RESUMO
ABSTRACT: The aim of this study was to analyze whether interpersonal sensitivity mediates the effect of qualitative parenting characteristics experienced during childhood on the appraisal of life experiences and depression severity during adulthood in adult community volunteers. A total of 404 Japanese adult volunteers answered the following four self-report questionnaires: Parental Bonding Instrument, Interpersonal Sensitivity Measure, Life Experiences Survey, and Patient Health Questionnaire-9. Structural equation modeling was performed to analyze whether childhood parenting quality increases depressive symptom severity through interpersonal sensitivity, which then affects the appraisal of recent life events. In the two structural equation models, inadequate care and excessive overprotection received during childhood were associated with the negative evaluation of life experiences and depression severity in adulthood through high interpersonal sensitivity. Our findings indicate interpersonal sensitivity as a mediator of the effect of inadequate care and excessive overprotection experienced in childhood on the negative evaluation of life experiences and depression severity in adulthood.
Assuntos
Depressão , Poder Familiar , Adulto , Humanos , Pais , Inquéritos e Questionários , Questionário de Saúde do PacienteRESUMO
AIM: The risk of falls owing to simultaneous use of multiple hypnotics has not been clarified. The aim of this study was to assess the association between the simultaneous use of 2 hypnotics and the occurrence of falls in hospitalized patients. METHODS: A matched case-control study was conducted at Tokyo Medical University Hospital in Tokyo, Japan, utilizing data from medical records. Cases were 434 hospitalized patients who experienced falls during their hospital stay between January 2016 and December 2016, and controls were 434 hospitalized patients without falls, individually matched by age, sex, and clinical department. The outcome was the occurrence of an in-hospital fall. The associations between the use of 1 hypnotic and falls, and between the use of 2 hypnotics and falls were assessed by conditional logistic regression analyses. The main multivariable conditional logistic regression model was adjusted for potential risk factors, including the use of other classes of psychotropics (antipsychotics, antidepressants, and anxiolytics), in addition to patient characteristics. RESULTS: The main multivariable conditional logistic regression analyses showed that the simultaneous use of 2 hypnotics (odds ratio [OR] = 2.986; 95% confidence interval [CI], 1.041-8.567), but not the use of a single hypnotic (OR = 1.252; 95% CI, 0.843-1.859), was significantly associated with an increased OR of falls. CONCLUSION: The simultaneous use of 2 hypnotics is a risk factor for falls among hospitalized patients, whereas the use of a single hypnotic may not.
Assuntos
Acidentes por Quedas , Hipnóticos e Sedativos , Humanos , Hipnóticos e Sedativos/efeitos adversos , Estudos de Casos e Controles , Hospitais Universitários , Fatores de RiscoRESUMO
BACKGROUND: Personality traits, such as neuroticism, that results in vulnerability to stress, and resilience, a measure of stress coping, are closely associated with the onset of depressive symptoms, whereas regular physical activity habits have been shown to reduce depressive symptoms. In this study, the mediating effects of neuroticism and resilience between physical activity duration and depressive symptoms were investigated by a covariance structure analysis. METHODS: Between April 2017 and April 2018, 526 adult volunteers were surveyed using self-administered questionnaires. Demographic information, habitual physical activity duration (PAD), neuroticism, and resilience were investigated. The effects of these factors on depressive symptoms were analyzed by a covariance structure analysis. This study was conducted with the approval of the Medical Ethics Committee of Tokyo Medical University. RESULTS: The dose-response curves of physical activity duration and depression scores were U-shaped: the optimal physical activity duration for the lowest depression score was 25.7 h/week. We found that the greater the difference from the optimal PAD, the higher the neuroticism and the lower the resilience, and the more severe the depressive symptoms. Covariance structure analysis demonstrated that neuroticism and resilience significantly and completely mediated the effects of the difference from the optimal PAD on depressive symptoms (coefficient of determination R2 = 0.349). CONCLUSION: Our study suggests that there is an optimal PAD that reduces depressive symptoms, and that a greater difference from the optimal PAD increases depressive symptoms through neuroticism and resilience.
