Predictors Of Major Depression Research Articles

A cross-sectional study of university students' mental health and lifestyle practices amidst the COVID-19 pandemic.

University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students' mental health, specifically depression, anxiety, and stress, during Lebanon's extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it. An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05. Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the "poor" and "fair" overall-reported health groups having higher odds than the "Excellent" group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours. Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.

Predictors of major depression and generation of a screening score in the SARS-CoV-2 pandemic: Subanalysis of the survey ImPPaCTS-SAC.20

to describe predictors of depression in health workers in Argentina during SARS-CoV-2 pandemic and to generate a score for their screening. Subanalysis of the Argentine ImPPaCTS-SAC.20 Survey, including health workers with major depression according to PHQ 9 (Patient Health Questionnaire 9). Predictors were evaluated by multivariate analysis; a new score was constructed in the referral cohort and its cut-off point was determined. whose quality was evaluated in the total cohort and in the validation cohort. 270 workers (22.1%) had major depression. Predictors of major depression were female gender (p = 0.002), feeling discriminated against (p = 0.001), use of anxiolytics (p = 0.001) and smoking (p = 0.025). A score was prepared with these variables (female gender 2 points, feeling discriminated against 1.5 points, use of anxiolytics 2.5 points and smoking 3 points), with an area under the curve of 0.65 and a cut-off point of 2. In the validation cohort the area under the curve was 0.66. Compared with PHQ 9, the negative predictive value was 84%. Health workers in Argentina had a high prevalence of major depression during the pandemic, associated with predictive factors. A test was developed to detect those who are at low risk for it.

The joint effects of genetic liability and the death of close relatives on risk for major depression and alcohol use disorder in a Swedish national sample.

To determine whether genetic risk factors for major depression (MD) and alcohol use disorder (AUD) interact with a potent stressor - death of spouse, parent, and sibling - in predicting episodes of, respectively, MD and AUD. MD and AUD registrations were assessed from national Swedish registries. In individuals born in Sweden 1960-1970, we identified 7586, 388 459, and 34 370 with the loss of, respectively, a spouse, parent, and sibling. We started following subjects at age 18 or the year 2002 with end of follow-up in 2018. We examined time to event - a registration for MD within 6 months or AUD within a year - on an additive scale, using the Nelson-Aalen estimator. Genetic risk was assessed by the Family Genetic Risk Score (FGRS). In separate models controlling for the main effects of death of spouse, parent, and sibling, FGRS, and sex, significant interactions were seen in all analyses between genetic risk for MD and death of relative in prediction of subsequent MD registration. A similar pattern of results, albeit with weaker interaction effects, was seen for genetic risk for AUD and risk for AUD registration. Genetic risk for bipolar disorder (BD) and anxiety disorders (AD) also interacted with event exposure in predicting MD. Genetic risk for both MD and AUD act in part by increasing the sensitivity of individuals to the pathogenic effects of environmental stressors. For prediction of MD, similar effects are also seen for genetic risk for AD and BD.

Social Media Use May Not Be As Bad As Some Suggest: Implication for Older Adults.

Social media use (SMU) has increased over the past decade among older adults. Cross-sectional studies report SMU is related to negative mental health outcomes (i.e., depression). Given depression is the most common mental health issue for older adults and increases the risk of morbidity and mortality, determining longitudinally whether SMU is related to increased depression is critical. This study examined the longitudinal relationship between SMU and depression. Data from 6 waves (2015-20) of the National Health and Aging Trends Study (NHATS) were analyzed. Participants included a nationally representative sample of U.S. older adults, aged 65 years and older (N = 7,057). We used a Random Intercept Cross-Lagged Panel Modeling (RI-CLPM) framework to examine the relationship between primary outcomes of SMU and depression symptoms. No pattern was found of SMU predicting depression symptoms, or depression symptoms predicting SMU. The major driver of SMU in each wave was SMU in the previous wave. On average, our model accounted for 3.03% of the variance in SMU. The major predictor of depression in each wave was the pre-existing depression. Our model accounted for an average of 22.81% of the variance in depressive symptoms. The results suggest that SMU and depressive symptoms are driven by the previous patterns of SMU and depression, respectively. We did not find any patterns of SMU and depression influencing each other. NHATS measures SMU with a binary instrument. Future longitudinal research should employ measures that account for SMU duration, type, and purpose. These findings suggest that SMU may not be related to negative health outcomes, in this case, depression, for older adults.

