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Zuloaga DG, Lafrican JJ, Zuloaga KL. Androgen regulation of behavioral stress responses and the hypothalamic-pituitary-adrenal axis. Horm Behav 2024; 162:105528. [PMID: 38503191 PMCID: PMC11144109 DOI: 10.1016/j.yhbeh.2024.105528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/02/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
Testosterone is a powerful steroid hormone that can impact the brain and behavior in various ways, including regulating behavioral and neuroendocrine (hypothalamic-pituitary-adrenal (HPA) axis) stress responses. Early in life androgens can act to alter development of brain regions associated with stress regulation, which ultimately impacts the display of stress responses later in life. Adult circulating androgens can also influence the expression of distinct genes and proteins that regulate stress responses. These changes in the brain are hypothesized to underlie the potent effects of androgens in regulating behaviors related to stress and stress-induced activation of the HPA axis. Androgens can induce alterations in these functions through direct binding to the androgen receptor (AR) or following conversion to estrogens and subsequent binding to estrogen receptors including estrogen receptor alpha (ERα), beta (ERβ), and G protein-coupled estrogen receptor 1 (GPER1). In this review, we focus on the role of androgens in regulating behavioral and neuroendocrine stress responses at different stages of the lifespan and the sex hormone receptors involved in regulating these effects. We also review the specific brain regions and cell phenotypes upon which androgens are proposed to act to regulate stress responses with an emphasis on hypothalamic and extended amygdala subregions. This knowledge of androgen effects on these neural systems is critical for understanding how sex hormones regulate stress responses.
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Affiliation(s)
- Damian G Zuloaga
- Department of Psychology, University at Albany, Albany, NY, USA.
| | | | - Kristen L Zuloaga
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
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Al-Mamun F, Islam J, Muhit M, Mamun MA. Prevalence of emotional and behavioral problems among adolescents in Bangladesh. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02673-7. [PMID: 38684517 DOI: 10.1007/s00127-024-02673-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Emotional and behavioral problems among adolescents is a global concern. Previous studies conducted in Bangladesh have highlighted the importance to effectively prevent and address emotional and behavioral problems among adolescents to improve their psychological well-being. Despite these efforts, there remains limited research specifically addressing emotional and behavioral problems, conduct disorders, hyperactivity/attention disorders, and peer relationship problems among adolescents in Bangladesh in terms of age, gender, grade, and location. To address this knowledge gap, the present study aimed to comprehensively investigate the prevalence of emotional and behavioral problems among school-going adolescents in Bangladesh. METHODS The study employed a two-stage stratified cluster sampling technique to recruit a total of 1496 participants. The socio-demographic characteristics of the participants, such as age, gender, grade, location, birth order, family type, monthly family income, and parental education were collected. Emotional and behavioral problems were assessed using the Strength and Difficulties Questionnaire (SDQ), while the chi-square test and logistic regression were used to analyze the data with STATA software. RESULTS The prevalence of emotional disorder was 9.09% (7.73 - 10.65%). The rate was 21.72% (19.70 - 23.88%) for conduct disorder, 6.21% (5.09 - 7.55%) for hyperactivity, and for peer-relationship problem, the rate was 15.10% (13.37 - 17.01%) among adolescents. Overall, gender, grade, location, monthly family income, and parental education were significantly associated with emotional and behavioral problems. More specifically, adolescent girls (OR = 2.90 for the emotional disorder), grade (8th: OR = 2.07, 9th: OR = 1.95, for the emotional disorder), urban residents (OR = 2.46, for conduct disorder; OR = 2.29, for hyperactivity; OR = 2.03, for peer-relationship problem), poor monthly family income (OR = 2.84, for peer-relationship problem) significantly increased the risk of psychiatric morbidity. CONCLUSION The study highlights the need for school-based intervention programs to address adolescent emotional and behavioral problems. By targeting vulnerable individuals, these programs can effectively reduce mental health problems among adolescents.
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Affiliation(s)
- Firoj Al-Mamun
- Department of Public Health, University of South Asia, Dhaka, Bangladesh.
- CHINTA Research Bangladesh, Savar, 1342, Dhaka, Bangladesh.
- Department of Public Health & Informatics, Jahangirnagar University, Savar, 1342, Dhaka, Bangladesh.
| | - Johurul Islam
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
- CSF Global, Banani, 1213, Dhaka, Bangladesh
| | - Mohammad Muhit
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
- CSF Global, Banani, 1213, Dhaka, Bangladesh
| | - Mohammed A Mamun
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
- CHINTA Research Bangladesh, Savar, 1342, Dhaka, Bangladesh
- Department of Public Health & Informatics, Jahangirnagar University, Savar, 1342, Dhaka, Bangladesh
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Holley D, Campos LJ, Drzewiecki CM, Zhang Y, Capitanio JP, Fox AS. Rhesus infant nervous temperament predicts peri-adolescent central amygdala metabolism & behavioral inhibition measured by a machine-learning approach. Transl Psychiatry 2024; 14:148. [PMID: 38490997 PMCID: PMC10943234 DOI: 10.1038/s41398-024-02858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
Anxiety disorders affect millions of people worldwide and impair health, happiness, and productivity on a massive scale. Developmental research points to a connection between early-life behavioral inhibition and the eventual development of these disorders. Our group has previously shown that measures of behavioral inhibition in young rhesus monkeys (Macaca mulatta) predict anxiety-like behavior later in life. In recent years, clinical and basic researchers have implicated the central extended amygdala (EAc)-a neuroanatomical concept that includes the central nucleus of the amygdala (Ce) and the bed nucleus of the stria terminalis (BST)-as a key neural substrate for the expression of anxious and inhibited behavior. An improved understanding of how early-life behavioral inhibition relates to an increased lifetime risk of anxiety disorders-and how this relationship is mediated by alterations in the EAc-could lead to improved treatments and preventive strategies. In this study, we explored the relationships between infant behavioral inhibition and peri-adolescent defensive behavior and brain metabolism in 18 female rhesus monkeys. We coupled a mildly threatening behavioral assay with concurrent multimodal neuroimaging, and related those findings to various measures of infant temperament. To score the behavioral assay, we developed and validated UC-Freeze, a semi-automated machine-learning (ML) tool that uses unsupervised clustering to quantify freezing. Consistent with previous work, we found that heightened Ce metabolism predicted elevated defensive behavior (i.e., more freezing) in the presence of an unfamiliar human intruder. Although we found no link between infant-inhibited temperament and peri-adolescent EAc metabolism or defensive behavior, we did identify infant nervous temperament as a significant predictor of peri-adolescent defensive behavior. Our findings suggest a connection between infant nervous temperament and the eventual development of anxiety and depressive disorders. Moreover, our approach highlights the potential for ML tools to augment existing behavioral neuroscience methods.
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Affiliation(s)
- D Holley
- University of California, Department of Psychology, Davis, CA, USA
- California National Primate Research Center, Davis, CA, USA
| | - L J Campos
- University of California, Department of Psychology, Davis, CA, USA
- California National Primate Research Center, Davis, CA, USA
| | - C M Drzewiecki
- California National Primate Research Center, Davis, CA, USA
| | - Y Zhang
- Columbia University, Department of Statistics, New York, NY, USA
| | - J P Capitanio
- University of California, Department of Psychology, Davis, CA, USA
- California National Primate Research Center, Davis, CA, USA
| | - A S Fox
- University of California, Department of Psychology, Davis, CA, USA.
