Factors In Development Of Depression Research Articles

Screening for depressive symptoms in postbariatric surgery patients using a validated Arabic version of Patient Health Questionnaire.

BACKGROUND:The prevalence of depressive symptoms in obese patients is higher than nonobese patients. Evidence shows an improvement of depressive symptoms after bariatric surgery, but this improvement fluctuates 3–4 years after surgery. Some studies report a worsening of depressive symptoms, but that the type of surgery and surgical complications contribute to the high depression rate. Our objective was to assess depressive symptoms in postbariatric surgery patients using an Arabic version of Patient Health Questionnaire-9 (PHQ-9).MATERIALS AND METHODS:A cross-sectional study was conducted in a tertiary care hospital in Riyadh from January to December 2019 using a validated Arabic version of PHQ-9. The questionnaires sent through Google Survey link to patient phone numbers were registered in an electronic record system. Data analysis was analyzed using SPSS version 23. Frequency and percentages were computed for the categorical variables and mean and standard deviation were calculated for the continuous variables. Chi-square test performed to test for the association between categorical variables and depression and logistic regression analysis were performed to determine the risk factors for development of depression after bariatric surgery.RESULTS:A total of 152 patients were included in the study. Fifty percent patients did not have depression, 26.3% had mild depression, 15.8% had moderate depression, 7.2% had moderately severe depression, and only one patient (0.7%) had severe depression. Only marital status was significantly associated with depression after bariatric surgery (P = 0.019). Gender, education, marital status, and income when used in the multivariate logistic regression could not predict the incidence of depression.CONCLUSION:Using a score of 10 in PHQ-9 as a cutoff, the prevalence of depressive disorder in postbariatric surgery patients was 23.7%, which is similar to the prevalence of nonobese general Saudi population of 20%.

Depression in adolescents exposed to war trauma Risk factors for development of depression in adolescents exposed to war trauma: does PTSD matter?

Background: Depression is frequently comorbid with posttraumatic stress disorder (PTSD) and substantially influences its severity, course and outcomes. Published studies linking war-related paediatric PTSD and Major depressive disorder (MDD) were mainly based on cross-sectional studies. Objective: To prospectively examine the role of PTSD and other risk/protective factors in the development of depression among adolescents with war-related trauma. Methods: A longitudinal study of 160 adolescents aged 15–17 years with war-related trauma and displacement due to war in Eastern Ukraine was performed. Of the 160 adolescents, N = 86 met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4) criteria for PTSD. All adolescents underwent comprehensive psychiatric assessments that included Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL) administered to both parents and children. Traumatic exposure was assessed using the modified Traumatic Events Screening Inventory for children (TESI-C). PTSD and MDD were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) and Children’s Depression Rating Scale-Revised (CDRS-R), and diagnosed using DSM-4 criteria. Follow-up and repeated measurements occurred at 6 and 12 months. During the study, adolescents requiring clinical care were referred for best available care in the community. Results: Among 92.6% of study completers, 26/79 youth with PTSD developed MDD (32.9%), compared to 6/70 without PTSD (8.5%): relative risk (RR) = 3.83 (95% CI 1.67-8.78), p = 0.0014; Number needed to harm (NNTH) = 4.108 (8.53–2.7). Using logistic regression, variables of school attendance, ‘secondary’ traumatic exposure, and treatment with Trauma-focused Cognitive Behavioral Therapy (TF-CBT) were significantly correlated with the incidence of new-onset depression among adolescents with PTSD. Conclusions: War-related trauma with subsequent PTSD appears to be a significant risk factor for the later development of depression in adolescents. The role of PTSD as a moderator of depression merits further investigation in larger scale longitudinal studies in diverse populations.

Depression in adolescents exposed to war trauma Risk factors for development of depression in adolescents exposed to war trauma: does PTSD matter?

Abstract Background Depression is frequently comorbid with posttraumatic stress disorder (PTSD) and substantially influences its severity, course and outcomes. Published studies linking war-related paediatric PTSD and Major depressive disorder (MDD) were mainly based on cross-sectional studies. Objective To prospectively examine the role of PTSD and other risk/protective factors in the development of depression among adolescents with war-related trauma. Methods A longitudinal study of 160 adolescents aged 15–17 years with war-related trauma and displacement due to war in Eastern Ukraine was performed. Of the 160 adolescents, N = 86 met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4) criteria for PTSD. All adolescents underwent comprehensive psychiatric assessments that included Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL) administered to both parents and children. Traumatic exposure was assessed using the modified Traumatic Events Screening Inventory for children (TESI-C). PTSD and MDD were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) and Children's Depression Rating Scale-Revised (CDRS-R), and diagnosed using DSM-4 criteria. Follow-up and repeated measurements occurred at 6 and 12 months. During the study, adolescents requiring clinical care were referred for best available care in the community. Results Among 92.6% of study completers, 26/79 youth with PTSD developed MDD (32.9%), compared to 6/70 without PTSD (8.5%): relative risk (RR) = 3.83 (95% CI 1.67–8.78), p = 0.0014; Number needed to harm (NNTH) = 4.108 (8.53–2.7). Using logistic regression, variables of school attendance, ‘secondary’ traumatic exposure, and treatment with Trauma-focused Cognitive Behavioral Therapy (TF-CBT) were significantly correlated with the incidence of new-onset depression among adolescents with PTSD. Conclusions War-related trauma with subsequent PTSD appears to be a significant risk factor for the later development of depression in adolescents. The role of PTSD as a moderator of depression merits further investigation in larger scale longitudinal studies in diverse populations.

