Search

Abstract: Objective: In multiple sclerosis (MS), depression rating scales may be used as case-finding instruments for depressive disorders, but depressive symptom ratings may have clinical implications beyond their case-finding role. The objective of this analysis was to explore this possibility by carrying out descriptive analyses of symptom ratings obtained using the Center for Epidemiological Studies Depression Rating Scale (CES-D) in an MS clinic population. Method: The analysis used cross-sectional baseline data collected from 589 subjects enrolled in a prospective cohort study. Data collection included demographic and clinical information including Extended Disability Status Scale ratings, a 54-item MS Quality of Life Scale and the Fatigue Impact Scale. Results: Across a spectrum of CES-D scores, correlations with other health indicators were observed. Depressive symptoms were higher in more disabled subjects. CES-D scores were correlated with the emotional well-being dimension of quality of life and with a social fatigue impact dimension. Alternative scoring of the CES-D had a negligible impact on the pattern of correlation. Conclusions: CES-D ratings appear to be interpretable beyond the traditional yes/no categorization used in case finding. CES-D ratings are predictive of other clinical parameters in domains relevant to mental health. [Copyright &y& Elsevier]

Abstract: Objectives: To estimate the cumulative incidence of major depressive episode (MDE) over 6 years and the associations between demographic and socioeconomic variables and MDE in a sample of the Canadian national population. Methods: Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used. MDE was assessed using the Composite International Diagnostic Interview — Short Form for Major Depression. Participants of the 2000/01 NPHS were followed until 2006/07. Individuals with previous MDE were excluded from the analysis. Proportional hazard models were developed to assess the associations between demographic, socioeconomic characteristics and MDE. Results: The cumulative incidence of MDE at 2002/03, 2004/05 and 2006/07 was 2.9% (95% confidence interval: 2.3%, 3.4%), 5.7% (95% confidence interval: 4.9%, 6.4%) and 7.2% (95% confidence interval: 6.4%, 8.1%). Women, youth, participants with one or more chronic medical conditions and those who reported family history of MDE were more likely to have developed MDE. Family history was the strongest risk factor for MDE (hazard ratio=2.01, 95% confidence interval: 1.51, 2.68). Conclusion: It may be valuable for primary and secondary prevention efforts to target women and young people. Family history is an important factor which should be considered in epidemiological studies about major depression, and also can assist in identifying those at high risk of new-onset MDE. [Copyright &y& Elsevier]

Abstract: Background: The objective of this study was to determine whether major depressive episodes (MDEs) are associated transitions between active and inactive recreational activity patterns. Methods: The data source was the Canadian National Population Health Survey (NPHS). The NPHS included a brief instrument to assess MDEs and collected data on participation in recreational activities. In order to meaningfully categorize participation in recreational activities, the participation data was translated into overall estimated metabolic energy expenditure. A threshold of 1.5 kcal/kg per day was used to distinguish between active and inactive activity patterns. Proportional hazards models were used to compare the incidence of inactivity in initially active respondents with and without MDE and to compare the frequency of becoming active among initially inactive respondents with and without MDE. Results: For active respondents with MDE, an elevated risk of transition into an inactive pattern was observed [adjusted hazard ratio (HR)=1.6; 95% CI 1.2–1.9]. However, MDE did not affect the probability of moving from an inactive to an active lifestyle (adjusted HR=1.0; 95% CI 0.78–1.19). Conclusions: Major depressive episodes are associated with an increased risk of transition from an active to an inactive pattern of activity. [Copyright &y& Elsevier]

