Prevalence Of Affective Disorders Research Articles

Adaptation and analysis of the Hungarian version of the Snaith-Hamilton Pleasure Scale

IntroductionAnhedonia (loss of ability of experience pleasure) is a transdiagnostic symptom which is presented as a prominent complain in several psychiatric disorders, such as depressive disorders, schizophrenia, bipolar disorder, addictive disorders, certain personality disorders etc. Specific instruments for assessment of anhedonia have been published in the international literature but their Hungarian versions are not available so far, however, the prevalence of affective disorders and suicide are also high in Hungary. The Snaith-Hamilton Pleasure Scale (SHAPS) is an instrument developed in 1995 (Snaith et al. Br J Psychiatry1995;167:99-103) which purposley has been constructed with items that can be easily translated into other languages.ObjectivesThe aim of our study was to translate the 14 items into Hungarian and analyse its reability and sensitivity in a Hungarian sample consists of patinets and control persons. Further aim was to explore the differences of anhedonia profiles among diagnostic categories and subgroup of major disorders.MethodsWe recruited 170 subjects (101 controls and 59 patients; 78 men and 82 women; mean age=37,9±6,1y) into our study. Among the patients there were 27 subjects with major depressive disorer (MDD), 10 subjects with bipolar disorder (BD), 9 patients with schizophrenia (SCZ), 6 patients with addictive disorder (AD) and 7 patients with anxiety disorder (ANX)±. We created two major subgorups from the dfferent diagnostic categories: affective and psychotic subgroups to compare the anhedonic profiles. Differences of mean values between case and control, men and women and subgroups were analysed by t-tests and diganostic categories by ANOVA tests performing in SPSS 20.0 software.ResultsAmong the MDD, the BD, the SCZ, the AD and the ANX groups, patients with MDD produced the highest score (6.9±3.5; 3.9±2.4; 5.9±3.9; 2.8±2.7;2.3±1.8, respectively), while controls prohibited 1.6±1.3. The case group scored significantly higher on the SHAPS than the control group (5.3± 3.6 vs. 1.6±1.3; p=0.0001). The means of SHAPS did not differ significantly between the affective subgroup and the psychotic subgroup (6.0±3.7 vs. 4.8±3.2; p=0.24). Among the subgroup of women, the age was significantly associated with the SHAPS score (p=0,04), however, this association has been not detected in men.ConclusionsThe Hungarian version of the SHAPS detected marked difference between cases and controls with good reliability and sensitivity. The instrument can be useful in daily clinical routin becuase subjects could fill it easily and quickly. In case of patients with pronounced anhedonia, treatments with spcifically targeting anhedonia can be preferred (e.g. rTMS as it was demonstrated in our earlier publications, see Lazary et al. Sci Rep 2021,11:8867; Elemery et al. Front Psychiatry 2022, 13:806731). This study was supported by the grant EFOP 5.6.2.Disclosure of InterestNone Declared

Affective Disorders and General Health Status in Patients with Total Laryngectomy

Introduction: Total laryngectomy (TL) is a procedure that severely affects the patient's quality of life. This study determined the prevalence of general health and affective disorders as an often neglected aspect of cancer care in patients following TL. Methods: This is a cross-sectional case-control study. We enrolled 80 participants into two groups; male patients who had undergone TL due to advanced squamous cell laryngeal cancer from 1 to 3 years ago (n=45) and a control group of healthy individuals (n=35). The DASS-21 and SF-36 questionnaires were used to evaluate participants' affective disorders and general health, respectively. Data were analyzed using SPSS, and a p-value <0.05 was considered significant. Results: The mean age of the patients and control group were 57.9±7.7 and 55.4±8.7 years, respectively (p=0.338). The mean scores of general health status were significantly lower in TL patients than in the control group (84.9±13.1 vs. 94.9±8.4, respectively, p=0.011), and the mean scores of overall affective disorders were higher in TL patients than in the control group (40.8±25.1 vs. 26.7±19.0, respectively, p=0.009). Also, we found a significant positive relationship between the prevalence of affective disorders and patients' age (r= 0.46, p=0.004). But there was no correlation between other demographic variables, affective disorders, and general health status. Conclusions: Significant high status of depression and anxiety and lower general health state were seen in TL patients compared with the control group. To enhance patients' quality of life, supporting patients before and after surgery is recommended.

Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson's disease

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

Incidence rate and clinical characteristics of seasonal affective disorders in senior medical students

Aim. To study the incidence rate, clinical features, and prognosis of seasonal affective disorder (SAD) in senior (6th-year) medical students.Materials and methods. SAD screening using the Seasonal Pattern Assessment Questionnaire (SPAQ, 1987) included 119 undergraduate medical students. 78 students were females (65.5%) and 41 – males (34.5%) (p = 0.001). The average age of women was 23 (22; 23) years, the average age of men – 23 (22; 24) years. Statistical processing was performed using the Mann – Whitney U-test, Pearson’s χ2 test, and Spearman’s rank correlation coefficient (rs).Results. The data on the prevalence of affective disorders with a seasonal pattern in medical students were obtained: SAD – 9.2%, sub-SAD – 13.5%, psychological undulation of season perception (PUSP) – 16.8%. The number of students who did not exhibit seasonal undulation of the six main characteristics recorded by the SPAQ was 72 (60.5%) (p = 0.001). There were statistically significant differences in the higher median Global Seasonality Score of the SPAQ for SAD compared with PUSP, both with and without account of the gender factor (p = 0.001). The use of a binary logistic regression model made it possible to identify groups of students with or without SAD according to the SPAQ. The data obtained determined the contribution of the following factors: gender, seasonality, body weight, and the number of sleep hours per day in spring.Conclusion. The study made it possible to obtain a logistic regression model that allowed to predict the greatest likelihood of developing SAD.

COVID-19 and people who use drugs: Impact of the pandemic on general anxiety and depressive disorders among adults in Belgium

BackgroundDuring previous pandemics people who use drugs (PWUD) were categorized among the most vulnerable. In the current study, firstly, we wanted to evaluate the impact of the COVID-19 crisis on the prevalence of anxiety and depressive disorders among PWUD. Furthermore, we wanted to compare the prevalence of these disorders with that of members from the general population who did not use drugs. MethodsWe used a matched cohort design based on two separate repeated cross-sectional online surveys (April and November 2020) among PWUD and the general population. Results of GAD-7 and PHQ-9 were used as outcome variables. We calculated absolute and relative risks for matched pairs for both affective disorders, and logistic regression to compare affective disorders over both waves for PWUD. ResultsIn April, the prevalence of affective disorders was similar for PWUD and the general population. In November, the risks for anxiety disorders increased with 64% for PWUD compared to non-PWUD (RR = 1.64, 95%CI 1.42–1.88), whereas the risks for depressive disorders more than doubled (RR = 2.29, 95%CI 1.97–2.67). Having a job and being male were protective factors for PWUD for both anxiety and depressive disorders. LimitationsAs this study used self-reported data, GAD-7 and PHQ-9 give an indication of the presence of anxiety and depression which might differ from a clinician's judgement. ConclusionsPWUD might be disproportionally affected by COVID-19. Health care providers should be attentive to substance use as an indicator for increased risk of mental health problems.

Narrative review of anxiety and depression in patients with esophageal cancer: underappreciated and undertreated.

