1
|
Kim H, Lee YB, Lee J, Kang D, Kim G, Jin SM, Kim JH, Hur KY, Jeon HJ. Association between depression, antidepressant use, and the incidence of atherosclerotic cardiovascular diseases. J Affect Disord 2024; 352:214-221. [PMID: 38378089 DOI: 10.1016/j.jad.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To examine the association between depression, the use of antidepressants, and atherosclerotic cardiovascular disease (ASCVD). METHODS The South Korean national claims data was used. Among a nationally representative population, 273,656 subjects who had been diagnosed with depression and prescribed antidepressants ("DEP with antidepressants") and 78,851 subjects who had been diagnosed with depression but not prescribed antidepressants ("DEP without antidepressants") were identified to be eligible. Healthy controls (HCs) were 1:1 matched with DEP with antidepressants group for age and sex. We followed up on the occurrence of ASCVD including ischemic heart diseases and ischemic stroke. RESULTS The risk of ASCVD was increased in the DEP with antidepressants group and decreased in the DEP without antidepressants group compared to HCs. Among those under antidepressants, tricyclic antidepressant users showed the highest risk of ASCVD compared to HCs. Among young adults, the risk of ASCVD was increased in both groups. CONCLUSION The risk of ASCVD increased in depression patients taking antidepressants, while it decreased in depression patients not taking antidepressants. However, the relationship showed differences according to drug class and age group.
Collapse
Affiliation(s)
- Hyewon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, South Korea
| | - Dongwoo Kang
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, South Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
| |
Collapse
|
2
|
Kim H, Lee YB, Lee J, Kang D, Kim G, Jin SM, Kim JH, Hur KY, Jeon HJ. Depression, antidepressant use, and the risk of type 2 diabetes: a nationally representative cohort study. Front Psychiatry 2023; 14:1275984. [PMID: 38125283 PMCID: PMC10731300 DOI: 10.3389/fpsyt.2023.1275984] [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: 08/11/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
Background Previous studies have reported that depression can increase the risk of type 2 diabetes. However, they did not sufficiently consider antidepressants or comorbidity. Methods The National Health Insurance Sharing Service database was used. Among the sample population, 276,048 subjects who had been diagnosed with depression and prescribed antidepressants (DEP with antidepressants group) and 79,119 subjects who had been diagnosed with depression but not prescribed antidepressants (DEP without antidepressants group) were found to be eligible for this study. Healthy controls (HCs) were 1:1 matched with the DEP with antidepressants group for age and sex. We followed up with them for the occurrence of type 2 diabetes. Results In the group of DEP with antidepressants, although the risk of type 2 diabetes increased compared to HCs in a crude analysis, it decreased when comorbidity was adjusted for. In the group of DEP without antidepressants, the risk of type 2 diabetes decreased both in the crude model and the adjusted models. The risk varied by age group and classes or ingredients of antidepressants, with young adult patients showing an increased risk even in the fully adjusted model. Conclusion Overall, those with depression had a reduced risk of type 2 diabetes. However, the risk varied according to the age at onset, comorbidity, and type of antidepressants.
Collapse
Affiliation(s)
- Hyewon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Dongwoo Kang
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Department of Medical Device Management and Research, and Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| |
Collapse
|
3
|
Dachew B, Ayano G, Duko B, Lawrence B, Betts K, Alati R. Paternal Depression and Risk of Depression Among Offspring: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2329159. [PMID: 37585203 PMCID: PMC10433087 DOI: 10.1001/jamanetworkopen.2023.29159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/09/2023] [Indexed: 08/17/2023] Open
Abstract
Importance Existing epidemiological evidence is equivocal as to whether paternal depression poses a consequent risk of depression in offspring; meta-analysis of findings can help inform preventative intervention efforts. Objective To conduct a systematic review and meta-analysis of observational studies examining the association between paternal and offspring depression. Data Sources Embase, PubMed, PsycINFO, Scopus, and Web of Science databases were searched between inception and December 2022. Study Selection The review included all observational studies that investigated the association between paternal and offspring depression and 10 606 studies were initially identified. Data Extraction and Synthesis This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. The review protocol was prospectively registered in PROSPERO. Summary odds ratios (ORs) and 95% CIs were pooled using inverse variance weighted random effect meta-analysis. Subgroup and sensitivity analyses were performed. Main Outcomes and Measures The main outcome of interest was offspring depression measured using recognized depression assessment tools. Results Sixteen observational studies published between 2002 and 2021 were included, with a combined sample of 7 153 723 father-child dyads. A meta-analysis of these studies showed that paternal depression was associated with an increased risk of depression in offspring (OR, 1.42; 95% CI, 1.17-1.71). The risk was higher among offspring exposed to paternal depressive disorders (OR, 1.65; 95% CI, 1.28-2.12) than those exposed to depression as defined by a nonclinical symptom scale (OR, 1.12; 95% CI, 1.06-1.19). Sensitivity analysis revealed consistent pooled estimates ranging from 1.35 (95% CI, 1.12-1.62) to 1.45 (95% CI, 1.18-1.78). Conclusions and Relevance Paternal depression was associated with subsequent offspring depression. This finding shows the intergenerational transmission of mental health problems and suggests that mental health interventions benefit not only the patient but also the family as a whole, including both parents.
