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Ten Have M, Tuithof M, van Dorsselaer S, Schouten F, Luik AI, de Graaf R. Prevalence and trends of common mental disorders from 2007-2009 to 2019-2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic. World Psychiatry 2023; 22:275-285. [PMID: 37159351 PMCID: PMC10168151 DOI: 10.1002/wps.21087] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 05/11/2023] Open
Abstract
Up-to-date information on the prevalence and trends of common mental disorders is relevant to health care policy and planning, owing to the high burden associated with these disorders. In the first wave of the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a nationally representative sample was interviewed face-to-face from November 2019 to March 2022 (6,194 subjects; 1,576 interviewed before and 4,618 during the COVID-19 pandemic; age range: 18-75 years). A slightly modified version of the Composite International Diagnostic Interview 3.0 was used to assess DSM-IV and DSM-5 diagnoses. Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by comparing these rates between NEMESIS-3 and NEMESIS-2 (6,646 subjects; age range: 18-64 years; interviewed from November 2007 to July 2009). Lifetime DSM-5 prevalence estimates in NEMESIS-3 were 28.6% for anxiety disorders, 27.6% for mood disorders, 16.7% for substance use disorders, and 3.6% for attention-deficit/hyperactivity disorder. Over the last 12 months, prevalence rates were 15.2%, 9.8%, 7.1%, and 3.2%, respectively. No differences in 12-month prevalence rates before vs. during the COVID-19 pandemic were found (26.7% pre-pandemic vs. 25.7% during the pandemic), even after controlling for differences in socio-demographic characteristics of the respondents interviewed in these two periods. This was the case for all four disorder categories. From 2007-2009 to 2019-2022, the 12-month prevalence rate of any DSM-IV disorder significantly increased from 17.4% to 26.1%. A stronger increase in prevalence was found for students, younger adults (18-34 years) and city dwellers. These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic. The already high mental disorder risk of young adults has particularly further increased in recent years.
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Affiliation(s)
- Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Frederiek Schouten
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Annemarie I Luik
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
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Yildirim M, Gaynes BN, Keskinocak P, Pence BW, Swann J. The cost-effectiveness of depression screening for the general adult population. J Affect Disord 2022; 303:306-314. [PMID: 35181387 DOI: 10.1016/j.jad.2022.02.044] [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: 11/08/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is a treatable disease, and untreated depression can lead to serious health complications and decrease the quality of life. Therefore, prevention, early identification, and treatment efforts are essential. Screening has an essential role in preventive medicine in the general population. Ideally, screening tools detect patients early enough to manage the disease and reduce symptoms. We aimed to determine the cost-effectiveness of routine screening schedules. METHODS We used a discrete-time nonstationary Markov model to simulate the progression of depression. We used Monte Carlo techniques to simulate the stochastic model for 20 years or during the lifetime of individuals. Baseline and screening scenario models with screening frequencies of annual, 2-year, and 5-year strategies were compared based on incremental cost-effectiveness ratios (ICER). Monte Carlo (MC) simulation and one-way sensitivity analysis were conducted to manage uncertainties. RESULTS In the general population, all screening strategies were cost-effective compared to the baseline. However, male and female populations differed based on cost over quality-adjusted life years (QALY). Females had lower ICERs, and annual screening had the highest ICER for females, with 11,134$/QALY gained. In contrast, males had around three times higher ICER, with annual screening costs of 34,065$/QALY gained. LIMITATIONS We assumed that the screening frequency was not changing at any time during the screening scenario. In our calculations, false-positive cases were not taking into account. CONCLUSIONS Considering the high lifetime prevalence and recurrence rates of depression, detection and prevention efforts can be one critical cornerstone to support required care. Our analysis combined the expected benefits and costs of screening and assessed the effectiveness of screening scenarios. We conclude that routine screening is cost-effective for all age groups of females and young, middle-aged males.
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Affiliation(s)
- Melike Yildirim
- School of Industrial and Systems Engineering and Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, GA, USA; Institute for Technology Assessment and Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Pinar Keskinocak
- School of Industrial and Systems Engineering and Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, GA, USA; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Brian W Pence
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Swann
- Department of Industrial and Systems Engineering, North Carolina State University, 111 Lampe Drive CB7906, Raleigh, NC 27695, USA.
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Short NA, Austin AE, Wolfson AR, Rojo-Wissar DM, Munro CA, Eaton WW, Bienvenu OJ, Spira AP. The association between traumatic life events and insomnia symptoms among men and women: Results from the Baltimore Epidemiologic Catchment Area follow-up study. Sleep Health 2022; 8:249-254. [PMID: 35151605 PMCID: PMC8995334 DOI: 10.1016/j.sleh.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/29/2021] [Accepted: 11/14/2021] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVES Trauma exposure likely contributes to poor sleep, but relatively few studies have empirically tested this, instead focusing on posttraumatic stress disorder. Moreover, little is known about sex differences in sleep after trauma. The current study used a cross-sectional and retrospective design to test hypotheses that trauma exposure would be associated with subsequent insomnia symptoms, particularly among women, even after accounting for important covariates. METHOD Data from Wave 3 (1993-1996) of the Baltimore Epidemiologic Catchment Area Study (N = 1920) were used to examine associations between remote (prior to past year) and recent (past year) trauma and current sleep disturbance (insomnia, hypersomnia symptoms) in the total sample (Mage= 55, 63.2% women, 57.7% white), and separately in men and women. Sensitivity analyses were conducted among individuals with no pretrauma sleep disturbance to examine incident sleep disturbance. RESULTS Among all participants, both remote (odds ratio [OR] = 1.95, 95% confidence interval [CI] [1.34, 2.85]) and recent (OR = 1.94, 95% CI [1.31, 2.87]) trauma exposure were associated with increased odds of insomnia (OR = 2.41, 95% CI [1.54, 3.76]) but not hypersomnia. Associations between trauma and insomnia were particularly strong among women, but null among men. The relationship between trauma exposure and insomnia symptoms persisted among individuals with no pretrauma history of insomnia. CONCLUSION Results suggest women may be vulnerable to insomnia symptoms as sequelae of trauma. Future research should examine prospective associations between trauma and sleep in larger samples and how assessment and treatment of insomnia among women trauma survivors reduces the public health impact of trauma and poor sleep.
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Affiliation(s)
- Nicole A Short
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
| | - Anna E Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amy R Wolfson
- Department of Psychology, Loyola University Maryland, Baltimore, Maryland, USA
| | - Darlynn M Rojo-Wissar
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Cynthia A Munro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - O Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center for Aging and Health, Baltimore, Maryland, USA
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Yildirim M, Gaynes BN, Keskinocak P, Pence BW, Swann J. DIP: Natural history model for major depression with incidence and prevalence. J Affect Disord 2022; 296:498-505. [PMID: 34624435 DOI: 10.1016/j.jad.2021.09.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 08/11/2021] [Accepted: 09/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Major depression is a treatable disease, and untreated depression can lead to serious health complications. Therefore, prevention, early identification, and treatment efforts are essential. Natural history models can be utilized to make informed decisions about interventions and treatments of major depression. METHODS We propose a natural history model of major depression. We use steady-state analysis to study the discrete-time Markov chain model. For this purpose, we solved the system of linear equations and tested the parameter and transition probabilities empirically. RESULTS We showed that bias in parameters might collectively cause a significant mismatch in a model. If incidence is correct, then lifetime prevalence is 33.2% for females and 20.5% for males, which is higher than reported values. If prevalence is correct, then incidence is .0008 for females and .00065 for males, which is lower than reported values. The model can achieve feasibility if incidence is at low levels and recall bias of the lifetime prevalence is quantified to be 31.9% for females and 16.3% for males. LIMITATIONS This model is limited to major depression, and patients who have other types of depression are assumed healthy. We assume that transition probabilities (except incidence rates) are correct. CONCLUSION We constructed a preliminary model for the natural history of major depression. We determined the lifetime prevalences are underestimated and the average incidence rates may be underestimated for males. We conclude that recall bias needs to be accounted for in modeling or burden estimates, where the recall bias should increase with age.
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Affiliation(s)
- Melike Yildirim
- School of Industrial and Systems Engineering and Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Pinar Keskinocak
- School of Industrial and Systems Engineering and Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, Georgia, USA; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Brian W Pence
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julie Swann
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA.
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Lipsitz O, Di Vincenzo JD, Rodrigues NB, Cha DS, Lee Y, Greenberg D, Teopiz KM, Ho RC, Cao B, Lin K, Subramaniapillai M, Flint AJ, Kratiuk K, McIntyre RS, Rosenblat JD. Safety, Tolerability, and Real-World Effectiveness of Intravenous Ketamine in Older Adults With Treatment-Resistant Depression: A Case Series. Am J Geriatr Psychiatry 2021; 29:899-913. [PMID: 33478865 DOI: 10.1016/j.jagp.2020.12.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the safety, tolerability, and effectiveness of repeated doses of intravenous (IV) ketamine in older adults (i.e., ≥60 years of age) with treatment-resistant depression. METHOD In this case series, fifty-three older adults (Mage = 67, SD = 6; 57% female [n = 30]) received 4 IV ketamine infusions, administered over 1-2 weeks. Effectiveness of IV ketamine was measured using the Quick Inventory for Depressive Symptomatology-Self Report 16 (QIDS-SR16) approximately 2 days after infusions 1-3, and 1-2 weeks after infusion 4. Safety was measured as hemodynamic changes before, during, immediately after, and 20 minutes after each infusion. Tolerability was assessed via systematic reporting of treatment-emergent adverse events during and after each infusion, in addition to symptoms of dissociation measured using the Clinician Administered Dissociative States Scale. Partial response (25%-50% symptomatic improvement from baseline), response (≥50% symptomatic improvement from baseline), clinically significant improvements (≥25% symptomatic improvement from baseline), and remission rates (QIDS-SR16 ≤5) were also calculated. RESULTS Participants reported significant decreases in depressive symptoms (i.e., as measured by the QIDS-SR16) with repeated ketamine infusions (F(4, 92) = 7.412, p <0.001). The mean QIDS-SR16 score was 17.12 (SD = 5.33) at baseline and decreased to 12.52 (SD = 5.79) following 4 infusions. After 4 infusions, 31% (n = 8) of participants partially responded to IV ketamine, 27% (n = 7) responded, 58% (n = 15) experienced clinically significant improvements, and 10% (n = 3) met remission criteria. Thirty-six participants (69%) experienced treatment-emergent hypertension during at least 1 infusion, and 10 (19%) required intervention with an antihypertensive. Drowsiness was the most commonly reported adverse event (50% of infusions; n = 73). CONCLUSION Ketamine was associated with transient treatment-emergent hypertension. Response and remission rates were comparable to those reported in general adult samples. Findings are limited by the open-label, chart review nature of this study.
