Biomedical subjects

A E Korten

Publications and source records attributed to A E Korten.

At least 19 recordsLinked to original sources

PubMed2003

Providing information about the effectiveness of treatment options to depressed people in the community: a randomized controlled trial of effects on mental health literacy, help-seeking and symptoms.

BACKGROUND: Many people who are depressed do not receive any professional help and their beliefs about the helpfulness of treatment do not always correspond with those of health professionals. To facilitate choices about treatment, the present study examined the effects of providing depressed people in the community with evidence on whether various treatment options work. METHOD: A randomized controlled trial was carried out with 1094 persons selected at random from the community who screened positive for depressive symptoms and agreed to participate. Participants were mailed either an evidence-based consumer guide to treatments for depression or, as a control, a general brochure on depression. Outcomes were the rated usefulness of the information provided, changes in attitudes to depression treatments, actions taken to reduce depression, and changes in depressive symptoms, anxiety symptoms and disability. RESULTS: Participants rated the evidence-based consumer guide as more useful than the control brochure. Attitudes to some treatments changed. Improvements in symptoms and disability did not differ significantly between interventions. CONCLUSION: Providing people who are depressed with evidence on which treatments work produces some changes in attitudes and behaviour. However, this intervention may need to be enhanced if it is to produce symptom change.

Adult↗

PubMed2002

Patterns of association between alcohol consumption and symptoms of depression and anxiety in young adults.

AIMS: Recent epidemiological findings indicate that non-drinkers as well as hazardous/harmful drinkers experience higher levels of distress than moderate drinkers. Little is known about the age at which this develops. This paper examines levels of affect, depression and anxiety over the full range of alcohol consumption in young adults. DESIGN: Cross-sectional findings from the first wave of a prospective, longitudinal study are presented. PARTICIPANTS: The general population sample comprised of 2404 young adults (aged 20-24 years). living in the Canberra region. Measures included: the Goldberg Depression and Anxiety scales, the Positive and Negative Affect Schedule, and the Alcohol Use Disorders Identification Test. FINDINGS: For men, both non/occasional and hazardous/harmful consumption were associated with lower levels of positive affect and higher levels of anxiety and depression. The higher levels of distress evident for male abstainers were related to being less extroverted and less healthy and not to past hazardous/harmful alcohol consumption, current tobacco or marijuana use. For women, only hazardous/harmful drinkers were found to have higher levels of depression and negative affect. Hazardous/harmful consumption was related to using marijuana, tobacco and recent stressful events in both men and women. CONCLUSIONS: Higher levels of distress are already evident in male non-drinkers in early adulthood. The findings counter theories that distress in non-drinkers is due to past hazardous/harmful alcohol consumption, marijuana or tobacco use, or characteristics in common with hazardous/harmful drinkers. Alcohol use disorders and mental health problems are pertinent issues for young adults. However, more understanding is needed of the experiences of non-drinkers in an alcohol consuming culture.

Adult↗

PubMed2001

The cognitive decline scale of the psychogeriatric assessment scales (PAS): longitudinal data on its validity.

OBJECTIVE: The Cognitive Decline scale of the Psychogeriatric Assessment Scales (PAS)1 uses informant data to assess retrospectively change from earlier in life. Data from a 7-8-year longitudinal study were used to assess the validity of this scale against changes in cognitive performance and mortality. DESIGN AND MEASURES: PAS data were collected on three occasions, with gaps of 3.6 and 4.1 years between the waves. The Cognitive Decline score at Wave 3 was validated retrospectively against actual change on a brief test of current cognitive status (the PAS Cognitive Impairment scale) over the three waves, while the Cognitive Decline score at Wave 1 was assessed for predictive validity against future mortality and cognitive change. SETTING: A community survey in the Australian cities of Canberra and Queanbeyan. PARTICIPANTS: Participants were aged 70+ at the beginning of the study. The sample size varied from 729 to 279, depending on the number of waves involved. RESULTS: Participants with scores of 4+ on the Cognitive Decline scale at Wave 3 showed substantial deterioration over the previous 7-8 years. Scores of 4+ at Wave 1 predicted mortality and further cognitive deterioration. CONCLUSIONS: The Cognitive Decline scale allows a valid retrospective assessment of change and has predictive validity for subsequent cognitive deterioration and increased mortality.

Aged↗

PubMed2001

Age is no kinder to the better educated: absence of an association investigated using latent growth techniques in a community sample.