Collapse
Affiliation(s)
- Berihun Dachew
- School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Getinet Ayano
- School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | - Bereket Duko
- School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Blake Lawrence
- School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Kim Betts
- School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | - Rosa Alati
- School of Population Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
4
|
Gronemann FH, Jacobsen RK, Wium-Andersen MK, Jørgensen MB, Osler M, Jørgensen TSH. Association of Familial Aggregation of Major Depression With Risk of Major Depression. JAMA Psychiatry 2023; 80:350-359. [PMID: 36753297 PMCID: PMC9909579 DOI: 10.1001/jamapsychiatry.2022.4965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/28/2022] [Indexed: 02/09/2023]
Abstract
Importance Major depression (MD) aggregates within families, but how family history of MD confers risk of MD over the life course is unclear. Such knowledge is important to identify and prevent possible depressogenic effects of family environment. Objective To examine the association between family MD history and risk of MD including association with age, sex, type of kinship, and age of the affected family member. Design, Setting, and Participants This cohort study included all Danish citizens born from 1960 to 2003 with known parental identity followed up from their 15th birthday until time of MD, censoring, or December 31, 2018. Analysis took place between April 2022 and December 2022. Exposures Family members with first-time MD using International Classification of Diseases, Eighth Revision codes 296.09, 296.29, 298.09, and 300.49 or 10th Revision codes F32.0-F33.9, family members' age at MD onset, and individuals' age at exposure to family MD. Main Outcomes and Measures Multivariable Poisson regression was applied to estimate the incidence rate ratio (IRR) with 95% CI of first-time MD. Results Of 2 903 430 individuals (1 486 574 [51.2%] men), 37 970 men (2.6%) and 70 223 women (5.0%) developed MD during follow-up. For men, exposure to maternal, paternal, or full sibling MD were associated with a 2-times higher risk of MD (IRR, 2.10 [95% CI, 2.02-2.19]; IRR, 2.04 [95% CI, 1.94-2.14]; IRR, 2.08 [95% CI, 1.97-2.19]) and the associated risk increased with number of affected family members. This pattern was similar for women. For men, family members' age at MD onset was not associated with MD. For women, maternal MD onset at 69 years or younger was associated with higher IRRs of MD (age <40 years: IRR, 1.64 [95% CI, 1.28-2.10]; age 40-49 years: IRR, 1.62 [95% CI, 1.27-2.07]; age 50-59 years: IRR, 1.56 [95% CI, 1.22-2.00]; and age 60-69 years: IRR, 1.67 [95% CI, 1.28-2.16]) compared with women with maternal MD onset at 70 years or older. For men, exposure to maternal MD younger than 30 years (age <1 year: IRR, 1.95 [95% CI, 1.70-2.25]; age 1 to <12 years: IRR, 2.31 [95% CI, 2.16-2.47]; age 12 to <19 years: IRR, 2.18 [95% CI, 2.03-2.35]; age 19 to <30 years: IRR, 1.42 [95% CI, 1.32-1.53]) was associated with increased IRRs, while exposure to maternal MD at 30 years or older was associated with a lower IRR (0.77 [95% CI, 0.70-0.85]). The findings were similar across type of kinships and for women. Conclusions and Relevance In this study, risk of MD was associated with increased numbers of affected family members but did not vary by gender or type of kinship. Exposure to family MD during childhood and adolescence was associated with increased risk.
