Previous History Of Depression Research Articles

The prevalence of depression in relation to cerebral atrophy and cognitive performance in 70- and 74-year-old women in Gothenburg. The Women's Health Study.

Hospital-based studies report that depression in the elderly is associated with brain atrophy. This notion could not be confirmed in a population study on 85-year-olds. We aimed to assess depression in relation to brain atrophy and cognition in 70- and 74-year-old women. METHODS; A representative sample of 70- and 74-year-old women (N = 501) was examined with a psychiatric examination including the Mini-Mental State Examination (MMSE), measuring global cognitive function, and computerized tomography (CT) of the brain (N = 268). Depression was diagnosed according to DSM-III-R. Previous depression was diagnosed by history and by information from previous examinations in this 24-year longitudinal study. The prevalence of depression was 11.6%, including 8.4% with major depression (MDD). Among those who were currently mentally healthy, 43.0% had a history of previous depression. Women with current MDD had lower scores on the MMSE than the mentally healthy women. This association was only found in women with a lower level of education. Current depressives, previous depressives and mentally healthy women without a history of depression did not differ on CT with regard to brain atrophy or white matter lesions. The association between MDD and lower cognitive performance was independent of the association of cognitive performance with structural brain changes on CT. Brain atrophy on CT is not associated with depression in the general population, despite the fact that individuals with depression have a worse cognitive performance. The finding that cognitive performance was not decreased in individuals with previous depression suggests that cognitive dysfunction is a state phenomenon in depression.

Life stress as a risk factor for postpartum depression: Current research and methodological issues.

There is compelling evidence to suggest that acute adverse life events and certain stressors specific to motherhood increase the risk of maternity blues and diagnoses of postpartum depression. Other psychosocial factors that are likely to explain vulnerability to postpartum depression include previous history of depression and the stress-moderating effects of social support and coping responses. This article reviews the emerging empirical literature on stress and postpartum depression and presents a discussion of methodological issues relevant to advancing this area of research. Multivariate models that examine the interplay of these variables are now required to further our understanding of these syndromes.

Major depression in a population of demented and nondemented older people: prevalence and correlates.

To analyze the differences between variables associated with depression and symptoms of depression in demented and nondemented persons. A survey design was used. A total of 1101 older persons registered in a district of Stockholm, Sweden, participated in the study. Subjects were given physical and psychiatric examinations by physicians, and informants interviews and medical records were assessed. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria and major depression according to DSM-IV. The variables studied were age, gender, martial status, institutionalization, Mini-Mental State Exam score, disability in daily life, physical disorders with symptoms affecting daily life, and a previous history of depression (early and late). 27.8% of the patients in the study sample were demented according to DSM-III-R. Major depression was diagnosed in 3.9% of the nondemented and in 11.8% of the demented subjects. Some of the depressive symptoms, such as lack of energy, thinking/concentration difficulties, loss of interest, and psychomotor disturbance, were found more commonly in demented than in nondemented persons. Increased disability was associated with major depression both in demented and nondemented persons. In this study, the prevalence of depression was higher in demented than in nondemented persons. Among the factors that were studied, increased disability was associated with depression both in demented and nondemented persons. No differences were found regarding the other studied variables.

Prevention of Depression and Anxiety in Patients with Cardiovascular Disease

Depression and anxiety are common in patients with cardiovascular disease (CVD). Depending on the time and method of assessment, depression occurs in 9-27% of patients, and anxiety is nearly universal in patients who have had an acute myocardial infarction (MI), at least during hospitalization. Depression has a major impact on mortality, morbidity and functional recovery and there is evidence that treating depression may improve outcome. While few studies have examined risk factors for depression in patients with CVD, the risk factors for depression identified in other clinical populations, such as previous history of depression, are undoubtedly relevant to CVD patients. Our data suggest that women are much more likely to be depressed than men, and to remain so in the course of recovery. Few strategies have been evaluated for primary prevention of depression or anxiety, even in the general population, and no studies have been undertaken in patients with CVD. While primary prevention of depression in postM...

