Persistence Of Major Depressive Disorder Research Articles

Risk factors for mental health disorders during the COVID-19 pandemic in Spain: A cohort study

Abstract Background Data comparing the populations’ mental health from before, during and after the pandemic is needed. We aim to assess the risk factors for the first-onset and persistence of major depressive disorder (MDD) and suicidal thoughts and behaviours (STB) during the first year of the pandemic among the Spanish general population. Methods Cohort study through two online surveys from before the pandemic (N = 2,005, October/November 2019) and 12-months later (N = 1,357) on an adult Spanish, nationally representative, population-based sample. Multiple logistic regression models were used to assess the association between socio-demographic, COVID-19 related variables and healthcare received during the pandemic with the onset and persistence of MDD and STB. Results Women have more than 3-fold risk for the onset (OR 3.18; CI95% 1.40 -7.22) and persistence (OR 8.62; CI95% 1.74-42.48) of MDD. Studying and working at the same time (OR 10.13; CI95% 2.17-47.35) and having close relatives/friends with COVID-19 infection (OR 14.84; CI95% 1.91-115.18) or death (OR 5.26; CI95% 1.56-17.73) due to COVID-19 are risk factors for MDD onset. Sick-leave (OR 17.19; CI95% 2.65-112.56) and unemployment (OR 7.01; CI95% 1.85-26.43) increased the risk for MDD persistence. Death of friends/colleagues due to COVID-19 (OR 8.40; CI95% 1.47-48.07) increased the risk for STB onset, and being on sick-leave (OR 7.91; CI95% 1.80-34.66) for STB persistence. Conclusions During the COVID-19 pandemic, women were consistently more at risk of having worse mental health than men. Direct and indirect consequences caused or aggravated by the pandemic are common risk factors for the increased risk for the onset and persistence of both MDD and STB. Identification of high-risk subgroups and risk factors for MDD and STB among the Spanish general population will allow the developing and implementing of evidence-driven strategies for reducing the long-term impact of the pandemic in populations’ mental health. Key messages • The pandemic consequences, whether due to having had COVID-19, having close people affected or who have died from the infection and the social consequences increase the risk for worse mental health. • Evidence-driven strategies for reducing the long-term impact of the pandemic in populations’ mental health should be a public health priority.

Major Depressive Disorder Among HIV Infected Youth in Uganda: Incidence, Persistence and Their Predictors.

Incidence and persistence of major depressive disorder (MDD) in children and adolescents with HIV (CA-HIV) in Uganda is described. 1339 CA-HIV attending care were enrolled and followed up for 12months. MDD was assessed using the DSM-5 referenced Child and Adolescent Symptom Inventory-5 (CASI-5), with a prevalence for MDD at baseline of 5% (95% CI 3.3-7.3). Kaplan-Meir method was used to estimate incidence of MDD and Cox models were fitted to investigate predictors of incident MDD. Cumulative incidence of MDD over 12months was 7.6 per 100 person-years 95% CI (6.2-9.4) and a rate of persistent MDD of 10/105 (9.5% CI 3.9-15.1). Significant independent predictors of incident MDD were: highest educational level of CA-HIV (protective), increasing depressive scores and decreasing CD4 Nadir. These finding have implications for what should constitute components of a mental health integration model in HIV youth services and for the future development of individualised mental health care.

Experiential Avoidance Predicts Persistence of Major Depressive Disorder and Generalized Anxiety Disorder in Late Adolescence.

