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Sample records for late life depression

  1. Cognition in Late Life Depression: Treatment Considerations

    PubMed Central

    Koenig, Aaron M.

    2014-01-01

    Opinion statement Late life depression (LLD) frequently presents with cognitive impairment, and growing evidence suggests that these disease processes are “linked” in multiple ways. For some individuals, LLD may be a recurrence of a long-standing depressive illness, while for others it may be the leading symptom of a developing neuropathological disorder. Overall, studies investigating the relationship between treatment of LLD and improvement in cognitive functioning have yielded mixed results. Research suggests that a subset of individuals with LLD and cognitive dysfunction will experience an improvement in cognitive function after antidepressant treatment, though a significant proportion will continue to exhibit cognitive impairment following resolution of their depressive symptoms. From a treatment standpoint, it is critical to ensure that an individual's depressive symptoms have been treated to remission, measured by a standardized rating scale such as the Geriatric Depression Scale (GDS). SSRI or SNRI monotherapy is often effective, and may be enhanced by employing an evidence-based psychotherapy such as Problem Solving Therapy (PST) or Interpersonal Therapy (IPT), modified to accommodate cognitive impairments that may be present. With respect to specific treatment of cognitive dysfunction, cognitive augmentation or training strategies can be helpful for some patients, and may be explored in combination with treatment of the primary depressive episode. While the introduction of a cholinesterase inhibitor (e.g. donepezil) may be considered, the potential benefit (modest improvement in cognition and functioning) must be weighed against an increased risk for worsening or recurrent depression. Finally, lifestyle factors—such as aerobic exercise, follow-up with a primary care physician for management of co-morbid medical illnesses, and regular participation in stimulating activities (such as through a senior center)—are important and should be included as

  2. What are the causes of late-life depression?

    PubMed

    Aziz, Rehan; Steffens, David C

    2013-12-01

    Although depression in old age is less common than depression in younger populations, it still affects more than 1 million community-living older adults. Depression in late life has been associated with reduced quality of life and increased mortality from both suicide and illness. Its causes are multifactorial but are prominently related to both biologic and social factors. Psychological factors, although less studied in elders, are also important in understanding its cause. In this article, multiple facets of late-life depression are reviewed, including its clinical presentation, epidemiology, and biopsychosocial causes.

  3. Clinical interventions for late-life anxious depression.

    PubMed

    Diefenbach, Gretchen J; Goethe, John

    2006-01-01

    Anxiety symptoms are frequently present in patients with late-life depression. The designation "anxious depression" has been used to describe major depressive disorder (MDD) accompanied by clinically significant but subsyndromal anxiety symptoms. MDD may also present comorbid with diagnosable anxiety disorders, although this presentation is less common in late life. Diagnosis of anxious depression in the elderly is complicated by several factors (eg, their tendency to experience and report psychiatric symptoms as somatic illness) and is associated with a more severe clinical presentation, increased risk for suicidal ideation, increased disability, and poorer prognosis. Standard pharmacotherapy for depression may be sufficient but for many patients must be modified or augmented. Psychosocial interventions may also be an important component in the treatment of these patients, although no specific psychosocial treatments have been developed for late-life anxious depression.

  4. Treatment-resistant Late-life Depression: Challenges and Perspectives

    PubMed Central

    Knöchel, Christian; Alves, Gilberto; Friedrichs, Benedikt; Schneider, Barbara; Schmidt-Rechau, Anna; Wenzlera, Sofia; Schneider, Angelina; Prvulovic, David; Carvalho, André F.; Oertel-Knöchel, Viola

    2015-01-01

    The current Review article provides a narrative review about the neurobiological underpinnings and treatment of treatment resistant late-life depression (TRLLD). The manuscript focuses on therapeutic targets of late-life depression, which include pharmacological, psychological, biophysical and exercise treatment approaches. Therefore, we summarize available evidences on that kind of therapies for patients suffering from late-life depression. The search for evidences of therapeutic options of late-life depression were done using searching websites as “pubmed”, and using the searching terms “depression”, “late-life depression”, “treatment”, “biophysical therapy”, “exercise therapy”, “pharmacological therapy” and “psychological therapy”. To the end, we summarize and discuss current data, providing some directions for further research. Treatment recommendations for elderly depressive patients favour a multimodal approach, containing psychological, pharmacological and secondary biophysical therapeutic options. Particularly, a combination of psychotherapy and antidepressant medication reflects the best therapeutic option. However, mostly accepted and used is the pharmacological treatment although evidence suggests that the drug therapy is not as effective as it is in younger depressive patients. Further studies employing larger samples and longer follow-up periods are necessary and may focus on comparability of study designs and involve novel approaches to establish the validity and reliability of multimodal treatment programs. PMID:26467408

  5. THE DEFAULT MODE NETWORK IN LATE-LIFE ANXIOUS DEPRESSION

    PubMed Central

    Andreescu, Carmen; Wu, Minjie; Butters, Meryl A.; Figurski, Jennifer; Reynolds, Charles F.; Aizenstein, Howard J

    2011-01-01

    Objectives The aim of this exploratory study is to examine the default-mode network (DMN) functional connectivity pattern in elderly depressed subjects with and without comorbid anxiety. Methods Functional MRI data were collected for 11 elderly depressed subjects with high comorbid anxiety and 8 elderly depressed subjects with low anxiety. We analyzed the resting connectivity patterns of the posterior cingulate cortex. We compared the DMN activity in the elderly depressed subjects with high versus low comorbid anxiety. Results Depressed elderly with high comorbid anxiety had increased functional connectivity in the posterior regions of the DMN and decreased functional connectivity in the anterior regions of the DMN. Conclusion Elderly depressed subjects with high anxiety display a dissociative pattern of connectivity in the DMN when compared with elderly depressed subjects with low anxiety. These results suggest a unique biological signature of the anxiety symptoms in the context of late-life depression. PMID:21765344

  6. The Phenomenology of Late Life Depression.

    ERIC Educational Resources Information Center

    Blazer, Dan; And Others

    The paper reports results of one project from the National Institute of Mental Health Epidemiologic Catchment Area (ECA) Program: the Duke ECA study (also known as the Piedmont Health Survey). To determine if depressive symptoms are different in the depressed elderly, 46 community subjects, over 60 years of age with a current diagnosis of…

  7. The impact of psychosocial factors on late-life depression.

    PubMed

    Areán, Patricia A; Reynolds, Charles F

    2005-08-15

    Mental illnesses in later life are multidimensional phenomena that occur in interpersonal, psychosocial, and biological contexts. With depression used as an example, the purpose of this article is to review how psychosocial variables contribute to the onset and maintenance of depression in late life, as well as influence treatment outcomes. Particular issues discussed are how these variables can be modified to prevent the onset and relapse of depression, how nonmodifiable risk factors can be addressed to prevent onset and relapse, and how research in this area needs to evolve to improve prevention and treatment.

  8. Treatment of Late-Life Depression Alleviates Caregiver Burden

    PubMed Central

    Martire, Lynn M.; Schulz, Richard; Reynolds, Charles F.; Karp, Jordan F.; Gildengers, Ariel G.; Whyte, Ellen M.

    2010-01-01

    Objectives To describe the burden experienced by family caregivers of older adults with depression and to examine the positive effects on caregivers of treating late-life depression. Design Two-phase treatment study for major depressive disorder (MDD) that included 6 weeks of open treatment with antidepressant medication for all older patients followed by 16 weeks of randomized treatment for patients who were partial responders, comparing a combination of medication and interpersonal psychotherapy with medication alone. Setting Primary care and university late-life mental health research clinic. Participants Adults aged 60 and older participating in a randomized trial for treatment of MDD who enrolled in a family caregiver study and their caregiver (N = 244 dyads). Measurements Improvement in patient symptoms during open treatment (lower scores on the Hamilton Rating Scale for Depression (HRSD)) and remission of depression during randomized treatment (3 consecutive weekly HRSD scores of ≤7) were examined as predictors of lower general caregiver burden and burden specific to patient depression. Results Caregivers reported a moderate to high level of general caregiver burden on average. Change in patient depression during open treatment was associated with significantly decreased depression-specific burden (β = −0.22, P =.001) and a trend toward lower general burden (β = − 0.08, P =.08). Caregivers of patients who remitted showed significantly decreased depression-specific burden (F (1,76) = 4.27, P =.04). Conclusion Treatment of late-life depression has benefits that extend to the family members on whom patients depend. Caregiver education and support may strengthen these effects. PMID:19943833

  9. Late-life Depressive Symptoms: Prediction Models of Change

    PubMed Central

    García-Peña, Carmen; Wagner, Fernando A.; Sánchez-García, Sergio; Espinel-Bermúdez, Claudia; Juárez-Cedillo, Teresa; Pérez-Zepeda, Mario; Arango-Lopera, Victoria; Franco-Marina, Francisco; Ramírez-Aldana, Ricardo; Gallo, Joseph

    2013-01-01

    Background Depression is a well-recognised problem in the elderly. The aim of this study was to determine the factors associated with predictors of change in depressive symptoms, both in subjects with and without baseline significant depressive symptoms. Methods Longitudinal study of community-dwelling elderly people (>60 years or older), baseline evaluations, and two additional evaluations were reported. Depressive symptoms were measured using a 30-item Geriatric Depression Scale, and a score of 11 was used as cutoff point for significant depressive symptoms in order to stratify the analyses in two groups: with significant depressive symptoms and without significant depressive symptoms. Sociodemographic data, social support, anxiety, cognition, positive affect, control locus, activities of daily living, recent traumatic life events, physical activity, comorbidities, and quality of life were evaluated. Multi-level generalised estimating equation model was used to assess the impact on the trajectory of depressive symptoms. Results 7,882 subjects were assessed, with 29.42% attrition. At baseline assessment, mean age was 70.96 years, 61.15% were women. Trajectories of depressive symptoms had a decreasing trend. Stronger associations in those with significant depressive symptoms, were social support (OR .971, p<.001), chronic pain (OR 2.277, p<.001) and higher locus of control (OR .581, p<.001). In contrast for those without baseline significant depressive symptoms anxiety and a higher locus of control were the strongest associations. Conclusions New insights into late-life depression are provided, with special emphasis in differentiated factors influencing the trajectory when stratifying regarding basal status of significant depressive symptoms. Limitations The study has not included clinical evaluations and nutritional assessments PMID:23731940

  10. Protein Binding in Patients With Late-Life Depression

    PubMed Central

    Kumar, Anand; Kepe, Vladimir; Barrio, Jorge R.; Siddarth, Prabha; Manoukian, Vicki; Elderkin-Thompson, Virginia; Small, Gary W.

    2013-01-01

    Context Depression has been identified as a risk factor and a prodrome of dementia. Common neurobiological mechanisms may underlie this clinical and phenomenologic overlap. Objective To examine and compare protein (amyloid and tau) binding in critical brain regions in patients diagnosed as having late-life major depressive disorder (MDD) and healthy control individuals using 2-(1-{6-[(2-[18F]fluoroethyl) (methyl)-amino]-2-naphthyl}ethylidene) malononitrile ([18F]FDDNP) positron emission tomography. Design A cross-section neuroimaging study using positron emission tomography. Setting University of California, Los Angeles. Patients Our samples comprised 20 patients diagnosed as having MDD and 19 healthy control individuals of comparable age, sex, and educational level. Main Outcome Measure Relative distribution volume in regions of interest was used as the measure of [18F]FDDNP binding in all study participants. Results When compared with controls, [18F]FDDNP binding was significantly higher overall and in the posterior cingulate and lateral temporal regions in the MDD group. Conclusions These findings suggest that neuronal injury associated with higher protein load in critical brain regions might provide a mechanism in the pathophysiologic manifestation of MDD in late life and have implications for the therapeutics of depression in elderly individuals. PMID:22065530

  11. MRI Predictors of Treatment Response in Late-Life Depression

    PubMed Central

    Aizenstein, Howard J.; Khalef, Alexander; Walker, Sarah E.; Andreescu, Carmen

    2014-01-01

    In older adults, depression not only results in more years lived with disability than any other disease, but it also carries additional risk for suicide, medical comorbidities, and family care-giving burden. Because it can take many months to identify an effective treatment regimen, it is of upmost importance to shorten the window of time and identify early on what medication(s) and dosages will work effectively for individuals suffering from depression. Late-life depression (LLD) has been associated with greater burden of age-related changes, including atrophy, white matter ischemic changes, and alterations in functional connectivity (FC). Depression in midlife has been shown to alter affective reactivity and regulation, and functional magnetic resonance imaging (fMRI) studies in LLD have replicated the same abnormalities. Effective treatment can normalize these alterations. This article provides a review of the current literature using structural and functional neuroimaging to identify magnetic resonance imaging (MRI) predictors of treatment response in LLD. The majority of the literature on structural MRI has focused on the vascular depression hypothesis, and studies support the view that loss of brain volume and white matter integrity is associated with poorer treatment outcomes. Studies using fMRI have reported that lower task-based activity in the prefrontal cortex (PFC) and limbic regions is associated with poorer outcome. These imaging markers may be integrated into clinical decision-making to better treatment outcomes in the future. PMID:24381231

  12. DYNAMIC PREDICTION OF TREATMENT RESPONSE IN LATE-LIFE DEPRESSION

    PubMed Central

    Joel, Ian; Begley, Amy E.; Mulsant, Benoit H.; Lenze, Eric J.; Mazumdar, Sati; Dew, Mary Amanda; Blumberger, Daniel; Butters, Meryl; Reynolds, Charles F.

    2013-01-01

    Objective 1) identify actionable predictors of remission to antidepressant pharmacotherapy in depressed older adults and 2) use signal detection theory to develop decision trees to guide clinical decision making Method We treated 277 participants with current major depression using open-label venlafaxine XR (up to 300 mg/day) for 12 weeks, in an NIMH-sponsored randomized, placebo-controlled augmentation trial of adjunctive aripiprazole. Multiple logistic regression and signal detection approaches identified predictors of remission in both completer and intent-to-treat samples. Results Higher baseline depressive symptom severity (OR, 0.86, 95% CI, 0.80-0.93; p <0.001), smaller symptom improvement during the first two weeks of treatment (OR, 0.96, 95% CI, 0.94-0.97; p <0.001), male sex (OR, 0.41 95% CI, 0.18-0.93, p=0.03), duration of current episode ≥ 2 years (OR, 0.26 95% CI, 0.12-0.57, p<0.001) and adequate past depression treatment (ATHF >=3) (OR, 0.34 95% CI, 0.16-0.74, p=0.006) predicted lower probability of remission in the completer sample. Subjects with Montgomery Asberg (MADRS) decreasing by >27% in the first two weeks and with baseline MADRS scores of <27 (percentile rank = 51) had the best chance of remission (89%). Subjects with small symptom decrease in the first 2 weeks with adequate prior treatment and younger than 75 yrs old had the lowest chance of remission (16%). Conclusion Our results suggest the clinical utility of measuring pre-treatment illness severity and change during the first two weeks of treatment in predicting remission of late-life major depression. PMID:23567441

  13. Impacting late life depression: integrating a depression intervention into primary care.

    PubMed

    Oishi, Sabine M; Shoai, Rebecca; Katon, Wayne; Callahan, Christopher; Unützer, Jürgen; Arean, Patricia; Callahan, Christopher; Della Penna, Richard; Harpole, Linda; Hegel, Mark; Noel, Polly Hitchcock; Hoffing, Marc; Hunkeler, Enid M; Katon, Wayne; Levine, Stuart; Lin, Elizabeth H B; Oddone, Eugene; Oishi, Sabine; Unützer, Jürgen; Williams, John

    2003-01-01

    groups and semi-structured individual interviews with all Depression Clinical Specialists (DCSs) working with Project IMPACT (Improving Mood: Promoting Access to Collaborative Treatment), a study testing a collaborative care intervention for late life depression, to examine integration of the intervention model into primary care. DCSs described key intervention components, including supervision from a psychiatrist and a liaison primary care provider, weekly team meetings, computerized patient tracking, and outcomes assessment tools as effective in supporting patient care. DCSs discussed details of protocols, training, environmental set-up, and interpersonal factors that seemed to facilitate integration. DCSs also identified research-related factors that may need to be preserved in the real world. Basic elements of the IMPACT model seem to support integration of late life depression care into primary care. Research-related components may need modification for dissemination.

  14. Diagnosis and treatment of depression and cognitive impairment in late life.

    PubMed

    Morimoto, Sarah Shizuko; Kanellopoulos, Dora; Manning, Kevin J; Alexopoulos, George S

    2015-05-01

    Cognitive impairment in late-life depression is prevalent, disabling, and heterogeneous. Although mild cognitive impairment in depression does not usually progress to dementia, accurate assessment of cognition is vital to prognosis and treatment planning. For example, executive dysfunction often accompanies late-life depression, influences performance across cognitive domains, and is associated with poor antidepressant treatment outcomes. Here, we review how assessment can capture dysfunction across cognitive domains and discuss cognitive trajectories frequently observed in late-life depression in the context of the neurobiology of this disorder. We also review the efficacy of a sample of interventions tailored to specific cognitive profiles.

  15. fMRI Activation in Late-Life Anxious Depression: a Potential Biomarker

    PubMed Central

    Andreescu, Carmen; Butters, Meryl; Lenze, Eric J.; Venkatraman, Vijay K; Nable, Megan; Reynolds, Charles F.; Aizenstein, Howard J.

    2009-01-01

    Objective and Methods The neurobiology of late-life anxious depression (LLAD) is poorly characterized despite evidence that this is a common and severe subtype of late-life depression. To identify the neuroanatomical substrate of late-life anxious depression, we examined event-related fMRI data collected in 8 subjects with late-life depression, half of whom had high levels of comorbid anxiety. Subjects were trained on the Preparing to Overcome Prepotency (POP) task, which is an executive control task that reliably activates the lateral prefrontal cortex - anterior cingulate cortex cognitive control circuit. Results Time series analysis showed that, when compared with elderly depressed subjects, elderly subjects with anxious depression performing the POP task produced a significantly greater and more sustained signal in three regions: BA 24 (dorsal anterior cingulate), BA31 (posterior cingulate) and BA6 (prefrontal cortex). While elderly subjects with pure depression presented a bimodal activation curve in the dorsal anterior cingulate and the posterior cingulate, elderly subjects with anxious depression presented a sustained unimodal activation pattern. Conclusions Our preliminary results suggest specific activation patterns unique to anxious depression that may suggest greater and more sustained efforts of the ACC to carry out cognitive control tasks. Further research is needed to clarify the neuroanatomical basis of late-life anxious depression. PMID:19575412

  16. Late-life depression symptom profiles are differentially associated with immunometabolic functioning.

    PubMed

    Vogelzangs, Nicole; Comijs, Hannie C; Oude Voshaar, Richard C; Stek, Max L; Penninx, Brenda W J H

    2014-10-01

    Growing evidence suggests immune and metabolic dysregulation among depressed persons, possibly restricted to specific subgroups. This study explores the association between depressive disorders and characteristics with immunometabolic functioning among older persons. Data are from the baseline assessment of the Netherlands Study of Depression in Older Persons, including 131 non-depressed and 358 depressed (6-month DSM-IV major depressive disorder) persons (60-93 years). Immune (C-reactive protein, interleukin [IL]-6) and metabolic (waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, fasting glucose) factors were measured. Depression characteristics included severity, age of onset, symptom profile (atypical/melancholic) and antidepressant use. Depressed persons showed lower IL-6 levels compared with non-depressed persons. Depressed persons, except those with atypical depression, had lower waist circumference, lower glucose levels and scored lower on an overall index including all immunometabolic factors. Low waist circumference was more pronounced among those with less severe depression and those with a later age of onset, whom also had lower blood pressure levels. Atypical depression was associated with higher triglyceride levels. Antidepressant use was not clearly associated with immunometabolic functioning. To conclude, contrary to our expectations, we found overall immunometabolic downregulation in older depressed persons, in particular among those with less severe symptoms and those with late-life onset. However, persons with atypical depression presented with metabolic upregulation compared with other depressed persons. Taking depression symptom profiles into account is important when examining biological dysregulation in late-life depression.

  17. COGNITION AS A THERAPEUTIC TARGET IN LATE-LIFE DEPRESSION: POTENTIAL FOR NICOTINIC THERAPEUTICS

    PubMed Central

    Zurkovsky, Lilia; Taylor, Warren D.; Newhouse, Paul A.

    2013-01-01

    Depression is associated with impairments to cognition and brain function at any age, but such impairments in the elderly are particularly problematic because of the additional burden of normal cognitive aging and in some cases, structural brain pathology. Individuals with late-life depression exhibit impairments in cognition and brain structural integrity, alongside mood dysfunction. Antidepressant treatment improves symptoms in some but not all patients, and those who benefit may not return to the cognitive and functional level of nondepressed elderly. Thus, for comprehensive treatment of late-life depression, it may be necessary to address both the affective and cognitive deficits. In this review, we propose a model for the treatment of late-life depression in which nicotinic stimulation is used to improve cognitive performance and improve the efficacy of an antidepressant treatment of the syndrome of late-life depression. The cholinergic system is well-established as important to cognition. Although muscarinic stimulation may exacerbate depressive symptoms, nicotinic stimulation may improve cognition and neural functioning without a detriment to mood. While some studies of nicotinic subtype specific receptor agonists have shown promise in improving cognitive performance, less is known regarding how nicotinic receptor stimulation affects cognition in depressed elderly patients. Late-life depression thus represents a new therapeutic target for the development of nicotinic agonist drugs and parallel treatment of cognitive dysfunction along with medical and psychological approaches to treating mood dysfunction may be necessary to ensure full resolution of depressive illness in aging. PMID:23933385

  18. What is the role of alternative treatments in late-life depression?

    PubMed

    Nyer, Maren; Doorley, James; Durham, Kelley; Yeung, Albert S; Freeman, Marlene P; Mischoulon, David

    2013-12-01

    Late-life depression remains challenging to treat. One major limitation to treatment is the concern over medication-related side effects to which the elderly are especially vulnerable. Also, because many elderly people are already taking multiple medications for medical conditions, there is the concern over drug-drug interactions. This article reviews various complementary and alternative medicine interventions for late-life depression, including natural remedies, exercise, yoga, tai chi, massage therapy, music therapy, and religion and spirituality.

  19. Involvement of Brain-Derived Neurotrophic Factor in Late-Life Depression

    PubMed Central

    Dwivedi, Yogesh

    2013-01-01

    Brain-derived neurotrophic factor (BDNF), one of the major neurotrophic factors, plays an important role in the maintenance and survival of neurons, synaptic integrity, and synaptic plasticity. Evidence suggests that BDNF is involved in major depression, such that the level of BDNF is decreased in depressed patients and that antidepressants reverse this decrease. Stress, a major factor in depression, also modulates BDNF expression. These studies have led to the proposal of the neurotrophin hypothesis of depression. Late-life depression is associated with disturbances in structural and neural plasticity as well as impairments in cognitive behavior. Stress and aging also play a crucial role in late-life depression. Many recent studies have suggested that not only expression of BDNF is decreased in the serum/plasma of patients with late-life depression, but structural abnormalities in the brain of these patients may be associated with a polymorphism in the BDNF gene, and that there is a relationship between a BDNF polymorphism and antidepressant remission rates. This review provides a critical review of the involvement of BDNF in major depression, in general, and in late-life depression, in particular. PMID:23570887

  20. A Comparison of Brain Structural Variables, Neuropsychological Factors, and Treatment Outcome in Early Versus Late Onset Late Life Depression

    PubMed Central

    Disabato, Brianne M.; Morris, Carrie; Hranilovich, Jennifer; D’Angelo, Gina; Zhou, Gongfu; Wu, Ningying; Doraiswamy, P. Murali; Sheline, Yvette I.

    2013-01-01

    Objective To compare differences in grey matter volumes, white matter and subcortical gray matter hyperintensities, neuropsychological factors, and treatment outcome between early and late onset late life depressed (LLD) subjects. Design Two-site, prospective, nonrandomized controlled trial. Setting Outpatient clinics at Washington University and Duke University. Participants 126 subjects aged 60 years or older, met DSM-IV criteria for major depression, scored 20 or more on the Montgomery-Asberg Depression Rating Scale (MADRS), received neuropsychological testing and magnetic resonance imaging, excluded for cognitive impairment or severe medical disorders. Intervention Twelve weeks of sertraline treatment. Main Outcome Measure Subjects’ MADRS scores over time, neuropsychological factors. Results Left anterior cingulate thickness was significantly smaller in the late onset depressed group than early onset LLD subjects. The late onset group also had more hyperintensities than the early onset LLD subjects. There was no difference in neuropsychological factor scores or treatment outcome between early onset and late onset LLD subjects. Conclusions Age of onset of depressive symptoms in the late life depressed are associated with differences in cortical thickness, and white matter and subcortical gray matter hyperintensities, but age of onset did not affect neuropsychological factors or treatment outcome. PMID:23768683

  1. Late-life depression with comorbid cognitive impairment and disability: nonpharmacological interventions

    PubMed Central

    Wilkins, Victoria M; Kiosses, Dimitris; Ravdin, Lisa D

    2010-01-01

    Less than half of older adults with depression achieve remission with antidepressant medications, and rates of remission are even poorer for those with comorbid conditions. Psychosocial interventions have been effective in treating geriatric depression, either alone or better yet, in combination with antidepressant medications. Traditional strategies for nonpharmacological treatment of late-life depression do not specifically address the co-occurring cognitive impairment and disability that is prevalent in this population. Newer therapies are recognizing the need to simultaneously direct treatment efforts in late-life depression towards the triad of depressive symptoms, cognitive dysfunction, and functional disability that is so often found in geriatric depression, and this comprehensive approach holds promise for improved treatment outcomes. PMID:21228897

  2. Mindfulness-based cognitive therapy in patients with late-life depression: A case series

    PubMed Central

    Mathur, Sonal; Sharma, Mahendra Prakash; Bharath, Srikala

    2016-01-01

    Depression is the most common mental illness in the elderly, and cost-effective treatments are required. Therefore, this study is aimed at evaluating the effectiveness of a mindfulness-based cognitive therapy (MBCT) on depressive symptoms, mindfulness skills, acceptance, and quality of life across four domains in patients with late-onset depression. A single case design with pre- and post-assessment was adopted. Five patients meeting the specified inclusion and exclusion criteria were recruited for the study and assessed on the behavioral analysis pro forma, geriatric depression scale, Hamilton depression rating scale, Kentucky inventory of mindfulness skills, Acceptance and Action Questionnaire II, The World Health Organization quality of life Assessment Brief version (WHOQO-L-BREF). The therapeutic program consisted of education regarding the nature of depression, training in formal and informal mindfulness meditation, and cognitive restructuring. A total of 8 sessions over 8 weeks were conducted for each patient. The results of this study indicate clinically significant improvement in the severity of depression, mindfulness skills, acceptance, and overall quality of life in all 5 patients. Eight-week MBCT program has led to reduction in depression and increased mindfulness skills, acceptance, and overall quality of life in patients with late-life depression. PMID:27512325

  3. Mindfulness-based cognitive therapy in patients with late-life depression: A case series.

    PubMed

    Mathur, Sonal; Sharma, Mahendra Prakash; Bharath, Srikala

    2016-01-01

    Depression is the most common mental illness in the elderly, and cost-effective treatments are required. Therefore, this study is aimed at evaluating the effectiveness of a mindfulness-based cognitive therapy (MBCT) on depressive symptoms, mindfulness skills, acceptance, and quality of life across four domains in patients with late-onset depression. A single case design with pre- and post-assessment was adopted. Five patients meeting the specified inclusion and exclusion criteria were recruited for the study and assessed on the behavioral analysis pro forma, geriatric depression scale, Hamilton depression rating scale, Kentucky inventory of mindfulness skills, Acceptance and Action Questionnaire II, The World Health Organization quality of life Assessment Brief version (WHOQO-L-BREF). The therapeutic program consisted of education regarding the nature of depression, training in formal and informal mindfulness meditation, and cognitive restructuring. A total of 8 sessions over 8 weeks were conducted for each patient. The results of this study indicate clinically significant improvement in the severity of depression, mindfulness skills, acceptance, and overall quality of life in all 5 patients. Eight-week MBCT program has led to reduction in depression and increased mindfulness skills, acceptance, and overall quality of life in patients with late-life depression. PMID:27512325

  4. Late Life Recurrent Depression: Challenge to Mental Health Care.

    ERIC Educational Resources Information Center

    Hinrichsen, Gregory A.

    For the vast majority of persons of all ages who suffer from major depression, it is recurrent. A traditional wisdom has been that elderly persons respond more poorly to treatment for serious depression than younger persons. The psychiatric status of 127 elderly persons hospitalized for an episode of major depression was systematically assessed…

  5. Default-mode network connectivity and white matter burden in late-life depression.

    PubMed

    Wu, Minjie; Andreescu, Carmen; Butters, Meryl A; Tamburo, Robert; Reynolds, Charles F; Aizenstein, Howard

    2011-10-31

    The brain's default-mode network has been the focus of intense research. This study characterizes the default-mode network activity in late-life depression and the correlation of the default-mode network activity changes with the white-matter hyperintensities burden. We hypothesized that elderly depressed subjects would have altered default-mode network activity, which would correlate with the increased white-matter hyperintensities burden. Twelve depressed subjects (mean Hamilton Depression Rating Scale 19.8±4.1, mean age 70.5±4.9) and 12 non-depressed, comparison subjects (mean age 69±6.5) were included. Functional magnetic resonance imaging (fMRI) data were collected while subjects performed a low cognitive load, event-related task. We compared the default-mode network activity in these groups (including depressed subjects pre- and post-antidepressant treatment). We analyzed the resting connectivity patterns of the posterior cingulate cortex. Deconvolution was used to evaluate the correlation of resting-state connectivity scores with the white-matter hyperintensities burden. Compared with non-depressed elderly, depressed subjects pretreatment had decreased connectivity in the subgenual anterior cingulate cortex and increased connectivity in the dorsomedial prefrontal cortex and the orbito-frontal cortex. The abnormal connectivity was significantly correlated with the white-matter hyperintensities burden. Remitted elderly depressed subjects had improved functional connectivity compared to pretreatment, although alterations persisted in the anterior cingulate and the prefrontal cortex when remitted elderly depressed subjects were compared with non-depressed elderly. Our study provides evidence for altered default-mode network connectivity in late-life depression. The correlation between white-matter hyperintensities burden and default-mode network connectivity emphasizes the role of vascular changes in late-life depression etiopathogenesis. PMID:21824753

  6. Default-mode network connectivity and white matter burden in late-life depression

    PubMed Central

    Wu, Minjie; Andreescu, Carmen; Butters, Meryl A.; Tamburo, Robert; Reynolds, Charles F.; Aizenstein, Howard

    2011-01-01

    The brain's default-mode network has been the focus of intense research. This study characterizes the default-mode network activity in late-life depression and the correlation of the default-mode network activity changes with the white-matter hyperintensities burden. We hypothesized that elderly depressed subjects would have altered default-mode network activity, which would correlate with the increased white-matter hyperintensities burden. Twelve depressed subjects (mean Hamilton Depression Rating Scale 19.8±4.1, mean age 70.5±4.9) and 12 non-depressed, comparison subjects (mean age 69±6.5) were included. Functional MRI data were collected while subjects performed a low cognitive load, event-related task. We compared the default-mode network activity in these groups (including depressed subjects pre and post antidepressant treatment). We analyzed the resting connectivity patterns of the posterior cingulate cortex. Deconvolution was used to evaluate the correlation of resting-state connectivity scores with the white-matter hyperintensities burden. Compared with non-depressed elderly, depressed subjects pretreatment had decreased connectivity in the subgenual anterior cingulate cortex and increased connectivity in the dorsomedial prefrontal cortex and the orbitofrontal cortex. The abnormal connectivity was significantly correlated with the white-matter hyperintensities burden. Remitted elderly depressed subjects had improved functional connectivity compared to pretreatment, although alterations persisted in the anterior cingulate and the prefrontal cortex when remitted elderly depressed subjects were compared with non-depressed elderly. Our study provides evidence for altered default-mode network connectivity in late-life depression. The correlation between white-matter hyperintensities burden and default-mode network connectivity emphasizes the role of vascular changes in late-life depression etiopathogenesis. PMID:21824753

  7. [Role of personality in depression of the elderly: difference between early and late life depression].

    PubMed

    Nubukpo, Philippe; Hartmann, Joël; Clément, Jean-Pierre

    2005-03-01

    Personality disorders have been implicated in the occurrence of depression in the elderly. The main purpose of this study was to assess the role of personality disorders in depression of the elderly and to distinguish between early and late onset depression. The study included 48 subjects over 65 years of age from a department of psychiatry, who suffered from a major depressive episode according to the criteria of the DSM-III-R, without bipolar characteristics. The patients were examined at two different times. At the first interview, depression was assessed by the mini-GDS and the CES-D scales, and a cognitive disorder was ruled out by the Mini-Mental State Examination. The patients were then classified in two groups according to the time of the first occurrence of depression, before (early onset depression) or after (late onset depression) 65 years of age. A second evaluation was performed after the cure of the depression. The patients' personality was then assessed using the International Personality Disorder Examination, in its VKP French-translated version, which evaluates personality disorders as defined by the criteria of the DSM-III-R and the ICD-10. The frequency of personality disorders was higher in patients with early-onset depression rather than in those with late onset depression. The most frequent personality disorder was avoiding personality (Cluster C) according to categorical as well as dimensional assessment. "Dependant personality" (Cluster C) was also quite often associated with early-onset depression. However this results should be confirmed by a larger study.

  8. fMRI Correlates of White Matter Hyperintensities in Late-Life Depression

    PubMed Central

    Aizenstein, Howard J.; Andreescu, Carmen; Edelman, Kathryn L.; Cochran, Jennifer L.; Price, Julie; Butters, Meryl A.; Karp, Jordan; Patel, Meenal; Reynolds, Charles F.

    2013-01-01

    Objective This study tests whether or not the structural white matter lesions that are characteristic of late-life depression are associated with alterations in the functional affective circuits of late-life depression. This study used an emotional faces paradigm that has been shown to engage the affective limbic brain regions. Method Thirty-three elderly depressed patients and 27 nondepressed comparison subjects participated in this study. The patients were recruited through the NIMH-sponsored Advanced Center for Interventions and Services Research for the Study of Late-Life Mood Disorders at the University of Pittsburgh Center for Bioethics and Health Law. Structural and functional MRI was used to assess white matter hyperintensity (WMH) burden and functional magnetic resonance imaging (fMRI) blood-oxygen-level-dependent (BOLD) response on a facial expression affective-reactivity task in both elderly participants with nonpsychotic and non-bipolar major depression (unmedicated) and nondepressed elderly comparison subjects. Results As expected, greater subgenual cingulate activity was observed in the depressed patients relative to the nondepressed comparison subjects. This same region showed greater task-related activity associated with a greater burden of cerebrovascular white matter change in the depressed group. Moreover, the depressed group showed a significantly greater interaction of WMH by fMRI activity effect than the nondepressed group. Conclusions The observation that high WMH burden in late-life depression is associated with greater BOLD response on the affective-reactivity task supports the model that white matter ischemia in elderly depressed patients disrupts brain mechanisms of affective regulation and leads to limbic hyperactivation. PMID:21799066

  9. Association Between Depressive Symptoms and Negative Dependent Life Events from Late Childhood to Adolescence

    PubMed Central

    Johnson, Daniel P.; Whisman, Mark A.; Corley, Robin P.; Hewitt, John K.; Rhee, Soo Hyun

    2012-01-01

    The association between stressful life events and depression has been consistently supported in the literature; however, studies of the developmental trajectories of these constructs and the nature of their association over time are limited. We examined trajectories of depressive symptoms and negative dependent life events and the associations between these constructs in a sample of 916 youth assessed annually from age 9 to 16, using latent growth curve modeling. Youth depressive symptoms, as rated by youth, parents, and teachers, decreased from late childhood into adolescence, whereas rates of youth-rated life events did not change significantly over time. Initial levels of depressive symptoms were positively associated with initial levels of life events. Furthermore, after controlling for the initial association between the two constructs, increases in depressive symptoms (as assessed by parents and youth) were positively associated with increases in life events over time. The study builds on prior research by focusing specifically on negative dependent life events, examining results across multiple informants, and employing latent growth curve modeling to evaluate associations between trajectories of life events and depressive symptoms in a longitudinal adolescent sample. Additional studies employing latent growth modeling to examine the changes in this association during adolescence are needed. PMID:22592931

  10. [The cognitive deficits in the late-life depression and their prognostic value for pharmacotherapy].

    PubMed

    Sołtys, Krzysztof; Bidzan, Leszek; Turczyński, Jacek; Łapin, Joanna

    2002-01-01

    The cognitive deficits in the late-life depression are considered as risk factor for presentation of dementia in the long-term prognosis. In this research we were looking for correlations between the cognitive deficits and depression, their influence for the short-term prognosis and the activity of daily living in the elderly. 90 patients with depression (ICD-10 criteria were used) were assessed with scales: MADRS, MMSE, ADAS, IADL. After 3 months the evaluation with clinical improvement scale was made. The results indicate for correlations between the cognitive deficits and intensity of depression. No influence of cognitive deficits level for the clinical improvement after 3 months was proved. The intensity of depression was connected with lower level of daily living activities (assessed with IADL). PMID:12647436

  11. Being stuck in a vice: The process of coping with severe depression in late life

    PubMed Central

    Bjørkløf, Guro Hanevold; Kirkevold, Marit; Engedal, Knut; Selbæk, Geir; Helvik, Anne-Sofie

    2015-01-01

    Articles describing older persons’ experiences of coping with severe depression are, to our knowledge, lacking. This article is methodologically grounded in phenomenological hermeneutics, inspired by Paul Ricoeur, and applies a descriptive design with in-depth interviews for producing the data. We included 18 older persons, 13 women and 5 men, with a mean age of 77.9 years, depressed to a severe or moderate degree, 1–2 weeks after admission to a hospital for treatment of depression. We found the metaphor “being in a vice” to capture the essence of meaning from the participants’ stories, and can be understood as being stuck in an immensely painful existence entirely dominated by depression in late life. This is the first article where coping in older men and women experiencing the most severe phase of depression is explored. PMID:26119368

  12. Late-Life Depressive Symptoms, Religiousness, and Mood in the Last Week of Life

    PubMed Central

    Braam, Arjan W.; Klinkenberg, Marianne; Galenkamp, Henrike; Deeg, Dorly J. H.

    2012-01-01

    Aim of the current study is to examine whether previous depressive symptoms modify possible effects of religiousness on mood in the last week of life. After-death interviews with proxy respondents of deceased sample members of the Longitudinal Aging Study Amsterdam provided information on depressed mood in the last week of life, as well as on the presence of a sense of peace with the approaching end of life. Other characteristics were derived from interviews with the sample members when still alive. Significant interactions were identified between measures of religiousness and previous depressive symptoms (CES-D scores) in their associations with mood in the last week of life. Among those with previous depressive symptoms, church-membership, church-attendance and salience of religion were associated with a greater likelihood of depressed mood in the last week of life. Among those without previous depressive symptoms, church-attendance and salience of religion were associated with a higher likelihood of a sense of peace. For older adults in the last phase of life, supportive effects of religiousness were more or less expected. Fore those with recent depressive symptoms, however, religiousness might involve a component of existential doubt. PMID:22844587

  13. Applications of magnetic resonance imaging for treatment-resistant late-life depression.

    PubMed

    Agudelo, Christian; Aizenstein, Howard J; Karp, Jordan F; Reynolds, Charles F

    2015-06-01

    Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator).

  14. Neuroanatomical correlates of apathy in late-life depression and antidepressant treatment response

    PubMed Central

    Yuen, Genevieve S.; Gunning, Faith M.; Woods, Eric; Klimstra, Sibel A.; Hoptman, Matthew J.; Alexopoulos, George S.

    2014-01-01

    Background Apathy is a prominent feature of geriatric depression that predicts poor clinical outcomes and hinders depression treatment. Yet little is known about the neurobiology and treatment of apathy in late-life depression. This study examined apathy prevalence in a clinical sample of depressed elderly, response of apathy to selective serotonin reuptake inhibitor (SSRI) treatment, and neuroanatomical correlates that distinguished responders from nonresponders and healthy controls. Methods Participants included 45 non-demented, elderly with major depression and 43 elderly comparison individuals. After a 2-week single-blind placebo period, depressed participants received escitalopram 10mg daily for 12 weeks. The Apathy Evaluation Scale (AES) and 24-item Hamilton Depression Rating Scale (HDRS) were administered at baseline and 12 weeks. MRI scans were acquired at baseline for concurrent structural and diffusion tensor imaging of anterior cingulate grey matter and associated white matter tracts. Results 35.5% of depressed patients suffered from apathy. This declined to 15.6% (p<0.1) following treatment, but 43% of initial sufferers continued to report significant apathy. Improvement of apathy with SSRI was independent of change in depression but correlated with larger left posterior subgenual cingulate volumes and greater fractional anisotropy of left uncinate fasciculi. Limitations modest sample size, no placebo control, post-hoc secondary analysis, use of 1.5T MRI scanner Conclusions While prevalent in geriatric depression, apathy is separable from depression with regards to medication response. Structural abnormalities of the posterior subgenual cingulate and uncinate fasciculus may perpetuate apathetic states by interfering with prefrontal cortical recruitment of limbic activity essential to motivated behavior. PMID:25012429

  15. BDNF promoter methylation and genetic variation in late-life depression

    PubMed Central

    Januar, V; Ancelin, M-L; Ritchie, K; Saffery, R; Ryan, J

    2015-01-01

    The regulation of the brain-derived neurotrophic factor (BDNF) is important for depression pathophysiology and epigenetic regulation of the BDNF gene may be involved. This study investigated whether BDNF methylation is a marker of depression. One thousand and twenty-four participants were recruited as part of a longitudinal study of psychiatric disorders in general population elderly (age⩾65). Clinical levels of depression were assessed using the Mini International Neuropsychiatric Interview for the diagnosis of major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder IV criteria, and the Centre for Epidemiologic Studies Depression Scale (CES-D) for assessment of moderate to severe depressive symptoms. Buccal DNA methylation at the two most widely studied BDNF promoters, I and IV, was investigated using the Sequenom MassARRAY platform that allows high-throughput investigation of methylation at individual CpG sites within defined genomic regions. In multivariate linear regression analyses adjusted for a range of participant characteristics including antidepressant use, depression at baseline, as well as chronic late-life depression over the 12-year follow-up, were associated with overall higher BDNF methylation levels, with two sites showing significant associations (promoter I, Δ mean=0.4%, P=0.0002; promoter IV, Δ mean=5.4%, P=0.021). Three single-nucleotide polymorphisms (rs6265, rs7103411 and rs908867) were also found to modify the association between depression and promoter I methylation. As one of the largest epigenetic studies of depression, and the first investigating BDNF methylation in buccal tissue, our findings highlight the potential for buccal BDNF methylation to be a biomarker of depression. PMID:26285129

  16. A Meta-Analysis of Executive Dysfunction and Antidepressant Treatment Response in Late-Life Depression

    PubMed Central

    Pimontel, Monique A.; Rindskopf, David; Rutherford, Bret R.; Brown, Patrick J.; Roose, Steven P.; Sneed, Joel R.

    2015-01-01

    Objective Depressed older adults with executive dysfunction (ED) may respond poorly to antidepressant treatment. ED is a multifaceted construct and different studies have measured different aspects of ED, making it unclear which aspects predict poor response. Meta-analytic methods were used to determine whether ED predicts poor antidepressant treatment response in late-life depression and to determine which domains of executive functioning are responsible for this relationship. Methods A Medline search was conducted to identify regimented treatment trials contrasting executive functioning between elderly responders and nonresponders; only regimented treatment trials for depressed outpatients aged 50 and older were included. Following the most recent PRISMA guidelines, 25 measures of executive functioning were extracted from eight studies. Six domains were identified: cognitive flexibility, planning and organization, response inhibition, selective attention, verbal fluency, and the Dementia Rating Scale Initiation/Perseveration composite score (DRS I/P). Hedge’s g was calculated for each measure of executive functioning. A three-level Bayesian hierarchical linear model (HLM) was used to estimate effect sizes for each domain of executive functioning. Results The effect of planning and organization was significantly different from zero (Bayesian HLM estimate of domain effect size: 0.91; 95% CI: 0.32–1.58), whereas cognitive flexibility, response inhibition, selective attention, verbal fluency, and the DRS I/P composite score were not. Conclusion The domain of planning and organization is meaningfully associated with poor antidepressant treatment response in late-life depression. These findings suggest that therapies that focus on planning and organization may provide effective augmentation strategies for antidepressant nonresponders with late-life depression. PMID:26282222

  17. Spouse health status, depressed affect, and resilience in mid and late life: a longitudinal study.

    PubMed

    Bookwala, Jamila

    2014-04-01

    This study used longitudinal data to examine the effects of spousal illness on depressive symptoms among middle-aged and older married individuals and the extent to which the adverse effects of illness in a spouse were mitigated by 2 psychological resources, mastery and self-esteem. Using 1,704 married participants who were 51 years of age on average, depressive symptoms were compared in 4 groups varying in their experience of spousal health transitions: those whose spouse remained ill at T1 and T2, those whose spouse declined in health from T1 to T2, those whose spouse's health improved from T1 to T2, and those whose spouse remained healthy at both time points. Mixed analyses of covariance showed that, as hypothesized, having a spouse who became or remained ill over time was linked to greater depressed affect by T2, whereas having a spouse improve in health was associated with a decline in depressive symptomatology. Moderated regression analyses indicated that while higher mastery and self-esteem were linked to lower depressed affect in general, these resources were especially protective against depressed affect for those whose spouse remained ill at both time points. These findings are at the intersection of life course theory and the stress process model highlighting the contextual forces in and the interconnectedness of individual development as well as the plasticity and resilience evident in adaptation to stress during mid and late life.

  18. Atypical antipsychotics as add-on treatment in late-life depression

    PubMed Central

    Cakir, Sibel; Senkal, Zeynep

    2016-01-01

    Background Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study. Methods The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results Thirty-five patients were screened: 21 (60%) had quetiapine, twelve (34.28%) had aripiprazole, and two (5.71%) had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02). Of the 35 patients, 23 (65.7%) patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. PMID:27672315

  19. Atypical antipsychotics as add-on treatment in late-life depression

    PubMed Central

    Cakir, Sibel; Senkal, Zeynep

    2016-01-01

    Background Second-generation antipsychotics (SGAs) have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study. Methods The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results Thirty-five patients were screened: 21 (60%) had quetiapine, twelve (34.28%) had aripiprazole, and two (5.71%) had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02). Of the 35 patients, 23 (65.7%) patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients.

  20. Resting state functional connectivity and treatment response in late-life depression

    PubMed Central

    Andreescu, Carmen; Tudorascu, Dana L.; Butters, Meryl A.; Tamburo, Erica; Patel, Meenal; Price, Julie; Karp, Jordan F.; Reynolds, Charles F.; Aizenstein, Howard

    2013-01-01

    Indices of functional connectivity in the default mode network (DMN) are promising neural markers of treatment response in late-life depression. We examined the differences in DMN functional connectivity between treatment-responsive and treatment-resistant depressed older adults. Forty-seven depressed older adults underwent MRI scanning pre- and post- pharmacotherapy. Forty-six never depressed older adults underwent MR scanning as comparison subjects. Treatment response was defined as achieving a Hamilton Depression Rating Scale of 10 or less post-treatment. We analyzed resting state functional connectivity using the posterior cingulate cortex as the seed region-of-interest. The resulting correlation maps were employed to investigate between-group differences. Additionally we examined the association between white matter hyperintensity burden and functional connectivity results. Comparison of pre- and post-treatment scans of depressed participants revealed greater post-treatment functional connectivity in the frontal precentral gyrus. Relative to treatment-responsive participants, treatment-resistant participants had increased functional connectivity in the left striatum. When adjusting for white matter hyperintensity burden, the observed differences lost significance for the PCC-prefrontal functional connectivity, but not for the PCC-striatum functional connectivity. The post-treatment “frontalization” of the DMN connectivity suggests a normalizing effect of antidepressant treatment. Moreover, our study confirms the central role of white matter lesions in disrupting brain functional connectivity. PMID:24144505

  1. Resting state functional connectivity and treatment response in late-life depression.

    PubMed

    Andreescu, Carmen; Tudorascu, Dana L; Butters, Meryl A; Tamburo, Erica; Patel, Meenal; Price, Julie; Karp, Jordan F; Reynolds, Charles F; Aizenstein, Howard

    2013-12-30

    Indices of functional connectivity in the default mode network (DMN) are promising neural markers of treatment response in late-life depression. We examined the differences in DMN functional connectivity between treatment-responsive and treatment-resistant depressed older adults. Forty-seven depressed older adults underwent MRI scanning pre- and post-pharmacotherapy. Forty-six never depressed older adults underwent MR scanning as comparison subjects. Treatment response was defined as achieving a Hamilton Depression Rating Scale of 10 or less post-treatment. We analyzed resting state functional connectivity using the posterior cingulate cortex as the seed region-of-interest. The resulting correlation maps were employed to investigate between-group differences. Additionally we examined the association between white matter hyperintensity burden and functional connectivity results. Comparison of pre- and post-treatment scans of depressed participants revealed greater post-treatment functional connectivity in the frontal precentral gyrus. Relative to treatment-responsive participants, treatment-resistant participants had increased functional connectivity in the left striatum. When adjusting for white matter hyperintensity burden, the observed differences lost significance for the PCC-prefrontal functional connectivity, but not for the PCC-striatum functional connectivity. The post-treatment "frontalization" of the DMN connectivity suggests a normalizing effect of antidepressant treatment. Moreover, our study confirms the central role of white matter lesions in disrupting brain functional connectivity. PMID:24144505

  2. Self-efficacy and depression in late life: a primary prevention proposal.

    PubMed

    Blazer, D G

    2002-11-01

    Feelings of sadness and loneliness are ubiquitous in late life and a risk factor for depression and perhaps other mental illnesses in late life. Targeting sadness and loneliness for an intervention addresses both primary risk reduction for depressive disorders and promotion of overall mental health in the elderly. Nevertheless, few studies document the efficacy of primary prevention efforts in preventing depressive disorders in the elderly. The author argues that the attainment of positive mental health depends in considerable part upon an individual's self-efficacy--the belief that one can organize and execute the courses of action required to develop and enhance a person's belief that he or she can act in ways that lead to a desired goal. Self-efficacy is strengthened, not by some general or abstract instruction, but rather by the experience of successfully dealing with and thus overcoming specific problems. The extant literature suggests that many potential approaches may be available to develop and enhance self-efficacy in the elderly--approaches that potentially could be broadly applicable in community settings.

  3. Autonomous neurobiological pathways to late-life major depressive disorder: clinical and pathophysiological implications.

    PubMed

    Kumar, Anand; Mintz, Jim; Bilker, Warren; Gottlieb, Gary

    2002-02-01

    The objective of our study was to elucidate distinct paths to depression in a model that incorporates age, measures of medical comorbidity, neuroanatomical compromise, and cognitive status in a sample of patients with late-life major depressive disorder (MDD) and nondepressed controls. Our study was cross-sectional in nature and utilized magnetic resonance imaging (MRI) estimates of brain and high-intensity lesion volumes together with clinical indices of cerebrovascular and nonvascular medical comorbidity. Neuroanatomic and clinical measures were incorporated into a structural covariance model in order to test pathways to MDD. Our data indicate that there are two paths to MDD; one path is represented by vascular and nonvascular medical comorbidity that contribute to high-intensity lesions that lead to depression. Smaller brain volumes represent a distinct path to the mood disorder. Age influences depression by increasing atrophy and overall medical comorbidity but has no direct impact on MDD. These findings demonstrate that there are distinct biological substrates to the neuroanatomical changes captured on MRI. These observations further suggest that neurobiological mechanisms acting in parallel may compromise brain structure/function, thereby predisposing individuals to clinical brain disorders such as depression. PMID:11790518

  4. Magnetic resonance imaging predictors of treatment response in late-life depression.

    PubMed

    Aizenstein, Howard J; Khalaf, Alexander; Walker, Sarah E; Andreescu, Carmen

    2014-03-01

    In older adults, depression not only results in more years lived with disability than any other disease but it also carries additional risks of suicide, medical comorbidities, and family caregiving burden. Because it can take many months to identify an effective treatment regimen, it is of utmost importance to shorten the window of time and identify early on what medications and dosages will work effectively for individuals having depression. Late-life depression (LLD) has been associated with greater burden of age-related changes (eg, atrophy, white matter ischemic changes, and functional connectivity). Depression in midlife has been shown to alter affective reactivity and regulation, and functional magnetic resonance imaging (fMRI) studies in LLD have replicated the same abnormalities. Effective treatment can normalize these alterations. This article provides a review of the current literature using structural and functional neuroimaging to identify MRI predictors of treatment response in LLD. The majority of the literature on structural MRI has focused on the vascular depression hypothesis, and studies support the view that loss of brain volume and white matter integrity was associated with poorer treatment outcomes. Studies using fMRI have reported that lower task-based activity in the prefrontal cortex and limbic regions was associated with poorer outcome. These imaging markers may be integrated into clinical decision making to attain better treatment outcomes in the future. PMID:24381231

  5. Neuroanatomical correlates of late-life depression and associated cognitive changes.

    PubMed

    Lebedeva, Aleksandra; Borza, Tom; Håberg, Asta Kristine; Idland, Ane-Victoria; Dalaker, Turi Olene; Aarsland, Dag; Selbaek, Geir; Beyer, Mona K

    2015-11-01

    We compared cortical thickness between patients with late-life depression (LLD) and healthy controls and between patients with early-onset (EOD) and late-onset (LOD) depression. We also tested age effects on cortical thickness in LLD and controls and if cortical thickness and hippocampal volumes were associated with cognitive performance in LLD. Three-dimensional T1-weighted magnetic resonance images were obtained in 49 LLD and 49 matched hospital controls and processed using FreeSurfer. General linear model analysis was used as a statistical approach. LLD group had thinning in the left parahippocampal, fusiform, and inferior-parietal cortex compared with controls. Age correlated with cortical thinning in controls but not in LLD. Women in the LOD groups had extensive cortical thinning in the lateral prefrontal cortex bilaterally compared with EOD women. Absence of statistically significant changes observed in men should however be treated with caution because of the low number of men in the study. Mini-Mental Status Examination score correlated with lateral prefrontal cortical thickness bilaterally and hippocampal volume in the total group of LLD and in LOD but not EOD. LLD is associated with cortical thinning, which is associated with age at depression onset, gender, and level of cognitive functioning.

  6. Applications of magnetic resonance imaging for treatment-resistant late-life depression

    PubMed Central

    Agudelo, Christian; Aizenstein, Howard J.; Karp, Jordan F.; Reynolds III, Charles F.

    2015-01-01

    Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator). PMID:26246790

  7. Structural Imaging in Late Life Depression: Association with Mood and Cognitive Responses to Antidepressant Treatment

    PubMed Central

    Marano, Christopher M.; Workman, Clifford I.; Lyman, Christopher H.; Munro, Cynthia A.; Kraut, Michael A.; Smith, Gwenn S.

    2014-01-01

    Objectives Recent positron emission tomography studies of cerebral glucose metabolism have identified the functional neural circuitry associated with mood and cognitive responses to antidepressant treatment in late life depression (LLD). The structural alterations in these networks are not well understood. The present study used magnetic resonance (MR) imaging and voxel-based morphometry (VBM) to evaluate the association between grey matter volumes and changes in mood symptoms and cognitive function with treatment with the antidepressant citalopram. Design Open label trial with baseline brain MR scan. Mood and cognitive assessments performed at baseline and during citalopram treatment. Setting Outpatient clinics of an academic medical center. Participants 17 previously unmedicated patients age 55 or older with a major depressive episode and 17 non-depressed comparison subjects. Intervention 12 week trial of flexibly dosed citalopram. Measurements Grey matter volumes, Hamilton Depression Rating Scale, California Verbal Learning Test, Delis–Kaplan Executive Function System™. Results In LLD, higher grey matter volumes in the cingulate gyrus, superior and middle frontal gyri, middle temporal gyrus and precuneus was associated with greater mood improvement. Higher grey matter volumes in primarily frontal areas were associated with greater improvement in verbal memory and verbal fluency performance. Conclusions Associations with antidepressant induced improvements in mood and cognition were observed in several brain regions previously correlated with normalization of glucose metabolism after citalopram treatment in LLD. Future studies will investigate molecular mechanisms underlying these associations (e.g. beta-amyloid, inflammation, glutamate). PMID:24238925

  8. Longitudinal Studies of Cerebral Glucose Metabolism in Late-Life Depression and Normal Aging

    PubMed Central

    Marano, Christopher M.; Workman, Clifford I.; Kramer, Elisse; Hermann, Carol R.; Ma, Yilong; Dhawan, Vijay; Chaly, Thomas; Eidelberg, David; Smith, Gwenn S.

    2014-01-01

    Objective Late-life depression (LLD) has a substantial public health impact and is both a risk factor for and prodrome of dementia. Positron Emission Tomography (PET) studies of cerebral glucose metabolism have demonstrated sensitivity in evaluating neural circuitry involved in depression, aging, incipient cognitive decline and dementia. The present study evaluated the long term effects of a course of antidepressant treatment on glucose metabolism in LLD patients. Methods Nine LLD patients and 7 non-depressed control subjects underwent clinical and cognitive evaluations as well as brain magnetic resonance imaging and PET studies of cerebral glucose metabolism at baseline, after 8 weeks of treatment with citalopram for a major depressive episode (patients only), and at an approximately 2 year follow-up. Results The majority of LLD patients were remitted at follow-up (7/9). Neither patients nor controls showed significant cognitive decline. The patients showed greater increases in glucose metabolism than the controls in regions associated with mood symptoms (anterior cingulate and insula). Both groups showed decreases in metabolism in posterior association cortices implicated in dementia. Conclusions Longitudinal changes in cerebral glucose metabolism are observed in controls and LLD patients without significant cognitive decline that are more extensive than the decreases in brain volume. Longer duration follow-up studies and the integration of other molecular imaging methods will have implications for understanding the clinical and neurobiological significance of these metabolic changes. PMID:22740289

  9. Late-life depression: evidence-based treatment and promising new directions for research and clinical practice.

    PubMed

    Andreescu, Carmen; Reynolds, Charles F

    2011-06-01

    As the population ages, successive cohorts of older adults will experience depressive disorders. Late-life depression (LLD) carries additional risk for suicide, medical comorbidity, disability, and family caregiving burden. Although response and remission rates to pharmacotherapy and electroconvulsive therapy are comparable with those in midlife depression, relapse rates are higher, underscoring the challenge to achieve and maintain wellness. This article reviews the evidence base for LLD treatment options and provides an analysis of treatment options for difficult-to-treat LLD variants (eg, psychotic depression, vascular depression). Treatment algorithms are also reviewed based on predictors of response and promising novel treatment options. PMID:21536162

  10. Directions for Effectiveness Research to Improve Health Services for Late-Life Depression in the United States.

    PubMed

    Hoeft, Theresa J; Hinton, Ladson; Liu, Jessica; Unützer, Jürgen

    2016-01-01

    Considerable progress has been made in the treatment of late-life depression over the past 20 years, yet considerable gaps in care remain. Gaps in care are particularly pronounced for older men, certain racial and ethnic minority groups, and those with comorbid medical or mental disorders. We reviewed the peer-reviewed literature and conducted interviews with experts in late-life depression to identify promising directions for effectiveness research to address these gaps in care. We searched the PubMed, PsychInfo, and CINHAL databases between January 1, 1998, through August 31, 2013, using terms related to late-life depression and any of the following: epidemiology, services organization, economics of care, underserved groups including health disparities, impact on caregivers, and interventions. The results of this selective review supplemented by more current recommendations from national experts highlight three priority research areas to improve health services for late-life depression: focusing on the unique needs of the patient through patient-centered care and culturally sensitive care, involving caregivers outside the traditional clinical care team, and involving alternate settings of care. We build on these results to offer five recommendations for future effectiveness research that hold considerable potential to advance intervention and health services development for late-life depression.

  11. The Age-by-Disease Interaction Hypothesis of Late-Life Depression

    PubMed Central

    McKinney, Brandon Chad; Sibille, Etienne

    2012-01-01

    The phenomenological diagnosis of depression is successful in increasing diagnostic reliability, but it is a classification scheme without biological bases. One subtype of depression for which evidence suggests a unique biological basis is late-life depression (LLD), with first onset of symptoms after the age of 65. LLD is common and poses a significant burden on affected individuals, caretakers, and society. The pathophysiology of LLD includes disruptions of the neural network underlying mood, which can be conceptualized as the result of dysfunction in multiple underlying biological processes. Here, we briefly review current LLD hypotheses and then describe the characteristics of molecular brain aging and their overlap with disease processes. Further, we propose a new hypothesis for LLD, the Age-by-Disease Interaction hypothesis, which posits that the clinical presentation of LLD is the integrated output of specific biological processes that are pushed in LLD-promoting directions by changes in gene expression naturally occurring during brain aging, hence leading the brain to a physiological state that is more susceptible to LLD, since additional pushes by genetic, environmental and biochemical factors may now be sufficient to generate dysfunctional states that produce depressive symptoms. We put our propositions together into a decanalization model to aid in illustrating how age-related biological changes of the brain can shift the repertoire of available functional states in a pro-depression direction, and how additional factors can readily lead the system into distinct and stable maladaptive phenotypes, including LLD. This model brings together basic research on neuropsychiatric and neurodegenerative diseases more closely with the investigation of normal aging. Specifically, identifying biological processes affected during normal aging may inform the development of new interventions for the prevention and treatment of LLD. PMID:23570886

  12. Is Old Age Depressing? Growth Trajectories and Cohort Variations in Late-Life Depression

    ERIC Educational Resources Information Center

    Yang, Yang

    2007-01-01

    Findings in previous research on the association of old age and depression are inconsistent due to a confounding of age changes and cohort differences. Using data from an accelerated longitudinal design from the National Institute of Aging Established Populations for Epidemiologic Studies of the Elderly, this study addresses three questions: (1)…

  13. White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression.

    PubMed

    Khalaf, Alexander; Edelman, Kathryn; Tudorascu, Dana; Andreescu, Carmen; Reynolds, Charles F; Aizenstein, Howard

    2015-12-01

    White matter hyperintensities (WMHs) have been shown to be associated with the development of late-life depression (LLD) and eventual treatment outcomes. This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis. All depressed subjects started pharmacological treatment for depression shortly after a baseline magnetic resonance imaging (MRI) scan. At 12 weeks, patients underwent a follow-up MRI scan, and were categorized as either treatment remitters (n=23) or non-remitters (n=24). Among all patients, there was as a significant increase in WMHs over 12 weeks (t(46)=2.36, P=0.02). When patients were stratified by remission status, non-remitters demonstrated a significant increase in WMHs (t(23)=2.17, P=0.04), but this was not observed in remitters (t(22)=1.09, P=0.29). Other markers of brain integrity were also investigated including whole brain gray matter volume, hippocampal volume, and fractional anisotropy. No significant differences were observed in any of these markers during treatment, including when patients were stratified based on remission status. These results add to existing literature showing the association between WMH accumulation and LLD treatment outcomes. Moreover, this is the first study to demonstrate similar findings over a short interval (ie 12 weeks), which corresponds to the typical length of an antidepressant trial. These findings serve to highlight the acute interplay of cerebrovascular ischemic disease and LLD. PMID:26058663

  14. Functional Connectivity in the Cognitive Control Network and the Default Mode Network in Late-life Depression

    PubMed Central

    Alexopoulos, George S.; Hoptman, Matthew J.; Kanellopoulos, Dora; Murphy, Christopher F.; Lim, Kelvin O.; Gunning, Faith M.

    2011-01-01

    Background Abnormalities have been identified in the Cognitive Control Network (CCN) and the default mode network (DMN) during episodes of late-life depression. This study examined whether functional connectivity at rest (FC) within these networks characterize late-life depression and predict antidepressant response. Methods 26 non-demented, non-MCI older adults were studied. Of these, 16 had major depression and 10 had no psychopathology. Depressed patients were treated with escitalopram (target dose 20 mg) for 12 weeks after a 2-week placebo phase. Resting state timeseries was determined prior to treatment. FC within the CCN was determined by placing seeds in the dACC and the DLPFC bilaterally. FC within the DMN was assessed from a seed placed in the posterior cingulate. Results Low resting state FC within the CCN and high FC within the DMN distinguished depressed from normal elderly subjects. Beyond this “double dissociation”, low resting state FC within the CCN predicted low remission rate and persistence of depressive symptoms and signs, apathy, and dysexecutive behavior after treatment with escitalopram. In contrast, resting state FC within the DMN was correlated with pessimism but did not predict treatment response. Conclusions If confirmed, these findings may serve as a signature of the brain’s functional topography characterizing late-life depression and sustaining its symptoms. By identifying the network abnormalities underlying biologically meaningful characteristics (apathy, dysexecutive behavior, pessimism) and sustaining late-life depression, these findings can provide a novel target on which new somatic and psychosocial treatments can be tested. PMID:22425432

  15. Relationship Between Hippocampal Volume, Serum BDNF, and Depression Severity Following Electroconvulsive Therapy in Late-Life Depression.

    PubMed

    Bouckaert, Filip; Dols, Annemiek; Emsell, Louise; De Winter, François-Laurent; Vansteelandt, Kristof; Claes, Lene; Sunaert, Stefan; Stek, Max; Sienaert, Pascal; Vandenbulcke, Mathieu

    2016-10-01

    Recent structural imaging studies have described hippocampal volume changes following electroconvulsive therapy (ECT). It has been proposed that serum brain-derived neurotrophic factor (sBDNF)-mediated neuroplasticity contributes critically to brain changes following antidepressant treatment. To date no studies have investigated the relationship between changes in hippocampal volume, mood, and sBDNF following ECT. Here, we combine these measurements in a longitudinal study of severe late-life unipolar depression (LLD). We treated 88 elderly patients with severe LLD twice weekly until remission (Montgomery-Åsberg Depression Rating Scale (MADRS) <10). sBDNF and MADRS were obtained before ECT (T0), after the sixth ECT (T1), 1 week after the last ECT (T2), 4 weeks after the last ECT (T3), and 6 months after the last ECT (T4). Hippocampal volumes were quantified by manual segmentation of 3T structural magnetic resonance images in 66 patients at T0 and T2 and in 23 patients at T0, T2, and T4. Linear mixed models (LMM) were used to examine the evolution of MADRS, sBDNF, and hippocampal volume over time. Following ECT, there was a significant decrease in MADRS scores and a significant increase in hippocampal volume. Hippocampal volume decreased back to baseline values at T4. Compared with T0, sBDNF levels remained unchanged at T1, T2, and T3. There was no coevolution between changes in MADRS scores, hippocampal volume, and sBDNF. Hippocampal volume increase following ECT is an independent neurobiological effect unrelated to sBDNF and depressive symptomatology, suggesting a complex mechanism of action of ECT in LLD. PMID:27272769

  16. Exploring the Relationship between Absolute and Relative Position and Late-Life Depression: Evidence from 10 European Countries

    ERIC Educational Resources Information Center

    Ladin, Keren; Daniels, Norman; Kawachi, Ichiro

    2010-01-01

    Purpose: Socioeconomic inequality has been associated with higher levels of morbidity and mortality. This study explores the role of absolute and relative deprivation in predicting late-life depression on both individual and country levels. Design and Methods: Country- and individual-level inequality indicators were used in multivariate logistic…

  17. Are depression and frailty overlapping syndromes in mid- and late-life? A latent variable analysis

    PubMed Central

    Mezuk, Briana; Lohman, Matt; Dumenci, Levent; Lapane, Kate L.

