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Ahmed U, Lin JCW, Srivastava G. Graph Attention-Based Curriculum Learning for Mental Healthcare Classification. IEEE J Biomed Health Inform 2024; 28:2581-2591. [PMID: 37155396 DOI: 10.1109/jbhi.2023.3274486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Current research has examined the use of user-generated data from online media to identify and diagnose depression as a serious mental health issue that can significantly impact an individual's daily life. To this end, many studies examined words in personal statements to identify depression. In addition to aiding in the diagnosis and treatment of depression, this study uses and utilizes a Graph Attention Network (GAT) model for the classification of depression from online media. The model is based on masked self-attention layers, that assigns different weight to each node in a neighborhood without costly matrix operations. In addition, an emotion lexicon was extended using hypernyms to improve the model performance. Furthermore, embedding of the model was used to illustrate the contribution of the activated words to each symptom and to obtain qualitative agreement from psychiatrists. This technique uses previously learned embedding to illustrate the contribution of activated words to depressive symptoms in online forums. A significant improvement was observed in the model's performance through the use of the lexicon extension method, resulting in an increase in the ROC performance. The performance was also enhanced by an increase in vocabulary and the adoption of a graph-based curriculum. The lexicon expansion method involves the generation of additional words with similar semantic attributes, utilizing similarity metrics to reinforce lexical features. The graph-based curriculum learning also utilized to handle more challenging training samples, allowing the model to develop increasing expertise in learning complex correlations between input data and output labels.
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Hill C, de Beer LT, Bianchi R. Validation and measurement invariance of the Occupational Depression Inventory in South Africa. PLoS One 2021; 16:e0261271. [PMID: 34914772 PMCID: PMC8675679 DOI: 10.1371/journal.pone.0261271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/28/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to validate the recently developed Occupational Depression Inventory (ODI) in South Africa. A total of 327 employees (60% female) participated in the study. Bifactor exploratory structural equation modeling analysis indicated that the ODI can be considered essentially unidimensional. The ODI displayed strong scalability (e.g., scale-level H = 0.657). No monotonicity violation was detected. The reliability of the instrument, as indexed by Cronbach's alpha, McDonald's omega-total, Guttman's λ2, and the Molenaar-Sijtsma statistic, was highly satisfactory. Measurement invariance was observed across age groups, sexes, and ethnicities, as well as between our sample and the ODI's original validation sample. As expected, the ODI showed both a degree of convergent validity and a degree of discriminant validity vis-à-vis a measure of "cause-neutral" depressive symptoms. Moreover, the ODI manifested substantial associations, in the anticipated directions, with measures of work engagement, job satisfaction, and life satisfaction. Overall, the ODI exhibited excellent structural and psychometric properties within the South African context. Consistent with previous research, this study suggests that occupational health specialists can confidently rely on the ODI to investigate job-related distress.
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Affiliation(s)
- Carin Hill
- Department of Industrial Psychology and People Management, School of Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
| | - Leon T de Beer
- WorkWell Research Unit, North-West University, Potchefstroom, South Africa
| | - Renzo Bianchi
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
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Farewell CV, Donohoe R, Thayer Z, Paulson J, Nicklas J, Walker C, Waldie K, Leiferman JA. Maternal depression trajectories and child BMI in a multi-ethnic sample: a latent growth modeling analysis. BMC Pregnancy Childbirth 2021; 21:827. [PMID: 34903186 PMCID: PMC8667413 DOI: 10.1186/s12884-021-04308-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum. METHODS This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass index at 54-months (n=4897). RESULTS The average slope of depression for this sample is low and decreases over time. When child BMI was added to the model as an outcome variable, both antenatal depression (B=.25, p<.01), and the rate of change of depression across the perinatal and postpartum periods (B=.09, p<.01) were associated with child BMI at 54-months postpartum. After controlling for sociodemographic characteristics, antenatal depression, but not the slope of depression, remained significantly associated with child BMI (B=.05, p<.05). When controlling for maternal pre-pregnancy BMI the effect of antenatal depression on child BMI at 54-months was entirely attenuated (χ2 (9) = 39.60, p < .05, SRMR = 0.01, CFI = .99, RMSEA = 0.03, BIC=53213). CONCLUSIONS Our findings align with the Developmental Origins of Health and Disease theory and imply that both the physical and mental health of mothers during pregnancy may be important indicators of child growth and development outcomes. Early intervention directed towards women who have even mild depression scores during pregnancy may promote healthy child development outcomes. Additionally, given the heterogeneity of depressive symptoms over time seen in this study, multiple assessment periods across the postpartum period may be valuable to adequately address and support maternal mental health.
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Affiliation(s)
- Charlotte V Farewell
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA.
| | - Ryley Donohoe
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA
| | | | - James Paulson
- Old Dominion University, Norfolk University, Norfolk, VA, USA
| | - Jacinda Nicklas
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA
| | | | | | - Jenn A Leiferman
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA
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Kung B, Chiang M, Perera G, Pritchard M, Stewart R. Identifying subtypes of depression in clinician-annotated text: a retrospective cohort study. Sci Rep 2021; 11:22426. [PMID: 34789827 PMCID: PMC8599474 DOI: 10.1038/s41598-021-01954-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Current criteria for depression are imprecise and do not accurately characterize its distinct clinical presentations. As a result, its diagnosis lacks clinical utility in both treatment and research settings. Data-driven efforts to refine criteria have typically focused on a limited set of symptoms that do not reflect the disorder's heterogeneity. By contrast, clinicians often write about patients in depth, creating descriptions that may better characterize depression. However, clinical text is not commonly used to this end. Here we show that clinically relevant depressive subtypes can be derived from unstructured electronic health records. Five subtypes were identified amongst 18,314 patients with depression treated at a large mental healthcare provider by using unsupervised machine learning: severe-typical, psychotic, mild-typical, agitated, and anergic-apathetic. Subtypes were used to place patients in groups for validation; groups were found to be associated with future outcomes and characteristics that were consistent with the subtypes. These associations suggest that these categorizations are actionable due to their validity with respect to disease prognosis. Moreover, they were derived with automated techniques that might theoretically be widely implemented, allowing for future analyses in more varied populations and settings. Additional research, especially with respect to treatment response, may prove useful in further evaluation.
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Affiliation(s)
| | | | - Gayan Perera
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Megan Pritchard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Fenton C, McLoughlin DM. Usefulness of Hamilton rating scale for depression subset scales and full versions for electroconvulsive therapy. PLoS One 2021; 16:e0259861. [PMID: 34752484 PMCID: PMC8577745 DOI: 10.1371/journal.pone.0259861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives We investigated the predictive value of subset scales and full versions of the Hamilton Rating Scale for Depression (HAMD) for therapeutic outcomes in ECT. Methods This secondary analysis of patients with major depression (N = 136; 63% female; age = 56.7 [SD = 14.8]) from the EFFECT-Dep trial (NCT01907217) examined the predictive value of Evans-6, Toronto-7, Gibbons-8 and Maier-Philip 6 HAMD subset scales and three ‘full’ versions (HAMD-17, HAMD-21 and HAMD-24) on therapeutic outcomes. We also examined early improvement on subset scales and full versions as predictors of response and remission and explored predictive abilities of individual HAMD-24 items. Results The subset scales and full scales lacked sufficient predictive ability for response and remission. Receiver operating characteristic curves identified a lack of discriminative capacity of HAMD subset scales and full versions at baseline to predict response and remission. Only the Maier-Philip-6 was significantly associated with percentage reduction in HAMD-24 scores from baseline to end of ECT course. Early improvement on most of the subset scales and full versions was a sensitive and specific predictor of response and remission. Four of the HAMD-24 items were significantly associated with response and one with remission. Conclusions Limited utility of the HAMD subset scales and full versions in this context highlight a need for more tailored depression rating scales for ECT.
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Affiliation(s)
- Caoimhe Fenton
- Department of Psychiatry, Trinity College Dublin, St Patrick’s University Hospital, Dublin, Ireland
- * E-mail:
| | - Declan M. McLoughlin
- Department of Psychiatry, Trinity College Dublin, St Patrick’s University Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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Lalousis PA, Wood SJ, Schmaal L, Chisholm K, Griffiths SL, Reniers RLEP, Bertolino A, Borgwardt S, Brambilla P, Kambeitz J, Lencer R, Pantelis C, Ruhrmann S, Salokangas RKR, Schultze-Lutter F, Bonivento C, Dwyer D, Ferro A, Haidl T, Rosen M, Schmidt A, Meisenzahl E, Koutsouleris N, Upthegrove R. Heterogeneity and Classification of Recent Onset Psychosis and Depression: A Multimodal Machine Learning Approach. Schizophr Bull 2021; 47:1130-1140. [PMID: 33543752 PMCID: PMC8266654 DOI: 10.1093/schbul/sbaa185] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 11/14/2022]
Abstract
Diagnostic heterogeneity within and across psychotic and affective disorders challenges accurate treatment selection, particularly in the early stages. Delineation of shared and distinct illness features at the phenotypic and brain levels may inform the development of more precise differential diagnostic tools. We aimed to identify prototypes of depression and psychosis to investigate their heterogeneity, with common, comorbid transdiagnostic symptoms. Analyzing clinical/neurocognitive and grey matter volume (GMV) data from the PRONIA database, we generated prototypic models of recent-onset depression (ROD) vs. recent-onset psychosis (ROP) by training support-vector machines to separate patients with ROD from patients with ROP, who were selected for absent comorbid features (pure groups). Then, models were applied to patients with comorbidity, ie, ROP with depressive symptoms (ROP+D) and ROD participants with sub-threshold psychosis-like features (ROD+P), to measure their positions within the affective-psychotic continuum. All models were independently validated in a replication sample. Comorbid patients were positioned between pure groups, with ROP+D patients being more frequently classified as ROD compared to pure ROP patients (clinical/neurocognitive model: χ2 = 14.874; P < .001; GMV model: χ2 = 4.933; P = .026). ROD+P patient classification did not differ from ROD (clinical/neurocognitive model: χ2 = 1.956; P = 0.162; GMV model: χ2 = 0.005; P = .943). Clinical/neurocognitive and neuroanatomical models demonstrated separability of prototypic depression from psychosis. The shift of comorbid patients toward the depression prototype, observed at the clinical and biological levels, suggests that psychosis with affective comorbidity aligns more strongly to depressive rather than psychotic disease processes. Future studies should assess how these quantitative measures of comorbidity predict outcomes and individual responses to stratified therapeutic interventions.
