Lifetime MDD Research Articles

The impact of physical conditions on the incidence of major depressive disorder in Chinese university students: Results from a longitudinal study

BackgroundMajor depressive disorder (MDD) is prevalent, and highly comorbid with physical illnesses. Few longitudinal studies have investigated the relationship between physical health conditions and MDD. The objectives of this study were to investigate the comorbid relationship between physical conditions and MDD, and the association between physical conditions and the 2-year risk of MDD. MethodsA study was conducted in first-year Chinese university students (n = 8,079) over two and half years, using a longitudinal design. An adapted version of the Composite International Diagnostic Interview (CIDI – 3.0) was used to assess for MDD. The presence of physician diagnosed physical conditions was assessed using ten self-report questions. Cross-sectional and longitudinal associations between self-reported physical conditions and MDD were estimated, adjusting for possible confounders. ResultsThe most frequently reported physical conditions were migraines, chronic rhinitis, and gastritis. We found that migraines, gastritis, and stomach ulcers were associated with a significantly higher lifetime prevalence of MDD than those without any physical health conditions. In those without a lifetime MDD, migraines, gastritis and stomach ulcers were also found to be significant predictors for 2-year risk of new onset MDD. LimitationsRecall and selection biases are possible when using self-reporting measures. Additionally, the COVID-19 outbreak impacted the response rate at the second follow-up assessment. Lastly, the severity of the physical conditions was not measured. ConclusionsPhysical conditions and MDD are highly prevalent and comorbid in university students. Migraines, gastritis and stomach ulcers are associated with the risk of developing MDD. Future studies should further investigate how this information can be used to prevent MDD.

Associations between borderline personality disorder features and the risk of first onset major depressive disorder: Findings from a 2-year longitudinal study in a sample of first-year university students in China

Background: The objective of this study was to estimate the associations between specific BPD features on the risk of first onset MDD over 2 years and to investigate the roles of sex, baseline depression and anxiety in the associations. Methods: A longitudinal study of Chinese first-year university students aged between 15 and 24 years and who did not have a lifetime MDD (n = 7,627). Random effect logistic regression modeling was used to estimate the associations between specific BPD features, the number of BPD features, and the risk of MDD. Results: The feeling of emptiness (OR = 2.14, 95% CI: 1.57, 2.92), paranoid/ dissociation (OR = 2.01, 95% CI: 1.43, 2.82), affective instability (OR = 1.71, 95% CI: 1.22, 2.39) conferred significant risk of MDD. Baseline depression and anxiety interacted with unstable relationship, identity disturbance and paranoid/disassociation in relation to the risk of MDD. A higher number of BPD features is associated with an increased risk of MDD. Limitations: Data collection relied on self-report. Thus, recall and reporting biases are possible. Due to the pandemic public health restrictions, we had to change the method of data collection at second annual assessment, which resulted in a lower response rate (66.5%). Conclusions: Mental health professionals should pay attention to the presence of BPD features in youth and young adults, as they are at high risk of developing a MDD in a short time period, and the risk increases with the number of BDP features.

Psychiatric Disorders and Substance Use Among African American Women in HIV Care.

African-American (AA) women are overrepresented among women with HIV (WWH). In the United States, psychiatric disorders are prevalent among WWH and associated with adverse outcomes. However, little research has examined psychiatric disorders among AA WWH. 315 AA women who were hazardous/heavy drinkers (HD) or moderate/non-drinkers (ND) were recruited from an HIV clinic in a study on alcohol use disorders. We compared sample prevalence of Axis-1 psychiatric diagnoses using the Structured Clinical Interview for DSM-IV with those from general population AA women in the National Comorbidity Survey-Replication (NCS-R). While 29.9% of general population AA women had any lifetime disorder, 66.9% of HD and 62.4% of ND WWH met criteria for a lifetime Axis-1 disorder. Specifically, lifetime PTSD and lifetime MDD were over threefold higher; current PTSD and current MDD respectively were 11-fold and threefold higher. PTSD was the most frequent comorbid diagnosis. HD and ND WWH did not differ in prevalence of psychiatric diagnoses despite significantly higher rates of substance use among HD women. Diagnostic evaluation and intervention for psychiatric disorders should be a priority in HIV medical care settings to improve health outcomes. Interventions should be tailored to address the particular stressors, challenges, and resiliencies among AA WWH.

