uses a randomized controlled trial to examine the effectiveness of Tai Chi for young adults with subthreshold depression and explore neurophysiological mechanisms. If the test results are positive, it can be verified that Tai Chi can promote the physical and mental health of young adults with subthreshold depression. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900028289 . Registered on 17 December 2019.
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Affiliation(s)
- Xiaoting Xie
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China
| | - Jian Song
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China
| | - Jingfang Zhu
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China
| | - Mengyu Han
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China
| | - Youze He
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China
| | - Jia Huang
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China.,TCM Rehabilitation Research Center Of SATCM, Fuzhou, 350122, China
| | - Jing Tao
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China.,TCM Rehabilitation Research Center Of SATCM, Fuzhou, 350122, China
| | - Jingsong Wu
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China. .,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China. .,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China. .,TCM Rehabilitation Research Center Of SATCM, Fuzhou, 350122, China.
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11
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Ma M, Zhang X, Zhang Y, Su Y, Yan H, Tan H, Zhang D, Yue W. Childhood Maltreatment Was Correlated With the Decreased Cortical Function in Depressed Patients Under Social Stress in a Working Memory Task: A Pilot Study. Front Psychiatry 2021; 12:671574. [PMID: 34305677 PMCID: PMC8295536 DOI: 10.3389/fpsyt.2021.671574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/25/2021] [Indexed: 01/30/2023] Open
Abstract
Background: Major depressive disorder (MDD) is a common psychiatric disorder associated with working memory (WM) impairment. Neuroimaging studies showed divergent results of the WM process in MDD patients. Stress could affect the occurrence and development of depression, in which childhood maltreatment played an important role. Methods: Thirty-seven MDD patients and 54 healthy control subjects were enrolled and completed a WM functional magnetic resonance imaging task with maintenance and manipulation conditions under stress and non-stress settings. We collected demographical and clinical data, using 17-item Hamilton Depression Scale (HAMD-17) and Childhood Trauma Questionnaire (CTQ) in MDD patients. In the WM task, we analyzed the main diagnosis effect and explored the correlation of impaired brain regions in MDD patients with CTQ and HAMD-17. Results: No group differences were found in the accuracy rate and reaction time between the two groups. MDD patients had lower brain activation in following regions (P FWE < 0.05). The left fusiform gyrus showed less activation in all conditions. The right supplementary motor area (SMA) exhibited decreased activation under non-stress. The anterior prefrontal cortex showed reduced activation during manipulation under stress, with the β estimations of the peak voxel showing significant group difference negatively correlated with childhood sex abuse (P Bonferroni < 0.05). Conclusions: In our pilot study, MDD patients had reduced brain activation, affecting emotional stimuli processing function, executive function, and cognitive control function. Childhood maltreatment might affect brain function in MDD. This work might provide some information for future studies on MDD.
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Affiliation(s)
- Mengying Ma
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Xiao Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Yuyanan Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Yi Su
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Hao Yan
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Haoyang Tan
- Lieber Institute for Brain Development, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Dai Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China.,Lieber Institute for Brain Development, Baltimore, MD, United States
| | - Weihua Yue
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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12
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Wolf RT, Jeppesen P, Gyrd-Hansen D, Oxholm AS. Evaluation of a screening algorithm using the Strengths and Difficulties Questionnaire to identify children with mental health problems: A five-year register-based follow-up on school performance and healthcare use. PLoS One 2019; 14:e0223314. [PMID: 31644540 PMCID: PMC6808306 DOI: 10.1371/journal.pone.0223314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Treatment of mental health problems (MHP) is often delayed or absent due to the lack of systematic detection and early intervention. This study evaluates the potential of a new screening algorithm to identify children with MHP. METHODS The study population comprises 2,015 children from the Copenhagen Child Cohort 2000 whose mental health was assessed at age 11-12 years and who had no prior use of specialised mental health services. A new algorithm based on the Strengths and Difficulties Questionnaire (SDQ) is utilised to identify MHP by combining parent-reported scores of emotional and behavioural problems and functional impairments. The screening is done on historical data, implying that neither parents, teachers nor health care professionals received any feedback on the screening status. The screening status and results of an IQ-test were linked to individual-level data from national registries. These national registers include records of each child's school performance at the end of compulsory schooling, their health care utilisation, as well as their parents' socio-economic status and health care utilisation. RESULTS 10% of the children screen positive for MHP. The children with MHP achieve a significantly lower Grade Point Average on their exams, independently of their IQ-score, perinatal factors and parental characteristics. On average, the children with MHP also carry higher health care costs over a five-year follow-up period. The higher health care costs are only attributed to 23% of these children, while the remaining children with MHP also show poorer school performance but receive no additional health care. CONCLUSIONS The results demonstrate that children with MHP and a poor prognosis can be identified by the use of the brief standardised questionnaire SDQ combined with a screening algorithm.
