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Cuomo A, Aguglia A, De Berardis D, Ventriglio A, Gesi C, Fagiolini A. Individualized strategies for depression: narrative review of clinical profiles responsive to vortioxetine. Ann Gen Psychiatry 2024; 23:20. [PMID: 38755657 PMCID: PMC11097484 DOI: 10.1186/s12991-024-00505-1] [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: 01/31/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Depression is a highly heterogeneous disorder, often resulting in suboptimal response and remission rates. This underscores the need for more nuanced clinical characterization of patients to tailor individualized treatment plans. Emerging evidence highlights the critical role of cognitive and emotional dysfunction in major depression, prompting the exploration of novel therapeutic interventions that target these specific symptom domains. MAIN TEXT Vortioxetine, a multimodal antidepressant, enhances serotonergic activity while also modulating several other neurotransmitter systems involved in depressive symptoms such as emotional blunting, anhedonia, and cognitive dysfunction. Numerous randomized, placebo-controlled trials have demonstrated vortioxetine's efficacy and safety in treating depression, particularly in specific subgroups of depressed patients, including those with cognitive deficits and comorbid anxiety symptoms or disorders. Although not randomized or placebo-controlled, studies have also shown vortioxetine's efficacy in depressed patients with emotional blunting or anhedonia. Vortioxetine's ability to effectively treat a range of depressive symptoms, including anhedonia, emotional blunting, anxiety, and cognitive dysfunction, provides an individualized treatment solution for depressed individuals suffering from these symptoms. The purpose of this paper is to identify clinical profiles of patients who may benefit from vortioxetine, with the goal of optimizing therapeutic outcomes. CONCLUSION Vortioxetine has been shown to be effective for patients with depression and symptoms such as anhedonia, emotional blunting, anxiety, and cognitive dysfunction. Tailoring treatment plans to individual needs and personalizing treatment choices based on the specific symptoms presented by depressed patients improve treatment outcomes.
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Affiliation(s)
- Alessandro Cuomo
- Department of Molecular and Developmental Medicine, University of Siena School of Medicine, Siena, Italy.
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenfratelli-Sacco, Milan, Italy
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, University of Siena School of Medicine, Siena, Italy
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Platona RI, Voiță-Mekeres F, Tudoran C, Tudoran M, Enătescu VR. The Contribution of Genetic Testing in Optimizing Therapy for Patients with Recurrent Depressive Disorder. Clin Pract 2024; 14:703-717. [PMID: 38804388 PMCID: PMC11130888 DOI: 10.3390/clinpract14030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
(1) Background: The aim of this study was to analyze the impact of pharmacogenetic-guided antidepressant therapy on the 12-month evolution of the intensity of depressive symptoms in patients with recurrent depressive disorder (RDD) in comparison to a control group of depressive subjects who were treated conventionally. (2) Methods: This prospective longitudinal study was conducted between 2019 and 2022, and the patients were evaluated by employing the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and the Clinical Global Impressions Scale: Severity and Improvement. We followed them up at 1, 3, 6, and 12 months. (3) Results: Of the 76 patients with RDD, 37 were tested genetically (Group A) and 39 were not (Group B). Although the patients from Group A had statistically significantly more severe MDD at baseline than those from Group B (p < 0.001), by adjusting their therapy according to the genetic testing, they had a progressive and more substantial reduction in the severity of RDD symptoms [F = 74.334; η2 = 0.674; p < 0.001], indicating a substantial association with the results provided by the genetic testing (67.4%). (4) Conclusions: In patients with RDD and a poor response to antidepressant therapy, pharmacogenetic testing allows for treatment adjustment, resulting in a constant and superior reduction in the intensity of depression and anxiety symptoms.
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Affiliation(s)
- Rita Ioana Platona
- Doctoral School, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania;
- Psychiatry Department, County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania
| | - Florica Voiță-Mekeres
- Psychiatry Department, County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania
- Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Cristina Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (C.T.); (M.T.)
- Center of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania
- Cardiology Clinic, County Emergency Hospital “Pius Brinzeu”, L. Rebreanu, No. 156, 300723 Timisoara, Romania;
| | - Mariana Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (C.T.); (M.T.)
- Center of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania
- Cardiology Clinic, County Emergency Hospital “Pius Brinzeu”, L. Rebreanu, No. 156, 300723 Timisoara, Romania;
| | - Virgil Radu Enătescu
- Cardiology Clinic, County Emergency Hospital “Pius Brinzeu”, L. Rebreanu, No. 156, 300723 Timisoara, Romania;
- Discipline of Psychiatry, Department of Neurosciences, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timişoara, Romania
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Wijnen J, Gordon NL, van 't Hullenaar G, Pont ML, Geijselaers MWH, Van Oosterwijck J, de Jong J. An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders. Front Psychiatry 2023; 14:1113356. [PMID: 37426091 PMCID: PMC10326275 DOI: 10.3389/fpsyt.2023.1113356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Although multimodal interventions are recommended in patients with severe depressive and/or anxiety disorders, available evidence is scarce. Therefore, the current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, for patients with (comorbid) depressive and/or anxiety disorders. Methods Participants were 3,900 patients diagnosed with a depressive and/or anxiety disorder. The primary outcome was Health-Related Quality of Life (HRQoL) measured with the Research and Development-36 (RAND-36). Secondary outcomes included: (1) current psychological and physical symptoms measured with the Brief Symptom Inventory (BSI) and (2) symptoms of depression, anxiety, and stress measured with the Depression Anxiety Stress Scale (DASS). The healthcare program consisted of two active treatment phases: main 20-week program and a subsequent continuation-phase intervention (i.e., 12-month relapse prevention program). Mixed linear models were used to examine the effects of the healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of 12-month relapse prevention program (T3). Results Results showed significant improvements from T0 to T2 for the primary variable (i.e., RAND-36) and secondary variables (i.e., BSI/DASS). During the 12-month relapse prevention program, further significant improvements were mainly observed for secondary variables (i.e., BSI/DASS) and to a lesser extent for the primary variable (i.e., RAND-36). At the end of the relapse prevention program (i.e., T3), 63% of patients achieved remission of depressive symptoms (i.e., DASS depression score ≤ 9) and 67% of patients achieved remission of anxiety symptoms (i.e., DASS anxiety score ≤ 7). Conclusion An interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, seems effective for patients suffering from depressive and/or anxiety disorders with regard to HRQoL and symptoms of psychopathology. As reimbursement and funding for interdisciplinary multimodal interventions in this patient group has been under pressure in recent years, this study could add important evidence by reporting on routinely collected outcome data from a large patient group. Future studies should further investigate the long-term stability of treatment outcomes after interdisciplinary multimodal interventions for patients suffering from depressive and/or anxiety disorders.
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Affiliation(s)
- Jaap Wijnen
- Intergrin Academy, Geleen, Netherlands
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
| | | | | | | | | | - Jessica Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Center for InterProfessional Collaboration in Education Research and Practice (IPC-ERP UGent), Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Suárez-Castro D, Barroso-Hurtado M, Martínez-Vispo C, Becoña E, López-Durán A. Boredom Susceptibility and Quit Smoking: The Role of Anxiety Symptoms. THE JOURNAL OF PSYCHOLOGY 2023; 157:242-251. [PMID: 36944190 DOI: 10.1080/00223980.2023.2183933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Boredom is one of the main reported motives for smoking. However, scarce research has examined the relationship between boredom susceptibility and abstinence achievement in treatment-seeking smokers. The aim of this study is to examine the mediating effect of anxiety symptoms in the relationship between boredom susceptibility and abstinence at the end of a smoking cessation treatment. The sample was composed of 481 Spanish smokers who received a cognitive-behavioral treatment to quit (Mage= 45.51, SD = 11.16; 60.6% female). The Boredom Susceptibility subscale of the Sensation Seeking Scale Form-V and the Beck Anxiety Inventory were used. Pearson correlations and mediation analyses were conducted to examine the relationships between the study variables. Boredom susceptibility was significantly and positively correlated to anxiety symptoms, but not to abstinence. Anxiety symptoms were significantly and negatively correlated to abstinence. A significant indirect effect of boredom susceptibility on abstinence at the end of treatment through anxiety symptoms was found. There was no direct relation between boredom susceptibility and abstinence. These findings extend previous literature by showing that higher boredom susceptibility is associated with less likelihood to be abstinent at the end of the treatment through higher anxiety symptoms. These results highlight the relevance of considering the inclusion of boredom and anxiety management techniques in smoking cessation interventions.
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Robberegt SJ, Kooiman BEAM, Albers CJ, Nauta MH, Bockting C, Stikkelbroek Y. Personalised app-based relapse prevention of depressive and anxiety disorders in remitted adolescents and young adults: a protocol of the StayFine RCT. BMJ Open 2022; 12:e058560. [PMID: 36521888 PMCID: PMC9756181 DOI: 10.1136/bmjopen-2021-058560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 10/05/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Youth in remission of depression or anxiety have high risks of relapse. Relapse prevention interventions may prevent chronicity. Aim of the study is therefore to (1) examine efficacy of the personalised StayFine app for remitted youth and (2) identify high-risk groups for relapse and resilience. METHOD AND ANALYSIS In this Dutch single-blind parallel-group randomised controlled trial, efficacy of app-based monitoring combined with guided app-based personalised StayFine intervention modules is assessed compared with monitoring only. In both conditions, care as usual is allowed. StayFine modules plus monitoring is hypothesised to be superior to monitoring only in preventing relapse over 36 months. Participants (N=254) are 13-21 years and in remission of depression or anxiety for >2 months. Randomisation (1:1) is stratified by previous treatment (no treatment vs treatment) and previous episodes (1, 2 or >3 episodes). Assessments include diagnostic interviews, online questionnaires and monitoring (ecological momentary assessment with optional wearable) after 0, 4, 12, 24 and 36 months. The StayFine modules are guided by certified experts by experience and based on preventive cognitive therapy and ingredients of cognitive behavioural therapy. Personalisation is based on shared decision-making informed by baseline assessments and individual symptom networks. Time to relapse (primary outcome) is assessed by the Kiddie Schedule for Affective Disorders and Schizophrenia-lifetime version diagnostic interview. Intention-to-treat survival analyses will be used to examine the data. Secondary outcomes are symptoms of depression and anxiety, number and duration of relapses, global functioning, and quality of life. Mediators and moderators will be explored. Exploratory endpoints are monitoring and wearable outcomes. ETHICS, FUNDING AND DISSEMINATION The study was approved by METC Utrecht and is funded by the Netherlands Organisation for Health Research and Development (636310007). Results will be submitted to peer-reviewed scientific journals and presented at (inter)national conferences. TRIAL REGISTRATION NUMBER NCT05551468; NL8237.