Measurement and genetic architecture of lifetime depression in the Netherlands as assessed by LIDAS (Lifetime Depression Assessment Self-report).

Major depressive disorder (MDD) is a common mood disorder, with a heritability of around 34%. Molecular genetic studies made significant progress and identified genetic markers associated with the risk of MDD; however, progress is slowed down by substantial heterogeneity as MDD is assessed differently across international cohorts. Here, we used a standardized online approach to measure MDD in multiple cohorts in the Netherlands and evaluated whether this approach can be used in epidemiological and genetic association studies of depression. Within the Biobank Netherlands Internet Collaboration (BIONIC) project, we collected MDD data in eight cohorts involving 31 936 participants, using the online Lifetime Depression Assessment Self-report (LIDAS), and estimated the prevalence of current and lifetime MDD in 22 623 unrelated individuals. In a large Netherlands Twin Register (NTR) twin-family dataset (n ≈ 18 000), we estimated the heritability of MDD, and the prediction of MDD in a subset (n = 4782) through Polygenic Risk Score (PRS). Estimates of current and lifetime MDD prevalence were 6.7% and 18.1%, respectively, in line with population estimates based on validated psychiatric interviews. In the NTR heritability estimates were 0.34/0.30 (s.e. = 0.02/0.02) for current/lifetime MDD, respectively, showing that the LIDAS gives similar heritability rates for MDD as reported in the literature. The PRS predicted risk of MDD (OR 1.23, 95% CI 1.15-1.32, R2 = 1.47%). By assessing MDD status in the Netherlands using the LIDAS instrument, we were able to confirm previously reported MDD prevalence and heritability estimates, which suggests that this instrument can be used in epidemiological and genetic association studies of depression.

Childhood overweight and obesity and the risk of depression across the lifespan

BackgroundObesity has been longitudinally associated with depression but only few studies take a life course approach. This longitudinal study investigates whether being overweight or obese at age 8 and 13 years is associated with depressive symptoms more than 60 years later and whether this association is independent of late-life body mass index (BMI). We also investigated the association of being overweight/obese at age 8 or 13 years with ever having major depressive disorder (lifetime MDD).MethodThis analysis is based on a sub-sample of 889 AGES-Reykjavik participants with measured BMI data from early life. Late-life depressive symptoms were measured with the Geriatric Depression Scale (GDS) and lifetime MDD was assessed at late-life using the Mini International Neuropsychiatric Interview. Logistic regression analysis was used to estimate the relationships between BMI (continuous and categorical) at age 8 or 13 years, and late-life depressive symptoms (measured as GDS ≥ 5) or lifetime MDD, adjusted for sex, education, physical activity, smoking status and alcohol use. In a separate model, additional adjustments were made for late-life BMI.ResultsOne hundred and one subjects (11%) had depressive symptoms at late-life (GDS ≥ 5), and 39 subjects (4.4%) had lifetime MDD. Being overweight or obese at age 8 or 13 years was not associated with higher depressive symptoms during late-life, irrespective of late-life BMI. Being overweight or obese at age 8 years, but not age 13 years was associated with an increased risk of lifetime MDD (Odds Ratio (OR) (95% confidence interval [CI]) for age 8 = 4.03[1.16–13.96]P = 0.03 and age 13 = 2.65[0.69–10.26] P = 0.16, respectively).ConclusionBeing overweight in childhood was associated with increased odds of lifetime MDD, although the magnitude of the risk is uncertain given the small numbers of participants with lifetime MDD. No clear association was observed between childhood and adolescent overweight/obesity and late-life depressive symptoms irrespective of late life BMI.