RESUMO
BACKGROUND: Primary progressive aphasia is a clinical dementia syndrome secondary to neurodegenerative disease characterized by language-related difficulties. Currently, there is no effective treatment for language impairment in primary progressive aphasia. In the present study, we investigated the feasibility of Internet video-based speech-language activities for this condition. METHODS: Twenty-three people with primary progressive aphasia (pwPPA) participated in the study and were provided with twelve speech-language activity videos on a dedicated website, with three sessions per week. The group that chose to continue with participation after three months of intervention received Internet activities for one year. Cognitive domains associated with persistence, treatment motivation, and video difficulty settings were statistically analyzed. RESULTS: After three months, 17 out of 23 participants opted to continue with the activities. The ability to follow oral commands which was measured pre intervention was higher in the group that continued compared with those participants who discontinued activity. The scores of two Standard Language Test of Aphasia subtests, sentence repetition and narrative writing-associated with the ability to comprehend and produce sentence structure-were highly correlated with motivation, interest and concentration in activity. Participants with different levels of primary progressive aphasia progression could participate in the same video-based activities when high-frequency words were used in the video. CONCLUSIONS: Internet video-based speech-language activity at home has potential as a useful tool for future primary progressive aphasia treatment because it provides a cost-effective approach to intensive intervention and overcomes barriers associated with traditional therapy approaches.
Assuntos
Afasia Primária Progressiva , Doenças Neurodegenerativas , Humanos , Estudos de Viabilidade , Fonoterapia , Fala , Pacientes Ambulatoriais , Afasia Primária Progressiva/terapiaRESUMO
BACKGROUND: Previous studies have reported that physical activity can prevent the onset of depression and reduces anxiety. In the present study, the hypothesis that total physical activity time influences depressive symptoms via state and trait anxiety was tested by a path analysis. METHODS: Self-administered questionnaires were used to survey 526 general adult volunteers from April 2017 to April 2018. Demographic information, physical activity, and state and trait anxiety were investigated. RESULTS: The association between physical activity time and depressive symptoms was expressed as a U-shape curve. The results of the covariance structure analysis showed that differences from the optimal physical activity time (DOT) had direct positive effects on state and trait anxiety. DOT affected depressive symptoms only via trait anxiety, and this was a complete mediation model. CONCLUSION: The present study suggests that an optimal physical activity time exists for depressive symptoms. The path model demonstrated an association between the three factors of optimal physical activity time, trait anxiety, and depressive symptoms, and the effect was fully mediated by trait anxiety.
Assuntos
Ansiedade , Depressão , Adulto , Humanos , Depressão/epidemiologia , Transtornos de Ansiedade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Stressful life events (SLE) impact psychosocial functioning. However, the psychological mechanism underlying the association between SLE and functional disability (FD) has not been fully elucidated. This study focused on whether depressive symptoms (DS) and subjective cognitive dysfunction (SCD) mediated the influence of SLE, comprising negative SLE (NSLE) and positive SLE (PSLE), on FD. METHODS: A total of 514 adults from Tokyo, Japan, completed the self-administered questionnaires to evaluate DS, SCD, SLE, and FD. We investigated the relationships among the variables using path analysis. RESULTS: Path analyses showed that NSLE positively affected FD directly (ß = 0.253, p < .001), and indirectly via DS and SCD (ß = 0.192, p < .001). PSLE negatively affected FD indirectly via DS and SCD (ß = -0.068, p = .010), although PSLE did not affect FD directly (ß = -0.049, p = .163). LIMITATIONS: Causal relationships could not be determined owing to the cross-sectional design. All participants were recruited in Japan, which limits the generalization of findings to other countries. CONCLUSIONS: DS and SCD, in this order, may partially mediate the positive effect of NSLE on FD. DS and SCD may fully mediate the negative effect of PSLE on FD. When considering the impact of SLE on FD, evaluating the mediating role of DS and SCD could be useful. Our findings may elucidate how perceived life stress affects daily functioning via depressive and cognitive symptoms. In the future, it is desirable to conduct a longitudinal study based on our results.
