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Schulz W, Hahlweg K, Job AK, Supke M. Prevalence, persistence, and course of symptoms of depression, anxiety, and stress of mothers and fathers. Results of an 18-year longitudinal study. J Affect Disord 2024; 344:301-310. [PMID: 37805157 DOI: 10.1016/j.jad.2023.10.005] [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] [Received: 05/16/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Mental health problems in mothers and fathers are common. This longitudinal study analyzed the prevalence, course, and persistence of symptoms of depression, anxiety, and stress over 18 years in parents based on a sample from the Future Family project (N = 316). METHODS At pre-assessment the children were on average 4.2, the mothers 35.3, and the fathers 38.1 years old. Over time, the parents repeatedly filled out the "Depression, Anxiety, Stress Scales" (DASS). Analyses included descriptive methods, Chi2-tests, binary logistic regression models, and different analytical approaches (number chains, transition probability). RESULTS Approximately 6.2 % of mothers and 8.2 % of fathers suffered from borderline clinical or clinically relevant depression (anxiety: 5.4 %/6.3 %, stress: 12.6 %/14.2 %). The largest proportion of the sample was stable healthy over the 18-year period (depression: 89.1 %/86.8 %; anxiety: 90.2 %/86.2 %; stress: 75.3 %/75.7 %), whereas 2.2 % of mothers and 3.9 % of fathers showed chronic symptoms of depression (anxiety: 1.8 %/3.9 %; stress: 5.1 %/9.2 %). The remaining mothers and fathers were distributed among positive, negative, and transient courses. Child's mental health problems and mother's traumatic experiences in childhood were found to be important predictors of maternal chronic symptoms of depression, anxiety, and stress. Based on the selected models, no significant prediction was found for fathers. The average short-term persistence (from one assessment to the next) was 42 % in mothers and 44 % in fathers, the average long-term persistence rates (over 18 years) were somewhat lower (35 %/38 %). CONCLUSION Prevention programs and psychotherapy should be considered as an effective and economic approach to reduce mothers' and fathers' psychopathology in Germany.
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Affiliation(s)
- Wolfgang Schulz
- Institute for Psychology, Technische Universität Braunschweig, Germany.
| | - Kurt Hahlweg
- Institute for Psychology, Technische Universität Braunschweig, Germany
| | - Ann-Katrin Job
- Institute for Psychology, Technische Universität Braunschweig, Germany
| | - Max Supke
- Institute for Psychology, Technische Universität Braunschweig, Germany
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Krumm S, Krieg G, Lamp N, Marek F, Nickel P, Panzirsch M, Stiawa M, Beschoner P, Brieger P, Frasch K, Gertzen M, Gündel H, Hasan A, Jäger M, Kling-Lourenco P, Koussemou JM, Steber R, Kilian R. The transformation of masculinity orientations and work-related attitudes in men treated for depression (TRANSMODE): study protocol for a mixed-methods observational study. BMC Psychiatry 2023; 23:492. [PMID: 37430236 DOI: 10.1186/s12888-023-04979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Masculinity norms play a crucial role in men's help-seeking behaviors, service-use, and coping strategies for depression. While previous studies provided evidence for the association between gender role orientations, work related attitudes, stigmatization of men with depression and depressive symptoms, it remains unclear to what extent gender role orientations change over time and whether psychiatric and psychotherapeutic treatment have an impact on these transformations. Additionally, the role of partners in supporting depressed men and the impact of dyadic coping on these processes have not been explored. The aim of this study is to investigate how masculinity orientations and work-related attitudes change over time in men treated for depression, and to examine the role of their partners and dyadic coping in these transformation processes. METHODS TRANSMODE is a prospective longitudinal mixed-methods study investigating the transformation of masculinity orientations and work-related attitudes in men treated for depression between the ages of 18 and 65 from different settings in Germany. The study will recruit 350 men from various settings for quantitative analysis. By applying a latent transition analysis, the primary outcome are changes in masculine orientations and work-related attitudes over time, measured at four times (t0, t1, t2, t3) with intervals of 6 months. Qualitative interview with a subsample of depressed men selected using latent profile analysis, will be conducted between t0 and t1 (a1) with a follow-up of 12 months (a2). In addition, qualitative interviews with the partners of depressed men will be conducted between t2 and t3 (p1). Qualitative data will be analysed using qualitative structured content analysis. DISCUSSION A comprehensive understanding of the transformation processes of masculinity orientations over time including the impact of psychiatric/psychotherapeutic treatment and the role of partners can lead to the development of gender-sensitive depression treatment tailored to the unique needs of men with depression. Thus, the study can promote more effective and successful treatment outcomes and further contribute to reducing the stigma surrounding mental health issues among men and encourage them for mental health service use. TRIAL REGISTRATION This study is registered in the German Clinical Trail Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00031065 (Date of registration 06 February 2023).
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Affiliation(s)
- Silvia Krumm
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany.
| | - Gironimo Krieg
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Natalie Lamp
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Franziska Marek
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Paul Nickel
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Maria Panzirsch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus Donauwörth, Donauwörth, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Christophsbad Clinic, Göppingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | | | - Karel Frasch
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus Donauwörth, Donauwörth, Germany
| | - Marcus Gertzen
- Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Alkomiet Hasan
- Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | | | | | - José Marie Koussemou
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, Heidenheim Clinic, Heidenheim, Germany
| | | | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
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3
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Moon JY, Choi TY, Won ES, Won GH, Kim SY, Lee HJ, Yoon S. The Relationship Between Workplace Burnout and Male Depression Symptom Assessed by the Korean Version of the Gotland Male Depression Scale. Am J Mens Health 2022; 16:15579883221123930. [PMID: 36113189 PMCID: PMC9483954 DOI: 10.1177/15579883221123930] [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] [Indexed: 01/26/2023] Open
Abstract
Screening for depression in males is important because their symptoms differ from those of females, ranging from indications of aggression to attempts at suicide. Men and women differ in their responses to job stress. There are no tools that have been verified, developed, or translated for screening male depression in Korea. Our team translated the Gotland Male Depression Scale (GMDS) into Korean. The Korean version of GMDS (K-GMDS) and Maslach Burnout Inventory-General Survey (MBI-GS) were administered to 277 office workers in one public institution. Gender differences in each scale score were measured along with the correlation between the K-GMDS and the MBI-GS. There was no significant difference in the K-GMDS score between males and females, whereas females scored significantly higher on the MBI-GS (p < .001). The correlation between the K-GMDS total score and the MBI total score (male: r = .702, p < .001, female: r = .375, p < .001) and MBI subscale scores were higher in males than females. Gender moderated the relationship between total K-GMDS and total MBI scores (p < .001). The Korean version of the GMDS is suitable for screening male depression symptoms in the workplace. The results of the K-GMDS demonstrated a strong correlation between depressive symptoms and work-related burnout among men. This study can be used as a basis for studying male depression symptoms in Korea, which has not been studied extensively. This will prove beneficial for work environments.
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Affiliation(s)
- Jung Yeon Moon
- Department of Psychiatry, Daegu
Catholic University School of Medicine, Daegu, Republic of Korea
| | - Tae Young Choi
- Department of Psychiatry, Daegu
Catholic University School of Medicine, Daegu, Republic of Korea
| | - Eun Soo Won
- Department of Psychiatry, CHA Bundang
Medical Center, CHA University, Seongnam, Republic of Korea,Department of Psychiatry, Chaum, Seoul,
Republic of Korea
| | - Geun Hui Won
- Department of Psychiatry, Daegu
Catholic University School of Medicine, Daegu, Republic of Korea
| | - So Yeun Kim
- Department of Counselling and Social
Welfare, Kyungwoon University, Gumi, Republic of Korea
| | - Hye Jeong Lee
- Department of Psychiatry, Daegu
Catholic University School of Medicine, Daegu, Republic of Korea
| | - Seoyoung Yoon
- Department of Psychiatry, Daegu
Catholic University School of Medicine, Daegu, Republic of Korea,Seoyoung Yoon, Department of Psychiatry,
Daegu Catholic University School of Medicine, 33, Duryugongwon-ro 17-gil,
Nam-gu, Daegu 42471, Republic of Korea.
