Risk Factors For Depressive Symptomatology Research Articles

Subjective well-being’s alterations as risk factors for major depressive disorder during the perimenopause onset: an analytical cross-sectional study amongst Mexican women residing in Guadalajara, Jalisco

BackgroundSubjective well-being (SWB) can be defined as a self-report evaluation that reflects the satisfaction, and emotional level, over several social and personal indicators. Alterations in these indicators could become risk factors (RF) for major depressive disorder (MDD), but this association has not been studied at women’s life stages such as the perimenopause onset, despite its increasing prevalence for depressive symptomatology. Therefore, the aim of this study was to identify if SWB’s alterations determine RF for MDD during the perimenopause.MethodsAn analytical cross-sectional study was realized in 252 Mexican women with perimenopause’s age range (48 ± 1.7) and menopausal symptomatology, treated on Medical Units belonging to Jalisco’s 13th Health-Region. We applied the INEGI’s Basic Self-Reported Wellbeing Survey (BIARE) that measured 30 SWB’s indicators. To identify MDD’s presence, the Beck’s Depression Inventory-II (BDI-II) was applied. The sample was studied with associative analysis, along with logistic regression models, to determine adjusted odds ratio (aOR) and corresponding 95% confidence interval (95% CI).ResultsTrough the BDI-II we identified 40.5% women with MDD. When compared with the undepressed group we found lower scores in all the SWB’s indicators, along with significant associations for depressive symptomatology. However, the logistic regression allowed us to identify significant RF when the women specifically reported personal life-dissatisfaction (aOR 9.6, 95% CI 1.90–17.68), emotional imbalances between happiness/sadness (aOR 7.1, 95% CI 1.49–13.57) and concentration/boredom (aOR 6.7, 95% CI 1.43–13.48); free-time dissatisfaction (aOR 5.5, 95% CI 1.17–5.70), public security unconformity (aOR 5.4, 95% CI 2.20–11.3), and sense of purposelessness (aOR 4.2, 95% CI 1.07–19.41).ConclusionThe main objective of the study was to determine if SWB’s alterations are RF for depressive symptomatology, finding that social indicators with low scores are associated with MDD by means of aOR -Which were higher when compared to international research studies. Considering this, we suggest that more studies should be implemented, in order to understand and correctly attend the women’s social conditions during their perimenopause transition.

Recreational Screen Time Activities and Depressive Symptomatology Among Adolescents: the Moderating Role of Interpersonal Factors and Gender

The purpose of the study was to examine the moderating role of attachment style, coping style, and perceived social support in the relationship between daily recreational screen time and depressive symptomatology over time. Complete data from 170 adolescents (106 females) from a larger research study were included at each time point. The mean age at baseline was 13.21 years (SD = 1.06) for females and 12.67 years (SD = 0.64) for males. Data related to depressive symptomatology (Children’s Depression Inventory), attachment style (Adolescent Relationship Questionnaire), coping style (Coping Inventory for Stressful Situation), perceived social support (McKnight Risk Factor Survey-IV), recreational screen time activities, and sociodemographic information were analyzed. Hierarchical linear regression models showed that daily recreational screen time at baseline (T0) predicted depressive symptomatology at T4 (4-year follow-up) (B = 0.49, p < .001), but attachment style, coping style, and perceived social support at baseline (T0) did not moderate this relationship. However, a significant three-way interaction emerged. Among adolescents who reported receiving high levels of perceived social support, higher daily recreational screen time was associated with higher levels of depressive symptomatology over time (Β = 2.29, p < .05) and this relationship was stronger for males. A significant two-way interaction emerged between gender and attachment style (B = − 4.98, p < .05), with insecure attachment style as a risk factor for depressive symptomatology over time, for males. Findings highlight the importance of considering gender and interpersonal factors in gaining a better understanding of how recreational screen time may influence depressive symptomatology among adolescents.

