Long term life dissatisfaction and subsequent major depressive disorder and poor mental health

<p>Abstract</p> <p>Background</p> <p>Poor mental health, especially due to depression, is one of the main public health problems. Early indicators of poor mental health in general population are needed. This study examined the relationship between long-term life dissatisfaction and subsequent mental health, including major depressive disorder.</p> <p>Method</p> <p>Health questionnaires were sent to a randomly selected population-based sample in 1998 and repeated in 1999 and 2001. In 2005, a clinically studied sub-sample (n = 330) was composed of subjects with (n = 161) or without (n = 169) repeatedly reported adverse mental symptoms at all three previous data collection times. Clinical symptom assessments were performed with several psychometric scales: life satisfaction (<b>LS</b>), depression (<b>HDRS, BDI</b>), hopelessness (<b>HS</b>), mental distress (<b>GHQ</b>), dissociative experiences (<b>DES</b>), and alexithymia (<b>TAS</b>). The long-term life dissatisfaction burden was calculated by summing these life satisfaction scores in 1998, 1999, 2001 and dividing the sum into tertiles. Psychiatric diagnoses were confirmed by SCID-I for DSM-IV in 2005. Logistic regression analyses were performed to assess the studied relationship.</p> <p>Results</p> <p>The previous life dissatisfaction burden associated with adverse socio-demographic, life style and clinical factors. In adjusted logistic regression analyses, it was independently and strongly associated with subsequent major depressive disorder in 2005, even when the concurrent LS score in 2005 was included in the model. Excluding those with reported major depressive disorder in 1999 did not alter this finding.</p> <p>Limitations</p> <p>MDD in 1999 was based on self-reports and not on structured interview and LS data in 2001-2005 was not available.</p> <p>Conclusions</p> <p>The life satisfaction burden is significantly related to major depressive disorder and poor mental health, both in cross-sectional and longitudinal settings.</p

Life satisfaction and morbidity among postmenopausal women

OBJECTIVE: To investigate associations between morbidity and global life satisfaction in postmenopausal women taking into account type and number of diseases. MATERIALS AND METHODS: A total of 11,084 women (age range 57-66 years) from a population-based cohort of Finnish women (OSTPRE Study) responded to a postal enquiry in 1999. Life satisfaction was measured with a 4-item scale. Self-reported diseases diagnosed by a physician and categorized according to ICD-10 main classes were used as a measure of morbidity. Enquiry data on health and lifestyle were used as covariates in the multivariate logistic models. RESULTS: Morbidity was strongly associated with life dissatisfaction. Every additional disease increased the risk of life dissatisfaction by 21.1% (p &lt; .001). The risk of dissatisfaction was strongest among women with mental disorders (OR = 5.26; 95%CI 3.84-7.20) and neurological disorders (OR = 3.62; 95%CI 2.60-5.02) compared to the healthy (each p &lt; .001). Smoking, physical inactivity and marital status were also associated with life dissatisfaction (each p &lt; .001) but their introduction to the multivariate model did not attenuate the pattern of associations. CONCLUSIONS: Morbidity and life dissatisfaction have a disease-specific and dose-dependent relationship. Even if women with mental and neurological disorders have the highest risk for life dissatisfaction, monitoring life satisfaction among aging women regardless of disorders should be undertaken in order to intervene the joint adverse effects of poor health and poor well-being

The stability of life satisfaction in a 15-year follow-up of adult Finns healthy at baseline

BACKGROUND: While physical health has improved considerably over recent decades in Finland, the disease burden of mental health, especially that of depression, has become increasingly demanding. However, we lack long-term data on the natural course of subjective well-being in the general population. The aim of this study was to investigate the long-term course of self-reported life satisfaction. METHODS: This was a 15-year prospective cohort study on a nationwide sample of adult Finnish twins (N = 9679), aged 18–45 and healthy at baseline, who responded to postal questionnaires in 1975, 1981 and 1990 including a 4-item life satisfaction scale (happiness/easiness/interest in life and feelings of loneliness). Life satisfaction score (range: 4–20) was classified into three categories: satisfied (4–6), intermediate (7–11) and dissatisfied group (12–20). The associations between life satisfaction scores during the follow-up were studied with linear/logistic regression. RESULTS: Moderate stability and only a slight effect of age or birth-cohort on mean life satisfaction score (LS) were detected. In 1990, 56% of all and 31% of the dissatisfied remained in the same LS category as at baseline. Only 5.9% of the study subjects changed from being satisfied to dissatisfied or vice versa. Correlations between continuous scores (1975, 1981 and 1990) were 0.3–0.4. Baseline dissatisfaction (compared to satisfaction) predicted dissatisfaction in 1981 (OR = 10.4; 95%CI 8.3–13.1) and 1990 (5.6; 4.6–6.8). Multiple adjustments decreased the risk only slightly. CONCLUSIONS: Life satisfaction in adult Finns was moderately stable during 15 years. Among an identifiable group (i.e. the dissatisfied) life dissatisfaction may become persistent, which places them at a greater risk of adverse health outcomes

