Presence Of Stressful Life Events Research Articles

The contributing role of family, religious activities and school in protecting the mental well-being of school going adolescents in a rural district of Sri Lanka

Introduction: Mental health problems in adolescence are common.Objectives: To assess the mental health of grade 10 students in Ampara District and their associated factorsMethods: This descriptive study was conducted from May to November 2018. Strengths and Difficulties Questionnaire (SDQ) was used to assess the students’ mental health status under five domains. They were total abnormal scores (TAS), emotional problems (EP), conduct problems (CP), hyperactive/inattention problems (HIP) and peer problems (PP). The prevalence of mental health problems was summarized as percentages. The significance of associated factors was assessed at p<0.05 and presented in adjusted odds ratio (aOR).Results: Of the 1340 students, 11.9% had reported TAS. The prevalence of EP, CP, PP and HIP were 15.1%, 12.9%, 12.1% and 11.7%, respectively. Eight factors associated with abnormal scores were identified. Difficulties in schoolwork were associated with all five domains (aOR=5.9; 95% CI: 2.5, 13.6 for TAS; aOR=4.0; 95% CI: 2.1, 7.7 for EP, aOR=2.9; 95% CI: 1.6, 5.4 for CP, aOR =2.6; 95% CI: 1.4, 4.6 for PP and aOR=2.5; 95% CI: 1.4, 4.5 for HIP). Not involving in religious activities regularly at home was associated with all domains except emotional problems (aOR=2.4; 95% CI: 1.3, 4.3 for TAS, aOR=2.2; 95% CI: 1.2, 3.9 for PP, aOR=2.1; 95% CI: 1.2, 3.6 for HIP and aOR=1.9; 95% CI: 1.2, 3.5 for CP). Not having a close family member to discuss their problems was associated with TAS (aOR=2.4; 95% CI: 1.4, 4.2), EP (aOR=3.4; 95% CI: 1.9, 5.8) and HIP (aOR=2.2; 95% CI: 1.3, 3.7). The presence of stressful life events was associated with TAS (aOR= 1.9; 95% CI: 1.1, 3.4), EP (aOR=1.9; 95% CI: 1.1, 3.5) and CP (aOR=2.3; 95% CI: 1.3, 4.3). Tobacco smoking habit of father was associated with TAS (aOR=2.9; 95% CI: 1.2, 6.6) and CP (aOR=2.3; 95% CI: 1.1, 4.6). The alcohol-drinking habit of father was associated with EP (aOR=3.0; 95% CI: 1.3, 7.0). Not attending to additional tuition classes was associated with EP (aOR=1.9; 95% CI: 1.1, 3.4) and PP (aOR=2.6; 95% CI: 1.4, 4.6). The low educational level of the mother was associated with the TAS (aOR=1.9; 95% CI: 1.2, 3.4).Conclusions & Recommendations: Mental health problems are common among school-going adolescents. All mental health problems were significantly associated with difficulties in schoolwork and most of the others were modifiable family-related factors. School mental health screening programmes are recommended with special attention on students with difficulties in schoolwork. School Mental health awareness and promotional programmes should target the students as well as teachers and parents to create a supportive school and family environment.

Penerapan Empty Chair Therapy pada Individu Dewasa dengan Diagnosa Episode Depresif Ringan

Depression has a serious impact that includes emotional, motivational, behavioral, physical and cognitive domains. One of the vulnerability factors for depression is the presence of stressful life events. According to the Humanistic view, a person can experience depression when they cannot fill their existence with meaning. Gestalt counseling is a counseling method that is often used in the humanistic approach because it has the main goal of achieving awareness centered on "here" and "now". One of the intervention methods in gestalt counseling is the empty chair technique. In this technique two chairs are placed in the middle of the room and the client sits while playing the role of top dog and under dog alternately. The subject in this study was a 44-year-old woman who experienced mild depressive episode disorder. Data collection methods used are observation, interviews and psychological tests consisting of cognitive tests (WAIS), personality (Graphic), SSCT (Sack's Sentence Completion Test) and Back Depression Inventory (BDI). This research uses a quantitative approach with an experimental method using a single case pre test and post test design. Researchers used the empty chair technique to reduce depression in the subject. The intervention results show that the empty chair technique can be used as an intervention for patients with mild depressive episode disorder. This is evidenced by a positive change related to depressive symptoms in the subject. Meanwhile, based on the calculation of the BDI score, there was a decrease in the score from the original pre-test of 40 (severe depressive) down to 19 (Mild) in the post-test.

