- Email: [email protected]
Lower levels of physical activity in childhood predict adult depression
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Abstracts / Journal of Affective Disorders 107 (2008) S53–S122
as defined by alcohol abuse/dependence, drugs abuse/ dependence, years of education, work level, social and occupational disruption, euthymic functioning, number of episodes, increasing episodes and suicide risk. Method: 245 bipolar out-patients where recruited. Comorbid anxiety disorders were determined using structured interviews (MINI), for information about the course of bipolar disorder we used a clinical questionnaire retrospective “life chart method. Results: In our population, 42% had at least 1 comorbid anxiety disorder, and 33.9% had 2 or more comorbid anxiety disorders. The group of patients with one comorbid anxiety disorder had a significantly earlier age of onset, experienced more depressive episodes, had a more rapid cycling course, and a much higher suicide risk. Social and occupational functioning was significantly less, also in a euthymic phase. Patients with multiple anxiety disorders differed significantly on the same measures, resulting in an even more severe course for bipolar patients with multiple anxiety disorders. No relevant differences between the types of anxiety disorders were found. Discussion: Our data indicates that the presence of (multiple) anxiety disorders, correlate with a more severe course of bipolar disorder on symptom level and social functioning. The type of anxiety disorder is not important. In development of guide lines this should be taken in account as a specific point of assessment and subsequent intervention. Keywords: Anxiety disorders, Course severity, Bipolar disorders, Outcome
2003, in the 10th postgraduate year (T3). Mean observational time was 9.5 years (0.6). The response rates varied from 62–83%, whereas 260 (41%) responded at all four time points. We measured at all observations a short version of Hopkins Symptom check list (SCL-5) that has been validated to tap anxiety and depressive symptoms. Both trends and individual predictors such as personality traits (Basic Character Inventory) and coping strategies (Ways of Coping Check List) were analyzed by Mixed model repeated measures statistics. Results: There was a significant decrease in anxiety and depressive symptoms from T1 to T2, and from T2 to T3, whereas they stayed on the same levels from T3 to T4. When we adjusted for age and sex we found the following fixed effects significant predictors of anxiety and depressive symptoms: vulnerability trait (neuroticism) (P = 0.003), reality weakness trait (P b 0.001), wishful thinking (P = 0.01), and seeking social support (P = 0.04) as ways of coping. The decrease from T1 to T2 was predicted by all the variables above except for reality weakness, whereas all four variables above predicted the decrease from T2 to T3. Discussion: In terms of individual factors, both personality traits and ways of coping are possible risk factors of anxiety and depression among medical doctors, and they should be targeted early in the career. Keywords: Anxiety, Depression, Cohort study, Physicians
doi:10.1016/j.jad.2007.12.019
[O2.4] Lower levels of physical activity in childhood predict adult depression
[O2.3] Anxiety and depressive symptoms among Norwegian doctors: A ten-year longitudinal and nationwide study of course and predictors
F.N. Jacka*, J.A. Pasco, S. Dodd, L.J. Williams, G.C. Nicholson, M. Berk
doi:10.1016/j.jad.2007.12.020
University of Melbourne, Australia R. Tyssen*, J.O. Røvik, Ø. Ekeberg, P. Vaglum University of Oslo, Norway Introduction: There are relatively high levels of depressive symptoms (and suicide) in medical doctors. This study aims to find the course and individual predictors of such symptoms over ten years of the medical career. Method: Prospective mailed survey of a nationwide cohort (N = 631) of all Norwegian medical students in their graduating semester in 1993/94 (T1).They were approached again one year later, at the end of internship (T2), in the fourth postgraduate year (T2), and finally in
Background: In cross-sectional and longitudinal community studies, regular exercise has been shown to be protective against the development of depression and has a therapeutic role in depression, while physical inactivity is a demonstrated risk factor for the development of depressive symptoms. Emerging evidence indicates that early life exposures influence adult health outcomes and there is cause to hypothesise a role for physical activity (PA) in childhood as a protective factor in adult depression. This investigation focused on the association between self-reported levels of PA in childhood and self-reported depressive illness in adulthood in
Abstracts / Journal of Affective Disorders 107 (2008) S53–S122
a community sample of adult men and women from South-eastern Australia. Methods: This study assessed 1404 men (20–96 yr) and 748 women (20–97 yr) participating in an ongoing Australian epidemiological study involving subjects randomly selected from the community (Geelong Osteoporosis Study). A self-report questionnaire based on DSMIV criteria was utilised to determine lifetime prevalence rates of depression, and another ascertained levels of physical activity (Low PA vs High PA) in childhood, defined as b 15 yr of age. Results: In this sample, 141 women (18.9%) and 169 men (12.0%) reported ever having a depressive episode ( p b 0.001). Moreover, women were more likely than men to report Low PA in childhood (45.7% vs 23.2%, pb 0.001). Results of logistic regression analyses showed that Low PA in childhood was associated with an increased risk of reporting depression in adulthood (OR = 1.70, 95% CI =1.32–2.17, p b 0.001). Adjustment for gender attenuated the relationship somewhat (OR = 1.53, 95%CI= 1.19–1.97, p = 0.001), however further adjustment for age and/or country of birth did not affect this relationship. Discussion: In this community-based study, lower levels of self-reported PA in childhood increased the risk for self-reported depression in adulthood by more than 50%. These results indicate that lower levels of PA in childhood may be a risk factor for adult depression. Keywords: Depression, Exercise, Childhood, Epidemiology doi:10.1016/j.jad.2007.12.021
[O2.5] Adjuvant occupational therapy for work-related major depression: 3.5 year follow up of a randomized controlled trial including economic evaluation A.H. Schene*,a, M.J. Kikkerta, J.A. Swinkelsa, M.W.J Koetera, P. Mc Croneb a
S59
addition of occupational therapy to treatment as usual on recovery from depression, work resume, work stress and costs. Method: Setting: Program for Mood Disorders AMC. Design: Randomized controlled trial. Follow up period: 42 months. Participants: 62 adults with major depression; mean absenteeism: 242 days. Interventions: Treatment as usual (TAU; outpatient psychiatric treatment); TAU plus occupational therapy (OT; 24 weekly group sessions+ 12 individual sessions). Outcome: Assessments at baseline, 3, 6, 12 and 42 months. Outcome domains: Depression, depression symptoms, work resume, work stress, and costs. Results: Improvement on depression over 42 months did not differ between conditions (TAU and TAU + OT). Time between baseline and the moment of any work resume showed a significant (p = .001) difference in favor of OT (207 vs. 299 days). Over the first 18 months TAU + OT patients worked significantly more hours (p = .003), while both groups did not differ during months 19–42. Work stress was the same in both groups. OT increased total mental health care costs, but overall showed an economic gain caused by greater productivity. Discussion: The addition of OT to TAU significantly reduces absenteeism but not depression. OT reduces total costs. This effect endures for a period of at least 12 months after the intervention. The study shows that the impact of depression on work is substantial, but can be reversed by specific interventions which do not increase work stress. Keywords: Depression, Work, Work stress, Costs, Occupational therapy Corresponding author: Prof. Dr. A.H. Schene, Professor of Psychiatry, Head Program Mood Disorders, Academic Medical Center, Amsterdam, The Netherlands(e-mail:[email protected]) Keywords: Depression, Work stress, Occupational therapy, Costs doi:10.1016/j.jad.2007.12.022
University of Amsterdam, The Netherlands King's College London, United Kingdom
b
Objective: Major depression has far-reaching consequences including impairment in work functioning and absenteeism. Until recently these consequences were a neglected topic in depression literature. If depression is related to impairment in occupational functioning, recovery may stagnate if ‘work’ is not part of the treatment plan. We determined – for the first time – the effectiveness of the
[O2.6] Mindfulness based cognitive therapy: A randomized controlled study on its efficiency to reduce depressive relapse/recurrence G.B. Bertschy*, F. Jermann, L. Bizzini, B. Weber-Rouget, M. Myers-Arrazola, M. van der Linden Geneva University Hospitals, Switzerland
