Stress Incubation and the Onset of Affective Disorders

1993 ◽  
Vol 162 (3) ◽  
pp. 358-362 ◽  
Author(s):  
Paul Bebbington ◽  
Geoff Der ◽  
Brigid Maccarthy ◽  
Til Wykes ◽  
Terry Brugha ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Depressive Disorder ◽  
Psychiatric Disorder ◽  
Life Events ◽  
Affective Disorders ◽  
Depressive Illness ◽  
Neurotic Symptom ◽  
Symptom Patterns

Incubation is the process by which life events influence the onset of psychiatric disorder after an appreciable delay. It has long been recognised clinically. In this paper we use data from the Camberwell Collaborative Depression Study to see whether incubation effects can be demonstrated in depressive illness. We used a novel adaptation of survival analysis for this purpose. The results suggest that incubation does occur in depressive disorder, that it is much less important than the effect of life events close to onset, that it is apparent in women but not in men, and that it is no more evident preceding endogenous than neurotic symptom patterns.

scholarly journals The Symptom Structure of Postdisaster Major Depression: Convergence of Evidence from 11 Disaster Studies Using Consistent Methods

2021 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Carol S. North ◽  
David Baron
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Diagnostic Assessment ◽  
Self Report ◽  
Depression Symptoms ◽  
Symptom Scale ◽  
Major Depressive ◽  
Report Symptom ◽  
Symptom Patterns

Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grouping of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary.

scholarly journals Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study

2020 ◽  
Vol 29 ◽  
Author(s):  
C. E. Lloyd ◽  
N. Sartorius ◽  
H. U. Ahmed ◽  
A. Alvarez ◽  
S. Bahendeka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Life Events ◽  
Stressful Life Events ◽  
Regression Analyses ◽  
Major Depressive

Abstract Aims To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. Methods People with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. Results In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. Conclusion This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.

The Role of Major Depressive Disorder and its Moderating Effect on the Impact of Exposure to Violence for Predicting Recidivism among Juvenile Offenders: A Survival Analysis Approach

2021 ◽  
pp. 003288552110481
Author(s):  
Thomas Wojciechowski
Keyword(s):  
Major Depressive Disorder ◽  
Survival Analysis ◽  
Juvenile Offenders ◽  
Depressive Disorder ◽  
Exposure To Violence ◽  
Past Research ◽  
Major Depressive ◽  
Moderation Effect ◽  
Kaplan Meier ◽  
The Impact

Past research has indicated that Major Depressive Disorder and exposure to violence are risk factors for offending. However, researchers have yet to examine how this disorder may predict recidivism risk among juvenile offenders and how the disorder moderates the effect of exposure to violence. Kaplan-Meier survival analysis was used to determine the impact of Major Depressive Disorder on time to recidivism. Cox proportional hazard modeling was applied to examine Major Depressive Disorder as a moderator of exposure to violence. Results indicated that participants with Major Depressive Disorder demonstrate greater risk for recidivism post-adjudication. The proposed moderation effect was not supported.

Basic mechanisms of, and treatment targets for, depressive disorders

2020 ◽  
pp. 779-788
Author(s):  
Marcela Pereira ◽  
Roberto Andreatini ◽  
Per Svenningsson
Keyword(s):  
Major Depressive Disorder ◽  
Immune System ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Sleep Disturbances ◽  
Depressive Disorders ◽  
Signs And Symptoms ◽  
Molecular Pathways ◽  
Therapy Targets ◽  
Gene Environment

The diagnosis of major depressive disorder (MDD) relies on the presence of a certain number of signs and symptoms, including feelings of guilt, hopelessness, dysphoria, cognitive dysfunction, persistent sleep, and appetite abnormalities. These signs and symptoms overlap with other conditions such as anxiety, bipolar, and seasonal affective disorders. This chapter provides an overview of the basic neurobiological mechanisms underlying MDD and its treatment. There are several alterations in the molecular pathways and neuronal networks associated with MDD. The chapter focuses here on: gene × environment interactions, dysfunctional brain circuitries, neurotransmitter alterations, maladaptation in neurotrophins and neuroplasticity, hypothalamus–pituitary–adrenal (HPA) axis dysfunction, abnormal immune system responses, circadian arrhythmicity, and sleep disturbances. The chapter briefly describes the mechanisms of actions for approved antidepressant therapies and also discusses recent insights into the pathophysiology of MDD and future possible therapy targets.

