Lifetime History Of Depression Research Articles

Hypothalamic-Pituitary-Adrenal Axis Reactivity in the Preschool-Age Offspring of Depressed Parents

The hypothalamic-pituitary-adrenal axis is thought to play a role in the pathogenesis of depression. In the study reported here, we tested the hypothesis that parenting behavior moderates the relation between parents’ lifetime history of depression and their offspring’s cortisol reactivity to a psychosocial stressor. We exposed 160 preschool-age children to stress-inducing laboratory tasks, during which we obtained four salivary cortisol samples. Parents completed clinical interviews and an observational parent-child interaction task. The results confirmed our hypothesis: The offspring who evidenced high and increasing cortisol levels were those whose parents had a history of depression and demonstrated hostility toward their child. This moderating effect was specific to offspring who were exposed to maternal depression during the first few years of life. As do findings in animals, results of this study underscore the importance of the early rearing environment in the intergenerational transmission of stress sensitivity.

Enhancing Memory in Late-Life Depression: The Effects of a Combined Psychoeducation and Cognitive Training Program

To evaluate the efficacy of a multifactorial cognitive training (CT) program for older people with a lifetime history of depressive disorder. This was a single-blinded waitlist control design. The study was conducted in the Healthy Brain Ageing Clinic, a specialist outpatient clinic at the Brain & Mind Research Institute, Sydney, Australia. Forty-one participants (mean age = 64.8 years, sd = 8.5) with a lifetime history of major depression were included. They were stabilized on medication and had depressive symptoms in the normal to mild range. The intervention encompassed both psychoeducation and CT. Each component was 1-hour in duration and was delivered in a group format over a 10-week period. Psychoeducation was multifactorial, was delivered by health professionals and targeted cognitive strategies, as well depression, anxiety, sleep, vascular risk factors, diet and exercise. CT was computer-based and was conducted by Clinical Neuropsychologists. Baseline and follow-up neuropsychological assessments were conducted by Psychologists who were blinded to group allocation. The primary outcome was memory whilst secondary outcomes included other aspects of cognition and disability. CT was associated with significant improvements in visual and verbal memory corresponding to medium to large effect sizes. CT may be a viable secondary prevention technique for late-life depression, a group who are at risk of further cognitive decline and progression to dementia.

Depression in Women with Spontaneous 46, XX Primary Ovarian Insufficiency

Context: A high prevalence of depressive symptoms is observed in women with primary ovarian insufficiency (POI) compared with women in whom the menopause is normally timed. Indeed, studies suggest that depression and/or its pharmacological treatment contribute to the onset of POI. Objectives: We characterize the prevalence of psychiatric disorders and the timing of onset of clinically significant depression relative to both the diagnosis of POI and the onset of menstrual irregularity in women with POI. Design and Setting: We conducted a cross-sectional clinic-based study at the National Institutes of Health Clinical Research Center. Patients: A total of 174 women with spontaneous 46, XX POI and 100 women with Turner syndrome participated in the study. Main Outcome Measures: The structured clinical interview for DSM-IV was performed. Results: Lifetime histories of depression in POI exceeded rates of depression reported in women with Turner syndrome and community-based samples of women (P < 0.001). The onset of depression frequently preceded the diagnosis of POI but occurred after the onset of menstrual irregularity. Analyses standardizing the periods of risk for depression showed that similar numbers of depressions occurred before and after these events. Conclusions: POI is associated with an increased lifetime risk for major depression. Attention to the presence of depression in POI should become an important part of the care for these women. The onset of depression frequently occurs after signs of altered ovarian function but before the diagnosis of POI. Thus, in some women the association between POI and depression suggests an overlapping pathophysiology rather than a causal relationship.