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Affiliation(s)
- Rasmus Trap Wolf
- University of Southern Denmark, Department of Public Health, Danish Centre for Health Economics, Odense, Denmark
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Pia Jeppesen
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Gyrd-Hansen
- University of Southern Denmark, Department of Public Health, Danish Centre for Health Economics, Odense, Denmark
| | | | - Anne Sophie Oxholm
- University of Southern Denmark, Department of Public Health, Danish Centre for Health Economics, Odense, Denmark
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13
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Kwong ASF, López-López JA, Hammerton G, Manley D, Timpson NJ, Leckie G, Pearson RM. Genetic and Environmental Risk Factors Associated With Trajectories of Depression Symptoms From Adolescence to Young Adulthood. JAMA Netw Open 2019; 2:e196587. [PMID: 31251383 PMCID: PMC6604106 DOI: 10.1001/jamanetworkopen.2019.6587] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/14/2019] [Indexed: 12/17/2022] Open
Abstract
Importance Less favorable trajectories of depressive mood from adolescence to early adulthood are associated with current and later psychopathology, impaired educational attainment, and social dysfunction, yet the genetic and environmental risk factors associated with these trajectories are not fully established. Examining what risk factors are associated with different trajectories of depressive mood could help identify the nature of depression symptoms and improve preventive interventions for those at most risk. Objective To examine the differential associations of genetic and environmental risk factors with trajectories of depression symptoms among individuals observed from ages 10 to 24 years. Design, Setting, and Participants In a longitudinal cohort study established in 1990 and currently ongoing (the Avon Longitudinal Study of Parents and Children [ALSPAC]), growth mixture modeling was used to identify trajectories of depression symptoms in 9394 individuals in the United Kingdom. Associations of different risk factors with these trajectories were then examined. Analysis was conducted between August 2018 and January 2019. Main Outcomes and Measures Trajectories were composed from depression symptoms measured using the Short Mood and Feelings Questionnaire at 9 occasions from ages 10 to 24 years. Risk factors included sex, a polygenic risk score taken from a recent genome-wide association study of depression symptoms, maternal postnatal depression, partner cruelty to the offspring's mother when the child was aged 2 to 4 years, childhood anxiety at age 8 years, and being bullied at age 10 years. Results Data on all risk factors, confounders, and the outcome were available for 3525 individuals, including 1771 (50.2%) who were female. Trajectories were assessed between the mean (SD) age of 10.7 (0.3) years and mean (SD) age of 23.8 (0.5) years. Overall, 5 distinct trajectories of depression symptoms were identified: (1) stable low (2506 individuals [71.1%]), (2) adolescent limited (325 individuals [9.2%]), (3) childhood limited (203 individuals [5.8%]), (4) early-adult onset (393 individuals [11.1%]), and (5) childhood persistent (98 individuals [2.8%]). Of all the associations of risk factors with trajectories, sex (odds ratio [OR], 6.45; 95% CI, 2.89-14.38), the polygenic risk score for depression symptoms (OR, 1.47; 95% CI, 1.10-1.96), and childhood anxiety (OR, 1.30; 95% CI, 1.16-1.45) showed the strongest association with the childhood-persistent trajectory of depression symptoms compared with the stable-low trajectory. Maternal postnatal depression (OR, 2.39; 95% CI, 1.41-4.07) had the strongest association with the early-adult-onset trajectory, while partner cruelty to mother (OR, 2.30; 95% CI, 1.36-3.90) had the strongest association with the adolescent-limited trajectory. Bullying (OR, 8.08; 95% CI, 4.92-13.26) showed the strongest association with the childhood-limited trajectory. Conclusions and Relevance The least favorable trajectories of depression symptoms (childhood persistent and early-adult onset) were associated with both genetic and environmental risk factors, but the 2 trajectories of limited duration that had resolved by early adulthood (childhood limited and adolescent limited) were not associated with the polygenic risk score or maternal postnatal depression. Bullying was strongly associated with both the childhood-persistent and childhood-limited trajectories, suggesting that this risk factor may have a time-specific effect. These findings suggest that examining genetic and multiple time-specific environmental antecedents could help identify trajectories of varying onset and chronicity.
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Affiliation(s)
- Alex S. F. Kwong
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
| | - José A. López-López
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Gemma Hammerton
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
| | - David Manley
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
| | - Nicholas J. Timpson
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Leckie
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Rebecca M. Pearson
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
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14
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Kwong ASF, Manley D, Timpson NJ, Pearson RM, Heron J, Sallis H, Stergiakouli E, Davis OSP, Leckie G. Identifying Critical Points of Trajectories of Depressive Symptoms from Childhood to Young Adulthood. J Youth Adolesc 2019; 48:815-827. [PMID: 30671716 PMCID: PMC6441403 DOI: 10.1007/s10964-018-0976-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 02/07/2023]
Abstract
Depression is a common mental illness and research has focused on late childhood and adolescence in an attempt to prevent or reduce later psychopathology and/or social impairments. It is important to establish and study population-averaged trajectories of depressive symptoms across adolescence as this could characterise specific changes in populations and help identify critical points to intervene with treatment. Multilevel growth-curve models were used to explore adolescent trajectories of depressive symptoms in 9301 individuals (57% female) from the Avon Longitudinal Study of Parents and Children, a UK based pregnancy cohort. Trajectories of depressive symptoms were constructed for males and females using the short mood and feelings questionnaire over 8 occasions, between 10 and 22 years old. Critical points of development such as age of peak velocity for depressive symptoms (the age at which depressive symptoms increase most rapidly) and the age of maximum depressive symptoms were also derived. The results suggested that from similar initial levels of depressive symptoms at age 11, females on average experienced steeper increases in depressive symptoms than males over their teenage and adolescent years until around the age of 20 when levels of depressive symptoms plateaued and started to decrease for both sexes. Females on average also had an earlier age of peak velocity of depressive symptoms that occurred at 13.5 years, compared to males who on average had an age of peak velocity at 16 years old. Evidence was less clear for a difference between the ages of maximum depressive symptoms which were on average 19.6 years for females and 20.4 for males. Identifying critical periods for different population subgroups may provide useful knowledge for treating and preventing depression and could be tailored to be time specific for certain groups. Possible explanations and recommendations are discussed.
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Affiliation(s)
- Alex S F Kwong
- School of Geographical Sciences, University of Bristol, University Road, Bristol, BS8 1SS, UK.