Sintomatología depresiva, estrés y funcionamiento familiar en madres adultas del norte de México

El objetivo de este estudio fue determinar la prevalencia de la sintomatología depresiva y analizar su relación con el estrés percibido y el funcionamiento familiar en una muestra de madres adultas del norte de México. Se realizó un estudio observacional analítico de corte transversal en una muestra de 118 mujeres residentes en la Zona Metropolitana de la Laguna (ZMLL), México. Para evaluar la sintomatología depresiva se utilizó el Inventario de Depresión de Beck (BDI, por sus siglas en inglés); para el estrés percibido se empleó la Escala de Estrés Percibido; y el funcionamiento familiar se evaluó mediante la Escala de Relaciones Intrafamiliares. Se utilizó el coeficiente r de Pearson para determinar el nivel de correlación entre las variables y regresión logística binomial para determinar los factores de riesgo para sintomatología depresiva en los grupos de participantes, formados de acuerdo a la edad. Los resultados indican una prevalencia del 12.7% de sintomatología depresiva clínicamente relevante, estableciendo un riesgo ocho veces mayor de presentar sintomatología depresiva para las participantes menores de 30 años que refieren niveles bajos de funcionamiento familiar (RM= 9.60, IC 95%= 1.1-84.5). Para las participantes mayores de 30 años se determinó un riesgo 15 veces mayor de presentar sintomatología depresiva, si presentan estrés percibido elevado (RM = 16.65, IC 95% = 2.7-101.3). Los factores de riesgo para presentar sintomatología depresiva varían de acuerdo a la edad de la mujer. Esto hace indispensable instrumentar medidas que amplíen la cobertura preventiva, privilegiando modelos comunitarios, sobre todo en los grupos más vulnerables.

Latent toxoplasmosis aggravates anxiety- and depressive-like behaviour and suggest a role of gene-environment interactions in the behavioural response to the parasite.

Toxoplasma gondii (TOX) is an intracellular parasite which infects warm-blooded animals including humans. An increasing number of clinical studies now hypothesize that latent toxoplasmosis may be a risk factor for the development of psychiatric disease. For depression, the results have been varied and we speculate that genetic background is important for the response to latent toxoplasmosis. The main objective of this study was to elucidate gene - environment interactions in the behavioural response to TOX infection by use of genetically vulnerable animals (Flinders sensitive line, FSL) compared to control animals (Flinders resistant line, FRL). Our results show that all infected animals displayed increased anxiety-like behaviour whereas only genetically vulnerable animals (FSL rats) showed depressive-like behaviour as a consequence of the TOX infection. Furthermore, peripheral cytokine expression was increased following the infection, primarily independent of strain. In the given study 14 cytokines, chemokines, metabolic hormones, and growth factors were quantified with the bead-based Luminex200 system, however, only IL-1α expression was affected differently in FSL animals compared to FRL rats. These results suggest that latent TOX infection can induce anxiety-like behaviour independent of genetic background. Intriguingly, we also report that for depressive-like behaviour only the vulnerable rat strain is affected. This could explain the discrepancy in the literature as to whether TOX infection is a risk factor for depressive symptomatology. We propose that the low grade inflammation caused by the chronic infection is related to the development of behavioural symptoms.

Emotion regulation during adolescence: Antecedent or outcome of depressive symptomology?

Consistently, moderate to strong correlations between emotion regulation and depressive symptomology are well documented. This relationship is most often conceptualized as unidirectional, in that poor emotion regulation acts as a pre-existing risk factor for depressive symptomatology. However, explicit examinations of the direction of this relationship have been limited, and support for a directional relation between emotion regulation and psychopathology has been inconsistent. Moreover, the majority of the research exploring these associations relies on adult participants and the studies that have examined emotion regulation and depression in adolescents have relied almost exclusively on cross-sectional data. As a replication and extension of work that has been done by others, the current study assessed Suppression and Reappraisal use and Depressive Symptoms in 1343 adolescents (Mean age = 12.9 years, SD = 0.85) who completed assessments of emotion regulation and depressive symptoms four times over two years. Results indicated that only Suppression but not Reappraisal was concurrently correlated with Depressive Symptoms. Moreover, a correlated slopes analysis showed that within-subject changes in use of Suppression, but not Reappraisal, were associated with within-subject changes in Depressive Symptoms over time. Finally, a cross-lag panel analysis showed that while Depressive Symptoms were predictive of future Suppression use, Suppression use did not predict later Depressive Symptoms. Therefore, while Suppression and Depressive Symptoms seem to be associated during adolescence, associations between reappraisal and depressive symptomology were not present in the current study. Moreover, despite previous evidence supporting emotion regulation as a risk factor for depression, suppression may be the outcome, rather than the antecedent, of depressive symptoms during adolescence.

