Elevated Levels Of Depression Research Articles

Comorbid intermittent explosive disorder and posttraumatic stress disorder: Clinical correlates and relationship to suicidal behavior

ObjectivePosttraumatic stress disorder (PTSD) is associated with both aggressive and suicidal behavior. Recent research suggests that the diagnosis of intermittent explosive disorder (IED), an impulse-control disorder characterized by repeated impulsive aggressive behavior, may help to identify individuals at risk for attempting suicide. Given the relationship between anger and PTSD, there is likely to be an increased prevalence of IED among individuals with PTSD; however, little is known about the overlap in these two disorders, including how individuals with comorbid IED and PTSD may differ from those with either disorder alone. The purpose of this study is to examine the clinical correlates of comorbid IED and PTSD and the contribution of these two disorders (among others) to lifetime suicide attempt and characteristics of suicidal behavior. MethodIn a large sample of community research volunteers (N=1460), we compared individuals with PTSD, IED, and comorbid PTSD and IED on measures of current mood, trait aggression, and trait impulsivity. We also examined the contributions of PTSD, IED, and other syndromal and personality disorders to the prediction of lifetime aggression and lifetime suicide attempt, and their relationship to characteristics of suicide attempts, including level of intent, use of violent versus non-violent means, and the medical seriousness of the attempt. ResultsComorbid PTSD and IED was associated with significantly elevated levels of depression, anxiety, anger, aggression, and impulsivity, as well as with high rates of comorbidity with other psychiatric disorders. IED (β=.56, p<.001), but not PTSD, significantly and uniquely predicted lifetime aggressive behavior. Both IED and PTSD were associated with lifetime suicide attempt in multivariate analysis (ORs: 1.6 and 1.6, ps<.05). The results show that IED, when comorbid with PTSD, identifies a subgroup of individuals with particularly high levels of aggressive behavior and a high rate of suicide attempt (41.4% in this sample). ConclusionThese findings add support to the notion that the diagnosis of IED may aid in identifying individuals at risk for aggressive and suicidal behavior.

THE ASSOCIATION OF DEPRESSION WITH C-REACTIVE PROTEIN (THE DATA OF ESSE-RF EPIDEMIOLOGICAL STUDY)

Aim. To study the association of depression with a high-sensitivity C-reactive protein (hsCRP) level, taking into account the main risk factors and noncommunicable diseases in Russia residents. Material and methods. The data of ESSE-RF multicenter study (a representative sample of the unorganized male and female population aged 25-64 years from 8 regions surveyed in 2012-2014) were used in the work. A total 11884 people were involved into the study including 35.9% men. The examination included a survey on the standard questionnaire containing data on disease history, etc. The level of depression was assessed by the validated in Russian Hospital Anxiety and Depression Scale (HADS, 1983). hsCRP level was determined in all patients. Results. The continuing association between elevated levels of depression (HADS-D ≥8+) and high level of hsCRP ≥3.0 mg/l (odds ratio [OR] 1.15; 95% confidence interval [CI] 1.03-1.27; p=0.009) was found in the multivariate model, after adjustment for sex, age, education, and risk factors. Reducing of the relationship of elevated levels of depression with a high level of hsCRP (OR 1.11; 95% CI 1.00-1.24; p=0.048) was found with the additional introduction of diseases in the model. This relationship was reduced to not statistically significant level (OR 1.08; 95% CI 0.98-1.20; p=0.134) in the full model adjusted for regions. Conclusion. The reduced association of depression with hsCRP ajusted for aggregate risk factors was found in the study. This suggests about multifactor affecting on this relationship.

Variations in psychological distress between gender and sexual minority groups

ABSTRACTThe purpose of this study was to compare rates of elevated levels of depression, anxiety, and stress among six different lesbian, gay, bisexual, and transgender (LGBT) subgroups (cisgender lesbians, cisgender gay males, cisgender bisexual females, cisgender bisexual males, transgender females, and transgender males). A total of 2,702 LGBT-identified individuals participated in the online study. While controlling for other demographic factors, rates of elevated levels of depression (p < 0.001), anxiety (p = 0.015), and stress (p < 0.001) all varied significantly between LGBT subgroups. Post-hoc examinations of pairwise differences revealed substantial and unexpected variations, highlighting the importance of separately examining LGBT subgroups when considering mental health outcomes.