- Centre for Multilevel Modelling, University of Bristol, Bristol, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
| | - David Manley
- School of Geographical Sciences, University of Bristol, University Road, Bristol, BS8 1SS, UK
- Centre for Multilevel Modelling, University of Bristol, Bristol, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca M Pearson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health at the University of Bristol, Bristol, UK
| | - Jon Heron
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health at the University of Bristol, Bristol, UK
| | - Hannah Sallis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health at the University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Oliver S P Davis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - George Leckie
- Centre for Multilevel Modelling, University of Bristol, Bristol, UK
- School of Education, University of Bristol, Bristol, UK
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15
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Hartmann JA, Nelson B, Ratheesh A, Treen D, McGorry PD. At-risk studies and clinical antecedents of psychosis, bipolar disorder and depression: a scoping review in the context of clinical staging. Psychol Med 2019; 49:177-189. [PMID: 29860956 DOI: 10.1017/s0033291718001435] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Identifying young people at risk of developing serious mental illness and identifying predictors of onset of illness has been a focus of psychiatric prediction research, particularly in the field of psychosis. Work in this area has facilitated the adoption of the clinical staging model of early clinical phenotypes, ranging from at-risk mental states to chronic and severe mental illness. It has been a topic of debate if these staging models should be conceptualised as disorder-specific or transdiagnostic. In order to inform this debate and facilitate cross-diagnostic discourse, the present scoping review provides a broad overview of the body of literature of (a) longitudinal at-risk approaches and (b) identified antecedents of (homotypic) illness progression across three major mental disorders [psychosis, bipolar disorder (BD) and depression], and places these in the context of clinical staging. Stage 0 at-risk conceptualisations (i.e. familial high-risk approaches) were identified in all three disorders. However, formalised stage 1b conceptualisations (i.e. ultra-high-risk approaches) were only present in psychosis and marginally in BD. The presence of non-specific and overlapping antecedents in the three disorders may support a general staging model, at least in the early stages of severe psychotic or mood disorders.
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Affiliation(s)
- Jessica A Hartmann
- Orygen, the National Centre of Excellence in Youth Mental Health,Melbourne,Australia
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health,Melbourne,Australia
| | - Aswin Ratheesh
- Orygen, the National Centre of Excellence in Youth Mental Health,Melbourne,Australia
| | - Devi Treen
- Department of Child and Adolescent Psychiatry and Psychology,Hospital Sant Joan de Déu,Barcelona
| | - Patrick D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health,Melbourne,Australia
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16
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Tuithof M, Ten Have M, van Dorsselaer S, Kleinjan M, Beekman A, de Graaf R. Course of subthreshold depression into a depressive disorder and its risk factors. J Affect Disord 2018; 241:206-215. [PMID: 30130686 DOI: 10.1016/j.jad.2018.08.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/17/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Information on the natural course of subthreshold depression and risk factors for the development of a full-blown depressive disorder in the general population is scarce. This information is crucial to understand the development of depression and to advance indicated depression prevention. METHODS Using longitudinal data from a representative population-based study (the Netherlands Mental Health Survey and Incidence Study-2) we assessed 3-year course of subthreshold depression (depressive symptoms causing clinically significant distress for at least 2 weeks, or for 3 days per month for a year; n = 120), compared to an asymptomatic group (n = 4111) and a depressive disorder group (major depression or dysthymia; n = 294). Next, risk factors for the development of a depressive disorder among adults with subthreshold depression were determined. RESULTS Twelve percent of the subthreshold cases developed a full-blown depressive disorder during 3-year follow-up. Risk factors were lower social support, having recurrent short episodes of depressive symptomatology, remitted and current anxiety disorder, remitted substance use disorder, lifetime suicide thoughts, a chronic physical disorder and diminished mental and physical functioning. LIMITATIONS The number of subjects with subthreshold depression that developed a depressive disorder was small. This limits the possibility to detect significant risk factors. CONCLUSION Only a minority of the subthreshold cases developed a full-blown depressive disorder over three years. This shows that subthreshold depression does not, by itself, carry an a priori risk to warrant focusing indicated prevention. The identified risk factors could help to detect those subthreshold cases in whom depression prevention is economically and practically viable.
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Affiliation(s)
- Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | | | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Utrecht University, Utrecht, The Netherlands
| | | | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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17
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Uchida M, Fitzgerald M, Woodworth H, Carrellas N, Kelberman C, Biederman J. Subsyndromal Manifestations of Depression in Children Predict the Development of Major Depression. J Pediatr 2018; 201:252-258.e1. [PMID: 30007773 PMCID: PMC6153024 DOI: 10.1016/j.jpeds.2018.05.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/30/2018] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the utility of assessing subsyndromal symptoms of major depressive disorder in childhood, indexed through the Child Behavior Checklist (CBCL) anxiety/depression scale, in predicting risk of developing major depressive disorder in adolescent and young adult years. STUDY DESIGN The sample consisted of 537 children, 6-17 years of age, originally ascertained for a longitudinal family genetic study of youth with and without attention-deficit hyperactivity disorder and their first-degree relatives who were followed prospectively and blindly for 10 years from childhood into young adult years. Children with full diagnosis major depressive disorder at baseline were excluded. For analysis, the sample was stratified into 4 groups based on the presence or absence of parental mood disorders and by the presence or absence of subsyndromal scores on the CBCL anxiety/depression scale at baseline assessment in childhood. RESULTS Children of parents with mood disorders plus subsyndromal scores on the CBCL anxiety/depression scale at baseline (n = 22) had the highest risk for developing major depressive disorder and anxiety disorders at the 10-year follow-up when compared with the other groups. Children with either subsyndromal scores on the CBCL anxiety/depression scale at baseline alone (n = 22) or parental mood disorders alone (n = 172) had intermediate outcomes. CONCLUSION The CBCL anxiety/depression scale was useful in identifying children at high risk for the development of major depressive disorder and anxiety disorders at the 10-year prospective follow-up. Furthermore, our results emphasized the importance of familial psychiatric history in youth with subthreshold symptoms of depression. Parental mood disorder and subthreshold anxiety/depressive symptoms were predictive of developing depression.
