Prevalence of Adverse Life Events, Depression and Suicidal Thoughts and Behaviour among a Community Sample of Young People aged 15-24 Years

Objective: To provide prevalence data on several key mental health indicators for young people aged 15 to 24 years. Methods: A cross-sectional household survey, using telephone recruitment followed by a postal pencil-and-paper questionnaire. The overall response rate was 67.3%. Results: Difficulties with interpersonal relationships are common causes of distress for young people, in particular problems with parents, problems with friends and relationship break-ups. Depressive symptomatology is common among young people with approximately one in eight males and one in four females reporting current depressive symptomatology. One in three young people reported that they had had suicidal thoughts at some time in the past, 1.2% of young people reported that they had made a plan on how to kill themselves in the four-week period prior to completing the survey and 6.9% of young people reported that they had tried to kill themselves at some time during their life time (4.2% of males and 9.0% of females). Conclusions and implications: The prevalence figures for the various mental health indicators presented in this paper represent good baseline information upon which to examine the progress over time of interventions designed to improve the mental health of young people.

The Alcohol Helplessness Scale and its prediction of depression among problem drinkers

Event-specific scales commonly have greater power than generalized scales in prediction of specific disorders and in testing mediator models for predicting such disorders. Therefore, in a preliminary study, a 6-item Alcohol Helplessness Scale was constructed and found to be reliable for a sample of 98 problem drinkers. Hierarchical multiple regression and its derivative path analysis were used to test whether helplessness and self-efficacy moderate or mediate the link between alcohol dependence and depression, A test of a moderation model was not supported, whereas a test of a mediation model was supported. Helplessness and self-efficacy both significantly and independently mediated between alcohol dependence and depression. Nevertheless, a significant direct effect of alcohol dependence on depression also remained, (C) 2001 John Wiley & Sons, Inc.

A Devonian (Givetian) fore-reef slope sequence at Liangshuijing and implication for Devonian platform-to-depression development in Guilin, South China

Three Bahama-like carbonate plaforms-the Guilin, Yangshuo and Yanshan-occurred in Guilin and the surrounding regions during Middle and Late Devonian, which, at a broad scale, are part of an extensive carbonate platform (Xiangzhou carbonate platform) facies in South China. The intraplatform depression facies, a unique characteristic of the Chinese Devonian depositional sequence, separates Bahama-like (platform-to-depression) carbonate subplatfonns. Intraplatform depressions resulted from syndepositional faulting that cut the basement of carbonate subplatforms and affected further platform development. The Liangshuijing section, located between the Guilin platform in the north and the Yangshuo platform in the south, is representative of the fore-reef slope facies neighboring an intraplatform. depression. The South edge of the fore-reef slope lies adjacent to the Yangshuo reef carbonate platform, and the north edge graded into the Yangdi pelagic depression facies. A detailed sedimentary and microfacies analysis work done in this study at the Liangshuijing section shows a distinct vertical facies change from back-reef, restricted platform, hemipelagic, to fore-reefslope facies, differing from either shallow-water benthic facies or typical pelagic facies. Various benthic and pelagic lithofacies and their associations have been recognized in the Liangshuijing section, including dolomitic rudstone, gastropod wackestone, Amphipora floatstone, tentaculitoid wackestone, stromatolite and oncoid limestone, Amphipora grainstone, grain flows, laminated limestone, flat-pebble and brachiopod floatstone, and carbonate turbidites. Eight types of sedimentary cycles composed of two or three lithofacies have been distinguished, which are able to indicate environment changes. Stromatolites, oncoids, grain flows, carbonate turbidites, and tentaculitoid limestones characterize the slope and intraplatform depression lithofacies. Analysis of the vertical sedimentary cycles in the Liangshuijinag section and the lateral stratigraphic equivalents suggest the differing facies patterns occurred at the middle Varcus Zone (Givetian) of Middle Devonian, coeval with the development of fore-reef slope facies in the Guilin area in response to syndeposifional faulting.

