Depressive Reactions Research Articles

Acute Stress among Healthcare Staff during a Public Health Emergency in México

The United Nations through the World Health Organization has shown that crises or disasters can have a profound impact on the population’s physical and mental health(World Health Organization, 2003). In 2009 a new strain of the human influenza virus (AH1N1) appeared and reached pandemic levels, initiating an epidemiological alert in Mexico in April of the same year. Its impact was significant because it was a new subtype of the virus, especially for the severity of the symptoms and number of deaths, which required taking security, hygiene and social isolation measures to reduce the risk of contagion. In critical periods, clear, direct, objective and timely information is the most important preventive measure. However, when the available information is inadequate, depressive or anxious emotional reactions and distress may be observed in risk behaviours among the general population. Straus and collaborators (2004) suggested that during an outbreak, limited availability of information about the disease can have a negative impact on healthcare staff. In addition, Maunder (2004) highlights the importance of effective risk communication. In the case of healthcare providers, when they are overwhelmed by the emergency, the capacity and quality of the service provided may be affected.

Psychoactive substance use and general mental health among refugees in a Nigerian camp

Background: Refugees are a vulnerable people. They started coming into Nigeria in the nineties. Studies among them in Nigeria had been limited to depression and post-traumatic stress reaction. Therefore, this study aimed to survey drug abuse and mental health among them.Methods: The study was a cross-sectional survey among the refugee population in one of the refugee camps in Nigeria. Data were elicited with the use of General Health Questionnaire and the Structured Clinical Interview Schedule.Results: The 105 participants had mean age of 26.6 years. They were mostly males (60.9%), single (76.2%), and unemployed (35.2%). The rate of alcohol, tobacco and cannabis use were 24.8%, 15.2% and 6.7 respectively. Age range of 31–40 years was significantly associated with higher rate of alcohol, tobacco and cannabis use. Tobacco use was significantly more prevalent among the males and the unemployed. Use of drugs in the past 30 days was associated with General Health Questionnaire positive screening.Conclusion: Alcohol or drug use is prevalent among the refugees in Nigeria. It is strongly associated with probable mental illness.

Ultrasound-Guided Femoral Nerve Blocks.

Pediatric acute femur fractures are a relatively common major orthopedic injury seen in emergency departments. Providing adequate and safe analgesia is essential while patients await definitive management of these fractures. Opioid medications are typically used to treat fracture-associated pain but have well-known adverse effects including respiratory and central nervous system depression, pruritus, nausea, and allergic reactions. Dose titration of opioids in pediatric patients may be difficult and requires frequent nursing and physician reassessments. Regional anesthesia using ultrasound guidance has been proposed as a reliable and safe method to provide pain relief for this population and to decrease reliance on opioid medications. There is a growing body of literature on the utility and safety of ultrasound-guided femoral nerve blocks for pediatric patients in the acute care setting. This review article covers recent literature on point-of-care ultrasound-guided femoral nerve blocks for pediatric patients, with a discussion of the indications, sonographic anatomy, selection of anesthetics, nerve block technique, and complications. This review supplements the expert supervision and practice required to gain competency.

Resilience and quality of life in chronically ill youth

<b>Background</b><br /> The goal of this article is to present some issues related to the concept of resilience and subjective quality of life of youth. This study was concerned with subjective quality of life, and the variables important for adaptation in the face of stress associated with illness, treatment and hospitalization. The assessment of psychological variables included social skills/competences, sense of self-efficacy, perceived social support, coping strategies, depression and subjective quality of life.<br /> <br /> <b>Participants and procedure</b><br /> The study involved 154 participants (102 girls) aged 11-18, who were hospitalised with chronic illnesses. K-means cluster analysis allowed us to distinguish between three subgroups of youth, which were then compared in terms of the variables of interest.<br /> <br /> <b>Results</b><br /> Among the participants there are well-adapted and resilient individuals, individuals of intermediate levels of adaptation and maladapted individuals (risk subgroup). These subgroups differ significantly in terms of psychosocial variables, coping strategies, depressive symptoms and subjective quality of life. Resilience co-occurs with adaptive coping strategies, low levels of depressive reactions and high quality of life.<br /> <br /> <b>Conclusions</b><br /> Our results suggest the need to appreciate the role of protective factors for health and quality of life, and to facilitate the strengthening of the personal and social resources of less adapted individuals. It is important to take actions to help youths who fall into the risk group, who are vulnerable to abnormal adaptation processes and are at risk of further problems, affecting both their mental and somatic health.