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Affiliation(s)
- Suzanne J Robberegt
- Department of Psychiatry, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Depression Expertise Centre-Youth, GGZ Oost Brabant, Boekel, The Netherlands
| | - Bas E A M Kooiman
- Depression Expertise Centre-Youth, GGZ Oost Brabant, Boekel, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Casper J Albers
- Department of Psychometrics and Statistics, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Maaike H Nauta
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Child Study Centre, Accare, Groningen, The Netherlands
| | - Claudi Bockting
- Department of Psychiatry, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Yvonne Stikkelbroek
- Depression Expertise Centre-Youth, GGZ Oost Brabant, Boekel, The Netherlands
- Department of Clinical Child and Family Studies, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
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Bach B, Bo S, Simonsen E. Maladaptive personality traits may link childhood trauma history to current internalizing symptoms. Scand J Psychol 2022; 63:468-475. [PMID: 35606936 PMCID: PMC9790355 DOI: 10.1111/sjop.12830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/08/2022] [Accepted: 04/22/2022] [Indexed: 12/30/2022]
Abstract
Research supports a strong relationship between childhood maltreatment and internalizing psychopathology (e.g., anxiety and depression), and features of personality are assumed to explain some of this relationship. In this study, we proposed a model in which maladaptive traits mediate the effect of childhood trauma history on internalizing symptoms in adult individuals. A mixed sample (N = 462) composed of 142 psychiatric patients and 320 community-dwelling individuals completed the Childhood Trauma Questionnaire (CTQ), the Personality Inventory for DSM-5 (PID-5), and the Symptom Checklist (SCL-27) for internalizing psychopathology. The effect of childhood traumas explained 34% of the variance in internalizing symptoms while controlling for the influence of age and gender. The traits accounted for 78% of this effect, which was predominantly exerted through the domains of Negative Affectivity, Detachment, and Psychoticism, and specifically through the facets of Depressivity, Suspiciousness, Anxiousness, Perceptual Dysregulation, and Distractibility. This finding provides preliminary support for the proposed model indicating that the aforementioned maladaptive trait domains potentially function as mediating links by which childhood traumas are translated into internalizing symptoms in adulthood. However, these findings must be interpreted with caution due to the cross-sectional and retrospective mono-method design of this study. Clinical implications are discussed in relation to transdiagnostic treatment and the potential value of specifying trait domain specifiers in ICD-11 and DSM-5 models of personality disorders.
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Affiliation(s)
- Bo Bach
- Psychiatric Research UnitCenter for Personality Disorder Research, Region ZealandSlagelseDenmark
| | - Sune Bo
- Department of Child and Adolescent PsychiatryRegion ZealandRoskildeDenmark
| | - Erik Simonsen
- Psychiatric Research UnitCenter for Personality Disorder Research, Region ZealandSlagelseDenmark,Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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Ho CSH, Chua J, Tay GWN. The diagnostic and predictive potential of personality traits and coping styles in major depressive disorder. BMC Psychiatry 2022; 22:301. [PMID: 35484526 PMCID: PMC9047339 DOI: 10.1186/s12888-022-03942-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/11/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals. METHODS Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals. RESULTS Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD. CONCLUSIONS Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.
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Affiliation(s)
- Cyrus S. H. Ho
- grid.410759.e0000 0004 0451 6143Department of Psychological Medicine, National University Health System, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J. Chua
- grid.4280.e0000 0001 2180 6431Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Gabrielle W. N. Tay
- grid.410759.e0000 0004 0451 6143Department of Psychological Medicine, National University Health System, Singapore, Singapore
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Hanke N, Penzel N, Betz LT, Rohde M, Kambeitz-Ilankovic L, Kambeitz J. Personality traits differentiate patients with bipolar disorder and healthy controls - A meta-analytic approach. J Affect Disord 2022; 302:401-411. [PMID: 35041870 DOI: 10.1016/j.jad.2022.01.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 01/08/2022] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Expression of specific personality traits has been associated with the presence and disease course of bipolar disorder (BD) in multiple studies. However, until today findings are inconsistent and potentially confounding factors such as age and gender as well as the limited sample size of previous studies make it difficult to generalize these findings. To overcome these limitations and to specify the role of personality traits in the context of BD, we performed a meta-analysis in patients with BD and healthy controls (HC), focusing on the traits of the big three and the big five: Neuroticism (N), Extraversion (E), Openness (O), Conscientiousness (C), Agreeableness (A) and Psychoticism (P). METHODS Two online databases (Pubmed and Web of Science) were searched systematically to identify relevant articles, including publications up to December 31, 2019. From studies that met our inclusion criteria (n = 18), we extracted relevant data of patients with BD (n = 1694) and HC (n = 2153) and calculated effect sizes for each personality trait. Further, we performed moderator analysis on gender, age, quality score and years of publication. RESULTS Our results indicate that patients with BD exhibit higher scores on N (large positive effect size; n = 18, g = 1.44, 95%-CI : 1.11 to 1.77) and lower scores on C (medium negative effect size; n = 6, g = -0.78, 95%-CI: -1.13 to -0.43) and E (small negative effect size; n = 13, g = -0.38, 95%-CI: -0.52 to -0.23) compared to HC. We found a moderating effect of mean age on the effect size of N with smaller differences in N levels between patients with BD and HC in older samples (-0.0437, z = - 3.96, p <0.0001). Our results were robust with respect to potential publication biases and the inclusion of potentially confounding factors such as gender, age, quality score and years of publication. LIMITATIONS Due to the lack of available data no subgroup analysis on the effect of mood states of patients and subtypes of BD could be performed. Moreover, our analyses are based on cross-sectional data so that findings should be interpreted with care, especially concerning causal conclusions. CONCLUSIONS Patients with BD showed differences in several personality traits compared to HC. Our results provide the basis for future research with focus on personality and psychopathology in patients with BD. Identifying the interaction between expressions of personality traits and BD might provide novel approaches in prevention and therapy.
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Affiliation(s)
- Natalie Hanke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany
| | - Melanie Rohde
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany.
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Masuya J, Ichiki M, Morishita C, Higashiyama M, Ono M, Honyashiki M, Iwata Y, Tanabe H, Inoue T. Childhood Victimization and Neuroticism Mediate the Effects of Childhood Abuse on Adulthood Depressive Symptoms in Volunteers. Neuropsychiatr Dis Treat 2022; 18:253-263. [PMID: 35210773 PMCID: PMC8857998 DOI: 10.2147/ndt.s337922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/02/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND When assessing patients with depressive and anxiety disorders in psychiatric clinical practice, it is common to encounter children and adolescents who have experienced abuse and victimization. To date, it has been clarified that experiences of "childhood abuse" and "childhood victimization" lead to "neuroticism", and that neuroticism leads to "adult depressive symptoms". In this study, we analyzed how these four factors are interrelated. SUBJECTS AND METHODS The following self-administered questionnaire surveys were conducted in 576 adult volunteers: Patient Health Questionnaire-9, Eysenck Personality Questionnaire-revised shortened version, Child Abuse and Trauma Scale, and Childhood Victimization Rating Scale. For statistical analysis, Pearson correlation coefficient analysis, t-test, multiple regression analysis, and covariance structure analysis (path analysis) were performed. RESULTS Path analysis showed that the indirect effects of childhood abuse and childhood victimization on depressive symptoms through neuroticism were statistically significant. In addition, the indirect effects of childhood abuse on neuroticism through childhood victimization were statistically significant. Finally, the indirect effects of childhood abuse on depressive symptoms through the combined paths of childhood victimization and neuroticism were statistically significant. CONCLUSION Our results suggest that "childhood abuse (A)" induces changes in the personality trait of "neuroticism (C)" with "childhood victimization (B)" as a mediator, and that these adversities affect the expression of "depressive symptoms in adulthood (D)" through "neuroticism (C)" as a mediator. In other words, to our knowledge, this is the first study to clarify that these four factors are not only individually associated with each other but also cause a chain reaction of A to B to C to D.
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Affiliation(s)
- Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Chihiro Morishita
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Motoki Higashiyama
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Miki Ono
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Mina Honyashiki
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yoshio Iwata
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hajime Tanabe
- Faculty of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka, 422-8529, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
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Capaldi DM, Wiesner M, Kerr DCR, Owen LD, Tiberio SS. Intergenerational Associations in Crime for an At-Risk Sample of US Men: Factors that May Mitigate or Exacerbate Transmission. JOURNAL OF DEVELOPMENTAL AND LIFE-COURSE CRIMINOLOGY 2021; 7:331-358. [PMID: 35531311 PMCID: PMC9070987 DOI: 10.1007/s40865-021-00168-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/10/2021] [Accepted: 05/22/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To examine moderation of intergenerational transmission of crime and antisocial behavior of parents to adult arrests of sons (from age 18 years to ages 37-38 years). Moderators examined were from late childhood (constructive parenting and sons' inhibitory control, internalizing symptoms, and cognitive function), adolescence (delinquency and deviant peer association), and early adulthood (educational achievement, employment history, substance use, deviant peer association, and partner antisocial behavior). METHODS Study participants were parents and sons (N = 206) from the longitudinal Oregon Youth Study, recruited from schools in the higher crime areas of a medium-sized metropolitan region in the Pacific Northwest. Assessment included official arrest records, school data, interviews, and questionnaires. RESULTS As hypothesized, parents' and sons' histories of two or more arrests were significantly associated. Predictions of sons' arrests from a broader construct of parental antisocial behavior were significantly moderated by sons' late childhood cognitive function and early adult employment history, substance use, and romantic partner's antisocial behavior. Overall, there was relatively little intergenerational association in crime at low levels of these moderators. CONCLUSIONS Findings indicate relatively large intergenerational associations in crime. The identified moderators may be used as selection criteria or targeted in prevention and treatment efforts aimed at reducing such associations.
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Affiliation(s)
| | - Margit Wiesner
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
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Ishii Y, Masuya J, Morishita C, Higashiyama M, Inoue T, Ichiki M. Victimization in Childhood Mediates the Association Between Parenting Quality, Stressful Life Events, and Depression in Adulthood. Neuropsychiatr Dis Treat 2021; 17:3171-3182. [PMID: 34703237 PMCID: PMC8541763 DOI: 10.2147/ndt.s323592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Various stressors during childhood and adulthood, such as experiencing poor parenting, abuse, and harassment, have long-lasting effects on depression. The long-term effects of childhood stressors, such as childhood abuse and inappropriate parenting experiences, on adult depression are mediated by personality traits. In the present study, we hypothesized that parental bonding in childhood influences adulthood depression, and that this association is mediated by childhood victimization experiences and negative life event evaluations in adulthood. To test this hypothesis, multiple regression analysis and structural equation modeling were performed. METHODS A questionnaire survey, including Patient Health Questionnaire-9, victimization scale in childhood, Parental Bonding Instrument (PBI), and Life Experiences Survey was administered to 449 general adult volunteers (age: 41.1 ± 11.7 years; 196 men and 253 women). Multiple variables were analyzed by multiple regression analysis and structural equation modeling. RESULTS Multiple regression analysis demonstrated that victimization experiences in childhood affect adulthood depression independently of several other factors. Structural equation modeling showed that the "parental care" subscale of the PBI decreased adulthood depression directly, as well as indirectly through its effects on victimization experiences in childhood and negative life events. On the other hand, the "parental overprotection" subscale of the PBI increased adulthood depression directly, as well as indirectly through its effects on the experience of victimization in childhood and negative life events. CONCLUSION The present study indicates that the experience of victimization in childhood is a risk factor of adulthood depression. Furthermore, we found that parenting quality experienced in childhood influences adulthood depression, and that these effects are mediated by the experiences of victimization in childhood and negative life events in adulthood.