Prevalence and correlates of suicidal thoughts in patients with neuropsychiatric lupus.

Suicidal ideation is observed in patients with systemic lupus erythematosus (SLE). No study on this notable phenomenon in neuropsychiatric SLE (NPSLE) is available so far. Participants were 53 consecutive outpatients with NPSLE (48 women; mean age 43.8 years) diagnosed according to the American College of Rheumatology nomenclature for SLE neuropsychiatric syndromes. A Neuropsychiatric Questionnaire (NP-Q) concerning 45 neurological, cognitive and psychiatric symptoms was used to assess the prevalence of self-perceived neuropsychiatric symptoms. The Modified Hospital Anxiety and Depression Scale (HADS-M) was used to assess the level of anxiety, depression and irritability. Formal neuropsychological examination was performed. Clinical data were collected by means of medical charts review and structured interview. Suicidal thoughts were present in 25% of patients with NPSLE, irrespective of sex, age, education, work status, disease duration and steroid treatment. Suicidal ideation was connected with elevated levels of depression, anxiety and irritability. In patients with suicidal ideation the prevalence of cognitive, psychiatric and neurological self-perceived problems was significantly higher. Suicidal thoughts are common in patients with NPSLE. Neuropsychiatric manifestation per se, depression, anxiety and patients' subjective complaints can be risk factors for suicidal ideation. Screening for suicidal thoughts is vital in routine care of SLE patients.

Systematic Review and Individual Patient Data Meta-Analysis of Sex Differences in Depression and Prognosis in Persons With Myocardial Infarction: A MINDMAPS Study.

Using combined individual patient data from prospective studies, we explored sex differences in depression and prognosis post-myocardial infarction (MI) and determined whether disease indices could account for found differences. Individual patient data analysis of 10,175 MI patients who completed diagnostic interviews or depression questionnaires from 16 prospective studies from the MINDMAPS study was conducted. Multilevel logistic and Cox regression models were used to determine sex differences in prevalence of depression and sex-specific effects of depression on subsequent outcomes. Combined interview and questionnaire data from observational studies showed that 36% (635/1760) of women and 29% (1575/5526) of men reported elevated levels of depression (age-adjusted odds ratio = 0.68, 95% confidence interval [CI] = 0.60-0.77). The risk for all-cause mortality associated with depression was higher in men (hazard ratio = 1.38, 95% CI = 1.30-1.47) than in women (hazard ratio = 1.22, 95% CI = 1.14-1.31; sex by depression interaction: p < .001). Low left ventricular ejection fraction (LVEF) was associated with higher depression scores in men only (sex by LVEF interaction: B = 0.294, 95% CI = 0.090-0.498), which attenuated the sex difference in the association between depression and prognosis. The prevalence of depression post-MI was higher in women than in men, but the association between depression and cardiac prognosis was worse for men. LVEF was associated with depression in men only and accounted for the increased risk of all-cause mortality in depressed men versus women, suggesting that depression in men post-MI may, in part, reflect cardiovascular disease severity.

Pedagogical psychology: beyond the 21st century.

Pedagogical psychology: beyond the 21st century.

Female Medical Students' (Silencing the) Self: Effects on Depression and Dyadic/Sexual Dissatisfaction

Female physicians, residents, and medical students commonly suffer from depression and dyadic and sexual dissatisfaction. To identify self-related risk factors for depression and dyadic and sexual dissatisfaction in female medical students in Israel. In Study 1, 194 female medical students were assessed twice over a 1-year interval. Depressive symptoms, dyadic, and sexual dissatisfaction, and three self-concept factors—self-criticism, self-concept clarity, and silencing the self—were measured twice. Physical symptoms were also assessed at Time 2. In Study 2, 14 female medical students with elevated levels of depression were interviewed, and their narrative accounts were analyzed qualitatively. Elevated baseline levels of silencing the self predicted an increase in depressive symptoms and dyadic and sexual dissatisfaction over time, and high levels of physical symptoms at Time 2. The effect of silencing the self on depression was particularly pronounced under low self-concept clarity. All 14 interviewees alluded to the painful tension between their inner, tumultuous self, and their rehearsed self-presentation and a social prohibition to express negative emotions. Resources should be dedicated in order to assess, trace, and treat masked (silenced) distress among female medical students, interns, and residents.

