Clinical depression and day-to-day social interaction in a community sample.

Adult participants recruited from the community, one half of whom met criteria for clinical depression, described their day-to-day social interactions using a variant of the Rochester Interaction Record. Compared with the nondepressed participants, depressed participants found their interactions to be less enjoyable and less intimate, and they felt less influence over their interactions. Differences between the two groups in intimacy occurred only in interactions with close relations and not in interactions with nonintimates, and differences in influence were more pronounced for those who were cohabiting than for those who were not. There were no differences in how socially active depressed and nondepressed people were or in the amount of contact they had with different relational partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Electroencephalographic asymmetries in adolescents with major depression: Influence of comorbidity with anxiety disorders.

This study examined whether adolescents with major depressive disorder (MDD) display the abnormal electroencephalographic (EEG) alpha asymmetries found in depressed adults. Resting EEG was recorded in 25 right-handed female outpatients (19 with MDD, 11 of whom also had a current anxiety disorder; 6 with anxiety disorders only) and 10 non-ill controls. In contrast to the non-ill controls, adolescents having MDD but no anxiety disorder showed alpha asymmetry indicative of less activation over right than over left posterior sites. Within the MDD patient group, comorbid anxiety disorders reduced the posterior alpha asymmetry, supporting the potential importance of evaluating anxiety in studies of regional brain activation in adolescent MDD. These preliminary findings are similar to those from adult studies that suggest that MDD is associated with right parietotemporal hypoactivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample.

The comorbidity of current and lifetime DSM-IV anxiety and mood disorders was examined in 1,127 outpatients who were assessed with the Anxiety Disorders Interview Schedule for DSM-IV:Lifetime version (ADIS-IV-L). The current and lifetime prevalence of additional Axis I disorders in principal anxiety and mood disorders was found to be 57% and 81%, respectively. The principal diagnostic categories associated with the highest comorbidity rates were mood disorders, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). A high rate of lifetime comorbidity was found between the anxiety and mood disorders; the lifetime association with mood disorders was particularly strong for PTSD, GAD, obsessive-compulsive disorder, and social phobia. The findings are discussed in regard to their implications for the classification of emotional disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, depression, and comorbid PTSD/depression in a community sample of Latina immigrants.

Trauma exposure is frequently overlooked as a risk factor for psychiatric morbidity among studies with Latinos. The purpose of this study was to examine the relationships among trauma history, immigration-related factors, and mental health status among Latina immigrants. The current study used baseline data from a randomized clinical trial for the treatment of depression of 64 women with comorbid posttraumatic stress disorder and depression, 69 with depression-only, and 61 with no Axis I mental disorder. Sixty-four percent of the sample was Central American and 75% reported trauma exposure. Multinomial logit analysis suggested fewer years in the United States was associated with worse mental health status. Having a nonmarried marital status was also associated with worse mental health. Reporting four or more types of traumatic events was associated with an increase in the probability of comorbidity. These findings have important implications for future research and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining a dimensional representation of depression and anxiety disorders' comorbidity in psychiatric outpatients with item response modeling.

The current study replicated, in a sample of 2,300 outpatients seeking psychiatric treatment, a previous study (R. F. Krueger & M. S. Finger, 2001) that implemented an item response theory approach for modeling the comorbidity of common mood and anxiety disorders as indicators along the continuum of a shared latent factor (internalizing). The 5 disorders examined were major depressive disorder, social phobia, panic disorder/agoraphobia, specific phobia, and generalized anxiety disorder. The findings were consistent with the prior research. First, a confirmatory factor analysis yielded sufficient evidence for a nonspecific factor underlying the 5 diagnostic indicators. Second, a 2-parameter logistic item response model showed that the diagnoses were represented in the upper half of the internalizing continuum, and each was a strongly discriminating indicator of the factor. Third, the internalizing factor was significantly associated with 3 indexes of social burden: poorer social functioning, time missed from work, and lifetime hospitalizations. Rather than the categorical system of presumably discrete disorders presented in DSM-IV, these 5 mood and anxiety disorders may be alternatively viewed as higher end indicators of a common factor associated with social cost. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use diagnosis within a community sample of adults: Distinction, comorbidity, and progression over time.

