1
|
Myroniuk S, Reitsema AM, de Jonge P, Jeronimus BF. Childhood abuse and neglect and profiles of adult emotion dynamics. Dev Psychopathol 2024:1-19. [PMID: 38196323 DOI: 10.1017/s0954579423001530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Childhood maltreatment (CM) is experienced by ∼40% of all children at major personal and societal costs. The divergent associations between emotional, physical, and sexual abuse or neglect in childhood and differences in adult emotional functioning and regulation were examined in terms of daily emotion intensity, variability, instability, inertia, and diversity, reported over 30 days by 290 Dutch aged 19-73. Participants described their abuse/neglect experiences retrospectively using the Childhood Trauma Questionnaire (CTQ). Dissecting CM effects on adult emotion dynamics may inform theories on the ontogenesis and functioning of emotions, on effects of abuse and neglect, to better understand (dys)functional emotional development, and to prevent their adverse sequelae. Structural equation models (SEM) showed that most types of CM were associated with specific patterns of emotion dynamics, and only emotional abuse had no unique effects on the emotional dynamic indices. Emotional neglect was associated with most measures of emotion dynamics (i.e., less intense, variable, unstable, and diverse emotions). Sexual abuse associated with increases and physical neglect decreases in negative affect variability and instability. Physical abuse was associated with inertia but with a small effect size. Social contact frequency did not mediate much of the relationship between CM types and emotion dynamics.
Collapse
Affiliation(s)
- S Myroniuk
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - A M Reitsema
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
- Department of Developmental Psychology, University of Utrecht, Utrecht, The Netherlands
| | - P de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - B F Jeronimus
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
2
|
Wigman J, Wardenaar K, Wanders R, Booij S, Jeronimus B, van der Krieke L, Wichers M, de Jonge P. Dimensional and discrete variations on the psychosis continuum in a Dutch crowd-sourcing population sample. Eur Psychiatry 2020; 42:55-62. [DOI: 10.1016/j.eurpsy.2016.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/24/2016] [Accepted: 11/27/2016] [Indexed: 12/18/2022] Open
Abstract
AbstractBackgroundMild psychotic experiences are common in the general population. Although transient and benign in most cases, these experiences are predictive of later mental health problems for a significant minority. The goal of the present study was to perform examinations of the dimensional and discrete variations in individuals’ reporting of subclinical positive and negative psychotic experiences in a unique Dutch internet-based sample from the general population.MethodsPositive and negative subclinical psychotic experiences were measured with the Community Assessment of Psychic Experiences in 2870 individuals. First, the prevalence of these experiences and their associations with demographics, affect, psychopathology and quality of life were investigated. Next, latent class analysis was used to identify data-driven subgroups with different symptom patterns, which were subsequently compared on aforementioned variables.ResultsSubclinical psychotic experiences were commonly reported. Both positive and negative psychotic experiences were associated with younger age, more negative affect, anxiety and depression as well as less positive affect and poorer quality of life. Seven latent classes (‘Low psychotic experiences’, ‘Lethargic’, ‘Blunted’, ‘Distressed’, ‘Paranormal’, ‘Distressed_grandiose’ and ‘Distressed/positive psychotic experiences’) were identified that demonstrated both dimensional differences in the number/severity of psychotic experiences and discrete differences in the patterns of reported experiences.ConclusionSubclinical psychotic experiences show both dimensional severity variations and discrete symptom-pattern variations across individuals. To understand and capture all interindividual variations in subclinical psychotic experiences, their number, nature and context (co-occurrence patterns) should be considered at the same time. Only some psychotic experiences may lay on a true psychopathological psychosis continuum.
Collapse
|
3
|
de Vries YA, ten Have M, de Graaf R, van Dorsselaer S, de Ruiter NMP, de Jonge P. The relationship between mental disorders and actual and desired subjective social status. Epidemiol Psychiatr Sci 2019; 29:e83. [PMID: 31839021 PMCID: PMC8061247 DOI: 10.1017/s2045796019000805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/13/2019] [Accepted: 11/24/2019] [Indexed: 12/21/2022] Open
Abstract
AIMS Mental disorders are associated with lower subjective social status (SSS), but a more nuanced understanding of this relationship is needed. We examined the influence of disorder age of onset and recency on SSS and studied whether mental disorders are also associated with the discrepancy between actual and desired SSS. METHOD Data are from the baseline and second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0), while both actual and desired SSS were assessed with a ten-rung ladder. Linear regression was used to examine the association between mental disorders and SSS. RESULTS Of 5303 participants, 2237 had a lifetime mental disorder at baseline. These participants reported significantly lower actual SSS (6.28) at follow-up than healthy participants (6.66, B = -0.38 [95% CI -0.48 to -0.27], p < 0.001) and a significantly greater actual-desired SSS discrepancy (1.14 v. 1.05 after controlling for actual SSS, B = 0.09 [0.01-0.17], p = 0.024). Lower age of onset of the first mental disorder was marginally significantly associated with lower actual SSS (B = 0.006 [0.000-0.012], p = 0.046). More recent disorders were also associated with lower actual SSS (B = 0.015 [0.005-0.026], p = 0.005), such that participants whose disorder remitted ⩾6 years before baseline were statistically indistinguishable from healthy participants. CONCLUSIONS Lifetime mental disorders are associated with lower actual SSS and a slightly greater discrepancy between actual and desired SSS. However, people with mental disorders in (long-term) remission have a similar social status as healthy participants.
Collapse
Affiliation(s)
- Y. A. de Vries
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M. ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - R. de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S. van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - N. M. P. de Ruiter
- University College Groningen, University of Groningen, Groningen, The Netherlands
| | - P. de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
4
|
de Vos S, Patten S, Wit EC, Bos EH, Wardenaar KJ, de Jonge P. Subtyping psychological distress in the population: a semi-parametric network approach. Epidemiol Psychiatr Sci 2019; 29:e36. [PMID: 31088585 PMCID: PMC8061241 DOI: 10.1017/s204579601900026x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 02/24/2019] [Accepted: 04/14/2019] [Indexed: 11/08/2022] Open
Abstract
AIMS The mechanisms underlying both depressive and anxiety disorders remain poorly understood. One of the reasons for this is the lack of a valid, evidence-based system to classify persons into specific subtypes based on their depressive and/or anxiety symptomatology. In order to do this without a priori assumptions, non-parametric statistical methods seem the optimal choice. Moreover, to define subtypes according to their symptom profiles and inter-relations between symptoms, network models may be very useful. This study aimed to evaluate the potential usefulness of this approach. METHODS A large community sample from the Canadian general population (N = 254 443) was divided into data-driven clusters using non-parametric k-means clustering. Participants were clustered according to their (co)variation around the grand mean on each item of the Kessler Psychological Distress Scale (K10). Next, to evaluate cluster differences, semi-parametric network models were fitted in each cluster and node centrality indices and network density measures were compared. RESULTS A five-cluster model was obtained from the cluster analyses. Network density varied across clusters, and was highest for the cluster of people with the lowest K10 severity ratings. In three cluster networks, depressive symptoms (e.g. feeling depressed, restless, hopeless) had the highest centrality. In the remaining two clusters, symptom networks were characterised by a higher prominence of somatic symptoms (e.g. restlessness, nervousness). CONCLUSION Finding data-driven subtypes based on psychological distress using non-parametric methods can be a fruitful approach, yielding clusters of persons that differ in illness severity as well as in the structure and strengths of inter-symptom relationships.
Collapse
Affiliation(s)
- S. de Vos
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - S. Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - E. C. Wit
- University of Groningen, Johann Bernoulli Institute of Mathematics and Computer Science, Groningen, The Netherlands
| | - E. H. Bos
- Department of Developmental Psychology, University of Groningen, Faculty of Behavioural and Social Sciences, Groningen, The Netherlands
| | - K. J. Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - P. de Jonge
- Department of Developmental Psychology, University of Groningen, Faculty of Behavioural and Social Sciences, Groningen, The Netherlands
| |
Collapse
|
5
|
de Vries YA, Roest AM, de Jonge P. [Evidence-b(i)ased psychiatry: research into the evidence for effectiveness and safety of antidepressants in depression and anxiety disorders]. Tijdschr Psychiatr 2019; 61:635-643. [PMID: 31560783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Antidepressants remain controversial, partly due to allegations that disappointing results were buried and because of their modest average efficacy.<br/> AIM: To investigate bias in the antidepressant literature and the possibilities for predicting which patients with depression or anxiety do receive significant benefits from antidepressants.<br/> METHOD: We investigated bias by comparing information from the US Food and Drug Administration with the published literature. To predict response, we used patient data from randomized trials.<br/> RESULTS: Of all studies on depression or anxiety, 50% and 72% were positive, compared to 95% and 96% of all published studies. Safety outcomes were poorly reported in published articles and unpublished studies were often 'bundled' into pooled-trials publications with positive conclusions. We found an association between severity and antidepressant efficacy for some, but not all, anxiety disorders; previous research has found inconsistent evidence for this association for depression. Furthermore, patients with depression that showed early improvement were more likely to attain a good response, irrespective of which symptoms improved.<br/> CONCLUSION: These results demonstrate the severe impact of bias on the antidepressant literature. Severity and early improvement predicted a good response, but more information is needed to improve predictions. The increased accessibility of individual patient data will hopefully soon enable further progress in this area.
Collapse
|
6
|
de Vries YA, Roest AM, de Jonge P, Cuijpers P, Munafò MR, Bastiaansen JA. The cumulative effect of reporting and citation biases on the apparent efficacy of treatments: the case of depression. Psychol Med 2018; 48:2453-2455. [PMID: 30070192 PMCID: PMC6190062 DOI: 10.1017/s0033291718001873] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/29/2017] [Accepted: 06/26/2018] [Indexed: 01/11/2023]
Affiliation(s)
- Y. A. de Vries
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Developmental Psychology, Department of Psychology, University of Groningen, Groningen, the Netherlands
| | - A. M. Roest
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Developmental Psychology, Department of Psychology, University of Groningen, Groningen, the Netherlands
| | - P. de Jonge
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Developmental Psychology, Department of Psychology, University of Groningen, Groningen, the Netherlands
| | - P. Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M. R. Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - J. A. Bastiaansen
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, The Netherlands
| |
Collapse
|
7
|
Bos EH, Ten Have M, van Dorsselaer S, Jeronimus BF, de Graaf R, de Jonge P. Functioning before and after a major depressive episode: pre-existing vulnerability or scar? A prospective three-wave population-based study. Psychol Med 2018; 48:2264-2272. [PMID: 29331152 DOI: 10.1017/s0033291717003798] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The vulnerability hypothesis suggests that impairments after remission of depressive episodes reflect a pre-existing vulnerability, while the scar hypothesis proposes that depression leaves residual impairments that confer risk of subsequent episodes. We prospectively examined vulnerability and scar effects in mental and physical functioning in a representative Dutch population sample. METHODS Three waves were used from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study with a 6-years follow-up. Mental and physical functioning were assessed with the Medical Outcomes Study Short Form (SF-36). Major depressive disorder (MDD) was assessed with the Composite International Diagnostic Interview 3.0. Vulnerability effects were examined by comparing healthy controls (n = 2826) with individuals who developed a first-onset depressive episode during first follow-up but did not have a lifetime diagnosis of MDD at baseline (n = 181). Scarring effects were examined by comparing pre- and post-morbid functioning in individuals who developed a depressive episode after baseline that was remitted at the third wave (n = 108). RESULTS Both mental (B = -5.4, s.e. = 0.9, p < 0.001) and physical functioning (B = -8.2, s.e. = 1.1, p < 0.001) at baseline were lower in individuals who developed a first depressive episode after baseline compared with healthy controls. This effect was most pronounced in people who developed a severe episode. No firm evidence of scarring in mental or physical functioning was found. In unadjusted analyses, physical functioning was still lowered post-morbidly (B = -5.1, s.e. = 2.1, p = 0.014), but this effect disappeared in adjusted analyses. CONCLUSIONS Functional impairments after remission of depression seem to reflect a pre-existing vulnerability rather than a scar.