Insomnia and depression: risk factors for development of depression in male Japanese workers during 2011-2013.

This 3-year cohort study was conducted to investigate the relation between insomnia and development of depression in male workers, and to clarify the association between the severity of insomnia and the onset of depression. Self-administered questionnaire surveys on depression and insomnia were conducted on male workers for 3years. Depression was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), and insomnia was examined using the Athens Insomnia Scale (AIS). The analysis was done with 840 men who had no depression at baseline. Depression symptoms were newly found in 113 men during this study. Cox regression analyses showed that people with insomnia (AIS score of≥1) at baseline had about a 7 times greater risk for onset of depression. Furthermore, compared with those with AIS score of 0 (no insomnia), people with AIS score of 1-3 had a 5.2-fold greater risk of depression and those with a score of 4 or higher indicated about tenfold greater risk. A new finding was that the risk for onset of depression increased with the severity of insomnia.

Perinatal depression in HIV-infected African women: a systematic review.

To systematically review the literature on prevalence and incidence of perinatal depression in human immunodeficiency virus (HIV)-infected African women. We searched 17 databases, including PubMed, PsycINFO, Cochrane, EMBASE, Web of Science, ClinicalTrials.gov, Google Scholar, and OpenGrey, from inception through August 2014 using the search strategy ((antenatal OR peripartum OR perinatal OR postnatal OR postpartum) AND (depression OR mental disorder) AND HIV AND Africa NOT (-) American). We included English-language articles on studies conducted in Africa with prevalence or incidence rates of diagnostically confirmed depression or suspected depression in HIV-infected women during pregnancy through 12 months postpartum. We examined details of study design, location, means of measurement, incidence and prevalence rates of diagnostically confirmed depression or suspected depression and any associated risk factors for development of depression. Mean prevalence rates were calculated and weighted based on study size. Twenty-two articles met inclusion criteria. Two reported diagnostically confirmed antenatal depression, and 9 reported suspected antenatal depression prevalence. Two reported diagnostically confirmed postnatal depression, and 10 reported suspected postnatal depression prevalence. Weighted mean prevalence of antenatal depression was 23.4%, and suspected antenatal depression was 43.5%. Weighted mean prevalence of postnatal depression was 22.5%, and suspected postnatal depression was 31.1%. No studies reported incidence rates. Few studies have examined the rate of perinatal depression in HIV-infected African women. Existing studies show a high prevalence of perinatal depression, with even higher prevalence rates of suspected depression. No data on the incidence of perinatal depression in this population exist.

Abstract T P356: Predictors of Depression 6 Months After Aneurysmal Subarachnoid Hemorrhage

Background: Functional outcome is of increasing importance among survivors of aneurysmal subarachnoid hemorrhage (SAH). Depression is commonly reported after stroke and may play a significant role in functional recovery after SAH. Our goal was to determine the prevalence and predictors of depression among survivors of SAH at 6 months. Methods: Six-month follow up data was analyzed from a cohort study of SAH patients at a tertiary care center. With IRB approval and consent, patients completed serial 6-month outcome assessments including the Modified Rankin Scale (mRS) and the Hospital Anxiety and Depression Scale (HADS). Independent predictors of poor functional (mRS>2) and mood outcomes (HADS≥10) were determined using univariate and multivariate statistics. Results: Of 247 subjects (74% female, mean age 55), 7% had poor functional outcome. Depression was reported in 17%. Poor functional outcome was significantly associated with a longer hospitalization (mean 26 days, p=0.02), placement of an EVD and VP shunt (p=0.008 & 0.02) and antibiotic use (p=0.001). Depression was significantly associated with poor functional outcome, prior history of depression, and vasospasm (p=0.001, 0.004 & 0.05). Depression showed a trend in those who received an EVD, ventilator, and antibiotics. Depression was not significantly associated with treatment modality. Multivariate logistic analyses demonstrated that poor functional outcome (OR=5.25, CI=1.44-19.10, p=0.01), history of depression (OR=7.66, CI=1.87-31.45, p=0.005), and vasospasm (OR=2.65, CI=1.04-6.75, p=0.04) remain significant predictors of depression, however, EVD, ventilator, antibiotics, and Hunt Hess Grade are not significant. Conclusion: Depression is not uncommon after SAH, and highly associated with poor neurological recovery at 6 months. Risk factors for development of depression include prior history of depression and cerebral vasospasm. Based on these results, we recommend screening for depression and consideration for early treatment for patients at highest risk after SAH.