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Affiliation(s)
- Paris Alexandros Lalousis
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- To whom correspondence should be addressed; 52 Pritchatts Road, B15 2SA, Birmingham, UK; e-mail:
| | - Stephen J Wood
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Department of Psychology, Aston University, Birmingham, UK
| | - Sian Lowri Griffiths
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Renate L E P Reniers
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
- Department of Psychiatry and Psychotherapy, Center of Brain, Behavior and Metabolism, University of Lübeck, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Ludwig Maxmilians University, Munich, Germany
| | - Rebekka Lencer
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carolina Bonivento
- IRCCS “E. Medea” Scientific Institute, San Vito al Tagliamento (Pn), Italy
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maxmilians University, Munich, Germany
| | - Adele Ferro
- Department of Neurosciences and Mental Health, IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Theresa Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Andre Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maxmilians University, Munich, Germany
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
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Jia S, Li C, Lei Z, Xia Q, Jiang Y. Determinants of anxiety and depression among pheochromocytoma patients: A case-control study. Medicine (Baltimore) 2021; 100:e24335. [PMID: 33546066 PMCID: PMC7837965 DOI: 10.1097/md.0000000000024335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/13/2020] [Accepted: 12/28/2020] [Indexed: 01/18/2023] Open
Abstract
Phaeochromocytomas are catecholamine-producing neuroendocrine tumors that may manifest in many ways, specifically as sustained or paroxysmal hypertension. Data, including data from mental status screening, were prospectively collected from suspected patients. The Hospital Anxiety and Depression Scale was used as a screening tool to identify abnormal mental status. Results showed phaeochromocytoma patients were more likely to experience anxiety and depression. For future phaeochromocytoma treatment, early screening for anxiety and depression should be recommended.
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Affiliation(s)
- Siming Jia
- Department of Urological Surgical, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei
| | - Chengbai Li
- Department of Urological Surgical, Wuxi Ninth People's Hospital, Wuxi, Jiangsu, China
| | - Zhuqing Lei
- Department of Urological Surgical, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei
| | - Qiang Xia
- Department of Urological Surgical, Wuxi Ninth People's Hospital, Wuxi, Jiangsu, China
| | - Yuqing Jiang
- Department of Urological Surgical, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei
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Cai N, Choi KW, Fried EI. Reviewing the genetics of heterogeneity in depression: operationalizations, manifestations and etiologies. Hum Mol Genet 2020; 29:R10-R18. [PMID: 32568380 PMCID: PMC7530517 DOI: 10.1093/hmg/ddaa115] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023] Open
Abstract
With progress in genome-wide association studies of depression, from identifying zero hits in ~16 000 individuals in 2013 to 223 hits in more than a million individuals in 2020, understanding the genetic architecture of this debilitating condition no longer appears to be an impossible task. The pressing question now is whether recently discovered variants describe the etiology of a single disease entity. There are a myriad of ways to measure and operationalize depression severity, and major depressive disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders-5 can manifest in more than 10 000 ways based on symptom profiles alone. Variations in developmental timing, comorbidity and environmental contexts across individuals and samples further add to the heterogeneity. With big data increasingly enabling genomic discovery in psychiatry, it is more timely than ever to explicitly disentangle genetic contributions to what is likely 'depressions' rather than depression. Here, we introduce three sources of heterogeneity: operationalization, manifestation and etiology. We review recent efforts to identify depression subtypes using clinical and data-driven approaches, examine differences in genetic architecture of depression across contexts, and argue that heterogeneity in operationalizations of depression is likely a considerable source of inconsistency. Finally, we offer recommendations and considerations for the field going forward.
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Affiliation(s)
- Na Cai
- Helmholtz Pioneer Campus, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA 02142, USA
| | - Eiko I Fried
- Department of Psychology, Leiden University, Leiden 2333 AK, Netherlands
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Abstract
Categorising mental disorders for purposes of diagnosis, research and practice has historically been justified on philosophical terms as a pragmatic activity; categories which have been subject to wide-ranging philosophical critique have been defended on the grounds that they serve as heuristic devices providing loose representations of shared experiences, not labels for real structures. In acknowledgement of this, there has been increasing recognition that subclassifying multiple discrete forms of persistent depression moves too far away from the notion of a heuristic and that attempts to create more precise categories become less clinically useful. Hence the most recent Diagnostic and Statistical Manual of Mental Disorders (V.5) and International Classification of Diseases (V.11) both group persistent forms of depression together. However, the UK National Institute for Health and Care Excellence has delineated certain subclassifications of persistent depression in its new guideline, which grossly distorts the phenomenology of depression. This approach commits a fundamental philosophical error in conflating absence of knowledge with knowledge of absence. In this sense, the new guideline appears to be engaging in an activity akin to the digital game Minecraft, in which the craft of building structures from units of construction is largely divorced from the laws of physics. The risk of ignoring these philosophical errors and making false claims about scientific plausibility is that the guideline recommendations inevitably represent a highly distorted phenomenology of depression and will be of very little value to patients or practitioners looking for guidance on best possible treatment options.
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Affiliation(s)
- Susan McPherson
- Health and Social Care, University of Essex, Colchester CO4 3SQ, UK
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10
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van Mol MMC, Wagener S, Latour JM, Boelen PA, Spronk PE, den Uil CA, Rietjens JAC. Developing and testing a nurse-led intervention to support bereavement in relatives in the intensive care (BRIC study): a protocol of a pre-post intervention study. BMC Palliat Care 2020; 19:130. [PMID: 32811499 PMCID: PMC7433274 DOI: 10.1186/s12904-020-00636-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 08/11/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND When a patient is approaching death in the intensive care unit (ICU), patients' relatives must make a rapid transition from focusing on their beloved one's recovery to preparation for their unavoidable death. Bereaved relatives may develop complicated grief as a consequence of this burdensome situation; however, little is known about appropriate options in quality care supporting bereaved relatives and the prevalence and predictors of complicated grief in bereaved relatives of deceased ICU patients in the Netherlands. The aim of this study is to develop and implement a multicomponent bereavement support intervention for relatives of deceased ICU patients and to evaluate the effectiveness of this intervention on complicated grief, anxiety, depression and posttraumatic stress in bereaved relatives. METHODS The study will use a cross-sectional pre-post design in a 38-bed ICU in a university hospital in the Netherlands. Cohort 1 includes all reported first and second contact persons of patients who died in the ICU in 2018, which will serve as a pre-intervention baseline measurement. Based on existing policies, facilities and evidence-based practices, a nurse-led intervention will be developed and implemented during the study period. This intervention is expected to use 1) communication strategies, 2) materials to make a keepsake, and 3) a nurse-led follow-up service. Cohort 2, including all bereaved relatives in the ICU from October 2019 until March 2020, will serve as a post-intervention follow-up measurement. Both cohorts will be performed in study samples of 200 relatives per group, all participants will be invited to complete questionnaires measuring complicated grief, anxiety, depression and posttraumatic stress. Differences between the baseline and follow-up measurements will be calculated and adjusted using regression analyses. Exploratory subgroup analyses (e.g., gender, ethnicity, risk profiles, relationship with patient, length of stay) and exploratory dose response analyses will be conducted. DISCUSSION The newly developed intervention has the potential to improve the bereavement process of the relatives of deceased ICU patients. Therefore, symptoms of grief and mental health problems such as depression, anxiety and posttraumatic stress, might decrease. TRIAL REGISTRATION Netherlands Trial Register Registered on 27/07/2019 as NL 7875, www.trialregister.nl.
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Affiliation(s)
- Margo M. C. van Mol
- Department of Intensive Care Adults, Erasmus MC University Medical Center, P.O. Box 2040, Room Ne409, 3000 CA Rotterdam, the Netherlands
| | - Sebastian Wagener
- Department of Intensive Care Adults, Erasmus MC University Medical Center, P.O. Box 2040, Room Ne409, 3000 CA Rotterdam, the Netherlands
| | - Jos M. Latour
- School of Nursing and Midwifery, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Paul A. Boelen
- Clinical Psychology Faculty Social Sciences, Arq Psychotrauma Expert Groep, University Utrecht, Utrecht, Netherlands
| | - Peter E. Spronk
- Department of Intensive Care Medicine, ExpIRA - Expertise Center for Intensive Care Rehabilitation Apeldoorn, Gelre Hospitals Apeldoorn, Apeldoorn, The Netherlands
| | - Corstiaan A. den Uil
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Judith A. C. Rietjens
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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11
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Shahidullah JD, Forman SG, Lekwa AJ. Assessment and management of depression and suicidality: Pediatric resident perspectives on training and practice. Fam Syst Health 2020; 38:172-183. [PMID: 32525351 DOI: 10.1037/fsh0000484] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Primary care is a common access point for children and adolescents with depression and suicidality concerns. In this setting, pediatricians typically function as front-line providers given barriers that patients face in accessing mental health clinicians. METHOD This study surveyed chief residents from all pediatric residency programs in the United States (N = 214) to evaluate (a) their attitudes, knowledge, practices, and comfort in managing depression and suicidality concerns in primary care, and (b) the relationship between residency training processes and pediatric residents' practices, knowledge, and comfort related to identifying and managing depression and suicidality. RESULTS The usable response rate was 37.6%. The large majority of respondents are involved in evaluation and management of depression and suicidality; yet many respondents reported a lack of knowledge and comfort in these roles. CONCLUSIONS Recommendations for pediatric residency program training processes are discussed, including the potential added value of colocating mental health clinicians into the primary care continuity training clinic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Cortés-Álvarez NY, Piñeiro-Lamas R, Vuelvas-Olmos CR. Psychological Effects and Associated Factors of COVID-19 in a Mexican Sample. Disaster Med Public Health Prep 2020; 14:413-424. [PMID: 32576317 PMCID: PMC7385317 DOI: 10.1017/dmp.2020.215] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [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] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/11/2020] [Accepted: 06/21/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID 19) is a new viral zoonosis of global concern that could cause psychological sequelae. We examined the levels of psychological distress, anxiety, depression, and stress during the COVID-19 outbreak in a Mexican sample. METHODS An online survey was applied that collected information on demographic and financial status data, physical status, contact history, knowledge, concerns, and precautionary measures concerning COVID-19. Impact of Event Scale-Revised and Depression, Anxiety, and Stress Scale were included. RESULTS A total of 50.3% of respondents rated psychological distress as moderate-severe; 15.7% reported moderate-severe depressive symptoms; 22.6% reported moderate-severe anxiety symptoms; and 19.8% reported moderate-severe stress levels. Female gender, older age, divorced status, lack of confidence related to security of the test, lower satisfaction of health information concerning COVID-19, history of direct or indirect contact with a COVID-19 confirmed case, live with just 1 other person, and spent >9 h/d at home were associated with greater psychological distress and/or higher levels of stress, anxiety, and depression. By contrast, precautionary measures, such as hand hygiene and wearing masks, were associated with lower levels of psychological distress, depression, anxiety, and stress. CONCLUSIONS COVID-19 outbreak results in considerable psychological effects among the Mexican sample.
