Lifetime Rates Of Major Depression Research Articles

Receipt of Disability Payments by Substance Users: Mental and Physical Health Correlates

Since 1997, substance users have received disability benefits only for impairments apart from their substance use disorders. It is hypothesized that substance users currently receiving disability benefits would be more severely compromised, medically and/or psychiatrically, than those not receiving disability. Enrolling a community sample of 330 heroin and cocaine users between January 2002 and January 2004, it was found that individuals who were not receiving disability payments had similar mental health scores, current depressive symptoms scores, and lifetime rates of major depression compared to those receiving payments, but significantly lower rates of bipolar or psychotic disorders and psychiatric hospitalization (p < .01). Physically disabled persons had lower physical function scores and were more likely to be HIV-infected or taking medications regularly (p < .001). The authors conclude that schizophrenia, bipolar disorders, and chronic physical illness, but not major depression, are qualifying substance users for disability benefits. Longitudinal studies of disability status and its effects on the lives of substance users are warranted.

Childhood abuse and lifetime psychopathology in a community sample.

The authors assessed lifetime psychopathology in a general population sample and compared the rates of five psychiatric disorder categories between those who reported a childhood history of either physical or sexual abuse and those who did not. A modified version of the Composite International Diagnostic Interview and a self-completed questionnaire on child abuse were administered to a probability sample (N=7,016) of Ontario residents 15 to 64 years of age. Those reporting a history of childhood physical abuse had significantly higher lifetime rates of anxiety disorders, alcohol abuse/dependence, and antisocial behavior and were more likely to have one or more disorders than were those without such a history. Women, but not men, with a history of physical abuse had significantly higher lifetime rates of major depression and illicit drug abuse/dependence than did women with no such history. A history of childhood sexual abuse was also associated with higher rates of all disorders considered in women. In men, the prevalence of disorders tended to be higher among those who reported exposure to sexual abuse, but only the associations with alcohol abuse/dependence and the category of one or more disorders reached statistical significance. The relationship between a childhood history of physical abuse and lifetime psychopathology varied significantly by gender for all categories except for anxiety disorders. Although not statistically significant, a similar relationship was seen between childhood history of sexual abuse and lifetime psychopathology. A history of abuse in childhood increases the likelihood of lifetime psychopathology; this association appears stronger for women than men.

Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model.

Prepubescent boys are, if anything, more likely than girls to be depressed. During adolescence, however, a dramatic shift occurs: between the ages of 11 and 13 years, this trend in depression rates is reversed. By 15 years of age, females are approximately twice as likely as males to have experienced an episode of depression, and this gender gap persists for the next 35 to 40 years. We offer a theoretical framework that addresses the timing of this phenomenon. First, we discuss the social and hormonal mechanisms that stimulate affiliative needs for females at puberty. Next, we describe how heightened affiliative need can interact with adolescent transition difficulties to create a depressogenic diathesis as at-risk females reach puberty. This gender-linked vulnerability explains why adolescent females are more likely than males to become depressed when faced with negative life events and, particularly, life events with interpersonal consequences.

Psychiatric disorder in HIV infection.

This study aimed to investigate rates of psychiatric disorder in human immunodeficiency virus (HIV) infection, in an Australian sample of homosexual and bisexual men. A cross-sectional study of a total of 65 HIV sero-negative (HIV-) and 164 HIV sero-positive men (HIV+) (79 CDC stage II/III and 85 CDC stage IV) was conducted in three centres. Lifetime and current prevalence rates of psychiatric disorder were evaluated using the Diagnostic Interview Schedule Version IIIR (DIS-IIIR). Elevated current and lifetime rates of major depression were detected in both HIV negative and HIV positive homosexual/bisexual men. Lifetime rates of alcohol abuse/dependence were significantly elevated in HIV positive men (CDC group IV) when compared with HIV negative men. Among the HIV positive group the majority of psychiatric disorders detected were preceded by a pre-HIV diagnosis of psychiatric disorder. Major depression represented the disorder most likely to have first onset after HIV infection diagnosis. Lifetime rates of major depression were elevated in this sample of HIV-negative and HIV-positive men. In the HIV-positive men, psychiatric disorder was significantly associated with the presence of lifetime psychiatric disorder prior to HIV infection diagnosis. The findings indicate the importance of evaluation of psychiatric history prior to HIV infection and the clinical significance of depressive syndromes in this population.

Fifteen years on: evolving ideas in researching sex differences in depression.