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4
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Smith DT, Mouzon DM, Elliott M. Hegemonic Masculinity and Mental Health Among Older White Men in the U.S.: The Role of Health and Wealth Decline. SEX ROLES 2022. [DOI: 10.1007/s11199-022-01291-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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5
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Pitzer C, Kurpiers B, Eltokhi A. Sex Differences in Depression-Like Behaviors in Adult Mice Depend on Endophenotype and Strain. Front Behav Neurosci 2022; 16:838122. [PMID: 35368297 PMCID: PMC8969904 DOI: 10.3389/fnbeh.2022.838122] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/14/2022] [Indexed: 12/27/2022] Open
Abstract
Depression affects women nearly twice as frequently as men. In contrast, rodent models of depression have shown inconsistent results regarding sex bias, often reporting more depression-like behaviors in males. This sex discrepancy in rodents modeling depression may rely on differences in the baseline activity of males and females in depression-related behavioral tests. We previously showed that the baseline despair and anhedonia behaviors, major endophenotypes of depression, are not sex biased in young adolescent wild-type mice of C57BL/6N, DBA/2, and FVB/N strains. Since the prevalence of depression in women peaks in their reproductive years, we here investigated sex differences of the baseline depression-like behaviors in adult mice using these three strains. Similar to the results in young mice, no difference was found between adult male and female mice in behavioral tests measuring despair in both tail suspension and forced swim tests, and anhedonia in the sucrose preference test. We then extended our study and tested apathy, another endophenotype of depression, using the splash test. Adult male and female mice showed significantly different results in the baseline apathy-like behaviors depending on the investigated strain. This study dissects the complex sex effects of different depression endophenotypes, stresses the importance of considering strain, and puts forward a hypothesis of the inconsistency of results between different laboratories investigating rodent models of depression.
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Affiliation(s)
- Claudia Pitzer
- Interdisciplinary Neurobehavioral Core, Heidelberg University, Heidelberg, Germany
- *Correspondence: Claudia Pitzer,
| | - Barbara Kurpiers
- Interdisciplinary Neurobehavioral Core, Heidelberg University, Heidelberg, Germany
| | - Ahmed Eltokhi
- Department of Pharmacology, University of Washington, Seattle, WA, United States
- Ahmed Eltokhi,
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6
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Möller-Leimkühler AM, Jackl A, Weissbach L. [Gender-Sensitive Depression Screening (GSDS) - Further Validation of a New Self-Rating Instrument]. PSYCHIATRISCHE PRAXIS 2021; 49:367-374. [PMID: 34921365 DOI: 10.1055/a-1615-8274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To check the validity of the preliminary results with the Gender-Sensitive Depression Screening (GSDS) in two German samples of non-psychiatric outpatients. METHODS The psychometric validation of the GSDS-33 was performed in a sample of non-psychiatric outpatients of different clinics belonging to the Ludwig-Maximilians-University of Munich (n = 958) and in a male non-psychiatric sample of the Men's Health Center in Berlin (n = 237). RESULTS Findings of the first validation study of the GSDS (Möller-Leimkühler, Mühleck 2020) were largely confirmed. The data also confirmed the factors 'aggressiveness' and 'emotional control' as important components of an increasing depression risk. Compared to a standard screening the GSDS again identified more risk cases among men in the two samples (8 % and 18 %). CONCLUSIONS The GSDS-25 is a multidimensional, valid and reliable scale for better identifying men with a risk of depression.
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Bartova L, Dold M, Fugger G, Kautzky A, Mitschek MMM, Weidenauer A, Hienert MG, Frey R, Mandelli L, Zohar J, Mendlewicz J, Souery D, Montgomery S, Fabbri C, Serretti A, Kasper S. Sex-related effects in major depressive disorder: Results of the European Group for the Study of Resistant Depression. Depress Anxiety 2021; 38:896-906. [PMID: 34110066 PMCID: PMC8453858 DOI: 10.1002/da.23165] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/19/2021] [Accepted: 04/19/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Sex-related effects on the evolution and phenotype of major depressive disorder (MDD) were reported previously. METHODS This European multicenter cross-sectional study compared sociodemographic, clinical, and treatment patterns between males and females in a real-world sample of 1410 in- and outpatients with current MDD. RESULTS Male MDD patients (33.1%) were rather inpatients, suffered from moderate to high suicidality levels, received noradrenergic and specific serotonergic antidepressants (ADs) as first-line AD treatment, generally higher mean AD daily doses, and showed a trend towards a more frequent administration of add-on treatments. Female MDD patients (66.9%) were rather outpatients, experienced lower suicidality levels, comorbid thyroid dysfunction, migraine, asthma, and a trend towards earlier disease onset. CONCLUSIONS The identified divergencies may contribute to the concept of male and female depressive syndromes and serve as predictors of disease severity and course, as they reflect phenomena that were repeatedly related to treatment-resistant depression (TRD). Especially the greater necessity of inpatient treatment and more complex psychopharmacotherapy in men may reflect increased therapeutic efforts undertaken to treat suicidality and to avoid TRD. Hence, considering sex may guide the diagnostic and treatment processes towards targeting challenging clinical manifestations including comorbidities and suicidality, and prevention of TRD and chronicity.
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Affiliation(s)
- Lucie Bartova
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Markus Dold
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Gernot Fugger
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Alexander Kautzky
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | | | - Ana Weidenauer
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Marius G. Hienert
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Richard Frey
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - Laura Mandelli
- Department of Biomedical and NeuroMotor SciencesUniversity of BolognaBolognaItaly
| | - Joseph Zohar
- Psychiatric DivisionChaim Sheba Medical CenterTel HashomerIsrael
| | | | - Daniel Souery
- School of MedicineFree University of BrusselsBrusselsBelgium,Psy Pluriel ‐ European Centre of Psychological MedicineBrusselsBelgium
| | - Stuart Montgomery
- Imperial College School of MedicineUniversity of LondonLondonUnited Kingdom
| | - Chiara Fabbri
- Department of Biomedical and NeuroMotor SciencesUniversity of BolognaBolognaItaly,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor SciencesUniversity of BolognaBolognaItaly
| | - Siegfried Kasper
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria,Center for Brain ResearchMedical University of ViennaViennaAustria
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8
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Prevalence of Depression in Iranian College Students: A Systematic Review and Meta-analysis. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2021. [DOI: 10.5812/ijpbs.101524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context: Depression is a common problem in students. The current study aimed to determine the prevalence of depression in Iranian college students. Evidence Acquisition: The study was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA). We searched both international (i.e. PubMed, Scopus, Science Direct, Web of Science, Embase, and Google Scholar) and national (i.e. SID, Magiran, Iranmedex, and IranDoc) databases from 1991 to June 2019 to identify relevant studies. Cochran’s Q test, I2 index, and τ2 index were used to assess the heterogeneity. A random-effects model was employed to combine the results using comparative meta-analysis software version 2.2. Results: Overall, 89 studies dealing with a total of 33,564 Iranian students were included. The prevalence of depression was estimated at 48.0% [95% confidence interval (CI): 43.6 - 52.5%]. The prevalence of depression was 51.3% (95% CI: 41.1 - 61.4%) and 48.9% (95% CI: 41.0 - 54.8%) in males and females, respectively. The prevalence of mild, moderate, and severe depression was estimated at 26.1% (95% CI: 23.8 - 28.6%), 15.5% (95% CI: 13.1 - 18.3%), and 6.4% (95% CI: 5.1 - 8%), respectively. The Beck-I Questionnaire and the GHQ-28 Questionnaire indicated the highest and the lowest prevalence of depression [68.4% (95% CI: 38.8 - 88.1%) vs. 39.2% (95% CI: 24.6 - 56.1%)], respectively. It was proved that the prevalence of depression among Iranian college students has significantly increased during the study period (P < 0.001). Interest in the field was significantly correlated with depression (P < 0.001). Conclusions: Given the high prevalence of depression among Iranian college students, prevention and treatment programs are strongly recommended.
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9
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Macdonald JA, Graeme LG, Wynter K, Cooke D, Hutchinson D, Kendall G, StGeorge J, Dowse E, Francis LM, McBride N, Fairweather AK, Manno LD, Olsson CA, Allsop S, Leach L, Youssef GJ. How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years. J Affect Disord 2021; 281:727-737. [PMID: 33234285 DOI: 10.1016/j.jad.2020.11.081] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/18/2020] [Accepted: 11/08/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. METHODS Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. RESULTS Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LIMITATIONS This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. CONCLUSIONS A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.