    2012-01-01

    Background Depression and frailty both predict disability and morbidity in later life. However, it is unclear to what extent these common geriatric syndromes represent overlapping constructs. Objective To examine the joint relationship between the constructs of depression and frailty. Methods Data come from 2004/5 wave of the Baltimore Epidemiologic Catchment Area Study and analysis is limited to participants aged 40 and older with complete data on frailty and depression indicators (N = 683). Depression was measured using the Diagnostic Interview Schedule and frailty was indexed by modified Fried criteria. A series of confirmatory latent class analyses (LCA) were used to assess the degree to which depression and frailty syndromes identify the same populations. A latent Kappa coefficient (Кl) was also estimated between the constructs. Results Confirmatory LCA indicated that depression and frailty represent distinct syndromes rather than a single construct. The joint modeling of the two constructs supported a three class solution for depression and two class solution for frailty, with 2.9% categorized as severe depression, 19.4% as mild depression, and 77.7% as not depressed, and 21.1% categorized as frail and 78.9% as not frail. The chance-corrected agreement statistic indicated moderate correspondence between the depression and frailty constructs (Кl: 66, 95% CI: 0.58 – 0.74). Conclusions Results suggest that depression and frailty are interrelated concepts, yet their operational criteria identify substantively overlapping subpopulations. These findings have implications for understanding factors that contribute to the etiology and prognosis of depression and frailty in later life. PMID:23567406

  18. Association of Cerebral Amyloidosis, Blood Pressure, and Neuronal Injury with Late-Life Onset Depression

    PubMed Central

    Byun, Min Soo; Choe, Young Min; Sohn, Bo Kyung; Yi, Dahyun; Han, Ji Young; Park, Jinsick; Choi, Hyo Jung; Baek, Hyewon; Lee, Jun Ho; Kim, Hyun Jung; Kim, Yu Kyeong; Yoon, Eun Jin; Sohn, Chul-Ho; Woo, Jong Inn; Lee, Dong Young

    2016-01-01

    Previous literature suggests that Alzheimer's disease (AD) process may contribute to late-life onset depression (LLOD). Therefore, we investigated the association of LLOD with cerebral amyloidosis and neuronal injury, the two key brain changes in AD, along with vascular risks. Twenty nine non-demented individuals who first experienced major depressive disorder (MDD) after age of 60 years were included as LLOD subjects, and 27 non-demented elderly individuals without lifetime experience of MDD were included as normal controls (NC). Comorbid mild cognitive impairment (MCI) was diagnosed in 48% of LLOD subjects and in 0% of NC. LLOD, irrespective of comorbid MCI diagnosis, was associated with prominent prefrontal cortical atrophy. Compared to NC, LLOD subjects with comorbid MCI (LLODMCI) showed increased cerebral 11C-Pittsburg compound B (PiB) retention and plasma beta-amyloid 1–40 and 1–42 peptides, as measures of cerebral amyloidosis; and, such relationship was not observed in overall LLOD or LLOD without MCI (LLODwoMCI). LLOD subjects, particularly the LLODwoMCI, had higher systolic blood pressure (SBP) than NC. When analyzed in the same multiple logistic regression model that included prefrontal gray matter (GM) density, cerebral amyloidosis, and SBP as independent variables, only prefrontal GM density showed a significant independent association with LLOD regardless of MCI comorbidity status. Our findings suggest AD process might be related to LLOD via prefrontal neuronal injury in the MCI stage, whereas vascular processes—SBP elevation, in particular—are associated with LLOD via prefrontal neuronal injury even in cognitively intact or less impaired individuals. PMID:27790137

  19. Advancing the Screening of Fibromyalgia in Late-Life Depression: Practical Implications for Psychiatric Settings

    PubMed Central

    Jochum, John R.; Begley, Amy; Dew, Mary Amanda; Weiner, Debra K.; Karp, Jordan F.

    2015-01-01

    Background Fibromyalgia (FM) is common in older adults suffering from mood disorders. However, clinical diagnosis of FM is challenging, particularly in psychiatric settings. We examined the prevalence of FM and the sensitivity of three simple screeners for FM. Methods Using cross-sectional data, we evaluated three tests against the American College of Rheumatology (ACR) 1990 Criteria for the Classification of Fibromyalgia: a “Do you often feel like you hurt all over?” question, a pain map score, and the Pope and Hudson (PH) interview for FM. Participants: were 185 community-dwelling adults ≥ 60 years old with comorbid depression and chronic low back pain evaluated at a late-life mental health clinic. Results 53 of 185 subjects (29%) met the ACR 1990 FM criteria. Compared to those without FM, the FM group had more “yes” answers to the “hurt all over?” question and higher pain map scores. To reach a sensitivity of at least 0.90, the cut-off score for the pain map was 8. The sensitivity of the pain map, “hurt all over?” question, and PH criteria were 0.92 [95%CI 0.82–0.98], 0.91 [95%CI 0.79–0.97], and 0.94 [95%CI 0.843–0.99] respectively. Conclusions Nearly one in three older adults suffering from depression and chronic low back pain met ACR 1990 FM criteria. Three short screening tests showed high sensitivity when compared to the ACR 1990 FM criteria. Implementation of one of the simple screeners for FM in geriatric psychiatry settings may guide the need for further diagnostic evaluation. PMID:25907254

  20. Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study

    PubMed Central

    Guerra, Mariella; Ferri, Cleusa P.; Sosa, Ana Luisa; Salas, Aquiles; Gaona, Ciro; Gonzales, Victor; de la Torre, Gabriela Rojas; Prince, Martin

    2009-01-01

    Background The proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide. Aims To estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America. Method A one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM–IV and ICD–10 criteria, Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) algorithm and EURO–D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD–10 depression. Results For DSM–IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD–10 depressive episode between 4.5% and 5.1%, for GMS–AGECAT depression between 30.0% and 35.9% and for EURO–D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD–10 and DSM–IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD–10 depressive episode. Conclusions The treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector. PMID:19949200

  1. Depressive Symptoms and the Experience of Pleasure in Daily Life: An Exploration of Associations in Early and Late Adolescence.

    PubMed

    van Roekel, Eeske; Bennik, Elise C; Bastiaansen, Jojanneke A; Verhagen, Maaike; Ormel, Johan; Engels, Rutger C M E; Oldehinkel, Albertine J

    2016-07-01

    Although loss of pleasure (i.e., anhedonia) is one of the two core symptoms of depression, very little research has examined the relation between depressive symptoms and the experience of pleasure in daily life. This exploratory study in two population-based adolescent samples aimed to examine how depressive symptoms and anhedonia specifically were related to (1) the proportion and intensity of positive events, (2) mean and variability of positive affect (PA), (3) reactivity to positive events, and (4) reactivity to PA (i.e., whether PA elicits positive events). We used Experience Sampling to measure positive events and PA several times a day during 6 to 14 days in early (N = 284) and late (N = 74) adolescents. Results showed that depressive symptoms were related to a lower proportion and intensity of positive events, lower mean PA, and higher variability in PA regardless of sex and stage of adolescence. No clear evidence was found for differential reactivity to positive events or to PA. Anhedonia was not associated with most daily life experiences of pleasure. Our findings, though preliminary, suggest that although adolescents with many depressive symptoms experience less positive events and lower PA, they are able to enjoy pleasurable events to the same extent as individuals with fewer depressive symptoms.

  2. Withdrawal, apathy and lack of vigor in late life depression: factorial validity and relationship to diagnosis.

    PubMed

    Cheng, Sheung-Tak; Chan, Alfred C M

    2007-09-01

    Withdrawal, apathy and lack of vigor (WAV) describe a pattern of lack of vitality and dropping of interests and activities in later life, which may or may not indicate depression. This study examines (a) whether the Geriatric Depression Scale (GDS) contains a measure of this symptom cluster, and if so, (b) whether the presence of WAV leads to more false positive predictions by the GDS. A total of 444 Chinese older persons responded to the GDS and the Mini-Mental State Examination (MMSE), and were independently assessed by psychiatrists for depression and other diagnoses. Confirmatory factor analysis showed that six WAV symptoms formed a distinct cluster on the GDS. WAV was positively correlated with age and MMSE but most other symptom clusters measured on the GDS were not. Nonetheless, the ROC curves were essentially the same, regardless of whether the WAV items were included or not. Further analysis revealed that the optimal cutoff for the GDS without WAV produced fewer false positives, but also missed more true cases, than the full scale. The extent to which false positives become an issue depends on the specific threshold chosen (which entails a tradeoff with sensitivity) rather than the presence of WAV items.

  3. GWAS-identified risk variants for major depressive disorder: Preliminary support for an association with late-life depressive symptoms and brain structural alterations.

    PubMed

    Ryan, Joanne; Artero, Sylvaine; Carrière, Isabelle; Maller, Jerome J; Meslin, Chantal; Ritchie, Karen; Ancelin, Marie-Laure

    2016-01-01

    A number of genome-wide association studies (GWAS) have investigated risk factors for major depressive disorder (MDD), however there has been little attempt to replicate these findings in population-based studies of depressive symptoms. Variants within three genes, BICC1, PCLO and GRM7 were selected for replication in our study based on the following criteria: they were identified in a prior MDD GWAS study; a subsequent study found evidence that they influenced depression risk; and there is a solid biological basis for a role in depression. We firstly investigated whether these variants were associated with depressive symptoms in our population-based cohort of 929 elderly (238 with clinical depressive symptoms and 691 controls), and secondly to investigate associations with structural brain alterations. A number of nominally significant associations were identified, but none reached Bonferroni-corrected significance levels. Common SNPs in BICC1 and PCLO were associated with a 50% and 30% decreased risk of depression, respectively. PCLO rs2522833 was also associated with the volume of grey matter (p=1.6×10(-3)), and to a lesser extent with hippocampal volume and white matter lesions. Among depressed individuals rs9870680 (GRM7) was associated with the volume of grey and white matter (p=10(-4) and 8.3×10(-3), respectively). Our results provide some support for the involvement of BICC1 and PCLO in late-life depressive disorders and preliminary evidence that these genetic variants may also influence brain structural volumes. However effect sizes remain modest and associations did not reach corrected significance levels. Further large imaging studies are needed to confirm our findings.

  4. The relationship between fasting serum glucose and cerebral glucose metabolism in late-life depression and normal aging

    PubMed Central

    Marano, Christopher M.; Workman, Clifford I.; Lyman, Christopher H.; Kramer, Elisse; Hermann, Carol R.; Ma, Yilong; Dhawan, Vijay; Chaly, Thomas; Eidelberg, David; Smith, Gwenn S.

    2015-01-01

    Evidence exists for late-life depression (LLD) as both a prodrome of and risk factor for Alzheimer’s disease (AD). The underlying neurobiological mechanisms are poorly understood. Impaired peripheral glucose metabolism may explain the association between depression and AD given the connection between type 2 diabetes mellitus with both depression and AD. Positron emission tomography (PET) measures of cerebral glucose metabolism are sensitive to detecting changes in neural circuitry in LLD and AD. Fasting serum glucose (FSG) in non-diabetic young (YC; n=20) and elderly controls (EC; n=12) and LLD patients (n=16) was correlated with PET scans of cerebral glucose metabolism on a voxel-wise basis. The negative correlations were more extensive in EC versus YC and in LLD patients versus EC. Increased FSG correlated with decreased cerebral glucose metabolism in LLD patients to a greater extent than in EC in heteromodal association cortices involved in mood symptoms and cognitive deficits observed in LLD and dementia. Negative correlations in YC were observed in sensory and motor regions. Understanding the neurobiological consequences of diabetes and associated conditions will have substantial public health significance given that this is a modifiable risk factor for which prevention strategies could have an important impact on lowering dementia risk. PMID:24650451

  5. Anxiety disorders in late life.

    PubMed Central

    Flint, A. J.

    1999-01-01

    OBJECTIVE: To review the epidemiology, clinical characteristics, and treatment of anxiety disorders in late life. QUALITY OF EVIDENCE: Epidemiologic and comorbidity data are derived from well designed random-sample community surveys. There are virtually no controlled data specific to treatment of anxiety in the elderly. Guidelines for treating anxiety disorders in late life, therefore, must be extrapolated from results of randomized controlled trials conducted in younger patients. MAIN MESSAGE: Generalized anxiety disorder and agoraphobia account for most cases of anxiety disorder in late life. Late-onset generalized anxiety is usually associated with depressive illness and, in this situation, the primary pharmacologic treatment is antidepressant medication. Most elderly people with agoraphobia do not give a history of panic attacks; exposure therapy is the preferred treatment for agoraphobia without panic. CONCLUSIONS: Physicians need to make more use of antidepressant medication and behavioural therapy and less use of benzodiazepines in treating anxiety disorders in late life. PMID:10587775

  6. Late-life depressed mood and weight change contribute to the risk of each other

    PubMed Central

    Koster, Annemarie; van Gool, Coen H.; Kempen, Gertrudis I.J.M.; Penninx, Brenda W.J.H.; Lee, Jung Sun; Rubin, Susan M.; Tylavsky, Frances A.; Yaffe, Kristine; Newman, Anne B.; Harris, Tamara B.; Pahor, Marco; Ayonayon, Hilsa N.; van Eijk, Jacques Th.M.; Kritchevsky, Stephen B.

    2010-01-01

    Objectives Weight change may be considered an effect of depression. In turn, depression may follow weight change. Deteriorations in health may mediate these associations. The objective was to examine reciprocal associations between depressed mood and weight change, and the potentially mediating role of deteriorations in health (interim hospitalizations and incident mobility imitation) in these associations. Design Prospective observational cohort study Settings Memphis, Tennessee and Pittsburgh, Pennsylvania Participants 2406 black and white men and women, aged 70–79 participating in the Health, Aging and Body composition (Health ABC) study. Measurements Depressed mood at baseline (T1) and 3-year follow-up (T4) was measured with the CES-D scale. Three weight change groups (T1–T4) were created: loss (≥5% loss), stable (within ±5% loss or gain), and weight gain (≥5% gain). Results At T1 and T4, respectively 4.4% and 9.5% of the analysis sample had depressed mood. T1 depressed mood was associated with weight gain over the 3-year period (OR:1.91; 95%CI:1.13–3.22). Weight loss over the 3-year period was associated with T4 depressed mood (OR:1.51; 95%CI:1.05–2.16). Accounting for deteriorations in health in the reciprocal associations between weight change and depressed mood reduced effect sizes between 16–27%. Conclusions In this study, depressed mood predicted weight gain over three years, while weight loss over three years predicted depressed mood. These associations were partly mediated through deteriorations in health. Implications for clinical practice and prevention include increased awareness that depressed mood can cause weight change, but can also be preceded by deteriorations in health and weight change. PMID:20224519

  7. A Daily Diary Study of Co-Rumination, Stressful Life Events, and Depressed Mood in Late Adolescents

    ERIC Educational Resources Information Center

    White, Megan E.; Shih, Josephine H.

    2012-01-01

    The purpose of this study was to extend the research on co-rumination and depressed mood by examining the impact of co-rumination on depressed mood on a daily basis while controlling for the effects of daily stress events in a sample of late adolescents. Two-hundred and seventy-nine predominantly Caucasian college students (95 male, 184 female)…

  8. The temptation of suicide: striatal gray matter, discounting of delayed rewards, and suicide attempts in late-life depression

    PubMed Central

    Dombrovski, Alexandre Y.; Siegle, Greg J.; Szanto, Katalin; Clark, Luke; Reynolds, Charles F.; Aizenstein, Howard

    2012-01-01

    Background Converging evidence implicates basal ganglia alterations in impulsivity and suicidal behavior. For example, D2/D3 agonists and subthalamic nucleus stimulation in Parkinson’s disease trigger impulse control disorders and possibly suicidal behavior. Further, suicidal behavior has been associated with structural basal ganglia abnormalities. Finally, low-lethality, unplanned suicide attempts are associated with increased discounting of delayed rewards, a behavior dependent upon the striatum. Thus, we tested whether, in late-life depression, changes in the basal ganglia were associated with suicide attempts and with increased delay discounting. Methods Fifty-two persons aged ≥60 underwent extensive clinical and cognitive characterization: 33 with major depression (13 suicide attempters [SA], 20 non-suicidal depressed elderly), and 19 non-depressed controls. Participants had high-resolution T1-weighted MPRAGE MRI scans. Basal ganglia gray matter voxel counts were estimated using atlas-based segmentation, with a highly-deformable automated algorithm. Discounting of delayed rewards was assessed using the Monetary Choice Questionnaire, and delay aversion with the Cambridge Gamble Task. Results SA had lower putamen but not caudate or pallidum gray matter voxel counts, compared to the control groups. This difference persisted after accounting for substance use disorders and possible brain injury from suicide attempts. SA with lower putamen gray matter voxel counts displayed higher delay discounting on the MCQ, but not delay aversion on the CGT. Secondary analyses revealed that SA had lower voxel counts in associative and possibly ventral, but not sensorimotor striatum. Conclusions Our findings, while limited by small sample size and case-control design, suggest that striatal lesions could contribute to suicidal behavior by increasing impulsivity. PMID:21999930

  9. [Use of tianeptine (coaxil) in the treatment of late-life depression].

    PubMed

    Andrusenko, M P; Sheshenin, V S; Iakovleva, O B

    1999-01-01

    Efficacy and safety of tianeptine (coaxil) for treatment of depressions in old age were studied in 15 depressed patients at the age of 54-78 years meeting ICD-10 criteria for depressive episode. Open method with a set of rating scales was employed. After the 28-day treatment relief of depressive symptoms was registered by all the scales since the therapy day 7. The degree of improvement on HAMD-scale was 50%, amount of responders--60%. The improvement of cognitive functions by the end of therapy was noted. Clinical predictors of Coaxil efficacy were determined by means of correlation and factor analyses. Relationship between the therapy efficacy and severity of some symptoms in the structure of depression were analyzed. The greatest efficacy of Coaxil was found in depression with prevalence of asthenic and somatovegetative symptoms, in patients with mild anxiety opposite the decrease of the effect in those with severe agitated depressions. The analysis of both frequency and severity of the side-effects has shown good tolerance to Coaxil. The adverse effects manifested with mild gastrointestinal disturbances and drowsiness during daytime.

  10. Spouse Health Status, Depressed Affect, and Resilience in Mid and Late Life: A Longitudinal Study

    ERIC Educational Resources Information Center

    Bookwala, Jamila

    2014-01-01

    This study used longitudinal data to examine the effects of spousal illness on depressive symptoms among middle-aged and older married individuals and the extent to which the adverse effects of illness in a spouse were mitigated by 2 psychological resources, mastery and self-esteem. Using 1,704 married participants who were 51 years of age on…

  11. Reward signals, attempted suicide, and impulsivity in late-life depression.

    PubMed

    Dombrovski, Alexandre Y; Szanto, Katalin; Clark, Luke; Reynolds, Charles F; Siegle, Greg J

    2013-10-01

    IMPORTANCE—Suicide can be viewed as an escape from unendurable punishment at the cost of any future rewards. Could faulty estimation of these outcomes predispose to suicidal behavior? In behavioral studies, many of those who have attempted suicide misestimate expected rewards on gambling and probabilistic learning tasks.OBJECTIVES—To describe the neural circuit abnormalities that underlie disadvantageous choices in people at risk for suicide and to relate these abnormalities to impulsivity, which is one of the components of vulnerability to suicide.DESIGN—Case-control functional magnetic resonance imaging study of reward learning using are inforcement learning model.SETTING—University hospital and outpatient clinic.PATIENTS—Fifty-three participants 60 years or older, including 15 depressed patients who had attempted suicide, 18 depressed patients who had never attempted suicide (depressed control subjects), and 20 psychiatrically healthy controls.MAIN OUTCOMES AND MEASURES—Components of the cortical blood oxygenation level–dependent response tracking expected and unpredicted rewards.RESULTS—Depressed elderly participants displayed 2 distinct disruptions of control over reward-guided behavior. First, impulsivity and a history of suicide attempts (particularly poorly planned ones) were associated with a weakened expected reward signal in the paralimbic cortex,which in turn predicted the behavioral insensitivity to contingency change. Second, depression was associated with disrupted corticostriatothalamic encoding of unpredicted rewards, which in turn predicted the behavioral over sensitivity to punishment. These results were robust to the effects of possible brain damage from suicide attempts, depressive severity, co-occurring substance use and anxiety disorders, antidepressant and anticholinergic exposure, lifetime exposure to electroconvulsive therapy, vascular illness, and incipient dementia.CONCLUSIONS AND RELEVANCE—Altered paralimbic reward

  12. Anxiety Impairs Depression Remission in Partial Responders During Extended Treatment in Late-Life

    PubMed Central

    Greenlee, Adam; Karp, Jordan F.; Dew, Mary Amanda; Houck, Patricia; Andreescu, Carmen; Reynolds, Charles F.

    2010-01-01

    Objectives More than half of older adults with major depressive disorder require extended treatment because of incomplete response during acute treatment. This study characterizes the effect of anxiety on remission during extended treatment for partial responders. Methods Following 6 weeks of escitalopram 10mg/day + Depression Care Management (DCM), 124 partial-responders (Hamilton Rating Scale for Depression (HRSD) scores of 11–14) were randomly assigned to receive extended treatment with escitalopram 20 mg/day + DCM with or without interpersonal psychotherapy (IPT) for 16 weekly sessions. Remission was defined as three consecutive weekly scores ≤7 on the HRSD. We assessed concurrent symptoms of anxiety using the Hamilton Rating Scale for Anxiety (HRSA) at pre-treatment and after 6 weeks. We conducted Cox regression analysis of time to remission and logistic modeling of rates of remission. We also explored whether anxiety severity altered any impact of IPT. Results Pre-treatment anxiety was not associated with time to or rates of remission during 16 weeks of extended treatment. In contrast, more severe psychological symptoms of anxiety after 6 weeks of treatment was associated with both longer time to and lower rates of remission. However, there was no evidence that IPT showed any differential effects as a function of anxiety. Conclusions In partial responders to six weeks of lower-dose escitalopram and DCM, planning for extended treatment should account for psychological symptoms of anxiety. PMID:20186975

  13. Parental Religious Socialization Practices, Connectedness With Others, and Depressive Symptoms in Late Life

    PubMed Central

    2012-01-01

    This purpose of this study is to examine two constructs that have been largely overlooked in the study of religious involvement among older people: parental religious socialization practices and feelings of connectedness with others. The data are from an ongoing nationwide survey of older people. Findings from a latent variable model that was designed to examine the two focal constructs provides support for the following relationships:(1) older people whose parents encouraged them to become more involved in religion are more likely to attend worship services; (2) older people whose parents promoted religious involvement and older individuals who attend church more often are more likely to report that they see a fundamental connection among all human beings; (3) older adults who feel more closely connected to others will be more likely to forgive people for the things they have done; and (4) older people who are more forgiving are likely to experience fewer symptoms of depression over time. PMID:22468116

  14. Resting-State Functional Connectivity in Late-Life Depression: Higher Global Connectivity and More Long Distance Connections

    PubMed Central

    Bohr, Iwo Jerzy; Kenny, Eva; Blamire, Andrew; O’Brien, John T.; Thomas, Alan J.; Richardson, Jonathan; Kaiser, Marcus

    2013-01-01

    Functional magnetic resonance imaging recordings in the resting-state (RS) from the human brain are characterized by spontaneous low-frequency fluctuations in the blood oxygenation level dependent signal that reveal functional connectivity (FC) via their spatial synchronicity. This RS study applied network analysis to compare FC between late-life depression (LLD) patients and control subjects. Raw cross-correlation matrices (CM) for LLD were characterized by higher FC. We analyzed the small-world (SW) and modular organization of these networks consisting of 110 nodes each as well as the connectivity patterns of individual nodes of the basal ganglia. Topological network measures showed no significant differences between groups. The composition of top hubs was similar between LLD and control subjects, however in the LLD group posterior medial-parietal regions were more highly connected compared to controls. In LLD, a number of brain regions showed connections with more distant neighbors leading to an increase of the average Euclidean distance between connected regions compared to controls. In addition, right caudate nucleus connectivity was more diffuse in LLD. In summary, LLD was associated with overall increased FC strength and changes in the average distance between connected nodes, but did not lead to global changes in SW or modular organization. PMID:23316175

  15. Models of Care for Late-Life Depression of the Medically Ill: Examples from COPD and Stroke

    PubMed Central

    Avari, Jimmy N.; Alexopoulos, George S.

    2014-01-01

    Depression worsens most treatment outcomes in medically ill older adults. Chronic medical illnesses weaken and demoralize patients and compromise their ability to adhere to treatments requiring consistency and effort. Acute medical illnesses create a psychosocial storm that finds patients and their ecosystem unprepared. We describe two intervention models that can be used to target and personalize treatment in depressed, chronically or acutely medically ill older adults. Personalized Adherence Intervention for Depression and COPD (PID-C) is a model intervention for depressed patients with chronic medical illnesses. It targets patient-specific barriers to treatment engagement and aims to shift the balance in favor of treatment participation. PID-C led to higher remission rates of depression, reduction in depressive symptoms, and reduction in dyspnea-related disability. Addition of problem solving training enables patients to utilize resources available to them and hopefully improve their outcomes. Ecosystem Focused Therapy (EFT) is a model intervention for depression developing in the context of an acute medical event. It was developed for patients with post-stroke depression (PSD) and targets five areas, part of the “psychosocial storm” originating from the patient’s sudden disability and the resulting change in the patient’s needs and family’s life. A preliminary study suggests that EFT is feasible and efficacious in reducing depressive symptoms and signs and disability in PSD. PMID:25028344

  16. A training programme involving automatic self-transcending meditation in late-life depression: preliminary analysis of an ongoing randomised controlled trial

    PubMed Central

    Arena, Amanda; Burhan, Amer M.; Ionson, Emily; Hirjee, Hussein; Maldeniya, Pramudith; Wetmore, Stephen; Newman, Ronnie I.

    2016-01-01

    Late-life depression affects 2–6% of seniors aged 60 years and above. Patients are increasingly embracing non-pharmacological therapies, many of which have not been scientifically evaluated. This study aimed to evaluate a category of meditation, automatic self-transcending meditation (ASTM), in alleviating symptoms of depression when augmenting treatment as usual (NCT02149810). The preliminary results of an ongoing single-blind randomised controlled trial comparing a training programme involving ASTM with a wait-list control indicate that a 12-week ASTM programme may lead to significantly greater reductions in depression and anxiety severity. As such, ASTM may be an effective adjunctive therapy in the treatment of late-life depression. Declaration of interest R.I.N. is Director of Research and Health Promotion for the Art of Living Foundation, Canada and supervised the staff providing ASTM training. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703774

  17. Psychosocial Interventions for the Acute Treatment of Late-life Major Depression: A Systematic Review of Evidence-based Treatments, Predictors of Treatment Outcomes and Moderators of Treatment Effects

    PubMed Central

    Kiosses, Dimitris N.; Leon, Andrew C.; Areán, Patricia A.

    2011-01-01

    The goal of this systematic review is to evaluate the efficacy of psychosocial interventions for the acute treatment of late-life depression and identify predictors of treatment outcomes and moderators of treatment effects. The results of the systematic review may help to advance the development of personalized psychosocial treatments for late-life major depression. Based on our criteria, Problem Solving Therapy (PST), Cognitive Behavioral Therapy (CBT), and Treatment Initiation and Participation Program (TIP) have supportive evidence of efficacy, pending replication. Even though the data on the predictors of treatment outcomes and moderators of treatment effects are still preliminary, it appears that baseline anxiety and stress level, personality pathology, endogenous depression, and reduced self-rated health are associated with worse depression outcomes. More research is also recommended to examine the moderating effects of baseline depression severity; for instance, our review indicates that Interpersonal Psychotherapy (IPT) may work better in participants with high baseline depression severity than in participants with low depression severity. Recommendations for future novel psychosocial interventions for the acute treatment of late-life major depression include application of these interventions in non-traditional settings, involvement of the caregivers in the treatment of cognitively and functionally impaired older adults with major depression, and expansion of research to include more racially and ethnically diverse populations as the samples of the examined studies is highly selective, i.e. overly healthy, cognitively intact, Caucasian, and highly educated. PMID:21536164

  18. Distinct serial position profiles and neuropsychological measures differentiate late life depression from normal aging and Alzheimer's disease.

    PubMed

    Foldi, Nancy S; Brickman, Adam M; Schaefer, Lynn A; Knutelska, Margaret E

    2003-08-30

    Geriatric depression is associated with cognitive deficits that share similar features with Alzheimer's disease (AD) and normal aging. This study examined cognitive profiles and serial position effects in patients with geriatric depression (N=20) or AD (N=32) and in elderly controls (N=18). Groups were compared on two measures of serial position of the California Verbal Learning Test (CVLT), scaled scores and regional scores. Newly devised regional scores measure the percentage of items recalled as a function of the possible number of items presented from three regions of the list. Regional scores significantly differentiated depressed from control groups, with reduction of recalled items from the middle region. Scaled scores distinguished the depression from the AD groups on primacy and recency regions, with the characteristic recency effect seen in the AD group. Deficits in regional scores of the middle region are discussed in the context of lower resources in depression.

  19. Combining moderators to identify clinical profiles of patients who will, and will not, benefit from aripiprazole augmentation for treatment resistant late-life major depressive disorder.

    PubMed

    Smagula, Stephen F; Wallace, Meredith L; Anderson, Stewart J; Karp, Jordan F; Lenze, Eric J; Mulsant, Benoit H; Butters, Meryl A; Blumberger, Daniel M; Diniz, Breno S; Lotrich, Francis E; Dew, Mary Amanda; Reynolds, Charles F

    2016-10-01

    Personalizing treatment for late-life depression requires identifying and integrating information from multiple factors that influence treatment efficacy (moderators). We performed exploratory moderator analyses using data from a multi-site, randomized, placebo-controlled, double-blind trial of aripiprazole augmentation. Patients (n = 159) aged ≥60 years had major depressive disorder that failed to remit with venlafaxine monotherapy. We examined effect sizes of 39 potential moderators of aripiprazole (vs. placebo) augmentation efficacy using the outcome of percentage reduction in depressive symptom after 12 weeks. We then incorporated information from the individually relevant variables in combined moderators. A larger aripiprazole treatment effect was related to: white race, better physical function, better performance on Trail-Making, attention, immediate, and delayed memory tests, greater psychomotor agitation and suicidality symptoms, and a history of adequate antidepressant pharmacotherapy. A smaller aripiprazole treatment effect was observed in patients with: more pain and more work/activity impairment and libido symptoms. Combining information from race and Trail-Making test performance (base combined moderator (Mb*)) produced a larger effect size (Spearman effect size = 0.29 (95% confidence interval (CI): 0.15, 0.42)) than any individual moderator. Adding other individually relevant moderators in the full combined moderator (Mf*) further improved effect size (Spearman effect size = 0.39 (95% CI: 0.25, 0.52)) and identified a sub-group benefiting more from placebo plus continuation venlafaxine monotherapy than adjunctive aripiprazole. Combining moderators can help clinicians personalize depression treatment. We found the majority of our patients benefited from adjunctive aripiprazole, but a smaller subgroup that is identifiable using clinical measures appeared to benefit more from continuation venlafaxine plus placebo. PMID:27438687

  20. Shared Decision-Making in the Primary Care Treatment of Late-Life Major Depression: A Needed New Intervention?

    PubMed Central

    Raue, Patrick J.; Schulberg, Herbert C.; Lewis-Fernandez, Roberto; Boutin-Foster, Carla; Hoffman, Amy S.; Bruce, Martha L.

    2010-01-01

    Objective We suggest that clinicians consider models of shared decision-making for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions. Methods We explore the characteristics and techniques of patient-clinician shared decision-making, with particular emphasis on this model’s relevance to the unique treatment concerns of depressed older adults. Results We describe a shared decision-making intervention to engage older adults in depression treatment in the primary care sector. Conclusions It is timely to examine shared decision-making models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes. PMID:19946872

  1. How Does Functional Disability Affect Depressive Symptoms in Late Life? The Role of Perceived Social Support and Psychological Resources

    ERIC Educational Resources Information Center

    Yang, Yang

    2006-01-01

    This study examines the process whereby functional disability amplifies depressive symptoms through decreasing perceived social support and psychological resources. The study analyzed two waves of panel data (1986 to 1992) of a large sample of older adults from the National Institutes of Aging Established Populations for Epidemiologic Studies of…

  2. [Late-onset depression : Pathophysiology, diagnostics and treatment].

    PubMed

    Notzon, S; Alferink, J; Arolt, V

    2016-09-01

    Late-onset depression (LOD) is defined as depression manifesting for the first time in later life. Up to now, there has been no exact definition of the lower age limit for LOD. Psychopathological symptoms of LOD do not fundamentally differ from depression in other phases of life; however, cognitive deficits are typically more pronounced. The LOD is associated with an increased risk of developing dementia. Imaging studies show reduction in gray matter volume and white matter lesions caused by vascular diseases. The occurrence of depression with vascular lesions of the brain is also referred to as "vascular depression". The diagnostic procedure includes a detailed medical history and the observation of psychopathological changes, physical examination, laboratory tests, electroencephalograph (EEG), electrocardiograph (ECG) and magnetic resonance imaging (MRI) of the head and neuropsychological tests to measure cognitive deficits. Psychotherapy is an effective treatment option. Selective serotonin reuptake inhibitors are the first-line pharmacological therapy. PMID:27531211

  3. Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study

    PubMed Central

    Tang, Tan; Yang, Xuemei; Zhang, Weijun; Wang, Xiaohua; Ji, Li; Xiao, Yun; Ma, Kun; Wang, Ying; Kong, Xianglei; Wang, Jianping; Liu, Jun; Xu, Qian; Tian, Donghua; Qu, Zhiyong

    2015-01-01

    Background The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. Methods We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. Results The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. Conclusions The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed. PMID:26371473

  4. Differences Between Early and Late Onset Adult Depression

    PubMed Central

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj; Gether, Ulrik; Kessing, Lars Vedel

    2011-01-01

    Background: It is unclear, whether age-of-onset identifies subgroups of depression. Aim: To assess the clinical presentation of depression with onset in the early adult age (18-30 years) as compared to depression with later onset (31-70 years). Method: A total number of 301 patients with first episode depression were systematically recruited. Characteristics including psychiatric co-morbidity, personality disorders and traits, stressful life events prior to onset, family history, and treatment outcome were assessed by structured interviews and compared by chi-square tests for categorical data, t-tests for continuous parametric data and Mann-Whitney U-test for continuous nonparametric data. Logistic and multiple regression analyses were used to adjust the analyses for potentially confounding variables. Results: Patients with early onset of depression were characterised by a higher prevalence of co-morbid personality disorders, higher levels of neuroticism, and a lower prevalence of stressful life events preceding onset compared to patients with later age-of-onset. There were no differences in severity of the depressive episode, treatment outcome or family loading of psychiatric illness. Conclusion: Early adult onset of depression is associated with co-morbid personality deviances, whereas late onset is associated with environmental risk factors. PMID:21866230

  5. Abnormalities of CSF flow patterns in the cerebral aqueduct in treatment-resistant late-life depression: a potential biomarker of microvascular angiopathy.

    PubMed

    Naish, Josephine H; Baldwin, Robert C; Patankar, Tufail; Jeffries, Suzanne; Burns, Alistair S; Taylor, Christopher J; Waterton, John C; Jackson, Alan

    2006-09-01

    There is growing evidence that microvascular angiopathy (MVA) plays an important role in the development of dementia and affective disorders in older people. At currently available image resolutions it is not possible to image directly the vascular changes associated with MVA, but the effects on blood and cerebrospinal fluid (CSF) flow may be detectable. The aim of this study was to investigate a potential biomarker for MVA based on MRI of abnormalities in CSF flow. Since there is considerable indirect evidence that treatment resistance in late-onset depressive disorder is related to MVA, we assessed the method in a group of 22 normal volunteers and 29 patients with responsive (N=21) or treatment-resistant (N=8) late-onset depressive disorder. Single-slice quantified phase-contrast (PC) images of cerebral blood and CSF flow were collected at 15 points over a cardiac cycle, and the resulting flow curves were parameterized. Significant differences in the CSF flow (width of systolic flow peak and diastolic flow volume, both P<0.01) through the cerebral aqueduct were observed for the group of treatment-resistant patients when compared to age matched controls. No significant difference was observed for a group of 21 patients with treatment-responsive depression. The findings support the hypothesis that MR measurement of CSF flow abnormalities provides a biomarker of MVA, and thus could have application in a wide range of age-related diseases.

  6. Characterization of brain mGluR5 binding in a pilot study of late-life major depressive disorder using positron emission tomography and [11C]ABP688

    PubMed Central

    DeLorenzo, C; Sovago, J; Gardus, J; Xu, J; Yang, J; Behrje, R; Kumar, J S D; Devanand, D P; Pelton, G H; Mathis, C A; Mason, N S; Gomez-Mancilla, B; Aizenstein, H; Mann, J J; Parsey, R V

    2015-01-01

    The metabotropic glutamate receptor subtype 5 (mGluR5) has been implicated in the pathophysiology of mood and anxiety disorders and is a potential treatment target in major depressive disorder (MDD). This study compared brain mGluR5 binding in elderly patients suffering from MDD with that in elderly healthy volunteers using positron emission tomography (PET) and [11C]ABP688. Twenty elderly (mean age: 63.0±6.3) subjects with MDD and twenty-two healthy volunteers in the same age range (mean age: 66.4±7.3) were examined with PET after a single bolus injection of [11C]ABP688, with many receiving arterial sampling. PET images were analyzed on a region of interest and a voxel level to compare mGluR5 binding in the brain between the two groups. Differences in [11C]ABP688 binding between patients with early- and late-onset depression were also assessed. In contrast to a previously published report in a younger cohort, no significant difference in [11C]ABP688 binding was observed between elderly subjects with MDD and healthy volunteers. [11C]ABP688 binding was also similar between subgroups with early- or late-onset depression. We believe this is the first study to examine mGluR5 expression in depression in the elderly. Although future work is required, results suggest potential differences in the pathophysiology of elderly depression versus depression earlier in life. PMID:26645628

  7. Loneliness and Solitude in Late Late Life.

    ERIC Educational Resources Information Center

    Barer, Barbara M.; Johnson, Colleen L.

    In American society, being alone is confounded with the concept of loneliness which has a negative image suggesting deficits in an individual's life situation. It is possible, however, that with advancing age the need for sociability decreases. This study examined the issues of loneliness and being alone among a sample of 150 older adults. Both…

  8. MRI studies in late-life mood disorders.

    PubMed

    Andreescu, Carmen; Aizenstein, Howard

    2012-01-01

    There are well-established patterns of structural brain changes associated with aging. The change in brain volume with age and with the diseases of aging presents a particular challenge for MRI studies in the elderly. Structural MRI is important for studies in normal aging, late-life depression, dementia, Alzheimer disease and other cognitive disorders to examine how age-associated changes in neuroanatomy are associated with specific age-related changes in brain function. Functional MRI has been a major advance for the fields of cognitive and affective neuroscience by allowing investigators to test theories of the underlying neural pathways controlling cognitive and emotional processes. In this chapter, we will review the contribution of MRI studies to late-life mood and anxiety disorders: major depression, bipolar disorder and anxiety disorders in late-life. PMID:22167336

  9. MRI Studies in Late-Life Mood Disorders

    PubMed Central

    Andreescu, Carmen

    2013-01-01

    There are well-established patterns of structural brain changes associated with aging. The change in brain volume with age and with the diseases of aging presents a particular challenge for MRI studies in the elderly. Structural MRI is important for studies in normal aging, late-life depression, dementia, Alzheimer disease and other cognitive disorders to examine how age-associated changes in neuroanatomy are associated with specific age-related changes in brain function. Functional MRI has been a major advance for the fields of cognitive and affective neuroscience by allowing investigators to test theories of the underlying neural pathways controlling cognitive and emotional processes. In this chapter, we will review the contribution of MRI studies to late-life mood and anxiety disorders: major depression, bipolar disorder and anxiety disorders in late-life. PMID:22167336

  10. Are flatter diurnal cortisol rhythms associated with major depression and anxiety disorders in late adolescence? The role of life stress and daily negative emotion.

    PubMed

    Doane, Leah D; Mineka, Susan; Zinbarg, Richard E; Craske, Michelle; Griffith, James W; Adam, Emma K

    2013-08-01

    Alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning have been associated with major depression disorder (MDD) and some anxiety disorders. Few researchers have tested the possibility that high levels of recent life stress or elevations in negative emotion may partially account for the HPA axis alterations observed in these disorders. In a sample of 300 adolescents from the Youth Emotion Project, we examined associations between MDD and anxiety disorders, dimensional measures of internalizing symptomatology, life stress, mood on the days of cortisol testing, and HPA axis functioning. Adolescents with a past MDD episode and those with a recent MDD episode comorbid with an anxiety disorder had flatter diurnal cortisol slopes than adolescents without a history of internalizing disorders. Higher reports of general distress, a dimension of internalizing symptomatology, were also associated with flatter slopes. Negative emotion, specifically sadness and loneliness, was associated with flatter slopes and partially accounted for the associations between comorbid MDD and anxiety disorders and cortisol. The associations between past MDD and cortisol slopes were not accounted for by negative emotion, dimensional variation in internalizing symptomatology, or levels of life stress, indicating that flatter cortisol slopes may also be a "scar" marker of past experiences of MDD.

  11. Sodium Butyrate, a Histone Deacetylase Inhibitor, Reverses Behavioral and Mitochondrial Alterations in Animal Models of Depression Induced by Early- or Late-life Stress.

    PubMed

    Valvassori, Samira S; Resende, Wilson R; Budni, Josiane; Dal-Pont, Gustavo C; Bavaresco, Daniela V; Réus, Gislaine Z; Carvalho, André F; Gonçalves, Cinara L; Furlanetto, Camila B; Streck, Emilio L; Quevedo, João

    2015-01-01

    The aim of the present study was to evaluate the effects of sodium butyrate on depressive-like behavior and mitochondrial alteration parameters in animal models of depression induced by maternal deprivation or chronic mild stress in Wistar rats. maternal deprivation was established by separating pups from their mothers for 3 h daily from postnatal day 1 to day 10. Chronic mild stress was established by water deprivation, food deprivation, restraint stress, isolation and flashing lights. Sodium butyrate or saline was administered twice a day for 7 days before the behavioral tests. Depressive behavior was evaluated using the forced swim test. The activity of tricarboxylic acid cycle enzymes (succinate dehydrogenase and malate dehydrogenase) and of mitochondrial chain complexes (I, II, II-III and IV) was measured in the striatum of rats. From these analyses it can be observed that sodium butyrate reversed the depressive-like behavior observed in both animal models of depression. Additionally, maternal deprivation and chronic mild stress inhibited mitochondrial respiratory chain complexes and increased the activity of tricarboxylic acid cycle enzymes. Sodium butyrate treatment reversed -maternal deprivation and chronic mild stress- induced dysfunction in the striatum of rats. In conclusion, sodium butyrate showed antidepressant effects in maternal deprivation and chronic mild stress-treated rats, and this effect can be attributed to its action on the neurochemical pathways related to depression.

  12. Depression in Later Life: Recognition and Treatment.

    ERIC Educational Resources Information Center

    Schmall, Vicki L.; And Others

    This guide is designed to help readers understand depression and factors related to its onset in later life; recognize signs of depression and potential suicide; and know actions they can take if they suspect an older family member or friend may be depressed or contemplating suicide. Following a brief introduction, a chapter on depression…

  13. [Disaster psychiatry in late life].

    PubMed

    Awata, Shuichi

    2013-10-01

    Disaster preparedness in geriatric psychiatry was proposed on the basis of experience of the Great East Japan Earthquake. 1) Frail or demented elderly should be considered as a special population at risk for disaster victims and addressed in local disaster prevention programs. 2) To response to various psychiatric symptoms(delirium, BPSD, depression, anxiety, insomnia, and posttraumatic stress disorder) caused by medical conditions and rapid environmental changes due to disaster, linkage and coordination systems between psychiatric and medical sections should be established. 3) As a medium- and long-term support for the elderly who lost the community familiar to them, creation of a new community should be promoted in order to prevent depression, alcohol dependence, BPSD, and suicide.

  14. Mild cognitive impairment, poor episodic memory, and late-life depression are associated with cerebral cortical thinning and increased white matter hyperintensities

    PubMed Central

    Fujishima, Motonobu; Maikusa, Norihide; Nakamura, Kei; Nakatsuka, Masahiro; Matsuda, Hiroshi; Meguro, Kenichi

    2014-01-01

    In various independent studies to date, cerebral cortical thickness and white matter hyperintensity (WMH) volume have been associated with episodic memory, depression, and mild cognitive impairment (MCI). The aim of this study was to uncover variations in cortical thickness and WMH volume in association with episodic memory, depressive state, and the presence of MCI simultaneously in a single study population. The participants were 186 individuals with MCI (clinical dementia rating [CDR] of 0.5) and 136 healthy elderly controls (HCs; CDR of 0) drawn from two community-based cohort studies in northern Japan. We computed cerebral cortical thickness and WMH volume by using MR scans and statistically analyzed differences in these indices between HCs and MCI participants. We also assessed the associations of these indices with memory performance and depressive state in participants with MCI. Compared with HCs, MCI participants exhibited thinner cortices in the temporal and inferior parietal lobes and greater WMH volumes in the corona radiata and semioval center. In MCI participants, poor episodic memory was associated with thinner cortices in the left entorhinal region and increased WMH volume in the posterior periventricular regions. Compared with non-depressed MCI participants, depressed MCI participants showed reduced cortical thickness in the anterior medial temporal lobe and gyrus adjacent to the amygdala bilaterally, as well as greater WMH volume as a percentage of the total intracranial volume (WMHr). A higher WMHr was associated with cortical thinning in the frontal, temporal, and parietal regions in MCI participants. These results demonstrate that episodic memory and depression are associated with both cortical thickness and WMH volume in MCI participants. Additional longitudinal studies are needed to clarify the dynamic associations and interactions among these indices. PMID:25426066

  15. Depression, Life Events and Somatic Symptoms.

    ERIC Educational Resources Information Center

    Rozzini, Renzo; And Others

    1988-01-01

    Investigated the relationship between somatic symptoms, depression, and life events (health status, function, social satisfaction, income) in a population of 1,201 elderly persons living at home. Found depression was the most important factor in the appearance of somatic complaints; however, life events were important cofactors in defining…

  16. Eating Disorders in Late-life

    PubMed Central

    Luca, Antonina; Luca, Maria; Calandra2, Carmela

    2015-01-01

    Eating disorders are a heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity, or even death, if underestimated and untreated. The main disorders enlisted in the chapter of the Diagnostic and Statistic Manual of Mental Disorders-5 dedicated to “Feeding and Eating Disorders” are: anorexia nervosa, bulimia nervosa and binge eating disorder. Even though these abnormal behaviours are mostly diagnosed during childhood, interesting cases of late-life eating disorders have been reported in literature. In this review, these eating disorders are discussed, with particular attention to the diagnosis and management of those cases occurring in late-life. PMID:25657852

  17. Obsessive-Compulsive Disorder in Late Life

    ERIC Educational Resources Information Center

    Calamari, John E.; Pontarelli, Noelle K.; Armstrong, Kerrie M.; Salstrom, Seoka A.

    2012-01-01

    Although obsessive-compulsive disorder (OCD) has received increasing attention, the study and treatment of OCD in late life has been neglected. The obsessions and compulsions seen with older adults do not appear to differ from the symptoms experienced by other age groups, although developmental issues might influence symptom focus (e.g., memory…

  18. Evolution of late-life fecundity in Drosophila melanogaster.

    PubMed

    Rauser, C L; Tierney, J J; Gunion, S M; Covarrubias, G M; Mueller, L D; Rose, M R

    2006-01-01

    Late-life fecundity has been shown to plateau at late ages in Drosophila analogously to late-life mortality rates. In this study, we test an evolutionary theory of late life based on the declining force of natural selection that can explain the occurrence of these late-life plateaus in Drosophila. We also examine the viability of eggs laid by late-age females and test a population genetic mechanism that may be involved in the evolution of late-life fecundity: antagonistic pleiotropy. Together these experiments demonstrate that (i) fecundity plateaus at late ages, (ii) plateaus evolve according to the age at which the force of natural selection acting on fecundity reaches zero, (iii) eggs laid by females in late life are viable and (iv) antagonistic pleiotropy is involved in the evolution of late-life fecundity. This study further supports the evolutionary theory of late life based on the age-specific force of natural selection.

  19. Midlife Eriksonian psychosocial development: Setting the stage for late-life cognitive and emotional health.

    PubMed

    Malone, Johanna C; Liu, Sabrina R; Vaillant, George E; Rentz, Dorene M; Waldinger, Robert J

    2016-03-01

    Erikson's (1950) model of adult psychosocial development outlines the significance of successful involvement within one's relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses prospective longitudinal data to examine how the quality of assessed Eriksonian psychosocial development in midlife relates to late-life cognitive and emotional functioning. In particular we were interested to see whether late-life depression mediated the relationship between Eriksonian development and specific domains of cognitive functioning (i.e., executive functioning and memory). Participants were 159 men from the over-75 year longitudinal Study of Adult Development. The sample was comprised of men from both higher and lower socioeconomic strata. Eriksonian psychosocial development was coded from men's narrative responses to interviews between the ages of 30-47 (Vaillant & Milofsky, 1980). In late life (ages 75-85) men completed a performance-based neuropsychological assessment measuring global cognitive status, executive functioning, and memory. In addition depressive symptomatology was assessed using the Geriatric Depression Scale. Our results indicated that higher midlife Eriksonian psychosocial development was associated with stronger global cognitive functioning and executive functioning, and lower levels of depression 3 to 4 decades later. There was no significant association between Eriksonian development and late-life memory. Late-life depression mediated the relationship between Eriksonian development and both global cognition and executive functioning. All of these results controlled for highest level of education and adolescent intelligence. Findings have important implications for understanding the lasting benefits of psychosocial engagement in mid-adulthood for late-life cognitive and emotional health. In addition

  20. Musical Training and Late-Life Cognition

    PubMed Central

    Gooding, Lori F; Abner, Erin L; Jicha, Gregory A; Kryscio, Richard J; Schmitt, Fredrick A

    2014-01-01

    This study investigated effects of early- to mid-life musical training on cognition in older adults. A Musical Training Survey examined self-reported musical experience and objective knowledge in 237 cognitively intact participants. Responses were classified into Low, Medium, and High knowledge groups. Linear mixed models compared the groups’ longitudinal performance on the Animal Naming Test (ANT; semantic verbal fluency) and Logical Memory Story A Immediate Recall (LMI; episodic memory) controlling for baseline age, time since baseline, education, sex, and full-scale IQ. Results indicate that High knowledge participants had significantly higher LMI scores at baseline and over time compared to Low knowledge participants. ANT scores did not differ among the groups. Ability to read music was associated with higher mean scores for both ANT and LMI over time. Early-to mid-life musical training may be associated with improved late-life episodic and semantic memory as well as a useful marker of cognitive reserve. PMID:24375575

  1. Midlife migraine and late-life parkinsonism

    PubMed Central

    Ross, G. Webster; Sigurdsson, Sigurdur; Garcia, Melissa; Gudmundsson, Larus S.; Sveinbjörnsdóttir, Sigurlaug; Wagner, Amy K.; Gudnason, Vilmundur; Launer, Lenore J.

    2014-01-01

    Objective: In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). Methods: The AGES-Reykjavik cohort (born 1907–1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. Results: Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7–4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2–5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3–4.0]) or sibling (ORMA = 1.78 [95% CI 1.1–2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. Conclusions: These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms. PMID:25230997

  2. Quality of Life, Health Status, and Depression

    PubMed Central

    Pike, Nancy A.; Evangelista, Lorraine S.; Doering, Lynn V.; Eastwood, Jo-Ann; Lewis, Alan B.; Child, John S.

    2012-01-01

    Background Quality of life (QOL) in adolescents and adults who have undergone the Fontan procedure and are living with only 1 ventricle is presumed to be diminished. Objectives This study aimed to compare QOL, health status, and prevalence of depression in adolescents/adults after the Fontan procedure with healthy counterparts and to identify predictors of QOL in the Fontan group. Methods Using a comparative, cross-sectional design, 54 adolescents and adults with single ventricle congenital heart disease who have undergone the Fontan procedure were compared with 66 age-matched healthy counterparts. Quality of life, health status, depression, and social support were measured using the Satisfaction With Life Scale, Short Form Survey Version 2, Patient Health Questionnaire Depression Module, and Multidimensional Scale of Perceived Social Support. Clinical variables were abstracted from medical records. Predictors of QOL were determined using multiple linear regression. Results Adolescents and adults in the Fontan group reported lower physical health status (mean [SD] = 46.5 [9.3] vs mean [SD] = 55.9 [5.1], P < .001) and were more depressed (mean [SD] = 7.3 [5.9] vs mean [SD] = 4.5 [4.3], P < .004) than their healthy counterparts. There were no differences in QOL, mental health status, or social support between the 2 groups. Functional status (New York Heart Association class), depression, and social support accounted for 55% of the variance in QOL in the Fontan group. Conclusions Despite lower levels of physical health, the QOL of Fontan patients was comparable with that of their healthy counterparts; this finding contradicts previous proxy reports, self-reports, and assumptions that QOL is lower in patients with complex single ventricle congenital heart disease. However, because Fontan patients were more depressed than their healthy counterparts, the need for early screening and detection is warranted. PMID:21912272

  3. Witnessing Violence across the Life Course, Depressive Symptoms, and Alcohol Use among Older Persons

    ERIC Educational Resources Information Center

    Colbert, Sha Juan; Krause, Neal

    2009-01-01

    The purpose of this study is to see whether witnessing a very violent act at any point in the life course is associated with depressive symptoms and alcohol use in late life. The data come from a nationwide probability sample of older adults (N = 1,498). The findings reveal that witnessing violence is associated with more symptoms of depression…

  4. The fallacy of late-life divorce in Japan.

    PubMed

    Kumagai, Fumie

    2006-01-01

    Late-life divorces in Japan, that is, divorces by couples with more than 20 years' duration of marriage at the time of divorce, have become increasingly conspicuous since in the mid-1990s. However, an increase in the number of late-life divorces is not the same as an increase in the divorce rate. That is, the conspicuous phenomenon of late-life divorces may not reflect the true nature of the institution of divorce. It may be a fallacy of late-life divorce in Japan today. This is the starting point of the present study. Five major findings have emerged. First, late-life divorces did increase dramatically over the recent past. Second, late-life divorces will continue to increase after 2007, when the new old-age pension division scheme for couples who pursue divorce will be in effect. Third, the increment in late-life divorce cases is due primarily to the baby-boomers born between 1947 and 1949 who are pursuing such late-life divorces. Fourth, as the duration of marriage increases, Japanese married couples are less inclined to pursue divorce. Fifth, the reasons for late-life divorces differ from those expressed for divorces in general. It is hoped that these findings will provide valuable insights for Japanese couples married for many years who may wish to reconsider and to reconstruct their marital relationship for the better.

  5. Paradoxical Physiological Transitions from Aging to Late Life in Drosophila

    PubMed Central

    Quach, Julie; Mueller, Laurence D.; Rose, Michael R.

    2012-01-01

    Abstract In a variety of organisms, adulthood is divided into aging and late life, where aging is a period of exponentially increasing mortality rates and late life is a period of roughly plateaued mortality rates. In this study we used ∼57,600 Drosophila melanogaster from six replicate populations to examine the physiological transitions from aging to late life in four functional characters that decline during aging: desiccation resistance, starvation resistance, time spent in motion, and negative geotaxis. Time spent in motion and desiccation resistance declined less quickly in late life compared to their patterns of decline during aging. Negative geotaxis declined at a faster rate in late life compared to its rate of decline during aging. These results yield two key findings: (1) Late-life physiology is distinct from the physiology of aging, in that there is not simply a continuation of the physiological trends which characterize aging; and (2) late life physiology is complex, in that physiological characters vary with respect to their stabilization, deceleration, or acceleration in the transition from aging to late life. These findings imply that a correct understanding of adulthood requires identifying and appropriately characterizing physiology during properly delimited late-life periods as well as aging periods. PMID:22233126

  6. Measuring Depression at the End of Life: Is the Hamilton Depression Rating Scale a Valid Instrument?

    ERIC Educational Resources Information Center

    Olden, Megan; Rosenfeld, Barry; Pessin, Hayley; Breitbart, William

    2009-01-01

    Depression at the end of life is a common mental health issue with serious implications for quality of life and decision making. This study investigated the reliability and validity of one of the most frequently used measures of depression, the Hamilton Depression Rating Scale (HAM-D) in 422 patients with terminal cancer admitted to a palliative…

  7. The influence of pubertal timing and stressful life events on depression and delinquency among Chinese adolescents.

    PubMed

    Chen, Jie; Yu, Jing; Wu, Yun; Zhang, Jianxin

    2015-06-01

    This study aimed to investigate the influences of pubertal timing and stressful life events on Chinese adolescents' depression and delinquency. Sex differences in these influences were also examined. A large sample with 4,228 participants aged 12-15 years (53% girls) was recruited in Beijing, China. Participants' pubertal development, stressful life events, depressive symptoms, and delinquency were measured using self-reported questionnaires. Both early maturing girls and boys displayed more delinquency than their same-sex on-time and late maturing peers. Early maturing girls displayed more depressive symptoms than on-time and late maturing girls, but boys in the three maturation groups showed similar levels of depressive symptoms. The interactive effects between early pubertal timing and stressful life events were significant in predicting depression and delinquency, particularly for girls. Early pubertal maturation is an important risk factor for Chinese adolescents' depression and delinquency. Stressful life events intensified the detrimental effects of early pubertal maturation on adolescents' depression and delinquency, particularly for girls. PMID:26261908

  8. Life expectancy without depression increases among Brazilian older adults

    PubMed Central

    Andrade, Flávia Cristina Drumond; Wu, Fan; Lebrão, Maria Lúcia; Duarte, Yeda Aparecida de Oliveira

    2016-01-01

    ABSTRACT OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness. PMID:27143612

  9. Late- versus early-onset geriatric depression in a memory research center

    PubMed Central

    Dillon, Carol; Allegri, Ricardo F; Serrano, Cecilia M; Iturry, Mónica; Salgado, Pablo; Glaser, Frank B; Taragano, Fernando E

    2009-01-01

    Objective To contrast early-onset (<60 years) and late-onset (>60 years) depression in geriatric patients by evaluating differences in cognition, vascular comorbidity and sociological risk factors. Both patient groups were compared with normal subjects. Materials and methods We recruited 76 patients with depressive symptoms (37 late onset and 39 early onset) and 17 normal controls matched by age and educational level. All subjects were assessed using a semistructured neuropsychiatric interview and an extensive neuropsychological battery. Vascular and sociological risk factors were also evaluated. Results We found a significant variation in performance between depressive patients and normal controls in most cognitive functions, especially memory (P < 0.0001), semantic fluency (P < 0.0001), verbal fluency, and digit-symbol (P < 0.0001). Late-onset depression patients scored lower and exhibited more severe impairment in memory domains than early-onset depression patients (P < 0.05). Cholesterol levels and marital status were significantly (P < 0.05) different between the depressive groups. Both depressed groups (early- and late-onset) were more inactive than controls (P < 0.05; odds ratio: 6.02). Conclusion Geriatric depression may be a manifestation of brain degeneration, and the initial symptom of a dementia. It is important to consider this in the treatment of patients that exhibit late-onset depressive symptoms. PMID:19851519

  10. Cognitive function, functional performance and severity of depression in Chinese older persons with late-onset depression.

    PubMed

    Tam, C W C; Lam, L C W

    2012-03-01

    OBJECTIVES. The relationship between cognitive status and depressive symptoms and their liability to cause functional decline are of clinical and public health importance as it appears to be common, frequently coexists, and may be treatable. This study examined the relationship of depression severity and cognitive performance and the impact of such an interaction on functional ability in Chinese elderly subjects with late-onset depression. METHODS. A total of 105 non-demented elderly patients with late-onset depression were recruited. Impairment in instrumental activities of daily living and severity of depression were respectively assessed with the Disability Assessment for Dementia scale and the 24-item Hamilton Depression Rating Scale. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, and executive functions. The relationship between specific cognitive impairment and mood symptom severity was assessed. The clinical correlates of functional performance were also examined. RESULTS. Increasingly severe depression was associated with lower scores in the Mini-Mental State Examination, delayed recall, and poorer performance in the Trail Making Test-Part A (after adjusting for the effect of age and education). The severity of apathy correlated negatively with the Mini-Mental State Examination scores only. Among the depressed subjects, greater levels of depression and apathy, poorer performance in Trail Making Test-Part B, and mild parkinsonian signs were associated with lower functional scores. CONCLUSIONS. Lack of interest and motivation, depressive mood, compounded by behavioural abnormalities resulting from executive dysfunction, accounted for functional disability in elderly subjects with late-onset depression. These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression.

  11. Evolution of late-life mortality in Drosophila melanogaster.

    PubMed

    Rose, Michael R; Drapeau, Mark D; Yazdi, Puya G; Shah, Kandarp H; Moise, Diana B; Thakar, Rena R; Rauser, Casandra L; Mueller, Laurence D

    2002-10-01

    Aging appears to cease at late ages, when mortality rates roughly plateau in large-scale demographic studies. This anomalous plateau in late-life mortality has been explained theoretically in two ways: (1) as a strictly demographic result of heterogeneity in life-long robustness between individuals within cohorts, and (2) as an evolutionary result of the plateau in the force of natural selection after the end of reproduction. Here we test the latter theory using cohorts of Drosophila melanogaster cultured with different ages of reproduction for many generations. We show in two independent comparisons that populations that evolve with early truncation of reproduction exhibit earlier onset of mortality-rate plateaus, in conformity with evolutionary theory. In addition, we test two population genetic mechanisms that may be involved in the evolution of late-life mortality: mutation accumulation and antagonistic pleiotropy. We test mutation accumulation by crossing genetically divergent, yet demographically identical, populations, testing for hybrid vigor between the hybrid and nonhybrid parental populations. We found no difference between the hybrid and nonhybrid populations in late-life mortality rates, a result that does not support mutation accumulation as a genetic mechanism for late-life mortality, assuming mutations act recessively. Finally, we test antagonistic pleiotropy by returning replicate populations to a much earlier age of last reproduction for a short evolutionary time, testing for a rapid indirect response of late-life mortality rates. The positive results from this test support antagonistic pleiotropy as a genetic mechanism for the evolution of late-life mortality. Together these experiments comprise the first corroborations of the evolutionary theory of late-life mortality.

  12. Security of attachment to spouses in late life: Concurrent and prospective links with cognitive and emotional wellbeing

    PubMed Central

    Waldinger, Robert J.; Cohen, Shiri; Schulz, Marc S.; Crowell, Judith A.

    2014-01-01

    Social ties are powerful predictors of late-life health and wellbeing. Although many adults maintain intimate partnerships into late life, little is known about mental models of attachment to spouses and how they influence aging. Eighty-one elderly heterosexual couples (162 individuals) were interviewed to examine the structure of attachment security to their partners and completed measures of cognition and wellbeing concurrently and 2.5 years later. Factor analysis revealed a single factor for security of attachment. Higher security was linked concurrently with greater marital satisfaction, fewer depressive symptoms, better mood, and less frequent marital conflicts. Greater security predicted lower levels of negative affect, less depression, and greater life satisfaction 2.5 years later. For women, greater security predicted better memory 2.5 years later and attenuated the link between frequency of marital conflict and memory deficits. Late in life, mental models of attachment to partners are linked to wellbeing concurrently and over time. PMID:26413428

  13. Factors Influencing Adjustment to Late-Life Divorce.

    ERIC Educational Resources Information Center

    Wilson, Keren Brown; DeShane, Michael R.

    Although the rate of divorce among older Americans has increased steadily, little attention has been paid to late life divorce. To describe the role of age and other factors which might influence adjustment to divorce in later life, data from a larger pilot study were used: 81 divorced persons over the age of 60 completed in-depth, structured…

  14. Pathways to Childlessness and Late-Life Outcomes

    ERIC Educational Resources Information Center

    Dykstra, Pearl A.; Wagner, Michael

    2007-01-01

    Via a simultaneous analysis of different life course pathways (marital, occupational, and childbearing histories) and different outcomes, this article addresses the question When does childlessness matter in late life and how? Survey data from Amsterdam (N = 661) and Berlin, Germany (N = 516) are used. Lifelong childlessness results in smaller…

  15. Life Stress, the "Kindling" Hypothesis, and the Recurrence of Depression: Considerations From a Life Stress Perspective

    ERIC Educational Resources Information Center

    Monroe, Scott M.; Harkness, Kate L.

    2005-01-01

    Major depression is frequently characterized by recurrent episodes over the life course. First lifetime episodes of depression, however, are typically more strongly associated with major life stress than are successive recurrences. A key theoretical issue involves how the role of major life stress changes from an initial episode over subsequent…

  16. Non-suicidal self-injury prospectively predicts interpersonal stressful life events and depressive symptoms among adolescent girls.

    PubMed

    Burke, Taylor A; Hamilton, Jessica L; Abramson, Lyn Y; Alloy, Lauren B

    2015-08-30

    Non-suicidal self-injury (NSSI) is the deliberate self-harm of one's tissue, engaged in without lethal intent, and occurs frequently among late adolescents. Although research has indicated that NSSI predicts depression, the potential psychosocial mechanisms through which engagement in NSSI makes one susceptible to future depressive symptoms remain unclear. The present study examined whether NSSI increases the risk of experiencing stressful life events, which, in turn, heightens the risk for subsequent depressive symptoms. Drawn from a sample specifically selected for adolescents at high and low risk for developing bipolar spectrum disorders, a total of 110 late-adolescents (mean age=18.74, SD=.69; 73% female) were administered measures of lifetime and past year engagement in NSSI and current depressive symptomatology. Approximately 6 months later, they completed a measure of depressive symptoms and a questionnaire and interview assessing life events that occurred over the 6-month interval. Results suggest that the frequency of lifetime and past year NSSI predicted the occurrence of interpersonal stressful life events beyond the effects of initial depressive symptoms, but only for late adolescent girls. Results further suggest that higher levels of interpersonal stressful life events mediated the relationship between NSSI frequency and prospective increases in depressive symptoms among girls.

  17. The importance of cultivating mindfulness for cognitive and emotional well-being in late life.

    PubMed

    Fiocco, Alexandra J; Mallya, Sasha

    2015-01-01

    The cultivation of mindfulness has received increasing attention over the past 2 decades because of its association with increased psychological well-being and reduced stress-related health disorders. Given the robust positive association between perceived stress and cognitive impairment in late life, the current study evaluated the association between trait mindfulness, psychological well-being, and cognitive function in 73 healthy community-dwelling older adults. Controlling for a priori covariates, multivariate regression analyses showed a significant association between trait mindfulness and measures of psychological well-being, including self-reported depressive symptoms, quality of life, and stress profile. Analyses further showed a significant association between trait mindfulness and executive function, namely set shifting. No association was found for declarative memory. Mediation analyses showed that the association between mindfulness and cognitive function is mediated by perceived stress. This research supports the importance of cultivating mindfulness in late life to ensure cognitive and emotional well-being.