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Affiliation(s)
- Yoshitaka Ishii
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan.,Fuji Psychosomatic Rehabilitation Institute Hospital, Fujinomiya, Shizuoka, 418-0035, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Chihiro Morishita
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Motoki Higashiyama
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan
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12
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Chang HA, Fang WH, Liu YP, Tzeng NS, Shyu JF, Wan FJ, Huang SY, Chang TC, Chang CC. Sex-specific pathways among tri-allelic serotonin transporter polymorphism, trait neuroticism and generalized anxiety disorder. J Psychiatry Neurosci 2020; 45:379-386. [PMID: 32293839 PMCID: PMC7595742 DOI: 10.1503/jpn.190092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Neuroticism personality trait is recognized as an important endophenotypic predictor of generalized anxiety disorder (GAD). Furthermore, endophenotype-based pathway approaches have recently been shown to have greater advantages for gene-finding strategies than traditional case-control studies. In the present study, in addition to conventional case-control methods, we used pathway analyses to test whether the tri-allelic serotonin transporter promoter polymorphism (combining 5-HTTLPR and rs25531) is associated with risk of GAD through its effects on trait neuroticism. METHODS We included 2236 Han Chinese adults in this study, including 736 patients with GAD and 1500 healthy participants. We genotyped the 5-HTTLPR and rs25531 polymorphisms using the polymerase chain reaction restriction fragment length polymorphism method. We used the Neuroticism scale of the Maudsley Personality Inventory (MPI) short version (MPI-Neuroticism) to measure participants' tendency toward neuroticism. RESULTS Using endophenotype-based path analyses, we found significant indirect effects of the tri-allelic genotype on risk of GAD, mediated by MPI-Neuroticism in both men and women. Compared to women carrying the S'S' genotype, women carrying the L' allele had higher levels of MPI-Neuroticism, which in turn were associated with higher risk of GAD. Men, however, showed the opposite pattern. Using traditional case-control comparisons, we observed that the effect of tri-allelic genotype on GAD was significant, but only in women. LIMITATIONS Participants were restricted to Han Chinese, and we used only 1 questionnaire to assess neuroticism. CONCLUSION These findings are the first to show that the triallelic 5-HTTLPR polymorphism is associated with elevated risk of GAD, and that this effect is mediated via increased trait neuroticism, a sex-dependent risk pathway.
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Affiliation(s)
- Hsin-An Chang
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Wen-Hui Fang
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Yia-Ping Liu
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Nian-Sheng Tzeng
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Jia-Fwu Shyu
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Fang-Jung Wan
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - San-Yuan Huang
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Tieh-Ching Chang
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
| | - Chuan-Chia Chang
- From the Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (H.-A. Chang, Liu, Tzeng, Shyu, Wan, Huang, T.-C. Chang, C.-C. Chang); the Department of Family and Community Medicine, TriService General Hospital, National Defense Medical Center, Taipei, Taiwan (Fang); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Liu); the Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan (Liu); and the Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan (Shyu)
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13
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Vittengl JR, Stutzman S, Atluru A, Jarrett RB. Do Cognitive Therapy Skills Neutralize Lifetime Stress to Improve Treatment Outcomes in Recurrent Depression? Behav Ther 2020; 51:739-752. [PMID: 32800302 PMCID: PMC7431681 DOI: 10.1016/j.beth.2019.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 11/27/2022]
Abstract
Cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but not all patients respond. Past research suggests that stressful life events (SLE; e.g., childhood maltreatment, emotional and physical abuse, relationship discord, physical illness) sometimes reduce the efficacy of depression treatment, whereas greater acquisition and use of CT skills may improve patient outcomes. In a sample of 276 outpatient participants with recurrent MDD, we tested the hypothesis that patients with more SLE benefit more from CT skills in attaining response and remaining free of relapse/recurrence. Patients with more pretreatment SLE did not develop weaker CT skills, on average, but were significantly less likely to respond to CT. However, SLE predicted non-response only for patients with relatively weak skills, and not for those with stronger CT skills. Similarly, among acute-phase responders, SLE increased risk for MDD relapse/recurrence among patients with weaker CT skills. Thus, the combination of more SLE and weaker CT skills forecasted negative outcomes. These novel findings are discussed in the context of improving CT for depression among patients with greater lifetime history of SLE and require replication before clinical application.
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14
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Khan WU, Michelini G, Battaglia M. Twin studies of the covariation of pain with depression and anxiety: A systematic review and re-evaluation of critical needs. Neurosci Biobehav Rev 2020; 111:135-148. [DOI: 10.1016/j.neubiorev.2020.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/13/2019] [Accepted: 01/15/2020] [Indexed: 01/21/2023]
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15
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Welsh J, Korda RJ, Banks E, Strazdins L, Joshy G, Butterworth P. Identifying long-term psychological distress from single measures: evidence from a nationally representative longitudinal survey of the Australian population. BMC Med Res Methodol 2020; 20:55. [PMID: 32138694 PMCID: PMC7059354 DOI: 10.1186/s12874-020-00938-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 02/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Single time-point assessments of psychological distress are often used to indicate chronic mental health problems, but the validity of this approach is unclear. The aims of this study were to investigate how a single assessment of distress relates to longer-term assessment and quantify misclassification from using single measures to indicate chronic distress. METHODS Data came from the Household, Income and Labour Dynamics in Australia Survey, a nationally representative study of Australian adults. Psychological distress, measured with the Kessler10 and categorised into low (scores:10- < 12), mild (12- < 16), moderate (16- < 22) and high (22-50), has been assessed in the Survey biennially since wave 7. Among respondents who were aged ≥25 years and participated in all waves in which distress was measured, we describe agreement in distress categories, and using a mixed linear model adjusting for age and sex we estimate change in scores, over a two-, four-, six- and eight-year follow-up period. We applied weights, benchmarked to the Australian population, to all analyses. RESULTS Two-years following initial assessment, proportions within identical categories of distress were 66.0% for low, 54.5% for mild, 44.0% for moderate and 50.3% for high, while 94.1% of those with low distress initially had low/mild distress and 81.4% with high distress initially had moderate/high distress. These patterns did not change materially as follow-up time increased. Over the full eight-year period, 77.3% of individuals with high distress initially reported high distress on ≥1 follow-up occasion. Age-and sex- adjusted change in K10 scores over a two-year period was 1.1, 0.5, - 0.7 and - 4.9 for low, mild, moderate and high distress, respectively, and also did not change materially as follow-up time increased. CONCLUSION In the absence of repeated measures, single assessments are useful proxies for chronic distress. Our estimates could be used in bias analyses to quantify the magnitude of the bias resulting from use of single assessments to indicate chronic distress.
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Affiliation(s)
- J Welsh
- Research School of Population Health, Australian National University, Building 62, Mills Rd, Acton, ACT, 2601, Australia.
| | - R J Korda
- Research School of Population Health, Australian National University, Building 62, Mills Rd, Acton, ACT, 2601, Australia
| | - E Banks
- Research School of Population Health, Australian National University, Building 62, Mills Rd, Acton, ACT, 2601, Australia
- The Sax Institute, Ultimo, Australia
| | - L Strazdins
- Research School of Population Health, Australian National University, Building 62, Mills Rd, Acton, ACT, 2601, Australia
| | - G Joshy
- Research School of Population Health, Australian National University, Building 62, Mills Rd, Acton, ACT, 2601, Australia
| | - P Butterworth
- Research School of Population Health, Australian National University, Building 62, Mills Rd, Acton, ACT, 2601, Australia
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
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16
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Schouw JEMC, Verkes RJ, Schene AH, Schellekens AFA. The relationship between childhood adversity and adult personality revealed by network analysis. CHILD ABUSE & NEGLECT 2020; 99:104254. [PMID: 31765851 DOI: 10.1016/j.chiabu.2019.104254] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/21/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Childhood adversity is known to influence personality development. Studies suggest that distinct types of childhood adversities have differential effects on personality dimensions. However, different types of adversity often co-occur, and personality dimensions are strongly interconnected. OBJECTIVE The aim of this study was to use a network approach to analyze the interrelationships between different types of childhood adversity and diverse personality dimensions integratively. PARTICIPANTS AND SETTING We used previously collected data on 142 alcohol dependent patients and 102 healthy controls. METHODS The participants completed the Interview for Traumatic Events in Childhood, the Parental Acceptance and Rejection Questionnaire and the Temperament and Character Inventory. Outcomes on the subscales of these instruments were included in the network analysis. RESULTS The resulting network showed strong connections between different types of childhood adversity, and between the different temperaments and characters of personality. Childhood adversity, mainly physical abuse and maternal rejection, was connected to most personality dimensions, except for reward dependence. Physical abuse showed the highest centrality measures, indicating a central, important role in the network. CONCLUSIONS These findings confirm that different types of childhood adverse experiences often co-occur, and suggest that specifically physical and emotional abuse, and maternal rejection might play a prominent role in shaping personality.
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Affiliation(s)
- Jessica E M C Schouw
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands.
| | - Robbert J Verkes
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Aart H Schene
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
| | - Arnt F A Schellekens
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands; Nijmegen Institute for Science Practitioners in Addiction, Radboud University Nijmegen, the Netherlands
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17
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Serafini G, Gonda X, Canepa G, Geoffroy PA, Pompili M, Amore M. Recent Stressful Life Events in Euthymic Major Depressive Disorder Patients: Sociodemographic and Clinical Characteristics. Front Psychiatry 2020; 11:566017. [PMID: 33024438 PMCID: PMC7516258 DOI: 10.3389/fpsyt.2020.566017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Stressful life events (SLE) may influence the illness course and outcome. This study aimed to characterize socio-demographic and clinical features of euthymic major depressive disorder (MDD) outpatients with SLE compared with those without. METHODS The present sample included 628 (mean age=55.1 ± 16.1) currently euthymic MDD outpatients of whom 250 (39.8%) reported SLE and 378 (60.2%) did not. RESULTS After univariate analyses, outpatients with SLE were most frequently widowed and lived predominantly with friends/others. Moreover, relative to outpatients without SLE, those with SLE were more likely to have a family history of suicidal behavior, manifested melancholic features, report a higher Coping Orientation to the Problems Experienced (COPE) positive reinterpretation/growth and less likely to have a comorbid panic disorder, residual interepisodic symptoms, use previous psychiatric medications, and currently use of antidepressants. Having a family history of suicide (OR=9.697; p=≤.05), history of psychotropic medications use (OR=2.888; p=≤.05), and reduced use of antidepressants (OR=.321; p=.001) were significantly associated with SLE after regression analyses. Mediation analyses showed that the association between current use of antidepressants and SLE was mediated by previous psychiatric medications. CONCLUSION Having a family history of suicide, history of psychotropic medications use, and reduced use of antidepressants is linked to a specific "at risk" profile characterized by the enhanced vulnerability to experience SLE.