The natural course and outcome of major depressive disorder in primary care: the PREDICT-NL study

PurposeTo examine the natural course and outcome of major depressive disorder (MDD) in primary care over 39 months.MethodsProspective cohort study of 1,338 consecutive attendees with follow-up after 6, 12, and 39 months with DSM-IV MDD using the Composite International Diagnostic Interview (CIDI). We measured severity of depressive symptoms (Patient Health Questionnaire 9), somatic symptoms (Patient Health Questionnaire 15), and mental and physical function (Short Form 12, mental and physical component summary). Analysis of variance and random coefficient models were performed.ResultsAt baseline, 174 people (13%) had MDD of which 17% had a chronic and 40% had a fluctuating course, while 43% remitted. Patients with chronic courses had more severe depressive symptoms (mean difference 6.54; 95% CI 4.38–8.70), somatic symptoms (mean difference 3.31; 95% CI 1.61–5.02), and greater mental dysfunction (mean difference −10.49; 95% CI −14.42 to −6.57) at baseline than those who remitted from baseline, independent of age, sex, level of education, presence of a chronic disease, and a lifetime history of depression.ConclusionsAlthough 43% of patients with MDD attending primary care recover, this leaves a majority of patients (57%) who have a chronic or intermittent course. Chronic courses are associated with higher levels of depressive symptoms and somatic symptoms and greater mental dysfunction at baseline.

Depression in Women with Spontaneous 46, XX Primary Ovarian Insufficiency

A high prevalence of depressive symptoms is observed in women with primary ovarian insufficiency (POI) compared with women in whom the menopause is normally timed. Indeed, studies suggest that depression and/or its pharmacological treatment contribute to the onset of POI. We characterize the prevalence of psychiatric disorders and the timing of onset of clinically significant depression relative to both the diagnosis of POI and the onset of menstrual irregularity in women with POI. We conducted a cross-sectional clinic-based study at the National Institutes of Health Clinical Research Center. A total of 174 women with spontaneous 46, XX POI and 100 women with Turner syndrome participated in the study. The structured clinical interview for DSM-IV was performed. Lifetime histories of depression in POI exceeded rates of depression reported in women with Turner syndrome and community-based samples of women (P < 0.001). The onset of depression frequently preceded the diagnosis of POI but occurred after the onset of menstrual irregularity. Analyses standardizing the periods of risk for depression showed that similar numbers of depressions occurred before and after these events. POI is associated with an increased lifetime risk for major depression. Attention to the presence of depression in POI should become an important part of the care for these women. The onset of depression frequently occurs after signs of altered ovarian function but before the diagnosis of POI. Thus, in some women the association between POI and depression suggests an overlapping pathophysiology rather than a causal relationship.

Depressive Symptoms Are Associated with Medication Use and Lower Health-Related Quality of Life in Overweight Women with Binge Eating Disorder

Background Depression is a most burdensome illness, with personal and societal costs surpassing those of any other illness. Furthermore, depression affects women at a much higher rate than men. The most prevalent eating disorder among adult women is binge eating disorder (BED). Depression and obesity are common in women with BED, most of whom seek treatment later in life. Depression, obesity, and age are associated with greater health care use and lower health-related quality of life (HRQOL). Hence, for women with BED estimating the effects of depression can be confounded by both age and body mass index (BMI). The current study examined the relationships between depression, HRQOL, and health care utilization among treatment seeking women with BED. Methods Participants ( n = 105) completed the Structured Clinical Interview for DSM-IV, a health care utilization and cost survey, the Personality Assessment Inventory depression scale, and the EQ-5D to measure HRQOL. Findings On average, participants were severely obese with a mean BMI of 38.20 (SD = 6.80); 67.27% had a lifetime history of depression. Participants had higher health care costs and lower HRQOL than published age- and gender-matched norms. After controlling for age and BMI, depressive symptoms were significantly related to greater medication use (excluding antidepressants), and lower HRQOL. Conclusion Results suggest that targeting depressive symptoms may reduce the economic and personal burden of BED for women.

