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1.
Am J Med Genet B Neuropsychiatr Genet ; 183(6): 309-330, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32681593

RESUMO

It is imperative to understand the specific and shared etiologies of major depression and cardio-metabolic disease, as both traits are frequently comorbid and each represents a major burden to society. This study examined whether there is a genetic association between major depression and cardio-metabolic traits and if this association is stratified by age at onset for major depression. Polygenic risk scores analysis and linkage disequilibrium score regression was performed to examine whether differences in shared genetic etiology exist between depression case control status (N cases = 40,940, N controls = 67,532), earlier (N = 15,844), and later onset depression (N = 15,800) with body mass index, coronary artery disease, stroke, and type 2 diabetes in 11 data sets from the Psychiatric Genomics Consortium, Generation Scotland, and UK Biobank. All cardio-metabolic polygenic risk scores were associated with depression status. Significant genetic correlations were found between depression and body mass index, coronary artery disease, and type 2 diabetes. Higher polygenic risk for body mass index, coronary artery disease, and type 2 diabetes was associated with both early and later onset depression, while higher polygenic risk for stroke was associated with later onset depression only. Significant genetic correlations were found between body mass index and later onset depression, and between coronary artery disease and both early and late onset depression. The phenotypic associations between major depression and cardio-metabolic traits may partly reflect their overlapping genetic etiology irrespective of the age depression first presents.

2.
Biol Psychiatry ; 87(5): 419-430, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31570195

RESUMO

BACKGROUND: The prevalence of depression is higher in individuals with autoimmune diseases, but the mechanisms underlying the observed comorbidities are unknown. Shared genetic etiology is a plausible explanation for the overlap, and in this study we tested whether genetic variation in the major histocompatibility complex (MHC), which is associated with risk for autoimmune diseases, is also associated with risk for depression. METHODS: We fine-mapped the classical MHC (chr6: 29.6-33.1 Mb), imputing 216 human leukocyte antigen (HLA) alleles and 4 complement component 4 (C4) haplotypes in studies from the Psychiatric Genomics Consortium Major Depressive Disorder Working Group and the UK Biobank. The total sample size was 45,149 depression cases and 86,698 controls. We tested for association between depression status and imputed MHC variants, applying both a region-wide significance threshold (3.9 × 10-6) and a candidate threshold (1.6 × 10-4). RESULTS: No HLA alleles or C4 haplotypes were associated with depression at the region-wide threshold. HLA-B*08:01 was associated with modest protection for depression at the candidate threshold for testing in HLA genes in the meta-analysis (odds ratio = 0.98, 95% confidence interval = 0.97-0.99). CONCLUSIONS: We found no evidence that an increased risk for depression was conferred by HLA alleles, which play a major role in the genetic susceptibility to autoimmune diseases, or C4 haplotypes, which are strongly associated with schizophrenia. These results suggest that any HLA or C4 variants associated with depression either are rare or have very modest effect sizes.

3.
Nat Genet ; 50(5): 668-681, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29700475

RESUMO

Major depressive disorder (MDD) is a common illness accompanied by considerable morbidity, mortality, costs, and heightened risk of suicide. We conducted a genome-wide association meta-analysis based in 135,458 cases and 344,901 controls and identified 44 independent and significant loci. The genetic findings were associated with clinical features of major depression and implicated brain regions exhibiting anatomical differences in cases. Targets of antidepressant medications and genes involved in gene splicing were enriched for smaller association signal. We found important relationships of genetic risk for major depression with educational attainment, body mass, and schizophrenia: lower educational attainment and higher body mass were putatively causal, whereas major depression and schizophrenia reflected a partly shared biological etiology. All humans carry lesser or greater numbers of genetic risk factors for major depression. These findings help refine the basis of major depression and imply that a continuous measure of risk underlies the clinical phenotype.