BACKGROUND: Higher education has been posited to protect against cognitive decline, either because the rate of decline is slower in the more highly educated or the start of decline is delayed. Latent growth models provide improved methodology to examine this issue. METHODS: The sample consisted of 887 participants aged 70-93 years in 1991 and followed up in 1994 and 1998. Latent growth models and standard regression techniques were used to examine the rate of cognitive decline in four cognitive measures while controlling for health status and sex. A delayed start model was examined by incorporating interaction effects in a regression model. RESULTS: Neither the latent growth models nor the regression techniques revealed a slower rate of decline for the more highly educated. The proportion of the highly educated showing no change was no larger than the proportion of the less well educated. There were no significant age by education interaction effects, no chronologically later accelerations in the rate of change as a function of education, and no differences in rate of decline between the first measurement interval and the second. CONCLUSIONS: Education may not protect against cognitive decline although it is associated with long-term individual differences in level of functioning. The discrepancy between our study and others may be attributable to attrition effects, follow-up length, sample age, scaling artefacts and negative publication bias. Most importantly, practice effects may favour the better educated and hence account for the supposed protective effect in many longitudinal studies of cognitive change.

Activities of Daily Living↗

PubMed2001

Memory complaints as a precursor of memory impairment in older people: a longitudinal analysis over 7-8 years.

BACKGROUND: There is considerable dispute about the validity of memory complaints. While some studies find that complaints are an early indicator of dementia or cognitive decline, there are also many studies showing that complaints are more closely associated with negative affect (depression, anxiety and neuroticism). The present paper used three-wave longitudinal data to test three hypotheses: (1) that memory complaints reflect an evaluation of present and past memory performance; (2) that memory complaints predict future memory performance; and (3) that memory complaints predict current and future negative affect. METHODS: A longitudinal study was carried out with a community sample of people aged 70 and over. Participants were assessed for memory complaints, memory performance and negative affect at three waves separated by 3.6 years and 4.0 years. There were 331 persons with data on all relevant variables. The data were analysed using structural equation modelling. RESULTS: Significant paths in the structural model were found from memory performance to future memory complaints, as well as from memory complaints to future memory performance, supporting hypotheses 1 and 2. Memory complaints were associated with current negative affect, but did not predict future negative affect. CONCLUSIONS: Memory complaints do reflect perceptions of past memory performance and are also an early manifestation of memory impairment. However, current negative affect (anxiety and depression symptoms) shows the greatest association with memory complaints.

Affect↗

PubMed2000

Association of smoking and personality with a polymorphism of the dopamine transporter gene: results from a community survey.

In studies that used mixed volunteer samples, Lerman et al. [1999: Health Psychol 18:14-20] and Sabol et al. [1999: Health Psychol 18:7-13] reported on an association of smoking with a polymorphism of the dopamine transporter gene. We attempted to replicate this association in a nonvolunteer community sample of 861 Caucasians. No associations were found with either smoking initiation or smoking cessation. Sabol et al. [1999] also reported on an association of the dopamine transporter polymorphism with the personality trait of novelty seeking. However, we failed to find any associations with a range of personality traits, including a scale of fun seeking that correlates with novelty seeking. These negative findings suggest that either the original associations are not replicable or that any association is very small.

Adult↗

PubMed2000

COMT and DRD3 polymorphisms, environmental exposures, and personality traits related to common mental disorders.

In a community sample of 2,327 Caucasians, we tested the hypotheses that polymorphisms in the COMT and DRD3 genes are associated with personality traits conferring vulnerability to anxiety, depression, or alcohol misuse, or with current symptoms of these; and that the association is stronger in persons who also have been exposed to stressor experiences. To conserve resources and to allow replication, the genetic analysis was undertaken in two stages. For the COMT polymorphism, no statistically significant associations were found in the first sample of 862 persons. The remainder of the sample was therefore not analysed for that gene. For the DRD3 polymorphism, those in the first sample with at least one of the Ser(9) alleles had significantly higher scores in neuroticism (p=0.006) and behavioral inhibition (p=0.003). There was a trend, failing to meet the 1% significance criterion, for those with this genotype also to have higher depression and anxiety. The groups did not differ in alcohol use. In persons with the Ser(9) allele who were also exposed to stressors, there was a higher level of depression at the 5% level; and the depression level was higher in homozygotes. But when the remainder of the sample (1,465) was analysed, none of the associations reached statistical significance. We conclude that neither the COMT nor DRD3 polymorphisms are associated with anxiety, depression, or alcohol abuse. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:102-107, 2000

Catechol O-Methyltransferase↗

PubMed2000

Public belief systems about the helpfulness of interventions for depression: associations with history of depression and professional help-seeking.