The association of cognitive deficits with mental and physical Quality of Life in Major Depressive Disorder

BackgroundPatients with Major Depressive Disorder experience significantly reduced subjective Quality of Life (QOL), including impaired social and emotional functioning and greater fatigue and physical pain. Mounting evidence suggests that cognitive dysfunction (e.g., deficits in memory, executive function) contributes independently to the onset of reduced QOL, however the domain-specific nature of this relationship has not been investigated. The present study examined the relationship between specific cognitive domains (e.g., attention, spatial cognition) and specific deficits in mental and physical QOL in subjects with lifetime MDD, as well as acutely depressed, remitted and healthy participants. MethodsData were obtained (N = 387) from the Cognitive Function and Mood Study (COFAMS), a cross-sectional study of emotional, functional and cognitive status in individuals with mood disorders. Participants' (acutely depressed n = 93, remitted n = 170, and healthy control n = 124) QOL was assessed with the 36-Item Short Form Health Survey (SF-36) and cognitive functioning was evaluated with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Colorado Assessment Tests (CATs) and the Psychology Experiment Building Language (PEBL). ResultsAnalyses revealed that poor immediate and delayed memory were associated with reduced mental QOL in individuals with lifetime MDD, acutely depressed, and healthy controls. In contrast, cognitive functioning was not associated with mental QOL in remitted patients. No cognitive domains were significantly related to physical QOL in any participant group. ConclusionsThe result suggests that deficits in immediate and delayed memory may contribute to reduced mental QOL in acute MDD, whereas cognition does not appear to play a role in physical QOL. Memory should be considered important cognitive treatment targets for MDD patients suffering specifically from reduced mental QOL.

Network outcome analysis identifies difficulty initiating sleep as a primary target for prevention of depression: a 6-year prospective study.

Study ObjectivesMajor depressive disorder (MDD) is the leading cause of disability worldwide. Its high recurrence rate calls for prevention of first-onset MDD. Although meta-analysis suggested insomnia as the strongest modifiable risk factor, previous studies insufficiently addressed that insomnia might also occur as a residual symptom of unassessed prior depression, or as a comorbid complaint secondary to other depression risks.MethodsIn total, 768 participants from the Netherlands Study of Depression and Anxiety who were free from current and lifetime MDD were followed-up for four repeated assessments, spanning 6 years in total. We performed separate Cox proportional hazard analyses to evaluate whether baseline insomnia severity, short-sleep duration, and individual insomnia complaints prospectively predicted first-onset MDD during follow-up. The novel method of network outcome analysis (NOA) allowed us to sort out whether there is any direct predictive value of individual insomnia complaints among several other complaints that are associated with insomnia.ResultsOver 6-year follow-up, 141 (18.4%) were diagnosed with first-onset MDD. Insomnia severity but not sleep duration predicted first-onset MDD (HR = 1.11, 95% CI: 1.07–1.15), and this was driven solely by the insomnia complaint difficulty initiating sleep (DIS) (HR = 1.10, 95% CI: 1.04–1.16). NOA likewise identified DIS only to directly predict first-onset MDD, independent of four other associated depression complaints.ConclusionsWe showed prospectively that DIS is a risk factor for first-onset MDD. Among the different other insomnia symptoms, the specific treatment of DIS might be the most sensible target to combat the global burden of depression through prevention.

A 6-year longitudinal study of predictors for suicide attempts in major depressive disorder.