Body image mediates the effect of cancer-related stigmatization on depression: A new target for intervention.

Because cancer-related stigmatization is prevalent but difficult to change, research on its impact on psychological burden and respective intervening variables is needed. Therefore, we investigated the effect of stigmatization on depressive symptomatology and whether body image mediates this relationship. This bicentric study assessed patients of 4 major tumor entities. We measured stigmatization (SIS-D), depressive symptomatology (PHQ-9), and body image (FKB-20). Applying multiple mediator analyses, we calculated the total effect of stigmatization on depressive symptomatology and the indirect effects exerted via the 2 body image scales rejecting body evaluation and vital body dynamics. Among the 858 cancer patients recruited (breast: n=297; prostate: n=268; colorectal: n=168; lung: n=125), stigmatization showed total effects on depressive symptomatology across all stigma dimensions (all ptotal sample <.001). Except for lung cancer patients, this result was replicated for each cancer group. Body image as a whole was shown to mediate the effect across all samples (γtotal sample =.04, 95%-CI: 0.03-0.06). Among the total sample and prostate cancer patients, the mediating effect of rejecting body evaluation was significantly larger than the effect of vital body dynamics (dtotal sample =.02, 95%-CI: 0.01-0.04). Perceived stigmatization is an important and generalizable risk factor for depressive symptomatology among cancer patients. Apart from interventions addressing stigmatization, improving body image could additionally help to reduce the psychological burden in stigmatized patients.

Risk Factors for Depressive Symptomatology among Higher Education Students

Higher education students experience high rates of mental health problems, and depression is one of the most common mental illnesses referred. The identification of modifiable risk factors for the development of depressive symptomatology is crucial. The current study was designed to examine the associations among vulnerability to stress, pessimism, dysfunctional attitudes and personality with depressive symptomatology in a sample of higher education students. A total of 257 higher education students completed an online questionnaire, which assessed: depressive symptomatology (BDI-II; Beck, Steer, & Brown, 1996), vulnerability to stress (QVS; Vaz Serra, 2000), pessimism (LOTR; Scheier, Carver, & Bridges, 1994), dysfunctional attitudes (DAS; Weissman & Beck, 1978) and personality (NEO-FFI; Mccrae & Costa, 2004). The main results indicated that vulnerability to stress, pessimism, dysfunctional attitudes and neuroticism were positively associated with depressive symptomatology. Multiple regression analysis was used to test if the vulnerability to stress, neuroticism and pessimism predicted participants’ ratings of depressive symptomatology. The results of the regression indicated the three predictors explained 58% of the variance (R2 = .58, F (3, 226) = 103.98, p < .001). Vulnerability to stress (b = .28, p < .001) and neuroticism (b = .54, p < .001) are significantly predicted by depressive symptomatology. Findings suggested that the risk factors considered, particularly vulnerability to stress and neuroticism, may be crucial to the comprehension of vulnerability to depressive symptomatology among higher education students. Implications of these results on future prevention programs are discussed.

A Closer Look at Self-Esteem, Perceived Social Support, and Coping Strategy: A Prospective Study of Depressive Symptomatology Across the Transition to College

The first year of college is a significant life transition, which is often characterized by stress and may contribute to the development or exacerbation of depressive symptoms. Due to the considerable negative outcomes that are associated with depressive symptoms across the lifespan, it is important to understand the mechanisms and pathways through which depressive symptoms arise. This prospective study examines the mediating and moderating roles of perceived social support and disengagement coping on the association between self-esteem and depressive symptomatology in a sample of 1,118 first-year college students. Results of longitudinal cross-lagged path analyses indicate that self-esteem predicts depressive symptomatology via perceived social support and disengagement coping. The association between self-esteem and perceived social support appear to be bidirectional, in that level of self-esteem predicts perceived social support, and vice versa. Furthermore, disengagement coping was found to moderate the effect of self-esteem on depressive symptomatology, in that increased levels of disengagement coping led to greater depressive symptoms within the context of both high and low self-esteem. However, this pattern was not observed at lower levels of disengagement coping, which indicates high levels of disengagement coping as a particular risk factor for depressive symptomatology, diminishing the advantage of high self-esteem.