The risk and protective factors associated with depression and anxiety in a national sample of Irish adolescents.

The aim of this study is to examine the risk and protective factors associated with anxiety and depression in a representative sample of Irish adolescents. Data used in this study were drawn from a subset of the My World Survey (MWS). The MWS-Second Level (MWS-SL) subset consists of a randomised sample of 72 schools, with a final sample of 6085 students. Outcome measures were depression and anxiety. Risk and protective factors included measures within the socio-demographic, psychosocial and risk-taking domains. One in three adolescents experienced elevated levels of depression and anxiety. Age, gender, maternal education, family composition, parental mental health as well as the experience of racism and bereavement were associated with elevated distress. Psychosocial factors associated with depression and anxiety included optimism, personal competence, life-satisfaction, self-esteem, anger, body dissatisfaction, family competence, maternal and paternal criticism, experiencing the break-up of a romantic relationship, school and peer connectedness as well as the availability of one good adult. Finally, engaging in substance misuse was found to increase the likelihood of anxiety and depression. Since factors protecting and putting adolescents at risk of anxiety and depression exist at every level of the adolescent's ecological system, the study supports a community-based approach to youth mental health.

Maternal depressive symptoms have a negative impact on prenatal attachment – findings from a Swedish community sample

Objective: The objective of this study was to evaluate attachment and its association to obstetric and demographic factors as well as emotional well-being using a standard measure of prenatal attachment during pregnancy. Background: The strength of the mothers’ relationship with her baby has important implications in the postnatal period, influencing the relationship she develops with her child, and the quality of the care she provides. Methods: This was a population-based longitudinal survey comprising a consecutive sample from a one-year cohort in a Swedish county. In this study the three subscales of PAI-R (Prenatal Attachment Inventory – Revised) were used for evaluation of attachment. In total, 718 pregnant women participated in this study. Results: Women with elevated levels of depression (HADS-D > 8) recorded lower attachment scores across all three PAI-R subscales. Lack of perceived support from partner was associated with lower scores on Interaction. Lack of support from own mother and own father were also associated with lower scores on all subscales. Attachment was also associated with feelings about the approaching birth and about the first weeks with the newborn, with women who reported less than positive feelings recording lower scores on each of the PAI-R subscales. Conclusion: A focus on attachment during antenatal care and the use of PAI-R during pregnancy provides a means of identifying those women who show lower levels of attachment and possible emotional problems that may impact on emotional health and the birth process.

Risk and protective factors for depressive symptoms among American Indian older adults: Adverse childhood experiences and social support

Objectives: Despite efforts to promote health equity, many American Indian and Alaska Native (AI/AN) populations, including older adults, experience elevated levels of depression. Although adverse childhood experiences (ACE) and social support are well-documented risk and protective factors for depression in the general population, little is known about AI/AN populations, especially older adults. The purpose of this study was to examine factors related to depression among a sample of AI older adults in the midwest.Method: Data were collected using a self-administered survey completed by 233 AIs over the age of 50. The survey included standardized measures such as the Geriatric Depression Scale-Short Form, ACE Questionnaire, and the Multidimensional Scale of Perceived Social Support. Hierarchical multivariate regression analyses were conducted to evaluate the main hypotheses of the study.Results: Two dimensions of ACE (i.e., childhood neglect, household dysfunction) were positively associated with depressive symptoms; social support was negatively associated with depressive symptoms. Perceived health and living alone were also significant predictors.Conclusion: ACE may play a significant role in depression among AI/AN across the life course and into old age. Social support offers a promising mechanism to bolster resilience among AI/AN older adults.