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Affiliation(s)
- Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, St. Rokus Clinical Center, Semmelweis University, Budapest, Hungary.,MTA-SE Neuropsychopharmacology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary.,NAP-2-SE New Antidepressant Target Research Group, Hungarian Brain Research Programme, Semmelweis University, Budapest, Hungary
| | - Giovanna Canepa
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pierre A Geoffroy
- Department of Psychiatry and Addiction Medicine, AP-HP, Hopital Bichat-Claude Bernard, Paris, France.,NeuroDiderot, Inserm, Paris University, Paris, France
| | - Maurizio Pompili
- Department of Neurosciences, Suicide Prevention Center, Sant'Andrea Hospital, University of Rome, Rome, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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18
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Kendler KS, Gardner CO, Neale MC, Aggen S, Heath A, Colodro-Conde L, Couvyduchesne B, Byrne EM, Martin NG, Gillespie NA. Shared and specific genetic risk factors for lifetime major depression, depressive symptoms and neuroticism in three population-based twin samples. Psychol Med 2019; 49:2745-2753. [PMID: 30563581 PMCID: PMC6584059 DOI: 10.1017/s003329171800377x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Vulnerability to depression can be measured in different ways. We here examine how genetic risk factors are inter-related for lifetime major depression (MD), self-report current depressive symptoms and the personality trait Neuroticism. METHOD We obtained data from three population-based adult twin samples (Virginia n = 4672, Australia #1 n = 3598 and Australia #2 n = 1878) to which we fitted a common factor model where risk for 'broadly defined depression' was indexed by (i) lifetime MD assessed at personal interview, (ii) depressive symptoms, and (iii) neuroticism. We examined the proportion of genetic risk for MD deriving from the common factor v. specific to MD in each sample and then analyzed them jointly. Structural equation modeling was conducted in Mx. RESULTS The best fit models in all samples included additive genetic and unique environmental effects. The proportion of genetic effects unique to lifetime MD and not shared with the broad depression common factor in the three samples were estimated as 77, 61, and 65%, respectively. A cross-sample mega-analysis model fit well and estimated that 65% of the genetic risk for MD was unique. CONCLUSION A large proportion of genetic risk factors for lifetime MD was not, in the samples studied, captured by a common factor for broadly defined depression utilizing MD and self-report measures of current depressive symptoms and Neuroticism. The genetic substrate for MD may reflect neurobiological processes underlying the episodic nature of its cognitive, motor and neurovegetative manifestations, which are not well indexed by current depressive symptom and neuroticism.
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MESH Headings
- Adult
- Australia/epidemiology
- Comorbidity
- Depressive Disorder, Major/diagnosis
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/genetics
- Diseases in Twins/epidemiology
- Diseases in Twins/genetics
- Extraversion, Psychological
- Female
- Genetic Predisposition to Disease
- Humans
- Male
- Middle Aged
- Models, Genetic
- Neurotic Disorders/diagnosis
- Neurotic Disorders/epidemiology
- Neurotic Disorders/genetics
- Personality/genetics
- Personality Inventory/statistics & numerical data
- Psychometrics
- Risk Factors
- Sex Factors
- Twins, Dizygotic/genetics
- Twins, Dizygotic/psychology
- Twins, Dizygotic/statistics & numerical data
- Twins, Monozygotic/genetics
- Twins, Monozygotic/psychology
- Twins, Monozygotic/statistics & numerical data
- Virginia/epidemiology
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics,
Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University
School of Medicine, Richmond, VA, USA
| | - Charles O. Gardner
- Virginia Institute for Psychiatric and Behavioral Genetics,
Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University
School of Medicine, Richmond, VA, USA
| | - Michael C. Neale
- Virginia Institute for Psychiatric and Behavioral Genetics,
Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University
School of Medicine, Richmond, VA, USA
| | - Steve Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics,
Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University
School of Medicine, Richmond, VA, USA
| | - Andrew Heath
- Department of Psychiatry, Washington University in St
Louis, St Louis MO, USA
| | - Lucía Colodro-Conde
- Genetic Epidemiology, QIMR Berghofer Medical Research
Institute, Brisbane, Queensland, Australia
| | - Baptiste Couvyduchesne
- Genetic Epidemiology, QIMR Berghofer Medical Research
Institute, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland,
Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of
Queensland, Brisbane, Queensland, Australia
| | - Enda M. Byrne
- Genetic Epidemiology, QIMR Berghofer Medical Research
Institute, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of
Queensland, Brisbane, Queensland, Australia
| | - Nicholas G. Martin
- Genetic Epidemiology, QIMR Berghofer Medical Research
Institute, Brisbane, Queensland, Australia
- School of Psychology, University of Queensland, Brisbane,
Queensland, Australia
| | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics,
Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University
School of Medicine, Richmond, VA, USA
- Genetic Epidemiology, QIMR Berghofer Medical Research
Institute, Brisbane, Queensland, Australia
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19
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Shen X, Adams MJ, Ritakari TE, Cox SR, McIntosh AM, Whalley HC. White Matter Microstructure and Its Relation to Longitudinal Measures of Depressive Symptoms in Mid- and Late Life. Biol Psychiatry 2019; 86:759-768. [PMID: 31443934 PMCID: PMC6906887 DOI: 10.1016/j.biopsych.2019.06.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Studies of white matter microstructure in depression typically show alterations in individuals with depression, but they are frequently limited by small sample sizes and the absence of longitudinal measures of depressive symptoms. Depressive symptoms are dynamic, however, and understanding the neurobiology of different trajectories could have important clinical implications. METHODS We examined associations between current and longitudinal measures of depressive symptoms and white matter microstructure (fractional anisotropy and mean diffusivity [MD]) in the UK Biobank Imaging Study. Depressive symptoms were assessed on two to four occasions over 5.9 to 10.7 years (n = 18,959 individuals on at least two occasions, n = 4444 on four occasions), from which we derived four measures of depressive symptomatology: cross-sectional measure at the time of scan and three longitudinal measures, namely trajectory and mean and intrasubject variance over time. RESULTS Decreased white matter microstructure in the anterior thalamic radiation demonstrated significant associations across all four measures of depressive symptoms (MD: βs = .020-.029, pcorr < .030). The greatest effect sizes were seen between white matter microstructure and longitudinal progression (MD: βs = .030-.040, pcorr < .049). Cross-sectional symptom severity was particularly associated with decreased white matter integrity in association fibers and thalamic radiations (MD: βs = .015-.039, pcorr < .041). Greater mean and within-subject variance were mainly associated with decreased white matter microstructure within projection fibers (MD: βs = .019-.029, pcorr < .044). CONCLUSIONS These findings indicate shared and differential neurobiological associations with severity, course, and intrasubject variability of depressive symptoms. This enriches our understanding of the neurobiology underlying dynamic features of the disorder.
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Affiliation(s)
- Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom.
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Tuula E Ritakari
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Simon R Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
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van Montfort E, de Vries J, Arts R, Aerts JG, Kloover JS, Traa MJ. The relation between psychological profiles and quality of life in patients with lung cancer. Support Care Cancer 2019; 28:1359-1367. [PMID: 31264187 PMCID: PMC6989652 DOI: 10.1007/s00520-019-04923-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/05/2019] [Indexed: 01/06/2023]
Abstract
Objective Previous studies in patients with lung cancer examined the association between psychological factors with quality of life (QoL), as well as the association between psychological factors with sociodemographic and medical characteristics. However, knowledge about the impact of combinations of psychological characteristics on QoL is still lacking. Therefore, the current study aimed to identify psychological profiles, covering multiple psychological factors. Additionally, the association between these profiles with QoL and with sociodemographic and medical characteristics was explored. Methods Patients with lung cancer (n = 130, mean age = 68.3 ± 8.6 years; 49% men) completed questionnaires focusing on sociodemographic information, anxiety and depressive symptoms (HADS), coping (COPE-easy), perceived social support (PSSS), and QoL (WHOQOL-BREF). Medical information was extracted from patients’ medical records. A step-3 latent profile analysis was performed to identify the psychological profiles. Multinomial logit models were used to explore the medical and sociodemographic correlates of the profiles and the relation with QoL. Results Four psychological profiles were identified as follows: (1) anxious, extensive coping repertoire (33%); (2) depressive, avoidant coping (23%); (3) low emotional symptoms, active/social coping (16%); and (4) low emotional symptoms, limited coping repertoire (29%). QoL in profile 1 (QoL = 6.59) was significantly different from QoL in profile 3 (QoL = 8.11, p = .001) and profile 4 (QoL = 7.40, p = .01). QoL in profile 2 (QoL = 6.43) was significantly different from QoL in profile 3 (QoL = 8.11, p = .003) and profile 4 (QoL = 7.40, p = .02). Regarding QoL, no other significant differences were found. Sociodemographic and medical characteristics were not distinctive for the profiles (all p values > .05). Conclusion Determining psychological profiles of patients with lung cancer in an early stage provides information that may be helpful in aligning care with patients’ unique needs, as it will help in more adequately selecting those patients who are in need of psychological screening and/or psychological treatment as compared with determining scores on single psychological factors.
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Affiliation(s)
- Eveline van Montfort
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | - Jolanda de Vries
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
| | - Rita Arts
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
| | | | - Jeroen S Kloover
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
| | - Marjan J Traa
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands
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21
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Zhou J, Feng L, Hu C, Pao C, Xiao L, Wang G. Associations Among Depressive Symptoms, Childhood Abuse, Neuroticism, Social Support, and Coping Style in the Population Covering General Adults, Depressed Patients, Bipolar Disorder Patients, and High Risk Population for Depression. Front Psychol 2019; 10:1321. [PMID: 31231288 PMCID: PMC6560051 DOI: 10.3389/fpsyg.2019.01321] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/21/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Exposure to childhood abuse has been identified as a salient risk factor for the development of depression. However, the mediating factors between childhood abuse and depressive symptoms have not been sufficiently elucidated. This study aims to investigate the mediating effects of neuroticism, social support, and coping style between childhood abuse and depressive symptoms in population covering general adults, depressed patients, bipolar disorder patients, and high risk population for depression. METHODS This is a cross-sectional study. Five validated questionnaires were used to measure the psychological outcomes (Childhood Trauma Questionnaire CTQ-SF, Eysenck Personality Questionnaire EPQR-S, Social Support Rating Scale SSRS, Simplified Coping Style Questionnaire SCSQ, and Patient Health Questionnaire-9 PHQ-9) of 312 participants. Multiple regressions and structural equation modeling (SEM) were used to conduct data analysis. RESULTS Multiple regression analysis and SEM showed a significant association between childhood emotional abuse and depression symptoms. Neuroticism, use of social support, and active coping style were important mediating variables of this association. The R 2 for our model was 0.456, indicating that 45.6% of the variability in depressive symptoms can be explained by the model. CONCLUSION This study suggested that neuroticism, active coping, and use of social support play important role in mediating the effects of childhood abuse on adult depressive symptoms.
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Affiliation(s)
- Jia Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Changqing Hu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Christine Pao
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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22
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Polidoro Lima M, Santos de Oliveira D, Quarti Irigaray T. Symptoms of depression and anxiety in cancer outpatients: predictive variables. ACTA ACUST UNITED AC 2018. [DOI: 10.5209/psic.61443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives: The objectives of the present study are to investigate the association among symptoms of depression and anxiety, sociodemographic variables and personality factors and also verify the predictive power of these variables in cancer outpatients. Method: The sample was composed by 220 individuals, 138 (62.7%) women and 82 (37.3%) men. The instruments used were: Questionnaire on sociodemographic and clinical data; NEO-FFI Personality Inventory Revised (NEO-FFI-R) and Hospital Anxiety and Depression Scale (HADS). The t test and the Spearman correlation were used to verify the relation between sociodemographic and clinic variables and symptoms of anxiety and depression. A Multiple Linear Regression analysis was made to verify the predictive power of sociodemographic and clinic variables and personality factors. Results: The personality factor neuroticism was predictor of anxiety symptoms. The variable previous psychiatric history and the personality factors neuroticism and extraversion were predictors of depressive symptoms. Conclusion: Depression and anxiety symptoms are associated with some sociodemographic variables and personality factors, and these variables can be deemed risk factors for the development of these symptoms. It is important that health professionals who follow-up this population design strategies to collect this information, in order to help patients manage treatment the best way possible.