Violent assault, posttraumatic stress disorder, and depression. Risk factors for cigarette use among adult women.

Cigarette smoking may be conceptualized as a strategy to cope with negative affect. Therefore, rates of cigarette use might be expected to be greater in individuals experiencing events that produce negative affect, such as assault. To test this hypothesis, a national sample of 3,006 women aged 18 and older was assessed for lifetime and current cigarette use, previous history of physical and sexual assault, lifetime and current incidence of depression, and lifetime and current incidence of PTSD. Results indicated that the odds of active smoking in women with a lifetime history of assault were 1.82 times those of women with no previous history of assault. Similarly, risk of active cigarette use in women with a previous history of depression or PTSD was 2.22 and 1.34 times those of women with no depressive or PTSD history, respectively. Recent assault, current PTSD, or current depression status were not associated with increased cigarette use.

A meta-analysis of predictors of postpartum depression.

A meta-analysis of 44 studies was conducted to determine the magnitude of the relationship between postpartum depression and each of the following predictor variables: prenatal depression, history of previous depression, social support, life stress, child care stress, maternity blues, marital satisfaction, and prenatal anxiety. Effect sizes were calculated three ways: unweighted, weighted by sample size, and weighted by quality index score. Moderate to large significant effect sizes were revealed between these eight predictor variables and postpartum depression. The mean r effect size indicator range for each predictor variable was as follows: prenatal depression (.49 to .51), child care stress (.48 to .49), life stress (.36 to .40), social support (.37 to .39), prenatal anxiety (.30 to .36), maternity blues (.35 to .37), marital satisfaction (.29 to .37), and history of previous depression (.27 to .29).

MATERNAL DEPRESSION FOLLOWING VERY PRETERM BIRTH † 1584

Aim: To ascertain the prevalence of depression in mothers following a very preterm (VP < 33weeks) or VLBW delivery and to test if a cognitive behavioural therapy intervention (CBTI) program reduces the prevalence. Design: Randomized single blind control trial; stratified for gestation < 28 weeks and parity. Subjects: English speaking mothers of VP/VLBW infants admitted to KEMH nursery.Intervention: A 6 session CBTI program provided by a research midwife between weeks 3 to 6 after birth. Outcome: Depression and stress disorders assessed by a research clinical psychologist at structured interview, the Schedule for Affective Disorders & Schizophrenia (SADS), using Research Diagnostic Criteria at 2 weeks, 2,6 and 12 months.Results: Of 220 mothers enrolled 21 were depressed at initial interview and not randomized, 199 mothers were randomized (102 CBTI: 97 Control). There were no differences in gestation, parity, previous history of depression or other demographic or obstetric factor between the groups.There was no effect of the CBTI on the prevalence of depression; 25/102 (24.5%) CBTI v 20/97 (20.6%) Control [Relative Risk 1.2 (95% CI 0.71,2.0)]. Overall 66/220(30%) of mothers experienced a minor or major depressive illness in the first 6-12 months. An additional 12 mothers had a diagnosed stress reaction giving a total prevalence of psychiatric disorder of 88/220 (40%).Conclusions: Maternal depression is common after VP delivery. A CBTI program did not reduce this prevalence. Paediatricians have a duty of care to assess maternal psychological well-being during follow-up of these infants. Maternal depression may account for some of the increased behavioural and cognitive problems reported in very preterm or very low birthweight infants.