- California National Primate Research Center, Davis, CA, USA.
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Ho TC, Buthmann J, Chahal R, Miller JG, Gotlib IH. Exploring sex differences in trajectories of pubertal development and mental health following early adversity. Psychoneuroendocrinology 2024; 161:106944. [PMID: 38171040 PMCID: PMC10842731 DOI: 10.1016/j.psyneuen.2023.106944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
Despite evidence that early life adversity (ELA) affects mental health in adolescence, we know little about sex differences in how distinct dimensions of adversity affect development and their corresponding effects on mental health. In this three-wave longitudinal study, 209 participants (118 females; ages 9-13 years at baseline) provided objective (salivary hormones, BMI, age of menarche) and subjective (perceived gonadal and adrenal status) measures of puberty and physical development, and reported on levels of internalizing and externalizing symptoms at all timepoints. Participants also reported lifetime exposure to three distinct types of ELA: deprivation, threat, and unpredictability. Using generalized additive mixed models, we tested within each sex whether dimensions of adversity were associated with longitudinal changes in measures of pubertal and physical development, and whether these indices of development were associated with trajectories of internalizing and externalizing symptoms. In females, experiences of threat and unpredictability were significantly associated with earlier pubertal timing (e.g., age of menarche) whereas experiences of deprivation were associated with steeper increases in BMI; further, faster pubertal tempo (i.e., steeper increases in pubertal stage) was associated with increases in internalizing and externalizing symptoms. In males, however, ELA was not associated with any measures of pubertal or physical development or with symptoms. Together, our results suggest that adverse experiences during early life have sex-selective consequences for pubertal and physical maturation and mental health trajectories in ways that may elucidate why females are at higher risk for mental health difficulties during puberty, particularly following exposure to unpredictable and threatening experiences of adversity.
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Affiliation(s)
- Tiffany C Ho
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jessica Buthmann
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Rajpreet Chahal
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Jonas G Miller
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, United States.
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5
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Fulfs T, Poulain T, Vogel M, Nenoff K, Kiess W. Associations between sleep problems and emotional/behavioural difficulties in healthy children and adolescents. BMC Pediatr 2024; 24:15. [PMID: 38183087 PMCID: PMC10768421 DOI: 10.1186/s12887-023-04487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/14/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study aimed to (1) characterise sleep disturbances and emotional/behavioural difficulties among healthy German children and adolescents aged 3 to 13 years, (2) examine the association between parent-reported sleep problems and emotional/behavioural difficulties, (3) point out possible relations between specific kinds of sleep disturbances and different behavioural difficulties. METHODS Data were collected between 2011 and 2015 within the LIFE Child study in Germany. The sample included 1101 3- to 13-year-old children and adolescents. Information on sleep disturbances-assessed via the Children's Sleep Habits Questionnaire (CSHQ), emotional/behavioural difficulties-assessed via the Strengths and Difficulties Questionnaire (SDQ), and socioeconomic status was provided by participants' parents. Multiple regressions were applied to analyse the associations between general and specific sleep disturbances (independent variables) and emotional/behavioural difficulties (dependent variables). RESULTS The total CSHQ score was positively associated with the total SDQ score and all SDQ subscales (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems). Most of the CSHQ subscales were related to SDQ subscale scores, except for a few non-significant relations with hyperactivity/inattention and conduct problems. The CSHQ total score, daytime sleepiness, sleep duration and parasomnias showed the strongest associations with the SDQ total score. CONCLUSION This study confirms an association between children's and adolescents' sleep habits and psychological health. We were able to demonstrate the association between sleep problems and emotional/behavioural difficulties in a large sample of healthy participants. In particular, we observed a significant relation between parasomnias and hyperactive/inattentive behaviour as well as a significant association between emotional problems and sleep problems, especially daytime sleepiness, sleep anxiety and parasomnias.
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Affiliation(s)
- Theresa Fulfs
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Kolja Nenoff
- Medical Department for Hematology, Cell Therapy and Hemostaseology, Leipzig University, Liebigstrasse. 20/22, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
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Wright EC, Luo PX, Zakharenkov HC, Serna Godoy A, Lake AA, Prince ZD, Sekar S, Culkin HI, Ramirez AV, Dwyer T, Kapoor A, Corbett C, Tian L, Fox AS, Trainor BC. Sexual differentiation of neural mechanisms of stress sensitivity during puberty. Proc Natl Acad Sci U S A 2023; 120:e2306475120. [PMID: 37847733 PMCID: PMC10614610 DOI: 10.1073/pnas.2306475120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
Anxiety disorders are a major public health concern and current treatments are inadequate for many individuals. Anxiety is more common in women than men and this difference arises during puberty. Sex differences in physiological stress responses may contribute to this variability. During puberty, gonadal hormones shape brain structure and function, but the extent to which these changes affect stress sensitivity is unknown. We examined how pubertal androgens shape behavioral and neural responses to social stress in California mice (Peromyscus californicus), a model species for studying sex differences in stress responses. In adults, social defeat reduces social approach and increases social vigilance in females but not males. We show this sex difference is absent in juveniles, and that prepubertal castration sensitizes adult males to social defeat. Adult gonadectomy does not alter behavioral responses to defeat, indicating that gonadal hormones act during puberty to program behavioral responses to stress in adulthood. Calcium imaging in the medioventral bed nucleus of the stria terminalis (BNST) showed that social threats increased neural activity and that prepubertal castration generalized these responses to less threatening social contexts. These results support recent hypotheses that the BNST responds to immediate threats. Prepubertal treatment with the nonaromatizable androgen dihydrotestosterone acts in males and females to reduce the effects of defeat on social approach and vigilance in adults. These data indicate that activation of androgen receptors during puberty is critical for programming behavioral responses to stress in adulthood.