Collapse
Affiliation(s)
- E H Bos
- Department of Developmental Psychology,Behavioural and Social Sciences,University of Groningen,Groningen,The Netherlands
| | - M Ten Have
- Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - B F Jeronimus
- Department of Developmental Psychology,Behavioural and Social Sciences,University of Groningen,Groningen,The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - P de Jonge
- Department of Developmental Psychology,Behavioural and Social Sciences,University of Groningen,Groningen,The Netherlands
| |
Collapse
|
8
|
Abstract
BACKGROUND Literature has shown that obesity, metabolic syndrome and inflammation are associated with depression, however, evidence suggests that these associations are specific to atypical depression. Which of the atypical symptoms are driving associations with obesity-related outcomes and inflammation is unknown. We evaluated associations between individual symptoms of depression (both atypical and non-atypical) and body mass index (BMI), metabolic syndrome components and inflammatory markers. METHODS We included 808 persons with a current diagnosis of depression participating in the Netherlands Study of Depression and Anxiety (67% female, mean age 41.6 years). Depressive symptoms were derived from the Composite International Diagnostic Interview and the Inventory of Depressive Symptomatology. Univariable and multivariable regression analyses adjusting for sex, age, educational level, depression severity, current smoking, physical activity, anti-inflammatory medication use, and statin use were performed. RESULTS Increased appetite was positively associated with BMI, number of metabolic syndrome components, waist circumference, C-reactive protein and tumor necrosis factor-α. Decreased appetite was negatively associated with BMI and waist circumference. Psychomotor retardation was positively associated with BMI, high-density lipoprotein cholesterol and triglycerides, and insomnia with number of metabolic syndrome components. CONCLUSION Increased appetite - in the context of a depressive episode - was the only symptom that was associated with both metabolic as well as inflammatory markers, and could be a key feature of an immuno-metabolic form of depression. This immuno-metabolic depression should be considered in clinical trials evaluating effectiveness of compounds targeting metabolic and inflammatory pathways or lifestyle interventions.
Collapse
Affiliation(s)
- F Lamers
- Department of Psychiatry,Amsterdam Public Health Research Institute and Amsterdam Neuroscience research institute,VU University Medical Center/GGZ inGeest,Amsterdam,the Netherlands
| | - Y Milaneschi
- Department of Psychiatry,Amsterdam Public Health Research Institute and Amsterdam Neuroscience research institute,VU University Medical Center/GGZ inGeest,Amsterdam,the Netherlands
| | - P de Jonge
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),University of Groningen, University Medical Center,Groningen,the Netherlands
| | - E J Giltay
- Department of Psychiatry,Leiden University Medical Center,Leiden,the Netherlands
| | - B W J H Penninx
- Department of Psychiatry,Amsterdam Public Health Research Institute and Amsterdam Neuroscience research institute,VU University Medical Center/GGZ inGeest,Amsterdam,the Netherlands
| |
Collapse
|
9
|
Kovess-Masfety V, Saha S, Lim C, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Borges G, de Girolamo G, de Jonge P, Demyttenaere K, Florescu S, Haro J, Hu C, Karam E, Kawakami N, Lee S, Lepine J, Navarro-Mateu F, Stagnaro J, ten Have M, Viana M, Kessler R, McGrath J. Psychotic experiences and religiosity: data from the WHO World Mental Health Surveys. Acta Psychiatr Scand 2018; 137:306-315. [PMID: 29453789 PMCID: PMC6839106 DOI: 10.1111/acps.12859] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Religiosity is often associated with better health outcomes. The aim of the study was to examine associations between psychotic experiences (PEs) and religiosity in a large, cross-national sample. METHODS A total of 25 542 adult respondents across 18 countries from the WHO World Mental Health Surveys were assessed for PEs, religious affiliation and indices of religiosity, DSM-IV mental disorders and general medical conditions. Logistic regression models were used to estimate the association between PEs and religiosity with various adjustments. RESULTS Of 25 542 included respondents, 85.6% (SE = 0.3) (n = 21 860) respondents reported having a religious affiliation. Overall, there was no association between religious affiliation status and PEs. Within the subgroup having a religious affiliation, four of five indices of religiosity were significantly associated with increased odds of PEs (odds ratios ranged from 1.3 to 1.9). The findings persisted after adjustments for mental disorders and/or general medical conditions, as well as religious denomination type. There was a significant association between increased religiosity and reporting more types of PEs. CONCLUSIONS Among individuals with religious affiliations, those who reported more religiosity on four of five indices had increased odds of PEs. Focussed and more qualitative research will be required to unravel the interrelationship between religiosity and PEs.
Collapse
Affiliation(s)
- V. Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - S. Saha
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - C.C.W. Lim
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - A. Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - G. Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - G. de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni 4, Brescia, Italy
| | - P. de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, NL; Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, NL
| | - K. Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - S. Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - J.M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - E.G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - J.P. Lepine
- Hôpital Lariboisière- Fernand Widal, Assistance Publique Hôpitaux de Paris; Universités Paris Descartes-Paris Diderot;INSERM UMR-S 1144, Paris, France
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - J.C. Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - M. ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - M.C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - R.C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - J.J. McGrath
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia; and National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | | |
Collapse
|
10
|
Bos FM, Blaauw FJ, Snippe E, van der Krieke L, de Jonge P, Wichers M. Exploring the emotional dynamics of subclinically depressed individuals with and without anhedonia: An experience sampling study. J Affect Disord 2018; 228:186-193. [PMID: 29253685 DOI: 10.1016/j.jad.2017.12.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/13/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Anhedonia has been linked to worse prognosis of depression. The present study aimed to construct personalized models to elucidate the emotional dynamics of subclinically depressed individuals with versus without symptoms of anhedonia. METHODS Matched subclinically depressed individuals with and without symptoms of anhedonia (N = 40) of the HowNutsAreTheDutch sample completed three experience sampling methodology assessments per day for 30 days. For each individual, the impact of physical activity, stress experience, and high/low arousal PA/NA on each other was estimated through automated impulse response function analysis (IRF). These individual IRF associations were combined to compare anhedonic versus non-anhedonic individuals. RESULTS Physical activity had low impact on affect in both groups. In non-anhedonic individuals, stress experience increased NA and decreased PA and physical activity more strongly. In anhedonic individuals, PA high arousal showed a diminished favorable impact on affect (increasing NA/stress experience, decreasing PA/physical activity). Finally, large heterogeneity in the personalized models of emotional dynamics were found. LIMITATIONS Stress experience was measured indirectly by assessing level of distress; the timeframe in between measurements was relatively long with 6h; and only information on one of the two hallmarks of anhedonia, loss of interest, was gathered. CONCLUSIONS Our results suggest different pathways of emotional dynamics underlie depressive symptomatology. Subclinically depressed individuals with anhedonic complaints are more strongly characterized by diminished favorable impact of PA high arousal and heightened NA reactivity, whereas subclinically depressed individuals without these anhedonic complaints seem more characterized by heightened stress reactivity. The automatically generated personalized models may offer patient-specific insights in emotional dynamics, which may show clinical relevance.
Collapse
Affiliation(s)
- F M Bos
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Rob Giel Research Center, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands.
| | - F J Blaauw
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands; Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands; Johann Bernoulli Institute for Mathematics and Computer Science (JBI), Distributed Systems Group, University of Groningen, Groningen, The Netherlands
| | - E Snippe
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - L van der Krieke
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Rob Giel Research Center, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - P de Jonge
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands; Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - M Wichers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| |
Collapse
|
11
|
Rosellini AJ, Liu H, Petukhova MV, Sampson NA, Aguilar-Gaxiola S, Alonso J, Borges G, Bruffaerts R, Bromet EJ, de Girolamo G, de Jonge P, Fayyad J, Florescu S, Gureje O, Haro JM, Hinkov H, Karam EG, Kawakami N, Koenen KC, Lee S, Lépine JP, Levinson D, Navarro-Mateu F, Oladeji BD, O’Neill S, Pennell BE, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Torres Y, Viana MC, Zaslavsky AM, Kessler RC. Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychol Med 2018; 48:437-450. [PMID: 28720167 PMCID: PMC5758426 DOI: 10.1017/s0033291717001817] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. METHODS The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD. RESULTS 20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2-0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66-55% v. 43%) and later-recovery (75-68% v. 39%). CONCLUSIONS We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.
Collapse
Affiliation(s)
- A. J. Rosellini
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - H. Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. V. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA
| | - J. Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - G. Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - G. de Girolamo
- IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - P. de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - J. Fayyad
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
| | - S. Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - H. Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - E. G. Karam
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - K. C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - J. P. Lépine
- Hôpital Lariboisière-Fernand Widal, Assistance Publique Hôpitaux de Paris, Universités Paris Descartes-Paris Diderot, INSERM UMR-S 1144, Paris, France
| | - D. Levinson
- Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | - B. D. Oladeji
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - S. O’Neill
- School of Psychology, Ulster University, Londonderry, UK
| | - B.-E. Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - M. Piazza
- Universidad Cayetano Heredia, National Institute of Health, Lima, Peru
| | | | - K. M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - D. J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa
| | - Y. Torres
- Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - A. M. Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
12
|
Sorgdrager FJH, Doornbos B, Penninx BWJH, de Jonge P, Kema IP. The association between the hypothalamic pituitary adrenal axis and tryptophan metabolism in persons with recurrent major depressive disorder and healthy controls. J Affect Disord 2017; 222:32-39. [PMID: 28668713 DOI: 10.1016/j.jad.2017.06.052] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/02/2017] [Accepted: 06/23/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Persistent changes in serotonergic and hypothalamic pituitary adrenal (HPA) axis functioning are implicated in recurrent types of major depressive disorder (MDD). Systemic tryptophan levels, which influence the rate of serotonin synthesis, are regulated by glucocorticoids produced along the HPA axis. We investigated tryptophan metabolism and its association with HPA axis functioning in single episode MDD, recurrent MDD and non-depressed individuals. METHODS We included depressed individuals (n = 1320) and controls (n = 406) from the Netherlands Study of Depression and Anxiety (NESDA). The kynurenine to tryptophan ratio (kyn/trp ratio) was established using serum kynurenine and tryptophan levels. Several HPA axis parameters were calculated using salivary cortisol samples. We adjusted the regression analyses for a wide range of potential confounders and differentiated between single episode MDD, recurrent MDD and control. RESULTS Tryptophan, kynurenine and the kyn/trp ratio did not differ between controls and depressed individuals. Increased evening cortisol levels were associated with a decreased kyn/trp ratio in the total sample (Crude: β = -.102, p < .001; Adjusted: β = -.083, p < .001). This association was found to be restricted to recurrently depressed individuals (Crude: β = -.196, p < .001; Adjusted: β = -.145, p = .001). Antidepressant treatment did not affect this association. CONCLUSIONS Our results suggest that an imbalance between HPA axis function and tryptophan metabolism could be involved in recurrent depression.