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Affiliation(s)
- Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Joshua D Di Vincenzo
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto (JDV, RSM), Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Danielle S Cha
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; School of Medicine, Faculty of Medicine, University of Queensland (DSC), Brisbane, QLD, Australia
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - David Greenberg
- Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Kayla M Teopiz
- Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore (RCH), Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore (RCH), Singapore
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University (BC), Chongqing, 400715, PR China
| | - Kangguang Lin
- Department of Affective Disorder, The Affiliated Brain Hospital of Guangzhou Medical University, (Guangzhou Huiai Hospital), Guangzhou Medical University (KL), Guangzhou, China; Laboratory of Emotion and Cognition, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou Medical University (KL), Guangzhou, China
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada
| | - Alastair J Flint
- Department of Psychiatry, University of Toronto (AJF, RSM, JDR), Toronto, ON, Canada; Centre for Mental Health, University Health Network (AJF), Toronto, ON, Canada
| | - Kevin Kratiuk
- Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada; Department of Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada; Department of Psychiatry, University of Toronto (AJF, RSM, JDR), Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto (JDV, RSM), Toronto, ON, Canada.
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network (OL, JDV, NBR, DSC, YL, MS, RSM, JDR), Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence (OL, NBR, YL, DG, KMT, MS, KK RSM, JDR), Mississauga, ON, Canada; Department of Psychiatry, University of Toronto (AJF, RSM, JDR), Toronto, ON, Canada
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Greene MC, Yangchen T, Lehner T, Sullivan PF, Pato CN, McIntosh A, Walters J, Gouveia LC, Msefula CL, Fumo W, Sheikh TL, Stockton MA, Wainberg ML, Weissman MM. The epidemiology of psychiatric disorders in Africa: a scoping review. Lancet Psychiatry 2021; 8:717-731. [PMID: 34115983 PMCID: PMC9113063 DOI: 10.1016/s2215-0366(21)00009-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
This scoping review of population-based epidemiological studies was done to provide background information on the prevalences and distribution of psychiatric disorders in Africa for calls to broaden diversity in psychiatric genetic studies. We searched PubMed, EMBASE, and Web of Science to retrieve relevant literature in English, French, and Portuguese from Jan 1, 1984, to Aug 18, 2020. In 36 studies from 12 African countries, the lifetime prevalence ranged from 3·3% to 9·8% for mood disorders, from 5·7% to 15·8% for anxiety disorders, from 3·7% to 13·3% for substance use disorders, and from 1·0% to 4·4% for psychotic disorders. Although the prevalence of mood and anxiety disorders appears to be lower than that observed in research outside the continent, we identified similar distributions by gender, although not by age or urbanicity. This review reveals gaps in epidemiological research on psychiatric disorders and opportunities to leverage existing epidemiological and genetic research within Africa to advance our understanding of psychiatric disorders. Studies that are methodologically comparable but diverse in geographical context are needed to advance psychiatric epidemiology and provide a foundation for understanding environmental risk in genetic studies of diverse populations globally.
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Affiliation(s)
- M Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Tenzin Yangchen
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Thomas Lehner
- New York Genome Center, New York, NY, USA; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Patrick F Sullivan
- Center for Psychiatric Genomics, Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Carlos N Pato
- Institute for Genomic Health, SUNY Downstate, Health Science University, Brooklyn, NY, USA
| | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Lidia C Gouveia
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Chisomo L Msefula
- Pathology Department, College of Medicine, University of Malawi, Chichiri, Blantyre, Malawi
| | - Wilza Fumo
- Department of Mental Health, Ministry of Health-Mozambique, Maputo, Mozambique
| | - Taiwo L Sheikh
- Department of Psychiatry, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Melissa A Stockton
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, New York, NY, USA.
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Riehm KE, Holingue C, Smail EJ, Kapteyn A, Bennett D, Thrul J, Kreuter F, McGinty EE, Kalb LG, Veldhuis CB, Johnson RM, Fallin MD, Stuart EA. Trajectories of Mental Distress Among U.S. Adults During the COVID-19 Pandemic. Ann Behav Med 2021; 55:93-102. [PMID: 33555336 PMCID: PMC7929474 DOI: 10.1093/abm/kaaa126] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cross-sectional studies have found that the coronavirus disease 2019 (COVID-19) pandemic has negatively affected population-level mental health. Longitudinal studies are necessary to examine trajectories of change in mental health over time and identify sociodemographic groups at risk for persistent distress. PURPOSE To examine the trajectories of mental distress between March 10 and August 4, 2020, a key period during the COVID-19 pandemic. METHODS Participants included 6,901 adults from the nationally representative Understanding America Study, surveyed at baseline between March 10 and 31, 2020, with nine follow-up assessments between April 1 and August 4, 2020. Mixed-effects logistic regression was used to examine the association between date and self-reported mental distress (measured with the four-item Patient Health Questionnaire) among U.S. adults overall and among sociodemographic subgroups defined by sex, age, race/ethnicity, household structure, federal poverty line, and census region. RESULTS Compared to March 11, the odds of mental distress among U.S. adults overall were 1.84 (95% confidence interval [CI] = 1.65-2.07) times higher on April 1 and 1.92 (95% CI = 1.62-2.28) times higher on May 1; by August 1, the odds of mental distress had returned to levels comparable to March 11 (odds ratio [OR] = 0.80, 95% CI = 0.66-0.96). Females experienced a sharper increase in mental distress between March and May compared to males (females: OR = 2.29, 95% CI = 1.85-2.82; males: OR = 1.53, 95% CI = 1.15-2.02). CONCLUSIONS These findings highlight the trajectory of mental health symptoms during an unprecedented pandemic, including the identification of populations at risk for sustained mental distress.
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Affiliation(s)
- Kira E Riehm
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
| | - Calliope Holingue
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Emily J Smail
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
| | - Arie Kapteyn
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Daniel Bennett
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Frauke Kreuter
- Joint Program in Survey Methodology, University of Maryland, College Park, College Park, MD, USA
- School of Social Sciences, University of Mannheim, Mannheim, Germany
- Statistical Methods Group, Institute for Employment Research, Nuremberg, Germany
| | - Emma E McGinty
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Luther G Kalb
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA
| | | | - Renee M Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
| | - M Daniele Fallin
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA
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8
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Sutin AR, Costa PT, Miech R, Eaton WW. Personality and Career Success: Concurrent and Longitudinal Relations. EUROPEAN JOURNAL OF PERSONALITY 2020; 23:71-84. [PMID: 19774106 DOI: 10.1002/per.704] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The present research addresses the dynamic transaction between extrinsic (occupational prestige, income) and intrinsic (job satisfaction) career success and the Five-Factor Model of personality. Participants (N = 731) completed a comprehensive measure of personality and reported their job title, annual income, and job satisfaction; a subset of these participants (n = 302) provided the same information approximately 10 years later. Measured concurrently, emotionally stable and conscientious participants reported higher incomes and job satisfaction. Longitudinal analyses revealed that, among younger participants, higher income at baseline predicted decreases in Neuroticism and baseline Extraversion predicted increases in income across the 10 years. Results suggest that the mutual influence of career success and personality is limited to income and occurs early in the career.
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The Impact of Systematic Depression Screening in Primary Care on Depression Identification and Treatment in a Large Health Care System: A Cohort Study. J Gen Intern Med 2020; 35:3141-3147. [PMID: 32495093 PMCID: PMC7661597 DOI: 10.1007/s11606-020-05856-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/13/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Unless implementation of systematic depression screening is associated with timely treatment, quality measures based on screening are unlikely to improve outcomes. OBJECTIVE To assess the impact of integrating systematic depression screening with clinical decision support on depression identification and treatment. DESIGN Retrospective pre-post study. PARTICIPANTS Adults with a primary care visit within a large integrated health system in 2016 were included. Adults diagnosed with depression in 2015 or prior to their initial primary care visit in 2016 were excluded. INTERVENTION Initiation of systematic screening using the Patient Health Questionnaire (PHQ) which began in mid-2016. MAIN MEASURES Depression diagnosis was based on ICD codes. Treatment was defined as (1) antidepressant prescription, (2) referral, or (3) evaluation by a behavioral health specialist. We used an adjusted linear regression model to identify whether the percentage of visits with a depression diagnosis was different before versus after implementation of systematic screening. An adjusted multilevel regression model was used to evaluate the association between screening and odds of treatment. KEY RESULTS Our study population included 259,411 patients. After implementation, 59% of patients underwent screening. Three percent scored as having moderate to severe depression. The rate of depression diagnosis increased by 1.2% immediately after systematic screening (from 1.7 to 2.9%). The percent of patients with diagnosed depression who received treatment within 90 days increased from 64% before to 69% after implementation (p < 0.01) and the adjusted odds of treatment increased by 20% after implementation (AOR 1.20, 95% CI 1.12-1.28, p < 0.01). CONCLUSIONS Implementing systematic depression screening within a large health care system led to high rates of screening and increased rates of depression diagnosis and treatment.
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U.S. Simulation of Lifetime Major Depressive Episode Prevalence and Recall Error. Am J Prev Med 2020; 59:e39-e47. [PMID: 32446751 PMCID: PMC7375917 DOI: 10.1016/j.amepre.2020.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Simulation models can improve measurement and understanding of mental health conditions in the population. Major depressive episodes are a common and leading cause of disability but are subject to substantial recall bias in survey assessments. This study illustrates the application of a simulation model to quantify the full burden of major depressive episodes on population health in the U.S. METHODS A compartmental model of major depressive episodes that explicitly simulates individuals' under-reporting of past episodes was developed and calibrated to 2005-2017 National Surveys on Drug Use and Health data. Parameters for incidence of a first major depressive episode and the probability of under-reporting past episodes were estimated. Analysis was conducted from 2017 to 2019. RESULTS The model estimated that 30.1% of women (95% range: 29.0%-32.5%) and 17.4% of men (95% range: 16.7%-18.8%) have lifetime histories of a major depressive episode after adjusting for recall error. Among all adults, 13.1% of women (95% range: 8.1%-16.5%) and 6.6% of men (95% range: 4.0%-8.3%) failed to report a past major depressive episode. Under-reporting of a major depressive episode history in adults aged >65 years was estimated to be 70%. CONCLUSIONS Simulation models can address knowledge gaps in disease epidemiology and prevention and improve surveillance efforts. This model quantifies the under-reporting of major depressive episodes and provides parameter estimates for future research. After adjusting for under-reporting, 23.9% of adults have a lifetime history of major depressive episodes, which is much higher than based on self-report alone (14.0%). Far more adults would benefit from depression prevention strategies than what survey estimates suggest.
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Steffen A, Thom J, Jacobi F, Holstiege J, Bätzing J. Trends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims data. J Affect Disord 2020; 271:239-247. [PMID: 32479322 DOI: 10.1016/j.jad.2020.03.082] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/21/2020] [Accepted: 03/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies based on health insurance funds unanimously indicate a rise in administrative prevalence of depression, while population surveys with standardized diagnostic procedures do not. We describe recent trends in the prevalence of depressive disorders as diagnosed in routine care from 2009-2017 in Germany. METHODS We used nationwide ambulatory claims data from all residents with statutory health insurance, covering 87% of the total population. Cases were defined as persons with at least one documented diagnosis of depression (ICD-10-GM codes: F32, F33 or F34.1). The administrative prevalence was computed for each year according to age, sex, degree of urbanization and severity of depression diagnosis. RESULTS The prevalence increased from 12.5% in 2009 to 15.7% in 2017 (+26%). Overall, women were twice as likely as men to receive a diagnosis, although the prevalence increased more strongly in men compared to women (+40% vs. +20%). Age- and sex-stratified analyses revealed the highest prevalence increase in adolescents and young men at the ages of 15-19 years (+95%) and 20-25 years (+72%). Rural areas with a low population density showed the highest rise in administrative prevalence (+34%), while big urban municipalities showed the lowest (+25%). LIMITATIONS Administrative claims data rely on diagnoses coded for billing purposes and thus depend on coding practice as well as patients' help seeking behavior. CONCLUSIONS Depressive disorders are of increasing importance in ambulatory health care in Germany. Parts of the increase may be attributed to changing cultural constructions of mental health along with the expansion of mental health care supply.