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Hengartner MP. [A Patient´s Personality: A Frequently Ignored but Important Component in General Medical Practice]. PRAXIS 2018; 107:641-647. [PMID: 29871573 DOI: 10.1024/1661-8157/a002998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A Patient´s Personality: A Frequently Ignored but Important Component in General Medical Practice Abstract. In general medical practice, a patient's personality is hardly considered and assessed. In this mini-review the author summarises how a comprehensive personality assessment may provide valuable patient information. Prospective effects of personality traits on general lifestyle as well as mental and physical health are presented. In addition, original research is introduced that shows meaningful associations between personality traits, clinical disease markers, and all-cause mortality. These findings are discussed with respect to selected etiological models. The studies illustrate that a personality assessment could be a useful aid for diagnosis, prognosis, and treatment planning.
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Affiliation(s)
- Michael P Hengartner
- 1 Departement für Angewandte Psychologie, Zürcher Hochschule für Angewandte Wissenschaften, Zürich
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Pettersson E, Lahey BB, Larsson H, Lichtenstein P. Criterion Validity and Utility of the General Factor of Psychopathology in Childhood: Predictive Associations With Independently Measured Severe Adverse Mental Health Outcomes in Adolescence. J Am Acad Child Adolesc Psychiatry 2018; 57:372-383. [PMID: 29859553 DOI: 10.1016/j.jaac.2017.12.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/10/2017] [Accepted: 04/11/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We examined whether a parent-rated general factor of psychopathology in childhood would predict independently measured, severe adverse mental health outcomes in adolescence. METHOD We used the Child and Adolescent Twin Study in Sweden, which targets all twin children in Sweden. Parents rated their children (N = 16,806) on 43 symptoms of inattention, hyperactivity/impulsivity, conduct problems, and anxiety/emotionality when the twins turned 9 or 12 years of age. Adverse mental health outcomes in adolescence were retrieved from national registers, and included psychiatric diagnoses, prescription of anxiolytic or antidepressant medication, court convictions of crimes, and failure to achieve eligibility for high school. RESULTS Parent-rated inattention, hyperactivity/impulsivity, conduct problems, and anxiety/emotionality in childhood predicted all adverse mental health outcomes in adolescence (mean odds ratio = 1.76; range = 1.41-2.18; all p < .05). However, several of these associations were nonsignificant in a multiple regression framework, suggesting the influence of common variance. A general factor of psychopathology uniquely predicted all outcomes (mean odds ratio = 1.58; range = 1.34-1.84; all p < .05), whereas the specific factors predicted only a subset of the outcomes. CONCLUSION Mental health problems in childhood are associated with a host of adverse outcomes in adolescence, and, to a considerable extent, these associations are driven by a general factor of psychopathology. The general factor may therefore be important to clinical prognosis, which informs clinical decision making for children.
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Affiliation(s)
| | | | - Henrik Larsson
- Karolinska Institutet, Stockholm; School of Medical Sciences for Örebro University in Örebro, Sweden
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25
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Bach B, Fjeldsted R. The role of DSM-5 borderline personality symptomatology and traits in the link between childhood trauma and suicidal risk in psychiatric patients. Borderline Personal Disord Emot Dysregul 2017; 4:12. [PMID: 28638621 PMCID: PMC5474295 DOI: 10.1186/s40479-017-0063-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/12/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Childhood traumas appear to be linked to suicidal behavior. However, the factors that mediate between these two phenomena are not sufficiently understood. Recent findings suggest that borderline personality disorder (BPD) may explain some of the association. METHOD The present study investigated the potential mediating role of BPD symptomatology and traits between reported childhood trauma and suicidal risk in adult psychiatric outpatients (N = 124). BPD symptomatology was measured with DSM-5 Section II criterion-counts (SCID-II; Structured Clinical Interview for DSM-IV Axis II), whereas BPD traits were measured with specified DSM-5 Section III traits (PID-5; Personality Inventory for DSM-5). Childhood traumas were self-reported (CTQ; Childhood Trauma Questionnaire), whereas level of suicidal risk was measured with a structured interview (MINI Suicidality Module; Mini International Neuropsychiatric Interview). Mediation effects were tested by bias-corrected (10.000 boot-strapped samples) confidence intervals. RESULTS BPD features account for a considerable part of the cross-sectional association between childhood trauma and level of suicidal risk, even when controlling for the influence of gender, age, and educational level. This finding remained stable when testing the model without the suicidality-related BPD criterion and PID-5 items. DSM-5 Section II BPD criterion-counts explained 67% of the total effect, whereas DSM-5 Section III BPD traits accounted for 82% of the total effect. The specific DSM-5 Section III trait facets of "Depressivity" (52%) and "Perceptual Dysregulation" (37%) accounted for most of this effect. CONCLUSIONS The findings provide preliminary support for the proposed mediation model indicating that BPD features may help explain relations between childhood trauma and elevated suicidal risk in adult life, in particular for DSM-5 Section III personality traits of depressivity (e.g., pessimism, guilt, and shame) and perceptual dysregulation (e.g., dissociation). To reduce the suicidal risk among those with a history of childhood trauma, BPD features (including "Depressivity" and "Perceptual Dysregulation") might be an important target of assessment, risk management, and treatment. However, other factors are likely to be involved, and a longitudinal and more large-scale design is warranted for a conclusive test of mediation.
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Affiliation(s)
- Bo Bach
- Center of Excellence on Personality Disorder, Psychiatric Research Unit, Slagelse Psychiatric Hospital, Fælledvej 6, 4200 Slagelse, Denmark
- Psychiatric Clinic, Slagelse Psychiatric Hospital, Slagelse, Denmark
| | - Rita Fjeldsted
- Psychiatric Clinic, Slagelse Psychiatric Hospital, Slagelse, Denmark
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Lager E, Melin B, Hemmingsson T, Sörberg Wallin A. The evolving relationship between premorbid intelligence and serious depression across the lifespan - A longitudinal study of 43,540 Swedish men. J Affect Disord 2017; 211:37-43. [PMID: 28088056 DOI: 10.1016/j.jad.2016.12.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/01/2016] [Accepted: 12/31/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND An association between higher intelligence and lower probability of serious depression has previously been established. Yet, to our knowledge, no large prospective study has examined the relationship across the lifespan. METHODS A cohort of 49,321 Swedish men was followed from conscription in 1969-70 (age 18-20) through to 2008. Odds ratios (OR) for first time hospitalisation for depression (FTHD) were calculated in relation to intelligence for distinct time periods across the lifespan, while controlling for established risk factors for depression. RESULTS There was a linear association between higher intelligence in youth and lower odds for FTHD during the entire follow-up period, 1973-2008. The association got progressively weaker across the lifespan. During 1973-80, one step down on the stanine scale was associated with an unadjusted increase in OR of 1.34 [95% confidence interval (CI) 1.26-1.42], adjusted OR 1.23 [1.15-1.32]; while, during 2001-2008, the ORs were less than half of the magnitude of the first period, unadjusted 1.14 [1.07-1.21], and adjusted 1.09 [1.01-1.17]. LIMITATIONS The study includes men only, and the number of available places for in-patient care decreased during the follow-up period. CONCLUSION For the first time, we have shown that the association between lower intelligence and depression decreases over time. The attenuation of the association in the adjusted models suggests a slower accumulation of depressogenic stressors among people with a higher IQ-score. Further exploration of intelligence's role in the etiology of depression across the lifespan is required in order to facilitate adequate diagnoses and ameliorating interventions.
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Affiliation(s)
- Emil Lager
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
| | - Bo Melin
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Tomas Hemmingsson
- Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Alma Sörberg Wallin
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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27
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Ono K, Takaesu Y, Nakai Y, Shimura A, Ono Y, Murakoshi A, Matsumoto Y, Tanabe H, Kusumi I, Inoue T. Associations among depressive symptoms, childhood abuse, neuroticism, and adult stressful life events in the general adult population. Neuropsychiatr Dis Treat 2017; 13:477-482. [PMID: 28243100 PMCID: PMC5317351 DOI: 10.2147/ndt.s128557] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. SUBJECTS AND METHODS A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire - Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3) and single and multiple regressions were used to analyze the data. RESULTS Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. LIMITATIONS There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. CONCLUSION This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms.
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Affiliation(s)
- Kotaro Ono
- Department of Psychiatry, Tokyo Medical University, Tokyo
| | | | - Yukiei Nakai
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido
| | | | - Yasuyuki Ono
- Department of Psychiatry, Tokyo Medical University, Tokyo
| | | | | | - Hajime Tanabe
- Department of Clinical Human Sciences, Graduate school of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo
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Fowler JC, Clapp JD, Madan A, Allen JG, Frueh BC, Oldham JM. An Open Effectiveness Trial of a Multimodal Inpatient Treatment for Depression and Anxiety Among Adults With Serious Mental Illness. Psychiatry 2017; 80:42-54. [PMID: 28409715 DOI: 10.1080/00332747.2016.1196072] [Citation(s) in RCA: 8] [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
OBJECTIVE This prospective open effectiveness trial examined symptom change trajectories and rates of remission from depression and anxiety in an intensive multimodal inpatient treatment for adults with serious mental illness (SMI). Patient baseline characteristics were examined as mediators/moderators of treatment response. METHODS Adult inpatients with SMI (N = 994) completed an average of 39 days of inpatient treatment. Latent growth curve (LGC) methods were used to model symptom trajectories, estimating expected remission based on individual patterns of change observed across the sample. RESULTS Absolute reductions in symptoms were substantial, with large effect size improvements for both depression (d = 1.21, 95% CI [1.13, 1.29]) and anxiety (d = 1.13, 95% CI [1.05, 1.21]). For those presenting with elevated depressive symptoms (Patient Health Questionnaire-Depression ≥ 5.0; 87.5% of the sample), 46.9% evidenced remission from admission to discharge. Among patients presenting with significant anxiety (Patient Health Questionnaire-Generalized Anxiety Disorder Screener ≥ 5.0; 84.5% of the sample), 50.0% evidenced remission from admission to discharge. Mediation analyses revealed that depression and anxiety severity decreased more rapidly with increasing age and initial levels of experiential avoidance. CONCLUSIONS Rates of remission of depression and anxiety were greater than anticipated in this large cohort of adult SMI inpatients and may be related to intensity and length of hospitalization.