Monoamine oxidase A and B activities in heavy smokers

There is a strong association between depression and smoking. Because monoamine oxidase (MAO) inhibition leads to antidepressant effect and in vitro studies have shown that cigarette smoke inhibits MAO activity, it is conceivable that smoking may have an antidepressant effect, if smokers have reduced MAO activity. Therefore, we assessed platelet MAO-B activity and plasma concentration of catecholamine metabolites reflecting MAO-A activity in heavy dependent smokers and nonsmokers matched for sociodemographic characteristics. Platelet MAO-B activity, plasma 3,4-dihydroxyphenylglycol, plasma 3,4-dihydroxyphenylacetic acid, and plasma 3,4-dihydroxyphenylalanine concentrations were significantly lower in smokers than in nonsmokers, whereas plasma norepinephrine did not differ. Significantly more smokers reported previous history of depression, manic episode, panic attack, agoraphobia, and simple phobia. Smokers had higher scores (p < 0.001) on the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Scales. It is concluded that the activities of both forms of the MAO are reduced in heavy dependent smokers.

Risk factors for post‐stroke depression

An unselected cohort of 285 stroke patients, median age 69 years, were studied for correlation between potential risk factors and the 1-year incidence of post-stroke depression (PSD). The following factors correlated significantly with PSD: a history of previous stroke, a history of previous depression, female gender, living alone and social distress prestroke. Further, social inactivity, decrease in social activity, pathological crying and intellectual impairment at 1 month but not functional outcome correlated to PSD. A multivariate regression analysis showed that intellectual impairment explained 42% of variance of mood score. Major depression was unrelated to lesion location. We conclude that etiology to PSD is a complex mixture of prestroke personal and social factors, and stroke induced social, emotional and intellectual handicap.

Emergence of depressive symptoms during treatment for panic disorder with specific 5-hydroxytryptophan reuptake inhibitors.

Selective serotonin reuptake inhibitors (SSRI) have been established as effective drugs in the treatment of depressive and anxiety disorders. However, there are also reports that they can induce depressive symptoms and suicidal thoughts in patients. Eighty of 230 patients who met the DSM-III-R criteria for panic disorder received, during the course of treatment, fluvoxamine (a selective serotonin reuptake inhibitor) at a dose level between 50-200 mg/day. The patients were clinically evaluated for a history of affective disorder and for the presence of affective symptoms before the treatment and for emergence of depressive symptoms during the treatment. Seven of the 80 patients (9%) developed symptoms of depression despite a good antianxiety response. Five of the 7 patients received fluvoxamine as second choice after tricyclic antidepressants (TCA). These patients had no history of affective disorder, and no symptoms of depression were present before the treatment with fluvoxamine. The depressive symptoms abated after the fluvoxamine was discontinued and TCA or clonazepam was prescribed. The depressive symptoms reappeared when fluoxetine was administered. None of these 7 patients developed depressive symptoms while treated with TCA or clonazepam. Among the 150 patients treated with TCA and benzodiazepines, not a single case of depression was seen in patients without a previous history of depression. These results suggest a vulnerability among some of panic disorder patients to noradrenergic-serotonergic imbalance caused by SSRI, which has to be taken into clinical consideration.

Depression in stroke rehabilitation

Despite recent advances in understanding the pathophysiology of poststroke depression, major questions remain. They include the relative importance of lesion location and size and the confounding effects of time since stroke, age, prior history of depression, and cerebral atrophy. To evaluate these issues, we systematically assessed depressive features, functional status, and brain structure with computer tomography scans in 91 men undergoing stroke rehabilitation. Forty percent met DSM-III criteria for major depressive disorder. Mood disturbance was more severe for patients with right than with left hemisphere lesions, correlated with functional disability and lesion size, and was associated with previous history of depression. Age, time since stroke, and atrophy did not correlate with mood. Depression is common in delayed stroke recovery, regardless of lesion location. Because there are no demographic or anatomic features that predict the absence of depression, depression screening should be part of the assessment of all patients undergoing stroke rehabilitation.