Stressful life events and low back pain in older men: A cross-sectional and prospective analysis using data from the MrOS study.

Stressful life events, such as loss of a partner, loss of a pet or financial problems, are more common with increasing age and may impact the experience of pain. The aim of the current study is to determine the cross-sectional and prospective association between stressful life events and low back pain reporting in the Osteoporotic Fracture in Men Study, a cohort of older men aged ≥65 years. At a study visit (March 2005-May 2006), 5149 men reported whether they had experienced a stressful life event or low back pain in the prior 12 months. Following that visit, data on low back pain patients were gathered through triannual questionnaires every 4 months for 1 year. Multivariable logistic regression analyses estimated the association of stressful life events with recent past low back pain or future low back pain. N = 2930, (57%) men reported at least one stressful life event. The presence of a stressful life event was associated with greater odds of any low back pain (OR = 1.42 [1.26-1.59]) and activity-limiting low back pain (OR = 1.74 [1.50-2.01]) in the same period and of any low back pain (OR = 1.56 [1.39-1.74]) and frequent low back pain (OR = 1.80 [1.55-2.08]) in the following year. In this cohort of men, the presence of stressful life events increased the likelihood of reporting past and future low back pain. Stressful life events such as accident or illness to a partner are common in later life and may impact the experience of pain. We present cross-sectional and prospective data highlighting a consistent association between stressful life events and low back pain in older men. Further, there is evidence to suggest that this relationship is upregulated by an individual's living situation. This information may be used to strengthen a biopsychosocial perspective of an individual's pain experience.

PREDISPOSING FACTORS FOR THE INCIDENCE OF SUICIDE IN YOUNG PEOPLE

Introduction: Suicide stands out as a global public health problem, as this practice intentionally involves the act of causing one’s own death. Thus, several factors and circumstances contribute to such an event occurring. In view of the above, this study is justified by its academic, scientific and social relevance, whose purpose is to put on the agenda all epidemiological aspects and risk factors that are directly related to the incidence of care among young people. In this respect, the relevance of this research aims at contributing to science and notoriety in the face of this social problem in which suicide encompasses. Objective: To evaluate the main factors that trigger the risk of suicide in the young population. Methodology: The methodology selected for the basis of this study was the integrative literature review, with a descriptive approach. This integrative review will be carried out through data searches through the scientific bases: LILACS, SCIELO and BDENF. Results and Discussion: Consequently, the main risk factors for suicide among adolescents are the presence of stressful life events, exposure to different types of violence, drug use, family history of suicide, family problems, financial problems, and they are shown to be related to media influence. In addition, the literature points out that the male public is more likely to commit suicide. Conclusion: Considering that this research highlights and emphasizes the importance of knowing the predisposing factors for the incidence of suicide, it is important to take into account the need to develop strategies and prevention to reduce risks. In this sense, it is proposed to strengthen support networks for young people.

COMT but Not 5HTTLPR Gene Is Associated with Depression in First-Episode Psychosis: The Role of Stressful Life Events.