Major depressive disorder (MDD), represent a major source of risk for suicidality. However, knowledge about risk factors for future suicide attempts (SAs) within MDD is limited. The present longitudinal study examined a wide range of putative non-clinical risk factors (demographic, social, lifestyle, personality) and clinical risk factors (depressive and suicidal indicators) for future SAs among persons with MDD. Furthermore, we examined the relationship between a number of significant predictors and the incidence of a future SA. Data are from 1713 persons (18-65 years) with a lifetime MDD at the baseline measurement of the Netherlands Study of Depression and Anxiety who were subsequently followed up 2, 4 and 6 years. SAs were assessed in the face-to-face measurements. Cox proportional hazard regression analyses were used to examine a wide range of possible non-clinical and clinical predictors for subsequent SAs during 6-year follow-up. Over a period of 6 years, 3.4% of the respondents attempted suicide. Younger age, lower education, unemployment, insomnia, antidepressant use, a previous SA and current suicidal thoughts independently predicted a future SA. The number of significant risk factors (ranging from 0 to 7) linearly predicted the incidence of future SAs: in those with 0 predictors the SA incidence was 0%, which increased to 32% incidence in those with 6+ predictors. Of the non-clinical factors, particularly socio-economic factors predicted a SA independently. Furthermore, preexisting suicidal ideation and insomnia appear to be important clinical risk factors for subsequent SA that are open to preventative intervention.

Assessment of subjective emotional valence and long-lasting impact of life events: development and psychometrics of the Stralsund Life Event List (SEL)

BackgroundLife events (LEs) are associated with future physical and mental health. They are crucial for understanding the pathways to mental disorders as well as the interactions with biological parameters. However, deeper insight is needed into the complex interplay between the type of LE, its subjective evaluation and accompanying factors such as social support. The “Stralsund Life Event List” (SEL) was developed to facilitate this research.MethodsThe SEL is a standardized interview that assesses the time of occurrence and frequency of 81 LEs, their subjective emotional valence, the perceived social support during the LE experience and the impact of past LEs on present life. Data from 2265 subjects from the general population-based cohort study “Study of Health in Pomerania” (SHIP) were analysed. Based on the mean emotional valence ratings of the whole sample, LEs were categorized as “positive” or “negative”. For verification, the SEL was related to lifetime major depressive disorder (MDD; Munich Composite International Diagnostic Interview), childhood trauma (Childhood Trauma Questionnaire), resilience (Resilience Scale) and subjective health (SF-12 Health Survey).ResultsThe report of lifetime MDD was associated with more negative emotional valence ratings of negative LEs (OR = 2.96, p < 0.0001). Negative LEs (b = 0.071, p < 0.0001, β = 0.25) and more negative emotional valence ratings of positive LEs (b = 3.74, p < 0.0001, β = 0.11) were positively associated with childhood trauma. In contrast, more positive emotional valence ratings of positive LEs were associated with higher resilience (b = − 7.05, p < 0.0001, β = 0.13), and a lower present impact of past negative LEs was associated with better subjective health (b = 2.79, p = 0.001, β = 0.05). The internal consistency of the generated scores varied considerably, but the mean value was acceptable (averaged Cronbach’s alpha > 0.75).ConclusionsThe SEL is a valid instrument that enables the analysis of the number and frequency of LEs, their emotional valence, perceived social support and current impact on life on a global score and on an individual item level. Thus, we can recommend its use in research settings that require the assessment and analysis of the relationship between the occurrence and subjective evaluation of LEs as well as the complex balance between distressing and stabilizing life experiences.

Religion, spirituality, and mental health of U.S. military veterans: Results from the National Health and Resilience in Veterans Study