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Affiliation(s)
- Emily C. Wright
- Department of Psychology, University of California, Davis, CA95616
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA95616
| | - Pei X. Luo
- Department of Psychology, University of California, Davis, CA95616
| | | | | | - Alyssa A. Lake
- Department of Psychology, University of California, Davis, CA95616
| | - Zhana D. Prince
- Department of Psychology, University of California, Davis, CA95616
| | - Shwetha Sekar
- Department of Psychology, University of California, Davis, CA95616
| | - Hannah I. Culkin
- Department of Psychology, University of California, Davis, CA95616
| | | | - Tjien Dwyer
- Department of Psychology, University of California, Davis, CA95616
| | - Amita Kapoor
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI53715
| | - Cody Corbett
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI53715
| | - Lin Tian
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA95616
| | - Andrew S. Fox
- Department of Psychology, University of California, Davis, CA95616
- California National Primate Research Center, University of California, Davis, CA95616
| | - Brian C. Trainor
- Department of Psychology, University of California, Davis, CA95616
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Mohammadi S, Seyedmirzaei H, Salehi MA, Jahanshahi A, Zakavi SS, Dehghani Firouzabadi F, Yousem DM. Brain-based Sex Differences in Depression: A Systematic Review of Neuroimaging Studies. Brain Imaging Behav 2023; 17:541-569. [PMID: 37058182 PMCID: PMC10102695 DOI: 10.1007/s11682-023-00772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
Major depressive disorder (MDD) is a common psychiatric illness with a wide range of symptoms such as mood decline, loss of interest, and feelings of guilt and worthlessness. Women develop depression more often than men, and the diagnostic criteria for depression mainly rely on female patients' symptoms. By contrast, male depression usually manifests as anger attacks, aggression, substance use, and risk-taking behaviors. Various studies have focused on the neuroimaging findings in psychiatric disorders for a better understanding of their underlying mechanisms. With this review, we aimed to summarize the existing literature on the neuroimaging findings in depression, separated by male and female subjects. A search was conducted on PubMed and Scopus for magnetic resonance imaging (MRI), functional MRI (fMRI), and diffusion tensor imaging (DTI) studies of depression. After screening the search results, 15 MRI, 12 fMRI, and 4 DTI studies were included. Sex differences were mainly reflected in the following regions: 1) total brain, hippocampus, amygdala, habenula, anterior cingulate cortex, and corpus callosum volumes, 2) frontal and temporal gyri functions, along with functions of the caudate nucleus and prefrontal cortex, and 3) frontal fasciculi and frontal projections of corpus callosum microstructural alterations. Our review faces limitations such as small sample sizes and heterogeneity in populations and modalities. But in conclusion, it reflects the possible roles of sex-based hormonal and social factors in the depression pathophysiology.
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Affiliation(s)
- Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Jahanshahi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Sina Zakavi
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, USA.
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Bliddal M, Kildegaard H, Rasmussen L, Ernst M, Jennum PJ, Mogensen SH, Pottegård A, Wesselhoeft R. Melatonin use among children, adolescents, and young adults: a Danish nationwide drug utilization study. Eur Child Adolesc Psychiatry 2023; 32:2021-2029. [PMID: 35792937 DOI: 10.1007/s00787-022-02035-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
We aimed to provide a detailed description of the use of melatonin in Danish children, adolescents, and young adults during 2012-2019. We identified melatonin users 0-24 years of age (n = 43,652; median age 16 years) via the Danish nationwide health registers. Melatonin is a prescription drug in Denmark. The incidence of melatonin use increased from 2.4 to 3.9/1000 person-years during 2012 to 2019. Among 6,557 incident users in 2019, 53% filled only a single prescription within the first 6 months. Long-term use was most common among the younger age groups, with 17% of 5-9-year-olds and 14% of 10-13-year-olds being in continued treatment (no treatment breaks) 12 months after their first melatonin prescription. Disregarding treatment breaks, 3 in 10 were using melatonin 12 months after their first melatonin prescription and this proportion was also highest among 5-9-year-olds (63%) and 10-13-year-olds (51%). Psychopathology was common among melatonin users with 75% registered with either a psychiatric disorder diagnosis (54%), a filled prescription for another psychotropic (58%), or a contact to a private practice psychiatrist (15%) within ± 12 months of treatment initiation. General practitioners authorized melatonin prescriptions to almost half of all new users (48%), while psychiatric specialists authorized 37% of first prescriptions. In conclusion, the incidence of melatonin use increased in Denmark from 2012 to 2019. A substantial proportion of users had concurrent psychopathology most likely explaining their use of melatonin. Long-term melatonin use was more common among the youngest age groups, which should be a focus of interest due to limited safety data.
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Affiliation(s)
- Mette Bliddal
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Helene Kildegaard
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lotte Rasmussen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Martin Ernst
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Poul Jørgen Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, Denmark
| | | | - Anton Pottegård
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Rikke Wesselhoeft
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
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Panayiotou M, Finning K, Hennessey A, Ford T, Humphrey N. Longitudinal pathways between emotional difficulties and school absenteeism in middle childhood: Evidence from developmental cascades. Dev Psychopathol 2023; 35:1323-1334. [PMID: 34955109 DOI: 10.1017/s095457942100122x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emotional difficulties are associated with both authorized and unauthorized school absence, but there has been little longitudinal research and the temporal nature of these associations remains unclear. This study presents three-wave random-intercepts panel models of longitudinal reciprocal relationships between teacher-reported emotional difficulties and authorized and unauthorized school absence in 2,542 English children aged 6 to 9 years old at baseline, who were followed-up annually. Minor differences in the stability effects were observed between genders but only for the authorized absence model. Across all time points, children with greater emotional difficulties had more absences, and vice versa (authorized: ρ = .23-.29, p < .01; unauthorized: ρ = .28, p < .01). At the within-person level, concurrent associations showed that emotional difficulties were associated with greater authorized (β = .15-.17, p < .01) absence at Time 3 only, but with less unauthorized (β = -.08-.13, p < .05) absence at Times 1 and 2. In cross-lagged pathways, neither authorized nor unauthorized absence predicted later emotional difficulties, and emotional difficulties did not predict later authorized absence at any time point. However, greater emotional difficulties were associated with fewer unauthorized absences across time (β = -13-.22, p < .001). The implications of these findings are discussed.
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Affiliation(s)
| | | | | | | | - Neil Humphrey
- University of Manchester, Manchester Institute of Education, Manchester, UK
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10
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Olfson M, Wall M, Wang S, Blanco C. Prevalence and Correlates of Mental Disorders in Children Aged 9 and 10 Years: Results From the ABCD Study. J Am Acad Child Adolesc Psychiatry 2023:S0890-8567(23)00178-8. [PMID: 37062398 DOI: 10.1016/j.jaac.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/21/2022] [Accepted: 04/07/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE To estimate the prevalence of current DSM-5 disorders in children, ages 9 to 10 years, and their associations with sociodemographic and physical characteristics. METHOD In this analysis of the Adolescent Brain Cognitive Development (ABCD) first wave study data, current child mental disorders were based on the computerized parent version of the Kiddie Schedule for Affective Disorders and Schizophrenia for DSM-5 (N=11,874) supplemented with the child version for mood and selected anxiety disorders and with teacher Brief Problem Monitor ratings for the attention and externalizing scales. Child sociodemographic (race/ethnicity, nativity, parental marital status, parental education, family income) and physical characteristics (sex, pubertal stage, weight status, maternal age) were derived from parent report and anthropometric measurement. Odds ratios (OR) with 95% Confidence Intervals (95%CI) assessed associations with child mental disorders. RESULTS The prevalence of any current mental disorder was 10.11% including 11.48% among boys and 8.68% among girls. After controlling for several sociodemographic and physical characteristics, boys (OR=1.53; 95%CI=1.17-1.99), children from families with incomes below $25,000 (OR=2.05; 95%CI=1.31-3.22), incomes of $25,000-$49,000 (OR=1.90; 95%CI=1.20-3.00) ($75,000, reference) and obese children (OR=1.45, 95%CI=1.16-1.81) (healthy weight, reference) were at increased risk for any current child mental disorder. Children from the lowest family income group were at particularly high risk for ADHD (OR=3.86, 95%CI=1.69-8.79) and disruptive behavior behaviors (OR=4.13; 95%CI=1.86-9.15). CONCLUSION These patterns underscore the importance of strengthening service planning, preventive interventions, and etiological research focused on children from low income families.