P03-509 - The role of perfectionism in perinatal depression (ICD-10, DSM-IV and BDI-II, PDSS)

AimsThe role of perfectionism as a correlate of perinatal depressive symptomatology, and as a predictor of postpartum depressive disorder was examined.Methods386 women in their third trimester of pregnancy (mean age = 30.08 years; SD = 4.205; range = 19–44) completed the Portuguese versions of Multidimensional Perfectionism Scale, Beck Depression Inventory-II/BDI-II, Postpartum Depression Screening Scale/PDSS and three additional questions evaluating anxiety trait, life stress perception and social support. Diagnoses of depression (ICD-10/DSM-IV) were obtained using the Portuguese version of the Diagnostic Interview for Genetic Studies/OPCRIT system. Women who were clinically depressed in pregnancy (ICD-10/DSM-IV) were excluded from the analysis.ResultsSelf-Oriented Perfectionism/SOP and Socially Prescribed Perfectionism/SPP subcomponents were significant correlates of depressive symptomatology (BDI-II/PDSS) in pregnancy. SPP-Others High Standards/OHS was a significant predictor of postpartum depressive symptomatology (BDI-II/PDSS), and SPP-Conditional Acceptance/CA was a predictor of postpartum depressive symptomatology (PDSS). None of the perfectionism subscales predicted postpartum depressive disorder (ICD-10/DSM-IV).ConclusionsSOP and SPP have shown to be relevant correlates of depressive symptomatology in pregnancy. In the present study, SPP-OHS and SPP-CA were also significant correlates of perinatal depressive symptomatology, as well as important risk factors for depressive symptomatology in postpartum. Perfectionism subscales were not significant predictors of postpartum depressive disorder (ICD-10/DSM-IV). While SPP maladaptive influence was supported, SOP was shown to be more heterogeneous in its consequences. These findings may have important implications both for clinical practice and for research.

Depressive Symptomatology in High School Students: The Role of Age, Gender and Academic Pressure

To clarify the prevalence of depressive symptomatology in high school students in Athens and to evaluate risk factors for depressive symptomatology the CES-D scale was administered to 713 students (age 15-18). Demographic, school performance and extracurricular activities data were collected. A high prevalence (26.2%) of depressive symptomatology (CES-D cut-off score >28) was found. Regression analysis showed depressive symptomatology to be associated to gender (girls had higher scores than boys), school record (students with a better record had lower scores) and the interaction of gender and grade (males were found to have higher depressive symptomatology scores as they grew older).

Brief report: Effect of menarcheal status and family structure on depressive symptoms and emotional/behavioural problems in young adolescent girls

The study investigated the relationship between depressive symptoms and emotional/behavioural problems in adolescent girls ( N = 553 ) aged 12–13 years, menarcheal status and family structure, and considered whether the effect of family structure was the same in the presence or absence of menses. The Children's Depression Inventory (CDI) and the Strengths and Difficulties Questionnaire (SDQ) were administered to a representative sample of adolescents. Results showed main effects of menarcheal status and family structure on SDQ scores and a significant interaction on CDI scores only. A non-intact family appeared to be a stronger risk factor for depressive symptomatology than for emotional/behavioural problems in menarcheal girls.

Supplemental private health insurance and depressive symptoms in older married couples.

Stress process theory is applied to examine lack of supplemental private health insurance as a risk factor for depressive symptomatology among older married couples covered by Medicare. Dyadic data from 130 African-American couples and 1,429 White couples in the 1993 Asset and Health Dynamics Among the Oldest-Old Survey were analyzed using hierarchical generalized linear modeling. Lack of supplemental insurance is operationalized at the household level in terms of neither spouse covered, one spouse covered, or both spouses covered. Controlling for covariates at both individual and couple levels, supplemental insurance has significant impact on depression, but the pattern differs by race. White couples report the highest depression when neither spouse is covered by private health insurance; African-American couples report the highest depression when only one spouse is covered. Results suggest lack of supplemental private health insurance coverage is a stressor that significantly affects depressive symptoms.