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Affiliation(s)
- Mai Uchida
- Department of Psychiatry, Clinical and Research Programs in Pediatric Psychopharmacology and Adult Attention-Deficit Hyperactivity Disorder, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.
| | - Maura Fitzgerald
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Hilary Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Nicholas Carrellas
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Caroline Kelberman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
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18
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Allen AN, Kilgus SP, Eklund K. An Initial Investigation of the Efficacy of the Resilience Education Program (REP). SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9276-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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19
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Mouri A, Ukai M, Uchida M, Hasegawa S, Taniguchi M, Ito T, Hida H, Yoshimi A, Yamada K, Kunimoto S, Ozaki N, Nabeshima T, Noda Y. Juvenile social defeat stress exposure persistently impairs social behaviors and neurogenesis. Neuropharmacology 2018; 133:23-37. [DOI: 10.1016/j.neuropharm.2018.01.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/23/2017] [Accepted: 01/10/2018] [Indexed: 10/18/2022]
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20
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Fatori D, Salum G, Itria A, Pan P, Alvarenga P, Rohde LA, Bressan R, Gadelha A, de Jesus Mari J, Conceição do Rosário M, Manfro G, Polanczyk G, Miguel EC, Graeff-Martins AS. The economic impact of subthreshold and clinical childhood mental disorders. J Ment Health 2018; 27:588-594. [DOI: 10.1080/09638237.2018.1466041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Daniel Fatori
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
| | - Giovanni Salum
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
| | - Alexander Itria
- Department of Collective Health, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil, and
| | - Pedro Pan
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Pedro Alvarenga
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
| | - Luis Augusto Rohde
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
| | - Rodrigo Bressan
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Ary Gadelha
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Gisele Manfro
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
| | - Guilherme Polanczyk
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
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21
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Scott J, Davenport TA, Parker R, Hermens DF, Lind PA, Medland SE, Wright MJ, Martin NG, Gillespie NA, Hickie IB. Pathways to depression by age 16 years: Examining trajectories for self-reported psychological and somatic phenotypes across adolescence. J Affect Disord 2018; 230:1-6. [PMID: 29355726 DOI: 10.1016/j.jad.2017.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/16/2017] [Accepted: 12/03/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Sex differences in rates of depression emerge during adolescence. However, it is unclear whether symptom patterns and trajectories differ significantly according to gender in youth. Barriers to research include the fact that most self-report tools are weighted towards psychological rather than somatic symptoms. METHODS Data were collected on symptoms of depression in about 1800 individuals at ages 12, 14 and 16 years. Odds ratios and 95% confidence intervals were used to examine the trajectory of psychological and somatic phenotypes and self-reported depression caseness over time. RESULTS At age 12, 24% of participants met criteria for self-reported depression caseness. Although there was only a small incremental increase in the prevalence over time (about 5%), 57% of participants met criteria for self-reported depression caseness at least once. Generic symptoms at age 12 were associated with depression longitudinally, although early transition to caseness was reported in females only. Categorization as a psychological phenotype at age 12 predicted depression at age 14 and/or 16 years, especially in females. The somatic phenotype was more common in males, but showed a weaker association with self-reported depression caseness over time. LIMITATIONS Depression was assessed by self-report; only 30% of participants had ratings for age 12, 14 and 16. CONCLUSIONS Although sub-threshold psychological and somatic syndromes often co-occur in cases of self-reported depression in adolescence, longitudinally they may represent independent symptom trajectories. However, it is important to remember that self-reported depression is indicative of, but not confirmation of a depressive episode that meets diagnostic criteria.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Brain & Mind Centre, University of Sydney, Sydney, Australia.
| | | | - Richard Parker
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Penelope A Lind
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia
| | - Sarah E Medland
- Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia
| | - Margaret J Wright
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia; Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia
| | - Nicholas G Martin
- Queensland Brain Institute, the University of Queensland, Brisbane, Australia
| | - Nathan A Gillespie
- Centre for Advanced Imaging, the University of Queensland, Brisbane, Australia; Virginia Institute for Psychiatric and Behavioral Genetics, VCU, Richmond, VA, USA
| | - Ian B Hickie
- Brain & Mind Centre, University of Sydney, Sydney, Australia
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Wong SYS, Sun YY, Chan ATY, Leung MKW, Chao DVK, Li CCK, Chan KKH, Tang WK, Mazzucchelli T, Au AML, Yip BHK. Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness. Ann Fam Med 2018; 16. [PMID: 29531101 PMCID: PMC5847348 DOI: 10.1370/afm.2206] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We undertook a randomized controlled trial to assess the efficacy of group-based behavioral activation with mindfulness (BAM) for treating subthreshold depression in primary care in Hong Kong. METHODS We recruited adult patients aged 18 years or older with subthreshold depression from public primary care clinics and randomly assigned them to a BAM intervention group or a usual care group. The BAM group was provided with eight 2-hour weekly BAM sessions by trained allied health care workers. Patients in the usual care group received usual medical care with no additional psychological interventions. The primary outcome was depressive symptoms measured by the Beck Depression Inventory-II at 12 months. Secondary outcomes included incidence of major depressive disorder at 12 months. We assessed quality of life, activity and circumstances change, functional impairment, and anxiety at baseline, end of intervention, 5 months, and 12 months. RESULTS We randomly allocated 115 patients to the BAM intervention and 116 patients to usual care. At 12 months, compared with usual care peers, BAM patients had a slightly more favorable change in levels of depressive symptoms on the Beck Depression Inventory-II (between-group mean difference in score = -3.85; 95% CI, -6.36 to -1.34; Cohen d = -0.46, 95% CI, -0.76 to -0.16). Incidence of major depressive disorder was lower with BAM (10.8% vs 26.8%, P = .01), whereas groups did not differ significantly on other secondary outcomes at 12 months. CONCLUSIONS Group BAM appears to be efficacious for decreasing depressive symptoms and reducing the incidence of major depression among patients with subthreshold depression in primary care, although generalizability of our findings may be limited.