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Affiliation(s)
- Annika Steffen
- Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi).
| | - Julia Thom
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Frank Jacobi
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Jakob Holstiege
- Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi)
| | - Jörg Bätzing
- Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi)
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12
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Dong L, Kalesnikava VA, Gonzalez R, Mezuk B. Beyond Depression: Estimating 12-Months Prevalence of Passive Suicidal Ideation in Mid- and Late-Life in the Health and Retirement Study. Am J Geriatr Psychiatry 2019; 27:1399-1410. [PMID: 31353189 PMCID: PMC6842696 DOI: 10.1016/j.jagp.2019.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/21/2019] [Accepted: 06/26/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To provide valid estimates of the 12-month prevalence of passive suicidal ideation among older adults, without conditioning on depression status, using the Health and Retirement Study (HRS). METHODS Data come from the 2012 HRS (n = 17,434) and 2004/5 Baltimore Epidemiologic Catchment Area (ECA) Study (n = 755). In the HRS, passive suicidal ideation (i.e., thought a lot about death-your own, someone else's, or death in general) is only assessed on respondents who reported dysphoria/anhedonia; in the ECA, ideation is assessed on all respondents, regardless of depression. We compare two approaches to estimating the 12-month prevalence of passive suicidal ideation in the HRS without conditioning on depression symptoms: 1) a probit selection model within the HRS, and 2) a prediction model developed using appended ECA data applied to the HRS. RESULTS Using observed data alone on those who screened positive for depression, 6% of older adults reported passive suicidal ideation in the past year. Depending on the approach used, between 5.4% and 9.2% of HRS respondents who screened negative for depression would have reported passive suicidal ideation had they been assessed. Correcting for this selection bias, between 10.9% and 13.4% of U.S. adults over age 50 experienced passive suicidal ideation in 2012. CONCLUSIONS Population surveillance of suicidal ideation among older adults is biased by survey approaches that only assess ideation in the context of depression.
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Affiliation(s)
- Liming Dong
- Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI
| | - Viktoryia A Kalesnikava
- Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI
| | - Richard Gonzalez
- Research Center for Group Dynamics (RG, BM), Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychology (RG), University of Michigan, Ann Arbor, MI
| | - Briana Mezuk
- Department of Epidemiology (LD, VK, BM), University of Michigan School of Public Health, Ann Arbor, MI; Research Center for Group Dynamics (RG, BM), Institute for Social Research, University of Michigan, Ann Arbor, MI.
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Trends in working conditions and health across three cohorts of older workers in 1993, 2003 and 2013: a cross-sequential study. BMC Public Health 2019; 19:1376. [PMID: 31655549 PMCID: PMC6815392 DOI: 10.1186/s12889-019-7736-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/09/2019] [Indexed: 11/30/2022] Open
Abstract
Background Over the past decades, the number of older workers has increased tremendously. This study examines trends from 1993 to 2013 in physical, cognitive and psychological functioning among three successive cohorts of Dutch older workers. The contribution of the changes in physical and psychosocial work demands and psychosocial work resources to change in functioning is examined. Insight in health of the older working population, and in potential explanatory variables, is relevant in order to reach sustainable employability. Methods Data from three cohorts (observations in 1993, 2003 and 2013) of the Longitudinal Aging Study Amsterdam (LASA) were used. Individuals aged 55–65 with a paid job were included (N = 1307). Physical functioning was measured using the Timed Chair Stand Test, cognitive functioning by a Coding Task and psychological functioning by the positive affect scale from the CES-D. Working conditions were deduced from a general population job exposure matrix. Linear and logistic regression analyses were performed. Results From 1993 to 2013, time needed to perform the Timed Chair Stand Test increased with 1.3 s (95%CI = 0.89–1.71), to a mean of 11.5 s. Coding Task scores increased with 1.7 points (95%CI = 0.81–2.59), to a mean of 31 points. The proportion of workers with low positive affect increased non-significantly from 15 to 20% (p = 0.088). Only the improvement in cognitive functioning was associated with the change in working conditions. The observed decrease of physically demanding jobs and increase of jobs with higher psychosocial resources explained 8% of the improvement. Conclusions Changes in working conditions may not contribute to improved physical and psychological functioning, but do contribute to improved cognitive functioning to some extent. Further adjustment of physical work demands and psychosocial work resources may help to reach sustainable employability of older workers.
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Schneider KE, Holingue C, Roth KB, Eaton WW. Enduring mental health in the Baltimore epidemiologic catchment area follow-up study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:997-1006. [PMID: 30790027 PMCID: PMC6675629 DOI: 10.1007/s00127-019-01676-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To estimate the prevalence of enduring mental health (EMH) and examine important correlates of EMH 23 years later in the Baltimore Epidemiologic Catchment Area Follow-Up study. METHODS We estimated the prevalence of EMH among 964 adults with diagnostic data at all four study waves (1981-2004). Those with EMH were compared to those with any mental or behavioral disorder by demographic, psychosocial, and health characteristics. We used forward selection models to identify the most important predictors of EMH. RESULTS Twenty-six percent of participants met criteria for enduring mental health across the four waves. Neuroticism, GHQ-20 score, childhood conduct problems, female sex, maternal depression, and poor self-rated health were negatively associated with EMH. CONCLUSIONS We identified several malleable factors associated with a decreased likelihood of enduring mental health. Interventions that target high neuroticism, childhood conduct problems, or maternal depression may increase the likelihood that children achieve EMH later in life. Identifying and treating other factors such as poor self-reported health and greater psychological distress may also keep sub-clinical symptoms from developing into a full mental or behavioral disorder.
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Affiliation(s)
- Kristin E Schneider
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 886, Baltimore, MD, 21205-1999, USA.
| | - Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 886, Baltimore, MD, 21205-1999, USA
| | - Kimberly B Roth
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 886, Baltimore, MD, 21205-1999, USA
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15
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Keyes KM, Gary D, O'Malley PM, Hamilton A, Schulenberg J. Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018. Soc Psychiatry Psychiatr Epidemiol 2019; 54:987-996. [PMID: 30929042 PMCID: PMC7015269 DOI: 10.1007/s00127-019-01697-8] [Citation(s) in RCA: 200] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 03/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Mental health problems and mental health related mortality have increased among adolescents, particularly girls. These trends have implications for etiology and prevention and suggest new and emerging risk factors in need of attention. The present study estimated age, period, and cohort effects in depressive symptoms among US nationally representative samples of school attending adolescents from 1991 to 2018. METHODS Data are drawn from 1991 to 2018 Monitoring the Future yearly cross-sectional surveys of 8th, 10th, and 12th grade students (N = 1,260,159). Depressive symptoms measured with four questions that had consistent wording and data collection procedures across all 28 years. Age-period-cohort effects estimated using the hierarchical age-period-cohort models. RESULTS Among girls, depressive symptoms decreased from 1991 to 2011, then reversed course, peaking in 2018; these increases reflected primarily period effects, which compared to the mean of all periods showed a gradual increase starting in 2012 and peaked in 2018 (estimate = 1.15, p < 0.01). Cohort effects were minimal, indicating that increases are observed across all age groups. Among boys, trends were similar although the extent of the increase is less marked compared to girls; there was a declining cohort effect among recently born cohorts, suggesting that increases in depressive symptoms among boys are slower for younger boys compared to older boys in recent years. Trends were generally similar by race/ethnicity and parental education, with a positive cohort effect for Hispanic girls born 1999-2004. CONCLUSIONS Depressive symptoms are increasing among teens, especially among girls, consistent with increases in depression and suicide. Population variation in psychiatric disorder symptoms highlight the importance of current environmental determinants of psychiatric disorder risk, and provide evidence of emerging risk factors that may be shaping a new and concerning trend in adolescent mental health.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, Suite 724, New York, NY, 10032, USA.
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile.
| | - Dahsan Gary
- Department of Epidemiology, Mailman School of Public Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, Suite 724, New York, NY, 10032, USA
| | - Patrick M O'Malley
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Ava Hamilton
- Department of Epidemiology, Mailman School of Public Health, Mailman School of Public Health, Columbia University, 722 West 168th Street, Suite 724, New York, NY, 10032, USA
| | - John Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology and Center for Growth and Human Development, University of Michigan, Ann Arbor, MI, USA
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Munro CA, Wennberg AM, Bienko N, Eaton WW, Lyketsos CG, Spira AP. Stressful life events and cognitive decline: Sex differences in the Baltimore Epidemiologic Catchment Area Follow-Up Study. Int J Geriatr Psychiatry 2019; 34:1008-1017. [PMID: 30901482 PMCID: PMC6579669 DOI: 10.1002/gps.5102] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 03/17/2019] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The reasons why women are at higher risk than men for developing dementia are unclear. Although studies implicate sex differences in the effect of stress on cognitive functioning, whether stressful life events are associated with subsequent cognitive decline has received scant research attention. METHODS In Wave 3 (1993-1996) of the Baltimore Epidemiologic Catchment Area study, 337 men and 572 women (mean age = 47 years) reported recent (within the last year) and remote (from 1981 until 1 year ago) traumatic events (eg, combat) and stressful life events (eg, divorce/separation). At Waves 3 and 4 (2004-2005), they completed the Mini Mental State Examination (MMSE) and a word-list memory test. Multivariable models were used to examine the association between traumatic and stressful life events at Wave 3 and cognitive change by Wave 4. RESULTS A greater number of recent stressful life events at Wave 3, but not of more remote stressful events, was associated with greater verbal memory decline by Wave 4 in women but not in men. Stressful events were not associated with change in MMSE, and there were no associations between traumatic events occurring at any time and subsequent memory or MMSE decline in either sex. CONCLUSIONS Unlike men, middle-aged women with a greater number of recent stressful life events demonstrate memory decline over a decade later. Sex differences in cognitive vulnerability to stressful life events may underlie women's increased risk of memory impairment in late life, suggesting that stress reduction interventions may help prevent cognitive decline in women.