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Affiliation(s)
- Mark Olfson
- College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York.
| | - Melanie Wall
- College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York
| | - Shuai Wang
- National Institute on Drug Abuse, Rockville, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
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11
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Turek J, Gąsior Ł. Estrogen fluctuations during the menopausal transition are a risk factor for depressive disorders. Pharmacol Rep 2023; 75:32-43. [PMID: 36639604 PMCID: PMC9889489 DOI: 10.1007/s43440-022-00444-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023]
Abstract
Women are significantly more likely to develop depression than men. Fluctuations in the ovarian estrogen hormone levels are closely linked with women's well-being. This narrative review discusses the available knowledge on the role of estrogen in modulating brain function and the correlation between changes in estrogen levels and the development of depression. Equally discussed are the possible mechanisms underlying these effects, including the role of estrogen in modulating brain-derived neurotrophic factor activity, serotonin neurotransmission, as well as the induction of inflammatory response and changes in metabolic activity, are discussed.
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Affiliation(s)
- Justyna Turek
- Department of Neurobiology, Maj Institute of Pharmacology Polish Academy of Sciences, Smetna 12 Street, 31-343 Krakow, Poland
| | - Łukasz Gąsior
- Department of Neurobiology, Maj Institute of Pharmacology Polish Academy of Sciences, Smetna 12 Street, 31-343 Krakow, Poland
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12
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Prevalence of pica and rumination behaviours in adults and associations with eating disorder and general psychopathology: findings form a population-based study. Epidemiol Psychiatr Sci 2022; 31:e40. [PMID: 35678377 PMCID: PMC9220787 DOI: 10.1017/s2045796022000208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
AIMS Pica and rumination disorder are known as feeding disorder diagnoses in childhood, but little is known about their occurrence in adulthood. This study aimed to assess prevalence rates of one-time and recurrent pica and rumination behaviours (PB and RB) in adults, including sociodemographic subgroups, and to examine associations with other eating disorder and general psychopathology. METHODS The representative population sample (N = 2403) completed measures on PB and RB, symptoms of avoidant/restrictive food intake disorder (ARFID), body image and symptoms of depression and anxiety. RESULTS Any PB and RB were reported in 5.33 and 5.49%, respectively, while recurrent PB or RB occurred in 1.08 and 0.71%, respectively. Co-occurrence was high, with 35.29% of recurrent PB in RB, and 23.08% vice versa. Prevalence rates of recurrent PB or RB did not differ by gender, weight status, educational or migration history from those without recurrent behaviours. Adults with v. without recurrent PB and RB showed more symptoms of ARFID, general eating disorders depression and anxiety, and behavioural symptoms of eating disorders (with the exception of compensatory behaviours in recurrent PB), and less positive body image. However, there were no differences regarding age and body mass index. CONCLUSIONS Our findings highlight the clinical significance of PB and RB in adults regarding both prevalence and associations with other psychopathological symptoms. In particular, associations with body image need to be investigated further, as in contrast to other eating disorders, body image disturbance is not yet represented in the diagnostic criteria for pica and rumination disorder. In sum, the findings highlight the need for clinical attention for these disorders and related behaviours in adults.
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13
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Familial clustering of birth risk for adverse childhood outcomes. J Perinatol 2022; 42:603-610. [PMID: 34795406 DOI: 10.1038/s41372-021-01264-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/21/2021] [Accepted: 10/28/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To identify classes of children exposed to distinct clusters of perinatal and familial risk factors at the time of birth, and examine relationships between class membership and a variety of adverse outcomes in childhood. DESIGN A prospective longitudinal study of children (and their parents) born between 2002 and 2004 and who have been followed-up until 12-13 years of age. A combination of latent class analysis and logistic regression analyses were used. RESULTS Adverse developmental, social, and mental health outcomes in early and middle childhood were greatest for children with 'pervasive familial risk' (i.e., parental mental illness, parental criminality, and perinatal risk factors) at the time of birth; some associations were stronger among girls. CONCLUSION Pervasive exposure to multiple risk factors in the pre- and perinatal period increases the risk of adverse outcomes in childhood. Future interventions should tailor strategies to address unique combinations of adverse risk exposures in vulnerable families.
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Khanal P, Ståhlberg T, Luntamo T, Gyllenberg D, Kronström K, Suominen A, Sourander A. Time trends in treated incidence, sociodemographic risk factors and comorbidities: a Finnish nationwide study on anxiety disorders. BMC Psychiatry 2022; 22:144. [PMID: 35193518 PMCID: PMC8864838 DOI: 10.1186/s12888-022-03743-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 01/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND There has been a lack of research about the time trends and socio-demographic risk factors for children and adolescents who receive treatment for anxiety disorders. This study aimed to fill these gaps in our knowledge by examining a nationwide sample of Finnish children and adolescents diagnosed in specialized healthcare settings. METHODS This study comprised national register data of all singleton children born in Finland from 1992-2006 who were diagnosed with anxiety disorders from 1998-2012. The changes in time trends in incidence were studied by dividing the study sample into three cohorts by birth years: 1992-1996, 1997-2001 and 2002-2006, who were followed up until the age of 20, 15 and 10 years, respectively. The 22,388 individuals with anxiety disorders were age and gender matched with 76,139 controls from the general population. Logistic regression was used to examine the socio-demographic risk factors and anxiety disorders in the entire sample. Comorbid disorders were examined in the oldest birth cohort (1992-1996 born). RESULTS Comparing the 1992-1996 and 2002-2006 cohorts showed that the cumulative incidence of treated anxiety disorders at the age of 10 increased from 0.3 to 1.2% among females and 0.46 to 1.9% among males. Subjects had higher likelihood for being diagnosed with an anxiety disorder if their mothers had low maternal socio-economic status class at birth (OR 1.53, 95% CI 1.45-1.61) compared to higher SES class, and marital status was single at the time of birth (OR 2.02, 95% CI 1.87-2.17) compared to married or in a relationship. They had lower risk of anxiety disorders diagnosis if born in rural (OR 0.82, 95% CI 0.79-0.86) or semi-urban areas (OR 0.79, 95% CI 0.76-0.82) when compared to urban residence. There was a wide range of psychiatric comorbidities, and unipolar depression was the most common (31.2%). CONCLUSION Anxiety disorders diagnosed by specialized Finnish services increased from 1998-2012 in both genders. This could indicate a real increase in overall anxiety disorders or an increase in treatment seeking. The findings on maternal socioeconomic status and single parenting improve the recognition of the environmental risk factors for anxiety disorders among children and adolescents.