Collapse
Affiliation(s)
- Frederikke Hørdam Gronemann
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Rikke Kart Jacobsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Marie Kim Wium-Andersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Martin Balslev Jørgensen
- Mental Health Centre Copenhagen, Copenhagen, Denmark, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
5
|
Propper L, Sandstrom A, Rempel S, Howes Vallis E, Abidi S, Bagnell A, Lovas D, Alda M, Pavlova B, Uher R. Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder. Psychol Med 2023; 53:559-566. [PMID: 34140050 DOI: 10.1017/s0033291721001951] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Offspring of parents with major mood disorders (MDDs) are at increased risk for early psychopathology. We aim to compare the rates of neurodevelopmental disorders in offspring of parents with bipolar disorder, major depressive disorder, and controls. METHOD We established a lifetime diagnosis of neurodevelopmental disorders [attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, communication disorders, intellectual disabilities, specific learning disorders, and motor disorders] using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version in 400 participants (mean age 11.3 + s.d. 3.9 years), including 93 offspring of parents with bipolar disorder, 182 offspring of parents with major depressive disorder, and 125 control offspring of parents with no mood disorder. RESULTS Neurodevelopmental disorders were elevated in offspring of parents with bipolar disorder [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.23-4.47, p = 0.010] and major depressive disorder (OR 1.87, 95% CI 1.03-3.39, p = 0.035) compared to controls. This difference was driven by the rates of ADHD, which were highest among offspring of parents with bipolar disorder (30.1%), intermediate in offspring of parents with major depressive disorder (24.2%), and lowest in controls (14.4%). There were no significant differences in frequencies of other neurodevelopmental disorders between the three groups. Chronic course of mood disorder in parents was associated with higher rates of any neurodevelopmental disorder and higher rates of ADHD in offspring. CONCLUSIONS Our findings suggest monitoring for ADHD and other neurodevelopmental disorders in offspring of parents with MDDs may be indicated to improve early diagnosis and treatment.
Collapse
Affiliation(s)
- L Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Rempel
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - E Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - D Lovas
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - B Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - R Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| |
Collapse
|
6
|
Kim H, Yoo J, Han K, Jeon HJ. Physical activity and cardiovascular health in depression: Links between changes in physical activity and cardiovascular risk. Gen Hosp Psychiatry 2022; 78:35-41. [PMID: 35843062 DOI: 10.1016/j.genhosppsych.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine the association between changes in physical activity before and after a diagnosis of depression and risks of cardiovascular diseases (CVDs) and all-cause mortality. METHOD A total of 1,282,160 patients with depression were included in the analyses. Subjects were divided into four groups (never, beginning, maintenance, and discontinuation) according to changes in physical activity before and after the diagnosis of depression. The occurrence of CVD including myocardial infarction (MI) and ischemic stroke and all-cause mortality were determined. RESULTS The beginning group showed decreased risks of MI (adjusted hazard ratio [aHR]: 0.85; 95% confidence interval [CI]: 0.81-0.89), ischemic stroke (aHR: 0.89; 95% CI: 0.85-0.93), and all-cause mortality (aHR: 0.80; 95% CI: 0.77-0.82) than the never group. Compared to the maintenance group, the discontinuation group showed increased risks of MI (aHR: 1.15; 95% CI: 1.08-1.23), ischemic stroke (aHR: 1.13; 95% CI: 1.06-1.21), and all-cause mortality (aHR: 1.29; 95% CI: 1.23-1.35). CONCLUSIONS Beginning regular physical activity after a diagnosis of depression was associated with a decreased cardiovascular risk. Discontinuing regular physical activity after a diagnosis of depression was associated with an increased cardiovascular risk.