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Affiliation(s)
- Cynthia A. Munro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | | | - Nicholas Bienko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - William W. Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Constantine G. Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Adam P. Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Johns Hopkins Center on Aging and Health, Baltimore, MD, United States
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Abstract
AIMS Studying birth-cohort differences in depression incidence and their explanatory factors may provide insight into the aetiology of depression and could help to optimise prevention strategies to reduce the worldwide burden of depression. METHODS Data were used from the Longitudinal Aging Study Amsterdam, a nationally representative study among community dwelling older adults in the Netherlands. Cohort differences in depression incidence over a 10-year-period (score ⩾16 on the Center for Epidemiologic Studies Depression scale) were tested using a cohort-sequential-longitudinal-design, comparing two identically measured cohorts of non-depressed 55-64-year-olds, born 10-years apart. Baseline measurements took place in 1992/93 (early cohort, n = 794), and 2002/03 (recent cohort, n = 771). As indicated by the dynamic equilibrium model of depression, potential explanatory factors were distinguished in risk and protective factors. RESULTS The incidence rates for depression in the early and recent cohort were 1.91 (95% confidence interval (CI) 1.59-2.27) and 1.60 (95% CI 1.31-1.94) per 100 person-years, respectively. A 29% risk reduction in depression incidence was observed in the recent cohort (HRcohort: 0.71, 95% CI 0.54-0.92, p = 0.011), as compared with the early cohort, even though average levels of risk factors such as chronic disease and functional limitations had increased. This reduction was primarily explained by increased levels of education, mastery and labour market participation. CONCLUSIONS These findings suggest that favourable developments of protective factors have counterbalanced unfavourable effects of risk factors on the incidence of depression, resulting in a net reduction of depression incidence among young-old adults. However, maintaining a good physical health must be a priority to further decrease depression rates.
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18
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Bretschneider J, Janitza S, Jacobi F, Thom J, Hapke U, Kurth T, Maske UE. Time trends in depression prevalence and health-related correlates: results from population-based surveys in Germany 1997-1999 vs. 2009-2012. BMC Psychiatry 2018; 18:394. [PMID: 30572872 PMCID: PMC6302526 DOI: 10.1186/s12888-018-1973-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/05/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although an "epidemic" of depression is frequently claimed, empirical evidence is inconsistent, depending on country, study design and depression assessment. Little is known about changes in depression over time in Germany, although health insurance companies report frequency increases. Here we examined time trends in depression prevalence, severity and health-related correlates in the general population. METHODS Data were obtained from the mental health module of the "German Health Interview and Examination Survey for Adults" (2009-2012, n = 3265) and the mental health supplement of the "German National Health Interview and Examination Survey 1998" (1997-1999, n = 4176), excluding respondents older than 65. 12-month major depressive disorder (MDD), severity and symptoms were assessed based on the WHO Composite International Diagnostic Interview. Health-related quality of life (SF-36), self-reported sick days or days with limitations in normal daily life activities were examined, too. Calculations were carried out population-weighted. Additional age-standardized analyses were conducted to account for demographic changes. RESULTS Overall, MDD 12-month prevalence remained stable at 7.4%. Women showed a shifted age distribution with increased prevalence at younger ages, and increasing MDD severity. Time trends in health-related correlates occurred both in participants with and without MDD. Mental health disability increased over time, particularly among men with MDD, reflected by the mental component score of the SF-36 and days with activity limitation due to mental health problems. Demographic changes had a marginal impact on the time trends. CONCLUSIONS In contrast to the ongoing international debate regarding increased depression rates in western countries, we found no increase in overall MDD prevalence in Germany over a long period. In conclusion, increased depression frequencies in national health insurance data and growing health care costs associated with depression are not attributable to overall prevalence changes at a population level. However, shifted age distribution and increased severity among women may reflect a rising depression risk within this specific subgroup, and changes in health-related correlates indicate a growing mental health care need for depression, particularly among men.
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Affiliation(s)
- Julia Bretschneider
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Silke Janitza
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Frank Jacobi
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Julia Thom
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Ulfert Hapke
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike E. Maske
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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19
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Teague S, Youssef GJ, Macdonald JA, Sciberras E, Shatte A, Fuller-Tyszkiewicz M, Greenwood C, McIntosh J, Olsson CA, Hutchinson D. Retention strategies in longitudinal cohort studies: a systematic review and meta-analysis. BMC Med Res Methodol 2018; 18:151. [PMID: 30477443 PMCID: PMC6258319 DOI: 10.1186/s12874-018-0586-7] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 10/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participant retention strategies that minimise attrition in longitudinal cohort studies have evolved considerably in recent years. This study aimed to assess, via systematic review and meta-analysis, the effectiveness of both traditional strategies and contemporary innovations for retention adopted by longitudinal cohort studies in the past decade. METHODS Health research databases were searched for retention strategies used within longitudinal cohort studies published in the 10-years prior, with 143 eligible longitudinal cohort studies identified (141 articles; sample size range: 30 to 61,895). Details on retention strategies and rates, research designs, and participant demographics were extracted. Meta-analyses of retained proportions were performed to examine the association between cohort retention rate and individual and thematically grouped retention strategies. RESULTS Results identified 95 retention strategies, broadly classed as either: barrier-reduction, community-building, follow-up/reminder, or tracing strategies. Forty-four of these strategies had not been identified in previous reviews. Meta-regressions indicated that studies using barrier-reduction strategies retained 10% more of their sample (95%CI [0.13 to 1.08]; p = .01); however, studies using follow-up/reminder strategies lost an additional 10% of their sample (95%CI [- 1.19 to - 0.21]; p = .02). The overall number of strategies employed was not associated with retention. CONCLUSIONS Employing a larger number of retention strategies may not be associated with improved retention in longitudinal cohort studies, contrary to earlier narrative reviews. Results suggest that strategies that aim to reduce participant burden (e.g., flexibility in data collection methods) might be most effective in maximising cohort retention.
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Affiliation(s)
- Samantha Teague
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Adrian Shatte
- School of Engineering & Information Technology, Faculty of Science & Technology, Federation University, Melbourne, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - Chris Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - Jennifer McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia. .,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia. .,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia. .,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Dong L, Eaton WW, Spira AP, Agnew J, Surkan PJ, Mojtabai R. Job strain and cognitive change: the Baltimore Epidemiologic Catchment Area follow-up study. Occup Environ Med 2018; 75:856-862. [PMID: 30323011 DOI: 10.1136/oemed-2018-105213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the association between job strain and subsequent cognitive change over approximately 11 years, using data from the population-based Baltimore Epidemiologic Catchment Area follow-up study. METHODS The sample ranged from 555 to 563 participants, depending on the outcome, who reported psychosocial characteristics corresponding to the full-time job they held at baseline (1993-1996). Overall cognitive performance was measured by the Mini-Mental State Examination (MMSE), and verbal memory was measured by the ImmediateWord Recall Task and Delayed Word Recall Task at baseline and follow-up (2004-2005). Multiple linear regression was used to examine the association between job strain and cognitive change, and inverse probability weighting was used to account for differential attrition. RESULTS Participants with high job demands (psychological or physical demands) and/or low job control had greater decrease in the MMSE and memory scores than those with low job demands and high job control. After adjustment for baseline outcome scores, age and sex, the greatest decrease was observed in participants with high job demands and low job control (MMSE: -0.24, 95% CI -0.36 to -0.11; verbal memory scores: -0.26, 95% CI -0.44 to -0.07). The differences were partially explained by sociodemographic characteristics, occupational prestige and health factors. CONCLUSIONS Findings from this prospective study suggest that job strain is associated with and may be a potential modifiable risk factor for adverse cognitive outcomes.
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Affiliation(s)
- Liming Dong
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - William W Eaton
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jacqueline Agnew
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Eaton WW, Bienvenu OJ, Miloyan B. Specific phobias. Lancet Psychiatry 2018; 5:678-686. [PMID: 30060873 PMCID: PMC7233312 DOI: 10.1016/s2215-0366(18)30169-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/21/2018] [Accepted: 04/19/2018] [Indexed: 12/31/2022]
Abstract
Anxiety disorders are among the most prevalent mental disorders, but the subcategory of specific phobias has not been well studied. Phobias involve both fear and avoidance. For people who have specific phobias, avoidance can reduce the constancy and severity of distress and impairment. However, these phobias are important because of their early onset and strong persistence over time. Studies indicate that the lifetime prevalence of specific phobias around the world ranges from 3% to 15%, with fears and phobias concerning heights and animals being the most common. The developmental course of phobias, which progress from fear to avoidance and then to diagnosis, suggests the possibility that interrupting the course of phobias could reduce their prevalence. Although specific phobias often begin in childhood, their incidence peaks during midlife and old age. Phobias persist for several years or even decades in 10-30% of cases, and are strongly predictive of onset of other anxiety, mood, and substance-use disorders. Their high comorbidity with other mental disorders, especially after onset of the phobia, suggests that early treatment of phobias could also alter the risk of other disorders. Exposure therapy remains the treatment of choice, although this approach might be less effective in the long term than previously believed. This Review discusses the literature regarding the prevalence, incidence, course, risk factors, and treatment of specific phobias, and presents epidemiological data from several population-based surveys.
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Affiliation(s)
- William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - O Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Jeuring HW, Comijs HC, Deeg DJH, Stek ML, Huisman M, Beekman ATF. Secular trends in the prevalence of major and subthreshold depression among 55-64-year olds over 20 years. Psychol Med 2018; 48:1824-1834. [PMID: 29198199 DOI: 10.1017/s0033291717003324] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Studying secular trends in the exposure to risk and protective factors of depression and whether these trends are associated with secular trends in the prevalence of depression is important to estimate future healthcare demands and to identify targets for prevention. METHODS Three birth cohorts of 55-64-year olds from the population-based Longitudinal Aging Study Amsterdam were examined using identical methods in 1992 (n = 944), 2002 (n = 964) and 2012 (n = 957). A two-stage screening design was used to identify subthreshold depression (SUBD) and major depressive disorder (MDD). Multinomial logistic regression analyses were used to identify secular trends in depression prevalence and to identify factors from the biopsychosocial domains of functioning that were associated with these trends. RESULTS Compared with 1992, MDD became more prevalent in 2002 (OR 1.90, 95% CI 1.10-3.28, p = 0.022) and 2012 (OR 1.80, 95% CI 1.03-3.14, p = 0.039). This was largely attributable to an increase in the prevalence of chronic diseases and functional limitations. Socioeconomic and psychosocial improvements, including an increase in labor market participation, social support and mastery, hampered MDD rates to rise more and were also associated with a 32% decline of SUBD-rates in 2012 as compared with 2002 (OR 0.68, 95% CI 0.48-0.96, p = 0.03). CONCLUSIONS Among late middle-aged adults, there is a substantial net increase of MDD, which is associated with deteriorating physical health. If morbidity and disability continue to increase, a further expansion of MDD rates may be expected. Improving socioeconomic and psychosocial conditions may benefit public health, as these factors were protective against a higher prevalence of both MDD and SUBD.