Prevalence of Depression in adults with type 2 Diabetes Mellitus in the Middle East countries and the factors associated with it: A systematic review

Aims and Objectives: This study aims to assess the prevalence of depression in adults with type 2 diabetes mellitus in Middle East countries and the factors associated with it. Method: This narrative systematic review followed the Preferred Reporting Items for Systematic Review guidelines. Studies published from January 2000 to December 2020 were retrieved through database search engines from PubMed, EMBASE, Medline Ovid, and Google Scholar. Joanna Briggs Institute checklist for prevalence studies was used to assess the quality of the studies. Results: A total of 12 studies were retrieved from search databases from 8 different countries in the Middle East including Saudi Arabia, Egypt, UAE, Iran, Iraq, Kuwait, Israel, and Palestine, and the data are summarized in narration. The prevalence of depression in type 2 diabetes mellitus in the Middle East is found to be fairly high ranging from 17% to 74.4%. Egypt has the highest prevalence of depression whereas UAE has the lowest. Female gender, uncontrolled glycemia, and diabetic complications are the major predictors of depression in type 2 diabetics. Longer duration of diabetes, low education, low socioeconomic status, physical inactivity, and insulin users are among other associated factors. Conclusion: The prevalence of depression in adults with type 2 diabetes mellitus in Middle East countries is high with a wide-ranging difference. The factors associated with the development of depression in type 2 diabetes need to be addressed and taken care of. Lack of meta-analysis is the major limitation of this study that could be considered for future reviews. Keywords: depression, adults, type 2 diabetes mellitus, Middle East

The Mediating Role of Meaning in the Relationship Between Depression and Hope

The purpose of study is to examine whether meaning mediates the correlation between depression and hope among students. Participants include 512 undergraduates sampled from a public university. After giving their consent, participants responded to a set of self-report instruments. Structural Equation Modelling (SEM) and path analysis were used to analyze the data. As hypothesized, findings revealed significant negative correlations between hope (agency and pathways) and meaning with depression. Furthermore, results indicate that meaning mediates the connection between depression and hope. Also, findings revealed that presence of meaning, and hope dimensions (agency and pathway thinking) indicated major predictors of depression with presence of meaning being connected with less symptoms of depression. Ostensibly, students with more depressive symptoms reflects the tendency of experiencing less presence of meaning. Furthermore, one major implication of this study is that policy makers and the management of universities need to give greater attention to including positive psychology into the curriculum for all students. Besides, as every student faces the ongoing pandemic experience, school psychologists can see more reason why hope and meaning-related interventions need to be integrated into practice.

Gender differences in vulnerability to maternal depression during early adolescence: Girls appear more susceptible than boys

AbstractMaternal depression has consistently demonstrated reliability as a predictor of major depression in children. However, the effect of gender as a potential moderator remains under‐researched. This study examined gender differences in depression and hypothesized that maternal depression would be more greatly associated with depression in girls by early adolescence. A representative sample of 7237 participants from the Growing Up in Ireland national longitudinal study of Irish children was examined across two waves when participants were aged 9 and 13. Separate multiple regression analyses were run for girls and boys to ascertain if maternal depression and other key variables predicted child depression by age 13. A third analysis looked at the effect of gender. Maternal depression when the children were aged 9 was found predictive of depressive symptomology by age 13 in girls but not for boys. Additionally, conflict with caregivers, household income, and bullying were significant predictors for both genders. Gender significantly predicted youth depression when the child was female (R² = .13, ƒ2 = .25). These findings indicate that late childhood to early adolescence is a vulnerable period for girls during which they appear more susceptible to developing depressive symptomology than boys, particularly when exposed to maternal depression.