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Affiliation(s)
- Nadia Yanet Cortés-Álvarez
- School of Medicine, University of Colima, Colima, Mexico
- School of Medicine, José Martí University, Colima, México
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Abstract
Objective We aimed to investigate the difference in serum uric acid(SUA)levels between subtypes of depression and normal population, and whether SUA can be used to identify bipolar disorder depressive episode and major depressive disorder and predict the length of hospital stay. Methods 1543 depression patients and 1515 healthy controls were obtained according to the entry and exclusion criteria from one mental health center of a tertiary hospital in southwestern China. The diagnosis and classification of depression was in accordance with ICD-10. The SUA value was derived from fasting plasma samples analysis. The level of SUA of all the participants was quantified using Roche cobas8000-c702-MSB automatic biochemical analyzer. Data were analyzed by SPSS18.0 statistical software package. Results Overall, the level of SUA in patients with depression was lower than that in normal control. Specifically, males’ SUA levels were in the interval of [240, 323.3) and [323.3, 406.6), and women were in the [160, 233.3] levels. The SUA level of bipolar disorder depressive episode was higher compared to major depressive disorder level. Interestingly, male patients who were hospitalized for two weeks had higher SUA than those who were hospitalized for three weeks or four weeks. Conclusions Our results suggest that the length of hospital stay may be associated with SUA, and when it is difficult to make a differential diagnosis of bipolar disorder depressive episode and major depressive disorder, the level of SUA may be considered. The adjustment of SUA as a method for treating depression needs to be carefully assessed.
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Affiliation(s)
- Xiandong Meng
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xia Huang
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Deng
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jiping Li
- Nursing department of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail:
| | - Tao Li
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Guilera G, Pino O, Barrios M, Rojo E, Vieta E, Gómez-Benito J. Towards an ICF Core Set for functioning assessment in severe mental disorders: Commonalities in bipolar disorder, depression and schizophrenia. Psicothema 2020; 32:7-14. [PMID: 31954410 DOI: 10.7334/psicothema2019.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND The International Classification of Functioning, Disability and Health (ICF) offers an internationally accepted standard for describing and assessing functioning and disability in any health condition. A specific list of ICF categories, an ICF Core Set (CS), has been developed for bipolar disorder, depression and schizophrenia. The aim of this study was to determine commonalities in the ICF-CSs for these three disorders, and to identify relevant categories for the development of tentative ICF-CSs for severe mental disorders in general. METHODS The ICF categories of all three mental health conditions were examined and compared. RESULTS Comparison of the Comprehensive ICF-CSs for the three mental health conditions revealed a set of 34 common categories (i.e., 10 from the Body functions component, 14 from the Activities and participation component, and 10 Environmental factors ). These categories formed the proposed Comprehensive ICF-CS for severe mental disorders. A total of 11 categories were common to the Brief ICF-CSs of the three mental health conditions, and these formed the Brief ICF-CS for severe mental disorders (i.e., 3 from the Body functions component, 6 from the Activities and participation component, and 2 Environmental factors ). All the categories included refer to key aspects of functioning for severe mental disorders. CONCLUSIONS The proposed ICF-CSs for severe mental disorders may be applicable across a number of psychotic and affective disorders and they should prove useful for mental health services whose care remit covers a range of conditions.
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Simon CB, Valencia C, Coronado RA, Wu SS, Li Z, Dai Y, Farmer KW, Moser MM, Wright TW, Fillingim RB, George SZ. Biopsychosocial Influences on Shoulder Pain: Analyzing the Temporal Ordering of Postoperative Recovery. J Pain 2019; 21:808-819. [PMID: 31891763 DOI: 10.1016/j.jpain.2019.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 10/03/2019] [Accepted: 11/19/2019] [Indexed: 01/16/2023]
Abstract
Shoulder surgery is a primary intervention for shoulder pain, yet many individuals experience persistent postoperative pain. Previously, we found individuals categorized as having a high-risk phenotype (comprised of COMT variation and pain catastrophizing) had approximately double the chance of not reaching a 12-month pain recovery criterion. As a means to better understand the development of persistent postoperative shoulder pain, this study advanced our previous work by examining temporal ordering of postoperative shoulder recovery based on potential mediating factors, and expansion of outcomes to include movement-evoked pain and shoulder active range of motion. Before surgery, individuals were categorized as either high-risk (high pain catastrophizing, COMT-genotype linked to low enzyme activity [n = 41]) or low-risk (low pain catastrophizing, COMT-genotype linked to normal enzyme activity [n = 107]). We then compared potential mediating variables at 3, 6, and 12 months postoperatively 1) endogenous pain modulation defined by a conditioned pain modulation paradigm; and 2) and emotion factors such as anxiety, fear of movement, and depressive symptoms. At 3 months, the high-risk subgroup had higher fear and movement-evoked pain, and causal mediation analysis confirmed the direct effect of risk subgroup on 12-month movement evoked pain. However, baseline to 12-month change in depressive symptoms were found to mediate 53% of the total effect of risk subgroup on 12-month movement-evoked pain. This study introduces potential temporal components and relationships to the development of persistent postoperative shoulder pain, which future studies will confirm and assess for potential therapeutic targets. PERSPECTIVE: This study expands upon postoperative shoulder recovery measures to include movement-evoked pain and depressive symptoms, and provides preliminary indication of temporal ordering to postoperative shoulder recovery for a preidentified high-risk subgroup. Future studies will distinguish temporal components of shoulder surgery that may optimize treatment targets of postoperative recovery.
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Affiliation(s)
- Corey B Simon
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina.
| | - Carolina Valencia
- Department of Rehabilitation Sciences, University of Texas at El Paso, El Paso, Texas
| | - Rogelio A Coronado
- Department of Orthopedic Surgery and Rehabilitation, Vanderbilt University, Nashville, Texas
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Zhigang Li
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Kevin W Farmer
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - Michael M Moser
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - Thomas W Wright
- Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
| | - Steven Z George
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Duke University, Durham, North Carolina
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Mills JC, Pence BW, Edmonds A, Adedimeji A, Schwartz RM, Kassaye S, Cocohoba J, Cohen MH, Neigh G, Fischl MA, Kempf MC, Adimora AA. The Impact of Cumulative Depression Along the HIV Care Continuum in Women Living With HIV During the Era of Universal Antiretroviral Treatment. J Acquir Immune Defic Syndr 2019; 82:225-233. [PMID: 31335585 PMCID: PMC6791755 DOI: 10.1097/qai.0000000000002140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Data are limited on cumulative impacts of depression on engagement in care and HIV outcomes in women living with HIV (WLWH) during the era of universal antiretroviral therapy (ART). Understanding the relationship of accumulated depression with HIV disease management may help identify benefits of interventions to reduce severity and duration of depressive episodes. SETTING A cohort of WLWH (N = 1491) from the Women's Interagency HIV Study at 9 sites across the US. METHODS This longitudinal observational cohort study (2013-2017) followed WLWH for a maximum of 9 semiannual visits. Depression was quantified as a time-updated measure of percent of days depressed (PDD) created from repeated assessments using the Center for Epidemiologic Studies Depression scale. Marginal structural Poisson regression models were used to estimate the effects of PDD on the risks of missing an HIV care appointment, <95% ART adherence, and virological failure (≥200 copies/mL). RESULTS The risk of missing an HIV care appointment [risk ratio (RR) = 1.16, 95% confidence interval = 0.93 to 1.45; risk difference (RD) = 0.01, -0.01 to 0.03], being <95% ART adherent (RR = 1.27, 1.06-1.52; RD = 0.04, -0.01 to 0.07), and virological failure (RR = 1.09, 1.01-1.18; RD = 0.01, -0.01 to 0.03) increased monotonically with increasing PDD (comparing those with 25 to those with 0 PDD). The total effect of PDD on virological failure was fully (%100) mediated by being <95% ART adherent. CONCLUSIONS Time spent depressed increases the risk of virological failure through ART adherence, even in the era of universal ART regimes forgiving of imperfect adherence.
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Affiliation(s)
- Jon C Mills
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Andrew Edmonds
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY
| | - Rebecca M Schwartz
- Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY
| | - Seble Kassaye
- Department of Infectious Diseases, Georgetown University Medical Center, Georgetown University, Washington, DC
| | - Jennifer Cocohoba
- Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, San Francisco, CA
| | - Mardge H Cohen
- Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL
| | - Gretchen Neigh
- Department of Anatomy and Neurobiology, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Margaret A Fischl
- Department of Medicine/Infectious Diseases, Miami Center for AIDS Research, University of Miami, Miller School of Medicine, Miami, FL
| | - Mirjam-Colette Kempf
- Schools of Nursing, Public Health and Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Adaora A Adimora
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC
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de Lijster JM, van den Dries MA, van der Ende J, Utens EMWJ, Jaddoe VW, Dieleman GC, Hillegers MHJ, Tiemeier H, Legerstee JS. Developmental Trajectories of Anxiety and Depression Symptoms from Early to Middle Childhood: a Population-Based Cohort Study in the Netherlands. J Abnorm Child Psychol 2019; 47:1785-1798. [PMID: 31069583 PMCID: PMC6805800 DOI: 10.1007/s10802-019-00550-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Developmental patterns of anxiety and depression symptoms in early childhood have previously been related to anxiety and mood disorders in middle childhood. In the current study, trajectories of anxiety and depression symptoms (1.5-10 years) were related to children's broader psychosocial and school-related functioning at 10 years. We included a population-based sample of 7499 children, for whom primary caregivers reported anxiety and depression symptoms on the Child Behavior Checklist, at children's ages of 1.5, 3, 6, and 10. Growth Mixture Modeling identified four distinct, gender-invariant, trajectories of anxiety and depression symptoms: low (82.4%), increasing (7.4%), decreasing (6.0%), and increasing symptoms up to age 6 followed by a decrease to age 10 (preschool-limited, 4.2%). Children with a non-Dutch ethnicity had lower odds to be in the increasing trajectory and higher odds to be in the decreasing and pre-school limited trajectory. Also, low maternal education predicted the decreasing and pre-school limited trajectory. Higher levels of psychopathology during pregnancy for both mothers and fathers predicted the increasing, decreasing, and preschool-limited trajectory, compared to the low trajectory. At age 10, children in the increasing and preschool-limited trajectory had diminished psychosocial outcomes (friendship-quality and self-esteem) and worse school-related outcomes (school performance and school problems). This study adds to current knowledge by demonstrating that developmental patterns of anxiety and depression symptoms in early childhood are related to broader negative outcomes in middle childhood. Child and family factors could guide monitoring of anxiety and depression symptoms in the general population and provide targets for prevention programs.
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Affiliation(s)
- Jasmijn M de Lijster
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Michiel A van den Dries
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Elisabeth M W J Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
- Academic Center for Child Psychiatry the Bascule /Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Vincent W Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gwendolyn C Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2060, Wytemaweg 80, 3000, CB, Rotterdam, the Netherlands.
