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Life events and changes in the course of depression in young adults
- Robert H. Friis, Hans-Ulrich Wittchen, Hildegard Pfister, Roselind Lieb
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- Journal:
- European Psychiatry / Volume 17 / Issue 5 / September 2002
- Published online by Cambridge University Press:
- 16 April 2020, pp. 241-253
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Background.
Few community-based studies have examined the impact of life events, life conditions and life changes on the course of depression. This paper examines associations of life events on depressive symptom onset, improvement, and stability.
Methods.Direct interview data from the Early Developmental Stages of Psychopathology Study (EDSP), a 4–5 year prospective-longitudinal design based on a representative community sample of adolescents and young adults, aged 14–24 years at baseline, are used. Life events were measured using the Munich Event-Questionnaire (MEL) consisting of 83 explicit items from various social role areas and subscales for the assessment of life event clusters categorized according to dimensions such as positive and negative and controllable and uncontrollable. Depressive disorders were assessed with the DSM-IV version of the Munich Composite Diagnostic Interview (M-CIDI). Multiple logistic regression analyses examined the effects of 22 predictors on the course of depression (onset, improvement, stability).
Results.Younger age, low social class, negative and stressful life events linked to the family were associated with increased risk of new onset of depression. Anxiety was a significant independent predictor of new onset of depression. Absence of stressful school and family events was related to improvement in depression. The weighted total number of life events predicted stable depression.
Conclusions.The association between life events and the course of depression appears to vary according to the outcome being examined, with different clusters of life events differentially predicting onset, improvement, and stability.
The clinical application of ABCB1 genotyping in antidepressant treatment: a pilot study
- Barbara Breitenstein, Sandra Scheuer, Hildegard Pfister, Manfred Uhr, Susanne Lucae, Florian Holsboer, Marcus Ising, Tanja M. Brückl
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- Journal:
- CNS Spectrums / Volume 19 / Issue 2 / April 2014
- Published online by Cambridge University Press:
- 23 July 2013, pp. 165-175
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Background
The gene product of the ABCB1 gene, the P-glycoprotein, functions as a custodian molecule in the blood–brain barrier and regulates the access of most antidepressants into the brain. Previous studies showed that ABCB1 polymorphisms predicted the response to antidepressants that are substrates of the P-gp, while the response to nonsubstrates was not influenced by ABCB1 polymorphisms. The aim of the present study was to evaluate the clinical application of ABCB1 genotyping in antidepressant pharmacotherapy.
MethodsData came from 58 depressed inpatients participating in the Munich Antidepressant Response Signature (MARS) project, whose ABCB1 gene test results were implemented into the clinical decision making process. Hamilton Depression Rating Scale (HAM-D) scores, remission rates, and duration of hospital stay were documented with dose and kind of antidepressant treatment.
ResultsPatients who received ABCB1 genotyping had higher remission rates [χ2(1) = 6.596, p = 0.005, 1-sided] and lower Hamilton sores [t(111) = 2.091, p = 0.0195, 1-sided] at the time of discharge from hospital as compared to patients without ABCB1 testing. Among major allele homozygotes for ABCB1 single nucleotide polymorphisms (SNPs) rs2032583 and rs2235015 (TT/GG genotype), an increase in dose was associated with a shorter duration of hospital stay [rho(28) = –0.441, p = 0.009, 1-sided], whereas other treatment strategies (eg, switching to a nonsubstrate) showed no significant associations with better treatment outcome.
DiscussionThe implementation of ABCB1 genotyping as a diagnostic tool influenced clinical decisions and led to an improvement of treatment outcome. Patients carrying the TT/GG genotype seemed to benefit from an increase in P-gp substrate dose.
ConclusionResults suggest that antidepressant treatment of depression can be optimized by the clinical application of ABCB1 genotyping.