Practicing psychologists conceptualize, assess, and treat clients who use substances in different ways. Using longitudinal data from a multiethnic community sample of 470 adults, the authors examine patterns of abuse and dependence on alcohol, marijuana, and cocaine. Men were significantly more abusive, dependent, and polysubstance dependent on all drugs than women. A large percentage of drug abusers, and over 1/3 with drug dependence, remitted without formal treatment. However, early severe problems with cocaine increased later alcohol problems. Traditional disease progression and drug use acquisition models are not supported. Psychologists should incorporate the natural course of substance use into treatment and prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpartum depression: a review for perinatal social workers

Postpartum depression is a common and treatable clinical syndrome which effects up to fifty percent of all women and which can best be considered as a triad of disorders. Postpartum blues, postpartum affective disorders or major depressions, and postpartum psychosis have distinct symptoms with corresponding implications for social work interventions and treatment strategies. The role of prevention can be pivotal in terms of reducing negative impacts of psychological problems after birth and minimizing adverse consequences for the new baby and all family members.     

The meeting of pain and depression: comorbidity in women

The use of allogeneic BMT in patients with relapsed non-Hodgkin lymphoma (NHL) offers the advantage of tumor-free bone marrow and possibly a 'graft-versus-lymphoma effect' which may decrease the risk of recurrence. However, allogeneic BMT also poses an increased risk of death due to graft-versus-host disease (GVHD) which can be ameliorated by T cell depletion. We performed a retrospective review of 37 patients who underwent T cell-depleted allogeneic BMT for aggressive and indolent NHL between 1988 and 1996. Polymerase chain reaction (PCR) was used to identify indolent NHL patients with the BCL2/IgH translocation which served as a marker of residual disease. Sixteen of 37 patients (44%) are alive and progression-free with a median follow-up of 4.4 years (range 1-10.3). The incidence of grade 2-4 acute GVHD was 36% and extensive chronic GVHD developed in 12%. Patients with aggressive NHL have an overall PFS of 33% (12-54%); those with chemotherapy-resistant and sensitive disease have PFS of 17% (0-47%), and 40% (15-65%) respectively at 5 years. Patients with indolent histologies have overall PFS of 62% (37-86%); those with chemotherapy-resistant and sensitive disease have PFS of 55% (25-85%) and 80% (45-100%) respectively at 5 years. Eight patients with indolent disease had a BCL2/IgH translocation detectable by PCR. Five of these eight patients remain alive and progression free at a median of 6.5 years after BMT (range 2.1-7.4 years), four of whom remain PCR positive from 1.7 to 2.9 years after transplantation. We conclude that T cell-depleted allogeneic BMT poses a low risk for death due to GVHD, and should be considered for patients with relapsed and refractory indolent NHL.     

Screening instruments for depression and anxiety following stroke: experience in the Perth community stroke study

Evaluation of the relative efficacy of three screening instruments for depression and anxiety in a group of stroke patients was undertaken as part of the Perth community stroke study. Data are presented on the sensitivity and specificity of the Hospital Anxiety and Depression Scale (HAPS), the Geriatric Depression Scale and the General Health Questionnaire (GHQ) (28-item version) in screening patients 4 months after stroke for depressive and anxiety disorders diagnosed according to DSM-III criteria. The GHQ-28 and GDS but not the HADS depression, were shown to be satisfactory screening instruments for depression, with the GHQ-28 having an overall superiority. The performance of all 3 scales for screening post-stroke anxiety disorders was less satisfactory. The HADS anxiety had the best level of sensitivity, but the specificity and positive predictive values were low and the misclassification rate high.     

Postpartum depression: A critical review.

A review of the literature suggests that there are 3 types of postpartum dysphoric mood states: the maternity blues (a fairly common, transient disorder), postpartum affective psychosis (relatively rare), and postpartum depression (as many as 20% of postpartum women may develop mild to moderate depression). The etiology of postpartum depression remains unclear, although numerous biological, psychological, and sociopsychological factors have been proposed as etiologically relevant. There is some empirical support for these notions, but methodological and conceptual problems hinder the development of a coherent theoretical framework for understanding the etiology, course, and treatment of the disorder. Recent data indicate a relation between stress and depression; future research into postpartum depression is needed to determine the contribution of psychosocial factors (e.g., life events and social support). Medical complications during pregnancy, infant variables, and the effect on the infant–mother relationship also need to be studied. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood history of anxiety in adults with panic disorder: association with anxiety sensitivity and comorbidity

Converging lines of evidence indicate a nonspecific link between childhood anxiety disorders and adult panic disorder. Anxiety sensitivity, defined as the fear of anxiety symptoms, was hypothesized to be a potential mediating variable in this link. This study examined the association among childhood history of anxiety disorders, current anxiety symptoms, and anxiety sensitivity in a sample of 100 patients with panic disorder undergoing treatment. Fifty-five percent of the patients had histories of one or more childhood anxiety disorders. Despite the heterogeneity of symptoms and treatment interventions among these patients, a childhood history of anxiety was associated with comorbid anxiety conditions, agoraphobic avoidance, and anxiety sensitivity scores. Anxiety sensitivity was itself a significant predictor of current severity of illness, but a childhood history of anxiety was not. These findings are consistent with the hypothesis that having an anxiety disorder during childhood is linked with patterns of anxiety and phobic avoidance in adulthood, including the level of anxiety sensitivity in patients with panic disorder.     

