Life events as predictors of mania and depression in bipolar I disorder.

[Correction Notice: An erratum for this article was reported in Vol 117(3) of Journal of Abnormal Psychology (see record 2008-11014-022). In the aforementioned article, Amy K. Cuellar's last name was misspelled. The corrected list of author names is: Sheri L. Johnson, Amy K. Cuellar, Camilo Ruggero, Carol Winett-Perlman, Paul Goodnick, Richard White, and Ivan Miller.] 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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life stressors, social resources, coping, and the 4-year course of unipolar depression.

Little is known about the effects of psychosocial factors on the long-term course of unipolar depression. This article examines the 4-year stability and change in life stressors, social resources, and coping, and their effect on the course of treated unipolar depression among 352 men and women. Depressed patients were assessed at treatment intake and at 1-year and 4-year follow-ups. Over the 4 years, patients improved in symptom outcomes, the quality of social resources, and coping responses; there were some declines in life stressors. Life stressors, social resources, and coping were related to patient functioning concurrently, after controlling for demographics, initial treatment, and initial dysfunction severity. Preintake medical conditions and family conflict consistently predicted poorer long-term outcomes. The findings imply that medical conditions and family conflict are important risk factors that predict poorer long-term outcome of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life stressors, personal and social resources, and depression: A 4-year structural model.

By extending earlier stress-resistance research with a 1-yr time lag, findings with 254 adults show that adaptive personality characteristics and positive family support operate prospectively over 4 yrs in predicting reduced depression even when prior depression is controlled. By strengthening knowledge about the determinants and mediational role of coping, the results demonstrate in a 2-group LISREL analysis that the pattern of predictive relations differs under high and low stressors. Under high stressors, personal and social resources relate to future psychological health indirectly, through more adaptive coping strategies. Under low stressors, these resources relate directly to psychological health. The results support the idea that such resources play a causal role in maintaining psychological health, and they suggest the potential for a general, adaptively oriented framework applicable to adjustment under both high and low stressors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family and extrafamily resources and the 10-year course of treated depression

A group of 313 depressed patients and 284 controls was assessed at baseline (treatment intake for the patients) and at 1-year, 4-year, and 10-year follow-ups. Stably remitted patients achieved levels of family and extrafamily resources that were comparable with those of the controls. Although partially remitted and nonremitted patients' social resources improved, they continued to show deficits in these areas relative to controls and stably remitted patients. Several indexes of social resources predicted stable remission: more family independence, fewer family arguments and less conflict, and more helpful friends and activities with friends. Assessment of social resources at treatment intake and short-term follow-ups can help identify and provide intervention foci for patients at risk for nonremission of depression.     

Marital satisfaction and depression as predictors of physical health status.

Investigated the multiple correlation between physical health status and a set of marriage-related "predictor" variables. Family practice physicians provided a sample of 104 married couples (average age, 30 yrs). Marital satisfaction, depression, number of visits to physician, and educational level were among the set of cross-validated "predictors" of reported physical health status. The correlation between physical health status (the Cornell Medical Index) and depression (Zung Self-Rating Depression Scale) was significantly greater for wives than husbands. For wives, marital satisfaction (Locke-Wallace Marital Adjustment Test) and depression were related primarily through the uncontrolled variance in physical health status, whereas for husbands a significant relationship between marital satisfaction and depression remained for husbands when physical health status was partialed out. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dependency and self-criticism as predictors of depression in young doctors.

Brief measures of depression and of dependency and self-criticism, personality factors believed to convey vulnerability to depression, were administered to 318 medical students. Depression was subsequently measured 2 years later (in the highly stressful 1st postgraduate year) and 10 years later when careers were established. When initial symptom levels and concurrent workload were controlled, dependency and, more particularly, self-criticism were significant predictors of depression for male doctors in the 1st postgraduate year. For female doctors, self-criticism was the only significant predictor. Ten years later, the predictive effects for male doctors were similar, but rather weaker, whereas none of the variables predicted depression in female doctors. Implications for preventive interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life regrets and current goals as predictors of psychological adjustment.

Life regrets and current goals were examined as predictors of psychological adjustment in a sample of 155 Ss who rated these constructs along 13 theoretically derived dimensions. Relative to regrets, goals were perceived as more impactful, important, controllable, achievable, socially supported, and desirable, and as occupying more time and energy. Hierarchical regression models indicated that regret ratings account for an additional 19.8% of the variance in life satisfaction and 11.9% of the variance in depression scores after removing the variance attributed to goal ratings. Furthermore, regrets contributed to the prediction of psychological adjustment after controlling for negative affectivity. A content analysis of respondents' regrets is presented and related to chronological age and gender. A goal-based reformulation of regrets is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mathematical background and grade-point average as predictors of course grade in an undergraduate behavioral statistics course.