The main clinical and psychopathological phenomena of social phobia and features of its subjective evaluation in students

Aim – to carry out the comparative analysis of features of subjective perception of own psychic state in students depending on presence/absence of the signs of social phobia for detecting the necessity of the further medical and psychological work with this contingent.Contingent. The 120 1-11year students of Vinnitsa national medical University.Methods. Clinical and psychopathological, psychodiagnostic ones with the use of M. Lubovits social anxiety scale, C. D. Spilberg-Y.L. Hanin methodology of diagnostic of self-rating, Zunge methodology of differential diagnostics of depressive states and L. Rider psychosocial stress scale.Results. The main clinic and psychological phenomena of social phobia (SP) in students are: the fear of assessment (critic, blame) of another people in social situations; pronounced constant fear of situations of self-presentation in front of people when the feeling of agitation or humiliation can appear; drive to avoid situations that arouse fear; the high level of pathologic anxiety; the signs of depressive reaction; the high load of psychosocial stress-factors.Among the variants of distortion of interaction between a person with SP and society the next ones are peculiar for students: deformation of relationship “person – micro social environment” as a main factor of social maladjustment – 13,4 %; deformation of relationship “person – meso social environment” as a main factor of social maladjustment – 37,3 %; deformation of relationships “person – general social sphere” as a main factor of social maladjustment – 49,3 %.Conclusions. The described features of subjective evaluation of clinical and psychological SP in students were used as a basis at elaboration of complex program of psychocorrection and psychoprophylaxis of social maladjustment in given contingent

Non-suicidal self-injury among Dutch and Belgian adolescents: Personality, stress and coping

BackgroundThis study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping. MethodsA total of 946 Flemish (46%) and Dutch (54%) non-institutionalized adolescents (Mean age=15.52; SD=1.34, 44% females) were surveyed. Measures included the NSSI subscale of the Self-Harm-Inventory, the Dutch Quick Big Five Personality questionnaire, the Perceived Stress Scale and the Utrecht Coping List for Adolescents. Examination of zero-order correlations was used to reveal associations, and hierarchical regression analysis was used to reveal potential mediators which were further examined within parallel mediation models by using a bootstrapping-corrected procedure. ResultsLifetime prevalence of NSSI was 24.31%. Neuroticism; perceived stress; and distractive, avoidant, depressive, and emotional coping were positively associated with NSSI engagement, whereas Agreeableness, Conscientiousness; and active, social, and optimistic coping were negatively associated with NSSI engagement. Observed relationships between personality traits and NSSI engagement were consistently explained by perceived stress and depressive coping. A higher versatility of NSSI was not associated with any Big Five personality trait, but was associated with higher scores on perceived stress and depressive coping and with lower scores on active and optimistic coping. ConclusionOur study suggests that a specific personality constellation is associated with NSSI engagement via high stress levels and a typical depressive reaction pattern to handle stressful life events.

Patterns of Family Functioning and Parenting Style of Adolescents with Depressive Reactions

This paper examines family functioning from the systemic perspective while endeavoring to point out to the correlation between family functioning, parenting style and depressive reactions of adolescents. The research was conducted with the aim to determine a correlation between patterns of family functioning, parenting style and presence of adolescents’ depressive reactions. A FACES III (Olson, Portner & Levi, 1985) and EMBU (Arrindell, 2005) scales were used in order to determine the patterns of family functioning and parenting style. Two groups of adolescents were examined: 20 adolescents with depressive reactions who had ambulance or hospital treatment at the Clinic for Mental Health Protection in Nis and 20 adolescents who did not have any problems with depressive reactions. The results showed that there are statistically significant differences between these two groups. Statistically significant difference between families of depressed adolescents and adolescents from the control group has been present on the dimension of cohesion (t (38)=2.896, p<0.01) arithmetic mean for cohesiveness in the families of depressed adolescents is 34.35, while for the subjects from the control group is significantly above 41.05, which indicates that closeness, togetherness and a sense of belonging to the family are very important for the development outcomes of adolescents. Mothers of depressed adolescents who have expressed overprotective have low flexibility (r=-0473, p<0.05). Also, low emotional warmth of the mother points to the low flexibility and vice versa (r=0.451, p<0.05). When we talk about the sample of fathers, high rejecting of fathers indicates on low cohesiveness of the family system (r=-0.699, p<0.01), expressed overprotective of fathers also indicates to the low cohesiveness of the family system (r=-0576, p<0.01 level), and it is also associated with the denial of the emotional warmth of fathers toward their children (r=0.762, p<0.01 level). It can be concluded that the potentiation of closeness and togetherness in family functioning, which is promoted as a pattern in culture, have in a certain way, the protective function, as well as the contribution of fathers is very important for the development outcomes of adolescents.

