New-onset Depressive Disorder Research Articles

Risk of new-onset depressive disorders after hearing impairment in adults: A nationwide retrospective cohort study

Previous studies reported that hearing impairment has been associated with depressive disorders, but little is known about the risk of newly diagnosed depression after hearing impairment diagnosed by a physician and registered with the government. We evaluated the risk of new-onset depressive disorders following hearing impairment in adults. We used data from the Korean National Health Insurance Service-National Sample Cohort and included adults with hearing impairment, and a comparison group without hearing impairment, selected by a 1:3 propensity score matching between 2004 and 2012. The dependent variable was a depressive disorder diagnosis. The hazard ratio of risk of depression was estimated using a Cox proportional hazard model. In the sample of 14,212 adults, 15.0% of people with hearing impairment (n = 3,553) experienced a depressive disorder following their hearing impairment. Those who had not experienced depression previously were more likely to develop a new-onset depressive disorder following hearing impairment than the comparison group. Male, female, old adults (60–74 years) and very-old adults (≥ 75 years) with hearing impairment were associated with an increased risk for a new-onset depressive disorders than their matched counterparts. These findings suggest a need for psychological support along with hearing rehabilitation, especially for older adults.

Depression-free after Interferon-α exposure indicates less incidence of depressive disorder: A longitudinal study in Taiwan

BackgroundIFN-α-induced depression in patients undergoing hepatitis C virus (HCV) treatment provides powerful support for the inflammation hypothesis of depression. Most studies have focused on the occurrence of depressive symptoms, but there has been no study yet in depression-free HCV patients receiving IFN-α. We hypothesized that HCV patients who did not develop depression after IFN-α exposure might have a lower incidence of depressive disorders after the IFN-α treatment. MethodsWe conducted a twelve-year population-based cohort study of chronic HCV patients who received IFN-α therapy. The data were obtained from the Taiwan National Health Insurance Research Database. The study cohort was patients without any depressive disorder nor antidepressant use before and during IFN-α therapy. They were matched randomly by age, sex income and urbanization at a ratio of 1:4 with the control cohort of HCV patients without IFN-α therapy. The follow-up started after the last administration of IFN-α, and the primary outcome was the incidence of depressive disorders after IFN-α therapy. ResultsA total of 20,468 depression-free subjects were identified from records of HCV patients receiving IFN-α therapy. Patients without IFN-α-induced depression were associated with a significantly lower incidence (per 10,000 person-years) of new-onset depressive disorders (126.8, 95% Confidential Interval [CI] of 118.5–135.6) as compared to the control cohort (145.2, 95% CI of 140.0–150.6) (p < 0.001). After adjusting for age, sex, income, urbanization and comorbid diseases, the crude hazard ratio for the incident depressive disorder was 0.87 (95% CI, 0.80–0.87) and the adjusted hazard ratios was 0.79 (95% CI, 0.72–0.87) for IFN-α-induced depression-free subjects as compared to the controls. DiscussionOur study indicates that IFN-α treated depression-free patients have a lower risk for depressive disorders. This hypothesized mechanism might derive from an IFN-α-induced resilience factor as yet to be defined. ConclusionsOur study might suggest a new possibility for a new pharmacological strategy against depression.

Predictors of new-onset depressive disorders – Results from the longitudinal Finnish Health 2011 Study

BackgroundIdentifying risk factors for depression is important for understanding etiological mechanisms and targeting preventive efforts. No prior studies have compared risk factors of dysthymia and major depressive disorder (MDD) in a longitudinal setting. MethodsPredictors of new-onset MDD and dysthymia were examined in a longitudinal general population study (Health 2000 and 2011 Surveys, BRIF8901). 4057 persons free of depressive disorders at baseline were followed up for 11 years. DSM-IV MDD and dysthymia were diagnosed with the Composite International Diagnostic Interview. Results126 persons (4.4%, 95%CI 3.6–5.2) were diagnosed with MDD or dysthymia at follow-up. Predictors of new-onset depressive disorders were younger age (adjusted OR 0.97, 95%CI 0.95–0.99 per year), female gender (aOR 1.46, 95%CI 1.01–2.12), multiple childhood adversities (aOR 1.76, 95%CI 1.10–2.83), low trust dimension of social capital (aOR 0.58, 95%CI 0.36–0.96 for high trust), baseline anxiety disorder (aOR 2.75, 95%CI 1.36–5.56), and baseline depressive symptoms (aOR 1.65, 95%CI 1.04–2.61 for moderate and aOR 2.49, 95%CI 1.20–5.17 for severe symptoms). Risk factors for MDD were younger age, female gender, anxiety disorder and depressive symptoms, whereas younger age, multiple childhood adversities, low trust, and having 1–2 somatic diseases predicted dysthymia. LimitationsWe only had one follow-up point at eleven years, and did not collect information on the subjects’ health during the follow-up period. ConclusionsPersons with subclinical depressive symptoms, anxiety disorders, low trust, and multiple childhood adversities have a higher risk of depressive disorders. Predictors of MDD and dysthymia appear to differ. This information can be used to target preventive efforts and guide social policies.