Accuracy of Teachers in Identifying Elementary School Students Who Report At-Risk Levels of Anxiety and Depression

Internalizing disorders, specifically depression and anxiety, affect up to 14 and 32 % of youth, respectively (Merikangas et al. in J Am Acad Child Adolesc Psychiatry 49:980–989, 2010). In part to overcome barriers to receiving community services, schools have become a major provider of mental health services to children. Schools need effective mechanisms in place to accurately identify students who may need such services. The current study examined the accuracy of one such method, teacher nominations, in identifying elementary school children who self-report elevated levels of depression and/or anxiety. Participants were 238 fourth and fifth-grade students within a large, urban school district in a southeastern state and their 26 classroom teachers. Regarding sensitivity, teachers identified 50 and 40.7 % of students who repeatedly reported at-risk levels of depression and anxiety, respectively. Teachers falsely identified as symptomatic 16.2 and 17.5 % of students with typical levels of depression and anxiety, respectively. These findings suggest teachers can identify approximately half of children who experience at-risk levels of depression and anxiety, but substantial miss rates call into question this method for use as either an alternative to universal screenings or as an initial step (gatekeeper role) in a multi-modal identification process.

Efficacy of the Getting Ready Intervention and the Role of Parental Depression

Research Findings: This study reports the results of a randomized trial of a parent engagement intervention (the Getting Ready intervention) on directly observed learning-related social behaviors of children from low-income families in the context of parent–child interactions. The study explored the moderating effect of parental depression on intervention outcomes. Participants were 204 children and their parents as well as 29 Head Start teachers. Semistructured parent–child interaction tasks were videotaped 2 times annually over the course of 2 academic years. Observational codes of child behaviors included agency, persistence, activity level, positive affect, distractibility, and verbalizations. Practice or Policy: When gender and disability concerns were controlled, those in the treatment condition experienced a significant decline in activity level relative to children in the control group. Furthermore, compared to children of nondepressed mothers and to control children, those in the experimental condition whose parent reported elevated levels of depression showed greater gains in positive affect and in verbalizations.

Neural changes associated with emotion processing in children experiencing peer rejection: a functional MRI study.

This study was performed to investigate differences between children who did and did not experience peer rejection in psychological state through surveys and in emotion processing during an interpersonal stress challenge task to reflect naturalistic interpersonal face-to-face relationships. A total of 20 right-handed children, 10 to 12 yr of age, completed self-rating questionnaires inquiring about peer rejection in school, depression, and anxiety. They then underwent an interpersonal stress challenge task simulating conditions of emotional stress, in reaction to positive, negative and neutral facial expression stimuli, using interpersonal feedbacks, and functional magnetic resonance imaging (FMRI) for an analysis of neural correlates during the task. Ten were the peer-rejection group, whereas the remainder were the control group. Based on the behavioral results, the peer-rejection group exhibited elevated levels of depression, state anxiety, trait anxiety and social anxiety as compared to the control group. The FMRI results revealed that the peer-rejection group exhibited greater and remarkably more extensive activation of brain regions encompassing the amygdala, orbitofrontal cortex and ventrolateral prefrontal cortex in response to negative feedback stimuli of emotional faces. The different brain reactivities characterizing emotion processing during interpersonal relationships may be present between children who do and do not experience peer rejection.Graphical

Acculturation and Religious Coping as Moderators of the Association Between Discrimination and Depressive Symptoms Among Mexican-American Vocational Students

Although perceived discrimination has been associated with depressive symptoms among Hispanic adults, not all individuals who report discrimination will report elevated levels of depression. This study examined whether acculturation and religious coping would moderate the association between past-year perceived discrimination and depressive symptoms in a sample of 247 Mexican-American post-secondary vocational students (59.6% males; mean age=26.81). Results from hierarchical regression analyses indicated that perceived discrimination, positive religious coping, and negative religious coping were significantly associated with depressive symptoms. Further analyses indicated that positive religious coping moderated the perceived discrimination-depressive symptoms association. Students reporting using positive religious coping were protected from experiencing heightened levels of depressive symptoms when faced with discrimination. Acculturation was not directly associated with depressive symptoms nor did it function as a moderator. The salutary influences of positive religious coping for Mexican-American students are discussed. Study limitations and future directions for research are also discussed.