BackgroundIn the last three decades, there has been increased interest in studying the association between religion/spirituality (R/S), and mental health and functional outcomes. MethodsUsing data from a contemporary, nationally representative sample of 3151 U.S. military veterans maintained by GfK Knowledge Networks, Inc., we evaluated the relation between R/S and a broad range of mental health, and psychosocial variables. Veterans were grouped into three groups based on scores on the Duke University Religion Index: High R/S (weighted 11.6%), Moderate R/S (79.7%) and Low R/S (8.7%). ResultsA “dose-response” protective association between R/S groups and several mental health outcomes was revealed, even after adjustment for sociodemographic and military variables. High R/S was associated with decreased risk for lifetime posttraumatic stress disorder (odds ratio [OR]=0.46), major depressive disorder (MDD; OR=0.50), and alcohol use disorder (OR=0.66), while Moderate R/S was associated with decreased risk for lifetime MDD (OR=0.66), current suicidal ideation (OR=0.63), and alcohol use disorder (OR=0.76). Higher levels of R/S were also strongly linked with increased dispositional gratitude, purpose in life, and posttraumatic growth. LimitationsIn this cross-sectional study, no conclusions regarding causality can be made. The study provides a current snapshot of the link between R/S and mental health. The study also cannot determine whether religious coping styles (negative vs positive coping) contributed to observed differences. ConclusionsAlthough the present study does not have treatment implications, our results suggest that higher levels of R/S may help buffer risk for certain mental disorders and promote protective psychosocial characteristics in U.S. military veterans.

T26 - Brief Assessment Of Major Depression For Genetic Studies: Validation Of Cidi-Sf Screening With Scid Interviews

Background Studies of common genetic variants in complex psychiatric disorders such as major depression require samples that are too large (tens or hundreds of thousands) than can typically be collected with phenotyping methods involving direct interviews by trained clinicians. Many studies are no identifying cases and controls with self-report questionnaires, electronic medical records or registry data. Few data are available to determine the accuracy of these methods compared to direct interviews. Here, we present data on 1,263 individuals for whom online and direct interview data were available. Methods The Depression Genes and Networks study (DGN) recruited cases with recurrent MDD and controls with no lifetime MDD for a study of whole-blood gene expression. A research company emailed invitations to 14,463 survey panel members; 9,569 completed an online screen including the CIDI-Short Form depression and substance dependence modules, of whom 1,263 eventually gave blood samples and completed telephone SCID-IV interviews: 669 prospective cases (CIDI-SF recurrent MDD without current substance dependence) and 594 prospective controls (no 2-week period of depression or anhedonia with >2 MDD criteria; no current substance dependence). For this analysis we also identified narrow screening criteria for controls (no 2-week period with both depression and anhedonia; or one of these but not most of the day, nearly every day; no lifetime antidepressant [AD] use [SCID]). Polygenic score predictions were then examined in the GenRED-I GWAS cohort (which used non-overlapping controls screened with CIDI-SF) using broad vs. narrow controls. Results Among prospective cases, SCID diagnosis was MDD recurrent (N=547, 81.2%; some were excluded from DGN for other reasons) or uncomplicated single episode (39, 5.8%) totaling 87% with diagnoses that would be included in most genetic studies of MDD; 18 (2.7%) had major depressive episodes with complications that would typically be excluded (bereavement, medical or substance-related factors), and 65 (9.7%) had such exclusions as bipolar disorders (28, 4.2%), no MDD (30, 4.5%), or unreliable histories (7, 1%). Among prospective controls, 108 (18.2%) were excluded by SCID, primarily for MDD (57, 9.6%), sub-threshold depression (25, 4.2%), or a bipolar disorder (6, 1%). Narrow screening criteria would have excluded 76 (70%) of the 108 ineligible controls (57 by CIDI-SF clinical screening, 19 for self-reported AD use) and 44 (9.1%) of the SCID-eligible controls, thus predicting 93.2% validation by SCID. PRS prediction was improved in the GenRED cohort using only narrow controls. Discussion Online CIDI-SF screening for MDD-R has a high rate of validation by SCID interviews: 81.8% for MDD-R, and 87.6% if uncomplicated single-episode MDD is considered part of the genetic spectrum. Only 4.5% had no major depressive episode by SCID, but 4.2% received bipolar diagnoses. Although self-report screening for mania is only modestly accurate, we recommend using it to increase the proportion of positive cases. The false-positive rate in controls could be largely controlled by using a very strict threshold for self-reported history of depression (basically, not endorsing depression screening items) and by excluding for any self-reported antidepressant use. This excludes a small proportion of true controls, but an excess of prospective controls is typically available

