Genetic Risk and High Burden of Depression and Suicide in the Maya-Mestizo Population of Yucatán, México.

Background: Antepartum depression (APD) is also of immense concern because of its grave consequences on the mother, pregnancy outcomes, child development and the family. Its prevalence is under the influence of several factors. Aim: To determine the impact of patients’ socio-demographic and obstetric characteristics on the prevalence of major antenatal depression in Rivers State University Teaching hospital, Nigeria. Methods: This was a cross-sectional study of 163 pregnant women who were recruited via systematic random sampling in the antenatal clinic of Rivers State University Teaching Hospital over a period of 4 months. Data on socio-demographic and obstetrics characteristics of the patients were obtained with the aid of semi-structured interviewer-administered questionnaire. Screening for and diagnosis of depression was done using the Edinburgh Postnatal Depression Scale (EPDS). Data collected was analyzed using the Statistical Package for Social Sciences (SPSS) version 20 statistical software. Descriptive analysis of all the variables in the study was carried out using frequency tables and bar charts. The associations between depression during pregnancy and the independent variables (socio-demographic, gestational and obstetric characteristics) were assessed using Chi-square test or a Fisher’s exact test when the expected cell count was less than five in at least twenty percent of the cells. Level of significance was set at p<0.05. Results: The mean age of the participants was 29.1±4.53 years with an age range of 20-40 years. Majority of the participants were married (87.1%) from monogamous families (73.6%) and had tertiary level of education (67.5%), Majority were within high social class (56.4%), and did not experience intimate partner violence (92.6%). The prevalence of depression was 44.8%. Educational level showed significant statistical relationship with antepartum depression (X2=9.773, p<0.009). APD was not shown to have significant association with the age of the mothers (X2=4.60, P<0.203) and marital status (X2=0.847, p <0.738). Furthermore, there were no statistically significant differences in the prevalence of major depression among women in the three different trimesters of pregnancy. Conclusion: The prevalence of antepartum major depression at the RSUTH, Port Harcourt in Nigeria was high. There was statistically significant differences in the prevalence of major depression among different educational categories.

Objectives The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic. Method The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout. Results Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements. Conclusions In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.

Lifetime suicide risk in major depression: sex and age determinants

To determine whether the time periods surrounding the 2008 US economic downturn were accompanied by an increase in prevalence of depression in the US adult population. We used data from the 24,182 adults aged ≥ 18 years who participated in the National Health and Nutrition Examination Survey during 2005-2012. A cross-sectional analysis was performed at each time period to determine prevalence of major and other depression as assessed by standardized questionnaires based on 9 criteria for major depressive episodes defined by DSM-IV. The demographic characteristics of the US population were similar across time periods except for the percentage of adults living in poverty, which increased from 26.43% during 2005-2006 to 33.46% during 2011-2012. The prevalence of major depression increased from 2.33% (95% CI, 1.64%-3.01%) during 2005-2006 to 3.49% (95% CI, 2.84%-4.03%) in 2009-2010 to 3.79% (95% CI, 3.01%-4.57%) in 2011-2012. Prevalence of other depression increased from 4.10% (95% CI, 3.37%-4.88%) in 2005-2006 to 4.79% (95% CI, 4.10%-5.44%) in the 2009-2010 period but then declined to 3.68% (95% CI, 2.84%-4.48%) in the 2011-2012 time period (P = .4). After adjustment for the distribution of age, sex, race/ethnicity, education, insurance status, and poverty status in the US adult noninstitutionalized population, each 2-year period after the 2005-2006 time period was associated with a 0.4% increase in major depression prevalence (P < .001). No significant differences in other depression prevalence were noted by time period (P = .6). The time periods surrounding the recent economic recession were accompanied by a significant and sustained increase in major depression prevalence in the US population. It is plausible that the recession, given its strong, persistent, and negative effects on employment, job and housing security, and stock investments, contributed to the sustained increase in prevalence of major depression in the US population, but other factors associated with the recession time period could have played a role. The impact of the economic downturn on depression prevalence should be considered when formulating future policies and programs to promote and maintain the health of the US population.

Background Shortened telomere length has been associated with mortality in patients with coronary heart disease (CHD) and is considered an emerging marker of biological age. Whether short telomere length is associated with depression in patients with CHD has not been evaluated. Methods In a cross-sectional study of 952 outpatients with stable CHD, we ascertained the presence of major depressive disorder using the Computerized Diagnostic Interview Schedule. Relative mean telomere length was measured from leukocyte DNA using a quantitative polymerase chain reaction assay. We examined the association between depression and leukocyte telomere length using linear and logistic regression models. Results Of the 952 participants, 206 (22%) had current (past month) depression. Patients with depression had lower mean ± SE telomere length than those without depression ( Table ). Likewise, patients with MDD had a 70% greater odds of having telomere length in the lowest vs. highest quartile (adjusted OR 1.70. 95% CI, 1.05-2.76; p=0.03). Conclusion Major depressive disorder is associated with reduced leukocyte telomere length in patients with stable CHD. The potential mechanisms underlying this association deserve further study. Mean +/- SE telomere length by presence of major depressive disorder Adjusted for Current major depression N=206 No current major depression N=746 P value age, sex 0.86±0.02 0.90±0.1 .02 age, sex, diabetes, BMI, smoking 0.86±0.02 0.89±0.01 .04 age, sex, diabetes, BMI, smoking, LVEF, statin use 0.85±0.02 0.89±0.01 .03