Presents data suggesting that success in undergraduate behavioral statistics courses has little to do with mathematical background and seems to depend on overall ability as a student, as measured by cumulative grade point average (GPA). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depression and maternal treatment of siblings as predictors of child psychopathology.

Maternal treatment of sibling pairs with affectively ill and well mothers was examined longitudinally in relation to child psychiatric status. Mothers and children in 77 families (34 unipolar, 16 bipolar, and 27 control mothers) were observed in interaction across early, middle, and late childhood and early adolescence. Interaction was assessed on dimensions of maternal engagement and critical-irritable behavior. The study examined the relative contributions of maternal depression, the quality of maternal treatment, and differential treatment of siblings to each child's psychiatric status. By maternal report, older siblings' symptoms were predicted by maternal bipolar or unipolar illness; younger siblings' symptoms were predicted by lower maternal engagement and higher maternal critical-irritable behavior in early childhood, in addition to maternal affective illness. For the younger sibling, persistent patterns of maternal treatment were also related to both maternal and child reports of problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpsychotic depression and the need for personal significance

The author, who considers postpsychotic depression as a reaction to psychosis, illustrates some of the dynamics involved in the development and persistence of the state with letters from a patient. Among other dynamic and psychotherapeutic considerations, the need for self-realization and meaning in everyday life merits special emphasis in the treatment of those for whom escape from psychosis has meant not only deliverance from terror, but also a loss of grandeur and significance.     

"Life events as predictors of mania and depression in bipolar I disorder": Correction to Johnson et al. (2008).

Reports an error in "Life events as predictors of mania and depression in bipolar I disorder" by Sheri L. Johnson, Amy K. Cueller, Camilo Ruggero, Carol Winett-Perlman, Paul Goodnick, Richard White and Ivan Miller (Journal of Abnormal Psychology, 2008[May], Vol 117[2], 268-277). In the aforementioned article, Amy K. Cuellar's last name was misspelled. The corrected list of author names is: Sheri L. Johnson, Amy K. Cuellar, Camilo Ruggero, Carol Winett-Perlman, Paul Goodnick, Richard White, and Ivan Miller. (The following abstract of the original article appeared in record 2008-05639-002.) 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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expressed emotion and the course of late-life depression

This study examined rates of expressed emotion (EE) indexed by the Five Minute Speech Sample (FMSS; A. B. Magana et al., 1986) in adult children or spouses of 54 elderly patients hospitalized for major depressive disorder. It also examined whether EE was related to course of psychiatric illness in these elderly patients over 1 year. Among the family members, 40% were classified as high EE. EE was not significantly related to relapse in the total sample. However, there was an interaction between EE and relationship to the patient (i.e., spouse or adult child) on 1-year clinical outcomes of the elderly. Among adult children caring for older patients, high-EE status predicted higher rates of patient relapse and lower rates of complete and sustained recovery from depression than low EE. In contrast, there was a trend association among spouses between high EE and lower rates of relapse as well as higher rates of complete and sustained recovery.     

Life stress and treatment course of recurrent depression: I. Response during index episode.

Research on treatment course and outcome in depression is mixed with respect to the implications of life stress. Several concerns are addressed in a prospective study of 91 individuals treated for recurrent depression. Specific forms of stress occurring before treatment entry predicted a poor clinical response both after 16 wks and after a more extended intervention period. Specific forms of stress occurring during the 1st 6 wks of treatment also predicted poor response after 16 wks and after the extended intervention period. Severe stress occurring early in treatment predicted a longer time to attain relief for treatment responders. Concepts underlying the idea that stress-related disorders have a better clinical outcome are discussed, and it is proposed that life stress had different implications for individuals with and without recurrent depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life circumstances, lifestyles and oral health among older Canadians

Nucleation, growth and aggregation are thought to be the most important crystallization processes in stone formation. Since crystallization properties change with urinary dilution, centrifugation and filtration, crystallization should always be studied in freshly voided and not pretreated urine. Recently we developed an automated method where calcium oxalate crystallization is induced in native urine by an exogenous oxalate load and nucleation and growth are monitored by an ion-selective calcium electrode. The method has now been supplemented with the spectrophotometric measurement of crystal aggregation. Repeated experiments in the same urine with different oxalate loads enable the determination of the critical oxalate additionable to induce crystallization (metastable limit) and the calculation of an oxalate load-independent growth rate constant. Preliminary results obtained in the native urine of healthy controls showed an extremely high limit of metastability and a complete absence of crystal aggregation. These findings may explain why, despite frequent urinary calcium oxalate supersaturation, healthy people do not form stones.     

