Prevalence, 20-month incidence and outcome of 
unipolar depressive disorders in a community sample 
of adolescents

Background. This article presents prospective longitudinal findings on prevalence, incidence, patterns of change and stability of depressive disorders in a community sample of 1228 adolescents.Methods. Data were collected at baseline and follow-up (20 months later) in a representative population sample of 1228 adolescents, aged 14–17 at baseline. Diagnostic assessment was based on the Munich Composite International Diagnostic Interview (M-CIDI).Results. The overall cumulative lifetime incidence of any depressive condition was 20·0% (major depressive disorder (MDD), 12·2%; dysthymia, 3·5%; subthreshold MDD, 6·3%), of which about one-third were incident depressions in the period between baseline and follow-up. Depressive disorders rarely started before the age of 13. Females were about twice as likely as males to develop a depressive disorder. Overall, the 20-month outcome of baseline depression was unfavourable. Dysthymia had the poorest outcome of all, with a complete remission rate of only 33% versus 43% for MDD and 54% for subthreshold MDD. Dysthymia also had the highest number of depressive episodes, and most psychosocial impairment and suicidal behavioural during follow-up. Treatment rates were low (8–23%). Subthreshold MDD associated with considerable impairment had an almost identical course and outcome as threshold MDD.Conclusions. DSM-IV MDD and dysthymia are rare before the age of 13, but frequent during adolescence, with an estimated lifetime cumulative incidence of 14%. Only a minority of these disorders in adolescence is treated, and more than half of them persist or remit only partly.

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Recurrent brief depressive disorder reinvestigated: a community sample of adolescents and young adults

Psychological Medicine ◽

10.1017/s0033291702006967 ◽

2003 ◽

Vol 33 (3) ◽

pp. 407-418 ◽

Cited By ~ 23

Author(s):

L. PEZAWAS ◽

H.-U. WITTCHEN ◽

H. PFISTER ◽

J. ANGST ◽

R. LIEB ◽

...

Keyword(s):

Young Adults ◽

Depressive Disorder ◽

Depressive Disorders ◽

Suicide Attempts ◽

Community Sample ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Co Morbidity ◽

Course Stability ◽

Clinically Significant

Background. This article presents prospective lower bound estimations of findings on prevalence, incidence, clinical correlates, severity markers, co-morbidity and course stability of threshold and subthreshold recurrent brief depressive disorder (RBD) and other mood disorders in a community sample of 3021 adolescents.Method. Data were collected at baseline (age 14–17) and at two follow-up interviews within an observation period of 42 months. Diagnostic assessment was based on the Munich Composite International Diagnostic Interview (M-CIDI).Results. Our data suggest that RBD is a prevalent (2·6%) clinical condition among depressive disorders (21·3%) being at least as prevalent as dysthymia (2·3%) in young adults over lifetime. Furthermore, RBD is associated with significant clinical impairment sharing many features with major depressive disorder (MDD). Suicide attempts were reported in 7·8% of RBD patients, which was similar to MDD (11·9%). However, other features, like gender distribution or co-morbidity patterns, differ essentially from MDD. Furthermore, the lifetime co-occurrence of MDD and RBD or combined depression represents a severe psychiatric condition.Conclusions. This study provides further independent support for RBD as a clinically significant syndrome that could not be significantly explained as a prodrome or residual of major affective disorders.

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Diagnostic outcome of self-reported hallucinations in a community sample of adolescents

Psychological Medicine ◽

10.1017/s003329170200555x ◽

2002 ◽

Vol 32 (4) ◽

pp. 619-627 ◽

Cited By ~ 129

Author(s):

D. DHOSSCHE ◽

R. FERDINAND ◽

J. VAN DER ENDE ◽

M. B. HOFSTRA ◽

F. VERHULST

Keyword(s):

Depressive Disorders ◽

Psychotic Disorders ◽

Community Sample ◽

Age Groups ◽

Participation Rate ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Self Report ◽