Association of Serotonin Transporter Promoter Gene Polymorphism (5-HTTLPR) With Depression in Costa Rican Schizophrenic Patients

:Depression and suicidal behavior are frequently observed in patients with schizophrenia. The serotonin transporter protein regulates serotonergic signaling at synapses and is encoded by a single gene (SLC6A4; Locus Link ID: 6532), located at 17q11.1-q12 with two polymorphic variants (the short and the long allele). The short allele of serotonin transporter gene has been associated with depression and suicidality in individuals who suffered negative life events and with depression in individuals with chronic psychosis.. Subjects were recruited from a genetic study of schizophrenia conducted in Costa Rica. The authors replicated their previous research, using a more narrow phenotype (only schizophrenic subjects) and a more ethnically homogenous sample (only Costa Rican schizophrenic individuals who were not included in the previous study). The authors hypothesized that subjects with at least one copy of the serotonin transporter promoter gene polymorphism (5-HTTLPR) “s” allele would have a greater history of lifetime depression and suicidability rate than those who had an “l/l” genotype. The authors analyzed 155 subjects with a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of schizophrenia (73% male, age at interview 38.3, SD = 11.23). The genotype distribution was “ss” 58 (37%), “sl” 69 (45%), and “ll” 28 (18%). In the secondary analysis, the authors explored association of the “s” allele with lifetime history of suicide behavior in 173 subjects (18 more subjects than primary analysis because schizophrenic individuals were included regardless of history of depression). The authors found that subjects carrying at least one short allele had a significant increased lifetime risk for depressive syndromes (χ2 = 5.4, df = 1, P = 0.02; odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.15–6.3). No association was found for suicidal behavior in the same sample (χ2 = 0.928, P = 0.629). In conclusion, the genotype at the 5-HTTLPR promoter polymorphic locus increases the risk of developing major depression but not suicidal behavior during the course of the schizophrenia in these patients. Due to the small sample size, these results should be followed by definitive replication.

Maternally focused worry

Emerging evidence suggests that many women in the postnatal period experience clinically significant levels of anxiety but do not meet full diagnostic criteria for an existing anxiety disorder. In this study, 167 women with infants aged 2 weeks to 12 months were interviewed for current and lifetime history of depression and anxiety disorders using the SCID-I and completed a range of self-report measures measuring psychological risk factors and current depressive and anxiety symptomatology. Qualitative comments provided by women diagnosed with ADNOS (maternally focused worry) were analyzed and themes identified, and independent t-tests and chi-square tests were conducted to compare differences between these women and women with GAD. Results showed (1) there to be almost as many women who met criteria for ADNOS (maternally focused worry) as met criteria for GAD, and (2) that women with maternally focused worry were indistinguishable from women with GAD in terms of anxiety and depressive symptom severity, functional impairment and a range of risk factors. These results highlight the status of maternally focused worry as an under-recognized phenomenon and one in need of further clinical and research attention.

Depressive Störungen bei Demenzen und milder kognitiver Beeinträchtigung: Komorbidität, Ursache oder Risikofaktor?

Both depression and dementia occur by themselves or together in elderly subjects aged 65 and above. The aim of this review is to discuss several hypotheses which try to explain the frequent co-occurrence exceeding chance alone, based on a systematic literature search. A series of studies revealed potential biological similarities between both disorders which, however, were not found in all investigations. Lifetime history of depression can be considered as a distant risk factor for dementias. Depression occurs most frequently within one year before and after the onset of dementia, in which the association between both disorders is probably strongest. In a subgroup of subjects with more "cognitive reserve", depression was found to be a consequence of patient's realisation of beginning cognitive deficits. Several studies indicate that depression in Alzheimer and other dementia forms can be considered as a separate disease entity, as the clinical syndrome differs from depression in earlier periods of life. Studies on the therapy of depression in dementia have aroused increasing interest in recent years. Herewith, certain guidelines in the treatment of older patients with antidepressants must be followed.