Assuntos
Disfunção Cognitiva , Estresse Psicológico , Adulto , Humanos , Disfunção Cognitiva/psicologia , Estudos Transversais , Depressão/epidemiologia , Estudos Longitudinais , VoluntáriosRESUMO
BACKGROUND: The rising number of patients with dementia has become a serious social problem worldwide. To help detect dementia at an early stage, many studies have been conducted to detect signs of cognitive decline by prosodic and acoustic features. However, many of these methods are not suitable for everyday use as they focus on cognitive function or conversational speech during the examinations. In contrast, conversational humanoid robots are expected to be used in the care of older people to help reduce the work of care and monitoring through interaction. OBJECTIVE: This study focuses on early detection of mild cognitive impairment (MCI) through conversations between patients and humanoid robots without a specific examination, such as neuropsychological examination. METHODS: This was an exploratory study involving patients with MCI and cognitively normal (CN) older people. We collected the conversation data during neuropsychological examination (Mini-Mental State Examination [MMSE]) and everyday conversation between a humanoid robot and 94 participants (n=47, 50%, patients with MCI and n=47, 50%, CN older people). We extracted 17 types of prosodic and acoustic features, such as the duration of response time and jitter, from these conversations. We conducted a statistical significance test for each feature to clarify the speech features that are useful when classifying people into CN people and patients with MCI. Furthermore, we conducted an automatic classification experiment using a support vector machine (SVM) to verify whether it is possible to automatically classify these 2 groups by the features identified in the statistical significance test. RESULTS: We obtained significant differences in 5 (29%) of 17 types of features obtained from the MMSE conversational speech. The duration of response time, the duration of silent periods, and the proportion of silent periods showed a significant difference (P<.001) and met the reference value r=0.1 (small) of the effect size. Additionally, filler periods (P<.01) and the proportion of fillers (P=.02) showed a significant difference; however, these did not meet the reference value of the effect size. In contrast, we obtained significant differences in 16 (94%) of 17 types of features obtained from the everyday conversations with the humanoid robot. The duration of response time, the duration of speech periods, jitter (local, relative average perturbation [rap], 5-point period perturbation quotient [ppq5], difference of difference of periods [ddp]), shimmer (local, amplitude perturbation quotient [apq]3, apq5, apq11, average absolute differences between the amplitudes of consecutive periods [dda]), and F0cov (coefficient of variation of the fundamental frequency) showed a significant difference (P<.001). In addition, the duration of response time, the duration of silent periods, the filler period, and the proportion of fillers showed significant differences (P<.05). However, only jitter (local) met the reference value r=0.1 (small) of the effect size. In the automatic classification experiment for the classification of participants into CN and MCI groups, the results showed 66.0% accuracy in the MMSE conversational speech and 68.1% accuracy in everyday conversations with the humanoid robot. CONCLUSIONS: This study shows the possibility of early and simple screening for patients with MCI using prosodic and acoustic features from everyday conversations with a humanoid robot with the same level of accuracy as the MMSE.