Diagnostic Outcome

Objective. We aimed to assess the diagnostic outcome of self-reported hallucinations in adolescents from the general population.Method. The sample consisted of 914 adolescents between ages 11–18 participating in an ongoing longitudinal study. The participation rate from the original sample was 70%. Responses on the Youth Self-Report questionnaire were used to ascertain hallucinations in adolescents. Eight years later, Axis 1 DSM-IV diagnoses were assessed using the 12-month version Composite International Diagnostic Interview in 783 (86%) of 914 study subjects. No subjects were diagnosed with schizophreniform disorders or schizophrenia.Results. Hallucinations were reported by 6% of adolescents and 3% of young adults. Self-reported hallucinations were associated with concurrent non-psychotic psychiatric problems in both age groups. Adolescents who reported auditory, but not visual, hallucinations, had higher rates of depressive disorders and substance use disorders, but not psychotic disorders, at follow-up, compared to controls.Conclusions. Self-reported auditory hallucinations in adolescents are markers of concurrent and future psychiatric impairment due to non-psychotic Axis 1 disorders and possibly Axis 2 disorders. It cannot be excluded that there was selective attrition of children and adolescents who developed Schizophrenic or other psychotic disorders later in life.

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Self-rated general health and psychiatric disorders in a general population sample

European Psychiatry ◽

10.1016/j.eurpsy.2004.09.026 ◽

2005 ◽

Vol 20 (3) ◽

pp. 223-228 ◽

Cited By ~ 4

Author(s):

Ulrich John ◽

Christian Meyer ◽

Hans-Jürgen Rumpf ◽

Anja Schumann ◽

Horst Dilling ◽

...

Keyword(s):

General Population ◽

Psychiatric Disorders ◽

General Health ◽

Somatoform Disorders ◽

Population Sample ◽

Participation Rate ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Diagnostic And Statistical Manual

AbstractThe purpose of this study was to explore the relationships between nicotine and alcohol dependence, depressive, anxiety and somatoform disorders with self-rated general health (GH). A cohort study of a random sample of the non-institutionalised general population aged 18–64 with a participation rate of 70.2% was carried out in a German area (n = 4075 at baseline). A follow-up of tobacco smokers or heavy drinkers (n = 1083, 79.4% of those who had given consent to be followed-up) was conducted 30 months after baseline measurement. The assessments included self-ratings of GH and Diagnostic and Statistical Manual (DSM-IV) diagnoses based on the Composite International Diagnostic Interview. The results show that nicotine dependence, anxiety disorders and somatoform disorders moderately predicted self-rated GH at follow-up (general linear model, R2 = 0.12). We conclude that psychiatric disorders may contribute to the prediction of a low self-rated GH.

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Psychiatric history and subthreshold symptoms as predictors of the occurrence of depressive or anxiety disorder within 2 years

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.080572 ◽

2011 ◽

Vol 198 (3) ◽

pp. 206-212 ◽

Cited By ~ 72

Author(s):

Julie Karsten ◽

Catharina A. Hartman ◽

Johannes H. Smit ◽

Frans G. Zitman ◽

Aartjan T. F. Beekman ◽

...

Keyword(s):

Anxiety Disorder ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Depressive Disorders ◽

Depressive Symptomatology ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Self Report ◽

History Of ◽

History Of Depression

BackgroundPast episodes of depressive or anxiety disorders and subthreshold symptoms have both been reported to predict the occurrence of depressive or anxiety disorders. It is unclear to what extent the two factors interact or predict these disorders independently.AimsTo examine the extent to which history, subthreshold symptoms and their combination predict the occurrence of depressive (major depressive disorder, dysthymia) or anxiety disorders (social phobia, panic disorder, agoraphobia, generalised anxiety disorder) over a 2-year period.MethodThis was a prospective cohort study with 1167 participants: the Netherlands Study of Depression and Anxiety. Anxiety and depressive disorders were determined with the Composite International Diagnostic Interview, subthreshold symptoms were determined with the Inventory of Depressive Symptomatology–Self Report and the Beck Anxiety Inventory.ResultsOccurrence of depressive disorder was best predicted by a combination of a history of depression and subthreshold symptoms, followed by either one alone. Occurrence of anxiety disorder was best predicted by both a combination of a history of anxiety disorder and subthreshold symptoms and a combination of a history of depression and subthreshold symptoms, followed by any subthreshold symptoms or a history of any disorder alone.ConclusionsA history and subthreshold symptoms independently predicted the subsequent occurrence of depressive or anxiety disorder. Together these two characteristics provide reasonable discriminative value. Whereas anxiety predicted the occurrence of an anxiety disorder only, depression predicted the occurrence of both depressive and anxiety disorders.