  18. Prospective Association of Morning Salivary Cortisol with Depressive Symptoms in Mid-Life: A Life-Course Study

    PubMed Central

    Geoffroy, Marie-Claude; Li, Leah; Power, Chris

    2013-01-01

    Objective Associations of cortisol and depression vary at different life-stages, yet population-based, prospective studies are scarce. We aimed to assess associations of morning cortisol with depressive symptoms in mid-life taking account of lifetime psychological health. Methods Participants were 5,403 men and women from the 1958 British Birth Cohort whose salivary cortisol was assessed at 45y (45min after waking (T1) and 3h later (T2)) and who completed the 5-item Mental-Health Index (MHI-5) about depressive symptoms at age 50y. Lifetime psychological health was identified from child and adult measures. Results For women, higher T2 cortisol at 45y predicted depression (MHI-5 scores ≤52) at 50y (odds ratio [OR]=1.17; 95% confidence intervals [CI] 1.05,1.30 per standard deviation increase in T2 cortisol), attenuating when adjusted for current (45y) and previous (7-42y) psychological health (OR=1.11; 95% CI 0.98, 1.24). Similarly, an association in women of flatter cortisol delta (T2-T1) with depressive symptoms at 50y weakened after adjustment for current (45y) and previous (7-42y) psychological health. For men, lower T2 cortisol at 45y predicted greater depressive symptoms at 50y and the association strengthened when adjusted for lifetime psychological health. Likewise, lower cortisol AUC predicted higher risk of depression for men after adjusting for prior psychological health (OR=0.85; CI 0.72, 1.00). Associations were largely unaltered by control for covariates. Conclusions In women, higher cortisol in late morning at 45y is prospectively associated with depressive symptoms at 50y through a link with lifetime psychological health. In men, lower cortisol predicts subsequent symptoms, independent of depressive history. PMID:24265676

  19. Late diagnosis of chronic renal failure and the quality of life during dialysis treatment.

    PubMed

    Sesso, R; Yoshihiro, M M; Ajzen, H

    1996-10-01

    We evaluated the quality of life of 101 hemodialysis patients who had a late < or = 3 months before starting dialysis, N = 47) or early (> or = 6 months, N = 54) diagnosis of chronic renal failure. At the time of the survey patients had been stable on dialysis for at least 3 months and for less than 24 months; median duration of dialysis was 9.1 months. Quality of life was measured by the kidney disease questionnaire (including the intensity and duration of physical symptoms, fatigue, depression, relationship with others and frustration), the health and life satisfaction indices, functional status (Karnofsky scale), and the time trade-off method. Scores for the several indicators of quality of life were closely similar for the late and early diagnosis groups. Health satisfaction compared to one year prior to dialysis was slightly better for the early diagnosis group. For both groups, functional status was a little worse during the first year of dialysis than one year before its start. In the late diagnosis group, elderly patients and diabetics had more impairment in several dimensions assessed. In addition, in this group greater income was significantly correlated with better physical performance (r = 0.52, P < 0.001) and with health satisfaction (r = 0.36, P = 0.027). These findings suggest that after a median duration of 9 months on a dialysis program, patients with a late and early diagnosis of chronic renal failure have a similar performance in terms of quality of life parameters. Age, diabetes and income are associated with the quality of life of patients with a late diagnosis. PMID:9181098

  20. POVERTY, LIFE EVENTS AND THE RISK FOR DEPRESSION IN UGANDA

    PubMed Central

    2012-01-01

    Background Understanding the determinants of major depression in sub-Saharan Africa is important for planning effective intervention strategies. Objective To investigate the social and life-event determinants of major depressive disorder in the African socio-cultural context of rural Uganda. Methods A cross-section survey was carried out in 14 districts in Uganda from 1st June 2003-30th October 2004. 4660 randomly selected respondents (15 years and above) were interviewed. The primary outcome was the presence of major depressive disorder as assessed by the Hopkins Symptom Checklist (HSCL-25). Results The prevalence of major depressive disorder was 29.3% (95% confidence interval, 28.0%-30.6%). Factors independently associated with depression in both genders included: the ecological factor, district; age (increase with each age category after 35 years); indices of poverty and deprivation (no formal education, having no employment, broken family, and socio-economic classes III-V). Only a few adverse life events, notably those suggestive of a disrupted family background (death of a father in females and death of a mother in males) were associated with increased risk. Conclusion: Socioeconomic factors operating at both ecological and the individual level are the strongest independent determinants of depression. Adverse life events were less strongly associated with depression in this sample. PMID:19916062

  1. Counseling in Primary Care Improves Depression and Quality of Life

    PubMed Central

    Carta, MG; Petretto, D; Adamo, S; Bhat, KM; Lecca, ME; Mura, G; Carta, V; Angermeyer, M; Moro, MF

    2012-01-01

    Introduction: To measure the effectiveness on Quality of Life of adjunctive cognitive behavioral counseling in the setting of General Practitioners (GPs) along with the treatment as usual (TAU;) for the treatment of depression. Methods: Six month-controlled trial of patients who were referred to randomly assigned GPs (four for experimental group of patients and ten for the control) was done. Experimental sample had 34 patients with DSM-IV diagnosis of Depression (Depressed Episode, Dysthymia, or Adjustment Disorder with Depressed Mood) receiving the TAU supplemented with counseling. Control group had 30 patients with diagnosis of Depression receiving only the TAU. Results: The Beck Depression Inventory (BDI) score improved in both groups. Patients in the experimental group showed greater improvement compared to the control group at T2. The World Health Organization Quality OF Life Questionnaire (WHOQOL) score also improved in the experimental group but not in the control group. The improvement in the experimental group was statistically significant in terms of both BDI and WHOQOL scores. Conclusions: Adding counseling to TAU in general medical practice settings is more effective in controlling the symptoms of depression and improving the quality of life as measured over a period of six months, than TAU alone. These results while encouraging, also calls for a larger study involving a largersample size and a longer period of time. PMID:23173011

  2. Life on a Farm during the Great Depression.

    ERIC Educational Resources Information Center

    Musbach, Joan W.

    2001-01-01

    Presents a lesson plan for eighth-grade students where they learn about the Great Depression by studying rural life. Explains that the students explore farm records from June and December 1935 after reading an excerpt about rural life in the 1930s. Includes copies of the ledgers, photographs, and student handouts. (CMK)

  3. Personality, Stressful Life Events, and Treatment Response in Major Depression

    ERIC Educational Resources Information Center

    Bulmash, Eric; Harkness, Kate L.; Stewart, Jeremy G.; Bagby, R. Michael

    2009-01-01

    The current study examined whether the personality traits of self-criticism or dependency moderated the effect of stressful life events on treatment response. Depressed outpatients (N = 113) were randomized to 16 weeks of cognitive-behavioral therapy, interpersonal psychotherapy, or antidepressant medication (ADM). Stressful life events were…

  4. Financial Conflicts Facing Late-Life Remarried Alzheimer's Disease Caregivers

    ERIC Educational Resources Information Center

    Sherman, Carey Wexler; Bauer, Jean W.

    2008-01-01

    This qualitative study explores financial conflicts faced by late-life remarried wives providing care for their husbands with Alzheimer's disease. Interviews with 9 women identified intergenerational secrets and tensions regarding financial and inheritance decisions. Participants' remarried spouse status, underlying family boundary ambiguities,…

  5. Depression and life satisfaction among European and Confucian adolescents.

    PubMed

    Stankov, Lazar

    2013-12-01

    The purpose of this study was to compare adolescents from Europe and Confucian Asia on measures of psychological constructs that reflect either maladjustment or positive outlook on life. Empirical findings are reported based on N = 7,167 secondary school students (15 years old) from Confucian Asia (Hong Kong, Singapore, South Korea, and Taiwan) and from Europe (Denmark, Finland, Netherlands, Serbia, and Latvia with 2 nationalities-Latvian and Russian). Participants' responses were used to assess several aspects of personality and psychopathology, in addition to well-being, social attitudes, and parental styles. Exploratory factor analysis of these measures produced 4 factors: Depression, Life Satisfaction, Toughness and Modesty. Adolescents from Confucian countries show higher levels of Depression and lower levels of Life Satisfaction in comparison to their European counterparts. The most potent influences on Depression and Life Satisfaction were found to be Toughness and Parental Warmth variables, both of which are, in turn, linked to differences between regions/cultures. PMID:23914959

  6. Depression and life satisfaction among European and Confucian adolescents.

    PubMed

    Stankov, Lazar

    2013-12-01

    The purpose of this study was to compare adolescents from Europe and Confucian Asia on measures of psychological constructs that reflect either maladjustment or positive outlook on life. Empirical findings are reported based on N = 7,167 secondary school students (15 years old) from Confucian Asia (Hong Kong, Singapore, South Korea, and Taiwan) and from Europe (Denmark, Finland, Netherlands, Serbia, and Latvia with 2 nationalities-Latvian and Russian). Participants' responses were used to assess several aspects of personality and psychopathology, in addition to well-being, social attitudes, and parental styles. Exploratory factor analysis of these measures produced 4 factors: Depression, Life Satisfaction, Toughness and Modesty. Adolescents from Confucian countries show higher levels of Depression and lower levels of Life Satisfaction in comparison to their European counterparts. The most potent influences on Depression and Life Satisfaction were found to be Toughness and Parental Warmth variables, both of which are, in turn, linked to differences between regions/cultures.

  7. The relationship of sleep problems to life quality and depression

    PubMed Central

    Sarıarslan, Hacı A.; Gulhan, Yıldırım B.; Unalan, Demet; Basturk, Mustafa; Delibas, Senol

    2015-01-01

    Objective: To identify the level of depression, the level of life quality, and the relationship between these, in patients applying to sleep centers for various sleep problems. Methods: This cross-sectional study included 229 patients who applied for polysomnography at sleeping centers under supervision of the Neurology and Chest Diseases Clinics of Kayseri Education and Research Hospital, Kayseri, Turkey between June and August 2013. The data collection tools were a socio-demographical data form, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life Scale (WHOQOL-BREF). For statistical analyses, the Student t-test, Kruskal-Wallis-variant analysis, and chi-square tests were used. Significance level was considered as p<0.05. Results: In our study, patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom were observed to have significantly poorer sleep quality. While patients with any chronic disease had significantly higher scores for total PSQI and depression, their physical, mental, and social WHOQOL-BREF scores were significantly lower. The PSQI total scores, and depression scores of the smoking patients were significantly higher for physical, mental, and social WHOQOL-BREF fields. There was a positive correlation between PSQI scores and BDI scores while there was a negative correlation among BDI, PSQI, and WHOQOL-BREF life quality sub-scale scores. Conclusions: Sleep quality was significantly poorer in patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom. There was a significantly negative correlation among depression, sleep quality, and life quality, while there was a significantly positive correlation between life quality and depression. PMID:26166591

  8. Risk factors for depressive symptoms in adolescent pregnancy in a late-teen subsample.

    PubMed

    Koleva, Hristina; Stuart, Scott

    2014-04-01

    Depression in adolescent pregnancy is common but underrecognized and can be associated with negative medical outcomes. This brief report examines the relationship between depressive symptoms and various demographic and obstetrical risk factors, as well as the use of antidepressants in pregnant adolescents of late teenage years. Data were derived from a relatively large sample (506 women) recruited from university-based and community mental health centers in Iowa. A cross-sectional analysis did not reveal significant statistical associations between the risk factors and depressive symptoms (Beck Depression Inventory). Antidepressant use was very low (3.7 %), and adolescents with higher depression scores were more likely to take medications. In conclusion, screening for depression in pregnant adolescents should be universal, regardless of demographic and obstetrical risk factors, and promptly addressed.

  9. Purpose in life, depression, and locus of control.

    PubMed

    Phillips, W M

    1980-07-01

    Parallel to Frankl's theory of the search for meaning, which posits the separateness but intertwining of the psychological and existential realms, the Purpose In Life Test (PIL) has been found to have a low to moderate relationship with most conceptually related psychological measures. Extending separate correlational studies of the PIL with depression and locus of control, the current study inspected the relationship of individual PIL items to groups formed according to Zung Self-Rating Depression Scale and Rotter Internal-External Locus Of Control scores. One-hundred thirty-four Ss were split into four groups: Depressed external, depressed internals, nondepressed externals, and nondepressed internals. Although ungrouped correlational analysis of PIL items revealed only seven significant relationships with depression and two with locus of control, multiple discriminate analysis was successful in correctly classifying depressed externals about three-fourths of the time, and the overall "hit rate" for the four groups was above 60%. In addition to further validating the interaction of purpose in life with related psychological and social expectancy variables, results indicated a compounding effect between depression and external perception of reinforcement control with PIL scores in general, and two items (#4, 12) in particular, which appear to reflect the experience of current congruent involvement between the individual and his world.

  10. Tobacco smoking and depressed mood in late childhood and early adolescence.

    PubMed Central

    Wu, L T; Anthony, J C

    1999-01-01

    OBJECTIVES: This study builds on previous observations about a suspected causal association linking tobacco smoking with depression. With prospective data, the study sheds new light on the temporal sequencing of tobacco smoking and depressed mood in late childhood and early adolescence. METHODS: The epidemiologic sample that was studied consisted of 1731 youths (aged 8-9 to 13-14 years) attending public schools in a mid-Atlantic metropolitan area, who were assessed at least twice from 1989 to 1994. A survival analysis was used to examine the temporal relationship from antecedent tobacco smoking to subsequent onset of depressed mood, as well as from antecedent depressed mood to subsequent initiation of tobacco use. RESULTS: Tobacco smoking signaled a modestly increased risk for the subsequent onset of depressed mood, but antecedent depressed mood was not associated with a later risk of starting to smoke tobacco cigarettes. CONCLUSIONS: This evidence is consistent with a possible causal link from tobacco smoking to later depressed mood in late childhood and early adolescence, but not vice versa. PMID:10589312

  11. New Wine in Old Bottle: Late-Life Psychosis

    PubMed Central

    Iglewicz, Alana; Meeks, Thomas W.; Jeste, Dilip V.

    2011-01-01

    Psychosis is common in late life and exacts enormous costs to society, affected individuals, and their caregivers. A multitude of etiologies for late-life psychosis exist, the two most prototypical being schizophrenia and psychosis of Alzheimer’s Disease (AD). As such, this review will focus on the non-affective, neuropsychiatric causes of chronic psychosis in the elderly, specifically schizophrenia, delusional disorder, and the psychosis of AD and other dementias. As evidenced in this review, the current research regarding the onset and course of late-life schizophrenia reflects a more favorable prognosis than that painted by the Kraepelinian notion of schizoprenia as “dementia praecox.” Antipsychotics are useful in controlling the symptoms of late-life schizophrenia, but their use among older adults warrants increased vigilance because of older adults’ increased proclivity to side effects. Psychosocial interventions can be effective, usually in conjunction with medication. Meanwhile, psychosis of AD occurs in nearly half of people with AD and is associated with increased hospitalizations, institutionalization, caregiver distress, and mortality. Despite the profound consequences of psychotic symptoms associated with dementias, the extant literature does not afford clinicians clear, consistent guidance on how to provide optimal treatment to specific patients. Second generation antipsychotics are usually the choice treatment for psychosis, but the black box warning regarding their associated 1–2% increased absolute risk in stroke and overall mortality in patients with dementia complicates their use. Using second generation antipsychotics in low doses for brief periods and discontinuing them when possible is the best clinical practice for dementia-related psychosis. Psychosocial interventions for the treatment of psychosis with AD appear promising in empirical research, but more rigorous study is needed. PMID:21536160

  12. Stressful life events and depression among adolescent twin pairs.

    PubMed

    Boardman, Jason D; Alexander, Kari B; Stallings, Michael C

    2011-01-01

    Using the twin pairs sample from the National Longitudinal Study ofAdolescent Health, we estimate bivariate Cholesky models for the influence of stressful life events (SLEs) on depressive symptoms. We show that depressive symptoms (h2Depression = .28) and dependent SLEs (events influenced by an individual's behavior) are both moderately heritable (h2SLE Dependent = .43). We find no evidence for the heritability of independent SLEs. Results from the bivariate Cholesky model suggest that roughly one-half of the correlation between depression and dependent SLEs is due to common genetic factors. Our findings suggest that attempts to characterize the causal effect of SLEs on mental health should limit their list of SLEs to those that are outside of the control of the individual.

  13. Life Enhancement Counseling: Treating Depression Among Hispanic Elders.

    ERIC Educational Resources Information Center

    Szapocznik, Jose; And Others

    Depression is the single most widespread mental health problem facing the elderly, with pharmacotherapy the most frequent standard treatment modality for these patients. A psycho-therapeutic alternative to pharmacotherapy is Life Enhancement Counseling, a counseling approach matching therapeutic techniques to client characteristics and providing…

  14. Spouses of Older Adults With Late-Life Drinking Problems: Health, Family, and Social Functioning*

    PubMed Central

    Moos, Rudolf H.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Bernice S.

    2010-01-01

    Objective: This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Method: Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. Results: At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Conclusions: Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits. PMID:20553658

  15. Anger, Happiness, and Sadness: Associations with Depressive Symptoms in Late Adolescence

    ERIC Educational Resources Information Center

    Chaplin, Tara M.

    2006-01-01

    This study used self-report and observational methods to examine associations between depressive symptoms and patterns of emotional experience and expression during late adolescence. Fifty-one male and 49 female first and second year college students completed questionnaires on emotion experience and were videotaped while completing a frustrating…

  16. Do Late Adolescent Fathers Have More Depressive Symptoms than Older Fathers?

    ERIC Educational Resources Information Center

    Lee, Yookyong; Fagan, Jay; Chen, Wan-Yi

    2012-01-01

    Although fathers are increasingly a focus of attention in research, there is a dearth of research on depressive symptoms among fathers, especially young fathers with toddlers. This study used longitudinal data to examine what risk factors, including the age status of fathers (e.g., late adolescence, emerging adulthood, and adulthood), may be…

  17. Complementary and alternative medicine use for treatment and prevention of late-life mood and cognitive disorders

    PubMed Central

    Lavretsky, Helen

    2009-01-01

    Late-life mood disorders and cognitive aging are the most common reasons for using complementary and alternative therapies. The amount of rigorous scientific data to support the efficacy of complementary therapies in the treatment of depression or cognitive impairment is extremely limited. The areas with the most evidence for beneficial effects are exercise, herbal therapy (Hypericum perforatum), the use of fish oil, and, to a lesser extent, acupuncture and relaxation therapies. There is a need for further research involving randomized, controlled trials to investigate the efficacy of complementary and alternative therapies in the treatment of depression and cognitive impairment in late-life. This research may lead to the development of effective treatment and preventive approaches for these serious conditions. PMID:19956796

  18. History of Depression and Frontostriatal Connectivity during Reward Processing in Late Adolescent Boys

    PubMed Central

    Morgan, Judith K.; Shaw, Daniel S.; Olino, Thomas M.; Musselman, Samuel C.; Kurapati, Nikhil T.; Forbes, Erika E.

    2015-01-01

    Objective Given that depression in men is associated with risk for seriously adverse consequences, evaluating how putative neural mechanisms of depression—such as reward-related frontostriatal connectivity—may be altered in late adolescent boys with a history of depression is an important research aim. Adolescents and adults with depression have been demonstrated to show blunted striatal response and heightened medial prefrontal cortex (mPFC) activation to winning reward. Function in reward circuits appears to be best understood as coordination of regions within frontostriatal circuitry, and alterations to this circuitry could occur in those with a history of depression. Method The current study evaluated functional connectivity between the nucleus accumbens and mPFC in a sample of 166 ethnically-diverse boys with and without a history of depression. Participants completed an fMRI monetary reward paradigm at age 20. Lifetime history of depression and other psychiatric illnesses was measured prospectively and longitudinally, using structured clinical interviews at 7 time points from ages 8 to 20. Results Boys with a history of depression showed heightened positive connectivity between the nucleus accumbens and the mPFC relative to boys with no psychiatric history when winning rewards relative to losing rewards. This altered frontostriatal connectivity pattern was also associated with greater number of depressive episodes in the boys’ lifetime. Conclusions History of depression in late adolescent boys may be associated with altered coordination between the nucleus accumbens and mPFC when winning reward. This coordination could reflect over-signaling of the mPFC to dampen typical VS response or enhance weak VS response. PMID:25915469

  19. Quality of life and anxiety and depressive disorder comorbidity.

    PubMed

    Norberg, Melissa M; Diefenbach, Gretchen J; Tolin, David F

    2008-12-01

    The present investigation evaluated the relations among anxiety and depressive disorder comorbidity and quality of life (QOL) by utilizing self-report measures of life satisfaction and functional disability. Participants were 94 individuals who were presented for treatment at an outpatient anxiety disorders clinic and 26 nonclinical participants. Results indicated that participants diagnosed with anxiety disorders reported lower QOL than did nonclinical participants. Anxiety disorder comorbidity did not additionally impact QOL; however, presence of a depressive disorder comorbid with an anxiety disorder did negatively impact QOL as these individuals reported significantly more functional disability and less life satisfaction than did individuals with anxiety disorders alone or those without a psychiatric diagnosis. These results highlight the negative nature of anxiety disorders and improve clarification on the role of diagnostic comorbidity on QOL among those with an anxiety disorder.

  20. Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress.

    PubMed

    Hankin, Benjamin L; Young, Jami F; Abela, John R Z; Smolen, Andrew; Jenness, Jessica L; Gulley, Lauren D; Technow, Jessica R; Gottlieb, Andrea Barrocas; Cohen, Joseph R; Oppenheimer, Caroline W

    2015-11-01

    Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly through semistructured diagnostic interviews every 6 months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. This study used repeated assessments of diagnostic interviewing in a moderately large sample of youth over 3 years to show that depression rates increase in middle to late adolescence, or postpubertally, and that the gender difference in depression emerges earlier in adolescence (age 12.5), or postpubertally. Additionally, genetically susceptible older adolescents who experience chronic peer stress were the most likely to become depressed over time. PMID:26595469

  1. The Cumulative Impact of Nonsevere Life Events Predicts Depression Recurrence during Maintenance Treatment with Interpersonal Psychotherapy

    ERIC Educational Resources Information Center

    Lenze, Shannon N.; Cyranowski, Jill M.; Thompson, Wesley K.; Anderson, Barbara; Frank, Ellen

    2008-01-01

    Although much research has focused on the role of severe life events as risk factors for depression onset, less is known about the relationship between nonsevere life events and depression recurrence. The current study examined the cumulative effects of nonsevere and positive life events on depression recurrence in an outpatient sample of…

  2. What Are the Causes of Late-Life Depression?

    PubMed Central

    Aziz, Rehan; Steffens, David C.

    2014-01-01

    Overview The rapid increase in the numbers of older adults worldwide makes a focus on mental disorders and aging both timely and imperative. According to the 2010 census, in the United States, there were 40.3 million adults aged 65 years and older. This number represented an increase of 5.3 million over the 2000 census. Between 2000 and 2010, the number of elders increased at a faster rate (15.1%) than the total US population (9.7%).1 These numbers are projected to continue to diverge, and the disparity between age groups will widen further as a consequence. By 2050, an estimated 20.2% of the population will be 65 years of age and older.2 PMID:24229653

  3. Depression.

    PubMed

    Stewart, Donna E; Gucciardi, Enza; Grace, Sherry L

    2004-08-25

    HEALTH ISSUE: Depression causes significant distress or impairment in physical, social, occupational and other key areas of functioning. Women are approximately twice as likely as men to experience depression. Psychosocial factors likely mediate the risks for depression incurred by biological influences. KEY FINDINGS: Data from the 1999 National Population Health Survey show that depression is more common among Canadian women, with an annual self-reported incidence of 5.7% compared with 2.9% in men. The highest rates of depression are seen among women of reproductive age. Predictive factors for depression include previous depression, feeling out of control or overwhelmed, chronic health problems, traumatic events in childhood or young adulthood, lack of emotional support, lone parenthood, and low sense of mastery. Although depression is treatable, only 43% of depressed women had consulted a health professional in 1998/99 and only 32.4% were taking antidepressant medication. People with lower education, inadequate income, and fewer contacts with a health professional were less likely to receive depression treatment. DATA GAPS AND RECOMMENDATIONS: A better understanding of factors that increase vulnerability and resilience to depression is needed. There is also a need for the collection and analysis of data pertaining to: prevalence of clinical anxiety; the prevalence of depression band 12 months after childbirth factors contributing to suicide contemplation and attempts among adolescent girls, current treatments for depression and their efficacy in depressed women at different life stages; interprovincial variation in depression rates and hospitalizations and the impact and costs of depression on work, family, individuals, and society.

  4. Libraries of life: using life history books with depressed care home residents.

    PubMed

    Plastow, Nicola Ann

    2006-01-01

    Depression is a common, and often undetected, psychiatric disorder in geriatric care home residents. Reminiscence, an independent nursing therapy used by a variety of health and social care professionals, can prevent or reduce depression. This practice development project explored the use of reminiscence life history books as an interpersonal therapeutic tool with 3 depressed care-home residents living in residential care and skilled nursing facilities. The process of choosing to produce a book, assessment of capabilities, and methods of construction are described using 3 illustrative case studies. Three themes emerged: reviewing the past, accepting the present, and dreaming of an alternative future. This project demonstrated that life history books, tailored to individual needs and abilities, can facilitate reminiscence and reduce depression by increasing social interaction. The benefits to residents, their families, and care staff are discussed and the relevance to nursing practice highlighted.

  5. [Occupational complexity and late-life memory and reasoning abilities].

    PubMed

    Ishioka, Yoshiko; Gondo, Yasuyuki; Masui, Yukie; Nakagawa, Takeshi; Tabuchi, Megumi; Ogawa, Madoka; Kamide, Kei; Ikebe, Kazunori; Arai, Yasumichi; Ishizaki, Tatsuro; Takahashi, Ryutaro

    2015-08-01

    This study examined the associations between the complexity of an individual's primary lifetime occupation and his or her late-life memory and reasoning performance, using data from 824 community-dwelling participants aged 69-72 years. The complexity of work with data, people, and things was evaluated based on the Japanese job complexity score. The associations between occupational complexity and participant's memory and reasoning abilities were examined in multiple regression analyses. An association was found between more comple work with people and higher memory performance, as well as between more complex work with data and higher reasoning performance, after having controlled for gender, school records, and education. Further, an interaction effect was observed between gender and complexity of work with data in relation to reasoning performance: work involving a high degree of complexity with data was associated with high reasoning performance in men. These findings suggest the need to consider late-life cognitive functioning within the context of adulthood experiences, specifically those related to occupation and gender. PMID:26402953

  6. Buldir Depression - A Late Tertiary graben on the Aleutian Ridge, Alaska

    USGS Publications Warehouse

    Marlow, M. S.; Scholl, D. W.; Buffington, E.C.; Boyce, R.E.; Alpha, T.R.; Smith, P.J.; Shipek, C.J.

    1970-01-01

    Buldir Depression is a large, rectilinear basin that lies on the northern edge of the Aleutian Ridge and is aligned with the arcuate chain of active volcanoes on the ridge crest. The depression appears to be a volcanic-tectonic feature, which began to form in Late Tertiary time and which is still forming. It is a graben formed by extensional rifting and accompanied by contemporaneous volcanism on the Aleutian Ridge. Subsidence rates for the depression are estimated at 20-70 cm/1,000 years. Sediments in the depression are 300 m thick and are probably pelagic and turbidite deposits of Pleistocene age. The turbidites were apparently derived from the plateau area of the Aleutian Ridge surrounding the depression. Older sediments on the northern slope of the Aleutian Ridge have a maximum thickness of 550 m and are deformed and slumped toward the Bering Sea. These sediments are postulated to overlie a mid-flank terrace on the northern Aleutian Ridge that titled to the north during the formation of Buldir Depression. ?? 1970.

  7. Treatment of major depression in later life: a life cycle perspective.

    PubMed

    Reynolds, C F

    1997-01-01

    The goal of this article is to provide a life-cycle perspective on the treatment of major depressive episodes in later life. Our studies have suggested that older patients appear to benefit as much, though perhaps more slowly, than mid-life patients from acute combined treatment (nortriptyline+interpersonal psychotherapy) of major depression. Given also the apparently higher relapse rate among the elderly, however, continuation treatment needs to be vigorous and closely monitored. The occurrence of severe life events prior to the index episode and the co-existence of an anxiety disorder both appear to prolong treatment response times, while chronic medical burden per se neither compromises response rates nor prolongs time to response. Self-rated perception of health improves with remission of depression in the elderly. As in mid-life patients, both antidepressant medication (nortriptyline) and interpersonal psychotherapy appear to possess chronic efficacy with respect to the prevention of recurrent episodes and prolongation of wellness. Finally, treatment of depression in the elderly results in improved quality of life, especially in domains of well being and coping. Particular challenges in the treatment of elderly patients are noncompliance and the prevention of suicide. The latter is closely linked to feelings of hopelessness, and these may be persistent in some patients. PMID:9237318

  8. Neuropathological analysis of lacunes and microvascular lesions in late-onset depression

    PubMed Central

    Santos, Micaela; Gold, Gabriel; Kövari, Enikö; Herrmann, François R.; Hof, Patrick R.; Bouras, Constantin; Giannakopoulos, Panteleimon

    2010-01-01

    Aims Previous neuropathological studies documented that small vascular and microvascular pathology is associated with cognitive decline. More recently, we showed that thalamic and basal ganglia lacunes are associated with post-stroke depression and may affect emotional regulation. The present study examines whether this is also the case for late-onset depression. Methods We performed a detailed analysis of small macrovascular and microvascular pathology in the postmortem brains of 38 patients with late-onset major depression (LOD) and 29 healthy elderly controls. A clinical diagnosis of LOD was established while the subjects were alive using the DSM-IV criteria. Additionally, we retrospectively reviewed all charts for the presence of clinical criteria of vascular depression. Neuropathological evaluation included bilateral semiquantitative assessment of lacunes, deep white matter and periventricular demyelination, cortical microinfarcts and both focal and diffuse gliosis. The association between vascular burden and LOD was investigated using Fisher’s exact test and univariate and multivariate logistic regression models. Results Neither the existence of lacunes nor the presence of microvascular ischaemic lesions was related to occurrence of LOD. Similarly, there was no relationship between vascular lesion scores and LOD. This was also the case within the subgroup of LOD patients fulfilling the clinical criteria for vascular depression. Conclusions Our results challenge the vascular depression hypothesis by showing that neither deep white matter nor periventricular demyelination is associated with LOD. In conjunction with our previous observations in stroke patients, they also imply that the impact of lacunes on mood may be significant solely in the presence of acute brain compromise. PMID:20609111

  9. Late-life homicide-suicide: a national case series in New Zealand.

    PubMed

    Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

    2016-01-01

    Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy.

  10. Late-life homicide-suicide: a national case series in New Zealand.

    PubMed

    Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

    2016-01-01

    Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy. PMID:25735608

  11. Long-term course of severe depression: late remission and recurrence may be found in a follow-up after 38–53 years

    PubMed Central

    Crona, Lisa; Brådvik, Louise

    2012-01-01

    This study is a follow-up of inpatients diagnosed with severe depression/melancholia between 1956 and 1969. During this period, all inpatients at the Department of Psychiatry, University Hospital, Lund, were rated on a multidimensional diagnostic schedule on discharge. There were 471 patients born from 1920 onward. In the present follow-up, 2006 to 2010, 169 survivors could be traced. They were asked to participate in the study involving a telephone interview, in which a structured life chart was used. Of the patients contacted, 16 were ill or confused and 3 did not remember ever being depressed, leaving 150 who could participate. Seventy-five of these agreed to participate in the study. Long-term course of depression was evaluated by cluster analysis and compared to background variables, such as heredity for depression, perceived parental rearing behaviour, and treatment of index depressive episode. Using a cluster analysis the patients could be separated into six clusters describing the course: i) single or few episodes followed by long-lasting remission; ii) single or few episodes followed by long-lasting remission, although shorter; iii) single or few episodes followed by late recurrence; iv) single or few episodes, but more frequently ill, followed by late recurrence; v) several episodes followed by lasting remission; vi) chronic course of episodes. Remission or recurrence could therefore occur even after more than a decade. In summary, there was a short-term course with or without recurrence or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course with or without late remission. PMID:25478118

  12. Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress

    PubMed Central

    Hankin, Benjamin L.; Young, Jami F.; Abela, John R. Z.; Smolen, Andrew; Jenness, Jessica L.; Gulley, Lauren D.; Technow, Jessica R.; Gottlieb, Andrea Barrocas; Cohen, Joseph R.; Oppenheimer, Caroline W.

    2015-01-01

    Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly via semi-structured diagnostic interviews every 6-months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. PMID:26595469

  13. The Game of Late Life: A Novel Education Activity for the Psychology of Ageing

    ERIC Educational Resources Information Center

    Brinker, Jay K.; Roberts, Pamela; Radnidge, Belinda

    2014-01-01

    This article describes the development and evaluation of The Game of Late Life--a novel education activity for the psychology of ageing. The game was designed to provide transformational learning where students imagine themselves as older adults and move through late life via a game board, encountering various life events along the way. One of the…

  14. Late-life brain volume: a life-course approach. The AGES-Reykjavik study.

    PubMed

    Muller, Majon; Sigurdsson, Sigurdur; Kjartansson, Olafur; Gunnarsdottir, Ingibjorg; Thorsdottir, Inga; Harris, Tamara B; van Buchem, Mark; Gudnason, Vilmundur; Launer, Lenore J

    2016-05-01

    The "fetal-origins-of-adult-disease" hypothesis proposes that an unfavorable intrauterine environment, estimated from small birth size, may induce permanent changes in fetal organs, including the brain. These changes in combination with effects of (cardiovascular) exposures during adult life may condition the later risk of brain atrophy. We investigated the combined effect of small birth size and mid-life cardiovascular risk on late-life brain volumes. Archived birth records of weight and height were abstracted for 1348 participants of the age, gene/environment susceptibility-Reykjavik study (RS; 2002-2006) population-based cohort, who participated in the original cohort of the RS (baseline 1967). Mid-life cardiovascular risk factors (CVRF) were collected in the RS. As a part of the late-life age, gene/environment susceptibility-RS examination, a brain magnetic resonance imaging was acquired and from it, volumes of total brain, gray matter, white matter, and white matter lesions were estimated. Adjusting for intracranial volume, demographics, and education showed small birth size (low ponderal index [PI]) and increased mid-life cardiovascular risk had an additive effect on having smaller late-life brain volumes. Compared with the reference group (high PI/absence of mid-life CVRF), participants with lower PI/presence of mid-life CVRF (body mass index >25 kg/m(2), hypertension, diabetes, "ever smokers") had smaller total brain volume later in life; B (95% confidence interval) were -10.9 mL (-21.0 to -0.9), -10.9 mL (-20.4 to -1.4), -20.9 mL (-46.9 to 5.2), and -10.8 mL (-19.3 to -2.2), respectively. These results suggest that exposure to an unfavorable intrauterine environment contributes to the trajectory toward smaller brain volume, adding to the atrophy that may be associated with mid-life cardiovascular risk. PMID:27103521

  15. Maternal Depression and Mother-Child Interaction Patterns: Association with Toddler Problems and Continuity of Effects to Late Childhood

    ERIC Educational Resources Information Center

    Leckman-Westin, Emily; Cohen, Patricia R.; Stueve, Ann

    2009-01-01

    Objective: Increased behavior problems have been reported in offspring of mothers with depression. In-home observations link maternal depressive symptoms (MDS) and mother-child interaction patterns with toddler behavior problems and examine their persistence into late childhood. Method: Maternal characteristics (N = 153) and behaviors of…

  16. Hope as a moderator of negative life events and depressive symptoms in a diverse sample.

    PubMed

    Visser, Preston L; Loess, Priya; Jeglic, Elizabeth L; Hirsch, Jameson K

    2013-02-01

    Depression is a significant public health problem for young adults of college age, and negative life events exacerbate risk. Not all individuals who experience negative life events, however, report depressive symptoms, perhaps owing to protective characteristics. We examined one such characteristic, trait hope, a goal-oriented construct, as a potential moderator of the association between negative life events and depressive symptoms in an ethnically diverse sample of 386 college students. In support of our hypotheses, negative life events were significantly associated with greater levels of depressive symptoms, and higher levels of hope attenuated this relationship, such that those with greater hope reported fewer depressive symptoms related to potentially traumatic events. The moderating effect of hope did not differ across ethnic groups. Our findings have implications for managing the sequelae of negative life events, including depression. Cognitive-behavioural interventions tailored to help young adults identify and attain important life goals might help to overcome psychopathology associated with life stress.

  17. Do Afterlife Beliefs Affect Psychological Adjustment to Late-Life Spousal Loss?

    PubMed Central

    2014-01-01

    Objectives. We explore whether beliefs about the existence and nature of an afterlife affect 5 psychological symptoms (anxiety, anger, depression, intrusive thoughts, and yearning) among recently bereaved older spouses. Method. We conduct multivariate regression analyses using data from the Changing Lives of Older Couples (CLOC), a prospective study of spousal loss. The CLOC obtained data from bereaved persons prior to loss and both 6 and 18 months postloss. All analyses are adjusted for health, sociodemographic characteristics, and preloss marital quality. Results. Bleak or uncertain views about the afterlife are associated with multiple aspects of distress postloss. Uncertainty about the existence of an afterlife is associated with elevated intrusive thoughts, a symptom similar to posttraumatic distress. Widowed persons who do not expect to be reunited with loved ones in the afterlife report significantly more depressive symptoms, anger, and intrusive thoughts at both 6 and 18 months postloss. Discussion. Beliefs in an afterlife may be maladaptive for coping with late-life spousal loss, particularly if one is uncertain about its existence or holds a pessimistic view of what the afterlife entails. Our findings are broadly consistent with recent work suggesting that “continuing bonds” with the decedent may not be adaptive for older bereaved spouses. PMID:23811692

  18. Inbreeding depression in an insect with maternal care: influences of family interactions, life stage and offspring sex.

    PubMed

    Meunier, J; Kölliker, M

    2013-10-01

    Although inbreeding is commonly known to depress individual fitness, the severity of inbreeding depression varies considerably across species. Among the factors contributing to this variation, family interactions, life stage and sex of offspring have been proposed, but their joint influence on inbreeding depression remains poorly understood. Here, we demonstrate that these three factors jointly shape inbreeding depression in the European earwig, Forficula auricularia. Using a series of cross-breeding, split-clutch and brood size manipulation experiments conducted over two generations, we first showed that sib mating (leading to inbred offspring) did not influence the reproductive success of earwig parents. Second, the presence of tending mothers and the strength of sibling competition (i.e. brood size) did not influence the expression of inbreeding depression in the inbred offspring. By contrast, our results revealed that inbreeding dramatically depressed the reproductive success of inbred adult male offspring, but only had little effect on the reproductive success of inbred adult female offspring. Overall, this study demonstrates limited effects of family interactions on inbreeding depression in this species and emphasizes the importance of disentangling effects of sib mating early and late during development to better understand the evolution of mating systems and population dynamics.

  19. Prevention and early intervention for depression in adolescence and early adult life.

    PubMed

    Harrington, R; Clark, A

    1998-01-01

    Over the past decade there has been increasing interest in the possibility that early intervention might prevent mental disorders later in life. Indeed, in the United Kingdom the Department of Health recommends that health promotion should be one of the main functions of child mental health services, a suggestion that has been endorsed by professional bodies. It is easy to see why both purchasers and providers of mental health services would be interested in prevention, but will preventive interventions work in practice? This paper discusses the possibility of preventing depressive disorder in late adolescence and early adult life by intervening in childhood and early adolescence. The paper begins with a description of the phenomenology of depression and its risk factors. It then goes on to describe a framework of prevention and within this framework explores whether there is an adequate knowledge base. The general perspective that is presented is one of cautious scepticism. It is argued that difficulties in defining depression and identifying risk factors that can easily be remedied make it unlikely that within the foreseeable future primary prevention programmes will prove to be more effective than treatment and rehabilitation of affected individuals. The possibility that preventive programmes could do harm will also be discussed. The paper concludes with some proposals about appropriate targets for prevention. It is suggested that apart from a few policy areas where there are some relatively harmless measures that could protect from later depression, a balanced preventive programme will give higher priority to treatment services than to those concerned with early intervention.

  20. Clinical and cognitive diversity of psychotic states arising in late life (late paraphrenia).

    PubMed

    Almeida, O P; Howard, R J; Levy, R; David, A S; Morris, R G; Sahakian, B J

    1995-07-01

    This study aimed to explore the heterogeneity of paranoid psychosis with onset in late life by using cognitive factors in a centroid method of cluster analysis. Forty-seven subjects were allocated to two different clusters, the first with 24 (51.1%) and the second with 23 (48.9%) patients. Their cognitive attainment was evaluated against the performance of 33 elderly controls, all groups being matched for age, sex, and the numbers of years of education. Patients in cluster 2 showed a pattern of widespread cognitive impairment, which involved general measures of cognitive performance (MMSE, CAMCOG, WAIS-R verbal and performance scores), memory (digit and spatial span, delayed matching-to-sample, recognition memory for words and faces), and executive functions (verbal fluency, extra and intra-dimensional shift ability, spatial working memory, and planning). In contrast, patients in cluster 1 were only impaired on their extra-dimensional set shift and planning abilities, suggesting a more specific and restricted executive functioning deficit. We also analysed the impact that the use of antipsychotic medication could have had on patients' cognitive performance, which was shown to be negligible. In addition, there was no difference between the clusters with regard to the number of patients using neuroleptics, suggesting that the medication was unlikely to have introduced a performance bias in the two patient clusters. The validity of the subdivision of these patients into two separate groups was further supported by other clinical findings. Patients in cluster 1 exhibited more severe psychotic symptoms, as measured by the SAPS, than their counterparts in cluster 2, and were also more likely to display first-rank symptoms of Schneider. Conversely, cluster 2 membership was strongly associated with the presence of neurological signs and negative symptoms. We suggest that psychotic states arising in late life are a heterogeneous condition that may be best divided in two

  1. Drinking, smoking, and psychological distress in middle and late life.

    PubMed

    Choi, Namkee G; Dinitto, Diana M

    2011-08-01

    A limited number of studies have examined the co-occurrence of alcohol use and smoking and their mental health effects in middle and late life. In this study, using the 2008 National Survey of Drug Use and Health, the characteristics of individuals aged 50 and older who abstained from both substances, who used both substances, and who used one or the other substance were examined. Then, the main and interaction effects of drinking and smoking on psychological distress were analyzed. Findings show that smoker-nondrinkers are the most disadvantaged group in terms of sociodemographic and health characteristics, while drinker-nonsmokers are the most advantaged group. When sociodemographic, health, and other factors were controlled, no direct effects of drinking or interaction effect of drinking and smoking were detected for either gender. However, heavy smoking (6+ cigarettes on a typical smoking day) was significantly associated with an elevated level of psychological distress among women. The findings highlight the vulnerability of heavy smoking middle-aged and older women. These women are the most psychologically distressed and may need interventions designed to help them quit smoking, reduce or quit drinking, and alleviate psychological distress.

  2. The APOE epsilon 4 polymorphism does not predict late onset depression: the Three-City Study.

    PubMed

    Tully, Phillip J; Péres, Karine; Berr, Claudine; Tzourio, Christophe

    2016-04-01

    The apolipoprotein E ε4 allele (APOE4) is an established risk factor for dementia; however, conflicting findings have been reported as to whether this phenotype confers a heightened risk for late onset depression (LOD) independent of dementia. We examined 2242 persons for incident LOD who also underwent genotyping for APOE4. Major LOD was associated with female sex (odds ratio, 3.61; 95% confidence interval, 1.89-6.90). APOE4 was not associated with major LOD regardless of whether dementia was excluded. In conclusion, we showed that the APOE4 phenotype holds no predictive value for major LOD.

  3. Evidence on early-life income and late-life health from America's Dust Bowl era.

    PubMed

    Cutler, David M; Miller, Grant; Norton, Douglas M

    2007-08-14

    In recent decades, elderly Americans have enjoyed enormous gains in longevity and reductions in disability. The causes of this progress remain unclear, however. This paper investigates the role of fetal programming, exploring how economic progress early in the 20th century might be related to declining disability today. Specifically, we match sudden unexpected economic changes experienced in utero in America's Dust Bowl during the Great Depression to unusually detailed individual-level information about old-age disability and chronic disease. We are unable to detect any meaningful relationship between early life factors and outcomes in later life. We conclude that, if such a relationship exists in the United States, it is most likely not a quantitatively important explanation for declining disability today.

  4. Evidence on early-life income and late-life health from America's Dust Bowl era.

    PubMed

    Cutler, David M; Miller, Grant; Norton, Douglas M

    2007-08-14

    In recent decades, elderly Americans have enjoyed enormous gains in longevity and reductions in disability. The causes of this progress remain unclear, however. This paper investigates the role of fetal programming, exploring how economic progress early in the 20th century might be related to declining disability today. Specifically, we match sudden unexpected economic changes experienced in utero in America's Dust Bowl during the Great Depression to unusually detailed individual-level information about old-age disability and chronic disease. We are unable to detect any meaningful relationship between early life factors and outcomes in later life. We conclude that, if such a relationship exists in the United States, it is most likely not a quantitatively important explanation for declining disability today. PMID:17686988

  5. Adolescent Depression and Negative Life Events, the Mediating Role of Cognitive Emotion Regulation

    PubMed Central

    Stikkelbroek, Yvonne; Bodden, Denise H. M.; Kleinjan, Marloes; Reijnders, Mirjam; van Baar, Anneloes L.

    2016-01-01

    Background Depression during adolescence is a serious mental health problem. Difficulties in regulating evoked emotions after stressful life events are considered to lead to depression. This study examined if depressive symptoms were mediated by various cognitive emotion regulation strategies after stressful life events, more specifically, the loss of a loved one, health threats or relational challenges. Methods We used a sample of 398 adolescents (Mage = 16.94, SD = 2.90), including 52 depressed outpatients, who all reported stressful life event(s). Path analyses in Mplus were used to test mediation, for the whole sample as well as separately for participants scoring high versus low on depression, using multigroup analyses. Results Health threats and relational challenging stressful life events were associated with depressive symptoms, while loss was not. More frequent use of maladaptive strategies was related to more depressive symptoms. More frequent use of adaptive strategies was related to less depressive symptoms. Specific life events were associated with specific emotion regulation strategies. The relationship between challenging, stressful life events and depressive symptoms in the whole group was mediated by maladaptive strategies (self-blame, catastrophizing and rumination). No mediation effect was found for adaptive strategies. Conclusion The association between relational challenging, stressful life events and depressive symptoms was mediated by maladaptive, cognitive emotion regulation strategies. PMID:27571274

  6. Making Sense of Intimate Partner Violence in Late Life: Comments from Online News Readers

    ERIC Educational Resources Information Center

    Brossoie, Nancy; Roberto, Karen A.; Barrow, Katie M.

    2012-01-01

    Purpose: The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper. Design and Methods: Using grounded theory techniques, online news items covering 24 incidents of IPV in late life, and the reader comments posted to…

  7. Life Course Socioeconomic Position and Mid-Late Life Cognitive Function in Eastern Europe

    PubMed Central

    2014-01-01

    Objectives. To investigate whether the positive relation between socioeconomic position (SEP) across the life course and later life cognitive function observed in Western populations exists in former communist countries with apparently smaller income inequalities. Method. Structural equation modeling analysis of cross-sectional data on 30,846 participants aged 45–78 years in four Central and Eastern European centers: Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania), and six Czech towns from the HAPIEE (Health, Alcohol, and Psychosocial factors In Eastern Europe) study. SEP was measured using self-reported childhood (maternal education, household amenities), adult (education), and older adult (current material circumstances) indicators. Latent variable for cognition was constructed from word recall, animal naming, and letter search. Results. Associations between SEP measures over the life course and cognition were similar across study centers. Education had the strongest direct association with cognition, followed by current material circumstances. Indirect path from education to cognition, mediated by current SEP, was small. Direct path from mother’s education to cognition was significant but modest, and partially mediated by later SEP measures, particularly education. Discussion. In these Eastern European populations, late life cognition reflected life course socioeconomic trajectories similarly to findings in Western countries. PMID:24598045

  8. Serum lipid levels and cognitive change in late life

    PubMed Central

    Reynolds, Chandra A.; Gatz, Margaret; Prince, Jonathan A.; Berg, Stig; Pedersen, Nancy L.

    2010-01-01

    Objectives To assess the importance of lipids and lipoproteins on longitudinal cognitive performance and cognitive health in late life and to consider moderating factors such as age and sex which may clarify conflicting prior evidence. Design A 16-year prospective cohort study of health and cognitive aging. Participants 819 adults from the Swedish Adoption Twin Study of Aging (SATSA), 50 years and older at the first cognitive testing, including 21 twin pairs discordant for dementia. Measurements Up to five occasions of cognitive measurements encompassing verbal, spatial, memory and perceptual speed domains across a 16-year span. Baseline serum lipids and lipoproteins including HDL, apoA1, apoB, total serum cholesterol, and triglycerides. Results The effect of lipids on cognitive change was most evident prior to age 65. In women higher HDL and lower apoB and triglycerides predicted better maintenance of cognitive abilities over age, particularly verbal ability and perceptual speed. Lipid values were less predictive of cognitive trajectories in men and, where observed, were in the contrary direction: i.e., higher total cholesterol and apoB values predicted better perceptual speed performance though faster rates of decline. In twin pairs discordant for dementia, higher total cholesterol and apoB levels were observed in the twin who subsequently developed dementia. Conclusions Elevated lipids may constitute a more important risk factor for cognitive health before age 65 than after. Findings for women are consistent with clinical recommendations, while for men the findings correspond with earlier age-associated shifts in lipid profiles and the importance of lipid homeostasis to cognitive health. PMID:20398119

  9. Blood Transcriptomic Markers in Patients with Late-Onset Major Depressive Disorder.

    PubMed

    Miyata, Shigeo; Kurachi, Masashi; Okano, Yoshiko; Sakurai, Noriko; Kobayashi, Ayumi; Harada, Kenichiro; Yamagata, Hirotaka; Matsuo, Koji; Takahashi, Keisuke; Narita, Kosuke; Fukuda, Masato; Ishizaki, Yasuki; Mikuni, Masahiko

    2016-01-01

    We investigated transcriptomic markers of late-onset major depressive disorder (LOD; onset age of first depressive episode ≥ 50 years) from the genes expressed in blood cells and identified state-dependent transcriptomic markers in these patients. We assessed the genes expressed in blood cells by microarray and found that the expression levels of 3,066 probes were state-dependently changed in the blood cells of patients with LOD. To select potential candidates from those probes, we assessed the genes expressed in the blood of an animal model of depression, ovariectomized female mice exposed to chronic ultra-mild stress, by microarray and cross-matched the differentially expressed genes between the patients and the model mice. We identified 14 differentially expressed genes that were similarly changed in both patients and the model mice. By assessing statistical significance using real-time quantitative PCR (RT-qPCR), the following 4 genes were selected as candidates: cell death-inducing DFFA-like effector c (CIDEC), ribonuclease 1 (RNASE1), solute carrier family 36 member-1 (SLC36A1), and serine/threonine/tyrosine interacting-like 1 (STYXL1). The discriminating ability of these 4 candidate genes was evaluated in an independent cohort that was validated. Among them, CIDEC showed the greatest discriminant validity (sensitivity 91.3% and specificity 87.5%). Thus, these 4 biomarkers should be helpful for properly diagnosing LOD.

  10. Blood Transcriptomic Markers in Patients with Late-Onset Major Depressive Disorder.

    PubMed

    Miyata, Shigeo; Kurachi, Masashi; Okano, Yoshiko; Sakurai, Noriko; Kobayashi, Ayumi; Harada, Kenichiro; Yamagata, Hirotaka; Matsuo, Koji; Takahashi, Keisuke; Narita, Kosuke; Fukuda, Masato; Ishizaki, Yasuki; Mikuni, Masahiko

    2016-01-01

    We investigated transcriptomic markers of late-onset major depressive disorder (LOD; onset age of first depressive episode ≥ 50 years) from the genes expressed in blood cells and identified state-dependent transcriptomic markers in these patients. We assessed the genes expressed in blood cells by microarray and found that the expression levels of 3,066 probes were state-dependently changed in the blood cells of patients with LOD. To select potential candidates from those probes, we assessed the genes expressed in the blood of an animal model of depression, ovariectomized female mice exposed to chronic ultra-mild stress, by microarray and cross-matched the differentially expressed genes between the patients and the model mice. We identified 14 differentially expressed genes that were similarly changed in both patients and the model mice. By assessing statistical significance using real-time quantitative PCR (RT-qPCR), the following 4 genes were selected as candidates: cell death-inducing DFFA-like effector c (CIDEC), ribonuclease 1 (RNASE1), solute carrier family 36 member-1 (SLC36A1), and serine/threonine/tyrosine interacting-like 1 (STYXL1). The discriminating ability of these 4 candidate genes was evaluated in an independent cohort that was validated. Among them, CIDEC showed the greatest discriminant validity (sensitivity 91.3% and specificity 87.5%). Thus, these 4 biomarkers should be helpful for properly diagnosing LOD. PMID:26926397

  11. Blood Transcriptomic Markers in Patients with Late-Onset Major Depressive Disorder

    PubMed Central

    Miyata, Shigeo; Kurachi, Masashi; Okano, Yoshiko; Sakurai, Noriko; Kobayashi, Ayumi; Harada, Kenichiro; Yamagata, Hirotaka; Matsuo, Koji; Takahashi, Keisuke; Narita, Kosuke; Fukuda, Masato; Ishizaki, Yasuki; Mikuni, Masahiko

    2016-01-01

    We investigated transcriptomic markers of late-onset major depressive disorder (LOD; onset age of first depressive episode ≥ 50 years) from the genes expressed in blood cells and identified state-dependent transcriptomic markers in these patients. We assessed the genes expressed in blood cells by microarray and found that the expression levels of 3,066 probes were state-dependently changed in the blood cells of patients with LOD. To select potential candidates from those probes, we assessed the genes expressed in the blood of an animal model of depression, ovariectomized female mice exposed to chronic ultra-mild stress, by microarray and cross-matched the differentially expressed genes between the patients and the model mice. We identified 14 differentially expressed genes that were similarly changed in both patients and the model mice. By assessing statistical significance using real-time quantitative PCR (RT-qPCR), the following 4 genes were selected as candidates: cell death-inducing DFFA-like effector c (CIDEC), ribonuclease 1 (RNASE1), solute carrier family 36 member-1 (SLC36A1), and serine/threonine/tyrosine interacting-like 1 (STYXL1). The discriminating ability of these 4 candidate genes was evaluated in an independent cohort that was validated. Among them, CIDEC showed the greatest discriminant validity (sensitivity 91.3% and specificity 87.5%). Thus, these 4 biomarkers should be helpful for properly diagnosing LOD. PMID:26926397

  12. Prospective Interrelationships Between Late Adolescent Personality and Major Depressive Disorder in Early Adulthood

    PubMed Central

    Wilson, Sylia; DiRago, Ana C.; Iacono, William G.

    2013-01-01

    Background A well-established body of literature demonstrates concurrent associations between personality traits and major depressive disorder (MDD), but there have been relatively fewer investigations of their dynamic interplay over time. Methods Prospective interrelationships between late adolescent personality and MDD in early adulthood were examined in a community sample of male and female twins from the Minnesota Twin Family Study (N = 1252). Participants were classified into naturally occurring MDD groups based on the timing (adolescent- versus adult-onset) and course (chronic/recurrent versus remitting) of MDD. MDD diagnoses were assessed at ages 17, 20, 24, and 29, and personality traits (Negative Emotionality [NEM], Positive Emotionality [PEM], Constraint [CON]) were assessed at ages 17, 24, and 29. Results Multilevel modeling analyses indicated that higher age-17 NEM was associated with the subsequent development of MDD, and any MDD, regardless of onset or course, was associated with higher NEM through age 29. Moreover, the chronic/recurrent MDD groups failed to show the normative decrease in NEM from late adolescence to early adulthood. Lower age-17 PEM was also associated with the subsequent development of MDD, but only among the chronic/recurrent MDD groups. Finally, the adolescent-onset MDD groups reported lower age-17 CON relative to the never depressed and adult-onset MDD groups. Conclusions Taken together, results speak to the role of personality traits for conferring risk for the onset of MDD in late adolescence and early adulthood, as well as the pernicious implications of chronic/recurrent MDD, particularly when it onsets during adolescence, for adaptive personality development. PMID:23689064

  13. Life expectancy and late stroke following carotid endarterectomy.

    PubMed Central

    Bernstein, E F; Humber, P B; Collins, G M; Dilley, R B; Devin, J B; Stuart, S H

    1983-01-01

    A review of the UCSD experience with 456 consecutive carotid endarterectomy procedures confirms the acceptably low operative mortality and morbidity associated with this operation. Immediate complications were not different when routine or selective shunting was performed, but the patients with a low internal carotid artery back pressure had higher operative complication rates. The coexistence of atherosclerosis in other parts of the body severe-enough to warrant surgery for them was not associated with either higher early or late carotid surgery complication rates. Following both coronary bypass and carotid procedures, the late mortality was decreased, and the late incidence of stroke was particularly low in comparison to the remainder of the patient group. Late follow-up emphasized the high continuing attrition rate from all causes in these patients. Late strokes continued to occur, particularly in patients with prior strokes and severe preoperative bilateral carotid disease. The late course of patients with posterior circulation transient ischemic attacks treated by carotid endarterectomy was quite similar to that of patients treated for anterior circulation transient ischemia attacks (TIAs). Newer postoperative screening procedures may decrease the incidence of late postoperative stroke by identifying recurrent carotid stenosis while it is still in the asymptomatic stage. PMID:6602597

  14. Cognitive Distortions as Mediators between Life Stress and Depression in Adolescents.

    ERIC Educational Resources Information Center

    Deal, Saundra L.; Williams, John E.

    1988-01-01

    Administered measures of cognitive distortion, life stress, and depressive tendencies to 103 high school students. Findings were consistent with predictions that measures of cognitive distortion would be better predictors of depressive tendencies than were measures of life stress; cognitive distortions would affect perceived stressfulness of life…

  15. Prevalence, work-loss days and quality of life of community dwelling subjects with depressive symptoms.

    PubMed

    Sohn, Jee Hoon; Ahn, Seung Hee; Seong, Su Jeong; Ryu, Ji Min; Cho, Maeng Je

    2013-02-01

    The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea.

  16. Early life stress affects limited regional brain activity in depression.

    PubMed

    Du, Lian; Wang, Jingjie; Meng, Ben; Yong, Na; Yang, Xiangying; Huang, Qingling; Zhang, Yan; Yang, Lingling; Qu, Yuan; Chen, Zhu; Li, Yongmei; Lv, Fajin; Hu, Hua

    2016-05-03

    Early life stress (ELS) can alter brain function and increases the risk of major depressive disorder (MDD) in later life. This study investigated whether ELS contributes to differences in regional brain activity between MDD patients and healthy controls (HC), as measured by amplitude of low-frequency fluctuation (ALFF)/fractional (f)ALFF. Eighteen first-episode, treatment-naïve MDD patients and HC were assessed with the Childhood Trauma Questionnaire and resting-state functional magnetic resonance imaging. We compared ALFF/fALFF between MDD patients and HC, with or without controlling for ELS, and determined whether ELS level was correlated with regional brain activity in each group. After regressing out ELS, we found that ALFF increased in bilateral amygdala and left orbital/cerebellum, while fALFF decreased in left inferior temporal and right middle frontal gyri in MDD patients relative to controls. ELS positively correlated with regional activity in the left cerebellum in MDD and in the right post-central/inferior temporal/superior frontal cingulate, inferior frontal gyrus and bilateral cerebellum in HC. Our findings indicate that there is only very limited region showing correlation between ELS and brain activity in MDD, while diverse areas in HC, suggesting ELS has few impacts on MDD patients.

  17. Early life stress affects limited regional brain activity in depression

    PubMed Central

    Du, Lian; Wang, Jingjie; Meng, Ben; Yong, Na; Yang, Xiangying; Huang, Qingling; Zhang, Yan; Yang, Lingling; Qu, Yuan; Chen, Zhu; Li, Yongmei; Lv, Fajin; Hu, Hua

    2016-01-01

    Early life stress (ELS) can alter brain function and increases the risk of major depressive disorder (MDD) in later life. This study investigated whether ELS contributes to differences in regional brain activity between MDD patients and healthy controls (HC), as measured by amplitude of low-frequency fluctuation (ALFF)/fractional (f)ALFF. Eighteen first-episode, treatment-naïve MDD patients and HC were assessed with the Childhood Trauma Questionnaire and resting-state functional magnetic resonance imaging. We compared ALFF/fALFF between MDD patients and HC, with or without controlling for ELS, and determined whether ELS level was correlated with regional brain activity in each group. After regressing out ELS, we found that ALFF increased in bilateral amygdala and left orbital/cerebellum, while fALFF decreased in left inferior temporal and right middle frontal gyri in MDD patients relative to controls. ELS positively correlated with regional activity in the left cerebellum in MDD and in the right post-central/inferior temporal/superior frontal cingulate, inferior frontal gyrus and bilateral cerebellum in HC. Our findings indicate that there is only very limited region showing correlation between ELS and brain activity in MDD, while diverse areas in HC, suggesting ELS has few impacts on MDD patients. PMID:27138376

  18. Negative Inferential Style, Emotional Clarity, and Life Stress: Integrating Vulnerabilities to Depression in Adolescence

    PubMed Central

    Stange, Jonathan P.; Alloy, Lauren B.; Flynn, Megan; Abramson, Lyn Y.

    2012-01-01

    Objective Negative inferential style and deficits in emotional clarity have been identified as vulnerability factors for depression in adolescence, particularly when individuals experience high levels of life stress. However, previous research has not integrated these characteristics when evaluating vulnerability to depression. Method In the present study, a racially-diverse community sample of 256 early adolescents (ages 12 and 13) completed a baseline visit and a follow-up visit nine months later. Inferential style, emotional clarity, and depressive symptoms were assessed at baseline, and intervening life events and depressive symptoms were assessed at follow-up. Results Hierarchical linear regressions indicated that there was a significant three-way interaction between adolescents’ weakest-link negative inferential style, emotional clarity, and intervening life stress predicting depressive symptoms at follow-up, controlling for initial depressive symptoms. Adolescents with low emotional clarity and high negative inferential styles experienced the greatest increases in depressive symptoms following life stress. Emotional clarity buffered against the impact of life stress on depressive symptoms among adolescents with negative inferential styles. Similarly, negative inferential styles exacerbated the impact of life stress on depressive symptoms among adolescents with low emotional clarity. Conclusions These results provide evidence of the utility of integrating inferential style and emotional clarity as constructs of vulnerability in combination with life stress in the identification of adolescents at risk for depression. They also suggest the enhancement of emotional clarity as a potential intervention technique to protect against the effects of negative inferential styles and life stress on depression in early adolescence. PMID:23215673

  19. Late Life Immigration and Quality of Life among Asian Indian Older Adults.

    PubMed

    Mukherjee, Anita J; Diwan, Sadhna

    2016-09-01

    Late-life immigration among seniors for purposes of family reunification is a growing phenomenon in developed countries. Using the World Health Organization's Quality of Life instrument short form (WHOQOL-BREF) and other psychosocial measures related to the political/legal context of immigration, and personal and environmental autonomy (mastery, immigration status, access to transportation, and language barrier), this study examined quality of life (QoL) in Asian Indian seniors (N = 109), who immigrated to the United States to reunite with their adult children. The sample scores on Overall QoL and QoL domains (physical and psychological health, social relationships, and environment) were similar to established norms. Although all QoL domains correlated significantly with Overall QoL at the bivariate level, multivariate analysis showed that only environmental domain contributed significantly to Overall QoL. Linear regressions indicated: Mastery contributed significantly to Overall QoL and all QoL domains; access to transport contributed to Overall QoL, physical health, and environmental QoL; immigration status (a proxy for political/legal context) contributed to environmental QoL whereas language barrier contributed to none. Implications for improving perceptions of QoL, mastery, access to transport and other services are discussed. PMID:27245988

  20. Late Life Immigration and Quality of Life among Asian Indian Older Adults.

    PubMed

    Mukherjee, Anita J; Diwan, Sadhna

    2016-09-01

    Late-life immigration among seniors for purposes of family reunification is a growing phenomenon in developed countries. Using the World Health Organization's Quality of Life instrument short form (WHOQOL-BREF) and other psychosocial measures related to the political/legal context of immigration, and personal and environmental autonomy (mastery, immigration status, access to transportation, and language barrier), this study examined quality of life (QoL) in Asian Indian seniors (N = 109), who immigrated to the United States to reunite with their adult children. The sample scores on Overall QoL and QoL domains (physical and psychological health, social relationships, and environment) were similar to established norms. Although all QoL domains correlated significantly with Overall QoL at the bivariate level, multivariate analysis showed that only environmental domain contributed significantly to Overall QoL. Linear regressions indicated: Mastery contributed significantly to Overall QoL and all QoL domains; access to transport contributed to Overall QoL, physical health, and environmental QoL; immigration status (a proxy for political/legal context) contributed to environmental QoL whereas language barrier contributed to none. Implications for improving perceptions of QoL, mastery, access to transport and other services are discussed.

  1. Negative life events and symptoms of depression and anxiety: Stress causation and/or stress generation

    PubMed Central

    Phillips, Anna C.; Carroll, Douglas; Der, Geoff

    2016-01-01

    Background and Objectives Stressful life events are known to contribute to development of depression, however, it is possible this link is bi-directional. The present study examined whether such stress generation effects are greater than the effects of stressful life events on depression, and whether stress generation is also evident with anxiety. Design Participants were two large age cohorts (N = 732 aged 44 years; N = 705 aged 63 years) from the West of Scotland Twenty-07 study. Methods Stressful life events, depression and anxiety symptoms were measured twice five years apart. Cross-lagged panel analysis examined the mutual influences of stressful life events on depression and on anxiety over time. Results Life events predicted later depressive symptomatology (p = .01), but the depression predicting life events relationship was less strong (p = .06), whereas earlier anxiety predicted life events five years later (p = .001). There was evidence of sex differences in the extent to which life events predicted later anxiety. Conclusions This study provides evidence of stress causation for depression and weaker evidence for stress generation. In contrast, there was strong evidence of stress generation for anxiety but weaker evidence for stress causation, and that differed for men and women. PMID:25572915

  2. Evaluation of the late life disability instrument in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The late life disability instrument (LLDI) was developed to assess limitations in instrumental and management roles using a small and restricted sample. In this paper we examine the measurement properties of the LLDI using data from the Lifestyle Interventions and Independence for Elders Pilot (LIFE...

  3. Depression and frailty in later life: a systematic review.

    PubMed

    Vaughan, Leslie; Corbin, Akeesha L; Goveas, Joseph S

    2015-01-01

    Frailty and depression are important issues affecting older adults. Depressive syndrome may be difficult to clinically disambiguate from frailty in advanced old age. Current reviews on the topic include studies with wide methodological variation. This review examined the published literature on cross-sectional and longitudinal associations between frailty and depressive symptomatology with either syndrome as the outcome, moderators of this relationship, construct overlap, and related medical and behavioral interventions. Prevalence of both was reported. A systematic review of studies published from 2000 to 2015 was conducted in PubMed, the Cochrane Database of Systematic Reviews, and PsychInfo. Key search terms were "frailty", "frail", "frail elderly", "depressive", "depressive disorder", and "depression". Participants of included studies were ≥ 55 years old and community dwelling. Included studies used an explicit biological definition of frailty based on Fried et al's criteria and a screening measure to identify depressive symptomatology. Fourteen studies met the inclusion/exclusion criteria. The prevalence of depressive symptomatology, frailty, or their co-occurrence was greater than 10% in older adults ≥ 55 years old, and these rates varied widely, but less in large epidemiological studies of incident frailty. The prospective relationship between depressive symptomatology and increased risk of incident frailty was robust, while the opposite relationship was less conclusive. The presence of comorbidities that interact with depressive symptomatology increased incident frailty risk. Measurement variability of depressive symptomatology and inclusion of older adults who are severely depressed, have cognitive impairment or dementia, or stroke may confound the frailty syndrome with single disease outcomes, accounting for a substantial proportion of shared variance in the syndromes. Further study is needed to identify medical and behavioral interventions for

  4. Motivation in Late Life: The Personal Need for Challenge.

    ERIC Educational Resources Information Center

    Wolf, Mary Alice

    Older adults attend continuing education courses for a variety of reasons. Some, like Wuschko K., seek to make sense of their early life experiences. Wuschko is a Polish immigrant who wanted to go on with his education in early life but was prevented from doing so by poverty and war. He spent years in a concentration camp, then became a carpenter…

  5. Explaining Late Life Urban vs. Rural Health Discrepancies in Beijing

    ERIC Educational Resources Information Center

    Zimmer, Zachary; Kaneda, Toshiko; Tang, Zhe; Fang, Xianghua

    2010-01-01

    Social characteristics that differ by place of residence are consequential for health. To study implications of this among older adults in rural vs. urban China, this study employs data from the Beijing municipality, a region that has witnessed growth and gaps in development. Life and active life expectancy is assessed using a multistate life…

  6. Adolescent depression. Epidemiology, nosology, life stress and social network. Minireview based on a doctoral thesis.

    PubMed

    Olsson, G

    1998-01-01

    The study engaged a total population of 16-17-year-old urban high-school students and 2300 (93%) were screened for depression and previous suicide attempts. Adolescents with high depression scores in self-evaluation (12.3%) or reporting previous suicide attempts (2.4%) were diagnostically interviewed together with one control for each, matched for gender and educational program. After the interview self-ratings were completed regarding social network, family climate, and life events. Major depression was prevalent during the last year in 5.8% and during life time in 11.4%, 4 girls for every boy. A depression with remaining symptoms for a year or more was the most common type. Dysthymia without major depressive episodes was diagnosed in 1.1%, two girls for every boy. Short hypomanic episodes had been experienced by 13.2% of those with major depressive disorder. Anxiety disorder was comorbid to depression in one half and conduct disorder in one forth of the depressed adolescents. Alcohol was abused by 6.5% and used regularly by another 12%. Other drugs were used by 6.5% of depressed adolescents and not at all by controls. The depressed used tobacco twice as frequently as non-depressed. Social network and family climate were compared within the originally matched pairs. Adolescents with long-lasting depressions had a smaller and unsatisfying social network. They also had experienced many stressful life events related to family adversities, while those with shorter depressive episodes had stress related to the peer group. Depressed adolescents with comorbid conduct disorder reported insufficient support from the close network and a more negative family climate. PMID:9923068

  7. The Vascular Depression Hypothesis: Mechanisms Linking Vascular Disease with Depression

    PubMed Central

    Taylor, Warren D.; Aizenstein, Howard J.; Alexopoulos, George S.