Acute stress reactions

2012 ◽  
pp. 693-700
Author(s):  
Anke Ehlers ◽  
Allison G. Harvey ◽  
Richard A. Bryant
Keyword(s):  
Life Events ◽  
Stressful Life Events ◽  
Acute Stress ◽  
Psychological Symptoms ◽  
Stressful Life ◽  
Stress Reactions ◽  
Extreme Stress ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Symptom Patterns

Exceptionally stressful life events can cause severe psychological symptoms, including anxiety, feelings of derealization and depersonalization, and hyperarousal. In one of the first studies to comprehensively document acute reactions to extreme stress, Lindemann observed that the symptoms reported by survivors of the Coconut Grove Fire included avoidance, re-experiencing scenes from the fire, reports of derealization, and the experience of anxiety when exposed to reminders of the event. Similarly, acute responses reported by soldiers who fought in the First and Second World Wars included re-experiencing symptoms and dissociative responses such as numbing, amnesia, and depersonalization. The International Classification of Diseases has recognized acute stress reactions since 1948 (ICD-6). In the most recent edition (ICD-10), early reactions to exceptionally stressful life events are diagnosed as acute stress reaction, one of the diagnoses in the section headed ‘reactions to severe stress, and adjustment disorders’. The diagnoses of acute stress reactions in ICD-10 and of acute stress disorder in DSM-IV have similarities in that they are caused by extreme stress and have some overlap in symptom patterns. They can be considered as two separate points on a continuum from transient to more enduring symptoms. However, there are also differences in the underlying concepts, as we will discuss in this chapter.

Dexamethasone Suppression Test in Depression and other Psychiatric Illness

1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Psychiatric Illness ◽  
Dexamethasone Suppression Test ◽  
Major Depressive ◽  
Abnormal Response ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Normal Controls

SummaryThe prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

Plasma II-Hydroxycorticosteroids in Affective Disorders

1967 ◽  
Vol 113 (497) ◽  
pp. 395-404 ◽  
Author(s):  
B. W. L. Brooksbank ◽  
Alec Coppen
Keyword(s):  
Emotional Stress ◽  
Affective Disorders ◽  
Depressive Illness ◽  
Pathological Changes ◽  
Adrenocortical Hormones ◽  
The Relationship ◽  
Psychological Studies

From diverse physiological and psychological studies in animals and in man, it is generally concluded that increased secretion of adrenocortical steroids accompanies emotional stress. The relationship between mood, especially the pathological changes of mood found in a depressive illness, and adrenocortical hormones is not so clearly defined.

scholarly journals Agomelatine: Its Role in the Management of Major Depressive Disorder

2012 ◽  
Vol 4 ◽  
pp. CMPsy.S7989 ◽  
Author(s):  
Daniel P. Cardinali ◽  
María F. Vidal ◽  
Daniel E. Vigo
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Circadian Rhythm ◽  
Depressive Disorder ◽  
Seasonal Affective Disorder ◽  
Rapid Onset ◽  
Depressive Illness ◽  
Melatonin Secretion ◽  
Major Depressive ◽  
Onset Of Action

Circadian rhythm abnormalities, as shown by sleep/wake cycle disturbances, constitute one the most prevalent signs of depressive illness; advances or delays in the circadian phase are documented in patients with major depressive disorder (MDD), bipolar disorder, and seasonal affective disorder (SAD). The disturbances in the amplitude and phase of rhythm in melatonin secretion that occur in patients with depression resemble those seen in chronobiological disorders, thus suggesting a link between disturbed melatonin secretion and depressed mood. Based on this, agomelatine, the first MT1/MT2 melatonergic agonist displaying also 5-HT2C serotonergic antagonism, has been introduced as an antidepressant. Agomelatine has been shown to be effective in several animal models of depression and anxiety and it has beneficial effects in patients with MDD, bipolar disorder, or SAD. Among agomelatine's characteristics are a rapid onset of action and a pronounced effectiveness for correcting circadian rhythm abnormalities and improving the sleep/wake cycle. Agomelatine also improves the 3 functional dimensions of depression—emotional, cognitive, and social—thus aiding in the full recovery of patients to a normal life.

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