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Affiliation(s)
- Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Liam G Graeme
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Karen Wynter
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia; Deakin University, Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Australia
| | - Dawson Cooke
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia; University of New South Wales, National Drug and Alcohol Research Centre, Sydney, Australia
| | - Garth Kendall
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | | | - Eileen Dowse
- University of Newcastle, School of Nursing and Midwifery, Newcastle, Australia
| | - Lauren M Francis
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Nyanda McBride
- Curtin University, National Drug Research Institute, Perth, Australia
| | - A Kate Fairweather
- Flinders University, Discipline of Behavioural Health, College of Medicine and Public Health, Adelaide, Australia
| | - Laura Di Manno
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Perth, Australia
| | - Liana Leach
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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10
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Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. Front Psychiatry 2021; 12:589687. [PMID: 34759845 PMCID: PMC8572815 DOI: 10.3389/fpsyt.2021.589687] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
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Affiliation(s)
- Peixia Shi
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Aigang Yang
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qing Zhao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaohua Chen
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Xiaomei Ren
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qin Dai
- Department of Nursing Psychology, Army Medical University, Chongqing, China
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11
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Macdonald JA, Greenwood CJ, Francis LM, Harrison TR, Graeme LG, Youssef GJ, Di Manno L, Skouteris H, Fletcher R, Knight T, Williams J, Milgrom J, Olsson CA. Profiles of Depressive Symptoms and Anger in Men: Associations With Postpartum Family Functioning. Front Psychiatry 2020; 11:578114. [PMID: 33329118 PMCID: PMC7719778 DOI: 10.3389/fpsyt.2020.578114] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Evidence suggests that men commonly experience depression as feelings of anger; yet, research has not investigated what this means for the manifestation of depressive symptoms in the early years of fatherhood and for key indicators of family functioning. Methods: Using data from a longitudinal cohort study of men at the normative age for entering fatherhood (28-32 years), we conducted latent class analyses to identify patterns of depressive symptoms and 3 sub-types of state anger (feeling; verbal; physical). We then assessed whether class membership was associated with paternity status (n = 535). In a subsample of fathers of infants aged up to 18 months (n = 162), we prospectively assessed associations with paternal-infant bonding, co-parenting, perceived social support, paternal involvement in childcare and alcohol use up to 2 years later. Results: Five classes emerged that differentiated men by anger and depressive symptom severity and by the degree to which men endorsed the feeling of wanting to express anger physically. Compared to the reference class with minimal symptoms, fathers had a higher probability of being in either the mild or most severe symptom classes. Men in symptomatic classes were at higher risk of lower levels of social support, co-parenting problems, and paternal-infant bonds. Class membership was not associated with alcohol use or paternal involvement in childcare. Conclusions: Our results reveal patterns of co-existing symptoms of depression and anger in fathers of infants that will be relevant to men's own need for support, their family safety, partner mental health and child developmental outcomes.
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Affiliation(s)
- Jacqui A. Macdonald
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Lauren M. Francis
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Tessa R. Harrison
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Liam G. Graeme
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - George J. Youssef
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Laura Di Manno
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Richard Fletcher
- Faculty of Health and Medicine, Family Action Centre, University of Newcastle, Callaghan, NSW, Australia
| | - Tess Knight
- Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Craig A. Olsson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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12
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Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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13
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Allabadi H, Probst-Hensch N, Alkaiyat A, Haj-Yahia S, Schindler C, Kwiatkowski M, Zemp E. Mediators of gender effects on depression among cardiovascular disease patients in Palestine. BMC Psychiatry 2019; 19:284. [PMID: 31510958 PMCID: PMC6739957 DOI: 10.1186/s12888-019-2267-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 08/29/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Among patients suffering from coronary heart disease (CHD) and comorbid depression, women experience a higher burden compared to men. Little is known on the characteristics that differentiate men and women with both diseases and whether these factors mediate gender effects on depression. This study assessed whether women are more likely to suffer from depression and which characteristics mediate gender effects on depression among a cardiac population in Palestine, specifically addressing the role of post-traumatic stress disorder (PTSD). METHODS Using a cross-sectional design, patients consecutively admitted with a CHD to one of the four main hospitals in Nablus, Palestine, were interviewed using a structured questionnaire with validated instruments. Data was also obtained from hospital medical records. Patients were assessed for depression using the Cardiac Depression Scale (CDS). Bivariate analysis was conducted to compare characteristics of women and men with and without depressive symptoms. Mediators (direct and indirect effects) of the association between gender and depression were evaluated using a structural equation model (SEM). RESULTS Women were more likely to suffer from severe depression than men (28.7% vs. 18.8%). Female gender was positively associated with higher PTSD symptoms, comorbidities, somatic symptoms and income, and with lower resilience, self-esteem, quality of life, education, prevalence of smoking and physical activity. Structural equation modeling revealed negative indirect effects of gender on depression (CDS score) through resilience, self-esteem and physical activity, whereas positive indirect effects of gender on depression were observed through PTSD, comorbidities, somatic symptoms and smoking. There was no direct effect of gender on depression. CONCLUSION This study found a higher prevalence of severe depression in female patients with cardiac disease compared to male cardiac patients. Our findings provide novel information on mediating factors of the association between gender and depression among cardiac patients, in particular PTSD. The results emphasize the need for further research on potential mediating factors that could account for gender differences in depression and the need to provide support programs for female patients with comorbid CHD and depression to improve their psycho-social well-being.
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Affiliation(s)
- Hala Allabadi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland. .,University of Basel, Petersplatz 1, 4001, Basel, Switzerland. .,Faculty of Medicine and Health Sciences, An-Najah National University, Rafidia Street, P.O. Box 7, Nablus, Palestine.
| | - Nicole Probst-Hensch
- 0000 0004 0587 0574grid.416786.aDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Abdulsalam Alkaiyat
- 0000 0004 0587 0574grid.416786.aDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3University of Basel, Petersplatz 1, 4001 Basel, Switzerland ,0000 0004 0631 5695grid.11942.3fFaculty of Medicine and Health Sciences, An-Najah National University, Rafidia Street, P.O. Box 7, Nablus, Palestine
| | - Saleem Haj-Yahia
- 0000 0004 0631 5695grid.11942.3fAn-Najah National University Hospital, Asira Street, Nablus, Palestine ,0000 0004 1936 7603grid.5337.2School of Clinical Sciences, University of Bristol, 69 St Michael’s Hill, Bristol, BS2 8DZ UK ,0000 0001 2193 314Xgrid.8756.cInstitute of Cardiovascular and Medical Sciences, Glasgow University, 126 University Place, Glasgow, G12 8TA UK
| | - Christian Schindler
- 0000 0004 0587 0574grid.416786.aDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Marek Kwiatkowski
- 0000 0004 0587 0574grid.416786.aDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Elisabeth Zemp
- 0000 0004 0587 0574grid.416786.aDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland ,0000 0004 1937 0642grid.6612.3University of Basel, Petersplatz 1, 4001 Basel, Switzerland
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14
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Differences in the Expression of Symptoms in Men Versus Women with Depression: A Systematic Review and Meta-analysis. Harv Rev Psychiatry 2018; 25:29-38. [PMID: 28059934 DOI: 10.1097/hrp.0000000000000128] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While some studies suggest that men and women report different symptoms associated with depression, no published systematic review or meta-analysis has analyzed the relevant research literature. This article aims to review the evidence of gender differences in symptoms associated with depression. METHODS PubMed, Cochrane, and PsycINFO databases, along with further identified references lists, were searched. Thirty-two studies met the inclusion criteria. They included 108,260 participants from clinical and community samples with a primary presentation of unipolar depression. All 32 studies were rated for quality and were tested for publication bias. Meta-analyses were conducted on the 26 symptoms identified across the 32 studies to assess for the effect of gender. RESULTS The studies indicate a small, significant association of gender with some symptoms. Depressed men reported alcohol/drug misuse (Hedges's g = 0.26 [95% confidence interval (CI), 0.11-0.42]) and risk taking/poor impulse control (g = 0.58 [95% CI, 0.47-0.69]) at a greater frequency and intensity than depressed women. Depressed women reported symptoms at a higher frequency and intensity that are included as diagnostic criteria for depression such as depressed mood (g = -0.20 [95% CI, -0.33 to -0.08]), appetite disturbance/weight change (g = -0.20 [95% CI, -0.28 to -0.11]), and sleep disturbance (g = -0.11 [95% CI, -0.19 to -0.03]). CONCLUSIONS Results are consistent with existing research on gender differences in the prevalence of substance use and mood disorders, and of their co-occurrence. They highlight the potential utility of screening for substance misuse, risk taking, and poor impulse control when assessing depression in men. Future research is warranted to clarify gender-specific presentations of depression and co-occurring symptoms.
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Abstract
Men are a numerical minority group receiving a diagnosis of, and treatment
for, depression. However, community surveys of men and of their mental
health issues (e.g. suicide and alcoholism) have led some to suggest that
many more men have depression than are currently seen in healthcare
services. This article explores current approaches to men and depression,
which draw on theories of sex differences, gender roles and hegemonic
masculinity. The sex differences approach has the potential to provide
diagnostic tools for (male) depression; gender role theory could be used to
redesign health services so that they target individuals who have a
masculine, problem-focused coping style; and hegemonic masculinity
highlights how gender is enacted through depression and that men's
depression may be visible in abusive, aggressive and violent practices.
Depression in men is receiving growing recognition, and recent policy
changes in the UK may mean that health services are obliged to incorporate
services that meet the needs of men with depression.
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Hankerson SH, Suite D, Bailey RK. Treatment disparities among African American men with depression: implications for clinical practice. J Health Care Poor Underserved 2016; 26:21-34. [PMID: 25702724 DOI: 10.1353/hpu.2015.0012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research.