Factors Associated with Depression in Pregnant Immigrant Women

This study examined psychosocial risk factors for depressive symptomatology in a community sample of pregnant immigrant women in Montreal, Canada. One hundred and nineteen participants were recruited through hospitals and responded to questionnaires assessing depression, somatic symptoms, functional status, social support, stressful life events and marital adjustment. Forty-two percent of participants scored above the cut-off for depression. Depressive symptoms were associated with poorer functional status and more somatic symptoms. Depressed women reported a lack of social support, more stressful life events and poorer marital adjustment. Transitions associated with migration may place pregnant immigrant women at high risk for depression.

Identifying women at-risk for postpartum depression in the immediate postpartum period.

To develop a multifactorial predictive model of depressive symptomatology in the first week postpartum in order to assist in targeted screening procedures. As part of a longitudinal study, a population-based sample of 594 mothers in a health region near Vancouver, British Columbia completed a mailed questionnaire at 1-week postpartum that included diverse risk factors from the following domains: sociodemographic, biological, pregnancy-related, life stressors, social support, obstetric and adjustment to motherhood. Following univariate analysis, sequential regression analysis was completed to develop a multifactorial predictive model. In the multivariate model, the factors predictive of depressive symptomatology at 1-week postpartum included immigration within the last 5 years, history of depression independent of childbirth, diagnosis of pregnancy-induced hypertension, vulnerable personality style, stressful life events, lack of perceived support, lack of readiness for hospital discharge and dissatisfaction with infant feeding method. The findings suggest that several risk factors for depressive symptomatology in the immediate postpartum period are consistent with previously identified factors but other factors such as recent immigrant status, feeling unready for hospital discharge, dissatisfaction with their infant feeding method, and pregnancy-induced hypertension should also be examined.

Depression in older Chinese migrants to Auckland.

This study was conducted to identify risk factors for depressive symptomatology among older Chinese migrants. One hundred and sixty-two Chinese migrants aged 55 years or older, living in the community and recruited via Chinese community organizations and general practitioners, were interviewed using a Chinese version of the Geriatric Depression Scale and measures of stressful life events, morbid conditions, self-rated health, acculturation, social support and service utilization. Twenty-six percent of participants met the criteria for depressive symptomatology. No recent migrants showed symptoms of depression. Multiple logistic regression analysis showed that lower emotional support, greater number of visits to a doctor, difficulties in accessing health services and low New Zealand cultural orientation increased the risk of showing symptoms of depression. Significant numbers of older Chinese migrants appear to be depressed or at risk for depression and, while participants with depressive symptoms consulted general practitioners more than their counterparts without such symptoms, they reported greater difficulty in accessing health services. The findings point to the need for further epidemiological study of this growing sector of the population and investigation of the nature of its engagement with health services. Social support and aspects of acculturation may play a significant role in preventing depression. This also requires further investigation.

Menopausal transition and increased depressive symptomatology: A community based prospective study

Objective: Prevalence of depression is suggested to be substantially higher in women around menopause. Declining estrogen levels might be an explanation. This study attempts to determine whether depressive symptomatology in healthy women is independently related to menopausal transition. Method: All caucasian women born between 1941 and 1947, living in the city of Eindhoven the Netherlands were invited to take part in a screening program ( n=8098) of whom 78% participated ( n=6648). About 92% returned the questionnaires of which 81% ( n=4975) was fully completed. Women using estrogens and/or having undergone hysterectomy and/or ovariectomy were excluded (43.6%). Of the remaining 2820 women, after 3.5 years, 2748 returned another postal questionnaire, of which 76% was fully completed ( n=2103). Depressive symptomatology was assessed using the Edinburgh Depression Scale (EDS). Independent relationship between an intra-individual change in EDS score during the follow-up period and menopausal transition was analysed by multiple logistic regression (enter as well as stepwise method). Results: Beside the classical determinants of depression (unemployment OR 3.1, CI 1.6–5.8, inability to work OR 1.7, CI 1.0–2.8, financial problems OR 2.9, CI 1.1–7.3 death of a partner OR 2.6, CI 1.1–6.1, death of a child OR 5.9, CI 1.1–32.1 and a previous episode of depression OR 2.0, CI 1.5–2.7) transition from pre to perimenopause and peri to postmenopause was significantly related to a high increase (>5.4) of the EDS score (OR 1.8, CI 1.1–3.3 and OR 1.8, CI 1.5–2.7, respectively). Conclusion: The transition from pre to perimenopause as well as from peri to postmenopause seems to be independently related to a high increase of depressive symptomatology. This suggests that the decrease of ovarian estrogen production is a risk factor for depressive symptomatology.