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Carey M, Bryant J, Zucca A, Hall A, Grady A, Dilworth S, Peek K. How well do cancer survivor self-classifications of anxiety, depression and stress agree with a standardised tool? Results of a cross-sectional study. PLoS One 2019; 14:e0222107. [PMID: 31539386 PMCID: PMC6754128 DOI: 10.1371/journal.pone.0222107] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/21/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is poor uptake of psychosocial interventions offered to people with cancer who record high scores on distress screening scales. Intervention uptake may be influenced by a mismatch between consumer (bottom-up) and professional (top-down) paradigms of wellbeing. The current research aims to compare cancer survivors' 'self-judgements' about their levels of anxiety, depression and stress, to classifications derived via a professional-driven measure, the Depression, Anxiety and Stress Scale (DASS-21). METHODS A cross-sectional study was undertaken with haematological cancer survivors recruited from three population-based cancer registries in Australia. Consenting participants were mailed a questionnaire package; and non-responders received a second questionnaire package after 3-weeks and a reminder call after 6-weeks. The consumer-driven perspective was assessed via three separate single items asking survivors to self-classify their levels of anxiety, depression and stress over the past week on a scale from 'normal' to 'extremely severe'. The professional-driven classification was assessed via the DASS-21. Kappa statistics were used to assess agreement between consumer- and professional-driven measures. RESULTS Of 2,971 eligible haematological cancer survivors, 1,239 (42%) provided written consent and were mailed a questionnaire package. Of these, 984 (79%) returned a completed questionnaire. The simple kappa for agreement between the DASS-21 and self-classified measures for anxiety was 0.47 (95% CI: 0.39 to 0.54, p<0.0001). The weighted kappa for agreement between the DASS-21 and self-classified measures of depression was 0.60 (95% CI: 0.53 to 0.67, p<0.0001) and for measures of stress was 0.51 (95% CI: 0.44 to 0.59, p<0.0001). CONCLUSIONS Moderate agreement between self-classification and professional-driven assessments was found. The value of screening is predicated on the assumption that those with identified needs will be offered and take up services that will benefit them. Our results suggest that to improve the utility of distress screening it may be important to include assessment of survivor views about their symptoms.
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Affiliation(s)
- Mariko Carey
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- * E-mail:
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alison Zucca
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alix Hall
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alice Grady
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Local Health District, Population Health, Wallsend, NSW, Australia
| | - Sophie Dilworth
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kerry Peek
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
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Nicolau J, Simó R, Conchillo C, Sanchís P, Blanco J, Romerosa JM, Fortuny R, Bonet A, Masmiquel L. Differences in the cluster of depressive symptoms between subjects with type 2 diabetes and individuals with a major depressive disorder and without diabetes. J Endocrinol Invest 2019; 42:881-888. [PMID: 30788770 DOI: 10.1007/s40618-019-01020-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 02/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Depressive disorder encompasses a wide spectrum of somatic and psychological symptoms. It is not known whether there are differences regarding the cluster of depressive symptomatology between subjects with depression with and without T2DM. PURPOSE To explore whether the cluster of depression that prevails among depressive subjects with T2DM differs from individuals with depression, but without T2DM. METHODS 87 T2DM patients with a pathological Beck Depression Inventory test (BDI) were compared with 50 age- and gender-matched individuals with a major depressive disorder. All 21 items expressed in the BDI were compared between the two groups. RESULTS The score obtained after administering the BDI was comparable between patients with T2DM and significant depressive symptoms and the control group (18.8 ± 2.7 vs 18.9 ± 3.4; p = 0.9). Subjects with T2DM had higher scores compared with the control group in the following items: sadness (1.4 ± 0.9 vs 0.9 ± 0.9; p = 0.011), difficulty in concentration (1.3 ± 0.8 vs 0.8 ± 0.8; p = 0.01), indecisiveness (1.1 ± 0.8 vs 0.5 ± 0.9; p = 0.012), worries about their health (1.3 ± 0.9 vs 0.6 ± 0.9; p < 0.0001), fatigue (1.2 ± 0.6 vs 0.8 ± 0.7; p = 0.003) and loss of sexual appetite (2.7 ± 0.6 vs 1.2 ± 1.3; p = 0.0001). Suicidal ideation was significantly lower among subjects with T2DM compared with the control group (0.1 ± 0.3 vs 0.6 ± 0.8; p = 0.0001). CONCLUSIONS Subjects with T2DM and a positive screening for depression presented a different cluster of depression compared with depressed subjects without T2DM, with a predominance of somatic-biological depressive symptoms rather than psychological-cognitive cluster and negative emotions, such as suicidal ideation.
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Affiliation(s)
- J Nicolau
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain.
| | - R Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Barcelona, Spain
| | - C Conchillo
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - P Sanchís
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - J Blanco
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - J M Romerosa
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - R Fortuny
- Hormonal Laboratory Department, Hospital Son Llàtzer, Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - A Bonet
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - L Masmiquel
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Palma (IdISPa), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
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Beijers L, Wardenaar KJ, Bosker FJ, Lamers F, van Grootheest G, de Boer MK, Penninx BW, Schoevers RA. Biomarker-based subtyping of depression and anxiety disorders using Latent Class Analysis. A NESDA study. Psychol Med 2019; 49:617-627. [PMID: 29860945 PMCID: PMC6393228 DOI: 10.1017/s0033291718001307] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 09/28/2017] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Etiological research of depression and anxiety disorders has been hampered by diagnostic heterogeneity. In order to address this, researchers have tried to identify more homogeneous patient subgroups. This work has predominantly focused on explaining interpersonal heterogeneity based on clinical features (i.e. symptom profiles). However, to explain interpersonal variations in underlying pathophysiological mechanisms, it might be more effective to take biological heterogeneity as the point of departure when trying to identify subgroups. Therefore, this study aimed to identify data-driven subgroups of patients based on biomarker profiles. METHODS Data of patients with a current depressive and/or anxiety disorder came from the Netherlands Study of Depression and Anxiety, a large, multi-site naturalistic cohort study (n = 1460). Thirty-six biomarkers (e.g. leptin, brain-derived neurotrophic factor, tryptophan) were measured, as well as sociodemographic and clinical characteristics. Latent class analysis of the discretized (lower 10%, middle, upper 10%) biomarkers were used to identify different patient clusters. RESULTS The analyses resulted in three classes, which were primarily characterized by different levels of metabolic health: 'lean' (21.6%), 'average' (62.2%) and 'overweight' (16.2%). Inspection of the classes' clinical features showed the highest levels of psychopathology, severity and medication use in the overweight class. CONCLUSIONS The identified classes were strongly tied to general (metabolic) health, and did not reflect any natural cutoffs along the lines of the traditional diagnostic classifications. Our analyses suggested that especially poor metabolic health could be seen as a distal marker for depression and anxiety, suggesting a relationship between the 'overweight' subtype and internalizing psychopathology.
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Affiliation(s)
- Lian Beijers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Klaas J. Wardenaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Fokko J. Bosker
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Femke Lamers
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Gerard van Grootheest
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Marrit K. de Boer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W.J.H. Penninx
- GGZ inGeest and Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Lichtenthal WG, Catarozoli C, Masterson M, Slivjak E, Schofield E, Roberts KE, Neimeyer RA, Wiener L, Prigerson HG, Kissane DW, Li Y, Breitbart W. An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation. Palliat Support Care 2019; 17:2-12. [PMID: 30683164 PMCID: PMC6401220 DOI: 10.1017/s1478951518000925] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the preliminary feasibility, acceptability, and effects of Meaning-Centered Grief Therapy (MCGT) for parents who lost a child to cancer. METHOD Parents who lost a child to cancer and who were between six months and six years after loss and reporting elevated levels of prolonged grief were enrolled in open trials of MCGT, a manualized, one-on-one cognitive-behavioral-existential intervention that used psychoeducation, experiential exercises, and structured discussion to explore themes related to meaning, identity, purpose, and legacy. Parents completed 16 weekly sessions, 60-90 minutes in length, either in person or through videoconferencing. Parents were administered measures of prolonged grief disorder symptoms, meaning in life, and other assessments of psychological adjustment preintervention, mid-intervention, postintervention, and at three months postintervention. Descriptive data from both the in-person and videoconferencing open trial were pooled.ResultEight of 11 (72%) enrolled parents started the MCGT intervention, and six of eight (75%) participants completed all 16 sessions. Participants provided positive feedback about MCGT. Results showed postintervention longitudinal improvements in prolonged grief (d = 1.70), sense of meaning (d = 2.11), depression (d = 0.84), hopelessness (d = 1.01), continuing bonds with their child (d = 1.26), posttraumatic growth (ds = 0.29-1.33), positive affect (d = 0.99), and various health-related quality of life domains (d = 0.46-0.71). Most treatment gains were either maintained or increased at the three-month follow-up assessment.Significance of resultsOverall, preliminary data suggest that this 16-session, manualized cognitive-behavioral-existential intervention is feasible, acceptable, and associated with transdiagnostic improvements in psychological functioning among parents who have lost a child to cancer. Future research should examine MCGT with a larger sample in a randomized controlled trial.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - David W Kissane
- The University of Notre Dame Australia,Fremantle,Western Australia
| | - Yuelin Li
- Memorial Sloan Kettering Cancer Center,New York,NY
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22
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van der Cruijsen R, Murphy J, Bird G. Alexithymic traits can explain the association between puberty and symptoms of depression and anxiety in adolescent females. PLoS One 2019; 14:e0210519. [PMID: 30650139 PMCID: PMC6334924 DOI: 10.1371/journal.pone.0210519] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/22/2018] [Indexed: 12/21/2022] Open
Abstract
Symptoms of internalizing disorders such as depression and anxiety increase in adolescence, especially in females. However, gender differences in depression and anxiety symptoms emerge only after puberty onset. Levels of alexithymia, characterized by difficulties identifying and describing one's emotions, are elevated in depression and anxiety, and fluctuate across adolescence in a gender-specific manner. This study investigated changes in alexithymia across adolescence, and explored the potential role of alexithymia in the development of depression and anxiety, separately for females and males. Accordingly, 140 adolescents aged 11 to 21 years (77 female) completed self-report measures of alexithymia, depression and anxiety, and pubertal development. For females alone, pubertal maturation was associated with alexithymic traits (specifically difficulties identifying and describing feelings), as well as symptoms of depression and anxiety. After accounting for alexithymia, the relationship between puberty and depression and anxiety was absent or reduced in females. Thus, alexithymic traits may have differential consequences for males and females, and possibly contribute towards increased depression and anxiety symptoms in females during adolescence. We propose that developmental changes in alexithymia should be considered when studying the onset and development of internalizing psychological disorders during adolescence.