The Impact of COVID-19 Pandemic on Practice Patterns and Psychological Status of Ophthalmologists in Turkey

Aim: To investigate the changes in ophthalmologists' working conditions and mental health status in Turkey during the first wave of the COVID-19 outbreak and reveal the relevant individual and workplace-related factors.Methods: This cross-sectional, nationwide, the survey-based study collected data between June and September 2020. Demographic characteristics, working conditions, precautionary measures in the workplace, and participants' Depression Anxiety Stress Scale (DASS-21) and Insomnia Severity Index (ISI) ratings were investigated.Results: This study included 360 actively working ophthalmologists. While 64% of them worked in the pandemic hospitals, 44% were actively involved in COVID-related departments. Among those, 56 (35%) declared that they had all personal protective equipment in sufficient quantity in their COVID department. Despite the restrictions, 32% reported continuing to see 25 to 50 patients per day in ophthalmology clinics, with the most common complaint being the ocular "itching and burning" sensation. 53% stated that they did not perform any surgeries. Symptoms of depression, anxiety, stress and insomnia were present in 65%, 56.9%, and 43% and 46.9% of participants, respectively. All DASS-21 subscales and ISI scores were found to be significantly higher during the pandemic. Female gender, older age, and lower satisfaction levels of hygiene conditions in COVID clinics were independent predictors of higher DASS-21 subscale scores in multivariate analysis. Being a resident was a major predictor of depression. Ophthalmologists working in a pandemic hospital were more likely to experience insomnia.Conclusion: Ophthalmologists have actively worked in COVID departments during the pandemic. Increased psychological distress among ophthalmologists compared to the pre-pandemic period is caused by personal factors and many determinants related to the workplace and practice patterns. Therefore, decreasing the transmission risk by creating a protective workplace and developing psychological support policies should be considered to minimize adverse psychological effects.

Determinant Factors of Depression in Patients with Coronary Heart Disease

Depression has been related to poor quality of life and recurrence in CHD patients. It is important to explore factors associated with the depression to prevent problems and to assist with appropriate intervention. Furthermore, the determinants of depression in CHD patients in Indonesia are still unknown. This study aimed to identify the determinants of depression in CHD patients in Indonesia. This study was a quantitative study with a cross-sectional approach. Samples were recruited from outpatient care in a referral hospital in Bandung using a consecutive sampling technique for a-2 month period (n=101). Data were collected using a questionnaire package consisting of a demographic questionnaire, Beck Depression Index [BDI] (II), Zung Self-rating Anxiety Scale, Seattle Angina Questionnaire, and Spirituality Index of Well-Being. Data were analyzed using mean, frequency distribution, chi-square and logistic regression analysis. In terms of its association with depression in CHD patients, low spiritual well-being had the highest odds ratio [OR] (OR = 9.3, 95% CI = 2.968 - 29.451, p <0.01); non-anxious state and medication history had low ORs (sequentially OR = 0.2, 95% CI = 0.067 - 0.644, p < 0.01; OR=0.2 95% CI = 0.062 - 0.772, p < 0.01); PCI (percutaneous coronary intervention) with medication had the lowest OR value (OR = 0.02, 95% CI = 0.002 - 0.278, p <0.01). On the other hand, unmarried status and male gender were identified as confounding variables. Low spiritual well-being was a major predictor of depression in CHD patients, whereas no anxiety, and history of medication, consist of CHD medication and reperfusion therapy contributed to a lower risk of depression. It is recommended to include strategies in improving spiritual well being and managing anxiety to reduce the risk of depression among CHD patients.