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DHA mediates the protective effect of fish consumption on new episodes of depression among women

British Journal Of Nutrition ◽

10.1017/s0007114517002768 ◽

2017 ◽

Vol 118 (9) ◽

pp. 743-749 ◽

Cited By ~ 1

Author(s):

John L. Reeves ◽

Petr Otahal ◽

Costan G. Magnussen ◽

Terry Dwyer ◽

Antti J. Kangas ◽

...

Keyword(s):

Fatty Acids ◽

Fish Consumption ◽

Reference Group ◽

Composite International Diagnostic Interview ◽

Continuous Variable ◽

Diagnostic Interview ◽

Relative Risks ◽

Binomial Regression ◽

Depressive Episodes

AbstractIn a longitudinal cohort study of young Australian adults, we reported that for women higher baseline levels of fish consumption were associated with reduced incidence of new depressive episodes during the 5-year follow-up. Fish are high in bothn-3 fatty acids and tyrosine. In this study, we seek to determine whethern-3 fatty acids or tyrosine explain the observed association. During 2004–2006, a FFQ (nine fish items) was used to estimate weekly fish consumption among 546 women aged 26–36 years. A fasting blood sample was taken and high-throughput NMR spectroscopy was used to measure 233 metabolites, including serumn-3 fatty acids and tyrosine. During 2009–2011, new episodes of depression since baseline were identified using the lifetime version of the Composite International Diagnostic Interview. Relative risks were calculated using log-binomial regression and indirect effects estimated using the STATA binary_mediation command. Potential mediators were added to separate models, and mediation was quantified as the proportion of the total effect due to the mediator. Then-3 DHA mediated 25·3 % of the association between fish consumption and depression when fish consumption was analysed as a continuous variable and 16·6 % when dichotomised (reference group: <2 serves/week). Tyrosine did not mediate the association (<0·1 %). Components in fish other thann-3 fatty acids and tyrosine might be beneficial for women’s mental health.

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Prevalence, incidence and stability of premenstrual dysphoric disorder in the community

Psychological Medicine ◽

10.1017/s0033291701004925 ◽

2002 ◽

Vol 32 (1) ◽

pp. 119-132 ◽

Cited By ~ 287

Author(s):

H.-U. WITTCHEN ◽

E. BECKER ◽

R. LIEB ◽

P. KRAUSE

Keyword(s):

Suicide Attempts ◽

Community Sample ◽

Composite International Diagnostic Interview ◽

Premenstrual Dysphoric Disorder ◽

Epidemiological Data ◽

Co Morbidity ◽

Menstrual Symptoms ◽

Dsm Iv ◽

Prospective Longitudinal

Background. Despite an abundance of clinical research on premenstrual and menstrual symptoms, few epidemiological data provide estimates of the prevalence, incidence, co-morbidity, stability and correlates of premenstrual dysphoric disorder (PMDD) in the community.Aims. To describe the prevalence, incidence, 12 co-morbidity factors and correlates of threshold and subthreshold PMDD in a community sample of young women.Methods. Findings are based on prospective–longitudinal community survey of 1488 women aged 14–24, who were followed-up over a period of 48 months (follow-up, N = 1251) as part of the EDSP sample. Diagnostic assessments were based on the Composite International Diagnostic Interview (CIDI) and its 12-month PMDD diagnostic module administered by clinical interviewers. Diagnoses were calculated using DSM-IV algorithms, but daily ratings of symptoms, as required, were not available.Results. The baseline 12-month prevalence of DSM-IV PMDD was 5·8%. Application of the diagnostic exclusion rules with regard to concurrent major depression and dysthymia decreased the rate only slightly (5·3%). An additional 18·6% were ‘near-threshold’ cases, mostly because they failed to meet the mandatory impairment criterion. Over the follow-up period only few new PMDD cases were observed: cumulative lifetime incidence was 7·4%. PMDD syndrome was stable across 48 months with <10% complete remissions among baseline PMDD cases. The 12-month and lifetime co-morbidity rates were high (anxiety disorders 47·4%, mood disorders 22·9%; somatoform 28·4%), only 26·5% had no other mental disorder. Particularly high odds ratios were found with nicotine dependence and PTSD. In terms of correlates increased rates of 4-weeks impairment days, high use of general health and mental health services, and increased rates of suicide attempts were found.Conclusion. In this sample of adolescents and young adults, premenstrual symptoms were widespread. However, DSM-IV PMDD was considerably less prevalent. PMDD is a relatively stable and impairing condition, with high rates of health service utilization, increased suicidality and substantial co-morbidity.