Ambiguous loss. Psychopathological and psychosocial consequences in the context of violent conflicts

Disappearances are a frequent phenomenon in the context of violent conflicts. Although it is widely assumed that relatives of missing people face particularly complex adaptation difficulties due to the uncertainty regarding the fate of their loved ones, little is known about the psychological and social consequences for those left behind. The aim of this article is to provide an empirical overview on studies addressing ambiguous loss in violent conflicts as well as to highlight potential risk factors for negative mental health outcomes relevant in this group. Due to the limited number of studies, only preliminary conclusions can be drawn. Studies show that the disappearance of a loved one can adversely affect mental health in a substantial number of those left behind. Studies indicate that relatives of missing persons suffer from higher psychological distress than bereaved persons with confirmed losses, particularly in terms of symptom severity of depression and prolonged grief reactions. Research on factors contributing to these mental health outcomes suggests an elevated risk for exposure to traumatic events and lack of social support among relatives of missing persons. The extent of hope regarding the fate of the missing loved one might prevent relatives from achieving closure and facilitate prolonged grief reactions. Lack of grief rituals and complex family dynamics may furthermore exacerbate coping with the loss. Future research should focus on the verification of these findings and evaluate the impact of resilience factors that can protect relatives from maladaptive mental health consequences. Research in this regard can help identify persons at high risk and allow the development of adequate and effective interventions.

Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS): Psychometric Testing of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool

Post disaster psychosocial surveillance procedures are important for guiding effective and efficient recovery. The Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS) is a model designed with the goal of assisting recovering communities in understanding the needs of and targeting services toward children and adolescents. As a critical, yet understudied, component to the KIDS model, the objective of this study is to test the psychometric properties of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool for Children and Adolescents. Exploratory factor analysis (EFA) was used to investigate the factor structure of the NCTSN Hurricane Assessment and Referral Tool. The convenience sample included 7530, 9–18 years old students who completed the school initiated screener in Southeastern Louisiana schools from December 2005 to December 2006. On a small treatment seeking population (N = 62), associations among the referral tool and the PTSD Reaction Index were also explored. EFA of the referral tool revealed a two factor solution, anxious and depressive reactions, that accounted for 45.8 % of model variance. Internal consistency was high and symptom scores were moderately associated with the PTSD Reaction Index. The cutoff score was also confirmed with scores ≥4 suggesting the need for referral. This study allows for the recommendation of the NCTSN Hurricane Assessment and Referral Tool as a reliable and valid part of the KIDS model; together they provide an initial step toward addressing the needs of child and adolescent disaster survivors.

Personality, negative affect coping, and drinking alone: a structural equation modeling approach to examine correlates of adolescent solitary drinking.