Instagram Addiction and Depression among College Students

This study attempted to find out the relationship between depression and Instagram addiction of students pursuing pre university and degree courses. The sample consisted of 131 students comprising of students aged between 14-23 years. The students completed Test for Instagram addiction (TIA) developed by D’Souza, Samyukta and Bivera (2018) and depression measurement from DASS (Lovibond & Lovibond, 1995). Test for Instagram addiction measured addiction in 6factors–Lack of control, Disengagement, Escapism, Health and interpersonal troubles, Excessive use and Obsession. Through DASS, the authors measured depression scores. Pearson’s product moment correlations were employed to find out the relationship between factors of Instagram addiction and stress. Stepwise multiple regression was employed to find out the predictors of depression from components of the test of Instagram addiction. As the addiction to Instagram increased depression of the students also increased linearly and significantly. Health and interpersonal troubles and obsession component of Instagram addiction were the major predictors of depression.

Depression and associated physical co-morbidities in elderly prison inmates

ABSTRACTElderly prisoners constitute a group of vulnerable individuals in correctional institutions with more propensities for the negative effect of incarceration with its attendant public health problems. Many studies had explored and confirmed a higher rate of psychiatric morbidity among elderly prison inmates in most part of the globe; however, data in this part of the globe is practically unavailable. This study aims at determining the prevalence and pattern of major depressive disorder and physical co-morbidity among elderly inmates aged 50 and above in the Ogun State Prisons. This is a cross-sectional descriptive study of the population of elderly male prisoners aged 50 and above across a state in Nigeria. They were assessed using a proforma incorporating a sociodemographic, medical/forensic questionnaire, designed by the authors, and depression modules of the structured clinical interview schedule for axis I DSM-IV Disorder (SCID). Diagnosis of depression was made according to the DSM–IV criteria. Depression severity was measured using Montgomery–Asberg Depression Rating Scale (MADRS). All the eighty-five elderly inmates studied were male with mean age of 58.65 years. Majority had none or primary education, were from a polygamous background, and 43.5 percent were on current medicare. The prevalence of Major Depressive Disorder was 24.7 percent. Depression was significantly associated with prison locations, perceived condition of the prisons, and current medical care. Prevalence of Major Depressive disorders and physical morbidity among elderly male inmates were high. The presence of physical co-morbidity as well as the inmate’s perception of the prison were major predictor of depression and hence the need for modalities to detect and treat both emotional and physical disorders and to upgrade the prison environment in order to improve the quality of life of the inmates.

Predictors of Major Depression and Posttraumatic Stress Disorder Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Although major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) are prevalent after traumatic brain injury (TBI), little is known about which patients are at risk for developing them. The authors systematically reviewed the literature on predictors and multivariable models for MDD and PTSD after TBI. The authors included 26 observational studies. MDD was associated with female gender, preinjury depression, postinjury unemployment, and lower brain volume, whereas PTSD was related to shorter posttraumatic amnesia, memory of the traumatic event, and early posttraumatic symptoms. Risk of bias ratings for most studies were acceptable, although studies that developed a multivariable model suffered from methodological shortcomings.

Effects of typhoid vaccine on inflammation and sleep in healthy participants: a double-blind, placebo-controlled, crossover study.

RationaleAn increasing body of evidence links the occurrence of sleep continuity disturbances with increased inflammation and both sleep disturbances and inflammation are associated with clinical depression. Typhoid vaccination results in a mild inflammatory response that significantly increases levels of the proinflammatory cytokine, interleukin (IL)-6.ObjectivesThe present exploratory study aimed to enhance our understanding of the link between inflammation, sleep and depression by examining the effects of typhoid vaccine on the sleep polysomnogram.MethodsWe studied the effects of a single injection of typhoid polysaccharide vaccine and placebo (saline solution) on sleep in 16 healthy male and female participants aged 20–38 years, sleeping at home in a randomized, double-blind, balanced order, crossover design. Subjective measures of mood, sleep and adverse effects were elicited and plasma samples analysed for IL-6 levels.ResultsIL-6 levels (in picogramme per millilitre) significantly increased 2 h post vaccine compared to placebo (0.90 vs 0.53, p = 0.026, r = 0.55). Relative to placebo, typhoid vaccination produced significant impairment in several measures of sleep continuity. Total sleep time (in minute) (426.1 vs 410.7, p = 0.005, r = 0.62) and sleep efficiency percent (94.3 vs 91.5, p = 0.007, r = 0.65) were decreased; with increases in wake after sleep onset (in minute) (25.5 vs 38.8, p = 0.007,r = 0.65), total wake (in minute) (34.9 vs 50.3, p = 0.005,r = 0.67), sleep stage transitions (155.9 vs 173.1, p = 0.026, r = 0.56), number of awakenings (27.2 vs 36.1, p = 0.007, r = 0.64) and awakening index (3.8 vs 5.3, p = 0.005, r = 0.67) (means, significance level and effect size).ConclusionsInflammatory mechanisms may underlie the impairment in sleep efficiency which is a hallmark of major depression. Because impaired sleep is also a predictor of major depression, there may be a role for suitable anti-inflammatory approaches in strategies designed to prevent the onset of depression.ClinicalTrials.gov (http://www.clinicaltrials.gov): NCT02628054Electronic supplementary materialThe online version of this article (doi:10.1007/s00213-016-4381-z) contains supplementary material, which is available to authorized users.

