Assessing quality of life: mother–child agreement in depressed and non-depressed Hungarian

Purpose: An important question in child psychiatry is the agreement between parents and children. We studied mother–child concordance about the quality of life of children (QoL). We hypothesized that mothers of depressed children rate lower QoL than children for themselves while mothers of non-depressed children rate better QoL; that inter-informant agreement is higher in the non-depressed sample; and finally that agreement increases with age of the child. Methods: QoL of depressed children (N = 248, mean age 11.45 years, SD 2.02) were compared to that of non-depressed children (N = 1695, mean age 10.34 years, SD 2.19). QoL was examined by a 7 item questionnaire (ILK). Results: Mothers of depressed children rated lower QoL than their children while mothers of nondepressed children rated higher QoL than their children. Agreement was low in both samples but higher in the controls. Inter-informant agreement was only influenced by depression. Conclusions: Our results show that mothers relate more serious negative effects to childhood depression than their children and rate less problems for their non-depressed children compared to self-reports. Mother–child agreement is negatively influenced by depression which further stresses the importance of obtaining reports from the child and at least one parent in order to understand the subjective experiences caused by the illness

BDNF Val66Met polymorphism and stressful life events in melancholic childhood-onset depression

INTRODUCTION: Brain-derived neurotrophic factor (BDNF) polymorphisms have been examined for their contribution toward depression with equivocal results. More homogeneous phenotypes might be used to improve our understanding of genetic liability to depression. The aim of our study was to (a) test for an association between the BDNF Val66Met polymorphism and childhood-onset melancholic depression and (b) to examine the interactive effects of stressful life events (SLE) and the Val66Met polymorphism on the risk of childhood-onset melancholic depression. MATERIALS AND METHODS: A total of 583 depressed probands were involved in this study (162 of the melancholic subtype). Diagnoses were derived through the Interview Schedule for Children and Adolescents - Diagnostic Version and life event data were collected using an Intake General Information Sheet. RESULTS: Overall, 27.8% of the participants fulfilled the criteria for melancholy. In the melancholic group, the proportion of females was higher (53.1%), although there were more males in the overall depressed sample. We detected no significant differences in genotype or allele frequency between the melancholic and the nonmelancholic depressed group. The BDNF Val66Met polymorphism and SLE interaction was not significantly associated with the melancholy outcome. CONCLUSION: In our study, females were more prone to developing the early-onset melancholic phenotype. To our knowledge, this is the first study to investigate the differentiating effect of the genotype and the GxE interaction on the melancholic phenotype in a large sample of depressed young patients. We did not find an association between the melancholic subtype of major depression and the BDNF genotype and SLE interaction in this sample, which is representative of the Hungarian clinic-referred population of depressed youths

Short-Term Blood Pressure Variability Among Young Adults at High or Low Risk for Depression

Background: Depression has been shown to have adverse effects on blood pressure (BP) and is associated with high blood pressure variability (BPV). In turn, high short-term BPV has been related to eventual cardiovascular risk. But it is not clear how early in adulthood the detrimental effects of depression on BPV may be discerned, if being at high risk for depression also compromises BPV, and whether the clinical features of depression moderate its adverse effects. We investigated these three issues among young adults using an office-like setting. Methods: In total, 218 subjects with a history of childhood-onset major depressive episodes (probands), 206 never-depressed full biological siblings of the probands (high-risk siblings), and 166 emotionally healthy unrelated controls received a psychiatric evaluation and three standardized-sitting BP measurements 5 min apart. Short-term BPV was defined as the maximum difference between measures (range) for each case. The statistical methods included analyses of variance/covariance, chi-square tests, and multiple regression. Results: Systolic and diastolic BP decreased over consecutive measurements (p \u3c 0.001). After controlling for age, the probands, siblings, and controls did not differ significantly in terms of BPV. However, the number of lifetime depressive episodes did predict the diastolic BP range (p = 0.005): probands with the highest number of depressive episodes had the largest short-term diastolic BPV. Conclusions: On a group level, the adverse effects on BPV of having experienced or being at high risk for depression are not yet evident during young adulthood. However, the number of major depressive episodes, which is an index of lifetime depression burden, predicts higher BPV. Thus, BPV monitoring for young adults with clinical depression histories could be part of an early intervention program to reduce the risk of eventual cardiovascular disease

Familiality of mood repair responses among youth with and without histories of depression

Affect regulation skills develop in the context of the family environment, wherein youths are influenced by their parents', and possibly their siblings', regulatory responses and styles. Regulatory responses to sadness (mood repair) that exacerbate or prolong dysphoria (maladaptive mood repair) may represent one way in which depression is transmitted within families. We examined self-reported adaptive and maladaptive mood repair responses across cognitive, social and behavioural domains in Hungarian 11- to 19-year-old youth and their parents. Offspring included 214 probands with a history of childhood-onset depressive disorder, 200 never depressed siblings and 161 control peers. Probands reported the most problematic mood repair responses, with siblings reporting more modest differences from controls. Mood repair responses of parents and their offspring, as well as within sib-pairs, were related, although results differed as a function of the regulatory response domain. Results demonstrate familiality of maladaptive and adaptive mood repair responses in multiple samples. These familial associations suggest that relationships with parents and siblings within families may impact the development of affect regulation in youth

Telementális egészségügyi ellátás a gyermek- és ifjúságpszichiátriában [Telemental health service in child and adolescent psychiatry]

Even though mental disorders present significant health burden worldwide, most patients with mental disorders do not receive adequate healthcare. The possibility of telemental health service came into prominence in Hungary due to the restriciton of face-to-face doctor-patient meetings. The present review, based on the last 20 years' scientific literature, aims to summarize the feasability, efficacy and effectivity of telemedicine services in child and adolescent psychiatry.A review by Gloff et al (17) summarized telepsychiatry service in children and adolescents before 2015. A literature search was generated in order to summarize current knowledge based on 3 international databases (Pubmed, Cochrane Database of Systematic Reviews és Web of Science) for scientific publi - cations after 2015. Search words were telemental health, children, adolescent, and telepsychiatry.International literature showed similar feasability, efficacy and effectivity of evidence based diagnostic and therapeutic methods in tele- child and adolescent psychiatry as in face-to-face services.The application of telemedicine in child and adolescent psychiatry is internationally accepted, feasible and effective. Its widespread use in Hungary would require a professional protocol which specifies the conditions and advices of telemental health services in this age group