New Cases Of Depression Research Articles

Increased prevalence of depression in cohorts of the elderly: an 11-year follow-up in the general population – the HUNT study

Depression is a common disorder in late life. As the elderly population continues to grow worldwide, depression is also likely to become an increasing health problem. The aim of this study was to examine changes in prevalence of depression in various age cohorts over an 11-year period. This study involved two cross-sectional studies (HUNT 2 and HUNT 3) of all adult inhabitants of the Norwegian county of Nord-Trøndelag with an 11 year-interval between the two studies. The participants aged 45 years or above at HUNT 2 and with a valid depression rating at both HUNT 2 (baseline) and HUNT 3 (follow-up) (N = 16517), were included and divided into five-year age cohorts. Depression was measured by the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). A significant increase in depression was found in all age cohorts from 76 years at follow-up, with the greatest increase (9.6%) in the oldest age cohort (86-90 years at follow-up). The incidence of depression is increasing with age, with over 10% new cases in all age cohorts aged 81 years and above at follow-up. About 5% of the participants in all age cohorts reported depression at both measure points, and there is a decrease in recovery from depression from baseline to follow-up with increasing age. We found increased prevalence of depression and a large number of new cases of depression in the oldest age cohorts.

Patterns and correlates of depression in hospitalized older adults

Depression is often associated with illness or injury requiring acute hospitalization, particularly in older adults. We sought to determine patterns of change in depressive symptoms in older adults from hospitalization to 3 months post discharge and to examine factors associated with depressive symptoms 3 months after discharge. The study included 197 patients aged 65 years or older hospitalized with an acute medical illness. Sociodemographic and clinical measures, including depressive symptoms using the Center for Epidemiologic Study—Depression (CES-D) scale, were collected during the inpatient stay and at 3 months post discharge. Mean age was 75.3 ± 7.5 (±S.D.) years, 59% of the participants were female, 61% unmarried, and 72% had a high school education or more. High depressive symptoms (i.e., CES-D ≥ 16) were reported in 37% at admission. Of the 8% depressed at follow-up, 81% were also depressed at admission; 19% were new cases of depression. Depressive symptoms 3 months post-hospitalization were significantly associated with follow-up daily living skills ( p = 0.001) and social support ( p < 0.0001). Patients with persistent depressive symptoms make up the majority of post-hospitalization depression cases. Post-hospitalization social support and daily living skills appear to be important in the management of follow-up depressive symptoms.

P03-14 - Increased prevalence of depression in cohorts of elderly. A longitudinal epidemiological study: The hunt-study

IntroductionAs the elderly population is growing world-wide, depression in the elderly is becoming an increasing health problem. Studies of depression shows varying results in development patterns with age (1, 2).AimsTo study changes in prevalence and new cases of depression in elderly age cohorts.MethodsThe Nord-Trøndelag Health Survey (HUNT) is a general health survey conducted in Nord-Trøndelag County with a follow-up after 11 years. The participants aged 45 years or above at baseline were included. Depression was covered by the depression sub-scale of the Hospital Anxiety and Depression Scale (HADS-D; 3). Prevalence and incidence of depression was estimated in the different age cohorts.Results16517 participants were included and divided in age cohorts based on their age at baseline. A significant increase in depression was found in all age cohorts from 76 years at follow-up. The oldest age cohort (86–90 years at follow-up) had the greatest increase with a change from 11.3% to 20.9%. New cases of depression is increasing with age, with over 10% new cases in all age cohorts aged 81 years and above at follow-up.ConclusionsWe found increased prevalence of depression and a large number of new cases of depression in the oldest age cohorts.

Dietary fat intake and the risk of depression: the SUN Project.

Emerging evidence relates some nutritional factors to depression risk. However, there is a scarcity of longitudinal assessments on this relationship.ObjectiveTo evaluate the association between fatty acid intake or the use of culinary fats and depression incidence in a Mediterranean population.Material and MethodsProspective cohort study (1999–2010) of 12,059 Spanish university graduates (mean age: 37.5 years) initially free of depression with permanently open enrolment. At baseline, a 136-item validated food frequency questionnaire was used to estimate the intake of fatty acids (saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), trans unsaturated fatty acids (TFA) and monounsaturated fatty acids (MUFA) and culinary fats (olive oil, seed oils, butter and margarine) During follow-up participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression models were used to calculate Hazard Ratios (HR) of incident depression and their 95% confidence intervals (CI) for successive quintiles of fats.ResultsDuring follow-up (median: 6.1 years), 657 new cases of depression were identified. Multivariable-adjusted HR (95% CI) for depression incidence across successive quintiles of TFA intake were: 1 (ref), 1.08 (0.82–1.43), 1.17 (0.88–1.53), 1.28 (0.97–1.68), 1.42 (1.09–1.84) with a significant dose-response relationship (p for trend = 0.003). Results did not substantially change after adjusting for potential lifestyle or dietary confounders, including adherence to a Mediterranean Dietary Pattern. On the other hand, an inverse and significant dose-response relationship was obtained for MUFA (p for trend = 0.05) and PUFA (p for trend = 0.03) intake.ConclusionsA detrimental relationship was found between TFA intake and depression risk, whereas weak inverse associations were found for MUFA, PUFA and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to subtypes of fat intake.