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Affiliation(s)
- Prakash Khanal
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland. .,INVEST Research Flagship Center, University of Turku, Turku, Finland.
| | - Tiia Ståhlberg
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - Terhi Luntamo
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - David Gyllenberg
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.14758.3f0000 0001 1013 0499National Institute of Health and Welfare, Helsinki, Finland ,grid.15485.3d0000 0000 9950 5666Department of Adolescent Psychiatry, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland
| | - Kim Kronström
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland
| | - Andre Sourander
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship Center, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland
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15
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Piirtola M, Kaprio J, Baker TB, Piasecki TM, Piper ME, Korhonen T. The associations of smoking dependence motives with depression among daily smokers. Addiction 2021; 116:2162-2174. [PMID: 33629475 PMCID: PMC8274496 DOI: 10.1111/add.15390] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/16/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
AIMS To investigate how strongly smoking dependence and smoking dependence motives are associated with depressive symptoms among daily smokers and if these associations are independent of measured confounders and shared familial factors. DESIGN Cross-sectional individual-based and within-pair analyses. SETTING Fourth wave of the population-based Finnish Twin Cohort conducted in 2011. PARTICIPANTS 918 daily smokers born 1945-1957 (48% men), mean age 59.5 years including 38 twin pairs discordant for depression. MEASUREMENTS Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale with a cut off value ≥20 for depression. Smoking dependence was assessed using the Fagerström Test for Cigarette Dependence (FTCD) and smoking dependence motives with three subscales from the multi-dimensional Brief Wisconsin Inventory of Smoking Dependence Motives (WISDM): primary dependence motives (PDM), affective enhancement (AE), and Taste. Logistic regressions, using standardized scores of independent variables and adjusted for multiple confounders with correction for sampling as twin pairs, were used in the individual-based analyses. Conditional logistic regression was used to control for shared familial factors in discordant twin pairs. FINDINGS Prevalence of depression was 18% (n = 163: 61 [14%] in men, n = 102 [22%] in women). Higher smoking dependence measured by the FTCD (OR 1.45; 95% CI 1.20, 1.75), and dependence motives measured by the PDM (1.56; 1.30, 1.87) and the AE (1.54; 1.28, 1.85) were associated with higher odds of depression. The associations remained after adjusting for individual confounders, except for neuroticism, which attenuated all associations. FTCD, PDM, and AE showed associations with depression within depression-discordant monozygotic pairs, suggesting an association independent of familial factors. CONCLUSIONS Depression appears to be associated with smoking dependence and smoking dependence motives related to heavy, automatic use and use to regulate affective states. The associations appear to be confounded or mediated by neuroticism but are independent of shared familial influences.
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Affiliation(s)
- Maarit Piirtola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Po. Box 20, 20014 University of Helsinki, Helsinki, Finland
| | - Timothy B. Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Madison, WI 53711 -2059, United States
| | - Thomas M. Piasecki
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, United States
| | - Megan E. Piper
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Madison, WI 53711 -2059, United States
| | - Tellervo Korhonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland
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16
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Lei R, Sun Y, Liao J, Yuan Y, Sun L, Liu Y, Yang X, Ma W, Yu Z. Sex hormone levels in females of different ages suffering from depression. BMC WOMENS HEALTH 2021; 21:215. [PMID: 34022874 PMCID: PMC8141202 DOI: 10.1186/s12905-021-01350-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 05/09/2021] [Indexed: 11/15/2022]
Abstract
Background There are only a few studies on sex hormones in females of different ages suffering from depression, and their conclusions are not uniform until now. This study aimed to investigate the correlation between the severity of depression in females and factors such as sex hormones and differences in sex hormone levels in females of different ages, exploring variations after treatment. Methods A total of 169 females with depression were selected and divided into the first-episode (91 cases) and recurrent (78 cases) groups. Then, on the basis of their age, the first-episode patients were divided into the young (48 cases, age < 45 years), perimenopausal (20 cases, 45–55 years), and elderly groups (23 cases, age > 55 years); the patients with recurrent depression were classified into the young (37 cases, age < 45 years), perimenopausal (19 cases, 45–55 years), and elderly groups (22 cases, age > 55 years). The patients were assessed in accordance with the International Classification of Diseases of mental and behavioral disorders. The serum progesterone, prolactin, estradiol, and testosterone levels in the patients were measured, and differences in sex hormone levels of the groups were analyzed. Results The estradiol level was negatively correlated with age and the prolactin level was positively correlated with occupation. The severity of depression in females was found to be negatively correlated with age. The serum progesterone and estradiol levels in the young group were significantly higher than those in the elderly group, regardless of the first episode or recurrence. Estradiol levels in the perimenopausal and elderly groups with first-episode depression were significantly higher than those in the same group with recurrent depression. However, there was no significant difference in the serum progesterone, prolactin, estradiol, and testosterone levels in the recurrent group before and after treatment. Conclusions Sex hormone levels, especially estradiol, varied among females of different ages suffering from depression. Recurrent depression also has a certain effect on sex hormone levels in females. Not only should the age and relapse be considered when studying the sex hormone levels of females with depression, but also attention should be paid to whether the patients have used antidepressants before their sexual hormonal testing.
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Affiliation(s)
- Rong Lei
- Department of Adult Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Yan Sun
- Department of Clinical Psychology, Kailuan Mental Health Centre Affiliated to North China University of Science and Technology, Tangshan, China
| | - Jiawen Liao
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Yuan Yuan
- Department of Geriatric Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Linlin Sun
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Yugeng Liu
- Department of Mood Disorders, Tianjin Mental Health Centre, Tianjin, China
| | - Xinyu Yang
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Wenyou Ma
- Department of Clinical Psychology, Kailuan Mental Health Center Affiliated to North China University of Science and Technology, Tangshan, China.
| | - Zhenjian Yu
- Department of Clinical Psychology, Kailuan Mental Health Center Affiliated to North China University of Science and Technology, Tangshan, China.
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17
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Tang S, Werner-Seidler A, Torok M, Mackinnon AJ, Christensen H. The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. Clin Psychol Rev 2021; 86:102021. [PMID: 33798997 DOI: 10.1016/j.cpr.2021.102021] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/03/2021] [Accepted: 03/17/2021] [Indexed: 12/20/2022]
Abstract
An increase in time spent on screen-based technologies has been suggested to underlie recent increases in mental health problems among young people. However, this hypothesis has primarily been based on the findings of cross-sectional studies. The aim of the current review was to provide a comprehensive overview of longitudinal studies examining the relationship between screen time and internalising mental health symptoms. PsycINFO, PubMed/Medline and EMBASE were systematically searched for articles published up to August 2020. Thirty-five studies, with sample sizes ranging from 126 to 12,866 participants, met inclusion criteria. The association between screen time and subsequent depressive symptoms was found to be small to very small in size. There was limited evidence of any reverse association between depressive symptoms and subsequent screen time. The association between screen time and depressive symptoms varied between different devices and uses. In contrast to depressive symptoms, evidence to support longitudinal associations between screen time and other internalising mental health symptoms, including anxiety, self-esteem, and general internalising problems, was lacking. Together, these results suggest that the impact of increased screen time on the prevalence of mental health problems among young people is likely to be negligible or small. Further longitudinal studies that examine screen content and motivations underlying screen use are required to better discern any relationship between screen time and internalising mental health symptoms.