Cortical thinning in persons at increased familial risk for major depression

The brain disturbances that place a person at risk for developing depression are unknown. We imaged the brains of 131 individuals, ages 6 to 54 years, who were biological descendants (children or grandchildren) of individuals identified as having either moderate to severe, recurrent, and functionally debilitating depression or as having no lifetime history of depression. We compared cortical thickness across high- and low-risk groups, detecting large expanses of cortical thinning across the lateral surface of the right cerebral hemisphere in persons at high risk. Thinning correlated with measures of current symptom severity, inattention, and visual memory for social and emotional stimuli. Mediator analyses indicated that cortical thickness mediated the associations of familial risk with inattention, visual memory, and clinical symptoms. These findings suggest that cortical thinning in the right hemisphere produces disturbances in arousal, attention, and memory for social stimuli, which in turn may increase the risk of developing depressive illness.

The serotonin transporter 5‐HTTPR polymorphism is associated with current and lifetime depression in persons with chronic psychotic disorders

Variation in the serotonin transporter gene (SLC6A4) promoter region has been shown to influence depression in persons who have been exposed to a number of stressful life events. We evaluated whether genetic variation in 5-HTTLPR, influences current depression, lifetime history of depression and quantitative measures of depression in persons with chronic psychotic disorders. This is an association study of a genetic variant with quantitative and categorical definitions of depression conducted in the southwest US, Mexico and Costa Rica. We analyzed 260 subjects with a history of psychosis, from a sample of 129 families. We found that persons carrying at least one short allele had a statistically significant increased lifetime risk for depressive syndromes (P < 0.02, odds ratio 2.18, 95% CI 1.10-4.20). The 'ss' or 'sl' genotype at the 5-HTTLPR promoter polymorphic locus increases the risk of psychotic individuals to develop major depression during the course of their illness.

Persistence of abnormal cortisol levels in elderly persons after recovery from major depression

Background Cortisol hypersecretion is characteristic of acute clinical depression, but little is known in fully recovered, non-treated elderly persons with a lifetime history of depression. This study was designed to examine patterns of diurnal cycle of cortisol in an elderly cohort without current depression or treatment for depression according to whether the person has or has not experienced a previous episode of depression or co-morbid depression with anxiety. Methods Cortisol secretion was evaluated in 162 community-dwelling elderly on a stressful and a non-stressful day (basal level). Past depression and anxiety disorders were assessed using a standardized psychiatric examination based on DSM-IV criteria (the Mini International Neuropsychiatric Interview). Results Antidepressant-free persons with a history of non-co-morbid major depression (6.8% of the sample) showed basal cortisol hypersecretion compared to those with depression and anxiety (8.6%) or controls. Several hours after exposure to a stressful situation, controls showed a sustained increase in cortisol secretion, which was not observed in persons with a history of depression. Persons with a history of depression with anxiety showed a similar cortisol secretion at baseline to controls but a heightened response to stressful situation; a pattern comparable to that observed in subjects with pure anxiety disorders (16.7%). Conclusion An abnormal HPA response persists even after effective treatment for depression. A history of co-morbid depression and anxiety gives rise to changes characteristic of anxiety alone. Our findings suggest that cortisol abnormalities may be trait markers for vulnerability to depression and for the differentiation of depression and depression with co-morbid anxiety.

Depression, Antidepressants, and Bone Mineral Density in a Population-Based Cohort

It is uncertain whether depression and antidepressant use are associated with decreased bone mineral density (BMD) and whether these relationships differ for men and women. The study used a case-cohort design within the Baltimore Epidemiologic Catchment Area Study, a population-based sample of adults that recently completed its 23-year follow-up. Depression was measured at four time points during the follow-up period by the Diagnostic Interview Schedule. Lower spine BMD was measured at the fourth wave by dual-energy x-ray absorptiometry. The association of BMD with lifetime history of depression and antidepressant medication use was studied using linear regression with bootstrap standard errors. A history of depression was associated with lower spine BMD after controlling for age, sex, race, calcium intake, alcohol use, smoking status, level of physical activity, percent body fat, and antidepressant medication use (-0.140 g/cm(2); p <.002). After controlling for depression, antidepressant medication use was associated with decreased BMD in women but not in men (-0.218 g/cm(2); p <.016). A history of depression predicted decreased lumbar spine BMD in men and women, and antidepressant use predicted decreased BMD in women even after controlling for depression. The magnitude of the effect of depression on BMD was approximately equivalent to 1 standard deviation in BMD and was therefore clinically significant. Providers should be aware of the physiologic consequences of depression as well as the possible risks to bone strength associated with antidepressant use in older patients.

