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Biomedical subjects

Johan Ormel

Publications and source records attributed to Johan Ormel.

At least 37 records · Page 2Linked to original sources
PubMed2006

The association between levels of cortisol secretion and fear perception in patients with remitted depression predicts recurrence.

This study examines the association between cortisol secretion and fear perception in remitted patients to identify mechanisms underlying risk for recurrence of depression. We hypothesized that the stronger the association between cortisol secretion and fear perception in persons with remitted depression, the more recurrence would be experienced. We also investigated whether high levels of cortisol and fear perception per se predict more recurrence. These effects were assumed to be stronger in women than in men. In a prospective design, we investigated 77 outpatients with remitted depression and related the association between their 24-hour urinary free cortisol secretion and fear perception (from ambiguous faces and from vocal expressions) to recurrence of depression within 2 years. We applied Cox regression models, partial correlations, and Fisher z tests. In 21 patients, depression recurred. Irrespective the channel of perception (eye or ear), the interaction between fear perception and cortisol secretion was significantly related to recurrence of depression. Patients high or low on both variables are more at risk. This increased risk was also reflected by a significant association between cortisol secretion and facial fear perception, but only among subjects who experienced recurrence. A trend in the same direction was found for vocal fear perception. Fear perception and cortisol secretion per se did not predict recurrence. No gender differences were found. The association between cortisol secretion and fear perception (probably indicative for altered fear circuits in the brain) constitutes a mechanism underlying risk for recurrence of depression.

Adult↗
PubMed2006

Hypothalamic-pituitary-adrenal axis activity and early onset of cannabis use.

AIMS: To identify early onset cannabis users by measuring basal hypothalamic-pituitary-adrenal (HPA) axis activity, which may be a risk factor for early onset substance use when showing low activity. DESIGN: In a prospective cohort study, adolescents who initiated cannabis use at an early age (9-12 years), those who initiated at a later age (13-14 years) and those who did not use cannabis by the age of 14 were compared with respect to HPA axis activity. SETTING AND PARTICIPANTS: Data were used from the first and second assessment wave of the TRacking Adolescents' Individual Lives Survey (TRAILS), that included 1768 Dutch young adolescents aged 10-12 years who were followed-up across a period of 2 years. MEASUREMENTS: Cortisol was measured in saliva samples at awakening, 30 minutes later and at 8 p.m. at age 10-12. Self-reported age at first cannabis use was used. FINDINGS: The early onset group had lower cortisol levels 30 minutes after awakening than the late onset group (OR = 0.93, 95% CI: 0.86-0.99). Furthermore, compared to non-users, the early and late onset cannabis users had higher levels of cortisol at 8 p.m. (OR = 1.25, 95% CI: 1.03-1.53 and OR = 1.21, 95% CI: 1.01-1.45, respectively). CONCLUSIONS: Some evidence was found for HPA axis hypo-activity at awakening in adolescents with early onset of cannabis use compared to late onset users, which might indicate an increased risk for early onset users of seeking stimulation to restore arousal levels by using substances.

Adolescent↗
PubMed2006

Temperament, parenting, and depressive symptoms in a population sample of preadolescents.

BACKGROUND: Depressive symptoms can be triggered by negative social experiences and individuals' processing of these experiences. This study focuses on the interaction between temperament, perceived parenting, and gender in relation to depressive problems in a Dutch population sample of preadolescents. METHODS: The sample consisted of 2230 ten-to-twelve-year-olds from the North of The Netherlands. Perceived parenting (overprotection, rejection, emotional warmth) was assessed by the EMBU (a Swedish acronym for My Memories of Upbringing) for Children, temperament (fearfulness and frustration) by the parent version of the Early Adolescent Temperament Questionnaire-Revised, and depressive problems by the Child Behavior Checklist (parent report) and the Youth Self-Report (child report). RESULTS: All parenting and temperament factors were significantly associated with depressive problems. Frustration increased the depressogenic effect of parental overprotection and lack of emotional warmth. Fearfulness increased the effect of rejection in girls, but not in boys. Furthermore, the association between frustration and depression was stronger in boys. CONCLUSIONS: These findings support the hypothesis that the effect of specific parenting behaviors depends on the temperament and gender of the child.

Child↗
PubMed2006

Symptom dimensions of depression following myocardial infarction and their relationship with somatic health status and cardiovascular prognosis.