076 Binge drinking in midlife and the risk of developing depression during 24 years of follow-up

ObjectiveTo examine the relationship between binge drinking at baseline and the onset of new depression during 24 years of follow-up after adjustment for age, socio-economic status, education and marital status.Design...

Stepped care for depression in primary care: what should be offered and how?

Stepped-care approaches may offer a solution to delivering accessible, effective and efficient services for individuals with depression. In stepped care, all patients commence with a low-intensity, low-cost treatment. Treatment results are monitored systematically, and patients move to a higher-intensity treatment only if necessary. We deliver a stepped-care model targeting patients with depression. The first step consists of "watchful waiting", as half of all patients with a depressive episode recover spontaneously within 3 months. The second step, guided self-help, is the key element of the stepped-care model. Guided self-help, especially when offered through the internet, is effective and cost-efficient. The third step consists of brief face-to-face psychotherapy. Finally, in the fourth step, longer-term face-to-face psychotherapy and antidepressant medication might be considered. Patients are monitored by one person, a care manager, who is responsible for the decision to step up to the next treatment and for continuity of care. The different treatments within the stepped-care model are evidence-based. Data on cost-effectiveness of the full model are still scarce, but we recently demonstrated that the incidence of new cases of depression and anxiety could be halved by introducing stepped care. Effects of web-based guided self-help could be enhanced by incorporating them in a stepped-care model.

Association of the Mediterranean Dietary Pattern With the Incidence of Depression

Adherence to the Mediterranean dietary pattern (MDP) is thought to reduce inflammatory, vascular, and metabolic processes that may be involved in the risk of clinical depression. To assess the association between adherence to the MDP and the incidence of clinical depression. Prospective study that uses a validated 136-item food frequency questionnaire to assess adherence to the MDP. The MDP score positively weighted the consumption of vegetables, fruit and nuts, cereal, legumes, and fish; the monounsaturated- to saturated-fatty-acids ratio; and moderate alcohol consumption, whereas meat or meat products and whole-fat dairy were negatively weighted. A dynamic cohort of university graduates (Seguimiento Universidad de Navarra/University of Navarra Follow-up [SUN] Project). A total of 10 094 initially healthy Spanish participants from the SUN Project participated in the study. Recruitment began on December 21, 1999, and is ongoing. Participants were classified as having incident depression if they were free of depression and antidepressant medication at baseline and reported a physician-made diagnosis of clinical depression and/or antidepressant medication use during follow-up. After a median follow-up of 4.4 years, 480 new cases of depression were identified. The multiple adjusted hazard ratios (95% confidence intervals) of depression for the 4 upper successive categories of adherence to the MDP (taking the category of lowest adherence as reference) were 0.74 (0.57-0.98), 0.66 (0.50-0.86), 0.49 (0.36-0.67), and 0.58 (0.44-0.77) (P for trend <.001). Inverse dose-response relationships were found for fruit and nuts, the monounsaturated- to saturated-fatty-acids ratio, and legumes. Our results suggest a potential protective role of the MDP with regard to the prevention of depressive disorders; additional longitudinal studies and trials are needed to confirm these findings.

Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database

Objective To explore the reasons behind the recent increase in antidepressant prescribing in the United Kingdom.Design Detailed retrospective analysis of data on general practitioner consultations and antidepressant prescribing.Data source Data...

Letting Go of the Hope That Psychotherapy Prolongs Cancer Survival

Letting Go of the Hope That Psychotherapy Prolongs Cancer Survival

Depressive disorders among young Canadians: associated factors of continuity and discontinuity.