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Affiliation(s)
- Hans W Jeuring
- Department of Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Max L Stek
- Department of Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
- Department of Sociology, VU University, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
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The Heavy Cost of Care: Systemic Challenges in Norwegian Work Absenteeism. SOCIAL SCIENCES-BASEL 2018. [DOI: 10.3390/socsci7060094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Haigh EAP, Bogucki OE, Sigmon ST, Blazer DG. Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions. Am J Geriatr Psychiatry 2018; 26:107-122. [PMID: 28735658 DOI: 10.1016/j.jagp.2017.06.011] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 12/16/2022]
Abstract
Is depression among older adults symptomatically different than younger adults? Is it more common or chronic or difficult to treat? Is depression in late life more likely to be attributed to psychological problems? Twenty-years ago, Dan Blazer, a pioneer known for his groundbreaking work on depression in older adulthood, conducted an important review of the existing literature to refute five commonly held beliefs about depression in late life. Now, two decades later, we call upon selected articles that are representative of our current knowledge to provide an update and identify research priorities. The research consensus spanning the past 20 years suggests that when compared with their younger counterparts, depression in older adults is not more common and is not more often caused by psychological factors. Although some studies have suggested that depression in late life may be symptomatically different and characterized by a more somatic presentation, there is insufficient empirical evidence to conclude that depression presents differently across adulthood. Overall, older adults respond to psychological interventions as well as younger adults, although evidence suggests that antidepressants are less efficacious in late life. Finally, compared with middle-aged adults, depression in older adults is associated with a more chronic course (i.e., higher rate of relapse), which is likely moderated by medical comorbidity. This special article summarizes our current understanding of the nature and treatment of late-life depression and highlights areas of inquiry in need of further study.
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Dessotte CAM, Silva FS, Furuya RK, Ciol MA, Hoffman JM, Dantas RAS. Somatic and cognitive-affective depressive symptoms among patients with heart disease: differences by sex and age. Rev Lat Am Enfermagem 2017; 23:208-15. [PMID: 26039290 PMCID: PMC4458993 DOI: 10.1590/0104-1169.0287.2544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 10/26/2014] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE: this study investigated the association of somatic and cognitive-affective
symptoms with sex and age, among patients hospitalized with heart disease. METHOD: this study was a secondary analysis of two previous observational studies
totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two
public hospitals in Ribeirão Preto, state of São Paulo, Brazil. Somatic and
cognitive-affective symptoms were assessed using the subscales of the Beck
Depression Inventory - I (BDI-I). RESULTS: of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0) for
males and 56.2 years (SD= 12.1) for females. Analyses of variance showed an effect
of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms), but
no effect of age. Women presented with higher mean values than men in both BDI-I
subscales: 7.1 (4.5) vs. 5.4 (4.3) for somatic, and 8.3 (7.9) vs. 6.7 (7.2) for
cognitive-affective symptoms. There were no differences by age for somatic
(p=0.84) or cognitive-affective symptoms (p=0.84). CONCLUSION: women hospitalized with heart disease had more somatic and cognitive-affective
symptoms than men. We found no association of somatic and cognitive-affective
symptoms with age. Future research for these patients could reveal whether these
differences according to sex continue throughout the rehabilitation process.
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Affiliation(s)
| | - Fernanda Souza Silva
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rejane Kiyomi Furuya
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcia Aparecida Ciol
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, United States
| | - Jeanne Marie Hoffman
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, United States
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Tanaka T, Matsuda T, Hayes LN, Yang S, Rodriguez K, Severance EG, Yolken RH, Sawa A, Eaton WW. Infection and inflammation in schizophrenia and bipolar disorder. Neurosci Res 2016; 115:59-63. [PMID: 27856235 DOI: 10.1016/j.neures.2016.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/02/2016] [Accepted: 11/10/2016] [Indexed: 12/18/2022]
Abstract
The present study investigated the relationship between exposure to infectious agents and inflammation markers in individuals with schizophrenia (SZ), bipolar disorder (BP), and controls without a psychiatric disorder. We measured plasma levels of antibodies and innate immune markers and correlated them with clinical symptoms and cognitive function. In both SZ and BP, we found an increase in soluble CD14, and in BP an increase in C-reactive protein, IgM class antibodies against cytomegalovirus (CMV), and IgG class antibodies against herpes simplex virus 2. Furthermore in BP, we observed a negative relationship between IgG antibodies against CMV and scores for cognitive function.
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Affiliation(s)
- Teppei Tanaka
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Taro Matsuda
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Lindsay N Hayes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Shuojia Yang
- Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Katrina Rodriguez
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Emily G Severance
- Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Robert H Yolken
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
| | - William W Eaton
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
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Mental disorder and long-term risk of mortality: 41 years of follow-up of a population sample in Stockholm, Sweden. Epidemiol Psychiatr Sci 2016; 25:384-92. [PMID: 26028123 PMCID: PMC7137603 DOI: 10.1017/s2045796015000487] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND An increased mortality risk associated with mental disorder has been reported for patients, but there are few studies are based on random samples with interview-based psychiatric diagnoses. Part of the increased mortality for those with mental disorder may be attributable to worse somatic health or hazardous health behaviour - consequences of the disorder - but somatic health information is commonly lacking in psychiatric samples. This study aims to examine long-term mortality risk for psychiatric diagnoses in a general population sample and to assess mediation by somatic ill health and hazardous health behaviour. METHOD We used a double-phase stratified random sample of individuals aged 18-65 in Stockholm County 1970-1971 linked to vital records. First phase sample was 32 186 individuals screened with postal questionnaire and second phase was 1896 individuals (920 men and 976 women) that participated in a full-day examination (participation rate 88%). Baseline examination included both a semi-structured interview with a psychiatrist, with mental disorders set according to the 8th version of the International Classification of Disease (ICD-8), and clinical somatic examination, including measures of body composition (BMI), hypertension, fasting blood glucose, pulmonary function and self-reported tobacco smoking. Information on vital status was obtained from the Total Population Register for the years 1970-2011. Associations with mortality were studied with Cox proportional hazard analyses. RESULTS A total of 883 deaths occurred among the participants during the 41-year follow-up. Increased mortality rates were found for ICD-8 functional psychoses (hazard ratio, HR = 2.22, 95% confidence interval (95% CI): 1.15-4.30); psycho-organic symptoms (HR = 1.94, 95% CI: 1.31-2.87); depressive neuroses (HR = 1.71, 95% CI: 1.23-2.39); alcohol use disorder (HR = 1.91, 95% CI: 1.40-2.61); drug dependence (HR = 3.71, 95% CI: 1.80-7.65) and psychopathy (HR = 2.88, 95% CI: 1.02-8.16). Non-participants (n = 349) had mortality rates similar to participants (HR = 0.98, 95% CI: 0.81-1.18). In subgroup analyses of those with psychoses, depression or alcohol use disorder, adjusting for the potential mediators smoking and pulmonary function, showed only slight changes in the HRs. CONCLUSIONS This study confirms the increased risk of mortality for several psychiatric diagnoses in follow-up studies on American, Finnish and Swedish population-based samples. Only a small part of the increased mortality hazard was attributable to differences in somatic health or hazardous health behaviour measured at baseline.
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Donnelly TT, Al Suwaidi JM, Al-Qahtani A, Asaad N, Fung T, Singh R, Qader NA. Mood disturbance and depression in Arab women following hospitalisation from acute cardiac conditions: a cross-sectional study from Qatar. BMJ Open 2016; 6:e011873. [PMID: 27388362 PMCID: PMC4947790 DOI: 10.1136/bmjopen-2016-011873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Depression is associated with increased morbidity and mortality rates among cardiovascular patients. Depressed patients have three times higher risk of death than those who are not. We sought to determine the presence of depressive symptoms, and whether gender and age are associated with depression among Arab patients hospitalised with cardiac conditions in a Middle Eastern country. SETTING Using a non-probability convenient sampling technique, a cross-sectional survey was conducted with 1000 Arab patients ≥20 years who were admitted to cardiology units between 2013 and 2014 at the Heart Hospital in Qatar. Patients were interviewed 3 days after admission following the cardiac event. Surveys included demographic and clinical characteristics, and the Arabic version of the Beck Depression Inventory Second Edition (BDI-II). Depression was assessed by BDI-II clinical classification scale. RESULTS 15% of the patients had mild mood disturbance and 5% had symptoms of clinical depression. Twice as many females than males suffered from mild mood disturbance and clinical depression symptoms, the majority of females were in the age group 50 years and above, whereas males were in the age group 40-49 years. χ(2) Tests and multivariate logistic regression analyses indicated that gender and age were statistically significantly related to depression (p<0.001 for all). CONCLUSIONS Older Arab women are more likely to develop mood disturbance and depression after being hospitalised with acute cardiac condition. Gender and age differences approach, and routine screening for depression should be conducted with all cardiovascular patients, especially for females in the older age groups. Mental health counselling should be available for all cardiovascular patients who exhibit depressive symptoms.
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Affiliation(s)
- Tam Truong Donnelly
- Faculty of Nursing and Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jassim Mohd Al Suwaidi
- Department of Adult Cardiology, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
| | - Awad Al-Qahtani
- Department of Adult Cardiology, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
| | - Nidal Asaad
- Department of Adult Cardiology, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
| | - Tak Fung
- University of Calgary, Math/Information Technology, Calgary, Alberta, Canada
| | - Rajvir Singh
- Hamad Medical Corporation, Hamad General Hospital, Research Center/Adult Cardiology, Doha, Qatar
| | - Najlaa Abdul Qader
- Department of Psychiatry, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar
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Williams LJ, Pasco JA, Jackson H, Kiropoulos L, Stuart AL, Jacka FN, Berk M. Depression as a risk factor for fracture in women: A 10 year longitudinal study. J Affect Disord 2016; 192:34-40. [PMID: 26706830 DOI: 10.1016/j.jad.2015.11.048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/25/2015] [Accepted: 11/28/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous research has demonstrated deficits in bone mineral density (BMD) among individuals with depression. While reduced BMD is a known risk for fracture, a direct link between depression and fracture risk is yet to be confirmed. METHODS A population-based sample of women participating in the Geelong Osteoporosis Study was studied using both nested case-control and retrospective cohort study designs. A lifetime history of depression was identified using a semi-structured clinical interview (SCID-I/NP). Incident fractures were identified from radiological reports and BMD was measured at the femoral neck using dual energy absorptiometry. Anthropometry was measured and information on medication use and lifestyle factors was obtained via questionnaire. RESULTS Among 179 cases with incident fracture and 914 controls, depression was associated with increased odds of fracture (adjusted odds ratio (OR) 1.57, 95%CI 1.04-2.38); further adjustment for psychotropic medication use appeared to attenuate this association (adjusted OR 1.52, 95%CI 0.98-2.36). Among 165 women with a history of depression at baseline and 693 who had no history of depression, depression was associated with a 68% increased risk of incident fracture (adjusted hazard ratio (HR) 1.68, 95%CI 1.02-2.76), with further adjustment for psychotropic medication use also appearing to attenuate this association (adjusted HR 1.58, 95%CI 0.95-2.61). LIMITATIONS Potential limitations include recall bias, unrecognised confounding and generalizability. CONCLUSIONS This study provides both cross-sectional and longitudinal evidence to suggest that clinical depression is a risk factor for radiologically-confirmed incident fracture, independent of a number of known risk factors. If there is indeed a clinically meaningful co-morbidity between mental and bone health, potentially worsened by psychotropic medications, the issue of screening at-risk populations needs to become a priority.