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Affiliation(s)
- Samuel Y S Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Yu Ying Sun
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Aaroy T Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Maria K W Leung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - David V K Chao
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Carole C K Li
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - King K H Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Wai Kwong Tang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Trevor Mazzucchelli
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Alma M L Au
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
| | - Benjamin H K Yip
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
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Prevalence of emotional and behavioral problems and subthreshold psychiatric disorders in Austrian adolescents and the need for prevention. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1325-1337. [PMID: 30159723 PMCID: PMC6267139 DOI: 10.1007/s00127-018-1586-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/20/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Epidemiological data are crucial to plan adequate prevention strategies. Thus, this study aims at obtaining the prevalence of mental health problems (MHP) and subthreshold psychiatric disorders based on a representative sample of Austrian adolescents. METHODS Adolescents aged 10-18 were recruited from Austrian schools. Emotional and behavioral problems were determined using the Youth Self-Report (YSR); the point prevalence of subthreshold psychiatric disorders was assessed using structured diagnostic interviews. Sociodemographic variables including socioeconomic background, migration status, family structure, and place of residence were obtained. In addition, a non-school sample (unemployed adolescents, and child and adolescent psychiatry patients) was included to enhance representativeness and generalizability. RESULTS 3446 students, 37 unemployed adolescents, and 125 child and adolescent psychiatric patients provided analyzable YSR data sets. In the school sample, 16.5% scored in the clinically relevant range, while internalizing problems were more prevalent (17.8%) than externalizing problems (7.4%). These prevalences increased by 0.7-2.0% when the non-school sample was taken into account. A low socioeconomic status (SES) and living in single parent families were associated with higher problem scores. Regarding the interviewed sample (377 students and 407 parents), subthreshold psychiatric disorders were observed in 12.7% of students. 92.5% of them have not yet received any kind of help. CONCLUSIONS A significant proportion of Austrian adolescents are at risk for MHP. A non-responder analysis indicates that the observed prevalence may be even underestimated. These findings emphasize the urgent need for targeted prevention, especially for reducing anxiety and depressive symptoms and for adolescents in disadvantaged families.
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24
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Utilization of psychiatric care and antidepressants among people with different severity of depression: a population-based cohort study in Stockholm, Sweden. Soc Psychiatry Psychiatr Epidemiol 2018; 53:607-615. [PMID: 29651622 PMCID: PMC5959996 DOI: 10.1007/s00127-018-1515-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 04/09/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To identify how severity of depression predicts future utilization of psychiatric care and antidepressants. METHODS Data derived from a longitudinal population-based study in Stockholm, Sweden, include 10443 participants aged 20-64 years. Depression was assessed by Major Depression Inventory and divided into subsyndromal, mild, moderate and severe depression. Outcomes were the first time of hospitalization, specialized outpatient care and prescribed drugs obtained from national register records. The association between severity of depression and outcomes was tested by Cox regression analysis, after adjusting for gender, psychiatric treatment history and socio-environmental factors. RESULTS The cumulative incidences of hospitalizations, outpatient care and antidepressants were 4.0, 11.2, and 21.9% respectively. Compared to the non-depressed group, people with different severity of depression (subsyndromal, mild, moderate and severe depression) all had significantly higher risk of all three psychiatric services (all log-rank test P < 0.001). Use of psychiatric care and antidepressants increased by rising severity of depression. Although the associations between severity of depression and psychiatric services were significant, the dose relationship was not present in people with previous psychiatric history or after adjusting for gender and other factors. CONCLUSIONS People with subsyndromal to severe depression all have increased future psychiatric service utilization compared to non-depressed people.
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25
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Lee Y, Kim BN, Park MH, Park S. Familial, Cognitive, and Behavioral Characteristics of Adolescents with Depression. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.3.168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yeeun Lee
- Department of Psychology, Korea University, Seoul, Korea
| | - Bung-Nyun Kim
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Hyeon Park
- Department of Psychiatry, The Catholic University of Korea, St. Paul’s Hospital, Seoul, Korea
| | - Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
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Poirier M, Marcotte D, Joly J, Fortin L. Évaluation de la qualité de l’implantation du programme Pare-Chocs à l’école secondaire. SANTE MENTALE AU QUEBEC 2017. [DOI: 10.7202/1040259ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Malgré l’importante augmentation de la prévalence de la dépression durant l’adolescence, seulement une faible proportion des adolescents qui présentent des symptômes dépressifs élevés bénéficie des services de santé mentale en milieu scolaire. De plus, les programmes offerts à ces élèves souffrent souvent d’une implantation lacunaire, limitant ainsi leur efficacité potentielle. L’identification des facteurs qui influencent la fidélité de l’implantation est donc essentielle pour améliorer la qualité des services offerts. Guidés par le modèle d’évaluation basé sur la théorie des programmes (theory-driven evaluation), nous évaluons la qualité de l’implantation du programme Pare-Chocs et les facteurs qui l’ont influencée à l’aide des composantes du modèle d’action de Chen (2005). Une approche multi-méthodes a été utilisée pour obtenir des données quantitatives sur la fidélité d’implantation dans les six groupes et des données qualitatives sur les composantes du modèle d’action. Les résultats suggèrent que l’adhésion, le dosage et la participation étaient élevés. Les contraintes de temps et le peu de formation antérieure en lien avec la théorie du programme ont limité la fidélité de l’implantation tandis que la formation, la supervision et le manuel y ont contribué. Ces résultats confirment que les programmes de prévention disséminés dans les milieux scolaires peuvent être implantés avec un niveau de fidélité élevé, même si certains défis doivent être pris en considération lors de la planification de l’intervention pour contribuer à des effets plus importants du programme. De plus, la fidélité devrait être évaluée de manière systématique dans ce contexte.