RESUMO
Background: Parenting quality experienced in childhood affects depressive symptoms in adulthood, and neuroticism and resilience are attracting attention as personality traits that mediate the effects of parental rearing quality experienced in childhood on adulthood depressive symptoms. However, the interaction between neuroticism and resilience remains unclear. In this study, we hypothesized that resilience and neuroticism are mediators between parental rearing quality experienced in childhood and depressive symptoms in adulthood, and furthermore, that resilience and neuroticism interact with each other in their effects on depressive symptoms. To test these hypotheses, we conducted structural equation modeling and hierarchical multiple regression analysis including interactions in adult volunteers. Methods: A self-administered questionnaire survey was conducted on 528 adult volunteers recruited at Tokyo Medical University for 1 year from April 2017 to April 2018. The Parental Bonding Instrument (PBI), Eysenck Personality Questionnaire-revised short version, Connor-Davidson Resilience Scale, and Patient Health Questionnaire-9 were used as questionnaires, and their scores were analyzed using structure equation modeling. The interaction between resilience and neuroticism was analyzed using hierarchical multiple regression analysis. Results: Structural equation modeling showed that parenting quality (care and overprotection) experienced in childhood had a significant indirect effect on the severity of depressive symptoms in adulthood, mediated by both neuroticism and resilience. Among the subscores of the PBI, "care" showed opposite effects to "overprotection". Structural equation modeling of "care" and "overprotection" explained 36.9% and 36.6% of the variability in depressive symptoms in adulthood, respectively. Hierarchical multiple regression analysis showed that the negative interaction between neuroticism and resilience had a significant effect on depressive symptom severity in adulthood. Conclusion: The results of this study show that resilience and neuroticism are mediators of the effects from parental child-rearing to depressive symptoms in adulthood. Furthermore, resilience antagonizes the effect of neuroticism on adulthood depressive symptoms.
RESUMO
INTRODUCTION: Misalignment of chronotype and social schedules result in sleep and health impairments. Presenteeism, the work productivity loss caused by health problems, has much more social costs than absenteeism and is associated with sleep disturbance. However, little is known about the link between chronotype and presenteeism. In this study, the associations between chronotype, sleep schedules, presenteeism, and the mediating role of sleep disturbance were examined. METHODS: A cross-sectional survey was conducted on 8155 office workers from 42 companies in Japan, from 2017 to 2019. The participants answered self-administered questionnaires asking about presenteeism (Work Limitations Questionnaire [WLQ]), sleep disturbance (Pittsburgh Sleep Quality Index [PSQI]), and habitual sleep schedules which enable to calculate the midpoint of sleep on free days, sleep corrected (MSFsc). The mediating effect was examined by using structural equation modeling (SEM). RESULTS: The participants comprised 4462 males and 3677 females (mean age: 36.7 years), and their mean productivity loss was 5.97%. A later sleep onset (+0.29%/h), early wakeup (+0.14%/h), and eveningness (+0.27%/h, MSFsc) were associated with presenteeism in all participants; however, the effect size and significance differed depending on their chronotype. SEM demonstrated a complete mediation model between chronotype and presenteeism, mediated by sleep disturbance and adjusted by age. CONCLUSIONS: Chronotype did not directly, but indirectly affected presenteeism through sleep disturbance. Eveningness leads to sleep disturbance, which then causes presenteeism. On workdays, early sleep times for morningness people, and late wakeup times for eveningness people may improve their work productivity.
Assuntos
Ritmo Circadiano , Transtornos do Sono-Vigília , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Sono , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Sleep disturbance, state anxiety, and cognitive complaints (CCs) have been recognized as important issues in public health. Although the mediating role of CCs has been proposed, their role in the relationships between sleep disturbance, state anxiety, and subjective well-being (SWB) and subjective ill-being (SIB) are not yet fully understood. This study used path analyses to investigate whether CCs mediate these relationships. METHODS: The study recruited 523 Japanese adult volunteers using convenience sampling. Participants completed the Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory (Form Y), Cognitive Complaints in Bipolar Disorder Rating Assessment, and Subjective Well-Being Inventory to evaluate sleep disturbance, state anxiety, CCs, and SWB and SIB, respectively. Path analyses were conducted to assess the mediating effects of CCs. RESULTS: The path analyses showed significant indirect associations of sleep disturbance and state anxiety with SWB (p = 0.024 and p = 0.012) and SIB (p < 0.001 and p < 0.001), respectively, mediated by CCs. Furthermore, there were significant indirect associations of sleep disturbance with CCs (p < 0.001), SWB (p < 0.001), and SIB (p < 0.001), via state anxiety, respectively. CONCLUSIONS: This study suggests that CCs mediate the associations of sleep disturbance and state anxiety with SWB and SIB, respectively, in adult community volunteers. To address SWB and SIB associated with sleep disturbance and state anxiety, evaluating CCs may be useful in public mental health. Our findings will encourage health care workers to assess CCs more systematically. Future studies may need to target CCs to develop interventions for SWB and SIB.