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Affiliation(s)
- Renske van der Cruijsen
- Department of Developmental Psychology, Leiden University, the Netherlands, Leiden, The Netherlands
| | - Jennifer Murphy
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Geoffrey Bird
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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23
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Krysiak R, Kowalcze K, Okopień B. Sexual function and depressive symptoms in young women with overt hyperthyroidism. Eur J Obstet Gynecol Reprod Biol 2019; 234:43-48. [PMID: 30654201 DOI: 10.1016/j.ejogrb.2018.12.035] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/15/2018] [Accepted: 12/27/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Despite high prevalence in a female population, surprisingly little is known about sexual functioning of women with thyroid hyperfunction. This study was aimed at assessing female sexual function and depressive symptoms in women with overt hyperthyroidism of autoimmune and non-autoimmune origin. STUDY DESIGN The study included three age-matched groups of young women inhabiting the Upper Silesia (a selenium-deficient and iodine-sufficient area): individuals with overt hyperthyroidism induced by Graves' disease (group A, n = 31), women with overt hyperthyroidism caused by toxic multinodular goiter or toxic adenoma (group B, n = 30) and women with normal thyroid function (group C, n = 34). Apart from measuring serum hormone levels, serum antibody titers and determining calculated parameters of thyroid homeostasis, all women completed questionnaires evaluating femalesexual function (FSFI) and depressive symptoms (BDI-II). RESULTS The mean total FSFI score and all domain scores were lower while the overall BDI-II score was higher in both groups of women with overt hyperthyroidism than in the control group, and correlated with thyrotropin and free thyroid hormone levels, as well as with the SPINA-GT index. The FSFI score as well as domain scores for desire, arousal and sexual satisfaction were lower, while the BDI-II score was higher in group A than in group B. In group A, the total FSFI score, desire, arousal, sexual satisfaction and severity of depressive symptoms correlated with TRAb and TPOAb titers. CONCLUSION The obtained results suggest that excessive thyroid hormone production and thyroid autoimmunity have an additive effect on sexual functioning and mood.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Karolina Kowalcze
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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24
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Bretschneider J, Janitza S, Jacobi F, Thom J, Hapke U, Kurth T, Maske UE. Time trends in depression prevalence and health-related correlates: results from population-based surveys in Germany 1997-1999 vs. 2009-2012. BMC Psychiatry 2018; 18:394. [PMID: 30572872 PMCID: PMC6302526 DOI: 10.1186/s12888-018-1973-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/05/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although an "epidemic" of depression is frequently claimed, empirical evidence is inconsistent, depending on country, study design and depression assessment. Little is known about changes in depression over time in Germany, although health insurance companies report frequency increases. Here we examined time trends in depression prevalence, severity and health-related correlates in the general population. METHODS Data were obtained from the mental health module of the "German Health Interview and Examination Survey for Adults" (2009-2012, n = 3265) and the mental health supplement of the "German National Health Interview and Examination Survey 1998" (1997-1999, n = 4176), excluding respondents older than 65. 12-month major depressive disorder (MDD), severity and symptoms were assessed based on the WHO Composite International Diagnostic Interview. Health-related quality of life (SF-36), self-reported sick days or days with limitations in normal daily life activities were examined, too. Calculations were carried out population-weighted. Additional age-standardized analyses were conducted to account for demographic changes. RESULTS Overall, MDD 12-month prevalence remained stable at 7.4%. Women showed a shifted age distribution with increased prevalence at younger ages, and increasing MDD severity. Time trends in health-related correlates occurred both in participants with and without MDD. Mental health disability increased over time, particularly among men with MDD, reflected by the mental component score of the SF-36 and days with activity limitation due to mental health problems. Demographic changes had a marginal impact on the time trends. CONCLUSIONS In contrast to the ongoing international debate regarding increased depression rates in western countries, we found no increase in overall MDD prevalence in Germany over a long period. In conclusion, increased depression frequencies in national health insurance data and growing health care costs associated with depression are not attributable to overall prevalence changes at a population level. However, shifted age distribution and increased severity among women may reflect a rising depression risk within this specific subgroup, and changes in health-related correlates indicate a growing mental health care need for depression, particularly among men.
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Affiliation(s)
- Julia Bretschneider
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Silke Janitza
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Frank Jacobi
- Psychologische Hochschule Berlin, Berlin, Germany
| | - Julia Thom
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Ulfert Hapke
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Tobias Kurth
- Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike E. Maske
- Unit 26 Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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Hankin BL, Young JF, Gallop R, Garber J. Cognitive and Interpersonal Vulnerabilities to Adolescent Depression: Classification of Risk Profiles for a Personalized Prevention Approach. J Abnorm Child Psychol 2018; 46:1521-1533. [PMID: 29368207 PMCID: PMC6060038 DOI: 10.1007/s10802-018-0401-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Despite interest in psychosocial vulnerabilities to depression, little is known about reliable and valid individualized risk profiles that can be used to match individuals to evidence-based interventions for depression. This study investigated well-established cognitive and interpersonal vulnerabilities to depression among youth to discern an evidence-based risk classification approach which is being used in a personalized depression prevention randomized clinical trial. Data were drawn from a general community sample of adolescents (N = 467; ages 10-16, mean 13.14, SD = 1.62; 57% females) who were followed prospectively for 3 years. Youth completed measures of cognitive (negative cognitive style, dysfunctional attitudes, rumination) and interpersonal (support and conflict with peers and parents, excessive reassurance seeking, social competence, co-rumination) risks to depression, and then were followed longitudinally for onset of depression. Principal axis factor analyses showed that three latent factors--cognitive vulnerability, interpersonal support, and interpersonal conflict--optimally represented the structure of these risk factors. Clinically practical and meaningful cutoffs, based on tertile cut-off scores on cognitive and interpersonal risk measures, were used to categorize youth into relatively balanced high and low cognitive and interpersonal risk groups. These risk classification groups exhibited validity (AUC > 0.70) by predicting prospective onsets of depressive episodes at 18-months follow-ups. These findings demonstrate a reliable and valid approach to synthesize psychosocial vulnerabilities to depression, specifically cognitive and interpersonal risks. Results are discussed in terms of using these risk classifications profiles to test personalized prevention of depression during adolescence.
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Affiliation(s)
- Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E Daniel St, Champaign, IL, 61820, USA.
| | - Jami F Young
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Ulbricht CM, Chrysanthopoulou SA, Levin L, Lapane KL. The use of latent class analysis for identifying subtypes of depression: A systematic review. Psychiatry Res 2018; 266:228-246. [PMID: 29605104 PMCID: PMC6345275 DOI: 10.1016/j.psychres.2018.03.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [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] [Received: 02/23/2017] [Revised: 01/24/2018] [Accepted: 03/02/2018] [Indexed: 01/08/2023]
Abstract
Depression is a significant public health problem but symptom remission is difficult to predict. This may be due to substantial heterogeneity underlying the disorder. Latent class analysis (LCA) is often used to elucidate clinically relevant depression subtypes but whether or not consistent subtypes emerge is unclear. We sought to critically examine the implementation and reporting of LCA in this context by performing a systematic review to identify articles detailing the use of LCA to explore subtypes of depression among samples of adults endorsing depression symptoms. PubMed, PsycINFO, CINAHL, Scopus, and Google Scholar were searched to identify eligible articles indexed prior to January 2016. Twenty-four articles reporting 28 LCA models were eligible for inclusion. Sample characteristics varied widely. The majority of articles used depression symptoms as the observed indicators of the latent depression subtypes. Details regarding model fit and selection were often lacking. No consistent set of depression subtypes was identified across studies. Differences in how models were constructed might partially explain the conflicting results. Standards for using, interpreting, and reporting LCA models could improve our understanding of the LCA results. Incorporating dimensions of depression other than symptoms, such as functioning, may be helpful in determining depression subtypes.
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Affiliation(s)
- Christine M Ulbricht
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Stavroula A Chrysanthopoulou
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Len Levin
- Lamar Soutter Library, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Kate L Lapane
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA
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27
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Hidese S, Asano S, Saito K, Sasayama D, Kunugi H. Association of depression with body mass index classification, metabolic disease, and lifestyle: A web-based survey involving 11,876 Japanese people. J Psychiatr Res 2018; 102:23-28. [PMID: 29567524 DOI: 10.1016/j.jpsychires.2018.02.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 07/14/2017] [Revised: 02/02/2018] [Accepted: 02/09/2018] [Indexed: 12/31/2022]
Abstract
Body mass index (BMI) and lifestyle-related physical illnesses have been implicated in the pathology of depression. We aimed to investigate the association of depression wih BMI classification (i.e., underweight, normal, overweight, and obese), metabolic disease, and lifestyle using a web-based survey in a large cohort. Participants were 1000 individuals who have had depression (mean age: 41.4 ± 12.3 years, 501 men) and 10,876 population-based controls (45.1 ± 13.6 years, 5691 men). The six-item Kessler scale (K6) test was used as a psychological distress scale. Compared to in the controls, obesity and hyperlipidemia were more common and frequency of a snack or night meal consumption was higher, whereas frequencies of breakfast consumption and vigorous and moderate physical activities were lower in the patients. K6 test scores were higher for underweight or obese people compared to normal or overweight people. A logistic regression analysis showed that the K6 test cut-off score was positively associated with being underweight, hyperlipidemia, and the frequency of a snack or night meal consumption, whereas it was negatively associated with the frequency of breakfast consumption in the patients. Logistic regression analyses showed that self-reported depression was positively associated with metabolic diseases and the frequency of a snack or night meal consumption, whereas it was negatively associated with the frequency of breakfast consumption. The observed associations of depression with BMI classification, metabolic disease, and lifestyle suggest that lifestyle and related physical conditions are involved in at least a portion of depressive disorders.
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience (NCNP), National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan; Department of NCNP Brain Physiology and Pathology, Division of Cognitive and Behavioral Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shinya Asano
- Genequest Inc, 5-22-37, Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-0022, Japan
| | - Kenji Saito
- Genequest Inc, 5-22-37, Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-0022, Japan
| | - Daimei Sasayama
- Department of Mental Disorder Research, National Institute of Neuroscience (NCNP), National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan; Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, 390-8621, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience (NCNP), National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan; Department of NCNP Brain Physiology and Pathology, Division of Cognitive and Behavioral Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Eastman M, Foshee V, Ennett S, Sotres-Alvarez D, Reyes HLM, Faris R, North K. Profiles of internalizing and externalizing symptoms associated with bullying victimization. J Adolesc 2018; 65:101-110. [PMID: 29573643 PMCID: PMC5932115 DOI: 10.1016/j.adolescence.2018.03.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 11/23/2022]
Abstract
This study identified profiles of internalizing (anxiety and depression) and externalizing (delinquency and violence against peers) symptoms among bullying victims and examined associations between bullying victimization characteristics and profile membership. The sample consisted of 1196 bullying victims in grades 8-10 (Mage = 14.4, SD = 1.01) who participated in The Context Study in three North Carolina counties in Fall 2003. Five profiles were identified using latent profile analysis: an asymptomatic profile and four profiles capturing combinations of internalizing and externalizing symptoms. Associations between bullying characteristics and membership in symptom profiles were tested using multinomial logistic regression. More frequent victimization increased odds of membership in the two high internalizing profiles compared to the asymptomatic profile. Across all multinomial logistic regression models, when the high internalizing, high externalizing profile was the reference category, adolescents who received any type of bullying (direct, indirect, or dual) were more likely to be in this category than any others.