Experiential avoidance (EA) is a transdiagnostic construct that may underlie the high comorbidity between major depressive disorder (MDD) and generalized anxiety disorder (GAD). This analysis used data from a longitudinal study (conducted September 2010-April 2016) to examine whether adolescent EA varies by MDD and GAD symptomatology trajectory and predicts said trajectories. Longitudinal associations between EA, anxiety, and depression symptoms were also examined. Adolescents aged 15 to 20 years (N = 183) were followed for 2 years using a comprehensive assessment battery. Symptom trajectory modeling, using weekly symptom ratings, identified 4 MDD and 4 GAD trajectories that were collapsed to form combined MDD/GAD trajectory groups: Persistent (n = 81), High-Decreasing (n = 44), Normal-Increasing (n = 37), and Minimal (n = 21). Group-based trajectory modeling, analyses of covariance, structural equation modeling, and linear regression analyses were performed. DSM-IV-TR criteria were used for MDD and GAD diagnoses. The Persistent adolescents had higher EA than other groups (P values ≤ .001), with greater EA stability versus High-Decreasing adolescents (P = .008). EA predicted anxiety and depressive symptoms alike (P values ≤ .005), which in turn did not predict EA (P values ≥ .188). EA, at both time points, predicted combined MDD/GAD trajectories after adjustment for depressive and anxiety symptoms and other confounders (P values < .001). EA appears to be an important predictor of MDD and GAD symptomatology in older adolescents, potentially serving as a treatment target. Findings suggest a possible trait-like nature for EA, perhaps increasing risk for the emergence and persistence of MDD and/or GAD. ClinicalTrials.gov identifier: NCT02147184​.

Relationship between major depressive disorder, generalized anxiety disorder and coronary artery disease in the US general population

ObjectiveTo evaluate whether the changes and persistence of major depressive disorder (MDD) and generalized anxiety disorder (GAD) affect the risk of incident coronary artery disease (CAD) in the US general population. MethodsData was retrieved from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) conducted in 2001/2002 (Wave 1) and 2004/2005 (Wave 2). At both Wave 1 and one year before Wave 2, MDD and GAD were measured using the Alcohol Use Disorders and Associated Disabilities Interview Schedule IV. CAD was considered present at Wave 1 or Wave 2 based on the participants' self-reported physician diagnosis. Relationship between MDD, GAD and CAD was examined using generalized linear regression model. ResultsThe study included 32,345 participants without CAD at Wave 1, with 3.3% developing CAD at Wave 2. After adjustment, persistence of MDD/GAD and GAD predicted highest risk of developing CAD respectively (MDD/GAD: RR = 2.01, 95% CI: 1.54–2.64; GAD: RR = 2.09, 95% CI: 1.22–3.58), while positive changes predicted lowest risk (MDD/GAD: RR = 1.43, 95% CI: 1.15–1.78; GAD: RR = 1.68, 95% CI: 1.21–2.33). Negative change of MDD is associated with highest risk of developing CAD (RR = 2.07, 95% CI: 1.69–2.54), while positive changes predicted lowest risk (RR = 1.38, 95% CI: 1.11–1.73). ConclusionsExistence of MDD/GAD, MDD, or GAD increase the risk of new-onset CAD. Positive change in MDD and GAD is associated with reduced risk of incident CAD, which highlights the importance of treating MDD and GAD in preventing the development of CAD.

Cost-Effectiveness and the Role of Psychodynamic Psychotherapies

Cost-Effectiveness and the Role of Psychodynamic Psychotherapies

Incidence and Persistence of Major Depressive Disorder Among People Living with HIV in Uganda.

Data on the course of major depressive disorder (MDD) among people living with HIV (PLWH) are needed to inform refinement of screening and interventions for MDD. This paper describes the incidence and persistence rate of MDD in PLWH in Uganda. 1099 ART-naïve PLWH attending HIV clinics in Uganda were followed up for 12months. MDD was assessed using the DSM IV based Mini-International Neuropsychiatric Interview with a prevalence for MDD at baseline of 14.0% (95% CI 11.7-16.3%) reported. Multivariable logistic regression was used to determine predictors of incident and persistent MDD. Cumulative incidence of MDD was 6.1 per 100 person-years (95% CI 4.6-7.8) with significant independent predictors of study site, higher baseline depression scores and increased stress. Persistence of MDD was 24.6% (95% CI 17.9-32.5%) with independent significant predictors of study site, higher baseline depression scores, and increased weight. Risks of incident and persistent MDD observed in this study were high. Potentially modifiable factors of elevated baseline depressive scores and stress (only for incident MDD) were important predictors of incident and persistent MDD.