A cohort study of a socially homogeneous group of teachers was commenced in 1978 to pursue possible risk factors contributing to the recognized female preponderance of depression. Multiple measures of depressive experience included: (i) lifetime rates, duration and number of depressive episodes using two caseness definitions, DSM-III-R major depression and 'all depression' (which included a category of minor depression); (ii) self-report measures of state and trait depression, neuroticism, and self-esteem. DSM-III-R anxiety disorder rates are also reported and co-morbidity with major depression examined. At the 15-year review in 1993, the sample had a mean age of 39 years, there was a trend for a female preponderance in lifetime rates of major depression and 'all depression' (and which was more pronounced with the inclusion of data for anxiety disorders), with statistically significant differences in rates of social and simple phobias and combined anxiety disorders. Mean neuroticism scores were consistently higher for women. The strong association between anxiety and depressive disorders suggests that greater reporting of anxiety and higher neuroticism scores in women may be a key determinant that contributes to any female preponderance in depression rates.

Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict.

Physically abused women seeking treatment for marital difficulties (abused women, n = 49) were compared with maritally discordant, nonabused women (discordant only, n = 23) and maritally satisfied nonabused women (community control, n = 25). Abused women reported significantly more fear of their spouses and reported that their spouses were significantly more coercive and psychologically aggressive than women in the 2 matched nonabused groups. Abused women did not report higher rates of abuse as a child, nor did they report higher rates of past psychopathology than women in the nonabused groups. However, abused women and nonabused discordant women reported higher rates of emotional abuse in childhood than maritally satisfied nonabused women. Furthermore, both clinical groups had a tendency to have higher lifetime rates of major depression before their current marriage than the maritally satisfied women. This result suggests that childhood abuse and a history of depression may be risk factors for women in abusive and nonabusive discordant relationships. As expected, abused women reported higher rates of posttraumatic stress disorder than women in the discordant-only and community control groups. Treatment implications for both standard treatments for marital problems and treatments for victims of physical abuse are discussed.

Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict.

Physically abused women seeking treatment for marital difficulties (abused women, n = 49) were compared with maritally discordant, nonabused women (discordant only, n = 23) and maritally satisfied nonabused women (community control, n = 25). Abused women reported significantly more fear of their spouses and reported that their spouses were significantly more coercive and psychologically aggressive than women in the 2 matched nonabused groups. Abused women did not report higher rates of abuse as a child, nor did they report higher rates of past psychopathology than women in the nonabused groups. However, abused women and nonabused discordant women reported higher rates of emotional abuse in childhood than maritally satisfied nonabused women. Furthermore, both clinical groups had a tendency to have higher lifetime rates of major depression before their current marriage than the maritally satisfied women. This result suggests that childhood abuse and a history of depression may be risk factors for women in abusive and nonabusive discordant relationships. As expected, abused women reported higher rates of posttraumatic stress disorder than women in the discordant-only and community control groups. Treatment implications for both standard treatments for marital problems and treatments for victims of physical abuse are discussed.

Association of binge eating disorder and psychiatric comorbidity in obese subjects.

The authors determined the prevalence of binge eating disorder in a self-referred study group of moderately and severely obese subjects and investigated whether binge eating disorder was associated with psychiatric disorders, a history of psychotherapy, a family history of psychiatric illness, or a history of sexual abuse. They interviewed 89 obese women and 39 obese men (body mass index > 30 kg/m2) who were not currently in weight loss treatment, using the Binge Eating Disorder Clinical Interview, the Structured Clinical Interview for DSM-III-R, and the Structured Clinical Interview for DSM-III-R Personality Disorders. Forty-three (34%) of the subjects met criteria for binge eating disorder--33 women and 10 men. Black and white subjects had similar rates of binge eating disorder. Subjects with binge eating disorder were significantly more likely than those without the disorder to have a lifetime prevalence of a DSM-III-R axis I or axis II diagnosis and to have undergone psychotherapy or counseling. The lifetime rates of major depression, panic disorder, bulimia nervosa, borderline personality disorder, and avoidant personality disorder were all significantly higher in subjects with binge eating disorder. The rate of reported sexual abuse was not higher among subjects with binge eating disorder; however, they were significantly more likely to have a family history of substance abuse. The relative risks for psychiatric disorders were higher in both moderately and severely obese subjects with binge eating disorder than in those without the disorder. Among both moderately and severely obese subjects, binge eating disorder is associated with higher rates of axis I and axis II psychiatric disorders.