Depression and anxiety are emotional disorders that commonly affect patients with esophageal cancer. As a result of its high morbidity, mortality, and complication rates, this population is at particularly high risk for developing or exacerbating affective disorders; even when compared to patients with other forms of cancer. Many of the medical conditions and social behaviors that predispose patients to this disease are also independently associated with affective disorders, and likely compound their effects. Unfortunately, in the existing literature, there is wide variability in study design and diagnostic criteria. There is no standard method of evaluation, many studies are limited to written surveys, and widespread mental health screening is not included as a part of routine care. As a result, the prevalence of these illnesses remains elusive. Additionally, psychiatric and psychosocial illness can affect compliance with surveillance and treatment, and gaps in knowledge may ultimately influence patient outcomes and survival. This review will discuss the existing literature on depression and anxiety in patients with esophageal cancer. It will highlight current methods of psychological evaluation, the prevalence of affective disorders in this population, and their effects on treatment, compliance, and outcomes. It will also discuss possible screening tools, treatments and interventions for these comorbid illnesses that may improve oncologic outcomes as well as quality of life.

Affective Disorder and Functional Status as well as Selected Sociodemographic Characteristics in Patients with Multiple Sclerosis, Parkinson's Disease and History of Stroke.

The main arguments in support of researching anxiety and depression in patients with chronic somatic diseases are the prevalence of affective disorders in the population, somatic conditions as risk factors of affective disorders and the search for effective preventative and therapeutic strategies. The aim of the study was to determine the association between the functional status, selected sociodemographic characteristics and prevalence as well as severity of anxiety and depression in patients with multiple sclerosis (MS), Parkinson’s disease (PD) and history of stroke (S). Material and methods: Eighty participants (44 women and 36 men) with MS (n = 22), PD (n = 31) and history of stroke (n = 27) were enrolled. All participants completed a questionnaire consisting of metrics, the Katz Index of Independence in Activities of Daily Living and the Hospital Anxiety and Depression Scale (HADS). Results: Fifty-five per cent of all participants did not present with anxiety or depression, 20% scored above the diagnostic threshold on the anxiety scale and 26% scored above the diagnostic threshold on the depression scale. Subgroup analysis revealed that anxiety and depression sufferers were 13.64% and 13.64% of MS patients, respectively; 22.58% and 35.48% of PD patients, respectively; and 22.22% and 25.93% of stroke survivors, respectively. There was a significant correlation between depression and independence level in the entire group and between depression and marital status in stroke survivors. Conclusions: Although depression and anxiety are highly prevalent in patients with neurological conditions, the disorder has a very individual nature and is not associated with the patient’s age, duration of a condition or concomitant diseases. Screening for depression and anxiety as a part of comprehensive approach may increase treatment efficacy in neurological patients

Prevalence of affective disorders and dementia in inflammatory polyarthropathies.

Comorbid disorders are common in psychiatric diseases and understanding the risk of secondary diseases can aid successful clinical treatment. The objective of this study was to compare the frequency of comorbid dementia, affective disorders, and inflammatory polyarthropathies. Healthcare data obtained via the German Hospital Fees Act from two independent databases with more than 7.4 million cases were analyzed to compare the prevalence of comorbid disorders. Comorbid inflammatory polyarthropathy was observed in 2.27% of patients diagnosed with affective disorders and 1.35% of patients with dementia (p < 0.001). Among patients with a primary diagnosis of inflammatory polyarthropathy, 1.27% of patients were diagnosed with dementia, whereas 4.55% of age-matched patients without inflammatory polyarthropathies had comorbid dementia (p < 0.001). The opposite effect was demonstrated for affective disorders, as 5.77% of patients with a primary diagnosis of inflammatory polyarthropathy also had comorbid affective disorders, while 4.87% of age-matched patients without inflammatory polyarthropathy had an accompanying affective disease (p < 0.001). These findings show an association between the occurrence of inflammatory polyarthropathies, dementia, and affective disorders. This correlation might improve diagnosis and treatment for patients with comorbidities. Moreover, further exploration of the molecular pathophysiology underlying these relationships could be relevant for the development of novel treatment options.