Assuntos
Ansiedade , Transtornos do Sono-Vigília , Adulto , Ansiedade/epidemiologia , Cognição , Estudos Transversais , Depressão/complicações , Humanos , Sono , Transtornos do Sono-Vigília/epidemiologiaRESUMO
BACKGROUND: Childhood parental bonding and cognitive complaints (CCs) affect a worker's mental health (MH), and CCs affect presenteeism. However, the impact of childhood parental bonding on presenteeism and the mediating effect of CCs with respect to the association among childhood parental bonding and presenteeism remain poorly understood. AIM: We aimed to investigate the mediating role of CCs on the relationship between childhood parental bonding and presenteeism to better understand the influence of childhood parental bonding on adulthood presenteeism. SETTING: A total of 440 Japanese adult workers recruited using convenience sampling were evaluated. METHODS: The Parental Bonding Instrument, Cognitive Complaints in Bipolar Disorder Rating Assessment and Work Limitations Questionnaire 8 were used to assess childhood parental bonding, CCs, and presenteeism, respectively. We performed Spearman's correlation analysis and path analysis to investigate the relationship among the variables. RESULTS: Path analysis revealed that childhood parental bonding and CCs significantly affected presenteeism. More specifically, CCs fully and partially mediated the effect of paternal and maternal care on presenteeism, respectively. Moreover, CCs partially mediated the effects of both paternal and maternal overprotection on presenteeism. CONCLUSION: The mediating role of CCs on the relationship between childhood parental bonding and presenteeism was shown in this study. In occupational MH, evaluating the mediating effect of CCs may be useful for addressing adulthood presenteeism associated with childhood parental bonding.
Assuntos
Apego ao Objeto , Presenteísmo , Adulto , Cognição , Humanos , Pais , Inquéritos e QuestionáriosRESUMO
BACKGROUND: In recent years, the roles of rumination, subjective cognitive impairment (SCI), and presenteeism have been emphasized in occupational mental health. However, associations between rumination, SCI, presenteeism, and psychological well-being are not fully understood. We hypothesized that SCI and presenteeism mediate the associations between rumination and subjective well-being (SWB) and subjective ill-being (SIB). Hence, we investigated the mediating roles of SCI and presenteeism in this study. METHODS: A total of 458 adult workers (mean age, 40.8±11.9 years; 44.1% male), who were recruited in Tokyo using convenience sampling, were analyzed in this study. The Ruminative Responses Scale, Cognitive Complaints in Bipolar Disorder Rating Assessment, Work Limitations Questionnaire 8, and Subjective Well-being Inventory were used to evaluate rumination, SCI, presenteeism, and psychological well-being (SWB and SIB), respectively. Path analyses were performed to evaluate the relations between these parameters. RESULTS: The path analysis indicated that rumination, SCI, and presenteeism were directly and negatively associated with SWB and SIB. Regarding indirect effects, rumination was negatively associated with SWB and SIB via SCI, presenteeism, and both SCI and presenteeism. Furthermore, SCI was negatively associated with SWB and SIB via presenteeism. CONCLUSIONS: The results suggest that SCI and presenteeism mediate the associations of rumination with SWB and SIB in Japanese adult workers. To address the psychological well-being associated with rumination, evaluating SCI and presenteeism simultaneously may be useful in occupational mental health. This study provides key insights into the development of comprehensive intervention strategy based on the biopsychosocial perspective for worker's psychological well-being.