Serotonergic and dopaminergic systems are involved in the regulation of mood and reactivity to psychological stress. This study explores, in a sample of first episode psychosis (FEP) patients, whether more severe depressive symptoms were found in those who: (1) experienced a major stressful event in the 6 months preceding illness onset; and (2) were homozygous for the COMT Val158 allele or carrying the S allele of 5-HTTLPR. A total of 186 FEP patients recruited were assessed using the Hamilton Rating Scale for Depression (HAMD) for depressive symptoms. Stressful life events (SLEs) were collected by the List of Events Scale. The genotypes of 5-HTTLPR, rs25531, and COMT Val158 Met were performed. It has been found that higher levels of depression is associated with the presence of SLEs (p = 0.019) and with COMT Val158 allele homozygosity (p = 0.029), but not with carrying the S allele of 5-HTTLPR. The COMT gene moderates the association between depression and SLEs as Val158 allele homozygote patients experiencing SLEs had the highest level of depressive symptoms compared to the others (p = 0.002). The present study provides initial evidence for an effect of the COMT Val158 homozygosity and severe stressful life events on the severity of depressive symptoms in first episode psychosis.

Modelling the Relationship Between Resilience to Depression and Recent Stressful Life Events in University Students.

Resilience, or successful coping with the experience of stressful life events (SLEs), protects against depression, but its operational mechanisms are unclear. Views diverge whether resilience intervenes as a trait or as a process of dynamic interactions of protective factors, such as self-esteem, social support and family cohesion. We evaluated five theoretically-based models of how resilience, defined as either a trait or a process, interacts with recent SLEs, to explain depressive symptomatology in 2434 university students. The moderating effect of problematic, age-inappropriate parenting (i.e., helicopter parenting) was also assessed. SLEs moderated both the effects of trait and process resilience on depression, but models conceptualising resilience as a dynamic process of interacting components showed better explanatory power than models conceptualising resilience solely as a trait. Trait resilience was protective through self-esteem at all levels of SLEs exposure (low, mild, moderate or high), and significantly, but less so through hope or social support. Experiencing helicopter parenting weakened the protective influence of process resilience, through decreasing family cohesion in the presence of SLEs. The overall assessment of the five models supports a process conceptualisation of resilience to depression in the face of adversity. However, the results also suggest that not all protective factors are equally important, with self-esteem appearing a significant and strong mediator of resilience to depression in all models including it as a variable. Building process resilience is proposed as a key intervention target for depressive symptoms. Clinical assessments and interventions following SLEs should routinely consider both trait resilience and self-esteem, as the interaction of these two factors protects against depression even at the highest levels of adversity exposure. Depression prevention approaches should address the individual's experience of overparenting, given the deleterious influence of helicopter parenting on resilience.

Stressful Life Events In First Episode Psychosis

Introduction: First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context.
 Material And Method: It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES).
 Results: There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P <0.05).
 Conclusion: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.

Risky Sexual Behavior and Its Association With Attention-Deficit Hyperactivity Disorder, Stressful Life Events, and Other Psychiatric Correlates Among Women in Sex Work

Introduction: Numerous psychiatric disorders are known to be associated with risky sexual behavior (RSB). Depression or substance use is known to be higher in those who are in sex work. Recent literature has also described the association between attention-deficit hyperactivity disorder (ADHD) and RSB. However, the association between ADHD and RSB among women in sex work (WSW) is relatively unknown. In this background, this study was conducted to study the prevalence of ADHD and associated psychiatric correlates among WSW and also to study the prevalence of RSB in this population. Methodology: A sample of 96 women who were in sex work and consented to be the part of the study were recruited. They were later administered Adult ADHD Self-Report Scale to screen for adult ADHD symptoms, Wender Utah Rating Scale to retrospectively look into a childhood diagnosis of ADHD, MINI neuropsychiatric interview for DSM 4-TR psychiatric diagnoses, HIV Risk Behavior Scale to study RSB, Beck’s Depression Inventory to quantify depression, and Presumptive Stressful Life Events Scale to quantify the presence of stressful life events. Results: The prevalence of Adult ADHD in the sample was 32.20 % (n = 31). Individuals with ADHD had a higher prevalence of RSB ( P = .02), comorbid depression ( P = .04), presence of stressful life events ( P = .001), and a higher prevalence of sexually transmitted infections ( P = .03). Conclusion: The prevalence of ADHD is high among WSW (32%). Risky sexual behavior in this population could be probably due to higher prevalence of associated psychiatric conditions including depression, higher presence of stressful life events, and ADHD, the association which is less understood. There is a need to replicate these findings in larger samples to study ADHD and its relationship with risky sexual behavior among WSW.