Depression-sleep disturbance-chronic pain syndrome

Context: Chronic pain, depression and poor sleep quality are the most prevalent cause of human suffering, often co-occurring in a mutually reinforcing relationship. However, the prevalence and the risk factors for development of depression and poor sleep quality in Indian patients suffering from chronic pain remains elusive. Aims: The purpose of the present study was to study the prevalence and severity of depression, self-reported sleep disturbance and their co-relation with various pain descriptors such as intensity and duration of pain in 471 Indian patients suffering from chronic pain (more than 3 months). Materials and Methods: The patients were assessed for depression and sleep disturbance by using preformed questionnaires. Depression was evaluated by 'Patient Health Questionnaire 9 (PHQ-9) depression scale', a self-administered version of mental disorder assessing tool PRIME-MD. Self-reported descriptors like 'waking up refreshed', 'waking up fatigued', 'can't find a comfortable position' and 'toss and turn frequently' were used to assess sleep quality and classify patients into those with good (waking up refreshed) or poor (waking up fatigued, cannot find a comfortable position and toss and turn frequently) sleep quality. Results: We found a high prevalence (87.6%) of depression among Indian patients suffering from chronic pain. Moderate-severe depression was found in 31.2% of patients and 68.8% of patients reportedly having poor sleep quality. Females outnumbered males in terms of suffering from chronic pain, moderate-severe depression and poor sleep quality with a female:male of 1:0.514, 1:0.43 and 1:0.6, respectively. Patients suffering from moderate-severe depression and poor sleep quality reported greater perceived intensity of pain, P = 0.005 and 0.012, respectively. Conclusion: Depression and pain frequently co-exist and evaluation and treatment of both are of paramount importance for optimal treatment. Female sex, intensity of pain and poor sleep quality act as risk factors for development of depression in Indian patients suffering from chronic pain.

Involvement of Genetic an d Environmental Factors in the Onset of Depression

First, this article provides a brief overview of the previous hypotheses regarding depression and then focuses on involvement of genetic and environmental factors in development of depression. According to epidemiological research, 30~40% of occurrences of bipolar disorder involve a genetic factor. Therefore, environmental factors play a more important role in development of depression. Resilience and resistance to stress are common; therefore, although a certain extent of stress might be received during the embryonic or perinatal period, having a genetic predisposition to mental disorders does not imply that a mental disorder will develop. However, having a genetic predisposition to disorders does weaken resistance to stresses received during puberty, and without the ability to recover, a mental disorder is triggered. The importance of epigenetics in maintaining normal development and biology is reflected by the observation that development of many diseases occurs when the wrong type of epigenetic marks are introduced or are added at the wrong time or in the wrong place. Involvement of genetic and environmental factors in the onset of depression was investigated in relation to epigenetics. When mice with the disrupted in schizophrenia 1 (DISC1) abnormal gene received isolated rearing stress, depression-like abnormal behaviors and decreased gene expression of tyrosine hydroxylase in the frontal cortex by epigenetical suppression via DNA methylation were observed. Decrease of dopamine in the frontal cortex triggers behavioral disorders. Administration of a glucocorticoid receptor antagonist resulted in full recovery from neurological and behavioral disorders. These results suggest a new therapeutic approach to depression.

Cluster randomized controlled trial of a psycho-educational intervention for people with a family history of depression for use in general practice.

BackgroundThe strongest risk factor for depression is having a family history of the condition. Many individuals with a family history of depression are concerned about their personal risk for depression and report unmet educational and psychological support needs. No supportive and/or educational interventions are currently available that target this group of individuals. In this study we will develop and evaluate the first online psycho-educational intervention targeted to individuals with a family history of depression. Genetic risk information and evidence-rated information on preventive strategies for depression will be provided to such individuals in a general practice setting. The intervention will also incorporate a risk assessment tool. The content and delivery of the intervention will be pilot-tested.Methods/designThe proposed intervention will be evaluated in the general practitioner (GPs) setting, using a cluster randomized controlled trial. GP practices will be randomized to provide either access to the online, targeted psycho-educational intervention or brief generic information about depression (control) to eligible patients. Eligibility criteria include having at least one first-degree relative with either major depressive disorder (MDD) or bipolar disorder (BD). The primary outcome measure is 'intention to adopt, or actual adoption of, risk-reducing strategies’. Secondary outcome measures include: depression symptoms, perceived stigma of depression, knowledge of risk factors for development of depression and risk-reducing strategies, and perceived risk of developing depression or having a recurrence of family history. Over the course of the study, participants will complete online questionnaires at three time points: at baseline, and two weeks and six months after receiving the intervention or control condition.DiscussionThis novel psycho-educational intervention will provide individuals with a family history of depression with information on evidence-based strategies for the prevention of depression, thus, we hypothesize, enabling them to make appropriate lifestyle choices and implement behaviors designed to reduce their risk for depression. The online psycho-educational intervention will also provide a model for similar interventions aimed at individuals at increased familial risk for other psychiatric disorders.Trial registrationThe study is registered with the Australian and New Zealand Clinical Trials Group (Registration no: ACTRN12613000402741).