Collapse
Affiliation(s)
- F J H Sorgdrager
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - B Doornbos
- University Center Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Interdisciplinary Center of Psychiatric Epidemiology, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; GGZ Drenthe Mental Health Center, Department of Affective and Bipolar Disorders, Assen, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - P de Jonge
- Interdisciplinary Center of Psychiatric Epidemiology, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - I P Kema
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
13
|
McGrath JJ, McLaughlin KA, Saha S, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Bruffaerts R, de Girolamo G, de Jonge P, Esan O, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Kovess-Masfety V, Lee S, Lepine JP, Lim CCW, Medina-Mora ME, Mneimneh Z, Pennell BE, Piazza M, Posada-Villa J, Sampson N, Viana MC, Xavier M, Bromet EJ, Kendler KS, Kessler RC. The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries. Psychol Med 2017; 47:1230-1245. [PMID: 28065209 PMCID: PMC5590103 DOI: 10.1017/s0033291716003263] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations. METHOD We assessed CAs, PEs and DSM-IV mental disorders in 23 998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models. RESULTS Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.9-2.6]. CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR 8.5, 95% CI 3.6-20.2), whereas Other CA types were associated with PE onset in adolescence. Associations of other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF). CONCLUSIONS Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood-onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.
Collapse
Affiliation(s)
- J J McGrath
- Queensland Centre for Mental Health Research, andQueensland Brain Institute,University of Queensland,Australia
| | - K A McLaughlin
- Department of Psychology,University of Washington,Seattle,Washington,USA
| | - S Saha
- Queensland Centre for Mental Health Research, andQueensland Brain Institute,University of Queensland,Australia
| | - S Aguilar-Gaxiola
- Center for Reducing Health Disparities,UC Davis Health System,Sacramento,California,USA
| | - A Al-Hamzawi
- College of Medicine, Al-Qadisiya University,Diwaniya governorate,Iraq
| | - J Alonso
- Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain
| | - R Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg,Leuven,Belgium
| | - G de Girolamo
- IRCCS St John of God Clinical Research Centre,IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy
| | - P de Jonge
- Department of Developmental Psychology,Research Program Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen,Groningen,The Netherlands
| | - O Esan
- Department of Psychiatry,University of Ibadan,Nigeria
| | - S Florescu
- National School of Public Health, Management and Professional Development,Bucharest,Romania
| | - O Gureje
- Department of Psychiatry,University College Hospital,Ibadan,Nigeria
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain
| | - C Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital,Shenzhen,China
| | - E G Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine,Balamand University,Beirut,Lebanon
| | - V Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris,France
| | - S Lee
- Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong
| | - J P Lepine
- Hôpital Lariboisière Fernand Widal,Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144,University Paris Diderot and Paris Descartes,Paris,France
| | - C C W Lim
- Queensland Brain Institute, The University of Queensland,St. Lucia, Queensland,Australia
| | - M E Medina-Mora
- National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico
| | - Z Mneimneh
- Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor,Michigan,USA
| | - B E Pennell
- Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor,Michigan,USA
| | - M Piazza
- Universidad Cayetano Heredia,Lima,Peru
| | - J Posada-Villa
- Colegio Mayor de Cundinamarca University,Bogota,Colombia
| | - N Sampson
- Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA
| | - M C Viana
- Department of Social Medicine,Federal University of Espírito Santo,Vitoria,Brazil
| | - M Xavier
- Department of Mental Health,Faculdade de Ciências Médicas,Chronic Diseases Research Center (CEDOC) and Universidade Nova de Lisboa,Campo dos Mártires da Pátria,Lisbon,Portugal
| | - E J Bromet
- Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook,New York,USA
| | - K S Kendler
- Department of Psychiatry,Virginia Commonwealth University,USA
| | - R C Kessler
- Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA
| |
Collapse
|
14
|
Roest AM, de Jonge P, Lim C, Stein DJ, Al-Hamzawi A, Alonso J, Benjet C, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, Ciutan M, de Girolamo G, Hu C, Levinson D, Nakamura Y, Navarro-Mateu F, Piazza M, Posada-Villa J, Torres Y, Wojtyniak B, Kessler RC, Scott KM. Fear and distress disorders as predictors of heart disease: A temporal perspective. J Psychosom Res 2017; 96:67-75. [PMID: 28545795 PMCID: PMC5674522 DOI: 10.1016/j.jpsychores.2017.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Few studies have been able to contrast associations of anxiety and depression with heart disease. These disorders can be grouped in fear and distress disorders. Aim of this study was to study the association between fear and distress disorders with subsequent heart disease, taking into account the temporal order of disorders. METHODS Twenty household surveys were conducted in 18 countries (n=53791; person years=2,212,430). The Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of disorders, and respondents were categorized into categories based on the presence and timing of fear and distress disorders. Heart disease was indicated by self-report of physician-diagnosed heart disease or self-report of heart attack, together with year of onset. Survival analyses estimated associations between disorder categories and heart disease. RESULTS Most respondents with fear or distress disorders had either pure distress or pure fear (8.5% and 7.7% of total sample), while fear preceded distress in the large majority of respondents with comorbid fear and distress (3.8% of total sample). Compared to the "no fear or distress disorder" category, respondents with pure fear disorder had the highest odds of subsequent heart disease (OR:1.8; 95%CI:1.5-2.2; p<0.001) and compared to respondents with pure distress disorder, these respondents were at a significantly increased risk of heart disease (OR:1.3; 95%CI:1.0-1.6; p=0.020). CONCLUSION This novel analytic approach indicates that the risk of subsequent self-reported heart disease associated with pure fear disorder is significantly larger than the risk associated with distress disorder. These results should be confirmed in prospective studies using objective measures of heart disease.
Collapse
Affiliation(s)
- AM Roest
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - P de Jonge
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - C Lim
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - DJ Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa
| | - A Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq
| | - J Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - C Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - R Bruffaerts
- Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg Leuven, Belgium
| | - B Bunting
- Psychology Research Institute, Ulster University, Northern Ireland
| | - JM Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Ciutan
- National School of public Health, Management and Professional Development, Bucharest, Romania
| | - G de Girolamo
- IRCCS St John of God Clinical Research Centre, IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - C Hu
- Shenzhen Insitute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China
| | - D Levinson
- Ministry of Health Israel, Mental Health Services, Israel
| | - Y Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - F Navarro-Mateu
- IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar (Murcia), Spain
| | - M Piazza
- National Institute of Health, Peru, Universidad Cayetano Hereidia, Peru
| | - J Posada-Villa
- Colegio Mayor de Cundinamarca University, Bogota, Colombia
| | - Y Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - B Wojtyniak
- Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - RC Kessler
- Department of Health Care Policy, Harvard University Medical School, Boston, MA, United States
| | - KM Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
15
|
Bromet EJ, Atwoli L, Kawakami N, Navarro-Mateu F, Piotrowski P, King AJ, Aguilar-Gaxiola S, Alonso J, Bunting B, Demyttenaere K, Florescu S, de Girolamo G, Gluzman S, Haro JM, de Jonge P, Karam EG, Lee S, Kovess-Masfety V, Medina-Mora ME, Mneimneh Z, Pennell BE, Posada-Villa J, Salmerón D, Takeshima T, Kessler RC. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys. Psychol Med 2017; 47:227-241. [PMID: 27573281 PMCID: PMC5432967 DOI: 10.1017/s0033291716002026] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies. METHOD Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders). RESULTS Disaster-related PTSD prevalence was 0.0-3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk. CONCLUSION Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.
Collapse
Affiliation(s)
- E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - L. Atwoli
- Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - F. Navarro-Mateu
- Subdirección General de Salud Mental, Servicio Murciano de Salud, IMIB-Arrixaca, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia, Spain
| | - P. Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - A. J. King
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | | | - J. Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - B. Bunting
- School of Psychology, University of Ulster, Londonderry, UK
| | - K. Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - S. Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - G. de Girolamo
- IRCCS St. John of God Clinical Research Centre, Brescia, Italy
| | - S. Gluzman
- Ukrainian Psychiatric Association, Kiev, Ukraine
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - P. de Jonge
- Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E. G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
- Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - V. Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France
| | - M. E. Medina-Mora
- Ramon de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Z. Mneimneh
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - B.-E. Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - D. Salmerón
- Department of Epidemiology, Department of Health and Social Sciences, Murcia Regional Health Council, IMIB-Arrixaca, CIBER Epidemiología y Salud Pública (CIBERESP), Universidad de Murcia, Murcia, Spain
| | - T. Takeshima
- Department of Health and Welfare for the Disabled, Health and Welfare Bureau, Kawasaki City, Japan
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
16
|
Oude Oosterik NAM, Bouwmans MEJ, de Groot IW, Bos EH, de Jonge P. [The bidirectional relationship between physical activity and sleep in depressed versus non-depressed individuals]. Tijdschr Psychiatr 2017; 59:78-86. [PMID: 28350149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Sleep and physical activity are related, but the direction of this relationship is unclear and it is not known whether the direction differs in depressed and non-depressed persons. AIM To study the bidirectional relationship between physical activity and sleep in daily life by making repeated measurements in depressed and non-depressed people. METHOD Every day for 30 consecutive days each depressed (N = 27) and non-depressed (N = 27) participant in our study had to complete an electronic questionnaire relating to subjective sleep quality and sleep duration and were required to wear an accelerometer that recorded physical activity. RESULTS Multi-level analysis showed that an increase in subjective sleep duration resulted in a decrease in physical activity. The differences between individuals with regard to the direction and strength of this relationship were significant. Changes in physical activity did not predict changes in sleep quality or sleep duration. We did not find any differences in the relationships for depressed and non-depressed participants. CONCLUSION Change in sleep duration predicts change in physical activity, although there was significant heterogeneity in the results for individuals. Our findings underline the importance of further research and of the development of interventions that are tailored to the precise needs of the individual patient.