Collapse
Affiliation(s)
- Hyewon Kim
- Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea
| | - Juhwan Yoo
- Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Health Sciences & Technology, Department of Medical Device Management & Research, Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
| |
Collapse
|
7
|
Kim H, Choi J, Jeong B, Fava M, Mischoulon D, Park MJ, Kim HS, Jeon HJ. Impaired Oxygenation of the Prefrontal Cortex During Verbal Fluency Task in Young Adults With Major Depressive Disorder and Suicidality: A Functional Near-Infrared Spectroscopy Study. Front Psychiatry 2022; 13:915425. [PMID: 35815016 PMCID: PMC9260011 DOI: 10.3389/fpsyt.2022.915425] [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: 04/08/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Few previous studies have focused on prefrontal activation in young adults diagnosed with major depressive disorder (MDD) and suicidality via functional near-infrared spectroscopy (fNIRS). MATERIALS AND METHODS A total of 59 healthy controls (HCs), 35 patients with MDD but without suicidality, and 25 patients with MDD and suicidality, between the ages of 18-34 years, were enrolled. Changes in oxygenated hemoglobin (oxy-Hb) levels of the prefrontal cortex at baseline, 4 weeks, and 8 weeks, were evaluated using a protocol consisting of three consecutively repeated trials of rest, speech, and verbal fluency test (VFT) via fNIRS. MDD was diagnosed and suicidality was evaluated based on Mini International Neuropsychiatric Interview (MINI). RESULTS Oxy-Hb levels were impaired in patients with MDD compared with HCs (p = 0.018 for left prefrontal cortex; p = 0.021 for right ventromedial prefrontal cortex; p = 0.002 for left frontopolar cortex). Among the three groups including HCs, MDD without suicidality, and MDD with suicidality, prefrontal oxygenation was most decreased in MDD patients with suicidality. A significantly impaired prefrontal oxygenation in the right ventrolateral prefrontal cortex (VLPFC) was detected after adjusting for covariates in MDD patients with suicidality, compared to those without suicidality. CONCLUSION Impaired prefrontal oxygenation during cognitive execution may serve as a diagnostic biomarker for suicidality in young adult patients with MDD.
Collapse
Affiliation(s)
- Hyewon Kim
- Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea
| | | | - Bumseok Jeong
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Mi Jin Park
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Soo Kim
- Department of Psychiatry, Dong-A University Hospital, Busan, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, Department of Medical Device Management and Research, and Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.,Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea.,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
| |
Collapse
|
8
|
Agerbo E, Trabjerg BB, Børglum AD, Schork AJ, Vilhjálmsson BJ, Pedersen CB, Hakulinen C, Albiñana C, Hougaard DM, Grove J, McGrath JJ, Bybjerg-Grauholm J, Mors O, Plana-Ripoll O, Werge T, Wray NR, Mortensen PB, Musliner KL. Risk of Early-Onset Depression Associated With Polygenic Liability, Parental Psychiatric History, and Socioeconomic Status. JAMA Psychiatry 2021; 78:387-397. [PMID: 33439215 PMCID: PMC7807393 DOI: 10.1001/jamapsychiatry.2020.4172] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Combining information on polygenic risk scores (PRSs) with other known risk factors could potentially improve the identification of risk of depression in the general population. However, to our knowledge, no study has estimated the association of PRS with the absolute risk of depression, and few have examined combinations of the PRS and other important risk factors, including parental history of psychiatric disorders and socioeconomic status (SES), in the identification of depression risk. OBJECTIVE To assess the individual and joint associations of PRS, parental history, and SES with relative and absolute risk of early-onset depression. DESIGN, SETTING, AND PARTICIPANTS This case-cohort study included participants from the iPSYCH2012 sample, a case-cohort sample of all singletons born in Denmark between May 1, 1981, and December 31, 2005. Hazard ratios (HRs) and absolute risks were estimated using Cox proportional hazards regression for case-cohort designs. EXPOSURES The PRS for depression; SES measured using maternal educational level, maternal marital status, and paternal employment; and parental history of psychiatric disorders (major depression, bipolar disorder, other mood or psychotic disorders, and other psychiatric diagnoses). MAIN OUTCOMES AND MEASURES Hospital-based diagnosis of depression from inpatient, outpatient, or emergency settings. RESULTS Participants included 17 098 patients with depression (11 748 [68.7%] female) and 18 582 (9429 [50.7%] male) individuals randomly selected from the base population. The PRS, parental history, and lower SES were all significantly associated with increased risk of depression, with HRs ranging from 1.32 (95% CI, 1.29-1.35) per 1-SD increase in PRS to 2.23 (95% CI, 1.81-2.64) for maternal history of mood or psychotic disorders. Fully adjusted models had similar effect sizes, suggesting that these risk factors do not confound one another. Absolute risk of depression by the age of 30 years differed substantially, depending on an individual's combination of risk factors, ranging from 1.0% (95% CI, 0.1%-2.0%) among men with high SES in the bottom 2% of the PRS distribution to 23.7% (95% CI, 16.6%-30.2%) among women in the top 2% of PRS distribution with a parental history of psychiatric disorders. CONCLUSIONS AND RELEVANCE This study suggests that current PRSs for depression are not more likely to be associated with major depressive disorder than are other known risk factors; however, they may be useful for the identification of risk in conjunction with other risk factors.
