The difference in chronic inflammation between individuals with officially documented and self-reported adverse childhood experiences is maintained until older middle-age

Non peer reviewe

Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study

Globally, cancer is the second leading cause of death. Loneliness has been suggested as a risk factor for cancer mortality. However, connections between loneliness, social isolation, and cancer are poorly understood. In our longitudinal study (mean follow-up: 20.44 years) of 2570 middle-aged men, loneliness, social isolation, and health-related factors were measured at baseline. Cox proportional hazards analysis was used to examine the association between cancer incidence, loneliness, and social isolation. The effect of relationship status on cancer mortality among cancer patients was tested with the Kaplan-Meier method. Loneliness was associated with total cancer incidence after adjustments for tested lifestyle and health-related covariates. Social Isolation was associated with total cancer incidence, except when adjusted for lifestyle, diet, or Human Population Laboratory (HPL) Depression Scale scores. Loneliness was associated with lung cancer incidence, except when adjusted for HPL Depression Scale scores. There was no significant association between social isolation and lung cancer. Neither loneliness nor social isolation were connected with prostate or colorectal cancer. Being single at baseline was associated with worse survival outcomes for cancer patients. Our findings suggest that regardless of the social network size, loneliness among middle-aged men is associated with an increased likelihood of cancer.Peer reviewe

Concordance and discordance in how patients and therapists experience the psychotherapy process in the treatment of depression

Despite the extensive literature on the outcome and process of psychotherapy in the treatment of depression, little is known about how the underlying factors of depression and the therapy process are experienced by the patients and therapists. In particular, the recognition of themes that are discordantly experienced by patients and therapists may have practical significance for how the therapy process should be conducted. We have previously developed a process description questionnaire to explore the views of patients with major depression and their therapists during the psychodynamic therapy process. In this study, we used factor analysis on the data collected with the process description questionnaire to explore the perceptions of the patients and therapists at different stages of the therapy process. We derived 15 clusters of variables from the questionnaire, on which we conducted primary and secondary factor analysis. The formation of the factors was found to be largely consistent between the patients and therapists regarding the alliance and affectively neutral aspects of the treatment process, whereas the variables of the patients vs. therapists concerning symptoms of depression and their underlying factors dispersed to a greater extent into separate factors. Dispersion was found especially in the experience of processing affectively laden themes and the developmental background factors underlying depression. Our findings refer to a defective insight of the patients into the developmental, interactional and affective factors underlying their symptoms. These factors should be especially targeted in psychotherapy of depression

Depression and loneliness may have a direct connection without mediating factors

Purpose of the article There is growing interest in loneliness and its various adverse effects on mental and physical health. While depression is one of the adverse health effects associated with loneliness, there have been some limitations in previous studies: 1) Research has mostly been carried out either in depressed patient samples or in general population samples with depressive symptoms as an outcome, 2) the follow-up times have been rather short, and 3) the mechanisms through which loneliness associates with depression are still unclear. Materials and methods We examined the association between loneliness and incident depression and possible mechanisms underlying this association in a population-based sample of middle-aged men (N = 2339; mean age 53; mean follow-up time 23.5 years). The association between loneliness and depression was explored with Cox proportional hazard analysis, and mediation analyses were performed with the PROCESS macro for SPSS. We used 13 health and lifestyle-related variables as covariates for adjustments in multivariate models and as mediators in simple mediation models. Results Those with depression as an outcome (n = 99) had significantly higher loneliness scale scores at baseline, and baseline loneliness was associated with depression, despite adjustments for potential confounding factors. No mediating factors were observed. Conclusions There was a strong direct association between loneliness and the incidence of depression. Based on our results, we encourage future researchers to look for possible mediators in wider range of variables.Peer reviewe

The impact of lifestyle factors on the intensity of adverse effects in single and repeated session protocols of transcranial electrical stimulation : an exploratory pilot study

Transcranial electrical stimulation (tES) has shown promise in the treatment of conditions such as depression and chronic pain with mild-to-moderate adverse effects (AEs). Few previous studies have attempted to identify factors predicting tES-induced AEs. In particular, AEs resulting from repeated sessions of tES remain understudied. We conducted an exploratory retrospective analysis of two independent randomized controlled studies to investigate whether lifestyle factors (i.e. chronic alcohol use, smoking, exercise, and quality and length of sleep) modify the severity and frequency of tES-induced AEs, and evaluated the progression of AEs over repeated sessions. We utilized two double-blinded samples: 1) a male sample (n=82) randomized to receive transcranial direct current stimulation (tDCS) or sham for 5 days, and 2) a mixed-sex sample (n=60) who received both transcranial random noise stimulation (tRNS) and sham in a crossover setting. The severity of AEs was recorded on a scale of 0-100. The data was analysed using negative binomial models. In addition, we performed power calculations and, to guide future research, evaluated the numbers of individuals needed to detect non-significant observations as significant. By day 5, the tDCS group experienced more sensations under the electrodes than the sham group. Alcohol use, smoking, exercise, or quality or duration of sleep did not appear to be associated with the intensity of the AEs. The subsequent power analyses indicated that substantially larger samples would be needed to detect the observed associations as significant. Repetitive sessions do not appear to introduce additional AE burden to individuals receiving either tDCS or tRNS, at least with protocols lasting up to 5 days. Alcohol use, smoking, exercise, or quality or duration of sleep appear to only have an effect of negligible size, if any, on AEs induced by tDCS or tRNS, and studies with sample sizes ranging from roughly 100 individuals to hundreds of thousands of individuals would be required to detect such effects as significant