    2013-01-01

    The ‘Vascular Depression’ hypothesis posits that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between late-life depression, vascular risk factors, and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in late-life depression, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression but also provide guidance on the potential repurposing of pharmacological agents that may improve late-life depression outcomes. PMID:23439482

  8. Orthognathic surgery improves quality of life and depression, but not anxiety, and patients with higher preoperative depression scores improve less.

    PubMed

    Brunault, P; Battini, J; Potard, C; Jonas, C; Zagala-Bouquillon, B; Chabut, A; Mercier, J-M; Bedhet, N; Réveillère, C; Goga, D; Courtois, R

    2016-01-01

    This study assessed quality of life (QoL), depression, and anxiety before and after orthognathic surgery and identified risk factors for poorer postoperative outcome. This multicentre prospective study included 140 patients from five French medical centres. We assessed patients before surgery (T1), 3 months after surgery (T2), and 12 months after surgery (T3). We assessed the severity of the orofacial deformity, physical, psychological, social, and environmental QoL (WHOQOL-BREF), and depression and anxiety (GHQ-28). Risk factors for poorer outcome were identified using linear mixed models. Between baseline and 12 months, there was significant improvement in psychological and social QoL and in depression (although below the norms reported in the general population), but not in anxiety. Physical QoL was poorer in patients who were younger, who had a mild orofacial deformity, and who were depressed. Psychological QoL was poorer in younger patients and in depressed patients. Social QoL was poorer in patients who were single, who had a mild orofacial deformity, and who were depressed. Although orthognathic surgery provides a moderate improvement in psychological and social QoL, the systematic screening and treatment of depression could further improve QoL after surgery because it is a major predictor of poor QoL in this population.

  9. Type and Intensity of Negative Life Events Are Associated With Depression in Adults With Intellectual Disabilities.

    PubMed

    Hove, Oddbjørn; Assmus, Jörg; Havik, Odd E

    2016-09-01

    This study investigated the associations between types and intensity of life events and symptoms of depression among adults with intellectual disabilities. A community sample (N = 593) was screened for current depression and exposure to life events (i.e., loss, illness, change, and bullying) during the previous 12 months. Symptoms of depression were measured using the Psychopathology Checklists for Adults With Intellectual Disabilities. Exposure to three of the four types of life events studied (loss, illness, and bullying) and the intensity of the events were associated with depression, particularly in the cases of loss of relatives and bullying. Quality of care moderated the association between bullying and depression and may buffer the adverse consequences of bullying. PMID:27611352

  10. Teenage Childbearing, Marital Status, and Depressive Symptoms in Later Life.

    ERIC Educational Resources Information Center

    Kalil, Ariel; Kunz, James

    2002-01-01

    This longitudinal study tested the contribution of age and marital status at first birth to depressive symptomatology in early adulthood. Findings indicated that unmarried teenage childbearers displayed higher levels of depressive symptoms than women who first gave birth as married adults. The psychological health of married teenage mothers in…

  11. QUALITY OF LIFE, PAIN, ANXIETY AND DEPRESSION IN PATIENTS SURGICALLY TREATED WITH CANCER OF RECTUM

    PubMed Central

    SANTOS, Letácio José Freire; GARCIA, João Batista dos Santos; PACHECO, Jairo Sousa; VIEIRA, Érica Brandão de Morais; dos SANTOS, Alcione Miranda

    2014-01-01

    Background The rectum cancer is associated with high rates of complications and morbidities with great impact on the lives of affected individuals. Aim To evaluate quality of life, pain, anxiety and depression in patients treated for medium and lower rectum cancer, submitted to surgical intervention. Methods A descriptive cross-sectional study. Eighty-eight records of patients with medium and lower rectum cancer, submitted to surgical intervention were selected, and enrolled. Forty-seven patients died within the study period, and the other 41 were studied. Question forms EORTC QLQ-C30 and EORTC QLQ-CR38 were used to assess quality of life. Pain evaluation was carried out using the Visual Analogical Scale, depression and anxiety were assessed through Depression Inventories and Beck's Anxiety, respectively. The correlation between pain intensity, depression and anxiety was carried out, and between these and the EORTC QLQ-C30 General Scale for Health Status and overall quality of life, as well as the EORTC QLQ-CR38 functional and symptom scales. Results Of the 41 patients of the study, 52% presented pain, depression in 47%, and anxiety in 39%. There was a marking positive correlation between pain intensity and depression. There was a moderate negative correlation between depression and general health status, and overall quality of life as well as pain intensity with the latter. There was a statistically significant negative correlation between future depression perspective and sexual function, and also a strong positive correlation between depression and sexual impairments. A positive correlation between anxiety and gastro-intestinal problems, both statistically significant, was observed. Conclusion Evaluation scales showed detriment on quality life evaluation, besides an elevated incidence of pain, depression, and anxiety; a correlation among these, and factors which influence on the quality of life of post-surgical medium and lower rectum cancer patients was

  12. Association of Types of Life Events with Depressive Symptoms among Puerto Rican Youth

    PubMed Central

    2016-01-01

    The main objective of this study was to examine the association between four types of adverse life events (family environment, separation, social adversity, and death) and the development of depressive symptoms among Puerto Rican youth. This was a secondary analysis using three waves (2000–2004) of interview data from the Boricua Youth Study of 10–13 year old Puerto Rican youth residing in New York and Puerto Rico with no depressive symptoms at baseline (n = 977). Depressive symptoms increased with an increase in social adversity, separation, death, and death events. Youth support from parents was a significant protective factor for all adverse events and parent coping was a protective factor in social adversity events. Relying on standard diagnostic tools is ideal to identify youth meeting the criteria for a diagnosis of depression but not useful to detect youth who present with subclinical levels of depression. Youth with sub-clinical levels of depression will not get treated and are at increased risk of developing depression later in life. Adverse life events are potentially relevant to use in conjunction with other screening tools to identify Puerto Rican youth who have subclinical depression and are at risk of developing depression in later adolescence. PMID:27788173

  13. Influence of Serotonin Transporter Gene Polymorphisms and Adverse Life Events on Depressive Symptoms in the Elderly: A Population-Based Study

    PubMed Central

    Davin, Annalisa; Monti, Maria Cristina; Polito, Letizia; Vaccaro, Roberta; Abbondanza, Simona; Gnesi, Marco; Villani, Simona; Guaita, Antonio

    2015-01-01

    Background Depression is common in the elderly. The role of genetic and environmental factors in modulating depressive symptoms is not clear. Methods We evaluated the influence of serotonin transporter gene polymorphisms and recent adverse life events on depressive symptoms in an elderly Italian population. We used data from “InveCe.Ab”, a population-based study of 1321 subjects aged 70–74 years. We used the 15-item Geriatric Depression Scale (GDS) to assess depressive symptoms–a GDS score ≥5 points (GDS≥5) indicated the presence of clinically relevant symptoms–and performed 5-HTTLPR and rs25531 genotyping to obtain the triallelic polymorphism of the serotonin transporter. We used the Geriatric Adverse Life Events Scale to measure adverse life events, and logistic regression models to evaluate the role of genotype and recent adverse life events in depressive symptoms, controlling for potential confounders and independent predictors. Results Two hundred subjects (15.76%) had a GDS≥5. The 5-HTTLPR triallelic polymorphism was significantly associated with GDS≥5. Only S′S′ carriers showed an increased risk of depressive symptoms (ORadj = 1.81, p = .022); one extra adverse life event increased this risk by 14% (p = .061) independently of genotype. Other factors significantly related to GDS≥5 were: female gender (ORadj = 2.49, p < .001), age (ORadj = 1.19, p = .007), a history of depression (ORadj = 4.73, p < .001), and comorbidity (ORadj = 1.23, p = .001). One extra adverse life event increased the risk of depressive symptoms by 57% (p = .005) only in the L′L′ carriers, while antidepressant intake was directly related to GDS≥5 in the L′S′ carriers (ORadj = 2.46, p = .036) and borderline significant in the S′S′ carriers (ORadj = 2.41, p = .081). Discussion The S′S′ genotype and recent exposure to adverse life events were independently associated with depressive symptoms. The S′S′ genotype, compared with the environment

  14. Links between Antisocial Behavior and Depressed Mood: The Role of Life Events and Attributional Style

    ERIC Educational Resources Information Center

    Rowe, Richard; Maughan, Barbara; Eley, Thalia C.

    2006-01-01

    Comorbidity between antisocial behavior and depression in adolescence is widely recognized. This paper examines whether links with depressed mood differ among three subtypes of antisocial behavior: oppositionality, physical aggression and delinquency. In addition we examine two possible contributors to these links: negative life events that are…

  15. A Model Community Education Program on Depression and Suicide in Later Life.

    ERIC Educational Resources Information Center

    Pratt, Clara C.; And Others

    1991-01-01

    Describes development and evaluation of three-hour multimedia community education program on depression and suicide in later life. Designed for families, older adults, and service providers, program provides information and teaches skills to recognize and respond to depression and suicidal behavior in elderly. Compared with controls, participants…

  16. Positive Psychology Intervention to Alleviate Child Depression and Increase Life Satisfaction: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Kwok, Sylvia Y. C. L.; Gu, Minmin; Kit, Katrina Tong Kai

    2016-01-01

    Purpose: The study aims to examine the effectiveness of a positive psychology group-based intervention program, incorporating elements of hope and gratitude, in decreasing depression and increasing life satisfaction among primary school students in Hong Kong. Method: A total of 68 children, with the Depression score of Chinese Hospital Anxiety and…

  17. Adaptive and Maladaptive Perfectionism as Mediators of Adult Attachment Styles and Depression, Hopelessness, and Life Satisfaction

    ERIC Educational Resources Information Center

    Gnilka, Philip B.; Ashby, Jeffrey S.; Noble, Christina M.

    2013-01-01

    This study examined the relationships between adaptive and maladaptive perfectionism, anxious and avoidant adult attachment styles, depression, hopelessness, and life satisfaction among a sample of 180 undergraduate students. Maladaptive perfectionism mediated the relationship between both forms of adult attachment and depression, hopelessness,…

  18. Functioning and Quality of Life in the Treatment for Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    Vitiello, Benedetto; Rohde, Paul; Silva, Susan; Wells, Karen; Casat, Charles; Waslick, Bruce; Simons, Anne; Reinecke, Mark; Weller, Elizabeth; Kratochvil, Christopher; Walkup, John; Pathak, Sanjeev; Robins, Michele; March, John

    2006-01-01

    Obective: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents. Method: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of fluoxetine, cognitive-behavioral therapy (CBT), their combination (COMB), or clinical…

  19. Stressful Life Events and Depressive Symptoms: Social Support and Sense of Control as Mediators or Moderators?

    ERIC Educational Resources Information Center

    Chou, Kee-Lee; Chi, Iris

    2001-01-01

    Examined the impact of a series of common stressful life events (SLEs) on change in depressive symptoms among the elderly of the Hong Kong Chinese Society. Using multiple regression models, it was found that sense of control acted as a mediator in the linkage between the number of SLEs and depressive symptoms. Findings suggest that sense of…

  20. Abnormal Functional Connectivity of Amygdala in Late-Onset Depression Was Associated with Cognitive Deficits

    PubMed Central

    Yue, Yingying; Yuan, Yonggui; Hou, Zhenghua; Jiang, Wenhao; Bai, Feng; Zhang, Zhijun

    2013-01-01

    Background Major depressive disorder (MDD) is associated with decreased function of cortico-limbic circuits, which play important roles in the pathogenesis of MDD. Abnormal functional connectivity (FC) with the amygdala, which is involved in cortico-limbic circuits, has also been observed in MDD. However, little is known about connectivity alterations in late-onset depression (LOD) or whether disrupted connectivity is correlated with cognitive impairment in LOD. Methods and Results A total of twenty-two LOD patients and twenty-two matched healthy controls (HC) underwent neuropsychological tests and resting state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) and FC with bilateral amygdala seeds were used to analyze blood oxygen level-dependent fMRI data between two groups. Compared with HC, LOD patients showed decreased ReHo in the right middle frontal gyrus and left superior frontal gyrus. In the LOD group, the left amygdala had decreased FC with the right middle frontal gyrus and the left superior frontal gyrus in the amygdala positive network, and it had increased FC with the right post-central gyrus in the amygdala negative network. However, significantly reduced FC with the right amygdala was observed in the right middle occipital gyrus in the amygdala negative network. Further correlative analyses revealed that decreased FC between the amygdala and the right middle occipital gyrus was negatively correlated with the verbal fluency test (VFT, r = −0.485, P = 0.022) and the digit span test (DST, r = −0.561, P = 0.007). Conclusions Our findings of reduced activity of the prefrontal gyrus and abnormal FC with the bilateral amygdala may be key markers of cognitive dysfunction in LOD patients. PMID:24040385

  1. Early life stress and blood pressure levels in late adulthood.

    PubMed

    Alastalo, H; Räikkönen, K; Pesonen, A-K; Osmond, C; Barker, D J P; Heinonen, K; Kajantie, E; Eriksson, J G

    2013-02-01

    Severe stress experienced in early life may have long-term consequences on adult physiological functions. We studied the long-term effects of separation on blood pressure levels in non-obese subjects who were separated temporarily in childhood from their parents during World War II (WWII). The original clinical study cohort consists of people born during 1934-1944 in Helsinki, Finland. This substudy includes 1361 non-obese subjects (body mass index <30 kg m(-2)). Of these, 192 (14.1%) had been evacuated abroad during WWII. The remaining subjects served as controls. Blood pressure levels and use of blood pressure medication were studied. The separated subjects had significantly higher systolic blood pressure values than the non-separated (148.6+21.5 vs 142.2+19.6 mm Hg, P<0.0001) in adult life. Those subjects separated in early childhood had markedly higher systolic and diastolic blood pressure values in adult life compared with the non-separated (154.6 vs 142.5 mm Hg; 95% confidence interval (CI) 2.6-14.7; P<0.005 and 90.8 vs 87.7 mm Hg; 95% CI 1.0-7.3; P<0.02, respectively). Systolic blood pressure was also higher in the group separated for a duration of <1 year (151.7 vs 142.2 mm Hg; 95% CI 0.0-12.4; P<0.05) compared with the non-separated. Besides being separated, age at separation and duration of separation also influenced blood pressure levels in adult life. This could be due to early hormonal and metabolic programming, during plastic periods in early life, influencing blood pressure levels in adult life.

  2. Relationships among Social Support, Perceived Control, and Psychological Distress in Late Life

    ERIC Educational Resources Information Center

    Nemeroff, Robin; Midlarsky, Elizabeth; Meyer, Joseph F.

    2010-01-01

    Social support has been shown to buffer the relationship between life stress and psychological distress in late life. However, little attention has been paid to personality variables that are associated with the capacity to effectively utilize social support. Although the buffering effects of social support were replicated in our sample of 134…

  3. Negative Life Events and Substance Use Moderate Cognitive-Behavioral Adolescent Depression Prevention Intervention

    PubMed Central

    Gau, Jeff M.; Stice, Eric; Rohde, Paul; Seeley, John R.

    2013-01-01

    Objective Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral depression prevention program for adolescents with elevated depressive symptoms. Method Using data from a randomized trial (Registration No. NCT00183417; N = 173) in which adolescents (M age = 15.5, SD = 1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Results Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Conclusions Results imply that high-risk adolescent with either high rates of major life stress or initial substance use may require specialized depression prevention efforts. PMID:22414236

  4. Social Support Buffers the Impact of Depressive Symptoms on Life Satisfaction in Old Age

    PubMed Central

    Adams, Tangeria R.; Rabin, Laura A.; Da Silva, Valdiva G.; Katz, Mindy J.; Fogel, Joshua; Lipton, Richard B.

    2015-01-01

    Objectives Life satisfaction is an important component of overall well-being. Decline in life satisfaction is related to many adverse health outcomes including mortality. Methods We investigate the association of various psychosocial and health-related factors to life satisfaction in 237 non-demented community-dwelling older adults. Results Lower levels of depressive symptoms, less perceived stress, higher levels of social support, and better self-perceived general health were significantly associated with higher life satisfaction. Social support buffered the adverse impact of depressive symptoms on life satisfaction where more depressive symptoms were associated with much lower life satisfaction at low levels of social support than at high levels of social support. Discussion We discuss study implications, future research directions, and possible interventions that involve boosting social support in at-risk older adults. PMID:27418714

  5. Trajectories of Social Engagement and Limitations in Late Life

    ERIC Educational Resources Information Center

    Thomas, Patricia A.

    2011-01-01

    Although studies have established important links between social relations and health, much of this research does not take into account the dynamic nature of both social relations and health over time. The present study combines person-centered and variable-centered approaches and uses social integration theory within the life course framework to…

  6. Late-Life Divorce: Its Impact on Family Rituals.

    ERIC Educational Resources Information Center

    Pett, Marjorie A.; And Others

    1992-01-01

    Examined perceived changes in specific family celebrations, traditions, important life cycle events, and day-to-day family contact that occurred for 115 adult children whose parents had divorced after long-term marriage. Found strong positive correlation between perceived disruptiveness of parental divorce and changes in family rituals,…

  7. Term life birth after late abortion of the first twin.

    PubMed

    Wouters, Karlijn A; Gianotten, Judith; Bayram, Neriman; Doornbos, Johannes P R

    2009-01-01

    The incidence of multiple pregnancy has increased significantly in recent years as a result of assisted reproductive therapy. The most important complication of these pregnancies remains preterm delivery. We report an extraordinary case of delayed delivery after late abortion of the first twin. Tocolysis successfully prolonged the pregnancy for more than three months, and combined with antibiotics and corticosteroids resulted in a term delivery of a second healthy sibling. A total of 37 reports that describe 145 cases of intentional delayed delivery are available. Delay of delivery may offer significant improvement in survival and outcome for the remaining fetus. Delay of delivery beyond 37 weeks is uncommon with only eight reports. A protocol for the procedure of delayed delivery of the second twin is suggested.

  8. Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder.

    PubMed

    Raab, Phillip A; Mackintosh, Margaret-Anne; Gros, Daniel F; Morland, Leslie A

    2015-01-01

    For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.

  9. Predicting first onset of depression in young girls: Interaction of diurnal cortisol and negative life events.

    PubMed

    LeMoult, Joelle; Ordaz, Sarah J; Kircanski, Katharina; Singh, Manpreet K; Gotlib, Ian H

    2015-11-01

    Interactions between biological vulnerability and environmental adversity are central to the pathophysiology of depression. Given evidence that the hypothalamic-pituitary-adrenal (HPA) axis influences biological responses to environmental events, in the current longitudinal study the authors examined HPA-axis functioning, negative life events, and their interaction as predictors of the first onset of depression. At baseline, girls ages 9 to 14 years provided saliva samples to assess levels of diurnal cortisol production, quantified by total cortisol production (area under the curve with respect to ground; AUCg) and the cortisol awakening response (CAR). The authors then followed these participants until they reached age 18 in order to assess their subsequent experience of negative life events and the onset of a depressive episode. They found that the influence of negative life events on the subsequent onset of depression depended on HPA-axis functioning at baseline. Specifically, negative life events predicted the onset of depression in girls with higher levels of AUCg, but not in girls with lower levels of AUCg. In contrast, CAR did not predict the onset of depression either alone or in interaction with negative life events. These findings suggest that elevated total cortisol production in daily life potentiates susceptibility to environmental adversity and signals the need for early intervention. PMID:26595472

  10. Predicting First Onset of Depression in Young Girls: Interaction of Diurnal Cortisol and Negative Life Events

    PubMed Central

    LeMoult, Joelle; Ordaz, Sarah J.; Kircanski, Katharina; Singh, Manpreet K.; Gotlib, Ian H.

    2015-01-01

    Interactions between biological vulnerability and environmental adversity are central to the pathophysiology of depression. Given evidence that the hypothalamic-pituitary-adrenal (HPA) axis influences biological responses to environmental events, in the current longitudinal study we examined HPA-axis functioning, negative life events, and their interaction as predictors of the first onset of depression. At baseline, girls ages 9 to 14 years provided saliva samples to assess levels of diurnal cortisol production, quantified by total cortisol production (area under the curve with respect to ground; AUCg) and the cortisol awakening response (CAR). We then followed these participants until they reached age 18 in order to assess their subsequent experience of negative life events and the onset of a depressive episode. We found that the influence of negative life events on the subsequent onset of depression depended on HPA-axis functioning at baseline. Specifically, negative life events predicted the onset of depression in girls with higher levels AUCg, but not in girls with lower levels of AUCg. In contrast, CAR did not predict the onset of depression either alone or in interaction with negative life events. These findings suggest that elevated total cortisol production in daily life potentiates susceptibility to environmental adversity and signals the need for early intervention. PMID:26595472

  11. Longitudinal Trajectories of Cholesterol from Midlife through Late Life according to Apolipoprotein E Allele Status

    PubMed Central

    Downer, Brian; Estus, Steven; Katsumata, Yuriko; Fardo, David W.

    2014-01-01

    Background: Previous research indicates that total cholesterol levels increase with age during young adulthood and middle age and decline with age later in life. This is attributed to changes in diet, body composition, medication use, physical activity, and hormone levels. In the current study we utilized data from the Framingham Heart Study Original Cohort to determine if variations in apolipoprotein E (APOE), a gene involved in regulating cholesterol homeostasis, influence trajectories of total cholesterol, HDL cholesterol, and total: HDL cholesterol ratio from midlife through late life. Methods: Cholesterol trajectories from midlife through late life were modeled using generalized additive mixed models and mixed-effects regression models. Results: APOE e2+ subjects had lower total cholesterol levels, higher HDL cholesterol levels, and lower total: HDL cholesterol ratios from midlife to late life compared to APOE e3 and APOE e4+ subjects. Statistically significant differences in life span cholesterol trajectories according to gender and use of cholesterol-lowering medications were also detected. Conclusion: The findings from this research provide evidence that variations in APOE modify trajectories of serum cholesterol from midlife to late life. In order to efficiently modify cholesterol through the life span, it is important to take into account APOE allele status. PMID:25325355

  12. Depression in Older Adults

    PubMed Central

    Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret

    2010-01-01

    Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support. PMID:19327033

  13. Illness perceptions mediate the relationship between depression and quality of life in patients with epilepsy.

    PubMed

    Shallcross, Amanda J; Becker, Danielle A; Singh, Anuradha; Friedman, Daniel; Montesdeoca, Jacqueline; French, Jacqueline; Devinsky, Orrin; Spruill, Tanya M

    2015-11-01

    The current study examined whether negative illness perceptions help explain the link between depression and quality of life. Seventy patients with epilepsy completed standardized self-report questionnaires measuring depression, illness perception, and quality of life (QOL). Illness perception statistically mediated the relationship between depression and QOL (Indirect effect (CI; confidence interval) = -.72, lower limit = -1.7, upper limit = -.22, p < .05). Results held with and without adjusting for potential confounding variables (age, sex, ethnicity, income, and seizure frequency) and when operationalizing depression as a continuous variable that indexed severity of symptoms or as a dichotomous variable that indexed criteria consistent with a diagnosis of major depressive disorder. This study is the first to suggest that illness perceptions may be a useful target in screening and intervention approaches in order to improve QOL among low-income, racially/ethnically diverse patients with epilepsy.

  14. Daily life behaviors and depression risk following stroke: a preliminary study using ecological momentary assessment.

    PubMed

    Jean, François A M; Swendsen, Joel D; Sibon, Igor; Fehér, Kristoffer; Husky, Mathilde

    2013-09-01

    Approximately one-third of stroke survivors have symptoms of depression. A better understanding of the early risk factors implicated in this form of comorbidity may contribute to the development of early prevention strategies and to improving outcomes for this population. The current study uses ecological momentary assessment techniques to identify behavioral risk factors for depression 3 months after stroke. Thirty-six participants completed ambulatory monitoring of daily life circumstances (location, social environment, and activity) 5 times per day during a 1-week period after hospital discharge. Clinician-administered measures of depression were also provided before discharge and 3 months later. Ambulatory monitoring revealed that depression scores at 3 months were lower among individuals with more social interactions but higher among those who reported having sports activities and working in the week following hospital discharge. Daily life behaviors may have important implications for understanding the risk of poststroke depression, and mobile technologies may provide important contributions to their investigation.

  15. Antenatal depressive symptoms associated with specific life events and sources of social support among Italian women.

    PubMed

    Agostini, Francesca; Neri, Erica; Salvatori, Paola; Dellabartola, Sara; Bozicevic, Laura; Monti, Fiorella

    2015-05-01

    This study aimed to identify different kinds of stressful life events and social support associated with antenatal depressive symptoms in a sample of pregnant Italian women. We conducted the study at a primary health-care centre in an urban area (northeast Italy). Mainly recruited at antenatal classes, 404 eligible pregnant women completed a socio-demographic questionnaire that included questions about the present pregnancy, the Edinburgh Depression Scale (EDS) to estimate the prevalence of depressive symptoms, the Multidimensional Scale of Perceived Social Support and List of Threatening Experiences Questionnaire to investigate the quality and nature of social support and recent negative life events. Of the 404 women, 60 (14.9 %) scored 13 or higher on the EDS. This group reported significantly lower social support from various sources-family, friends, and significant others; only in primiparous women were depressive symptoms significantly related to lower support from friends. Women with EDS scores equal or higher than 13 also reported a higher occurrence of recent stressful life events-specifically, death or a serious problem with a close friend or relative, unemployment, financial problems, and moving or housing difficulties. Regression analyses showed that women with high levels of social support or with a positive experience of pregnancy were less likely to experience antenatal depressive symptoms. Our results underscore the associations among antenatal depression, specific life stressors, and low social support from various sources. Clinical attention to these psychosocial correlates is recommended toward detecting vulnerability to antenatal depressive symptoms.

  16. Jungian spirituality: a developmental context for late-life growth.

    PubMed

    Patton, Julie F

    2006-01-01

    Ira Byock's "opportunities for growth" at the end of life have become defining features of the hospice and palliative care movement and create a strong moral imperative against futile and distracting treatment for the terminally ill. This article examines a larger developmental and cultural context that includes the work of Carl Jung and others who describe similar growth as characteristic of the midlife transition and the movement toward "gerotranscendence" in later life. The author suggests that in developmental terms, gerotranscendence forms a bridge between the work of Jung and that of Byock. She examines archetypal concepts and practices that facilitate psychospiritual growth and argues that these may be used with terminally ill patients to help them engage the process of "dying well." She notes that these modern findings lie within a long and cross-cultural humanistic tradition that anticipates the development of wisdom for those whose aging occurs within a spiritual framework that involves identifying with the soul rather than with the body. PMID:17060294

  17. On the analysis and interpretation of late-life fecundity in Drosophila melanogaster.

    PubMed

    Curtsinger, James W

    2015-12-01

    Late-life plateaus have been described in both cohort and individual trajectories of fecundity in Drosophila melanogaster females. Here I examine life history data recently analyzed by Le Bourg and Moreau (2014) and show that non-linearity in the cohort trajectory of fecundity is largely explained by heterogeneity in the duration of reproductive life spans. A model specifying linear post-peak decline of fecundity in individual flies provides a better fit to the data than one that combines linear decline with late-life fecundity plateaus. Using repeated measures analysis of variance, I show that age-dependent trends in individual fecundity are mostly linear, while among the most longevous individuals up to 20% of the variation in trends is non-linear. Plateaus in individual trajectories might be explained by evolutionary processes or by random environmental variation. The dominant role of environmental variation is supported by several observations, including the high variability of late-life fecundity, the occurrence of occasional individual plateaus in inbred lines, and the observation of plateaus in only a fraction of the population. Plateau and non-plateau flies identified by Le Bourg and Moreau (2014) have, on average, the same total fecundity and the same fecundity trajectories. The available evidence suggests that the environmental variance for late-life fecundity is sufficiently large to produce occasional individual trajectories that resemble plateaus but are not heritable. PMID:26344177

  18. Life Events as Predictors of Mania and Depression in Bipolar I Disorder

    PubMed Central

    Johnson, Sheri L.; Cueller, Amy K.; Ruggero, Camilo; Winett-Perlman, Carol; Goodnick, Paul; White, Richard; Miller, Ivan

    2010-01-01

    To date, few prospective studies of life events and bipolar disorder are available, and even fewer have separately examined the role of life events in depression and mania. The goal of this study was to prospectively examine the role of negative and goal-attainment life events as predictors of the course of bipolar disorder. One hundred twenty-five individuals with bipolar I disorder were interviewed monthly for an average of 27 months. Negative and goal-attainment life events were assessed with the Life Events and Difficulties Schedule. Changes in symptoms were evaluated using the Modified Hamilton Rating Scale for Depression and the Bech-Rafaelsen Mania Scale. The clearest results were obtained for goal-attainment life events, which predicted increases in manic symptoms over time. Negative life events predicted increases in depressive symptoms within regression models but were not predictive within multilevel modeling of changes in depressive symptoms. Given different patterns for goal attainment and negative life events, it appears important to consider specific forms of life events in models of bipolar disorder. PMID:18489203

  19. A perspective on psychosis in late life and deficits in social cognition.

    PubMed

    La Salvia, Elizabeth; Chemali, Zeina

    2011-01-01

    The etiology of new psychotic symptoms in late life, including subtle changes in cognition, is a controversial emerging area of study. The development of psychotic symptoms, particularly paranoia, is a common occurrence in late life, and the symptoms of cognitive dysfunction and psychosis are often prominent in dementia, schizophrenia, and mood disorders. This intermixing of symptoms has inescapably led to diagnostic confusion with regard to elderly patients with new-onset psychosis. The complex relationship among different domains of psychopathology makes it difficult to tease apart disorders of affect from psychosis, affect from cognition, and psychosis from cognition. It is therefore potentially useful to modify and expand our approach to how we conceptualize these patients. Emerging evidence suggests that those with dementia, psychotic disorders, and mood disorders suffer from growing cognitive deficits. The article suggests that deficits in social cognition, in particular, may be the unifying deficit that helps to explain why heterogeneous patients may develop paranoia and psychotic symptoms in late life.

  20. A Community-Based Study of Quality of Life and Depression among Older Adults.

    PubMed

    Cao, Wenjun; Guo, Chongzheng; Ping, Weiwei; Tan, Zhijun; Guo, Ying; Zheng, Jianzhong

    2016-01-01

    The goal of the study was to assess the quality of life (QOL) and depression and provide further insights into the relationship between QOL and depression among community-dwelling elderly Chinese people. Baseline data were collected from 1168 older adults (aged ≥ 60) in a large, prospective cohort study on measurement and evaluation of health-promoting and health-protecting behaviors intervention on chronic disease in different community-dwelling age groups. QOL was assessed using the 26-item, World Health Organization Quality of Life, brief version (WHOQOL-BREF) and depression was assessed using the 30-item Geriatric Depression Scale (GDS). The mean WHOQOL-BREF score for all dimensions was approximately 60, with the highest mean value (61.92) observed for social relationships, followed by environment, physical health, and psychological health domains. In this cohort, 26.1% of elderly urban adults met GDS criteria for depression. There were negative correlations between physical health (Odds Ratio (OR) = 0.928, 95% Confidence Interval (CI): 0.910-0.946), psychological health (OR = 0.906, 95% CI: 0.879-0.934), environment (OR = 0.966, 95% CI: 0.944-0.989) and depression among elderly people. Those with depression were older, less educated, had a lower monthly income, and were more likely to report insomnia. All WHOQOL-BREF domains, with the exception of the social domain were negatively correlated with depression.

  1. A Community-Based Study of Quality of Life and Depression among Older Adults.

    PubMed

    Cao, Wenjun; Guo, Chongzheng; Ping, Weiwei; Tan, Zhijun; Guo, Ying; Zheng, Jianzhong

    2016-01-01

    The goal of the study was to assess the quality of life (QOL) and depression and provide further insights into the relationship between QOL and depression among community-dwelling elderly Chinese people. Baseline data were collected from 1168 older adults (aged ≥ 60) in a large, prospective cohort study on measurement and evaluation of health-promoting and health-protecting behaviors intervention on chronic disease in different community-dwelling age groups. QOL was assessed using the 26-item, World Health Organization Quality of Life, brief version (WHOQOL-BREF) and depression was assessed using the 30-item Geriatric Depression Scale (GDS). The mean WHOQOL-BREF score for all dimensions was approximately 60, with the highest mean value (61.92) observed for social relationships, followed by environment, physical health, and psychological health domains. In this cohort, 26.1% of elderly urban adults met GDS criteria for depression. There were negative correlations between physical health (Odds Ratio (OR) = 0.928, 95% Confidence Interval (CI): 0.910-0.946), psychological health (OR = 0.906, 95% CI: 0.879-0.934), environment (OR = 0.966, 95% CI: 0.944-0.989) and depression among elderly people. Those with depression were older, less educated, had a lower monthly income, and were more likely to report insomnia. All WHOQOL-BREF domains, with the exception of the social domain were negatively correlated with depression. PMID:27409627

  2. A Community-Based Study of Quality of Life and Depression among Older Adults

    PubMed Central

    Cao, Wenjun; Guo, Chongzheng; Ping, Weiwei; Tan, Zhijun; Guo, Ying; Zheng, Jianzhong

    2016-01-01

    The goal of the study was to assess the quality of life (QOL) and depression and provide further insights into the relationship between QOL and depression among community-dwelling elderly Chinese people. Baseline data were collected from 1168 older adults (aged ≥ 60) in a large, prospective cohort study on measurement and evaluation of health-promoting and health-protecting behaviors intervention on chronic disease in different community-dwelling age groups. QOL was assessed using the 26-item, World Health Organization Quality of Life, brief version (WHOQOL-BREF) and depression was assessed using the 30-item Geriatric Depression Scale (GDS). The mean WHOQOL-BREF score for all dimensions was approximately 60, with the highest mean value (61.92) observed for social relationships, followed by environment, physical health, and psychological health domains. In this cohort, 26.1% of elderly urban adults met GDS criteria for depression. There were negative correlations between physical health (Odds Ratio (OR) = 0.928, 95% Confidence Interval (CI): 0.910–0.946), psychological health (OR = 0.906, 95% CI: 0.879–0.934), environment (OR = 0.966, 95% CI: 0.944–0.989) and depression among elderly people. Those with depression were older, less educated, had a lower monthly income, and were more likely to report insomnia. All WHOQOL-BREF domains, with the exception of the social domain were negatively correlated with depression. PMID:27409627

  3. Loneliness and depressive symptoms among older adults: The moderating role of subjective life expectancy.

    PubMed

    Bodner, Ehud; Bergman, Yoav S

    2016-03-30

    Loneliness and depressive symptoms are closely related, and both are indicators of reduced physical and mental well-being in old age. In recent years, the subjective perception of how long an individual expects to live (subjective life expectancy) has gained importance as a significant predictor of future psychological functioning, as well as of physical health. The current study examined whether subjective life expectancy moderates the connection between loneliness and depressive symptoms in a representative sample of older adults. Data was collected from the Israeli component of the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel). Participants (n=2210; mean age=70.35) completed measures of loneliness, depressive symptoms, and life expectancy target age. A hierarchical regression analysis predicting depressive symptoms yielded a significant interaction of loneliness and subjective life expectancy. Further analyses demonstrated that low subjective life expectancy mitigated the loneliness-depressive symptoms connection. Findings are discussed in light of the potential burden of higher subjective life expectancy for lonesome older adults, and practical implications are suggested.

  4. Loneliness and depressive symptoms among older adults: The moderating role of subjective life expectancy.

    PubMed

    Bodner, Ehud; Bergman, Yoav S

    2016-03-30

    Loneliness and depressive symptoms are closely related, and both are indicators of reduced physical and mental well-being in old age. In recent years, the subjective perception of how long an individual expects to live (subjective life expectancy) has gained importance as a significant predictor of future psychological functioning, as well as of physical health. The current study examined whether subjective life expectancy moderates the connection between loneliness and depressive symptoms in a representative sample of older adults. Data was collected from the Israeli component of the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel). Participants (n=2210; mean age=70.35) completed measures of loneliness, depressive symptoms, and life expectancy target age. A hierarchical regression analysis predicting depressive symptoms yielded a significant interaction of loneliness and subjective life expectancy. Further analyses demonstrated that low subjective life expectancy mitigated the loneliness-depressive symptoms connection. Findings are discussed in light of the potential burden of higher subjective life expectancy for lonesome older adults, and practical implications are suggested. PMID:26921056

  5. Motivational Antecedents of Preventive Proactivity in Late Life: Linking Future Orientation and Exercise1

    PubMed Central

    Kahana, Eva; Kahana, Boaz; Zhang, Jianping

    2007-01-01

    Future orientation is considered as a motivational antecedent of late-life proactivity. In a panel study of 453 old-old adults, we linked future orientation to exercise, a key component of late-life proactivity. Findings based on hierarchical linear modeling reveal that future orientation at baseline predicts changes in exercise during the subsequent four years. Whereas exercise behavior generally declined over time, future orientation and female gender were associated with smaller decline. These results suggest that future-oriented thinking has a lasting impact on health promotion behavior. Future orientation thus represents a dispositional antecedent of preventive proactivity as proposed in our successful aging model. PMID:18080009

  6. Conservative Christianity, partnership, hormones, and sex in late life.

    PubMed

    Das, Aniruddha; Nairn, Stephanie

    2014-10-01

    Using nationally representative data from the 2005-2006 U.S. National Social Life, Health, and Aging Project, this study queried relationship, sexual, and sex hormone patterns among married evangelical women and men aged 57-85, relative to those in other religions. Results suggested that despite potentially more unequal gender roles, evangelical older women may have better marital quality, perhaps due to the recent transformation of their male counterparts into authoritative, yet-supportive, "soft patriarchs." Correspondingly, these women, especially those with greater subjective religiosity or more support from a spouse, reported consistently better sexual outcomes than their counterparts in other religions. In addition, they also had lower estradiol, whether due to psychobiological effects of their better relationships or self-selection of those with differential hormone levels into particular partnership patterns. While older men in these communities also experienced more satisfactory marriages, and had lower androgens (testosterone, DHEA), their relational assets were less uniformly matched by better sexual outcomes, perhaps reflecting a gender disparity in the linkage between these factors.

  7. First-Generation Undergraduate Students' Social Support, Depression, and Life Satisfaction

    ERIC Educational Resources Information Center

    Jenkins, Sharon Rae; Belanger, Aimee; Connally, Melissa Londono; Boals, Adriel; Duron, Kelly M.

    2013-01-01

    First-generation undergraduate students face challenging cross-socioeconomic cultural transitions into college life. The authors compared first- and non-first-generation undergraduate students' social support, posttraumatic stress, depression symptoms, and life satisfaction. First-generation participants reported less social support from…

  8. The Effect of Group Logotherapy on Meaning in Life and Depression Levels of Iranian Students

    ERIC Educational Resources Information Center

    Robatmili, Somaye; Sohrabi, Faramarz; Shahrak, Mohammad Ali; Talepasand, Siavash; Nokani, Mostafa; Hasani, Mohaddese

    2015-01-01

    This paper identifies the effectiveness of group logotherapy in reducing depression and increasing meaning in life levels of university students in Iran. A randomized controlled trial was conducted with a pre- post- and follow-up test design. The instruments used were the "Purpose in Life" (PIL) test and the "Beck Depression…

  9. The Association between Child Autism Symptomatology, Maternal Quality of Life, and Risk for Depression

    ERIC Educational Resources Information Center

    Zablotsky, Benjamin; Anderson, Connie; Law, Paul

    2013-01-01

    Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother's quality of life, and mother's risk for depression in a sample of 1,110 mothers recruited from a…

  10. Early-late life trade-offs and the evolution of ageing in the wild

    PubMed Central

    Lemaître, Jean-François; Berger, Vérane; Bonenfant, Christophe; Douhard, Mathieu; Gamelon, Marlène; Plard, Floriane; Gaillard, Jean-Michel

    2015-01-01

    Empirical evidence for declines in fitness components (survival and reproductive performance) with age has recently accumulated in wild populations, highlighting that the process of senescence is nearly ubiquitous in the living world. Senescence patterns are highly variable among species and current evolutionary theories of ageing propose that such variation can be accounted for by differences in allocation to growth and reproduction during early life. Here, we compiled 26 studies of free-ranging vertebrate populations that explicitly tested for a trade-off between performance in early and late life. Our review brings overall support for the presence of early-late life trade-offs, suggesting that the limitation of available resources leads individuals to trade somatic maintenance later in life for high allocation to reproduction early in life. We discuss our results in the light of two closely related theories of ageing—the disposable soma and the antagonistic pleiotropy theories—and propose that the principle of energy allocation roots the ageing process in the evolution of life-history strategies. Finally, we outline research topics that should be investigated in future studies, including the importance of natal environmental conditions in the study of trade-offs between early- and late-life performance and the evolution of sex-differences in ageing patterns. PMID:25833848

  11. Early-late life trade-offs and the evolution of ageing in the wild.

    PubMed

    Lemaître, Jean-François; Berger, Vérane; Bonenfant, Christophe; Douhard, Mathieu; Gamelon, Marlène; Plard, Floriane; Gaillard, Jean-Michel

    2015-05-01

    Empirical evidence for declines in fitness components (survival and reproductive performance) with age has recently accumulated in wild populations, highlighting that the process of senescence is nearly ubiquitous in the living world. Senescence patterns are highly variable among species and current evolutionary theories of ageing propose that such variation can be accounted for by differences in allocation to growth and reproduction during early life. Here, we compiled 26 studies of free-ranging vertebrate populations that explicitly tested for a trade-off between performance in early and late life. Our review brings overall support for the presence of early-late life trade-offs, suggesting that the limitation of available resources leads individuals to trade somatic maintenance later in life for high allocation to reproduction early in life. We discuss our results in the light of two closely related theories of ageing-the disposable soma and the antagonistic pleiotropy theories-and propose that the principle of energy allocation roots the ageing process in the evolution of life-history strategies. Finally, we outline research topics that should be investigated in future studies, including the importance of natal environmental conditions in the study of trade-offs between early- and late-life performance and the evolution of sex-differences in ageing patterns.

  12. Reducing depression among community-dwelling older adults using life-story review: a pilot study.

    PubMed

    Chan, Moon Fai; Leong, Katherine S P; Heng, Boon Ling; Mathew, Blessy Koottappal; Khan, Sher Banu A L; Lourdusamy, Sumathi Sagayamary; Nagapan, Mina; Woo, Sook Fan; Chee, Wai Yan; Ho, Roger C M; Taylor, Beverley Joan

    2014-01-01

    A life-story review can serve as an effective intervention to express one's inner feelings and provide emotional catharsis. The research aim was to examine the effects of life-story review on depression levels in community-dwelling older adults in Singapore. This pilot experimental pre-post-follow-up study was conducted from July 2012 to February 2013. Twenty-nine older Malays aged 60 and above, with mild to moderate depression, were randomly allocated to the life-story review (intervention) group (n = 15) or the non life-story review (control) group (n = 14). Depressive symptoms were measured by the Geriatric Depression Scale-15 and collected five times over eight weeks. Generalized estimating equations were used to examine the effects of the intervention on the elders' depression levels, controlled for age, gender, medication use, existence of chronic disease, and diary writing experience. Reductions in depression scores were found in the intervention group from week 1 (Mean ± SD 5.9 ± 2.3) to week 8 (1.9 ± 1.6) compared with the control group (week 1: 5.0 ± 1.3; week 8: 3.5 ± 1.5). At week 8, the intervention group showed a significantly lower level of depression than the control group (χ(2) = 14.61, p < 0.001). This study adds to prior research supporting the use of life story review in improving depression levels in cognitively intact community dwelling older adults.

  13. Depression and Quality of Life in Patients With Type 2 Diabetes

    PubMed Central

    Derakhshanpour, Firooze; Vakili, Mohammad Ali; Farsinia, Maryam; Mirkarimi, Kamal

    2015-01-01

    Background: Frequency of mood disorders in patients with chronic diseases, especially diabetes and its effects on life quality are dramatically increasing. Objectives: This study aimed to investigate the relation between depression and quality of life in patients with diabetes. Patients and Methods: This is a cross sectional survey. Subjects were selected from 330 eligible people referred to the only diabetes clinic in Gorgan City during 6 months, using systematic random sampling. Beak Depression questionnaire and the brief questioner with 26 questions recommended by the World Health Organization (WHOQOL-BREF) were used to measure depression and quality of life, respectively. Data were analyzed through descriptive methods, Chi-square, Independent t test and linear regression model using SPSS16; moreover, P value < 0.05 was considered as significant. Results: In total, 330 patients with diabetes (35.5 % male and 64.5% women) were studied. The mean and standard deviation of their age and years involved with diabetes were 50.6 ± 9.0 and 5.4 ± 4.5 years, respectively. Range of age was 25 - 75 years, as well. The prevalence of depression in all patients with diabetes was 58.2% (124 mild, 56 medium, and 12 with severe depression). Hypertension was 13.9% more in diabetic patients with depression (P value < 0.001) and physical activity in 24.7% of the cases was less with a meaningful difference (P value = 0.01). The mean and standard deviation of quality of life in diabetic patients with and without depression was 50.7 ± 14 and 60.5 ± 13.3, respectively that was significant in two groups (P < 0.0001). Conclusions: The prevalence of depression is high in patients with diabetes and has a considerable impact on the consequences of diabetes and quality of life too. PMID:26082854

  14. Lubavitch Women: Depression and Life Satisfaction in a Traditional Community.

    ERIC Educational Resources Information Center

    Dengelegi, Lidia; Kidder, Louise H.

    Given that traditional societies provide women with clearly defined roles, married women in traditional communities might experience less depression than women who have conflicting role expectations. To examine this issue, 43 Lubavitch Hassidic Jewish women from two northeastern communities were interviewed concerning their satisfaction with…

  15. Health Disparities in Mid-to-Late Life: The Role of Earlier Life Family and Neighborhood Socioeconomic Conditions

    PubMed Central

    Johnson, Rucker C.; Schoeni, Robert F.; Rogowski, Jeannette A.

    2012-01-01

    The relationship between neighborhoods of residence in young adulthood and health in mid to late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2,730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid to late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late-life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid to late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood. PMID:22212443

  16. Health disparities in mid-to-late life: the role of earlier life family and neighborhood socioeconomic conditions.

    PubMed

    Johnson, Rucker C; Schoeni, Robert F; Rogowski, Jeannette A

    2012-02-01

    The relationship between neighborhoods of residence in young adulthood and health in mid-to-late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid-to-late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later-life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid-to-late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood.

  17. Preventing Depression in Later Life: Translation From Concept to Experimental Design and Implementation

    PubMed Central

    Sriwattanakomen, Roy; Ford, Angela F.; Thomas, Stephen B.; Miller, Mark D.; Stack, Jacqueline A.; Morse, Jennifer Q.; Kasckow, John; Brown, Charlotte; Reynolds, Charles F.

    2009-01-01

    Objective The authors detail the public health need for depression prevention research and the decisions made in designing an experiment testing problem solving therapy as “indicated” preventive intervention for high-risk older adults with subsyndromal depression. Special attention is given to the recruitment of African Americans because of well-documented inequalities in mental health services and depression treatment outcomes between races. Methods A total of 306 subjects (half white, half African American) with scores of 16 or higher on the Center for Epidemiological Studies of Depression Scale, but with no history of major depressive disorder in the past 12 months, are being recruited and randomly assigned to either problem solving therapy-primary care or to a dietary education control condition. Time to, and rate of, incident episodes of major depressive disorder are to be modeled using survival analysis. Level of depressive symptoms will be analyzed via a mixed models approach. Results Twenty-two subjects have been recruited into the study, and to date eight have completed the randomly assigned intervention and postintervention assessment. Four of 22 have exited after developing major depressive episodes. None have complained about study procedures or demands. Implementation in a variety of community settings is going well. Conclusion The data collected to date support the feasibility of translating from epidemiology to RCT design and implementation of empirical depression prevention research in later life. PMID:18515690

  18. Depression

    MedlinePlus

    ... make negative thinking worse. previous continue Depression Can Go Unrecognized People with depression may not realize they ... themselves or who have eating disorders or who go through extreme mood changes may have unrecognized depression. ...

  19. Depression

    MedlinePlus

    ... The depression generally lifts during spring and summer. Bipolar disorder is different from depression but is included in this list is because someone with bipolar disorder experiences episodes of extreme low moods (depression). But ...

  20. Reconceptualizing Early- and Late-Onset: A Life Course Analysis of Older Heroin Users

    PubMed Central

    Boeri, Miriam Williams; Sterk, Claire E.; Elifson, Kirk W.

    2013-01-01

    Purpose Our knowledge regarding older users of illicit drugs is limited despite their increasing numbers. In this paper we apply a life course perspective to gain a further understanding of older adult drug use, specifically contrasting early- and late-onset heroin users. Design and Methods Qualitative data were collected from 29 older heroin users. Life course analysis focused on the users’ experiences across the life span. Results The findings suggest that those aging-into heroin use (late-onset) are disadvantaged compared to those who are maturing-in (early-onset) except in areas of health. Implications We propose that conceptualizing the use of heroin and other illicit drugs among older adults based on their life course trajectory will provide insights for social and health services, including drug treatment. PMID:18981280

  1. Associations between attempted suicide, violent life events, depressive symptoms, and resilience in adolescents and young adults.

    PubMed

    Nrugham, Latha; Holen, Are; Sund, Anne Mari

    2010-02-01

    Were violent/nonviolent traumatic life events and victimization by/witnessing violence associates of attempted suicide among depressed adolescents who were also less resilient at early adulthood? The present study examined a subset of mainly depressed, age- and gender-matched, adolescents derived from a representative sample of 2464 students (T1, mean age = 13.7 years) followed up after 1 year (T2Q) and reassessed 5 years later (T3, n = 252, mean age = 20.0 years, 73% participation), with a questionnaire, including the Connor-Davidson Resilience Scale and The Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version psychiatric interviews, which also tapped traumatic life events. Logistic regression analyses revealed that attempters were victims, not witnesses of violence, more depressed, and less resilient than nonattempters, and that resilience was a moderator of lifetime violent events and attempted suicide, even in the presence of antecedent depression. PMID:20145488

  2. Midlife coffee and tea drinking and the risk of late-life dementia: a population-based CAIDE study.

    PubMed

    Eskelinen, Marjo H; Ngandu, Tiia; Tuomilehto, Jaakko; Soininen, Hilkka; Kivipelto, Miia

    2009-01-01

    Caffeine stimulates central nervous system on a short term. However, the long-term impact of caffeine on cognition remains unclear. We aimed to study the association between coffee and/or tea consumption at midlife and dementia/Alzheimer's disease (AD) risk in late-life. Participants of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were randomly selected from the survivors of a population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD). Coffee drinkers at midlife had lower risk of dementia and AD later in life compared with those drinking no or only little coffee adjusted for demographic, lifestyle and vascular factors, apolipoprotein E epsilon4 allele and depressive symptoms. The lowest risk (65% decreased) was found in people who drank 3-5 cups per day. Tea drinking was relatively uncommon and was not associated with dementia/AD. Coffee drinking at midlife is associated with a decreased risk of dementia/AD later in life. This finding might open possibilities for prevention of dementia/AD.

  3. Perceived social support predicted quality of life in patients with heart failure, but the effect is mediated by depressive symptoms

    PubMed Central

    Chung, Misook L; Mosor, Debra K; Lennie, Terry A; Frazier, Susan K.

    2012-01-01

    Purpose Depressive symptoms and inadequate social support are well-known independent predictors of increased mortality and morbidity in heart failure (HF). However, it is unclear how depressive symptoms and social support interact to influence quality of life. Thus, the purpose of this study was to determine the nature of the relationships (direct, mediator, and moderator) among depressive symptoms, social support, and quality of life in patients with HF. Methods We performed a secondary data analysis that included 362 patients with HF who completed measures of depressive symptoms (the Beck Depression Inventory-II), perceived social support (the Multidimensional Scale of Perceived Social Support), and quality of life (the Minnesota Living with Heart Failure Questionnaire) instruments. The direct, mediator, and moderator effects of both depressive symptoms and social support on quality of life were tested using multiple regressions and 2×2 ANCOVA. Results Less social support and greater depressive symptoms independently predicted poorer quality of life. The relationship between social support and quality of life was mediated by depressive symptoms. Neither social support nor depressive symptoms moderated quality of life. Conclusion Promotion of social support will improve quality of life only when depressive symptoms are also effectively managed. PMID:23076798

  4. Long term life dissatisfaction and subsequent major depressive disorder and poor mental health

    PubMed Central

    2011-01-01

    Background Poor mental health, especially due to depression, is one of the main public health problems. Early indicators of poor mental health in general population are needed. This study examined the relationship between long-term life dissatisfaction and subsequent mental health, including major depressive disorder. Method Health questionnaires were sent to a randomly selected population-based sample in 1998 and repeated in 1999 and 2001. In 2005, a clinically studied sub-sample (n = 330) was composed of subjects with (n = 161) or without (n = 169) repeatedly reported adverse mental symptoms at all three previous data collection times. Clinical symptom assessments were performed with several psychometric scales: life satisfaction (LS), depression (HDRS, BDI), hopelessness (HS), mental distress (GHQ), dissociative experiences (DES), and alexithymia (TAS). The long-term life dissatisfaction burden was calculated by summing these life satisfaction scores in 1998, 1999, 2001 and dividing the sum into tertiles. Psychiatric diagnoses were confirmed by SCID-I for DSM-IV in 2005. Logistic regression analyses were performed to assess the studied relationship. Results The previous life dissatisfaction burden associated with adverse socio-demographic, life style and clinical factors. In adjusted logistic regression analyses, it was independently and strongly associated with subsequent major depressive disorder in 2005, even when the concurrent LS score in 2005 was included in the model. Excluding those with reported major depressive disorder in 1999 did not alter this finding. Limitations MDD in 1999 was based on self-reports and not on structured interview and LS data in 2001-2005 was not available. Conclusions The life satisfaction burden is significantly related to major depressive disorder and poor mental health, both in cross-sectional and longitudinal settings. PMID:21861908

  5. American Colonial Life in the Late 1700s: Distant Cousins. [Lesson Plan].

    ERIC Educational Resources Information Center

    2002

    In this lesson, students will explore daily life in the 13 original British colonies and its influences in the late 1700s for two families in different colonies--Delaware and Massachusetts. The lesson asks students to become historical detectives and learn to gather information from artifacts and make inferences about the lives and time they…

  6. Understanding quality-of-life while living with late-stage lung cancer: an exploratory study.

    PubMed

    Adorno, Gail; Brownell, Gracie

    2014-01-01

    U.S. Veterans have a higher prevalence of advanced lung cancer and poorer survival outcomes compared to the general population; yet, no studies exist which specifically explore the psychosocial and existential quality-of-life (QOL) of late-stage lung cancer among this population. This article presents the perspectives of older veterans (N = 12) living with late-stage lung cancer who were receiving chemotherapy, routine hospice care, or both concurrently. Based on individual interviews, themes associated with loss of functionality, close relationships, and communicative acts contributed to veterans' perceptions of diminished or enhanced QOL while living with advanced disease. An overarching theme, loss of the person I know myself to be, suggests that personhood is an important concept to consider in QOL assessment. While findings suggest that the experiences of older Veterans with late-stage lung cancer are similar to other populations of lung cancer patients, and persons with incurable cancer in general, further research regarding the influence of veteran identity at end-of-life is warranted. Further research is needed which explores the influence of a whole person approach to QOL during life-limiting illness and end-of-life decision-making, particularly while receiving late-stage cancer-directed therapy.

  7. The Identification and Assessment of Late-Life ADHD in Memory Clinics

    ERIC Educational Resources Information Center

    Fischer, Barbara L.; Gunter-Hunt, Gail; Steinhafel, Courtney Holm; Howell, Timothy

    2012-01-01

    Objective: Little data exist about ADHD in late life. While evaluating patients' memory problems, the memory clinic staff has periodically identified ADHD in previously undiagnosed older adults. The authors conducted a survey to assess the extent to which other memory clinics view ADHD as a relevant clinical issue. Method: The authors developed…

  8. A Longitudinal Analysis of Social Engagement in Late-Life Widowhood

    ERIC Educational Resources Information Center

    Isherwood, Linda M.; King, Debra S.; Luszcz, Mary A.

    2012-01-01

    Very little is known of the longitudinal changes that occur in contact with children and participation in social activities during late-life widowhood. Using data on social networks and activities drawn from the Australian Longitudinal Study of Ageing, trajectories of change in social engagement were modeled for 1,266 participants (mean age 76.7…

  9. Making Sense of Intimate Partner Violence in Late Life: Comments From Online News Readers

    PubMed Central

    Brossoie, Nancy; Roberto, Karen A.; Barrow, Katie M.

    2012-01-01

    Purpose: The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper. Design and Methods: Using grounded theory techniques, online news items covering 24 incidents of IPV in late life, and the reader comments posted to them were analyzed. The news items were examined for incident details, story framing, and reporting style. An open coding process (Charmaz, K. [2006]. Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage Publications.) was used to generate a comprehensive understanding of themes and patterns in the comments posted by readers. Results: Few posters indicated that incidents were episodes of IPV. As many posters struggled to make sense of incidents, they attempted to remove guilt from the perpetrator by assigning blame elsewhere. Comments were influenced by personal assumptions and perspectives about IPV, relationships, and old age; reporting style of the news items; and comments posted by other posters. Implications: Altering public views of IPV in late life requires raising awareness through education, reframing the ways in which information is presented, and placing greater emphasis on the context of the violence. By engaging interactive news media, reporters, participatory journalists, and policymakers can enhance public recognition and understanding of IPV in late life. PMID:22547086

  10. Integrating Religion and Spirituality into Treatment for Late-Life Anxiety: Three Case Studies

    ERIC Educational Resources Information Center

    Barrera, Terri L.; Zeno, Darrell; Bush, Amber L.; Barber, Catherine R.; Stanley, Melinda A.

    2012-01-01

    Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to…

  11. Reconceptualizing Early and Late Onset: A Life Course Analysis of Older Heroin Users

    ERIC Educational Resources Information Center

    Boeri, Miriam Williams; Sterk, Claire E.; Elifson, Kirk W.

    2008-01-01

    Purpose: Researchers' knowledge regarding older users of illicit drugs is limited despite the increasing numbers of users. In this article, we apply a life course perspective to gain a further understanding of older adult drug use, specifically contrasting early- and late-onset heroin users. Design and Methods: We collected qualitative data from…

  12. Measuring Meaning: Searching for and Making Sense of Spousal Loss in Late-Life

    ERIC Educational Resources Information Center

    Coleman, Rachel A.; Neimeyer, Robert A.

    2010-01-01

    Despite much recent theorizing, evidence regarding the temporal relationship of sense-making to adjustment following bereavement remains relatively sparse. This study examined the role of searching for and making sense of loss in late-life spousal bereavement, using prospective, longitudinal data from the Changing Lives of Older Couples (CLOC)…

  13. How Older People Position Their Late-Life Childlessness: A Qualitative Study

    ERIC Educational Resources Information Center

    Allen, Ruth E. S.; Wiles, Janine L.

    2013-01-01

    This research explored how older people describe their paths to late-life childlessness. In-depth accounts from 38 childless older people, age 63-93, highlight the complex journeys and diverse meanings of childlessness for male and female participants, single and partnered, including some who had outlived children. Positioning theory is used to…

  14. Cognitive Behavioral Therapy vs. Tai Chi for Late Life Insomnia and Inflammatory Risk: A Randomized Controlled Comparative Efficacy Trial

    PubMed Central

    Irwin, Michael R.; Olmstead, Richard; Carrillo, Carmen; Sadeghi, Nina; Breen, Elizabeth C.; Witarama, Tuff; Yokomizo, Megumi; Lavretsky, Helen; Carroll, Judith E.; Motivala, Sarosh J.; Bootzin, Richard; Nicassio, Perry

    2014-01-01

    Study Objectives: To investigate the comparative efficacy of cognitive behavioral therapy (CBT), Tai Chi Chih (TCC), and sleep seminar education control (SS) on the primary outcome of insomnia diagnosis, and secondary outcomes of sleep quality, fatigue, depressive symptoms, and inflammation in older adults with insomnia. Design: Randomized controlled, comparative efficacy trial. Setting: Los Angeles community. Patients: 123 older adults with chronic and primary insomnia. Interventions: Random assignment to CBT, TCC, or SS for 2-hour group sessions weekly over 4 months with follow-up at 7 and 16 months. Measurements: Insomnia diagnosis, patient-reported outcomes, polysomnography (PSG), and high-sensitivity C-reactive protein (CRP) levels. Results: CBT performed better than TCC and SS in remission of clinical insomnia as ascertained by a clinician (P < 0.01), and also showed greater and more sustained improvement in sleep quality, sleep parameters, fatigue, and depressive symptoms than TCC and SS (all P values < 0.01). As compared to SS, CBT was associated with a reduced risk of high CRP levels (> 3.0 mg/L) at 16 months (odds ratio [OR], 0.26 [95% CI, 0.07–0.97] P < 0.05). Remission of insomnia was associated with lower levels of CRP (P < 0.05) at 16 months. TCC was associated with improvements in sleep quality, fatigue, and depressive symptoms as compared to SS (all P's < 0.05), but not insomnia remission. PSG measures did not change. Conclusions: Treatment of late-life insomnia is better achieved and sustained by cognitive behavioral therapies. Insomnia treatment and remission reduces a marker of inflammatory risk, which has implications for cardiovascular morbidity and diabetes observed with sleep disturbance in epidemiologic surveys. Clinical Trial Registration: ClinicalTrials.gov, NCT00280020 Citation: Irwin MR, Olmstead R, Carrillo C, Sadeghi N, Breen EC, Witarama T, Yokomizo M, Lavretsky H, Carroll JE, Motivala SJ, Bootzin R, Nicassio P. Cognitive behavioral

  15. Selective neurocognitive deficits and poor life functioning are associated with significant depressive symptoms in alcoholism-HIV infection comorbidity.

    PubMed

    Sassoon, Stephanie A; Rosenbloom, Margaret J; Fama, Rosemary; Sullivan, Edith V; Pfefferbaum, Adolf

    2012-09-30

    Alcoholism, HIV, and depressive symptoms frequently co-occur and are associated with impairment in cognition and life function. We administered the Beck Depression Inventory-II (BDI-II), measures of life function, and neurocognitive tests to 67 alcoholics, 56 HIV+ patients, 63 HIV+ alcoholics, and 64 controls to examine whether current depressive symptom level (significant, BDI-II>14 vs. minimal, BDI-II<14) was associated with poorer cognitive or psychosocial function in alcoholism-HIV comorbidity. Participants with significant depressive symptoms demonstrated slower manual motor speed and poorer visuospatial memory than those with minimal depressive symptoms. HIV patients with depressive symptoms showed impaired manual motor speed. Alcoholics with depressive symptoms showed impaired visuospatial memory. HIV+ alcoholics with depressive symptoms reported the poorest quality of life; alcoholics with depressive symptoms, irrespective of HIV status, had poorest life functioning. Thus, significant depressive symptoms were associated with poorer selective cognitive and life functioning in alcoholism and in HIV infection, even though depressive symptoms had neither synergistic nor additive effects on cognition in alcoholism-HIV comorbidity. The results suggest the relevance of assessing and treating current depressive symptoms to reduce cognitive compromise and functional disability in HIV infection, alcoholism, and their comorbidity.

  16. DEPRESSIVE SYMPTOMS AFTER BREAST CANCER SURGERY: RELATIONSHIPS WITH GLOBAL, CANCER-RELATED, AND LIFE EVENT STRESS

    PubMed Central

    GOLDEN-KREUTZ, DEANNA M.; ANDERSEN, BARBARA L.

    2007-01-01

    SUMMARY For women with breast cancer, rates of depression are the third highest of any cancer diagnostic group. Stress, defined as life events or perceptions of stress, is associated with depressive symptoms. However, little is known about the relationships between different types of stress and these symptoms in women with breast cancer. This relationship was tested in 210 women assessed after initial surgical treatment for regional breast cancer. Using Hierarchical Multiple Regression, three types of stress were examined: the occurrence of five stressful life events in the year prior to cancer diagnosis, perceptions of global stress, and perceptions of cancer-related traumatic stress. Other potentially relevant correlates of depressive symptoms were also examined, including the personality trait neuroticism, sociodemographics, and disease/treatment characteristics. Fifty-three percent of the variance in depressive symptoms was accounted for by three stress variables (perceptions of global and cancer-related traumatic stress and the life event-major financial difficulty) and two control variables (neuroticism and racial group). Specifically, global stress perceptions coupled with cancer-related intrusive thoughts and financial concerns along with the tendency towards negativity (neuroticism) may conspire to heighten a women’s risk for depressive symptoms. Assessing multiple sources of stress would improve our ability to identify women ‘at risk’ for depressive symptoms and provide appropriate intervention. PMID:15022156

  17. Fetal Exposure to Maternal Depressive Symptoms is Associated with Cortical Thickness in Late Childhood

    PubMed Central

    Sandman, Curt A.; Buss, Claudia; Head, Kevin; Davis, Elysia Poggi

    2014-01-01

    Background Maternal depression is one of the most common prenatal complications. The consequences of fetal exposure to maternal depression are poorly understood. The aim of this study is to examine the association between fetal exposure to maternal depressive symptoms and cortical thickness in 6–9 year-old children. Methods A prospective, longitudinal study of maternal depressive symptoms at 19, 25 and 31 weeks gestation was followed by acquisition of a structural MRI scan in 81 children (86.1 ± 9.9 months). Results Significant (p<.01) cortical thinning in children primarily in the right frontal lobes was associated with exposure to prenatal maternal depression. The strongest association was at 25 weeks gestation; exposure to maternal depression at 25 gestational weeks was associated with cortical thinning in 19% of the whole cortex and 24% of the frontal lobes, primarily in the right superior, medial orbital and frontal pole regions of the prefrontal cortex (p<.01). The significant association between prenatal maternal depression and child externalizing behavior (p<.05) was mediated by cortical thinning in prefrontal areas of the right hemisphere. Conclusions The pattern of cortical thinning in children exposed to prenatal maternal depression is similar to patterns in depressed patients and in individuals with risk for depression. Exposure to prenatal depression coupled with subsequent cortical thinning was associated with presence of externalizing behavior in preadolescent children and may be prodromal markers of risk for dysphoria. Vulnerability to prenatal influences at 25 gestational weeks may result from the enormous growth and dramatic structural changes in the nervous system. PMID:25129235

  18. The Relationship Between Borderline Personality Disorder and Major Depression in Later Life: Acute Versus Temperamental Symptoms

    PubMed Central

    Galione, Janine N.; Oltmanns, Thomas F.