Abstract: Objective: Cross-sectional studies have consistently reported associations between major depression (MD) and chronic medical conditions. Such studies cannot clarify whether medical conditions increase the risk for MD or vice versa. The latter possibility has received relatively little attention in the literature. In this study, we evaluate the incidence of several important chronic medical conditions in people with and without MD. Method: The data source was the Canadian National Population Health Survey (NPHS). The NPHS included the Composite International Diagnostic Interview Short Form to assess past-year major depressive episodes. The NPHS also collected self-report data about professionally diagnosed long-term medical conditions. A longitudinal cohort was interviewed every 2 years between 1994 and 2002. Proportional hazards models were used to compare the incidence of chronic conditions in respondents with and without MD and to produce age-, sex- and covariate-adjusted estimates of the hazard ratios. Results: The adjusted hazard ratios associated with MD at baseline interview were elevated for several long-term medical conditions: heart disease (1.7), arthritis (1.9), asthma (2.1), back pain (1.4), chronic bronchitis or emphysema (2.2), hypertension (1.7) and migraines (1.9). The incidences of cataracts and glaucoma, peptic ulcers and thyroid disease were not higher in respondents with MD. Conclusion: A set of conditions characterized particularly by pain, inflammation and/or autonomic reactivity has a higher incidence in people with MD. [Copyright &y& Elsevier]

Objective To estimate the prevalence of depression across a range of neurological conditions in a nationally representative sample. Methods The data source was the Survey of Living with Neurological Conditions in Canada (SLNCC), which accrued its sample by selecting participants from the Canadian Community Health Survey. The point prevalence of depression was estimated by assessment of depressive symptoms with the Patient Health Questionnaire, Brief (Patient Health Questionnaire, 9-item). Results A total of n = 4408 participated in the SLNCC. The highest point prevalence of depression (> 30%) was seen in those with traumatic brain injury and brain/spinal cord tumors. Depression was also highly prevalent (18–28%) in those with (listed from highest to lowest) Alzheimer’s disease/dementia, dystonia, multiple sclerosis, Parkinson’s disease, stroke, migraine, epilepsy and spina bifida. The odds ratios for depression, with the referent group being the general population, were significant (from highest to lowest) for migraine, traumatic brain injury, stroke, dystonia and epilepsy. Conclusions All neurological conditions included in this study are associated with an elevated prevalence of depression in community populations. The conditions with the highest prevalence are traumatic brain injury and brain/spinal cord tumors. [ABSTRACT FROM AUTHOR]

Abstract: Background: Reports of bidirectional associations between smoking and major depression (MD) have been interpreted as providing evidence for confounding by shared-vulnerability factors (SV) that predispose individuals to both conditions. If this is true, then smoking cessation may not reduce the risk of MD. From clinical practice and public health perspectives, the long-term outcomes associated with smoking persistence and cessation are potentially important and deserve exploration. To this end, the 12-year risk of MD in persistent heavy smokers and abstainers who were former-heavy smokers with and without adjustment for potential confounders were compared. Methods: Follow-up data from the National Population Health Survey (NPHS) was used. Multinomial logistic (ML) models were fit to identify potential confounders. Using proportional hazard (PH) models, unadjusted and adjusted hazard ratios (HRs) for MD outcome were estimated for different smoking patterns. Results: The unadjusted HR relating the risk of MD among current-heavy versus former-heavy smokers was 4.3 (95% CI: 2.6–6.9, p < 0.001). Current-heavy smoking predicted onset of MD (HR = 3.1, 95% CI: 1.9–5.2, p < 0.001) even after adjustment for age, sex and stress – the main confounders. However, this was not the case for the never, former-light, and current-light categories. Evidence of decreased risk of MD among former-heavy relative to current-heavy smokers as function of smoking cessation maintenance time was also found. Conclusions: Contrary to common beliefs about the benefits of smoking for mental health, our results suggest that current-heavy rather than ever-heavy smoking is a major determinant of MD risk and point towards the benefits of smoking cessation maintenance. [Copyright &y& Elsevier]

Abstract: Objective: The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief (PHQ-9). Methods: The data source for this study was the Survey of Living with Neurological Conditions in Canada, which was derived from a representative sample of household residents. Results: The sample included 630 respondents with MS. With application of the standard PHQ-9 cut point (10+), the prevalence of depression was 26.0% (95% confidence interval 18.9%–33.0%). Depressed subjects had lower quality of life; an increased frequency of suicidal ideation; and more often reported a negative disease course, high stress, low social support and stigmatization. Conclusions: This study adds to the existing literature by providing point prevalence data: in any 2-week period, about one quarter of community residents with MS experience substantial levels of depressive symptoms. [Copyright &y& Elsevier]