Are tryptophan and 5-hydroxytryptophan effective treatments for depression? A meta-analysis

Objective: To review the literature regarding the effectiveness of 5-hydroxytryptophan (5-HT) and L-tryptophan in the treatment of unipolar depression. Methods: A systematic review of the literature from 1966 to 2000 using the search terms 'tryptophan', 5-hydroxytryptophan', '5-HTP', '5-HT' and 'depression'. We extracted and grouped data for meta-analysis by pooling odds ratios (OR) and relative risks where possible. Results: One hundred and eight studies were located of which only two studies, one of 5-HT and one of L-tryptophan, with a total of 64 patients met sufficient quality criteria to be included. These studies suggest 5-HT and L-tryptophan are better than placebo at alleviating depression (Peto OR = 4.1, 95% CI = 1.3-13.2). However, the small size of the studies, and the large number of inadmissible, poorly executed studies, casts doubt on the result from potential publication bias, and suggests that they are insufficiently evaluated to assess their effectiveness. Conclusions: A large body of evidence was subjected to very basic criteria for assessing reliability and validity, and was found to largely be of insufficient quality to inform clinical practice. More well-designed studies are urgently required to enable an assessment of what may be an effective class of agents.

The relationship of adult attachment dimensions to depression and agoraphobia

We examined the unique relations between the five dimensions of the Attachment Style Questionnaire (ASQ; Feeney, Noller, & Hanrahan, 1994) and depression and agoraphobic behavior (i.e., avoidance of situations where high anxiety is experienced). In addition, we examined mediation models in an attempt to clarify the link between adult attachment and these two dimensions of psychopathology. In testing these models, we administered the ASQ, General Self-Efficacy Scale, Agoraphobic Catastrophic Cognitions Questionnaire, Beck Depression Inventory, and the Mobility Inventory for Agoraphobia (a measure of the degree to which situations are avoided that are typically anxiety provoking for people with agoraphobia) to 122 participants (44 with agoraphobia, 25 with a current major depressive disorder, and 53 with no current psychopathology). The results showed that the insecure attachment dimensions of need for approval, preoccupation with relationships, and relationships as secondary were uniquely associated with depression and that general self-efficacy partly mediated the relationship between need for approval and depression. In contrast, only preoccupation with relationships was uniquely associated with agoraphobic behavior, and catastrophic cognitions about bodily sensations partly mediated this association.

Validade e fiabilidade da versão portuguesa do Stroke Aphasic Depression Questionnaire-21

O objectivo deste estudo é determinar as propriedades psicométricas da versão portuguesa do Stroke Aphasic Depression Questionnaire-21 (SADQ-21). Envolveu 120 sujeitos, 33 dos quais com afasia. Os resultados demonstraram que o SADQ-21 revela uma consistência interna muito elevada (α=0,87). A validade de construção identificou cinco domínios. A variância total explicada pelos factores foi elevada (65,85%). A correlação entre a medida de ouro e o SADQ-21 é estatisticamente significativa (p<0,05). Os indivíduos com afasia estão significativamente mais deprimidos que os sem afasia (p=0,0001). Conclui-se que o SADQ-21 é um instrumento adequado para a avaliação da sintomatologia depressiva em pessoas com afasia.

Factors associated with depression symptoms in high school students in São Paulo, Brazil

OBJECTIVE: To assess factors associated with depression symptoms in high school students. METHODS: A cross-sectional study involving high school students was conducted in the city of São Paulo, Brazil, 2001. A total of 724 students aged 14-18 years answered questionnaires on life and health conditions. Another questionnaire was applied to working (44.8%) and unemployed (22.9%) students to collect information on working conditions. Factors associated to depressive disorders were analyzed using multiple logistic regression controlled for occupational status. RESULTS: Overall prevalence rate of depression was 7.5%. Rates according to gender were 39 (10.3%) in females and 15 (4.3%) in males. The multiple logistic regression analysis showed that factors associated with depressive disorders were: poor self-perception of health (OR=5.78), being female (OR = 2.45), and alcohol consumption (OR=2.35). CONCLUSIONS: The study results showed that sociodemographic, lifestyle and health variables were associated with symptoms of depression in this population. These ndings suggest that it is important to have mental health professionals available in high schools for early detection of mental conditions and student counseling.

Determinants of the exclusive breastfeeding abandonment: psychosocial factors

OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period. RESULTS The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90), 47.6% (n = 80), and 69.6% (n = 117), respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care. CONCLUSIONS Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process.