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Affiliation(s)
- Lana J Williams
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, Australia.
| | - Julie A Pasco
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, Australia; The University of Melbourne, Department of Medicine, St Albans, Australia.
| | - Henry Jackson
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia.
| | - Litza Kiropoulos
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia; Royal Melbourne Hospital, Psychology Department, Australia.
| | - Amanda L Stuart
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, Australia.
| | - Felice N Jacka
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, Australia; The University of Melbourne, Department of Psychiatry, Parkville, Australia.
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, Australia; The University of Melbourne, Department of Psychiatry, Parkville, Australia; The University of Melbourne, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia; The University of Melbourne, Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.
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The epidemiology of common mental disorders from age 20 to 50: results from the prospective Zurich cohort Study. Epidemiol Psychiatr Sci 2016; 25:24-32. [PMID: 25802979 PMCID: PMC6998675 DOI: 10.1017/s204579601500027x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND There are only a small number of prospective studies that have systematically evaluated standardised diagnostic criteria for mental disorder for more than a decade. The aim of this study is to present the approximated overall and sex-specific cumulative incidence of mental disorder in the Zurich cohort study, a prospective cohort study of 18-19 years olds from the canton of Zurich, Switzerland, who were followed through age 50. METHOD A stratified sample of 591 participants were interviewed with the Structured Psychopathological Interview and Rating of the Social Consequences of Psychological Disturbances for Epidemiology, a semi-structured interview that uses a bottom-up approach to assess the past-year presence of 15 psychiatric syndromes. Seven interview waves took place between 1979 and 2008. Approximated cumulative incidence was estimated using Kaplan-Meier methods. RESULTS Rates of mental disorder were considerably higher than those generally reported in cross-sectional surveys. We found rates ranging from 32.5% for major depressive disorder to 1.2% for Bipolar I disorder. The cumulative probability of experiencing any of the mental disorders assessed by age 50 was 73.9%, the highest reported to date. We also found that rates differed by sex for most disorders, with females generally reporting higher rates of mood, anxiety and phobic disorder, and males reporting higher rates of substance- and alcohol-related disorders. CONCLUSIONS These findings confirm those of other long-term prospective studies that indicate the nearly universal nature of disturbances of emotion and behaviour across the life span. Greater community awareness of the normative nature of these experiences is warranted. An important area of future research is study long-term course and stability to determine who among those with such disturbances suffer from chronic disabling mental disorders. Such longitudinal studies may aid in directing services and intervention efforts where they are most needed.
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The persisting burden of psychiatric disorder. Epidemiol Psychiatr Sci 2016; 25:35-7. [PMID: 26515474 PMCID: PMC6998765 DOI: 10.1017/s2045796015000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kendrick T, Stuart B, Newell C, Geraghty AWA, Moore M. Changes in rates of recorded depression in English primary care 2003-2013: Time trend analyses of effects of the economic recession, and the GP contract quality outcomes framework (QOF). J Affect Disord 2015; 180:68-78. [PMID: 25881283 DOI: 10.1016/j.jad.2015.03.040] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/16/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Depression may be increasing, particularly since the economic recession. Introduction of quality outcomes framework (QOF) performance indicators may have altered GP recording of depression. METHODS Time trend analyses of GP recording of depression before and after the recession (from April 2008), and the QOF (from April 2006) were conducted on anonymised consultation data from 142 English practices contributing to the Clinical Practice Research Datalink, April 2003-March 2013. RESULTS 293,596 patients had computer codes for depressive diagnoses or symptoms in the 10 years. Prevalence of depression codes fell from 44.6 (95% CI 44.2, 45.0) per 1000 person years at risk (PYAR) in 2003/2004 to 38.0 (37.7, 38.3) in 2008/2009, rising to 39.5 (39.2, 39.9) in 2012/2013. Incidence of first-ever depression codes fell from 11.9 (95% CI 11.7, 12.1) per 1000 PYAR in 2003/2004 to 9.5 (9.3, 9.7) in 2008/2009, rising to 10.0 (9.8, 10.2) in 2012/1203. Prevalence increased in men but not women following the recession, associated with increased unemployment. Following introduction of the QOF, GPs used more non-QOF-qualifying symptom or other codes than QOF-qualifying diagnostic codes for new episodes. LIMITATIONS Clinical data recording is probably incomplete. Participating practices were relatively large and not representative across English regions. CONCLUSIONS Rates of recorded depression in English general practices were falling prior to the economic recession but increased again subsequently, among men, associated with increased unemployment. GPs responded to the QOF by switching from diagnostic to symptom codes, removing most depressed patients from the denominator for measuring GP performance in assessing depression.
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Affiliation(s)
- Tony Kendrick
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK.
| | - Beth Stuart
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK
| | - Colin Newell
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK
| | - Adam W A Geraghty
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK
| | - Michael Moore
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK
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Sharifi V, Eaton WW, Wu LT, Roth KB, Burchett BM, Mojtabai R. Psychotic experiences and risk of death in the general population: 24-27 year follow-up of the Epidemiologic Catchment Area study. Br J Psychiatry 2015; 207:30-6. [PMID: 25953893 PMCID: PMC4486819 DOI: 10.1192/bjp.bp.113.143198] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 11/24/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Psychotic experiences are common in the general population and are associated with adverse psychiatric and social outcomes, even in the absence of a psychotic disorder. AIMS To examine the association between psychotic experiences and mortality over a 24-27 year period. METHOD We used data on 15 049 adult participants from four sites of the Epidemiologic Catchment Area baseline survey in the USA in the early 1980s, linked to the National Death Index and other sources of vital status up until 2007. Psychotic experiences were assessed by the Diagnostic Interview Schedule. RESULTS Lifetime psychotic experiences at baseline (n = 855; weighted prevalence, 5.5%) were significantly associated with all-cause mortality at follow-up after adjustment for sociodemographic characteristics and psychiatric diagnoses, including schizophrenia spectrum disorders (P<0.05). Baseline psychotic experiences were associated with over 5 years' shorter median survival time. Among the underlying causes of death, suicide had a particularly high hazard ratio (9.16, 95% CI 3.19-26.29). CONCLUSIONS Future research needs to explore the association of psychotic experiences with physical health and lifestyle factors that may mediate the relationship of psychotic experiences with mortality.
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Affiliation(s)
- Vandad Sharifi
- Vandad Sharifi, MD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA and Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; William W. Eaton, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Li Tzy Wu, ScD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Kimberly B. Roth, MHS, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Bruce M. Burchett, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina; Ramin Mojtabai, MD, PhD, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Théaudin M, Romero K, Feinstein A. In multiple sclerosis anxiety, not depression, is related to gender. Mult Scler 2015; 22:239-44. [DOI: 10.1177/1352458515588582] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/11/2015] [Indexed: 01/21/2023]
Abstract
Background: There is a high prevalence of depressive and anxiety disorders in multiple sclerosis (MS), a disease 2.5 times more frequent in females. Contrary to the general population, in whom studies have demonstrated higher rates of depression and anxiety in females, little is known about the impact of gender on psychiatric sequelae in MS patients. Objectives: We conducted a retrospective study to try to clarify this uncertainty. Methods: Demographic, illness-related and behavioral variables were obtained from a neuropsychiatric database of 896 patients with a confirmed diagnosis of MS. Symptoms of depression and anxiety were obtained with the Hospital Anxiety and Depression Scale (HADS). Gender comparisons were undertaken and predictors of depression and anxiety sought with a linear regression analysis. Results: HADS data were available for 711 of 896 (79.35%) patients. Notable gender differences included a higher frequency of primary progressive MS in males ( p = 0.002), higher HADS anxiety scores in females ( p < 0.001), but no differences in HADS depression scores. Conclusion: In MS, gender influences the frequency of anxiety only. This suggests that the etiological factors underpinning anxiety and depression in MS are not only different from one another, but also in the case of depression, different from those observed in general population samples.
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Affiliation(s)
- Marie Théaudin
- Sunnybrook Health Sciences Centre, Canada/MS Clinic Saint Michael’s Hospital, Canada
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Takayanagi Y, Spira AP, McIntyre RS, Eaton WW. Sex hormone binding globulin and verbal memory in older men. Am J Geriatr Psychiatry 2015; 23:253-60. [PMID: 23800538 PMCID: PMC3785559 DOI: 10.1016/j.jagp.2013.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 10/17/2012] [Accepted: 01/14/2013] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Cognitive function in older adults may be affected by multiple factors, such as sex hormone levels, metabolic disturbances, and neuropsychiatric illness. However, relatively few studies have tested the associations between these factors and cognitive function in a single sample. A cross-sectional analysis was conducted to examine the association between sex hormones, metabolic parameters, and psychiatric diagnoses with verbal memory in nondemented older men. METHODS Participants were 112 men (mean age: 61.3 years) from the Baltimore Epidemiologic Catchment Area Follow-Up Study who completed measures of blood sex hormone levels, metabolic parameters (e.g., lipid profiles), and verbal memory. RESULTS Higher levels of serum sex hormone binding globulin (SHBG) were associated with lower delayed verbal memory scores (standardized coefficients [beta]=-0.19, t=-2.07, df=1, 105, p=0.04), and higher body mass index (BMI) was associated with better immediate (beta=0.21, t=2.41, df=1,105, p=0.02) and delayed (beta=0.22, t=2.46, df=1,105, p=0.02) verbal memory performance after adjustment for age, education, and psychiatric disorders. There was an inverse correlation between SHBG levels and BMI (Pearson's r=-0.37, N=112, p<0.001). Estimated free testosterone levels revealed curvilinear associations with verbal memory performance. CONCLUSION Our data suggest that higher SHBG levels are associated with worse verbal memory, whereas a higher BMI is associated with better verbal memory in older men. Higher SHBG levels due to lower adiposity may be a risk factor for cognitive dysfunction. The mechanisms linking SHBG to cognitive function have yet to be elucidated.
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Affiliation(s)
- Yoichiro Takayanagi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Takayanagi Y, Spira AP, Bienvenu OJ, Hock RS, Carras MC, Eaton WW, Mojtabai R. Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiologic Catchment Area Study. J Clin Psychiatry 2015; 76:40-4. [PMID: 25188822 PMCID: PMC4504011 DOI: 10.4088/jcp.13m08824] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 02/13/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Past studies have shown that many individuals who use antidepressants have no current or lifetime history of mental disorders. However, recent studies suggest that the one-time retrospective evaluation of mental disorders commonly used in such studies may substantially underestimate the true lifetime prevalence of mental disorders. We examined the prevalence of mental disorders, assessed prospectively over multiple interviews, among individuals currently using antidepressants in a community sample. METHOD Using data from the Baltimore Epidemiologic Catchment Area (ECA) Study Wave 1 (1981) through Wave 4 (2004-2005) (N = 1,071), we assessed lifetime prevalence of common mood and anxiety disorders according to DSM-III and DSM-III-R criteria, based on 4 interviews, among participants who reported current antidepressant use. Furthermore, we examined factors associated with current antidepressant use. RESULTS Thirteen percent of participants at Wave 4 reported currently using antidepressant medications. Among antidepressant users, 69% never met criteria for major depressive disorder (MDD); and 38% never met criteria for MDD, obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder in their lifetime. Female gender, Caucasian ethnicity, recent or current physical problems (eg, loss of bladder control, hypertension, and back pain), and recent mental health facility visits were associated with antidepressant use in addition to mental disorders. CONCLUSIONS Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.