Collapse
Affiliation(s)
- Esben Agerbo
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - Betina B. Trabjerg
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - Anders D. Børglum
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Department of Biomedicine and Center for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark,Center for Genomics and Personalized Medicine, Aarhus University, Aarhus, Denmark
| | - Andrew J. Schork
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona,Institute of Biological Psychiatry, Mental Health Center Sct Hans, Roskilde, Denmark
| | - Bjarni J. Vilhjálmsson
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Carsten B. Pedersen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - Christian Hakulinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Clara Albiñana
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - David M. Hougaard
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Jakob Grove
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Department of Biomedicine and Center for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark,Center for Genomics and Personalized Medicine, Aarhus University, Aarhus, Denmark,Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - John J. McGrath
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark,Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Jonas Bybjerg-Grauholm
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Ole Mors
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark
| | - Oleguer Plana-Ripoll
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Thomas Werge
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Institute of Biological Psychiatry, Mental Health Center Sct Hans, Roskilde, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Center for GeoGenetic, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Naomi R. Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Preben Bo Mortensen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - Katherine L. Musliner
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| |
Collapse
|
9
|
Filatova S, Upadhyaya S, Luntamo T, Sourander A, Chudal R. Parental age and risk of depression: A nationwide, population-based case-control study. J Affect Disord 2021; 282:322-328. [PMID: 33421859 DOI: 10.1016/j.jad.2020.12.197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/16/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The global prevalence of depression has increased in recent decades and so has the average age of parenthood. Younger and older parental age have been associated with several mental disorders in their offspring, but the associations for depression have been inconsistent. METHODS This study comprised 37,682 singleton births in Finland from 1987- 2007. The subjects were living in Finland at the end of 2012 and had a depressive disorder recorded in the Care Register for Health Care. We also randomly identified 148,795 controls from the Population Register. When missing obsevations excluded the sample was Ncases=18,708 and Ncontrols=77,243. The results were adjusted for the parents' psychiatric history, depression history, marital status and place of birth, the mothers' maternal socioeconomic status, smoking during pregnancy and previous births and the children's birth weight. RESULTS We found a U-shaped association between offspring depression and the age of both parents. The highest odds of depression occurred when the fathers were aged 50 plus years (adjusted Odds Ratio (ORa) 1.51, 95% CI 1.23-1.86) and the mothers were under 20 (ORa 1.44, 95% CI 1.29-1.60) compared to the reference category of parents aged 25-29 years. LIMITATIONS The study was limited to depression diagnosed by specialised health care services and had a relatively short follow-up period. Some data were missing and that could lead to risk estimation biases. CONCLUSION Diagnosed depression was higher among the offspring of younger and older parents. The results suggest that the age of the parent is etiologically associated with offspring depression.
Collapse
Affiliation(s)
| | - Subina Upadhyaya
- Research Centre for Child Psychiatry, University of Turku, Finland
| | - Terhi Luntamo
- Research Centre for Child Psychiatry, University of Turku, Finland; INVEST Research Flagship, University of Turku, Finland
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Finland; INVEST Research Flagship, University of Turku, Finland; Turku University Hospital, Turku, Finland
| | - Roshan Chudal
- Research Centre for Child Psychiatry, University of Turku, Finland
| |
Collapse
|
10
|
11th International Congress on Psychopharmacology & 7th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1606883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
11
|