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Affiliation(s)
- Meridith Eastman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
| | - Vangie Foshee
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Susan Ennett
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E. Franklin St., Suite 203, CB#8030, Chapel Hill, NC 27514, USA
| | - H Luz McNaughton Reyes
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Robert Faris
- Department of Sociology, University of California Davis, 2247 Social Sciences & Humanities, One Shields Avenue, Davis, CA 95616, USA
| | - Kari North
- Department of Epidemiology, Gillings School of Global Public Health and Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, 137 E. Franklin St., Suite 306, CB# 7435, Chapel Hill, NC 27514, USA
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Wong J, Abrahamowicz M, Buckeridge DL, Tamblyn R. Assessing the accuracy of using diagnostic codes from administrative data to infer antidepressant treatment indications: a validation study. Pharmacoepidemiol Drug Saf 2018; 27:1101-1111. [PMID: 29687504 PMCID: PMC6220980 DOI: 10.1002/pds.4436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/24/2018] [Accepted: 03/12/2018] [Indexed: 11/07/2022]
Abstract
PURPOSE To assess the accuracy of using diagnostic codes from administrative data to infer treatment indications for antidepressants prescribed in primary care. METHODS Validation study of administrative diagnostic codes for 13 plausible indications for antidepressants compared with physician-documented treatment indications from an indication-based electronic prescribing system in Quebec, Canada. The analysis included all antidepressant prescriptions written by primary care physicians between January 1, 2003 and December 31, 2012 using the electronic prescribing system. Patient prescribed antidepressants were linked to physician claims and hospitalization data to obtain all diagnoses recorded in the past year. RESULTS Diagnostic codes had poor sensitivity for all treatment indications, ranging from a high of only 31.2% (95% CI, 26.8%-35.9%) for anxiety/stress disorders to as low as 1.3% (95% CI, 0.0%-5.2%) for sexual dysfunction. Sensitivity was notably worse among older patients and patients with more chronic comorbidities. Physician claims data were a better source of diagnostic codes for antidepressant treatment indications than hospitalization data. CONCLUSIONS Administrative diagnostic codes are poor proxies for antidepressant treatment indications. Future work should determine whether the use of other variables in administrative data besides diagnostic codes can improve the ability to predict antidepressant treatment indications.
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Affiliation(s)
- Jenna Wong
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill UniversityMontrealCanada
- Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care InstituteBostonMAUSA
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill UniversityMontrealCanada
| | - David L. Buckeridge
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill UniversityMontrealCanada
| | - Robyn Tamblyn
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill UniversityMontrealCanada
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Abstract
Depression is one of the most common psychiatric disorders worldwide, with over 350 million people affected. Current methods to screen for and assess depression depend almost entirely on clinical interviews and self-report scales. While useful, such measures lack objective, systematic, and efficient ways of incorporating behavioral observations that are strong indicators of depression presence and severity. Using dynamics of facial and head movement and vocalization, we trained classifiers to detect three levels of depression severity. Participants were a community sample diagnosed with major depressive disorder. They were recorded in clinical interviews (Hamilton Rating Scale for Depression, HRSD) at seven-week intervals over a period of 21 weeks. At each interview, they were scored by the HRSD as moderately to severely depressed, mildly depressed, or remitted. Logistic regression classifiers using leave-one-participant-out validation were compared for facial movement, head movement, and vocal prosody individually and in combination. Accuracy of depression severity measurement from facial movement dynamics was higher than that for head movement dynamics, and each was substantially higher than that for vocal prosody. Accuracy using all three modalities combined only marginally exceeded that of face and head combined. These findings suggest that automatic detection of depression severity from behavioral indicators in patients is feasible and that multimodal measures afford the most powerful detection.
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Bachmann M, Päeske L, Kalev K, Aarma K, Lehtmets A, Ööpik P, Lass J, Hinrikus H. Methods for classifying depression in single channel EEG using linear and nonlinear signal analysis. Comput Methods Programs Biomed 2018; 155:11-17. [PMID: 29512491 DOI: 10.1016/j.cmpb.2017.11.023] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 11/14/2017] [Accepted: 11/24/2017] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Depressive disorder is one of the leading causes of burden of disease today and it is presumed to take the first place in the world in 2030. Early detection of depression requires a patient-friendly inexpensive method based on easily measurable objective indicators. This study aims to compare various single-channel electroencephalographic (EEG) measures in application for detection of depression. METHODS The EEG recordings were performed on a group of 13 medication-free depressive outpatients and 13 gender and age matched controls. The recorded 30-channel EEG signal was analysed using linear methods spectral asymmetry index, alpha power variability and relative gamma power and nonlinear methods Higuchi's fractal dimension, detrended fluctuation analysis and Lempel-Ziv complexity. Classification accuracy between depressive and control subjects was calculated using logistic regression analysis with leave-one-out cross-validation. Calculations were performed separately for each EEG channel. RESULTS All calculated measures indicated increase with depression. Maximal testing accuracy using a single measure was 81% for linear and 77% for nonlinear measures. Combination of two linear measures provides the accuracy of 88% and two nonlinear measures of 85%. Maximal classification accuracy of 92% was indicated using mixed combination of three linear and three nonlinear measures. CONCLUSIONS The results of this preliminary study confirm that single-channel EEG analysis, employing the combination of measures, can provide discrimination of depression at the level of multichannel EEG analysis. The performed study shows that there is no single superior measure for detection of depression.
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Affiliation(s)
- Maie Bachmann
- Centre for Biomedical Engineering, Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn 19086, Estonia.
| | - Laura Päeske
- Centre for Biomedical Engineering, Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn 19086, Estonia
| | - Kaia Kalev
- Centre for Biomedical Engineering, Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn 19086, Estonia
| | - Katrin Aarma
- Centre for Biomedical Engineering, Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn 19086, Estonia
| | - Andres Lehtmets
- Psychiatric Centre, West Tallinn Central Hospital, Paldiski mnt 68, Tallinn 10617, Estonia
| | - Pille Ööpik
- Ädala Family Medicine Center, Madara tn 29, Tallinn 10612, Estonia; Department of Family Medicine, University of Tartu, Ülikooli 18, Tartu 50090, Estonia
| | - Jaanus Lass
- Centre for Biomedical Engineering, Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn 19086, Estonia
| | - Hiie Hinrikus
- Centre for Biomedical Engineering, Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn 19086, Estonia
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Hart SR, Van Eck K, Ballard ED, Musci RJ, Newcomer A, Wilcox HC. Subtypes of suicide attempters based on longitudinal childhood profiles of co-occurring depressive, anxious and aggressive behavior symptoms. Psychiatry Res 2017; 257:150-155. [PMID: 28755606 DOI: 10.1016/j.psychres.2017.07.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/03/2017] [Accepted: 07/16/2017] [Indexed: 01/14/2023]
Abstract
Because suicide attempts are multi-determined events, multiple pathways to suicidal behaviors exist. However, as a low-frequency behavior, within group differences in trajectories to attempts may not emerge when examined in samples including non-attempters. We used longitudinal latent profile analysis to identify subtypes specific for suicide attempters based on longitudinal trajectories of childhood clinical symptoms (i.e., depression, anxiety, and aggression measured in 2nd, 4th-7th grades) for 161 young adults (35.6% male; 58.6% African American) who attempted suicide between ages 13-30 from a large, urban community-based, longitudinal prevention trial (n = 2311). Differences in psychiatric diagnoses, suicide attempt characteristics, criminal history and traumatic stress history were studied. Three subtypes emerged: those with all low (n = 32%), all high (n = 16%), and high depressive/anxious, but low aggressive (n = 52%) symptoms. Those with the highest levels of all symptoms were significantly more likely to report a younger age of suicide attempt, and demonstrate more substance abuse disorders and violent criminal histories. Prior studies have found that childhood symptoms of depression, anxiety and aggression are malleable targets; interventions directed at each reduce future risk for suicidal behaviors. Our findings highlight the link of childhood aggression with future suicidal behaviors extending this research by examining childhood symptoms of aggression in the context of depression and anxiety.
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Affiliation(s)
- Shelley R Hart
- Department of Child Development, California State University, Chico, CA, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathryn Van Eck
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Elizabeth D Ballard
- Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Rashelle J Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison Newcomer
- Psychology Department, The Catholic University of America, Washington DC, USA
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Abstract
In an Essay to highlight World Health Day 2017, Vikram Patel proposes a staged model, from wellness to distress to disorder, for classifying depressive symptoms.
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Affiliation(s)
- Vikram Patel
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Public Health Foundation of India, National Capital Region of New Delhi, India
- Sangath, Goa, Porvorim, India
- * E-mail:
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Rayner G, Jackson GD, Wilson SJ. Two distinct symptom-based phenotypes of depression in epilepsy yield specific clinical and etiological insights. Epilepsy Behav 2016; 64:336-344. [PMID: 27473594 DOI: 10.1016/j.yebeh.2016.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 05/18/2016] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 11/17/2022]
Abstract
Depression is common but underdiagnosed in epilepsy. A quarter of patients meet criteria for a depressive disorder, yet few receive active treatment. We hypothesize that the presentation of depression is less recognizable in epilepsy because the symptoms are heterogeneous and often incorrectly attributed to the secondary effects of seizures or medication. Extending the ILAE's new phenomenological approach to classification of the epilepsies to include psychiatric comorbidity, we use data-driven profiling of the symptoms of depression to perform a preliminary investigation of whether there is a distinctive symptom-based phenotype of depression in epilepsy that could facilitate its recognition in the neurology clinic. The psychiatric and neuropsychological functioning of 91 patients with focal epilepsy was compared with that of 77 healthy controls (N=168). Cluster analysis of current depressive symptoms identified three clusters: one comprising nondepressed patients and two symptom-based phenotypes of depression. The 'Cognitive' phenotype (base rate=17%) was characterized by symptoms taking the form of self-critical cognitions and dysphoria and was accompanied by pervasive memory deficits. The 'Somatic' phenotype (7%) was characterized by vegetative depressive symptoms and anhedonia and was accompanied by greater anxiety. It is hoped that identification of the features of these two phenotypes will ultimately facilitate improved detection and diagnosis of depression in patients with epilepsy and thereby lead to appropriate and timely treatment, to the benefit of patient wellbeing and the potential efficacy of treatment of the seizure disorder. This article is part of a Special Issue entitled "The new approach to classification: Rethinking cognition and behavior in epilepsy".