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Affiliation(s)
- Samantha Tang
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
| | | | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Andrew J Mackinnon
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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18
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Frederiksen LH, Bilenberg N, Andersen L, Henriksen N, Jørgensen J, Steinhausen HC, Wesselhoeft R. The validity of child and adolescent depression diagnoses in the Danish psychiatric central research register. Acta Psychiatr Scand 2021; 143:264-274. [PMID: 33216945 DOI: 10.1111/acps.13258] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examined the validity of childhood depression diagnoses in the Danish Psychiatric Central Research Register (DPCRR) and identified predictors of validity. METHODS A nationwide random sample of 500 children (6-17 years) diagnosed with depression between 1996 and 2016 was identified in the DPCRR. Psychiatric hospital records were reviewed and rated using an online checklist. The primary outcome was whether depressive symptoms and functional impairment documented in hospital records justified a depressive disorder diagnosis based on ICD-10 or DSM-5 diagnostic criteria. Diagnostic validity was calculated as the positive predictive value. Binary logistic regression analysis was used to identify potential predictors of diagnostic validity, and these were included in a multiple logistic regression. RESULTS Psychiatric hospital records were available for 393 patients (78.6%). The documentation in the records justified an ICD-10 depressive episode diagnosis in 72.8%, and DSM-5 major depressive disorder in 73.3% of the patients registered with a depression diagnosis. We identified three predictors of diagnostic validity: (i) The validity increased almost linearly from 2000 to 2016 (OR 1.14, 95% CI 1.07-1.20, p < 0.001), (ii) antidepressant use was associated with increased diagnostic validity (OR 2.27, 95% CI 1.35-3.82, p = 0.002) and (iii) emergency department admission predicted low diagnostic validity (OR 0.33, 95% CI 0.12-0.93, p = 0.036). CONCLUSION Childhood depression diagnoses registered in the DPCRR show a satisfactory validity according to both ICD-10 and DSM-5 diagnostic criteria. Diagnostic validity increased steadily from 2000 to 2016 and was positively correlated with antidepressant use. Depression diagnoses assigned in emergency departments had low diagnostic validity.
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Affiliation(s)
- Line Hofmann Frederiksen
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN, Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Lene Andersen
- Department of Child and Adolescent Mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Natasha Henriksen
- Department of Child and Adolescent Mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Jan Jørgensen
- Child and Adolescent Psychiatry, Private Practice, Odense, Denmark
| | - Hans-Christoph Steinhausen
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.,Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark.,Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, Zurich, Switzerland.,Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland
| | - Rikke Wesselhoeft
- Department of Child and Adolescent Mental Health Aabenraa, Mental Health Services in the Region of Southern Denmark, Aabenraa, Denmark.,Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Acceptability and Feasibility of Early Identification of Mental Health Difficulties in Primary Schools: A Qualitative Exploration of UK School Staff and Parents’ Perceptions. SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09398-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AbstractOne in eight children aged 5–19 years in the UK suffer from a psychiatric disorder, while fewer than 35% are identified and only 25% of children access mental health services. Whilst government policy states that primary schools are well-placed to spot the early warning signs of mental health issues in children, the implementation of early identification methods in schools remains under-researched. This study aims to increase understanding of the acceptability and feasibility of different early identification methods in this setting. Four primary schools in the East of England in the UK participated in a qualitative exploration of views about different methods that might enhance the early identification of mental health difficulties (MHDs). Twenty-seven staff and 20 parents took part in semi-structured interviews to explore current and future strategies for identifying pupils at risk of experiencing MHDs. We presented participants with four examples of identification methods selected from a systematic review of the literature: a curriculum-based approach delivered to pupils, staff training, universal screening, and selective screening. We used NVivo to thematically code and analyse the data, examining which models were perceived as acceptable and feasible as well as participants’ explanations for their beliefs. Three main themes were identified; benefits and facilitators; barriers and harms, and the need for a tailored approach to implementation. Parents and staff perceived staff training as the most acceptable and feasible approach to systematic identification, followed by a curriculum-based approach. Universal and selective screening garnered mixed responses. Findings suggest that a systematic and tailored approach to early identification would be most acceptable and feasible, taking into consideration school context. Teacher training should be a core component in all schools.
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20
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Tejerina‐Arreal M, Parker C, Paget A, Henley W, Logan S, Emond A, Ford T. Child and adolescent mental health trajectories in relation to exclusion from school from the Avon Longitudinal Study of Parents and Children. Child Adolesc Ment Health 2020; 25:217-223. [PMID: 32516500 PMCID: PMC7687195 DOI: 10.1111/camh.12367] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 12/05/2022]
Abstract
BACKGROUND As the prevalence of childhood mental health conditions varies by age and gender, we explored whether there were similar variations in the relationship between psychopathology and exclusion from school in a prospective UK population-based birth cohort. METHOD The Avon Longitudinal Study of Parents and Children collected reports of exclusion at 8 years and 16 years. Mental health was assessed at repeated time points using the Strengths and Difficulties Questionnaire (SDQ). RESULTS Using adjusted linear mixed effects models, we detected a nonlinear interaction between exclusion and age related to poor mental health for boys [adjusted coefficient 1.13 (95% confidence interval 0.55-1.71)] excluded by age 8, but not for girls. The SDQ scores of boys who were excluded in primary school were higher than their peers from age 3, and increasingly diverged over time. As teenagers, these interactions appeared for both genders [boys' adjusted coefficient 0.18 (0.10-0.27); girls 0.29 (0.17-0.40)]. For teenage girls, exclusion by 16 was followed by deteriorating mental health. Family adversity predicted exclusion in all analyses. CONCLUSION Prompt access to effective intervention for children in poor mental health may improve both mental health and access to education. KEY PRACTITIONER MESSAGE Children who were subsequently excluded from school often faced family adversity and had poor mental health, which suggests the need for an interdisciplinary response and a multiagency approach. Poor mental health may contribute to and result from exclusion from school, so both mental health and education practitioners have a key role to play. Boys who enter school with poor mental health are at high risk of exclusion in primary school, which prompt assessment and intervention may prevent. Both boys and girls who are excluded between the ages of 15 and 16 years may have poor, and in the case of girls, deteriorating, mental health.
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Affiliation(s)
| | - Claire Parker
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - William Henley
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Stuart Logan
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Alan Emond
- Bristol Medical SchoolUniversity of BristolBristolUK
| | - Tamsin Ford
- Department of PsychiatryUniversity of CambridgeCambridgeUK
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21
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Zinckernagel L, Ersbøll AK, Holmberg T, Pedersen SS, Timm HU, Zwisler AD. What are the prevalence and predictors of psychosocial healthcare among patients with heart disease? A nationwide population-based cohort study. BMJ Open 2020; 10:e037691. [PMID: 33040000 PMCID: PMC7549489 DOI: 10.1136/bmjopen-2020-037691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Psychosocial healthcare is recommended, but little is known about how patients perceive the level of care and whether subgroups of patients experience less psychosocial healthcare than others. We examined the prevalence of patient-reported psychosocial healthcare and factors predicting patient-reported lack of psychosocial healthcare among patients with heart disease. DESIGN A cohort study. SETTING Denmark, nationwide. PARTICIPANTS A registry-based random sample of 5000 patients with incident heart disease in 2013. MEASURES Patient-reported psychosocial healthcare was obtained from a survey and potential predictors before disease onset from registries. We used multivariable logistic regression analysis to determine predictors of patient-reported lack of care. RESULTS We received responses from 56%; 40% reported lacking information on psychosocial aspects, 51% lacking psychosocial rehabilitation and support and 32% reported lacking both types of psychosocial healthcare. The type of heart disease was the strongest predictor of patient-reported lack of psychosocial healthcare, especially among patients with atrial fibrillation (OR: 3.11-3.98). Older age (OR: 1.48-2.05), female gender (OR: 1.27-1.53) and no contact with general practitioner (OR: 1.47-1.84) also predicted patient-reported lack of psychosocial healthcare. Patients outside the labour force (OR: 1.29) and living in the capital region (OR: 1.50) more frequently reported lacking psychosocial rehabilitation and support, and patients with recent (OR: 1.63) or past (OR: 1.33) anxiety or depression and severe comorbidities (OR: 1.34) more frequently reported lacking both types of psychosocial healthcare. CONCLUSIONS Many patients with heart disease reported lacking psychosocial healthcare. Importantly, patients who most need psychosocial healthcare are not those who report receiving it. Our results call for action to translate guidelines into clinical practice.