Risk of depressive disorder among patients with herpes zoster: a nationwide population-based prospective study.

Herpes zoster results from reactivation of the endogenous varicella zoster virus infection. Previous studies have shown that herpes zoster and postherpetic neuralgia were associated with anxiety, depression, and insomnia. However, no prospective study has investigated the association between herpes zoster and the development of depressive disorder. Subjects were identified through the Taiwan National Health Insurance Research Database. Patients 18 years or older with a diagnosis of herpes zoster and without a psychiatric history were enrolled in 2000 and compared with age-/sex-matched controls (1:4). These participants were followed up to the end of 2010 for new-onset depressive disorder. A total of 1888 patients with herpes zoster were identified and compared with 7552 age-/sex-matched controls in 2000. Those with herpes zoster had a higher incidence of developing major depression (2.2% versus 1.4%, p = .018) and any depressive disorder (4.3% versus 3.2%, p = .020) than did the control group. The follow-up showed that herpes zoster was an independent risk factor for major depression (hazard ratio = 1.49, 95% confidence interval = 1.04-2.13) and any depressive disorder (hazard ratio = 1.32, 95% confidence interval = 1.03-1.70), after adjusting demographic data and comorbid medical diseases. This is the first study to investigate the temporal association between herpes zoster and depressive disorder. Further studies would be required to clarify the underlying pathophysiology about this association and whether proper treatment of herpes zoster could decrease the long-term risk of depressive disorder.

Depression and blood pressure in high-risk children and adolescents: an investigation using two longitudinal cohorts

ObjectiveTo examine the relationship between blood pressure and depressive disorder in children and adolescents at high risk for depression.DesignMultisample longitudinal design including a prospective longitudinal three-wave high-risk study of offspring...

Symptomatic menopausal transition increases the risk of new-onset depressive disorder in later life: a nationwide prospective cohort study in Taiwan.

IntroductionThe role of the menopausal transition and associated menopausal symptoms in the occurrence of depressive disorders has been discussed and debated for a long time. Most previous clinical studies had limited case samples, and did not control the attributable risk of medical comorbidities.MethodsPatients with a diagnosis of symptomatic menopausal transition and without a psychiatric history were enrolled in 2000 in Taiwan, and compared with age-matched controls (1∶4). These subjects were followed to the end of 2010 to investigate the association between symptomatic menopausal transition and new-onset depressive disorder; the effect of medical comorbidities was also assessed.ResultsA total of 5,837 women with symptomatic menopausal transition were identified, and compared with 23,348 age-matched controls in 2000. The follow-up showed that symptomatic menopausal transition was an independent risk factor for major depression (hazard ratio[HR]: 2.18, 95%CI: 1.79∼2.65) and any depressive disorder (HR: 2.34, 95%CI: 2.08∼2.63) after adjusting age at enrollment, monthly income, residence location, level of urbanization, and comorbid medical diseases. In addition, medical comorbidities, including cerebrovascular disease (HR: 1.77, 95% CI: 1.52∼2.07), cardiovascular diseases (HR: 1.35, 95% CI: 1.15∼1.57), congestive heart failure (HR: 1.35, 95% CI: 1.04∼1.75), and liver diseases (HR: 1.19, 95% CI: 1.03∼1.36) increased the risk of developing any depressive disorder.ConclusionOur population cohort study, with the largest study sample and medical record diagnosis thus far, supports an association between symptomatic menopausal transition and depressive disorder in midlife women, and an increased risk of depressive disorder with medical comorbidities.