T12 - The Lipidome In Major Depressive Disorder: Shared Genetic Influence For Ether-Phosphatidylcholines, A Plasma-Based Phenotype Related To Inflammation, And Disease Risk

Background The lipidome is rapidly garnering interest in the field of psychiatry. Recent studies have implicated lipidomic changes across numerous psychiatric disorders, not least in MDD—there is growing evidence that the concentrations of several classes of lipids are altered in those diagnosed with MDD. However, for lipidomic abnormalities to be considered potential treatment targets for MDD (rather than secondary manifestations of the disease), a shared etiology between lipid concentrations and MDD risk must be demonstrated. Methods In a sample of 567 individuals from 37 extended pedigrees (average size 13.57 people, range = 3-80) plus 30 singletons, we used mass-spectrometry lipidomic measures to evaluate the genetic overlap between twenty-three biologically distinct lipid classes and a continuous index of lifetime MDD risk. Results We found that the lipid class with the largest endophenotype ranking value (ERV, a standardized parametric measure of pleiotropy) were ether-phosphodatidylcholines (alkylphosphatidylcholine, PC(O) and alkenylphosphatidylcholine, PC(P) subclasses). Furthermore, we examined the cluster structure of the twenty-five species within the top-ranked lipid class, and the relationship of those clusters with MDD risk. This analysis revealed that species containing arachidonic acid generally exhibited the greatest degree of genetic overlap with MDD. Discussion This study is the first to demonstrate a shared genetic etiology between MDD risk and ether-phosphatidylcholine species containing arachidonic acid, an omega-6 fatty acid that is a precursor to inflammatory mediators, such as prostaglandins. The study highlights the potential utility of the well-characterized linoleic/arachidonic acid inflammation pathway as a diagnostic marker and/or treatment target for MDD.

The Interactive Effect of Major Depression and Nonsuicidal Self-Injury on Current Suicide Risk and Lifetime Suicide Attempts

This study examined the main and interactive effects of MDD and lifetime nonsuicidal self-injury (NSSI) on current suicide risk and past suicide attempts. We predicted that individuals with a history of NSSI and current MDD would be at greater suicide risk than those with either risk factor alone. An interaction between lifetime MDD and NSSI was hypothesized for past suicide attempts. 204 substance dependent inpatients completed self-report measures and a diagnostic interview. Patients with both a history of NSSI and current MDD, relative to all other groups, had the greatest suicide risk. No support was found for the lifetime MDD by NSSI interaction. Conclusion: Findings suggest the relevance of both NSSI and MDD in suicide risk.

Theory of mind in social anxiety disorder, depression, and comorbid conditions

Social anxiety disorder is characterized by marked interpersonal impairment, particularly when presenting with comorbid major depression. However, the foundational social-cognitive skills that underlie interpersonal impairment in comorbid and non-comorbid manifestations of SAD has to date received very little empirical investigation. In a sample of 119 young adults, the current study examined differences in theory of mind (ToM), defined as the ability to decode and reason about others’ mental states, across four groups: (a) non-comorbid SAD; (b) non-comorbid Lifetime MDD; (c) comorbid SAD and Lifetime MDD; and (d) healthy control. The non-comorbid SAD group was significantly less accurate at decoding mental states than the non-comorbid MDD and control groups. Further, both the comorbid and non-comorbid SAD groups made significantly more ‘excessive’ ToM reasoning errors than the non-comorbid MDD group, suggesting a pattern of over-mentalizing. Findings are discussed in terms of their implications for understanding the social cognitive foundations of social anxiety.

Major depressive disorder and current psychological distress moderate the effect of polygenic risk for obesity on body mass index.