Musliner KL, Mortensen PB, McGrath JJ, Suppli NP, Hougaard DM, Bybjerg-Grauholm J, Bækvad-Hansen M, Andreassen O, Pedersen CB, Pedersen MG, Mors O, Nordentoft M, Børglum AD, Werge T, Agerbo E. Association of Polygenic Liabilities for Major Depression, Bipolar Disorder, and Schizophrenia With Risk for Depression in the Danish Population. JAMA Psychiatry 2019; 76:516-525. [PMID: 30698613 PMCID: PMC6495355 DOI: 10.1001/jamapsychiatry.2018.4166] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Although the usefulness of polygenic risk scores as a measure of genetic liability for major depression (MD) has been established, their association with depression in the general population remains relatively unexplored. OBJECTIVE To evaluate whether polygenic risk scores for MD, bipolar disorder (BD), and schizophrenia (SZ) are associated with depression in the general population and explore whether these polygenic liabilities are associated with heterogeneity in terms of age at onset and severity at the initial depression diagnosis. DESIGN, SETTING, AND PARTICIPANTS Participants were drawn from the Danish iPSYCH2012 case-cohort study, a representative sample drawn from the population of Denmark born between May 1, 1981, and December 31, 2005. The hazard of depression was estimated using Cox regressions modified to accommodate the case-cohort design. Case-only analyses were conducted using linear and multinomial regressions. The data analysis was conducted from February 2017 to June 2018. EXPOSURES Polygenic risk scores for MD, BD, and SZ trained using the most recent genome-wide association study results from the Psychiatric Genomics Consortium. MAIN OUTCOMES AND MEASURES The main outcome was first depressive episode (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code F32) treated in hospital-based psychiatric care. Severity at the initial diagnosis was measured using the ICD-10 code severity specifications (mild, moderate, severe without psychosis, and severe with psychosis) and treatment setting (inpatient, outpatient, and emergency). RESULTS Of 34 573 participants aged 10 to 31 years at censoring, 68% of those with depression were female compared with 48.9% of participants without depression. Each SD increase in polygenic liability for MD, BD, and SZ was associated with 30% (hazard ratio [HR], 1.30; 95% CI, 1.27-1.33), 5% (HR, 1.05; 95% CI, 1.02-1.07), and 12% (HR, 1.12; 95% CI, 1.09-1.15) increases in the hazard of depression, respectively. Among cases, a higher polygenic liability for BD was associated with earlier depression onset (β = -.07; SE = .02; P = .002). CONCLUSIONS AND RELEVANCE Polygenic liability for MD is associated with first depression in the general population, which supports the idea that these scores tap into an underlying liability for developing the disorder. The fact that polygenic risk for BD and polygenic risk for SZ also were associated with depression is consistent with prior evidence that these disorders share some common genetic overlap. Variations in polygenic liability may contribute slightly to heterogeneity in clinical presentation, but these associations appear minimal.
Collapse
Affiliation(s)
- Katherine L. Musliner
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Preben B. Mortensen
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark,Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - John J. McGrath
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark,Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Nis P. Suppli
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - David M. Hougaard
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Jonas Bybjerg-Grauholm
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Marie Bækvad-Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Ole Andreassen
- The Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway,Oslo University Hospital, Oslo, Norway
| | - Carsten B. Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark,Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Marianne G. Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark,Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Ole Mors
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Merete Nordentoft
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anders D. Børglum
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Centre for Integrative Sequencing, Department of Biomedicine and iSEQ, Aarhus University, Aarhus, Denmark
| | - Thomas Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Institute of Biological Psychiatry, Copenhagen Mental Health Services, Copenhagen, Denmark
| | - Esben Agerbo
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark,Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | | |
Collapse
|
12
|
Rice F, Riglin L, Thapar AK, Heron J, Anney R, O’Donovan MC, Thapar A. Characterizing Developmental Trajectories and the Role of Neuropsychiatric Genetic Risk Variants in Early-Onset Depression. JAMA Psychiatry 2019; 76:306-313. [PMID: 30326013 PMCID: PMC6439821 DOI: 10.1001/jamapsychiatry.2018.3338] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/07/2018] [Indexed: 12/12/2022]
Abstract