    2012-01-01

    Objective A recent issue in the personality disorder field is the prevalence and course of Axis II symptoms in later life. Focusing on the presentation of personality disorder criteria over time may have some utility in exploring the relationship between borderline personality disorder (BPD) and major depression in older adults. Temperamental personality symptoms are relatively resistant to change but tend to be nonspecific to disorders, while acute symptoms remit relatively quickly. We predicted that temperamental BPD symptoms would be positively correlated with a history of depression and did not expect to find a relationship between major depression and acute BPD symptoms. Method One thousand six hundred and thirty participants between the ages of 55 and 64 were recruited to participate in a community-based longitudinal study representative of the St. Louis area. Participants completed a battery of assessments at baseline, including diagnostic interviews for all ten personality disorders and major depressive disorder. Results Temperamental and acute BPD symptoms were significantly correlated with a history of major depression. After adjustments were made for the effects of temperamental symptoms on depression, acute symptoms were no longer correlated with a history of depression. As predicted, temperamental symptoms remained significantly related to depression, even after controlling for the effects of acute symptoms. BPD acute symptoms showed a unique negative correlation with the amount of time following remission from a depressive episode. Conclusions Overall, this study supports associations between major depression and borderline personality in older adults. The findings indicate that a history of major depression is primarily related to stable BPD symptoms related to emotional distress, which are more prevalent in older adults compared to acute features. PMID:23567384

  19. Universality of bereavement life review for spirituality and depression in bereaved families.

    PubMed

    Ando, Michiyo; Sakaguchi, Yukihiro; Shiihara, Yasufumi; Izuhara, Kumi

    2014-05-01

    The present study aimed to investigate the effects of the Bereavement Life Review on depression and spiritual well-being of bereaved families in a setting that does not specialize in palliative care. The participants were 20 bereaved family members who underwent the Bereavement Life Review over 2 sessions in 2 weeks. Beck Depression Inventory Second Edition scores significantly decreased from 14.4 ± 9.2 to 11.6 ± 7.4 (t = 2.15, P = .045) and Functional Assessment Chronic Illness Therapy-Spiritual scores increased from 24.3 ± 10.1 to 25.9 ± 11 (t = -1.0, P = .341) from pre- to postintervention. These results show that the Bereavement Life Review can decrease depression and improve spiritual well-being of bereaved families after the death of a family member in a setting without specialized palliative care. The results also suggest the universality of this therapy.

  20. Universality of bereavement life review for spirituality and depression in bereaved families.

    PubMed

    Ando, Michiyo; Sakaguchi, Yukihiro; Shiihara, Yasufumi; Izuhara, Kumi

    2014-05-01

    The present study aimed to investigate the effects of the Bereavement Life Review on depression and spiritual well-being of bereaved families in a setting that does not specialize in palliative care. The participants were 20 bereaved family members who underwent the Bereavement Life Review over 2 sessions in 2 weeks. Beck Depression Inventory Second Edition scores significantly decreased from 14.4 ± 9.2 to 11.6 ± 7.4 (t = 2.15, P = .045) and Functional Assessment Chronic Illness Therapy-Spiritual scores increased from 24.3 ± 10.1 to 25.9 ± 11 (t = -1.0, P = .341) from pre- to postintervention. These results show that the Bereavement Life Review can decrease depression and improve spiritual well-being of bereaved families after the death of a family member in a setting without specialized palliative care. The results also suggest the universality of this therapy. PMID:23677768

  1. Reduced nucleus accumbens reactivity and adolescent depression following early-life stress.

    PubMed

    Goff, B; Gee, D G; Telzer, E H; Humphreys, K L; Gabard-Durnam, L; Flannery, J; Tottenham, N

    2013-09-26

    Depression is a common outcome for those having experienced early-life stress (ELS). For those individuals, depression typically increases during adolescence and appears to endure into adulthood, suggesting alterations in the development of brain systems involved in depression. Developmentally, the nucleus accumbens (NAcc), a limbic structure associated with reward learning and motivation, typically undergoes dramatic functional change during adolescence; therefore, age-related changes in NAcc function may underlie increases in depression in adolescence following ELS. The current study examined the effects of ELS in 38 previously institutionalized children and adolescents in comparison to a group of 31 youths without a history of ELS. Consistent with previous research, the findings showed that depression was higher in adolescents than children with a history of ELS. Additionally, functional magnetic resonance imaging results showed atypical NAcc development, where the ELS group did not show a typical increase in NAcc reactivity during adolescence. Consequently, the ELS group showed NAcc hypoactivation during adolescence, and lower NAcc reactivity was correlated with higher depression scores. The results have important implications for understanding how ELS may influence increases in depression via neural development during the transition to adolescence and highlight the importance of identifying at-risk individuals in childhood, a potential critical period for depression-targeted intervention. PMID:23262241

  2. Reduced Nucleus Accumbens Reactivity and Adolescent Depression following Early-life Stress

    PubMed Central

    Goff, Bonnie; Gee, Dylan G.; Telzer, Eva H.; Humphreys, Kathryn L.; Gabard-Durnam, Laurel; Flannery, Jessica; Tottenham, Nim

    2013-01-01

    Depression is a common outcome for those having experienced early life stress (ELS). For those individuals, depression typically increases during adolescence and appears to endure into adulthood, suggesting alterations in the development of brain systems involved in depression. Developmentally, the nucleus accumbens (NAcc), a limbic structure associated with reward learning and motivation, typically undergoes dramatic functional change during adolescence; therefore, age-related changes in NAcc function may underlie increases in depression in adolescence following ELS. The current study examined the effects of ELS in 38 previously institutionalized children and adolescents in comparison to a group of 31 youth without a history of ELS. Consistent with previous research, the findings showed that depression was higher in adolescents than children with a history of ELS. Additionally, fMRI results showed atypical NAcc development, where the ELS group did not show a typical increase in NAcc reactivity during adolescence. Consequently, the ELS group showed NAcc hypoactivation during adolescence, and lower NAcc reactivity was correlated with higher depression scores. The results have important implications for understanding how ELS may influence increases in depression via neural development during the transition to adolescence and highlight the importance of identifying at-risk individuals in childhood, a potential critical period for depression-targeted intervention. PMID:23262241

  3. Quality of life, fatigue, depression and cognitive impairment in Lyme neuroborreliosis.

    PubMed

    Dersch, Rick; Sarnes, Antonia A; Maul, Monika; Hottenrott, Tilman; Baumgartner, Annette; Rauer, Sebastian; Stich, Oliver

    2015-11-01

    The prognosis and impact of residual symptoms on quality of life in patients with Lyme neuroborreliosis (LNB) is subject to debate. The aim of this study was to assess quality of life, fatigue, depression, cognitive impairment and verbal learning in patients with definite LNB and healthy controls in a case-control study. We retrospectively identified all patients diagnosed with definite LNB between 2003 and 2014 in our tertiary care center. Healthy controls were recruited from the same area. Patients and healthy controls were assessed for quality of life [Short Form (36) with subscores for physical and mental components (PCS, MCS)], fatigue (fatigue severity scale), depression (Beck depression inventory), verbal memory and learning and cognitive impairment (mini-mental state examination). 53 patients with definite LNB could be identified, of which 30 partook in the follow-up assessment. Estimates for quality of life, fatigue, depression, verbal memory and cognitive impairment did not differ statistically significantly between 30 patients with LNB and 35 healthy controls. Patients with residual symptoms had lower scores for quality of life (PCS) compared to patients without residual symptoms. Our results do not support the hypothesis that a considerable proportion of patients with antibiotically treated LNB develop a 'post Lyme syndrome' consisting of debilitating fatigue or cognitive impairment or have severe limitations of quality of life. However, some patients experience residual symptoms of LNB.

  4. Femininity and Depression Mediated by Social and Relational Aggression in Late Adolescence

    ERIC Educational Resources Information Center

    Kolbert, Jered B.; Field, Julaine E.; Crothers, Laura M.; Schreiber, James B.

    2010-01-01

    Although studies have found a relation between the use of relational aggression and depressive symptomatology, there is less evidence for the relation of the role of gender identity in these processes. Consequently, this study investigated the roles of social and relational aggression and feminine gender role identity in depressive symptoms among…

  5. Depression, perceived control, and life satisfaction in university students from Central-Eastern and Western Europe.

    PubMed

    Wardle, Jane; Steptoe, Andrew; Gulis, Gabriel; Sartory, Gudrun; Sêk, Helena; Todorova, Irina; Vögele, Claus; Ziarko, Michal

    2004-01-01

    The poor health and psychological well-being of people in the former socialist states of Centeral-Eastern Europe are of serious concern and may be related to low perceived control. We compared depressive symptoms, life satisfaction, and self-rated health in 3,571 male and female university students from 5 Western European countries and 4,793 students from 5 Central-Eastern European countries. Depression scores (short Beck Depression Inventory; Beck & Beck, 1972) were higher in Central-Eastern than Western European samples. The prevalence of low life satisfaction was also greater in Central-Eastern Europeans, but ratings of self-rated health did not differ. Ratings of perceived control were diminished, but sense of mastery and internal health locus of control were higher in Central-Eastern Europe. Depression and low life satisfaction were associated with low perceived control and mastery and with strong beliefs in the influence of chance over health. However, taking these factors into account did not explain the East-West difference in depressive symptoms and low life satisfaction.

  6. Internet addiction, adolescent depression, and the mediating role of life events: finding from a sample of Chinese adolescents.

    PubMed

    Yang, Linsheng; Sun, Liang; Zhang, Zhihua; Sun, Yehuan; Wu, Hongyan; Ye, Dongqing

    2014-10-01

    The aim of this study is to examine the mediating role of life events in the relation between Internet addiction and depression using an adolescent sample in China. A total of 3507 urban adolescent students were asked to complete the questionnaires including Young's Internet Addiction Scale, Adolescent Self-Rating Life Events Checklist, and Center for Epidemiologic Studies Depression Scale, Parent-Child Conflict Tactics Scales, and demographic characteristics. Path analyses demonstrated that life events fully mediated the relationship between Internet addiction and adolescent depression. Specificity for the mediating role of life events was demonstrated in comparison to alternative competing mediation models. The findings support our hypothesis that the effect of Internet addiction on adolescent depression is mediated by the life events. Further research is required to test the temporal relationship between Internet addiction and adolescent depression and explore mechanisms underlying the pathways leading to adolescent depression.

  7. Depression, anxiety and stress among patients with dialysis and the association with quality of life.

    PubMed

    Bujang, Mohamad A; Musa, Ramli; Liu, Wen J; Chew, Thian F; Lim, Christopher T S; Morad, Zaki

    2015-12-01

    Studies addressing the nature of relationship between psychological symptoms and quality of life among dialysis patients in Malaysia are scarce. Hence, this study is intended to investigate the association between psychological symptoms such as depression, anxiety and stress on the quality of life in dialysis patients. A cross sectional multicentre study was conducted from May to October 2012 at 15 centres that provide haemodialysis and/or peritoneal dialysis. Apart from socio-demographic profile data collection, WHOQOL-BREF and DASS21 questionnaires were administered to study subjects. All three psychological symptoms had significant impact on quality of life domains of physical health, psychological health, social impact, perceived environment and overall quality of life. These findings suggest that subjects with symptoms of depression, anxiety and stress had poorer quality of life than those without, highlighting the negative impact of psychological symptoms.

  8. Depression, Anxiety, and Quality of Life In Children and Adolescents With Sickle Cell Disease.

    PubMed

    Graves, J Kelly; Hodge, Christopher; Jacob, Eufemia

    2016-01-01

    The relationships among depression, anxiety, and quality of life were tested, as were the effects of age, gender, and pain frequency on these variables in children (n = 44) and adolescents (n = 31) with sickle cell disease. Participants completed the Revised Child Anxiety and Depression Scale (ROADS) and the Pediatric Quality of Life (PedQL Generic Model). The mean and standard deviation for summary RCADS scores for the majority of participants were below the clinical thresholds of T < 65, indicating low risk for depression (n = 65; 89.3%) and anxiety (n = 70; 93.3%). The subscale scores for the different dimensions of QOL health were a) psychosocial (73.3 ± 15.9), b) emotional (75.0 ± 20.7), c) social (80.8 ± 19.1), d) school functioning (64.0 ≥ 19.8), and e) physical (77.4 ± 17.4). Significant negative correlations were found between mean total quality of life scores and symptoms of a) general anxiety (r = -0.51, p < 0.0001), b) depression (r = -0.66, p < 0.0001), c) obsessive compulsive (r = -0.53, p < 0.0001), d) panic (r = -0.60, p < 0.0001), and e) social phobia (r = -0.57, p < 0.0001). Age and gender did not have significant effects on risk for depression and anxiety or poor QOL. Pain frequency also did not have significant effects on the risk for depression and anxiety. Findings suggest that health care providers need to screen for anxiety and depression, and make referrals for early interventions to improve quality of life and promote school function in youth with sickle cell disease.

  9. Depression, Anxiety, and Quality of Life In Children and Adolescents With Sickle Cell Disease.

    PubMed

    Graves, J Kelly; Hodge, Christopher; Jacob, Eufemia

    2016-01-01

    The relationships among depression, anxiety, and quality of life were tested, as were the effects of age, gender, and pain frequency on these variables in children (n = 44) and adolescents (n = 31) with sickle cell disease. Participants completed the Revised Child Anxiety and Depression Scale (ROADS) and the Pediatric Quality of Life (PedQL Generic Model). The mean and standard deviation for summary RCADS scores for the majority of participants were below the clinical thresholds of T < 65, indicating low risk for depression (n = 65; 89.3%) and anxiety (n = 70; 93.3%). The subscale scores for the different dimensions of QOL health were a) psychosocial (73.3 ± 15.9), b) emotional (75.0 ± 20.7), c) social (80.8 ± 19.1), d) school functioning (64.0 ≥ 19.8), and e) physical (77.4 ± 17.4). Significant negative correlations were found between mean total quality of life scores and symptoms of a) general anxiety (r = -0.51, p < 0.0001), b) depression (r = -0.66, p < 0.0001), c) obsessive compulsive (r = -0.53, p < 0.0001), d) panic (r = -0.60, p < 0.0001), and e) social phobia (r = -0.57, p < 0.0001). Age and gender did not have significant effects on risk for depression and anxiety or poor QOL. Pain frequency also did not have significant effects on the risk for depression and anxiety. Findings suggest that health care providers need to screen for anxiety and depression, and make referrals for early interventions to improve quality of life and promote school function in youth with sickle cell disease. PMID:27468512

  10. Race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health.

    PubMed

    Hudson, Darrell L; Puterman, Eli; Bibbins-Domingo, Kirsten; Matthews, Karen A; Adler, Nancy E

    2013-11-01

    Greater levels of socioeconomic position (SEP) are generally associated with better health. However results from previous studies vary across race/ethnicity and health outcomes. Further, the majority of previous studies do not account for the effects of life course SEP on health nor the effects of racial discrimination, which could moderate the effects of SEP on health. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we examined the relationship between a life course SEP measure on depressive symptoms and self-rated health. A life course SEP was constructed for each participant, using a framework that included parental education and occupation along with respondents' highest level of education and occupation. Interaction terms were created between life course SEP and racial discrimination to determine whether the association between SEP and health was moderated by experiences of racial discrimination. Analyses revealed that higher levels of life course SEP were inversely related to depressive symptoms. Greater life course SEP was positively associated with favorable self-rated health. Racial discrimination was associated with more depressive symptoms and poorer self-rated health. Analyses indicated a significant interaction between life course SEP and racial discrimination on depressive symptoms in the full sample. This suggested that for respondents with greater levels of SEP, racial discrimination was associated with reports of more depressive symptoms. Future research efforts should be made to examine whether individuals' perceptions and experiences of racial discrimination at the interpersonal and structural levels limits their ability to acquire human capital as well as their advancement in education and occupational status.

  11. A Study of Depression and Quality of Life in Patients of Lichen Planus

    PubMed Central

    Sawant, Neena S.; Vanjari, Nakul A.; Khopkar, Uday; Adulkar, Satish

    2015-01-01

    The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck's depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life. PMID:25802892

  12. Quality of life, depression, anxiety and loneliness in patients with bullous pemphigoid. A case control study*

    PubMed Central

    Kouris, Anargyros; Platsidaki, Eftychia; Christodoulou, Christos; Armyra, Kalliopi; Korkoliakou, Panagiota; Stefanaki, Christina; Tsatovidou, Revekka; Rigopoulos, Dimitrios; Kontochristopoulos, George

    2016-01-01

    Background Bullous pemphigoid (BP) is a chronic, autoimmune blistering skin disease that affects patients' daily life and psychosocial well-being. Objective The aim of the study was to evaluate the quality of life, anxiety, depression and loneliness in BP patients. Methods Fifty-seven BP patients and fifty-seven healthy controls were recruited for the study. The quality of life of each patient was assessed using the Dermatology Life Quality Index (DLQI) scale. Moreover, they were evaluated for anxiety and depression according to the Hospital Anxiety Depression Scale (HADS-scale), while loneliness was measured through the Loneliness Scale-Version 3 (UCLA) scale. Results The mean DLQI score was 9.45±3.34. Statistically significant differences on the HADS total scale and in HADS-depression subscale (p=0.015 and p=0.002, respectively) were documented. No statistically significant difference was found between the two groups on the HADS-anxiety subscale. Furthermore, significantly higher scores were recorded on the UCLA Scale compared with healthy volunteers (p=0.003). Conclusion BP had a significant impact on quality of life and the psychological status of patients, probably due to the appearance of unattractive lesions on the skin, functional problems and disease chronicity.

  13. Life on hold: Staying in identity diffusion in the late twenties.

    PubMed

    Carlsson, Johanna; Wängqvist, Maria; Frisén, Ann

    2016-02-01

    This study adds to the understanding of the dark side of identity development by investigating what it means to experience long-term identity diffusion during the late twenties. In a study of change and stability in identity status between ages 25 and 29 (N = 124; 63 women), seven participants were assigned to identity diffusion at both ages. Longitudinal analysis of interviews with these participants showed that long-term experiences of identity diffusion may be described through individuals' approach to changing life conditions, the extent to which they engage in meaning making, and how they develop their personal life direction. In questionnaires, participants reported few signs of psychological distress. Even so, qualitative analyses showed a general trend among participants to keep life on hold through decreased activity or increased haphazard activity in relation to changing life conditions, to make little new meaning, and in some cases to dissolve their personal life direction.

  14. Think Positively and Feel Positively: Optimism and Life Satisfaction in Late Life

    ERIC Educational Resources Information Center

    Leung, Beeto Wai-Chung; Moneta, Giovanni B.; Mcbride-Chang, Catherine

    2005-01-01

    This study developed a dispositional path model of life satisfaction for community dwelling Chinese elderly living in Hong Kong. A sample of 117 elderly completed scales measuring life satisfaction, optimism, self-esteem, relationship harmony, self-construals, and perceived/expected health and financial status. Modeling revealed that life…

  15. Relation of Depression, Anxiety, and Quality of Life with Outcome after Percutaneous Transluminal Coronary Angioplasty

    PubMed Central

    Chaudhury, Suprakash; Srivastava, Kalpana

    2013-01-01

    Background. Despite, increasing number of percutaneous transluminal coronary angioplasty (PTCA) being performed, there is a paucity of Indian studies on the psychological effects of PTCA. Aim. To study the relation of anxiety, depression, and health related quality of life with outcome after PTCA. Methods. A total of 35 patients undergoing PTCA were included in the present project with their informed consent. All patients filled a specially designed proforma, the Hospital Anxiety and Depression Scale, Coronary Scale, Seattle Angina Questionnaire, and a health related quality of life measure (EQ 5D) one day before undergoing PTCA. Three days after PTCA patients were reassessed with the Hospital anxiety & depression scale, Seattle angina questionnaire and the EQ 5D. Results. Analysis showed that 46% had significant anxiety and 32.1% had significant depression before PTCA. Following successful PTCA, none of the patients had significant anxiety, and only 2 (3.6%) had significant depression. On the Seattle Angina Questionnaire, physical limitation reduced from 67.9 to 48. Disease perception improved from 21.2 to 37.1. On the EQ5D, the health status improved from 42.7 before PTCA to 78.7 after PTCA. Conclusion. Successful PTCA resulted in significant reduction in anxiety, depression, and physical limitation and improvement in disease perception and health status. PMID:24319368

  16. Prospects for delaying the rising tide of worldwide, late-life dementias.

    PubMed

    Larson, Eric B

    2010-12-01

    Worldwide, lifespan is lengthening. Concomitantly, late-life dementias are increasingly common, challenging both personal and public health internationally. After age 65, rates of dementia tend to double every five years in developed countries and every seven in developing ones. The late-life dementias, particularly Alzheimer's disease, have profound effects on aging individuals and their caregivers. Multidisciplinary research has explored the potential for various approaches to prevent or delay the onset of late-life dementias. Outlining that research, including our team's Adult Changes in Thought and Kame studies, this review concludes that delaying the onset of these dementias appears feasible, although absolute prevention may not be. Today, the most promising methods appear to include controlling vascular risk factors like hypertension and engaging in physical exercise - and possibly mental exercise. If people can delay the onset of dementias, they can lead more fulfilling lives for longer, spending less time suffering from dementia and letting their families spend less time coping with the disease. It is possible that trends toward more knowledge-based societies, where cognitive health is so vital, may increasingly exert evolutionary pressure favoring larger and healthier brains - and a "compression of cognitive morbidity" - well into old age. Public health's great triumph, increased lifespan, should give more of the world's people the reward of many years of dementia-free life. Rather than the personal difficulties and public health burdens of many years of functional impairment, dependency, and suffering with dementia, some interventions may delay the onset of Alzheimer's disease and other dementias.

  17. Life-space mobility, perceived health, and depression symptoms in a sample of Mexican older adults.

    PubMed

    González, Bertha Cecilia Salazar; Delgado, Leticia Hernández; Quevedo, Juana Edith Cruz; Gallegos Cabriales, Esther C

    2013-01-01

    Mobility in older adults is essential to preserving their physical independence and health. Changes in mobility are related to cognitive, physical, and emotional factors, among others. We explored symptoms of depression as a mediator variable between chronic diseases and comorbidities and the outcomes of perceived health and life-space mobility in a convenience sample of 135 older Mexican adults. A cross-sectional design was used. Simple and multiple linear regression models were adjusted to verify the assumptions of mediation using Baron and Kenny's model. Chronic diseases and comorbidities served as independent variables in two separate models, perceived health and life-space mobility served as dependent variables, and depressive symptoms as the mediator variable. Results showed that perceived health and life-space mobility are affected by chronic diseases and comorbidities. However, when symptoms of depression enter the equation, the β coefficients decreased suggesting partial mediation. It is important to assess and treat depression symptoms in older adults rather than assuming that, at their age, depression is normal.

  18. Interferon α Therapy in Patients with Chronic Hepatitis C Infection: Quality of Life and Depression

    PubMed Central

    Conversano, Ciro; Carmassi, Claudia; Carlini, Marina; Casu, Giulia; Gremigni, Paola; Dell’Osso, Liliana

    2015-01-01

    Health-related quality of life was examined in 49 patients with hepatitis C virus with no psychiatric history who received interferon (IFN)-α treatment. Quality of life was assessed at baseline, at 3-time points during IFN-α therapy and at 1-6 month follow-up, using SF-36. Hepatitis C virus patients showed poorer physical functioning and better social and mental functioning than a normal population. Significant decreases from baseline SF-36 scores were observed at an early phase of treatment. Six patients developed major depression during IFN-α treatment. At baseline, they had reported more bodily pain than patients who did not develop depression during treatment. Planned contrasts revealed that worsening in some dimensions of quality of life at 2 months was greater in depressed than in non-depressed patients. Results suggest that depressive symptoms should be accurately monitored during IFN-α therapy even in patients with no psychiatric history, especially if they present with bodily pain. PMID:25852845

  19. Social Determinants of Depression: Social Cohesion, Negative Life Events, and Depression Among People Living with HIV/Aids in Nigeria, West Africa

    PubMed Central

    Shittu, Rasaki O.; Issa, Baba A.; Olanrewaju, Ganiyu T.; Mahmoud, Abdulraheem O.; Odeigah, Louis O.; Sule, Abdullateef G.

    2014-01-01

    Background: People Living with HIV/AIDS (PLWHA) continue to face persistent and deep rooted social barriers. Incidentally, studies in social determinants of depression are very limited, necessitating this study, which examined social determinants of depression and the impact of these determinants on depression. Methods: This was a hospital based, cross sectional descriptive study of three hundred adult HIV/AIDS patients, attending the HIV clinic of Kwara State Specialist Hospital, Sobi, Ilorin, Nigeria. Depressive symptoms were measured by the PHQ-9 rating scale. Three variables of social determinants of depression: socio-economic status (years of school and self-reported economic status of family), social cohesion, and negative life events were examined. Results: The self-reported economic status of the family varied from good 35(11.7%), average 162(54%), and poor among 103(34.3%) of the respondents. Social cohesion was low in 199(66.3%), fair in 65(21.7%) and high among 36(12%) of the respondents. There was significant association between social cohesion, negative life events, and depression. Conclusion and Global Health Implications: Income was the most significant socio-economic determinant. Majority had very low social cohesion and more negative life events, while those with below average years of schooling were more depressed. These are statistically significant. Social determinants of depression should be given a lot of emphasis, when addressing the issue of depression, if we are to meaningfully tackle this increasing scourge in our society.

  20. Ruminative self-focus in daily life: associations with daily activities and depressive symptoms.

    PubMed

    Takano, Keisuke; Sakamoto, Shinji; Tanno, Yoshihiko

    2013-08-01

    The present study examined the situations and conditions in which ruminative self-focus is less likely to occur in daily life. Previous researchers have described a mood-brightening effect of depression, where depressed individuals exhibit greater positive emotional reactivity to positive daily events than do nondepressed individuals. To better understand this paradoxical effect, we investigated the moderating role of depression in the relationship between daily activities and ruminative thinking. Forty-one Japanese undergraduates (9 women and 32 men) recorded their thought contents and the type and subjective appraisals of activities that they engaged in 8 times a day for a week at semirandom intervals. Multilevel modeling analyses indicated that subjectively pleasant activities were associated with improved mood states and reduced ruminative thinking. However, some of these associations were moderated by depressive symptoms, suggesting that individuals with higher levels of depression showed a greater reduction of ruminative thinking during pleasant activities. These results imply that daily activities are important for reducing rumination, particularly for individuals with higher levels of depression, and that the brightening effect of depression is evident for cognitive as well as emotional activities. The cognitive basis of this paradoxical effect is discussed. PMID:23527502

  1. Daily Life or Diagnosis? Dual Perspectives on Perinatal Depression within Maternal and Child Health Home Visiting

    PubMed Central

    Price, Sarah Kye; Cohen-Filipic, Katherine

    2013-01-01

    This study describes a qualitative inquiry–informing program development in a maternal and child home visiting program. Low-income women's perceptions of the meaning and experiences of depression were ascertained through focus groups and interviews. Simultaneously, the study examines staff member perceptions and roles related to depression. Specific findings from clients and staff reveal culturally situated beliefs about depression and stressful life events; comparing and contrasting these beliefs offers a novel perspective on identification and intervention for maternal depression. This study offers a foundation for a translational research agenda that will be used for program and policy development to enhance mental health services situated within maternal and child health home visiting programs. PMID:23944165

  2. Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women: A Prospective Cohort Study.

    PubMed

    Neergaard, Jesper Skov; Dragsbæk, Katrine; Hansen, Henrik Bo; Henriksen, Kim; Christiansen, Claus; Karsdal, Morten Asser

    2016-03-01

    Since the first evidence of a decline in dementia incidence was reported in 2011, the focus on modifiable risk factors has increased. The possibility of risk factor intervention as a prevention strategy has been widely discussed; however, further evidence in relation to risk factors is still needed. The Prospective Epidemiologic Risk Factor (PERF I) study was an observational prospective study of postmenopausal Danish women who were initially examined between 1999 and 2001 (n = 5855). Follow-up data on diagnosis and survival as of December 31, 2014 was retrieved from the National Danish Patient Registry and the National Danish Causes of Death Registry. Cox proportional hazards regression model was applied to calculate adjusted hazard ratios (HR) for selected risk factors for dementia. Of 5512 eligible subjects, 592 developed dementia within the follow-up period of maximum 15 years. The independent factors associated with increased risk of all-cause dementia were depression (HR = 1.75 [95% CI 1.32-2.34]) and impaired fasting glucose levels. A dose-response relationship was observed between fasting glucose level and risk of dementia with HRs of 1.25 [1.05-1.49] and 1.45 [1.03-2.06] for impaired (5.6-6.9 mmol/L) and hyperglycemic (≥7.0 mmol/L) glucose levels, respectively. The factors associated with a decreased risk of dementia were overweight in late-life (HR = 0.75 [0. 62-0.89]) and physical activity at least once weekly (HR = 0.77 [0.61-0.96]). The identified risk factors for dementia in women in late-life are all considered modifiable. This supports the notion that prevention strategies may improve the poor future prospects for dementias in the ageing population.

  3. Attributional styles and life events in the classroom: vulnerability and invulnerability to depressive mood reactions.

    PubMed

    Metalsky, G I; Abramson, L Y; Seligman, M E; Semmel, A; Peterson, C

    1982-09-01

    A core prediction of the reformulated model of learned helplessness and depression (Abramson, Seligman, & Teasdale, 1978) is that when confronted with the same negative life event, people who display a generalized tendency to attribute negative outcomes to internal, stable, or global factors should be more likely to experience a depressive mood reaction than people who typically attribute negative outcomes to external, unstable, or specific factors. We tested this prediction with a prospective design in a naturalistic setting by determining whether the content of college students' attributional styles at one point in time predicted the severity of their depressive mood response to receiving a low grade on a midterm exam at a subsequent point in time. Consistent with the prediction, students with an internal or global attributional style for negative outcomes at Time 1 experienced a depressive mood response when confronted with a subsequent low midterm grade, whereas students with an external or specific attributional style for negative outcomes were invulnerable to this depressive mood response. In contrast to the results for the internality and globality dimensions, students' scores along the stability attribution dimension were not correlated with the severity of their depressive mood response to the low midterm grade. In the absence of a negative life event (i.e., receipt of a high midterm grade), students' generalized tendencies to make internal or global attributions for negative outcomes at Time 1 were not significantly correlated with their subsequent changes in depressive mood although there was a nonsignificant positive correlation between severity of depressive mood response and the tendency to make global attributions for negative outcomes at Time 1.

  4. STUDY OF CORRELATION OF INTENSITY OF SYMPTOMS WITH STRESSFUL LIFE EVENTS IN DEPRESSED PATIENTS

    PubMed Central

    Mahatme, S.S.; Dhavale, H.S.; Patkar, A.P.

    1989-01-01

    SUMMARY 60 patients suffering from “Depression” attending the Psychiatry outpatient clinic in a general hospital were studied. The intensity of symptoms, and life stress events for 12 months prior to episode were obtained and compared on the basis of sex of patient. The findings of the study indicate that, the depressed patients had the severity of symptomatology positively correlated with the severity of stress. Thus with the increase in stress, the severity of symptoms would be on increase. The findings also indicated the distribution of more physical and affective symptoms in depressed females and more of behavioural symptoms in depressed males. It was seen that occurrence of undesirable life events which could be specific for Indian culture were perceived more than desirable events by the sample. PMID:21927402

  5. The thread of depression throughout the life and works of Leo Tolstoy.

    PubMed

    Anargyros-Klinger, Annie

    2002-04-01

    Tolstoy, the author of two masterpieces, War and Peace and Anna Karenina, remains a writer of genius. Yet, after writing War and Peace, his existence had been torn apart by a serious depression. This depression, which was melancholic in character, almost destroyed him and, once he had finished Anna Karenina, led him to want to renounce not only sexuality but also literary creation and material possessions. Through examining Tolstoy's life and work, the author tries to uncover the underground paths of this depression, which emerged brutally in the middle of his life, and to understand why his creative genius dried up. Like Leonardo da Vinci, Tolstoy turned away from his artistic work, declaring that 'art is not only useless but even harmful', and thereafter devoted himself to philosophical, political and religious writings. These new sublimations would help him to recover his health.

  6. THE THREAD OF DEPRESSION THROUGHOUT THE LIFE AND WORKS OF LEO TOLSTOY.

    PubMed

    Anargyros-Klinger, Annie

    2002-04-01

    Tolstoy, the author of two masterpieces, War and Peace and Anna Karenina, remains a writer of genius. Yet, after writing War and Peace, his existence had been torn apart by a serious depression. This depression, which was melancholic in character, almost destroyed him and, once he had finished Anna Karenina, led him to want to renounce not only sexuality but also literary creation and material possessions. Through examining Tolstoy's life and work, the author tries to uncover the underground paths of this depression, which emerged brutally in the middle of his life, and to understand why his creative genius dried up. Like Leonardo da Vinci, Tolstoy turned away from his artistic work, declaring that 'art is not only useless but even harmful', and thereafter devoted himself to philosophical, political and religious writings. These new sublimations would help him to recover his health.

  7. Associations among depression, suicidal behavior, and quality of life in patients with human immunodeficiency virus

    PubMed Central

    Serafini, Gianluca; Montebovi, Franco; Lamis, Dorian A; Erbuto, Denise; Girardi, Paolo; Amore, Mario; Pompili, Maurizio

    2015-01-01

    AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus (HIV) patients. METHODS: A detailed MEDLINE search was carried out to identify all articles and book chapters in English published from January 1995 to January 2015. RESULTS: Based on the main findings, the prevalence of major depressive disorder (MDD) ranged from 14.0% to 27.2%. Furthermore, the prevalence of suicidal ideation varied from 13.6% to 31.0% whereas, attempted suicides were reported to range from 3.9% to 32.7%. Interestingly, various associated risk factors for both depression and suicide were identified in HIV patients. Finally, consistent associations were reported among MDD, suicidal ideation, and poor quality of life in individuals living with HIV. CONCLUSION: Although additional studies are needed to elucidate this complex association, our results suggest the importance of early detection of both MDD and suicidality in patients living with HIV. PMID:26279991

  8. The thread of depression throughout the life and works of Leo Tolstoy.

    PubMed

    Anargyros-Klinger, Annie

    2002-04-01

    Tolstoy, the author of two masterpieces, War and Peace and Anna Karenina, remains a writer of genius. Yet, after writing War and Peace, his existence had been torn apart by a serious depression. This depression, which was melancholic in character, almost destroyed him and, once he had finished Anna Karenina, led him to want to renounce not only sexuality but also literary creation and material possessions. Through examining Tolstoy's life and work, the author tries to uncover the underground paths of this depression, which emerged brutally in the middle of his life, and to understand why his creative genius dried up. Like Leonardo da Vinci, Tolstoy turned away from his artistic work, declaring that 'art is not only useless but even harmful', and thereafter devoted himself to philosophical, political and religious writings. These new sublimations would help him to recover his health. PMID:12040704

  9. Multidimensional Perfectionism, Depression, and Satisfaction with Life: Differences among Perfectionists and Tests of a Stress-Mediation Model

    ERIC Educational Resources Information Center

    Ashby, Jeffrey S.; Noble, Christina L.; Gnilka, Philip B.

    2012-01-01

    This study examined the relationship between adaptive and maladaptive perfectionism, stress, depression, and satisfaction with life in a sample of undergraduate women. The authors found that maladaptive perfectionists had lower satisfaction with life and higher stress and depression scores compared with adaptive perfectionists. Results also…

  10. Commentary: Beyond Stressful Life Events and Depression?--Reflections on Bogdan et al. (2014)

    ERIC Educational Resources Information Center

    Belsky, Jay

    2014-01-01

    In light of continuing disagreement, even at the meta-analytic level, as to whether the gene- × -environment (G×E) interaction involving 5-HTTLPR and stressful life events (SLEs) predicts depression, Bogdan and associates (this issue, Bogdan et al., 2014) sought to extend research on what has become a highly controversial general (GxE) and…

  11. Apathy in dementia: relations with depression, functional competence, and quality of life.

    PubMed

    Yeager, Catherine A; Hyer, Lee

    2008-06-01

    This study set out to clarify the association of apathy and depression in dementia as well as apathy's association with basic (ADLs) and instrumental (IADLs) activities of daily living and quality of life. 68 outpatients with mild dementia were assessed on apathy, depression, global cognition, traditional ADLs/IADLs, complex daily living activities requiring intact executive functioning (DAD: Disability Assessment for Dementia Scale), and quality of life. The sample was stratified into high and low global cognition groups and compared. While no relationship was found between scores on apathy and depression in the high cognition group, there was a significant relationship between apathy and depression in the low cognition group. Further, high and low cognition groups differed in the relationship between apathy and ability to perform basic and complex activities of daily living. Specifically, in the high cognition group, increased apathy was correlated with diminished ability to perform traditional IADLs as well as those activities requiring intact executive functioning (i.e., DAD). In the low cognition group, increased apathy was associated with poor performance on traditional ADLs and IADLs, but was not related to performance on independent daily activities demanding good executive functioning. Finally, increased apathy was significantly associated with worse quality of life, but this held for the high cognition group only, suggesting that dementia patients with better cognition have insight into their deficits and, perhaps, experience poor quality of life as a result.

  12. Quality of Life in Patients with Multiple Sclerosis: The Impact of Depression, Fatigue, and Disability

    ERIC Educational Resources Information Center

    Goksel Karatepe, Altlnay; Kaya, Taciser; Gunaydn, Rezzan; Demirhan, Aylin; Ce, Plnar; Gedizlioglu, Muhtesem

    2011-01-01

    Aim: The aim of this study was to assess the quality of life (QoL) in patients with multiple sclerosis (MS), and to evaluate its association with disability and psychosocial factors especially depression and fatigue. Methods: Demographic characteristics, education level, disease severity, and disease duration were documented for each patient. QoL,…

  13. Depression and the Family Life Cycle: Adjusting the System at Retirement.

    ERIC Educational Resources Information Center

    Shean, Glenn

    This document uses family systems constructs to explain the onset and maintenance of clinical symptoms such as depression and their relation to life cycle issues among the elderly. The basic assumptions of family systems thinking about structure and function are summarized. Figures and tables are used to illustrate changing family circumstances…

  14. Personal Resources and Homelessness in Early Life: Predictors of Depression in Consumers of Homeless Multiservice Centers

    ERIC Educational Resources Information Center

    DeForge, Bruce R.; Belcher, John R.; O'Rourke, Michael; Lindsey, Michael A.

    2008-01-01

    This study explored the relationship between personal resources and previous adverse life events such as homelessness and depression. Participants were recruited from two church sponsored multisite social service centers in Anne Arundel County, Maryland. The interview included demographics and several standardized scales to assess history of…

  15. Brain galanin system genes interact with life stresses in depression-related phenotypes

    PubMed Central

    Juhasz, Gabriella; Hullam, Gabor; Eszlari, Nora; Gonda, Xenia; Antal, Peter; Anderson, Ian Muir; Hökfelt, Tomas G. M.; Deakin, J. F. William; Bagdy, Gyorgy

    2014-01-01

    Galanin is a stress-inducible neuropeptide and cotransmitter in serotonin and norepinephrine neurons with a possible role in stress-related disorders. Here we report that variants in genes for galanin (GAL) and its receptors (GALR1, GALR2, GALR3), despite their disparate genomic loci, conferred increased risk of depression and anxiety in people who experienced childhood adversity or recent negative life events in a European white population cohort totaling 2,361 from Manchester, United Kingdom and Budapest, Hungary. Bayesian multivariate analysis revealed a greater relevance of galanin system genes in highly stressed subjects compared with subjects with moderate or low life stress. Using the same method, the effect of the galanin system genes was stronger than the effect of the well-studied 5-HTTLPR polymorphism in the serotonin transporter gene (SLC6A4). Conventional multivariate analysis using general linear models demonstrated that interaction of galanin system genes with life stressors explained more variance (1.7%, P = 0.005) than the life stress-only model. This effect replicated in independent analysis of the Manchester and Budapest subpopulations, and in males and females. The results suggest that the galanin pathway plays an important role in the pathogenesis of depression in humans by increasing the vulnerability to early and recent psychosocial stress. Correcting abnormal galanin function in depression could prove to be a novel target for drug development. The findings further emphasize the importance of modeling environmental interaction in finding new genes for depression. PMID:24706871

  16. Altruism, Helping, and Volunteering: Pathways to Well-Being in Late Life

    PubMed Central

    Kahana, Eva; Bhatta, Tirth; Lovegreen, Loren D.; Kahana, Boaz; Midlarsky, Elizabeth

    2013-01-01

    Objectives We examined the influence of prosocial orientations including altruism, volunteering, and informal helping on positive and negative well-being outcomes among retirement community dwelling elders. Method We utilize data from 2 waves, 3 years apart, of a panel study of successful aging (N = 585). Psychosocial well-being outcomes measured include life satisfaction, positive affect, negative affect, and depressive symptomatology. Results Ordinal logistic regression results indicate that altruistic attitudes, volunteering, and informal helping behaviors make unique contributions to the maintenance of life satisfaction, positive affect and other well being outcomes considered in this research. Predictors explain variance primarily in the positive indicators of psychological well-being, but are not significantly associated with the negative outcomes. Female gender and functional limitations are also associated with diminished psychological well-being. Discussion Our findings underscore the value of altruistic attitudes as important additional predictors, along with prosocial behaviors in fostering life satisfaction and positive affect in old age. PMID:23324536

  17. The Impact of Postpartum Depression on Quality of Life in Women After Child's Birth

    PubMed Central

    Sadat, Zohreh; Abedzadeh-Kalahroudi, Masoumeh; Kafaei Atrian, Mahboobeh; Karimian, Zahra; Sooki, Zahra

    2014-01-01

    Background: Postpartum depression (PPD) is a common problem after child's birth and may influence the quality of life (QOL). Investigation of postpartum QOL and depression can be useful for better care for mothers and improvement of their well-being. Objectives: The objective of this study was to assess the life quality in mothers with and without PPD. Patients and Methods: In a prospective study, women who had experienced child's birth with and without PPD were recruited in Kashan-Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS) and QOL was measured by SF-36 questionnaire. Data collection was conducted at two assessment points: second month (n = 321) and fourth month (n = 300) postpartum. Based on EPDS, a score of 13 or more was defined as PPD. Mean scores of SF-36 questionnaire were compared between women with and without PPD at two assessment points and within each group from the first to the second assessments. Moreover, correlation between scores of EPDS and scores of life quality dimensions were evaluated. Data were analyzed by using the Student’s t-test, Mann–Whitney U-test, ANOVA, Kruskal-Wallis, Chi-square test, Pair t test, Wilcoxon, Pearson and Spearman Correlation Coefficient. Results: Differences in seven out of eight mean scores of QOL dimensions (except role-physical) between depressed and non-depressed women at the first and the second assessments were significant. Results of changes in mean scores of QOL dimensions from the first to the second assessments in each group showed that non-depressed women scored higher in all of eight dimensions with significant differences in two dimensions (bodily pain and role-emotional as well as mental health component). In depressed women, scores of life quality decreased in some of QOL dimensions but differences were not significant. There were significant negative correlations between EPDS scores and scores of seven out of eight SF-36 sub-scales (except role-physical) in addition

  18. The New Demographic Transition: Most Gains in Life Expectancy Now Realized Late in Life.

    PubMed

    Eggleston, Karen N; Fuchs, Victor R

    2012-01-01

    The share of increases in life expectancy realized after age 65 was only about 20 percent at the beginning of the 20(th) century for the US and 16 other countries at comparable stages of development; but that share was close to 80 percent by the dawn of the 21(st) century, and is almost certainly approaching 100 percent asymptotically. This new demographic transition portends a diminished survival effect on working life. For high-income countries at the forefront of the longevity transition, expected lifetime labor force participation as a percent of life expectancy is declining. Innovative policies are needed if societies wish to preserve a positive relationship running from increasing longevity to greater prosperity.

  19. The New Demographic Transition: Most Gains in Life Expectancy Now Realized Late in Life

    PubMed Central

    Eggleston, Karen N.; Fuchs, Victor R.

    2013-01-01

    The share of increases in life expectancy realized after age 65 was only about 20 percent at the beginning of the 20th century for the US and 16 other countries at comparable stages of development; but that share was close to 80 percent by the dawn of the 21st century, and is almost certainly approaching 100 percent asymptotically. This new demographic transition portends a diminished survival effect on working life. For high-income countries at the forefront of the longevity transition, expected lifetime labor force participation as a percent of life expectancy is declining. Innovative policies are needed if societies wish to preserve a positive relationship running from increasing longevity to greater prosperity. PMID:25076810

  20. Determining the quality of life of depressed patients in Singapore through a multiple mediation framework.

    PubMed

    Tan, Shu Hui; Tang, Catherine; Ng, Winnie W N; Ho, Cyrus S H; Ho, Roger C M

    2015-12-01

    Quality of Life (QOL) is reported to be lower for patients with depression than the general population. This study aims to investigate the mediational effects of protective resource factors (PSFs), such as depressive symptom management ability, self-efficacy, social support and problem-focused coping act, in the relationship between dysfunctional attitudes and QOL. It is hypothesized that these PSFs have different mediating strengths. Self-report questionnaires which aimed to determine the influences of these PSFs through a multiple mediation framework were completed by 80 depressed adult outpatients from the National University Hospital of Singapore. PSFs have different influence on mental and physical QOL. Depressive symptom management ability is the most important PSF mediating both domains and better problem-focused coping abilities demonstrate improvement in the physical domain of QOL. Self-efficacy and social support are shown to be non-significant mediators. The results suggest for future effective interventions to focus primarily on improving depression patients' symptom management ability and problem-focused coping skills to raise their life quality. Furthermore, findings from this study have implications on the future investigation of QOL as a unitary construct.

  1. Anxiety, depression, and quality of life in Iranian mothers of children with autism spectrum disorder.

    PubMed

    Kousha, Maryam; Attar, Hoda Alizadeh; Shoar, Zohreh

    2016-09-01

    Autism spectrum disorder (ASD) is being more recognized and diagnosed in developing as well as developed countries. We aimed to investigate the frequency of anxiety, depression, and quality of life in mothers of children with ASD in Iranian families. We conducted a descriptive cross-sectional study on demographic data and mental health characteristics of 127 mothers of children with ASD. Mothers of children with ASD had high levels of anxiety (72.4%), depression (49.6%), and low scores of health-related quality of life (HRQOL). There was strong association between the child's age and the severity of mother's depression and QOL. Duration since diagnosis of ASD positively correlated with maternal depression. Anxiety, depression, and low HRQOL are more common in Iranian mothers with autistic children in our study. Our findings have implications for further investigation in mental health status of mothers of children with ASD, and providing educational support and interventional strategies may improve the mental health status of the entire family.

  2. Interleukin-6 promoter polymorphism interacts with pain and life stress influencing depression phenotypes.

    PubMed

    Kovacs, David; Eszlari, Nora; Petschner, Peter; Pap, Dorottya; Vas, Szilvia; Kovacs, Peter; Gonda, Xenia; Bagdy, Gyorgy; Juhasz, Gabriella

    2016-05-01

    Interleukin-6 (IL-6) has emerged as a potent biomarker for depression as its elevated plasma levels in patients with clinical depression have been confirmed by meta-analyses. Increased plasma IL-6 concentration was associated with various psychological stress factors and physical disorders accompanied by pain. Another modulator of the IL-6 level is rs1800795, a promoter polymorphism in the IL-6 gene which is able to influence its expression rate. Therefore, we examined in a Hungarian population sample of 1053 volunteers with European origins if rs1800795 polymorphism can affect depression symptoms measured by Zung Self-rating Depression Scale (ZSDS), and Brief Symptom Inventory (BSI). We also investigated the interactions of the polymorphism with reported painful physical conditions and Recent Negative Life Events (RLE) measured by the List of Life Threatening Experiences. Rs1800795 significantly interacted with both RLE and painful condition on depressive symptoms measured by ZSDS and BSI using different heritability models, while no main effects of the polymorphism were identified. After correction for multiple testing only the rs1800795 × RLE interaction effect (recessive model) remained significant on the BSI score, while both RLE and painful conditions significantly interacted on the ZSDS. In conclusion, the functional IL-6 rs1800795 polymorphism in interaction with various stress factors increases the risk of depression and has a greater impact on symptoms measured by the ZSDS. Thus, IL-6 and other cytokines may be more relevant in the development of somatic symptoms compared to affective signs of depression, delineating a specific genotype-phenotype relationship in this heterogeneous disorder.

  3. The Differential Influence Of Life Stress On Individual Symptoms Of Depression

    PubMed Central

    Fried, Eiko I.; Nesse, Randolph M.; Guille, Constance; Sen, Srijan

    2015-01-01

    Objective Life stress consistently increases the incidence of major depression. Recent evidence has shown that individual symptoms of Major Depressive Disorder (MDD) differ in important dimensions such as their genetic and etiological background, but the impact of stress on individual MDD symptoms is not known. Here we assess whether stress affects depression symptoms differentially. Method We used the chronic stress of medical internship to examine changes of the nine DSM-5 criterion symptoms for depression in 3,021 interns assessed prior to and throughout internship. Results All nine depression symptoms increased in response to stress (all p < 0.001), on average by 173%. Symptom increases differed substantially from each other (p < 0.001), with psychomotor problems (289%) and interest loss (217%) showing the largest increases, and suicidal ideation (146%) and sleep problems (52%) the smallest. Symptoms also differed in their severities under stress (p < 0.001): fatigue, appetite problems and sleep problems were most prevalent, psychomotor problems and suicidal ideation were least prevalent. Conclusion Stress differentially affects the DSM-5 depressive symptoms. Analyses of individual symptoms reveal important insights obfuscated by sum-scores. PMID:25650176

  4. Cross-Lagged Associations Between Adolescents' Depressive Symptoms and Negative Cognitive Style: The Role of Negative Life Events.

    PubMed

    Kindt, Karlijn C M; Kleinjan, Marloes; Janssens, Jan M A M; Scholte, Ron H J

    2015-11-01

    Previous research has established that cognitive theory-based depression prevention programs aiming change in negative cognitive style in early adolescents do not have strong effects in universal settings. Although theories suggest that a negative cognitive style precedes depressive symptoms, empirical findings are mixed. We hypothesized that negative cognitive style may not predict depressive symptoms in adolescents with normative depressive symptoms. Depressive symptoms, negative cognitive style and dependent negative life events were assessed in young adolescents (N = 1343; mean age = 13.4 years, SD = 0.77; 52.3 % girls) at four time points over an 18-month period. Using a cross-lagged panel design, results revealed that depressive symptoms predicted a negative cognitive style but not vice versa. However, when including dependent negative life events as a variable, depressive symptoms did not prospect a negative cognitive style consistently. When dependent negative life events were used as a time-varying covariate, depressive symptoms and a negative cognitive style were not related. We concluded that negative cognitive style is not predictive of depressive symptoms in a community sample of young adolescents. Moreover, the findings suggest that longitudinal relationships between depressive symptoms and a negative cognitive style are not meaningful when dependent negative life events are not considered. PMID:26036993

  5. Stuck in the past: negative bias, explanatory style, temporal order, and evaluative perspectives in life narratives of clinically depressed individuals.

    PubMed

    Habermas, Tilmann; Ott, Lisa-M; Schubert, Merve; Schneider, Beatrix; Pate, Anna

    2008-01-01

    This study attempted to replicate negative bias and depressive explanatory style in depression using life narratives. The two central aspects of narrative, temporal succession and evaluation, were also explored. These aspects were tested for the first time using entire life narratives of 17 depressed inpatients and non-depressed controls matched for sex and educational level. Negative bias and depressive explanatory style were replicated as typical for the depressed group. Life narratives of depressed patients also deviated more from a linear temporal order and compared less frequently the past with the present. Contrary to expectations, the depressed did not differ in the overall frequency of evaluations. However, they used more past than present evaluations and more experience-near evaluations than cognitive evaluations, suggesting that they are more immersed in past experiences. It is concluded that negative bias and depressive explanatory style can be found also in a naturalistic narrative measure, and that depression affects the two major aspects of narrative. It is argued that life narratives, as measures close to everyday clinical practice and as the most encompassing form of self-representation, should complement more experimental procedures in the study of cognitive and communicative processes in psychopathology.

  6. Cross-Lagged Associations Between Adolescents' Depressive Symptoms and Negative Cognitive Style: The Role of Negative Life Events.

    PubMed

    Kindt, Karlijn C M; Kleinjan, Marloes; Janssens, Jan M A M; Scholte, Ron H J

    2015-11-01

    Previous research has established that cognitive theory-based depression prevention programs aiming change in negative cognitive style in early adolescents do not have strong effects in universal settings. Although theories suggest that a negative cognitive style precedes depressive symptoms, empirical findings are mixed. We hypothesized that negative cognitive style may not predict depressive symptoms in adolescents with normative depressive symptoms. Depressive symptoms, negative cognitive style and dependent negative life events were assessed in young adolescents (N = 1343; mean age = 13.4 years, SD = 0.77; 52.3 % girls) at four time points over an 18-month period. Using a cross-lagged panel design, results revealed that depressive symptoms predicted a negative cognitive style but not vice versa. However, when including dependent negative life events as a variable, depressive symptoms did not prospect a negative cognitive style consistently. When dependent negative life events were used as a time-varying covariate, depressive symptoms and a negative cognitive style were not related. We concluded that negative cognitive style is not predictive of depressive symptoms in a community sample of young adolescents. Moreover, the findings suggest that longitudinal relationships between depressive symptoms and a negative cognitive style are not meaningful when dependent negative life events are not considered.

  7. Depression, anxiety and quality of life in suicide survivors: a comparison of close and distant relationships.

    PubMed

    Mitchell, Ann M; Sakraida, Teresa J; Kim, Yookyung; Bullian, Leann; Chiappetta, Laurel

    2009-02-01

    The study's purpose was to describe and compare depression, anxiety, and quality of life, by degree of relationship, between closely related and distantly related survivors (persons close to the suicide victim, or "suicide survivors"; N = 60) during the acute phase of bereavement (within 1 month of the death). The close relationship category included spouses, parents, children, and siblings, whereas the distant relationship category included in-laws, aunts/uncles, and nieces/nephews. Analysis of covariance examined differences between the two groups on the symptom measures. Results indicate that, after controlling for age and gender effects, closely related survivors had significantly higher mean levels of depression and anxiety and had lower levels of mental health quality of life. There were no statistically significant differences on the physical health quality of life subscale.

  8. Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life.

    PubMed

    Mystakidou, K; Tsilika, E; Parpa, E; Katsouda, E; Galanos, A; Vlahos, L

    2005-10-01

    The growing interest in the mental health and quality of life of cancer patients, has been the major reason for conducting this study. The aims were to compare advanced cancer patients' responses to Hospital Anxiety and Depression (HAD) scale with those to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0), as well as the impact of quality of life dimensions (as measured by EORTC QLQ-C30) on the levels of anxiety and depression. The analysis, conducted in 120 advanced cancer patients, showed that the most significant associations were found between emotional functioning and HAD-T (total sum of scores) (r=-0.747; p < 0.0005), HAD-A (anxiety) (r=-0.725; p < 0.0005) and HAD-D (depression) (r=-0.553; p < 0.0005). In the prediction of HAD-T, the contribution of physical, emotional, role, and social functioning along with nausea-vomiting, dyspnea, sleep disturbance and gender is high. For anxiety, the predictor variables were physical, role, cognitive, emotional, and social functioning, followed by dyspnea, sleep disturbance, and appetite loss, while depression was predicted by physical, role, emotional, and social functioning, the symptoms of nausea-vomiting, pain, sleep disturbance, constipation, as well as the variables of age, gender, anticancer treatment and performance status. Concluding, psychological morbidity, in this patient population, was predominantly predicted by the emotional functioning dimension of EORTC QLQ-C30. PMID:16155770

  9. Loneliness and Depression in Middle and Late Childhood: The Relationship to Attachment and Parental Styles

    ERIC Educational Resources Information Center

    Richaud de Minzi, Maria Cristina

    2006-01-01

    In this study, the author analyzed the relationship between (a) parenting and attachment and (b) self-competence, loneliness, and depression in children aged 8-12 years. The author administered (a) the Argentine Scale of Perception of the Relationships with Parents (M. C. Richaud de Minzi, 2004), (b) the Kerns' Security Scale (K. A. Kerns, L.…

  10. Relational Stressors and Depressive Symptoms in Late Adolescence: Rejection Sensitivity as a Vulnerability

    ERIC Educational Resources Information Center

    Chango, Joanna M.; McElhaney, Kathleen Boykin; Allen, Joseph P.; Schad, Megan M.; Marston, Emily

    2012-01-01

    The role of rejection sensitivity as a critical diathesis moderating the link between adolescent relational stressors and depressive symptoms was examined using multi-method, multi-reporter data from a diverse community sample of 173 adolescents, followed from age 16 to 18. Relational stressors examined included emotional abuse, maternal behavior…

  11. Developmental Trajectories of Perceived Friendship Intimacy, Constructive Problem Solving, and Depression from Early to Late Adolescence

    ERIC Educational Resources Information Center

    Selfhout, M. H. W.; Branje, S. J. T.; Meeus, W. H. J.

    2009-01-01

    This study examined friendship types in developmental trajectories of perceived closeness and balanced relatedness. In addition, differences between friendship types in the development of constructive problem solving and depression were examined. Questionnaire data of five annual waves were used from two adolescent cohorts (cohort 1: M = 12.41…

  12. Health-related quality of life and depression among medical sales representatives in Pakistan.

    PubMed

    Atif, Muhammad; Bashir, Arslan; Saleem, Quratulain; Hussain, Rabia; Scahill, Shane; Babar, Zaheer-Ud-Din

    2016-01-01

    Pharmaceutical companies have been known to pose stress and mental harassment on medical sales representatives (MSRs) in-order to increase pharmaceutical sales. This cross sectional descriptive study, conducted during November and December 2014 in the Lahore and Bahawalpur districts of Punjab, Pakistan, evaluates the Health-Related Quality of Life (HRQoL) and extent of depression among MSRs in Pakistan. The significant predictors of HRQoL and depression among the MSRs were also determined. Using a convenience sampling technique, all consenting MSRs (N = 318) of pharmaceutical companies were asked to self-complete the Short Form-36 (SF-36v2) Health Survey and Stanford Personal Health Questionnaire (PHQ-8). The standard scoring scheme for the SF36v2 and PHQ-8 questionnaires was used. The PHQ-8 scores showed that 16.4 % (n = 52) and 2.5 % of respondents were suffering from major depression and severe major depression, respectively. Being depressed and having difficulty in achieving sales targets were the factors independently associated with lower physical health. Similarly, depression, insufficient time for the family and monthly income less than 36,000 Pakistan Rupees were significant predictors of lower mental health. The factors associated with depression included insufficient time for the family and unsatisfactory behavior of the managers. Compromised mental health and the prevalence of depression among the MSRs suggest pharmaceutical companies need to devise health management strategies and interventions to ensure effective prevention and management of mental health problems among Pakistani MSRs. PMID:27462496

  13. Religion, finding interests in life, and change in self-esteem during late life.

    PubMed

    Krause, Neal; Hayward, R David

    2014-05-01

    Research indicates that greater involvement in activities is essential for successful aging. The purpose of the current study is to examine a construct that motivates involvement in activities-finding interests in life. In the process, we also show how involvement in religion may help promote interests. In order to examine these issues, a conceptual model is tested that contains the following core hypotheses: (1) older people who go to church more often will be more likely to have stronger God-mediated control beliefs (i.e., the belief that God works together with people to resolve problems and reach desired goals); (2) older adults with a stronger sense of God-mediated control will be more likely to find things in life that are interesting; and (3) older individuals with more interests experience a greater sense of self-worth over time. Findings from a nationwide survey provide support for the key relationships described above.

  14. Emotional Symptoms in Children: The Effect of Maternal Depression, Life Events, and COMT Genotype

    PubMed Central

    Evans, Jonathan; Xu, Ke; Heron, Jon; Enoch, Mary-Anne; Araya, Ricardo; Lewis, Glyn; Timpson, Nic; Davies, Simon; Nutt, David; Goldman, David

    2009-01-01

    Early adversity predicts anxiety and depression but variation in response to adversity is not understood. We investigated whether association between early adversity and emotional symptoms in young children differs according to variation of the COMT gene. The main outcome measure was the emotionality subscale of the Strengths and Difficulties Questionnaire (SDQ) completed by mothers for 8,431 children aged 6–7 years old in the Avon Longitudinal Study of Parents and Children. Adversity measures included exposure to maternal postpartum depressive symptoms and adverse life events for children. DNA from the children was genotyped for five COMT polymorphisms including the COMT Val158Met locus. Maternal depression increased the odds of high emotionality in the children, (OR 1.99, 95% CI 1.73–2.29, P<0.001) as did life events score, (OR 1.21 for each s.d. increase in life event score, 95% CI 1.15–1.27, P<0.001). There was no main effect of Val158Met genotype on emotional symptoms (OR for effect of each copy of the methionine allele was 1.04, 95% CI 0.97–1.10, P = 0.284). The relationship between adversity and emotional symptoms did not vary by genotype (G × E for maternal depression χ2 = 3.17, P = 0.205; G × E for life events χ2 = 1.69, P = 0.430). There was no main effect of COMT haplotype, nor was there an interaction with adversity. Early adversity predicts emotional symptoms in children aged 6–7 years. Although some studies indicate a role for COMT in emotionality, anxiety, and depression in adults, no direct effect or interaction of COMT genotype was observed in this large sample of young children. PMID:18535998

  15. The affective profiles in the USA: happiness, depression, life satisfaction, and happiness-increasing strategies

    PubMed Central

    Schütz, Erica; Sailer, Uta; Al Nima, Ali; Rosenberg, Patricia; Andersson Arntén, Ann-Christine; Archer, Trevor

    2013-01-01

    Background. The affective profiles model categorizes individuals as self-fulfilling (high positive affect, low negative affect), high affective (high positive affect, high negative affect), low affective (low positive affect, low negative affect), and self-destructive (low positive affect, high negative affect). The model has been used extensively among Swedes to discern differences between profiles regarding happiness, depression, and also life satisfaction. The aim of the present study was to investigate such differences in a sample of residents of the USA. The study also investigated differences between profiles with regard to happiness-increasing strategies. Methods. In Study I, 900 participants reported affect (Positive Affect Negative Affect Schedule; PANAS) and happiness (Happiness-Depression Scale). In Study II, 500 participants self-reported affect (PANAS), life satisfaction (Satisfaction With Life Scale), and how often they used specific strategies to increase their own happiness (Happiness-Increasing Strategies Scales). Results. The results showed that, compared to the other profiles, self-fulfilling individuals were less depressed, happier, and more satisfied with their lives. Nevertheless, self-destructive individuals were more depressed, unhappier, and less satisfied than all other profiles. The self-fulfilling individuals tended to use strategies related to agentic (e.g., instrumental goal-pursuit), communal (e.g., social affiliation), and spiritual (e.g., religion) values when pursuing happiness. Conclusion. These differences suggest that promoting positive emotions can positively influence a depressive-to-happy state as well as increasing life satisfaction. Moreover, the present study shows that pursuing happiness through strategies guided by agency, communion, and spirituality is related to a self-fulfilling experience described as high positive affect and low negative affect. PMID:24058884

  16. The affective profiles in the USA: happiness, depression, life satisfaction, and happiness-increasing strategies.

    PubMed

    Schütz, Erica; Sailer, Uta; Al Nima, Ali; Rosenberg, Patricia; Andersson Arntén, Ann-Christine; Archer, Trevor; Garcia, Danilo

    2013-01-01

    Background. The affective profiles model categorizes individuals as self-fulfilling (high positive affect, low negative affect), high affective (high positive affect, high negative affect), low affective (low positive affect, low negative affect), and self-destructive (low positive affect, high negative affect). The model has been used extensively among Swedes to discern differences between profiles regarding happiness, depression, and also life satisfaction. The aim of the present study was to investigate such differences in a sample of residents of the USA. The study also investigated differences between profiles with regard to happiness-increasing strategies. Methods. In Study I, 900 participants reported affect (Positive Affect Negative Affect Schedule; PANAS) and happiness (Happiness-Depression Scale). In Study II, 500 participants self-reported affect (PANAS), life satisfaction (Satisfaction With Life Scale), and how often they used specific strategies to increase their own happiness (Happiness-Increasing Strategies Scales). Results. The results showed that, compared to the other profiles, self-fulfilling individuals were less depressed, happier, and more satisfied with their lives. Nevertheless, self-destructive individuals were more depressed, unhappier, and less satisfied than all other profiles. The self-fulfilling individuals tended to use strategies related to agentic (e.g., instrumental goal-pursuit), communal (e.g., social affiliation), and spiritual (e.g., religion) values when pursuing happiness. Conclusion. These differences suggest that promoting positive emotions can positively influence a depressive-to-happy state as well as increasing life satisfaction. Moreover, the present study shows that pursuing happiness through strategies guided by agency, communion, and spirituality is related to a self-fulfilling experience described as high positive affect and low negative affect. PMID:24058884

  17. Purpose and pleasure in late life: Conceptualising older women's participation in art and craft activities.

    PubMed

    Liddle, Jeannine L M; Parkinson, Lynne; Sibbritt, David W

    2013-12-01

    The fourth age, as the last stage of life, represents a final challenge to find personal meaning in the face of changing capacities, illness and disability. Participation in valued activities is important for sustaining interest in life and has been associated with enhanced health and well-being. Art and craft activities are a popular form of participation amongst women in late life with growing international interest in the potential for these types of activities to maintain health and well-being and address problems of social isolation. Drawing on open text comments from 114 women enrolled in the Australian Longitudinal Study on Women's Health and in-depth interviews with 23 women all aged in their eighties, this paper explores the nature of older women's participation in art and craft activities and conceptualises links between participation in these activities and health and well-being in late life. Participation in art and craft activities is complex and dynamic, comprising cognitive and physical processes infused with emotion and occurs in the context of social relationships, physical spaces, physical ailments and beliefs about the value of the activities. By participating in art and craft activities, older women find purpose in their lives, contributing to their subjective well-being whilst helping and being appreciated by others. They develop a self view as enabled and as such take on new art and craft challenges, continue to learn and develop as art and craft makers and remain open to new possibilities.

  18. African American Children’s Depressive Symptoms: The Prospective Effects of Neighborhood Disorder, Stressful Life Events, and Parenting

    PubMed Central

    Ge, Xiaojia; Brody, Gene H.; Simons, Ronald L.; Gibbons, Frederick X.; Cutrona, Carolyn E.

