Risk factors for major depression during midlife among a community sample of women with and without prior major depression: are they the same or different?

BACKGROUND: Women's vulnerability for a first lifetime-onset of major depressive disorder (MDD) during midlife is substantial. It is unclear whether risk factors differ for first lifetime-onset and recurrent MDD. Identifying these risk factors can provide more focused depression screening and earlier intervention. This study aims to evaluate whether lifetime psychiatric and health histories, personality traits, menopausal status and factors that vary over time, e.g. symptoms, are independent risk factors for first-onset or recurrent MDD across 13 annual follow-ups. METHOD: Four hundred and forty-three women, aged 42-52 years, enrolled in the Study of Women's Health Across the Nation in Pittsburgh and participated in the Mental Health Study. Psychiatric interviews obtained information on lifetime psychiatric disorders at baseline and on occurrences of MDD episodes annually. Psychosocial and health-related data were collected annually. Cox multivariable analyses were conducted separately for women with and without a MDD history at baseline. RESULTS: Women without lifetime MDD at baseline had a lower risk of developing MDD during midlife than those with a prior MDD history (28% v. 59%) and their risk profiles differed. Health conditions prior to baseline and during follow-ups perception of functioning (ps < 0.05) and vasomotor symptoms (VMS) (p = 0.08) were risk factors for first lifetime-onset MDD. Being peri- and post-menopausal, psychological symptoms and a prior anxiety disorder were predominant risk factors for MDD recurrence. CONCLUSIONS: The menopausal transition warrants attention as a period of vulnerability to MDD recurrence, while health factors and VMS should be considered important risk factors for first lifetime-onset of MDD during midlife.

Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS).

BACKGROUND: In women, anxiety symptoms are common and increase during midlife, but little is known about whether these symptoms predict onsets of major depressive disorder (MDD) episodes. We examined whether anxiety symptoms are associated with subsequent episodes of MDD in midlife African-American and Caucasian women, and whether they confer a different risk for first versus recurrent MDD episodes. METHOD: A longitudinal analysis was conducted using 12 years of data from the Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS). The baseline sample comprised 425 Caucasian (n=278) and African American (n=147) community-dwelling women, aged 46.1±2.5 years. Anxiety symptoms measured annually using a self-report questionnaire were examined in relation to MDD episodes in the subsequent year, assessed with the SCID. Multivariable models were estimated with random effects logistic regression. RESULTS: Higher anxiety symptoms scores were associated with a significantly higher adjusted odds of developing an episode of MDD at the subsequent annual visit [odds ratio (OR) 1.47, p=0.01], specifically for a recurrent episode (OR 1.49, p=0.03) but non-significant for a first episode (OR 1.32, p=0.27). There were no significant racial effects in the association between anxiety symptoms and subsequent MDD episodes. CONCLUSIONS: Anxiety symptoms often precede MDD and may increase the vulnerability of midlife women to depressive episodes, particularly recurrences. Women with anxiety symptoms should be monitored clinically during the ensuing year for the development of an MDD episode.

Patient education as a quality indicator in critical care: ischemic heart disease--recognition and response.

Medical critical care unit (MCCU) nurses at a VA medical center designed a quality assurance monitor for educating cardiac patients. Patients with a diagnosis of rule-out myocardial infarction are interviewed about their preadmission use of nitroglycerin and entry into emergency treatment facilities. The MCCU nurses teach a five-point "ischemic heart disease--recognition and response" lesson, and ascertain the patient's immediate level of understanding. If the patient returns to the MCCU at a later date, nurses record the appropriateness of his use of nitroglycerin and entry into emergency treatment facilities. Thus, both short- and long-term gains in patient knowledge are assessed. Solutions to problems encountered in the quality assurance monitor implementation process are discussed. Benefits of the project to patients, the nursing department, and other departments are identified. A sample monthly report and the monitor data collection tool illustrate the process. Future directions for patient education efforts in the MCCU are outlined.

Effects of vestibular stimulation on sleep states in premature infants.