Migraine, physical health and psychiatric disorder: A prospective epidemiologic study in young adults

In a prospective study of a random sample of 1,007 young adults, we examined the association between migraine and psychiatric disorder, physical complaints, indicators of functional impairment, and use of mental health services. A history of migraine was associated with increased lifetime rates of major depression, anxiety disorders, illicit drug use disorders, nicotine dependence, and suicide attempts. Compared with subjects without a history of migraine, those with such a history had significantly more physical symptoms and were more likely to report job absenteeism, assess their general health as fair or poor, and use mental health services. Follow-up data, gathered 14 months after the baseline interview, revealed that subjects with a history of migraine at the baseline had significantly increased rates of first incidence major depression and panic disorder during the interval period (odds ratio (OR) for major depression = 4.2, 95% confidence interval (CI) 2.0–9.2; and OR for panic disorder = 12.8, 95% CI 4.1–39.8). The risk for these psychiatric disorders in persons with prior history of migraine was unrelated to the recentness of their migraine attacks. These findings suggest that the link between migraine, major depression and anxiety might reflect a common predisposition.

The Changing Rate of Major Depression

To estimate temporal trends in the rates of major depression cross-nationally.Nine epidemiologic surveys and three family studies.Approximately 39,000 subjects in population-based samples from nine epidemiologic surveys, and 4000 relatives from three family studies that were conducted independently but using similar methodology in the 1980s in North America, Puerto Rico, Western Europe, the Middle East, Asia, and the Pacific Rim.Age at first onset of major depression by birth cohort and time period.There was an increase in the cumulative lifetime rates of major depression with each successively younger birth cohort at all sites with the exception of the Hispanic samples, in whom the rates in the older cohort (1915 through 1935) were approximately equal to those of the younger cohorts. However, results of fitting statistical models that separate period and cohort effects showed an overall increase in the rates of major depression over time over all countries, although the magnitude of the increase varied by country. The average relative risk of major depression between a particular cohort and the cohort born immediately before varied between 2.6 (95% confidence interval, 1.8 to 3.7) in Florence, Italy, and 1.3 (95% confidence interval, 1.2 to 1.4) in Christchurch, New Zealand. Short-term fluctuations in the rates of major depression during specific time periods and in specific cohorts also varied by country.Cross-nationally, the more recent birth cohorts are at increased risk for major depression. There are, however, variations in the long- and short-term trends for major depression by country, which suggests that the rates in these countries may have been affected by differing historical, social, economic, or biological environmental events. The linking of demographic, epidemiologic, economic, and social indices by country to these changes may clarify environmental conditions that influence the rates of major depression.

Prevalence, onset, and risk of psychiatric disorders in men with chronic low back pain: a controlled study

This study used structured diagnostic interviews and DSM-III criteria to assess lifetime prevalence and pre-morbid risk of psychiatric disorder in a sample of men with long-standing chronic back pain (CLPB) attending a primary care clinic. A control group of age and demographically matched men without history of back pain was also studied. Compared to controls, men with CLBP had significantly higher lifetime rates of major depression (32% vs. 16%), alcohol use disorder (64.9% vs. 38.8%), and a major anxiety disorder (30.9% vs. 14.3%). Almost all CLBP men ever experiencing a mood disorder reported recurrent, not single, episodes. The 6 month point prevalence of major depression, but not other disorders, was also significantly elevated for men with CLBP. In CLBP, the first episode of major depression generally (58.1%) followed pain onset. While the initial major depressive episode usually commenced within the first 2 years of established pain, late onset mood disorder was also common. By comparison in most cases (81%) onset of alcohol use disorders considerably preceded pain. When an age-matching procedure was used to gauge relative vulnerability to psychiatric illness in patients and controls, CLBP patients had significantly higher pre-pain rates of alcohol use disorder but not depression. After age of pain onset, CLBP subjects had over 9 times the risk of developing major depression, but had similar rates of developing alcoholism. We conclude that (1) alcohol use disorders rather than depression may increase risk of developing CLBP, and (2) risk of new onset and recurrent major depression remains high for men throughout their pain career. This suggests that psychological adaptation to long-standing pain may be less successful than previously thought, especially with regard to recurrent mood disorder.

Risk Rates for Depression-Reply

In Reply.— Dr Baldessarini has raised important questions about the variability in the rates of depression between our studies. Since similar questions undoubtedly will be raised by others, publication of our exchange of letters might help to clarify these issues. We expect that increased interest in the variability in the rates of disorders will be generated as data on ongoing family and epidemiologic studies are published. The major question is about the differences in the rates of affective disorders among relatives in our general population studies compared with those among the relatives in our family studies. Lifetime rates of major depression are higher in the general population studies than in the relatives of normal controls in the family studies because of the following qualifications. Different Diagnostic Criteria.— In the family study we used stricter modified criteria for major depression. We required a four-week instead of a twoweek duration of symptoms; a minimum