    2012-01-01

    The prospective effects of observed neighborhood disorder, stressful life events, and parents’ engagement in inductive reasoning on adolescents’ depressive symptoms were examined using data collected from 777 African American families. Multilevel analyses revealed that stressful life events experienced at age 11 predicted depressive symptoms at age 13. Furthermore, a significant interaction between neighborhood disorder and parents’ engagement in inductive reasoning was found, indicating that parental use of inductive reasoning was a protective factor for depressive symptoms particularly for youths living in highly disordered neighborhoods. The importance of examining correlates of depressive symptoms from a contextual framework, focusing on individuals, families, and neighborhood contexts, is emphasized. PMID:17294122

  19. Spousal Caregiving in Late Mid-Life Versus Older Ages: Implications of Work and Family Obligations

    PubMed Central

    Lima, Julie C.; Allen, Susan M.; Goldscheider, Frances; Intrator, Orna

    2015-01-01

    Objectives This study examined life stage differences in the provision of care to spouses with functional impairment. Methods We examined 1218 married adults aged 52 and older from the 2000 wave of the Health and Retirement Study (HRS) who received impairment-related help with at least one activity of daily living. We examined the differential likelihood that spouses serve as primary caregiver and the hours of care provided by spousal primary caregivers by life stage. Results We found that late middle-aged care recipients were more likely than their older counterparts to receive the majority of their care from their spouse, but received fewer hours of spousal care, mostly when spouses worked full time. Competing demands of caring for children or parents did not affect the amount of care provided by a spouse. Discussion Late middle-aged adults with functional limitations are more likely than older groups to be married and cared for primarily by spouses; however they may be particularly vulnerable to unmet need for care. As the baby boom generation ages, retirement ages increase, and federal safety nets weaken, people with health problems at older ages may soon find themselves in the same caregiving predicament as those in late middle age. PMID:18689772

  20. Cognitive-behavioral Therapy for Late-life Anxiety: Similarities and Differences between Veteran and Community Participants

    PubMed Central

    Barrera, Terri L.; Cully, Jeffrey A.; Amspoker, Amber B.; Wilson, Nancy L.; Kraus-Schuman, Cynthia; Wagener, Paula D.; Calleo, Jessica S.; Teng, Ellen J.; Rhoades, Howard M.; Masozera, Nicholas; Kunik, Mark E.; Stanley, Melinda A.

    2015-01-01

    Cognitive-behavioral therapy (CBT) is an evidence-based treatment for anxiety; however, a growing body of research suggests that CBT effect sizes are smaller in Veteran samples. The aim of this study was to perform secondary data analyses of a randomized controlled trial of CBT for late-life generalized anxiety disorder compared with treatment as usual (TAU) in a Veteran (n = 101) and community-based (n = 122) sample. Veterans had lower income and less education than community participants, greater severity on baseline measures of anxiety and depression, poorer physical health, and higher rates of psychiatric comorbidity. Treatment effects were statistically significant in the community sample (all ps < .01), but not in Veterans (all ps > .05). Further analyses in Veterans revealed that poorer perceived social support significantly predicted poorer outcomes (all ps <.05). Our results underscore the complexity of treating Veterans with anxiety, and suggest that additional work is needed to improve the efficacy of CBT for Veterans, with particular attention to social support. PMID:26005839

  1. Cognitive-Behavioral Therapy for Depression in an Older Gay Man: A Clinical Case Study

    ERIC Educational Resources Information Center

    Satterfield, Jason M.; Crabb, Rebecca

    2010-01-01

    Although strong evidence supports cognitive-behavioral therapy for late-life depression and depression in racial and ethnic minorities, there are no empirical studies on the treatment of depression in older sexual minorities. Three distinct literatures were tapped to create a depression treatment protocol for an older gay male. Interventions were…

  2. Impact of depression on quality-adjusted life expectancy (QALE) directly as well as indirectly through suicide

    PubMed Central

    Zack, Matthew M.; Thompson, William W.; Crosby, Alex E.; Gottesman, Irving I.

    2015-01-01

    Purpose To estimate quality-adjusted life expectancy (QALE) loss among US adults due to depression and QALE losses associated with the increased risk of suicide attributable to depression. Method We ascertained depressive symptoms using the eight-item Patient Health Questionnaire (PHQ-8) on the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) surveys. We estimated health-related quality of life (HRQOL) scores from BRFSS data (n = 276,442) and constructed life tables from US Compressed Mortality Files to calculate QALE by depression status. QALE loss due to depression is the difference in QALE between depressed and non-depressed adults. QALE loss associated with suicide deaths is the difference between QALE from only those deaths that did not have suicide recorded on the death certificate and QALE from all deaths including those with a suicide recorded on the death certificate. Results At age 18, QALE was 28.0 more years for depressed adults and 56.8 more years for non-depressed adults, a 28.9-year QALE loss due to depression. For depressed adults, only 0.41 years of QALE loss resulted from deaths by suicide, and only 0.26 years of this loss could be attributed to depression. Conclusion Depression symptoms lead to a significant burden of disease from both mortality and morbidity as assessed by QALE loss. The 28.9-year QALE loss at age 18 associated with depression markedly exceeds estimates reported elsewhere for stroke (12.4-year loss), heart disease (10.3-year loss), diabetes mellitus (11.1-year loss), hypertension (6.3-year loss), asthma (7.0-year loss), smoking (11.0-year loss), and physical inactivity (8.0-year loss). PMID:25660550

  3. Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

    ERIC Educational Resources Information Center

    Rogers, Cynthia E.; Lenze, Shannon N.; Luby, Joan L.

    2013-01-01

    Objective: Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early…

  4. Sexual satisfaction, anxiety, depression and quality of life in testicular cancer survivors.

    PubMed

    Alacacioglu, Ahmet; Ulger, Eda; Varol, Umut; Yavuzsen, Tugba; Akyol, Murat; Yildiz, Yasar; Yildiz, Ibrahim; Bayoglu, Vedat; Dirican, Ahmet; Demir, Lutfiye; Salman, Tarik; Kucukzeybek, Yuksel; Alacacioglu, Inci; Can, Huseyin; Tarhan, Mustafa Oktay

    2014-07-01

    We aimed to investigate anxiety, depression and sexual satisfaction levels of testicular cancer survivors (TCSs) and compare the scores with healthy men's. The Hospital Anxiety and Depression Scale (HADS), Golombok-Rust Inventory of Sexual Satisfaction (GRISS) and European Organization for Research on Treatment of Cancer Questionnaires Quality of Life-C30 were used. Forty-one TCSs and thirty-eight healthy men were participated in this study. The total HADs scores of TCSs (12.21 ± 8.19) were less than the healthy group (14.44 ± 6.53; p > 0.05). The high depression scores rate was 29.2 and 55.2, and high anxiety scores rate was 24.4 and 28.9 for TCSs and healthy group, respectively. When we evaluated GRISS subscores and anxiety levels, we found significantly increase only in avoidance subscores in the TCSs (p = 0.04). When we evaluated GRISS subscores and depression levels, GRISS subscores of the TCSs who had high depression scores were also high. However, statistical significance was found in satisfaction (p = 0.009), touch (p = 0.04), avoidance (p = 0.01) and erectile dysfunction (p = 0.04) subscores in the TCSs. In the TCSs whose anxiety scores were high, emotional functioning (p = 0.009) and global QoL (p = 0.01) subscores of GRISS was found significantly low. In the TCSs whose depression scores were high, physical (p = 0.01), cognitive (p = 0.04), emotional (p = 0.03), social functioning (p = 0.02) and global QoL (p < 0.001) subscores of GRISS were found significantly low. Anxiety, depression and sexual satisfaction levels of TCSs were found to be similar with the control population.

  5. Health Related Quality of Life, Depression, Anxiety and Stress in Patients with Beta-Thalassemia Major

    PubMed Central

    Adib-Hajbaghery, M; Ahmadi, M; S, Poormansouri

    2015-01-01

    Background Awareness of factors associated with quality of life (QOL) in patients with beta-Thalassemia major (β-TM) is necessary to develop clinical programs in order to improve social support and QOL in β-TM patients. This study aimed to examine QoL, depression, anxiety, and stress in β-TM patients in Ahvaz, Iran. Materials and Methods A cross-sectional study was conducted on173 β-TM patients aged ≥12 years (12-18=55, ≥19=118). Subjects were selected using a census method. Data collection instrument consisted of three parts including: demographic questions, SF-36 questionnaire and depression, anxiety, and stress scale (DAS-21). Results The participants obtained a mean score of 64.38±18.20 for QOL, 6.4±5.1 for depression, 4.8±3.9 for anxiety, and 7.3±4.9 for stress. Significant relationship was found between QOL and employment (P=0.02) and education level (P<0.001). Patients in the age group of 12-18 years old had higher mean scores in the majority of QoL dimensions than those aged ≤19. The mean scores of depression, anxiety, and stress were higher in patients aged ≤19. No significant correlation was observed between QOL and depression, anxiety, stress scores, and other demographic variables. Moreover, a significant inverse correlation was found between QOL and depression (P<0.001,r= -0.62), anxiety (P<0.001,r= -0.55), and stress scores (P<0.001, r= -0.5) . Conclusion This study showed that β-TM patients experienced a considerable decrease both in their overall QoL and in its dimensions. A majority of the β-TM patients were also suffered from mild to severe depression, anxiety, and stress. PMID:26985352

  6. Early Life Stress and Physical and Psychosocial Functioning in Late Adulthood

    PubMed Central

    Alastalo, Hanna; von Bonsdorff, Mikaela B.; Räikkönen, Katri; Pesonen, Anu-Katriina; Osmond, Clive; Barker, David J. P.; Heinonen, Kati; Kajantie, Eero; Eriksson, Johan G.

    2013-01-01

    Background Severe stress experienced in early life may have long-term effects on adult physiological and psychological health and well-being. We studied physical and psychosocial functioning in late adulthood in subjects separated temporarily from their parents in childhood during World War II. Methods The 1803 participants belong to the Helsinki Birth Cohort Study, born 1934–44. Of them, 267 (14.8%) had been evacuated abroad in childhood during WWII and the remaining subjects served as controls. Physical and psychosocial functioning was assessed with the Short Form 36 scale (SF-36) between 2001 and 2004. A test for trends was based on linear regression. All analyses were adjusted for age at clinical examination, social class in childhood and adulthood, smoking, alcohol intake, physical activity, body mass index, cardiovascular disease and diabetes. Results Physical functioning in late adulthood was lower among the separated men compared to non-separated men (b = −0.40, 95% confidence interval [95% CI]: −0.71 to −0.08). Those men separated in school age (>7 years) and who were separated for a duration over 2 years had the highest risk for lower physical functioning (b = −0.89, 95% CI: −1.58 to −0.20) and (b = −0.65, 95% CI: −1.25 to −0.05), respectively). Men separated for a duration over 2 years also had lower psychosocial functioning (b = −0.70, 95% CI: −1.35 to −0.06). These differences in physical and psychosocial functioning were not observed among women. Conclusion Early life stress may increase the risk for impaired physical functioning in late adulthood among men. Timing and duration of the separation influenced the physical and psychosocial functioning in late adulthood. PMID:23861956

  7. Punishment for bedwetting is associated with child depression and reduced quality of life.

    PubMed

    Al-Zaben, Faten Nabeel; Sehlo, Mohammad Gamal

    2015-05-01

    This study assessed the relationship between parental punishment and depression as well as quality of life in children with primary monosymptomatic nocturnal enuresis (PMNE). A consecutive sample of 65 children (7-13 years) with PMNE and 40 healthy children, selected as controls (Group III), were included in the study. The children with PMNE were further sub-classified into two groups: Group I, which included children who received parental punishment for enuresis and Group II, which comprised children who were not punished for bedwetting. Depression and health-related quality of life (HRQL) were assessed among the three groups. The number of wet nights per week was significantly increased in Group I compared with Group II (P<.001). In addition, the severity of depressive symptoms increased in Group I as compared to the other two groups (P<.001). Similarly, the psychosocial HRQL lower in Group compared to the control group (Group III) (P<.001). Prior parental discipline, including corporal punishment (B=0.55, P=.008), as well as the frequency (B=0.73, P<.001) and duration of punishment (B=0.33, P=.02) were strong predictors of increased depressive symptom severity. It was also found that prior punishment (B=-0.42, P=.01) and the frequency (B=-0.62, P<.001) and duration of punishment (B=-0.34, P=.02) were strong predictors for poor psychosocial HRQL. Overall, parental punishment has a poor outcome in children with PMNE.

  8. Opening toward life: Experiences of basic body awareness therapy in persons with major depression

    PubMed Central

    Danielsson, Louise; Rosberg, Susanne

    2015-01-01

    Although there is a vast amount of research on different strategies to alleviate depression, knowledge of movement-based treatments focusing on body awareness is sparse. This study explores the experiences of basic body awareness therapy (BBAT) in 15 persons diagnosed with major depression who participated in the treatment in a randomized clinical trial. Hermeneutic phenomenological methodology inspired the approach to interviews and data analysis. The participants’ experiences were essentially grasped as a process of enhanced existential openness, opening toward life, exceeding the tangible corporeal dimension to also involve emotional, temporal, and relational aspects of life. Five constituents of this meaning were described: vitality springing forth, grounding oneself, recognizing patterns in one's body, being acknowledged and allowed to be oneself, and grasping the vagueness. The process of enhanced perceptual openness challenges the numbness experienced in depression, which can provide hope for change, but it is connected to hard work and can be emotionally difficult to bear. Inspired by a phenomenological framework, the results of this study illuminate novel clinical and theoretical insight into the meaning of BBAT as an adjunctive approach in the treatment of depression. PMID:25956354

  9. Postnatal quality of life, depressive symptoms, and social support among women in southern India.

    PubMed

    Bodhare, Trupti N; Sethi, Pruthwiraj; Bele, Samir D; Gayatri, Dasari; Vivekanand, Achanta

    2015-01-01

    Evaluation of postnatal quality of life (QOL) has remained a poorly researched area in India. The present cross-sectional study assessed postnatal QOL, using the Mother Generated Index (MGI) and its associated risk factors, and was conducted during January-March 2013 among 274 mothers, 6-8 weeks postnatally. A semi-structured questionnaire was used to evaluate sociodemographic and obstetric characteristics and social support. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and QOL using the MGI. The vast majority (90.1 percent) of respondents in our study had a primary MGI score <5, those with significantly higher prevalence of physical problems and psychological distress. A total of 39.8 percent of respondents were screened as having other (not major) depressive symptoms and 4.7 percent as having major depressive symptoms. Multiple regression analysis revealed that age (β = 0.033, p = .018) and socioeconomic status (β = 0.156, p < .001) were significantly positively associated with QOL, while increased depressive symptom scores (β = -0.075, p < .001) were significantly negatively associated with QOL. A wide spectrum of QOL aspects were reported, including physical, emotional, social, and economic concerns by the mothers. Prevention, evaluation, and treatment of postnatal depressive symptoms and impaired QOL are warranted, taking into account the role of various biopsychosocial risk factors and specific concerns raised by the mothers. PMID:25719436

  10. The Effect of Vascular Neuropathology on Late-life Cognition: Results from the SMART Project

    PubMed Central

    Kryscio, R.J.; Abner, E.L.; Nelson, P.T.; Bennett, D.; Schneider, J.; Yu, L.; Hemmy, L.S.; Lim, K.O.; Masaki, K.; Cairns, N.; Xiong, C.; Woltjer, R.; Dodge, H.H.; Tyas, S.; Fardo, D.W.; Lou, W.; Wan, L.; Schmitt, F.A.

    2016-01-01

    Background Cerebral vascular pathology may contribute to cognitive decline experienced by some elderly near death. Given evidence for mixed neuropathologies in advanced age, preventing or reducing cerebrovascular burden in late life may be beneficial. Objective To correlate measures of cerebral vascular pathology with cognitive trajectories. Setting Observational study. Participants A cohort of 2,274 individuals who came to autopsy at a mean age of 89.3 years and 82 percent of whom had at least two cognitive assessments within the last six years of life was compiled from six centers conducting longitudinal studies. Measurements For each cognitive domain: immediate and delayed memory, language, and naming, three trajectories were examined: good, intermediate, and poor cognition. The probability of a participant belonging to each trajectory was associated with measures of cerebral vascular pathology after adjustment for demographics, APOE, and Alzheimer neuropathology. Results A large proportion of the cohort (72-94%) experienced good or intermediate cognition in the four domains examined. The presence of arteriolosclerosis and the presence of lacunar infarcts doubled the odds of belonging to the poor cognitive trajectory for language when compared to the good trajectory. The presence of lacunar infarcts increased the odds of an intermediate or poor trajectory for immediate and delayed recall while the presence of large artery infarcts increased the odds of poor trajectories for all four cognitive domains examined. Microinfarcts and cerebral amyloid angiopathy had little effect on the trajectories. Conclusion Indicators of cerebral vascular pathology act differently on late life cognition.

  11. Depression.

    ERIC Educational Resources Information Center

    Strock, Margaret

    Approximately ten percent of the population suffers from a depressive illness each year. Although the economic cost is high, the cost in human suffering is immeasurable. To help educate the population about this disorder, this paper presents a definition of depression and its common manifestations. The symptoms that people often experience are…

  12. Late-life dementia. Review of the APA guidelines for patient management.

    PubMed

    Schindler, R J; Cucio, C P

    2000-10-01

    Management of dementia in older patients requires an individualized and multimodal approach that involves use of psychiatric, psychotherapeutic, psychosocial, and somatic tools and treatments, in addition to patient and family education. The progressive nature of dementia and the invariable presence of comorbidity complicates the management task, although symptoms characteristic of dementia's phases can provide helpful clinical clues to guide evolving care. In 1997, the American Psychiatric Association published the "Practice guideline for the treatment of patients with Alzheimer's disease and other dementias of late life." To date, this is the most comprehensive clinical guideline available to physicians caring for patients with Alzheimer's disease and other related dementias.

  13. Geomorphological evolution of Mediterranean enclosed depressions in the Late glacial and Holocene: The example of Canohès (Roussillon, SE France)

    NASA Astrophysics Data System (ADS)

    Carozza, Jean-Michel; Llubes, Muriel; Danu, Mihaela; Faure, Elodie; Carozza, Laurent; David, Mélodie; Manen, Claire

    2016-11-01

    The origin and evolution of the enclosed depressions (pans) of southern France during the period from the Late Glacial to the Holocene are discussed on the basis of new stratigraphical, geophysical and chronological (14C) data from the Canohès depression (Roussillon, Southern of France) and its nearby environment. The Canohès depression is non-karstic, excavated from Pliocene arkosic sands that were shaped by eolian erosion during cold stages of the Middle and Upper Pleistocene. The timing and controlling factors of eolian carving of the depression are discussed on the basis of geomorphological data, surrounding alluvial terrace chronology, preserved ledge within the depression and alluvial infill of the depression. Formation of the depression was controlled, locally, by climate variability and its consequences on vegetation and water table position and, regionally, by the sea base level. The enclosed depression probably started to form during MIS 6, reaching its maximum depth during MIS 2. Climate variability in the region is recorded in the depression's infill. The basal deposits are of fluvial origin and record the increase of moisture and temperature during the Early Late-Glacial. The first lacustrine deposits are observed during the Bölling/GI-1e stage, while continental sedimentation and drying occurred during the Alleröd and Younger Dryas stages. During the Early and Middle Holocene, lacustrine conditions prevailed, except during short periods of drying. The specific evolution of the Canohès depression as regards other such formations is discussed in light of regional deglaciation and climate chronology. A regional synthesis of eolian erosion is proposed.

  14. Symptom Burden, Depression, and Quality of Life in Chronic and End-Stage Kidney Disease

    PubMed Central

    Abdel-Kader, Khaled; Unruh, Mark L.; Weisbord, Steven D.

    2009-01-01

    Background and objectives: While many patients with end-stage renal disease (ESRD) have impaired physical and psychologic well-being, less is known about these health domains in patients with advanced chronic kidney disease (CKD). The authors sought to compare symptoms, depression, and quality of life in patients with ESRD and those with CKD. Design, setting, participants, & measurements: Patients with ESRD and subjects with advanced CKD were enrolled. Patients’ symptoms, depression, and quality of life were assessed using the Dialysis Symptom Index (DSI), Patient Health Questionnaire-9 (PHQ-9), and Short Form 36 (SF-36), respectively, and these health domains were compared between patient groups. Results: Ninety patients with ESRD and 87 with CKD were enrolled. There were no differences in the overall number of symptoms or in the total DSI symptom-severity score. Median scores on the PHQ-9 were similar, as was the proportion of patients with PHQ-9 scores >9. SF-36 Physical Component Summary scores were comparable, as were SF-36 Mental Component Summary scores. Conclusions: The burden of symptoms, prevalence of depression, and low quality of life are comparable in patients with ESRD and advanced CKD. Given the widely recognized impairments in these domains in ESRD, findings of this study underscore the substantial decrements in the physical and psychologic well-being of patients with CKD. PMID:19423570

  15. The Specific Role of Relationship Life Events in the Onset of Depression during Pregnancy and the Postpartum

    PubMed Central

    Wright, Nicola; Hill, Jonathan; Pickles, Andrew; Sharp, Helen

    2015-01-01

    Background The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. Methods A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. Results 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). Conclusions The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum. PMID:26645963

  16. Anxiety, depression and quality of life in individuals with phantom limb pain

    PubMed Central

    Padovani, Mariana Theozzo; Martins, Marielza Regina Ismael; Venâncio, Alexandre; Forni, José Eduardo Nogueira

    2015-01-01

    OBJECTIVE: This study aims to evaluate emotional factors such as anxiety and depression, and the Quality of Life of individuals with chronic persistent pain after amputation in order to identify the interindividual variation in response to pain. METHODS: This was a descriptive, exploratory and cross-sectional study with quantitative approach. Twenty seven patients were interviewed. The instruments have rated the sociodemographic, clinical and economic profile (semistructured interview) and the Quality of Life (generic Quality of Life questionnaire SF-12) and emotional factors (HAD scale) of the interviewed patients. RESULTS: It was identified that the most frequent amputations occur in males aged 18-38 years and are related to occupational accidents. The Quality of Life was compromised in both components of physical and mental health. Furthermore, anxiety levels were more prevalent in the range from aged 18 to 38 years old, while the levels of depression were most prevalent among the elderly (60 to 80 years old). CONCLUSION: The impairment of Quality of Life and change in the perception of body image has a major impact on adherence to the rehabilitation program and the functional prognosis. Therapeutic orientation is, therefore, critical after this type of surgery. Level of Evidence II, Descriptive and Exploratory Study. PMID:27069411

  17. Influence of Craniosacral Therapy on Anxiety, Depression and Quality of Life in Patients with Fibromyalgia

    PubMed Central

    Matarán-Peñarrocha, Guillermo A.; Castro-Sánchez, Adelaida María; García, Gloria Carballo; Moreno-Lorenzo, Carmen; Carreño, Tesifón Parrón; Zafra, María Dolores Onieva

    2011-01-01

    Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The causes of pathologic mechanism underlying fibromyalgia are unknown, but fibromyalgia may lead to reduced quality of life. The objective of this study was to analyze the repercussions of craniosacral therapy on depression, anxiety and quality of life in fibromyalgia patients with painful symptoms. An experimental, double-blind longitudinal clinical trial design was undertaken. Eighty-four patients diagnosed with fibromyalgia were randomly assigned to an intervention group (craniosacral therapy) or placebo group (simulated treatment with disconnected ultrasound). The treatment period was 25 weeks. Anxiety, pain, sleep quality, depression and quality of life were determined at baseline and at 10 minutes, 6 months and 1-year post-treatment. State anxiety and trait anxiety, pain, quality of life and Pittsburgh sleep quality index were significantly higher in the intervention versus placebo group after the treatment period and at the 6-month follow-up. However, at the 1-year follow-up, the groups only differed in the Pittsburgh sleep quality index. Approaching fibromyalgia by means of craniosacral therapy contributes to improving anxiety and quality of life levels in these patients. PMID:19729492

  18. Loneliness and depression in middle and late childhood: the relationship to attachment and parental styles.

    PubMed

    Richaud de Minzi, María Cristina

    2006-06-01

    In this study, the author analyzed the relationship between (a) parenting and attachment and (b) self-competence, loneliness, and depression in children aged 8-12 years. The author administered (a) the Argentine Scale of Perception of the Relationships with Parents (M. C. Richaud de Minzi, 2004), (b) the Kerns' Security Scale (K. A. Kerns, L. Klepac, & A. K. Cole, 1996; M. C. Richaud de Minzi, C. Sacchi, & J. E. Moreno, 2001, Argentine adaptation), (c) the Self-Perception Profile for Children (S. Harter, 1985; M. C. Richaud de Minzi et al.), (d) the Dimensions of Depression Profile for Children and Adolescents (S. Harter & M. Nowakowski, 1987), and (e) the Louvain Loneliness Scale for Children and Adolescents (A. Marcoen, L. Goossens, & P. Caes, 1987; M. C. Richaud de Minzi et al.) to 1,019 children (8-12 years of age, 483 boys, 536 girls). Results indicated that attachment and parent-child relationship styles were differentiated constructs. Parents' acceptance promoted secure attachment and positive outcomes in children. Moreover, fathers' lack of interest had a marked negative effect. The author found differences in the perceptions and influences of fathers and mothers, which follow the cultural patterns of gender attribution.

  19. Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

    ERIC Educational Resources Information Center

    Espejo, Emmanuel Peter; Hammen, Constance; Brennan, Patricia A.

    2012-01-01

    The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents…

  20. Depression.

    PubMed

    Weissman, Myrna

    2009-04-01

    This is an invited article on how my career as an epidemiologist studying depression unfolded. The role of the Civil Rights movement in opening the PhD doors to women at Yale began my career. The unfolding of depression studies are described. These studies included a clinical trial of medication and what later was known as interpersonal psychotherapy (IPT), the first community survey of psychiatric disorder, family genetic and brain imaging studies or depression and anxiety disorders. I hope the new generation will have the wonderful opportunities I have had.

  1. Depression.

    PubMed

    Weissman, Myrna

    2009-04-01

    This is an invited article on how my career as an epidemiologist studying depression unfolded. The role of the Civil Rights movement in opening the PhD doors to women at Yale began my career. The unfolding of depression studies are described. These studies included a clinical trial of medication and what later was known as interpersonal psychotherapy (IPT), the first community survey of psychiatric disorder, family genetic and brain imaging studies or depression and anxiety disorders. I hope the new generation will have the wonderful opportunities I have had. PMID:19344866

  2. A life-history approach to the late Pleistocene megafaunal extinction.

    PubMed

    Zuo, Wenyun; Smith, Felisa A; Charnov, Eric L

    2013-10-01

    A major criticism of the "overkill" theory for the late Pleistocene extinction in the Americas has been the seeming implausibility of a relatively small number of humans selectively killing off millions of large-bodied mammals. Critics argue that early Paleoindian hunters had to be extremely selective to have produced the highly size-biased extinction pattern characteristic of this event. Here, we derive a probabilistic extinction model that predicts the extinction risk of mammals at any body mass without invoking selective human harvest. The new model systematically analyzes the variability in life-history characteristics, such as the instantaneous mortality rate, age of first reproduction, and the maximum net reproductive rate. It captures the body size-biased extinction pattern in the late Pleistocene and precisely predicts the percentage of unexpectedly persisting large mammals and extinct small ones. A test with a global late Quaternary mammal database well supports the model. The model also emphasizes that quantitatively analyzing patterns of variability in ecological factors can shed light on diverse behaviors and patterns in nature. From a macro-scale conservation perspective, our model can be modified to predict the fate of biota under the pressures from both climate change and human impacts.

  3. Early life trauma predicts self-reported levels of depressive and anxiety symptoms in nonclinical community adults: relative contributions of early life stressor types and adult trauma exposure.

    PubMed

    Chu, Denise A; Williams, Leanne M; Harris, Anthony W F; Bryant, Richard A; Gatt, Justine M

    2013-01-01

    Exposure to early life trauma is a known risk factor for depression and anxiety disorders in adulthood. This study aimed to evaluate the relative contributions of early life versus adult trauma in predicting levels of depressive and anxiety symptoms in nonclinical community adults. 1209 nonclinical community adults (18-70 years; 45% male) were assessed for mental health status, early life stressors, lifetime trauma exposure, and self-reported levels of depressive and anxiety symptoms. A subset of the full sample subjected to group comparisons (n = 1088) indicated that early life stressor exposure primarily accounted for significantly higher depressive and anxiety symptom scores when compared against adults reporting to be free of childhood stressor or adult trauma exposure. Subsequent hierarchical multiple regression analyses of this subset using five distinct early life stressor types, namely 'Interpersonal violation', 'Family breakup', 'Disasters/war', 'Familial health trauma/death' and 'Personal health trauma' derived from principal component analysis of a wide range of self-reported early stressor events in the full sample, showed childhood 'Interpersonal violation' differentially predicted higher self-reported depressive and anxiety symptom scores in both males and females. Adult trauma exposure did not significantly predict these symptom scores. These findings underline the relative importance of exposure to 'interpersonal violation' relative to other types of early life stressors and adult trauma in the risk of depressive and anxiety symptoms in nonclinical community adults.

  4. Falls, Depression and Antidepressants in Later Life: A Large Primary Care Appraisal

    PubMed Central

    Kerse, Ngaire; Flicker, Leon; Pfaff, Jon J.; Draper, Brian; Lautenschlager, Nicola T.; Sim, Moira; Snowdon, John; Almeida, Osvaldo P.

    2008-01-01

    Background Depression and falls are common and co-exist for older people. Safe management of each of these conditions is important to quality of life. Methods A cross-sectional survey was used to examine medication use associated with injurious and non-injurious falls in 21,900 community-dwelling adults, aged 60 years or over from 383 Australian general practices recruited for the DEPS-GP Project. Falls and injury from falls, medication use, depressive symptoms (Primary Health Questionnaire (PHQ-9)), clinical morbidity, suicidal ideation and intent, health status (SF-12 Health Survey), demographic and lifestyle information was reported in a standardised survey. Findings Respondents were 71.8 years (sd 7.7) of age and 58.4% were women. 24% 11% and 8% reported falls, fall related injury, and sought medical attention respectively. Antidepressant use (odds ratio, OR: 1.46; 95% confidence interval, 95%CI: 1.25, 1.70), questionable depression (5–14 on PHQ OR: 1.32, 95%CI: 1.13, 1.53) and clinically significant symptoms of depression (15 or more on PHQ OR: 1.70, 95%CI: 1.14, 1.50) were independently associated with multiple falls. SSRI use was associated with the highest risk of multiple falls (OR: 1.66, 95%CI: 1.36, 2.02) amongst all psychotropic medications. Similar associations were observed for injurious falls. Over 60% of those with four accumulated risk factors had multiple falls in the previous year (OR: 3.40, 95%CI: 1.79, 6.45); adjusted for other demographic and health factors. Interpretation Antidepressant use (particularly SSRIs) was strongly associated with falls regardless of presence of depressive symptoms. Strategies to prevent falls should become a routine part of the management of older people with depression. PMID:18560599

  5. Stressful life events, social rhythms, and depressive symptoms among the elderly: an examination of hypothesized causal linkages.

    PubMed

    Prigerson, H G; Reynolds, C F; Frank, E; Kupfer, D J; George, C J; Houck, P R

    1994-01-01

    This study sought to determine possible causal linkages among stressful life events, social rhythms, and levels of depressive symptomatology for 81 elderly subjects (51 recently widowed, 30 healthy controls). We examined the associations among stressful life events (i.e., bereavement status at baseline or a severely threatening event occurring between baseline and followup), social rhythm stability, and the level of depressive symptoms. Results indicated that while stressful life events were not associated with significant changes in social rhythm stability, social rhythm stability was a significant negative correlate of both baseline and followup levels of depressive symptomatology; that is, lower levels of social rhythm stability at baseline were associated with high levels of depressive symptoms at baseline (rho = -0.33, n = 81, p < 0.001) and at followup (rho = -0.23, n = 81, p < 0.05). Bereavement was also a significant positive correlate of depressive symptomatology both at baseline (rho = 0.79, n = 81), p < 0.0001) and at followup (rho = 0.55, n = 81, p < 0.0001). It is likely that future research will benefit from social rhythm assessment obtained temporally closer to major life events and from the use of structured interviews to ascertain the presence of syndromal major depression at followup as well as the inclusion of subjects with a wider range of functional impairments. Nevertheless, these results represent a first step in disentangling possible causal connections among stressful life events, social rhythms, and depressive symptomatology.

  6. Effect of Abstinence on Depression, Anxiety, and Quality of Life in Chronic Methamphetamine Users in a Therapeutic Community

    PubMed Central

    Bagheri, Maryam; Mokri, Azarakhsh; Khosravi, Aliakbar; Kabir, Kourosh

    2015-01-01

    Background: During withdrawal, patients experience different symptoms. These symptoms are associated with relapse. Understanding different outcomes of methamphetamine abstinence is useful for finding better treatments for dependence. Objectives: This study aimed to show the effects of abstinence on depression, anxiety, and quality of life in methamphetamine users. Patients and Methods: A prospective quasi-experimental (before and after study) method was used to show the effect of 3 weeks abstinence on depression, anxiety, and quality of life. A convenient sample of addicted people entered into the study and 34 people completed the study. Beck Depression Scale, Cattell Anxiety Inventory and Short Form Health Survey (SF-36) (for assessing quality of life), were used for outcome assessments. Results: The mean depression score after abstinence decreased significantly (P < 0.001). Both hidden and obvious anxiety and total anxiety had a high level at admission and after 3 weeks of abstinence, the mean level of anxiety did not change significantly (P < 0.096). However, the quality of life increased after 3 weeks of abstinence (P < 0.001). Conclusions: Depression and anxiety are prevalent in methamphetamine users. Short-term abstinence improves depression and quality of life but does not improve anxiety in methamphetamine abusers. During follow up of these patients, addressing depression and anxiety is important to achieve better results. PMID:26495258

  7. Depression

    MedlinePlus

    ... newborns, as well as jitteriness, difficulty feeding, and low blood sugar after delivery. However, moms who stop medications can ... a kind of antidepressant for treating depression and anxiety disorders. However, a number of research studies show ...

  8. Quality of life and anxiety in pregnancies after late pregnancy loss: a case-control study.

    PubMed

    Hunfeld, J A; Agterberg, G; Wladimiroff, J W; Passchier, J

    1996-09-01

    Pregnant women with (n = 24) and without (n = 26) a previous pregnancy loss (> 16 weeks) due to congenital anomalies were compared on quality of life and anxiety. Pregnant women with a previous loss were divided into those with and those without a normal livebirth since the loss [cases+ (n = 6) and cases- (n = 18), respectively]. Psychological measurements were carried out before and after an ultrasound scan in the second trimester of the pregnancy. Women with a previous loss who had not delivered a healthy infant between the loss and the present pregnancy showed a lower quality of life as revealed by feelings of social isolation, negative emotional reactions, and pain than the other groups. In addition, they showed more pregnancy-related anxiety. The negative emotions were particularly present just before the anomaly scan. Feelings of social isolation, negative emotional reactions, pain, and pregnancy-related anxiety were significantly positively related to trait anxiety, irrespective of having experienced late pregnancy loss. The implications of this study are that the referring gynaecologist, physician, or midwife should be aware of the strong emotions and major concerns of women in a pregnancy subsequent to a late pregnancy loss. In addition, they should offer these women the opportunity to express their emotional distress. PMID:8905891

  9. Do negative affect characteristics and subjective memory concerns increase risk for late life anxiety?

    PubMed

    Wilkes, Chelsey M; Wilson, Helen W; Woodard, John L; Calamari, John E

    2013-08-01

    To better understand the development and exacerbation of late-life anxiety, we tested a risk model positing that trait negative affect (NA) characteristics would interact with cognitive functioning, thereby increasing some older adults' risk for increased anxiety symptoms. The moderator-mediator model consisted of measures of NA, cognitive functioning, and their interaction, as predictors of later Hamilton Anxiety Rating Scale scores (HARS) via a mediational process, subjective memory concerns (SMCs). Older adults (aged 65-years and over; M(age)=76.7 years, SD=6.90 years) completed evaluations four times over approximately 18 months. A latent growth curve model including Anxiety Sensitivity Index total score (ASI), Mattis Dementia Rating Scale-2 (DRS) total raw score, the ASI×DRS interaction, a SMC measure as mediator, HARS intercept (scores at times 3 and 4), and HARS slope provided good fit. The ASI×DRS-2 interaction at Time 1 predicted HARS slope score (β=-.34, p<.05). When ASI score was high, stronger cognitive functioning was associated with fewer anxiety symptoms. The indirect effect of ASI score predicting HARS score 18-months later through the SMC mediator was statistically significant (β=.08, p<.05). Results suggest that the cognitive functioning changes associated with aging might contribute to the development of anxiety symptoms in older adults with specific NA traits. Implications for predicting and preventing late life anxiety disorders are discussed.

  10. Uraemic pruritus markedly affects the quality of life and depressive symptoms in haemodialysis patients with end-stage renal disease.

    PubMed

    Suseł, Joanna; Batycka-Baran, Aleksandra; Reich, Adam; Szepietowski, Jacek C

    2014-05-01

    Little is known about the influence of uraemic pruritus on patients' wellbeing. The aim of our study was to evaluate the impact of uraemic pruritus on quality of life and depressive symptoms in patients with end-stage renal disease. A total of 200 haemodialysis patients were included into the study. The prevalence of uraemic pruritus was 38%. Patients with uraemic pruritus had significantly lower quality of life according to SF-36 questionnaire compared to the remaining of analysed subjects. Among patients with uraemic pruritus, 64.5% individuals also showed impaired skin-related quality of life evaluated with Dermatology Life Quality Index. The quality of life impairment correlated with uraemic pruritus intensity assessed with VAS and the 4-item itch questionnaire. Depression level significantly correlated with quality of life and severity of depressive symptoms was significantly associated with uraemic pruritus intensity. Our study underscores that uraemic pruritus should be regarded as an important health problem among haemodialysis patients.

  11. Continuity and Discontinuity of Depressed Mood from Late Adolescence to Young Adulthood: The Mediating and Stabilizing Roles of Young Adults' Socioeconomic Attainment

    ERIC Educational Resources Information Center

    Wickrama, K. A. S.; Conger, Rand D.; Lorenz, Federick O.; Martin, Monica

    2012-01-01

    Using prospective, longitudinal data from 467 youth over a 13-year period (late adolescence and young adulthood), the present study investigates three research questions: (1) to what extent do elevations in depressed mood continue (homotypic continuity) from adolescence to young adulthood, (2) to what extent do young adults' socioeconomic…

  12. Plasticity and constraint in response to early-life stressors among late/final Jomon period foragers from Japan: evidence for life history trade-offs from incremental microstructures of enamel.

    PubMed

    Temple, Daniel H

    2014-12-01

    This study evaluates two hypotheses that address how Late/Final Jomon period people responded to early-life stress using linear enamel hypoplasia (LEH) and incremental microstructures of enamel. The first hypothesis predicts that Jomon people who experienced early-life stressors had greater physiological competence in responding to future stress events (predictive adaptive response). The second hypothesis predicts that Jomon people traded-off in future growth and maintenance when early investment in growth and survival was required (plasticity/constraint). High resolution tooth impressions were collected from intact, anterior teeth and studied under an engineer's measuring microscope. LEH were identified based on accentuated perikymata and depressions in the enamel surface profile. Age of formation for each LEH was estimated by summing counts of perikymata and constants associated with crown initiation and cuspal enamel formation times. The relationship between age-at-first-defect formation, number of LEH, periodicity between LEH, and mortality was evaluated using multiple regression and hazards analysis. A significant, positive relationship was found between age-at-death relative to age-at-first-defect formation and a significant, negative relationship was found between number of LEH relative to age-at-first-defect formation. Individuals with earlier forming defects were at a significantly greater risk of forming defects at later stages of development and dying at younger ages. These results suggest that Late/Final Jomon period foragers responded to early-life stressors in a manner consistent with the plasticity/constraint hypothesis of human life history. Late/Final Jomon period individuals were able to survive early-life stressors, but this investment weakened responses to future stress events and exacerbated mortality schedules. PMID:25156299

  13. The Impact of Environmental Experiences on Symptoms of Anxiety and Depression Across the Life Span

    PubMed Central

    Kendler, Kenneth S.; Eaves, Lindon J.; Loken, Erik K.; Pedersen, Nancy L.; Middeldorp, Christel M.; Reynolds, Chandra; Boomsma, Dorret; Lichtenstein, Paul; Silberg, Judy; Gardner, Charles O.

    2012-01-01

    Symptoms of anxiety and depression are relatively stable over time. Can this stability be explained by genetic influences, or is it caused by the long-lasting effects of accumulating environmental experiences? To address this question, we analyzed longitudinally assessed symptoms of anxiety and depression in eight samples of monozygotic twins of widely varying ages. These samples were drawn from American and European population-based registries. Using hierarchical linear modeling, we examined individual differences and individual changes in the level of symptoms over time. This method enabled us to decompose the variance into the predictable variance shared by both members of each pair of twins, the differences between individuals within pairs, and the residual variance. We then modeled how these components of individual variation changed over time. Within pairs, the twins’ predicted levels of symptoms increasingly diverged from childhood until late adulthood, at which point the divergence ceased. By middle adulthood, environmental experiences contributed substantially to stable and predictable interindividual differences in levels of anxiety and depression. PMID:21948854

  14. Cannabis use and mental health-related quality of life among individuals with depressive disorders.

    PubMed

    Aspis, Itay; Feingold, Daniel; Weiser, Mark; Rehm, Jurgen; Shoval, Gal; Lev-Ran, Shaul

    2015-12-15

    Cannabis is the most widely used illicit substance among individuals with depressive disorders. This study aimed to evaluate whether among individuals with depressive disorders, higher frequency of cannabis use would be associated with poorer Quality of Life (QoL), based on a large nationally representative US sample. Individuals with depressive disorders (N=3416) were divided into categories according to no use (N=3096), occasional use (less than weekly, N=176) and regular (at least weekly, N=144) use of cannabis in the past 12 months. QoL was assessed using the Short-Form 12 (SF-12) questionnaire. Women who used cannabis regularly had a significantly lower SF-12 Mental Component Summary score (MCS) compared to non-users, with a mean difference of 0.4 Standard Deviations (SDs). Comparison of subscale scores showed no significant differences. No significant difference was noted when comparing women who used cannabis occasionally to non-users. No differences were found among men when comparing MCS and mental subscale scores of both regular and occasional users to non-users. Our findings highlight the importance of taking gender and the frequency of cannabis use into account, when assessing functional and emotional aspects of cannabis use among individuals with depressive disorders.

  15. Cannabis use and mental health-related quality of life among individuals with depressive disorders.

    PubMed

    Aspis, Itay; Feingold, Daniel; Weiser, Mark; Rehm, Jurgen; Shoval, Gal; Lev-Ran, Shaul

    2015-12-15

    Cannabis is the most widely used illicit substance among individuals with depressive disorders. This study aimed to evaluate whether among individuals with depressive disorders, higher frequency of cannabis use would be associated with poorer Quality of Life (QoL), based on a large nationally representative US sample. Individuals with depressive disorders (N=3416) were divided into categories according to no use (N=3096), occasional use (less than weekly, N=176) and regular (at least weekly, N=144) use of cannabis in the past 12 months. QoL was assessed using the Short-Form 12 (SF-12) questionnaire. Women who used cannabis regularly had a significantly lower SF-12 Mental Component Summary score (MCS) compared to non-users, with a mean difference of 0.4 Standard Deviations (SDs). Comparison of subscale scores showed no significant differences. No significant difference was noted when comparing women who used cannabis occasionally to non-users. No differences were found among men when comparing MCS and mental subscale scores of both regular and occasional users to non-users. Our findings highlight the importance of taking gender and the frequency of cannabis use into account, when assessing functional and emotional aspects of cannabis use among individuals with depressive disorders. PMID:26388103

  16. Relationships among Depression, Anxiety, Sleep, and Quality of Life in Patients with Parkinson's Disease in Taiwan.

    PubMed

    Fan, Jun-Yu; Chang, Bao-Luen; Wu, Yih-Ru

    2016-01-01

    The aim of this study was to examine the relationships among depression, anxiety, sleep disturbances, Parkinson's disease (PD) symptoms, PD medications, and health-related quality of life (QOL) and to identify the predictors of health-related QOL in PD patients. To do this, we administered a battery of questionnaires and rating scales (validated Chinese versions), including the Unified Parkinson's Disease Rating Scale, 39-item Parkinson's Disease Questionnaire, Parkinson's Disease Sleep Scale-2, Beck Depression Inventory, and Beck Anxiety Inventory, to 134 patients with PD whose Minimental State Examination scores were ≥24. We found that patients who reported having poorer QOL had longer disease durations, more severe PD symptoms, higher Hoehn and Yahr stages, and higher levodopa dosages, as well as higher levels of anxiety and depression, more sleep disturbances, and poorer overall cognitive statuses. Among these variables, the cognitive status, dependency of activities of daily living, depression, and anxiety were identified as predictors of QOL in PD patients and were all significant and independent factors of poor QOL in PD patients. The clinicians should be aware of the effects of these factors on QOL and attempt to treat comorbid psychiatric conditions to improve the PD patients' QOL.

  17. Relationships among Depression, Anxiety, Sleep, and Quality of Life in Patients with Parkinson's Disease in Taiwan.

    PubMed

    Fan, Jun-Yu; Chang, Bao-Luen; Wu, Yih-Ru

    2016-01-01

    The aim of this study was to examine the relationships among depression, anxiety, sleep disturbances, Parkinson's disease (PD) symptoms, PD medications, and health-related quality of life (QOL) and to identify the predictors of health-related QOL in PD patients. To do this, we administered a battery of questionnaires and rating scales (validated Chinese versions), including the Unified Parkinson's Disease Rating Scale, 39-item Parkinson's Disease Questionnaire, Parkinson's Disease Sleep Scale-2, Beck Depression Inventory, and Beck Anxiety Inventory, to 134 patients with PD whose Minimental State Examination scores were ≥24. We found that patients who reported having poorer QOL had longer disease durations, more severe PD symptoms, higher Hoehn and Yahr stages, and higher levodopa dosages, as well as higher levels of anxiety and depression, more sleep disturbances, and poorer overall cognitive statuses. Among these variables, the cognitive status, dependency of activities of daily living, depression, and anxiety were identified as predictors of QOL in PD patients and were all significant and independent factors of poor QOL in PD patients. The clinicians should be aware of the effects of these factors on QOL and attempt to treat comorbid psychiatric conditions to improve the PD patients' QOL. PMID:27293956

  18. Quality of life, functioning and cognition in bipolar disorder and major depression: A latent profile analysis.

    PubMed

    Cotrena, Charles; Branco, Laura Damiani; Kochhann, Renata; Shansis, Flávio Milman; Fonseca, Rochele Paz

    2016-07-30

    This study aimed to identify profiles of functioning and quality of life (QOL) in depression (MDD), bipolar disorder (BD) and healthy adults, as well as the clinical, demographic and cognitive variables associated with each of these profiles. Participants completed the WHODAS 2.0 and WHOQOL-BREF, which were submitted to latent profile analysis. The four cluster solution provided the best fit for our data. Cluster 1 consisted mostly of healthy adults, and had the highest functioning and QOL. Clusters 2 contained older patients with subclinical depressive symptoms and psychiatric comorbidities, whose impairments in QOL and functioning were associated with mood symptoms and several cognitive abilities. Patients with MDD, BDI or BDII with mild to moderate depression, such as those in cluster 3, may benefit more significantly from interventions in cognitive flexibility, inhibition, planning, and sustained attention. Lastly, patients with mood disorders and clinically significant levels of depression, as well as a history of suicide attempts, like those in cluster 4, may benefit from interventions aimed at working memory, inhibitory control, and cognitive flexibility; that is, the three core executive functions. These findings should be further investigated, and used to guide treatments for patients with mood disorders and different patterns of functional impairment.

  19. Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model.

    PubMed

    Cano, Miguel Ángel; de Dios, Marcel A; Castro, Yessenia; Vaughan, Ellen L; Castillo, Linda G; Lorenzo-Blanco, Elma I; Piña-Watson, Brandy; Berger Cardoso, Jodi; Ojeda, Lizette; Cruz, Rick A; Correa-Fernandez, Virmarie; Ibañez, Gladys; Auf, Rehab; Molleda, Lourdes M

    2015-10-01

    Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes. PMID:26092776

  20. Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model.

    PubMed

    Cano, Miguel Ángel; de Dios, Marcel A; Castro, Yessenia; Vaughan, Ellen L; Castillo, Linda G; Lorenzo-Blanco, Elma I; Piña-Watson, Brandy; Berger Cardoso, Jodi; Ojeda, Lizette; Cruz, Rick A; Correa-Fernandez, Virmarie; Ibañez, Gladys; Auf, Rehab; Molleda, Lourdes M

    2015-10-01

    Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes.

  1. Impact of aggression, depression, and anxiety levels on quality of life in epilepsy patients

    PubMed Central

    Izci, Filiz; Fındıklı, Ebru; Camkurt, Mehmet Akif; Tuncel, Deniz; Şahin, Merve

    2016-01-01

    The aim of this study was to investigate the impact of aggression levels on the quality of life (QoL) of epilepsy patients. This study was conducted on 66 volunteer control subjects, who were matched by age and sex to the patient group, which consisted of 66 patients who applied to the Psychiatry and Neurology clinics for outpatient treatment, were aged between 18 years and 65 years, and were diagnosed with epilepsy. A sociodemographic and clinical data form designed by us was distributed among the study participants, along with Buss–Perry Aggression Scale, Beck Anxiety Scale, Beck Depression Scale, and the Quality of Life Scale Short Form (SF-36). Compared with the control group, the patient group displayed higher scores in all subgroups of Buss–Perry Aggression Scale subscales at a statistically significant level (P<0.05). As per the SF-36 questionnaire, physical functioning, physical role disability, general health perception, social functioning, mental health perception, and pain subscales were statistically lower in the patient group (P<0.05). Significant links between Beck Depression Scale and Beck Anxiety Scale levels, as well as some subscales of QoL and aggression levels, were also determined. In conclusion, epilepsy patients experienced impaired QoL compared with the healthy control group and their QoL was further impaired due to increased levels of anxiety, depression, and aggression. PMID:27785037

  2. Midlife Blood Pressure and Late-Life GFR and Albuminuria: An Elderly General Population Cohort

    PubMed Central

    Inker, Lesley A.; Okparavero, Aghogho; Tighiouart, Hocine; Aspelund, Thor; Andresdottir, Margret B.; Eiriksdottir, Gudny; Harris, Tamara; Launer, Lenore; Nikulasdottir, Hjalmfridur; Sverrisdottir, Johanna Eyrun; Gudmundsdottir, Hrefna; Noubary, Farzad; Mitchell, Gary; Palsson, Runolfur; Indridason, Olafur; Gudnason, Vilmundur; Levey, Andrew S.

    2015-01-01

    Background Chronic kidney disease (CKD) is common in the elderly, but the cause is often not identifiable. Some posit that age-related reductions in glomerular filtration rate (GFR) and increases in albuminuria are normal, whereas others suggest that they are a consequence of vascular disease. Study Design Cross-sectional analysis of a substudy of a prospective cohort. Setting & Participants AGES (Age, Gene/Environment Susceptibility)-Reykjavik Study. Predictor Exposure to higher blood pressure in midlife. Outcomes & Measurements Measured GFR using plasma clearance of iohexol and urine albumin-creatinine ratio (ACR). Results GFR was measured in 805 participants with mean age in midlife and late life of 51.0 ±5.8 and 80.8 ±4.0 (SD) years, respectively. Mean measured GFR was 62.4 ±16.5 ml/min/1.73 m2 and median albuminuria was 8.0 (IQR, 5.4–16.5) mg/g. Higher midlife systolic and diastolic blood pressures were associated with lower later life GFR. Associations persisted after adjustment. Higher midlife systolic and diastolic blood pressures were also associated with higher ACR, and associations remained significant even after adjustment. Limitations This is a study of survivors, and people who agreed to participate in this study were healthier than those who refused. Blood pressure may encompass effects of the other risk factors. Results may not be generalizable to populations of other races. We were not able to adjust for measured GFR or albuminuria at the midlife visit. Conclusions Factors other than advanced age may account for the high prevalence of CKD in the elderly. Midlife factors are potential contributing factors to late-life kidney disease. Further studies are needed to identify and treat midlife modifiable factors to prevent the development of CKD. PMID:25987258

  3. A randomized controlled trial exploring the effect of music on quality of life and depression in older people with dementia.

    PubMed

    Cooke, Marie; Moyle, Wendy; Shum, David; Harrison, Scott; Murfield, Jenny

    2010-07-01

    This randomized controlled trial investigated the effect of live music on quality of life and depression in 47 older people with dementia using the Dementia Quality of Life and Geriatric Depression Scale. The control/reading group reported higher mid-point feelings of belonging than the music group (F(1, 45) = 6.672, p < .05). Sub-analyses of >or= 50 per cent music session attendance found improvements in self-esteem over time (F(2, 46) = 4.471, p < .05). Participants with scores that were suggestive of increased depressive symptoms had fewer depressive symptoms over time (F(2, 22) = 8.129, p < .01). Findings suggest music and reading activities can improve self-esteem, belonging and depression in some older people with dementia.

  4. Depression and Health Related Quality of Life in Adolescent Survivors of a Traumatic Brain Injury: A Pilot Study

    PubMed Central

    Di Battista, Ashley; Godfrey, Celia; Soo, Cheryl; Catroppa, Cathy; Anderson, Vicki

    2014-01-01

    Traumatic brain injury is (TBI) a leading cause of morbidity and mortality in youth. Adult survivors of a severe pediatric TBI are vulnerable to global impairments, including greater employment difficulties, poor quality of life (HRQoL) and increased risk of mental health problems. When estimating the health related quality of life in adolescents, the presence of anxiety and depression and the quality of social relationships are important considerations, because adolescents are entrenched in social development during this phase of maturation. The influence of anxiety, depression and loneliness on health related quality of life in adolescent survivors of TBI has not been documented. This pilot study aimed to identify and measure the relationship between anxiety, depression and loneliness and perceived health related quality of life in adolescent survivors of a TBI. Method: mixed method/cohort pilot study (11 adolescents, mild to severe TBI; 9 parents), using self-report and proxy-report measures of anxiety, depression, health related quality of life, loneliness and clinical psychiatric interviews (adolescent only). Results: Self-reported depression was significantly correlated with self-reported HRQoL (rs [11] = −0.88, p<0.001). Age at injury was significantly correlated with self-reported HRQoL (rs [11] = −0.68, p = 0.02). Self-reported depression predicted self-reported HRQoL (R2 = 0.79, F [1, 10] = 33.48, p<0.001), but age at injury did not (R2 = 0.19, F [1, 10] = 2.09, p = 0.18). Conclusions: Our results suggest that depression is a predictor of health related quality of life in youth post-TBI. The possibility of using targeted assessment and therapy for depression post-TBI to improve health related quality of life should be explored. PMID:25010719

  5. How are spousal depressed mood, distress and quality of life associated with risk of depressed mood in cancer survivors? Longitudinal findings from a national sample

    PubMed Central

    Litzelman, Kristin; Yabroff, K. Robin

    2015-01-01

    Background Spouses of cancer survivors experience both positive and negative effects from caregiving. However, it is less clear what role spousal well-being may have on cancer survivors. This study aimed to determine the impact of spousal psychosocial factors on survivor depressed mood and whether this association differed by gender. Methods We examined longitudinal data on cancer survivors and their spouses (n=910 dyads) from the 2004-2012 Medical Expenditures Panel Survey and a matched sample of cancer-free dyads. Subjects reported depressed mood, psychological distress, and mental and physical health-related quality of life (HRQoL) at two time points (T1/T2). Dyadic multilevel models evaluated the impact of psychosocial factors at T1 on depressed mood at T2, controlling for sociodemographics, cancer type, survivor treatment status, and depressed mood at T1. Results Cancer survivors whose spouses reported depressed mood at T1 were 4.27 times more likely to report depressed mood at T2 (95% CI=2.01-9.07); this was stronger for female survivors (OR=9.49; 95% CI=2.42-37.20). Better spousal mental and physical HRQoL at T1 were associated with a 30% decrease in survivor depressed mood risk at T2. Most spillover effects were not observed in comparison dyads. Conclusion Depressed mood and poor HRQoL in spouses may increase the risk of depressed mood in cancer survivors. The risk may be especially strong for female survivors. Impact Identifying and improving spousal mental health and HRQoL problems may reduce the risk of depressed mood in cancer survivors. Future research should examine whether incorporating spousal care into psycho-oncology and survivorship programs improves survivor outcomes. PMID:26033755

  6. Pubertal development and school transition. Joint influences on depressive symptoms in middle and late adolescents.

    PubMed

    Koenig, L J; Gladstone, T R

    1998-07-01

    The impact of simultaneous changes in biological and social context on the mental health of adolescents was examined by testing the hypothesis that normative developmental transitions can be associated with increased dysphoria if they occur in close temporal proximity. Girls experiencing physical changes associated with middle or later stage pubertal development during the initial high school or college year were predicted to experience more dysphoria than those experiencing these changes during non-transitional times, with negative pubertal attitudes exacerbating the relation. Pubertal status and dysphoria of high school and college students were assessed. Among females experiencing pubertal changes, dysphoria was indeed highest for the 15 and 19 year olds, and lower for the 16, 17, and 18 year olds with females viewing menstrual onset as negative experienced depressive symptoms of moderate clinical severity. This pattern did not emerge for males, or females not experiencing pubertal changes. In contrast, the hypothesis was not supported when transition time was operationalized using grade level. Implications for psychopathology risk are discussed.

  7. The Depressive Personality Disorder Inventory and its relationship to quality of life, hopefulness, and optimism.

    PubMed

    Huprich, Steven K; Frisch, Michael B

    2004-08-01

    The construct validity of the Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996) was examined through its relationship to the constructs of hope, optimism, and quality of life (QOL). Three hundred thirty-two undergraduate students were administered the DPDI and measures of the aforementioned constructs. As predicted, the DPDI negatively correlated with all measures. Individuals classified with a depressive personality disorder had significantly higher scores on measures of hope, optimism, and QOL compared to a control group. Stepwise regression analysis indicated that optimism, QOL, and one component of hope significantly predicted DPDI scores, although more variance was accounted for in women than men. These findings are explained in light of Carver and Scheier's (2000) explanation of optimism and its relationship to hope. In sum, it appears that the construct validity of the DPDI is supported within an undergraduate sample.

  8. Development of the Computer-Adaptive Version of the Late-Life Function and Disability Instrument

    PubMed Central

    Tian, Feng; Kopits, Ilona M.; Moed, Richard; Pardasaney, Poonam K.; Jette, Alan M.

    2012-01-01

    Background. Having psychometrically strong disability measures that minimize response burden is important in assessing of older adults. Methods. Using the original 48 items from the Late-Life Function and Disability Instrument and newly developed items, a 158-item Activity Limitation and a 62-item Participation Restriction item pool were developed. The item pools were administered to a convenience sample of 520 community-dwelling adults 60 years or older. Confirmatory factor analysis and item response theory were employed to identify content structure, calibrate items, and build the computer-adaptive testings (CATs). We evaluated real-data simulations of 10-item CAT subscales. We collected data from 102 older adults to validate the 10-item CATs against the Veteran’s Short Form-36 and assessed test–retest reliability in a subsample of 57 subjects. Results. Confirmatory factor analysis revealed a bifactor structure, and multi-dimensional item response theory was used to calibrate an overall Activity Limitation Scale (141 items) and an overall Participation Restriction Scale (55 items). Fit statistics were acceptable (Activity Limitation: comparative fit index = 0.95, Tucker Lewis Index = 0.95, root mean square error approximation = 0.03; Participation Restriction: comparative fit index = 0.95, Tucker Lewis Index = 0.95, root mean square error approximation = 0.05). Correlation of 10-item CATs with full item banks were substantial (Activity Limitation: r = .90; Participation Restriction: r = .95). Test–retest reliability estimates were high (Activity Limitation: r = .85; Participation Restriction r = .80). Strength and pattern of correlations with Veteran’s Short Form-36 subscales were as hypothesized. Each CAT, on average, took 3.56 minutes to administer. Conclusions. The Late-Life Function and Disability Instrument CATs demonstrated strong reliability, validity, accuracy, and precision. The Late-Life Function and Disability Instrument CAT can achieve

  9. Risk Factors for Late-Life Cognitive Decline and Variation with Age and Sex in the Sydney Memory and Ageing Study

    PubMed Central

    Lipnicki, Darren M.; Sachdev, Perminder S.; Crawford, John; Reppermund, Simone; Kochan, Nicole A.; Trollor, Julian N.; Draper, Brian; Slavin, Melissa J.; Kang, Kristan; Lux, Ora; Mather, Karen A.; Brodaty, Henry

    2013-01-01

    Introduction An aging population brings increasing burdens and costs to individuals and society arising from late-life cognitive decline, the causes of which are unclear. We aimed to identify factors predicting late-life cognitive decline. Methods Participants were 889 community-dwelling 70–90-year-olds from the Sydney Memory and Ageing Study with comprehensive neuropsychological assessments at baseline and a 2-year follow-up and initially without dementia. Cognitive decline was considered as incident mild cognitive impairment (MCI) or dementia, as well as decreases in attention/processing speed, executive function, memory, and global cognition. Associations with baseline demographic, lifestyle, health and medical factors were determined. Results All cognitive measures showed decline and 14% of participants developed incident MCI or dementia. Across all participants, risk factors for decline included older age and poorer smelling ability most prominently, but also more education, history of depression, being male, higher homocysteine, coronary artery disease, arthritis, low health status, and stroke. Protective factors included marriage, kidney disease, and antidepressant use. For some of these factors the association varied with age or differed between men and women. Additional risk and protective factors that were strictly age- and/or sex-dependent were also identified. We found salient population attributable risks (8.7–49.5%) for older age, being male or unmarried, poor smelling ability, coronary artery disease, arthritis, stroke, and high homocysteine. Discussion Preventing or treating conditions typically associated with aging might reduce population-wide late-life cognitive decline. Interventions tailored to particular age and sex groups may offer further benefits. PMID:23799051

  10. Treatment of Insomnia in Depressed Insomniacs: Effects on Health-related Quality of Life, Objective and Self-Reported Sleep, and Depression

    PubMed Central

    McCall, W. Vaughn; Blocker, Jill N.; D'Agostino, Ralph; Kimball, James; Boggs, Niki; Lasater, Barbara; Haskett, Roger; Krystal, Andrew; McDonald, William M.; Rosenquist, Peter B.

    2010-01-01

    Study Objectives: Insomnia is associated with poor health related quality of life (HRQOL) in depressed patients. Prior clinical trials of hypnotic treatment of insomnia in depressed patients have shown improvement in HRQOL, but in these studies HRQOL was relegated to a secondary outcome, and objective measures of sleep were not undertaken. Design: Double-blind, randomized, placebo-controlled clinical trial Setting: Outpatient clinic and sleep laboratory Patients: 60 depressed, insomniac outpatients Interventions: one week of open-label fluoxetine (FLX), followed by 8 more weeks of FLX combined with either eszopiclone (ESZ) 3 mg or placebo at bedtime Measurements: The primary HRQOL measure was the daily living and role functioning subscale (DLRF) of the Basis-32. Other measures included the Q-LES-Q, self-reported sleep, PSG, actigraphy, depression severity (HRSD) Results: At the end of randomized treatment, patients receiving ESZ had lower (better) DLRF scores (0.81 ± 0.64) than those receiving placebo (1.2 ± 0.72), p = 0.01. The effect size for DLRF was 0.62, indicating a moderate effect. An advantage for ESZ was also seen in other measures of HRQOL, and most assessments of antidepressant efficacy and sleep. Women reported better end of treatment HRQOL scores than men. Conclusions: ESZ treatment of insomnia in depressed patients is associated with multiple favorable outcomes, including superior improvement in HRQOL, depression severity, and sleep. ClinicalTrials.gov Identifier: NCT00247624 Citation: McCall WV; Blocker JN; D'Agostino Jr R; Kimball J; Boggs N; Lasater B; Haskett R; Krystal A; McDonald WM; Rosenquist PB. Treatment of insomnia in depressed insomniacs: effects on health-related quality of life, objective and self-reported sleep, and depression. J Clin Sleep Med 2010;6(4):322-329. PMID:20726279

  11. Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study

    PubMed Central

    Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P

    2015-01-01

    Background Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. Objective The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. Methods A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. Results A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score <5), we achieved an accuracy of 86.5%. Furthermore, a regression model that used the same feature to estimate the participants’ PHQ-9 scores obtained an average error of 23.5%. Conclusions Features extracted from mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must

  12. Speech and Speech-Related Quality of Life After Late Palate Repair: A Patient's Perspective.

    PubMed

    Schönmeyr, Björn; Wendby, Lisa; Sharma, Mitali; Jacobson, Lia; Restrepo, Carolina; Campbell, Alex

    2015-07-01

    Many patients with cleft palate deformities worldwide receive treatment at a later age than is recommended for normal speech to develop. The outcomes after late palate repairs in terms of speech and quality of life (QOL) still remain largely unstudied. In the current study, questionnaires were used to assess the patients' perception of speech and QOL before and after primary palate repair. All of the patients were operated at a cleft center in northeast India and had a cleft palate with a normal lip or with a cleft lip that had been previously repaired. A total of 134 patients (7-35 years) were interviewed preoperatively and 46 patients (7-32 years) were assessed in the postoperative survey. The survey showed that scores based on the speech handicap index, concerning speech and speech-related QOL, did not improve postoperatively. In fact, the questionnaires indicated that the speech became more unpredictable (P < 0.01) and that nasal regurgitation became worse (P < 0.01) for some patients after surgery. A total of 78% of the patients were still satisfied with the surgery and all of the patients reported that their self-confidence had improved after the operation. Thus, the majority of interviewed patients who underwent late primary palate repair were satisfied with the surgery. At the same time, speech and speech-related QOL did not improve according to the speech handicap index-based survey. Speech predictability may even become worse and nasal regurgitation may increase after late palate repair, according to these results.

  13. Impact of borderline personality disorder in late life on systems of care.

    PubMed

    Rosowsky, E; Gurian, B

    1992-04-01

    Some symptoms that are benchmarks of borderline personality disorder in the younger patient--identity disturbance, impulsivity, self-mutilation, risk taking, and substance abuse--do not appear to define the disorder in late life. However, changes in the environment or social context of elderly persons may cause core symptoms to manifest differently. Identity disturbance in old age may be evidenced by an inability to formulate future plans or pursue goal-directed activities. Anorexia may be a substitute for more obvious forms of self-mutilation. Elderly patients with severe personality disorders may disrupt nursing homes and other service delivery systems. The authors suggest that staff who work with these patients receive special training and that more research is needed to identify which symptoms of personality disorders are maintained into old age.

  14. Trends in late-life disability in Taiwan: The roles of education, environment, and technology

    PubMed Central

    Martin, Linda G.; Zimmer, Zachary; Hurng, Baai-Shyun

    2011-01-01

    This analysis offers the first strong evidence of trends in late-life disability in an emerging economy. Consistent measures of limitations in seeing, hearing, physical functions, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) were available for three to six survey waves, depending on the outcome, from 1989 to 2007 for the population of Taiwan aged 65 and older. Limitations in seeing, hearing, and IADLs declined substantially, but trends were mixed for physical functions and flat for ADLs. The remarkable reduction in difficulty phoning, an IADL, may reflect changes in telecommunications infrastructure and highlights the roles of environment and technology in disability outcomes. Trends for urban residents were more advantageous than those for rural residents for seeing and hearing, but less so for physical functions and IADLs. Were it not for the substantial increase in educational attainment, trends in all outcomes would have been less favorable. PMID:21923619

  15. The long-term impact of early adversity on late-life psychiatric disorders.

    PubMed

    Gershon, Anda; Sudheimer, Keith; Tirouvanziam, Rabindra; Williams, Leanne M; O'Hara, Ruth

    2013-04-01

    Early adversity is a strong and enduring predictor of psychiatric disorders including mood disorders, anxiety disorders, substance abuse or dependence, and posttraumatic stress disorder. However, the mechanisms of this effect are not well understood. The purpose of this review is to summarize and integrate the current research knowledge pertaining to the long-term effects of early adversity on psychiatric disorders, particularly in late life. We explore definitional considerations including key dimensions of the experience such as type, severity, and timing of adversity relative to development. We then review the potential biological and environmental mediators and moderators of the relationships between early adversity and psychiatric disorders. We conclude with clinical implications, methodological challenges and suggestions for future research. PMID:23443532

  16. Long life, natural death. The learned ideal of dying in late medieval commentaries on Avicenna's Canon.

    PubMed

    van 't Land, Karine

    2014-01-01

    Within late medieval learned medicine, natural death functioned both as a theoretical concept and as a goal for practice. Late medieval commentaries on Avicenna's Canon are used as source material in this study, in order to investigate the ways in which these learned medical authors envisaged natural death. The findings are compared to descriptions of natural death by natural philosophers, and to ideals of dying in broader medieval culture. According to the physicians, natural death was caused by the extinction of innate heat, due to a lack of innate moisture. They discussed natural death in relation to regimen, as the right regimen protected the body's heat and moisture, and thus helped a patient to keep natural death aloof. So, in order to think about natural death, the physicians turned to the whole of life, during which heat dried out moisture and regimens ought to be followed. By contrast, natural philosophers tended to focus on the moment of death itself. The comparison of natural death with the Good Death in broad medieval culture highlights the amoral nature of the natural death.