Mental disorders during pregnancy and postpartum period

IntroductionMental disorders of pregnancy or postpartum correspond to all the psychopathological states linked to the period of the pregnancy-puerperium. They are the subject of prevention and screening and are currently a public health priorityObjectivesDescribe the socio-demographic characteristics of the patients who presented mental disorders during pregnancy and/or postpartum. Identify the various risk factors predisposing to these disordersMethodsWe carried out a retrospective descriptive analytical study including patients who presented mental disorders during their pregnancy or postpartum and who were hospitalized during the period from January to October 2020.We collected 20 patients.ResultsThe average age was 39.84 years. Mental disorders were present in 73.7% during the postpartum period. The patients had a personality disorder in 47.7%. They were smokers in 57% of cases. Pregnancy was desired in 73.7% with regular follow-up in 84.2%. Pregnancy was complicated by toxemia in 22% of cases and gestational diabetes in 27% of cases. Delivery was by caesarean section in 68.4% with primiparity in 50%. According to the DSM5, the psychic disorder most often found during pregnancy was the characterized depressive disorder 43%, and during the postpartum we found the brief psychotic episode 42.1%. The treatment was in half of the cases association between antidepressants and antipsychotics. Mental disorders were significantly correlated with the presence of stressful life events during pregnancy (p =0.02)ConclusionsMental disorders during pregnancy and postpartum are frequent and important to detect. Early diagnosis and adequate care are the two essential elements that should allow these women to fully experience their motherhood

Defensive responses to stressful life events associated with cancer diagnosis

Objectives : Stressful life events (SLEs) are common in patients who developed both physical and psychological syndromes. Research shown the role of psychological defense mechanisms in cancer progression and survival probability. The present study analyzed recent SLEs and defense mechanisms as characteristic of cancer patients and tested their role as potential predisposing factors to cancer development. Methods : This cross-sectional study enrolled 145 participants: 48 recently diagnosed cancer patients (CP), 43 recently diagnosed benign tumor patients (BT), and 54 healthy subjects (HC). Non-blinded raters assessed participants’ defense mechanisms using the Defense Mechanisms Rating Scales Q-sort version (DMRS-Q). Groups were compared on the presence of SLEs and on the maturity of defensive functioning. Significant associations between SLE and defense mechanisms as related to cancer diagnosis were explored. Results: Higher overall defensive functioning was associated with good physical conditions. Recent SLEs, higher use of neurotic defenses and lower use of obsessional defenses characterized cancer patients. CP showed higher use of suppression, repression, dissociation, rationalization and passive aggression and lower use of affiliation, sublimation, undoing, and devaluation of self-image as compared to controls. Hierarchical regression analysis showed that recent SLEs and defense mechanisms of suppression, repression, dissociation, displacement and omnipotence were associated with cancer diagnosis. Discussion : Recent SLEs and repressive defensive functioning characterized the CP’s defensive response to stress. Despite the relevance of present findings, this study shows several limitations. Prospective and longitudinal studies are needed to confirm these results and to investigate the potential role played by SLEs and defense mechanisms in cancer development.

Dhaka stress scale-adolescent: A scale for assessing psychosocial stressors among adolescents

This study was aimed to produce a culturally validated scale to determine the presence of stressful life events among adolescents in Bangladesh, and formulate the relative life change units for each event. The study used qualitative research, including a focus group and questionnaire, and quantitative analysis in the validation process. Researchers first developed a provisional stress scale that was translated in Bangla through a translation exercise. Using an open-ended question along with this provisional scale on a school sample of 449 (228 rated on imagination and 221 on actual experience) adolescents, researchers developed Dhaka stress scale– adolescent with 56 items and predictive interpretation of the overall score was made. Content validity was found excellent as item level content validity index was around 1 and the scale level validity index was 0.93. The correlation coefficient was 0.72 between this scale and adolescent life events stress scale. For reliability, Cronbach’s alpha values were ranged from 0.83 to 0.97. The scale is simple to administer to assess stress in adolescents and usable in both clinical and research settings.