Do gender differences in the role of dysfunctional attitudes in depressive symptoms depend on depression history?

Gender differences in the moderating role of dysfunctional attitudes in the relationship between life stress and depressive symptoms were examined with and without controlling for the presence of lifetime history of depression. When lifetime history of depression was controlled, dysfunctional attitudes played a moderating role in the relationship between life stress and depressive symptoms for both men and women. However, when lifetime history of depression was not controlled, dysfunctional attitudes moderated the relationship of life stress and depressive symptoms for women only. The results suggest gender differences in the moderating role of dysfunctional attitudes may be contingent on lifetime history of depression and that past depression may exert differing effects for men and women.

Association between physical illnesses and depressive symptoms requiring hospitalization in suicide victims

We examined an association between a history of hospital-treated depression and physical diseases in 1877 suicide victims from Northern Finland. Information on physical diseases and depression of victims was extracted from the Finnish Hospital Discharge Registers. Of suicide victims, 31% of female and 16% of male victims had a lifetime history of depression. When compared with victims without any lifetime hospital-treated physical illnesses, a history of depression was shown to associate with the diseases of the nervous, circulatory, respiratory, and musculoskeletal systems in the group of symptoms and signs, injuries and poisonings, and infectious diseases among male victims. Respectively, in female victims, an increased prevalence of depression was seen in endocrine, nutritional and metabolic diseases, diseases of the nervous, circulatory, genitourinary, skin and subcutaneous tissue, and musculoskeletal systems, and with injuries and poisonings, pregnancy-related problems and infectious diseases. This study is the first to evaluate comorbidity between physical illnesses and depression over the lifetime in suicide victims; earlier studies reported findings in living patients from epidemiological or clinical populations. Since depression can affect quality of life in severely ill patients, targeting depression in patients with chronic illness may assist in decreasing suicide rates.

Exploring Perceptions of Alcohol Use as Self-Medication for Depression Among Women Receiving Community-Based Treatment for Alcohol Problems

Although epidemiological literature reports a significant overlap between depression and alcoholism among women, the dynamics of this relationship requires further exploration. The present paper documents significant lifetime histories of depression among women in treatment for alcohol problems, and presents findings on these women's experiences of the relationship between depression and alcohol use problems. In this community-based treatment sample, 18 out of 18 women participating in qualitative interviews reported histories of depression and almost 80% were currently using anti-depressant medication. The use of alcohol as an attempt to escape difficult emotions or alternatively to produce positive emotional experiences is discussed within the gendered context of the stories women tell about their depression and alcohol use.

Selective serotonin reuptake inhibitor use and bone mineral density in women with a history of depression

Selective serotonin reuptake inhibitors (SSRIs) are a first-line treatment for depression. They have been reported to regulate serotonin signalling in bone cells and may influence bone metabolism. This study aimed to investigate the effect of SSRIs on bone mineral density (BMD) in a sample of women with a lifetime history of depression. In this community-based study of 607 women, a history of depression was ascertained using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR research version, non-patient edition. BMD was measured at the posterior-anterior (PA) spine, hip, total body and forearm using dual energy absorptiometry, and medication use and lifestyle factors were self-reported. Among 177 women with a lifetime history of depression, current users of bisphosphonates, glucocorticoids, hormone therapy and antidepressants other than SSRIs were excluded. Of the remaining 128 (median age 51.5 years, range 30-74), 26 (20.3%) reported current SSRI use. After controlling for age, weight, height and smoking history, BMD among SSRI users was 5.6% lower at the femoral neck (P=0.03), 6.2% lower at the trochanter (P=0.04) and 4.4% lower at the mid-forearm (P=0.03) than nonusers. No differences in BMD were detected at other sites. Although the mechanism remains unclear, these observations are consistent with a role for the serotonergic system in regulating bone metabolism.