The Noisy Elderly Patient: Prevalence, Assessment, and Response to the Antidepressant Doxepin

To measure the prevalence of noisy behavior as a nursing problem, a survey of head nurses was done in a chronic care hospital to identify patients whose vocalizing was frequently disturbing to other patients, staff, or visitors. We found 17 patients among the total of 154. Subsequently, the medical records of 13 surviving subjects were reviewed more exhaustively, and 11 were described as disruptive, usually when they were left alone. Of these "lonely" patients, eight had a previously documented diagnosis of depression. All were demented. Antipsychotic medication had previously been given to all 11 "lonely" patients, but had failed to control their disruptive behavior. Empirically, six patients were treated with doxepin, and in five, all with a history of previous depression, agitation and noisiness diminished. These observations suggest that the prevalence rate of disturbingly noisy behavior among long-term institutionalized elderly patients is about 11% and that the disturbingly noisy patient is often demonstrating depression in conjunction with dementia.

The impact of postnatal depression on infant development.

A large sample of primiparous women was screened for depression after childbirth. Those identified as depressed, women with a previous history of depression and a control group were followed up to 18 months, when their infants were assessed on measures of cognitive, social and behavioral development. Infants of postnatally depressed mothers performed worse on object concept tasks, were more insecurely attached to their mothers and showed more mild behavioural difficulties. Postnatal depression had no effect on general cognitive and language development, but appeared to make infants more vulnerable to adverse effects of lower social class and male gender.

The relationship between perimenstrual depressive mood and depressive illness

In a study of 144 women, mainly self-designated PMS sufferers, the premenstrual depression experienced was, apart from its shorter duration, quantitatively and qualitatively similar to major depressive disorder for a substantial proportion of subjects. The associations with previous history of depression were complex: the severity of premenstrual depression was related to previous history of postnatal depression, whereas its duration (i.e., whether it persisted through the menstrual phase or longer) was related to a history of treatment with antidepressants. Two independent dimensions are proposed. (i) A menstrual cycle-related factor which in vulnerable women can result in severe and disabling premenstrual dysphoria, and which may be aetiologically related to a subgroup of postnatal depression. (ii) In a minority of women a more general propensity for depressive illness evidenced as a tendency for any premenstrual depression to be prolonged.

Antidepressants in the medically ill: prediction of benefits.

Although depression secondary to medical illness occurs frequently, little is known about its response to conventional antidepressant therapy. In this retrospective study of 50 patients, the authors assessed the charted therapeutic effect of antidepressants and sought to define pretreatment features associated with good outcome. Half (9/18) of the patients with a previous history of depression improved while only 22% (7/32) of the patients without a previous history of depression showed improvement in mood. Those patients meeting DSM-III criteria for major depressive disorder were no more likely to benefit from antidepressants than were patients meeting criteria for adjustment disorder with depressed mood. The authors conclude that previous history of depression should be considered when assessing risks and benefits for antidepressants for medically ill patients with depressive syndromes.

Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood

Of 178 patients with AD, at least one depressive symptom was reported by 63%, 24% were rated as being depressed by a trained observer, and 43% were considered depressed by their relatives. Ten per cent had a previous history of depression. Elevated mood was rare, occurring in only six patients (3.5%). Subjects with depressive symptoms had less cognitive impairment and less ventricular enlargement on CT compared with those without symptoms. Widening of the interhemispheric fissure was associated with symptoms of mania but was inversely related to presence of depressive symptoms.

Interactions of pharmacological agents which alter biogenic amine metabolism and depression: An analysis of contributing factors within a primate model of depression