Exploring characteristics associated with first benzodiazepine prescription in patients with affective disorders and related diagnoses.

In patients with affective disorders, benzodiazepines (BZDs) are frequently administered at the onset, sometimes inappropriately. We sought to identify clinical variables associated with first BZD prescription in a large sample of patients with affective disorders. Four hundred sixty patients with mood or anxiety disorders attending different psychiatric services were assessed comparing those who received BZD as first treatment (BZD w/) and those who did not (BZD w/o). More than one third (35.7%) of the total sample had received BZDs as first prescription. In relation to mood disorders, BZD w/ subjects more frequently (a) had not a psychiatrist as first therapist, (b) had anxious symptoms at onset, (c) had adjustment disorder as first diagnosis, (d) were treated as outpatients. In relation to specific diagnoses, (a) personal decision of treatment for major depressive disorder, (b) outpatient status for bipolar disorder and (c) longer duration of untreated illness for adjustment disorder were more frequently associated with first BZD prescription. For anxiety disorders, the presence of stressful life events and the diagnoses of panic disorder or specific phobias were more frequently observed in BZD w/ patients. Patients with affective disorders frequently received BZDs as first prescription with significant differences between and within mood and anxiety disorders.

Internet gaming disorder in adolescence: Psychological characteristics of a clinical sample.

Background and aimsInternet gaming disorder (IGD) has become a topic of increasing research interest since its inclusion in Section 3 of the DSM-5. Given the lack of clinical studies concerning IGD, exploring the characteristics of clinical samples with IGD will help to delineate the gaming disorder construct and inform future treatment studies.MethodsData collection consisted of clinical interviews comprising 31 male adolescents diagnosed with IGD. Alongside the clinical interviews, the participants were administered a battery of psychometric tests assessing the following: IGD, personality traits, comorbid symptomatology, emotional intelligence (EI), and family environment characteristics.ResultsThe results showed that the adolescents with IGD and their relatives reported a high number of hours per week and high presence of stressful life events in the majority of the sample. High scores on scales assessing depression, anxiety, and somatic disorders were found. However, the findings indicate the presence of several other comorbid disorders meaning that some of the adolescent sample with IGD had different clinical profiles. Several personality traits were found to be highly associated with IGD including introversion, inhibition, submissiveness, self-devaluation, interpersonal sensibility, obsessive–compulsive tendencies, phobic anxiety, and hostility, as well as paranoid and borderline personality traits. Other negative characteristics found in the present sample included a high level of social problems, low EI, and dysfunctional family relationships.Discussion and conclusionsThe findings suggest a more global pattern of key psychological characteristics associated with Internet gaming disorder in adolescence. This may help in understanding the complexity of this proposed disorder and it may also help in designing more specialized interventions for adolescents with IGD. The findings have important implications for clinical practice and interventions.

Development and validation of the Questionnaire of Stressful Life Events (QSLE)

Stressful life events (SLEs) are important indicators prior to the onset of first-episode psychosis (FEP). Although there are well-validated interviews and self-reports for assessing SLE on proximate events, unfortunately there are no instruments to assess SLE covering an entire lifetime. This study includes detailed specific items of childhood, adolescence, and adulthood focused on the presence of SLE, emotional impact (stressfulness), and the age at which the event occurred. Our research describes 2 studies designed to develop and validate a new scale to assess SLE: the Questionnaire of Stressful Life Events (QSLE). In Study 1, an over-inclusive item pool was generated based on review of group of experts at Parc Sanitari Sant Joan de Déu and content validity was examined by an Expert Survey. The whole scale represents the content domain. In Study 2, item-level analyses revealed good distributional properties, intra-rater reliability, and convergent and discriminant validity. In the sensitivity and specificity analysis, 18 items had high relevance in the discriminability between patients with FEP and healthy controls. We note that there was an AUC of 0.676, indicating a good predictor. Using 7 as a cutoff to predict an individual as a patient would yield a sensitivity of 64.8% and a specificity of 65%. Overall, the QSLE displayed satisfactory psychometric characteristics in a Spanish population. These results suggest that QSLE gives us the opportunity to investigate childhood, adolescent, and adult life events by measuring the stress and age at the moment on a continuous scale.

Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study

BackgroundSuicide is a major public health problem worldwide. It contributes for more than one million deaths each year. Since previous suicidal attempt was considered as the best predictor of future suicide, identifying factors behind suicidal attempt are helpful to design suicide prevention strategies. The aim of this study was to assess socio-demographic characteristics, clinical profile and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of general hospitals in South Ethiopia.MethodsWe conducted a cross-sectional study on patients presenting with complications of suicidal attempt to emergency departments of two general hospitals in Hawassa city from November, 2014 to August, 2015. Data was collected using semi-structured questionnaire which contained socio-demographic and clinical variables. The Mini International Neuropsychiatric Interview version 5 (MINI PLUs) was used to assess the prevalence of existing mental illness among study participants. Data was entered and analyzed using IBM SPSS statistics 21 software package.ResultsA total of 96 individuals were assessed, of whom 56 (58.3%) were females. The mean age of study participants was 21.5 (8.0) years. The majority, 75 (78.1%), of the study participants were aged below 25 years. Ingesting pesticide poisons and corrosive agent were used by the majority to attempt suicide. Mental illness was found in only three (3.1%) of the study participants. Impulsivity (the time between decision to attempt suicide and the actual attempt of less than 5 min) was reported by 30 (31.2%) of the study participants, of whom 18 (60%) were males. Males were found three times more likely to attempt suicide impulsively than women (COR = 3.0, 95% CI 1.2–7.3). Quarreling with family members, facing financial crisis, and having unplanned and unwanted pregnancy were reported by the majority of study participants as immediate reasons to attempt suicide.ConclusionsThe presence of stressful life events and impulsivity behind suicidal behavior of the younger generation implies that designing suicide prevention strategies for this group is crucial. Moreover, further research is needed to systematically examine the relationship between the presence of mental illness and suicidal attempt with a larger sample size and more robust methodology.

Brain structural correlates of obsessive–compulsive disorder with and without preceding stressful life events

Objectives There is growing evidence supporting a role for stressful life events (SLEs) at obsessive–compulsive disorder (OCD) onset, but neurobiological correlates of such effect are not known. We evaluated regional grey matter (GM) changes associated with the presence/absence of SLEs at OCD onset. Methods One hundred and twenty-four OCD patients and 112 healthy controls were recruited. Patients were split into two groups according to the presence (n = 56) or absence (n = 68) of SLEs at disorder’s onset. A structural magnetic resonance image was acquired for each participant and pre-processed with Statistical Parametric Mapping software (SPM8) to obtain a volume-modulated GM map. Between-group differences in sociodemographic, clinical and whole-brain regional GM volumes were assessed. Results SLEs were associated with female sex, later age at disorder’s onset, more contamination/cleaning and less hoarding symptoms. In comparison with controls, patients without SLEs showed GM volume increases in bilateral dorsal putamen and the central tegmental tract of the brainstem. By contrast, patients with SLEs showed specific GM volume increases in the right anterior cerebellum. Conclusions Our findings support the idea that neuroanatomical alterations of OCD patients partially depend on the presence of SLEs at disorder’s onset.

Personality diatheses and Hurricane Sandy: effects on post-disaster depression.