Abstracts / Journal of Affective Disorders 107 (2008) S53–S122
as defined by alcohol abuse/dependence, drugs abuse/ dependence, years of education, work level, social and occupational disruption, euthymic functioning, number of episodes, increasing episodes and suicide risk. Method: 245 bipolar out-patients where recruited. Comorbid anxiety disorders were determined using structured interviews (MINI), for information about the course of bipolar disorder we used a clinical questionnaire retrospective “life chart method. Results: In our population, 42% had at least 1 comorbid anxiety disorder, and 33.9% had 2 or more comorbid anxiety disorders. The group of patients with one comorbid anxiety disorder had a significantly earlier age of onset, experienced more depressive episodes, had a more rapid cycling course, and a much higher suicide risk. Social and occupational functioning was significantly less, also in a euthymic phase. Patients with multiple anxiety disorders differed significantly on the same measures, resulting in an even more severe course for bipolar patients with multiple anxiety disorders. No relevant differences between the types of anxiety disorders were found. Discussion: Our data indicates that the presence of (multiple) anxiety disorders, correlate with a more severe course of bipolar disorder on symptom level and social functioning. The type of anxiety disorder is not important. In development of guide lines this should be taken in account as a specific point of assessment and subsequent intervention. Keywords: Anxiety disorders, Course severity, Bipolar disorders, Outcome
2003, in the 10th postgraduate year (T3). Mean observational time was 9.5 years (0.6). The response rates varied from 62–83%, whereas 260 (41%) responded at all four time points. We measured at all observations a short version of Hopkins Symptom check list (SCL-5) that has been validated to tap anxiety and depressive symptoms. Both trends and individual predictors such as personality traits (Basic Character Inventory) and coping strategies (Ways of Coping Check List) were analyzed by Mixed model repeated measures statistics. Results: There was a significant decrease in anxiety and depressive symptoms from T1 to T2, and from T2 to T3, whereas they stayed on the same levels from T3 to T4. When we adjusted for age and sex we found the following fixed effects significant predictors of anxiety and depressive symptoms: vulnerability trait (neuroticism) (P = 0.003), reality weakness trait (P b 0.001), wishful thinking (P = 0.01), and seeking social support (P = 0.04) as ways of coping. The decrease from T1 to T2 was predicted by all the variables above except for reality weakness, whereas all four variables above predicted the decrease from T2 to T3. Discussion: In terms of individual factors, both personality traits and ways of coping are possible risk factors of anxiety and depression among medical doctors, and they should be targeted early in the career. Keywords: Anxiety, Depression, Cohort study, Physicians
doi:10.1016/j.jad.2007.12.019
[O2.4] Lower levels of physical activity in childhood predict adult depression
[O2.3] Anxiety and depressive symptoms among Norwegian doctors: A ten-year longitudinal and nationwide study of course and predictors
F.N. Jacka*, J.A. Pasco, S. Dodd, L.J. Williams, G.C. Nicholson, M. Berk
doi:10.1016/j.jad.2007.12.020
University of Melbourne, Australia R. Tyssen*, J.O. Røvik, Ø. Ekeberg, P. Vaglum University of Oslo, Norway Introduction: There are relatively high levels of depressive symptoms (and suicide) in medical doctors. This study aims to find the course and individual predictors of such symptoms over ten years of the medical career. Method: Prospective mailed survey of a nationwide cohort (N = 631) of all Norwegian medical students in their graduating semester in 1993/94 (T1).They were approached again one year later, at the end of internship (T2), in the fourth postgraduate year (T2), and finally in
Background: In cross-sectional and longitudinal community studies, regular exercise has been shown to be protective against the development of depression and has a therapeutic role in depression, while physical inactivity is a demonstrated risk factor for the development of depressive symptoms. Emerging evidence indicates that early life exposures influence adult health outcomes and there is cause to hypothesise a role for physical activity (PA) in childhood as a protective factor in adult depression. This investigation focused on the association between self-reported levels of PA in childhood and self-reported depressive illness in adulthood in