Stability of alexithymia is low from adolescence to young adulthood, and the consistency of alexithymia is associated with symptoms of depression and dissociation

Background: The aims of this study were to investigate the stability of alexithymia from adolescence to young adulthood, as well as the association between alexithymia, peer relationships, and symptoms of depression and dissociation. Methods: The participants (n = 755, aged 13–18 years) were assessed with self-rated questionnaires and the 20-item Toronto Alexithymia Scale (TAS-20) at baseline in 2005 and on follow-up in 2011. Results: The changes in the TAS-20 total score (t = −12.26) and the scores for its subscales, difficulty identifying feelings (DIF) (t = −4.04), difficulty describing feelings (DDF) (t = −5.10), and externally oriented thinking (EOT) (t = −18.23), were statistically significant (p < 0.001). Effect sizes (Cohen's d) for the change indicating absolute stability were small for DIF (−0.15) and DDF (−0.19), medium for TAS-20 total (−0.45), and large for EOT (−0.66) scores. Moderate correlations in test–retests with Spearman's ρ (TAS-20 total 0.46, DIF 0.41, DDF 0.39, EOT 0.43) indicated relative stability, whereas low intraclass correlation coefficients (ICCs) (respectively 0.41, 0.39, 0.37, 0.37) indicated poor reliability of test–retests. In regression analyses, poor relationships with peers, loneliness, and symptoms of depression and dissociation at baseline associated with alexithymia at baseline and on follow-up. Unlike EOT, increases in the TAS-20 total, DIF, and DDF scores during the 6-year follow-up associated with baseline symptoms of depression and dissociation. Conclusions: Alexithymia in adolescence is not always a reliable predictor of alexithymia in young adulthood. Mental health symptoms appear to affect the consistency of alexithymia during adolescent development.publishedVersionPeer reviewe

Externally oriented thinking style increases primary health care use in adolescence

Background: Alexithymia has been related to adult health care use. We investigated the association between alexithymia and the utilization of primary health care services by adolescents and young adults. Methods: The participants (n = 751, aged 13-18 years) in this 5-year follow-up study were assessed with the 20-item Toronto Alexithymia Scale (TAS-20) and its three subscales, difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally oriented thinking (EOT), and the 21-item Beck Depression Inventory (BDI). Primary health care data were gathered from health care centre registers in 2005-10. Generalized linear models and mediation analyses were used. Results: An increase in the TAS-20 total score correlated with a higher number of primary health care and emergency care visits, but in multivariate general linear models, TAS-20 total scores were no longer significant. Younger age, female gender and an increase in the baseline EOT score are associated with a higher number of both primary health care and emergency room visits. In females, a smaller change in the EOT score from baseline to follow-up was associated with a higher number of primary health care visits. In mediation analyses, EOT had a direct effect on a higher number of primary health care and emergency room visits, whereas the BDI score mediated the incremental effect of DIF and DDF on visit numbers. Conclusions: The results suggest that an EOT style independently increases health care use by adolescents, whereas the effects of difficulties identifying and describing feelings on health care use are mediated by symptoms of depression.publishedVersionPeer reviewe

Purine metabolism is dysregulated in patients with major depressive disorder

Peer reviewe

Depression and loneliness may have a direct connection without mediating factors

A Brief ReportPurpose of the article There is growing interest in loneliness and its various adverse effects on mental and physical health. While depression is one of the adverse health effects associated with loneliness, there have been some limitations in previous studies: 1) Research has mostly been carried out either in depressed patient samples or in general population samples with depressive symptoms as an outcome, 2) the follow-up times have been rather short, and 3) the mechanisms through which loneliness associates with depression are still unclear.Materials and methods We examined the association between loneliness and incident depression and possible mechanisms underlying this association in a population-based sample of middle-aged men (N = 2339; mean age 53; mean follow-up time 23.5 years). The association between loneliness and depression was explored with Cox proportional hazard analysis, and mediation analyses were performed with the PROCESS macro for SPSS. We used 13 health and lifestyle-related variables as covariates for adjustments in multivariate models and as mediators in simple mediation models.Results Those with depression as an outcome (n = 99) had significantly higher loneliness scale scores at baseline, and baseline loneliness was associated with depression, despite adjustments for potential confounding factors. No mediating factors were observed.Conclusions There was a strong direct association between loneliness and the incidence of depression. Based on our results, we encourage future researchers to look for possible mediators in wider range of variables.</p