OBJECTIVE: Early age at menarche has been found to be associated with higher oestrogen levels among girls around the onset of puberty and in early adulthood. The role of oestrogen in depression is not clear, although it affects serotonergic functions in the central nervous system (CNS). We wanted to test the hypothesis that age at menarche is associated with depression in young adulthood. METHODS: The material consisted of 3952 women born in 1966 in Northern Finland. Depression was defined by the Hopkins Symptom Checklist-25 (HSCL-25), the use of antidepressants and by self-reported lifetime depression diagnosed by physician. Menarcheal age was divided as 9-11, 12-15 and 16 years or over. RESULTS: The prevalence of depression was 1.8-fold in current depression, 2.8-fold in the use of antidepressants and 2.1-fold in self-reported physician-diagnosed depression in women with menarche at the age of 16 years or later. After adjusting for confounders, the significant positive association between current depression and late menarche remained, but the use of antidepressants and depression diagnosed by physician had not statistically significant association with the age of menarche. CONCLUSION: A possible explanation for the result may be oestrogen as a protective factor against depression.
There is a lack of longitudinal studies assessing the significance of alexithymia on the emergence of mental illnesses. We aimed to evaluate the potential effect of alexithymia on postpartum anxiety and depression symptoms in a sample of parents to be.
In a pregnancy cohort, longitudinal data were available from three time points (gestational weeks 18-20, and 3 and 12 months postpartum) for 100 mothers and 65 fathers. The 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia, the State-Trait Anxiety Inventory (STAI) to evaluate anxiety symptoms and the Edinburgh Postnatal Depression Scale (EPDS) to assess depression. Linear regression analyses were used to estimate the effect of alexithymia on the symptom scale score changes from baseline.
Both in mothers and fathers, the TAS-20 total score was significantly correlated with the STAI and EPDS scores at several time-points, with a higher TAS-20 score indicating more symptoms. In the regression analyses, the association of alexithymia with later symptoms became non-significant in mothers. However, in fathers, the TAS-20 score had a statistically significant effect on the increase of the STAI score at 3 months postpartum (p?=?0.006). For the separate TAS-20 subscales, difficulty identifying feelings had a significant effect on the increase of anxiety by 12 months postpartum (p?=?0.023) and difficulty describing feelings on the increase by 3 months postpartum (p?
The objective of the present study was to assess alexithymia by means of the Toronto Alexithymia Scale (TAS-20) and The Emotion Protocol (EP) in a group of refugees. Eighty-six subjects were willing to participate. At last follow-up, 33 non-PTSD and 22 PTSD subjects had complete data. Subjects with PTSD had higher scores on the TAS-20 (F = 4.314, df = 77, p = 0.041), but on the subscale level, this was significant only with regard to Factor I, difficulties identifying feelings (F = 5.316, df = 77, p = 0.024). TAS Factor I and to a lower extent TAS Factor II (difficulties naming feelings) were significantly associated with the self-rated presence of dysphoric affects. At follow-up, an increase in TAS Factor I score was associated with increased prevalence of self-rated symptoms of PTSD, but not depression. Decrease in prolactin was associated with significant increase of TAS Factor I (rho = -0.396, n = 54, p = 0.003). The present study indicates that alexithymia as measured by TAS-20 is indeed associated with symptoms of PTSD. This association is almost exclusively explained by the TAS Factor I subscale and is in turn associated with a high level of self-reported dysphoric affect. The longitudinal inverse correlation with prolactin points to the possibility of an underlying disturbance in serotonergic and/or dopaminergic systems. The results thus indicate that secondary, or post-traumatic, alexithymia is a measure of suppressed or warded-off negative affects.
We investigated if alexithymia, a personality construct with difficulties in emotional processing, is stable in the general population.
Altogether 3083 unselected subjects aged 30 and older in Finland completed the 20-item Toronto Alexithymia Scale (TAS-20) in the longitudinal Health 2000 and Health 2011 general population surveys (BRIF8901). The stability of alexithymia at the 11-year follow-up was assessed with t-tests, correlations, and separate linear regression models with base-line and follow-up age, gender, marital status, education, and 12-month depressive and anxiety disorders as confounders.