Depression Following Traumatic Brain Injury

It is important for clinicians to recognize major depression following traumatic brain injury (TBI) because of its association with poor global and psychosocial outcome, postconcussive symptoms and cognitive deficits. The purpose of this review is to provide an up-to-date selective review of the current understanding of epidemiology, risk factors and management of major depression following TBI. Many studies of prevalence of depression following TBI have not used accepted structured criteria for the diagnoses, but those that did found wide ranges of rates, from 17% to 61%. The risk factors for development of depression following TBI are poorly understood, but past psychiatric history, frontal lesions and atrophy, and family dysfunction have been shown in more than one study to play important roles. There are few controlled trials of the treatment of major depression in patients with TBI using accepted diagnostic criteria for major depression, as well as defined criteria for response and remission. As such, it is important for clinicians to use best practice guidelines for the treatment of major depression in the absence of TBI.

Gebelikte Depresyon: Sıklık, Risk Faktörleri ve Tedavisi

Depression in pregnancy is a common psychiatric disorder affecting health of both the mother and the unborn child. The prevalence of depression and depressive symptoms during pregnancy ranges from 12% to 36%. Genetic, psychological, biological, environmental and hormonal factors comprise the predisposing factors for development of depression. Depression in pregnancy may cause such pregnancy and obstetrical complications as preterm delivery, preeclampsia, difficult birth, increased need for surgical intervention during delivery, smaller fetus compared to the gestational age, newborns with low birth weights and low apgar scores. It is also important due to its potential to increase the risk of suicide attempts and postpartum depression. Depression seen at an early period of the pregnancy affects both the mother and the fetus negatively in the long run. Therefore, early diagnosis of depression and its treatment will decrease the prospective risks for both parts. Health care staff play a key role in the early detection of the risk groups inclined to the gestational depression, in the prevention and treatment of depression. With the present work, we aimed at revising the diagnosis of the depression in pregnancy, its prevalence, risk factors for mother and fetus, its prevention and treatment during pregnancy.

Risk Factors for Development of Depression and Psychosis

Increased levels of glucocorticoid hormones-the main product of the hypothalamic-pituitary-adrenal (HPA) axis-have been considered to be "depressogenic," but this notion has largely derived from studies in patients with endocrine conditions, such as Cushing's syndrome or exogenous treatment with synthetic glucocorticoids. In these conditions, it is likely that the full impact of the high glucocorticoid levels is felt on the brain, through over-stimulation of the glucocorticoid receptors (GRs); indeed, normalizing these high levels leads to an improvement of mood in these patients. However, a completely different mechanism may be operating in major depression, where the increased levels of glucocorticoid hormones are conceptualized as driven by an impairment in GR function (glucocorticoid resistance), and therefore as a "compensatory" mechanism. Moreover, clinical and experimental studies have shown that antidepressants increase GR function, thus leading to resolution of glucocorticoid resistance. Interestingly, a number of studies have also demonstrated that manipulating GR function with both agonists and antagonists has an antidepressant effect, and indeed that other drugs targeting the HPA axis and cortisol secretion-even drugs with opposite effects on the HPA axis-have antidepressant effects. These studies do not support the notion that "high levels of glucocorticoids" always have a depressogenic effect, nor that decreasing the effects of these hormones always has an antidepressant effects.

Update on depression in neurologic illness: Stroke, epilepsy, and multiple sclerosis

The risk of depression is increased in chronic neurologic illness and can adversely affect the course of disease. Recent literature is reviewed for depression in stroke, epilepsy, and multiple sclerosis. Depression can share pathophysiologic aspects of the comorbid illness, such as neurotransmitter pathway disturbances, hypothalamus-pituitary-adrenal pathway disturbances, and changes in immunologic function. Depression also can be a psychologic reaction to the burden of the neurologic condition. Risk factors for development of depression are reviewed. Depression and other medical conditions can have shared symptoms (eg, fatigue, psychomotor retardation) that can complicate the diagnosis of depression in neurologic illness. Proper selection of antidepressant treatment is necessary to avoid worsening the neurologic disorder.