  17. Long life, natural death. The learned ideal of dying in late medieval commentaries on Avicenna's Canon.

    PubMed

    van 't Land, Karine

    2014-01-01

    Within late medieval learned medicine, natural death functioned both as a theoretical concept and as a goal for practice. Late medieval commentaries on Avicenna's Canon are used as source material in this study, in order to investigate the ways in which these learned medical authors envisaged natural death. The findings are compared to descriptions of natural death by natural philosophers, and to ideals of dying in broader medieval culture. According to the physicians, natural death was caused by the extinction of innate heat, due to a lack of innate moisture. They discussed natural death in relation to regimen, as the right regimen protected the body's heat and moisture, and thus helped a patient to keep natural death aloof. So, in order to think about natural death, the physicians turned to the whole of life, during which heat dried out moisture and regimens ought to be followed. By contrast, natural philosophers tended to focus on the moment of death itself. The comparison of natural death with the Good Death in broad medieval culture highlights the amoral nature of the natural death. PMID:25577929

  18. The interaction between child maltreatment, adult stressful life events and the 5-HTTLPR in major depression.

    PubMed

    Power, Robert A; Lecky-Thompson, Lucy; Fisher, Helen L; Cohen-Woods, Sarah; Hosang, Georgina M; Uher, Rudolf; Powell-Smith, Georgia; Keers, Robert; Tropeano, Maria; Korszun, Ania; Jones, Lisa; Jones, Ian; Owen, Michael J; Craddock, Nick; Craig, Ian W; Farmer, Anne E; McGuffin, Peter

    2013-08-01

    Both childhood maltreatment and adult stressful life events are established risk factors for the onset of depression in adulthood. However, the interaction between them can be viewed through two conflicting frameworks. Under a mismatch hypothesis stressful childhoods allow 'adaptive programming' for a stressful adulthood and so can be protective. Only when childhood and adulthood do not match is there a risk of behavioural problems. Alternatively, under the cumulative stress hypothesis we expect increased risk with each additional stressor. It has also been suggested that an individual's genetic background may determine the extent they undergo adaptive programming, and so which of these two hypotheses is relevant. In this study we test for an interaction between exposure to childhood maltreatment and adult stressful life events in a retrospective sample of 455 individuals, using major depression as the outcome. We also test whether this interaction differs by genotype at the 5-HTTLPR, a candidate for an individual's plasticity to adaptive programming. Early maltreatment and stressful life events in adulthood interacted to produce increased risk for depression over each individually (p = 0.055). This supports the cumulative stress hypothesis over the mismatch hypothesis, at least with respect to severe environmental risk factors. This effect was not altered by 5-HTTLPR allele, suggesting there was no difference by genotype in adaptive programming to these events. We suggest that the apparent additional vulnerability to stressful events of those who have experienced maltreatment has clinical relevance, highlighting the importance of providing support beyond the immediate aftermath of maltreatment into adulthood.

  19. Depression.

    PubMed

    Tallo, Donato

    2014-04-15

    Reading the CPD article was beneficial to my professional nursing practice and development. I gained a greater understanding of how depression is likely to exacerbate the effects of a physical illness or complicate the treatment of other health conditions. PMID:24712633

  20. Late-life effects on rat reproductive system after developmental exposure to mixtures of endocrine disrupters.

    PubMed

    Isling, Louise Krag; Boberg, Julie; Jacobsen, Pernille Rosenskjold; Mandrup, Karen Riiber; Axelstad, Marta; Christiansen, Sofie; Vinggaard, Anne Marie; Taxvig, Camilla; Kortenkamp, Andreas; Hass, Ulla

    2014-01-01

    This study examined late-life effects of perinatal exposure of rats to a mixture of endocrine-disrupting contaminants. Four groups of 14 time-mated Wistar rats were exposed by gavage from gestation day 7 to pup day 22 to a mixture of 13 anti-androgenic and estrogenic chemicals including phthalates, pesticides, u.v.-filters, bisphenol A, parabens, and the drug paracetamol. The groups received vehicle (control), a mixture of all 13 chemicals at 150-times (TotalMix150) or 450-times (TotalMix450) high-end human exposure, or 450-times a mixture of nine predominantly anti-androgenic chemicals (AAMix450). Onset of puberty and estrous cyclicity at 9 and 12 months of age were assessed. Few female offspring showed significantly regular estrus cyclicity at 12 months of age in the TotalMix450 and AAMix450 groups compared with controls. In 19-month-old male offspring, epididymal sperm counts were lower than controls, and in ventral prostate an overrepresentation of findings related to hyperplasia was observed in exposed groups compared with controls, particularly in the group dosed with anti-androgens. A higher incidence of pituitary adenoma at 19 months of age was found in males and females in the AAMix450 group. Developmental exposure of rats to the highest dose of a human-relevant mixture of endocrine disrupters induced adverse effects late in life, manifested as earlier female reproductive senescence, reduced sperm counts, higher score for prostate atypical hyperplasia, and higher incidence of pituitary tumors. These delayed effects highlight the need for further studies on the role of endocrine disrupters in hormone-related disorders in aging humans.

  1. Unexpected online gambling disorder in late-life: a case report

    PubMed Central

    Sauvaget, Anne; Jiménez-Murcia, Susana; Fernández-Aranda, Fernando; Fagundo, Ana B.; Moragas, Laura; Wolz, Ines; Veciana De Las Heras, Misericordia; Granero, Roser; del Pino-Gutiérrez, Amparo; Baño, Marta; Real, Eva; Aymamí, Maria N.; Grall-Bronnec, Marie; Menchón, José M.

    2015-01-01

    Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date. Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy. Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed. PMID:26074835

  2. Elevated body mass index and maintenance of cognitive function in late life: exploring underlying neural mechanisms

    PubMed Central

    Hsu, Chun Liang; Voss, Michelle W.; Best, John R.; Handy, Todd C.; Madden, Kenneth; Bolandzadeh, Niousha; Liu-Ambrose, Teresa

    2015-01-01

    Background: Obesity is associated with vascular risk factors that in turn, may increase dementia risk. However, higher body mass index (BMI) in late life may be neuroprotective. The possible neural mechanisms underlying the benefit of higher BMI on cognition in older adults are largely unknown. Thus, we used functional connectivity magnetic resonance imaging (fcMRI) to examine: (1) the relationship between BMI and functional brain connectivity; and (2) the mediating role of functional brain connectivity in the association between baseline BMI and change in cognitive function over a 12-month period. Methods:We conducted a 12-month, prospective study among 66 community-dwelling older adults, aged 70 to 80 years, who were categorized as: normal weight (BMI from 18.50 to 24.99); overweight (BMI from 25.00 to 29.99); and obese (BMI ≥ 30.00). At baseline, participants performed a finger-tapping task during fMRI scanning. Relevant neural networks were initially identified through independent component analysis (ICA) and subsequently examined through seed-based functional connectivity analysis. At baseline and 12-months, we measured three executive cognitive processes: (1) response inhibition; (2) set shifting; and (3) working memory. Results:Obese individuals showed lower task-related functional connectivity during finger tapping in the default mode network (DMN) compared with their healthy weight counterparts (p < 0.01). Lower task-related functional connectivity in the DMN at baseline was independently associated with better working memory performance at 12-months (p = 0.02). Finally, DMN functional connectivity during finger tapping significantly mediated the relationship between baseline BMI and working memory at 12-months (indirect effect: −0.155, 95% confidence interval [−0.313, −0.053]). Conclusions:These findings suggest that functional connectivity of the DMN may be an underlying mechanism by which higher BMI confers protective effects to cognition in

  3. Self-stigma and quality of life in patients with depressive disorder: a cross-sectional study

    PubMed Central

    Holubova, Michaela; Prasko, Jan; Ociskova, Marie; Marackova, Marketa; Grambal, Ales; Slepecky, Milos

    2016-01-01

    Background Self-stigma is a maladaptive psychosocial phenomenon that can affect many areas of patients’ lives and have a negative impact on their quality of life (QoL). This study explored the association between self-stigma, QoL, demographic data, and the severity of symptoms in patients with depressive disorder. Patients and methods Patients who met the International Classification of Diseases, 10th revision, research criteria for depressive disorder were enrolled in this cross-sectional study. All outpatients completed the following measurements: the Quality of Life Enjoyment and Satisfaction Questionnaire, the Internalized Stigma of Mental Illness Scale, demographic questionnaire, and the objective and subjective Clinical Global Impression-Severity scales that measure the severity of disorder. A total of 81 depressive disorder patients (with persistent affective disorder – dysthymia, major depressive disorder, or recurrent depressive disorder) and 43 healthy controls participated in this study. Results Compared with the healthy control group, a lower QoL was observed in patients with depressive disorder. The level of self-stigma correlated positively with total symptom severity score and negatively with QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and score of self-stigma were significantly associated with QoL. Conclusion This study suggests a lower QoL in patients with depressive disorder in comparison with healthy controls and a negative impact of self-stigma level on QoL in patients suffering from depressive disorders. PMID:27799775

  4. "I felt sad and did not enjoy life": Cultural context and the associations between anhedonia, depressed mood, and momentary emotions.

    PubMed

    Chentsova-Dutton, Yulia E; Choi, Eunsoo; Ryder, Andrew G; Reyes, Jenny

    2015-10-01

    The meanings of "anhedonia" and "depressed mood," the cardinal emotional symptoms of major depression, may be shaped by cultural norms regarding pleasure and sadness. Thirty-two European Americans, 26 Hispanic Americans, 33 Asian Americans, and 20 Russian Americans provided reports of (a) depressive symptoms, (b) momentary emotions and pleasure, and (c) global subjective well-being. Momentary reports were collected over 10 days using handheld personal digital assistants. Reports of anhedonia were associated with heightened levels of momentary low arousal negative emotions (e.g., sadness), whereas reports of depressed mood were associated with dampened levels of momentary positive emotions (e.g., happiness). Symptoms of anhedonia and depressed mood interacted in their associations with momentary pleasure. In addition, the associations of anhedonia and depressed mood with positive emotions and life satisfaction differed across cultural groups. Specifically, these symptoms were associated with dampened positive emotions in the Asian American group only. Additionally, anhedonia was associated with dampened global life satisfaction in the European American group only. These results suggest that reports of anhedonia and depressed mood cannot be interpreted at face value as specific and culture-free indicators of emotional deficits. Instead, they appear to signal changes in the balance of positive and negative emotions, with the exact nature of these signals shaped at least in part by cultural context. This conclusion has important consequences for the clinical interpretation of depressive symptoms in multicultural societies. PMID:25603917

  5. Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

    PubMed Central

    Espejo, Emmanuel P.; Hammen, Constance; Brennan, Patricia A.

    2012-01-01

    The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents who were administered diagnostic and life stress interviews at ages 15 and 20. Participants’ appraisals of the negative impact of LEs reported at age 15 were statistically adjusted using investigator-based ratings to control for objective differences across LEs. Higher appraisals of the negative impact of LEs were associated with both past and current depressive and anxiety disorders at age 15 and predicted subsequent first onsets of depressive and anxiety disorders occurring between ages 15 and 20. In addition, appraisals of the negative impact of LEs were particularly elevated among those experiencing both a depressive and anxiety disorder over the course of the study. The findings suggest that systematically elevated appraisals of the negative impact of LEs is a predisposing factor for depression and anxiety disorders and may represent a specific risk factor for co-morbid depression and anxiety in mid-adolescence and early adulthood. Keywords: depression; anxiety; stress appraisals; prospective study; PMID:21845380

  6. Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches.

    PubMed

    Eskin, Mehmet; Akyol, Ali; Çelik, Emine Yilmaz; Gültekin, Bülent Kadri

    2013-08-01

    This study aimed at investigating social problem solving, perceived stress, depression, and life-satisfaction in patients with tension type and migraine headaches. Forty-nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self-report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T-tests, chi-square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life-satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life-satisfaction in patients suffering from primary headache.

  7. The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study

    PubMed Central

    2013-01-01

    Background Previous findings suggest that stressful life events have a causal relationship with depressive symptoms. However, to date little is known concerning the contribution of the number and severity of recent stressful life events on the prevalence of depressive symptoms among university students. The aim of this study was to investigate the prevalence of depressive symptoms and its association with the number and the severity of self-reported stressful life events among university students in Cyprus. Methods A descriptive correlational design with cross sectional comparison was used. The CES-D scale was applied for the assessment of depressive symptoms and the LESS instrument for stressful life events. Both scales were completed anonymously and voluntarily by 1.500 students (response rate 85%). Results The prevalence of mild to moderate depressive symptoms [CES-D score between 16 and 21] and of clinically significant depressive symptoms [CES-D score ≥ 22] were 18.8% and 25.3% respectively. There were statistically significant differences in clinically significant depressive symptoms by gender, with higher rates among women (x2 = 8.53, df = 1, p = 0.003). Higher scores on the LESS scale were associated with more frequent reports of clinical depressive symptoms (x2 = 70.63, df = 4, p < 0.001). Similarly, an association was found between the number of life events and clinical depressive symptoms (x2 = 40.06, df = 4, p < 0.001). Logistic regression analysis after adjusting for socio-demographic characteristics confirmed that the responders who reported a high number (n = 12–21) of stressful life events during the previous year (OR = 2.64 95% CI: 1.02, 6.83) and a severe degree of stress due to these events (total LESS score > 351, OR = 3.03 95% CI: 1.66, 5.39) were more likely to manifest clinical depressive symptoms. Conclusions The high frequency of occurrence of depressive symptoms among Cypriot

  8. Improvement in Personal Meaning Mediates the Effects of a Life Review Intervention on Depressive Symptoms in a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Westerhof, Gerben J.; Bohlmeijer, Ernst T.; van Beljouw, Ilse M. J.; Pot, Anne Margriet

    2010-01-01

    Purpose: The purpose of the study was to assess the impact of a life review intervention on personal meaning in life and the mediating effect of personal meaning on depressive symptoms as the primary outcome of this form of indicated prevention. Design and Methods: A multicenter randomized controlled trial was conducted with one group of older…

  9. Physical activity, health-related quality of life and depression during pregnancy.

    PubMed

    Tendais, Iva; Figueiredo, Bárbara; Mota, Jorge; Conde, Ana

    2011-02-01

    This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL) and depression over pregnancy. 56 healthy pregnant women self-reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased after conception, moderate leisure physical activity and work related physical activity remained stable over time. The prevalence of recommended physical activity was 39.3% and 12.5% in the 1st and 2nd trimesters of pregnancy respectively, and 14.3% pre-pregnancy. From the 1st to the 2nd pregnancy trimester, most physical HRQoL dimensions scores decreased and only mental component increased, independently of physical activity status. No changes in mean depression scores were observed. These data suggest that physical activity patterns change with pregnancy and that physical and mental components are differentially affected by pregnancy course, independently of physical activity status.

  10. Bupropion in the treatment of major depressive disorder in real-life practice.

    PubMed

    Sennfelt, Diogo Azevedo Oliveira; Marques da Silva, Maria Alice Rodrigues; Tavares, Anabela Pereira da Silva

    2011-10-19

    Major depressive disorder (MDD) is one of the most common mental disorders, with a lifetime prevalence of approximately 13% in Europe. Although the primary symptom of MDD is depressed mood and a loss of interest or pleasure in everyday life, patients with MDD often present with a variety of other symptoms, such as sleep disturbances, fatigue, anxiety and somatic complaints. Antidepressant drugs are frequently used as first-line therapy for MDD. Bupropion is a second-generation antidepressant drug that inhibits reuptake of the neurotransmitters dopamine and norepinephrine, and has no direct serotonergic effects, a unique property among antidepressants. This article highlights the use of bupropion in the treatment of three patients with varying presentations of MDD, including as combination therapy in a patient refractory to treatment with a selective serotonin reuptake inhibitor, monotherapy in a patient with somatic symptoms of depression and loss of libido, and in a patient complaining of anxiety as a symptom of MDD. Bupropion treatment was successful in all patients, resulting in remission of symptoms and the patients returning to their normal lives.

  11. Loneliness, depression, social support, and quality of life in older chronically ill Appalachians.

    PubMed

    Theeke, Laurie A; Goins, R Turner; Moore, Julia; Campbell, Heather

    2012-01-01

    This study's purpose was to describe loneliness and to examine the relationships between loneliness, depression, social support, and QOL in chronically ill, older Appalachians. In-person interviews were conducted with a convenience sample of 60 older, chronically ill, community-dwelling, and rural adults. Those with dementia or active grief were excluded. The UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1985), Geriatric Depression Scale (Shiekh & Yesavage, 1986), Katz ADL scale (Katz, Down, & Cash, 1970), MOS Social Support Scale (Sherbourne & Stewart, 1991), and a visual analog scale for Quality of Life (Spitzer et al., 1981) scale were used. Diagnoses were obtained through chart reviews. SPSS was used for data analyses. The majority of the 65% female sample (M age = 75 years) were married and impoverished. Participants' number of chronic illnesses averaged more than 3. Over 88% of participants reported at least 1 area of functional impairment. Loneliness was prevalent with UCLA loneliness scores indicating moderate to high loneliness, ranging from 39 to 62 (possible scores were 20-80). Higher loneliness scores correlated with depression, lower Qol, and lower social support, particularly lower emotional support. This study provides evidence that loneliness is a significant problem for older chronically ill Appalachian adults and that it may be related to low emotional support. Further, it provides evidence that this population may be significantly lonely and may not self-identify as lonely. Screening for loneliness and designing interventions that target the emotional aspects of loneliness could be important in this population.

  12. The road not taken: life experiences in monozygotic twin pairs discordant for major depression

    PubMed Central

    Kendler, KS; Halberstadt, LJ

    2012-01-01

    In an effort to understand how environmental experiences contribute to risk for major depression (MD), we conducted joint autobiographical interviews with 14 pairs of monozygotic twins (mean age 51.2) rigorously discordant for a lifetime history of MD. Twelve of the pairs could be sorted into four broad categories. In two pairs, discordance was associated with a single traumatic event occurring to the affected twin. In seven pairs, the well twin had one stable, long-term, successful romantic relationship, whereas the affected co-twin had romantic reversals one or more of which precipitated depressive episodes. These pairs varied in the degree to which the romantic problems seemed to arise from bad luck or poor choices. In one pair, occupational difficulties were strongly related to discordance in experiences with MD. In two pairs, several mechanisms seemed to be at work. Discordance in the quality of intimate love relationships was the most common etiological factor revealed by interview in these discordant pairs, with single dramatic events and occupational problems being considerably rarer. Even in this best of natural experiments, the causal interrelationship between personality, environment and depressive episodes was not always clear. Many pairs illustrated the protective effects of planfulness and the malignant effect of cumulative continuity where early difficulties in relationships shaped the subsequent life course. These results speak both to the importance of environmental influences on human well-being and psychopathology, and the complexity of the causal paths underlying their effects. PMID:22641178

  13. Gene–environment interactions: early life stress and risk for depressive and anxiety disorders

    PubMed Central

    Tyrka, Audrey R.; Carpenter, Linda L.; Price, Lawrence H.

    2013-01-01

    Rationale Prior reviews have examined how stress, broadly defined, interacts with genetic diathesis in the pathogenesis of internalizing (i.e., depressive and anxiety) disorders. Recent findings have suggested a unique role for early life stress (ELS) in the development of internalizing disorders, contributing to the rapid proliferation of research in this area. Objective This paper critically reviews studies in humans examining gene–environment interaction (GxE) effects of ELS on the risk for depression and anxiety, primarily from a candidate gene perspective. Major methodological challenges that are unique to such studies are considered. Results The majority of published studies have focused on candidates that regulate the serotonin system, especially the serotonin transporter. More recent work has addressed interactions of ELS with candidates from the hypothalamic-pituitary-adrenal axis and neurotrophin system. Available studies vary greatly with respect to definitions of ELS, examination of gene–gene interactions, consideration of gender effects, and attention to analytic limitations. Conclusions Overall, there is support for GxE effects of ELS on the risk for depressive and anxiety outcomes. Future studies of ELS in this context will require careful attention to methodologic considerations. Such studies would benefit from more systematic assessment of positive environmental factors (e.g., social support) and greater utilization of developmentally sensitive paradigms. PMID:21225419

  14. Aberrant topographical organization of the default mode network underlying the cognitive impairment of remitted late-onset depression.

    PubMed

    Yin, Yingying; Wang, Zan; Zhang, Zhijun; Yuan, Yonggui

    2016-08-26

    To investigate the alteration of resting-state functional connectivity (FC) and topological organization of the default mode network (DMN), and their contribution to the cognitive impairment in remitted late-onset depression (rLOD) patients. Thirty-three rLOD patients and thirty-one healthy controls underwent clinical and cognitive evaluations as well as resting-state functional magnetic resonance imaging (R-fMRI) scans. The FC networks were constructed by thresholding Pearson correlation metrics of the DMN regions, and their topological properties were analyzed using graph theory-based approaches. Nonparametric permutation tests were further used for group comparisons of topological metrics. Finally, multiple linear regression analyses were performed to examine the relationships between the network measures and cognitive performances. Patients displayed universally decreased FC of DMN and abnormal global topology of the DMN (i.e., increased characteristic path length Lp and reduced global efficiency Eglob) compared with healthy controls. According to the distance-dependent FC results, the long-distance connections were mainly involved in the connectivity between anterior and posterior hubs, and the short-distance connections were primarily located in the frontal lobe. There were significant correlations between the global topology and the episodic memory performance in rLOD patients. In conclusion, the present study indicated that the disrupted topological organization of the DMN might be considered as a potential biomarker of the episodic memory deficits in rLOD patients. PMID:27365133

  15. Increased frequency of T cells expressing IL-10 in Alzheimer disease but not in late-onset depression patients.

    PubMed

    Torres, Karen Cecília; Araújo Pereira, Patrícia; Lima, Giselle Sabrina; Bozzi, Isadora Cristina; Rezende, Vitor Bortolo; Bicalho, Maria Aparecida; Moraes, Edgar Nunes; Miranda, Débora Marques; Romano-Silva, Marco Aurélio

    2013-12-01

    Higher risk of dementia is expected for patients with late onset depression (LOD) history. The IL-10 polymorphisms are associated with Alzheimer disease (AD). On the other hand, there is no study associating IL-10 polymorphisms to LOD. This study aimed to investigate the -1082G/A polymorphism association in LOD, AD patients and controls and also the peripheral expression of IL-10 in CD4+ T cells. It was done in a case-control study comparing immune system phenotype and genetic polymorphism association among control individuals, LOD and AD patients. Participants were 569 subjects composed the genetics sample (249 AD, 222 LOD and 98 controls) from a tertiary medical center based on Belo Horizonte, Brazil. Flow cytometry analysis was performed in 55 people (22 AD patients, 11 LOD patients and 22 controls). A real time PCR for IL-10 SNP (rs 1800896) through genotyping analysis and flow cytometry evaluation of CD4+ T cells expressing IL-10 was done. An increased CD4+ T cells expressing IL-10 were detected only in the AD group. There was no difference detected in allele or genotype analysis for IL-10 polymorphism among LOD, AD patients or controls. IL-10 might have a role in the modulation of immune response in AD patients, however it is not presented in LOD population.

  16. Maternal depression across the first years of life compromises child psychosocial adjustment; relations to child HPA-axis functioning.

    PubMed

    Apter-Levi, Yael; Pratt, Maayan; Vakart, Adam; Feldman, Michal; Zagoory-Sharon, Orna; Feldman, Ruth

    2016-02-01

    Maternal depression across the first years of life negatively impacts children's development. One pathway of vulnerability may involve functioning of the hypothalamic-pituitary-adrenal (HPA) axis. We utilize a community cohort of 1983 women with no comorbid risk repeatedly assessed for depression from birth to six years to form two groups; chronically depressed (N=40) and non-depressed (N=91) women. At six years, mother and child underwent psychiatric diagnosis, child salivary cortisol (CT) was assessed three times during a home-visit, mother-child interaction was videotaped, and child empathy was coded from behavioral paradigms. Latent Growth curve Model using Structural Equation Modeling (SEM) estimated the links between maternal depression and mother's negative parenting and three child outcomes; psychopathology, social withdrawal, and empathy as related to child CT baseline and variability. Depressed mothers displayed more negative parenting and their children showed more Axis-I psychopathology and social withdrawal. SEM analysis revealed that maternal depression was associated with reduced CT variability, which predicted higher child psychopathology and social withdrawal. Whereas all children exhibited similar initial levels of CT, children of controls reduced CT levels over time while children of depressed mothers maintained high, non-flexible levels. Mother negativity was related to lower initial CT levels, which predicted decreased empathy. Findings suggest that chronic maternal depression may compromise children's social-emotional adjustment by diminishing HPA-system flexibility as well as limiting the mother's capacity to provide attuned and predictable caregiving.

  17. Maternal depression across the first years of life compromises child psychosocial adjustment; relations to child HPA-axis functioning.

    PubMed

    Apter-Levi, Yael; Pratt, Maayan; Vakart, Adam; Feldman, Michal; Zagoory-Sharon, Orna; Feldman, Ruth

    2016-02-01

    Maternal depression across the first years of life negatively impacts children's development. One pathway of vulnerability may involve functioning of the hypothalamic-pituitary-adrenal (HPA) axis. We utilize a community cohort of 1983 women with no comorbid risk repeatedly assessed for depression from birth to six years to form two groups; chronically depressed (N=40) and non-depressed (N=91) women. At six years, mother and child underwent psychiatric diagnosis, child salivary cortisol (CT) was assessed three times during a home-visit, mother-child interaction was videotaped, and child empathy was coded from behavioral paradigms. Latent Growth curve Model using Structural Equation Modeling (SEM) estimated the links between maternal depression and mother's negative parenting and three child outcomes; psychopathology, social withdrawal, and empathy as related to child CT baseline and variability. Depressed mothers displayed more negative parenting and their children showed more Axis-I psychopathology and social withdrawal. SEM analysis revealed that maternal depression was associated with reduced CT variability, which predicted higher child psychopathology and social withdrawal. Whereas all children exhibited similar initial levels of CT, children of controls reduced CT levels over time while children of depressed mothers maintained high, non-flexible levels. Mother negativity was related to lower initial CT levels, which predicted decreased empathy. Findings suggest that chronic maternal depression may compromise children's social-emotional adjustment by diminishing HPA-system flexibility as well as limiting the mother's capacity to provide attuned and predictable caregiving. PMID:26610204

  18. An ecological theory for the sudden origin of multicellular life in the late precambrian.

    PubMed

    Stanley, S M

    1973-05-01

    According to modern ecological theory, high diversity at any trophic level of a community is possible only under the influence of cropping. Until herbivores evolved, single-celled algae of the Precambrain were resource-limited, and a small number of species saturated aquatic environments. In the near-absence of vacant niches, life diversified slowly. Because the changes required to produce the first algae-eating heterotrophs were therefore delayed, the entire system was self-limiting. When the "heterotroph barrier" was finally crossed in the late Precambrian, herbivorous and carnivorous protists arose almost simultaneously, for no major biological differences separate the two groups. These events automatically triggered the formation of a series of self-propagating feedback systems of diversification between adjacent trophic levels. Comparable systems arose among multi-cellular groups, which radiated rapidly from the newly diversifying protist taxa. The sudden proliferation of complex food webs formed by taxa invading previously vacant adaptive zones produced an explosive diversification of life over a period of a few tens of millions of years. The rapid appearance of skeletons in various groups, though of special geological importance, was no more dramatic than other aspects of the radiation. The overall rate of diversification was comparable to rates for less-extensive adaptive radiations of the Phanerozoic.

  19. The physiological impacts of wealth shocks in late life: Evidence from the Great Recession.

    PubMed

    Boen, Courtney; Yang, Y Claire

    2016-02-01

    Given documented links between individual socioeconomic status (SES) and health, it is likely that-in addition to its impacts on individuals' wallets and bank accounts-the Great Recession also took a toll on individuals' disease and mortality risk. Exploiting a quasi-natural experiment design, this study utilizes nationally representative, longitudinal data from the National Social Life, Health, and Aging Project (NSHAP) (2005-2011) (N = 930) and individual fixed effects models to examine how household-level wealth shocks experienced during the Great Recession relate to changes in biophysiological functioning in older adults. Results indicate that wealth shocks significantly predicted changes in physiological functioning, such that losses in net worth from the pre-to the post-Recession period were associated with increases in systolic blood pressure and C-reactive protein over the six year period. Further, while the association between wealth shocks and changes in blood pressure was unattenuated with the inclusion of other indicators of SES, psychosocial well-being, and health behaviors in analytic models, we document some evidence of mediation in the association between changes in wealth and changes in C-reactive protein, which suggests specificity in the social and biophysiological mechanisms relating wealth shocks and health at older ages. Linking macro-level conditions, meso-level household environments, and micro-level biological processes, this study provides new insights into the mechanisms through which economic inequality contributes to disease and mortality risk in late life.

  20. An Ecological Theory for the Sudden Origin of Multicellular Life in the Late Precambrian

    PubMed Central

    Stanley, Steven M.

    1973-01-01

    According to modern ecological theory, high diversity at any trophic level of a community is possible only under the influence of cropping. Until herbivores evolved, single-celled algae of the Precambrain were resource-limited, and a small number of species saturated aquatic environments. In the near-absence of vacant niches, life diversified slowly. Because the changes required to produce the first algae-eating heterotrophs were therefore delayed, the entire system was self-limiting. When the “heterotroph barrier” was finally crossed in the late Precambrian, herbivorous and carnivorous protists arose almost simultaneously, for no major biological differences separate the two groups. These events automatically triggered the formation of a series of self-propagating feedback systems of diversification between adjacent trophic levels. Comparable systems arose among multi-cellular groups, which radiated rapidly from the newly diversifying protist taxa. The sudden proliferation of complex food webs formed by taxa invading previously vacant adaptive zones produced an explosive diversification of life over a period of a few tens of millions of years. The rapid appearance of skeletons in various groups, though of special geological importance, was no more dramatic than other aspects of the radiation. The overall rate of diversification was comparable to rates for less-extensive adaptive radiations of the Phanerozoic. PMID:16592084

  1. Relation between depression, some laboratory parameters, and quality of life in hemodialysis patients.

    PubMed

    Dogan, Ekrem; Erkoc, Reha; Eryonucu, Buket; Sayarlioglu, Hayriye; Agargun, Mehmet Y A

    2005-01-01

    Depression is common in patients with end-stage renal disease (ESRD) and is associated with increased mortality and morbidity. Several investigators have estimated that depression occurs in about 20% to 30% of dialysis patients. The aim of this study was to investigate the relationship between depression, some laboratory parameters, and quality of life (QOL) in hemodialysis patients. Forty-three hemodialysis patients (mean age 40.5+/-15.2; M=28, F=15) were included in the study. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and short form with 36 (SF-36) were used for evaluation. Subsequently, patients were divided into two groups according to HAMD scores: group 1, those who had a low HAMD score (between 0 and 7), and group 2, those who had a high HAMD score (over 7). The two groups were compared in terms of anxiety scores, QOL scores, and some laboratory parameters. The group 2 patients (n=21; M= 13, F=8) had lower levels of hemoglobin than the group 1 patients (9.5+/-1.7 vs. 10.7+/- 1.4 g/dL, respectively; p<0.01). Group 2 patients also had lower SF-36 scores than group 1 patients (91.5+/-21.3 vs. 74.9+/- 13.6, respectively; p=0.03). On the contrary, the patients of group 2 had higher HAMA scores than group 1 patients (16.6+/-6.9 vs. 6.3+/-3.5, respectively; p<0.01) and CRP level (10.7+/-4.6 vs. 4.5+/-3.8, respectively; p<0.001). A significant correlation was found between depression scores and C-reactive protein (CRP) (r= 0.57, p < 0.001) and HAMA scores (r=-0.43, p<0.05). In contrast, a negative correlation was found between HAMD scores and albumin (r=-0.43, p<0.05), hemoglobin (r=-0.38, p=0.015) and SF-36 scores (r=0.39, p=0.032). These findings demonstrate that there is a relationship among high depression score, low levels of hemoglobin and albumin, high CRP level, low SF-36 score, and high anxiety score. Evaluation of psychiatric status should be part of the care provided to hemodialysis patients.

  2. Comparing Changes in Late-Life Depressive Symptoms across Aging, Disablement, and Mortality Processes

    ERIC Educational Resources Information Center

    Fauth, Elizabeth B.; Gerstorf, Denis; Ram, Nilam; Malmberg, Bo

    2014-01-01

    Developmental processes are inherently time-related, with various time metrics and transition points being used to proxy how change is organized with respect to the theoretically underlying mechanisms. Using data from 4 Swedish studies of individuals aged 70-100+ (N = 453) who were measured every 2 years for up to 5 waves, we tested whether…

  3. Dyspnea, depression and health related quality of life in pulmonary arterial hypertension patients

    PubMed Central

    Talwar, Arunabh; Sahni, Sonu; Kim, Eun Ji; Verma, Sameer; Kohn, Nina

    2015-01-01

    Pulmonary arterial hypertension (PAH) is a rare and devastating disease which is characterized by worsening dyspnea and exercise tolerance. These patients are often found to have concomitant, depression, anxiety and impaired health-related quality of life (HRQOL). The interrelationship of dyspnea, depression and HRQOL in these patients is not well studied. Retrospective analysis was performed on 46 PAH patients (mean age 51.73). Patients completed Medical Outcomes Study Short - Form 36 V2 (SF-36) to measure HRQOL, Modified Medical Research Council (mMRC) Dyspnea Scale and Zung Depression Scale (ZDS). Physical Health Composite Scores (PCS) and Mental Health Composite Scores (MCS) were derived from SF-36. Spearman’s correlation was computed to determine degree of correlation between pairs of scales. 46 patients (12 males, 34 females; median age 51.4 yr) with confirmed PAH were considered for the study of which 36 patients (9 males, 27 females, median age 50.1 yr), were eligible for further analysis. MMRC Dyspnea Scale Score was 1.0 (Q1 to Q3:1.0 to 2.0). Median MCS was 52.1 (Q1 to Q3:41.7 to 57.1) and PCS was 37.9 (Q1 to Q3: 30.7 to 49.6). There was a significant negative correlation between dyspnea and PCS (r =−0.660, P<0.0001) and MCS (r =−0.342, P<0.0411). The ZDS was available for 17 of these patients; their median score was 42.0 (Q1 to Q3: 33.0 to 46.0). There was a significant correlation between the ZDS and PCS (r =−0.578, P<0.0150,) MCS (r =−0.752, P<0.0005). Patients with PAH suffer from diminished HRQOL correlating with their dyspnea and underlying depression. PMID:26535216

  4. Childhood poverty and depressive symptoms for older adults in Mexico: a life-course analysis.

    PubMed

    Torres, Jacqueline M; Wong, Rebeca

    2013-09-01

    This study applies life-course theories of latent (direct), pathway (indirect) and conditional effects in an analysis of childhood poverty on later-life depressive symptoms among older adults in Mexico. Data are from the 2001 Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults born before 1951 (n = 8696). Respondents had a mean of 3.6 past-week depressive symptoms and 71% had no household sanitation facilities before age 10; this measure served as a proxy for childhood poverty. Childhood poverty is significantly related to scores on an adapted 9-item CES-D scale in the full model (b = 0.27, p < 0.001). This effect is partially mediated by four adult socio-economic status measures, although decomposition analysis reveals the mediation effect to be primarily driven by educational achievement. These findings have important implications for Mexico's rapidly aging population as well as efforts for childhood poverty reduction and gains in education.

  5. Childhood Poverty and Depressive Symptoms for Older Adults in Mexico: A Life-Course Analysis

    PubMed Central

    Wong, Rebeca

    2013-01-01

    This study applies life-course theories of latent (direct), pathway (indirect) and conditional effects in an analysis of childhood poverty on later-life depressive symptoms among older adults in Mexico. Data are from the 2001 Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults born before 1951 (n=8696). Respondents had a mean of 3.6 past-week depressive symptoms and 71 % had no household sanitation facilities before age 10; this measure served as a proxy for childhood poverty. Childhood poverty is significantly related to scores on an adapted 9-item CES-D scale in the full model (b=0.27, p<0.001). This effect is partially mediated by four adult socio-economic status measures, although decomposition analysis reveals the mediation effect to be primarily driven by educational achievement. These findings have important implications for Mexico’s rapidly aging population as well as efforts for childhood poverty reduction and gains in education. PMID:23783887

  6. Late Side Effects and Quality of Life After Radiotherapy for Rectal Cancer

    SciTech Connect

    Bruheim, Kjersti; Guren, Marianne G.; Skovlund, Eva; Hjermstad, Marianne J.; Dahl, Olav; Frykholm, Gunilla; Carlsen, Erik; Tveit, Kjell Magne

    2010-03-15

    Purpose: There is little knowledge on long-term morbidity after radiotherapy (50 Gy) and total mesorectal excision for rectal cancer. Therefore, late effects on bowel, anorectal, and urinary function, and health-related quality of life (QoL), were studied in a national cohort (n = 535). Methods and Materials: All Norwegian patients who received pre- or postoperative (chemo-)radiotherapy for rectal cancer from 1993 to 2003 were identified. Patients treated with surgery alone served as controls. Patients were without recurrence or metastases. Bowel and urinary function was scored with the LENT SOMA scale and the St. Marks Score for fecal incontinence and QoL with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Results: Median time since surgery was 4.8 years. Radiation-treated (RT+) patients (n = 199) had increased bowel frequency compared with non-radiation-treated (RT-) patients (n = 336); 19% vs. 6% had more than eight daily bowel movements (p < 0.001). In patients without stoma, a higher proportion of RT+ (n = 69) compared with RT- patients (n = 240), were incontinent for liquid stools (49% vs. 15%, p < 0.001), needed a sanitary pad (52% vs. 13%, p < 0.001), and lacked the ability to defer defecation (44% vs. 16%, p < 0.001). Daily urinary incontinence occurred more frequently after radiotherapy (9% vs. 2%, p = 0.001). Radiation-treated patients had worse social function than RT- patients, and patients with fecal or urinary incontinence had impaired scores for global quality of life and social function (p < 0.001). Conclusions: Radiotherapy for rectal cancer is associated with considerable long-term effects on anorectal function, especially in terms of bowel frequency and fecal incontinence. RT+ patients have worse social function, and fecal incontinence has a negative impact on QoL.

  7. Parental status and late-life well-being in rural China: The benefits of having multiple children

    PubMed Central

    Guo, Man

    2013-01-01

    Objectives This study examined potential differences among childless elders, elders with one child, and elders with multiple children in rural China in their levels of depression and life satisfaction, and investigated the mechanism behind the potential differences. Methods The sample consisted of 1,224 older adults in rural Anhui province, China. ANOVA tests were carried out to compare the three groups in depression and life satisfaction, respectively. Multiple regressions were carried out to predict depression and life satisfaction, with 1) parental status, 2) individual attributes (i.e., socio-demographic variables and functional health), and 3) variables representing family relations (i.e., living arrangement, intergenerational contact, and family support) entered sequentially in each regression. Results Overall, childless elders in rural China had significantly higher level of depression and lower level of life satisfaction than did older parents. The primary reason for such group differences was lack of monetary support from adult children, the effect of which was conditioned upon the income level of older adults. With a high level of income, the benefit of monetary support from children was negligible. However, the mere presence of multiple children was associated with a higher life satisfaction, independently of personal attributes and potential monetary support form children. Conclusion This study contributed to the “missing link” in the explanation by identifying the pathways through which parental status affect individual well-being. The findings indicate that local contexts such as affluence, social norms, and available formal support all play a role in shaping the consequences of childlessness in later life. PMID:23711296

  8. Proactive Aging: A Longitudinal Study of Stress, Resources, Agency and Well-being in Late Life

    PubMed Central

    Kahana, Eva; Kelley-Moore, Jessica; Kahana, Boaz

    2012-01-01

    Objectives Using the Proactivity Model of Successful Aging, we examined how internal and external resources contribute to the maintenance of psychological well-being and social activities among older adults who experience normative stressors of aging. Outcome variables in this study are collectively referred to as quality of life (QOL). We also examined the mediating role of proactive adaptations between internal and external resources and QOL indicators. Method Based on five annual interviews of a sample of 1,000 community dwelling older adults in Florida (effective N = 561), we tested the lagged effects of stressors on two indicators of QOL, four years later. In the full longitudinal model, using structural equations, we estimated the direct effects of internal and external resources on QOL, along with indirect effects through proactive adaptations. Results Stressors negatively influenced QOL four years later. Internal and external resources led to better QOL four years later, both directly and indirectly through proactive adaptations of marshaling support and planning for the future. Conclusion These findings lend support to the Proactivity Model of Successful Aging by documenting the value of proactive adaptations (i.e., exercise, planning ahead and marshaling support) as proximate influences on QOL outcomes (i.e., depressive symptomatology and social activities). Findings suggest that older adults can maintain successful aging even in the face of health-related and social stressors by invoking accumulated resources to deal actively with the challenges of aging. PMID:22299813

  9. Postmortem MRI: a novel window into the neurobiology of late life cognitive decline.

    PubMed

    Dawe, Robert J; Yu, Lei; Leurgans, Sue E; Schneider, Julie A; Buchman, Aron S; Arfanakis, Konstantinos; Bennett, David A; Boyle, Patricia A

    2016-09-01

    This study tested the hypothesis that indices of brain tissue integrity derived from postmortem magnetic resonance imaging (MRI) are associated with late life decline in cognitive function and dementia, over and above contributions from common age-related neuropathologies. Cerebral hemispheres were obtained from 425 deceased older adults who had undergone 2 or more annual cognitive assessments, which included clinical diagnosis of dementia. Specimens underwent MRI to produce maps of transverse relaxation rate, R2. Voxelwise regression revealed brain regions where R2 was associated with cognitive decline. We then used random effects models to quantify the extent to which R2 accounted for variation in decline, after adjustment for demographics and neuropathologic indices of the 3 most common causes of dementia: Alzheimer's disease, cerebrovascular disease, and Lewy body disease. We additionally tested whether R2 was tied to greater likelihood of clinical diagnosis of Alzheimer's dementia using logistic regression models. During an average of 8.1 years, the mean rate of decline in global cognitive function was 0.13 unit per year (p < 0.0001). The tissue alteration most commonly related to decline was R2 slowing in white matter. Each unit decrease in R2 was associated with an additional 0.053-unit per year steepening of the rate of global cognitive decline (p < 0.001). Furthermore, R2 accounted for 8.4% of the variance in rate of global cognitive decline, above and beyond the 26.5% accounted for by demographics and neuropathologic indices, and 7.1%-11.2% of the variance of the decline rates in episodic, semantic, and working memory and perceptual speed. Alterations in R2 were also related to an increased odds of clinical diagnosis of Alzheimer's dementia (odds ratio = 2.000, 95% confidence interval 1.600, 2.604). Therefore, postmortem MRI indices of brain tissue integrity, particularly in white matter, are useful for elucidating the basis of late life cognitive

  10. Age-related deficit accumulation and the risk of late-life dementia

    PubMed Central

    2014-01-01

    Introduction Many age-related health problems have been associated with dementia, leading to the hypothesis that late-life dementia may be determined less by specific risk factors, and more by the operation of multiple health deficits in the aggregate. Our study addressed (a) how the predictive value of dementia risk varies by the number of deficits considered and (b) how traditional (for example. vascular risks) and nontraditional risk factors (for example, foot problems, nasal congestion) compare in their predictive effects. Methods Older adults in the Canadian Study of Health and Aging who were cognitively healthy at baseline were analyzed (men, 2,902; women, 4,337). Over a 10-year period, 44.8% of men and 33.4% of women died; 7.4% of men and 9.1% of women without baseline cognitive impairment developed dementia. Self-rated health problems, including, but not restricted to, dementia risk factors, were coded as deficit present/absent. Different numbers of randomly selected variables were used to calculate various iterations of the index (that is, the proportion of deficits present in an individual. Risks for 10-year mortality and dementia outcomes were evaluated separately for men and women by using logistic regression, adjusted for age. The prediction accuracy was evaluated by using C-statistics. Results Age-adjusted odds ratios per additional deficit were 1.22 (95% confidence interval (CI), 1.18 to 1.26) in men and 1.14 (1.11 to 1.16) in women in relation to death, and 1.18 (1.12 to 1.25) in men and 1.08 (1.04 to 1.11) in women in relation to dementia. The predictive value increased with the number (n) of deficits considered, regardless of whether they were known dementia risks, and stabilized at n > 25. The all-factor index best predicted dementia (C-statistics, 0.67 ± 0.03). Conclusions The variety of items associated with dementias suggests that some part of the risk might relate more to aberrant repair processes, than to specifically toxic results

  11. A 10-week memantine treatment in bipolar depression: a case report. Focus on depressive symptomatology, cognitive parameters and quality of life.

    PubMed

    Strzelecki, Dominik; Tabaszewska, Agnieszka; Barszcz, Zbigniew; Józefowicz, Olga; Kropiwnicki, Paweł; Rabe-Jabłońska, Jolanta

    2013-12-01

    Memantine and other glutamatergic agents have been currently investigated in some off-label indications due to glutamatergic involvement in several psychoneurological disorders. We assumed that memantine similarly to ketamine may positively influence mood, moreover having a potential to improve cognition and general quality of life. We report a case of a 49-year-old male hospitalized during a manic and a subsequent moderate depressive episode. After an ineffective use of lithium, olanzapine and antidepressive treatment with mianserin, memantine was added up to 20 mg per day for 10 weeks. The mental state was assessed using the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Hamilton Anxiety Scale, the Clinical Global Inventory, the World Health Organization Quality of Life Scale and psychological tests. After 10 weeks the patient achieved a partial symptomatic improvement in mood, anxiety and quality of sleep, but his activity remained insufficient. We also observed an improvement in the parameters of cognitive functioning and quality of life. There was neither significant mood variations during the memantine use nor mood changes after its termination. No significant side effects were noted during the memantine treatment. We conclude that using memantine in bipolar depression may improve mood, cognitive functioning and quality of life. PMID:24474993

  12. Longitudinal Associations of Depressive Symptoms and Pain with Quality of Life in Patients Receiving Chronic Hemodialysis

    PubMed Central

    Belayev, Linda Y.; Mor, Maria K.; Sevick, Mary Ann; Shields, Anne Marie; Rollman, Bruce L.; Palevsky, Paul M.; Arnold, Robert M.; Fine, Michael J.; Weisbord, Steven D.

    2014-01-01

    Background Depressive symptoms and pain are common in patients on chronic hemodialysis (HD), yet their associations with quality of life (QOL) are not fully understood. We sought to characterize the longitudinal associations of these symptoms with QOL. Methods As part of a trial comparing two symptom management strategies in patients receiving chronic HD, we assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), and pain using the Short-Form McGill Pain Questionnaire (SF-MPQ) monthly over 24 months. We assessed health-related QOL (HR-QOL) quarterly using the Short Form 12 (SF-12) and global QOL (G-QOL) using a single item survey. We used random effects linear regression to analyze the independent associations of depressive symptoms and pain, scaled based on 5 point increments in symptom scores, with HR-QOL and G-QOL. Results Overall, 286 patients completed 1,417 PHQ-9 and SF-MPQ symptom assessments, 1,361 SF-12 assessments, and 1,416 G-QOL assessments. Depressive symptoms were independently and inversely associated with SF-12 physical HR-QOL scores (β= -1.09; 95% CI: -1.69, -0.50, p<0.001); SF-12 mental HR-QOL scores (β= -4.52; 95%CI: -5.15, -3.89, p<0.001); and G-QOL scores (β= -0.64; 95%CI: -0.79, -0.49, p<0.001). Pain was independently and inversely associated with SF-12 physical HR-QOL scores (β= -0.99; 95% CI: -1.30, -0.68, p<0.001) and G-QOL scores (β= -0.12; 95%CI: -0.20, -0.05, p=0.002); but not with SF-12 mental HR-QOL scores (β= -0.16; 95%CI: -0.050, 0.17, p=0.34). Conclusion In patients receiving chronic HD, depressive symptoms and to a lesser extent pain, are independently associated with reduced HR-QOL and G-QOL. Interventions to alleviate these symptoms could potentially improve patients' HR-QOL and G-QOL. PMID:25403142

  13. Longitudinal associations of depressive symptoms and pain with quality of life in patients receiving chronic hemodialysis.

    PubMed

    Belayev, Linda Y; Mor, Maria K; Sevick, Mary Ann; Shields, Anne Marie; Rollman, Bruce L; Palevsky, Paul M; Arnold, Robert M; Fine, Michael J; Weisbord, Steven D

    2015-04-01

    Depressive symptoms and pain are common in patients on chronic hemodialysis (HD), yet their associations with quality of life (QOL) are not fully understood. We sought to characterize the longitudinal associations of these symptoms with QOL. As part of a trial comparing two symptom management strategies in patients receiving chronic HD, we assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), and pain using the Short Form McGill Pain Questionnaire (SF-MPQ) monthly over 24 months. We assessed health-related QOL (HR-QOL) quarterly using the Short Form 12 (SF-12) and global QOL (G-QOL) using a single-item survey. We used random effects linear regression to analyze the independent associations of depressive symptoms and pain, scaled based on 5-point increments in symptom scores, with HR-QOL and G-QOL. Overall, 286 patients completed 1417 PHQ-9 and SF-MPQ symptom assessments, 1361 SF-12 assessments, and 1416 G-QOL assessments. Depressive symptoms were independently and inversely associated with SF-12 physical HR-QOL scores (β = -1.09; 95% confidence interval [CI]: -1.69, -0.50, P < 0.001); SF-12 mental HR-QOL scores (β = -4.52; 95% CI: -5.15, -3.89, P < 0.001); and G-QOL scores (β = -0.64; 95%CI: -0.79, -0.49, P < 0.001). Pain was independently and inversely associated with SF-12 physical HR-QOL scores (β = -0.99; 95% CI: -1.30, -0.68, P < 0.001) and G-QOL scores (β = -0.12; 95%CI: -0.20, -0.05, P = 0.002); but not with SF-12 mental HR-QOL scores (β = -0.16; 95%CI: -0.050, 0.17, P = 0.34). In patients receiving chronic HD, depressive symptoms and to a lesser extent pain, are independently associated with reduced HR-QOL and G-QOL. Interventions to alleviate these symptoms could potentially improve patients' HR-QOL and G-QOL.

  14. Early-life stress and HPA axis trigger recurrent adulthood depression.

    PubMed

    Juruena, Mario F

    2014-09-01

    It is now broadly accepted that psychological stress may change the internal homeostatic state of an individual. During acute stress, adaptive physiological responses occur, which include hyperactivity of the HPA axis. Whenever there is an acute interruption of this balance, illness may result. The social and physical environments have an enormous impact on our physiology and behavior, and they influence the process of adaptation or 'allostasis'. It is correct to state that at the same time that our experiences change our brain and thoughts, namely, changing our mind, we are changing our neurobiology. Increased adrenocortical secretion of hormones, primarily cortisol in major depression, is one of the most consistent findings in neuropsychiatry. A significant percentage of patients with major depression have been shown to exhibit increased concentrations of cortisol, an exaggerated cortisol response to adrenocorticotropic hormone, and an enlargement of both the pituitary and adrenal glands. The maintenance of the internal homeostatic state of an individual is proposed to be based on the ability of circulating glucocorticoids to exert negative feedback on the secretion of hypothalamic-pituitary-adrenal (HPA) hormones through binding to mineralocorticoid (MR) and glucocorticoid (GR) receptors limiting the vulnerability to diseases related to psychological stress in genetically predisposed individuals. The HPA axis response to stress can be thought of as a mirror of the organism's response to stress: acute responses are generally adaptive, but excessive or prolonged responses can lead to deleterious effects. Evidence indicates that early-life stress can induce persistent changes in the ability of the HPA axis to respond to stress in adulthood. These abnormalities appear to be related to changes in the ability of hormones to bind to GR and MR receptors. First episodes may begin with an environmental stressor, but if the cycles continue or occur unchecked, the brain

  15. Trends in the Use of Assistive Technology and Personal Care for Late-Life Disability, 1992-2001

    ERIC Educational Resources Information Center

    Freedman, Vicki A.; Agree, Emily M.; Martin, Linda G.; Cornman, Jennifer C.

    2006-01-01

    We describe national trends during the 1990s in late-life difficulty and assistance with self-care activities. Among older Americans living in the community and experiencing difficulty with self-care activities, assistive-technology use increased substantially whereas use of personal care declined. Using a decomposition technique, we demonstrate…

  16. Influence of anxiety and depression on quality of life of people with schizophrenia in the eastern region of poland.

    PubMed

    Makara-Studzińska, Marta; Wołyniak, Małgorzata; Kryś, Karolina

    2012-01-01

    Schizophrenia is the most severe and most debilitating mental illness, which is one of the first ten causes of disability in youth and elderly people. Regarding many consequences that schizophrenia brings for individual and social functioning of ill people, their assessment of the quality of their lives seems to be interesting. The aim of this study is to evaluate the incidence and severity of anxiety and depression as well as analysis of the impact level of anxiety and depression on life quality of people with schizophrenia. A group of patients with schizophrenia from psychiatric centers was involved in a study. A set of methods, included: author's questionnaire, the quality of life scale WHOQOL-BREF, and the hospital anxiety and depression scale (HADS). Anxiety disorders occurred in more than 78% of respondents, while depressive disorders in more than half of respondents. The more severe anxiety and depressive disorders, the lower values were observed in all tested components of quality of life. The study of quality of life of the mentally ill patients should be conducted on a continuous basis in order to explore the current factors influencing the improvement of their psychophysical welfare. It is necessary to promote prohealthy mental lifestyle.

  17. Disrupted Interhemispheric Synchrony in Default Mode Network Underlying the Impairment of Cognitive Flexibility in Late-Onset Depression

    PubMed Central

    Hou, Zhenghua; Sui, Yuxiu; Song, Xiaopeng; Yuan, Yonggui

    2016-01-01

    The intuitive association between cognitive impairment and aberrant functional activity in the brain network has prompted interest in exploring the role of functional connectivity in late-onset depression (LOD). The relationship of altered voxel-mirrored homotopic connectivity (VMHC) and cognitive dysfunction in LOD is not yet well understood. This study was designed to examine the implicit relationship between the disruption of interhemispheric functional coordination and cognitive impairment in LOD. LOD patients (N = 31) and matched healthy controls (HCs; N = 37) underwent neuropsychological tests and functional magnetic resonance imaging (fMRI) in this study. The intergroup difference of interhemispheric coordination was determined by calculating VMHC value in the whole brain. The neuro-behavioral relevancy approach was applied to explore the association between disrupted VMHC and cognitive measures. Receiver operating characteristic (ROC) curve analysis was used to determine the capability of disrupted regional VMHC to distinguish LOD. Compared to the HC group, significantly attenuated VMHC in the superior frontal gyrus (SFG), superior temporal gyrus (STG), posterior cerebellar lobe (CePL) and post- and precentral gyri were observed in the bilateral brain of LOD patients. The interhemispheric asynchrony in bilateral CePLs was positively correlated with the performance of trail making test B (TMT-B) in LOD patients (r = 0.367, P = 0.040). ROC analysis revealed that regions with abnormal VMHC could efficiently distinguish LOD from HCs (Area Under Curve [AUC] = 0.90, P < 0.001). Altered linkage patterns of intrinsic homotopic connectivity and impaired cognitive flexibility was first investigated in LOD, and it would provide a novel clue for revealing the neural substrates underlying cognitive impairment in LOD. PMID:27729858

  18. Late-stage stretching and subsidence rates in the Danakil Depression, evidenced from borehole records and seismic reflection data

    NASA Astrophysics Data System (ADS)

    Booth, Adam; Bastow, Ian; Magee, Craig; Keir, Derek; Corti, Giacomo; Jackson, Chris; Wilkinson, Jason

    2016-04-01

    . This depth change corresponds to a plausible vertical subsidence rate of between 2-20 mma-1 and, assuming a 60° fault dip, a horizontal extension rate of 1-12 mma-1 during the deposition of the Houston Formation, consistent with recent geodetic constraints offered by Ar Rajehi et al. (2010). The borehole archive shows no evidence of significant magmatism anywhere in the survey area, and the characteristic reflectivity of igneous bodies is absent in the seismic data. Extension of this basin is, therefore, not obviously explained by dyke intrusion. We consider that the ˜500 m change in elevation of the Houston Formation is instead diagnostic of rapid stretching, possibly indicating a late period of non-magmatic extension in the transition to sea-floor spreading in the Danakil Depression.

  19. Late-stage stretching and subsidence rates in the Danakil Depression, evidenced from borehole records and seismic reflection data

    NASA Astrophysics Data System (ADS)

    Booth, Adam; Bastow, Ian; Magee, Craig; Keir, Derek; Corti, Giacomo; Jackson, Chris; Wilkinson, Jason

    2016-04-01

    . This depth change corresponds to a plausible vertical subsidence rate of between 2-20 mma‑1 and, assuming a 60° fault dip, a horizontal extension rate of 1-12 mma‑1 during the deposition of the Houston Formation, consistent with recent geodetic constraints offered by Ar Rajehi et al. (2010). The borehole archive shows no evidence of significant magmatism anywhere in the survey area, and the characteristic reflectivity of igneous bodies is absent in the seismic data. Extension of this basin is, therefore, not obviously explained by dyke intrusion. We consider that the ˜500 m change in elevation of the Houston Formation is instead diagnostic of rapid stretching, possibly indicating a late period of non-magmatic extension in the transition to sea-floor spreading in the Danakil Depression.

  20. Long-term effects of early-life environmental manipulations in rodents and primates: Potential animal models in depression research.

    PubMed

    Pryce, Christopher R; Rüedi-Bettschen, Daniela; Dettling, Andrea C; Weston, Anna; Russig, Holger; Ferger, Boris; Feldon, Joram

    2005-01-01

    Depression is one of the most common human illnesses and is of immense clinical and economic significance. Knowledge of the neuro-psychology, -biology and -pharmacology of depression is limited, as is the efficacy of antidepressant treatment. In terms of depression aetiology, whilst the evidence for causal mechanisms is sparse, some genomic and environmental factors associated with increased vulnerability have been identified. With regards to the latter, the environments in which human infants and children develop are fundamental to how they develop, and parental loss, emotional and physical neglect, and abuse have been shown to be associated with: traits of depression, traits of predisposition to depression triggered by subsequent life events, and associated physiological abnormalities, across the life span. Studies of postnatal environmental manipulations in rodents and primates can potentially yield evidence that abnormal early-life experience leading to dysfunction of the neurobiology, physiology and behaviour of emotion is a general mammalian characteristic, and therefore, that this approach can be used to develop animal models for depression research, with aetiological, face, construct and predictive validity. The establishment of models with such validity, if at all achievable, will require a sophisticated combination of (1) appropriate postnatal manipulations that induce acute stress responses in the infant brain which in turn lead to long-term neurobiological consequences, and (2) appropriate behavioural and physiological assays to identify and quantify any depression-like phenotypes resulting from these long-term neurobiological phenotypes. Here, we review some of the evidence-positive and negative-that neglect-like environments in rat pups and monkey infants lead to long-term, depression-like behavioural traits of reduced motivation for reward and impaired coping with adversity, and to altered activity in relevant physiological homeostatic systems. PMID

  1. Interactive Voice Response Version of the Late-Life Function and Disability Instrument

    PubMed Central

    Chang, Feng-Hang; Latham, Nancy K.; Friedman, Robert H.; Jette, Alan M.

    2015-01-01

    OBJECTIVES To develop an interactive voice response (IVR) version of the Late Life Function and Disability Instrument Computer Adaptive Test (LLFDI-CAT) and evaluate its reliability and acceptability among older adults. DESIGN The IVR system (IVRS) was embedded within the LLFDI-CAT program. To test the test-retest reliability and concordance of the IVR version of LLFDI-CAT with the telephone interviewer form (TIF), participants received the two versions of LLFDI-test at baseline, and at 1-week follow-up. SETTING Community PARTICIPANTS Community dwelling adults aged 65 and older (N=50) MEASUREMENTS The LLFDI is a patient-reported outcome (PRO) measure developed to assess function and disability in older adults. RESULTS The IVR administered version of the LLFDI-CAT showed acceptable overall test-retest reliability (ICC=0.79–0.80) and concordance with the TIF (ICC=0.74–0.97). Although most participants preferred the TIF, the majority did not find the IVR version more difficult to use. CONCLUSION The IVR version of LLFDI-CAT achieved reliability levels that were comparable with the TIF version. Future work is needed to improve the IVR design to better fit older adults’ needs and preferences. PMID:25900491

  2. Effects of a late-life suicide risk--assessment training on multidisciplinary healthcare providers.

    PubMed

    Huh, Joung T; Weaver, Christopher M; Martin, Jennifer L; Caskey, Nicholas H; O'Riley, Alisa; Kramer, Betty Josea

    2012-04-01

    Older adults are among the highest at risk for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental health care, but providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of healthcare providers who may see older adults in their care settings. One hundred thirty-two participants from two Veterans Affairs Medical Centers participated in a 6.5-hour-long workshop in the assessment and management of suicide risk in older adults. Participants were asked to complete pre- and postworkshop case notes and report on subjective changes in knowledge, attitudes, and confidence in assessment and managing suicide risk in older adults. Participants included social workers, nurses, physicians, psychologists, and occupational therapists from a variety of care settings, including outpatient and inpatient medical, outpatient and inpatient mental health, specialty clinics, home, and community. After the workshop, participants demonstrated improvement in the overall quality of case notes (P = .001), greater ability to recognize important conceptual suicide risk categories (P = .003), and reported heightened awareness of the importance of late-life suicide. The results suggest that educational training may have beneficial effect on the ability of multidisciplinary care providers to identify and manage suicide risk in elderly adults.

  3. Late life function and disability instrument in African American women: function component.

    PubMed

    Murrock, Carolyn J; Zauszniewski, Jaclene A

    2011-07-22

    Obesity, age, and comorbidity can lead to limitations in physical function, especially in middle aged, community-dwelling, African American women. To determine the clinical implications of limitations in physical function, instruments that assess physical function need to be tested in this population. The purpose of the authors in this secondary analysis was to report the internal consistency and validity of the Physical Function component of the Late Life Function and Disability Instrument in middle-aged, community-dwelling, African American women. In 2006, 126 community-dwelling African American women completed the Physical Function component, the Physical Activity Scale for the Elderly, and the 6 Minute Walk Test at baseline. Results indicated Cronbach's alphas were excellent (all >.92) for the Physical Function component and the three subscales. The Physical Function component correlated directly with the Physical Activity Scale for the Elderly (r = .37, p < .01) and the 6 Minute Walk Test (r = .36, p < .01) but was inversely correlated with age (r = -.42, p < .01) and comorbidity (r = -.35, p < .01). However, obesity was not correlated (r = -.11, p > .05). A three-factor structure of the Physical Function component was confirmed. Thus, the Physical Function component was a reliable and valid measure to screen African American women who were at risk for function limitations. Future recommendations are discussed.

  4. Study of Inter-relationship of Depression, Seizure Frequency and Quality of Life of People with Epilepsy in India

    PubMed Central

    Tyagi, Alok; Tripathi, Richa; Kumar, Mahesh

    2014-01-01

    Epilepsy is a chronic neurological disorder that can have profound physical, social and psychological consequences. We aimed to assess the clinical predictors of quality of life of people with epilepsy. We recruited 31 patients suffering from epilepsy in this cross-sectional study. Their clinical profile was recorded. Quality Of Life in Epilepsy (QOLIE-31) was used to assess quality of life of our patients. Depression was screened by Neurological Disorders Depression Inventory in Epilepsy (NDDI-E). Among all the clinical variables, only seizure frequency significantly correlated with seizure worry (P=0.002), emotional well-being (P=0.026) and social functions (P=0.013) subscales of QOLIE-31. NDDIE score showed a significant negative correlation with all the subscales of QOLIE-31 except medication effects (P=0.993). A significant positive correlation was also noted between seizure frequency and NDDI-E score (r=0.417, P=0.020). Seizure frequency and depression are the most important predictors of quality of life in epilepsy patients. The management of patients with epilepsy should not only be aimed at just preventing seizures but the treating clinicians should also be cognizant about depression which itself can significantly affect the quality of life of patients. PMID:25478138

  5. A naturalistic observation study of the links between parental depressive symptoms and preschoolers' behaviors in everyday life.

    PubMed

    Slatcher, Richard B; Trentacosta, Christopher J

    2011-06-01

    Previous research has shown that parental depressive symptoms are linked to a number of negative child outcomes. However, the associations between parental depressive symptoms and actual child behaviors in everyday life remain largely unknown. The aims of this study were to investigate the links between parental depressive symptoms and everyday child behaviors and emotional language use using a novel observational methodology, and to explore the potential moderating role of parent-child conflict. We tracked the behaviors and language use of 35 preschool-aged children for two 1-day periods separated by one year using a child version of the Electronically Activated Recorder, a digital voice recorder that records ambient sounds while participants go about their daily lives. Parental depressive symptoms were positively associated with multiple problem behaviors among children (i.e., crying, acting mad, watching TV) when measured both concurrently and prospectively, and with negative emotion word use prospectively. Further, the links between parental depressive symptoms and child crying were moderated by parents' perceptions of parent-child conflict. This study offers the first empirical evidence of direct links between parental depressive symptoms and child behaviors in daily life and presents a promising research tool for the study of everyday child behaviors.

  6. Mediating effects of social support on depression and quality of life among patients with HIV infection in Taiwan.

    PubMed

    Hou, Wen-Li; Chen, Chia-En; Liu, Hsiao-Ying; Lai, Yi-Yin; Lee, Hsin-Chun; Lee, Nan-Yao; Chang, Chia-Ming; Chen, Po-Lin; Ko, Wen-Chien; Shu, Bih-Ching; Ko, Nai-Ying

    2014-01-01

    Few empirical studies have evaluated the mediating effects of quality of life (QoL) among people living with HIV/AIDS (PLWHA). The purposes of this study were to identify the predictors of QoL and to test the mediating effects of social support on depression and QoL among patients enrolled in an HIV case-management program in Taiwan. A cross-sectional, descriptive correlation design collected data from 108 HIV-infected individuals. Individuals were assessed using the Beck Depression Inventory II, the short version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF), and the Multidimensional Scale of Perceived Social Support between September 2007 and April 2010. After adjusting for sociodemographic characteristics (including age, gender, and mode of transmission) and clinical information (including CD4 count and time since diagnosis with HIV), the study findings showed that QoL was significantly and positively correlated with both social support and the initiation of highly active antiretroviral therapy (HAART), and was negatively correlated with depression and time since diagnosis with HIV. The strongest predictors for QoL were depression followed by the initiation of HAART and social support, with an R(2) of 0.40. Social support partially mediated the relationship between depression and QoL. Health professionals should enhance HIV-infected individuals' social support to alleviate the level of depression and further increase the QoL among PLWHA.

  7. Anxiety and Depression Are Better Correlates of Parkinson's Disease Quality of Life Than Apathy.

    PubMed

    Jones, Jacob D; Butterfield, London C; Song, Woojin; Lafo, Jacob; Mangal, Paul; Okun, Michael S; Bowers, Dawn

    2015-01-01

    Due to controversy regarding the influence of apathy on quality of life (QoL), the authors examined the independent influence of apathy, depression, and trait anxiety in a nondemented sample of patients with Parkinson disease (PD). Participants (N=107) completed standard self-report measures of QoL and mood/motivation. Analyses investigated the contribution of these measures and empirically derived factor scores on QoL. QoL was predicted by trait anxiety, dysphoria, and decreased interest, with no independent contribution of apathy. Different patterns emerged with respect to domain-specific QoL, with trait anxiety being the strongest predictor across most domains. Anxiety was most widely related to QoL in PD, with minimal contribution of apathy. Future studies should examine different roles of PD mood/motivation symptoms on caregiver QoL.