The mean score (SD) of the TAS-20 for the whole sample was 44.2 (10.4) in 2000 and 44.2 (10.9) in 2011 (p=0.731). The mean score of the TAS-20 subscale Difficulty Identifying Feelings increased by 0.3 points, Difficulty Describing Feelings decreased by 0.6 points and Externally Oriented Thinking increased by 0.3 points. The effect sizes of the changes varied from negligible to small. Age had little effect except for the group of the oldest subjects (75-97years): the TAS-20 mean (SD) score was 49.1 (10.1) in 2000 and 53.1 (10.3) in 2011 (p
The study investigated initial self-image (structural analysis of social behavior) and its relation to 36-month outcome, among patients with anorexia nervosa and bulimia nervosa. Hypotheses were that degree of different aspects of self-image would predict outcome in the groups.
Participants were 52 patients with anorexia and 91 with bulimia from a longitudinal naturalistic database, and outcome measures included eating disorder and psychiatric symptoms and a general outcome index. Stepwise regression was used to investigate which self-image variables were related to outcome, and multiple regression contrasted the groups directly on each obtained predictor.
Consistent with hypotheses, in bulimia degree of self-hate/self-love moderately predicted outcome, whereas self-control-related variables powerfully predicted outcome in anorexia.
It is important to focus on self-image in the treatment of both diagnostic groups, but especially in anorexia nervosa, where control-submission interactions between patient and therapist should be handled with care.
A study of the associations of maternal, paternal and peer attachment with the course of depression from adolescence to young adulthood. In the Youth and Mental Health study 242 adolescents completed the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version for depressive disorders at age 15 and 20. Attachment was measured with the inventory for parent and peer attachment, separately for mother, father, and peers, at age 15. Multinomial logistic regression, indicated insecure attachment relationships with both parents, but not with peers, and were associated with the course of depression. Less secure attachment to mothers was associated with becoming depressed. Less secure attachment to both parents was associated with becoming well and remaining depressed. These results suggest attachment relationships with parents as potential influences on the course of depression and may provide important framework for clinical work with adolescents and young adults.
Individual dispositions have previously been associated with increased risk for depressive symptoms. The direction of the association has been found to be sometimes reciprocal. We examined whether temperament traits are associated with depressive symptoms and whether depressive symptoms contribute to changes in temperament.
Participants (n=674-811) were from a population-based Young Finns Study. Temperament was assessed by a Finnish version of the Formal Characteristics of Behavior - Temperament Inventory. Depressive symptoms were assessed with modified BDI (mBDI) in 1997, 2001, 2007 and 2012, and BDI-II in 2012.
Higher perseveration and emotional reactivity were associated with higher level of depressive symptoms, and higher endurance was associated with lower level of depressive symptoms in 2007 and 2012. These associations were independent of several potential confounders and baseline depressive symptoms. The results of cross-lagged structural equation modeling showed that the associations between temperament and depressive symptoms were reciprocal: briskness, endurance and activity decreased the risk for depressive symptoms while depressive symptoms decreased the level of these characteristics. Perseveration, emotional reactivity and depressive symptoms reinforced each other over time.
The depressive symptoms scales we used are not meant for measuring clinically diagnosed depression. The relationships between temperament traits and depressive symptoms were not strong enough to provide a clinical basis for guiding treatment.
Lower perseveration, lower emotional reactivity and higher endurance seem to be health protective temperament characteristics that reduce the risk for depressive symptoms. The reciprocal associations between temperament and depressive symptoms imply mutual health protective and health declining effects. Clinical relevance of the study is that enhancing positive loops and self-concept, and supporting individual stress management might be helpful in prevention of depressive symptoms.
BACKGROUND: Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. METHODS: Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. RESULTS: 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. CONCLUSION: Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.
The purpose of this exploratory study was to examine change in internalizing symptoms from late childhood (age 10) into mid-adolescence (age 15) in a nationally representative sample of Canadian children. The roles of a child's sex, maternal depressive symptoms in late childhood, and their interactions were investigated.
The sample was derived from the National Longitudinal Survey of Children and Youth. Mothers reported on their own depressive symptoms and children reported on their own internalizing symptoms at three time (T) points (T1: 1994/1995; T2: 1996/1997; T3: 1998/1999). Change in children's internalizing symptoms was investigated using multiple regression.
Girls increased and boys decreased in their internalizing symptoms from T1 to T3. The effect of maternal depressive symptoms at T1 was moderated by sex and remained significant after controlling for maternal depressive symptoms at T2 and T3, with more adverse effects in girls.
The internalizing symptoms of girls increased from childhood to adolescence, whereas those for boys decreased. Female children exposed to maternal depressive symptoms T1 continued to show negative effects 4 years later.