The purpose of this study was to compare potential risk factors of depressive disorders among young Canadians (aged 15-24) to those of older age groups (25-34 and 35-44) and examine the contribution of individual and contextual factors in the continuity and discontinuity of depression. Data from the Canadian Community Health Survey--Cycle 1.2 were analyzed to examine the associations between individual, familial, social and environmental factors and the continuity or discontinuity of depressive disorders among young Canadians. The sample consisted of 5,673 Canadians aged 15-24, 5,830 aged 25-34 and 7,830 aged 35-44. Youths were also categorized according to the type of cases: non-case, new case, case in remission or long-lasting case. Among Canadian youth, 10.2% had suffered from depression during their lifetime. Social support was the only factor distinguishing the youngest age group from the others regarding depression. Compared to older age groups, stress levels were notably higher for young people. The combination of social network, social support and stress levels strongly distinguished between the long-term cases and the non-cases among youths. Weak feeling of community cohesion was also related to new cases of depression and could contribute to their beginnings. Potential targets for preventive measures lie in the contextual and social influences of youth; particularly what impacts stress levels, social support and social networks. Studying processes of continuity and discontinuity contribute to identifying distinct profiles of onset, recurrence or remission of depression that may point to avenues for prevention and early intervention.

Depressive Disorders Among Young Canadians

The purpose of this study was to compare potential risk factors of depressive disorders among young Canadians (aged 15–24) to those of older age groups (25–34 and 35–44) and examine the contribution of individual and contextual factors in the continuity and discontinuity of depression. Data from the Canadian Community Health Survey–Cycle 1.2 were analyzed to examine the associations between individual, familial, social and environmental factors and the continuity or discontinuity of depressive disorders among young Canadians. The sample consisted of 5,673 Canadians aged 15–24, 5,830 aged 25–34 and 7,830 aged 35–44. Youths were also categorized according to the type of cases: non-case, new case, case in remission or long-lasting case. Among Canadian youth, 10.2% had suffered from depression during their lifetime. Social support was the only factor distinguishing the youngest age group from the others regarding depression. Compared to older age groups, stress levels were notably higher for young people. The combination of social network, social support and stress levels strongly distinguished between the long-term cases and the non-cases among youths. Weak feeling of community cohesion was also related to new cases of depression and could contribute to their beginnings. Potential targets for preventive measures lie in the contextual and social influences of youth; particularly what impacts stress levels, social support and social networks. Studying processes of continuity and discontinuity contribute to identifying distinct profiles of onset, recurrence or remission of depression that may point to avenues for prevention and early intervention.

Do mail-shots improve access to primary care for young men with depression?

Young men with mental health problems often do not present to traditional primary care services. Novel methods to engage this population need to be explored. Between April and July 2005, Croydon Primary Care Trust developed a depression service for men aged 18 to 35 years. Part of this service was a mail-shot to all men in this age group registered with two general practices. The mail-shot informed them of the symptoms of depression, the importance of seeking help and where to obtain help. The objective of this research was to determine whether this mail-shot influenced the number of young men presenting to primary care with depression. Method: This was a before and after study. The quarterly incidences of depression in men aged 18 to 35 years was calculated from January 2000 to June 2005. Incidence risk ratios were calculated to compare pre-mail-shot incidence with the post mail-shot incidence. The cost of the mail-shot was calculated. Results: There were 148 new cases of depression diagnosed between January 2000 and June 2005 across the practices. There was a statistically significant increase in depressed young men contacting the two participating general practices in the quarter after the mail-shot compared with previous quarters (IRR 2.57; 95% CI 1.59-4.17; p < 0.001). The cost of the mail-shot was £1.00 per registered man aged between 18 and 35 years, or £297 (450 €) per case of depression detected. Conclusion: Mail-shots may be a cost-effective way to encourage this traditionally 'hard-to-reach' group to consult primary care professionals for depression treatment.

Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study.

The authors investigated the emergence of gender differences in clinical depression and the overall development of depression from preadolescence to young adulthood among members of a complete birth cohort using a prospective longitudinal approach with structured diagnostic interviews administered 5 times over the course of 10 years. Small gender differences in depression (females greater than males) first began to emerge between the ages of 13 and 15. However, the greatest increase in this gender difference occurred between ages 15 and 18. Depression rates and accompanying gender differences for a university student subsample were no different than for a nonuniversity subsample. There was no gender difference for depression recurrence or for depression symptom severity. The peak increase in both overall rates of depression and new cases of depression occurred between the ages of 15 and 18. Results suggest that middle-to-late adolescence (ages 15-18) may be a critical time for studying vulnerability to depression because of the higher depression rates and the greater risk for depression onset and dramatic increase in gender differences in depression during this period.

Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study.