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27
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Schmaal L, Hibar DP, Sämann PG, Hall GB, Baune BT, Jahanshad N, Cheung JW, van Erp TGM, Bos D, Ikram MA, Vernooij MW, Niessen WJ, Tiemeier H, Hofman A, Wittfeld K, Grabe HJ, Janowitz D, Bülow R, Selonke M, Völzke H, Grotegerd D, Dannlowski U, Arolt V, Opel N, Heindel W, Kugel H, Hoehn D, Czisch M, Couvy-Duchesne B, Rentería ME, Strike LT, Wright MJ, Mills NT, de Zubicaray GI, McMahon KL, Medland SE, Martin NG, Gillespie NA, Goya-Maldonado R, Gruber O, Krämer B, Hatton SN, Lagopoulos J, Hickie IB, Frodl T, Carballedo A, Frey EM, van Velzen LS, Penninx BWJH, van Tol MJ, van der Wee NJ, Davey CG, Harrison BJ, Mwangi B, Cao B, Soares JC, Veer IM, Walter H, Schoepf D, Zurowski B, Konrad C, Schramm E, Normann C, Schnell K, Sacchet MD, Gotlib IH, MacQueen GM, Godlewska BR, Nickson T, McIntosh AM, Papmeyer M, Whalley HC, Hall J, Sussmann JE, Li M, Walter M, Aftanas L, Brack I, Bokhan NA, Thompson PM, Veltman DJ. Cortical abnormalities in adults and adolescents with major depression based on brain scans from 20 cohorts worldwide in the ENIGMA Major Depressive Disorder Working Group. Mol Psychiatry 2017; 22:900-909. [PMID: 27137745 PMCID: PMC5444023 DOI: 10.1038/mp.2016.60] [Citation(s) in RCA: 713] [Impact Index Per Article: 101.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/25/2016] [Accepted: 03/17/2016] [Indexed: 12/20/2022]
Abstract
The neuro-anatomical substrates of major depressive disorder (MDD) are still not well understood, despite many neuroimaging studies over the past few decades. Here we present the largest ever worldwide study by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis) Major Depressive Disorder Working Group on cortical structural alterations in MDD. Structural T1-weighted brain magnetic resonance imaging (MRI) scans from 2148 MDD patients and 7957 healthy controls were analysed with harmonized protocols at 20 sites around the world. To detect consistent effects of MDD and its modulators on cortical thickness and surface area estimates derived from MRI, statistical effects from sites were meta-analysed separately for adults and adolescents. Adults with MDD had thinner cortical gray matter than controls in the orbitofrontal cortex (OFC), anterior and posterior cingulate, insula and temporal lobes (Cohen's d effect sizes: -0.10 to -0.14). These effects were most pronounced in first episode and adult-onset patients (>21 years). Compared to matched controls, adolescents with MDD had lower total surface area (but no differences in cortical thickness) and regional reductions in frontal regions (medial OFC and superior frontal gyrus) and primary and higher-order visual, somatosensory and motor areas (d: -0.26 to -0.57). The strongest effects were found in recurrent adolescent patients. This highly powered global effort to identify consistent brain abnormalities showed widespread cortical alterations in MDD patients as compared to controls and suggests that MDD may impact brain structure in a highly dynamic way, with different patterns of alterations at different stages of life.
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Affiliation(s)
- L Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - P G Sämann
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - G B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D Bos
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M W Vernooij
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - W J Niessen
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - H J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - D Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - R Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - M Selonke
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), partner site Griefswald, Greifswald, Germany
- German Center for Diabetes Research (DZD), partner site Griefswald, Greifswald, Germany
| | - D Grotegerd
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - U Dannlowski
- Department of Psychiatry, University of Muenster, Muenster, Germany
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - V Arolt
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - N Opel
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - W Heindel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - H Kugel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - D Hoehn
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - M Czisch
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - B Couvy-Duchesne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - M E Rentería
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - L T Strike
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - M J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - N T Mills
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - G I de Zubicaray
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - K L McMahon
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - S E Medland
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N G Martin
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - R Goya-Maldonado
- Centre for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - S N Hatton
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - J Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - I B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - A Carballedo
- Department of Psychiatry and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - E M Frey
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - L S van Velzen
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M-J van Tol
- Neuroimaging Center, Section of Cognitive Neuropsychiatry, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - N J van der Wee
- Department of Psychiatry and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - C G Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - B Mwangi
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Cao
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J C Soares
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - I M Veer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D Schoepf
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - B Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - C Konrad
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
| | - E Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - C Normann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - K Schnell
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - M D Sacchet
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - I H Gotlib
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - G M MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - B R Godlewska
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cogntive Ageing and Cogntive Epidemiology, University of Edinburgh, Edinburg, UK
| | - M Papmeyer
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - J Hall
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Department of Psychiatry, NHS Borders, Melrose, UK
| | - M Li
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - M Walter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry, University Tübingen, Tübingen, Germany
| | - L Aftanas
- Department of Experimental and Clinical Neuroscience, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - I Brack
- Department of Experimental and Clinical Neuroscience, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - N A Bokhan
- Mental Health Research Institute, Tomsk, Russia
- Faculty of Psychology, National Research Tomsk State University, Tomsk, Russia
- Department of General Medicine, Siberian State Medical University, Tomsk, Russia
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - D J Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review. J Affect Disord 2017; 210:166-173. [PMID: 28049101 DOI: 10.1016/j.jad.2016.12.037] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/21/2016] [Accepted: 12/22/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Major Depressive Disorder (MDD) among youth is a public health concern. Our aim was to examine the current body of knowledge to better characterize the prevalence and morbidity associated with subthreshold forms of MDD among youth. Given that MDD tends to develop gradually over time, we hypothesized a high prevalence and considerable impairment associated with youth suffering from depressive symptoms that fall short of full, syndromic status. METHODS A literature search was conducted using PubMed exclusively to identify studies assessing the prevalence and clinical characteristics of subthreshold MDD in adolescents. RESULTS Six scientific papers that met our priori inclusion and exclusion criteria were identified. All papers sampled adolescents. The prevalence of subthreshold MDD ranged from 5% over the past year, to 29% over the two weeks prior to screening. These papers reported clinically significant morbidity associated with subthreshold MDD among adolescents, with evidence for elevated rates of psychiatric comorbidities, impaired functioning in social and familial domains, increased suicidality, and frequent mental health service utilization. LIMITATIONS Though we examined a sizeable and diverse sample, we only identified six cross-sectional informative studies for this review. Variability of subthreshold MDD and major outcome definitions across studies, likely limits the specificity of findings. CONCLUSIONS Subthreshold MDD is prevalent among youth, and is associated with emotional and social impairments that reach the level of obtaining clinical care. These findings could lead to early intervention efforts aimed at mitigating the adverse outcomes associated with subthreshold MDD as well as the progression to full syndrome MDD. Our review documents that regardless of whether progression to full diagnostic status occurs, this condition is morbid.