Importance Depression often first manifests in adolescence. Thereafter, individual trajectories vary substantially, but it is not known what shapes depression trajectories in youth. Adult studies suggest that genetic risk for schizophrenia, a psychiatric disorder with a neurodevelopmental component, may contribute to an earlier onset of depression. Objective To test the hypothesis that there are distinct trajectories of depressive symptoms and that genetic liability for neurodevelopmental psychiatric disorders (eg, schizophrenia, attention deficit/hyperactivity disorder [ADHD]), as well as for major depressive disorder (MDD), contribute to early-onset depression. Design, Setting, and Participants The Avon Longitudinal Study of Parents and Children is an ongoing, prospective, longitudinal, population-based cohort that has been collecting data since September 6, 1990, including data on 7543 adolescents with depressive symptoms at multiple time points. The present study was conducted between November 10, 2017, and August 14, 2018. Main Outcomes and Measures Trajectories based on self-reported depressive symptoms dichotomized by the clinical cutpoint; MDD, schizophrenia, and ADHD polygenic risk score (PRS) were predictors. Results In 7543 adolescents with depression data on more than 1 assessment point between a mean (SD) age of 10.64 (0.25) years and 18.65 (0.49) years (3568 [47.3%] male; 3975 [52.7%] female), 3 trajectory classes were identified: persistently low (73.7%), later-adolescence onset (17.3%), and early-adolescence onset (9.0%). The later-adolescence-onset class was associated with MDD genetic risk only (MDD PRS: odds ratio [OR], 1.27; 95% CI, 1.09-1.48; P = .003). The early-adolescence-onset class was also associated with MDD genetic risk (MDD PRS: OR, 1.24; 95% CI, 1.06-1.46; P = .007) but additionally with genetic risk for neurodevelopmental disorders (schizophrenia PRS: OR, 1.22; 95% CI, 1.04-1.43; P = .01; ADHD PRS: OR, 1.32; 95% CI, 1.13-1.54; P < .001) and childhood ADHD (χ21 = 6.837; P = .009) and neurodevelopmental traits (pragmatic language difficulties: OR, 1.31; P = .004; social communication difficulties: OR, 0.68; P < .001). Conclusions and Relevance The findings of this study appear to demonstrate evidence of distinct depressive trajectories, primarily distinguished by age at onset. The more typical depression trajectory with onset of clinically significant symptoms at age 16 years was associated with MDD genetic risk. The less-common depression trajectory, with a very early onset, was particularly associated with ADHD and schizophrenia genetic risk and, phenotypically, with childhood ADHD and neurodevelopmental traits. Findings are consistent with emerging evidence for a neurodevelopmental component in some cases of depression and suggest that the presence of this component may be more likely when the onset of depression is very early.
Collapse
Affiliation(s)
- Frances Rice
- Medical Research Council for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Lucy Riglin
- Medical Research Council for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Ajay K. Thapar
- Medical Research Council for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Richard Anney
- Medical Research Council for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Michael C. O’Donovan
- Medical Research Council for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Anita Thapar
- Medical Research Council for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
13
|
Musliner KL, Zandi PP, Liu X, Laursen TM, Munk-Olsen T, Mortensen PB, Eaton WW. Vascular Pathology and Trajectories of Late-Life Major Depressive Disorder in Secondary Psychiatric Care. Am J Geriatr Psychiatry 2018; 26:386-395. [PMID: 28807498 PMCID: PMC5775925 DOI: 10.1016/j.jagp.2017.07.006] [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: 01/23/2017] [Revised: 06/16/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine 5-year trajectories of psychiatrist-treated late-life major depressive disorder (MDD), and evaluate whether previous vascular pathology is associated with more severe trajectories of late-life MDD. METHODS Data were obtained from nationally representative civil, psychiatric, hospital, and prescription registers in Denmark. The sample included 11,092 older adults (≥60 years) who received their first diagnosis of MDD in a psychiatric facility in Denmark between 2000 and 2007. Trajectories of inpatient or outpatient contact at psychiatric hospitals for MDD over the 5-year period following index MDD diagnosis were modeled using latent class growth analysis. Measures of vascular disease (stroke, heart disease, vascular dementia) and vascular risk factors (hypertension, diabetes) were defined based on medication prescriptions and hospital-based diagnoses. Other predictors included demographic characteristics and characteristics of the index MDD diagnosis. RESULTS The final model included 4 trajectories with consistently low (66% of the sample), high decreasing (19%), consistently high (9%), and moderate fluctuating (6%) probabilities of contact at a psychiatric hospital for MDD during the 5-year period following the index MDD diagnosis. We found no significant associations between any form of vascular pathology and trajectory class membership. Relative to the consistently low class, older age, greater severity and >12 months of prior antidepressant medication use predicted membership in the other three classes. CONCLUSIONS A notable proportion (34%) of individuals diagnosed with MDD in late-life require secondary psychiatric treatment for extended time periods. We did not find evidence that vascular pathology predicts hospital contact trajectories in secondary-treated late-life MDD.