Collapse
|
17
|
Wanders RBK, van Loo HM, Vermunt JK, Meijer RR, Hartman CA, Schoevers RA, Wardenaar KJ, de Jonge P. Casting wider nets for anxiety and depression: disability-driven cross-diagnostic subtypes in a large cohort. Psychol Med 2016; 46:3371-3382. [PMID: 27624913 DOI: 10.1017/s0033291716002221] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND In search of empirical classifications of depression and anxiety, most subtyping studies focus solely on symptoms and do so within a single disorder. This study aimed to identify and validate cross-diagnostic subtypes by simultaneously considering symptoms of depression and anxiety, and disability measures. METHOD A large cohort of adults (Lifelines, n = 73 403) had a full assessment of 16 symptoms of mood and anxiety disorders, and measurement of physical, social and occupational disability. The best-fitting subtyping model was identified by comparing different hybrid mixture models with and without disability covariates on fit criteria in an independent test sample. The best model's classes were compared across a range of external variables. RESULTS The best-fitting Mixed Measurement Item Response Theory model with disability covariates identified five classes. Accounting for disability improved differentiation between people reporting isolated non-specific symptoms ['Somatic' (13.0%), and 'Worried' (14.0%)] and psychopathological symptoms ['Subclinical' (8.8%), and 'Clinical' (3.3%)]. Classes showed distinct associations with clinically relevant external variables [e.g. somatization: odds ratio (OR) 8.1-12.3, and chronic stress: OR 3.7-4.4]. The Subclinical class reported symptomatology at subthreshold levels while experiencing disability. No pure depression or anxiety, but only mixed classes were found. CONCLUSIONS An empirical classification model, incorporating both symptoms and disability identified clearly distinct cross-diagnostic subtypes, indicating that diagnostic nets should be cast wider than current phenomenology-based categorical systems.
Collapse
Affiliation(s)
- R B K Wanders
- University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),Groningen,The Netherlands
| | - H M van Loo
- University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),Groningen,The Netherlands
| | - J K Vermunt
- Department of Methodology and Statistics,Tilburg University,Tilburg,The Netherlands
| | - R R Meijer
- Department of Psychometrics and Statistics,University of Groningen,Groningen,The Netherlands
| | - C A Hartman
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,Groningen,The Netherlands
| | - R A Schoevers
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,Groningen,The Netherlands
| | - K J Wardenaar
- University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),Groningen,The Netherlands
| | - P de Jonge
- University of Groningen, University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion regulation (ICPE),Groningen,The Netherlands
| |
Collapse
|
18
|
Blaauw F, Schenk H, Jeronimus B, van der Krieke L, de Jonge P, Aiello M, Emerencia A. Let’s get Physiqual – An intuitive and generic method to combine sensor technology with ecological momentary assessments. J Biomed Inform 2016; 63:141-149. [DOI: 10.1016/j.jbi.2016.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/11/2016] [Accepted: 08/02/2016] [Indexed: 11/16/2022]
|
19
|
de Vries YA, de Jonge P, Kalverdijk L, Bos HJ, Schuiling-Veninga CCM, Hak E. [Antidepressant guidelines poorly adhered to in young people]. Ned Tijdschr Geneeskd 2016; 160:D627. [PMID: 27552937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine if Dutch physicians adhere to the national guidelines on the treatment of depression in children and adolescents. DESIGN Retrospective database research. METHOD Data on children and adolescents aged between 6 and 17 years were selected from the IADB, a Dutch database of filled prescriptions. We examined whether children and adolescents were prescribed fluoxetine as recommended by the guideline, and whether the starting dose was in accordance with the guideline. RESULTS Of 2942 children and adolescents in whom antidepressant treatment was initiated, the proportion prescribed fluoxetine increased from 10.1% in 1994-2003 to 19.7% in 2010-2014. However, paroxetine (1994-2003) and citalopram (2004-2014) were the most frequently prescribed antidepressants. Starting doses were guideline-concordant in 58% of children, 31% of preadolescents and 16% of adolescents. Sixty percent of all adolescents were prescribed an adult starting dose. CONCLUSION Guideline adherence was poor. In contrast to the guidelines, physicians preferred citalopram to fluoxetine in children and adolescents with depression. Furthermore, adolescents often received an adult starting dose. These results suggest that dedicated effort is necessary to improve guideline adherence.
Collapse
Affiliation(s)
- Y A de Vries
- *Dit onderzoek werd eerder gepubliceerd in European Child and Adolescent Psychiatry (17 maart 2016 (epub)) met als titel 'Poor guideline adherence in the initiation of antidepressant treatment in children and adolescents in the Netherlands: choice of antidepressant and dose'. Afgedrukt met toestemming
| | | | | | | | | | | |
Collapse
|
20
|
van Ockenburg SL, Bos EH, de Jonge P, van der Harst P, Gans ROB, Rosmalen JGM. Stressful life events and leukocyte telomere attrition in adulthood: a prospective population-based cohort study. Psychol Med 2015; 45:2975-2984. [PMID: 26219269 DOI: 10.1017/s0033291715000914] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Telomere attrition might be one of the mechanisms through which psychosocial stress leads to somatic disease. To date it is unknown if exposure to adverse life events in adulthood is associated with telomere shortening prospectively. In the current study we investigated whether life events are associated with shortening of telomere length (TL). METHOD Participants were 1094 adults (mean age 53.1, range 33-79 years) from the PREVEND cohort. Data were collected at baseline (T1) and at two follow-up visits after 4 years (T2) and 6 years (T3). Life events were assessed with an adjusted version of the List of Threatening Events (LTE). TL was measured by monochrome multiplex quantitative PCR at T1, T2, and T3. A linear mixed model was used to assess the effect of recent life events on TL prospectively. Multivariable regression analyses were performed to assess whether the lifetime life events score or the score of life events experienced before the age of 12 predicted TL cross-sectionally. All final models were adjusted for age, sex, body mass index, presence of chronic diseases, frequency of sports, smoking status, and level of education. RESULTS Recent life events significantly predicted telomere attrition prospectively (B = -0.031, p = 0.007). We were not able to demonstrate a significant cross-sectional relationship between the lifetime LTE score and TL. Nor did we find exposure to adverse life events before the age of 12 to be associated with TL in adulthood. CONCLUSIONS Exposure to recent adverse life events in adulthood is associated with telomere attrition prospectively.
Collapse
Affiliation(s)
- S L van Ockenburg
- Interdisciplinary Center Psychopathology and Emotion regulation,University of Groningen,University Medical Center Groningen,The Netherlands
| | - E H Bos
- Interdisciplinary Center Psychopathology and Emotion regulation,University of Groningen,University Medical Center Groningen,The Netherlands
| | - P de Jonge
- Interdisciplinary Center Psychopathology and Emotion regulation,University of Groningen,University Medical Center Groningen,The Netherlands
| | - P van der Harst
- Department of Cardiology,University of Groningen,University Medical Center Groningen,The Netherlands
| | - R O B Gans
- Department of Internal Medicine,University of Groningen,University Medical Center Groningen,The Netherlands
| | - J G M Rosmalen
- Interdisciplinary Center Psychopathology and Emotion regulation,University of Groningen,University Medical Center Groningen,The Netherlands
| |
Collapse
|
21
|
Wardenaar KJ, Monden R, Conradi HJ, de Jonge P. Symptom-specific course trajectories and their determinants in primary care patients with Major Depressive Disorder: Evidence for two etiologically distinct prototypes. J Affect Disord 2015; 179:38-46. [PMID: 25845748 DOI: 10.1016/j.jad.2015.03.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND The course-heterogeneity of Major Depressive Disorder (MDD) hampers development of better prognostic models. Although latent class growth analyses (LCGA) have been used to explain course-heterogeneity, such analyses have failed to also account for symptom-heterogeneity of depressive symptoms. Therefore, the aim was to identify more specific data-driven subgroups based on patterns of course-trajectories on different depressive symptom domains. METHODS In primary care MDD patients (n=205), the presence of the MDD criterion symptoms was determined for each week during a year. Weekly 'mood/cognition' (MC) and 'somatic' (SOM) scores were computed and parallel processes-LCGA (PP-LCGA) was used to identify subgroups based on the course on these domains. The classes׳ associations with baseline predictors and 2-/3-year outcomes were investigated. RESULTS PP-LCGA identified four classes: quick recovery, persisting SOM, persisting MC, and persisting SOM+MC (chronic). Persisting SOM was specifically predicted by higher baseline somatic symptomatology and somatization, and was associated with more somatic depressive symptomatology at long-term follow-up. Persisting MC was specifically predicted by higher depressive severity, thinking insufficiencies, neuroticism, loneliness and lower self-esteem, and was associated with lower mental health related quality of life and more mood/cognitive depressive symptomatology at follow-up. LIMITATIONS The sample was small and contained only primary care MDD patients. The weekly depression assessments were collected retrospectively at 3-month intervals. CONCLUSIONS The results indicate that there are two specific prototypes of depression, characterized by either persisting MC or persisting SOM, which have different sets of associated prognostic factors and long-term outcomes, and could have different etiological mechanisms.
Collapse
Affiliation(s)
- K J Wardenaar
- University of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Centre Groningen (UMCG), Groningen, The Netherlands.
| | - R Monden
- University of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Centre Groningen (UMCG), Groningen, The Netherlands
| | - H J Conradi
- University of Amsterdam, Department of Clinical Psychology, The Netherlands
| | - P de Jonge
- University of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Centre Groningen (UMCG), Groningen, The Netherlands
| |
Collapse
|
22
|
van Ockenburg SL, Tak LM, Bakker SJL, Gans ROB, de Jonge P, Rosmalen JGM. Effects of adverse life events on heart rate variability, cortisol, and C-reactive protein. Acta Psychiatr Scand 2015; 131:40-50. [PMID: 24833194 DOI: 10.1111/acps.12286] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Our objective was to assess whether self-reported adverse life events during childhood or over the lifespan are associated with altered activity of the autonomic nervous system (ANS), the hypothalamic-pituitary-adrenal axis (HPA axis), and the immune system. METHOD This study was performed in a population-based cohort of 1094 adults aged 33-79 years, 46.3% male, average age 53 (SD 11.4). Two waves of data were collected at a 2-year interval, enabling replication of the analyses. Cumulative exposure to adverse life events was assessed by means of the List of Threatening Experiences. ANS function was assessed by spectral analysis of heart rate variability in the high-frequency band (HRV-HF). HPA axis function was assessed by 24-h urinary free cortisol (24-h UFC) excretion. Inflammation was assessed by high-sensitive C-reactive protein (hsCRP). RESULTS Multiple linear regression analyses did not reveal any significant associations, with the exception of one significant negative association between the lifetime score of adverse life events and HRV-HF β = -0.028; P = 0.037 at baseline, but not at follow up 2 years later. CONCLUSION In a large population-based cohort, adverse life events were not consistently associated with HRV-HF, 24-h UFC or (hsCRP).