RESUMO
Insomnia, job-related stress, and cognitive dysfunction affect the mental health of workers. However, the relationships among sleep reactivity, job-related stress, and subjective cognitive dysfunction in workers remains not fully understood. Therefore, this study seeks to investigate the relationships among these variables in Japanese adult workers. In total, 536 adult workers in Japan were evaluated using the Japanese version of Ford Insomnia Response to Stress Test, Brief Job Stress Questionnaire, and Cognitive Complaints in Bipolar Disorder Rating Assessment to assess sleep reactivity, job-related stress, and subjective cognitive function, respectively. Path analysis was also carried out. The results of the path analysis showed that sleep reactivity significantly influenced on subjective cognitive dysfunction directly and indirectly via job stressors and stress reaction. Our results may not be generalizable to underage workers because only adult workers were included, which is a limitation of this study. The results of the present study suggest that job-related stress mediates the effect of sleep reactivity on subjective cognitive dysfunction in Japanese adult workers. This underscores the need to evaluate the mediating effect of job-related stress in addressing the subjective cognitive dysfunction associated with insomnia in workers.
Assuntos
Disfunção Cognitiva , Estresse Ocupacional , Adulto , Estudos Transversais , Humanos , Japão , Sono , Estresse Psicológico , Inquéritos e QuestionáriosRESUMO
PURPOSE: Trait anxiety, depressive symptoms, and cognitive complaints affect mental health. The mediating role of cognitive complaints has been reported recently. However, the mediating effects of cognitive complaints in the relationships between trait anxiety, depressive symptoms, and subjective well-being (SWB) and ill-being (SIB) remain unknown. Therefore, we used path analyses to investigate these mediating effects. MATERIALS AND METHODS: A total of 554 adult community volunteers in Japan were studied using the State-Trait Anxiety Inventory (Form Y), Patient Health Questionnaire-9, Cognitive Complaints in Bipolar Disorder Rating Assessment, and Subjective Well-Being Inventory. These assessment tools evaluated trait anxiety, depressive symptoms, cognitive complaints, SWB, and SIB. Path analyses were performed in this study. RESULTS: Path analyses revealed that there were significant indirect effects, via cognitive complaints, of trait anxiety and depressive symptoms on SIB. However, there were no significant indirect effects of trait anxiety and depressive symptoms on SWB. There were significant indirect effects, via depressive symptoms, of trait anxiety on cognitive complaints, SWB, and SIB. CONCLUSION: The role of cognitive complaints may be different between SWB and SIB associated with trait anxiety and depressive symptoms. Evaluating the mediating effect of cognitive complaints may be more useful on SIB than SWB associated with trait anxiety and depressive symptoms. These findings may be useful when considering intervention targets in mental health.
RESUMO
Complaints of cognitive functions (CCFs), defined as subjective cognitive dysfunction, affect social function; additionally, for workers, this condition is an important factor in presenteeism and mediates the effect of depressive symptoms on presenteeism. This study aimed to investigate whether CCFs mediate the relationships among insomnia, state anxiety (SA), and presenteeism. Participants were 471 Japanese adult workers evaluated using the Athens Insomnia Scale, State-Trait Anxiety Inventory (Form Y), Cognitive Complaints in Bipolar Disorder Rating Assessment, and Work Limitations Questionnaire 8 to assess insomnia, SA, CCFs, and presenteeism, respectively. Path analysis was used to evaluate the correlations between variables. CCFs significantly mediated the associations among insomnia, SA, and presenteeism. To address the presenteeism associated with insomnia and SA, it may be useful to assess the mediating roles of CCFs.
Assuntos
Presenteísmo , Distúrbios do Início e da Manutenção do Sono , Adulto , Ansiedade/epidemiologia , Cognição , Humanos , Japão/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologiaRESUMO
BACKGROUND: Insomnia and affective temperaments influence depressive symptoms in the general population. However, the ways in which the interaction between insomnia and affective temperaments affects depressive symptoms remains unknown. We studied the moderating effects of affective temperaments on the relationship between insomnia and depressive symptoms in adult community volunteers. METHODS: The participants were recruited from a community in Japan (n = 525). The Athens Insomnia Scale; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire version; and Patient Health Questionnaire-9 were used to evaluate insomnia, affective temperaments, and depressive symptoms, respectively. A hierarchical multiple regression analysis were conducted to evaluate the interactions. RESULTS: Insomnia significantly and positively interacted with cyclothymic, depressive, and anxious temperaments with regard to depressive symptoms, while insomnia significantly and negatively interacted with hyperthymic temperament on depressive symptoms. No significant interaction between insomnia and irritable temperament with regard to depressive symptoms were observed. LIMITATIONS: Since the participants were adult community volunteers in Japan, the results may not be generalizable to other communities. CONCLUSIONS: This study suggests that the influence of insomnia on depressive symptoms is moderated positively by cyclothymic, depressive, and anxious temperament and negatively by hyperthymic temperament. In adult community volunteers, affective temperaments may moderate the influence that insomnia has on depressive symptoms. Therefore, it may be useful to consider affective temperaments while dealing with depressive symptoms associated with insomnia.