BACKGROUND: Previous research has found that there are major differences between public and professional beliefs about the helpfulness of interventions for depression. The public appear to be guided by general belief systems about the helpfulness of medical, psychological and lifestyle interventions rather than by specific knowledge about what interventions are effective for depression. The present paper examines the effect that experiencing depression and receiving treatment might have on these beliefs. METHOD: The study involved a postal survey of 3109 adults from a region of New South Wales, Australia. Respondents were presented with a vignette describing a person with depression. They were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions for the person described in the vignette. Respondents also completed the Goldberg Depression Scale and were asked whether they had ever had an episode of depression and whether they had seen a counsellor or a doctor for it at the time. Structural equation modelling was used to investigate the associations of history of depression and professional help-seeking with belief systems. RESULTS: A three-factor model was found to fit the helpfulness ratings, with factors reflecting beliefs in medical, psychological and lifestyle interventions. People who had sought help for depression were less likely to believe in the helpfulness of lifestyle interventions and more likely to believe in medical interventions. As well as these general associations with belief systems, having sought help for depression had a number of specific associations with beliefs. Controlling for general belief systems, those who had sought help were more likely to rate antidepressants, holidays, massage and new recreational pursuits as helpful, and were less likely to rate ECT and family as helpful. Those who had a history of depression but had not sought help were more likely to rate counselling as helpful, and less likely to rate family as helpful. Those with current depressive symptoms were less likely to rate telephone counselling, family and friends as helpful. CONCLUSION: Having sought help for depression is associated with general belief systems about the helpfulness of lifestyle and medical interventions and also has some associations with specific beliefs that may reflect experiences with treatment (e.g. the helpfulness of antidepressants). Those currently depressed or with a history of depression are less likely to regard family as helpful, possibly due to poorer social support. Generally speaking, having sought help is associated with beliefs closer to those of professionals.

Adult↗

PubMed2000

Non-linear relationships in associations of depression and anxiety with alcohol use.

BACKGROUND: Many studies have demonstrated co-morbidity of alcohol abuse/dependence with mood and anxiety disorders but relatively little is known about anxiety and depression across the full continua of alcohol consumption and problems associated with drinking. METHODS: Participants from a general population sample (N = 2725) aged 18-80 years completed the Alcohol Use Disorders Identification Test (AUDIT) and four measures of negative affect (two depression and two anxiety symptom scales) included in a self-completion questionnaire. RESULTS: High consumption, AUDIT total score, and AUDIT problems score were associated with high negative affect scores in participants under 60 years old (ORs in the range 1.80-2.83). Graphical and statistical analyses using continuous measures of alcohol use/problems and negative affect identified non-linear relationships where abstainers and occasional drinkers, as well as heavy and problem drinkers, were at risk of high anxiety and depression levels. This pattern, however, was not found in those aged > or = 60 years. The U-shaped relationship was not an artefact of abstainers being typical of the general population in their distribution of negative affect. CONCLUSIONS: Studies of co-morbidity should acknowledge the possibility of non-linear associations and employ both continuous and discrete measures. Abstainers, as well as heavy drinkers, are at increased risk of symptoms of depression and anxiety disorders. Psychosocial factors may play a role in the U-shaped relationship between alcohol consumption and mortality.

Adolescent↗

PubMed2000

Informant ratings of cognitive decline in old age: validation against change on cognitive tests over 7 to 8 years.

BACKGROUND: Informant questionnaires on cognitive decline are increasingly used as screening tests for dementia. Informants can provide a longitudinal perspective that is not possible with cognitive screening tests administered at one point in time. However, there are limited data on the validity of such questionnaires when judged against longitudinal change on cognitive tests. METHODS: A community sample of elderly people aged > or = 70 was assessed on cognitive tests at baseline and after a follow-up of 7-8 years. The participants were given the Mini-Mental State Examination and tests of episodic memory and mental speed. At follow-up, the short-form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was completed by informants for 287 of the participants. RESULTS: Elderly people who were rated by informants as having moderate or severe decline had declined significantly on cognitive tests. The IQCODE correlated as highly with cognitive test change scores as these change scores correlated with each other. CONCLUSIONS: The IQCODE is a valid way of assessing cognitive decline when assessment can be carried out only at one point in time.

Age Factors↗

PubMed2000

Predicting anxiety and depression from personality: is there a synergistic effect of neuroticism and extraversion?