OBJECTIVE: The reporting of depressive symptoms following myocardial infarction may be confounded by complaints originating from the myocardial infarction. Therefore, it is difficult to estimate the effects of post-myocardial infarction depression and its treatment on cardiovascular prognosis. The authors' goal was to study the relationship between depressive symptom dimensions following myocardial infarction and both somatic health status and prospective cardiovascular prognosis. METHOD: In two studies of myocardial infarction patients (N=494 and 1,972), the Beck Depression Inventory was used to determine the dimensional structure of depressive symptoms following myocardial infarction. Three symptom dimensions-somatic/affective, cognitive/affective, and appetitive-were compared with baseline left ventricular ejection fraction, Charlson comorbidity index, Killip class, and previous myocardial infarction. The relationship between depressive symptom dimensions and prospective cardiovascular mortality and cardiac-related readmissions was also examined (mean follow-up duration=2.5 years). RESULTS: Somatic/affective symptoms were associated with poor health status (left ventricular ejection fraction, Charlson comorbidity index, Killip class, and previous myocardial infarction) and predicted cardiovascular mortality and cardiac events. Cognitive/affective symptoms were only marginally associated with somatic health status and not with cardiovascular death and cardiac events. Appetitive symptoms were related to somatic health status but did not predict cardiovascular death or cardiac events. CONCLUSIONS: Somatic/affective depressive symptoms following myocardial infarction were confounded by somatic health status yet were prospectively associated with cardiac prognosis even after somatic health status was controlled. Cognitive/affective depressive symptoms were only marginally related to health status and not to cardiac prognosis. These findings suggest that treatment of depression following myocardial infarction might improve cardiovascular prognosis when it reduces somatic/affective symptoms.

Cause of Death↗
PubMed2005

The use of the GBI as predictor of bipolar disorder in a population of adolescent offspring of parents with a bipolar disorder.

OBJECTIVE: To assess the usefulness of the General Behavior Inventory (GBI) to predict the development of mood disorders in the offspring of parents with bipolar disorder. METHOD: The GBI and the K-SADS (first measurement) and the SCID (last measurement) were used to assess psychopathology among 129 adolescent and young adult offspring of a bipolar parent with an interval of 5 years. Based on the SCID results at the last measurement, the offspring were assigned to one of four groups: with bipolar mood disorder, with unipolar mood disorders, with non-mood disorders and without disorders and GBI-scores at the first measurement were compared across the four groups. RESULTS: The scores on the Depression scale of the GBI for the offspring who later developed a bipolar or any mood disorder were significantly higher than for the offspring who did not develop a mood disorder across a 5-year interval. For the offspring with a unipolar mood disorder at the first measurement, the scores on the Depression scale were significantly higher for those who switched to bipolar disorder versus those who remained unipolar. CONCLUSIONS: The GBI can be used in a high-risk sample of offspring of parents with bipolar disorder as a self-report measure as an aid to detect those who will develop bipolar disorder across a 5-year interval.

Adolescent↗
PubMed2005

Classes of adolescents with disruptive behaviors in a general population sample.

BACKGROUND: To study disruptive behaviors adequately, we need to distinguish between individuals with different types of problems that may have a different etiology. The availability of a taxonomic system that helps in identifying homogeneous groups of individuals, with similar patterns of disruptive behaviors, is crucial to achieve this goal. Therefore, we examine which classes of preadolescents with symptoms of Attention Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) can be identified in the general population. METHODS: Disruptive behaviors of 2,230 10-12 year olds from the Dutch general population were assessed with the Child Behavior Checklist and Youth Self-Report. RESULTS: Latent class analysis revealed three classes of preadolescents: the first characterized by high scores on ADHD, ODD, and CD items; a second by high probabilities of ADHD and ODD symptoms; a third with low scores on all items. CONCLUSIONS: Because classes of preadolescents with symptoms of only one type of disruptive behavior problems could not be identified, it can be questioned how useful separate diagnostic distinctions are in general population studies.

Adolescent↗
PubMed2005

Relationship between left ventricular dysfunction and depression following myocardial infarction: data from the MIND-IT.

AIMS: Depression in patients following myocardial infarction (MI) is associated with an increased risk of mortality, but this association may be confounded by cardiac disease severity. We explored the relationship between left ventricular ejection fraction (LVEF) and depression in MI patients. METHODS AND RESULTS: In the Myocardial Infarction and Depression-Intervention Trial (MIND-IT), 1989 MI patients were assessed for depressive symptoms [Beck Depression Inventory (BDI) t = 0, 3, 6, 9, and 12 months post-MI]. Patients with BDI score > or =10 were assessed for the presence of International Classification of Diseases, 10th revision (ICD-10) depressive disorder (t = 3, 6, 9, and 12 months post-MI). Patients were divided into categories according to their LVEF during hospitalization, i.e. LVEF <30%, LVEF 30-45%, LVEF 45-60%, and LVEF > or = 60%. During hospitalization, presence of depressive symptoms was higher in patients with LV dysfunction. A relationship was found between LVEF and ICD-10 depressive disorder, i.e. a lower LVEF was associated with a higher rate of depression from 3-12 months post-MI (P < 0.01). Levels of LVEF inversely correlated with the BDI score at 3 months post-MI. Associations persisted after adjustment for demographics, risk factors for coronary artery disease, co-morbidity, Killip class, and baseline BDI score. CONCLUSION: In MI patients, the rate of depression and the severity of depressive symptoms are significantly related to the severity of LV dysfunction. The association between depression and LV dysfunction must be acknowledged when evaluating the prognostic effects of depression in cardiac patients.