Physical activity and prevalence and incidence of mental disorders in adolescents and young adults
- ANDREAS STRÖHLE, MICHAEL HÖFLER, HILDEGARD PFISTER, ANNE-GRIT MÜLLER, JÜRGEN HOYER, HANS-ULRICH WITTCHEN, ROSELIND LIEB
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- Journal:
- Psychological Medicine / Volume 37 / Issue 11 / November 2007
- Published online by Cambridge University Press:
- 20 June 2007, pp. 1657-1666
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Background
Although positive effects of physical activity on mental health indicators have been reported, the relationship between physical activity and the development of specific mental disorders is unclear.
MethodA cross-sectional (12-month) and prospective-longitudinal epidemiological study over 4 years in a community cohort of 2548 individuals, aged 14–24 years at outset of the study. Physical activity and mental disorders were assessed by the DSM-IV Composite International Diagnostic Interview (CIDI) with an embedded physical activity module. Multiple logistic regression analyses controlling for age, gender and educational status were used to determine the cross-sectional and prospective associations of mental disorders and physical activity.
ResultsCross-sectionally, regular physical activity was associated with a decreased prevalence of any and co-morbid mental disorder, due to lower rates of substance use disorders, anxiety disorders and dysthymia. Prospectively, subjects with regular physical activity had a substantially lower overall incidence of any and co-morbid mental disorder, and also a lower incidence of anxiety, somatoform and dysthymic disorder. By contrast, the incidence of bipolar disorder was increased among those with regular physical activity at baseline. In terms of the population attributable fraction (PAF), the potential for preventive effects of physical activity was considerably higher for men than for women.
ConclusionsRegular physical activity is associated with a substantially reduced risk for some, but not all, mental disorders and also seems to reduce the degree of co-morbidity. Further examination of the evidently complex mechanisms and pathways underlying these associations might reveal promising new research targets and procedures for targeted prevention.
Acontecimientos vitales y cambios en el curso de la depresión en adultos jóvenes
- Robert H. Friis, Hans-UIrich Wittchen, Hildegard Pfister, Roselind Lieb
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- Journal:
- European Psychiatry (Ed.Española) / Volume 10 / Issue 3 / April 2003
- Published online by Cambridge University Press:
- 12 May 2020, pp. 162-176
- Print publication:
- April 2003
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Antecedentes:
Pocos estudios comunitarios han examinado las repercusiones de los acontecimientos vitales, las condiciones de vida y los cambios vitales en el curso de la depresión. Este artículo examina las asociaciones de los acontecimientos vitales en el comienzo, la mejoría y la estabilidad de los síntomas depresivos.
Métodos:Se utilizan datos directos de la entrevista con el Estudio de los Estadios Evolutivos Tempranos de las Manifestaciones Psicopatológicas (EDSP), un diseño prospectivo longitudinal de 4-5 años basado en una muestra comunitaria representativa de adolescentes y adultos jóvenes con 14-24 años en la línea de base. Los acontecimientos vitales se midieron utilizando el Cuestionario de Acontecimientos de Munich (MEL), que consta de 83 elementos explícitos de diversas áreas de rol social y subescalas para la evaluación de grupos de acontecimientos vitales clasificados según dimensiones como positivo y negativo y controlable e incontrolable. Los trastornos depresivos se evaluaron con la versión del DSM-IV de la Entrevista Diagnóstica Compuesta de Munich (M-CIDI). Análisis de regresión logística múltiple examinaron los efectos de 22 predictores en el curso (el comienzo, la mejoría y la estabilidad) de la depresión.
Resultados:Una menor edad, la clase social baja y los acontecimientos vitales negativos y cargados de estrés relacionados con la familia se asociaban con un aumento del riesgo de depresión de nuevo comienzo. La ansiedad era un predictor independiente significativo de la depresión de nuevo comienzo. La ausencia de acontecimientos escolares y familiares cargados de estrés se relacionaba con la mejoría en la depresión. El número total ponderado de acontecimientos vitales predecía depresión estable.
Conclusiones:La asociación entre los acontecimientos vitales y el curso de la depresión parece variar según la respuesta clínica que se examina, prediciendo diferencialmente distintos grupos de acontecimientos vitales el comienzo, la mejoría y la estabilidad.