This study examined the personality traits of negative emotionality and constraint and the ability to resist drinking during negative affective states as correlates of solitary drinking in adolescence. We hypothesized that higher levels of negative emotionality and lower levels of constraint would predict solitary drinking and that these relationships would be mediated by the ability to resist drinking in response to negative emotions. Structural equation modeling was used to fit a path model from the personality traits of negative emotionality and constraint to solitary drinking status through intermediate effects on the ability to resist drinking during negative emotions using cross-sectional data. Clinical and community settings in Pennsylvania, USA. The sample included 761 adolescent drinkers (mean age = 17.1). Adolescents completed the Lifetime Drinking History, the Multidimensional Personality Questionnaire, the Constructive Thinking Inventory and the Situational Confidence Questionnaire. The path model provided a good fit to the data. The association between trait negative emotionality and solitary drinking was fully mediated by adolescents' ability to resist drinking during negative affective states (b = 0.05, P = 0.01). In contrast, constraint had a direct effect on solitary drinking (odds ratio (OR) = 0.79, b = -0.23, P<0.01), as well as an indirect effect through the ability to resist drinking during negative affective states (b = -0.03, P = 0.02). The ability to resist drinking while experiencing negative feelings or emotions may be an important underlying mechanism linking trait negative emotionality (a tendency toward depression, anxiety and poor reaction to stress) and constraint (lack of impulsiveness) to adolescent solitary drinking.

Peculiarities of the Compliance in Male Patients with Depressive Disorders

Objectives The problem of prevalence and medical-social consequences of depressions stipulates for necessity of improvement of diagnosis and efficacy of therapy for such patients. In this aspect an important role belongs to adherence to the therapy which provides both cure and preventive influence of pharmacotherapy. Aim The aim of the study was to investigate medication compliance in male patients with depression. Methods The clinical-psychopathological method, the investigation of the compliance level and type, statistical methods were used. In the study 117 male patients with depressive disorders (62 with F43.21 and 55 with F32.0, F32.1) were examined. The control group consisted of 98 female patients (51 with F43.21 and 47 with F32.0, F32.1). Results It was demonstrated that male patients had a complete compliance in 25.6%, a partial compliance in 36.8%, and a poor compliance in 37.6% of cases. In male patients with depression a passive compliance type prevailed in 28.3% and a formal compliance type prevailed in 24.8% of cases. Wherein a formal compliance type predominated in male patients with depressive reaction F43.21 (32.2%) and a passive compliance type predominated in male patients with depressive episode F32.1 (41.48%). As compared with the control group, a statistically significant predominance of partial and poor compliances was detected in the group of male patients with depressions. Conclusions These data suggest that derelictions of adherence to the therapy occur more often in male patients with depressions than in female patients. It determines a necessity of measures to improve the compliance.

A Fresh Look at the Potential Mechanisms of Progressive Muscle Relaxation Therapy on Depression in Female Patients With Multiple Sclerosis.

Background:According to the World Health Organization (WHO) report released in 2000, about 121 million people worldwide suffer from depression. The major depressive disorder (MDD) among multiple sclerosis (MS) patients is one of the most common mood disorders experienced during life. MS patients who simultaneously suffer from depression have reported more severe symptoms of disease and slower adaptation to new conditions, which ultimately increase the cost of treatment.Objectives:The aim of this study was to assess the effectiveness of progressive muscle relaxation therapy (PMRT) as an adjunctive therapy for reducing level of depression for MS patients.Materials and Methods:This research had the randomized controlled trial design with pre and posttest. Thirty female patients based on criteria of MS and MDD disease, were selected from the MS Society of Shiraz, Iran. Beck Depression Inventory (BDI-II) was administered at pre and posttest. The participants were randomly allocated to two groups (experimental and control). Twelve sessions of PMRT using Bernstein and Borkovec’s method were held for the experimental group. Levin’s test, covariance and ANOVA with repeated measures were used for data analysis.Results:Experimental and control groups were compared before and after treatment. Analysis of covariance showed that seven levels of depression decreased in the experimental group and analysis of repeated measure showed that 49% of the changes were related to PMRT.Conclusion:According to the results, PMRT is effective in reducing depression. This therapy enables patients to reach relaxation quickly, and thus can cope with depression reactions effectively.