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29
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Bowen RC, Dong LY, Peters EM, Baetz M, Balbuena L. Mood Instability Is a Precursor of Relationship and Marital Difficulties: Results from Prospective Data from the British Health and Lifestyle Surveys. Front Psychiatry 2017; 8:276. [PMID: 29375402 PMCID: PMC5770655 DOI: 10.3389/fpsyt.2017.00276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 11/24/2017] [Indexed: 11/13/2022] Open
Abstract
The DSM system implies that affective instability is caused by reactivity to interpersonal events. We used the British Health and Lifestyle Survey that surveyed community residents in 1984 and again in 1991 to study competing hypotheses: that mood instability (MI) leads to interpersonal difficulties or vice versa. We analyzed data from 5,352 persons who participated in both waves of the survey. Factor analysis of the Eysenck Personality Inventory neuroticism scale was used to derive a 4-item scale for MI. We used depression measures that were previously derived by factor analyzing the General Health Questionnaire. We tested the competing hypotheses by regressing variables at follow-up against baseline variables. The results showed that MI in 1984 clearly predicted the development of interpersonal problems in 1991. After adjusting for depression, depression becomes the main predictor of spousal difficulties, but MI remains a predictor of interpersonal difficulties with family and friends. Attempts to investigate the reverse hypothesis were ambiguous. The clinical implication is that when MI and interpersonal problems are reported, the MI should be treated first, or at least concurrently.
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30
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Jeronimus BF, Kotov R, Riese H, Ormel J. Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants. Psychol Med 2016; 46:2883-2906. [PMID: 27523506 DOI: 10.1017/s0033291716001653] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND This meta-analysis seeks to quantify the prospective association between neuroticism and the common mental disorders (CMDs, including anxiety, depression, and substance abuse) as well as thought disorders (psychosis/schizophrenia) and non-specific mental distress. Data on the degree of confounding of the prospective association of neuroticism by baseline symptoms and psychiatric history, and the rate of decay of neuroticism's effect over time, can inform theories about the structure of psychopathology and role of neuroticism, in particular the vulnerability theory. METHOD This meta-analysis included 59 longitudinal/prospective studies with 443 313 participants. RESULTS The results showed large unadjusted prospective associations between neuroticism and symptoms/diagnosis of anxiety, depression, and non-specific mental distress (d = 0.50-0.70). Adjustment for baseline symptoms and psychiatric history reduced the associations by half (d = 0.10-0.40). Unadjusted prospective associations for substance abuse and thought disorders/symptoms were considerably weaker (d = 0.03-0.20), but were not attenuated by adjustment for baseline problems. Unadjusted prospective associations were four times larger over short (<4 year) than long (⩾4 years) follow-up intervals, suggesting a substantial decay of the association with increasing time intervals. Adjusted effects, however, were only slightly larger over short v. long time intervals. This indicates that confounding by baseline symptoms and psychiatric history masks the long-term stability of the neuroticism vulnerability effect. CONCLUSION High neuroticism indexes a risk constellation that exists prior to the development and onset of any CMD. The adjusted prospective neuroticism effect remains robust and hardly decays with time. Our results underscore the need to focus on the mechanisms underlying this prospective association.
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Affiliation(s)
- B F Jeronimus
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - R Kotov
- Department of Psychiatry,Stony Brook University,NY,USA
| | - H Riese
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - J Ormel
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
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Brenner AM. Revisiting the Biopsychosocial Formulation: Neuroscience, Social Science, and the Patient's Subjective Experience. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:740-746. [PMID: 27060094 DOI: 10.1007/s40596-016-0542-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 03/21/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Isolating biomarkers for symptomatic states: considering symptom-substrate chronometry. Mol Psychiatry 2016; 21:1180-7. [PMID: 27240533 PMCID: PMC5114713 DOI: 10.1038/mp.2016.83] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 03/22/2016] [Accepted: 04/18/2016] [Indexed: 12/12/2022]
Abstract
A long-standing goal of psychopathology research is to develop objective markers of symptomatic states, yet progress has been far slower than expected. Although prior reviews have attributed this state of affairs to diagnostic heterogeneity, symptom comorbidity and phenotypic complexity, little attention has been paid to the implications of intra-individual symptom dynamics and inter-relatedness for biomarker study designs. In this critical review, we consider the impact of short-term symptom fluctuations on widely used study designs that regress the 'average level' of a given symptom against biological data collected at a single time point, and summarize findings from ambulatory assessment studies suggesting that such designs may be sub-optimal to detect symptom-substrate relationships. Although such designs have a crucial role in advancing our understanding of biological substrates related to more stable, longer-term changes (for example, gray matter thinning during a depressive episode), they may be less optimal for the detection of symptoms that exhibit high frequency fluctuations, are susceptible to common reporting biases, or may be heavily influenced by the presence of other symptoms. We propose that a greater emphasis on intra-individual symptom chronometry may be useful for identifying subgroups of patients with common, proximal pathological indicators. Taken together, these three recent developments in the areas of symptom conceptualization and measurement raise important considerations for future studies attempting to identify reliable biomarkers in psychiatry.
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Kandler C, Ostendorf F. Additive and Synergetic Contributions of Neuroticism and Life Events to Depression and Anxiety in Women. EUROPEAN JOURNAL OF PERSONALITY 2016. [DOI: 10.1002/per.2065] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In this genetically informative and longitudinal study of women, we investigated the nature of individual differences in tendencies to depression (TD) and anxiety (TA) as well as in the probability to develop unipolar mood disorders (UMDs), anxiety disorders (ADs) or both. Specifically, we examined the roles of neuroticism, negative and positive life events and their interplay as heritable and environmental factors of variance in TD and TA. Cross–sectional data from a total of 1200 women including 232 patients (suffering from UMDs and/or ADs) and longitudinal data from 630 female twins including 260 complete pairs were analysed. The analyses yielded that variance in neuroticism mediated the vast majority of the genetic variance in both TD (about 85–90%) and TA (about 70–75%). Negative life events additionally contributed as risk factors accounting for common and specific environmental variance in both TD and TA, whereas positive life events only acted as protective factors in the case of TD. Moreover, TD but not TA was associated with both the probability of exposure and the sensitivity to negative life events and a negative life–event balance (i.e. more negative than positive experiences). The results were discussed within the framework of additive, dynamic and synergetic diathesis–stress models. Copyright © 2016 European Association of Personality Psychology
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Affiliation(s)
| | - Fritz Ostendorf
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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Spinhoven P, Elzinga BM, Van Hemert AM, de Rooij M, Penninx BW. Childhood maltreatment, maladaptive personality types and level and course of psychological distress: A six-year longitudinal study. J Affect Disord 2016; 191:100-8. [PMID: 26655119 DOI: 10.1016/j.jad.2015.11.036] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/18/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Childhood maltreatment and maladaptive personality are both cross-sectionally associated with psychological distress. It is unknown whether childhood maltreatment affects the level and longitudinal course of psychological distress in adults and to what extent this effect is mediated by maladaptive personality. METHODS A sample of 2947 adults aged 18-65, consisting of healthy controls, persons with a prior history or current episode of depressive and/or anxiety disorders according to the Composite Interview Diagnostic Instrument were assessed in six waves at baseline (T0) and 1 (T1), 2 (T2), 4 (T4) and 6 years (T6) later. At each wave psychological distress was measured with the Inventory of Depressive Symptomatology, Beck Anxiety Inventory, and Fear Questionnaire. At T0 childhood maltreatment types were measured with a semi-structured interview (Childhood Trauma Interview) and personality traits with the NEO-Five Factor Inventory. RESULTS Using latent variable analyses, we found that severity of childhood maltreatment (emotional neglect and abuse in particular) predicted higher initial levels of psychological distress and that this effect was mediated by maladaptive personality types. Differences in trajectories of distress between persons with varying levels of childhood maltreatment remained significant and stable over time. LIMITATIONS Childhood maltreatment was assessed retrospectively and maladaptive personality types and level of psychological distress at study entry were assessed concurrently. CONCLUSIONS Routine assessment of maladaptive personality types and possible childhood emotional maltreatment in persons with severe and prolonged psychological distress seems warranted to identify persons who may need a different or more intensive treatment.
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Affiliation(s)
- Philip Spinhoven
- Section of Clinical Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | - Bernet M Elzinga
- Section of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Albert M Van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark de Rooij
- Section of Methods and Statistics, Leiden University, Leiden, The Netherlands
| | - Brenda W Penninx
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychiatry/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Estabrook R, Sadler ME, McGue M. Differential item functioning in the Cambridge Mental Disorders in the Elderly (CAMDEX) Depression Scale across middle age and late life. Psychol Assess 2015; 27:1219-33. [PMID: 25938337 PMCID: PMC4633409 DOI: 10.1037/pas0000114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A long-standing and critical problem in the study of aging and depression is the comparability of measurement across age groups. While psychological measures of depression typically show increased incidence of symptoms with increasing age, rates of depression diagnosis do not show the same age trend. This analysis presents tests of differential item functioning on the depression section of the CAMDEX interview schedule, using factor analysis-derived affective and somatic subscales (McGue & Christensen, 1997). Results for the affective subscale show significant differences in item functioning in the majority of the affective items as a function of age (items "Happy Life," "Lonely," "Nervous" "Worthless," and "Future": χ6(2) = [30.193, 255.971] across items, all p < .0001). Analyses for the somatic subscale show differential item functioning is limited to a single item relating to coping (χ6(2) = 180.754, p < .0001). These results indicate that differences in depression symptoms across age groups are not entirely consistent with a unidimensional depression trait, and that the measurement structure of depression varies over the life span.
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Affiliation(s)
- Ryne Estabrook
- Department of Medical Social Sciences, Northwestern University
| | | | - Matt McGue
- The Danish Twin Registry and Danish Aging Research Center, University of Southern Denmark
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Treatment-resistant depression: are animal models of depression fit for purpose? Psychopharmacology (Berl) 2015; 232:3473-95. [PMID: 26289353 DOI: 10.1007/s00213-015-4034-7] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/20/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Resistance to antidepressant drug treatment remains a major health problem. Animal models of depression are efficient in detecting effective treatments but have done little to increase the reach of antidepressant drugs. This may be because most animal models of depression target the reversal of stress-induced behavioural change, whereas treatment-resistant depression is typically associated with risk factors that predispose to the precipitation of depressive episodes by relatively low levels of stress. Therefore, the search for treatments for resistant depression may require models that incorporate predisposing factors leading to heightened stress responsiveness. METHOD Using a diathesis-stress framework, we review developmental, genetic and genomic models against four criteria: (i) increased sensitivity to stress precipitation of a depressive behavioural phenotype, (ii) resistance to chronic treatment with conventional antidepressants, (iii) a good response to novel modes of antidepressant treatment (e.g. ketamine; deep brain stimulation) that are reported to be effective in treatment-resistant depression and (iv) a parallel to a known clinical risk factor. RESULTS We identify 18 models that may have some potential. All require further validation. Currently, the most promising are the Wistar-Kyoto (WKY) and congenital learned helplessness (cLH) rat strains, the high anxiety behaviour (HAB) mouse strain and the CB1 receptor knockout and OCT2 null mutant mouse strains. CONCLUSION Further development is needed to validate models of antidepressant resistance that are fit for purpose. The criteria used in this review may provide a helpful framework to guide research in this area.