Assuntos
Distúrbios do Início e da Manutenção do Sono , Temperamento , Adulto , Depressão/epidemiologia , Humanos , Japão/epidemiologia , Inventário de Personalidade , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Inquéritos e Questionários , VoluntáriosRESUMO
AIM: Early differential diagnosis between patients with major depressive disorder (MDD) and bipolar disorder (BD), and subsequently providing appropriate treatments are essential. There has been increased interest regarding the association between affective temperaments and mood disorder diagnosis. Our aim was to analyze the diagnostic validity of affective temperaments assessed by the short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A), in mood disorder patients. METHODS: Inpatients with MDD (n = 146) or BD (n = 128) completed the short version of TEMPS-A, and their depressive and manic symptom severities were evaluated. Data of MDD and BD patients were compared by univariable and multivariable analyses. RESULTS: Of the five affective temperament dimensions, substantially higher hyperthymic, irritable, and cyclothymic temperament scores were found in BD patients than in MDD patients. Using a multivariable logistic regression model built using the severities of depressed and manic conditions, and the five affective temperament subscale scores as independent variables, we identified two factors statistically associated with BD diagnosis (anxious temperament and cyclothymic temperament). The recommended cutoff point for the 12 items evaluating cyclothymic temperament to differentiate BD from MDD was 8 or more 'True' items (sensitivity: 35.9%, specificity: 87.7%). LIMITATIONS: Our design was cross-sectional, and therefore, there was a possibility of longitudinal diagnostic conversion of patients from MDD to BD. CONCLUSION: Cyclothymic and anxious temperaments on the short version of TEMPS-A, identified as diagnostic differentiating factors between MDD and BD, may play supplementary roles in the early identification of BD.
Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/fisiopatologia , Testes Neuropsicológicos/normas , Temperamento/fisiologia , Adulto , Ansiedade/diagnóstico , Ansiedade/fisiopatologia , Estudos Transversais , Transtorno Ciclotímico/diagnóstico , Transtorno Ciclotímico/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Humor Irritável/fisiologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
TAR DNA-binding protein of 43 kDa (TDP-43) is a major component of intracellular aggregates formed in brains of the patients with frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS), which are correctively referred to as TDP-43 proteinopathies. A link between Ataxin-2 (ATXN2) and TDP-43 proteinopathies was established when intermediate CAG repeat expansions of ATXN2 gene were found to be associated with ALS and it was shown that ATXN2 modifies TDP-43 toxicity. Although ATXN2's contribution to TDP-43 proteinopathies has been mostly studied in ALS, recent studies have shown that intermediate repeat expansions of ATXN2 also influence the phenotype of FTLD by an unknown mechanism. To address this issue, we immunohistochemically and biochemically analyzed the intracellular dynamics of ATXN2 in brains of normal controls and FTLD-TDP cases. The immunohistochemical studies revealed that ATXN2 localized in the neuronal cytoplasm and proximal dendrites, and expressed widely and uniformly in normal human brains. A semi-quantitative immunofluorescent analysis of normal brains revealed that the cytoplasmic ATXN2 strongly associates with ribosomal protein S6 and poly-A binding protein 1 and partially overlaps with the endoplasmic reticulum marker Calnexin, suggesting a major role of ATXN2 in protein synthesis. The results of immunohistochemical and biochemical analyses of brains from FTLD-TDP cases showed the colocalization of ATXN2 and phosphorylated TDP-43 in the dystrophic neurites and the neuronal cytoplasmic inclusions in the hippocampal region, and a significant reduction of ATXN2 protein compared to controls. These results suggest that ATXN2 is involved in the pathological process of FTLD-TDP. It remains to be clarified whether reduced ATXN2 expression induces neurodegeneration by impairing protein synthesis or plays a neuroprotective role by attenuating the toxicity of TDP-43 aggregates in FTLD-TDP and other TDP-43 proteinopathies.