The influence of lifetime depression on self-reported memory and cognitive problems: Results from the National Comorbidity Survey–Replication

The current study investigated the association between lifetime major depressive disorder (MDD) and self-reported memory and cognitive problems in a general population sample. The study was based on data from the National Comorbidity Survey-Replication (n = 5692). The relationship between lifetime MDD and self-reported memory and cognitive problems was examined while controlling for other 1-year and lifetime psychiatric disorders. We found a lifetime history of depression, but no other lifetime psychiatric disorder, to be associated with self-reported memory and cognitive problems. We review the results in relation to theories regarding the comorbidity of depression and cognitive problems. A history of depression increases the likelihood that individuals will make negative evaluations of their memory and cognitive functioning. Though depression is highly comorbid with other disorders, our results are unique in demonstrating the specificity of depression in its association with self-reported memory and cognitive problems. The observed association between depression and self-reported memory and cognitive problems may reflect that depression increases the risk for cognitive decline or may reflect that individuals with a history of depression tend to rate their memory as poor, or both.

Depressive disorders and bone mineral density in a community based sample of premenopausal women

Introduction There is data to suggest that the prevalence of low bone mineral density (BMD) is disproportionately higher among those with depression, although findings are equivocal. The aim of this study was to investigate the association between depression and BMD in 448 premenopausal women (20–58 yr) drawn from a randomly-selected community based sample of women participating in the Geelong Osteoporosis Study. Methods Lifetime history of depressive and anxiety disorders were diagnosed utilising a clinical interview (SCID-I/NP). BMD was measured at the PA-spine, hip, total body and forearm using dual energy absorptiometry (Lunar DPX-L) and anthropometric measurements were recorded. Medication use, menopause status, activity levels, dietary intake and smoking status were self-reported. Results There were no differences in age, weight, height, BMI, alcohol consumption, calcium intake, smoking or unadjusted BMD between the groups, although women with a lifetime history of depression were less physically active than those with no previous history (81.9% vs 90.8%, p = 0.009). Weight, height and anxiety-adjusted BMD was 2.4% lower at the PA-spine (1.263 (95% CI 1.238–1.289) vs 1.294 (1.270–1.318) g/cm2, p = 0.04) and age, weight and anxiety-adjusted BMD was 2.8% lower at the total hip (1.034 (1.014–1.055) vs 1.064 (1.044–1.083) g/cm2, p = 0.02) in those with a lifetime history of depression compared to those non-depressed. There was a trend towards BMD being lower at the total body (p = 0.12) but no relationship was detected at the forearm sites. These patterns persisted after further adjustment for smoking, physical activity, alcohol consumption, calcium intake and medications known to affect BMD. Conclusions BMD was reduced among those with a lifetime history of depression independent of age, weight, height, anxiety, smoking, physical activity, alcohol consumption, calcium intake and medications known to affect BMD. These data are consistent with previous findings and suggest that depression is a risk factor for reduced BMD among younger women.

Self-Reported Depression and Cardiovascular Risk Factors in a Community Sample of Women

The authors examined data collected from a randomly selected, representative sample of 755 women (ages 23-97 years) from southeastern Australia. Self-report questionnaires were utilized to determine lifetime rates of depression and cardiovascular risk factors within the study sample. A lifetime history of depression (LHx) was reported by 145 women (19.20%). There were no associations between indices of weight, cholesterol levels, hypertension, inactivity, diabetes, and LHx. However, a history of smoking increased the odds of reporting an LHx, whereas women with self-reported angina were more than four times more likely to report an age-adjusted LHx.