Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study.

BACKGROUND: Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. METHODS: We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. RESULTS: Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. CONCLUSIONS: Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.

Coping style and depressive symptomatology during pregnancy in a private setting sample

Aim: to evaluate the association of antenatal depressive symptomatology (AD) with life events and coping styles, the hypothesis was that certain coping strategies are associated to depressive symptomatology. Methods: we performed a cross sectional study of 312 women attending a private clinic in the city of Osasco, São Paulo from 27/05/1998 to 13/05/2002. The following instruments were used: Beck Depression Inventory (BDI), Holmes and Rahe Schedule of Recent Events (SSRS), Folkman and Lazarus Ways of Coping Questionnaire and questionnaire with social-demographic and obstetric data. Inclusion criteria: women with no past history of depression, psychiatric treatment, alcohol or drug abuse and no clinical-obstetrical complications. Odds ratios and 95% CI were used to examine the association between AD (according to BDI) and exposures variables. Hypothesis testing was done with X2 tests and a p value < .05. Results: AD occurred in 21.1% of pregnant women. By the univariate analyses, education, number of pregnancies, previous abortion, husband income, situation of marriage and score of SSRS were associated with AD. All coping styles were associated with AD, except seeking support and positive reappraisal. By the multivariate analyses, four coping styles were kept in the final model: confront (p = .039), accepting responsibility (p < .001), escape-avoidance (p = .002), problem-solving (p = .005). Conclusions: AD was highly prevalent and was associated with maladaptive coping styles (AU)

Objetivo: evaluar la asociación de la sintomatología depresiva antenatal (AD), con acontecimientos de la vida y estilos de afrontamiento, la hipótesis era que ciertas estrategias de afrontamiento se asocian a síntomas depresivos. Método: Se realizó un estudio transversal con 312 mujeres que asistían a una clínica privada en la ciudad de Osasco, São Paulo desde 27/05/1998 a 13/05/2002. Los instrumentos utilizados fueron: el Inventario de Depresión de Beck (BDI), la escala de reajuste social de Holmes y Rahe (SRRS), la escala de estrategias de afrontamiento (ways of Coping)de Folkman y Lazarus y un cuestionario de datos socio-demográficos y obstétricos. Criterios de inclusión: mujeres sin antecedentes de depresión, tratamiento psiquiátrico, o de abuso de drogas o alcohol y sin complicaciones clínico-obstétricas. Se utilizaron Odds ratios y IC del 95% para examinar la asociación entre AD (según BDI) y las variables de exposición. La prueba de hipótesis se llevó a cabo con tests de X2 y un valor de p < ,05. Resultados: AD se produjo en el 21,1% de las mujeres embarazadas. Con el análisis univariado, la educación, el número de embarazos, abortos anteriores, los ingresos del marido, la situación del matrimonio y la puntuación de SRRS se relacionan con AD. Todos los estilos de afrontamiento se asocian con AD, con excepción de la búsqueda de apoyo y la reevaluación positiva. Utilizando el análisis multivariado, cuatro estilos de afrontamiento se mantuvieron en el modelo final: enfrentamiento (p = ,039), aceptar responsabilidad (p < ,001), huida-evitación (p = ,002), y resolución de problemas (p = ,005). Conclusiones: La AD fue altamente prevalente y se asocia con conductas de afrontamiento mal adaptadas (AU)

Maternity “Blues”: Prevalence and Risk Factors

Objectives: estimate the prevalence and track the risk factors associated with, Maternity blues (MB). Methods: a transversal study was performed with 113 women, on the tenth day of puerperium. The following instruments were used: Pitt Scale (1968), Stein (1980), Inventory for stressful life events by Holmes & Rahe (1967), and a questionnaire with sociodemographic and obstetric data. Results: the prevalence of MB was 32.7% according to the Stein scale. In the univariated analysis, civil status and tobacco use were associated with MB. Legally married women and nonsmokers showed a risk approximately 4 times lower of experiencing the problem. Conclusions: MB was very prevalent in this sample. Obstetricians must be aware of this condition which may be associated with postpartum depression (AU)

Objetivos: estimar la prevalencia y rastrear los factores de riesgo asociados con la tristeza postparto (TP). Método: se realizó un estudio transversal con 113 mujeres, en el décimo día del puerperio. Se utilizaron los siguientes instrumentos: Pitt Scale (1968), Stein (1980), Inventory forStressful Life Events de Holmes & Rahe (1967) y un cuestionario de datos sociodemográficos y obstétricos. Resultados: la prevalencia de la TP fue de un 32.7% de acuerdo con la escala Stein. En el análisis univariado, el estado civil y el consumo de tabaco se asociaron a la TP. Las mujeres casadas y las no fumadoras mostraron un riesgo aproximadamente 4 veces más bajo de sufrir el problema. Conclusiones: se encontró una alta prevalencia de la TP en la muestra. Los obstetras deberían estar alerta ante este estado, que puede asociarse con la depresión postparto (AU)