Clinical value of preventive analgesia in patients with radical gastrectomy for gastric cancer: a prospective study

Objective To investigate the clinical value of preventive analgesia in patients with radical gastrectomy for gastric cancer. Methods The clinical data of 161 patients undergoing radical gastrectomy for gastric cancer at the Xijing Hospital from July 2012 to June 2013 were prospectively analyzed. A single-blind, randomized, controlled study was performed in the eligibe patients who were randomly divided into the preventive analgesia group and the control group based on a random number table. All the patients received major gastrectomy + Billroth Ⅱ anastomy or total gastrectomy + esophagojejunastomy, and then they received vein combined anesthesia and tracheal intubation. In the preventive analgesia group, 10 mg dexamethasone and 40 mg parecoxib were administered by intravenous infusion before operation, 7-8 mL ropivacaine (0. 5% ) were injected at the incisional site and transversus abdominis infiltration at open and close surgery and celecoxib was taken orally for 3 days. In the control group, vein analgesia pump was used after operation. The visual analogue scale (VAS), proportion of patients with postoperative out-off-bed activity time >8 hours, time of flatus, time of defecation and duration of hospital stay were recorded between the 2 groups. The measurement data with normal distribution were presented as ±s.The comparison between groups was evaluated with the t test and repeated measures ANOVA. The data with skew distrubution and ordinal data were analyzed by the analysis of variance, and the count data were analyzed using the chi-square test. Results All the 161 patients who were screened for eligibility were randomly divided into the preventive analgesia group (87 patients) and the control group (74 patients). The scores of the VAS at postoperative day 1, 2 and 3 were 2.8±0.6, 2.6±0.4 and 1.8±0.4 in the preventive analgesia group, and 5.3±0.5, 4.2±0.6 and 2.4±0.3 in the control group, with a significant difference between the 2 groups (F = 4. 25, P 8 hours at postoperative day 1, 2 and 3 were 8, 17 and 20 in the preventive analgesia group, and 0, 3 and 11 in the control group, with a significant difference between the 2 groups (χ2=7. 60, 10. 26, 3. 16, P <0.05). The time of flatus, time of defecation and duration of hospital stay were (51±24) hours, (61±24) hours and (5.5±3.0) days in the preventive analgesia group, compared with (71±23) hours, (83±30) hours and (6.3±2.1) days in the control group, showing a significant difference between the 2 groups (t =5. 32, 5. 04, 0. 17, P <0.05). All the patients in the 2 groups normally survived after surgery without respiratory depression, incision infection and adverse drug reaction. Conclusions Preventive analgesia in the perioperative treatment of patients with radical gastrectomy for gastric cancer could relieve the postoperative pain of patients, improve the bowel function and enhance the recovery of patients. Registry This study was registered with the Chinese Clinical Trial Registry with the registry number of ChiCTR-TRC-11001440. Key words: Gastric neoplasms; Enhanced recovery after surgery; Preventive analgesia; Gastrectomy

Effects of chronic interpersonal stress exposure on depressive symptoms are moderated by genetic variation at IL6 and IL1β in youth.

AimsClose to one third of patients with major depression show increases in pro-inflammatory cytokines, which are in turn associated with risk for inflammatory disease. Genetic variants that enhance immune reactivity may thus enhance inflammatory and depressive reactions to stress. The aim of the present study was to investigate a trio of functional SNPs in the promoter regions of IL6 (-174G>C, rs1800795), IL1β (-511C>T, rs16944), and TNF (-308G>A, rs1800629) as moderators of the relationship between chronic stress exposure and elevations in depressive symptoms.MethodsParticipants were 444 Australian youth (mean age = 20.12) whose exposure to chronic stress in the past 6 months was assessed using the semi-structured UCLA Life Stress Interview, and who completed the Beck Depression Inventory II at ages 15 and 20. Between ages 22 and 25, all participants in the selected sample provided blood samples for genotyping.ResultsIn line with a hypothesized moderation effect, -174G allele carriers at IL6 had fewer depressive symptoms following interpersonal stress, relative to C/C homozygotes with equal interpersonal stress exposure. However, IL6 genotype did not moderate the effects of non-interpersonal stress exposure (i.e., financial, work and health-related difficulties) on depression. Also in line with hypotheses, the -511C allele in IL1β, previously associated with higher IL-1β expression, was associated with more severe depression following chronic interpersonal stress exposure, relative to T/T homozygotes. Again, the moderating effect was specific to interpersonal stressors and did not generalize to non-interpersonal stress. TNF was not a moderator of the effects of either interpersonal or non-interpersonal stress on later depression outcomes.ConclusionFindings were consistent with the hypothesis that pro-inflammatory genetic variation increases the risk of stress-induced depression. The present results provide evidence of a genetic mechanism contributing to individual differences in depressive symptomatology following interpersonal stress exposure.