Current and past depression as predictors of family functioning: A comparison of men and women in a community sample.

The association between family functioning and parental depression has primarily been studied in samples of women. In particular, very little research exists that examines how parent gender and past diagnoses of depression are related to family functioning. The family relationships of 469 couples from a community sample were examined using self- and partner report measures of the marital relationship and youth report and interviewer-rated measures of the parent-youth relationship. Both currently and formerly depressed men and women were shown to have poorer family functioning than nondepressed and never depressed individuals, respectively. Interactions of gender and depression status indicated that depression and poorer marital functioning were more strongly related for women than for men, but there were few gender differences in the parent-youth relationship. The results highlight the need for further research on men's family functioning and suggest that targeting current depressive symptoms in treatment may not be sufficient to resolve marital and parent-youth difficulties that endure after depressive episodes remit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpartum depression and symbiotic illusion.

Discusses the phenomenon of postpartum depression from a transgenerational perspective. The concept of symbiosis is taken from the mother's point of view as well as from the baby's. Symbiosis is defined as a delusional 2-person fantasy of mutual dependence rather than as a normal phase of development. Analysis of a case of postnatal depression is presented to illustrate the clinical and theoretical implications of this viewpoint and how it was applied in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpartum depression in primiparous parents.

Investigated the hypothesis that postpartum depression is a function of disruption of parents' prepartum functioning by the subsequent demands of infant caretaking. 78 primiparous middle SES married couples (mean age 25.5 yrs) completed a battery of questionnaires, including the Beck Depression Inventory, at 8 wks prepartum and 8 wks postpartum, assessing indicators of stress related to childcare. Results indicate that when the level of prepartum depression was controlled, the reported experience of positively reinforcing events was negatively related to postpartum depression for women. For men, the degree to which their infant's behavior was viewed as better than the average was negatively related to postpartum depression. The strongest predictor of depression in both men and women was prepartum depression level. It is concluded that the findings were consistent with the social stress and behavioral theories' interpretation of postpartum depression. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance benefits of depression: Sequential decision making in a healthy sample and a clinically depressed sample.

Previous research reported conflicting results concerning the influence of depression on cognitive task performance. Whereas some studies reported that depression enhances performance, other studies reported negative or null effects. These discrepant findings appear to result from task variation, as well as the severity and treatment status of participant depression. To better understand these moderating factors, we study the performance of individuals—in a complex sequential decision task similar to the secretary problem—who are nondepressed, depressed, and recovering from a major depressive episode. We find that depressed individuals perform better than do nondepressed individuals. Formal modeling of participants' decision strategies suggested that acutely depressed participants had higher thresholds for accepting options and made better choices than either healthy participants or those recovering from depression. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Lifetime comorbidity among anxiety disorders and between anxiety disorders and other mental disorders in adolescents

We examine the lifetime comorbidity among anxiety disorders, and between anxiety disorders and other mental disorders, in a large (n = 1,507) community sample of high school students on whom extensive diagnostic data were available. Three diagnostic groups were formed: those with a lifetime anxiety disorder (n = 134); those with a nonanxiety disorder (n = 510); and those who had never met criteria for a mental disorder (n = 863). The intra-anxiety comorbidity rate was relatively low (18.7%), and was strongly associated with being female (92%). The lifetime comorbidity between anxiety and other mental disorders (primarily MDD) was substantial (73.1%) and was not associated with being female.     

DSM-III-R personality disorders in a mood and anxiety disorders clinic: prevalence, comorbidity, and clinical correlates

This study examined the prevalence, comorbidity, and clinical correlates of personality disorders in an outpatient sample (N = 352) with anxiety and depression. Subjects were diagnosed using the Structured Clinical Interview for DSM-III-R (SCID) on Axes I and II, and they also completed interview and self-report measures of symptoms. Subjects with a personality disorder were less likely to be married, more likely to be single or divorced, had lower family incomes, had more severe symptoms of both anxiety and depression, and had a greater number of lifetime Axis I diagnoses. Subjects with dysthymic and bipolar disorders were more likely, and subjects with panic disorder uncomplicated by agoraphobia were less likely to have a personality disorder compared to the rest of the sample. The most prevalent personality disorders were Avoidant, Obsessive-Compulsive, Paranoid, and Borderline. Paranoid co-occurred with Narcissistic, and Borderline co-occurred with Histrionic personality disorder significantly more often than chance and base rates would predict.