‘The risks of playing it safe’: a prospective longitudinal study of response to reward in the adolescent offspring of depressed parents

Alterations in reward processing may represent an early vulnerability factor for the development of depressive disorder. Depression in adults is associated with reward hyposensitivity and diminished reward seeking may also be a feature of depression in children and adolescents. We examined the role of reward responding in predicting depressive symptoms, functional impairment and new-onset depressive disorder over time in the adolescent offspring of depressed parents. In addition, we examined group differences in reward responding between currently depressed adolescents, psychiatric and healthy controls, and also cross-sectional associations between reward responding and measures of positive social/environmental functioning. Method We conducted a 1-year longitudinal study of adolescents at familial risk for depression (n=197; age range 10-18 years). Reward responding and self-reported social/environmental functioning were assessed at baseline. Clinical interviews determined diagnostic status at baseline and at follow-up. Reports of depressive symptoms and functional impairment were also obtained. Low reward seeking predicted depressive symptoms and new-onset depressive disorder at the 1-year follow-up in individuals free from depressive disorder at baseline, independently of baseline depressive symptoms. Reduced reward seeking also predicted functional impairment. Adolescents with current depressive disorder were less reward seeking (i.e. bet less at favourable odds) than adolescents free from psychopathology and those with externalizing disorders. Reward seeking showed positive associations with social and environmental functioning (extra-curricular activities, humour, friendships) and was negatively associated with anhedonia. There were no group differences in impulsivity, decision making or psychomotor slowing. Reward seeking predicts depression severity and onset in adolescents at elevated risk of depression. Adaptive reward responses may be amenable to change through modification of existing preventive psychological interventions.

GnRHアナログによるうつ病の1例

Gonadotropin-Releasing Hormone誘導体製剤 (以下，GnRHアナログ) は子宮内膜症に対する偽閉経療法として婦人科領域では広く使われている薬剤である。GnRHアナログ投与中は無月経状態となるので月経に伴う骨盤痛は回避できるが，更年期同様に低エストロゲン状態にさらされるので副作用として更年期症状を被る可能性がある。ほとんどの症例はGnRHアナログを中止する必要のない軽度の症状ですむが，時に重度の神経・精神症状の副作用を発現することもある。今回，直腸子宮内膜症でGnRHアナログ投与後にうつ病となり精神科病院で管理入院を必要とするほどの重度のうつ症状を呈した症例を経験したので報告する。さらにこの症例はGnRHアナログから黄体ホルモン薬であるディナゲストに変更後，うつ症状はすみやかに軽快し，直腸出血のコントロールも継続して確保され腸管子宮内膜症へのディナゲストの有用性が示された1例でもある。

Quality of Depression Care and Its Impact on Health Service Use and Mortality Among Veterans

Little is known about the effects of quality of depression care on patient outcomes other than depression status. This study examined Veterans Health Administration (VHA) data over a six-year period to determine whether quality of depression care was related to patients' health service use and mortality. Using a national VHA database, the authors identified 205,165 veterans with a new-onset depressive disorder and at least one filled prescription for an antidepressant medication between October 1, 1999, and September 30, 2005. Quality of depression care was assessed with antidepressant medication possession ratios and adequacy of follow-up care (three or more depression-related visits during the 84 days after a depression diagnosis). Logistic regression modeling was used to predict inpatient service use and all-cause mortality. Of the cohort 48% received an adequate supply of antidepressant medication and 31% had three or more follow-up visits during the 84-day profiling period. Rates of adequate medication supply did not change over the six-year period, but there were improvements in adequate follow-up care over the study period (p=.03). Adequate follow-up depression care was associated with increased health service use and decreased likelihood of 12-month all-cause mortality. According to the quality indicators, less than half of patients with newly diagnosed depression received high-quality care. Notably, adequate follow-up care for depression was significantly related to reduction in odds of patient mortality at the 12-month follow-up. These findings suggest that quality of depression care may significantly affect patient outcomes, including mortality, and that further efforts to improve quality appear warranted.

Psychiatric Sequelae to the Loss of an Adolescent Peer to Suicide

Objective This study was designed to learn whether friends and acquaintances of suicide victims were at increased risk for depression, post-traumatic stress disorder, and suicidal behavior after exposure to suicide. Method The social networks of 26 adolescent suicide victims, consisting of 146 adolescents, were interviewed 7 months after the death of the suicide victim and compared with 146 matched, unexposed controls. Results The rates of these disorders that had onset after exposure were elevated in the exposed group vs. controls: major depression, post-traumatic stress disorder, suicidal ideation with a plan or an attempt, but not suicidal attempts. Almost all of those exposed youth who developed new-onset suicidality did so in the context of a new-onset depressive episode. The majority of these new-onset depressive disorders began within 1 month of exposure. Conclusion Postvention programs not only should focus on the prevention of imitation of suicidal behavior, but also should provide longer term follow-up for potentially bereaved and depressed youth exposed to suicide. J. Am. Acad. Child Adolesc. Psychiatry, 1993, 32, 3:509–517.