COPD Assessment Test (CAT) score as a predictor of major depression among subjects with chronic obstructive pulmonary disease and mild hypoxemia: a case-control study.

BackgroundDepression is a common comorbidity among patients with Chronic Obstructive Pulmonary Disease (COPD) and has a significant impact on the course of the disease. The aim of this study is to determine association between COPD Assessment Test (CAT) and major depression among clinically stable out-patient COPD subjects with mild hypoxemia.MethodsCase–control study. Cases were 30 patients with major depression and controls were 30 patients without depression. Major depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders criteria by a psychiatric evaluation. All possible predictive variables were included in a multivariate logistic regression model to assess the association between major depression and each independent variable, while controlling for the sleep parameters.ResultsCAT score >20 was associated with major depression (OR 7.88; 95% CI 1.96 - 31.7; p = 0.004).ConclusionCAT score >20 was associated with major depression, suggesting CAT as a predictor variable of major depression among COPD patients with mild hypoxemia, and indicating that an additional specific evaluation for the presence of major depression should be done.

Prediction of major depression in adolescents using an optimized multi-channel weighted speech classification system

This study addresses an urgent need for objective measures allowing an efficient, early prediction of risk for depression in adolescents. An early intervention preventing the onset of clinical depression could significantly reduce the social and economic burden of the disease. Previous studies have shown that acoustic speech parameters are strong indicators of full blown depression symptoms in adults and adolescents. The current study investigates the effectiveness of acoustic speech analysis and classification in prediction of depression in adolescents before the full blown symptoms become apparent. The proposed optimized multi-channel weighted speech classification (OMCWSC) method introduces a two-stage multi-channel classification procedure. In the first stage, each channel of the OMCWSC performs an independent classification based on a single type of features (glottal, prosodic and Teager energy operator parameters derived from glottal waveform (TEOG)). In the second stage, the weighted classification outcomes from all channels are combined to deliver the final decision classifying an individual as “At Risk” (AR) or “Not at Risk” (NAR) of developing depression symptoms within the next 2.5 years. The weight values of the OMCWSC system are optimized to maximize the overall system classification accuracy. Experiments based on speech recordings collected from 15 AR and 15 NAR adolescents showed that while each of the three individual channels provided prediction accuracy above the chance level (69% glottal, 63% prosodic, 67% TEOG), the adaptive weighting system of the proposed OMCWSC procedure led to further improvement of the prediction results achieving up to 74% accuracy and a well-balanced sensitivity to specificity ratio of 77%/70%.