大学生の抑うつ症状に関連する要因についての短期的縦断研究

This study employed a longitudinal design to examine the psychosocial correlates and risk factors for depressive Symptomatology among undergraduate students. We determined the cross-sectional relation of the psychosocial variables to depressive symptoms at Time 1, and also identified the psychosocial risk factors for the emergence of depressive symptoms at Time 2. Self reported questionnaires were conducted using a sample of 532 students of a university in Okinawa, Japan. We assessed depressive symptomatology by the Center for Epidemiologic Studies Depression Scale (CES-D) at two different times 3 month apart. The psychosocial variables examined were life stressors, type A behavior, self-esteem, locus of control, coping style, perceived social support, and health practices. Multiple logistic regression analyses were conducted to examine the relation of the psychosocial variables to depressive symptoms. After controlling for the effects of demographic and other variables, many psychosocial variables such as life stressors, self-esteem, locus of control, coping style including accepting responsibility and planful problem-solving, father support, and mother support were associated with current depressive symptoms. Life stressors also acted as risk factors for future depressive symptoms. Students experienced high level on life stressors had a 10-fold increased risk for the onset of depression as compared with those had low stressors. These findings may be useful to identify high-risk students who need more intensive prevention programs for depression.

Risk factors for depressive symptoms in late adolescence: a longitudinal community study.

In a longitudinal study, following a community sample (N = 386) from age 5, early risk factors for depressive symptomatology at age 18 were examined separately for females and males. For females, predictors included low birthweight and death of a parent; for males, they included emotional dependency and internalizing behavior problems. Depressive symptomatology at age 15 emerged as an important risk factor for both genders. Clinical implications are discussed, and areas for further research are proposed.

A Longitudinal Study of Risk Factors for Depressive Symptomatology in Elderly Widowed and Married Women

Few studies have examined whether risk factors for depressive symptomatology differ in bereaved and nonbereaved individuals or whether risk factors differ in bereaved individuals over time. Between 1979 and 1983 in Washington County, Maryland, the associations between various health and social network variables and depressive symptomatology were evaluated prior to bereavement and at 1 and 12 months after bereavement in 136 widows and 409 married controls. Prior Center for Epidemiologic Studies Depression Scale scores were generally a good predictor of subsequent scores; however, shortly after bereavement prior scores proved relatively uninformative as most widows experienced a marked increase in depressive symptomatology. Poor health and limitations in physical activity at baseline were consistently associated with higher levels of symptomatology. Although having more friends was also consistently associated with lower levels of symptomatology, the effect of family size appeared to be time and circumstance specific. These results suggest that women at risk of prolonged depression after the death of their husbands can be identified prior to or at the time of bereavement and that widows have risk factors similar to those of women at risk of depression in the general community.

Major Depression and Depressive Symptomatology among the Physically Disabled

Although it is generally agreed that life stress represents a risk factor for depressive symptomatology, there is less agreement on the significance of such stress for the occurrence of major depression. Indeed, it has been suggested that stress factors of importance for depressive symptoms may be irrelevant for major depression. We report results based on a large sample of physically disabled and nondisabled adults that contradict this suggestion. The physically disabled show seriously elevated rates of both depressive symptomatology and major depressive disorder. Subgroup analyses confirmed the finding on depressive symptomatology within all age-gender groupings and the finding on major depression for young and middle-aged men and women but not for the aged. It is argued that these findings can be attributed to differences in chronic stress associated with disability status. We conclude that chronic stress represents a significant risk factor with respect to both depressive symptomatology and major depressive disorder.