A meta-analysis of predictors of postpartum depression

Minimal attention has been focused on the concept of panic in the discipline of nursing. Hindering a greater understanding of panic is its lack of explication and development in nursing. To help remedy this situation, a concept analysis of panic was performed. The hybrid model of concept development was used, which consists of an initial theoretical phase, a fieldwork phase, and a final analytical phase. In the theoretical phase, after a cross-disciplinary literature search was done, existing definitions and measurement of the concept of panic were analyzed, and a working definition of panic was formulated. In the fieldwork phase, women experiencing postpartum panic disorder were interviewed to collect qualitative data for further analysis of panic. The final phase focused on comparing and contrasting the findings from the theoretical phase with the insights discovered from the fieldwork. Applicability of panic across nursing is addressed along with implications for nursing theory, practice, and research.     

Autobiographical memory processes and the course of depression.

The authors report a 6-month follow-up study of clinically depressed patients. At baseline, 2 indexes of autobiographical memory functioning were assessed: the presence of spontaneous intrusive memories of stressful life events and performance on the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986), which measures overgeneral memory. The index of overgeneral memory was associated with greater levels of spontaneous intrusion of stressful memories. Overgeneral memory did not predict outcome, but depression at follow-up was predicted by the amount of intrusion and avoidance of stressful memories, even after controlling for initial severity of psychiatric symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial predictors of the short-term course and outcome of major depression: A longitudinal study of a nonclinical sample with recent-onset episodes.

Three variables have been hypothesized to play important roles in prolonging the course of depressive episodes: a ruminative response style, significant interpersonal relationships, and childhood adversity. The authors examined whether these variables predicted the short-term course of major depressive disorder (MDD). Participants (n/&=/&84) were college students with a recent-onset major depressive episode. Assessments included several interview and self-report measures, and data on interpersonal relationships were obtained from close confidants. Follow-up interviews were conducted 6 mo later. After controlling for baseline severity, harsh discipline in childhood significantly predicted mean level of depression across the follow-up and level of depression at follow-up. Harsh discipline was also significantly associated with relapse but not with recovery. After controlling for baseline severity, rumination and the interpersonal variables did not predict the outcome of MDD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder?

OBJECTIVE: The authors' goal was to examine the relationship between subclinical depressive symptoms in adolescence and major depressive episodes in adulthood. METHOD: An epidemiologic sample of 776 young people received psychiatric assessments in 1983, 1985, and 1992. Among adolescents not meeting criteria for major depression, the authors estimated the magnitude of the association between subclinical adolescent depressive symptoms and adult major depression. RESULTS: Symptoms of major depression in adolescence strongly predicted an adult episode of major depression: having depressive symptoms more than two-standard-deviations above the mean in number predicted a two-fold to three-fold greater risk for an adult major depressive episode. CONCLUSIONS: Symptoms of depression in adolescence strongly predict an episode of major depression in adulthood, even among adolescents without major depression.     

Illness severity and self-efficacy as course predictors of DSM-IV alcohol dependence in a multisite clinical sample

OBJECTIVE: To measure cardiac and other effects of thioridazine and relate these to the plasma concentration of the parent drug and its principal metabolites. METHODS: A double-blind, randomized-order crossover study involving nine healthy male subjects compared the effects of single doses of thioridazine (10 mg and 50 mg) with placebo. Plasma concentrations of thioridazine and its ring sulfoxide, side-chain sulfoxide, and side-chain sulfone metabolites were measured, together with effects on the ECG, blood pressure, salivary flow, and a batch of psychomotor tests for 72 hours after administration. RESULTS: Thioridazine, 50 mg, reduced standing systolic blood pressure (mean peak changes from baseline [95% CI] -32 mm Hg [-55, 10 mm Hg]; p < 0.01 versus placebo) and diastolic blood pressure (-14 mm Hg [-26, -2 mm Hg]; p < 0.05), increased standing heart rate (7 beats/min [-1, 16 beats/min]; p < 0.05), impaired psychomotor function, and prolonged the JT (20 ms1/2 [7, 34 ms1/2]; p < 0.05), QTa (22 ms1/2 [8, 36 ms1/2]; p < 0.05), and QTc (22 ms1/2 [11, 33 ms1/2]; p < 0.01) intervals, but had no effect on QT dispersion (-12 ms1/2 [-31, 6 ms1/2]). Thioridazine, 1.0 mg, also significantly increased QTc, but the effect was less marked (9 ms1/2 [-1, 19 ms1/2]; p < 0.05). Plasma thioridazine and metabolite concentrations did not correlate significantly with these effects. Maximum effects on QTc occurred after peak concentrations of thioridazine but before peak concentrations of the ring sulfoxide and side-chain sulfone metabolites. CONCLUSIONS: These data suggest that thioridazine has dose-related effects on ventricular repolarization and that the parent drug causes an important proportion of these effects, although its metabolites may also contribute.