According to diathesis-stress models, personality traits, such as negative emotionality (NE) and positive emotionality (PE), may moderate the effects of stressors on the development of depression. However, relatively little empirical research has directly examined whether NE and PE act as diatheses in the presence of stressful life events, and no research has examined whether they moderate the effect of disaster exposure on depressive symptoms. Hurricane Sandy, the second costliest hurricane in US history, offers a unique opportunity to address these gaps. A total of 318 women completed measures of NE and PE 5 years prior to Hurricane Sandy. They were also assessed for lifetime depressive disorders on two occasions, the latter occurring an average of 1 year before the hurricane. Approximately 8 weeks after the disaster (mean = 8.40, s.d. = 1.48 weeks), participants completed a hurricane stress exposure questionnaire and a measure of current depressive symptoms. Adjusting for lifetime history of depressive disorders, higher levels of stress from Hurricane Sandy predicted elevated levels of depressive symptoms, but only in participants with high levels of NE or low levels of PE. These findings support the role of personality in the development of depression and suggest that personality traits can be useful in identifying those most vulnerable to major stressors, including natural disasters.

Psychiatric morbidity and predisposing factors in a primary care population in Madrid.

The aim of this article is to estimate the prevalence of mental disorders in patients in primary care centers in an urban area of Madrid and to study possible associated risk factors. Cross-sectional month prevalence was evaluated in two phases in an urban area of Madrid. The sample for the first phase included 635 individuals (aged 18-65 years), and the second phase included 320 individuals. Socio-demographic variables (age, sex, educational level, living conditions and country of origin) and clinical variables (psychiatric diagnosis and level of psychosocial stress) were studied. The instruments used for screening were the General Health Questionnaire (GHQ)-28 item questionnaire and the MULTICAGE-CAD 4test. The Mini International Neuropsychiatric Interview (M.I.N.I.) was used in the second phase (in 'possible cases' and 20% of the 'non-cases'). Prevalence was calculated using weighted logistic regression with the observed sampling fractions of the patients in study phase 2 as sample weights. The month prevalence of mental disorders was 31.3% (95% confidence interval (CI) = [27.6, 35.2]). Anxiety disorders were the most frequent diagnoses with a prevalence of 22.4% (95% CI = [17.8, 27.1]), followed by depressive disorders (16.6%; 95% CI = [12.9, 20.3]), substance abuse or dependence disorders (5.6%; 95% CI = [3.2, 6.9]) and posttraumatic stress disorder (PTSD; 4.4%; 95% CI = [2.0, 2.8]). Factors associated with mental disorders were the presence of stressful life events in the previous 12 months, Latin American region of origin, being woman aged 25 and 34 years and having a low education level.

Neural signatures of the interaction between the 5-HTTLPR genotype and stressful life events in healthy women

A change in neural connectivity of brain structures implicated in the memory of negative life events has been hypothesized to explain the enhancement of memory encoding during the processing of negative stimuli in depressed patients. Here, we investigated the effects of the interaction between negative life events and the 5-HTTLPR genotype – a polymorphism of the serotonin transporter gene – on the functional and structural connectivity of the hippocampal area in 34 healthy women. All participants were genotyped for the presence of the 5-HTTLPR short variant and for the A/G single-nucleotide polymorphism; they underwent clinical assessment including structured diagnostic interviews to exclude the presence of psychiatric disorders and to assess the presence of stressful life events. Resting state functional magnetic resonance imaging and diffusion tensor imaging scans were performed. We found significant interactions between stressful events and the 5-HTTLPR genotype in both the functional connectivity of the parahippocampus with the posterior cingulate cortex and the structural connectivity between the hippocampus and both the amygdala and the putamen. In addition, we found several genotype-related differences in the relationship between functional/structural connectivity of the hippocampal area and the ability to update expectations or stress-related phenotypes, such as anxiety symptoms. If confirmed by future studies, these mechanisms may clarify the role of the 5HTTLPR genotype as a risk factor for depression, in interaction with negative events.

Sociodemographic and Clinical Differences Between Suicide Ideators and Attempters: A Study of Mood Disordered Patients 50 Years and Older

Our study sought to characterize mood disordered suicide ideators and attempters 50years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk.