Age at onset of recurrent major depression in Han Chinese women - a replication study.

BACKGROUND: The relationship between age at onset (AAO) and major depression (MD) has been studied in US, European and Chinese populations. However, larger sample studies are needed to replicate and extend earlier findings. METHODS: We re-examined the relationship between AAO and the clinical features of recurrent MD in Han Chinese women by analyzing the phase I (N=1848), phase II (N=4169) and total combined data (N=6017) from the CONVERGE project. Linear, logistic, multiple linear and multinomial logistic regression models were used to determine the association of AAO with continuous, binary and categorical variables. RESULTS: The effect size of the association between AAO and clinical features of MD was quite similar in the phase I and phase II samples. These results confirmed that MD patients with earlier AAO tended to suffer more severe, recurrent and chronic illness and cases of MD with earlier AAO showed increased neuroticism, greater family history and psychiatric comorbidity. In addition, we showed that earlier AAO of MD in Han Chinese women was associated with premenstrual symptoms, postnatal depression, a highly authoritarian or cold childhood parental rearing style and a reduced probability for having melancholia. LIMITATIONS: Data were collected retrospectively through interview and recall bias may have affected the results. CONCLUSIONS: MD with earlier AAO in Han Chinese women shows a distinct set of clinical features which are similar to those reported in Western populations.

The prevalence, clinical correlates and structure of phobic fears in Han Chinese women with recurrent major depression.

BACKGROUND: Phobic fears are common in the general population and among individuals with major depression (MD). We know little about the prevalence, clinical correlates, and structure of phobic fears in Chinese women with MD. METHODS: We assessed 22 phobic fears in 6017 Han Chinese women with MD. We used exploratory factor analysis to examine the structure of these phobic fears. We examined the relationship between individual phobic fears and the severity of MD, neuroticism, comorbid panic disorder, generalized anxiety disorder and dysthymia using logistic regression models. RESULTS: The frequency of phobic fears ranged from 3.0% (eating in public) to 36.0% (snakes). Phobic fears were significantly associated with more severe MD, high neuroticism, and co-morbid panic disorder, generalized anxiety disorder and dysthymia. Our factor analysis suggested four underlying subgroups of phobic fears which differed in their clinical correlates, severity and patterns of comorbidity. LIMITATIONS: Data were collected retrospectively through interview and recall bias may have affected the results. CONCLUSIONS: Phobic fears are correlated with comorbid MD and more severe MD. These phobic fears clearly subdivide into four subgroups that differ meaningfully from each other.

[Efficacy and safety of tandospirone in the treatment of patients with anxiety disorder].

OBJECTIVE: To explore the efficacy and safety of tandospirone for adolescents with anxiety disorder. METHODS: In this multicenter open-label 12-week study, a total of 169 adolescents met the criteria of DSM-IV for anxiety disorder were treated with flexible dose of tandospirone. The effects and safety of treatment were assessed by the Hamilton anxiety scale (HAMA), state-trait anxiety inventory (STAI), clinical global impression (CGI) and side effects at baseline and Weeks 2, 4, 8 and 12. RESULTS: In 151 cases completing the 12-week treatment, the scores of HAMA decreased by 18% ± 12%, 38% ± 16%, 54% ± 20% and 63% ± 17% at Weeks 2, 4, 8 and 12. Significant reductions in HAMA scores were seen at Weeks 2-12 (P < 0.01) and marked improvement appeared in 81.5% cases at Week 12 (reduction rate of HAMA: 50%). At Week 12, the HAMD(17) scores were markedly lower versus baseline (7 ± 2 vs 13 ± 3, P < 0.01). Adverse effect of tandospirone was scarcely found (9.9%). CONCLUSION: Tandospirone is an effective and safe anti-anxiety drug for adolescents.

Examining the relationship between lifetime stressful life events and the onset of major depression in Chinese women.

BACKGROUND: In European and US studies, patients with major depressive disorder (MDD) report more stressful life events (SLEs) than controls, but this relationship has rarely been studied in Chinese populations. METHODS: Sixteen lifetime SLEs were assessed at interview in two groups of Han Chinese women: 1970 clinically ascertained with recurrent MDD and 2597 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. RESULTS: 60% of controls and 72% of cases reported at least one lifetime SLE. Fourteen of the sixteen SLEs occurred significantly more frequently in those with MDD (median odds ratio of 1.6). The three SLEs most strongly associated with risk for MDD (OR>3.0) preceded the onset of MDD the majority of the time: rape (82%), physical abuse (100%) and serious neglect (99%). LIMITATIONS: Our results may apply to females only. SLEs were rated retrospectively and are subject to biases in recollection. We did not assess contextual information for each life event. CONCLUSIONS: More severe SLEs are more strongly associated with MDD. These results support the involvement of psychosocial adversity in the etiology of MDD in China.