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Affiliation(s)
- Genevieve Rayner
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia.
| | - Graeme D Jackson
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia; Comprehensive Epilepsy Programme, Austin Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria 3010, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia; Comprehensive Epilepsy Programme, Austin Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia
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Lin Y, Huang S, Simon GE, Liu S. Analysis of depression trajectory patterns using collaborative learning. Math Biosci 2016; 282:191-203. [PMID: 27789353 DOI: 10.1016/j.mbs.2016.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/19/2016] [Accepted: 10/23/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression is a common, complex, and dynamic mental disorder. Mitigating depression has become a national health priority as it affects 1 out of 10 American adults and is the most common mental illness seen in primary care. The emerging use of electronic health record (EHR) provides an unprecedented information infrastructure to understand depression trajectories. OBJECTIVE We aim to effectively analyze patterns in the collected depression trajectories of a treatment population and compare several methods to predict individual trajectories for monitoring treatment outcomes. METHODS Our data includes longitudinal Patient Health Questionnaire (PHQ)-9 scores over 4 years for assessing depression severity from the Mental Health Research Network. We analyzed > 3,000 patients with at least six PHQ-9 observations who have ongoing treatment. We used smoothing splines to model individual depression trajectories. We then used K-means clustering and collaborative modeling (CM) to identify subgroup patterns. We further predicted the individuals' PHQ-9 scores based on depression trajectories learnt from individual growth model (IGM), mixed effect model (MEM), CM, and similarity-based CM (SCM), and compared their predictive performances. RESULTS We found five broad trajectory patterns in the ongoing treatment population: stable high, stable low, fluctuating moderate, an increasing and a decreasing group. For prediction, the root mean square error (rMSE) in the testing set for IGM, MEM, CM, and SCM are 12.53, 5.91, 5.18, and 3.21. LIMITATIONS Our EHR data provide limited information on patients' demographic, socioeconomic, and other clinical factors that may be relevant to improve model performances. CONCLUSION We established a trajectory-based framework for depression assessment and prognosis that is adaptable to model population heterogeneity using EHR data. Collaborative modeling outperformed other established methods.
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Affiliation(s)
- Ying Lin
- Department of Industrial and Systems Engineering University of Washington, Box 352650, Seattle, WA 98195, United States
| | - Shuai Huang
- Department of Industrial and Systems Engineering University of Washington, Box 352650, Seattle, WA 98195, United States
| | - Gregory E Simon
- Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States; Psychiatry and Behavioral Sciences, University of Washington, Box 356560, Seattle, WA 98195, United States
| | - Shan Liu
- Department of Industrial and Systems Engineering University of Washington, Box 352650, Seattle, WA 98195, United States.
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Abstract
Objectives: To evaluate the effectiveness of an education programme for patients and carers recovering from stroke. Design: Randomized controlled trial. Subjects and setting: One hundred and seventy patients admitted to a stroke rehabilitation unit and 97 carers of these patients. Interventions: The intervention group received a specifically designed stroke information manual and were invited to attend education meetings every two weeks with members of their multidisciplinary team. The control group received usual practice. Measures: Primary outcome was knowledge of stroke and stroke services. Secondary outcomes were handicap (London Handicap Scale), physical function (Barthel Index), social function (Frenchay Activities Index), mood (Hospital Anxiety and Depression Scale) and satisfaction (Pound Scale). Carer mood was measured by the General Health Questionnaire-28. Results: There was no statistical evidence for a treatment effect on knowledge but there were trends that favoured the intervention. The education programme was associated with a significantly greater reduction in patient anxiety score at both three months (p=0.034) and six months (p=0.021) and consequently fewer ‘cases’ (Hospital Anxiety and Depression Scale anxiety subscale score ≥ 11). There were no other significant statistical differences between the patient or carer groups for other outcomes, although there were trends in favour of the education programme. Conclusion: An education programme delivered within a stroke unit did not result in improved knowledge about stroke and stroke services but there was a significant reduction in patient anxiety at six months post stroke onset.
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Affiliation(s)
- Jane Smith
- Bradford Elderly Care and Rehabilitation Research Department, St Luke's Hospital, Bradford, UK.
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Watkins CL, Lightbody CE, Sutton CJ, Holcroft L, Jack CIA, Dickinson HA, van den Broek MD, Leathley MJ. Evaluation of a single-item screening tool for depression after stroke: a cohort study. Clin Rehabil 2016; 21:846-52. [PMID: 17875564 DOI: 10.1177/0269215507079846] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To determine the accuracy and utility of a single-item screening tool for depression (the Yale, taken from the Yale—Brown Obsessive Compulsive Scale) in patients who have recently had a stroke. Design: Comparison of a clinical classification of depression with a screening tool in a defined cohort. Setting: A large teaching hospital in Liverpool, UK. Subjects: One hundred and twenty-two consecutive people admitted with an acute stroke who did not have severe cognitive or communication problems, and who were still in hospital in the second week post stroke. Main measures: Classification of depression using the Montgomery-Asberg Depression Rating Scale was compared with the Yale, a single-item screening tool. Results: When comparing the classification of depression according to the Montgomery-Asberg Depression Rating Scale and the response to the Yale we found that at week 2 the Yale had a sensitivity of 86% (57/66), a specificity of 84% (46/55), a positive predictive value of 86% (57/66) and a negative predictive value of 84% (46/55), with an overall efficiency of 85% (103/121); prevalence of depression was 54% (according to the Montgomery-Asberg Depression Rating Scale). At month 3 the Yale had a sensitivity of 95% (52/55), a specificity of 89% (32/36), a positive predictive value of 93% (52/56) and a negative predictive value of 91% (32/35), with an overall efficiency of 92% (84/91); prevalence of depression was 60%. Conclusions: The Yale, which only requires a `yes' or `no' answer to a single question, may prove a useful screening tool in identifying possible depression in people with stroke both two weeks and three months post stroke.
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Affiliation(s)
- Caroline L Watkins
- Clinical Practice Research Unit, Department of Nursing, Faculty of Health, University of Central Lancashire, Preston, and The Royal Group of Hospitals and Dental Hospital Health and Social Services Trust, Belfast, UK.
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Whalen DJ, Luby JL, Tilman R, Mike A, Barch D, Belden AC. Latent class profiles of depressive symptoms from early to middle childhood: predictors, outcomes, and gender effects. J Child Psychol Psychiatry 2016; 57:794-804. [PMID: 26748606 PMCID: PMC4914408 DOI: 10.1111/jcpp.12518] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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] [Accepted: 11/16/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND There has been little available data to inform the predictors and outcomes of latent class trajectories of depressive symptoms beginning during preschool and continuing throughout school age. Further, the extant literature in this domain has been limited by the use of parent report checklists of nonspecific 'internalizing' psychopathology rather than diagnostic interviews for depression. METHODS To address these gaps in the literature, this study applied growth mixture modeling to depressive symptom severity endorsed by children and/or their caregivers (N = 348) during a structured clinical interview in a 10-year longitudinal dataset spanning from preschool into late school age. RESULTS Three distinct trajectories of depressive symptom severity were found in boys and girls. For boys, but not girls, the high depression severity latent class increased in depressive symptoms from preschool through school age, followed by a decline in depressive symptom severity during later school age. For girls, the high depression severity latent class remained stable across time. Early childhood social adversity, familial history of affective disorder, preschool-onset ODD/CD, and school age functional impairment differentiated high-risk trajectory classes among both boys and girls. CONCLUSIONS Extending the literature on trajectories of depressive symptoms to the preschool period, these findings incorporate structured clinical interviews of depressive symptom severity and indicate gender differences as well as psychosocial predictors and functional outcomes among children in high severity latent classes. The findings from this study suggest that increased attention to screening for depressive symptoms in early childhood is of significant public health importance.
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Affiliation(s)
- Diana J. Whalen
- Department of Psychiatry, Washington University School of Medicine, MO, USA
| | - Joan L. Luby
- Department of Psychiatry, Washington University School of Medicine, MO, USA
| | - Rebecca Tilman
- Department of Psychiatry, Washington University School of Medicine, MO, USA
| | - Anissa Mike
- Department of Psychology, Washington University, MO, USA
| | - Deanna Barch
- Department of Psychiatry, Washington University School of Medicine, MO, USA
- Department of Psychology, Washington University, MO, USA
| | - Andy C. Belden
- Department of Psychiatry, Washington University School of Medicine, MO, USA
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Abstract
To examine individual, interpersonal, family, and community correlates associated with moderate-to-severe depressive symptoms among pregnant adolescents. A total of 249 primarily African American and Hispanic pregnant adolescents ages 15-18 years were recruited into either an intervention group utilizing Centering Pregnancy prenatal care and case management, or to a comparison group receiving case management only. Moderate-to-severe depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Intervention and comparison groups did not significantly differ on demographic characteristics or depression scores at baseline. A total of 115 (46.1 %) participants met criteria for moderate-to-severe depressive symptoms at entry into the program. Pregnant adolescents who were moderately-to-severely depressed were more likely to be African American, to have reported limited contact with the father of the baby, and to have experienced prior verbal, physical or sexual abuse. Depressed adolescents also experienced high levels of family criticism, low levels of general support, and exposure to community violence. A significant number of pregnant adolescents were affected by depression and other challenges that could affect their health. Comprehensive interventions addressing these challenges and incorporating partners and families are needed.
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Affiliation(s)
- Ruth S Buzi
- Population Program, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | - Peggy B Smith
- Population Program, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Claudia A Kozinetz
- East Tennessee State University, Lamb Hall, Johnson City, TN, 37614, USA
| | - Melissa Fleschler Peskin
- Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2658, Houston, TX, 77030, USA
| | - Constance M Wiemann
- Department of Pediatrics, Baylor College of Medicine, 6701 Fannin Street, CC1710, Houston, TX, 77030, USA
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Abstract
BACKGROUND A basic phenomenological question of much theoretical and empirical interest is whether the latent structure of depression is dimensional or categorical in nature. Prior taxometric studies of youth depression have yielded mixed findings. In a step towards resolving these contradictory findings, the current taxometric investigation is the first to utilize a recently developed objective index, the comparison curve fit index, to evaluate the latent structure of major depression in an epidemiological sample of children and adolescents. METHOD Data were derived from Mental Health of Children and Young People in Great Britain surveys. Participants were administered a structured diagnostic interview to assess for current depression. Parents (n = 683) were interviewed for children aged 5-16 years, and child interviews (n = 605) were conducted for those aged 11-16 years. RESULTS MAMBAC (mean above minus below a cut), MAXEIG (maximum eigenvalue) and L-Mode (latent mode) analyses provided convergent support for a dimensional latent structure. CONCLUSIONS The current findings suggest that depression in youth is more accurately conceptualized as a continuous syndrome rather than a discrete diagnostic entity.
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Affiliation(s)
- R T Liu
- Department of Psychiatry and Human Behavior,Alpert Medical School of Brown University,Bradley Hospital,East Providence,RI,USA
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Meesters Y, Duijzer WB, Nolen WA, Schoevers RA, Ruhé HG. [Reasons for including the Inventory of Depressive Symptomatology (IDS) and its shortened version (QIDS) in routine outcome monitoring by the Foundation Benchmark Mental Health (SBG)]. Tijdschr Psychiatr 2016; 58:48-54. [PMID: 26779755] [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: 06/05/2023]
Abstract
BACKGROUND Increasingly, health insurance companies are asking for treatment results in mental health care to be expressed in actual numbers. They base their request on the data supplied by sbg (Stichting Benchmark ggz) and the procedures that sbg has followed. For the purpose of benchmarking, the sbg has accepted a limited number of questionnaires. These tools are not suitable for performing routine outcome monitoring (rom) in clinical practice. There is a urgent need for these questionnaires to be replaced by a widely-used depression questionnaire, namely the ids. AIM To present arguments supporting the view that the ids is an excellent and useful instrument that the sbg should accept as a measuring tool. METHOD We discuss the quality of the ids by reviewing the literature. RESULTS The ids is a high quality instrument well suited for measuring the severity of depressions and also is sufficiently sensitive for measuring mood improvements.<br/> CONCLUSION The ids is an excellent tool for performing rom measurements and is available free of charge. The authors argue that the sbg should accept this questionnaire as a suitable instrument for benchmarking.