Collapse
Affiliation(s)
- S L van Ockenburg
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | | | | | |
Collapse
|
23
|
Wardenaar KJ, van Loo HM, Cai T, Fava M, Gruber MJ, Li J, de Jonge P, Nierenberg AA, Petukhova MV, Rose S, Sampson NA, Schoevers RA, Wilcox MA, Alonso J, Bromet EJ, Bunting B, Florescu SE, Fukao A, Gureje O, Hu C, Huang YQ, Karam AN, Levinson D, Medina Mora ME, Posada-Villa J, Scott KM, Taib NI, Viana MC, Xavier M, Zarkov Z, Kessler RC. The effects of co-morbidity in defining major depression subtypes associated with long-term course and severity. Psychol Med 2014; 44:3289-3302. [PMID: 25066141 PMCID: PMC4180779 DOI: 10.1017/s0033291714000993] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although variation in the long-term course of major depressive disorder (MDD) is not strongly predicted by existing symptom subtype distinctions, recent research suggests that prediction can be improved by using machine learning methods. However, it is not known whether these distinctions can be refined by added information about co-morbid conditions. The current report presents results on this question. METHOD Data came from 8261 respondents with lifetime DSM-IV MDD in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Outcomes included four retrospectively reported measures of persistence/severity of course (years in episode; years in chronic episodes; hospitalization for MDD; disability due to MDD). Machine learning methods (regression tree analysis; lasso, ridge and elastic net penalized regression) followed by k-means cluster analysis were used to augment previously detected subtypes with information about prior co-morbidity to predict these outcomes. RESULTS Predicted values were strongly correlated across outcomes. Cluster analysis of predicted values found three clusters with consistently high, intermediate or low values. The high-risk cluster (32.4% of cases) accounted for 56.6-72.9% of high persistence, high chronicity, hospitalization and disability. This high-risk cluster had both higher sensitivity and likelihood ratio positive (LR+; relative proportions of cases in the high-risk cluster versus other clusters having the adverse outcomes) than in a parallel analysis that excluded measures of co-morbidity as predictors. CONCLUSIONS Although the results using the retrospective data reported here suggest that useful MDD subtyping distinctions can be made with machine learning and clustering across multiple indicators of illness persistence/severity, replication with prospective data is needed to confirm this preliminary conclusion.
Collapse
Affiliation(s)
- K J Wardenaar
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,The Netherlands
| | - H M van Loo
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,The Netherlands
| | - T Cai
- Department of Biostatistics,Harvard School of Public Health,Boston, MA,USA
| | - M Fava
- Department of Psychiatry,MGH Clinical Trials Network and Institute,Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA,USA
| | - M J Gruber
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - J Li
- Department of Biostatistics,Harvard School of Public Health,Boston, MA,USA
| | - P de Jonge
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,The Netherlands
| | - A A Nierenberg
- Depression Clinical and Research Program and the Bipolar Clinic and Research Program,Massachusetts General Hospital and Harvard Medical School,Boston, MA,USA
| | - M V Petukhova
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - S Rose
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - N A Sampson
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| | - R A Schoevers
- Department of Psychiatry,University of Groningen, University Medical Center Groningen,The Netherlands
| | - M A Wilcox
- Johnson & Johnson Pharmaceutical Research and Development,Titusville, NJ,USA
| | - J Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar,Pompeu Fabra University (UPF), andCIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona,Spain
| | - E J Bromet
- Department of Psychiatry and Behavioral Science, Stony Brook School of Medicine,State University of New York at Stony Brook,Stony Brook, NY,USA
| | - B Bunting
- Psychology Research Institute,University of Ulster,Londonderry,UK
| | - S E Florescu
- National School of Public Health,Management and Professional Development, Bucharest,Romania
| | - A Fukao
- Department of Public Health,Yamagata University School of Medicine,Japan
| | - O Gureje
- University College Hospital,Ibadan,Nigeria
| | - C Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital,Guangdong Province,People's Republic of China
| | - Y Q Huang
- Institute of Mental Health, Peking University,Beijing,People's Republic of China
| | - A N Karam
- Department of Psychiatry and Clinical Psychology,St George Hospital University Medical Center,Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School, andInstitute for Development Research Advocacy and Applied Care (IDRAAC), Beirut,Lebanon
| | - D Levinson
- Research and Planning,Mental Health Services,Ministry of Health, Jerusalem,Israel
| | - M E Medina Mora
- National Institute of Psychiatry,Calzada Mexico Xochimilco, Mexico City,Mexico
| | - J Posada-Villa
- Universidad Colegio Mayor de Cundinamarca,Bogota,Colombia
| | - K M Scott
- Department of Psychological Medicine,University of Otago,Dunedin,New Zealand
| | - N I Taib
- Mental Health Center-Duhok,Kurdistan Region,Iraq
| | - M C Viana
- Department of Social Medicine,Federal University of Espirito Santo,Vitoria,Brazil
| | - M Xavier
- Department of Mental Health,Universidade Nova de Lisboa,Lisbon,Portugal
| | - Z Zarkov
- National Center of Public Health and Analyses,Department of Mental Health, Sofia,Bulgaria
| | - R C Kessler
- Department of Health Care Policy,Harvard Medical School,Boston, MA,USA
| |
Collapse
|
24
|
de Miranda Azevedo R, Roest AM, Hoen PW, de Jonge P. Cognitive/affective and somatic/affective symptoms of depression in patients with heart disease and their association with cardiovascular prognosis: a meta-analysis. Psychol Med 2014; 44:2689-2703. [PMID: 24467963 DOI: 10.1017/s0033291714000063] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Several prospective longitudinal studies have suggested that somatic/affective depressive symptoms, but not cognitive/affective depressive symptoms, are related to prognosis in patients with heart disease, but findings have been inconsistent. The aim of this study was to investigate the association of cognitive/affective and somatic/affective symptoms of depression with cardiovascular prognosis in patients with heart disease using a meta-analytic perspective. METHOD A systematic search was performed in PubMed, EMBASE and PsycInfo. Thirteen prospective studies on symptom dimensions of depression and cardiovascular prognosis fulfilled the inclusion criteria, providing data on a total of 11,128 subjects. The risk estimates for each dimension of depressive symptoms, demographic and methodological variables were extracted from the included articles. RESULTS In least-adjusted analyses, both the somatic/affective [hazard ratio (HR) 1.30, 95% confidence interval (CI) 1.19-1.41, p < 0.001] and cognitive/affective (HR 1.07, 95% CI 1.00-1.15, p = 0.05) dimensions of depressive symptoms were associated with cardiovascular prognosis. In fully adjusted analyses, somatic/affective symptoms were significantly associated with adverse prognosis (HR 1.19, 95% CI 1.10-1.29, p < 0.001) but cognitive/affective symptoms were not (HR 1.04, 95% CI 0.97-1.12, p = 0.25). An increase of one standard deviation (±1 s.d.) in the scores of the somatic/affective dimension was associated with a 32% increased risk of adverse outcomes (HR 1.32, 95% CI 1.17-1.48, p < 0.001). CONCLUSIONS Somatic/affective depressive symptoms were more strongly and consistently associated with mortality and cardiovascular events in patients with heart disease compared with cognitive/affective symptoms. Future research should focus on the mechanisms by which somatic/affective depressive symptoms may affect cardiovascular prognosis.
Collapse
Affiliation(s)
- R de Miranda Azevedo
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| | - A M Roest
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| | - P W Hoen
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| | - P de Jonge
- Department of Psychiatry,University Medical Center Groningen, University of Groningen,The Netherlands
| |
Collapse
|
25
|
Bot M, Pouwer F, de Jonge P, Snoek F. Response to Kawada. Depressive symptoms and HbA1c in patients with Type 1 and Type 2 diabetes. Diabet Med 2014; 31:760-1. [PMID: 24612198 DOI: 10.1111/dme.12421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M Bot
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Centre, and GGZ inGeest, Amsterdam, the Netherlands
| | | | | | | |
Collapse
|
26
|
van Ockenburg SL, de Jonge P, van der Harst P, Ormel J, Rosmalen JGM. Does neuroticism make you old? Prospective associations between neuroticism and leukocyte telomere length. Psychol Med 2014; 44:723-729. [PMID: 23834823 DOI: 10.1017/s0033291713001657] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Telomere attrition, causing accelerated aging, might be one of the mechanisms through which neuroticism leads to somatic disease and increased all-cause mortality. In the current study we investigated whether neuroticism is prospectively associated with shorter telomere length (TL), a biological marker of aging. METHOD Participants were 3432 adults (mean age 52.9 years, range 32-79). Data were collected at baseline (T1) and at two follow-up visits after 4 years (T2) and 6 years (T3). Neuroticism was assessed using the 12-item neuroticism scale of the Revised Eysenck Personality Questionnaire (EPQ-R) at T2 and T3. TL was measured by a monochrome multiplex quantitative polymerase chain reaction (PCR) assay at T1, T2 and T3. A linear mixed model was used to assess whether neuroticism could predict TL prospectively after adjusting for age, sex, body mass index (BMI), frequency of sports, smoking status, presence of chronic diseases and level of education. RESULTS Neuroticism was a significant negative predictor of TL at follow-up (B = -0.004, p = 0.044) after adjusting for sex, age, baseline TL and various biological and lifestyle factors. CONCLUSIONS High neuroticism is significantly and prospectively associated with telomere attrition independent of lifestyle and other risk factors.
Collapse
Affiliation(s)
- S L van Ockenburg
- Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands
| | - P de Jonge
- Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands
| | - P van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - J Ormel
- Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands
| | - J G M Rosmalen
- Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, The Netherlands
| |
Collapse
|
27
|
Vink AC, Zuidersma M, Boersma F, de Jonge P, Zuidema SU, Slaets JPJ. The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia: a randomised controlled trial. Int J Geriatr Psychiatry 2013; 28:1031-8. [PMID: 23280604 DOI: 10.1002/gps.3924] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to compare the effects of music therapy with general recreational day activities in reducing agitation in people with dementia, residing in nursing home facilities. METHODS In a randomised controlled design, residents with dementia (n = 94) were allocated to either music therapy or recreational activities. Both music therapy and general activities were offered twice weekly for 4 months. Changes in agitation were measured with a modified Cohen-Mansfield Agitation Inventory (CMAI) at four intervals on each intervention day. A mixed model analysis was used to evaluate the effectiveness of music therapy, compared with general activities, on CMAI scores at 4 h after the intervention, controlled for CMAI scores at 1 h before the session and session number. RESULTS Data were analysed for 77 residents (43 randomised to music therapy and 34 to general activities). In both groups, the intervention resulted in a decrease in agitated behaviours from 1 h before to 4 h after each session. This decrease was somewhat greater in the music therapy group than in the general activities group, but this difference was statistically not significant (F = 2.885, p = 0.090) and disappeared completely after adjustment for Global Deterioration Scale stage (F = 1.500; p = 0.222). CONCLUSIONS Both music therapy and recreational activities lead to a short-term decrease in agitation, but there was no additional beneficial effect of music therapy over general activities. More research is required to provide insight in the effects of music therapy in reducing agitation in demented older people.