Association between affective disorders presenting before and during pregnancy and pre-term birth, considering socio-demographic factors, obstetric factors, health conditions, and use of medication

ObjectiveTo study the relationship between maternal affective disorders (AD) before and during pregnancy, and pre-term birth. DesignRetrospective observational study. LocationSexual and reproductive health units at the Institut Català de la Salut (ICS) in Catalonia, Spain. ParticipantsPregnant women with a result of live-born child from 1/1/2012 to 30/10/2015. InterventionsData were obtained from the ICS Primary Care electronic medical record. Main measurementsDiagnosis of AD before and during pregnancy, months of pregnancy, and possible confusion factors were collected. Descriptive statistical analysis (median, interquartile range, and absolute and relative frequency), bivariate analysis (Wilcoxon test and Chi-square test), and multivariate analysis (logistic regression) were performed. Results102,086 women presented valid information for the study. Prevalence of AD during pregnancy was 3.5% (4.29% in pre-term and 3.46% in term births; p<0.004). Pregnant women with pre-term births presented a higher age, smoking habit, lower inter-pregnancy interval, and a lower socio-economic status. Pre-term birth was significantly associated to previous history of stress and dissociative disorder (SDD), anxiety, obsessive-compulsive disorder (OCD) and eating disorders (ED), and use of antidepressants. It was also associated to abuse of alcohol, smoking, and use of psychoactive substances, as well as SDD, ED, use of antipsychotics, and divorce during pregnancy. Multivariate analysis confirmed the relationship between pre-term birth and history of AD, SDD, ED, and smoking, but not with AD during pregnancy. ConclusionsExamining the previous history of SDD and ED in pregnant women, and SDD, and ED during pregnancy is highly relevant to avoid pre-term birth.

Severe mental disorders in rural China: a longitudinal survey

BackgroundLittle is known about the change in long-term prevalence of mental disorders during a period of sustained rapid socioeconomic development. Here we explore the prevalence change of severe mental disorders in a 21-year longitudinal study in a rural area of China. MethodsEpidemiological surveys of mental disorders were done in May, 1994, and October, 2015, in six townships (total population 170 174 in 2015) in Xinjin County, Chengdu, China. Psychoses Screening Schedule (PSS) together with key informant method for household survey and general psychiatric interview were administered to identify the persons with severe mental disorders according to International Classification of Mental and Behavioural Disorders-10 (ICD-10) criteria. FindingsAmong all persons aged 15 years and older, the age-standardised lifetime prevalence of all mental disorders increased 48·2% from 870·1 per 100 000 population (95% CI 811·3–928·9 per 100 000 population) in 1994 to 1289·4 per 100 000 population (1218·0–1360·8 per 100 000 population) in 2015. The age-standardised lifetime prevalence of schizophrenia was the highest among all mental disorders and remained relatively stable from 1994 (416·0 per 100 000 population) to 2015 (427·9 per 100 000 population). Between 1994 and 2015, the age-standardised lifetime prevalence increased for affective disorders (41%), alcohol dependence and alcoholism (373·8%), drug and substance abuse (1809%), and mental disorder plus cerebrovascular disease (214%), brain trauma (388%), and senile dementia (126%). Moreover, age-standardised lifetime prevalence was significantly higher in men (1465·5 per 100 000 population) than in women (1179·0 per 100 000) in 2015 (p<0·0001). InterpretationVarious mental disorders in people living in the rural community display different trends from 1994 to 2015. Although the age-standardised lifetime prevalence of all causes disorders increased from 1994 to 2015, the prevalence of schizophrenia remained relatively stable. Prevalence of affective disorders, alcohol dependence and alcoholism, drug and substance abuse, senile dementia, and other organic disorders increased sharply, possibly indicating the effect of socioeconomic development on mental disorders. Mental health policy and services should be improved and adjusted according to the prevalence change of mental disorders. The limitations of this study include: (1) the sample investigated was from one rural area of China; (2) only two surveys were done; and (3) as many young people in this rural area might move to work temporarily in urban areas, the final reported prevalence might underestimate the true prevalence in young people. FundingThe investigation in 1994 was supported in part by the China Medical Board of New York (CMB, 92-557, to MZX). The investigation in 2015 was supported in part by Seed Funding Programme for Basic Research (HKU, 2014-2016, to MSR), Seed Funding Programme for Applied Research (HKU, 2014-2016, to MSR), Strategic Research Theme (SRT): Contemporary China Seed Funding (HKU, 2014-2016, to MSR), Small Project Funding (HKU, 2014-2016, to CLWC), and Mental Health Research in Chengdu, China (Dept. Matching Fund, 2015-2017, to MSR).