The role of obesity measures in the development and persistence of major depressive disorder

BackgroundThe role of obesity with the development of major depressive disorder (MDD) requires conformation and whether obesity contributes to more chronic depression in persons with established (MDD) is unknown. This study examined the longitudinal relationship of body mass index (BMI) and waist circumference with the incidence and persistence of MDD over 2-year and 6-year periods. MethodData were sourced from the Netherlands Study of Depression and Anxiety. MDD was established with Composite International Diagnostic Interviews. The relationship of BMI and waist circumference with the development of depression two and six years later were estimated in the subsample with no current psychopathology at baseline. Associations with the persistence of depression was estimated in the subsample with current MDD. ResultsHigher BMI at baseline, but not waist circumference, slightly increased the odds of the development of MDD after two years (odds ratio (OR) per standard deviation increase: 1.11; p=0.03), This relationship was not significant after adjustment for health and lifestyle variables. Conversely, over a 6-year period both BMI and waist circumference moderately increased the odds of developing MDD even after adjustment (OR:1.17; p=0.05, OR:1.20; p=0.05). Persistence of MDD in currently depressed subjects, is not related with BMI or waist circumference (adjusted OR:0.93; p=0.2, OR:0.91; p=0.15). LimitationsDevelopment of depression may differ in participants lost to follow-up. ConclusionOver a 6 year period, patients with higher BMI show a slightly increased risk of development of depression. However, in depressed patients there is no relationship between BMI and the persistence of depression.

Cigarette smoking and the onset and persistence of major depressive disorder among adults in the United States: 1994–2005

s / Drug and Alcohol Dependence 146 (2015) e2–e33 e33 Financial support: NIH/NIDA R01 DA003240 (MEC), F31DA036248-01 (NEZ). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.768 Cigarette smoking and the onset and persistence of major depressive disorder among adults in the United States: 1994–2005 Michael Zvolensky1,2, Jafar Bakhshaie1, Renee Goodwin3,4 1 Psychology, University of Houston, Houston, TX, Unites States 2 MD Anderson Cancer Center, Houston, TX, Unites States 3 Psychology, Queens College, City University of New York, New York, NY, Unites States 4 Epidemiology, Columbia University, New York, NY, Unites States Aims: Thepresent study sought to investigatewhether cigarette smoking is (a) associated with increased risk of onset and persistence of major depressive disorder (MDD) and whether smoking cessation maintenance reduces the risk of onset and persistence of MDD over a 10-year period among adults in the United States. Methods: Data were drawn from the Midlife Development in the United States Survey (MIDUS) Waves I and II (N=2101). Logistic regression analyses were used to investigate the relations between smoking and the onset and persistent of MDD, adjusting for demographic characteristics and substance use problems. Results: Daily smoking in 1994 and persistent daily smoking (from 1994 to 2005) predicted a significantly increased likelihood of past-year incident and persistent MDD by 2005. These associations largely remained statistically significant after adjusting for demographics and substance use problems. Successful smoking abstention significantly reduced the risk of recent incidence and persistence of MDD. Conclusions: The present longitudinal data provide novel insights into the role of smoking in the onset and persistence of MDD. Namely, smoking is associated with a significant increased risk of MDD and quitting helps to reduce such risk. Specifically, the longer the duration of abstinence/successful quitting, the lower the riskof subsequentonset ofMDD. Themental healthbenefits of quitting smoking in the form of reduced risk of MDD should be added to common information listed as the reasons to quit. Financial support: None. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.777

Cigarette smoking and the onset and persistence of depression among adults in the United States: 1994–2005

BackgroundThe present study investigated the relationship between daily cigarette smoking and risk of onset and persistence of major depressive disorder (MDD) over a 10-year period among adults in the United States and whether successful smoking cessation reduced the risk for MDD. MethodData were drawn from the Midlife Development in the United States Survey (MIDUS; n=2101) Waves I and II. Logistic regressions were used to investigate the relations between smoking and the onset and persistence of MDD, adjusting for demographic characteristics and substance use problems. ResultsDaily smoking in 1994 [OR=1.9 (1.2–3.2)] and persistent daily smoking (in 1994 and 2005) [OR=2.2 (1.3–3.7)] were both associated with a significantly increased likelihood of MDD in 2005. Additionally, abstinence, compared to daily smoking, for more than 10years significantly reduced the risk of MDD in 2005 [OR=0.5 (0.3–0.87)] and persistent MDD in 1994 and 2005; [OR=0.5 (0.3–0.87)]. ConclusionsFindings from this study provide new insights into the role of smoking in the onset and persistence of MDD. Namely, among those in mid-adulthood, smoking is associated with greater MDD risk and quitting may help to reduce such risk. These results suggest that there may be merit in targeting smoking to reduce the risk of MDD and the mental health benefits of quitting smoking in the form of reduced risk of MDD could usefully be added to common information listed as reasons to quit.

Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence

About one-third of people with major depressive disorder (MDD) fail at least two antidepressant drug trials at 1 year. Together with clinical and experimental evidence indicating that the pathophysiology of MDD is multifactorial, this observation underscores the importance of elucidating mechanisms beyond monoaminergic dysregulation that can contribute to the genesis and persistence of MDD. Oxidative stress and neuroinflammation are mechanistically linked to the presence of neurovascular dysfunction with blood-brain barrier (BBB) hyperpermeability in selected neurological disorders, such as stroke, epilepsy, multiple sclerosis, traumatic brain injury, and Alzheimer’s disease. In contrast to other major psychiatric disorders, MDD is frequently comorbid with such neurological disorders and constitutes an independent risk factor for morbidity and mortality in disorders characterized by vascular endothelial dysfunction (cardiovascular disease and diabetes mellitus). Oxidative stress and neuroinflammation are implicated in the neurobiology of MDD. More recent evidence links neurovascular dysfunction with BBB hyperpermeability to MDD without neurological comorbidity. We review this emerging literature and present a theoretical integration between these abnormalities to those involving oxidative stress and neuroinflammation in MDD. We discuss our hypothesis that alterations in endothelial nitric oxide levels and endothelial nitric oxide synthase uncoupling are central mechanistic links in this regard. Understanding the contribution of neurovascular dysfunction with BBB hyperpermeability to the pathophysiology of MDD may help to identify novel therapeutic and preventative approaches.

The neural correlates of regulating positive and negative emotions in medication-free major depression

Depressive cognitive schemas play an important role in the emergence and persistence of major depressive disorder (MDD). The current study adapted emotion regulation techniques to reflect elements of cognitive behavioural therapy (CBT) and related psychotherapies to delineate neurocognitive abnormalities associated with modulating the negative cognitive style in MDD. Nineteen non-medicated patients with MDD and 19 matched controls reduced negative or enhanced positive feelings elicited by emotional scenes while undergoing functional magnetic resonance imaging. Although both groups showed significant emotion regulation success as measured by subjective ratings of affect, the controls were significantly better at modulating both negative and positive emotion. Both groups recruited regions of dorsolateral prefrontal cortex and ventrolateral prefrontal cortex (VLPFC) when regulating negative emotions. Only in controls was this accompanied by reduced activity in sensory cortices and amygdala. Similarly, both groups showed enhanced activity in VLPFC and ventral striatum when enhancing positive affect; however, only in controls was ventral striatum activity correlated with regulation efficacy. The results suggest that depression is associated with both a reduced capacity to achieve relief from negative affect despite recruitment of ventral and dorsal prefrontal cortical regions implicated in emotion regulation, coupled with a disconnect between activity in reward-related regions and subjective positive affect.

Can Epidemiology Translate Into Understanding Major Depression With Borderline Personality Disorder?

Can Epidemiology Translate Into Understanding Major Depression With Borderline Personality Disorder?

Short-Term Outcome of Major Depression: II. Life Events, Family Dysfunction, and Friendship Difficulties as Predictors of Persistent Disorder

To determine whether there is a pattern of social characteristics that specifically predicts persistent major depression at 36 weeks follow-up. Sixty-eight consecutive cases with a first-episode DSM-III-R diagnosis of major depression completed a life events and friendship difficulties interview at presentation and again at 36 weeks. Four factors were associated with persistent psychiatric disorder in general: lack of a maternal confiding relationship with current partner, family dysfunction and poor friendships at presentation, and severely disappointing events between presentation and follow-up. There was no association between these adverse experiences. No combination of long-term or recent life events or difficulties was, however, specifically associated with persistent depression. Nonsocial factors may need to be taken into account to specifically explain the phenotypic persistence of major depressive disorder in first-episode nonrecovered cases within a year of presentation. Psychosocial interventions with first-degree relatives and current close friendships should be considered as a part of the treatment strategy for first-episode major depression.