Major depression: does gender influence the risk of recurrence? A systematic review

Background and Objectives: A woman's lifetime risk of major depression is almost twice as high as that of a man. Major depression is associated with a high risk of recurrence, but the question of a differential risk of recurrence between genders is unclear. Based on a systematic review of the literature, this paper attempts to answer the following question: "Following a major depressive episode, do women and men have the same risk of recurrence?". Methods: We prospectively collected all studies from the period 2005-2014 where the variable gender was considered a potential predictor of recurrence. The database has also been expanded with articles cited in the bibliography of the prospectively collected articles and with a PubMed Database search covering the period January 2005-August 2014. Results: Of the prospective studies (n = 98), most found no influence of gender on recurrence risk, but a minority, mostly large sample studies, found that female gender is a statistically significant risk factor for recurrence. Results suggest a probable female-to-male relative risk of recurrence between 1.0 and 1.2. Given the heterogeneity of the studies (length of follow-up, populations, nature of the studies, choice of dependant variables, statistical methods, and available data) no meta-analyses were performed. There are many interfering variables (age of onset, subchronic evolution, treatments, etc.) that can influence the results of prospective studies. Conclusions: Women probably have a slightly higher risk of recurrence after a major depressive episode than men. This increased risk is much smaller than women's much higher lifetime risk of depression.

Predicting risk of violence through a self-appraisal questionnaire

The Self-Appraisal Questionnaire (SAQ) is a self-report that predicts the risk of violence and recidivism and provides relevant information about treatment needs for incarcerated populations. The objective of the present study was to evaluate the concurrent and predictive validity of this self-report in Spanish offenders. The SAQ was administered to 276 offenders recruited from several prisons in Madrid (Spain). SAQ total scores presented high levels of internal consistency (alpha = .92). Correlations of the instrument with violence risk instruments were statistically significant and showed a moderate magnitude, indicating a reasonable degree of concurrent validity. The ROC analysis carried out on the SAQ total score revealed an AUC of .80, showing acceptable accuracy discriminating between violent and nonviolent recidivist groups. It is concluded that the SAQ total score is a reliable and valid measure to estimate violence and recidivism risk in Spanish offenders.

Persistent infectious and tropical diseases in immigrant correctional populations

A number of infectious diseases amongst travelers and the immigrant populations are a major public health concern. Some have a long incubation period or remain asymptomatic or paucisymptomatic for many years before leading to significant clinical manifestations and/or complications. HIV, hepatitis B and C, tuberculosis or latent syphilis are among the most significant persistent diseases in migrants. Schistosomiasis and strongyloidiasis, for instance, are persistent helminthic infections that may cause significant morbidity, particularly in patients co-infected with HIV, hepatitis B and C. Chagas disease, which was initially confined to Latin America, must also now be considered in immigrants from endemic countries. Visceral leishmaniasis and malaria are other examples of parasitic diseases that must be taken into account by physicians treating incarcerated migrants. The focus of this review article is on the risk of neglected tropical diseases in particularly vulnerable correctional populations and on the risk of infectious diseases that commonly affect migrants but which are often underestimated.