Seventeen appropriate-for-gestational-age premature infants (birthweights 1000-1530 gm) were randomly assigned to control (7) and vestibular stimulation (10) groups. Those in the treatment group were exposed daily to three 15-minute sessions of sinusoidal vestibular stimulation over a 2-week period. At the end of that period, postconceptional age ranged from 34 to 37 weeks. As a measure of neurologic maturation, behavioral and physiologic parameters characterizing sleep states were recorded at the onset and termination of the 2-week period. The ratio of active-to-quiet sleep did not change significantly in control patients. Those exposed to vestibular stimulation showed a significant decrease in proportion of active and a concomitant increase in the proportion of quiet sleep. These results may indicate that vestibular stimulation, even at this early postconceptional age, results in a more mature sleep pattern.

Measurement of the plasma potential with ion acoustic waves.

Plasma potentials are determined from the bias of a Langmuir probe at which the ac probe current due to an externally excited ion wave vanishes.

The influence of exercise on muscle lysosomal enzymes.

Representative lysosomal enzyme activities were measured in muscles taken 0 h and 24 h after an acute exercise run that was completed without any overt signs of fatigue. The animals had progressed 2 and 4 weeks into a standard exercise program which typically produces adaptive changes in the working muscles. There was an increase in acetylglucosaminidase activity (12%) in the fast-twitch red muscle section of all animals that participated in the training program. This small increase may be representative of a delayed response found after more exhausting exercise. The single exercise bout, however, did not cause any acute change in lysosomal activity nor alter the partition of lysosomal enzymes between the "free" and particulate fractions. Thus, altered lysosomal enzyme activity does not appear to be a contributing influence that challenges muscle fiber homeostasis during moderately intense running.

Ion wave excitation with an array of wire probes.

A simple and inexpensive method to excite compressive ion acoustic waves with relative amplitudes deltan/n less, similar0.45 is described.

[Mother-child-relations from the anthropological point of view (author's transl)]. / Mutter-Kind-Beziehungen in anthropologischer Sicht.

Some aspects of the ontogenetical process in the field of the mother-child-relations are discussed; the available answers to pertinent questions according to the actual level of knowledge are reviewed. The fact, that in torrid biotopes the increase of the body weight of the fetus towards the end of the fetal time is insignificant in proportion to comparison-values from the temporate zone is traced back predominantly to the effect of social factors (deficiencies in nourishment of the pregnant women). Also with regard to the regional and temporal differences in the conceptive frequency it is necessary for explanation to quote social factors besides climatic ones. Against the increasing radiant exposition of certain population groups objections are advanced in view of a potential damage to embryos and foetes. The teratogenetic effect of certain chemical factors and of the deficiency or shortage of nourishment of pregnant women are illustrated by means of examples. The problematic subject of the variability with age and gender of the colour of eyes and hair is delineated, the implementation of new comprehensive family inquiries is called for.

[Unequal breast-nourishment as pretended cause of differences of features at twin-brothers (author's transl)]. / Ungleichartige Brustnahrung als vermeintliche Ursache für Wesensunterschiede bei Zwillingsbrüdern.

A theological polemical treatise of 1709, as a source for the general history and this history of civilization and especially of ethics, is exploited to declare some scientifical matters of fact. The conception, developed by the author by reason of the different behaviour of twins as adults, the nourishment assimilated in earliest youth would decide the future of man, is analyzed and compared with the modern state of knowledge of the twin-research. On the confrontation of the notions "nature" and "nurture", which can be traced back to Shakespeare, in Galton, the originator of the twin-research, is referred to.

Plasma enclosed in a magnetic field produced by flexible surface magnets.

A homogeneous steady state plasma with a usable volume of approximately 200 l and with an electron temperature of 1-2 eV and a plasma density of approximately 10(9)-10(10) cm(-3) is produced in a discharge chamber the outside of whose walls is covered with flexible magnetic strips. This magnet arrangement can be built at a fraction of the cost of a conventional system using rigid surface magnets. The magnetic multipole field leads to an increase of the plasma density by one to two orders of magnitude and it is also found to cause trapping of high energy electrons originating from the discharge region.