The observation that the biogenic amine depleting agent, reserpine, could induce severe depression in a small proportion of the patients treated with it has proved to be a seminal finding in what is now a much larger field of research relating the function of brain biogenic amine systems to emotions and behavior. A review of the human reserpine literature suggests, however, that factors other than pharmacologically produced alterations in brain biogenic amine metabolism must have been critical determinants of the eventual mood alterations observed in conjunction with reserpine treatment. While some of these factors, such as previous history of depression, ongoing psychosocial and environmental stress, can be intuitively identified, there are practical as well as ethical problems involved in actually testing the relative contribution of these factors in precipitating human depression and thereby determining their importance in a quantitative fashion. In the present paper we have attempted to examine, in a nonhuman primate model of depression, the degree to which factors such as prior rearing condition, repeated peer separation, and housing environment can interact with the behavioral effects produced by biogenic amine depleting agents. Major emphasis will be placed on studies utilizing alpha-methyl-para-tyrosine, an inhibitor of tyrosine hydroxylase, to ostensively reduce levels of the catecholamine neurotransmitters norepinephrine and dopamine. The results of these studies provide quantitative estimates, in terms of dose-effect relationships, of the degree to which a number of factors can combine to produce despair-like behavior in rhesus monkeys. These data may be of practical importance in evaluating the contribution of similar factors to the precipitation of human depression. Analysis of some of the existing literature relating alterations in behavior to changes in biogenic amine metabolism in animals suggests that there are important differences between rodent and primate species. These differences, when fully established, may indicate that additional research examining the mechanisms whereby modest alterations in biogenic amine metabolism can interact with environmental and social stress is needed.

Porcelain faeces after cremation

A 59-year-old male was admitted in December ]977 having swallowed ahnost a whole sachet of Weedol (70 g). There was a previous history of depression, diabetes mellitus, chronic lymphatic teukaemia and diverticular disease of the large bowel. On admission the patient seemed .depressed, but was conscious and cooperative. Physical examination revealed obesity, a tachycardia and a mildly elevated blood pressure. Gastric lay,age was performed. The gastric contents were strongly positive for paraquat. Treatment, which included Fuller's earth 200 ml hourly via a nasogastric tube, magnesium sulphate 10 ml every 6 hours, haemodialysis and haemoperfusion was instituted on the day of admission and repeated the next day when he complained o f chest pain. The following day the patient's condition suddenly deteriorated and he died. The autopsy showed 'the heart enlarged and mottled macroscopically. There was a .marked degree of atheroma of the coronary arteries. The large iiatest:ine was full of faeces and the diagnosis of diverticular disease was confirmed. Following cremation, amongst ~he bone debris, were .three hard, cinderlike, dark, brownish-black incombustible masses remiriiscent ofequine faeces. Two of them are depicted in Fig. I and weighed 35 g and 17g respe'qtively; ihaustration marks of the large bowel were clearly visible on one of the specimens. The third was amorphous and contained small pieces of vertebrae and ribs. The third specimen was discarded after the pieces of bone had been removed and ground up with .the rest of the bones in the cremulator. The cremation itself took I hour 37 minutes at a temperature o f between 6004 and 700°C. Subsequently 150 ml of Fuller's eaah suspension alone, and 150 ml of Fuller's earth mixed with faeces were heated in .the cremation furnace at 600°C for one hour. The result was amorphous masses of cinderlike material, which disintegrated on removal from the furnace.

Counselling the hysterectomy patient.

The problem of psychosexual disorders following hysterectomy is reviewed. A search of the current literature suggests that a large number of women who have post-hysterectomy depression, loss of libido, or other neuroses have a previous history of depression and neurosis, that they have a generally poor knowledge of their own anatomy and physiology, or that they have received poor counselling and explanation from their own doctor. The fact that the decision to perform a hysterectomy may have been incorrect has also been suggested as a possible cause for regret for the loss of their uterus in some women, whilst in others it is often related to the concept that the uterus is the source of a woman's femininity and the loss of this organ makes her less than a woman. A regime of counselling and the use of an explanatory pamphlet is proposed for all women who are to have a hysterectomy.

Parkinsonism, L-dopa and mental depression.

AbstractTwelve patients with classical idiopathic Parkinson's disease were treated with L‐dopa. All 12 experienced improvement in motor status. In 6, however, marked depressive symptoms developed after several months of treatment. Although the study involved only 12 patients, it reveals a disturbing aspect of the treatment of parkinsonism with l‐dopa. The occurrence of mental depression deprives the patient of the happier existence that increased mobility should offer. There is also the increased danger of suicide; the 2 patients who attempted it were the only ones with a previous history of depression. More studies must be made to determine to what degree mental depression may limit the use of L‐dopa.