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Danger and loss events and the incidence of anxiety and depressive disorders: a prospective-longitudinal community study of adolescents and young adults

Psychological Medicine ◽

10.1017/s0033291714001160 ◽

2014 ◽

Vol 45 (1) ◽

pp. 153-163 ◽

Cited By ~ 16

Author(s):

E. Asselmann ◽

H.-U. Wittchen ◽

R. Lieb ◽

M. Höfler ◽

K. Beesdo-Baum

Keyword(s):

Young Adults ◽

Depressive Disorders ◽

Community Sample ◽

Adolescents And Young Adults ◽

Co Morbidity ◽

Dsm Iv ◽

Logistic Regressions ◽

Anxiety Depression ◽

Prospective Longitudinal

BackgroundThere are inconclusive findings regarding whether danger and loss events differentially predict the onset of anxiety and depression.MethodA community sample of adolescents and young adults (n = 2304, age 14–24 years at baseline) was prospectively followed up in up to four assessments over 10 years. Incident anxiety and depressive disorders were assessed at each wave using the DSM-IV/M-CIDI. Life events (including danger, loss and respectively mixed events) were assessed at baseline using the Munich Event List (MEL). Logistic regressions were used to reveal associations between event types at baseline and incident disorders at follow-up.ResultsLoss events merely predicted incident ‘pure’ depression [odds ratio (OR) 2.4 per standard deviation, 95% confidence interval (CI) 1.5–3.9, p < 0.001] whereas danger events predicted incident ‘pure’ anxiety (OR 2.3, 95% CI 1.1–4.6, p = 0.023) and ‘pure’ depression (OR 2.5, 95% CI 1.7–3.5, p < 0.001). Mixed events predicted incident ‘pure’ anxiety (OR 2.9, 95% CI 1.5–5.7, p = 0.002), ‘pure’ depression (OR 2.4, 95% CI 1.6–3.4, p < 0.001) and their co-morbidity (OR 3.6, 95% CI 1.8–7.0, p < 0.001).ConclusionsOur results provide further evidence for differential effects of danger, loss and respectively mixed events on incident anxiety, depression and their co-morbidity. Since most loss events referred to death/separation from significant others, particularly interpersonal loss appears to be highly specific in predicting depression.

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Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study

Psychological Medicine ◽

10.1017/s0033291710001911 ◽

2010 ◽

Vol 41 (6) ◽

pp. 1165-1174 ◽

Cited By ~ 185

Author(s):

H. J. Conradi ◽

J. Ormel ◽

P. de Jonge

Keyword(s):

Prospective Study ◽

Depressive Symptomatology ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Residual Symptoms ◽

Full Remission ◽

Sleeping Problems ◽

The Individual ◽

Major Depressive Episodes ◽

Depressive Episodes

BackgroundResidual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual symptoms in particular.MethodIn a 3-year prospective study of 267 initially depressed primary care patients we established per week the presence/absence of the individual DSM-IV depressive symptoms during subsequent major depressive episodes (MDEs) and episodes of (partial) remission. This was accomplished by means of 12 assessments at 3-monthly intervals with the Composite International Diagnostic Interview (CIDI).ResultsIn general, residual depressive symptomatology was substantial, with on average two symptoms present during remissions. Three individual symptoms (cognitive problems, lack of energy and sleeping problems) dominated the course of depression and were present 85–94% of the time during depressive episodes and 39–44% of the time during remissions.ConclusionsResidual symptoms are prevalent, with some symptoms being present for almost half of the time during periods of remission. Treatment until full remission is achieved is not common practice, yet there is a clear need to do so to prevent relapse. Several treatment suggestions are made.

