scholarly journals Serotonin transporter polymorphism (5HTTLPR), severe childhood abuse and depressive symptom trajectories in adulthood

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 104-109 ◽  
Author(s):  
Timothy B. Nguyen ◽  
Jane M. Gunn ◽  
Maria Potiriadis ◽  
Ian P. Everall ◽  
Chad A. Bousman
Keyword(s):  
Depressive Symptom ◽  
Childhood Abuse ◽  
Serotonin Transporter ◽  
Symptom Severity ◽  
Cross Sectional ◽  
Symptom Trajectories ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Serotonin Transporter Polymorphism

BackgroundCross-sectional studies suggest that the serotonin transporter promoter region polymorphism (5-HTT gene-linked polymorphic region,5HTTLPR) moderates the relationship between childhood abuse and major depressive disorder.AimsTo examine whether the5HTTLPRpolymorphism moderates the effect childhood abuse has on 5-year depressive symptom severity trajectories in adulthood.MethodAt 5-year follow-up, DNA from 333 adult primary care attendees was obtained and genotyped for the5HTTLPRpolymorphism. Linear mixed models were used to test for a genotype × childhood abuse interaction effect on 5-year depressive symptom severity trajectories.ResultsAfter covariate adjustment, homozygoussallele carriers with a history of severe childhood abuse had significantly greater depressive symptom severity at baseline compared with those without a history of severe childhood abuse and this effect persisted throughout the 5-year period of observation.ConclusionsThe5HTTLPR s/sgenotype robustly moderates the effects of severe childhood abuse on depressive symptom severity trajectories in adulthood.

scholarly journals The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Joshua E. J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Phoebe Barnett ◽  
Katherine Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Panic Disorder ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Antidepressant Treatment ◽  
Patient Data ◽  
History Of ◽  
Depressive Symptom Severity

Abstract Background This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care. Methods We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Results Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions. Conclusions When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.

scholarly journals Absenteeism and associated labour costs according to depressive symptom severity in the German general population: why preventive strategies matter

2021 ◽  
Author(s):  
Roland Eßl-Maurer ◽  
Maria Flamm ◽  
Katharina Hösl ◽  
Jürgen Osterbrink ◽  
Antje van der Zee-Neuen
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Sick Leave ◽  
Symptom Severity ◽  
Health Condition ◽  
Economic Consequences ◽  
Cross Sectional ◽  
Men And Women ◽  
Labour Costs ◽  
Depressive Symptom Severity

Abstract Purpose Depression is a highly prevalent mental health condition with substantial individual, societal and economic consequences. This study focussed on the association of depressive symptom severity with absenteeism duration and employer labour costs. Methods Using cross-sectional data from the German Health Update 2014/2015, multivariable zero-inflated Poisson regression (ZIP) models explored the association of depressive symptom severity (8-item depression patient health questionnaire—PHQ-8), with absenteeism weeks during 12 months in men and women working full- or part-time. The predicted sick leave weeks were multiplied by mean average labour costs. Results The sample consisted of 12,405 persons with an average sick leave of 1.89 weeks (SD 4.26). Fifty-four % were women and 57% were between 40 and 59 years of age. In men and women, mild, moderate, moderately severe and severe depressive symptoms were associated with a significant factor increase in sick leave weeks compared to persons with no or minimal symptoms. Labour costs increased with increasing symptom severity from € 1468.22 for men with no or minimal depressive symptoms to € 7190.25 for men with severe depressive symptoms and from € 1045.82 to € 4306.30 in women, respectively. Conclusion The present results indicate that increasing depressive symptom severity is associated with increasing absenteeism and employer costs. They emphasize the need for implementation, realignment or extension of professional work-site health promotion programmes aiming at the improvement and maintenance of employee health and the reduction of labour costs associated with depression-related sick leave.

scholarly journals What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database

2019 ◽  
Vol 4 ◽  
pp. 69
Author(s):  
Joshua E.J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Katherine Clarke ◽  
Gareth Ambler ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptom ◽  
Life Events ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Inclusion Criteria ◽  
Related Factors ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Pre Treatment

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019)

scholarly journals What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database

2020 ◽  
Vol 4 ◽  
pp. 69
Author(s):  
Joshua E.J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Katherine Clarke ◽  
Gareth Ambler ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptom ◽  
Life Events ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Inclusion Criteria ◽  
Related Factors ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Pre Treatment

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019)

scholarly journals What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database

2019 ◽  
Vol 4 ◽  
pp. 69
Author(s):  
Joshua E.J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Katherine Clarke ◽  
Gareth Ambler ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptom ◽  
Life Events ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Inclusion Criteria ◽  
Related Factors ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Pre Treatment

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 13 RCTs were found to meet inclusion criteria. The Dep-GP database was formed from the 6271 participants. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019)

scholarly journals Copattern of depression and alcohol use in medical care patients: cross-sectional study in Germany

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e032826
Author(s):  
Diana Guertler ◽  
Anne Moehring ◽  
Kristian Krause ◽  
Anil Batra ◽  
Sandra Eck ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Major Depression ◽  
Alcohol Use ◽  
Symptom Severity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sum Score ◽  
Depressive Symptom Severity ◽  
Excessive Consumption

ObjectiveTo predict depressive symptom severity and presence of major depression along the full alcohol use continuum.DesignCross-sectional study.SettingAmbulatory practices and general hospitals from three sites in Germany.ParticipantsConsecutive patients aged 18–64 years were proactively approached for an anonymous health screening (participation rate=87%, N=12 828). Four continuous alcohol use measures were derived from an expanded Alcohol Use Disorder Identification Test (AUDIT): alcohol consumption in grams per day and occasion, excessive consumption in days per months and the AUDIT sum score. Depressive symptoms were assessed for the worst 2-week period in the last 12 months using the Patient Health Questionnaire (PHQ-8). Negative binomial and logistic regression analyses were used to predict depressive symptom severity (PHQ-8 sum score) and presence of major depression (PHQ-8 sum score≥10) by the alcohol use measures.ResultsAnalyses revealed that depressive symptom severity and presence of major depression were significantly predicted by all alcohol use measures after controlling for sociodemographics and health behaviours (p<0.05). The relationships were curvilinear: lowest depressive symptom severity and odds of major depression were found for alcohol consumptions of 1.1 g/day, 10.5 g/occasion, 1 excessive consumption day/month, and those with an AUDIT score of 2. Higher depressive symptom severity and odds of major depression were found for both abstinence from and higher levels of alcohol consumption. Interaction analyses revealed steeper risk increases in women and younger individuals for most alcohol use measures.ConclusionFindings indicate that alcohol use and depression in medical care patients are associated in a curvilinear manner and that moderation by gender and age is present.

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