Collapse
Affiliation(s)
- Katherine L Musliner
- National Center for Register-based Research, Department of Economics and Business Economics, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
| | - Peter P Zandi
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Xiaoqin Liu
- National Center for Register-based Research, Department of Economics and Business Economics, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
| | - Thomas M Laursen
- National Center for Register-based Research, Department of Economics and Business Economics, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
| | - Trine Munk-Olsen
- National Center for Register-based Research, Department of Economics and Business Economics, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark
| | - Preben B Mortensen
- National Center for Register-based Research, Department of Economics and Business Economics, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Copenhagen, Denmark; CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - William W Eaton
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| |
Collapse
|
14
|
Lewis G, Neary M, Polek E, Flouri E, Lewis G. The association between paternal and adolescent depressive symptoms: evidence from two population-based cohorts. Lancet Psychiatry 2017; 4:920-926. [PMID: 29153626 DOI: 10.1016/s2215-0366(17)30408-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/20/2017] [Accepted: 09/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many studies have methodological limitations. We aimed to assess the association between paternal and adolescent depressive symptoms in two large population-based cohort studies. METHODS We used data for two-parent families from two representative prospective cohorts in Ireland (Growing up in Ireland [GUI]) and the UK (Millennium Cohort Study [MCS]). Parental depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale in the GUI cohort when children were 9 years old, and the Kessler six-item psychological distress scale in the MCS cohort when children were 7 years old. Adolescent depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) at age 13 years in the GUI cohort and age 14 years in the MCS cohort. We analysed data using linear regression models, before and after adjustment for confounders, in both multiply imputed and complete case samples. FINDINGS There were 6070 families in GUI and 7768 in MCS. After all adjustments, a 1 SD (three-point) increase in paternal depressive symptoms was associated with an increase of 0·24 SMFQ points (95% CI 0·03-0·45; p=0·023) in the GUI cohort and 0·18 SMFQ points (0·01-0·36; p=0·041) in the MCS cohort. This association was independent of, and not different in magnitude to, the association between maternal and adolescent depressive symptoms (Wald test p=0·435 in the GUI cohort and 0·470 in the MCS cohort). INTERPRETATION Our results show an association between depressive symptoms in fathers and depressive symptoms in their adolescent offspring. These findings support the involvement of fathers as well as mothers in early interventions to reduce the prevalence of adolescent depression, and highlight the importance of treating depression in both parents. FUNDING Department of Children and Youth Affairs and Economic and Social Research Council.
Collapse
Affiliation(s)
- Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
| | - Martha Neary
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ela Polek
- School of Psychology, University College Dublin, Dublin, Ireland; Department of Psychiatry, Cambridge University, Cambridge, UK
| | - Eirini Flouri
- UCL Institute of Education, University College London, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| |
Collapse
|
15
|
Dahl SK, Larsen JT, Petersen L, Ubbesen MB, Mortensen PB, Munk-Olsen T, Musliner KL. Early adversity and risk for moderate to severe unipolar depressive disorder in adolescence and adulthood: A register-based study of 978,647 individuals. J Affect Disord 2017; 214:122-129. [PMID: 28288406 DOI: 10.1016/j.jad.2017.03.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/12/2017] [Accepted: 03/05/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Early adversity is a known risk factor for unipolar depression. We examined the impact of 9 types of early adversity on risk for moderate to severe unipolar depression in adolescence or adulthood, and evaluated whether these effects were moderated by gender and adversity timing. METHODS We conducted a prospective, population-based cohort study using Danish national registers. The sample included all individuals born in Denmark between 1980 and 1998 (N=978,647). Exposure to early adversity was assessed from ages 0-15. Types of adversity included parental illness, incarceration, death, disability, and psychiatric diagnosis; family disruption; out-of-home care; and childhood abuse. Individuals were followed from age 15 until first in- or outpatient depression diagnosis (ICD-10 codes F32, F33) in a psychiatric hospital, death, emigration, or December 31st, 2013, whichever came first. Hazard ratios (HRs) were calculated using Cox regressions. RESULTS All adversities were significantly associated with increased risk for moderate to severe adolescent/adult depression (HR range: 1.30-2.72), although the effects were attenuated after mutual adjustment (adjusted HR range: 1.06-1.70). None of the effects were moderated by gender. The effect of family disruption was strongest between ages 0-4 (HR=1.66, 95% CI=1.61-1.71), while the effect of out-of-home care was strongest between ages 10-14 (HR=2.45, 95% CI=2.28-2.64). LIMITATIONS Untreated and primary-care treated depression were not measured. CONCLUSIONS Our results support past findings that multiple types of early adversity increase risk for moderate to severe unipolar depression in adolescence and adulthood. Certain adversities may be more harmful if they occur during specific developmental time periods.
Collapse
Affiliation(s)
- Signe Kirk Dahl
- The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark
| | - Janne Tidselbak Larsen
- The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Liselotte Petersen
- The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Mads Bonde Ubbesen
- The National Institute for Municipalities' and Regions' Analyses and Research, KORA, Denmark
| | - Preben Bo Mortensen
- The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - Trine Munk-Olsen
- The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Katherine Louise Musliner
- The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
| |
Collapse
|