Effect of midazolam and butorphanol premedication on inhalant isoflurane anesthesia in mice.

Isoflurane is a representative inhalant anesthesia used in laboratory animals. However, isoflurane mediates respiratory depression and adverse clinical reactions during induction. In the present study, we established a novel balanced anesthesia method in mice that combined isoflurane anesthesia with midazolam and butorphanol (MB). Thirty-four male C57BL/6J mice received either isoflurane alone or isoflurane with an intra-peritoneal MB premedication (3 mg/kg midazolam and 4 mg/kg butorphanol). The minimum alveolar concentration (MAC) in each group was evaluated. Induction time and adverse clinical reactions were recorded in each group. Core body temperature, heart rate, respiratory rate, and oxygen saturation (SPO2) were assessed before and for 1 h after induction. Premedication with MB achieved a significant reduction in MAC compared with isoflurane monoanesthesia (isoflurane, 1.38 ± 0.15%; isoflurane with MB, 0.78 ± 0.10%; P<0.05). Induction time was significantly shortened with MB premedication, and adverse reactions such as excitement or incontinence were observed less frequently. Furthermore, isoflurane anesthesia with MB premedication caused increase of respiratory rates compared to isoflurane monoanesthesia. No significant decrease of SPO2 was observed in MBI anesthesia, while a decrease in SPO2 was apparent with isoflurane monoanesthesia (baseline, 98.3% ± 1.1; 10 min after induction, 91.8 ± 6.4%; P<0.05). In conclusion, premedication with MB was effective for the mitigation of respiratory depression induced by isoflurane in mice, with rapid induction and fewer adverse clinical reactions.

고 자외선 환경에서 식물의 광합성, 기공조절 및 탄수화물 합성

The ozone depletion has caused plants to be exposed to an increased penetration of solar ultraviolet-B (UV-B) radiation. Enhanced UV-B radiation may have influence on biological functions of plant in many aspects including inhibition of photosynthesis. It is evident that UV-B can potentially impair the performance of all three main component processes of photosynthesis, the photophosphorylation reactions of the thylakoid membrane, the CO2-fixation reactions of the Calvin cycle and stomatal control of CO2 supply. Owing to these depressed reactions, the production and allocation of carbohydrates might be markedly affected, and therefore, the growth and development of plant are distinctly reduced. In this review paper, we provide basic theory and further researches in terms of photosynthesis and carbohydrate synthesis in response to elevated UV-B radiation.

Quality of life and occurrence of depression under chemotherapy in patients suffering from lung carcinoma.

In Poland, lung carcinoma is the most frequent malignant neoplasm in men and the third most frequent in women. The neoplastic disease causes enormous psychic stress and may lead to depressive reactions. The purpose of this research was to assess the quality of life and the occurrence of depression in patients suffering from lung neoplasms and undergoing chemotherapy. The research covered 102 patients (test group TG) with lung carcinoma and undergoing chemotherapy. In the research, standardised questionnaires: EORTC-QLQ-C30, Beck Depression Inventory and a matrix developed by the researcher were applied. The control group (CG) consisted of 60 healthy people who were examined by the Beck Depression Inventory. A highly statistically significant dependency was found (p<0.01) between the general quality of life and the occurrence of depression. 51.5% of those examined with a very low level of general quality of life had the symptoms of severe depression. Those examined who had a very high level of general quality of life did not have features of severe depression. A statistically significant dependency (p<0.01) was ascertained between the occurrence of depression and the health condition of those examined. Depression symptoms occur more frequently and with greater intensity in patients suffering from lung neoplasm, compared to the group of healthy people (p<0.01). A statistically significant connection between marital status, place of residence, and assessment of quality of life was found out (p<0.05).