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Uchida M, Fitzgerald M, Lin K, Carrellas N, Woodworth H, Biederman J. Can subsyndromal manifestations of major depression be identified in children at risk? Acta Psychiatr Scand 2017; 135:127-137. [PMID: 27805260 DOI: 10.1111/acps.12660] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Children of parents with major depression are at significantly increased risk for developing major depression themselves; however, not all children at genetic risk will develop major depressive disorder (MDD). We investigated the utility of subsyndromal scores on the Child Behavior Checklist (CBCL) Anxiety/Depression scale in identifying children at the highest risk for pediatric MDD from among the pool of children of parents with MDD or bipolar disorder. METHOD The sample was derived from two previously conducted longitudinal case-control family studies of psychiatrically and pediatrically referred youth and their families. For this study, probands were stratified based on the presence or absence of a parental mood disorder. RESULTS Subsyndromal scores on the CBCL Anxiety/Depression scale significantly separated the children at high risk for pediatric MDD from those at low risk in a variety of functional areas, including social and academic functioning. Additionally, children at genetic risk without elevated CBCL Anxiety/Depression scale scores were largely indistinguishable from controls. CONCLUSION These results suggest that the CBCL Anxiety/Depression scale can help identify children at highest risk for pediatric MDD. If implemented clinically, this scale would cost-effectively screen children and identify those most in need of early intervention resources to impede the progression of depression.
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Affiliation(s)
- M Uchida
- Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - M Fitzgerald
- Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - K Lin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - N Carrellas
- Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - H Woodworth
- Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - J Biederman
- Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Hill RM, Mellick W, Temple JR, Sharp C. The role of bullying in depressive symptoms from adolescence to emerging adulthood: A growth mixture model. J Affect Disord 2017; 207:1-8. [PMID: 27665072 PMCID: PMC5107164 DOI: 10.1016/j.jad.2016.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/06/2016] [Accepted: 09/08/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The present study sought to identify trajectories of depressive symptoms in adolescence and emerging adulthood using a school-based sample of adolescents assessed over a five-year period. The study also examined whether bully and cyberbully victimization and perpetration significantly predicted depressive symptom trajectories. METHOD Data from a sample of 1042 high school students were examined. The sample had a mean age of 15.09 years (SD=.79), was 56.0% female, and was racially diverse: 31.4% Hispanic, 29.4% White, and 27.9% African American. Data were examined using growth mixture modeling. RESULTS Four depressive symptoms trajectories were identified, including those with a mild trajectory of depressive symptoms, an increasing trajectory of depressive symptoms, an elevated trajectory of depressive symptoms, and a decreasing trajectory of depressive symptoms. Results indicated that bully victimization and cyberbully victimization differentially predicted depressive symptoms trajectories across adolescence, though bully and cyberbully perpetration did not. LIMITATIONS Limitations include reliance on self-reports of bully perpetration and a limited consideration of external factors that may impact the course of depression. CONCLUSIONS These findings may inform school personnel in identifying students' likely trajectory of depressive symptoms and determining where depression prevention and treatment services may be needed.
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Affiliation(s)
- Ryan M Hill
- University of Texas Health Science Center at Houston, Houston, TX, USA.
| | | | - Jeff R Temple
- University of Texas Medical Branch, Galveston, TX, USA
| | - Carla Sharp
- University of Houston, Houston, TX, USA; University of the Free State, South Africa
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Prescott SL, Logan AC. Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111075. [PMID: 27827896 PMCID: PMC5129285 DOI: 10.3390/ijerph13111075] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/21/2016] [Accepted: 10/28/2016] [Indexed: 12/20/2022]
Abstract
The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.
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Affiliation(s)
- Susan L Prescott
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- School of Paediatrics and Child Health Research, University of Western Australia, P.O. Box D184, Princess Margaret Hospital, Perth 6001, Australia.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- PathLight Synergy, 23679 Calabassas Road, Suite 542, Calabassas, CA 91302, USA.
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Major depressive disorder and subthreshold depression in prepubertal children from the Danish National Birth Cohort. Compr Psychiatry 2016; 70:65-76. [PMID: 27624424 DOI: 10.1016/j.comppsych.2016.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 11/21/2022] Open
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Grunberg VA, Cordova KA, Bidwell LC, Ito TA. Can marijuana make it better? Prospective effects of marijuana and temperament on risk for anxiety and depression. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 29:590-602. [PMID: 26415059 DOI: 10.1037/adb0000109] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Increases in marijuana use in recent years highlight the importance of understanding how marijuana affects mental health. Of particular relevance is the effect of marijuana use on anxiety and depression given that marijuana use is highest among late adolescents/early adults, the same age range in which risk for anxiety and depression is the highest. Here we examine how marijuana use moderates the effects of temperament on level of anxiety and depression in a prospective design in which baseline marijuana use and temperament predict anxiety and depression 1 year later. We found that harm avoidance (HA) is associated with higher anxiety and depression a year later, but only among those low in marijuana use. Those higher in marijuana use show no relation between HA and symptoms of anxiety and depression. Marijuana use also moderated the effect of novelty seeking (NS), with symptoms of anxiety and depression increasing with NS only among those with high marijuana use. NS was unrelated to symptoms of anxiety and depression among those low in marijuana use. The temperament dimension of reward dependence was unrelated to anxiety and depression symptoms. Our results suggest that marijuana use does not have an invariant relationship with anxiety and depression, and that the effects of relatively stable temperament dimensions can be moderated by other contextual factors.