Collapse
Affiliation(s)
- A C Vink
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Music Therapy, ArtEZ School of Music, Enschede, The Netherlands; KenVaK Research Centre Art Therapies, The Netherlands
| | | | | | | | | | | |
Collapse
|
28
|
Stavrakakis N, Roest AM, Verhulst F, Ormel J, de Jonge P, Oldehinkel AJ. Physical activity and onset of depression in adolescents: a prospective study in the general population cohort TRAILS. J Psychiatr Res 2013; 47:1304-8. [PMID: 23820109 DOI: 10.1016/j.jpsychires.2013.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/30/2013] [Accepted: 06/05/2013] [Indexed: 11/19/2022]
Abstract
Although it has often been suggested that physical activity and depression are intertwined, only few studies have investigated whether specific aspects of physical activity predict the incidence of major depression in adolescents from the general population. Therefore the aim of this study was to investigate the effects of nature, frequency, duration and intensity of physical activity during early adolescence on the onset of a major depressive episode in early adulthood. In a population sample of adolescents (N = 1396), various aspects of physical activity were assessed at early adolescence (mean age 13.02, SD = 0.61). Major depressive episode onset was assessed using the Composite International Diagnostic Interview. A Cox regression model was performed to investigate whether physical activity characteristics and their interactions with gender predicted a major depressive episode onset up until mean age 18.5 (SD = 0.61). The individual characteristics of physical activity (nature, frequency, duration and intensity) or their interactions with gender did not predict a major depressive episode onset (p values >0.05). So far, there is no prospective evidence that physical activity protects against the development of adolescent depressive episodes in either boys or girls.
Collapse
Affiliation(s)
- N Stavrakakis
- Interdisciplinary Centre Psychopathology and Emotion Regulation and Groningen Graduate School Medical Sciences, Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
| | | | | | | | | | | |
Collapse
|
29
|
Meijer A, Conradi HJ, Bos EH, Anselmino M, Carney RM, Denollet J, Doyle F, Freedland KE, Grace SL, Hosseini SH, Lane DA, Pilote L, Parakh K, Rafanelli C, Sato H, Steeds RP, Welin C, de Jonge P. Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: individual patient data meta-analysis. Br J Psychiatry 2013; 203:90-102. [PMID: 23908341 DOI: 10.1192/bjp.bp.112.111195] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity. AIMS To combine original data from studies on the association between post-infarction depression and prognosis into one database, and to investigate to what extent such depression predicts prognosis independently of disease severity. METHOD An individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses. RESULTS Sixteen studies participated, creating a database of 10 175 post-infarction cases. Hazard ratios for post-infarction depression were 1.32 (95% CI 1.26-1.38, P<0.001) for all-cause mortality and 1.19 (95% CI 1.14-1.24, P<0.001) for cardiovascular events. Hazard ratios adjusted for disease severity were attenuated by 28% and 25% respectively. CONCLUSIONS The association between depression following myocardial infarction and prognosis is attenuated after adjustment for cardiac disease severity. Still, depression remains independently associated with prognosis, with a 22% increased risk of all-cause mortality and a 13% increased risk of cardiovascular events per standard deviation in depression z-score.
Collapse
Affiliation(s)
- A Meijer
- Interdisciplinary Centre for Psychiatric Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Lamers F, Vogelzangs N, Merikangas KR, de Jonge P, Beekman ATF, Penninx BWJH. Evidence for a differential role of HPA-axis function, inflammation and metabolic syndrome in melancholic versus atypical depression. Mol Psychiatry 2013; 18:692-9. [PMID: 23089630 DOI: 10.1038/mp.2012.144] [Citation(s) in RCA: 474] [Impact Index Per Article: 43.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis and the inflammatory response system have been suggested as pathophysiological mechanisms implicated in the etiology of major depressive disorder (MDD). Although meta-analyses do confirm associations between depression and these biological systems, effect sizes vary greatly among individual studies. A potentially important factor explaining variability is heterogeneity of MDD. Aim of this study was to evaluate the association between depressive subtypes (based on latent class analysis) and biological measures. Data from 776 persons from the Netherlands Study of Depression and Anxiety, including 111 chronic depressed persons with melancholic depression, 122 with atypical depression and 543 controls were analyzed. Inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor-α), metabolic syndrome components, body mass index (BMI), saliva cortisol awakening curves (area under the curve with respect to the ground (AUCg) and with respect to the increase (AUCi)), and diurnal cortisol slope were compared among groups. Persons with melancholic depression had a higher AUCg and higher diurnal slope compared with persons with atypical depression and with controls. Persons with atypical depression had significantly higher levels of inflammatory markers, BMI, waist circumference and triglycerides, and lower high-density lipid cholesterol than persons with melancholic depression and controls. This study confirms that chronic forms of the two major subtypes of depression are associated with different biological correlates with inflammatory and metabolic dysregulation in atypical depression and HPA-axis hyperactivity in melancholic depression. The data provide further evidence that chronic forms of depressive subtypes differ not only in their symptom presentation, but also in their biological correlates. These findings have important implications for future research on pathophysiological pathways of depression and treatment.
Collapse
Affiliation(s)
- F Lamers
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-3720, USA.
| | | | | | | | | | | |
Collapse
|
31
|
Shahly V, Chatterji S, Gruber MJ, Al-Hamzawi A, Alonso J, Andrade LH, Angermeyer MC, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, Hinkov HR, Hu C, Karam EG, Lépine JP, Levinson D, Medina-Mora ME, Posada-Villa J, Sampson NA, Trivedi J, Viana MC, Kessler RC. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. Psychol Med 2013; 43:865-879. [PMID: 22877824 PMCID: PMC4045502 DOI: 10.1017/s0033291712001468] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition. RESULTS Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4% money, while 24.4-30.6% felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle-income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. CONCLUSIONS Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries.
Collapse
Affiliation(s)
- V. Shahly
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | | | - M. J. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - A. Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L. H. Andrade
- Section of Psychiatric Epidemiology, Sãu Paulo, Brazil
| | | | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - B. Bunting
- University of Ulster, Londonderry, Northern Ireland, United Kingdom
| | - J. M. Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisbon, Portugal
| | - G. de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - P. de Jonge
- University Medical Center Groningen, Groningen, Netherlands
| | - S. Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - H. R. Hinkov
- National Center for Public Health Protection, Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, People’s Republic of China
| | - E. G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon
| | - J.-P. Lépine
- Hôpital Lariboisiére Fernand Widal, Paris, France
| | - D. Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - M. E. Medina-Mora
- Instituto Nacional de Psiquiatria Ramon de La Fuente Muñiz, Mexico City, Mexico
| | | | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - J.K. Trivedi
- Department of Psychiatry, C.S.M. Medical University, Lucknow, India
| | - M. C. Viana
- Department of Social Medicine, Center for Health Sciences, Vitória, Spain
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
32
|
Hoen PW, Rosmalen JGM, Schoevers RA, Huzen J, van der Harst P, de Jonge P. Association between anxiety but not depressive disorders and leukocyte telomere length after 2 years of follow-up in a population-based sample. Psychol Med 2013; 43:689-697. [PMID: 22877856 DOI: 10.1017/s0033291712001766] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Telomere length is considered an emerging marker of biological aging. Depression and anxiety are associated with excess mortality risk but the mechanisms remain obscure. Telomere length might be involved because it is associated with psychological distress and mortality. The aim of this study was to test whether anxiety and depressive disorders predict telomere length over time in a large population-based sample. Method All analyses were performed in a longitudinal study in a general population cohort of 974 participants. The Composite International Diagnostic Interview (CIDI) was used to measure the presence of anxiety and depressive disorders. Telomere length was measured using monochrome multiplex polymerase chain reaction (PCR) at approximately 2 years of follow-up. We used linear multivariable regression models to evaluate the association between anxiety and depressive disorders and telomere length, adjusting for adverse life events, lifestyle factors, educational level and antidepressant use. RESULTS The presence of anxiety disorders predicted shorter telomeres at follow-up (β = -0.073, t = -2.302, p = 0.022). This association was similar after controlling for adverse life events, lifestyle factors, educational level and antidepressant use (β = -0.077, t = -2.144, p = 0.032). No association was found between depressive disorders and shorter telomeres at follow-up (β = 0.010, t = 0.315, p = 0.753). CONCLUSIONS This study found that anxiety disorders predicted shorter telomere length at follow-up in a general population cohort. The association was not explained by adverse life events, lifestyle factors, educational level and antidepressant use. How anxiety disorders might lead to accelerated telomere shortening and whether this might be a mediator explaining the excess mortality risk associated with anxiety deserve further investigation.
Collapse
Affiliation(s)
- P W Hoen
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands.
| | | | | | | | | | | |
Collapse
|
33
|
Bot M, Pouwer F, de Jonge P, Tack CJ, Geelhoed-Duijvestijn PHLM, Snoek FJ. Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes. Diabet Med 2013. [PMID: 23181742 DOI: 10.1111/dme.12082] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIMS Depression is common in people with diabetes, and related to higher HbA(1c) levels. Depression, however, is a heterogeneous construct that involves a variety of symptoms. As little is known about the associations of individual depressive symptoms with HbA(1c), we explored these associations in outpatients with diabetes. METHODS The study was conducted in three tertiary diabetes clinics in the Netherlands. At baseline, the presence of the nine depressive symptoms that are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition was assessed with the nine-item Patient Health Questionnaire (PHQ-9). At baseline and after a 1-year follow-up, HbA(1c) was derived from the medical charts. RESULTS A total of 288 out of 646 subjects with diabetes (45%) reported one or more depressive symptom(s). Depressed mood (β = 0.11, P = 0.005), sleeping difficulties (β = 0.16, P < 0.001), appetite problems (β = 0.15, P < 0.001) and suicidal ideation (β = 0.14, P = 0.001) were significantly related to higher baseline HbA(1c) values. Furthermore, depressed mood (β = 0.09, P = 0.03) sleeping difficulties (β = 0.12, P = 0.004), appetite problems (β = 0.11, P = 0.01) and psychomotor agitation/retardation (β = 0.09, P = 0.04) were significantly related to higher HbA(1c) values at 1-year follow-up. Associations were more pronounced in Type 1 diabetes than in Type 2 diabetes. None of the depressive symptoms were related to change in HbA(1c) over time, except suicidal ideation. CONCLUSION In people with diabetes, several individual depressive symptoms were related to higher HbA(1c) levels. These associations persisted over time. More research is needed to investigate potential mechanistic pathways.