The Psychosocial and Affective Burden of Posttraumatic Stress Neuropathy Following Injuries to the Trigeminal Nerve

To explore the impact of trigeminal nerve injuries on quality of life, including the effect of pain on psychological and affective function. An observational, cross-sectional survey design was employed. Fifty-six patients with inferior alveolar nerve injury (IANI) and 33 patients with lingual nerve injury (LNI) completed standardized self-report measures of pain intensity, pain catastrophizing, self-efficacy to cope with pain, and mood, in addition to generic and oral health-related quality of life (HRQoL) indicators. The impact of pain severity on these aspects of psychosocial function was examined. Summary statistics were calculated for all measures and compared with norms or values of other relevant studies, when available, using t tests. The impact of pain severity on these aspects of psychosocial function was examined using analysis of variance and hierarchical multivariate regression models. The majority of patients reported pain associated with their nerve injury (86%). Nerve injury had a significant impact on all investigated domains, and this was closely linked with reported pain levels. Patients with severe pain showed particularly elevated levels of depression and pain catastrophizing, as well as substantially reduced HRQoL and coping efficacy levels. Pain intensity level was a significant predictor in all models except anxiety, uniquely contributing between 17% and 26% of variance to the prediction of pain catastrophizing, depression, coping efficacy, and generic and oral HRQoL. Traumatic injury to the trigeminal nerve is associated with a substantial patient burden, particularly in patients who experience severe neuropathic pain as part of their condition. These findings highlight the need to identify, develop, and evaluate more effective treatments for neuropathic pain in trigeminal nerve injury that will not only provide clinically meaningful reductions in pain but also improve patients' quality of life.

A goal management intervention for polyarthritis patients: rationale and design of a randomized controlled trial

BackgroundA health promotion intervention was developed for inflammatory arthritis patients, based on goal management. Elevated levels of depression and anxiety symptoms, which indicate maladjustment, are found in such patients. Other indicators of adaptation to chronic disease are positive affect, purpose in life and social participation. The new intervention focuses on to improving adaptation by increasing psychological and social well-being and decreasing symptoms of affective disorders. Content includes how patients can cope with activities and life goals that are threatened or have become impossible to attain due to arthritis. The four goal management strategies used are: goal maintenance, goal adjustment, goal disengagement and reengagement. Ability to use various goal management strategies, coping versatility and self-efficacy are hypothesized to mediate the intervention’s effect on primary and secondary outcomes. The primary outcome is depressive symptoms. Secondary outcomes are anxiety symptoms, positive affect, purpose in life, social participation, pain, fatigue and physical functioning. A cost-effectiveness analysis and stakeholders’ analysis are planned.Methods/designThe protocol-based psycho-educational program consists of six group-based meetings and homework assignments, led by a trained nurse. Participants are introduced to goal management strategies and learn to use these strategies to cope with threatened personal goals. Four general hospitals participate in a randomized controlled trial with one intervention group and a waiting list control condition.DiscussionThe purpose of this study is to evaluate the effectiveness of a goal management intervention. The study has a holistic focus as both the absence of psychological distress and presence of well-being are assessed. In the intervention, applicable goal management competencies are learned that assist people in their choice of behaviors to sustain and enhance their quality of life.Trial registrationNederlands Trial Register = NTR3606, registration date 11-09-2012.

YOGA FOR DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Mind-body medical interventions are commonly used to cope with depression and yoga is one of the most commonly used mind-body interventions. The aim of this review was to systematically assess and meta-analyze the effectiveness of yoga for depression. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through January 2013. Randomized controlled trials (RCTs) of yoga for patients with depressive disorders and individuals with elevated levels of depression were included. Main outcomes were severity of depression and remission rates, secondary outcomes were anxiety, quality of life, and safety. Twelve RCTs with 619 participants were included. Three RCTs had low risk of bias. Regarding severity of depression, there was moderate evidence for short-term effects of yoga compared to usual care (standardized mean difference (SMD) = -0.69; 95% confidence interval (CI) -0.99, -0.39; P < .001), and limited evidence compared to relaxation (SMD = -0.62; 95%CI -1.03, -0.22; P = .003), and aerobic exercise (SMD = -0.59; 95% CI -0.99, -0.18; P = .004). Limited evidence was found for short-term effects of yoga on anxiety compared to relaxation (SMD = -0.79; 95% CI -1.3, -0.26; P = .004). Subgroup analyses revealed evidence for effects in patients with depressive disorders and in individuals with elevated levels of depression. Due to the paucity and heterogeneity of the RCTs, no meta-analyses on long-term effects were possible. No RCT reported safety data. Despite methodological drawbacks of the included studies, yoga could be considered an ancillary treatment option for patients with depressive disorders and individuals with elevated levels of depression.