TAMEC: a new analogue of cyclomyrsinol diterpenes decreases anxiety- and depression-like behaviors in a mouse model of multiple sclerosis

ObjectivesThere is a significant prevalence of affective disorders including depression and anxiety in people with multiple sclerosis (MS), resulting in reduced quality of life. Since the current treatments are not generally effective, further studies are needed to find appropriate drugs to alleviate anxiety and depression symptoms in these patients.MethodsThe effects of a new analog of cyclomyrsinol diterpenes (TAMEC) isolated from Euphorbia sogdiana on the anxiety (open field and elevated plus maze test) and depressive-like behaviors (sucrose preference test and forced swim test) in EAE-induced C57BL/6 mice (EAE; a mouse model of MS) were investigated. Hippocampal tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β and IL-10 levels were also measured by ELISA.ResultsThe results indicated that TAMEC treatment reduced anxiety and depression-like behavior. This drug also decreased the levels of TNF-α and IL1β and increased IL-10 level in the hippocampus.DiscussionTaken together, our findings demonstrate that the drug we used here can reduce anxiety and depression-like symptoms in EAE-induced mice. However, more studies are still needed to validate, expand, and generalize these data.

Sex differences and sex hormones in anxiety-like behavior of aging rats

Sex differences in the prevalence of affective disorders might be attributable to different sex hormone milieu. The effects of short-term sex hormone deficiency on behavior, especially on anxiety have been studied in numerous animal experiments, mainly on young adult rats and mice. However, sex differences in aged animals and the effects of long-term hypogonadism are understudied. The aim of our study was to analyze sex differences in anxiety-like behavior in aged rats and to prove whether they can be attributed to endogenous sex hormone production in males. A battery of tests was performed to assess anxiety-like behavior in aged female, male and gonadectomized male rats castrated before puberty. In addition, the aged gonadectomized male rats were treated with a single injection of estradiol or testosterone or supplemented with estradiol for two-weeks. Female rats displayed a less anxious behavior than male rats in most of the conducted behavioral tests except the light-dark box. Long-term androgen deficiency decreased the sex difference in anxiety either partially (open field, PhenoTyper cage) or completely (elevated plus maze). Neither single injection of sex hormones, nor two-week supplementation of estradiol in gonadectomized aged male rats significantly affected their anxiety-like behavior in the elevated plus maze. In conclusion, our results confirm sex differences in anxiety in aged rats likely mediated by endogenous testosterone production in males. Whether long-term supplementation with exogenous sex hormones could affect anxiety-like behavior in elderly individuals remains to be elucidated.

The relative prevalence of schizophrenia among cannabis and cocaine users attending addiction services

BackgroundCannabis and cocaine are the most common illicit drugs for which people are treated in addiction services in Latin America. Much research has suggested that the use of cannabis increases the risk of schizophrenia; there is less evidence concerning cocaine. The aim of the present study was to establish the relative prevalence of schizophrenia in people treated for cannabis use and cocaine use disorders in Chile. MethodsA sample of 22,615 people treated for illicit drug use disorders was obtained from a national registry of addiction service users in Chile. Clinical diagnoses were established at admission to substance use treatment programs or at any point during the period of treatment. Prevalence rates of schizophrenia and related disorders, and affective disorders were calculated for the groups of people with cocaine use disorders, and cannabis use disorders. Odds ratios (OR) for schizophrenia and for affective disorders were calculated for cannabis users using the group of people treated for cocaine use disorders as reference category. ResultsThe prevalence of schizophrenia and related disorders was 1.1% in those with cocaine use disorders, but 5.2% in those with cannabis use disorders (OR 4.9; p<0.01). The prevalence of affective disorders was 9.3% in cocaine use disorders, and 13.2% in cannabis use disorders (OR 1.5; p<0.01). ConclusionsThe prevalence of schizophrenia and to a lesser extent affective disorders is higher among people with cannabis use disorder than cocaine use disorder among those attending addiction services.