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17
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Cavanagh A, Wilson CJ, Caputi P, Kavanagh DJ. Symptom endorsement in men versus women with a diagnosis of depression: A differential item functioning approach. Int J Soc Psychiatry 2016; 62:549-59. [PMID: 27335340 DOI: 10.1177/0020764016653980] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is some evidence that, in contrast to depressed women, depressed men tend to report alternative symptoms that are not listed as standard diagnostic criteria. This may possibly lead to an under- or misdiagnosis of depression in men. AIMS This study aims to clarify whether depressed men and women report different symptoms. METHODS This study used data from the 2007 Australian National Survey of Mental Health and Wellbeing that was collected using the World Health Organization's Composite International Diagnostic Interview. Participants with a diagnosis of a depressive disorder with 12-month symptoms (n = 663) were identified and included in this study. Differential item functioning (DIF) was used to test whether depressed men and women endorse different features associated with their condition. RESULTS Gender-related DIF was present for three symptoms associated with depression. Depressed women were more likely to report 'appetite/weight disturbance', whereas depressed men were more likely to report 'alcohol misuse' and 'substance misuse'. CONCLUSION While the results may reflect a greater risk of co-occurring alcohol and substance misuse in men, inclusion of these features in assessments may improve the detection of depression in men, especially if standard depressive symptoms are under-reported.
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Affiliation(s)
- Anna Cavanagh
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Coralie J Wilson
- Illawarra Health and Medical Research Institute, Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Peter Caputi
- Centre for Health Initiatives, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - David J Kavanagh
- Institute of Health & Biomedical Innovation, School of Psychology & Counselling, Queensland University of Technology, Brisbane, QLD, Australia
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18
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Hawkins M, Schaffer A, Reis C, Sinyor M, Herrmann N, Lanctôt KL. Suicide in males and females with cardiovascular disease and comorbid depression. J Affect Disord 2016; 197:88-93. [PMID: 26971126 DOI: 10.1016/j.jad.2016.02.061] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Myocardial infarction (MI) has been associated with an increased risk of suicide, further increased among individuals with a comorbid psychiatric illness. A paucity of studies have examined details of suicide among individuals with cardiovascular disease (CVD) and comorbid depression. We aimed to compare demographic, clinical and suicide-specific characteristics between suicide victims with CVD with depression (CVD+D) and without comorbid depression (CVD-D). METHODS Coroner data on suicide decedents with CVD (n=413) occurring in Toronto, Canada from 1998 to 2012 were collected. Characteristics were compared between the CVD+D and CVD-D groups. Regression analysis examined for gender differences in these groups. RESULTS CVD+D subjects compared to CVD-D were more likely to have had a past suicide attempt (p=0.008), and to have experienced a bereavement (p=0.008) or financial stressor (p=0.005) in the past year. Each of these variables remained significantly associated with the presence of depression after the regression analysis. Within the CVD+D group, females were more likely to die from suicide by self-poisoning (p<0.0001) and males by shooting (p=0.001). LIMITATIONS Psychological autopsies were not available. The definition of CVD was broad and the accuracy of its diagnosis could not be confirmed. CONCLUSION Individuals with CVD+D who died from suicide had significant differences in clinical characteristics and specific stressors compared to those without depression. These data may help to better characterize suicide risk and prevention in this vulnerable population.
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Affiliation(s)
- Michael Hawkins
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, Canada; Mood & Anxiety Disorders Program, Toronto, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada.
| | - Catherine Reis
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Mood & Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada; Departments of Psychiatry, and Pharmacology and Toxicology, University of Toronto, Toronto, Canada
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19
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Apesoa-Varano EC, Barker JC, Unutzer J, Aguilar-Gaxiola S, Johnson MD, Tran C, Guarnaccia P, Hinton L. Idioms of Distress Among Depressed White-Non-Mexican and Mexican-Origin Older Men. J Cross Cult Gerontol 2016. [PMID: 26208782 DOI: 10.1007/s10823-015-9267-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Older men are less likely than older women to receive depression treatment. Latino older men in particular have been found to have significantly lower rates of depression treatment than their white-non-Mexican (WNM) counterparts. Prior research has shown that men are less likely than women to express overt affect and/or report depression symptoms that may prompt primary care physicians' inquiry about depression. Previous studies have overlooked the idioms of distress common among older men. This study investigates: a) the range of idioms of distress that emerge in the narratives of depressed older men, and b) the use of these idioms among depressed WNM and Mexican-origin older men. The present report is based on qualitative data collected through the Men's Health and Aging Study (MeHAS), a mixed-method study of clinically depressed WNM and Mexican-origin older (65 and above) men recruited in primary care settings. Qualitative analysis of 77 interviews led to identification of idioms of distress and informed idiom categories. Study findings show that: a) both groups of men utilized a range of idioms of distress that met current DSM criteria for depression, b) both groups were also likely to utilize idioms that feel outside clinical depression criteria, and c) there were similarities as well as differences between WNM and Mexican-origin men. This study provides a larger vocabulary that clinicians might consider in recognizing depression and initiating depression care for older men from diverse ethnic backgrounds. This is important to improve depression care among older men in general and those of Mexican-origin in particular.
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20
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Price EC, Gregg JJ, Smith MD, Fiske A. Masculine Traits and Depressive Symptoms in Older and Younger Men and Women. Am J Mens Health 2015; 12:19-29. [PMID: 26634856 DOI: 10.1177/1557988315619676] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence suggests that men who strongly endorse masculine traits display an atypical presentation of depression, including more externalizing symptoms (e.g., anger or substance use), but fewer typical, internalizing symptoms (e.g., depressed mood or crying). This phenomenon has not been adequately explored in older adults or women. The current study used the externalizing subscale of the Masculine Depression Scale in older and younger men and women to detect atypical symptoms. It was predicted that individuals who more strongly endorsed masculine traits would have higher scores on the measure of externalizing symptoms relative to a measure of typical depressive symptoms Center for Epidemiologic Studies-Depression Scale. It was anticipated that results would differ by age-group but not by gender. Multigroup path analysis was used to test the hypothesis. The hypothesized path model, in which endorsement of masculine traits was associated with lower scores on the Center for Epidemiologic Studies-Depression Scale and with scores on the externalizing, but not internalizing, factor of the Masculine Depression Scale, fit the data well. Results differed significantly by age-group and gender. Masculine individuals reported lower levels of typical depressive symptoms relative to externalizing symptoms, but further research is needed within age- and gender groups. Results are consistent with the gendered responding framework and suggest that current assessment tools, which tend to focus on internalizing symptoms of depression, may not detect depression in individuals who endorse masculine traits.
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Affiliation(s)
- Elizabeth C Price
- 1 West Virginia University, Morgantown, WV, USA.,2 Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Jeffrey J Gregg
- 1 West Virginia University, Morgantown, WV, USA.,3 Durham VA Medical Center, Durham, NC, USA
| | - Merideth D Smith
- 1 West Virginia University, Morgantown, WV, USA.,4 PSIMED Corrections, LLC, Charleston, WV, USA
| | - Amy Fiske
- 1 West Virginia University, Morgantown, WV, USA
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21
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Ulbricht CM, Dumenci L, Rothschild AJ, Lapane KL. Changes in Depression Subtypes Among Men in STAR*D: A Latent Transition Analysis. Am J Mens Health 2015; 12:5-13. [PMID: 26438468 DOI: 10.1177/1557988315607297] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The burden of depression in men is high. Current diagnostic criteria may not fully capture men's experience with depression. Descriptions of the heterogeneity in depression among men are lacking. The purpose of the study was to characterize latent subtypes of major depression and changes in these subtypes among men receiving citalopram in Level 1 of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Latent transition analysis was applied to data from 387 men who completed baseline and Week 12 study visits in Level 1 of STAR*D. Items from the self-report version of the Quick Inventory of Depressive Symptomatology were used as indicators of latent depression subtypes. Four statuses were identified at baseline and Week 12. Baseline statuses were Mild (10% of men), Moderate (53%), Severe with Psychomotor Slowing (20%), and Severe with Psychomotor Agitation (17%). At Week 12, the statuses were Symptom Resolution (41%), Mild (36%), Moderate (18%), and Severe with Psychomotor Slowing (5%). Men in the Mild status were most likely to transition to Symptom Resolution (probability = 69%). Men in the Severe with Agitation status were least likely to transition to Symptom Resolution (probability = 0%). This work highlights the need to not focus solely on summary rating scores but to also consider patterns of symptoms when treating depression.
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Affiliation(s)
| | - Levent Dumenci
- 2 Temple University College of Public Health, Philadelphia, PA, USA
| | - Anthony J Rothschild
- 1 University of Massachusetts Medical School, Worcester, MA, USA.,3 UMassMemorial HealthCare, Worcester, MA, USA
| | - Kate L Lapane
- 1 University of Massachusetts Medical School, Worcester, MA, USA
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Bernegger A, Kienesberger K, Carlberg L, Swoboda P, Ludwig B, Koller R, Kapusta ND, Aigner M, Haslacher H, Schmöger M, Kasper S, Schosser A. Influence of Sex on Suicidal Phenotypes in Affective Disorder Patients with Traumatic Childhood Experiences. PLoS One 2015; 10:e0137763. [PMID: 26366559 PMCID: PMC4569479 DOI: 10.1371/journal.pone.0137763] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/21/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives In the current study, we aimed to investigate the impact of childhood trauma on suicidal behaviour phenotypes in a group of patients with diagnosed affective disorder (unipolar or bipolar affective disorder). Patients and Methods Patients with and without a history of childhood abuse, measured by Childhood Trauma Questionnaire (CTQ), were assessed to explore risks for suicidal behaviour (including suicide attempt, self-harm and non-suicidal self-injury). The tested sample consisted of 258 patients (111 males and 147 females, in-patients and out-patients at the Department of Psychiatry and Psychotherapy, Medical University of Vienna and University Hospital Tulln, Lower Austria). Psychiatric diagnoses were derived from the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) interview. In addition, patients were administered the Lifetime Parasuicidal Count (LPC), Suicidal Behaviour Questionnaire (SBQ-R), and Viennese Suicide Risk Assessment Scale (VISURIAS) questionnaires. Results In contrast to male suicide attempters, female suicide attempters showed both significantly higher total CTQ scores (p<0.001), and higher CTQ subscores (emotional, physical and sexual abuse, as well as emotional and physical neglect) in comparison to the non-suicidal control group. Besides, females with a history of self-harming behaviour (including suicidal intention) and Non-Suicidal-Self Injury (NSSI) had significantly higher CTQ total scores (p<0.001) than the control group. Conclusion These findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma.
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Affiliation(s)
- Alexandra Bernegger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Klemens Kienesberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Laura Carlberg
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Patrick Swoboda
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Birgit Ludwig
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Romina Koller
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nestor D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Martin Aigner
- University Hospital Tulln, Department of Psychiatry, Tulln, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Michaela Schmöger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Zentrum für Seelische Gesundheit LEOpoldau, BBRZ-Med, Vienna, Austria
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Abstract
OBJECTIVES Homicide is overwhelmingly committed by men compared to women. Conservative estimates suggest that more than a third of these individuals have a treatable psychiatric disorder. These data present an opportunity to mental health clinicians to assist in the prevention of homicide by improving men's mental health. METHODS We review the current literature on men's mental health with a focus on assessing and reducing homicide risk in men with psychiatric conditions. RESULTS Bipolar disorder and schizophrenia appear to share a neural endophenotype that is a risk factor for homicide. Dual disorders, or the presence of a substance use disorder with other major mental illness, are a major risk factor for homicide in males. Dual diagnosis disorders, personality disorders and pathological traits and male depression share emotion dysregulation, irritability, and reactive aggression. Promoting physician education, addressing firearm safety, reducing the reluctance of men relative to women to engage in help-seeking behaviour, and using targeted risk interviews which integrate these data are all currently recommended. CONCLUSIONS The main focus in prevention of homicidal behaviour in males with psychiatric disorders should be to identify high risk groups, to provide adequate treatment, and to facilitate compliance with long-term treatment while considering male specific problems and needs.
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Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai , New York , USA
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24
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Gender differences in a cohort of major depressive patients: further evidence for the male depression syndrome hypothesis. J Affect Disord 2015; 167:85-92. [PMID: 24953479 DOI: 10.1016/j.jad.2014.05.058] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 05/27/2014] [Accepted: 05/29/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND Previous studies have shown that major depressive patients may differ in several features according to gender, but the existence of a specific male depressive syndrome remains controversial. METHODS As part of the EPIDEP National Multisite French Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 125 (27.7%) were of male gender, whereas 317 (72.3%) were female, after exclusion of bipolar I patients. RESULTS Compared to women, men were more often married, had more associated mixed features, with more bipolar disorder NOS, more hyperthymic temperaments, and less depressive temperaments. Women had an earlier age at onset of depression, more depressive episodes and suicide attempts. A higher family loading was shown in men for bipolar disorder, alcohol use disorder, impulse control disorders and suicide, whereas their family loading for major depressive disorder was lower. Men displayed more comorbidities with alcohol use, impulse control, and cardiovascular disorders, with lower comorbidities with eating, anxiety and endocrine/metabolic disorders. The following independent variables were associated with male gender: hyperthymic temperament (+), alcohol use disorder (+), impulse control disorders (+), and depressive temperament (-). LIMITATIONS The retrospective design and the lack of specific tools to assess the male depressive syndrome. CONCLUSION Study findings may lend support to the male depression syndrome concept and draw attention to the role of hyperthymic temperament, soft bipolarity as well as comorbidities as determinants of this syndrome. The latter could help recognize an entity which is probably underdiagnosed, but conveys a high risk of suicide and cardiovascular morbidity.
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Sigurdsson B, Palsson SP, Aevarsson O, Olafsdottir M, Johannsson M. Validity of Gotland Male Depression Scale for male depression in a community study: the Sudurnesjamenn study. J Affect Disord 2015; 173:81-9. [PMID: 25462400 DOI: 10.1016/j.jad.2014.10.065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/26/2014] [Accepted: 10/28/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several studies suggest a "male depressive syndrome", where not only the standard symptoms of major depressive disorder (MDD) but also symptoms of anxiety, anger, irritability and antisocial behaviour are prominent. METHOD In a community study, 534 males were screened for possible depression by the Gotland Male Depression Scale (GMDS) and Beck's Depression Inventory (BDI). For comparison psychiatrists examined a sub-sample of healthy and depressive males (n=137). The validity of the GMDS was compared both with the BDI and MDD diagnosis according to DSM-IV. RESULTS GMDS was as good as BDI for screening males. ROC-curve analysis gave AUC 0.945 (95% CI 0.923-0.968) for GMDS when tested against BDI. Second, when both scales were tested by ROC-curves against DSM-IV, the GMDS had AUC=0.861 (95% CI 0.800-0.921) and BDI had AUC=0.822 (95% CI 0.751-0.893). The estimated prevalence was 14-15%. LIMITATIONS Low participation rate (25%) in the screening phase. CONCLUSION GMDS is a valid screening tool for detecting male depression (MDD). Furthermore it is a short self-rating scale, easy to use in daily practice to screen for depression. Our results support recent reports of high prevalence of depressions in the community which supports active screening of males in clinical practice.
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Affiliation(s)
- Bjarni Sigurdsson
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | | | - Olafur Aevarsson
- Center for Sport and Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Maria Olafsdottir
- Arbaer Health Clinic, Primary Health Care of the Capital Area, Reykjavik, Iceland
| | - Magnus Johannsson
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Apesoa-Varano EC, Barker JC, Hinton L. Shards of sorrow: Older men's accounts of their depression experience. Soc Sci Med 2014; 124:1-8. [PMID: 25461856 DOI: 10.1016/j.socscimed.2014.10.054] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 11/16/2022]
Abstract
The experience of depression is diverse based on social locations and context. A sociological perspective building on masculinity, illness work, and the self provides a useful theoretical framework to understand how older men negotiate emotional suffering. This article examines older men's accounts of their depression experience from a social constructionist approach. This analysis is based on data from 77 in-depth interviews with depressed older men who participated in a larger mixed-method study, the Men's Health and Aging Study (MeHAS). We show how older men construct depression accounts in which they integrate biological and social factors associated with feeling a loss of control. This is experienced as a shamed masculine self given their inability to perform manhood acts, which leads them to severe social bonds. Men's accounts also shed light on how they resist the shaming of the masculine self by deploying two primary strategies: acting overtly masculine through aggressive behavior and by retracting from social interactions that may lead to feelings of shame. These strategies appear futile and they are only partially able to embrace alternative masculine values in line with roles as grandparents and older, wiser men. Depression in older men is characterized by an ongoing negotiation of limited statuses and roles given dominant conceptions of masculinity.
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Characterization of patients with mood disorders for their prevalent temperament and level of hopelessness. J Affect Disord 2014; 166:285-91. [PMID: 25012443 DOI: 10.1016/j.jad.2014.05.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/13/2014] [Accepted: 05/15/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Mood disorders (MD) are disabling conditions throughout the world associated with significant psychosocial impairment. Affective temperaments, as well as hopelessness, may play a significant role in the pathophysiology of MD. The present study was designed to characterize patients with MD for their prevalent affective temperament and level of hopelessness. METHODS Five hundred fifty-nine (253 men and 306 women) consecutive adult inpatients were assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A), the Gotland Scale for Male Depression (GSMD), the Beck Hopelessness Scale (BHS) and the Mini International Neuropsychiatric Interview (MINI). RESULTS Higher cyclothymia and irritable temperaments were found in bipolar disorder-I (BD-I) patients compared to those with other Axis I diagnoses. Major depressive disorder (MDD) patients had lower hyperthymia than BD-I and BD-II patients and higher anxiety than patients with other Axis I diagnoses. Severe "male" depression was more common in BD-II patients compared to BD-I and MDD patients. BD-I patients and those with other axis I diagnoses reported lower BHS ≥9 scores than those with BD-II and MDD. LIMITATIONS The study had the limitations of all naturalistic designs, that is, potentially relevant variables were not addressed. Furthermore, the cross-sectional nature of the study did not allow conclusions about causation, and the use of self-report measures could be potentially biased by social desirability. CONCLUSION MDD patients were more likely to have higher anxious temperament, higher hopelessness and lower hyperthymic temperament scores, while BD-I patients more often had cyclothymic and irritable temperaments than patients with other Axis I diagnoses. The implications of the present results were discussed.
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Kasper S, Kranz GS, Lanzenberger R. Testosterone, neural circuits, and male depression. Biol Psychiatry 2014; 76:272-3. [PMID: 25060786 DOI: 10.1016/j.biopsych.2014.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
| | - Georg S Kranz
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Braca M, Berardi D, Mencacci E, Belvederi Murri M, Mimmi S, Allegri F, Mazzi F, Menchetti M, Tarricone I. Understanding psychopathology in migrants: a mixed categorical-dimensional approach. Int J Soc Psychiatry 2014; 60:243-53. [PMID: 23733828 DOI: 10.1177/0020764013484237] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Literature on mental disorders in migrants is constantly increasing. Only a few studies describe psychopathological dimensions in migrants over their nosographic diagnoses; however, there is a growing literature about the greater utility of a categorical-dimensional approach, rather than a solely categorical approach, in the understanding of mental disorders. The aim of this paper is to describe the phenomenology of mental disorders in migrants referred to the Transcultural Psychiatric Team of Bologna (BoTPT), by analysing the psychopathological dimensions that underlie their clinical diagnoses. METHODS We recruited all migrants who attended the BoTPT between May 1999 and July 2009. The psychopathological assessment was conducted with the Association for Methodology and Documentation in Psychiatry (AMDP) and clinical diagnoses were formulated according to ICD-10. We proceeded through a two-step analysis: (1) comparing the prevalence rates of psychopathological symptoms across diagnoses; then (2) conducting a factor analysis to assess how those symptoms configure psychopathological dimensions and how these dimensions underlie clinical diagnoses. RESULTS As expected, we found significant associations between diagnoses and the prevalence of their core psychopathological symptoms. Factor analysis revealed a strong polymorphism of the psychopathological presentation of mental disorders and unexpectedly showed that in each diagnostic cluster, the first extracted factor was not composed of core symptoms. CONCLUSIONS A mixed categorical-dimensional approach seems to improve the description of the psychopathology among migrants, as it adds relevant information regarding psychopathological dimensions useful to the understanding of the peculiar clinical expressivity of our patients.
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Affiliation(s)
- Mauro Braca
- 1Bologna Transcultural Psychiatric Team (BoTPT), Department of Medical and Surgical Sciences, University of Bologna, Italy
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Rodgers S, Grosse Holtforth M, Müller M, Hengartner MP, Rössler W, Ajdacic-Gross V. Symptom-based subtypes of depression and their psychosocial correlates: a person-centered approach focusing on the influence of sex. J Affect Disord 2014; 156:92-103. [PMID: 24373526 DOI: 10.1016/j.jad.2013.11.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 11/27/2013] [Accepted: 11/29/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reducing the complexity of major depressive disorder by symptom-based subtypes constitutes the basis of more specific treatments. To date, few studies have empirically derived symptom subtypes separated by sex, although the impact of sex has been widely accepted in depression research. METHODS The community-based sample included 373 males and 443 females from the Zurich Program for Sustainable Development of Mental Health Services (ZInEP) manifesting depressive symptoms in the past 12 months. Latent Class Analysis (LCA) was performed separately by sex to extract sex-related depression subtypes. The subtypes were characterized by psychosocial characteristics. RESULTS Three similar subtypes were found in both sexes: a severe typical subtype (males: 22.8%; females: 35.7%), a severe atypical subtype (males: 17.4%; females: 22.6%), and a moderate subtype (males: 25.2%; females: 41.8%). In males, two additional subgroups were identified: a severe irritable/angry-rejection sensitive (IARS) subtype (30%) comprising the largest group, and a small psychomotor retarded subtype (4%). Males belonging to the severe typical subtype exhibited the lowest masculine gender role orientation, while females of the typical subtype showed more anxiety disorders. The severe atypical subtype was associated with eating disorders in both sexes and with alcohol/drug abuse/dependence in females. In contrast, alcohol/drug abuse/dependence was associated with the severe IARS subtype in males. LIMITATIONS The study had a cross-sectional design, allowing for no causal inferences. CONCLUSIONS This study contributes to a better understanding of sex-related depression subtypes, which can be well distinguished on the basis of symptom profiles. This provides the base for future research investigating the etiopathogenesis and effective treatment of the heterogeneous depression disorder.
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Affiliation(s)
- Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
| | - Martin Grosse Holtforth
- Department of Psychology, University of Zurich, and Department of Psychology, University of Bern, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
| | - Michael P Hengartner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
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Schuch JJJ, Roest AM, Nolen WA, Penninx BWJH, de Jonge P. Gender differences in major depressive disorder: results from the Netherlands study of depression and anxiety. J Affect Disord 2014; 156:156-63. [PMID: 24388685 DOI: 10.1016/j.jad.2013.12.011] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 10/01/2013] [Accepted: 12/05/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although an overall gender difference in prevalence of major depressive disorder (MDD) has been well established, several questions concerning gender differences in the clinical manifestation of depression remain. This study aims to identify gender differences in psychopathology, treatment, and public health consequences in patients with MDD. METHODS Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1115 participants (364 men, 751 women, mean age 41 years) with a DSM-IV diagnosis of current MDD. Characteristics studied included symptom profiles, comorbidity, treatment, and public health consequences. RESULTS Women reported a younger age of onset of single (27.8 years vs. 31.6 years; p=0.001) and recurrent MDD (24.8 years vs. 27.6 years; p=0.014), a higher comorbidity of panic disorder with agoraphobia (24.9% vs. 17.3%; p=0.006) and life-time overall anxiety disorder (77.6% vs. 71.4%; p=0.029) than men. More men than women suffered from comorbid alcohol dependence or abuse (48.1% vs. 24.5%; p<0.001). An increased prevalence of atypical depression in women (24.6% vs. 17.3%; p=0.009) was found. Women were treated more frequently by an alternative caretaker (20.6% vs. 14.8%; p=0.025), men more often in mental health care organizations (61.0% vs. 53.7%; p=0.025). No gender differences in frequency of medication use or counseling were found. LIMITATIONS Cross sectional design. CONCLUSIONS Main gender differences in the clinical presentation of MDD concerned a younger age of onset, higher anxiety and lower alcohol use comorbidity and higher prevalence of atypical depression in women. These differences were accompanied by differences in health care use.
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Affiliation(s)
- Jérôme J J Schuch
- Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - Annelieke M Roest
- Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Willem A Nolen
- Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; Department of Psychiatry/EMGO Institute/Neuroscience, Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter de Jonge
- Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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Abstract
Understanding of depression among men remains poor. When compared to women, men remain under diagnosed for depression and continue to commit suicide four times the rate of women. This grounded theory study explored the social psychological process that occurred in men who suffered from depression. Nine men participated in the study that ranged in age, educational level, and marital status. The theory that emerged from this study was Navigating Inward and Outward Through Depression. This study uncovered six stages men navigated through: being different, concealing feelings disconnecting, hitting bottom, acknowledging and confronting and healing with others. This study advances our understanding of men and depression by providing meanings to the behaviors men express when depressed. Based on these findings, further research can lead to better screening tools and early diagnosis of depression in men.
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Chu CL, Chen Y, Jiang KH, Chen JL, Lee CP, Chau YL, Chen CY. Validity and clinical utilization of the Chinese version of the Gotland Male Depression Scale at a men's health polyclinic. Neuropsychiatr Dis Treat 2014; 10:1707-14. [PMID: 25246791 PMCID: PMC4166311 DOI: 10.2147/ndt.s67617] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Symptoms of depression in males, such as aggression and irritability, are different from those in females. However, there are no adequate scales for detecting possible diagnoses in the Chinese population. The aim of this study was to assess whether the Chinese version of the Gotland Male Depression Scale (CV-GMDS) could identify male depression as effectively as the English version. MATERIALS AND METHODS A total of 231 male outpatients were sampled from a men's health polyclinic. We used questionnaires to evaluate the characteristics and mood status of participants, including the CV-GMDS, the Chinese version of the Beck Depressive Inventory II (CV-BDI-II), and the Chinese version of the Aging Males' Symptoms (CV-AMS) scale. Cronbach's α-coefficient and Levene's test were used to investigate internal consistency and homogeneity, respectively. External validity was evaluated using Spearman's correlation coefficient. A factor analysis was conducted to evaluate the conceptual structure of the CV-GMDS, and a regression analysis was used to determine the relationship of the CV-AMS scale with the CV-GMDS and CV-BDI-II. RESULTS The mean age of the 231 participants was 46.1 years (standard deviation 11.0). Of the participants, 36.8% (n=85) were found to have depression according to the CV-GMDS and 34.6% (n=80) according to the CV-BDI-II. The internal consistency of the CV-GMDS was demonstrated by a Cronbach's α of 0.933, and the test of homogeneity revealed a P-value of 0.762. The external validity for the CV-GDMS and CV-BDI-II was demonstrated by an intercorrelation of 0.835. The third and fourth items of the GMDS differed from the others, and the CV-GMDS showed a better relationship (R (2)=0.616) with the CV-AMS scale than the CV-BDI-II did. CONCLUSION The CV-GMDS is a satisfactory and suitable psychometric questionnaire for detecting depression among a Chinese-speaking middle-aged or older male population. The results of this study could be used as a basis for investigating specific male depression and aging symptoms.
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Affiliation(s)
- Chun-Lin Chu
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu Chen
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan ; Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kun-Hao Jiang
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan ; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jiun-Liang Chen
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan ; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chin-Pang Lee
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yeuk-Lun Chau
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ching-Yen Chen
- Men's Health Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Rice SM, Fallon BJ, Aucote HM, Möller-Leimkühler AM. Development and preliminary validation of the male depression risk scale: furthering the assessment of depression in men. J Affect Disord 2013; 151:950-8. [PMID: 24051100 DOI: 10.1016/j.jad.2013.08.013] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 06/28/2013] [Accepted: 08/18/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND The last decade has seen the burgeoning publication of male-specific depression rating scales designed to assess externalising depression symptoms (e.g., substance use, risk-taking, and aggression). These symptoms are theorised to reflect the behavioural manifestation of depression amongst men who rigidly conform to masculine norms. To date, research findings from these scales have been mixed, and each scale is limited by psychometric shortcomings or constrained assessment of symptom sub-domains. METHODS The Male Depression Risk Scale (MDRS-22) was developed from online, non-clinical, community samples. Following best-practice recommendations, initial scale items were subject to expert review. Study 1 (male n=386) reduced the item pool via exploratory factor analysis while Study 2 (male n=499, female n=291) refined and validated the factor structure using confirmatory factor analysis. Sex and masculinity comparisons were evaluated. RESULTS Goodness of fit indices validated the six-factor solution with subscales assessing: emotional suppression, drug use, alcohol use, anger and aggression, somatic symptoms and risk-taking. Between-groups analyses indicated higher MDRS-22 scores for males reporting higher conformity to masculine norms. LIMITATIONS Data were drawn from an online community sample without use of diagnostic interview. Test-retest correlations were not evaluated. Future research should look to examine longitudinal typical-externalising symptom trajectories across a range of clinical and non-clinical settings. CONCLUSIONS The MDRS-22 reports satisfactory preliminary psychometric properties with validated subscales enabling multidimensional assessment of theorised externalising symptom sub-domains. MDRS-22 scale brevity may facilitate use in primary care settings enabling better identification of at-risk males.
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Affiliation(s)
- Simon M Rice
- Centre for Youth Mental Health, Orygen Youth Health Research Centre, University of Melbourne, Locked Bag 10, Parkville, VIC 3052, Australia.
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Grace SL, Yee J, Reid RD, Stewart DE. Measurement of depressive symptoms among cardiac patients: Should sex differences be considered? J Health Psychol 2013; 19:943-52. [DOI: 10.1177/1359105313482165] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Confounding of depressive and cardiac symptoms may hold implications for assessment. This study investigated psychometric properties and sex differences in two depression scales among cardiac patients. Cardiac inpatients from 11 hospitals were recruited and completed a mailed survey including the Beck Depression Inventory-II and Gotland Scale of Male Depression 1 year later. The scales were significantly correlated and both were associated with social desirability. Females scored higher than males on the fatigue factor only ( p < .001). Psychometric properties of the Beck Depression Inventory-II were more favorable in this population. Practitioners must not overlook reports of fatigue in female cardiac patients.
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Affiliation(s)
- Sherry L Grace
- York University, Canada
- University Health Network, Canada
- University of Toronto, Canada
| | | | | | - Donna E Stewart
- University Health Network, Canada
- University of Toronto, Canada
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Cyclothymic-depressive-anxious temperament pattern is related to suicide risk in 346 patients with major mood disorders. J Affect Disord 2012; 136:405-11. [PMID: 22177743 DOI: 10.1016/j.jad.2011.11.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 11/14/2011] [Indexed: 02/01/2023]
Abstract
BACKGROUND Suicidal behavior is one of the most alarming signs not only in psychiatry, and current major depressive episode is the most frequent medical condition among suicide victims and attempters. The aim of the study was to investigate the relationship between the individual pattern of affective temperaments, non-typical symptoms of depression as measured with the Gotland Scale for Male Depression (GSMD), hopelessness and suicidal behavior in major mood disorder patients. METHODS Participants were 346 adult inpatients (151 men and 195 women) with major mood disorders consecutively admitted to the Department of Psychiatry of the Sant'Andrea University Hospital in Rome, Italy. All the patients were administered the TEMPS-A, the GSMD, and the Beck Hopelessness Scale (BHS) and the Mini International Neuropsychiatric Interview (MINI). RESULTS A Two Step Cluster Analysis procedure, performed to reveal natural groupings within patients' response set, indicated that there were 2-groups: a cyclothymic-depressive-anxious group and a hyperthymic group. More than 81% of the patients with prevailing cyclothymic-depressive-anxious temperament had mild to severe suicidal risk on the MINI vs. only around 42% of the patients with prevailing hyperthymic temperament. Sixty-four percent of patients with prevailing cyclothymic-depressive-anxious temperament had BHS scores of 9 or higher versus only 13% of patients with prevailing hyperthymic temperament. Also, patients with prevailing cyclothymic-depressive-anxious temperament more likely had higher GSMD than patients with prevailing hyperthymic temperament. LIMITATIONS The correlational nature of the study limits causal conclusions to be drawn. CONCLUSIONS Our results indicate that affective temperament measure along with Gotland Scale for Male Depression could be useful tools in screening and identifying those affective disorder patients who are at higher risk of suicidal behavior.
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"He's more typically female because he's not afraid to cry": connecting heterosexual gender relations and men's depression. Soc Sci Med 2011; 73:775-82. [PMID: 21807445 DOI: 10.1016/j.socscimed.2011.06.034] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 06/17/2011] [Accepted: 06/21/2011] [Indexed: 11/22/2022]
Abstract
Depression, a disorder often thought of as a women's health issue, is underreported in men, and little is known about how heterosexual couples respond when the male partner is depressed. Within the context of men's depression, couples may be challenged to make life adjustments that impact their gender relations. The findings detailed in this article are drawn from an innovative qualitative study of 26 Canadian heterosexual couples (26 men and their 26 women partners) in which the man had a formal diagnosis and/or self-identified as depressed. Participants completed individual, semi structured interviews that focused on exploring how masculinities and femininities intersect to forge particular heterosexual gender relations in the context of men's depression. A social constructionist gender analysis revealed three couple patterns: trading places, business as usual, and edgy tensions. Trading places refers to couples who embodied some atypical masculine and feminine roles to compensate for the men's depression-induced losses (e.g., men as homemakers and women as breadwinners). Women partners in these dyads broke with feminine ideals in how they provided partner support by employing tough love strategies for self-protection and a means of prompting the men's self-management of their depression. Couples involved in business as usual co-constructed men's alignment with masculine workman ideals and women's support of their partner to counter and conceal men's depression induced-deficits. Also described were edgy tensions, where a mismatch of gender expectations fueled resentment and dysfunction that threatened the viability of some relationships. Overall, the limits of women's resilience and care-giving were evident, yet the findings also reveal how men's management of their depression was directly influenced by their partner. Opportunities for couples to assess their relationship dynamics within a broad range of gender relations might support couples' connectedness and life quality amid the challenges that accompany men's depression.
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Innamorati M, Pompili M, Gonda X, Amore M, Serafini G, Niolu C, Lester D, Rutz W, Rihmer Z, Girardi P. Psychometric properties of the Gotland Scale for Depression in Italian psychiatric inpatients and its utility in the prediction of suicide risk. J Affect Disord 2011; 132:99-103. [PMID: 21371756 DOI: 10.1016/j.jad.2011.02.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 01/13/2011] [Accepted: 02/01/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Rutz has postulated a "male depressive syndrome" measured by the Gotland Scale of Male Depression (GSMD). The aim of the study was to assess the psychometric properties of the GSMD in a sample of male and female psychiatric inpatients. METHODS The sample was composed of 326 Italian inpatients who completed the GSMD and the Beck Hopelessness Scale (BHS). RESULTS Our results indicated that all the items of the GSMD, except item #13, were highly interrelated, and that the first 12 items of the GSMD may be considered a homogeneous measure of depression. Furthermore, GSMD scores did not differ by sex. The GSMD had good convergent validity with the BHS and was useful in categorizing individuals admitted for a suicide attempt committed in the last 48h vs. those who had not. LIMITATIONS The study was retrospective in nature and did not assess the ability of the GSMD for predicting future suicidal behavior. CONCLUSIONS The GSMD may be considered to be a valid instrument for measuring non-typical ("suicidality-related") symptoms of depression in both male and female patients.