Major depressive disorder (MDD) and obesity are frequently co-morbid and this correlation is partly due to genetic factors. Although specific genetic risk variants are associated with body mass index (BMI) and with larger effect sizes in depressed individuals, the genetic overlap and interaction with depression has not been addressed using whole-genome data. Polygenic profile scores for MDD and BMI were created in 13 921 members of Generation Scotland: the Scottish Family Health Study and tested for their association with BMI, MDD, neuroticism and scores on the General Health Questionnaire (GHQ) (current psychological distress). The association between BMI polygenic profile scores and BMI was tested fitting GHQ, neuroticism or MDD status as an interaction term to test for a moderating effect of mood disorder. BMI polygenic profile scores were not associated with lifetime MDD status or neuroticism although a significant positive association with GHQ scores was found (P=0.0001, β=0.034, r2=0.001). Polygenic risk for MDD was not associated with BMI. A significant interaction between BMI polygenic profile scores and MDD (P=0.0003, β=0.064), GHQ (P=0.0005, β=0.027) and neuroticism (P=0.003, β=0.023) was found when BMI was the dependent variable. The effect of BMI-increasing alleles was greater in those with MDD, high neuroticism or current psychological distress. MDD, neuroticism and current psychological distress amplify the effect of BMI polygenic profile scores on BMI. Depressed individuals with a greater polygenic load for obesity are at greater risk of becoming obese than control individuals.

Mineralocorticoid receptor haplotypes sex-dependently moderate depression susceptibility following childhood maltreatment

The MR is an important regulator of the hypothalamic-pituitary-adrenal (HPA) axis and a prime target for corticosteroids. There is increasing evidence from both clinical and preclinical studies that the MR has different effects on behavior and mood in males and females. To investigate the hypothesis that the MR sex-dependently influences the relation between childhood maltreatment and depression, we investigated three common and functional MR haplotypes (GA, CA, and CG haplotype, based on rs5522 and rs2070951) in a population-based cohort (N = 665) and an independent clinical cohort from the Netherlands Study of Depression and Anxiety (NESDA) (N = 1639). The CA haplotype sex-dependently moderated the relation between childhood maltreatment and depressive symptoms both in the population-based sample (sex × maltreatment × haplotype: β = -4.07, P = 0.029) and in the clinical sample (sex × maltreatment × haplotype, β = -2.40, P = 0.011). Specifically, female individuals in the population-based sample were protected (β = -4.58, P = 2.0 e(-5)), whereas males in the clinical sample were at increased risk (β = 2.54, P = 0.0022). In line with these results, female GA haplotype carriers displayed increased vulnerability in the population-based sample (β = 4.58, P = 7.5 e(-5)) whereas male CG-carriers showed increased resilience in the clinical sample (β = -2.71, P = 0.016). Consistently, we found a decreased lifetime MDD risk for male GA haplotype carriers following childhood maltreatment but an increased risk for male CA haplotype carriers in the clinical sample. In both samples, sex-dependent effects were observed for GA-GA diplotype carriers. In summary, sex plays an important role in determining whether functional genetic variation in MR is beneficial or detrimental, with an apparent female advantage for the CA haplotype but male advantage for the GA and CG haplotype. These sex-dependent effects of MR on depression susceptibility following childhood maltreatment are relevant in light of the increased prevalence of mood disorders in women and point to a sex-specific role of MR in the etiology of depression following childhood maltreatment.

The clinical impact of mood disorder comorbidity on social anxiety disorder

BackgroundHigh comorbidity rates of mood disorders have been reported in patients with social anxiety disorder (SAD). Our study aims to identify the frequency of comorbid Axis I disorders in patients with SAD and to investigate the impact of psychiatric comorbidity on SAD. MethodsThe study included 247 patients with SAD. Thirty eight patients with bipolar depression (SAD-BD), 150 patients with major depressive disorder (SAD-MDD) and 25 patients who do not have any mood disorder comorbidity (SAD-NOMD) were compared. ResultsAround 90% of SAD patients had at least one comorbid disorder. Comorbidity rates of lifetime MDD and BD were 74.5% and 15.4%, respectively. There was no comorbidity in the SAD-NOMD group. Atypical depression, total number of depressive episodes and rate of PTSD comorbidity were higher in SAD-BD than in SAD-MDD. Additionally, OCD comorbidity was higher in SAD-BD than in SAD-NOMD. SAD-MDD group had higher social anxiety severity than SAD-NOMD. ConclusionsMood disorder comorbidity might be associated with increased severity and decreased functionality in patients with SAD.