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Affiliation(s)
- Yoichiro Takayanagi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205 ;
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Ringqvist Å, Bech P, Glenthøj B, Petersen E. Acute and long-term psychiatric side effects of mefloquine: a follow-up on Danish adverse event reports. Travel Med Infect Dis 2014; 13:80-8. [PMID: 25435322 DOI: 10.1016/j.tmaid.2014.10.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 10/21/2014] [Accepted: 10/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of the study was to explore the profile of acute and long-term psychiatric side effects associated with mefloquine. METHODS Subjects (n = 73) reported to a Danish national register during five consecutive years for mefloquine associated side effects were included. Acute psychiatric side effects were retrospectively assessed using the SCL-90-R and questions based on Present State Examination (PSE). Subjects reporting suspected psychotic states were contacted for a personal PSE interview. Electronic records of psychiatric hospitalizations and diagnoses were cross-checked. Long-term effects were evaluated with SF-36. SCL-90-R and SF-36 data were compared to age- and gender matched controls. RESULTS In the SCL-90-R, clinically significant scores for anxiety, phobic anxiety and depression were found in 55%, 51%, and 44% of the mefloquine group. Substantial acute phase psychotic symptoms were found in 15% and were time-limited. Illusions/hallucinations were more frequently observed among women. Cases of hypomania/mania in the acute phase were 5.5%. Significant long-term mental health effects were demonstrated for the SF-36 subscales mental health (MH), role emotional (RE), and vitality (VT) in the mefloquine group compared to matched controls. CONCLUSION The most frequent acute psychiatric problems were anxiety, depression, and psychotic symptoms. Data indicated that subjects experiencing acute mefloquine adverse side effects may develop long-term mental health problems with a decreased sense of global quality of life with lack of energy, nervousness, and depression.
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Affiliation(s)
- Åsa Ringqvist
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Pain Rehabilitation, Skane University Hospital, Lund, Sweden.
| | - Per Bech
- Psychiatric Center North Zealand, Psychiatric Research Unit, University of Copenhagen, Hillerød, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Birte Glenthøj
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Center Glostrup, Denmark
| | - Eskild Petersen
- Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark
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Brown QL, Linton SL, Harrell PT, Mancha BE, Alexandre PK, Chen KF, Eaton WW. The influence of religious attendance on smoking. Subst Use Misuse 2014; 49:1392-9. [PMID: 24827865 PMCID: PMC4144863 DOI: 10.3109/10826084.2014.912224] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Generalized linear models were used to assess the relationship between religious attendance and lifetime smoking status among middle-aged adults (n = 666) sampled from waves three (1993 to 1996) and four (2004 to 2005) of the Baltimore Epidemiologic Catchment Area (ECA) study. Religious attendance once per week or greater as compared to never was inversely associated with smoking status. Future research should explore potential mediating factors of the association between religious attendance and smoking among middle-aged adults in order to gain a greater understanding of the mechanisms underlying this relationship. FUNDING NIMH grant DA026652; NIDA grant T32DA007292.
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Affiliation(s)
- Qiana L Brown
- 1Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Aouizerate B, Gouzien C, Doumy O, Philip P, Semal C, Demany L, Piazza PV, Cota D. Toward a new computer-based and easy-to-use tool for the objective measurement of motivational states in humans: a pilot study. BMC Psychol 2014. [DOI: 10.1186/s40359-014-0023-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Longitudinal associations of obesity with affective disorders and suicidality in the Baltimore epidemiologic catchment area follow-up study. J Nerv Ment Dis 2014; 202:379-85. [PMID: 24727724 DOI: 10.1097/nmd.0000000000000135] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our aim was to examine the longitudinal associations between obesity and mental health variables (psychiatric diagnoses and suicidal behaviors). Data were from waves 3 and 4 of the Baltimore Epidemiologic Catchment Area study (N = 1071). Participants were aged 30 to 86 years at wave 3 (mean, 47.6 years; SD, 12.8). The prevalence of obesity increased from 27.6% to 39.1% during the follow-up. Logistic regression analyses revealed no associations between baseline obesity and onset of mental disorders or suicidal behaviors between waves 3 and 4 in fully adjusted models; however, baseline obesity predicted new-onset suicide attempts in models adjusted for sociodemographics and mental disorders. Baseline depression predicted weight gain during the 11-year follow-up period (F = 4.014, p < 0.05), even after controlling for important confounders. Overall, most mental health variables were not associated with obesity, suggesting that clinicians and others should be wary of "weight-ism" and avoid making the assumption that higher body weight relates to mental health problems.
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Kidwai R, Mancha BE, Brown QL, Eaton WW. The effect of spirituality and religious attendance on the relationship between psychological distress and negative life events. Soc Psychiatry Psychiatr Epidemiol 2014; 49:487-97. [PMID: 23732707 PMCID: PMC4157065 DOI: 10.1007/s00127-013-0723-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/25/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to assess the effect of religious attendance and spirituality on the relationship between negative life events and psychological distress. METHODS This was a cross-sectional study of 1,071 community dwelling adults from East Baltimore, Maryland who participated in the fourth (2004-2005) wave of the Baltimore Epidemiologic Catchment Area study. The 20-item General Health Questionnaire (GHQ-20) was used to measure psychological distress. Multiple regression models were used to assess the association between negative life events and distress as well as to measure the effect of religious attendance and spirituality on the association between psychological distress and negative events while adjusting for demographic variables, past distress and social support from friends and relatives. RESULTS In pooled analysis, negative events were significant predictors of distress, b = 1.00, β = 0.072, p < 0.05. Religious attendance and spirituality did not affect or modify the association between negative events and distress. However, religious attendance was inversely associated with distress with higher frequency of attendance associated with lower distress after controlling for demographic and social support factors, b = -2.10, β = -.110, p < 0.01 for attending 1-3 times a month; b = -2.39, β = -0.156, p < 0.01 for attending weekly; and b = -3.13, β = -0.160, p < 0.001 for attending more than once per week. In stratified analysis, negative events were associated with distress for those who were low on spirituality, b = 1.23, β = 0.092, p < .05, but not for those who were high on spirituality; the association between religious attendance and decreased distress was true only for those scoring high in spirituality. Social support accounted for some of the inverse association between religious and distress. CONCLUSION Religious attendance and spirituality may play a role in how people experience and deal with difficult life situations.
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Affiliation(s)
- Rubeena Kidwai
- College of Management Sciences, PAF-KIET, Main Campus, Korangi Creek, Karachi, Pakistan,
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Takayanagi Y, Spira AP, Roth KB, Gallo JJ, Eaton WW, Mojtabai R. Accuracy of reports of lifetime mental and physical disorders: results from the Baltimore Epidemiological Catchment Area study. JAMA Psychiatry 2014; 71:273-80. [PMID: 24402003 PMCID: PMC4135054 DOI: 10.1001/jamapsychiatry.2013.3579] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Our understanding of how mental and physical disorders are associated and contribute to health outcomes in populations depends on accurate ascertainment of the history of these disorders. Recent studies have identified substantial discrepancies in the prevalence of mental disorders among adolescents and young adults depending on whether the estimates are based on retrospective reports or multiple assessments over time. It is unknown whether such discrepancies are also seen in midlife to late life. Furthermore, no previous studies have compared lifetime prevalence estimates of common physical disorders such as diabetes mellitus and hypertension ascertained by prospective cumulative estimates vs retrospective estimates. OBJECTIVE To examine the lifetime prevalence estimates of mental and physical disorders during midlife to late life using both retrospective and cumulative evaluations. DESIGN, SETTING, AND PARTICIPANTS Prospective population-based survey (Baltimore Epidemiologic Catchment Area Survey) with 4 waves of interviews of 1071 community residents in Baltimore, Maryland, between 1981 and 2005. MAIN OUTCOMES AND MEASURES Lifetime prevalence of selected mental and physical disorders at wave 4 (2004-2005), according to both retrospective data and cumulative evaluations based on 4 interviews from wave 1 to wave 4. RESULTS Retrospective evaluations substantially underestimated the lifetime prevalence of mental disorders as compared with cumulative evaluations. The respective lifetime prevalence estimates ascertained by retrospective and cumulative evaluations were 4.5% vs. 13.1% for major depressive disorder, 0.6% vs. 7.1% for obsessive-compulsive disorder, 2.5% vs. 6.7% for panic disorder, 12.6% vs. 25.3% for social phobia, 9.1% vs. 25.9% for alcohol abuse or dependence, and 6.7% vs. 17.6% for drug abuse or dependence. In contrast, retrospective lifetime prevalence estimates of physical disorders ascertained at wave 4 were much closer to those based on cumulative data from all 4 waves. The respective prevalence estimates ascertained by the 2 methods were 18.2% vs. 20.2% for diabetes, 48.4% vs. 55.4% for hypertension, 45.8% vs. 54.0% for arthritis, 5.5% vs. 7.2% for stroke, and 8.4% vs. 10.5% for cancer. CONCLUSIONS AND RELEVANCE One-time, cross-sectional population surveys may consistently underestimate the lifetime prevalence of mental disorders. The population burden of mental disorders may therefore be substantially higher than previously appreciated.
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Affiliation(s)
- Yoichiro Takayanagi
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Adam P. Spira
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Kimberly B. Roth
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Joseph J. Gallo
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - William W. Eaton
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Ramin Mojtabai
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
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Nuttbrock L, Bockting W, Rosenblum A, Hwahng S, Mason M, Macri M, Becker J. Gender abuse and major depression among transgender women: a prospective study of vulnerability and resilience. Am J Public Health 2013; 104:2191-8. [PMID: 24328655 DOI: 10.2105/ajph.2013.301545] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the social and interpersonal context of gender abuse and its effects on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depression among transgender women. METHODS We conducted a 3-year prospective study (2004-2007) among 230 transgender women aged 19 to 59 years from the New York City Metropolitan Area. Statistical techniques included generalized estimating equations (logistic regression). RESULTS We observed significant associations of psychological and physical gender abuse with major depression during follow-up. New or persistent experiences of both types of abuse were associated with 4- to 7-fold increases in the likelihood of incident major depression. Employment, transgender presentation, sex work, and hormone therapy correlated across time with psychological abuse; the latter 2 variables correlated with physical abuse. The association of psychological abuse with depression was stronger among younger than among older transgender women. CONCLUSIONS Psychological and physical gender abuse is endemic in this population and may result from occupational success and attempts to affirm gender identity. Both types of abuse have serious mental health consequences in the form of major depression. Older transgender women have apparently developed some degree of resilience to psychological gender abuse.