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Affiliation(s)
- Line Zinckernagel
- The National Institute of Public Health, the University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, the University of Southern Denmark and Odense University Hospital, Nyborg, Denmark
| | - Annette Kjær Ersbøll
- The National Institute of Public Health, the University of Southern Denmark, Odense, Denmark
| | - Teresa Holmberg
- The National Institute of Public Health, the University of Southern Denmark, Odense, Denmark
| | - Susanne S Pedersen
- Department of Psychology, the University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Helle Ussing Timm
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, the University of Southern Denmark and Odense University Hospital, Nyborg, Denmark
| | - Ann-Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, the University of Southern Denmark and Odense University Hospital, Nyborg, Denmark
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22
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Frey M, Obermeier V, von Kries R, Schulte-Körne G. Age and sex specific incidence for depression from early childhood to adolescence: A 13-year longitudinal analysis of German health insurance data. J Psychiatr Res 2020; 129:17-23. [PMID: 32554228 DOI: 10.1016/j.jpsychires.2020.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Epidemiological studies indicate a disproportionate increase of depression incidence among adolescent girls, compared with boys. Since results regarding the age of onset of this sex difference are heterogeneous, this study aimed to investigate this difference on a large and representative sample. A second investigation sought to clarify whether there is a relevant sex difference in prepubertal onset of depression regarding the further course. METHODS Health insurance data of 6-18-year-old Barmer insured patients, representing a 7.9% sample of the German population born in 1999 (N = 61.199), were analyzed. The incidence of depression episodes (ICD-10 F32.x) was evaluated. Subsequently, the absolute and relative risk of a depression diagnosis (F32.x/F33.x) in early/late adolescence was analyzed based on the diagnosis of depression in primary school age in unstratified and stratified univariate analyses performed in SAS. RESULTS From 13 years of age, we found a significantly higher incidence of depressive disorders in girls than in boys. More than a fifth of the children with a depression diagnoses in primary school age had a depression relapse in early or late adolescence (early: 23.2%; 95% CI 19.6-26.9/late: 22.9%; 95% CI 19.3-26.5). Boys with depression in primary school age have a significantly higher relative risk for a depression relapse in late adolescence than girls (boys RR 4.2, 95% CI 3.3-5.2, girls RR: 2.1, 95% CI 1.7-2.7). LIMITATIONS The analysis is based on administrative data. Low sensitivity for depression in primary care setting and low service utilization leads to an underestimation of the incidence. CONCLUSIONS During puberty the risk for a first depressive episode increases more steeply in girls than in boys. Childhood depression has a high risk of relapse for both sexes, but is much more pronounced for boys.
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Affiliation(s)
- Michael Frey
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 5a, D-80336, Munich, Germany.
| | - Viola Obermeier
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Haydnstraße 5, D-80336, Munich, Germany.
| | - Rüdiger von Kries
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Haydnstraße 5, D-80336, Munich, Germany.
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 5a, D-80336, Munich, Germany.
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23
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Toth K, Samad L, Golden S, Johnston P, Hayes R, Ford T. What issues bring primary school children to counselling? A service evaluation of presenting issues across 291 schools working with Place2Be. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | - Rachel Hayes
- Institute of Health Research University of Exeter Medical School Exeter UK
| | - Tamsin Ford
- Department of Psychiatry University of Cambridge Cambridge UK
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24
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Wright EC, Hostinar CE, Trainor BC. Anxious to see you: Neuroendocrine mechanisms of social vigilance and anxiety during adolescence. Eur J Neurosci 2020; 52:2516-2529. [PMID: 31782841 PMCID: PMC7255921 DOI: 10.1111/ejn.14628] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 10/05/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022]
Abstract
Social vigilance is a behavioral strategy commonly used in adverse or changing social environments. In animals, a combination of avoidance and vigilance allows an individual to evade potentially dangerous confrontations while monitoring the social environment to identify favorable changes. However, prolonged use of this behavioral strategy in humans is associated with increased risk of anxiety disorders, a major burden for human health. Elucidating the mechanisms of social vigilance in animals could provide important clues for new treatment strategies for social anxiety. Importantly, during adolescence the prevalence of social anxiety increases significantly. We hypothesize that many of the actions typically characterized as anxiety behaviors begin to emerge during this time as strategies for navigating more complex social structures. Here, we consider how the social environment and the pubertal transition shape neural circuits that modulate social vigilance, focusing on the bed nucleus of the stria terminalis and prefrontal cortex. The emergence of gonadal hormone secretion during adolescence has important effects on the function and structure of these circuits, and may play a role in the emergence of a notable sex difference in anxiety rates across adolescence. However, the significance of these changes in the context of anxiety is still uncertain, as not enough studies are sufficiently powered to evaluate sex as a biological variable. We conclude that greater integration between human and animal models will aid the development of more effective strategies for treating social anxiety.
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Affiliation(s)
- Emily C Wright
- Department of Psychology, University of California, Davis, CA, USA
| | | | - Brian C Trainor
- Department of Psychology, University of California, Davis, CA, USA
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25
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Filatova S, Upadhyaya S, Kronström K, Suominen A, Chudal R, Luntamo T, Sourander A, Gyllenberg D. Time trends in the incidence of diagnosed depression among people aged 5-25 years living in Finland 1995-2012. Nord J Psychiatry 2019; 73:475-481. [PMID: 31443615 DOI: 10.1080/08039488.2019.1652342] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Knowledge of time trends for depression is important for disease prevention and healthcare planning. Only a few studies have addressed these questions regarding the incidence and cumulative incidence of diagnosed depression from childhood to early adulthood and findings have been inconclusive. Aim: The aim of this national register-based Finnish study was to report the time trends of the age-specific and gender-specific incidence and cumulative incidence of diagnosed depression. Methods: The study sample included all 1,245,502 singletons born in Finland between 1 January 1987 and 31 December 2007 and still living in Finland at the end of 2012. The participants were divided into three cohorts by birth year: 1987-1993, 1994-2000 and 2001-2007. Depression diagnoses (ICD-9: 2961; ICD-10: F32, F33) given in 1995-2012 were available and identified from the Care Register for Health Care. Results: Ten percent of the females and five percent of the males were diagnosed with depression in specialized services by age 25 years. The cumulative incidence of depression by age 15 years rose from 1.8% (95% CI 1.8-1.9) to 2.9% (95% CI 2.8-3.0) in females and from 1.0% (95% CI 1.1-1.2) to 1.6% (95% CI 1.6-1.7) in males when the cohorts born 1987-1993 and 1994-2000 were compared. Conclusions: A larger proportion of young people in Finland are diagnosed with depression in specialized services than before. This can be due to better identification, more positive attitudes to mental health problems and increased availability of the services.