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Resistance to antidepressant drugs: the case for a more predisposition-based and less hippocampocentric research paradigm. Behav Pharmacol 2015; 25:352-71. [PMID: 25083567 DOI: 10.1097/fbp.0000000000000066] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The first half of this paper briefly reviews the evidence that (i) stress precipitates depression by damaging the hippocampus, leading to changes in the activity of a distributed neural system involving, inter alia, the amygdala, the ventromedial and dorsolateral prefrontal cortex, the lateral habenula and ascending monoamine pathways, and (ii) antidepressants work by repairing the damaged hippocampus, thus restoring the normal balance of activity within that circuitry. In the second half of the paper we review the evidence that heightened vulnerability to depression, either because of a clinical history of depression or because of the presence of genetic, personality or developmental risk factors, also confers resistance to antidepressant drug treatment. Thus, although antidepressants provide an efficient means of reversing the neurotoxic effects of stress, they are much less effective in conditions where vulnerability to depression is elevated and the role of stress in precipitating depression is correspondingly lower. Consequently, the issue of vulnerability should feature much more prominently in antidepressant research. Most of the current animal models of depression are based on the induction of a depressive-like phenotype by stress, and pay scant attention to vulnerability. As antidepressants are relatively ineffective in vulnerable individuals, this in turn implies a need for the development of different clinical and preclinical methodologies, and a shift of focus away from the current preoccupation with the hippocampus as a target for antidepressant action in vulnerable patients.
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Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Ogawa A, Fujisawa D, Sone T, Yoshiuchi K, Goto K, Iwasaki M, Tsugane S, Uchitomi Y. Personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors. Jpn J Clin Oncol 2015; 45:456-63. [DOI: 10.1093/jjco/hyv024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/03/2015] [Indexed: 01/06/2023] Open
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Eaton NR, Rodriguez-Seijas C, Carragher N, Krueger RF. Transdiagnostic factors of psychopathology and substance use disorders: a review. Soc Psychiatry Psychiatr Epidemiol 2015; 50:171-82. [PMID: 25563838 DOI: 10.1007/s00127-014-1001-2] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Research on the structure of mental disorders and comorbidity indicates that many forms of psychopathology and substance use disorders are manifestations of relatively few transdiagnostic latent factors. These factors have important consequences for mental disorder research and applied practice. METHODS We provide an overview of the transdiagnostic factor literature, with particular focus on recent advances. RESULTS Internalizing and externalizing transdiagnostic factors have been well characterized in terms of their structures, links with disorders, stability, and statistical properties (e.g., invariance and distributions). Research on additional transdiagnostic factors, such as thought disorder, is quickly advancing latent structural models, as are integrations of transdiagnostic constructs with personality traits. Genetically informed analyses continue to clarify the origins of transdiagnostic factor levels, and links between these factors and important environmental exposures provide promising new avenues of inquiry. CONCLUSIONS Transdiagnostic factors account for the development and continuity of disorders and comorbidity over time, function as the primary links between disorders and important outcomes such as suicide, mediate associations between environmental exposures and disorders, provide an empirically supported classification system, and serve as foci for efficient, broadband intervention approaches. Overall, transdiagnostic factor research indicates the paramount importance of understanding these constructs and, thereby, broadening our understanding of mental disorder in general.
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Affiliation(s)
- Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794, USA,
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Schimmenti A, Bifulco A. Linking lack of care in childhood to anxiety disorders in emerging adulthood: the role of attachment styles. Child Adolesc Ment Health 2015; 20:41-48. [PMID: 32680332 DOI: 10.1111/camh.12051] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Emotional neglect can be characterized as cold or critical parenting and denotes a parent intentionally or unintentionally overlooking the signs that a child needs comfort or attention and ignoring its emotional needs. Parental emotional neglect is widely posited as an antecedent of anxiety disorder, with attachment researchers arguing for anxious-ambivalent attachment style as a mediating factor. METHOD Childhood experience of neglect and abuse, including antipathy (cold, critical parenting), attachment styles, and anxiety disorders were assessed in a high-risk sample of 160 adolescents and young adults by means of interview measures. RESULTS Antipathy was associated with 12-month prevalence of anxiety disorders in the sample. Anxious-ambivalent attachment scores statistically mediated the relationship between antipathy and anxiety disorders. CONCLUSIONS Clinicians treating anxiety disorders in youths need to consider that emotional neglect in childhood in the form of antipathy could lead to anxious-ambivalent internal working models operating around fear of rejection and fear of separation.
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Affiliation(s)
- Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Cittadella Universitaria, 94100, Italy
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Presurgical Psychological and Neuroendocrine Predictors of Psychiatric Morbidity After Major Vascular Surgery: A Prospective Longitudinal Study. Psychosom Med 2015; 77:993-1005. [PMID: 26461854 PMCID: PMC4643324 DOI: 10.1097/psy.0000000000000235] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Major life stressors, including major surgeries, are often followed by psychiatric symptoms and disorders. Prior retrospective work found abdominal aortic aneurysm (AAA) repair is followed by increased psychiatric morbidity, which may adversely influence physical and functional recovery. Identifying risk factors before surgery, such as dysregulation in stress response systems, might be useful in improving preventative intervention. METHODS Two hundred sixteen patients receiving open AAA or aortofemoral bypass surgeries, endovascular AAA repair, or nonsurgical AAA treatment were recruited from two vascular surgery services. Psychiatric symptoms and salivary cortisol measures (waking, 4 PM, and 11 PM, before and after low-dose dexamethasone) were obtained at intake and 3- and 9-month follow-ups. RESULTS After open surgeries, 18% of patients had new psychiatric disorders, compared with 4% of patients receiving endovascular AAA repair or nonsurgical treatment (odds ratio = 6.0, 95% confidence interval = 1.6-22.1, p = .007). Having a history of major depression predicted the onset of new disorders in surgical patients. Presurgical cortisol levels were associated with both baseline (r = 0.23, p < .05) and 9-month (r = 0.32, p < .01) psychiatric symptoms (cortisol B = 1.0, standard error = 0.48, p < .05, in repeated-measures mixed model). CONCLUSIONS Open AAA repair surgery is prospectively linked to the development of psychiatric morbidity, and history of depression elevates risk. Cortisol measures before surgery are associated with current and future psychological functioning, suggesting potential neurobiological mechanisms that may contribute to vulnerability. These results can help identify surgical patients at risk and point to potential targets for risk reduction interventions.
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Luoma I, Korhonen M, Salmelin RK, Helminen M, Tamminen T. Long-term trajectories of maternal depressive symptoms and their antenatal predictors. J Affect Disord 2015; 170:30-8. [PMID: 25218734 DOI: 10.1016/j.jad.2014.08.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 08/04/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depressive symptoms, often long-term or recurrent, are common among mothers of young children and a well-known risk for child well-being. We aimed to explore the antecedents of the long-term trajectories of maternal depressive symptoms and to define the antenatal factors predicting the high-symptom trajectories. METHODS The sample comprised 329 mothers from maternity centers. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4-5 years, 8-9 years and 16-17 years after delivery. Maternal expectations concerning the baby were assessed with the Neonatal Perception Inventory (NPI). Background information was gathered with questionnaires. RESULTS A model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. The high-stable and the intermittent trajectory were both predicted pairwise by a high antenatal EPDS sum score as well as high EPDS anxiety and depression subscores but the other predictors were specific for each trajectory. In multivariate analyses, the high-stable trajectory was predicted by a high antenatal EPDS sum score, a high EPDS anxiety subscore, diminished life satisfaction, loneliness and more negative expectations of babies on average. The intermittent trajectory was predicted by a high antenatal EPDS sum score, a poor relationship with own mother and urgent desire to conceive. LIMITATIONS Only self-report questionnaires were used. The sample size was rather small. CONCLUSIONS The results suggest a heterogeneous course and background of maternal depressive symptoms. This should be considered in intervention planning.
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Affiliation(s)
- Ilona Luoma
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland.
| | - Marie Korhonen
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland
| | - Raili K Salmelin
- Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland; University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland
| | - Mika Helminen
- University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland; Pirkanmaa Hospital District, Science Center, PO Box 2000, FI-33521 Tampere, Finland
| | - Tuula Tamminen
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland
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Maciejewski DF, van Lier PAC, Neumann A, Van der Giessen D, Branje SJT, Meeus WHJ, Koot HM. The development of adolescent generalized anxiety and depressive symptoms in the context of adolescent mood variability and parent-adolescent negative interactions. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:515-26. [PMID: 23982435 DOI: 10.1007/s10802-013-9797-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study explored the influence of adolescent mood variability on the symptom development of generalized anxiety and depression in the context of parent-adolescent negative interactions. Participants were 456 adolescents (55.7 % male) from a community sample, who were followed from age 13 to 16 years. During 4 annual assessments, adolescents reported on their generalized anxiety and depressive symptoms, and both parents and adolescents on levels of negative interactions with each other. Within each study year, adolescents rated their daily mood states during 5 consecutive days for 3 times per year (total of 9 weeks). The absolute differences between mood states on consecutive days were summed to construct a mood variability score. Results showed that high levels of adolescent mood variability predicted increases in generalized anxiety and depressive symptoms across the studied period. No influence of negative interactions on anxiety and depression development was found, but positive predictive links from mood variability to negative interactions at age 14 and 15 appeared. The study underscores the role of adolescent mood variability in the development of symptoms of generalized anxiety and depression during adolescence, but found little evidence for an influence of parent-adolescent negative interactions on internalizing problem development.
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Barlow DH, Ellard KK, Sauer-Zavala S, Bullis JR, Carl JR. The Origins of Neuroticism. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2014; 9:481-96. [DOI: 10.1177/1745691614544528] [Citation(s) in RCA: 187] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In this article, we provide a fresh perspective on the developmental origins of neuroticism—a dimension of temperament marked by elevated stress reactivity resulting in the frequent experience of negative emotions. This negative affectivity is accompanied by a pervasive perception that the world is a dangerous and threatening place, along with beliefs about one’s inability to manage or cope with challenging events. Historically, neuroticism has been viewed as a stable, genetically based trait. However, recent understanding of ongoing gene–environment interactions that occur throughout the life span suggests there may be a more complex and dynamic etiology. Thus, the purpose of this article is to offer a theory for understanding the development of neuroticism that integrates genetic, neurobiological, and environmental contributions to this trait. Given the strong correlation between neuroticism and the development of negative health outcomes—most notably, the full range of anxiety and mood disorders—an enhanced understanding of how neuroticism originates has implications for the treatment and prevention of a broad range of pathologies and, perhaps, even for the prevention of neuroticism itself.
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Affiliation(s)
- David H. Barlow
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
| | | | - Shannon Sauer-Zavala
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
| | - Jacqueline R. Bullis
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
| | - Jenna R. Carl
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
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Lewis GJ, Haworth CMA, Plomin R. Identical genetic influences underpin behavior problems in adolescence and basic traits of personality. J Child Psychol Psychiatry 2014; 55:865-75. [PMID: 24256444 PMCID: PMC4282475 DOI: 10.1111/jcpp.12156] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2013] [Indexed: 12/04/2022]
Abstract
BACKGROUND Understanding the etiology of adolescent problem behavior has been of enduring interest. Only relatively recently, however, has this issue been examined within a normal personality trait framework. Research suggests that problem behaviors in adolescence and beyond may be adequately explained by the taxonomy provided by the basic dimensions of normal personality: Such problem behaviors are suggested to be extreme points on a distribution of the full range of the underlying traits. We extend work in this field examining the extent to which genetic factors underlying the five-factor model of personality are common with genetic influences on adolescent behavior problems (namely, anxiety, peer problems, conduct, hyperactivity, and low prosociality). METHOD A nationally representative twin sample (Twins Early Development Study) from the general population of England and Wales, including 2031 pairs of twins aged 16 years old, was used to decompose variation into genetic and environmental components. Behavioral problems in adolescence were assessed by self-report with the Strengths and Difficulties Questionnaire. RESULTS Adolescent behavior problems were moderately associated with normal personality: Specifically, a fifth to a third of phenotypic variance in problem behaviors was accounted for by five-factor model personality traits. Of central importance here, genetic influences underpinning personality were entirely overlapping with those genetic factors underlying adolescent behavior problems. CONCLUSIONS These findings suggest that adolescent behavior problems can be understood, at least in part, within a model of normal personality trait variation, with the genetic bases of these behavior problems the same as those genetic influences underpinning normal personality.