A longitudinal study of anxiety, depression and distress as predictors of sexual and urinary quality of life in men with prostate cancer

To evaluate the prevalence of depression, anxiety and distress among active surveillance (AS) and radical prostatectomy (RP) patients. To evaluate the impact of these symptoms at baseline on urinary and sexual quality of life at follow-up. Patients managed with AS or RP who completed validated questionnaires assessing levels of depression, anxiety, distress and urinary (UF) and sexual function (SF) and bother comprised the final analytic cohort. These measures were completed at baseline, within 1 year, and between 1 and 3 years from baseline. Mixed model repeated measures analysis was used to examine associations between mental health at baseline and sexual and urinary outcomes in a subset of RP patients with complete follow-up. Among 679 men who comprised the study cohort, baseline prevalence of moderate or higher levels of depression or anxiety were low (<5%), while levels of mild depression or anxiety ranged from 3-16% over time. Baseline levels of elevated distress ranged from 8-20%. Among men who provided data at baseline and follow-up, there were no significant differences between AS and RP patients in the proportion of men with elevated levels of depression, anxiety, or distress. Among 177 men who underwent RP and had complete follow-up moderate or higher levels of depression or anxiety appeared to be associated with post-treatment SF and bother, while elevated levels of distress were associated with post-treatment UF. Moderate or higher levels of depression or anxiety were low in men with localised prostate cancer but were associated with sexual outcomes, while elevated distress was associated with urinary outcomes. Greater attention should be paid to mental health symptoms among men with prostate cancer, as these symptoms may be associated with quality of life outcomes.

Anabolic-Androgenic Steroids and Condom Use: Potential Mechanisms in Adolescent Males

Previous research has revealed a significant bivariate relationship between anabolic-androgenic steroid (AAS) use and reduced condom use among adolescent boys. However, to date, no known studies have explored the psychological mechanisms that may explain this relationship. Thus, the current study sought to examine two possible mediators in the association between AAS and condom use: depressive symptoms and substance use. Data were extracted from a nationally representative sample of U.S. adolescents. Participants were 3,780 U.S. high school boys who responded to self-report items assessing a number of health behaviors, including symptoms of depression, substance use, AAS use, and use of condoms during their most recent act of intercourse. Both depression and substance use were significant mediators in the relationship between AAS and condom use. However, when these effects were contrasted, the indirect effect of substance use was significantly stronger in magnitude than the effect of depression. Although AAS use was associated with sexual risk behaviors among adolescent boys, significant variance in this relationship was accounted for by elevated levels of depression and substance use, with substance use demonstrating a particularly salient pathway.

Russians in Treatment: The Evidence Base Supporting Cultural Adaptations

Despite large waves of westward migration, little is known about how to adapt services to assist Russian-speaking immigrants. In an attempt to bridge the scientist-practitioner gap, the current review synthesizes diverse literatures regarding what is known about immigrants from the Former Soviet Union. Relevant empirical studies and reviews from cross-cultural and cultural psychology, sociology, psychiatric epidemiology, mental health, management, linguistics, history, and anthropology literature were synthesized into three broad topics: culture of origin issues, common psychosocial challenges, and clinical recommendations. Russian speakers probably differ in their form of collectivism, gender relations, emotion norms, social support, and parenting styles from what many clinicians are familiar with and exhibit an apparent paradoxical mix of modern and traditional values. While some immigrant groups from the Former Soviet Union are adjusting well, others have shown elevated levels of depression, somatization, and alcoholism, which can inform cultural adaptations. Testable assessment and therapy adaptations for Russians were outlined based on integrating clinical and cultural psychology perspectives.