Psychiatric disorders, psychotropic medication use and falls among women: an observational study

BACKGROUND: Psychotropic agents known to cause sedation are associated with an increased risk of falls, but the role of psychiatric illness as an independent risk factor for falls is not clear. Thus, this study aimed to investigate the association between psychiatric disorders, psychotropic medication use and falls risk. METHODS: This study examined data collected from 1062 women aged 20-93 yr (median 50 yr) participating in the Geelong Osteoporosis Study, a large, ongoing, population-based study. Depressive and anxiety disorders for the preceding 12-month period were ascertained by clinical interview. Current medication use and falls history were self-reported. Participants were classified as fallers if they had fallen to the ground at least twice during the same 12-month period. Anthropometry, demographic, medical and lifestyle factors were determined. Logistic regression was used to test the associations, after adjusting for potential confounders. RESULTS: Fifty-six women (5.3%) were classified as fallers. Those meeting criteria for depression within the past 12 months had a 2.4-fold increased odds of falling (unadjusted OR&thinsp;=&thinsp;2.4, 95% CI 1.2-4.5). Adjustment for age and mobility strengthened the relationship (adjusted OR&thinsp;=&thinsp;2.7, 95% CI 1.4-5.2) between depression and falling, with results remaining unchanged following further adjustment for psychotropic medication use (adjusted OR&thinsp;=&thinsp;2.7, 95% CI 1.3-5.6). In contrast, past (prior to 12-month) depression were not associated with falls. No association was observed between anxiety and falls risk. Falling was associated with psychotropic medication use (unadjusted OR&thinsp;=&thinsp;2.8, 95% CI 1.5-5.2), as well as antidepressant (unadjusted OR&thinsp;=&thinsp;2.4, 95% CI 1.2-4.8) and benzodiazepine use (unadjusted OR&thinsp;=&thinsp;3.4, 95% CI 1.6-7.3); associations remained unchanged following adjustment for potential confounders. CONCLUSION: The likelihood of falls was increased among those with depression within the past 12 months, independent of psychotropic medication use and other recognised confounders, suggesting an independent effect of depression on falls risk. Psychotropic drug use was also confirmed as an independent risk factor for falls, but anxiety disorders were not. Further research into the underlying mechanisms is warranted

Life dissatisfaction is associated with a poorer surgery outcome and depression among lumbar spinal stenosis patients: a 2-year prospective study

The aim of this study was to examine the life satisfaction of lumbar spinal stenosis (LSS) patients up to the 2-year postoperative phase. Patients (N = 102, mean age, 62 years) with symptomatic LSS underwent decompressive surgery. Data collection took place with the same set of questionnaires before surgery and 3 months, 6 months, 1 year and 2 years postoperatively. Life satisfaction was assessed with the four-item Life Satisfaction scale and depression symptoms with the 21-item Beck Depression Inventory (BDI). In addition, a depression burden variable was included, comprising the sum of preoperative, 3- and 6-month BDI scores. Physical functioning and pain were assessed with the Oswestry disability index, Stucki questionnaire, self-reported walking ability, visual analogy scale and pain drawing. Two years postoperatively, 18% of the LSS patients was dissatisfied with their lives. As a whole, the life satisfaction of the LSS patients improved during the postoperative follow-up, reaching the level of the healthy adult Finnish population. However, 2 years postoperatively, dissatisfied patients reported significantly more pain, a poorer functional ability and more depressive symptoms and depression than the patients who were satisfied with life. This difference was seen throughout the postoperative follow up. In regression analyses, the only significant associations were between the depression burden and postoperative life dissatisfaction. Thus, subjective well-being as well as depression among LSS patients should be assessed pre- and postoperatively in order to enable early intervention for those at risk of poorer life satisfaction

Childhood chronic condition and subsequent self-reported internalizing and externalizing problems in adolescence:a birth cohort study

Abstract Chronic conditions are common in childhood. We investigated the associations of childhood chronic conditions reported by parents with subsequent self-reported internalizing and externalizing problems in adolescence. A sample of 6290 children (3142 boys and 3148 girls) with data on chronic condition reported by parents both at 7 and at 16 years of age was obtained from the Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort (n = 9432) from an unselected, regionally defined population. Internalizing and externalizing problems were measured at 8 years of age with Rutter Children’s Behavioral Questionnaire by teachers and at 16 years of age with Youth Self-Report by adolescents. When studying the effects of history of chronic conditions on these problems at 16 years of age, childhood internalizing and externalizing problems and social relations were adjusted. A history of chronic condition predicted subsequent somatic complaints among all adolescents. Early-onset chronic conditions were related to subsequent externalizing (OR 1.35; 1.02–1.79) and attention problems (OR 1.33; 1.01–1.75) and later onset of chronic conditions with internalizing (OR 1.49; 1.22–1.82) and thought problems (OR 1.50; 1.18–1.92). The effect was specific for sex and the type of chronic condition. Conclusion: Childhood chronic conditions predicted internalizing and externalizing problems in adolescence. To prevent poor mental health trajectories, children with chronic conditions during their growth to adolescence need early support and long-term monitoring