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Affiliation(s)
- Svetlana Filatova
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Subina Upadhyaya
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Kim Kronström
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,Department of Adolescent Psychiatry, Turku University Hospital , Turku , Finland
| | - Auli Suominen
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,Turku University Hospital , Turku , Finland
| | - Roshan Chudal
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Terhi Luntamo
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,Turku University Hospital , Turku , Finland.,INVEST Research Flagship, University of Turku , Turku , Finland
| | - David Gyllenberg
- Research Centre for Child Psychiatry, University of Turku , Turku , Finland.,National Institute of Health and Welfare , Helsinki , Finland.,Department of Adolescent Psychiatry, Helsinki University Central Hospital, University of Helsinki , Helsinki , Finland
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26
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Yang J, Zhang S, Lou Y, Long Q, Liang Y, Xie S, Yuan J. The Increased Sex Differences in Susceptibility to Emotional Stimuli during Adolescence: An Event-Related Potential Study. Front Hum Neurosci 2018; 11:660. [PMID: 29375354 PMCID: PMC5770399 DOI: 10.3389/fnhum.2017.00660] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 12/22/2017] [Indexed: 12/24/2022] Open
Abstract
The present study investigated how pubertal development and sex interact to influence humans’ emotion susceptibility during adolescence. Event-related potentials were recorded for highly emotional, mildly emotional and neutral stimuli in positive and negative blocks, when 73 adolescents (36 pre-/early pubertal students, 19 boys, 10–12 years old; 37 mid-/late pubertal students, 18 boys, 11–13 years old) performed an implicit emotion task. Behavioral analysis showed higher positive mood ratings for pre-/early compared to mid-/late pubertal subjects, irrespective of sex and block. ERP analysis demonstrated increasing Late Positive Potential (LPP) amplitudes from neutral, Mildly Positive (MP) to Highly Positive (HP) stimuli in pre-/early pubertal, but not in mid-/late pubertal adolescents. However, girls exhibited higher P3a amplitudes during mid-/late relative to pre-/early puberty for negative stimuli irrespective of intensity; while this puberty effect was absent in boys. In addition, girls compared to boys exhibited a more pronounced LPP enhancement effect for Highly Negative (HN) stimuli and a lower threshold of responding to negative stimuli in P3b amplitudes, regardless of puberty. These results suggest that, though there is a puberty-independent sensitivity to negative stimuli in girls relative to boys, puberty selectively intensifies girls’ attention bias for negative stimuli and reduces experiential sensitivity to positive stimuli in both sexes. The implication of these results for the sex-related psychopathology during adolescence were discussed.
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Affiliation(s)
- Jiemin Yang
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Shu Zhang
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Yixue Lou
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Quanshan Long
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Yu Liang
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Shixue Xie
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiajin Yuan
- The Laboratory for Affect Cognition and Regulation (ACRLAB), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
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Skovlund CW, Kessing LV, Mørch LS, Lidegaard Ø. Increase in depression diagnoses and prescribed antidepressants among young girls. A national cohort study 2000-2013. Nord J Psychiatry 2017; 71:378-385. [PMID: 28362191 DOI: 10.1080/08039488.2017.1305445] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS To analyse trends in depression diagnoses and antidepressant use according to age and gender. METHODS Nationwide cohort study including all women and men of 10-49 years living in Denmark during 2000-2013. The Psychiatric Registry and Prescription Registry provided data on depression diagnoses and antidepressant medication, respectively. Incidence rates as well as 1-year prevalence rates were calculated. RESULTS The incidence and 1-year prevalence rates of depression diagnoses increased during 2000-2013. The women/men rates were 2.0 for both 1-year prevalence of depressions diagnoses and antidepressant use. For adolescent girls, the absolute increase was 3 per 1000 for depression diagnoses and 8 per 1000 for first use of antidepressants, compared to boys who had an increase of 1.1 and 3 per 1000, respectively. Before puberty, boys and girls had almost the same incidence rates of both depression diagnoses and antidepressant use throughout the period. After puberty, girls had significantly higher incidence rates than boys, and experienced during the study period a steeper increase than boys. According to age, the girls/boys incidence rate ratio of a depression diagnosis increased from 0.8 in the 10-11 year age group to 2.7 at age 12-19 years and hereafter decreased with increasing age to 1.5 at age 45-49. CONCLUSIONS Depression diagnosed and first use of antidepressants increased more for girls of 12-19 years than for boys during 2000-2013, and the incidences were similar for girls and boys before puberty, but higher after puberty for girls.
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Affiliation(s)
- Charlotte Wessel Skovlund
- a Department of Gynaecology, Rigshospitalet, Faculty of Health Science , University of Copenhagen , Denmark
| | - Lars Vedel Kessing
- b Psychiatric Centre, Rigshospitalet, Faculty of Health Science , University of Copenhagen , Denmark
| | - Lina Steinrud Mørch
- a Department of Gynaecology, Rigshospitalet, Faculty of Health Science , University of Copenhagen , Denmark
| | - Øjvind Lidegaard
- a Department of Gynaecology, Rigshospitalet, Faculty of Health Science , University of Copenhagen , Denmark
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28
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Hantsoo L, Epperson CN. Anxiety Disorders Among Women: A Female Lifespan Approach. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2017; 15:162-172. [PMID: 28966563 DOI: 10.1176/appi.focus.20160042] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Anxiety symptoms may present differently between women and men, and at different points in the female lifespan. The female lifespan includes distinct epochs of hormonal function, including puberty, the premenstruum, in some women pregnancy or postpartum, and the menopausal transition. These stages give rise to important treatment considerations when treating anxiety in women. When making assessments, the clinician should consider reproductive events and hormonal status, as well as sex differences in anxiety presentation. This review is structured to: 1) Define major epochs of the female lifespan, 2) Provide a brief summary of the major anxiety disorders, with a focus on prevalence and presentation in the context of sex differences and at points in the female lifespan, 3) Describe potential biopsychosocial underpinnings of anxiety disorders among women, 4) Provide guidelines for assessment and differential diagnosis, and 5) Describe treatment options with attention to reproductive events such as pregnancy.
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Affiliation(s)
- Liisa Hantsoo
- Clinical Psychologist & Instructor, Penn Center for Women's Behavioral Wellness, Perelman School of Medicine, University of Pennsylvania
| | - C Neill Epperson
- Professor of Psychiatry and Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania and Director of the Penn Center for Women's Behavioral Wellness and Penn PROMOTES Research on Sex and Gender in Health, Perelman School of Medicine, University of Pennsylvania
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29
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Major depressive disorder and subthreshold depression in prepubertal children from the Danish National Birth Cohort. Compr Psychiatry 2016; 70:65-76. [PMID: 27624424 DOI: 10.1016/j.comppsych.2016.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 11/21/2022] Open
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