Depressive Disorder↗
PubMed2005

The care provided by general practitioners for persistent depression.

PURPOSE: To examine the care provided by general practitioners (GPs) for persistent depressive illness and its relationship to patient, illness and consultation characteristics. SUBJECTS AND METHOD: Using the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) a sample of 264 patients with ICD-10 depression was identified among consecutive primary care patients in the Netherlands. At 1-year follow-up 78 of these patients (30%) still fulfilled the criteria of an ICD-10 depression and were considered persistent cases. At baseline and follow-up the GPs specified their diagnosis and treatment. The extent of recognition as a mental health problem, accuracy of diagnosis as a depression and treatment in accordance with clinical guidelines for depression was examined. In addition it was examined whether these steps in adequate GP care for persistent depression were related to patient, illness and consultation characteristics. RESULTS: Twenty percent of the persistent depression cases were not recognized at baseline or during follow-up, 28% was recognized but not accurately diagnosed, 17% was accurately diagnosed, but did not receive adequate treatment and 35% was treated adequately. Recognition was associated with psychological reason for encounter; accurate diagnosis with absence of activity limitation days; and adequate treatment with severity of depression and higher educational level. CONCLUSION: Non-recognition, misdiagnosis and inadequate treatment are not limited to patients with a relatively mild and brief depression but are also prominent in patients with a persistent depression, who consulted their GP 8.2 times on average during the year their depression persisted.

Adult↗
PubMed2005

Latent class analysis of anxiety and depressive symptoms of the Youth Self-Report in a general population sample of young adolescents.

This study examined whether distinct groups of young adolescents with mainly anxiety or mainly depression could be identified in a general population sample. Latent class analysis was used on self-report ratings of DSM-IV symptoms of anxiety and depressive disorders, because it was hypothesized that these ratings provide a bigger chance to identify distinct groups than parent ratings of symptoms that are poorly associated with DSM-IV. Results from exploratory and confirmatory latent class analysis showed that only very small numbers of young adolescents had mainly anxiety or mainly depressive symptoms. Instead, a five-group model fitted the data best. These five groups contained young adolescents who either had a high, intermediate, or low probability to have comorbid symptoms of anxiety and depression. It was concluded that symptoms of DSM-IV anxiety and depressive disorders co-occur in young adolescents, and that latent class analysis on items that capture also severe symptoms like suicidal thoughts are needed to derive groups with specific comorbidity patterns in a general population sample.

Anxiety Disorders↗
PubMed2005

Prediction of depressive disorder following myocardial infarction data from the Myocardial INfarction and Depression-Intervention Trial (MIND-IT).

BACKGROUND: Depression following myocardial infarction (MI) is associated with complicated cardiac rehabilitation, non-compliance and poor prognosis. Whether depression following MI can be predicted from variables routinely assessed during hospitalization for MI is unknown. METHODS: Using data from the Myocardial INfarction and Depression-Intervention Trial (MIND-IT), we identified 2,177 MI patients (mean age 63 years; 23% female). Patients were randomly divided into a derivation and a validation sample. In the derivation sample, we analyzed variables potentially associated with the development of post-MI depressive disorder, which were tested in the validation sample. RESULTS: In the year following MI, 18.5% suffered from depressive disorder (ICD-10 criteria). In a multivariate model, factors associated with depression were younger age (OR 1.94; CI 1.38-2.74), hypercholesterolemia (OR 1.68; CI 1.08-2.61), the use of calcium channel blockers at discharge (OR 1.80; CI 1.20-2.71), and left ventricular ejection fraction (LVEF) (OR 4.14 for patients with LVEF <30%; CI (2.42-7.10). The derived predictors were tested in the validation sample. The final model yielded two clinical predictors, i.e., younger age and severe LV-dysfunction, which correctly predicted post-discharge depression status in 82.9% of the MI patients. The model yielded a high negative predictive value (89%). A positive depression questionnaire (BDI) during hospitalization increased the positive predictive value of 23% to 52%. CONCLUSIONS: During hospitalization for MI and using a two-step strategy with common clinical variables, i.e., younger age, severe LV-dysfunction and BDI score during hospitalization, it is possible to identify MI patients with a high risk for subsequent development of depression.