Evaluation of Computerized Adaptive Tests (CATs) for longitudinal monitoring of depression, anxiety, and stress reactions

BackgroundComputerized adaptive testing (CAT) based on Item Response Theory, (IRT) offers an efficient way for accurate measurement of patient reported outcomes. The efficiency lies within a minimal response burden and a high measurement precision over a broad measurement range. The objective of the study was to evaluate and compare the responsiveness of CATs measuring anxiety, depression, and stress reaction to standard static self-assessment tools. MethodsLongitudinal data of n=595 psychosomatic inpatients were analyzed for evaluating retest-reliability and sensitivity to change of the CATs compared to static measures (GAD-7, PHQ-9, and PSQ) using correlational and ANOVA statistics. The study hypothesized that CATs are at least as retest-reliable and as sensitive to change as static tools. ResultsThe three CATs show a low burden for patients, administering on average 5–7 (±2–6SD) items with similar retest-reliability compared to the static tools applied (A-CAT: r=.78 vs. GAD-7: r=.75, D-CAT: r=.71 vs. PHQ-9: r=.75, S-CAT: r=.80 vs. PSQworries scale: r=.80). The CATs were overall as sensitive to change as the static tools (Cohen׳s d ranged between .19 and .69). LimitationsThis is a monocenter, observational, longitudinal study without external clinical criteria; thus generalization to other settings may be limited. ConclusionsThe tested CATs belong to the first generation of CATs being used in daily routine for more than a decade. They are as retest reliable and sensitive to change as static tools. Newer CATs may provide further practical advantages.

Sensitizing effect of early adversity on depressive reactions to later proximal stress: Moderation by polymorphisms in serotonin transporter and corticotropin releasing hormone receptor genes in a 20-year longitudinal study.

Previous research supports gene-environment interactions for polymorphisms in the corticotropin hormone receptor 1 gene (CRHR1) and the serotonin transporter gene linked polymorphic region (5-HTTLPR) in predicting depression, but it has rarely considered genetic influences on stress sensitization processes, whereby early adversities (EA) increase depressive reactivity to proximal stressors later in life. The current study tested a gene-environment-environment interaction (G × E × E; specifically, gene-EA-proximal stress interaction) model of depression in a 20-year longitudinal study. Participants were assessed prospectively for EA up to age 5 and recent chronic stress and depressive symptoms at age 20 and genotyped for CRHR1 single nucleotide polymorphism rs110402 and 5-HTTLPR. EA predicted stronger associations between recent chronic stress and depression, and the effect was moderated by genes. CRHR1 A alleles and 5-HTTLPR short alleles were associated with greater stress sensitization (i.e., greater depressive reactivity to chronic stress for those also exposed to high levels of EA). The results are consistent with the notion that EA exposure results in neurobiological and cognitive-emotional consequences (e.g., altered hypothalamic-pituitary-adrenal axis functioning), leading to emotional distress in the face of recent stressors among those with certain genetic characteristics, although further research is needed to explore explanatory mechanisms.

Prevalence and risk factors for depressive reaction among resident survivors after the tsunami following the Great East Japan Earthquake, March 11, 2011.

ObjectivesThe Great East Japan Earthquake caused a gigantic tsunami which devastated coastal areas of northern Japan on 11 March 2011. Despite the large number of ‘resident survivors’ who continued to reside in their damaged houses on the second or upper floors, research on the mental health of these individuals has been limited. This study explored the prevalence of depressive reaction and risk factors for depressive reaction among these resident survivors.MethodsA cross-sectional household health support needs screening was conducted for resident survivors in Higashi-Matsushima city, Miyagi prefecture, two to four months after the tsunami. The health interview that was conducted including mental status, assessed by the Patient Health Questionnaire-2 (PHQ-2).ResultsOf 5,454 respondents, 8.1% had depressive reaction. After adjustment by the number of weeks from the tsunami and the mortality rate at each respondent's place of residence, depressive reaction was significantly associated with house flooding below or above the ground floor (odds ratios of 1.92, 2.36, respectively), the unavailability of gas supply (odds ratio, 1.67), being female (odds ratio, 1.47), middle aged or elderly (odds ratios of 2.41, 2.42, respectively), regular intake of psychotropic medicine(s) since before the tsunami (odds ratio, 2.53) and the presence of one to five or more than six cohabiters (odds ratios of 0.61, 0.52, respectively).ConclusionsThe results suggest a considerable psychological burden (depressive reaction) following the tsunami among resident survivors. Special supports for families with psychiatric problems need to be considered among resident survivors. Restoration of lifeline utilities and the strengthening of social ties of persons living alone may help prevent depressive reaction among resident survivors after a tsunami.