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Easterbrooks MA, Kotake C, Raskin M, Bumgarner E. Patterns of depression among adolescent mothers: Resilience related to father support and home visiting program. Am J Orthopsychiatry 2016; 86:61-8. [PMID: 26460697 DOI: 10.1037/ort0000093] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The negative consequences of maternal depression are a major public health concern, both for mothers and for their children. Despite the high prevalence of depression among adolescent mothers, little is known about the patterns of adolescent mothers' depression in the early parenting years. The present study examined mothers' depression during the first 2 years following childbirth in a sample of 428 young mothers (20 or younger at first childbirth) who were participants in a randomized controlled trial of a home visiting parenting support program. Depressive symptoms were assessed using the self-reported Center for Epidemiological Studies Depression Scale (CES-D). Mothers were classified into groups based on whether their depressive symptoms were below or above the cutoff for clinically significant symptomatology. Depression groups (stable nondepressed, stable depressed, remitted depression) were associated with variations in mothers' satisfaction with support from the baby's father and enrollment in the home visiting program. Maternal depression was more likely to remit when mothers were satisfied with father support; assignment to the home visiting program was associated with mothers remaining mentally healthy. Results have clinical and policy implications for prevention and intervention programs.
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Affiliation(s)
- M Ann Easterbrooks
- Eliot-Pearson Department of Child Study and Human Development, Tufts University
| | - Chie Kotake
- Eliot-Pearson Department of Child Study and Human Development, Tufts University
| | - Maryna Raskin
- Eliot-Pearson Department of Child Study and Human Development, Tufts University
| | - Erin Bumgarner
- Eliot-Pearson Department of Child Study and Human Development, Tufts University
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Gerber L, Gaudillière JP. Marketing Masked Depression: Physicians, Pharmaceutical Firms, and the Redefinition of Mood Disorders in the 1960s and 1970s. Bull Hist Med 2016; 90:455-490. [PMID: 27795456 DOI: 10.1353/bhm.2016.0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article investigates the redefinition of depression that took place in the early 1970s. Well before the introduction of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, this rather rare and severe psychiatric disorder hitherto treated in asylums was transformed into a widespread mild mood disorder to be handled by general practitioners. Basing itself on the archives of the Swiss firm Ciba-Geigy, the article investigates the role of the pharmaceutical industry in organizing this shift, with particular attention paid to research and scientific marketing. By analyzing the interplay between the firm, elite psychiatrists specializing in the study of depression, and general practitioners, the article argues that the collective construction of the market for first-generation antidepressants triggered two realignments: first, it bracketed etiological issues with multiple classifications in favor of a unified symptom-oriented approach to diagnosis and treatment; second, it radically weakened the differentiation between antidepressants, neuroleptics, and tranquilizers. The specific construction of masked depression shows how, in the German-speaking context, issues of ambulatory care such as recognition, classification, and treatment of atypical or mild forms of depression were reshaped to meet commercial as well as professional needs.
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Jung H, Park HA, Song TM. Development and Evaluation of an Adolescents' Depression Ontology for Analyzing Social Data. Stud Health Technol Inform 2016; 225:442-446. [PMID: 27332239] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study aims to develop and evaluate an ontology for adolescents' depression to be used for collecting and analyzing social data. The ontology was developed according to the 'ontology development 101' methodology. Concepts were extracted from clinical practice guidelines and related literatures. The ontology is composed of five sub-ontologies which represent risk factors, sign and symptoms, measurement, diagnostic result and management care. The ontology was evaluated in four different ways: First, we examined the frequency of ontology concept appeared in social data; Second, the content coverage of ontology was evaluated by comparing ontology concepts with concepts extracted from the youth depression counseling records; Third, the structural and representational layer of the ontology were evaluated by 5 ontology and psychiatric nursing experts; Fourth, the scope of the ontology was examined by answering 59 competency questions. The ontology was improved by adding new concepts and synonyms and revising the level of structure.
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Affiliation(s)
- Hyesil Jung
- College of Nursing, Seoul National University, Seoul
| | | | - Tae-Min Song
- Korea Institute for Health and social Affairs, Sejong, Korea
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Ulbricht CM, Rothschild AJ, Lapane KL. The association between latent depression subtypes and remission after treatment with citalopram: A latent class analysis with distal outcome. J Affect Disord 2015; 188:270-7. [PMID: 26384013 DOI: 10.1016/j.jad.2015.08.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 06/03/2015] [Revised: 08/12/2015] [Accepted: 08/17/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The objectives were to characterize latent depression subtypes by symptoms, evaluate sex differences in and examine correlates of these subtypes, and examine the association between subtype and symptom remission after citalopram treatment. METHODS Latent class analysis was applied to baseline data from 2772 participants in the Sequenced Treatment Alternatives to Relieve Depression trial. Indicators were from the Quick Inventory of Depressive Symptomatology. Separate multinomial logistic models identified correlates of subtypes and the association between subtype and the distal outcome of remission. RESULTS Four latent subtypes were identified: Mild (men: 37%, women: 27%), Moderate (men: 24%, women: 21%), Severe with Increased Appetite (men: 13%, women: 22%), and Severe with Insomnia (men: 26%, women: 31%). Generalized anxiety disorder, bulimia, and social phobia were correlated with Severe with Increased Appetite and generalized anxiety disorder, post-traumatic stress disorder, and social phobia with Severe with Insomnia. Relative to those with the Mild subtype, those with Severe with Increased Appetite (odds ratiomen (OR): 0.48; 95% confidence interval (CI): 0.25-0.92; OR women: 0.59; 95% CI: 0.41-0.86) and those with Severe Depression with Insomnia (ORmen: 0.65; 95% CI: 0.41-1.02; ORwomen: 0.45; 95% CI: 0.32-0.64) were less likely to achieve remission. LIMITATIONS The sample size limited exploration of higher order interactions. CONCLUSIONS Insomnia and increased appetite distinguished latent subtypes. Sex and psychiatric comorbidities differed between the subtypes. Remission was less likely for those with the severe depression subtypes. Sleep disturbances, appetite changes, and other mental disorders may play a role in the etiology and treatment of depression.
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Affiliation(s)
- Christine M Ulbricht
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester 01605, MA, United States.
| | - Anthony J Rothschild
- Center for Psychopharmacologic Research and Treatment, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - Kate L Lapane
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester 01605, MA, United States
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Stochl J, Khandaker GM, Lewis G, Perez J, Goodyer IM, Zammit S, Sullivan S, Croudace TJ, Jones PB. Mood, anxiety and psychotic phenomena measure a common psychopathological factor. Psychol Med 2015; 45:1483-1493. [PMID: 25394403 DOI: 10.1017/s003329171400261x] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [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: 12/26/2022]
Abstract
BACKGROUND Psychotic phenomena are common in the general population but are excluded from diagnostic criteria for mild to moderate depression and anxiety despite their co-occurrence and shared risk factors. We used item response theory modelling to examine whether the co-occurrence of depressive, anxiety and psychotic phenomena is best explained by: (1) a single underlying factor; (2) two separate, uncorrelated factors; (3) two separate yet linked factors; or (4) two separate domains along with an underlying 'common mental distress' (CMD) factor. We defined where, along any latent continuum, the psychopathological items contributed most information. METHOD We performed a secondary analysis of cross-sectional, item-level information from measures of depression, anxiety and psychotic experiences in 6617 participants aged 13 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort and 977 participants aged 18 years from the ROOTS schools-based sample. We replicated results from one sample in the other and validated the latent factors against an earlier parental measure of mental state. RESULTS In both cohorts depression, anxiety and psychotic items were best represented as a bi-factor model with a single, unitary CMD factor on which psychotic items conveyed information about the more severe end (model 4); residual variation remained for psychotic items. The CMD factor was significantly associated with the prior parental measure. CONCLUSIONS Psychotic phenomena co-occur with depression and anxiety in teenagers and may be a marker of severity in a single, unitary dimension of CMD. Psychotic phenomena should be routinely included in epidemiological assessments of psychiatric morbidity, otherwise the most severe symptomatology remains unmeasured.
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Affiliation(s)
- J Stochl
- Department of Psychiatry,University of Cambridge,NIHR Biomedical Research Centre and CLAHRC East of England,Cambridge,UK
| | - G M Khandaker
- Department of Psychiatry,University of Cambridge,NIHR Biomedical Research Centre and CLAHRC East of England,Cambridge,UK
| | - G Lewis
- Mental Health Sciences Unit,University College London,London,UK
| | - J Perez
- Department of Psychiatry,University of Cambridge,NIHR Biomedical Research Centre and CLAHRC East of England,Cambridge,UK
| | - I M Goodyer
- Department of Psychiatry,University of Cambridge,NIHR Biomedical Research Centre and CLAHRC East of England,Cambridge,UK
| | - S Zammit
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine,Cardiff,UK
| | - S Sullivan
- Centre for Academic Mental Health,School of Social and Community Medicine, University of Bristol,Bristol,UK
| | - T J Croudace
- Mental Health and Addiction Research Group (MHARG),Hull York Medical School (HYMS) and Department of Health Sciences,Seebohm Rowntree Building,University of York,York,UK
| | - P B Jones
- Department of Psychiatry,University of Cambridge,NIHR Biomedical Research Centre and CLAHRC East of England,Cambridge,UK
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Jung H, Park HA, Song TM, Jeon E, Kim AR, Lee JY. Development of an Adolescent Depression Ontology for Analyzing Social Data. Stud Health Technol Inform 2015; 216:1099. [PMID: 26262398] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Depression in adolescence is associated with significant suicidality. Therefore, it is important to detect the risk for depression and provide timely care to adolescents. This study aims to develop an ontology for collecting and analyzing social media data about adolescent depression. This ontology was developed using the 'ontology development 101'. The important terms were extracted from several clinical practice guidelines and postings on Social Network Service. We extracted 777 terms, which were categorized into 'risk factors', 'sign and symptoms', 'screening', 'diagnosis', 'treatment', and 'prevention'. An ontology developed in this study can be used as a framework to understand adolescent depression using unstructured data from social media.
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Affiliation(s)
- Hyesil Jung
- College of Nursing, Seoul National University
| | | | | | - Eunjoo Jeon
- College of Nursing, Seoul National University
| | - Ae Ran Kim
- College of Nursing, Seoul National University
| | - Joo Yun Lee
- College of Nursing, Seoul National University
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