Abstracts / Journal of Affective Disorders 107 (2008) S53–S122
a community sample of adult men and women from South-eastern Australia. Methods: This study assessed 1404 men (20–96 yr) and 748 women (20–97 yr) participating in an ongoing Australian epidemiological study involving subjects randomly selected from the community (Geelong Osteoporosis Study). A self-report questionnaire based on DSMIV criteria was utilised to determine lifetime prevalence rates of depression, and another ascertained levels of physical activity (Low PA vs High PA) in childhood, defined as b 15 yr of age. Results: In this sample, 141 women (18.9%) and 169 men (12.0%) reported ever having a depressive episode ( p b 0.001). Moreover, women were more likely than men to report Low PA in childhood (45.7% vs 23.2%, pb 0.001). Results of logistic regression analyses showed that Low PA in childhood was associated with an increased risk of reporting depression in adulthood (OR = 1.70, 95% CI =1.32–2.17, p b 0.001). Adjustment for gender attenuated the relationship somewhat (OR = 1.53, 95%CI= 1.19–1.97, p = 0.001), however further adjustment for age and/or country of birth did not affect this relationship. Discussion: In this community-based study, lower levels of self-reported PA in childhood increased the risk for self-reported depression in adulthood by more than 50%. These results indicate that lower levels of PA in childhood may be a risk factor for adult depression. Keywords: Depression, Exercise, Childhood, Epidemiology doi:10.1016/j.jad.2007.12.021
[O2.5] Adjuvant occupational therapy for work-related major depression: 3.5 year follow up of a randomized controlled trial including economic evaluation A.H. Schene*,a, M.J. Kikkerta, J.A. Swinkelsa, M.W.J Koetera, P. Mc Croneb a
S59
addition of occupational therapy to treatment as usual on recovery from depression, work resume, work stress and costs. Method: Setting: Program for Mood Disorders AMC. Design: Randomized controlled trial. Follow up period: 42 months. Participants: 62 adults with major depression; mean absenteeism: 242 days. Interventions: Treatment as usual (TAU; outpatient psychiatric treatment); TAU plus occupational therapy (OT; 24 weekly group sessions+ 12 individual sessions). Outcome: Assessments at baseline, 3, 6, 12 and 42 months. Outcome domains: Depression, depression symptoms, work resume, work stress, and costs. Results: Improvement on depression over 42 months did not differ between conditions (TAU and TAU + OT). Time between baseline and the moment of any work resume showed a significant (p = .001) difference in favor of OT (207 vs. 299 days). Over the first 18 months TAU + OT patients worked significantly more hours (p = .003), while both groups did not differ during months 19–42. Work stress was the same in both groups. OT increased total mental health care costs, but overall showed an economic gain caused by greater productivity. Discussion: The addition of OT to TAU significantly reduces absenteeism but not depression. OT reduces total costs. This effect endures for a period of at least 12 months after the intervention. The study shows that the impact of depression on work is substantial, but can be reversed by specific interventions which do not increase work stress. Keywords: Depression, Work, Work stress, Costs, Occupational therapy Corresponding author: Prof. Dr. A.H. Schene, Professor of Psychiatry, Head Program Mood Disorders, Academic Medical Center, Amsterdam, The Netherlands(e-mail:[email protected]) Keywords: Depression, Work stress, Occupational therapy, Costs doi:10.1016/j.jad.2007.12.022
University of Amsterdam, The Netherlands King's College London, United Kingdom
b
Objective: Major depression has far-reaching consequences including impairment in work functioning and absenteeism. Until recently these consequences were a neglected topic in depression literature. If depression is related to impairment in occupational functioning, recovery may stagnate if ‘work’ is not part of the treatment plan. We determined – for the first time – the effectiveness of the
[O2.6] Mindfulness based cognitive therapy: A randomized controlled study on its efficiency to reduce depressive relapse/recurrence G.B. Bertschy*, F. Jermann, L. Bizzini, B. Weber-Rouget, M. Myers-Arrazola, M. van der Linden Geneva University Hospitals, Switzerland