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Affiliation(s)
- Gary J Lewis
- Department of Psychology, University of YorkYork, UK
| | - Claire M A Haworth
- Department of Psychology, University of WarwickCoventry, UK,MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College LondonLondon, UK
| | - Robert Plomin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College LondonLondon, UK
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Abstract
We examined symptom-level relations between the emotional disorders and general traits within the five-factor model of personality. Neuroticism correlated strongly with the general distress/negative affectivity symptoms (depressed mood, anxious mood, worry) that are central to these disorders; more moderately with symptoms of social phobia, affective lability, panic, posttraumatic stress disorder, lassitude, checking, and obsessive intrusions; and more modestly with agoraphobia, specific phobia, and other symptoms of depression and obsessive-compulsive disorder. Extraversion was negatively correlated with symptoms of social anxiety/social phobia and was positively related to scales assessing expansive positive mood and increased social engagement in bipolar disorder. Conscientiousness, agreeableness, and openness showed weaker associations and generally added little to the prediction of these symptoms. It is noteworthy, moreover, that our key findings replicated well across (a) self-rated versus (b) interview-based symptom measures. We conclude by discussing the diagnostic and assessment implications of these data.
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Reichenheim ME, Moraes CL, Lopes CS, Lobato G. The role of intimate partner violence and other health-related social factors on postpartum common mental disorders: a survey-based structural equation modeling analysis. BMC Public Health 2014; 14:427. [PMID: 24884951 PMCID: PMC4047543 DOI: 10.1186/1471-2458-14-427] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 04/15/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although studies suggest the relevance of intimate partner violence (IPV) and other health-related social characteristics as risk factors for postpartum mental health, literature lacks evidence about how these are effectively connected. This study thus aims to explore how socio-economic position, maternal age, household and marital arrangements, general stressors, alcohol misuse and illicit drug abuse, and especially psychological and physical IPV relate in a framework leading to postpartum common mental disorder (CMD). METHODS The study was carried out in five primary health care units of Rio de Janeiro, Brazil, and included 810 randomly selected mothers of children up to five postpartum months waiting for pediatric visits. The postulated pathways between exposures and outcome were based on literature evidence and were further examined using structural equation models. RESULTS Direct pathways to postpartum CMD arose from a latent variable depicting socio-economic position, a general stressors score, and both IPV variables. Notably, the effect of psychological IPV on postpartum CMD ran partly through physical IPV. The effect of teenage pregnancy, conjugal instability and maternal burden apparently happens solely through substance use, be it alcohol misuse, illicit drug abuse or both in tandem. Moreover, the effect of the latter on CMD seems to be entirely mediated through both types of IPV. CONCLUSION Although the theoretical model underlying the analysis still requires in-depth detailing, results of this study may have shed some light on the role of both psychological and physical IPV as part of an intricate network of events leading to postpartum CMD. Health initiatives may want to make use of this knowledge when designing preventive and intervention approaches.
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Affiliation(s)
- Michael Eduardo Reichenheim
- Department of Epidemiology, Institute of Social Medicine (IMS), Rio de Janeiro State University (UERJ), Rua São Francisco Xavier 524, 7° andar, Rio de Janeiro, RJ 20550-013, Brazil
| | - Claudia Leite Moraes
- Department of Epidemiology, Institute of Social Medicine (IMS), Rio de Janeiro State University (UERJ), Rua São Francisco Xavier 524, 7° andar, Rio de Janeiro, RJ 20550-013, Brazil
- Family Health Master Program, Estácio de Sá University, Rua Riachuelo, 27, Rio de Janeiro, RJ 20230-010, Brazil
| | - Claudia Souza Lopes
- Department of Epidemiology, Institute of Social Medicine (IMS), Rio de Janeiro State University (UERJ), Rua São Francisco Xavier 524, 7° andar, Rio de Janeiro, RJ 20550-013, Brazil
| | - Gustavo Lobato
- Fernandes Figueira Institute, Oswaldo Cruz Foundation (FIOCRUZ), Avenida Rui Barbosa, 716 – 3° Andar, Rio de Janeiro, RJ 22250-020, Brazil
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Bolhuis K, McAdams TA, Monzani B, Gregory AM, Mataix-Cols D, Stringaris A, Eley TC. Aetiological overlap between obsessive-compulsive and depressive symptoms: a longitudinal twin study in adolescents and adults. Psychol Med 2014; 44:1439-49. [PMID: 23920118 PMCID: PMC3959155 DOI: 10.1017/s0033291713001591] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 05/29/2013] [Accepted: 06/01/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Depression is commonly co-morbid with obsessive-compulsive disorder (OCD). However, it is unknown whether depression is a functional consequence of OCD or whether these disorders share a common genetic aetiology. This longitudinal twin study compared these two hypotheses. METHOD Data were drawn from a longitudinal sample of adolescent twins and siblings (n = 2651; Genesis 12-19 study) and from a cross-sectional sample of adult twins (n = 4920). The longitudinal phenotypic associations between OCD symptoms (OCS) and depressive symptoms were examined using a cross-lag model. Multivariate twin analyses were performed to explore the genetic and environmental contributions to the cross-sectional and longitudinal relationship between OCS and depressive symptoms. RESULTS In the longitudinal phenotypic analyses, OCS at time 1 (wave 2 of the Genesis 12-19 study) predicted depressive symptoms at time 2 (wave 3 of the Genesis 12-19 study) to a similar extent to which depressive symptoms at time 1 predicted OCS at time 2. Cross-sectional twin analyses in both samples indicated that common genetic factors explained 52-65% of the phenotypic correlation between OCS and depressive symptoms. The proportion of the phenotypic correlation due to common non-shared environmental factors was considerably smaller (35%). In the adolescent sample, the longitudinal association between OCS at time 1 and subsequent depressive symptoms was accounted for by the genetic association between OCS and depressive symptoms at time 1. There was no significant environmental association between OCS and later depressive symptoms. CONCLUSIONS The present findings show that OCS and depressive symptoms co-occur primarily due to shared genetic factors and suggest that genetic, rather than environmental, effects account for the longitudinal relationship between OCS and depressive symptoms.
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Affiliation(s)
- K. Bolhuis
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, London, UK
| | - T. A. McAdams
- Social, Genetic and Developmental Psychiatry Centre, King's College London, Institute of Psychiatry, London, UK
| | - B. Monzani
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, Institute of Psychiatry, London, UK
| | - A. M. Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - D. Mataix-Cols
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, Institute of Psychiatry, London, UK
| | - A. Stringaris
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, London, UK
| | - T. C. Eley
- Social, Genetic and Developmental Psychiatry Centre, King's College London, Institute of Psychiatry, London, UK
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Morrison KE, Rodgers AB, Morgan CP, Bale TL. Epigenetic mechanisms in pubertal brain maturation. Neuroscience 2014; 264:17-24. [PMID: 24239720 PMCID: PMC3959229 DOI: 10.1016/j.neuroscience.2013.11.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/25/2013] [Accepted: 11/06/2013] [Indexed: 01/21/2023]
Abstract
Puberty is a critical period of development during which the reemergence of gonadotropin-releasing hormone secretion from the hypothalamus triggers a cascade of hormone-dependent processes. Maturation of specific brain regions including the prefrontal cortex occurs during this window, but the complex mechanisms underlying these dynamic changes are not well understood. Particularly, the potential involvement of epigenetics in this programming has been under-examined. The epigenome is known to guide earlier stages of development, and it is similarly poised to regulate vital pubertal-driven brain maturation. Further, as epigenetic machinery is highly environmentally responsive, its involvement may also lend this period of growth to greater vulnerability to external insults, resulting in reprogramming and increased disease risk. Importantly, neuropsychiatric diseases commonly present in individuals during or immediately following puberty, and environmental perturbations including stress may precipitate disease onset by disrupting the normal trajectory of pubertal brain development via epigenetic mechanisms. In this review, we discuss epigenetic processes involved in pubertal brain maturation, the potential points of derailment, and the importance of future studies for understanding this dynamic developmental window and gaining a better understanding of neuropsychiatric disease risk.
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Affiliation(s)
- K E Morrison
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, United States.
| | - A B Rodgers
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, United States
| | - C P Morgan
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, United States
| | - T L Bale
- Department of Animal Biology, School of Veterinary Medicine, University of Pennsylvania, United States
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Melartin T, Mantere O, Ketokivi M, Isometsä E. A prospective latent analysis study of Axis I psychiatric co-morbidity of DSM-IV major depressive disorder. Psychol Med 2014; 44:949-959. [PMID: 23834913 DOI: 10.1017/s0033291713001694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We tested the degree to which longitudinal observations fit two hypotheses of psychiatric co-morbidity in DSM-IV major depressive disorder (MDD) among adult patients: (1) Axis I co-morbidity is dependent on major depressive episode (MDE) course, and (2) Axis I co-morbidity is independent of MDE course. METHOD In the Vantaa Depression Study (VDS), 269 psychiatric secondary-care patients with a DSM-IV MDD were evaluated with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) at intake and at 6 and 18 months. Three evaluations of co-morbidity were available for 193 out of 259 living patients (75%). A latent curve model (LCM) was used to examine individual-level changes in depressive and anxiety symptoms across time. Outcome of MDD was modeled in terms of categorical DSM-IV diagnosis and Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) scores, and co-morbidity in terms of categorical DSM-IV anxiety and alcohol use disorder (AUD) diagnoses and Beck Anxiety Inventory (BAI) scores. RESULTS Depression and anxiety correlated cross-sectionally at baseline. Longitudinally, changes in depression and anxiety correlated in both the 0-6 and 6-18 months time windows. Higher baseline depression raised the likelihood of an AUD at 6 months, and patients with more depressive symptoms in the 0-6 months time window were more likely to have had an AUD at 6 months, which further linked to less improvement in depression symptoms in the 6-18 months time window. CONCLUSIONS Longitudinal and individual-level courses of both internalizing and externalizing disorders in adult patients with MDD seem to be dependent, albeit to differing degrees, on the course of depressive symptoms.
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Affiliation(s)
- T Melartin
- Mood, Depression and Suicidal Behavior Unit, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - O Mantere
- Mood, Depression and Suicidal Behavior Unit, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - M Ketokivi
- Operations and Technology Department, IE Business School, Madrid, Spain
| | - E Isometsä
- Mood, Depression and Suicidal Behavior Unit, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
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