Collapse
Affiliation(s)
- M Bot
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | | | | | | | | | | |
Collapse
|
34
|
Stavrakakis N, Oldehinkel AJ, Nederhof E, Oude Voshaar RC, Verhulst FC, Ormel J, de Jonge P. Plasticity genes do not modify associations between physical activity and depressive symptoms. Health Psychol 2013; 32:785-92. [DOI: 10.1037/a0030111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
35
|
Rosmalen JGM, Bos EH, de Jonge P. Validation of the Long-term Difficulties Inventory (LDI) and the List of Threatening Experiences (LTE) as measures of stress in epidemiological population-based cohort studies. Psychol Med 2012; 42:2599-2608. [PMID: 22490940 DOI: 10.1017/s0033291712000608] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Stress questionnaires are included in many epidemiological cohort studies but the psychometric characteristics of these questionnaires are largely unknown. The aim of this study was to describe these characteristics for two short questionnaires measuring the lifetime and past year occurrence of stress: the List of Threatening Events (LTE) as a measure of acute stress and the Long-term Difficulties Inventory (LDI) as a measure of chronic stress. METHOD This study was performed in a general population cohort consisting of 588 females (53.7%) and 506 males (46.3%), with a mean age of 53.5 years (s.d.=11.3 years). Respondents completed the LTE and the LDI for the past year, and for the age categories of 0-12, 13-18, 19-39, 40-60, and >60 years. They also completed questionnaires on perceived stress, psychological distress (the General Health Questionnaire, GHQ-12), anxiety and depression (the Symptom Checklist, SCL-8) and neuroticism (the Eysenck Personality Questionnaire - Revised Short Scale, EPQ-RSS-N). Approximately 2 years later, 976 respondents (89%) completed these questionnaires for a second time. RESULTS The stability of the retrospective reporting of long-term difficulties and life events was satisfactory: 0.7 for the lifetime LDI and 0.6 for the lifetime LTE scores. The construct validity of these lists is indicated by their positive associations with psychological distress, mental health problems and neuroticism. CONCLUSIONS This study in a large population-based sample shows that the LDI and LTE have sufficient validity and stability to include them in major epidemiological cohort studies.
Collapse
Affiliation(s)
- J G M Rosmalen
- Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands.
| | | | | |
Collapse
|
36
|
Abstract
BACKGROUND Identifying depressive subtypes is an important tool in reducing the heterogeneity of major depressive disorder. However, few studies have examined the stability of putative subtypes of depression over time. METHOD The sample included 488 persons from the Netherlands Study of Depression and Anxiety (NESDA) who had major depressive disorder at baseline and at the 2-year follow-up assessment. A latent transition analysis (LTA) was applied to examine the stability of depressive subtypes across time-points. Differences in demographic, clinical, psychosocial and health correlates between subtypes were evaluated in a subsample of persons with stable subtypes. RESULTS Three subtypes were identified at each time-point: a moderate subtype (prevalence T0 39%, T1 42%), a severe typical subtype (T0 30%, T1 25%), and a severe atypical subtype (T0 31%, T1 34%). The LTA showed 76% stability across the 2-year follow-up, with the greatest stability in the severe atypical class (79%). Analyses of correlates in the stable subtypes showed a predominance of women and more overweight and obesity in the severe atypical subtype, and a greater number of negative life events and higher neuroticism and functioning scores in the severe typical subtype. CONCLUSIONS Subtypes of major depressive disorder were found to be stable across a 2-year follow-up and to have distinct determinants, supporting the notion that the identified subtypes are clinically meaningful.
Collapse
Affiliation(s)
- F Lamers
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-3720, USA.
| | | | | | | | | | | |
Collapse
|
37
|
Hoenders R, Bos E, de Jonge P. P02.12. Temporal dynamics of symptom and treatment variables in a lifestyle-oriented approach to anxiety disorder: a single-subject time-series analysis. Altern Ther Health Med 2012. [PMCID: PMC3373822 DOI: 10.1186/1472-6882-12-s1-p68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
38
|
Zuidersma M, Ormel J, Conradi HJ, de Jonge P. An increase in depressive symptoms after myocardial infarction predicts new cardiac events irrespective of depressive symptoms before myocardial infarction. Psychol Med 2012; 42:683-693. [PMID: 22571951 DOI: 10.1017/s0033291711001784] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Depression after myocardial infarction (MI) is associated with poor cardiovascular prognosis. There is some evidence that specifically depressive episodes that develop after the acute event are associated with poor cardiovascular prognosis. The aim of the present study was to evaluate whether an increase in the number of depressive symptoms after MI is associated with new cardiac events. METHOD In 442 depressed and 325 non-depressed MI patients the Composite International Diagnostic Interview interview to assess post-MI depression was extended to evaluate the presence of the ICD-10 depressive symptoms just before and after the MI. The effect of an increase in number of depressive symptoms during the year following MI on new cardiac events up to 2.5 years post-MI was assessed with Cox regression analyses. RESULTS Each additional increase of one symptom was significantly associated with a 15% increased risk of new cardiac events, and this was stronger for non-depressed than for depressed patients. This association was independent of baseline cardiac disease severity. There was no interaction with the number of depressive symptoms pre-MI. CONCLUSIONS Our findings suggest that an increase in depressive symptoms after MI irrespective of the state of depression pre-MI explains why post-MI depression is associated with poor cardiovascular prognosis. Also increases in depressive symptoms after MI resulting in subthreshold depression should be evaluated as a prognostic marker. Whether potential mechanisms such as cardiac disease severity or inflammation underlie the association remains to be clarified.
Collapse
Affiliation(s)
- M Zuidersma
- Department of Psychiatry, University of Groningen, Groningen, the Netherlands.
| | | | | | | |
Collapse
|
39
|
Tulner DM, Smith ORF, Schins A, de Jonge P, Quere M, Delanghe JR, Crijns HJ, den Boer JA, Korf J, Honig A. Antidepressive effect of mirtazapine in post-myocardial infarction depression is associated with soluble TNF-R1 increase: data from the MIND-IT. Neuropsychobiology 2011; 63:169-76. [PMID: 21228609 DOI: 10.1159/000321624] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 09/27/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depressive disorder after myocardial infarction (MI) is associated with increased cardiac morbidity and mortality. Immune activity such as inflammation might be implicated as an underlying mechanism. The purpose of this study is to investigate whether the response to an antidepressant in post-MI depression is associated with changes of inflammatory markers in serum. METHODS In a double-blind placebo-controlled study with mirtazapine 30 mg/day (50 patients), the antidepressive effect was related to immune activation parameters. The cytokines interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α), the soluble cytokine receptors sIL-6R, sTNF-R1 and sTNF-R2, and the inflammation-sensitive plasma proteins C-reactive protein and neopterin were assessed. RESULTS Subgroup analyses revealed a highly significant correlation of pronounced sTNF-R1 increase with a decrease in depressive symptoms in antidepressant responders. CONCLUSION Significant effects on inflammation accompany the therapeutic efficacy of mirtazapine in contrast to the therapeutic efficacy of placebo and the nontherapeutic efficacy of mirtazapine.
Collapse
Affiliation(s)
- D M Tulner
- Department of Psychiatry, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
BACKGROUND The aim of this study was to develop empirically validated criteria for the diagnoses of clinically relevant somatization. METHOD This study was performed in a population-representative cohort consisting of 461 males (47.8%) and 503 females (52.2%), with an average age of 55.8 years (s.d.=11.1). Somatization, anxiety and depression were derived from the Composite International Diagnostic Interview. Mplus was used to perform confirmative factor analyses on the current DSM-IV symptom groups; on alternative symptom clusters previously suggested; and to perform latent class analysis in order to define an empirically derived cut-off for somatization. RESULTS The existence of symptom groups as described in DSM-IV was not supported by our data, whereas a differentiation between cardiopulmonary, musculoskeletal, gastrointestinal and general somatic symptoms did fit our data. Latent class analysis revealed two classes characterized by few (n=859) and many (n=105) symptoms. The class of subjects could be approached by a simple cut-off of four functional symptoms (sensitivity 79%, specificity 98%, positive predictive value 82%, negative predictive value 97%) regardless of the number of organ systems involved. CONCLUSIONS This study in a large population-representative cohort suggests that a simple symptom count can be used as a dimensional diagnosis of somatization. In those instances in which a categorical diagnosis is preferred, a simple cut-off of four out of 43 functional symptoms best fitted our data. We did not find any added value for incorporating the number of symptom clusters into the diagnostic criteria.
Collapse
|
41
|
Abstract
BACKGROUND Residual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular. METHOD In a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI). RESULTS In general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85-94% of the time during depressive episodes and 39-44% of the time during remissions. CONCLUSIONS Residual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.
Collapse
Affiliation(s)
- H J Conradi
- Department of Psychiatry, University of Groningen, The Netherlands.
| | | | | |
Collapse
|
42
|
Smith ORF, Kupper N, Denollet J, de Jonge P. Vital exhaustion and cardiovascular prognosis in myocardial infarction and heart failure: predictive power of different trajectories. Psychol Med 2011; 41:731-738. [PMID: 20553635 DOI: 10.1017/s0033291710001133] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We examined the different trajectories of vital exhaustion (VE) over a 12-month period and their impact on prognosis in a sample of myocardial infarction (MI) and chronic heart failure (CHF) patients. METHOD Consecutive MI (n=407) and CHF patients (n=297) were assessed at baseline, and at 3- and 12-month follow-up for symptoms of VE. Latent growth mixture modelling was used to examine the course of VE over time. The combined clinical endpoint was defined as cardiac hospital readmission or death. RESULTS Four distinct trajectories for VE were found: low VE, decreasing VE, increasing VE, and severe VE. Sex, marital status, left ventricular ejection fraction, psychotropic medication, sample group (CHF v. MI) and depressive symptoms were associated with VE, varying according to classes. The mean follow-up period was 25.3 months in which 34.7% of the patients experienced an event. Multivariate Cox regression showed that, compared with patients in the low VE class, patients in the increasing VE class [hazard ratio (HR)=1.16, 95% confidence interval (CI) 1.58-3.61, p=0.01], and the severe VE class (HR=1.69, 95% CI 1.31-2.64, p=0.02) had an increased risk for adverse cardiovascular events (i.e. cardiovascular hospital readmission or cardiovascular death). Decreasing VE was not related to adverse cardiovascular events (HR=0.97, 95% CI 0.66-1.69, p=0.81). CONCLUSIONS VE trajectories varied across cardiac patients, and had a differential effect on cardiovascular outcome. Increasing VE and severe VE classes were predictors of poor cardiovascular prognosis. These results suggest that identification of cardiac patients with an increased risk of adverse health outcomes should be based on multiple assessments of VE.
Collapse
Affiliation(s)
- O R F Smith
- CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | | | | | | |
Collapse
|
43
|
de Jonge P, Conradi HJ, Thombs BD, Rosmalen JGM, Burger H, Ormel J. Prevention of false positive findings in observational studies: registration will not work but replication might. J Epidemiol Community Health 2010; 65:95-6. [PMID: 21113013 DOI: 10.1136/jech.2010.125252] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
44
|
Bot M, Pouwer F, Assies J, Jansen EHJM, Diamant M, Snoek FJ, Beekman ATF, de Jonge P. Eicosapentaenoic acid as an add-on to antidepressant medication for co-morbid major depression in patients with diabetes mellitus: a randomized, double-blind placebo-controlled study. J Affect Disord 2010; 126:282-6. [PMID: 20466431 DOI: 10.1016/j.jad.2010.04.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 04/08/2010] [Accepted: 04/08/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression is common in individuals with diabetes. The present study is the first randomized controlled trial to test the efficacy of omega-3 ethyl-eicosapentaenoic acid (E-EPA) as adjuvant to antidepressant medication in the treatment of depression in adults with diabetes mellitus. METHODS In the VU University Medical Center, we conducted a 12-week, placebo-controlled, double-blind, parallel-group intervention study of E-EPA (1g/day) versus placebo in 25 diabetes patients meeting DSM-IV criteria for major depressive disorder, who were already using antidepressant medication. The primary outcome was severity of depressive symptoms, assessed by the Montgomery Asberg Depression Rating Scale (MADRS) at baseline and 12-week follow-up at two-weekly intervals. Blood samples were collected at baseline and at 12-week follow-up to determine EPA levels in erythrocyte membranes. Data were analyzed with ANOVA for repeated measures. RESULTS Thirteen participants were randomly assigned to E-EPA; 12 participants were given placebo. At 12-week follow-up, erythrocyte membranes from patients receiving E-EPA contained tripled levels of EPA, while no changes were noted in participants receiving placebo. In both groups, depressive symptoms significantly decreased over time (F=21.14, p<0.001), yet no significant differences were found between those treated with E-EPA versus placebo (F=1.63, p=0.17). LIMITATIONS Although having sufficient study power, this study had a relatively small sample size. Small effects could not be detected, and dose-dependent effects could not be studied. CONCLUSIONS No evidence was found for the efficacy of adding E-EPA to antidepressants in reducing depressive symptoms in diabetic patients with co-morbid depression.