Assuntos
Transtorno Depressivo Maior/genética , Herança Multifatorial , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla/métodos , Humanos , Masculino , Fenótipo , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Esquizofrenia/genética
4.
Psychiatry Res ; 263: 139-146, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29550719

RESUMO

To understand how cognitive dysfunction contributes to social cognitive deficits in depression, we investigated the relationship between executive function and social cognitive performance in adolescents and young adults during current and remitted depression, compared to healthy controls. Social cognition and executive function were measured in 179 students (61 healthy controls and 118 patients with depression; Mage = 20.60 years; SDage = 3.82 years). Hierarchical regression models were employed within each group (healthy controls, remitted depression, current depression) to examine the nature of associations between cognitive measures. Social cognitive and executive function did not significantly differ overall between depressed patients and healthy controls. There was no association between executive function and social cognitive function in healthy controls or in remitted patients. However, in patients with a current state of depression, lower cognitive flexibility was associated with lower performance in facial-affect recognition, theory-of-mind tasks and overall affect recognition. In this group, better planning abilities were associated with decreased performance in facial affect recognition and overall social cognitive performance. While we infer that less cognitive flexibility might lead to a more rigid interpretation of ambiguous social stimuli, we interpret the counterintuitive negative correlation of planning ability and social cognition as a compensatory mechanism.


Assuntos
Comportamento do Adolescente/psicologia , Cognição/fisiologia , Disfunção Cognitiva/psicologia , Transtorno Depressivo Maior/psicologia , Função Executiva/fisiologia , Comportamento Social , Adolescente , Adulto , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Ajustamento Social , Adulto Jovem
5.
Aust J Rural Health ; 18(4): 153-8, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20690911

RESUMO

OBJECTIVE: To examine rural and urban differences in depression-related mental health literacy, experience of depression and help-seeking. DESIGN: Cross-sectional population-based survey stratified by rural and urban area. SETTING: A random and representative sample of South Australian rural and urban young men aged between 15 and 30 years. OUTCOME MEASURES: Mental health literacy as determined by recognition and exposure to classical symptoms of depression; perceived helpfulness of various interventions and treatment-seeking behaviour. RESULTS: Recognition of depression increased significantly in rural and urban young men between 1998 and 2008. More rural young men than urban men identified symptoms of depression in 1998 (odds ratio (OR): 1.53, 95% confidence interval (CI), 1.01-2.40, P < 0.05), but that was not evident in 2008 (OR: 1.32, 95% CI, 0.80-2.25, P = 0.30). Both groups were more likely to have a close friend experience symptoms of depression and to use antidepressant medications in 2008 compared with 1998. Rural young men experienced a significant increase in recognition of personal depressive symptoms (OR: 3.73, 95% CI, 1.72-8.40) and levels of confidence in psychiatrists and psychologists (OR: 2.40, 95% CI, 1.34-4.31) in 2008 compared with 1998. Both rural and urban young men were significantly less likely to rate dealing with problems on their own as helpful in 2008 as in 1998. CONCLUSIONS: There has been an increase in both rural and urban young male mental health literacy between 1998 and 2008, especially in rural young men. Whether this will translate into a reduction of depression and associated suicide, with a reversal of the rural/urban suicide differential, remains to be seen.


Assuntos
Depressão/prevenção & controle , Letramento em Saúde/tendências , Saúde Mental , Aceitação pelo Paciente de Cuidados de Saúde , População Rural , População Urbana , Adolescente , Adulto , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Masculino , Austrália do Sul , Adulto Jovem
6.
Aust N Z J Psychiatry ; 43(7): 652-8, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19530022