Facing the Economic Crisis in Greece: The Effects of Grievances, Real and Perceived Vulnerability, and Emotions Towards the Crisis on Reactions to Austerity Measures

This research was conducted in Greece during a period of major economic crisis when everyday events contributed to a changing and threatening socio-political environment. The paper looks at the structure of reactions Greek people (N=1040) have towards the crisis. Informed by social psychological theories of collective action and relative deprivation it is hypothesized that these reactions would depend on people's actual financial position, their sense of grievances and feelings of vulnerability and the emotions they felt towards the crisis. Results show that people have multiple ways of reacting that go from radical and even violent practices towards individual solutions and depression. These reactions are differently predicted by people's position, feelings of vulnerability and sense of grievances and by different emotions. It is not people's actual position that influences reactions and feelings of vulnerability are a major predictor. Moreover, sense of grievances are linked to more radical forms of action but also to depression. Emotions play an important role in predicting reactions to the crisis. Anger is confirmed as a predictor of political participation and collective action whereas fear and frustration are a major predictor of depression. Positive emotions also predict collective action with the exception of violent practices.

Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis

Depression after stroke is a distressing problem that may be associated with other negative health outcomes. To estimate the natural history, predictors and outcomes of depression after stroke. Studies published up to 31 August 2011 were searched and reviewed according to accepted criteria. Out of 13 558 references initially found, 50 studies were included. Prevalence of depression was 29% (95% CI 25-32), and remains stable up to 10 years after stroke, with a cumulative incidence of 39-52% within 5 years of stroke. The rate of recovery from depression among patients depressed a few months after stroke ranged from 15 to 57% 1 year after stroke. Major predictors of depression are disability, depression pre-stroke, cognitive impairment, stroke severity and anxiety. Lower quality of life, mortality and disability are independent outcomes of depression after stroke. Interventions for depression and its potential outcomes are required.

1062 – Predictors for remission of major depression and anxious disorders and for developing disorders in an epidemiologic catchment area in montreal, canada: a longitudinal study

Objectives The aim of this study is identifying the predictors of major depression and anxiety disorders and the predictors of the remission of these disorders. Methods A longitudinal study under the form of a community survey includes a randomly selected sample of 2,434 individuals between 15 and 65 years of age (T1); 1,815 agreed to be re-interviewed two years later (T2). Mental disorders were identified with the Composite International Diagnostic Interview, including mood disorders (major depression, and mania), and some anxiety disorders: panic disorder (PD), social phobia (SP), and agoraphobia (AG). Logistic regression was used to identify predictors (T1) of remission of mood disoders and anxiety disorders at T2 and predictor of new cases at T2. Results The prevalence of mental disorders for the two waves of the research program will be presented. For major depression (MD), among the 145 subjects who had MD at T1, 69% recovered at T2 and among the 1553 that did not have MD at T1, 5.7% developed MD at T2. For anxiety disorders, among the 93 subjects who had these disorders at T1, 78.4% recovered at T2 and among the 1635 subjects who were free of an anxiety disorder at T1, 1.8% developed it at T2. Predictors identified for remission of disorders and for developing new disorders at T2 will be presented. Conclusion The predictors of new cases identified will allow to develop more effective prevention program and those associated to remissions will help to improve mental health services.

1982 – Depression in childhood and adolescence - family system from the clinical perspective

Introduction The description of clinical features of depression among children and adolescents in clinical research still remains insufficient. Better understanding of the family system and home relationships can contribute to the development of high-quality health care services for clinical patients. Objectives The purpose of the study was to evaluate children's perceptions of the quality of their parents' relationship and the level of their family systemic resources. Aims The goal was to advance a comprehensive understanding of families with children suffering from depression, the depiction of various processes within the family, and ultimately, attempt to define the major predictors of depression. Methods The subject group consisted of 46 children and adolescents aged 9-19 with diagnosed depressive episodes. Symptoms of depression in children and their parents were evaluated with the Beck Depression Inventory. The qualitative assessment was conducted with the use of the Assessment and Documentation of Psychopathology Scale - AMPD. Results Clinical group assessed their parents’ marital relationship as lower quality than the control group. Girls diagnosed with depression, perceived their parents’ relationship as more dysfunctional (t = 5,87; p Conclusions Depression in children and adolescents is connected with negative representation of parent - child and marital relationships and the systemic resources of the family as various sources of emotional security for the child.

Political violence and mental health in Nepal: prospective study

Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose-response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in post-conflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.