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la Roi C, Kretschmer T, Dijkstra JK, Veenstra R, Oldehinkel AJ. Disparities in Depressive Symptoms Between Heterosexual and Lesbian, Gay, and Bisexual Youth in a Dutch Cohort: The TRAILS Study. J Youth Adolesc 2016; 45:440-56. [PMID: 26748920 PMCID: PMC4749655 DOI: 10.1007/s10964-015-0403-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/12/2015] [Indexed: 11/03/2022]
Abstract
Lesbian, gay, and bisexual (LGB) youth experience elevated levels of depressive symptoms compared to heterosexual youth. This study examined how differences in depressive symptoms between heterosexual and LGB youth developed from late childhood to early adulthood. The association between sexual orientation and depressive symptoms was estimated from age 11 to 22 using data from the TRacking Adolescents' Individual Lives Survey, a longitudinal Dutch cohort study. Of the 1738 respondents (54.8 % girls) that provided information on sexual orientation, 151 self-identified as LGB. In line with the Minority Stress Framework, it was tested whether self-reported peer victimization and parental rejection mediated the association between sexual orientation and depressive symptoms. Results indicated that LB girls and bisexuals were at increased risk of depressive symptoms already at age 11. The difference increased over time and was related to pubertal development in girls and bisexual individuals. Furthermore, self-reported peer victimization (for both boys and girls), as well as parental rejection (for girls/bisexuals), mediated the association between sexual orientation and depressive symptoms. The authors conclude that already in late childhood, associations between sexual orientation and depressive symptoms are found, partly due to minority stress mechanisms.
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Affiliation(s)
- Chaïm la Roi
- Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands.
| | - Tina Kretschmer
- Department of Pedagogy and Educational Science, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Jan Kornelis Dijkstra
- Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| | - René Veenstra
- Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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van Zoonen K, Kleiboer A, Cuijpers P, Smit J, Penninx B, Verhaak P, Beekman A. Determinants of attitudes towards professional mental health care, informal help and self-reliance in people with subclinical depression. Int J Soc Psychiatry 2016; 62:84-93. [PMID: 26243151 DOI: 10.1177/0020764015597014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although little is known about which people with subclinical depression should receive care to prevent the onset of depression, it is clear that remediating symptoms of depression is important. However, depending on the beliefs people hold about help, some people will seek professional help, while others seek informal help or solve problems on their own. AIMS This study examined associations between attitudes about help and socio-demographic variables, mastery, severity of depressive symptoms, accessibility to care, and health care utilization at baseline and 4-year follow-up. METHODS Data were derived from a large cohort study, the Netherlands Study of Depression and Anxiety (NESDA). A total of 235 respondents with subclinical depression completed questionnaires at baseline and follow-up. Attitude was assessed using a short version of the 'Trust in mental health care' questionnaire. RESULTS Positive attitude towards professional care was associated with being male, younger age, higher mastery and easy accessibility to care. Positive attitude towards informal help was associated with higher mastery and unemployment. Older age, less accessibility to care and lower mastery were associated with positive attitude towards self-reliance. A change in care utilization was associated with positive attitudes towards professional care at follow-up. CONCLUSIONS People differ in the way they cope with symptoms which may influence their preferred care. Higher levels of mastery were positively associated with professional and informal care, but negatively associated with self-reliance. Both age and mastery showed relatively large effect sizes.
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Affiliation(s)
- Kim van Zoonen
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Annet Kleiboer
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jan Smit
- EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Brenda Penninx
- EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Verhaak
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Aartjan Beekman
- EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands
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Abstract
OBJECTIVES Clinical neuroscience is increasingly turning to imaging the human brain for answers to a range of questions and challenges. To date, the majority of studies have focused on the neural basis of current psychiatric symptoms, which can facilitate the identification of neurobiological markers for diagnosis. However, the increasing availability and feasibility of using imaging modalities, such as diffusion imaging and resting-state fMRI, enable longitudinal mapping of brain development. This shift in the field is opening the possibility of identifying predictive markers of risk or prognosis, and also represents a critical missing element for efforts to promote personalized or individualized medicine in psychiatry (i.e., stratified psychiatry). METHODS The present work provides a selective review of potentially high-yield populations for longitudinal examination with MRI, based upon our understanding of risk from epidemiologic studies and initial MRI findings. RESULTS Our discussion is organized into three topic areas: (1) practical considerations for establishing temporal precedence in psychiatric research; (2) readiness of the field for conducting longitudinal MRI, particularly for neurodevelopmental questions; and (3) illustrations of high-yield populations and time windows for examination that can be used to rapidly generate meaningful and useful data. Particular emphasis is placed on the implementation of time-appropriate, developmentally informed longitudinal designs, capable of facilitating the identification of biomarkers predictive of risk and prognosis. CONCLUSIONS Strategic longitudinal examination of the brain at-risk has the potential to bring the concepts of early intervention and prevention to psychiatry.
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Peters AT, Shankman SA, Deckersbach T, West AE. Predictors of first-episode unipolar major depression in individuals with and without sub-threshold depressive symptoms: A prospective, population-based study. Psychiatry Res 2015; 230:150-6. [PMID: 26343831 PMCID: PMC4692357 DOI: 10.1016/j.psychres.2015.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/25/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND The aim of this study is to assess predictors of first-episode major depression in a community-based sample of adults with and without sub-threshold depression. METHOD Data were from Waves 1 and 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Participants meeting criteria for a sub-threshold depressive episode (sMDE; n=3901) reported lifetime depressed mood/loss of interest lasting at least two weeks and at least two of the seven other DSM-IV symptoms of MDD. Predictors of MDE 3 years later were compared in those with and without (n=31022) sMDE. RESULTS Being female, history of alcohol or substance use, and child abuse increased the odds of developing MDD to a greater degree in individuals without sMDE relative to those with sMDE. Among those with sMDE and additional risk factors (low education, substance use), younger age was associated with marginally increased risk of MDD. CONCLUSION Several demographic risk factors may help identify individuals at risk for developing MDD in individuals who have not experienced an sMDE who may be candidates for early intervention. Future work should assess whether preventative interventions targeting substance/alcohol use and child abuse could reduce the risk of depression.
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Affiliation(s)
- Amy T. Peters
- University of Illinois at Chicago, Departments of Psychiatry and Psychology
| | | | - Thilo Deckersbach
- Massachusetts General Hospital, Department of Psychiatry,Harvard Medical School, Department of Psychiatry
| | - Amy E. West
- University of Illinois at Chicago, Departments of Psychiatry and Psychology
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