Incidence and risk factors for intimate partner violence during the postpartum period

OBJECTIVE To estimate the incidence and identify risk factors for intimate partner violence during postpartum.METHODS This prospective cohort study was conducted with women, aged between 18-49 years, enrolled in the Brazilian Family Health Strategy in Recife, Northeastern Brazil, between 2005 and 2006. Of the 1.057 women interviewed during pregnancy and postpartum, 539 women, who did not report violence before or during pregnancy, were evaluated. A theoretical-conceptual framework was built with three levels of factors hierarchically ordered: women’s and partners’ sociodemografic and behavioral characteristics, and relationship dynamics. Incidence and risk factors of intimate partner violence were estimated by Poisson Regression.RESULTS The incidence of violence during postpartum was 9.3% (95%CI 7.0;12.0). Isolated psychological violence was the most common (4.3%; 95%CI 2.8;6.4). The overlapping of psychological with physical violence occurred at 3.3% (95%CI 2.0;5.3) and with physical and/or sexual in almost 2.0% (95%CI 0.8;3.0) of cases. The risk of partner violence during postpartum was increased for women with a low level of education (RR = 2.6; 95%CI 1.3;5.4), without own income (RR = 1.7; 95%CI 1.0;2.9) and those who perpetrated physical violence against their partner without being assaulted first (RR = 2.0; 95%CI 1.2;3.4), had a very controlling partner (RR = 2.5; 95%CI 1.1;5.8), and had frequent fights with their partner (RR = 1.7; 95%CI 1.0;2.9).CONCLUSIONS The high incidence of intimate partner violence during postpartum and its association with aspects of the relationship’s quality between the couple, demonstrated the need for public policies that promote conflict mediation and enable forms of empowerment for women to address the cycle of violence.

Treatment of depression in older adults beyond fluoxetine

This review aimed to discuss the importance of the comprehensive treatment of depression among older adults in Brazil. The abuse of selective serotonin reuptake inhibitors, including fluoxetine hydrochloride, as antidepressants has been considered a serious public health problem, particularly among older adults. Despite the consensus on the need for a comprehensive treatment of depression in this population, Brazil is still unprepared. The interface between pharmacotherapy and psychotherapy is limited due to the lack of healthcare services, specialized professionals, and effective healthcare planning. Fluoxetine has been used among older adults as an all-purpose drug for the treatment of depressive disorders because of psychosocial adversities, lack of social support, and limited access to adequate healthcare services for the treatment of this disorder. Preparing health professionals is a sine qua non for the reversal of the age pyramid, but this is not happening yet.

Maternal mental health and nutritional status of six-month-old infants

ABSTRACT OBJECTIVE To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering the 2006 World Health Organization reference curves. Maternal mental health was measured by the 12-item General Health Questionnaire. The following cutoff points were used: ≥ 3 for common mental disorders, ≥ 5 for more severe mental disorders, and ≥ 9 for depression. The statistical analysis employed adjusted linear regression models. RESULTS The prevalence of common mental disorders, more severe mental disorders and depression was 39.9%, 23.7%, and 8.3%, respectively. Children of women with more severe mental disorders had, on average, a weight-for-length 0.37 z-scores lower than children of women without this health harm (p = 0.026). We also observed that the weight-for-length indicator of children of depressed mothers was, on average, 0.67 z-scores lower than that of children of nondepressed women (p = 0.010). Maternal depression was associated with lower mean values of weight-for-age z-scores (p = 0.041). CONCLUSIONS Maternal mental health is positively related to the inadequacy of the nutritional status of infants at six months.

Life expectancy without depression increases among Brazilian older adults

ABSTRACT OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness.

Executive Function Impairments in Patients with Depression

Depression, the most prevalent psychiatric disorder, has a lifelong risk of 20% and is related to high rates of death among the patients. Thus, this study aims to conduct a systematic review of changes in executive functions of adult patients diagnosed with depression. We found 1381 articles; however, only 28 were selected and recovered. The inclusion criteria was the assessment of executive functions with at least one neuropsychological test, and articles that evaluated primarily adult individuals with depression, without comparison to other psychiatric disorders. Although most of the studies (25 out of 28 analyzed) have shown deficits in some executive subcomponents, these findings are not conclusive because they used different parameters of assessment. Moreover, many variables were not controlled, such as the different subtypes of the disorder, the high level of severity, comorbidity and the use of drugs. Most studies showed different deficits in executive functions in depressed patients, but further longitudinal studies are needed in order to confirm these findings.