The EPDS-Lifetime: assessment of lifetime prevalence and risk factors for perinatal depression in a large cohort of depressed women

Perinatal depression (PND) is a common complication of pregnancy and postpartum associated with significant morbidity. We had three goals: (1) to explore the performance of a new lifetime version of the Edinburgh Postnatal Depression Scale (EPDS-Lifetime) to assess lifetime prevalence of PND; (2) to assess prevalence of lifetime PND in women with prior histories of major depressive episode (MDE); and (3) to evaluate risk factors for PND. Subjects were from the Netherlands Study of Depression and Anxiety (NESDA). The EPDS was modified by adding lifetime PND screening questions, assessing worst episode, and symptom timing of onset. Of 682 women with lifetime MDD and a live birth, 276 (40.4%) had a positive EPDS score of ≥12 consistent with PND. Women with PND more often sought professional help (p < 0.001) and received treatment (p = 0.001). Independent risk indicators for PND included younger age, higher education, high neuroticism, childhood trauma, and sexual abuse. We found that two in five parous women with a history of MDD had lifetime PND and that the PND episodes were more severe than MDD occurring outside of the perinatal period. The EPDS-Lifetime shows promise as a tool for assessing lifetime histories of PND in clinical and research settings.

Major depressive disorder and impulsive reactivity to emotion: toward a dual-process view of depression.

Dual-process theories of behaviour have been used to suggest that vulnerability to depression involves elevated reactivity to emotions. This study tests that idea, examining self-reported reactivity. Comparison between persons with at least one lifetime episode of major depressive disorder (lifetime MDD) and those without this diagnosis, controlling for symptoms of alcohol use (a potential externalizing confound) and current symptoms of depression (a potential state-dependent confound). Undergraduates (N = 120) completed a clinical interview to diagnose lifetime MDD and a series of self-reports bearing on diverse aspects of self-control, including reactivity to emotion. Thirty-four people were diagnosed with lifetime MDD; 86 did not meet criteria for MDD. The groups were then compared on three factors underlying the scales assessing self-control. The MDD group had higher scores than controls on the two factors that reflect impulsive reactivity to diverse emotions, including emotions that are positive in valence. These effects were not explained by associations with either externalizing symptoms or current depressive symptoms. Reflexive reactivity to emotions characterizes depression, in addition to some externalizing problems, and it may deserve study as a potential trans-diagnostic feature. Reflexive reactivity to emotions characterizes persons diagnosed with major depressive disorder. Findings suggest desirability of focusing treatment partly on management of reflexive reactions to emotions. Measures were self-reports, rather than behavioural responses to emotions.

Religious Involvement and DSM-IV 12-Month and Lifetime Major Depressive Disorder Among African Americans

This study explores relationships between lifetime and 12-month DSM-IV major depressive disorder and religious involvement within a nationally representative sample of African American adults (n = 3,570). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview. Multivariate findings indicate that reading religious materials were positively associated with 12-month (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.001-1.29) and lifetime (OR, 1.12; 95% CI, 1.03-1.21) MDD, religious service attendance was inversely associated with 12-month and lifetime MDD, and religious coping was inversely associated with 12-month MDD (OR, 0.75, 95% CI, 0.57-0.99). Findings are discussed in relation to the role of religion for African American mental health, prior research on the effects of religious involvement on physical and mental health, and theoretical and conceptual models of religion-health connections that specify multiple and often divergent pathways (e.g., prevention and resource mobilization) by which diverse forms of religious involvement impact mental health.