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Affiliation(s)
- Marco Innamorati
- Department of Neuroscience, Mental Health and Sensory Functions, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy
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Fields AJ, Cochran SV. Men and Depression: Current Perspectives for Health Care Professionals. Am J Lifestyle Med 2010. [DOI: 10.1177/1559827610378347] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Epidemiological and health care utilization rates document potential underidentification and under-treatment of men who may suffer from major depression. Limitations in diagnostic criteria may prevent health care professionals from clearly recognizing depression in the men they treat. Societal norms related to masculine gender role socialization may create barriers to help seeking for men who could benefit from treatment for depression. This review integrates up-to-date research with clinical reports and offers recommendations for health care professionals. The primary goals of the recommendations are to increase sensitivity to male patients who may suffer from depression and to equip professionals with scientifically informed strategies for recognizing and responding to men who are identified with depression.
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Strömberg R, Backlund LG, Löfvander M. A comparison between the Beck's Depression Inventory and the Gotland Male Depression Scale in detecting depression among men visiting a drop-in clinic in primary care. Nord J Psychiatry 2010; 64:258-64. [PMID: 20100134 DOI: 10.3109/08039480903511407] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Anger attacks and alcohol use may mask depressive symptoms in men. Only the Gotland Male Depression Scale (GS) includes such items. AIMS To study the usefulness of the GS and Beck Depression Inventory (BDI) in detecting depression among men in primary care. METHODS At a family doctor's drop-in clinic in Stockholm, Sweden, all men were invited into the study 2 days a week (opportunistic screening). On other days, the men who mentioned mental symptoms were invited (targeted screening). The men filled in BDI, GS and a social questionnaire. The doctor invited the men with BDI > or = 10 and /or GS > or = 13 to a repeat visit. The outcome was depression diagnosed according to DSM-IV and the severity was assessed with the Montgomery-Asberg Depression Rating Scale. RESULTS 223 men were recruited, 190 by opportunistic and 33 by targeted screening. Seventeen per cent of the men reported an alcohol consumption that might put them at risk. In the opportunistic screening, 23% scored BDI > or = 10 and 14% scored GS > or = 13. The prevalence of depression in the opportunistic screening was 10.5%. The proportion of depressed men in the targeted screening was 60.6%. In total, 40 men were depressed, 63% had a mild and 35% moderate depression. The correlation between the scales was 0.80. The GS identified no additional cases. CONCLUSIONS Clinical depression was quite common among those men who often had a high alcohol consumption, indicating an advantage for the GS when screening for depression among men. In primary care, a targeted screening procedure seems to be the most feasible method.
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Affiliation(s)
- Ranja Strömberg
- Center for Family and Community Medicine, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
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Oliffe JL, Robertson S, Kelly MT, Roy P, Ogrodniczuk JS. Connecting masculinity and depression among international male university students. QUALITATIVE HEALTH RESEARCH 2010; 20:987-98. [PMID: 20360568 DOI: 10.1177/1049732310365700] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
International university students can experience isolation amid academic pressures. Such circumstances can manifest as or exacerbate depression. This qualitative study involved 15 international male students at a Canadian university who were diagnosed or self-identified as having depression. Individual interviews revealed men's perspectives about causes, implications, and management of depression. Participants intertwined sex- and gender-based factors in detailing causes, and emphasized the potential for parents to impact depression. Implications of depression for embodying traditional masculine roles of breadwinner and career man influenced many men to filter details about their illness within "home" cultures. This practice often prevailed within Canada despite the men's perceptions that greater societal acceptance existed. Masculine ideals underpinned self-management strategies to fight depression and regain control. Counter to men's reluctance to disclose illness details were participants' self-management preference for peer-based support. Study findings highlight how masculine ideals and cultural constructs can influence depression experiences and expressions.
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Affiliation(s)
- John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada.
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Liedberg GM, Björk M, Hensing G. Occupational therapists’ perceptions of gender - A focus group study. Aust Occup Ther J 2010; 57:331-8. [DOI: 10.1111/j.1440-1630.2010.00856.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fountoulakis KN. The emerging modern face of mood disorders: a didactic editorial with a detailed presentation of data and definitions. Ann Gen Psychiatry 2010; 9:14. [PMID: 20385020 PMCID: PMC2865463 DOI: 10.1186/1744-859x-9-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 04/12/2010] [Indexed: 12/17/2022] Open
Abstract
The present work represents a detailed description of our current understanding and knowledge of the epidemiology, etiopathogenesis and clinical manifestations of mood disorders, their comorbidity and overlap, and the effect of variables such as gender and age. This review article is largely based on the 'Mood disorders' chapter of the Wikibooks Textbook of Psychiatry http://en.wikibooks.org/wiki/Textbook_of_Psychiatry/Mood_Disorders.
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Poutanen O, Koivisto AM, Mattila A, Joukamaa M, Salokangas RKR. Gender differences in the symptoms of major depression and in the level of social functioning in public primary care patients. Eur J Gen Pract 2009; 15:161-7. [DOI: 10.3109/13814780903186423] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rochlen AB, Paterniti DA, Epstein RM, Duberstein P, Willeford L, Kravitz RL. Barriers in diagnosing and treating men with depression: a focus group report. Am J Mens Health 2009; 4:167-75. [PMID: 19477750 DOI: 10.1177/1557988309335823] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study reports on the experiences of 45 male focus group participants with a history of depression. Men responded to questions addressing the interaction between the male role, masculinity, depression, and experiences with treatment for depression. Using a qualitative, thematic-based coding strategy, three primary themes emerged. First, participants described aspects of the male gender as being in conflict or incongruent with their experiences of depression and beliefs about appropriate help-seeking behaviors. Second, men outlined alternative symptom profiles that could interfere with the recognition of depression and willingness to seek help. Finally, men expressed a range of positive and negative reactions toward depression treatment and treatment providers. Implications for health care providers are provided.
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Affiliation(s)
- Aaron B Rochlen
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas 78712, USA.
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Pompili M, Innamorati M, Lester D, Akiskal HS, Rihmer Z, Casale AD, Amore M, Girardi P, Tatarelli R. Substance Abuse, Temperament and Suicide Risk: Evidence from a Case-Control Study. J Addict Dis 2009; 28:13-20. [DOI: 10.1080/10550880802544757] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kalpakjian CZ, Toussaint LL, Albright KJ, Bombardier CH, Krause JK, Tate DG. Patient health Questionnaire-9 in spinal cord injury: an examination of factor structure as related to gender. J Spinal Cord Med 2009; 32:147-56. [PMID: 19569462 PMCID: PMC2678286 DOI: 10.1080/10790268.2009.11760766] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Accepted: 07/30/2008] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/OBJECTIVE Despite the attention depression after spinal cord injury (SCI) has received, research and clinical practice have been hampered by inadequate emphasis on reliable and valid measurement. Assessment of symptoms in persons with SCI is challenged by the presence of "trans-diagnostic" symptoms and unexamined effects of gender. The objective of this study was to examine the factor structure of the Patient Health Questionnaire-9 (PHQ-9; the 9-item depression scale of the Patient Health Questionnaire) and determine whether the structure replicates across gender. METHODS A total of 1,168 women and men were matched on level/completeness of SCI, follow-up year, and age to create 584 pairs. Exploratory factor analysis examined 1- and 2-factor models and congruence in 2 randomly split half samples to establish congruence of the factor solution and replication across gender. RESULTS The 1- and 2-factor solutions fit the structure of the items accounting for 41% to 51% of original item variance. Congruence between random samples was uniformly high for the 1-factor solution (r = 0.791-0.948) but variable for the 2-factor solution. Although congruence was high for the combined sample and men (r = 0.90-0.97 and 0.71-0.94, respectively), it was variable for women (r = 0.29-0.85). CONCLUSIONS Although there was support for the 1-factor structure of the PHQ within and between sexes, the low congruence between sexes and within women for the 2-factor structure indicates potentially important differences about how certain symptoms may be experienced or interpreted differently, by men and women with SCI. Future research should focus on where sexes diverge in cognitive, affective, and somatic dimensions of depressive symptoms and whether sex-specific or sex-neutral measures are warranted.
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Affiliation(s)
- Claire Z Kalpakjian
- Model SCI System, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor 48109, USA.
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Oliffe JL, Phillips MJ. Men, depression and masculinities: A review and recommendations. JOURNAL OF MENS HEALTH 2008. [DOI: 10.1016/j.jomh.2008.03.016] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gender differences in help-seeking behavior on two internet forums for individuals with self-reported depression. ACTA ACUST UNITED AC 2008; 5:181-5. [DOI: 10.1016/j.genm.2008.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2007] [Indexed: 10/21/2022]
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