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Affiliation(s)
- Larry Nuttbrock
- At the time of this research, Larry Nuttbrock, Andrew Rosenblum, Sel Hwahng, Mona Mason, Monica Macri, and Jeffrey Becker were with the National Development and Research Institutes, New York, NY. Walter Bockting was with the Division of Gender, Sexuality and Health, New York State Psychiatric Institute, Columbia University, New York, NY
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Lee HB, Offidani E, Ziegelstein RC, Bienvenu OJ, Samuels J, Eaton WW, Nestadt G. Five-factor model personality traits as predictors of incident coronary heart disease in the community: a 10.5-year cohort study based on the Baltimore epidemiologic catchment area follow-up study. PSYCHOSOMATICS 2013; 55:352-361. [PMID: 24751113 DOI: 10.1016/j.psym.2013.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 11/11/2013] [Accepted: 11/19/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Certain personality and behavioral traits (e.g., type A and type D) have been reported to be associated with development and progression of coronary heart disease (CHD), but few have examined the relationship using a comprehensive assessment of personality along with a structured assessment of psychiatric disorders. METHODS Based on participants (age: 47.3 ± 12.8; female: 62.6%) of the Baltimore Epidemiologic Catchment Area follow-up study, we examined the relationship between the 5 major domains of personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and incident CHD between Wave III (1993-1996) and Wave IV (2004-2005). RESULTS Incident CHD developed in 65 participants during the follow-up. Those with incident CHD had lower on openness (44.06 ± 9.29 vs. 47.18 ± 8.80; p = 0.007) and extraversion (45.98 ± 9.25 vs. 49.12 ± 8.92; p = 0.007) scores than those without. Logistic regression models revealed an inverse association (OR = 0.73; 95% CI = 0.54-0.98) between openness factor z-scores and incident CHD after adjusting for putative confounding factors, including DSM III-R Major Depressive Disorder. CONCLUSION High openness appears to be an independent protective factor for incident CHD in the community. Future studies should examine behavioral and pathophysiologic mechanisms underlying this association.
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Affiliation(s)
| | | | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Oscar Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Mental Health, the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - William W Eaton
- Department of Mental Health, the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Mental Health, the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Wiberg P, Waern M, Billstedt E, Ostling S, Skoog I. Secular trends in the prevalence of dementia and depression in Swedish septuagenarians 1976-2006. Psychol Med 2013; 43:2627-2634. [PMID: 23480822 DOI: 10.1017/s0033291713000299] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is not clear whether the prevalence of dementia and depression among the elderly has changed during the past 30 years. METHOD Population-based samples from Gothenburg, Sweden were examined with identical psychiatric and neuropsychiatric examinations at age 70 years in 1976-1977 (n = 404, response rate 78.8%) and 2000-2001 (n = 579, response rate 66.4%), and at age 75 in 1976-1977 (n = 303, response rate 78%) and 2005-2006 (n = 753, response rate 63.4%). Depression was diagnosed according to DSM-IV and dementia according to Kay's criteria. General linear models (GLMs) were used to test for differences between groups. RESULTS Dementia was related to age but not to birth cohort or sex. Major depression was related to sex (higher in women) but not to birth cohort or age. Minor depression was related to birth cohort, sex (higher in women), age (higher at age 75) and the interaction effect of birth cohort × age; that is, the prevalence of minor depression increased with age in the 2000s but not in the 1970s. Thus, the prevalence of minor depression was higher in 2005-2006 than in 1976-1977 among 75-year-olds for both men (12.4% v. 3.7%) and women (19.1% v. 5.6%) whereas there were no birth cohort differences at age 70. CONCLUSIONS Secular changes were observed only for minor depression, which is considered to be related more to psychosocial factors than major depression. The high prevalence of minor depression in later-born birth cohorts emphasizes the importance of detecting minor depression in the elderly.
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Affiliation(s)
- P Wiberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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Kenna HA, Tartter M, Hall SS, Lightbody AA, Nguyen Q, de los Angeles CP, Reiss AL, Rasgon NL. High rates of comorbid depressive and anxiety disorders among women with premutation of the FMR1 gene. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:872-8. [PMID: 24003006 PMCID: PMC5756731 DOI: 10.1002/ajmg.b.32196] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 08/02/2013] [Indexed: 11/09/2022]
Abstract
Phenotypic variations are emerging from investigations of carriers of the fragile X mental retardation 1 (FMR1) premutation gene (55 to 200 CGG repeats). Initial studies suggest elevated psychiatric and reproductive system dysfunction, but have largely used self-reports for assessment of psychiatric history. The present study used diagnostic psychiatric interviews and assessed reproductive and menstrual history in women with FMR1 premutation. History of psychiatric diagnoses and data on reproductive functioning were collected in 46 women with FMR1 premutation who were mothers of at least one child with the fragile X full mutation. Results showed a significantly earlier age of menopause (mean age = 45.6 years) relative to the national average age of menopause (mean age = 51 years) and a high rate (76%) of lifetime depressive or anxiety history, with 43% of the overall sample reporting a comorbid history of both diagnoses. Compared to those free of psychiatric history, significantly longer premutation length was observed among women with psychiatric history after adjusting for age, with comorbid women having the highest number of CGG repeats (mean = 95.8) compared to women free of psychiatric history (mean = 79.9). Psychiatric history did not appear significantly related to reproductive system dysfunction, though results may have been obscured by the high rates of psychiatric dysfunction in the sample. These data add to the growing evidence base that women with the FMR1 premutation have an increased risk of psychiatric illness and risk for early menopause. Future investigations may benefit from inclusion of biochemical reproductive markers and longitudinal assessment of psychiatric and reproductive functioning.
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Affiliation(s)
| | | | | | | | | | | | | | - Natalie L. Rasgon
- Correspondence to: Natalie Rasgon, M.D., Ph.D., Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5723.
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de Graaf R, van Dorsselaer S, Tuithof M, ten Have M. Sociodemographic and psychiatric predictors of attrition in a prospective psychiatric epidemiological study among the general population. Result of the Netherlands Mental Health Survey and Incidence Study-2. Compr Psychiatry 2013; 54:1131-9. [PMID: 23810078 DOI: 10.1016/j.comppsych.2013.05.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 05/21/2013] [Accepted: 05/22/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In prospective psychiatric epidemiological studies, attrition at follow-up can be selective, and can bias the research findings. Therefore, knowledge of predictors of attrition and of its different types (noncontact, refusal, inability to participate) is of importance. METHODS By means of (multinomial) logistic regression analyses, predictors of attrition were studied in the first 3-year follow-up of the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2), a prospective psychiatric epidemiological study among 6646 subjects of the general population aged 18-64 years. Baseline sociodemographic characteristics, physical health, mental disorders and their clinical characteristics, and experience with the previous interview were studied as predictors of attrition and of its different types. RESULTS The attrition rate at follow-up was 20.2%. Refusal (14.2%) was more common than noncontact (4.6%) and inability to participate (1.4%). Compared to respondents, nonrespondents were more often younger, lower educated, unemployed and born outside the Netherlands. A less positive experience with the baseline interview and shorter interview duration also predicted attrition. Any 12-month mental disorder, the categories and separate mental disorders, and their clinical characteristics, were not significantly associated with attrition, after controlling for sociodemographics. Sociodemographic predictors and experience with the baseline interview differed between the three types of attrition, but these types were also hardly or not associated with previous mental disorders. CONCLUSIONS The authors conclude that bias due to selective attrition was limited to sociodemographics and experience with the baseline interview. Mental health status at baseline was not of influence, possibly due to the large time investment to persuade respondents to re-participate and to find them in case of noncontact or removal to an unknown address. During follow-up waves of future prospective studies it is important to implement an intensive recruitment period with special efforts among young adults and the lower educated.
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Affiliation(s)
- Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands.
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48
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Eaton WW, Roth KB, Bruce M, Cottler L, Wu L, Nestadt G, Ford D, Bienvenu OJ, Crum RM, Rebok G, Anthony JC, Muñoz A. The relationship of mental and behavioral disorders to all-cause mortality in a 27-year follow-up of 4 epidemiologic catchment area samples. Am J Epidemiol 2013; 178:1366-77. [PMID: 24091891 DOI: 10.1093/aje/kwt219] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Subjects from the Epidemiologic Catchment Area Program, interviewed during 1979-1983, were linked to data in the National Death Index through 2007 to estimate the association of mental and behavioral disorders with death. There were more than 25 years of follow-up for 15,440 individuals, with 6,924 deaths amounting to 307,881 person-years of observation. Data were analyzed by using age as the time scale and parametric approaches to quantify the years of life lost due to disorders. Alcohol, drug use, and antisocial personality disorders were associated with increased risk of death, but there was no strong association with mood and anxiety disorders. Results of high- and low-quality matches with the National Death Index were similar. The 3 behavioral disorders were associated with 5-15 years of life lost, estimated along the life course via the generalized gamma model. Regression tree analyses showed that risk of death was associated with alcohol use disorders in nonblacks and with drug disorders in blacks. Phobia interacted with alcohol use disorders in nonblack women, and obsessive-compulsive disorder interacted with drug use disorders in black men. Both of these anxiety disorders were associated with lower risk of death early in life and higher risk of death later in life.
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49
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Lee E, Cho HJ, Olmstead R, Levin MJ, Oxman MN, Irwin MR. Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults. Sleep 2013; 36:1685-91. [PMID: 24179302 DOI: 10.5665/sleep.3128] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES The objective of this study was to examine the associations between the temporal and severity characteristics of sleep disturbance and subsequent depression in community-dwelling older adults. DESIGN A prospective cohort study with assessment of sleep disturbance and depression at baseline and across 2 years of follow-up. SETTING Three urban communities in the United States. PARTICIPANTS Community-dwelling older adults in whom prior depression (n = 145), current depression (n = 68), or never mentally ill (n = 206) were diagnosed at the baseline assessment. MEASUREMENTS AND RESULTS Major depression at year 2, defined by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. Among patients with either a depression history or current depression at baseline, persistent sleep disturbance throughout year 1 was associated with persistent or recurrent depression at year 2, after adjustment for group status, antidepressant and hypnotic sedative use, severity of depressive symptoms, chronic medical burden, and sociodemographic variables (adjusted odds ratio = 5.20, 95% confidence interval [CI] = 1.16 to 23.29). Among those who were not depressed at year 1, persistent sleep disturbance throughout year 1 predicted depression recurrence during year 2 (adjusted hazards ratio = 16.05, CI = 1.21 to 213.06), independent of the severity of sleep disturbance. None of the older adults who were never mentally ill developed a depression. CONCLUSIONS Persistent sleep disturbance during a year-long period is associated with depression the following year. Among older adults with prior depression, identification of those with persistent sleep disturbance may optimize the efficacy of sleep related interventions to improve depression remission and/or prevent late-life depression.
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Affiliation(s)
- Eun Lee
- Department of Psychiatry, and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
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50
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Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJL, Vos T, Whiteford HA. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med 2013; 10:e1001547. [PMID: 24223526 PMCID: PMC3818162 DOI: 10.1371/journal.pmed.1001547] [Citation(s) in RCA: 1978] [Impact Index Per Article: 179.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/18/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease. METHODS AND FINDINGS Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8%) of global YLDs and dysthymia for 1.4% (0.9%-2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2%) of global DALYs and dysthymia for 0.5% (0.3%-0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8%) to 3.8% (3.0%-4.7%) of global DALYs. CONCLUSIONS GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Alize J Ferrari
- University of Queensland, School of Population Health, Herston, Queensland, Australia ; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
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