Major depression, a frequent psychiatric disease, is associated with ischemic heart disease. It is usually subdiagnosed and subtreated. To study the prevalence of major depression among survivors of an acute myocardial infarction. Retrospective study of 42 survivors of an acute myocardial infarction treated at a regional Chilean Hospital. The presence of major depression in the 6 months previous to the acute myocardial infarction, was investigated using the diagnostic instruments CIDI (Composite International Diagnostic Interview) and DIS (Diagnostic Interview Schedule), psychiatric diagnoses were based on DSMIII-R. The prevalence of depression was compared with that observed in a group of 156 healthy subjects participating in a psychiatric epidemiological study. Major depression was diagnosed in 12 male subjects with an acute myocardial infarction. The prevalence in the control group was significantly lower (15%, p < 0.049). Patients with depression were older and required longer hospital stay than patients without depression. Patients with acute myocardial infarction, had a significantly greater prevalence of major depression in the previous 6 months, than the general population. Thus, major depression could be an independent and modifiable coronary risk factor.

The association between suicidality and treatment with Selective Serotonin Reuptake Inhibitors in older people with major depression: a systematic review

Previous estimates of the prevalence of seasonal affective disorder (SAD) in community samples have been in the range 2-10%, using methods not derived from DSM algorithms. We report the first community-based study to estimate major and minor depression with a seasonal pattern in a community-based sample using a diagnostic instrument derived from DSM-III-R. A modified version of the Composite International Diagnostic Interview was administered to 8098 subjects in the 48 coterminous states of the USA (the National Comorbidity Survey) to assess the prevalence of major and minor depression with a seasonal pattern. The lifetime prevalence of major depression with a seasonal pattern was 0.4%, and the prevalence of major or minor depression with a seasonal pattern was 1.0%. Among respondents with major depression, male gender and older age were associated with a higher prevalence with a seasonal pattern. Prevalence estimates of major and minor depression with a seasonal pattern are much lower than those found in previous studies of SAD in the community, probably due to the approach to diagnosis used in the present study, which more accurately represents DSM-III-R criteria for major depression with a seasonal pattern. The distribution of the disorder is similar to that found in previous studies except for the higher prevalence among males.

This paper will summarize the authors' research that disproved the accepted lifetime suicide risk in major depression. It will then explore the pivotal issue of gender in understanding suicide risk in depression and raise questions as to whether this is adequately reflected in the current diagnostic construct of this condition. The methods of two recent papers published by the authors are briefly recounted. In the first of these papers, an age-specific algorithm was developed to reflect the necessary mathematical relationship between the prevalence of major depression, total population suicide rates and suicide risk in depression. It allowed for deaths in each age group from other causes, corrected for official underreporting, and was calculated on the entire population of the USA. In the second paper this methodology was further refined and applied to gender and age data. The suicide risk in major depression as it is currently defined diagnostically is of the order of 3.4% rather than the previously accepted figure of 15%. However, a single figure is misleading as it averages two highly disparate figures of almost 7% for men and only 1% for women. In youths (< age 25) the male: female ratio is even higher (10:1). Among sufferers of major depression, men and those who have been hospitalized have a much greater risk of suicide. These findings are sensitive to diagnostic inclusivity (the algorithm's denominator) which raises the question as to whether women with a depressive illness are more likely to be correctly identified than male sufferers? An argument is made for a gender-based nosological revision of the diagnostic criteria. In the interim, given the treatable morbidity of depression and the availability of safe, well-tolerated antidepressants, there is a prima facie case for lowering our threshold of treatment in men and youths presenting with a history of anger dyscontrol, or substance abuse, who have decompensated from previous levels of functioning and who show features of either typical or atypical depression.

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Depressive Disorders

The objective of this paper was to evaluate the lifetime and point prevalence of major depression in a population-based Multiple Sclerosis (MS) clinic sample, and to describe associations between selected biopsychosocial variables and the prevalence of lifetime major depression in this sample. Subjects who had participated in an earlier study were re-contacted for additional data collection. Eighty-three per cent (n=136) of those eligible consented to participate. Each subject completed the Composite International Diagnostic Interview (CIDI) and an interviewer-administered questionnaire evaluating a series of biopsychosocial variables. The lifetime prevalence of major depression in this sample was 22.8%, somewhat lower than previous estimates in MS clinic populations. Women, those under 35, and those with a family history of major depression had a higher prevalence. Also, subjects reporting high levels of stress and heavy ingestion of caffeine (>400 mg) had a higher prevalence of major depression. As this was a cross-sectional analysis, the direction of causal effect for the observed associations could not be determined. By identifying variables that are associated with lifetime major depression, these data generate hypotheses for future prospective studies. Such studies will be needed to further understand the etiology of depressive disorders in MS.