In a longitudinal study of college students, B. S. Gershuny and K. J. Sher (1998) found that high neuroticism and low extraversion had a synergistic effect in predicting anxiety and depression 3 years later. This article attempted to replicate their finding using data from 2 community samples: (a) a cross-sectional survey of 2,677 persons aged 18-79 years, and (b) a longitudinal study in which 441 persons aged 70 or older were followed over 3-4 years. Both studies found that neuroticism predicted anxiety and depression, but there were no Neuroticism x Extraversion interaction effects. These results cast doubt on the generalizability of the original findings.

Adolescent↗

PubMed2000

Risk factors for depression and anxiety in abstainers, moderate drinkers and heavy drinkers.

AIMS: To identify risk factors for depression and anxiety that are more prevalent in abstainers than in moderate drinkers and to estimate their contribution to U-shaped relationships of depression and anxiety with alcohol consumption. DESIGN: Cross-sectional general population sample. SETTING: Canberra, Australia. PARTICIPANTS: 2725 subjects completed questionnaires, including 1128 men and 1258 women aged 18-59 years. MEASUREMENTS: Consumption categories from AUDIT quantity/frequency items: (1) non-drinkers (no alcohol in the past year), (2) occasional drinkers (monthly or less), (3) lower-level drinkers (up to 14 standard drinks per week for men and seven for women), (4) higher-level drinkers (up to 28 and 14 standard drinks per week, respectively), and (5) those drinking at hazardous or harmful levels (over 28 and 14 standard drinks per week, respectively). Goldberg and DSSI/sAD depression and anxiety scales. A range of demographic, socio-economic, socio-environmental and personality factors. FINDINGS: Non-drinkers were more likely than lower-level drinkers to have low status occupations, poor education, current financial hardship, poor social support and recent stressful life events, and scored lower on extraversion, fun-seeking and drive. Many of these characteristics also applied to hazardous/harmful drinkers. In multivariate models, these risk factors accounted for a substantial part of the higher depression and anxiety scores of non-drinkers and occasional drinkers relative to lower-level drinkers. CONCLUSIONS: Abstainers have a range of characteristics known to be associated with anxiety, depression and other facets of ill health, and these factors may contribute significantly to their elevated levels of depression and anxiety.

Adolescent↗

PubMed2000

Attitudes towards people with depression: effects on the public's help-seeking and outcome when experiencing common psychiatric symptoms.

OBJECTIVE: To determine whether people's attitudes towards a person who has experienced depression influence them in (i) the types of actions they take to help themselves if they experience common psychiatric symptoms, and (ii) the degree to which their symptoms improve. METHOD: A postal survey was carried out with 3,109 adults to assess attitudes and symptoms of anxiety and depression. Attitudes were assessed by questions on a depressed person's likely long-term outcome in various areas of life and whether the respondents thought the depressed person was likely to experience discrimination. A follow-up survey was carried out 6 months later with 422 persons who had a high level of symptoms at baseline. These individuals were asked about whether they had taken various actions to relieve their symptoms. RESULTS: The attitude measures did not predict use of actions which involved someone else having to know that the person had psychiatric symptoms, nor use of actions which did not. The attitude measures also did not predict change in anxiety and depression symptoms. CONCLUSIONS: The attitude measures did not predict patterns of help-seeking or outcome for people with common psychiatric symptoms. However, attitudes towards depression were quite benign and the situation could be different for people with severe mental disorders.

Adult↗

PubMed2000

Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms.

OBJECTIVE: Previous research has shown that the public have different beliefs to mental health professionals about the helpfulness of interventions for mental disorders. However, it is not known whether the public's beliefs actually influence their behaviour when they develop psychiatric symptoms. METHOD: A postal survey of 3,109 Australian adults was used to assess beliefs about the helpfulness of a broad range of interventions for depression, as well as respondents' current level of anxiety and depression symptoms and any history of treated depression. A follow-up survey of 422 persons who had a high level of symptoms at baseline was conducted 6 months later. These people were asked which interventions they had used to reduce their symptoms. An analysis was carried out to see whether beliefs and other factors at baseline predicted subsequent use of interventions. RESULTS: There were some major discrepancies between the ranking of interventions as likely to be helpful and the ranking of how frequently they were actually used. Interventions involving mental health professionals were often rated as likely to be helpful, but were rarely used in practice. Other simple, cheap and readily available interventions were used the most frequently, but were not the most likely to be rated as helpful. The most consistent predictors across all interventions used were gender, history of treatment, current symptoms and belief in a particular intervention. Of particular interest was the finding that beliefs in the helpfulness of antidepressants predicted their use. However, beliefs were not predictors of use for all interventions. CONCLUSIONS: Beliefs about the helpfulness of an intervention did not always predict actual use of that intervention, although beliefs did predict use of antidepressants. Therefore, campaigns that change public beliefs about effective treatments may also influence actual use of treatments. Interventions preferred by professionals are not frequently used at present. Most people with anxiety and depression symptoms rely primarily on simple self-help interventions, the effectiveness of which has been little researched.