Assuntos
Ataxina-2/metabolismo , Encéfalo/metabolismo , Proteínas de Ligação a DNA/metabolismo , Degeneração Lobar Frontotemporal/metabolismo , Agregação Patológica de Proteínas/metabolismo , Idoso , Idoso de 80 Anos ou mais , Esclerose Lateral Amiotrófica/metabolismo , Esclerose Lateral Amiotrófica/patologia , Animais , Encéfalo/patologia , Estudos de Casos e Controles , Feminino , Degeneração Lobar Frontotemporal/patologia , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Agregação Patológica de Proteínas/patologiaRESUMO
BACKGROUND: Childhood maltreatment affects social functioning in the general adult population. However, how child abuse affects functional disability in adulthood remains unknown. Thus, we investigated the correlation between child abuse, depressive symptoms, cognitive complaints, and functional disability in adult community volunteers. METHODS: Participants (N = 556) completed the Child Abuse and Trauma Scale, Patient Health Questionnaire-9, Cognitive Complaints in Bipolar Disorder Rating Assessment, and Sheehan Disability Scale. Multiple regression analyses and structural equation modeling were performed to evaluate scale correlations. RESULTS: Structural equation modeling showed that the direct effect of childhood maltreatment on depressive symptoms, the indirect effect of childhood maltreatment on cognitive function via depressive symptoms, and the indirect effects of childhood maltreatment on functional disability via depressive symptoms and via cognitive function were all significant. The direct effects of childhood maltreatment on cognitive function and functional disability were not significant. There was no significant association between variables. LIMITATIONS: Cross-sectional designs cannot identify causal relationships between parameters. Participants were adult volunteers from the community; therefore, results may not be generalizable to individuals with psychiatric disorders. Sociodemographic variability was a limitation because we used self-reported childhood maltreatment. CONCLUSIONS: Childhood maltreatment indirectly affects functional disability via depressive symptoms and via cognitive function through depressive symptoms. We suggest that depressive symptoms and cognitive function play crucial roles in the influence of childhood maltreatment on functional disability in adult community volunteers.
Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Depressão/epidemiologia , Adolescente , Adulto , Criança , Maus-Tratos Infantis/psicologia , Cognição , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Previous studies reported that subjective well-being in adulthood correlates with perceived parental bonding in childhood as well as personality traits. However, whether personality traits mediate the effect of perceived parental bonding on well-being or not has not been reported to date. In this study, we hypothesized that 'parental care and overprotection' in childhood affect 'well-being' in adulthood through various 'personality traits', and analyzed this using structural equation modeling. METHODS: A total of 402 adult volunteers from the community provided responses to the following questionnaires: 1) Parental Bonding Instrument, 2) Temperament and Character Inventory, and 3) The Subjective Well-being Inventory. Two structural equation models were designed and the maximum likelihood estimation method was used for covariance structure analysis. RESULTS: Parental care in childhood directly increased well-being in adulthood and indirectly increased it through personality traits (harm avoidance, reward dependence, and self-directedness). Parental overprotection in childhood had no direct effect on well-being in adulthood but decreased well-being in adulthood indirectly through personality traits (harm avoidance, reward dependence, and self-directedness) and increased it through one personality trait (self-transcendence). CONCLUSIONS: This study showed that the influences of perceived parental bonding on well-being in adulthood are mediated by self-directedness, harm avoidance, reward dependence, and self-transcendence among the seven personality dimensions evaluated by the Temperament and Character Inventory.