Prevalence Of Affective Disorders Research Articles

Prevalence of depression in the terminally ill: effects of diagnostic criteria and symptom threshold judgments.

Two issues that may influence the diagnosis of depression in the medically ill are 1) the severity with which symptoms must be expressed before they are considered clinically significant and 2) how to deal with somatic symptoms that may be caused by medical illness. This study used different approaches to case identification to examine prevalence rates for major and minor depression in a group of terminally ill cancer patients. Semistructured diagnostic interviews were conducted with 130 patients receiving palliative care. Diagnoses according to the Research Diagnostic Criteria (RDC) were compared with diagnoses according to Endicott's revised criteria (which involve replacing somatic symptoms with non-somatic alternatives) when either a low-severity or a high-severity threshold for classifying RDC criterion A symptoms was used. A low-threshold (less stringent) diagnostic approach greatly increased the overall prevalence of major and minor depressive episodes with both the RDC and the Endicott criteria. With high thresholds, the RDC and the Endicott criteria were equivalent, whereas with low thresholds the Endicott substitutions identified fewer cases of major (but not minor) depression. Small differences between investigators in the applications of symptom-severity thresholds can result in large differences in prevalence rates for depression. However, the inclusions of somatic symptoms in the diagnostic criteria inflates the rates of diagnosis only when these symptoms are used in conjunction with a low-threshold approach.

Gender differences in lifetime psychiatric disorders between sons and daughters of alcoholic mothers: a pilot study.

Lifetime prevalence of selected psychiatric disorders was assessed in 24 independent pairs of adult siblings (brother-sister) with an alcoholic mother, using the Diagnostic Interview Schedule. Adult females were as likely as adult males to have had one or more lifetime diagnosis of psychiatric disorder. Lifetime prevalence of affective disorders was the same in male and female siblings. Although not statistically significant, compared with their sister, men were 3 times more likely to have had a diagnosis of alcohol abuse/dependence, and 3.5 times more likely to have had a diagnosis of general anxiety disorder. When compared with their brother, women were 1.66 times more likely to have had a diagnosis of drug abuse/dependence, 3 times more likely to have had a diagnosis of panic disorder, and 6 times more likely to have been diagnosed with phobia; however, these differences were not significant.

Prevalence of affective disorder in the child and adolescent offspring of a single kindred: a pilot study.

The study determined the prevalence of psychiatric disorders among the child and adolescent offspring of an extended family identified through a proband with bipolar affective disorder. All of the not mentally retarded offspring (ages 6 to 17 years) of a single extended bipolar affective disorder pedigree were studied. Data regarding psychiatric diagnoses, intelligence, school achievement, temperament, and family functioning were collected using structured and standardized instruments. When the child and adolescent offspring were stratified by degree of genetic relationship to an adult with an affective disorder, there were no differences in demographic variables, IQ, school achievement, or most temperamental and family characteristics. In contrast, there were increases in the rates of affective disorders and disruptive behavior disorders in the offspring that correlated with the degree of genetic relationship to an affected adult. The risk of developing an early onset affective disorder is correlated with the degree of genetic relatedness to affected adults in this single, extended family. This pilot study demonstrates that the inclusion of extended relatives in high-risk studies can enhance the discrimination of genetic and environmental contributions to the development of affective disorders.

Sexual Abuse and Premenstrual Syndrome: Comparison between a Lower and Higher Socioeconomic Group

Of 174 women presenting symptoms of premenstrual syndrome (PMS), 40% had a history as victims of sexual abuse. Thirty-three percent were of a high-SES (socioeconomic status) group and 52% of a low-SES group. The authors found a connection between sexual abuse and psychiatric hospitalization for women seeking treatment for PMS. Beck Depression Inventory scores were high, supporting current research indicating a prevalence of affective disorders in women seeking treatment for PMS. However, the authors found few differences between the high- and low-SES groups. Specific questioning regarding a history of adverse sexual experiences is critical in evaluating all patients.

Optimizing REM latency as a diagnostic test for depression using receiver operating characteristic analysis and information theory

New diagnostic techniques must be evaluated for their intrinsic accuracy and for their applicability to particular patient groups in specific clinical settings. Using receiver operating characteristics (ROC) analysis and concepts from information theory, we have developed a new mathematical and graphical method that can evaluate, compare, and optimize the performance of diagnostic tests for any value of disorder prevalence. Our analytic method is appropriate to any test that sorts disordered from nondisordered subjects using a continuous or nonbinary diagnostic variable; its characterization of the fundamental properties of such tests thus has important implications for the evaluation and optimization of diagnostic modalities used by clinicians in all medical specialties. We demonstrate our method using published data from five studies that used sleep architecture as a “biological marker” for depression. Our analysis confirms that REM latency is comparable to the dexamethasone suppression test in its ability to discriminate depressed from control subjects. For each of the five studies, we show how optimal REM latency cut-off times may be selected so that diagnostic information yield is maximized, and we compare the ability of each study to detect depressed subjects in populations where the prevalence of affective disorder can be specified.

Psychiatric and behavioural disorders amongst older severely mentally handicapped inpatients.

A retrospective survey of psychiatric disorders requiring medication amongst 50 mentally handicapped inpatients aged 60 years or more, revealed a high prevalence of affective disorder which increased with age. Behavioural problems such as aggression and overactivity improved with age in some, but not all, patients.