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Social support and delusional-like experiences: a nationwide population-based study

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796011000862 ◽

2012 ◽

Vol 21 (2) ◽

pp. 203-212 ◽

Cited By ~ 16

Author(s):

S. Saha ◽

J. Scott ◽

D. Varghese ◽

J. McGrath

Keyword(s):

Social Support ◽

General Population ◽

Community Sample ◽

Composite International Diagnostic Interview ◽

Population Based ◽

Diagnostic Interview ◽

Confounding Factors ◽

Poor Social Support ◽

Physical Disorders ◽

The Relationship

Background.Population-based studies have identified that delusional-like experiences (DLEs) are common in the general population. While there is a large literature exploring the relationship between poor social support and risk of mental illness, there is a lack of empirical data examining the association of poor social support and DLEs. The aim of the study was to explore the association between social support and DLEs using a large, nationally representative community sample.Methods.Subjects were drawn from a national multistage probability survey of 8841 adults aged between 16 and 85 years. The Composite International Diagnostic Interview was used to identify DLEs, common psychiatric disorders and physical disorders. Eight questions assessed various aspects of social support with spouse/partners and other family and friends. We examined the relationship between DLEs and social support using logistic regression, adjusting for potential confounding factors.Results.Of the sample, 8.4% (n = 776) positively endorsed one or more DLEs. Individuals who (a) had the least contact with friends, or (b) could not rely on or confide in spouse/partner, family or friends were significantly more likely to endorse DLEs. The associations remained significant after adjusting for a range of potential confounding factors.Conclusions.DLEs are associated with impoverished social support in the general population. While we cannot exclude the possibility that the presence of isolated DLEs results in a reduction of social support, we speculate that poor social support may contribute in a causal fashion to the risk of DLEs.

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Serotonin-Related Gene Variants in Patients with Irritable Bowel Syndrome and Depressive or Anxiety Disorders

Gastroenterology Research and Practice ◽

10.1155/2017/4290430 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Magdalena Grzesiak ◽

Jan Aleksander Beszłej ◽

Ewa Waszczuk ◽

Marcin Szechiński ◽

Monika Szewczuk-Bogusławska ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Anxiety Disorders ◽

Depressive Disorders ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

New Findings ◽

Rome Iii ◽

Irritable Bowel

Aim. To assess the association of six polymorphisms in serotonin-related genes with depressive or anxiety disorders in patients with irritable bowel syndrome (IBS).Methods. The lifetime prevalence of depressive and anxiety disorders was assessed in 95 IBS patients (85% women) using the Munich version of the Composite International Diagnostic Interview (CIDI). IBS was diagnosed according to the Rome III criteria.SCL6A4HTTLPR polymorphism (rs4795541) was determined using PCR-based method. Single-nucleotide polymorphisms inHTR1A(rs6295),HTR2A(rs6313 and rs6311),HTR2C(rs6318), andTPH1(rs1800532) were detected by minisequencing method.Results. IBS patients with depressive disorders were characterized by higher frequency of 5-HTTLPR L allele in comparison to IBS patients with anxiety disorders. The lower frequency of 1438 A allele inHTR2Awas found in IBS patients with depressive disorders in comparison to IBS patients without mental disorders. The lower G allele frequency inHTR2Crs6318 polymorphism among IBS patients with anxiety disorders was also observed.Conclusions. Our results provide further evidence for the involvement ofSLC6A4rs4795541 andHTR2Ars6311 polymorphisms in the pathophysiology of depressive disorders in IBS patients. The new findings indicate thatHTR2Crs6318 polymorphism may be associated with the susceptibility to anxiety disorders in IBS patients.

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