Association Between Baseline Affective Disorders and 30-Day Readmission Rates in Patients Undergoing Elective Spine Surgery

There is a growing understanding of the prevalence and impact of affective disorders on perception of health status in patients undergoing elective spine surgery. However, the role of these disorders in early readmission is unclear. The aim of this study is to investigate the influence of psychiatric comorbidities on 30-day all-cause readmissions after elective spine surgery. The medical records of 400 patients undergoing elective spine surgery at a major academic medical center were reviewed, of which 107 patients had comprehensive 1- and 2-year patient-reported outcomes data. We identified all unplanned readmissions within 30 days of discharge. The prevalence of affective disorders, such as depression and anxiety, were also assessed. All-cause readmissions within 30 days of discharge was the primary outcome variable. Baseline characteristics were similar between groups. Approximately 6% of patients in this study were readmitted within 30 days of discharge. The rate of readmission was 3-fold more for individuals with a psychiatric comorbidity compared with those without a psychiatric comorbidity (10.34% vs. 3.84%, P= 0.03). In a univariate analysis, race, body mass index, gender, patient age, smoking, diabetes, and fusion levels were associated withincreased 30-day readmission rates. However, in a multivariate logistic regression model, depression was an independent predictor of readmission within 30 days of discharge. In addition, there was no significant difference in baseline, 1- and 2-year patient-reported outcomes measures between groups. Our study suggests that psychologic disorders, like depression and anxiety, are independently associated with higher all-cause 30-day readmission rates after elective spine surgery.

Affective disorders in multiple sclerosis

BackgroundPsychiatric disorders have a remarquable frequency in multiple sclerosis. The leading group of these disorders consists of affective disorders. These psychiatric conditions can worsen the outcome of multiple sclerosis, thus contributing to increase the burden of the disease to both patients and relatives. Managing such a complicated situation needs a focus on the underlying links between affective disorders and multiple sclerosis.ObjectiveTo examine the hypotheses proposed to explain the high prevalence of affective disorders in patients with multiple sclerosis.MethodsLiterature was reviewed using the Medline database and the following keywords “bipolar disorder” “affective disorder”, “mania” and “multiple sclerosis”.ResultsPubMed research returned 13 results. After manual inspection, 10 articles were retained and examined. The cause of the high comorbidity between multiple sclerosis and mood disorders is regarded as being multifactorial: the medication used in multiple sclerosis possibly inducing/exacerbating mood disturbances, the demyelinazing brain lesions which could bring about depression or mania, genetic overlapping with affective disorders and last the psychological reactions and adjustment difficulties to the neurological handicap.ConclusionDespite the fact that the higher prevalence of affective disorders in multiple sclerosis is well established, these disorders still remain underdiagnosed and undertreated. A shift towards a better assessment of the psychiatric comorbidity in multiple sclerosis patients and the optimal treatment of those disorders is fundamental.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment of mild to moderate major depressive disorder with agomelatine in patients with cardiovascular disorders (national observational multicenter study “pulse”)

IntroductionThe urgency of depression treatment in patients with cardiovascular diseases (CVD) is determined by the increasing prevalence of affective disorders. For these patients, tolerance and safety of antidepressants are of great importance.ObjectiveTo obtain additional data on therapeutic efficacy and tolerance of agomelatine in the treatment of mild to moderate depressive disorders in cardiologic practice in Russia.MethodsEight hundred and ninety-six adult patients with CVD (86.5% arterial hypertension, 29.5% stable angina, 16% myocardial infarction, 23.6% conduction disturbances, 17.6% chronic heartfailure) were treated with agomelatine 25-50 mg for 12 weeks. Depression and anxiety symptoms were evaluated via Hospital Anxiety and Depression Scale (HADS), Clinical Global Impression (CGI-S and CGI-I), Visual Analog Scale (VAS), Spielberger Anxiety Scale (SAS), Whitely Hypochondria Index (WHI) and quality of life questionnaire (SF-36). Safety and tolerance were also monitored according to the summary of product characteristics recommendations.ResultsHADS scores decreased throughout the study and severe anxiety rate decreased from 95.9% to 15%. After 12 weeks of treatment, remission (HADS &lt; 7) rate was 84.6%. Subjective assessment of patient health significantly improved (P &lt; 0.00001). WHI decreased significantly (P &lt; 0.00001). Physical and mental health significantly improved (P &lt; 0.00001). Heart rate and blood pressure decreased. Treatment acceptability was considered “excellent” by 82% of doctors and 75% of patients.ConclusionAgomelatine significantly improved depressive symptoms, anxiety and hypochondria in depressed patients with CVD and demonstrated good tolerance. This suggests the possibility of wide and safe use of agomelatine for treatment of depression in patients with CVD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Differentiating disordered affect in children and adolescents with type 1 diabetes

BackgroundThere is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes. MethodsThe self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls (N=107; 7–18 yrs). ResultsCase participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD. LimitationsSelf-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument. ConclusionsAD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.

Depression and psychological distress in tobacco smokers and people with cannabis dependence in the National Survey of Mental Health and Wellbeing

To examine changes in the prevalence of affective disorders and psychological distress among smokers and people with cannabis dependence between 1997and 2007. Cross-sectional analysis of the 1997and 2007National Survey of Mental Health and Wellbeing. The Composite International Diagnostic Interview generated diagnoses of cannabis dependence and affective disorders based on criteria of the Diagnostic and statistical manual of mental disorders, fourth edition. Psychological distress was measured using the Kessler Psychological Distress Scale. Logistic regressions examined the relationship between affective disorders, psychological distress and (i) smoking status (current, former and never-smoker) and (ii) cannabis dependence. Affective disorders and psychological distress were more common among smokers than non-smokers and among cannabis-dependent participants in both years. The prevalence of affective disorders and psychological distress among smokers, ex-smokers and non-smokers did not change between 1997and 2007. Psychological distress and affective disorders were more common in cannabis-dependent participants in 2007than in 1997. Affective disorders were more common in current than never-smokers and in people with cannabis dependence than without. We did not find strong evidence that the prevalence of these disorders changed in smokers between 1997and 2007, but we did find such evidence in cannabis-dependent people.

Sociodemographic correlates of antidepressant utilisation in Australia

To investigate sociodemographic variation in antidepressant utilisation. Cross-sectional analysis of antidepressant prescription under the Pharmaceutical Benefits Scheme in Australia, 2003-2005. Antidepressant utilisation (defined daily dose/1000/day) by sex, age, socioeconomic status (SES) and geographical area. Total antidepressant utilisation increased with age. Among those aged > or = 15 years, female utilisation was about double that of males. About half of antidepressant utilisation was accounted for by sertraline, venlafaxine, citalopram, and paroxetine. SES differentials in antidepressant utilisation changed across age groups for males and females: among those aged < or = 19 years, total antidepressant utilisation was significantly less in lower SES groups (P < 0.001); there was no relationship to SES among 20-29-year-olds; and among those aged > or = 30 years, antidepressant utilisation was significantly higher in lower SES groups (P < 0.001). SES differences were attenuated after adjusting for urban or rural residence, but remained statistically significant. Antidepressant utilisation rates were highest in regional centres. Antidepressant utilisation in Australia partially reflects sociodemographic differences in the prevalence of affective disorder. Discrepancies between treatment provision and treatment need suggest that not all social strata in Australia have equal access to these treatments.