Sex differences in biological factors putatively related to depression

Gender differences in the prevalence of affective disorders were suggested by several authorities in the field. Such differences may be attributed to sex-related differences in levels or activity of monoamine transmitters, especially since some of these variables have been shown to be altered by gonadal hormones. The reported association of perimenstrual and postpartum dysphoria, with affective disorders may contribute to further elucidation of pathophysiology of depression in women — in light of the hormonal-behavioral dynamics of these periods. Several factors associated with monoamines biosynthesis, availability, uptake and metabolism were found to be more abnormal in normal and depressed women compared to men. Age-sex differences in some biological markers for depression are reported as well. Their relevance to the underlying pathophysiology of depression is unclear but they may provide clues for further research.

Affective disorder in the families of women with normal weight bulimia.

The authors determined the lifetime prevalence of affective disorder in the first- and second-degree relatives, excluding children, of 27 bulimic women who had never had anorexia nervosa and 27 women with no history of an eating disorder. Family diagnoses were made blind to the proband's diagnosis. The prevalence of affective disorder was 9% in the relatives of the bulimic probands and 10% in the relatives of the control probands, a nonsignificant difference. These findings are in contrast to reports of an increased prevalence of affective disorder in the relatives of patients with anorexia nervosa.

Depression in Children with Speech, Language, and Learning Disorders

Abstract This paper reports on the prevalence of affective disorders in a sample of children presenting to a community clinic for speech or language evaluation. It was found that, among 600 children studied, 4% had some type of affective disorder, according to DSM-HJ diagnostic criteria. The children with affective disorders were generally not typical of the children presenting for speech and language evaluation: they tended to be older on the average, to have more psychiatric disorders, and to have more learning disorders than the “typical” child presenting for speech/language evaluation. The relationships between affective disorders, learning disorders, and speech/language disorders are discussed.

Assortative mating for major affective disorder

The families of 26 married bipolar manic depressives were examined in detail. The rate of affective disorder in their spouses, and the parents and siblings of their spouses, was ascertained. The prevalence of affective disorder among the parents and siblings and of the spouses of age- and social class-matched schizophrenics and well controls was also ascertained. Finally, the prevalence of affective and other psychiatric disorders in the adult offspring of the bipolar probands was ascertained and related to the presence or absence of affective disorder in the spouse. We did not find clear evidence of assortative mating for major affective disorder, although dual mating for affective disorder had the expected result of increasing the risk for affective disorder in the adult offspring.

Prevalence of affective disorder in a sample of young men.

To evaluate the prevalence of depression among young men and the relationship between affective disturbances and drug- or alcohol-use patterns, the author mailed a questionnaire to male students and nonacademic staff, aged 21-25 years, at the University of California, San Diego. Of the 964 men responding, 173 (18%) reported a history of depression, including 69 (7%) whose depressions were serious enough to result in a major life upset. The 318 respondents with some alcohol- or drug- related life impairment (33%) were unevenly distributed among the three depressive history groups, with 44% to 48% of those with depressions also reporting substance problems while the same was true for only 30% of the depression-free men. The author advises clinicians to consider the possibility that a depressive disturbance in young populations may occur in relation to substance intake.

Transmitted factors in the morbid risk of affective disorders: A controlled study

Data on psychiatric disorders were collected on first-degree relatives and spouses of 70 patients with primary affective disorder and 75 patients admitted to a general hospital without psychiatric disorder, from the Jewish population of Jerusalem, Israel. Bipolar patients tended to have more bipolar relatives than unipolar patients, but unipolar patients had an observable morbid risk for bipolar disorder in their relatives. Ethnicity and age of onset did not appear to be related to transmissible factors in the prevalence of affective disorders in relatives, although age of onset was associated with morbid risk. Sex-linkage or genetic liability to affective disorder related to sex did not appear to be present. A spectrum of related disorders for this population was defined by those disorders which were more prevalent in relatives of affective disorder patients than in relatives of controls. Assortative mating was not found, but a modest degree of inbreeding appeared to be present. For purposes of testing liability-threshold models for genetic factors in the transmission of mood disorders, only the data on polarity seems suitable.

Affective disorder: VI. A family history study of prevalences, sex differences and possible genetic factors

1. 1.|This is a study of the family histories of 748 consecutive admissions to a psychiatric hospital and 250 stratified controls from a general hospital ill population. A sub-group of 366 affectively disordered patients in particular was studied. A systematic interview was used. 2. 2.|Prevalence of affective disorder in parents of a non-psychiatric hospital population was 2 ±0.62 per cent. 3. 3.|Psychiatric patients with a diagnosis other than that of an affective disorder exhibited a higher frequency of parental affective disorder than would have been expected from the data of our control population. 4. 4.|These non-affective disorder patients with a parental history of affective disorder showed a loading toward alcoholism and personality disorder. 5. 5.|Compared to parents of controls who had no psychiatric illness, parents of affectively disordered patients manifested a much higher rate of affective disorder ( p <0·01) and showed five times the prevalence of alcoholism. 6. 6.|Affectively disordered patients with a parental history of affective disorder showed a higher percentage of affectively disordered siblings than did a group of similar patients without a parental history. 7. 7.|Affective disorder appears to manifest itself more in females than in males, but both sexes transmit the disorder equally to their children. 8. 8.|Neither a simple dominant gene with complete penetrance hypothesis nor an X borne dominant gene hypothesis is satisfied as a mode of transmission by the data.