scholarly journals Major Depressive Episodes and Work Stress: Results From a National Population Survey

2007 ◽  
Vol 97 (11) ◽  
pp. 2088-2093 ◽  
Author(s):  
Emma Robertson Blackmore ◽  
Stephen A. Stansfeld ◽  
Iris Weller ◽  
Sarah Munce ◽  
Brandon M. Zagorski ◽  
...  
Keyword(s):  
Work Stress ◽  
Population Survey ◽  
Major Depressive ◽  
National Population ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Work stress as a risk factor for major depressive episode(s)

2004 ◽  
Vol 35 (6) ◽  
pp. 865-871 ◽  
Author(s):  
JIANLI WANG
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Major Depression ◽  
Work Stress ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Working Population ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background. Major depression is a prevalent mental disorder in the general population, with a multi-factorial etiology. However, work stress as a risk factor for major depression has not been well studied.Method. Using a longitudinal study design, this analysis investigated the association between the levels of work stress and major depressive episode(s) in the Canadian working population, aged 18 to 64 years. Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used (n=6663). The NPHS participants who did not have major depressive episodes (MDE) at baseline (1994–1995 NPHS) were classified into four groups by the quartile values of the baseline work stress scores. The proportion of MDE of each group was calculated using the 1996–1997 NPHS data.Results. The first three quartile groups had a similar risk of MDE. Those who had a work stress score above the 75th percentile had an elevated risk of MDE (7·1%). Using the 75th percentile as a cut-off, work stress was significantly associated with the risk of MDE in multivariate analysis (odds ratio=2·35, 95% confidence interval 1·54–3·77). Other factors associated with MDE in multivariate analysis included educational level, number of chronic medical illnesses and child and adulthood traumatic events. There was no evidence of effect modification between work stress and selected sociodemographic, clinical and psychosocial variables.Conclusions. Work stress is an independent risk factor for the development of MDE in the working population. Strategies to improve working environment are needed to keep workers mentally healthy and productive.

scholarly journals The National Population Health Survey’s assessment of depression risk factor associations: a simulation study assessing vulnerability to bias

2012 ◽  
Vol 32 (2) ◽  
pp. 70-75
Author(s):  
S.B. Patten
Keyword(s):  
Risk Factor ◽  
Population Health ◽  
Major Depressive ◽  
National Population ◽  
Depression Risk ◽  
Hazard Ratios ◽  
Substantial Bias ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background In Canada, the major source of longitudinal information on major depression epidemiology has been the National Population Health Survey (NPHS). However, the timing of NPHS interviews may raise concerns about the quality of its estimates. Specifically, the NPHS interview assesses major depressive episodes (MDE) in the year before an interview, whereas the interviews are conducted 2 years apart. The objective of this study was to determine whether this aspect of the NPHS can be expected to introduce bias into longitudinal estimates of risk factor associations. Methods A simulation model was used to represent the underlying epidemiology and the expected results of a study adopting the NPHS approach to assessment of MDE. The model was used to explore the extent of the resulting distortion of estimates across a range of underlying hazard ratios. Results The simulations indicated that the timing and coverage of depression interviews in the NPHS would not introduce substantial bias. The model suggested that incidence would be underestimated as a result of episodes being missed, but that this would not substantially distort estimates of association. Conclusion The timing of interviews in the NPHS is not expected to cause biased relative risk estimates. NPHS estimates may, of course, be influenced by other sources of bias.

What is the role of conventional antidepressants in the treatment of major depressive episodes with Mixed Features Specifier?

CNS Spectrums ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Gianni L. Faedda ◽  
Ciro Marangoni
Keyword(s):  
Clinical Trials ◽  
Unipolar Depression ◽  
Preliminary Evidence ◽  
Major Depressive ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Mixed Features ◽  
Effective Use ◽  
Major Depressive Episodes ◽  
Depressive Episodes

The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD).Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges. To understand the diagnostic context of DMX, we trace the nosological changes and collocation of intradepressive hypomanic symptoms, and examine diagnostic and prognostic implications of such mixed features.One of the reasons so little is known about the treatment of DMX is that depressed patients with rapid cycling, substance abuse disorder, and suicidal ideation/attempts are routinely excluded from clinical trials of antidepressants. The exclusion of DMX patients from clinical trials has prevented an assessment of the safety and tolerability of short- and long-term use of antidepressants. Therefore, the generalization of data obtained in clinical trials for unipolar depression to patients with intradepressive hypomanic features is inappropriate and methodologically flawed.A selective review of the literature shows that antidepressants alone have limited efficacy in DMX, but they have the potential to induce, maintain, or worsen mixed features during depressive episodes in BD. On the other hand, preliminary evidence supports the effective use of some atypical antipsychotics in the treatment of DMX.

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