The authors investigated the emergence of gender differences in clinical depression and the overall development of depression from preadolescence to young adulthood among members of a complete birth cohort using a prospective longitudinal approach with structured diagnostic interviews administered 5 times over the course of 10 years. Small gender differences in depression (females greater than males) first began to emerge between the ages of 13 and 15. However, the greatest increase in this gender difference occurred between ages 15 and 18. Depression rates and accompanying gender differences for a university student subsample were no different than for a nonuniversity subsample. There was no gender difference for depression recurrence or for depression symptom severity. The peak increase in both overall rates of depression and new cases of depression occurred between the ages of 15 and 18. Results suggest that middle-to-late adolescence (ages 15-18) may be a critical time for studying vulnerability to depression because of the higher depression rates and the greater risk for depression onset and dramatic increase in gender differences in depression during this period.

Treatment of depression by obstetrician-gynecologists: A survey study

We performed an exploratory survey of depression diagnosis, treatment, and patient referral patterns by Fellows of ACOG. We also examined obstetrician-gynecologists' professional training in the management of clinical depression. We sent a questionnaire to a total of 1370 ACOG Fellows. Sixty percent of the surveys were returned. As a group, obstetrician-gynecologists reported diagnosing an average of four new cases of depression per month. Within the overall sample, the number of new diagnoses of depression made each month was significantly greater for those defining themselves as primary care physicians than for those defining themselves as specialists. When treating depression pharmacologically, obstetrician-gynecologists reported that they overwhelmingly (74% of the time) chose selective serotonin reuptake inhibitor antidepressants. Ninety-five percent of obstetrician-gynecologists reported that they referred severely depressed patients to a mental health professional. A majority of respondents neither received residency training (80%) nor completed a continuing medical education course (60%) on the treatment of clinical depression in women. Obstetrician-gynecologists who describe themselves as primary care physicians make significantly more diagnoses of depression than those considering themselves specialists. Studies further to assess obstetrician-gynecologists' management of depression and better to define needs for professional education are warranted.

Predicting symptoms of depression from reports of early parenting: a one-year prospective study in a community sample.

The purpose of this study was to determine whether (reported) parental over involvement and lack of affection identify initially healthy subjects at risk for depression. One thousand subjects from the province of Utrecht, the Netherlands were randomly selected by using telephone addresses and asked to participate in a one-year prospective study on psychological risk factors of depression. From the 108 subjects that finally participated on both occasions, the reports of parental upbringing (Parental Bonding Instrument) of initially non-depressed subjects with a Zung Self-rating Depression Scale score below 49 points were used to predict new cases of depression one year later. Initially non-depressed subjects who reported maternal over involvement in the upper quartile of the distribution had an 8.5-fold increased risk (95% confidence interval 0.9 to 80.6) of becoming depressed one year later. Although initial reports of low paternal affection were positively associated with initial symptoms of depression, this characteristic failed to show predictive value. Parental upbringing deficiencies have frequently been shown in cross-sectional inpatient studies in which retrospective retrieval from memory because of depressive state characteristics may have caused negative colouring. Our results would suggest that maternal over involvement reported in the absence of a depressed mood still proves to be an important psychological risk factor in the aetiology of depression.

Interpersonal concomitants and antecedents of depression among college students.

Depressed college students were compared with other-psychopathology and normal controls regarding the relationship they developed with dormitory roommates during a 9-month period. Diagnostic status was periodically assessed via SADS interviews, thus also permitting identification of new cases of depression during the year. Psychosocial characteristics found to be uniquely associated with current depression were: (a) low social contact with roommates, (b) low enjoyability of these contacts, and (c) high life-event stress. Roommates of depressives reported low enjoyability of the relationship and high levels of aggressive behavior towards the depressive. No features were found to be uniquely associated with new cases before they became depressed; however, several antecedents of general psychopathology were identified.

The relationship of serotonin to depression in Parkinson's disease

We have previously reported a correlation between depression in patients with idiopathic Parkinson's disease and decreased concentrations of the cerebrospinal fluid content of the serotonin metabolite, 5-HIAA. To further examine this relationship, we repeated the study in a new cohort of patients while they remained on dopaminergic medications, conducted follow-up interviews and examinations in our original cohort, and conducted an open trial of the serotonin precursor, 5-hydroxytryptophan in a group of new patients with depression. We were again able to demonstrate a significant reduction in cerebrospinal 5-HIAA in depressed patients in comparison to controls and patients without depression. Demented patients with Parkinson's disease, particularly those with concurrent depression, had the lowest values of 5-HIAA. No new cases of depression occurred in our original cohort after 2 1/2 years of follow-up, and depression remitted following conventional or experimental treatment in four patients. Depression improved in six of the seven new patients following oral 5-hydroxytryptophan. Three of these patients allowed a repeat lumbar puncture, and the concentration of 5-HIAA increased following 5-hydroxytryptophan. These three studies support our hypothesis that depression in idiopathic Parkinson's disease is associated with a reduction in brain serotonin. However, it also suggests that other factors, biological or environmental, may be causal factors.