Adult↗

PubMed2000

Association of a functional polymorphism of the monoamine oxidase A gene promoter with personality and psychiatric symptoms.

A functional polymorphism in the promoter of the monoamine oxidase gene has recently been described by Sabol et al. This polymorphism is a strong candidate for associations with personality traits and psychiatric symptoms. We report relevant data from a general population sample of 850 Caucasian Australians. We found no associations with anxiety and depression symptoms, with personality traits that predispose to anxiety (neuroticism, behavioral inhibition, negative affect) or to a personality trait related to antisocial behavior (psychoticism).

Adult↗

PubMed1999

Smoking and mental health: results from a community survey.

OBJECTIVE: To assess the relationship of smoking with depression and anxiety symptoms and with risk factors for depression. DESIGN AND SETTING: A community survey conducted in Canberra in 1997. PARTICIPANTS: 2725 persons aged 18-79 sampled from the electoral roll. MAIN OUTCOME MEASURES: Smoking was investigated in relation to psychiatric symptoms (anxiety, depression, alcohol misuse), sociodemographic characteristics (age, sex, education, occupational status), social stressors (divorce, unemployment, financial difficulties, negative life events, childhood adversity), personality (extraversion, neuroticism, psychoticism), and social support (family and friends). RESULTS: Smokers had more depression and anxiety symptoms, more stressors and lower socioeconomic status compared with non-smokers. The association between smoking and psychiatric symptoms persisted even when stressors, socioeconomic characteristics and other factors were statistically controlled. CONCLUSIONS: Smoking is associated with poorer mental health. In helping patients to give up smoking, doctors need to be aware that some may have underlying mental health problems that require attention.

Adolescent↗

PubMed1999

Emotional response of participants to a mental health survey.

Following participation in a mental health survey of 2725 adults aged 18-79, respondents were asked if the questionnaire had made them feel distressed or depressed, and if it had been an intrusion on privacy or had made them feel good about themselves. While 5% reported feeling distressed, 3% depressed and 3% were concerned about privacy, 35% reported feeling good about themselves. The participants reporting negative feelings were more likely to be younger women, to be higher on negative personality measures, to report more anxiety and depression symptoms, and to have had more childhood adversity and lower social support. Those who reported positive feelings had higher positive personality scores, more social support and lower anxiety and depression. This group was more likely to be older women. Despite the sensitive nature of many of the questions, only a small percentage of respondents reported distress, while many found that the questionnaire had made them feel good about themselves. This is important information to present to Institutional Ethics Committees and to future participants in such studies.

Adolescent↗

PubMed1999

Age differences in depression and anxiety symptoms: a structural equation modelling analysis of data from a general population sample.

BACKGROUND: There is debate as to whether the elderly are really at lower risk for depressive disorders, or whether endorsement of symptoms is artefactually low. The present paper assesses the effects of age on anxiety and depression, and examines whether age has direct effects on self-report of individual symptoms independent of its effect on the underlying dimensions of anxiety and depression. METHODS: Structural equation modelling was used to assess the structure of the items and their associations with age and a number of demographic variables. The sample of 2622 participants aged between 18 and 79 years from Canberra (Australia) was drawn from the Electoral Roll. Two instruments were used: the anxiety and depression scales of Goldberg et al. (1988) and the Personal Disturbance Scale from the DSSI of Bedford et al. (1976). RESULTS: Both scales were found to fit satisfactorily to a two factor model. Age correlated negatively with depression. After controlling for the effects of gender, marital status, education and financial difficulty, direct effects of age were found on items from both instruments, indicating that certain depression items were associated with a differential probability of endorsement in older people, even when the level of depression was equal to that of younger people. Items with direct age effects reflected physical (feeling slowed down; waking early) and psychological (hopeless about the future) components of depression. Direct effects of age on items from both anxiety scales were also found. CONCLUSIONS: The nature of the depression and anxiety experienced by younger and older people may differ qualitatively. Depression may be associated with an increase in somatic symptoms linked to physical changes and to an increase in endorsement of items which reflect the narrowing of opportunities in the long-term.

Adolescent↗