Collapse
Affiliation(s)
- M Bot
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
BACKGROUND Individual symptoms of post-myocardial infarction (MI) depression may be differentially associated with cardiac prognosis, in which somatic/affective symptoms appear to be associated with a worse cardiovascular prognosis than cognitive/affective symptoms. These findings hold important implications for treatment but need to be replicated before conclusions regarding treatment can be drawn. We therefore examined the relationship between depressive symptom dimensions following MI and both disease severity and prospective cardiac prognosis. METHOD Patients (n=473) were assessed on demographic and clinical variables and completed the Beck Depression Inventory (BDI) within the first week of hospital admission for acute MI. Depressive symptom dimensions were associated with baseline left ventricular ejection fraction (LVEF) and prospective cardiac death and/or recurrent MI. The average follow-up period was 2.8 years. RESULTS Factor analysis revealed two symptom dimensions--somatic/affective and cognitive/affective--in the underlying structure of the BDI, identical to previous results. There were 49 events attributable to cardiac death (n=23) or recurrent MI (n=26). Somatic/affective (p=0.010) but not cognitive/affective (p=0.153) symptoms were associated with LVEF and cardiac death/recurrent MI. When controlling for the effects of previous MI and LVEF, somatic/affective symptoms remained significantly predictive of cardiac death/recurrent MI (hazard ratio 1.31, 95% confidence interval 1.02-1.69, p=0.038). Previous MI was also an independent predictor of cardiac death/recurrent MI. CONCLUSIONS We confirmed that somatic/affective, rather than cognitive/affective, symptoms of depression are associated with MI severity and cardiovascular prognosis. Interventions to improve cardiovascular prognosis by treating depression should be targeted at somatic aspects of depression.
Collapse
Affiliation(s)
- E J Martens
- Department of Medical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands.
| | | | | | | | | |
Collapse
|
46
|
Abstract
BACKGROUND To promote clinical application of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) system a shorter version (the mini-SCAN) was devised. Its psychometric properties were unknown. AIMS To establish the validity and practical properties of the mini-SCAN. METHOD One hundred and six participants were interviewed twice, once with the SCAN and once with the mini-SCAN. The level of agreement was established for the categories: no disorder, affective disorders, anxiety disorders, non-affective psychotic disorders, affective psychotic disorders. RESULTS The mini-SCAN is a valid instrument. Most kappa values were around 0.90. Only for the class of affective psychotic disorders was the agreement moderate. Mean duration of the mini-SCAN interviews was 25 min shorter than the SCAN interviews. Participants and interviewers were generally satisfied with the interview format and questions. CONCLUSIONS The mini-SCAN can be used as a diagnostic instrument for clinical purposes and for clinical studies when the present episode is the focus of attention.
Collapse
Affiliation(s)
- F J Nienhuis
- University Medical Centre Groningen, Department of Psychiatry, P.O. Box 30.01, 9700 RB Groningen, The Netherlands.
| | | | | | | | | |
Collapse
|
47
|
Denollet J, de Jonge P, Kuyper A, Schene AH, van Melle JP, Ormel J, Honig A. Depression and Type D personality represent different forms of distress in the Myocardial INfarction and Depression - Intervention Trial (MIND-IT). Psychol Med 2009; 39:749-756. [PMID: 18694538 DOI: 10.1017/s0033291708004157] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We investigated whether depressive disorder and Type D personality refer to different forms of distress in the Myocardial INfarction and Depression - Intervention Trial (MIND-IT). METHOD A total of 1205 myocardial infarction (MI) patients were screened at 3, 6, 9 and 12 months post-MI; those with a Beck Depression Inventory (BDI) score 10 underwent the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Patients completed the DS14 measure of Type D personality at 12 months and were stratified to one of four subgroups: depressed/Type D, depressed/non-Type D, non-depressed/Type D, or non-distressed. RESULTS Two hundred and six (17%) patients were diagnosed with depression and 224 (19%) with Type D. Only 7% (n=90) had both forms of distress, and 60% of Type D patients were free of depression in the first year post-MI. Type D moderated the relationship between depressive and cardiac disorder. Depressed patients without Type D had the worst clinical status (left ventricular dysfunction, heart failure, Killip class 2) as compared to other patients, whereas depressed patients with a Type D personality did not differ in clinical status from non-distressed patients. Contrasting 'pure' Type D and depression subgroups showed that Type D patients without depression were less likely to have left ventricular dysfunction [odds ratio (OR) 0.47, 95% confidence interval (CI) 0.35-0.65, p<0.0001] than depressed patients without Type D. CONCLUSIONS Depression and Type D refer to different forms of distress in post-MI patients; most Type D patients display non-psychiatric levels of distress and Type D moderates the relationship between depressive and cardiac disorder. Different depression/Type D subgroups may be involved in the prediction of cardiac prognosis.
Collapse
Affiliation(s)
- J Denollet
- CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
48
|
Martens EJ, de Jonge P. Developing depression after a myocardial infarction increases risk of cardiac mortality but pre-existing depression does not. Evidence-Based Mental Health 2009; 12:8. [DOI: 10.1136/ebmh.12.1.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
49
|
Buist-Bouwman MA, Ormel J, de Graaf R, de Jonge P, van Sonderen E, Alonso J, Bruffaerts R, Vollebergh WAM. Mediators of the association between depression and role functioning. Acta Psychiatr Scand 2008; 118:451-8. [PMID: 18853945 PMCID: PMC3659780 DOI: 10.1111/j.1600-0447.2008.01285.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE While the adverse effect of Major Depressive Episode on role functioning is well established, the exact pathways remain unclear. METHOD Data from The European Study of the Epidemiology of Mental Disorders, a cross-sectional survey including 21 425 adults from six European countries, were used to assess 12-month depression (Composite International Diagnostic Interview), activity limitations and role functioning in the past 30 days (Disability Assessment Schedule). An a priori model based on the World Health Organization's International Classification of Functioning, Disability and Health was designed and a structural equation model for categorical and ordinal data was used (MPlus) to estimate the extent to which six limitations mediated the association between depression and role functioning. RESULTS The unadjusted association between depression and role functioning was strong (0.43; SE = 0.04). In the best-fitting model, only concentration and attention problems and embarrassment mediated a significant amount of association (direct effect dropped to 0.17; SE = 0.10, which was no longer significant). CONCLUSIONS Targeting cognition and embarrassment in treatment could help reduce depression-associated role disfunctioning.
Collapse
Affiliation(s)
- M. A. Buist-Bouwman
- University Medical Center Groningen, University of Groningen,Graduate Research School of Behavior, Cognition and Neurosciences (BCN), University of Utrecht, the Netherlands,Netherlands Institute of Mental Health and Addiction, University of Utrecht, the Netherlands
| | - J. Ormel
- University Medical Center Groningen, University of Groningen,Graduate Research School of Behavior, Cognition and Neurosciences (BCN), University of Utrecht, the Netherlands
| | - R. de Graaf
- Netherlands Institute of Mental Health and Addiction, University of Utrecht, the Netherlands
| | - P. de Jonge
- University Medical Center Groningen, University of Groningen,Graduate Research School of Behavior, Cognition and Neurosciences (BCN), University of Utrecht, the Netherlands
| | - E. van Sonderen
- University Medical Center Groningen, University of Groningen,Northern Centre for Healthcare Research (NCH), University of Utrecht, the Netherlands
| | - J. Alonso
- Institut Municipal d’investigació Mèdica (IMIM), Spain
| | | | - W. A. M. Vollebergh
- Netherlands Institute of Mental Health and Addiction, University of Utrecht, the Netherlands,Faculty of Social and Behavioral Sciences, University of Utrecht, the Netherlands
| | | |
Collapse
|
50
|
Stiefel F, Zdrojewski C, Bel Hadj F, Boffa D, Dorogi Y, So A, Ruiz J, de Jonge P. Effects of a multifaceted psychiatric intervention targeted for the complex medically ill: a randomized controlled trial. Psychother Psychosom 2008; 77:247-56. [PMID: 18443391 DOI: 10.1159/000129658] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study evaluated a multifaceted psychiatric intervention targeted at the complex medically ill identified by means of the INTERMED, an instrument to assess case complexity. METHODS Of 885 rheumatology inpatients and diabetes outpatients who were assessed for eligibility, 247 were identified as complex (INTERMED score >20) and randomized to the intervention (n = 125, 84 rheumatology and 41 diabetes patients) or care as usual (n = 122, 78 rheumatology and 44 diabetes patients). For the majority of the cases the multifaceted intervention consisted of an intervention conducted by a psychiatric liaison nurse and/or of referral to a liaison psychiatrist, followed by advice to the treating physician or organization of a multidisciplinary case conference. Baseline and follow-up at months 3, 6, 9 and 12 measured prevalence of major depression (Mini-International Neuropsychiatric Interview), depressive symptoms (Center for Epidemiological Studies Depression Rating Scale), physical and mental health (SF-36), quality of life (EuroQol), health care utilization and HbA(1c) levels (diabetic patients). RESULTS Prevalence of major depression was reduced from 61% (T0) to 28% (T4) in the intervention group and remained stable in care as usual (57% at T0 to 50% at T4). Compared to care as usual, significant improvement over time was observed in the intervention group with regard to depressive symptoms (F = 11.9; p = 0.001), perception of physical (F = 5.7; p = 0.018) and mental health (F = 3.9; p = 0.047) and quality of life (F = 21.8; p < 0.001). Effects tended to be stronger in diabetes patients, in patients with baseline major depression and in patients with moderate INTERMED scores. Finally, hospital admissions occurred less often in the intervention group, reaching statistical significance for the period between 6 and 9 months of follow-up (p = 0.02). CONCLUSIONS The results suggest that a psychiatric intervention targeted for complex medical patients can improve health outcomes.
Collapse
Affiliation(s)
- F Stiefel
- Service de Psychiatrie de Liaison, University Hospital of Lausanne, Lausanne, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|