Research has shown an association between urinary incontinence and depression. Studies that use community-based samples and major depressive disorder diagnostic criteria are needed. The objective of this study was to estimate the prevalence of and factors associated with major depression in women with urinary incontinence. We conducted an age-stratified postal survey of 6,000 women aged 30-90 years. Subjects were randomly selected from enrollees in a large health maintenance organization in Washington state. Main outcome measures were prevalence of current major depression and adjusted odds ratios for factors associated with major depression in women with urinary incontinence. The response rate was 64% (n = 3,536) after applying exclusion criteria. The prevalence of urinary incontinence was 42% (n = 1,458). The prevalence of major depression was 3.7% (n = 129), with 2.2% in those without incontinence versus 6.1% in those with incontinence. Among women with incontinence, major depression prevalence rates differed by incontinence severity (2.1% in mild, 5.7% in moderate, and 8.3% in severe) and incontinence type (4.7% in stress, 6.6% in urge/mixed). Obesity (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.3-4.0), current smoking (OR 2.7, 95% CI 1.5-4.9), lower educational attainment (OR 2.0, 95% CI 1.2-3.3), moderate incontinence (OR 2.7, 95% CI 1.1-6.6), and severe incontinence (OR 3.8, 95% CI 1.6-9.1) were each associated with increased odds of major depression in women with urinary incontinence, controlling for age and medical comorbidity. Compared with women with incontinence alone, women with comorbid incontinence and major depression had significantly greater decrements in quality of life and functional status and increased incontinence symptom burden. Women with moderate-to-severe urinary incontinence should be screened for comorbid major depression and offered treatment if depression is present. II-2.

Background and Objectives:We examined the timing of suicide after stroke, the sociodemographic factors associated with the risk of suicide, and whether major depression modified the stroke–suicide association.Methods:We conducted a population-based retrospective cohort study of all adults in Ontario hospitalized for stroke between January 1, 2008, and December 31, 2017, who were matched 1:1 to controls from the general Ontario population on age, sex, neighborhood-level income, rurality, and comorbidities. Suicide, a composite of deliberate self-harm or death by suicide, was ascertained based on hospitalizations and emergency department visits. Cause-specific hazard models were used to evaluate the association between stroke and suicide, and major depression was treated as a time-varying covariate. Cause-specific hazard models evaluated the association between sociodemographic factors and suicide in stroke survivors. The modifying effect of major depression was assessed by adding an interaction term between stroke and major depression.Results:We included 64,719 matched pairs of patients with stroke and general population controls (45.4% female, mean age 71.4 years). In the 627,774 person-years follow-up, 436 cases and controls had an episode of self-harm or died by suicide, with 203 (67.4%) events in stroke survivors occurring after the first year. Compared to matched controls, stroke survivors had a higher rate of suicide (11.1 vs 3.2 per 10,000 person-years, hazard ratio (HR) 2.87; 2.35–3.51). The association between stroke and suicide did not vary by the presence of major depression (Pstroke*depression = 0.51). Suicide rates were elevated in younger stroke survivors (HR18–40 vs ⩾ 80 years 4.34; 2.48–7.61), those living in low-income neighborhoods (HRlowest vs highest quintile 1.88; 1.30–2.70), and those with major depression (HR 12.3; 7.63–19.7).Discussion:The elevated rate of suicide after stroke persists beyond one year, highlighting the need for long-term screening for suicidality, especially in younger stroke survivors and those residing in low-income neighborhoods and with major depression after stroke.

The purpose of this study was to examine the prevalence, risk factors, and correlates of depression among patients with Alzheimer's disease. A consecutive series of 103 patients with probable Alzheimer's disease were examined with a structured psychiatric interview and were assessed for the presence of cognitive impairments, deficits in activities of daily living, social functioning, and anosognosia. Fifty-one percent of the patients had depression (28% had dysthymia and 23% major depression). Women had a significantly higher prevalence of both major depression and dysthymia than men. Depressed and nondepressed patients had a similar frequency of family and personal histories of depression, a similar frequency of personality disorders before the onset of depression, and no significant differences in cognitive deficits and impairment in activities of daily living. Dysthymia usually started after the onset of dementia and was significantly more prevalent in the early stages of dementia; patients with dysthymia had a significantly better awareness of intellectual deficits than patients with major or no depression. On the other hand, patients with major depression had an earlier onset of depression (half of them before the onset of dementia), and the prevalence of major depression was similar across the different stages of the illness. This study demonstrates a high prevalence of dysthymia and major depression among patients with probable Alzheimer's disease. While dysthymia may be an emotional reaction to the progressive cognitive decline, major depression may be related to biological factors.

BackgroundPatients with major depressive disorder (MDD) may have an abnormal peripheral body temperature rhythm, but its relationship with suicidal risk and the response to treatment with antidepressants remain unknown.AimsThis study...