  8. The effects of early-life predator stress on anxiety- and depression-like behaviors of adult rats.

    PubMed

    Chen, Lu-jing; Shen, Bing-qing; Liu, Dan-dan; Li, Sheng-tian

    2014-01-01

    Childhood emotional trauma contributes significantly to certain psychopathologies, such as post-traumatic stress disorder. In experimental animals, however, whether or not early-life stress results in behavioral abnormalities in adult animals still remains controversial. Here, we investigated both short-term and long-term changes of anxiety- and depression-like behaviors of Wistar rats after being exposed to chronic feral cat stress in juvenile ages. The 2-week predator stress decreased spontaneous activities immediately following stress but did not increase depression- or anxiety-like behaviors 4 weeks after the stimulation in adulthood. Instead, juvenile predator stress had some protective effects, though not very obvious, in adulthood. We also exposed genetic depression model rats, Wistar Kyoto (WKY) rats, to the same predator stress. In WKY rats, the same early-life predator stress did not enhance anxiety- or depression-like behaviors in both the short-term and long-term. However, the stressed WKY rats showed slightly reduced depression-like behaviors in adulthood. These results indicate that in both normal Wistar rats and WKY rats, early-life predator stress led to protective, rather than negative, effects in adulthood. PMID:24839560

  9. Cerebrospinal fluid corticotropin-releasing factor and perceived early-life stress in depressed patients and healthy control subjects.

    PubMed

    Carpenter, Linda L; Tyrka, Audrey R; McDougle, Christopher J; Malison, Robert T; Owens, Michael J; Nemeroff, Charles B; Price, Lawrence H

    2004-04-01

    Previous studies have reported elevated concentrations of cerebrospinal fluid (CSF) corticotropin-releasing factor (CRF) in patients with major depression. Elevations of CSF CRF have also been reported in adult laboratory animals exposed to the stress of brief maternal deprivation or maternal neglect in the neonatal or preweaning period. The present study was designed to determine whether major depression and a history of perceived early adversity in childhood are independently associated with elevated CSF CRF concentrations in adults. In this case-control study, 27 medication-free adults with major depression and 25 matched controls underwent standardized lumbar puncture for collection of a single CSF sample at 1200. Subjects provided data about significant adverse early-life experiences and rated their global perceived level of stress during pre-school and preteen years on a six-point Likert scale. The mean difference in CSF CRF between depressed patients and controls did not reach statistical significance. In a regression model, perceived early-life stress was a significant predictor of CSF CRF, but depression was not. Perinatal adversity and perceived adversity in the preteen adversity years (ages 6-13 years) were both independently associated with decreasing CSF CRF concentrations. The relationship observed between perceived early-life stress and adult CSF CRF concentrations in this study closely parallels recent preclinical findings. More work is needed to elucidate the critical nature and timing of early events that may be associated with enduring neuroendocrine changes in humans. PMID:14702025

  10. Early life social stress induced changes in depression and anxiety associated neural pathways which are correlated with impaired maternal care

    PubMed Central

    Murgatroyd, Christopher A.; Peña, Catherine J.; Podda, Giovanni; Nestler, Eric J.; Nephew, Benjamin C.

    2015-01-01

    Exposures to various types of early life stress can be robust predictors of the development of psychiatric disorders, including depression and anxiety. The objective of the current study was to investigate the roles of the translationally relevant targets of central vasopressin, oxytocin, ghrelin, orexin, glucocorticoid, and the brain-derived neurotrophic factor (BDNF) pathway in an early chronic social stress (ECSS )based rodent model of postpartum depression and anxiety. The present study reports novel changes in gene expression and extracellular signal related kinase (ERK) protein levels in the brains of ECSS exposed rat dams that display previously reported depressed maternal care and increased maternal anxiety. Decreases in oxytocin, orexin, and ERK proteins, increases in ghrelin receptor, glucocorticoid and mineralocorticoid receptor mRNA levels, and bidirectional changes in vasopressin underscore related work on the adverse long-term effects of early life stress on neural activity and plasticity, maternal behavior, responses to stress, and depression and anxiety-related behavior. The differences in gene and protein expression and robust correlations between expression and maternal care and anxiety support increased focus on these targets in animal and clinical studies of the adverse effects of early life stress, especially those focusing on depression and anxiety in mothers and the transgenerational effects of these disorders on offspring. PMID:26049556

  11. Prevention of depression and anxiety in later life: design of a randomized controlled trial for the clinical and economic evaluation of a life-review intervention

    PubMed Central

    Korte, Jojanneke; Bohlmeijer, Ernst T; Smit, Filip

    2009-01-01

    Background Depressive and anxiety symptoms in older adults could develop into significant health problems with detrimental effects on quality of life and a possibly poor prognosis. Therefore, there is a need for preventive interventions which are at once effective, acceptable and economic affordable. Methods and design This paper describes the design of a study evaluating "The stories we live by", a preventive life-review group intervention, which was recently developed for adults of 55 years and over with depressive and anxiety symptoms. Both clinical and economic effectiveness will be evaluated in a pragmatic randomized controlled trial. The participants in the intervention condition will receive the 8-session preventive intervention. The participants in the control condition will have access to usual care. Clinical end-terms are depressive and anxiety symptoms, current major depressive episode, quality of life and positive mental health post-treatment (3 months after baseline) and at follow-ups (6 and 12 months after baseline). Additional goals of this study are to identify groups for whom the intervention is particularly effective and to identify the therapeutic pathways that are vital in inducing clinical change. This will be done by analyzing if treatment response is moderated by demographics, personality, past major depressive episodes, important life events and chronically disease, and mediated by reminiscence functions, perceived control, automatic positive thoughts and meaning in life. Finally the cost-effectiveness of the intervention relative to care as usual will be assessed by computing incremental costs per case of depression and anxiety avoided (cost-effectiveness) and per quality adjusted life year (QALY) (cost utility). Discussion It is expected that both the life-review intervention and its evaluation will contribute to the existing body of knowledge in several ways. First, the intervention is unique in linking life-review with narrative therapy

  12. Health Outcomes in Acromegaly: Depression and Anxiety are Promising Targets for Improving Reduced Quality of Life

    PubMed Central

    Geraedts, Victor Jacobus; Dimopoulou, Christina; Auer, Matthias; Schopohl, Jochen; Stalla, Günter Karl; Sievers, Caroline

    2015-01-01

    Introduction: Remission criteria of acromegaly are based on biochemical variables, i.e., normalization of increased hormone levels. However, the established reduction in Quality of Life (QoL) is suggested to be independent of biochemical control. The aim of this study was to test which aspects predict QoL best in acromegaly. Methods/design: This is a prospective cohort study in 80 acromegalic patients, with a cross-sectional and longitudinal part. The main outcome measure was health-related QoL, measured by a generic and a disease-specific questionnaire (the SF-36 and AcroQoL). Main predictors were age, gender, biochemical control, disease characteristics, treatment modalities, and psychopathology. Results: Our cohort of 80 acromegalics had a mean age 54.7 ± 12.3 years with an average disease duration of 10.8 ± 10.0 years. Ratio macro-/microadenoma was 54/26. In adjusted mixed method models, we found that psychopathology significantly predicts QoL in acromegaly (in models including the variables age, gender, disease duration, tumor size, basal hormone levels, relevant treatment modalities, and relevant comorbidities), with a higher degree of psychopathology indicating a lower QoL (depression vs. AcroQoL: B = −1.175, p < 0.001, depression vs. SF-36: B = −1.648, p < 0.001, anxiety vs. AcroQoL: B = −0.399, p < 0.001, anxiety vs. SF-36: B = −0.661, p < 0.001). The explained variances demonstrate superiority of psychopathology over biochemical control and other variables in predicting QoL in our models. Discussion: Superiority of psychopathology over biochemical control calls for a more extensive approach regarding diagnosing depression and anxiety in pituitary adenomas to improve QoL. Depressive symptoms and anxiety are modifiable factors that might provide valuable targets for possible future treatment interventions. PMID:25610427

  13. Quality of life, depression, anxiety and suicidal ideation among men who inject drugs in Delhi, India

    PubMed Central

    2013-01-01

    Background Mental disorders such as depression, anxiety and suicide represent an important public health problem in India. Elsewhere in the world a high prevalence of symptoms of common mental disorders have been found among people who inject drugs (PWID). Research in India has largely overlooked symptoms of common mental disorders among this high risk group. This paper reports on the results of a survey examining quality of life, depression, anxiety and suicidal ideation among adult males who inject drugs living in Delhi. Methods Participants (n = 420) were recruited from needle and syringe programs using time location sampling and were interviewed using an interviewer-administered questionnaire. Self-report symptom scales were used to measure the severity of symptoms of depression (PHQ-9) and anxiety (GAD-2) within the preceding 2 weeks. We assessed the presence of suicidal thoughts and attempts within the past 12 months. Results The mean length of injecting career was 20.9 years indicating a sample of chronic injecting drug users, of whom only one-third (38%) were born in Delhi. The level of illiteracy was very high (62%), and just 2% had completed class 12. Scavenging / rag picking was the main form of income for 48%, and many were homeless (69%). One-third (33%) had been beaten up at least twice during the preceding 6 months, and many either never (45%) or rarely (27%) attended family events. We found a high prevalence of depressive (84%, cut-off ≥10) and anxiety (71%, cut-off score of ≥3) symptoms. Fifty-three percent thought about killing themselves in the past 12 months, and 36% had attempted to kill themselves. Conclusions Our findings revealed a socially excluded population of PWID in Delhi who have minimal education and are often homeless, leaving them vulnerable to physical violence, poverty, poor health, imprisonment and disconnection from family. The high prevalence of psychological distress found in this study has implications for

  14. Effect of common neuropathologies on progression of late life cognitive impairment.

    PubMed

    Yu, Lei; Boyle, Patricia A; Leurgans, Sue; Schneider, Julie A; Kryscio, Richard J; Wilson, Robert S; Bennett, David A

    2015-07-01

    Brain pathologies of Alzheimer's (AD), cerebrovascular, and Lewy body diseases are common in old age, but the relationship of these pathologies with progression from normal cognitive function to the various stages of cognitive impairment is unknown. In this study, we fit latent Markov models from longitudinal cognitive data to empirically derive 3 latent stages corresponding to no impairment, mild impairment, and moderate impairment; then, we examined the associations of common neuropathologies with the rates of transition among these stages. Cognitive and neuropathological data were available from 653 autopsied participants in 2 ongoing cohort studies of aging who were cognitively healthy at baseline (mean baseline age 79.1 years) and had longitudinal cognitive data. On average, participants in these analyses developed mild impairment 5 years after enrollment, progressed to moderate impairment after an additional 3.4 years, and stayed impaired for 2.8 years until death. AD and chronic macroscopic infarcts were associated with a higher risk of progression to mild impairment and subsequently to moderate impairment. By contrast, Lewy bodies were associated only with progression from mild to moderate impairment. The 5-year probability of progression to mild or moderate impairment was 20% for persons without any of these 3 pathologies, 38% for AD only, 51% for AD and macroscopic infarcts, and 56% for AD, infarcts, and Lewy bodies. Thus, the presence of AD pathology alone nearly doubles the risk of developing cognitive impairment in late life, and the presence of multiple pathologies further increases this risk over multiple years before death. PMID:25976345

  15. The Association between Life Satisfaction and the Extent of Depression, Anxiety and Stress among Iranian Nurses: A Multicenter Survey

    PubMed Central

    Yazdanshenas Ghazwin, Manijeh; Kavian, Mohammad; Ahmadloo, Mohsen; Jarchi, Alemeh; Golchin Javadi, Shaghayegh; Latifi, Sahar; Ghajarzadeh, Mahsa

    2016-01-01

    Objective: The determinants of satisfaction of life (SWL) are poorly described among Iranian employed nurses. This study aimed to assess the effect of various factors including age, gender, marital status, depression, anxiety and stress on SWL among Iranian nurses. Method: Employed nurses in three teaching hospitals were invited to participate in this study. Ninety-four nurses (65 women and 29 men) participated in this study. Depression, anxiety, stress scale (DASS-21) was used to measure the related variables. Satisfaction with Life Scale (SWLS) was used to assess SWL. Multivariate analysis was utilized to examine the relationship between multiple variables. Results: A noticeable proportion of Iranian employed nurses were either dissatisfied or extremely dissatisfied with life (45%). Severe depression was related to lower scores of SWLS (P: 0.001, r = −0.32). The similar outcomes were detected between anxiety and stress scales, and SWLS (P: 0.023, r = −0.23 and P: 0.008, r = −0.27 for anxiety and stress, respectively). Although females were more vulnerable to depression (P: 0.010) and stress (P: 0.013), the overall effect of gender on SWL was insignificant (0.41). Satisfactions with financial power and work environment were associated with higher scores of SWLS (P: 0.030 and 0.042, respectively). Marital status was not related to severity of depression, anxiety, stress and SWLS (P: 0.39, 0.38, 0.80, and 0.61, respectively). Conclusion: This study revealed that poor satisfaction with financial status and work environment, depression, anxiety and stress are the major determinants of satisfaction with life among Iranian employed nurses. PMID:27437009

  16. Family Antecedents and Consequences of Trajectories of Depressive Symptoms from Adolescence to Young Adulthood: A Life Course Investigation

    ERIC Educational Resources Information Center

    Wickrama, K. A. S.; Conger, Rand D.; Lorenz, Frederick O.; Jung, Tony

    2008-01-01

    Using prospective data from 485 adolescents over a 10-year period, the present study identifies distinct segments of depressive symptom trajectories--a nonsignificant slope during adolescence and a significant negative slope during the transition to adulthood. The study hypothesized that different age-graded life experiences would differentially…

  17. The Moderating Effect of Impulsivity on the Relationship between Stressful Life Events and Depression among College Women

    ERIC Educational Resources Information Center

    Clarke, Dave

    2012-01-01

    Based on the transpersonal model of stress, the purpose of the study was to investigate the moderating effect of impulsivity on the relationship between stressful life events (SLE) and depression among first year university women. Impulsivity consists of tendencies towards lack of premeditation, lack of perseverance, urgency and sensation seeking.…

  18. The Relation of Parental Attitudes to Life Satisfaction and Depression in Early Adolescents: The Mediating Role of Self-Esteem

    ERIC Educational Resources Information Center

    Acun-Kapikiran, Necla; Körükçü, Özlem; Kapikiran, Sahin

    2014-01-01

    The purpose of this study is to determine whether self-esteem in adolescence has a mediator role in the relationship between parental attitude and life satisfaction and depression. Data was collected from 360 secondary school students ages ranging from 11 to 14 (M = 12.67, SD= 0.97) out of which 216 of them were female and 144 male. The…

  19. A Comparison of Levels of Quality of Life, Depression and Loneliness among Athletes with Different Levels of Training

    ERIC Educational Resources Information Center

    Unver, Saban; Atan, Tulin; Cavusoglu, Gul; Erim, Vedat; Yamak, Bade

    2015-01-01

    The purpose of this study is to compare the levels of life quality, depression and loneliness among the students of the Faculty of Sports Sciences (FSS), national wrestlers and non national wrestlers in terms of some demographic variables. The participants of the study included 37 students from the Faculty of Sports Sciences of Ondokuz Mayis…

  20. Differences in Affect, Life Satisfaction, and Depression between Successfully and Unsuccessfully Rehabilitated Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Chapin, Martha H.; Holbert, Donald

    2009-01-01

    This study assessed whether persons with spinal cord injuries who were successfully rehabilitated differed from those who were not with regard to positive and negative affect, life satisfaction, and depression. An ex post facto research design compared persons with spinal cord injuries who were previously employed with persons with spinal cord…

  1. Moderator Role of Self-Esteem on the Relationship between Life Satisfaction and Depression in Early Adolescents

    ERIC Educational Resources Information Center

    Civitci, Asim

    2010-01-01

    In this study, the moderator effects of global self-esteem on the relationship between life satisfaction domains (family, friends and school) and depression in early adolescents were examined. The participants consisted of 255 students, aged from 11 to 15 years, from three junior high schools in Turkey. Data were collected using the Rosenberg…

  2. Latent Growth-Curve Analysis Reveals That Worsening Parkinson’s Disease Quality of Life Is Driven by Depression

    PubMed Central

    Jones, Jacob D.; Marsiske, Michael; Okun, Michael S.; Bowers, Dawn

    2016-01-01

    Objective Parkinson’s disease (PD) is a neurodegenerative disorder resulting in a wide variety of symptoms. The current study examined the influence of apathy, depression and motor symptoms on quality of life (QoL) in PD patients. Information was drawn from an 18-month period. Method Participants (N = 397) were assessed for apathy (Apathy Scale; Starkstein et al., 1992), depression (Beck Depression Inventory-II; Beck, Steer, Ball & Ranieri, 1996), motor severity (Unified Parkinson’s Disease Rating Scale, Part III; UPDRS; Fahn, Elton & Committee, 1987), and QoL (Parkinson’s Disease Questionnaire-39; Jenkinson, Fitzpatrick, Peto, Greenhall, & Hyman,1997) at 3 time points: an initial clinical evaluation (baseline), a 6-month follow-up, and an 18-month follow-up. Latent growth-curve models were used to determine the influence of apathy, depression, and motor symptoms on QoL trajectories. Results Greater difficulties with QoL at baseline showed the strongest relationship to more severe depression symptoms, followed by more severe motor symptoms, younger age, and less education (all p values < .001). Worsening of QoL over the 18-month period was only predicted by a worsening of depression (p = .003). The relationship between QoL and depression symptoms remained significant in a subsample of nondepressed PD patients. Conclusion Overall, findings from the current study suggest that self-reported QoL among PD patients is primarily related to depression. Future efforts to improving clinical care of PD patients may benefit by focusing on improving psychosocial adjustment or treatments targeting depression. PMID:25365564

  3. A Home-Based Intervention to Reduce Depressive Symptoms and Improve Quality of Life in Older African Americans

    PubMed Central

    Gitlin, Laura N.; Harris, Lynn Fields; McCoy, Megan C.; Chernett, Nancy L.; Pizzi, Laura T.; Jutkowitz, Eric; Hess, Edward; Hauck, Walter W.

    2014-01-01

    Background Effective care models for treating older African Americans with depressive symptoms are needed. Objective To determine whether a home-based intervention alleviates depressive symptoms and improves quality of life in older African Americans. Design Parallel, randomized trial stratified by recruitment site. Interviewers assessing outcomes were blinded to treatment assignment. (ClinicalTrials.gov: NCT00511680) Setting A senior center and participants’ homes from 2008 to 2010. Patients African Americans aged 55 years or older with depressive symptoms. Intervention A multicomponent, home-based intervention delivered by social workers or a wait-list control group that received the intervention at 4 months. Measurements Self-reported depression severity at 4 months (primary outcome) and depression knowledge, quality of life, behavioral activation, anxiety, function, and remission at 4 and 8 months. Results Of 208 participants (106 and 102 in the intervention and wait-list groups, respectively), 182 (89 and 93, respectively) completed 4 months and 160 (79 and 81, respectively) completed 8 months. At 4 months, participants in the intervention group showed reduced depression severity (difference in mean change in Patient Health Questionnaire-9 score from baseline, −2.9 [95% CI, −4.6 to −1.2]; difference in mean change in Center for Epidemiologic Studies Depression Scale score from baseline, −3.7 [CI, −5.4 to −2.1]); improved depression knowledge, quality of life, behavioral activation, and anxiety (P < 0.001); and improved function (P = 0.014) compared with wait-list participants. More intervention than wait-list participants entered remission at 4 months (43.8% vs. 26.9%). After treatment, control participants showed benefits similar in magnitude to those of participants in the initial intervention group. Those in the initial intervention group maintained benefits at 8 months. Limitation The study had a small sample, short duration, and differential

  4. Nuclear attitudes and reactions: associations with depression, drug use, and quality of life

    SciTech Connect

    Newcomb, M.D.

    1986-05-01

    For 40 years the world has lived with the threat of nuclear war and, recently, with the possibility of nuclear power plant accidents. Although virtually every generation must confront various national or international crises, the threat of nuclear war is unprecedented in its destructive potential. This study is an attempt to assess attitudes and amount of distress associated with the ever-present threat of nuclear war and the possibility of accidents at nuclear power plants. The Nuclear Attitudes Questionnaire (NAQ) consists of 15 items and was administered to 722 young adults who have grown up in the nuclear age. The items were found to reflect four latent factors of nuclear concern, nuclear support, fear of the future, and nuclear denial, all of which in turn represent a second-order construct of nuclear anxiety. Women reported significantly more nuclear concern, less nuclear support, more fear of the future, and less nuclear denial than did men. In latent-variable models, nuclear anxiety was found to be significantly associated with less purpose in life, less life satisfaction, more powerlessness, more depression, and more drug use. It is concluded that the threat of nuclear war and accidents is significantly related to psychological distress and may disturb normal maturational development.

  5. Looking Inward: Introspectiveness, Physical Disability, and Depression across the Life Course.

    ERIC Educational Resources Information Center

    Van Gundy, Karen; Schieman, Scott

    2001-01-01

    This study investigates interrelationships among age, physical disability, introspectiveness, and depression. Results show that older people report less introspectiveness than do younger people. Disabled respondents experience a more positive relationship between introspectiveness and depression; however, disabled respondents' poorer global health…

  6. Depression over the adult life course for African American men: toward a framework for research and practice.

    PubMed

    Watkins, Daphne C

    2012-05-01

    Rarely are within-group differences among African American men explored in the context of mental health and well-being. Though current conceptual and empirical studies on depression among African American men exists, these studies do not offer a framework that considers how this disorder manifests over the adult life course for African American men. The purpose of this article is to examine the use of an adult life course perspective in understanding the complexity of depression for African American men. The proposed framework underscores six social determinants of depression (socioeconomic status, stressors, racial and masculine identity, kinship and social support, self-esteem and mastery, and access to quality health care) to initiate dialogue about the risk and protective factors that initiate, prolong, and exacerbate depression for African American men. The framework presented here is meant to stimulate discussion about the social determinants that influence depression for African American men to and through adulthood. Implications for the utility and applicability of the framework for researchers and health professionals who work with African American men are discussed.

  7. Patient-Centered Dialysis Care: Depression, Pain, and Quality of Life.

    PubMed

    Weisbord, Steven D

    2016-01-01

    Remarkable advancements have been made in the provision of chronic dialysis therapy since its inception decades ago. A series of studies inform current dialysis dosing recommendations, while advancements in strategies to treat mineral and bone disease, acid-base and electrolyte disturbances, and anemia have facilitated the management of these well-recognized complications of ESRD. The collective result has been a model of chronic dialysis care focused principally on the achievement of metabolic and dialysis-related targets. In fact, guidelines such as the Kidney Disease Outcomes Quality Initiative put forth by the National Kidney Foundation recommend metrics that characterize successful dialysis care, including the attainment of specific solute clearance targets; maintenance of hemoglobin, calcium, phosphorous, and parathyroid hormone levels within target ranges; and the preferred use of primary arteriovenous fistulae for vascular access. This focus on serologic and dialysis-specific outcomes has helped renal providers manage the biochemical effects related to the loss of kidney function and has reduced ESRD-related morbidity and mortality. Yet, absent from this model of care is an emphasis on the treatment of bothersome symptoms and the impact of such treatment on quality of life (QOL). Among the many symptoms that affect patients on chronic dialysis, depression and pain are particularly common, strongly associated with decrements in QOL, and potentially treatable. This review discusses key research findings and unanswered questions pertaining to the prevalence, significance, and treatment of depression and pain and the effect of such treatment on QOL in patients dependent on chronic dialysis, with the broad goal of incorporating symptom management strategies into a paradigm of patient-centered dialysis care.

  8. Association between Maternal Depression Symptoms across the First Eleven Years of Their Child's Life and Subsequent Offspring Suicidal Ideation.

    PubMed

    Hammerton, Gemma; Mahedy, Liam; Mars, Becky; Harold, Gordon T; Thapar, Anita; Zammit, Stanley; Collishaw, Stephan

    2015-01-01

    Depression is common, especially in women of child-bearing age; prevalence estimates for this group range from 8% to 12%, and there is robust evidence that maternal depression is associated with mental health problems in offspring. Suicidal behaviour is a growing concern amongst young people and those exposed to maternal depression are likely to be especially at high risk. The aim of this study was to utilise a large, prospective population cohort to examine the relationship between depression symptom trajectories in mothers over the first eleven years of their child's life and subsequent adolescent suicidal ideation. An additional aim was to test if associations were explained by maternal suicide attempt and offspring depressive disorder. Data were utilised from a population-based birth cohort: the Avon Longitudinal Study of Parents and Children. Maternal depression symptoms were assessed repeatedly from pregnancy to child age 11 years. Offspring suicidal ideation was assessed at age 16 years. Using multiple imputation, data for 10,559 families were analysed. Using latent class growth analysis, five distinct classes of maternal depression symptoms were identified (minimal, mild, increasing, sub-threshold, chronic-severe). The prevalence of past-year suicidal ideation at age 16 years was 15% (95% CI: 14-17%). Compared to offspring of mothers with minimal symptoms, the greatest risk of suicidal ideation was found for offspring of mothers with chronic-severe symptoms [OR 3.04 (95% CI 2.19, 4.21)], with evidence for smaller increases in risk of suicidal ideation in offspring of mothers with sub-threshold, increasing and mild symptoms. These associations were not fully accounted for by maternal suicide attempt or offspring depression diagnosis. Twenty-six percent of non-depressed offspring of mothers with chronic-severe depression symptoms reported suicidal ideation. Risk for suicidal ideation should be considered in young people whose mothers have a history of

  9. Volunteering and Depression in Later Life: Social Benefit or Selection Processes?

    ERIC Educational Resources Information Center

    Li, Yunqing; Ferraro, Kenneth F.

    2005-01-01

    Does volunteer participation reduce depressive symptoms among older people? Does depression influence whether older people will volunteer? Might nonrandom attrition in a longitudinal study bias the relationship between volunteering and depression? This research addresses these questions with three-wave data from the Americans' Changing Lives…

  10. Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adults.

    PubMed

    Salguero, Alfonso; Martínez-García, Raquel; Molinero, Olga; Márquez, Sara

    2011-01-01

    This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults.

  11. Changes in quality of life following group CBT for anxiety and depression in a psychiatric outpatient clinic.

    PubMed

    Oei, Tian Po; McAlinden, Niamh May

    2014-12-30

    The present study examined the relationship between quality of life and symptom change following group CBT treatment for anxiety or depression in a psychiatric hospital outpatient setting. One hundred seventy seven outpatients undergoing eight sessions of group CBT for anxiety (n=124) or mood disorders (n=53) participated. The Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (Zung-SRDS), Quality of Life Inventory (QOLI), and Satisfaction with Life Scale (SWLS) were administered at baseline and post-treatment. Additionally, the QOLI and SWLS scores of those who achieved reliable improvement or clinically significant symptom change were compared to those who experienced no reliable symptom improvement. There were significant changes across the QOLI, SWLS, BAI and Zung-SRDS outcome measures between baseline and post-treatment, with moderate to very large effect sizes observed. Patients with reliable or clinically significant change in their symptoms experienced significant increases in QOLI and SWLS scores when compared to those whose symptoms did not change reliably. Overall, in a psychiatric hospital outpatient setting, group CBT appeared to be successful in increasing quality of life and satisfaction with life in addition to reducing anxiety and depression symptoms.

  12. Melatonin treatment during early life interacts with restraint to alter neuronal morphology and provoke depressive-like responses

    PubMed Central

    Aubrecht, Taryn G.; Weil, Zachary M.; Nelson, Randy J.

    2014-01-01

    Stressors during early life induce anxiety- and depressive-like responses in adult rodents. Siberian hamsters (Phodopus sungorus) exposed to short days post-weaning also increase adult anxiety- and depressive-like behaviors. To test the hypothesis that melatonin and exposure to stressors early in life interact to alter adult affective responses, we administered melatonin either during the perinatal (gestational day 7 to postnatal day 14) or postnatal (day 15–56) periods and also exposed a subset of dams to restraint during gestation (1 h–2×/day for 4 days). During the final week of injections, depressive-like behaviors were assessed using the sucrose anhedonia and forced swim tests. Hamsters exposed to prenatal restraint and treated with melatonin only during the postnatal period increased depressive-like responses in the forced swim test relative to all other groups. Offspring from restrained dams increased the number of fecal boli produced during the forced swim test, an anxiety-like response. In the present study, prenatal restraint reduced CA1 dendritic branching overall and perinatal melatonin protected hamsters from this restraint-induced reduction. These results suggest that the photoperiodic conditions coincident with birth and early life stressors are important in the development of adult affective responses. PMID:24486255

  13. Melatonin treatment during early life interacts with restraint to alter neuronal morphology and provoke depressive-like responses.

    PubMed

    Aubrecht, Taryn G; Weil, Zachary M; Nelson, Randy J

    2014-04-15

    Stressors during early life induce anxiety- and depressive-like responses in adult rodents. Siberian hamsters (Phodopus sungorus) exposed to short days post-weaning also increase adult anxiety- and depressive-like behaviors. To test the hypothesis that melatonin and exposure to stressors early in life interact to alter adult affective responses, we administered melatonin either during the perinatal (gestational day 7 to postnatal day 14) or postnatal (day 15-56) periods and also exposed a subset of dams to restraint during gestation (1 h-2×/day for 4 days). During the final week of injections, depressive-like behaviors were assessed using the sucrose anhedonia and forced swim tests. Hamsters exposed to prenatal restraint and treated with melatonin only during the postnatal period increased depressive-like responses in the forced swim test relative to all other groups. Offspring from restrained dams increased the number of fecal boli produced during the forced swim test, an anxiety-like response. In the present study, prenatal restraint reduced CA1 dendritic branching overall and perinatal melatonin protected hamsters from this restraint-induced reduction. These results suggest that the photoperiodic conditions coincident with birth and early life stressors are important in the development of adult affective responses. PMID:24486255

  14. Peer-related loneliness across early to late adolescence: normative trends, intra-individual trajectories, and links with depressive symptoms.

    PubMed

    Ladd, Gary W; Ettekal, Idean

    2013-12-01

    Study aims were to: (a) describe normative levels and person-oriented developmental trends in loneliness across adolescence, and (2) examine the association between loneliness and depressive symptoms during this same epoch. Participants included 478 youth (239 males and females; 80% Caucasian, 16% African American, and 4% other). Measures of loneliness and multiple indicators of depressive symptoms were gathered yearly across grades 6 through 12 (ages 12-18). Findings implied that most adolescents experience loneliness more strongly during early rather than later adolescence, but not all adolescents traverse the same loneliness trajectories. Youth followed one of five distinct trajectories, characterized as: (a) stable non-lonely, (b) stable low lonely, (c) stable high (chronic) lonely, (d) moderate decliners, and (e) steep decliners. Adolescents following stable high and moderate loneliness trajectories displayed the most depressive symptoms and, although informant differences were found, these youth also manifest the largest gains in depressive symptoms over time.

  15. Effect of group cognitive-behavioral therapy on the quality of life and social functioning of patients with mild depression

    PubMed Central

    ZHANG, Boyuan; DING, Xuefan; LU, Weihong; ZHAO, Jing; LV, Qinyu; YI, Zhenghui; ZHANG, Shaoping; CHEN, Yindi

    2016-01-01

    Background Several studies of moderate-to-severe depression have shown that combined treatment with individual cognitive behavioral therapy (CBT) and antidepressant medication is better than either CBT or antidepressants alone. Less research has focused on the outcomes of group-CBT and antidepressants in persons with mild depression. Aim Evaluate the effects of group-CBT in combination with antidepressants on the quality of life and social functioning of outpatients with mild depression. Methods We randomized 62 outpatients with mild depression into a control group (n=30) that received antidepressant medication for 12 weeks and an intervention group (n=32) that received antidepressants and group-CBT for 12 weeks; both groups were then continued on antidepressants alone for one year. Blinded evaluators used Chinese versions of the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Social Disability Screening Schedule, Life Satisfaction Rating, Multidimensional Scale of Perceived Social Support, and Short Form Health Survey to assess participants after 12 weeks of treatment and at the end of one year of follow-up. Results Repeated measures analysis of variance showed that the depressive and anxiety symptoms of both groups improved significantly during treatment and that the improvement was greater in the CBT+antidepressant experimental group. Almost all of the social functioning, social support, and quality of life measures also showed significantly greater improvement in the CBT+antidepressant group than in the antidepressant-only group. Moreover, even after adjusting for differences in baseline demographic and clinical characteristics and for changes in the severity of depression and anxiety over time using an analysis of covariance, the greater improvement in the CBT+antidepressant group remained statistically significant both after the 12 weeks of group-CBT treatment and one year after the group CBT had ended. Conclusion Antidepressants alone or

  16. Relationship between depression and physical activity, disability, burden, and health-related quality of life among patients with arthritis.

    PubMed

    Joshi, Namita; Khanna, Rahul; Shah, Ruchit M

    2015-04-01

    This study purports to examine the relationship of depression with physical activity, disability, arthritis-attributable burden (joint limitation, work limitation, social activity limitation, and joint pain), and health-related quality of life (HRQOL) among arthritis patients. Data from the 2011 Behavioral Risk Factor Surveillance System, a nationally representative sample of noninstitutionalized adults in the United States, was used for the purpose of this study. Multivariable logistic regression was employed to address the study objectives. The final study sample included 167,068 arthritis patients, 45,459 of whom had comorbid depression. Arthritis patients with depression had lower odds of engaging in physical activity (odds ratio [OR]=1.070, confidence interval [CI] 1.006-1.139) and higher odds of being disabled (OR=1.411, CI 1.306-1.524). Arthritis patients with depression also had greater odds of arthritis-attributable joint limitations (OR=1.551, CI 1.460-1.648), work limitations (OR=1.506, CI 1.414-1.604), social activity limitations (OR=1.647, CI 1.557-1.742), and pain (OR=1.438, CI 1.364-1.517) as compared to those without depression. Arthritis patients with versus without depression had greater odds of poor general health status (OR=1.698, CI 1.586-1.819), physical HRQOL (OR=1.592, CI 1.486-1.704), mental HRQOL (OR=6.225, CI 5.768-6.718), and activity limitations (OR=2.345, CI 2.168-2.537). Study results indicate toward a negative functional impact of depression among arthritis patients. Policy makers should consider incorporating screening and management of depression into routine clinical care of arthritis patients.

  17. Daily life with depressive symptoms: Gender differences in adolescents' everyday emotional experiences.

    PubMed

    Frost, Allison; Hoyt, Lindsay T; Chung, Alissa Levy; Adam, Emma K

    2015-08-01

    Depression is a prevalent and debilitating illness facing many adolescents, especially adolescent girls, whose risk for this disorder is approximately twice that of boys. Many studies have identified mechanisms that place girls at higher risk for depression during adolescence. Few, however, have examined differences in the everyday emotional experiences of boys and girls with varying levels of depressive symptoms. Using the Experience Sampling Method, this study investigated the roles of gender and depressive symptomatology in the emotional experiences of a community sample of youth (11-18 year-olds) from the Sloan 500 Family Study. Females with higher levels of depressive symptoms were more likely than females with fewer depressive symptoms and all males to experience strong negative emotions and to attribute the cause of these emotions to other people. These results suggest that emotional reactivity in interpersonal contexts is especially important to understand gender differences in the daily experience of depressive symptoms. PMID:26107805

  18. Daily life with depressive symptoms: Gender differences in adolescents' everyday emotional experiences.

    PubMed

    Frost, Allison; Hoyt, Lindsay T; Chung, Alissa Levy; Adam, Emma K

    2015-08-01

    Depression is a prevalent and debilitating illness facing many adolescents, especially adolescent girls, whose risk for this disorder is approximately twice that of boys. Many studies have identified mechanisms that place girls at higher risk for depression during adolescence. Few, however, have examined differences in the everyday emotional experiences of boys and girls with varying levels of depressive symptoms. Using the Experience Sampling Method, this study investigated the roles of gender and depressive symptomatology in the emotional experiences of a community sample of youth (11-18 year-olds) from the Sloan 500 Family Study. Females with higher levels of depressive symptoms were more likely than females with fewer depressive symptoms and all males to experience strong negative emotions and to attribute the cause of these emotions to other people. These results suggest that emotional reactivity in interpersonal contexts is especially important to understand gender differences in the daily experience of depressive symptoms.

  19. RAndomised controlled trial to imProve depressIon and the quality of life of people with Dementia using cognitive bias modification: RAPID study protocol

    PubMed Central

    Almeida, Osvaldo P; MacLeod, Colin; Flicker, Leon; Ford, Andrew; Grafton, Ben; Etherton-Beer, Christopher

    2014-01-01

    Introduction Depressive symptoms are common and undermine the quality of life of people with Alzheimer's disease (AD). Cholinesterase inhibitors and antidepressants have all but no effect on the mood of patients, and their use increases adverse events. Cognitive bias modification (CBM) targets attentional and interpretative biases associated with anxiety, dysphoria and depression and may be useful to treat depression in AD (DAD). This trial aims to determine the effect of CBM on depression scores and the quality of life of people with DAD. Methods and analysis Randomised, double-blind, parallel, controlled trial of CBM (1:1 allocation ratio). Participants will be 80 adults with probable AD living in the Western Australian community who score 8 or more on the Cornell Scale for Depression in Dementia (CSDD). They will have mild to moderate dementia (Mini-Mental State Examination—MMSE score ≥15) and will be free of severe sensory impairment or suicidal intent. The intervention will consist of 10 40 min sessions of CBM delivered over 2 weeks using a high-resolution monitor using a local computer station at the Western Australian Centre for Health and Ageing. The primary outcomes of interest are the 2-week change, from baseline, in the severity of CSDD scores and the Quality of Life AD (QoL-AD) scores. Secondary outcomes include changes in the CSDD, QoL-AD after 12 weeks, and changes in MMSE scores, negative attentional and interpretative bias and the proportion of participants with CSDD <8 after 2 and 12 weeks. Ethics and dissemination The study will comply with the principles of the Declaration of Helsinki and participants will provide written informed consent. The Ethics Committee of the Royal Perth Hospital will approve and oversee the study (REG14-036). The results of this trial will provide level 2 evidence of efficacy for CBM as a treatment of DAD. Trial registration number Australian and New Zealand Clinical Trials Registry number ACTRN12614000420640

  20. Thermal State of the Lithosphere During Late Heavy Bombardment: Implications for Early Life

    NASA Astrophysics Data System (ADS)

    Abramov, O.; Mojzsis, S. J.

    2008-12-01

    We model thermal effects of impacts on the terrestrial lithosphere during the period of Late Heavy Bombardment (LHB), a putative ~100 Ma epoch of sharply elevated impactor flux that reached a maximum at ca. 3.9 Ga. The goals of this work include estimating the degree to which the crust was molten or thermally metamorphosed during the LHB and evaluating habitability during this time period. We created a stochastic cratering model which populates all or part of the Earth's surface with craters within a probability field of constraints derived from the lunar cratering record, the size/frequency distribution of the asteroid belt, and dynamical models. For each crater in the model, a temperature field was calculated using analytical expressions for shock-deposited heat and central uplift. The resulting thermal anomaly was then introduced into a 3-dimensional model of the lithosphere, and allowed to cool by conduction in the subsurface and radiation/convection at the atmosphere interface. Parameters tested in the model include the duration, mass flux, and average impact velocity during the LHB, mean lithospheric thickness, lithospheric composition, and the presence or absence of oceans. We also assessed habitability by monitoring habitable volumes for mesophile (~20-50° C), thermophile (~50-80° C), and hyperthermophile (~80-110° C) microbial life in what we term the "geophysical habitable zone"; the volume of inhabited crust within ~4 km of the surface. Results of this work indicate that most of the crust was not melted or thermally metamorphosed to a significant degree under any reasonable scenario evaluated. Smaller impactors (1-10 km) were as important as gigantic basin formers (100+ km) in terms of sterilizing the habitable zone in the near-surface due to their far greater numbers (~170,000 impactors in the 1-10 km diameter range versus ~30 impactors in the 100+ km diameter range). However, large basin-forming craters are nonetheless more thermally and

  1. Poor Vision, Functioning, and Depressive Symptoms: A Test of the Activity Restriction Model

    ERIC Educational Resources Information Center

    Bookwala, Jamila; Lawson, Brendan

    2011-01-01

    Purpose: This study tested the applicability of the activity restriction model of depressed affect to the context of poor vision in late life. This model hypothesizes that late-life stressors contribute to poorer mental health not only directly but also indirectly by restricting routine everyday functioning. Method: We used data from a national…

  2. Close Companion Friends, Self-Expression, and Psychological Well-Being in Late Life

    ERIC Educational Resources Information Center

    Krause, Neal

    2010-01-01

    This study has two central aims. Both are associated with self-expression, which is defined as the ability to fully utilize one's own talents and abilities. The first goal is to see if self-expression reduces depressive symptoms over time whereas the second aim is to see whether close companion friends help older people more fully utilize their…

  3. Anxiety and Depression during Transition from Hospital to Community in Older Adults: Concepts of a Study to Explain Late Age Onset Depression

    PubMed Central

    Lalor, Aislinn F.; Brown, Ted; Robins, Lauren; Lee, Den-Ching Angel; O’Connor, Daniel; Russell, Grant; Stolwyk, Rene; McDermott, Fiona; Johnson, Christina; Haines, Terry P.

    2015-01-01

    The transition between extended hospitalization and discharge home to community-living contexts for older adults is a critical time period. This transition can have an impact on the health outcomes of older adults such as increasing the risk for health outcomes like falls, functional decline and depression and anxiety. The aim of this work is to identify and understand why older adults experience symptoms of depression and anxiety post-discharge and what factors are associated with this. This is a mixed methods study of adults aged 65 years and over who experienced a period of hospitalization longer than two weeks and return to community-living post-discharge. Participants will complete a questionnaire at baseline and additional monthly follow-up questionnaires for six months. Anxiety and depression and their resulting behaviors are major public health concerns and are significant determinants of health and wellbeing among the ageing population. There is a critical need for research into the impact of an extended period of hospitalization on the health status of older adults post-discharge from hospital. This research will provide evidence that will inform interventions and services provided for older adults after they have been discharged home from hospital care. PMID:27417775

  4. Cognitive Personality Characteristics Impact the Course of Depression: A Prospective Test of Sociotropy, Autonomy and Domain-Specific Life Events

    PubMed Central

    Iacoviello, Brian M.; Grant, David A.; Alloy, Lauren B.; Abramson, Lyn Y.

    2010-01-01

    Prospective tests of the impact of sociotropy and autonomy on the course of depression are lacking. In a sample of 97 cognitive high-risk and 62 cognitive low-risk undergraduates who experienced at least one prospective depressive episode, the interactions of sociotropy and interpersonal life events and autonomy and achievement-related life events were examined as predictors of four indicators of the course of depression. Initial analyses failed to support the hypothesis that global scores for sociotropy and autonomy interact with domain-congruent life events to predict the course indicators. The autonomy-achievement events interaction predicted less severe episodes, contrary to hypothesis. Then, factors hypothesized to underlie Sociotropy (Fear of Criticism and Rejection; Preference for Affiliation) and Autonomy were also analyzed. The puzzling autonomy-achievement life event interaction was explained by the underlying Independent Goal Attainment factor. Interactions between Fear of Criticism and Rejection and achievement events, and between Sensitivity to Others’ Control and interpersonal events, significantly predicted chronicity, number and severity of episodes. The findings are discussed in terms of the event-congruency hypothesis. PMID:20216915

  5. The relationship between cough-specific quality of life and abdominal muscle endurance, fatigue, and depression in patients with COPD

    PubMed Central

    Arikan, Hulya; Savci, Sema; Calik-Kutukcu, Ebru; Vardar-Yagli, Naciye; Saglam, Melda; Inal-Ince, Deniz; Coplu, Lutfi

    2015-01-01

    Background Cough is a prevalent symptom that impacts quality of life in COPD. The aim of this study was to assess the relationship between cough-specific quality of life, abdominal muscle endurance, fatigue, and depression in stable patients with COPD. Methods Twenty-eight patients with COPD (mean age 60.6±8.7 years) referred for pulmonary rehabilitation participated in this cross-sectional study. Sit-ups test was used for assessing abdominal muscle endurance. Leicester Cough Questionnare (LCQ) was used to evaluate symptom-specific quality of life. Fatigue perception was evaluated with Fatigue Impact Scale (FIS). Beck Depression Inventory (BDI) was used for assessing depression level. Results The LCQ total score was significantly associated with number of sit-ups; BDI score; FIS total; physical, cognitive, and psychosocial scores (P<0.05). Scores of the LCQ physical, social, and psychological domains were also significantly related with number of sit-ups, FIS total score, and BDI score (P<0.05). FIS total score and number of sit-ups explained 58% of the variance in LCQ total score (r=0.76, r2=0.577, F(2–20)=12.296, P<0.001). Conclusion Chronic cough may adversely affect performance in daily life due to its negative effect on fatigue and decrease abdominal muscle endurance in patients with COPD. Decreased cough-related quality of life is related with increased level of depression in COPD patients. Effects of increased abdominal muscle endurance and decreased fatigue in COPD patients with chronic cough need further investigation. PMID:26379433

  6. The relationship between frailty, anxiety and depression, and health-related quality of life in elderly patients with heart failure

    PubMed Central

    Uchmanowicz, Izabella; Gobbens, Robbert JJ

    2015-01-01

    Objective Elderly people constitute over 80% of the population of patients with heart failure (HF). Frailty is a distinct biological syndrome that reflects decreased physiologic reserve and resistance to stressors. Moreover, frailty can serve as an independent predictor of visits to the emergency department, hospitalizations, and mortality. The purpose of this paper was to assess the relationship between frailty, anxiety and depression, and the health-related quality of life (HRQoL) of elderly patients with HF. Patients and methods The study included 100 patients (53 men and 47 women) with a diagnosis of HF. Frailty was measured using the Tilburg Frailty Indicator (TFI) scale. HRQoL was measured using the 36-Item Short Form Medical Outcomes Study Survey. To determine the prevalence of anxiety and depression, the Hospital Anxiety and Depression Scale was used. Results Frailty was found in 89% of the studied population. The study showed significant inverse correlations between the values of the physical component scale (PCS) domain results and TFI score, and a significant inverse correlation between the values of the mental component scale (MCS) domain and TFI score. When participants showed increased levels of frailty as measured by the TFI scale, there was also an increase in the levels of anxiety and depression. With increased anxiety and depression, there was deterioration in the quality of life of patients with HF. Conclusion Frailty has a negative impact on the HRQoL results of elderly patients with HF. The assessment of frailty syndrome, and anxiety and depression should be taken into account when estimating risk and making therapeutic decisions for cardiovascular disease treatment and care. PMID:26491276

  7. Mid-Life Proteinuria and Late-Life Cognitive Function and Dementia in Elderly Men: The Honolulu-Asia Aging Study

    PubMed Central

    Higuchi, Masaya; Chen, Randi; Abbott, Robert D.; Bell, Christina; Launer, Lenore; Ross, G. Webster; Petrovitch, Helen; Masaki, Kamal

    2015-01-01

    Background Impaired renal function has been linked to cognitive impairment. We assessed mid-life proteinuria and late-life cognitive function in elderly Asian males. Methods The Honolulu Heart Program is a prospective study that began in 1965 with 8,006 Japanese-American men ages 45–68 years. Mid-life proteinuria was detected by urine dipstick in 1971–74. The Honolulu-Asia Aging Study began 20 years later, with cognitive assessment by the Cognitive Abilities Screening Instrument (CASI) in 3,734 men. Standard criteria were used to classify 8-year incident dementia and subtypes. RESULTS The age-adjusted incidence of dementia increased significantly from 13.8, to 22.8, to 39.7 per 1,000 person years follow-up, among those with no, trace and positive mid-life proteinuria, p=0.004. Using linear regression adjusting for age, education, APOEε4, stroke, hypertension, systolic blood pressure, diabetes, fasting blood glucose, physical activity and baseline CASI, those with positive proteinuria had significantly higher annual change in CASI over 8 years follow-up (−1.24, p=0.02), reference=no proteinuria. Multivariate Cox regression found positive proteinuria had a significant association with incident all-cause dementia (RR=2.66, 95%CI=1.09–6.53, p=0.03), but no significant associations with incident Alzheimer’s disease or vascular dementia. CONCLUSION Mid-life proteinuria was an independent predictor for late-life incident all-cause dementia and cognitive decline over 8 years. PMID:25626635

  8. Deciphering the Late Quaternary fluvial dynamics at the foothill of an active orogen - the example of the Transcaucasian depression in eastern Georgia

    NASA Astrophysics Data System (ADS)

    von Suchodoletz, Hans; Faust, Dominik

    2013-04-01

    Generally, the dynamics of fluvial systems can be triggered by climate, tectonics, anthropogenic activity or internal mechanisms. The lowland of the Transcaucasian depression is located between the Greater Caucasus in the north and the Lesser Caucasus in the south. Both mountainous massifs form a part of the Alpidic orogenic belt and are thus characterized by a high tectonic activity. During the Weichselian glaciation, due to their altitude >3000 m the massifs were strongly glaciated. During the last years, we investigated fluvial sediment sequences of several rivers that originate from the mountain belts and cross the eastern semi-arid part of the Transcauscasian depression towards the Caspian Sea (e.g. Algeti, Khrami, Kura, Alazani), in order to decipher changes of their fluvial dynamics during the past. The investigated sediments of Late Pleistocene and Holocene age show thicknesses up to 50 m and are mostly well outcropped. Our morphologic, sedimentologic and chronostratigraphic investigations of different sediment sequences demonstrate distinctive changes of the fluvial dynamics between the Late Pleistocene and the Holocene, and show that high-frequent Holocene changes of the fluvial pattern of the rivers are probably linked to climatic and/or anthropogenic triggers. Additionally, on a longer time scale the fluvial dynamics of the rivers is obviously controlled by ongoing tectonic processes.

  9. The effects of psychiatric treatment on depression, anxiety, quality of life, and sexual dysfunction in patients with inflammatory bowel disease

    PubMed Central

    Yanartas, O; Kani, HT; Bicakci, E; Kilic, I; Banzragch, M; Acikel, C; Atug, O; Kuscu, K; Imeryuz, N; Akin, H

    2016-01-01

    Objective Depression and anxiety are common disorders in inflammatory bowel disease (IBD). Our aim is to prospectively determine the effect of psychiatric treatment on scores for depression, anxiety, quality of life (QoL), and sexual dysfunction in an outpatient population diagnosed with IBD and also anxiety and/or depression disorder. Patients and methods Patients who scored higher than the cutoff point on the Hospital Anxiety Depression Scale were referred for further structured psychiatric evaluation and determination of the need for psychiatric drug treatment. Patients who underwent drug therapy completed Short Form-36 (SF-36) and the Arizona Sexual Experience Scale at baseline and after 6 months of follow-up. Results Major depressive disorder and generalized anxiety disorder were the most common diagnoses. After 6 months, 47 patients had completely adhered to drug treatment (group A), whereas 20 were nonadherent (group B). In group A, all domains of SF-36, Arizona Sexual Experience Scale, depression/anxiety scores, and Crohn’s disease activity index were statistically improved after treatment when compared with the baseline. In group B, the three domains of SF-36, platelet count, and mean corpuscular volume were worse between baseline and at 6 months. Conclusion In IBD patients having any psychiatric disorder, 6 months of antidepressant drug treatment is associated with an improvement in depression, anxiety, QoL, and sexual functioning scores, as well as an improvement in Crohn’s disease activity index. On the other hand, insufficient psychiatric treatment seems to be related to a poor QoL. PMID:27069364

  10. Quality Improvement in Nursing Homes: Identifying Depressed Residents is Critical to Improving Quality of Life.

    PubMed

    Crogan, Neval L; Evans, Bronwynne C

    2008-05-01

    The prevalence of depression in nursing home residents is three to five times higher than in older adults from the community.1 Depression is thought to be related to the gloomy institutionalized environment and an assortment of losses, including those associated with function, independence, social roles, friends and relatives, and past leisure activities.2 Despite the public's increased awareness of depression, it remains underrecognized and undertreated by professionals who care for older residents in nursing homes.3 It seems intuitive that depression must be recognized before it can be treated, yet our national long-term care system continues to utilize an unreliable scale from the Minimum Data Set as its foundation for assessment. Warnings of the scale's inadequacy have been sounded repeatedly almost since its conception4,5 and its potential role in lack of recognition and treatment of depression by nursing home staff, nurse practitioners, and physicians is a troubling one.The purpose of this article is to (1) report the prevalence of depression in a sub-sample of residents from a National Institutes of Health study whose depression was not detected by the MDS and, consequently, was previously untreated, (2) compare their nutritional and functional status with residents whose depressive states were previously detected by the MDS and treated, and (3) recommend quality improvement strategies for identification and treatment of depression in nursing home residents.

  11. Quality of life and use of health care resources among patients with chronic depression

    PubMed Central

    Villoro, Renata; Merino, María; Hidalgo-Vega, Alvaro

    2016-01-01

    Purpose This study estimates the health-related quality of life and the health care resource utilization of patients diagnosed with chronic depression (CD) in Spain. Patients and methods We used the Spanish National Health Survey 2011–2012, a cross-sectional survey representative at the national level, that selects people aged between 18 and 64 years (n=14,691). We estimated utility indices through the EuroQol five-dimensional descriptive system questionnaire included in the survey. We calculated percentage use of health care resources (medical visits, hospitalizations, emergency services, and drug consumption) and average number of resources used when available. A systematic comparison was made between people diagnosed with CD and other chronic conditions (OCCs). The chi-square test, Mann–Whitney U-test, and Kruskal–Wallis test were used to determine the statistical significance of differences between comparison groups. Multivariate analyses (Poisson regression, logistic regression, and linear regression) were also carried out to assess the relationship between quality of life and consumption of health care resources. Results Approximately, 6.1% of the subjects aged between 18 and 64 years were diagnosed with CD (average age 48.3±11 years, 71.7% females). After controlling for age, sex, and total number of comorbidities, a diagnosis of CD reduced utility scores by 0.09 (P<0.05) vs OCCs, and increased the average number of hospitalizations by 15%, the average number of days at hospital by 51%, and the average number of visits to emergency services by 15% (P<0.05). CD also increased the average number of visits to secondary care by 14% and visits to general practitioners by 4%. People with CD had a higher probability of consuming drugs than people with OCCs (odds ratio [OR]: 1.24, P<0.05), but only 38.6% took antidepressants. Conclusion People with CD had significantly lower health-related quality of life than people with OCCs. CD was associated with

  12. Early life characteristics and late life burden of cerebral small vessel disease in the Lothian Birth Cohort 1936

    PubMed Central

    Field, Thalia S.; Doubal, Fergus N.; Johnson, Wendy; Backhouse, Ellen; McHutchison, Caroline; Cox, Simon; Corley, Janie; Pattie, Alison; Gow, Alan J.; Shenkin, Susan; Cvoro, Vera; Morris, Zoe; Staals, Julie; Bastin, Mark; Deary, Ian J.; Wardlaw, Joanna M.

    2016-01-01

    It is unknown whether relations between early-life factors and overall health in later life apply to burden of cerebral small vessel disease (cSVD), a major cause of stroke and dementia. We explored relations between early-life factors and cSVD in the Lothian Birth Cohort, a healthy aging cohort. Participants were recruited at age 70 (N = 1091); most had completed a test of cognitive ability at age 11 as part of the Scottish Mental Survey of 1947. Of those, 700 participants had brain MRI that could be rated for cSVD conducted at age 73. Presence of lacunes, white matter hyperintensities, microbleeds, and perivascular spaces were summed in a score of 0-4 representing all MRI cSVD features. We tested associations with early-life factors using multivariate logistic regression. Greater SVD score was significantly associated with lower age-11 IQ (OR higher SVD score per SD age-11 IQ = .78, 95%CI 0.65-.95, p=.01). The associations between SVD score and own job class (OR higher job class, .64 95%CI .43-.95, p=.03), age-11 deprivation index (OR per point deprivation score, 1.08, 95%CI 1.00-1.17, p=.04), and education (OR some qualifying education, .60 95%CI .37-.98, p=.04) trended towards significance (p<.05 for all) but did not meet thresholds for multiple testing. No early-life factor was significantly associated with any one individual score component. Early-life factors may contribute to age-73 burden of cSVD. These relations, and the potential for early social interventions to improve brain health, deserve further study. PMID:27652981

  13. Sequential Patterns of Health Conditions and Financial Outcomes in Late Life: Evidence From the Health and Retirement Study.

    PubMed

    Kim, Hyungsoo; Shin, Serah; Zurlo, Karen A

    2015-07-01

    The cost and prevalence of chronic health conditions increase in late life and can negatively impact accumulated wealth. Based on the financial challenges midaged and older adults face, we sought to understand the evolution of distinctive sequences of chronic health conditions and how these sequences affect retirement savings. We used 10 waves of the Health and Retirement Study and tracked the health states and changes in wealth of 5,540 individuals. We identified five typical sequences of chronic health conditions, which are defined as follows: Multimorbidity, Comorbidity, Mild Disease, Late Event, and No Disease. Wealth accumulation differed across the five sequences. Multimorbidity and Comorbidity were the most costly sequences. Individuals with these health patterns, respectively, had $91,205 and $95,140, less net worth than respondents identified with No Disease. Our findings suggest policy makers consider sequential disease patterns when planning for the health-care needs and expenditures of older Americans.

  14. Trendsetting Learning Biographies: Concepts of Navigating through Late-Modern Life and Learning

    ERIC Educational Resources Information Center

    Diepstraten, Isabelle; du Bois-Reymond, Manuela; Vinken, Henk

    2006-01-01

    In this article we build a theoretical framework with which to analyse trendsetting learning biographies; that is, biographies that are prototypical realisations of a cultural script about how young people learn and live in late modernity. In the current debate on lifelong learning in knowledge-based societies learners are interpreted in an…

  15. "The Business of Life": Educating Catholic Deaf Children in Late Nineteenth-Century England

    ERIC Educational Resources Information Center

    Mangion, Carmen M.

    2012-01-01

    Much of the debates in late nineteenth-century Britain regarding the education of deaf children revolved around communication. For many Victorians, sign language was unacceptable; many proponents of oralism attempted to "normalise" the hearing impaired by replacing deaf methods of communication with spoken language and lipreading. While debates on…

  16. Life-course exposure to early socioeconomic environment, education in relation to late life cognitive function among older Mexicans and Mexican Americans

    PubMed Central

    Al Hazzouri, Adina Zeki; Haan, Mary N; Galea, Sandro; Aiello, Allison E

    2012-01-01

    Objectives To examine the associations between life-course education and late-life cognitive function along with the modifying role of migration history. Methods The combined sample includes 1,789 participants from the Sacramento Area Latino Study on Aging and 5,253 participants from the Mexican Health and Aging Study. Aged 60+ at baseline, participants were classified as Mexican residents, Mexicans-return migrants, Mexicans-immigrants to the US, and Mexicans-US-born. Cognitive function was measured using standardized z-scores of a short-term verbal recall test. Multivariate linear regression analysis was conducted. Results Participants’ z-scores were higher among those whose mother had more than elementary education (β=0.28, p<0.05). Participant’s education mediated this association. For 5-year difference in education, the cognitive z-score increased by 0.3 points for a US-born. Results were similar with father’s education. Discussion Adult educational attainment mediates the effect of childhood socioeconomic status on late-life cognition. Migration plays a role in shaping cognitive aging. PMID:21948769

  17. Early-life Exposure to the SSRI Paroxetine Exacerbates Depression-like Behavior in Anxiety/Depression-prone rats

    PubMed Central

    Glover, Matthew E.; Pugh, Phyllis C.; Jackson, Nateka L.; Cohen, Joshua L.; Fant, Andrew D.; Akil, Huda; Clinton, Sarah M.

    2014-01-01

    Selective serotonin reuptake inhibitor (SSRI) antidepressants are the mainstay treatment for the 10–20% of pregnant and postpartum women who suffer major depression, but the effects of SSRIs on their children’s developing brain and later emotional health are poorly understood. SSRI use during pregnancy can elicit antidepressant withdrawal in newborns and increase toddlers’ anxiety and social avoidance. In rodents, perinatal SSRI exposure increases adult depression- and anxiety-like behavior, although certain individuals are more vulnerable to these effects than others. Our study establishes a rodent model of individual differences in susceptibility to perinatal SSRI exposure, utilizing selectively-bred Low Responder (bLR) and High Responder (bHR) rats that were previously bred for high versus low behavioral response to novelty. Pregnant bHR/bLR females were chronically treated with the SSRI paroxetine (10 mg/kg/day p.o.) to examine its effects on offspring’s emotional behavior and gene expression in the developing brain. Paroxetine treatment had minimal effect on bHR/bLR dams’ pregnancy outcomes or maternal behavior. We found that bLR offspring, naturally prone to an inhibited/anxious temperament, were susceptible to behavioral abnormalities associated with perinatal SSRI exposure (which exacerbated their Forced Swim test immobility), while high risk-taking bHR offspring were resistant. Microarray studies revealed robust perinatal SSRI-induced gene expression changes in the developing bLR hippocampus and amygdala (postnatal days 7–21), including transcripts involved in neurogenesis, synaptic vesicle components, and energy metabolism. These results highlight the bLR/bHR model as a useful tool to explore the neurobiology of individual differences in susceptibility to perinatal SSRI exposure. PMID:25451292

  18. Early-life exposure to the SSRI paroxetine exacerbates depression-like behavior in anxiety/depression-prone rats.

    PubMed

    Glover, M E; Pugh, P C; Jackson, N L; Cohen, J L; Fant, A D; Akil, H; Clinton, S M

    2015-01-22

    Selective serotonin reuptake inhibitor (SSRI) antidepressants are the mainstay treatment for the 10-20% of pregnant and postpartum women who suffer major depression, but the effects of SSRIs on their children's developing brain and later emotional health are poorly understood. SSRI use during pregnancy can elicit antidepressant withdrawal in newborns and increase toddlers' anxiety and social avoidance. In rodents, perinatal SSRI exposure increases adult depression- and anxiety-like behavior, although certain individuals are more vulnerable to these effects than others. Our study establishes a rodent model of individual differences in susceptibility to perinatal SSRI exposure, utilizing selectively bred Low Responder (bLR) and High Responder (bHR) rats that were previously bred for high versus low behavioral response to novelty. Pregnant bHR/bLR females were chronically treated with the SSRI paroxetine (10 mg/kg/day p.o.) to examine its effects on offspring's emotional behavior and gene expression in the developing brain. Paroxetine treatment had minimal effect on bHR/bLR dams' pregnancy outcomes or maternal behavior. We found that bLR offspring, naturally prone to an inhibited/anxious temperament, were susceptible to behavioral abnormalities associated with perinatal SSRI exposure (which exacerbated their Forced Swim Test immobility), while high risk-taking bHR offspring were resistant. Microarray studies revealed robust perinatal SSRI-induced gene expression changes in the developing bLR hippocampus and amygdala (postnatal days 7-21), including transcripts involved in neurogenesis, synaptic vesicle components, and energy metabolism. These results highlight the bLR/bHR model as a useful tool to explore the neurobiology of individual differences in susceptibility to perinatal SSRI exposure. PMID:25451292

  19. An online intervention for reducing depressive symptoms: secondary benefits for self-esteem, empowerment and quality of life.

    PubMed

    Crisp, Dimity; Griffiths, Kathleen; Mackinnon, Andrew; Bennett, Kylie; Christensen, Helen

    2014-04-30

    Internet-based interventions are increasingly recognized as effective for the treatment and prevention of depression; however, there is a paucity of research investigating potential secondary benefits. From a consumer perspective, improvements in indicators of wellbeing such as perceived quality of life may represent the most important outcomes for evaluating the effectiveness of an intervention. This study investigated the 'secondary' benefits for self-esteem, empowerment, quality of life and perceived social support of two 12-week online depression interventions when delivered alone and in combination. Participants comprised 298 adults displaying elevated psychological distress. Participants were randomised to receive: an Internet Support Group (ISG); an automated Internet psycho-educational training program for depression; a combination of these conditions; or a control website. Analyses were performed on an intent-to-treat basis. Following the automated training program immediate improvements were shown in participants׳ self-esteem and empowerment relative to control participants. Improvements in perceived quality of life were reported 6-months following the completion of the intervention when combined with an ISG. These findings provide initial evidence for the effectiveness of this online intervention for improving individual wellbeing beyond the primary aim of the treatment. However, further research is required to investigate the mechanisms underlying improvement in these secondary outcomes. PMID:24534125

  20. A paradoxical association of an oxytocin receptor gene polymorphism: early-life adversity and vulnerability to depression.

    PubMed

    McQuaid, Robyn J; McInnis, Opal A; Stead, John D; Matheson, Kimberly; Anisman, Hymie

    2013-01-01

    Several prosocial behaviors may be influenced by the hormone oxytocin. In line with this perspective, the oxytocin receptor (OXTR) gene single nucleotide polymorphism (SNP), rs53576, has been associated with a broad range of social behaviors. In this regard, the G allele of the OXTR SNP has been accompanied by beneficial attributes such as increased empathy, optimism, and trust. In the current study among university students (N = 288), it was shown that early-life maltreatment was associated with depressive symptoms, and that the OXTR genotype moderated this relationship, such that under high levels of childhood maltreatment, only individuals with GG/GA genotype demonstrated increased depressive symptomatology compared to those with the AA genotype. In addition, the role of distrust in mediating the relation between childhood maltreatment and depression seemed to be more important among G allele carriers compared to individuals with the AA genotype. Thus, a breach in trust (i.e., in the case of early-life abuse or neglect) may have a more deleterious effect among G carriers, who have been characterized as more prosocial and attuned to social cues. The data suggested that G carriers of the OXTR might favor social sensitivity and thus might have been more vulnerable to the effects of early-life adversity. PMID:23898235

  1. Racial/Ethnic Disparities in Midlife Depressive Symptoms: The Role of Cumulative Disadvantage Across the Life Course

    PubMed Central

    Garbarski, Dana

    2014-01-01

    This study examines the role of cumulative disadvantage mechanisms across the life course in the production of racial and ethnic disparities in depressive symptoms at midlife, including the early life exposure to health risk factors, the persistent exposure to health risk factors, and varying mental health returns to health risk factors across racial and ethnic groups. Using data from the over-40 health module of the National Longitudinal Study of Youth (NLSY) 1979 cohort, this study uses regression decomposition techniques to attend to differences in the composition of health risk factors across racial and ethnic groups, differences by race and ethnicity in the association between depressive symptoms and health risk factors, and how these differences combine within racial and ethnic groups to produce group-specific levels of—and disparities in—depressive symptoms at midlife. While the results vary depending on the groups being compared across race/ethnicity and gender, the study documents how racial and ethnic mental health disparities at midlife stem from life course processes of cumulative disadvantage through both unequal distribution and unequal associations across racial and ethnic groups. PMID:26047842

  2. Life Event Types and Attributional Styles as Predictors of Depression in the Elderly.

    ERIC Educational Resources Information Center

    Patrick, Linda F.; Moore, Janet S.

    The reformulated learned helplessness model for the prediction of depression has been investigated extensively in young adults. Results have linked attributions made to undesirable, controllable events to depression in this age group. This reformulated model was investigated in 97 elderly women and was contrasted to the original learned…

  3. Genetic and Environmental Influences on Negative Life Events from Late Childhood to Adolescence

    ERIC Educational Resources Information Center

    Johnson, Daniel P.; Rhee, Soo Hyun; Whisman, Mark A.; Corley, Robin P.; Hewitt, John K.

    2013-01-01

    This multiwave longitudinal study tested two quantitative genetic developmental models to examine genetic and environmental influences on