Childhood family stress and adult resilience in a sample of depressed patients

BACKGROUND

The aim of this study is to explore the effect of childhood family stress on depression, personal, and social resilience in depressed patients.

METHODS

We assessed childhood family stress (RFQ), depression (BSI, depression subscale), and resilience (RSA) in 152 depressed patients, 70 males, and 82 females. We calculated the 33rd and 66th percentiles of RFQ scores to divide the sample among Low, Medium, and High RFQ subgroups. A one-way ANOVA has been carried out to explore the differences between the variables in the subgroups. Finally, two regression analyses with depression, as the dependent variable, and resilience, divided for stress-sensitive and no stress-sensitive factors as independent variables, have been implemented.

RESULTS

The one-way ANOVA showed that the Low subgroup had a positive profile, the Medium had an intermediate profile, while the High had a negative one for depression, personal (structured style and social competence), and interpersonal (social resources) resilience. The other factors (perception of self, planned future, and family cohesion) did not show differences in the subgroups, suggesting they are no stress sensitive. Regression analysis showed that no stress-sensitive factors have a constant and significant predictive value for depression in all subgroups; while, stress-sensitive ones showed a growing predictive value for depression from Low to Medium, but not in High, suggesting a ceiling effect.

LIMITATIONS

The use of self-report measures, the cross-sectional nature of the study, and the lack of a non-clinical and/or outpatient samples.

CONCLUSIONS

This study provides a contribution to the understanding of the effect of childhood family stress on adult resilience and depression.

[Usefulness of bile analysis collected via endoscopy in the diagnosis of microlithiasis and biliary sludge]

The search for cholesterol crystals in the bile, drawn during the endoscopy, represents a simple and reliable method in the diagnosis of the symptomatic biliary sludge. In our patients it was present in 82% of the cases. The injection of cholecystokinin appears to us absolutely necessary in order to obtain vesicular bile. The sensitiveness of abdominal sonography in the diagnosis of biliary sludge is weak, 13% of our cases. The clinical evolution with ursodeoxycholic acid treatment has been favourable in 83% of the treated patients.

Phase I study of the combination of monthly carboplatin and weekly cisplatin

Two cycles of the combination of carboplatin (C), given every 4 weeks with weekly doses of cisplatin (P), were administered on an outpatient basis to 28 previously untreated patients. One cycle consisted of one dose of C and 4 doses of P. The toxicity of 250 mg/m2 of C, combined with escalating doses of P (20, 30, 35, 40 mg/m2) was evaluated first. Thrombocytopenia was dose-limiting and cumulative. At the dose level of 40 mg/m2 of P, the median Pt nadirs during the first and second cycles were 190 (range: 44 to 232) x 10(3)/microL and 90 (range: 15 to 165) x 10(3)/microL, respectively. The median delivered dose intensity (DI) of P was 40 mg/m2/wk in the first cycle and 40 mg/m2/wk in the second cycle. In the second part of the study, 40 mg/m2 of P were combined with a C dose adapted to individual renal function according to the formula dose (mg) = AUC x (GFR + 25) where AUC = 4.5 mg/mL/min. The administration of doses of C ranging from 219 to 493 mg/m2 was associated with a more severe and more variable thrombocytopenia, more frequent P delays and decrease of the median delivered DI of P (first cycle: 33 mg/m2/wk; second cycle: 32 mg/m2/wk). At all dose levels, leukopenia was mild to moderate, and neurotoxicity and severe GI toxicity were absent. No significant reductions of the creatinine clearance values were observed. All patients treated at 40 mg/m2 of P suffered from cumulative subjective toxicity during the second month of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)