RESUMO

OBJECTIVE: The aim of the present study was to examine the relationship between body mass index (BMI), mental health, and suicidal ideation in a general population. METHOD: Two random and representative samples were drawn from the South Australian population. The interview techniques differed, as did the measures of depression and suicidality. One involved 3034 people in face-to-face interviews, and the other involved 30 214 persons providing information via a computer-assisted telephone interviewing (CATI) system. BMI was classified according to World Health Organization criteria. In face-to-face interviews, major depression was defined by the Primary Care Evaluation of Mental Disorders (PRIME-MD) and suicidal ideation by direct enquiry. In the CATI data, psychological distress was assessed on the Kessler 10 instrument and suicidal ideation by four items on the General Health Questionnaire (GHQ). Data analysis controlled for demographic and physical health variables. RESULTS: In the face-to-face interviews, the combined obese and morbidly obese men were significantly less likely to have major depression or suicidal ideation than those of a healthy weight. For the telephone interview-derived data, the only significant finding was for overweight women to report less psychological distress than those of a healthy weight. CONCLUSIONS: It is no longer tenable to assume that increased BMI is necessarily associated with major depression, psychological distress, or suicidal ideation. Indeed, it appears protective for some people.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Entrevistas como Assunto , Obesidade/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Inquéritos e Questionários , Índice de Massa Corporal , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Vigilância da População , Austrália do Sul/epidemiologia
7.
Emerg Med Australas ; 21(3): 191-5, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19527278

RESUMO

OBJECTIVES: To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the documented care of those frequent attenders. METHOD: A retrospective descriptive study of those who attended the Queen Elizabeth Hospital, Woodville South, Australia ED on average at least once per month between 1 July 2006 and 15 March 2007. RESULTS: Of 11,594 attenders, 54 (0.47%) at the ED were frequent attenders with mental disorders. Their 735 attendances represented 4.5% of the total of 16,345 attendances. Of those frequent attenders, 34 (63%) also visited other Adelaide hospital ED on an additional 410 occasions. Presentations peaked on the weekends and between 18.00 h and midnight. Although 43% of frequent attenders had specific mental health-care plans, only two-thirds of those had been assigned to a mental health team. CONCLUSIONS: The documented management of frequent attenders with mental disorders at a general hospital ED appeared to be less than optimal. Furthermore, the majority of those frequent attenders also attended other general hospital ED in the same city, and this did not appear to be recognized.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Transtornos Mentais , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos
8.
J Clin Psychiatry ; 64(2): 175-81, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12633126

RESUMO

BACKGROUND: Motor vehicle accident studies thus far have focused primarily on psychiatric consequences and outcomes and medicolegal and treatment aspects, particularly of posttraumatic stress disorder (PTSD). This study aimed to determine the impact of motor vehicle accident-related psychiatric disorders on health and economic costs in quantitative terms. METHOD: Of the 3088 victims of motor vehicle accidents who made a claim through the State Insurance Commission, South Australia, between November 27, 1996, and March 23, 1999, 391 responded to the study and were assessed using the 28-item General Health Questionnaire, the PTSD Checklist-Civilian Version, and the Dissociative Experiences Scale. At the end of the study period, computerized cost records and accounting data on the health and economic costs incurred were obtained for each of the subjects. RESULTS: The total health and economic cost in Australian dollars for the 391 motor vehicle accident victims was A$6,369,519.52. At about 9 months after the accident, of the 391 subjects who replied to the questionnaires, 31% were identified as depressed and 62% as anxious, while 29% met criteria for PTSD. PTSD cases incurred significantly higher health care costs compared with non-PTSD cases (p <.001). Untreated PTSD cases incurred significantly higher economic losses compared with treated PTSD and non-PTSD cases (p <.05). CONCLUSION: The health and economic costs associated with motor vehicle accidents are enormous. Psychiatric morbidity among victims was high, and motor vehicle accident-related PTSD significantly contributed to increased overall health care and economic costs.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Transtornos de Estresse Pós-Traumáticos/economia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Acidentes de Trânsito/economia , Adulto , Assistência à Saúde/economia , Feminino , Seguimentos , Medicina Legal , Nível de Saúde , Humanos , Seguro de Responsabilidade Civil/economia , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/economia , Transtornos Mentais/epidemiologia , Prevalência , Estudos Prospectivos , Austrália do Sul/epidemiologia , Inquéritos e Questionários , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos
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