Facteurs sociodémographiques, conduites addictives et comorbidité psychiatrique des usagers de cannabis vus en consultation spécialisée

In the 1990s, cannabis consumption in France increased considerably. So, in 10 years, the number of adolescents reporting regular cannabis use (10 or more times during the last 12 months) tripled. In 2004, an official program to address problems related to cannabis addiction was implemented. As part of this program, specific outpatient settings for cannabis use disorders were created.We present the sociodemographic characteristics, the prevalence of cannabis, alcohol and others psychoactive substances and the prevalence of mental disorders in 90 cannabis users seen at an outpatient specific setting for cannabis use disorders in the Lariboisière hospital (a university hospital in Paris).Twelve months prevalence of substance abuse and dependence, psychiatric diagnoses based on the DSM-IV and the Mini-International Neuropsychiatric Interview (MINI) results are described.The study population had the following characteristics: 67% male, mean age 27.5 (S.D.=8.4) years and 59% single or divorced. Approximately, two-thirds of the users (67%) were students or currently working and 32% were unemployed. Twenty-two percent of the cannabis users received unemployment, welfare or disability benefits and 11% declared no source of revenue. Most of the users (63%) decided on their own to seek care at the setting. Seventy-three percent of the subjects had seen a psychologist or a psychiatrist in the past, with or without relation to cannabis use. By far, most of the users were cannabis dependent (82%) and 9% cannabis abusers in the last 12 months according to DSM-IV criteria prior to their visit. Seven percent of the cannabis users had alcohol dependence and 7% were abusers. The 12 months prevalence of cocaine or ecstasy dependence was 2% and the prevalence of benzodiazepines, heroin or stimulants dependence 1%. The main substances used over lifetime were tobacco (99%); alcohol (96%); cocaine (41%); benzodiazepines and hypnotics (41%); ecstasy (40%) and heroin (23%). Four percent of cannabis users had a history of intravenous drug use. The main consumption mode of cannabis in France is the blunt. About three-quarters of the consumption is in the form of resin (hashish) and one-quarter as marijuana (grass). The average consumption of cannabis in the last six months was equivalent to 5.8 blunts per day (S.D.=4.4) and 12 g per week (S.D.=10.5), and the average monthly cost was 159 euro (S.D.=133) (234 USD, S.D.=196). The prevalence of psychiatric disorders according to DSM-IV criteria in the sample is high. A current mood disorder was present in 48% and an anxiety disorder in 55% of the cannabis users in the last 12 months. The prevalence of affective disorders in the last 12 months was major depressive disorder (38%), dysthymia (19%), hypomania (3%) and mania (1%). The prevalence of anxiety disorders in the last 12 months was social phobia (29%); generalised anxiety disorder (17%); panic disorder with or without agoraphobia (16%); obsessive compulsive disorder (12%); agoraphobia without panic disorder (9%) and post-traumatic stress disorder (5%). The prevalence of schizophrenia was 4%. The prevalence of bulimia was 4% and no anorexia. Women are more likely to report an affective disorder (64% versus 41%; p=0.04) or a post-traumatic stress disorder (17% versus 0%; p<0.001) in the last 12 months. The prevalence of family history for psychiatric disorders was 52% and for addiction, 59%.The cannabis users seen in our specific setting are a fairly homogeneous group and for the most part addicted to cannabis only, but with very high rates of dependence. Indeed, other than tobacco dependence, 80% of the users were only dependent on, or abused on cannabis in the last 12 months. In comparison with the cohort of French cannabis users (n=4202) seen at specific outpatient settings for marijuana users in 2005, cannabis users seen in Lariboisière Hospital are older, the percentage of females is greater, they are more dependent on marijuana and have a high prevalence of affective and anxiety disorders.