Adult↗
PubMed2005

Determinants of smoking status: cross-sectional data on smoking initiation and cessation.

BACKGROUND: Cigarette smoking is known to increase the risk of chronic disease. Improved understanding of factors that contribute to smoking initiation and cessation may help to underpin strategies that lead to smoking behavior change. METHODS: Cross-sectional data obtained from 11,967 men and women, aged 20-65 years, were used to study associations with smoking initiation and smoking cessation within the general population. Information on smoking habits, socio-demographic factors and psychosocial factors were collected through self-administered questionnaires. Multiple logistic regression analyses were undertaken by gender. RESULTS: Adverse childhood experiences and personality characteristics (including extraversion, neuroticism and hostility) were found to be related to smoking initiation. Age, marital status and tobacco-related factors were consistently associated with smoking cessation. Older people, married persons and those who smoked more cigarettes per day had a higher likelihood of quitting, both for men and women. CONCLUSIONS: Smoking initiation was found to be associated with adverse childhood events and with measures of personality whereas smoking cessation was associated predominantly with socio-demographic and tobacco use-related factors.

Adult↗
PubMed2005

Concurrent validity of the DSM-IV scales Affective Problems and Anxiety Problems of the Youth Self-Report.

This study investigated the concurrent validity of the DSM-IV scales Anxiety Problems and Affective Problems of the Youth Self-Report (YSR) in a community sample of Dutch young adolescents aged 10-12 years. We first examined the extent to which the YSR/DSM-IV scales reflect symptoms of DSM-IV anxiety disorders and DSM-IV Major Depressive Disorder, assessed with the Revised Child Anxiety and Depression Scale (RCADS). Second, we examined whether the association between the YSR/DSM-IV scales and the RCADS scales was stronger than the association between the empirically derived YSR narrow-band scales Anxious/Depressed and Withdrawn and the same RCADS scales. Results showed that the YSR/DSM-IV scale Affective Problems had a stronger association with symptoms of DSM-IV Major Depressive Disorder than the YSR narrow-band scales Withdrawn and Anxious/Depressed. However, the YSR/DSM-IV scale Anxiety Problems had a weaker association with symptoms of DSM-IV anxiety disorders, compared to the YSR narrow-band scale Anxious/Depressed. It was concluded that the construction of the DSM-IV scales improved the correspondence with DSM-IV Major Depressive Disorder, but not with DSM-IV anxiety disorders.

Adolescent↗
PubMed2005

Differences between participants and non-participants in an RCT on physical activity and psychological interventions for older persons.

BACKGROUND AND AIMS: Volunteer bias in intervention studies on successful aging has been poorly explored. This paper investigated differences between participants and non-participants of the Groningen Intervention Study on Successful Aging (GISSA) over a wide range of demographic, physical, psychological and social subject characteristics. METHODS: Subjects were recruited among a longitudinal cohort study (Groningen Longitudinal Aging Study) and included 558 men and 711 women, aged 65-96 years, who were invited to participate in the GISSA. Measures were obtained by questionnaires at the moment of invitation and eight years before invitation. Participants were compared with three groups of non-participants: persons who refused to participate, those who did not respond after a reminder, and those who intended to participate but withdrew before pre-test. RESULTS: At the moment of invitation, participants were younger, better educated, and functionally and physically more active than the three groups of non-participants. They also had better scores on the physical functioning subscale of the medical outcome scale, better ADL, iADL and vigorous ADL functions and fewer depressive symptoms, and perceived less social support in everyday and problem situations. Participants reported a less strong rate of decline in physical and psychological functioning in the eight years prior to the invitation than did the other groups. CONCLUSION: Due to volunteer bias, results of intervention studies on successful aging may have limited generalizability.

Activities of Daily Living↗
PubMed2005

Does neuroticism explain variations in care service use for mental health problems in the general population? Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS).

BACKGROUND: Little is known about the role of personality characteristics in service utilisation for mental health problems. We investigate whether neuroticism: 1) predicts the use of primary and specialised care services for mental health problems, independently of whether a person has an emotional disorder; and 2) modifies any association between emotional disorder and service use. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) a prospective cohort study in the general population aged 18-64. Neuroticism was recorded at baseline, and emotional disorder and service use at 12-month follow-up, in a representative sample (N=7076), using the Composite International Diagnostic Interview. RESULTS: People with high neuroticism were more likely to receive care in the specialised mental health sector, and after entry to care they made more visits to the services, whether or not they had an emotional disorder. If they had an emotional disorder, their likelihood of receiving specialised mental health care showed an additional increase. Neuroticism also predicted the use of primary care for mental health problems, but greater numbers of visits were made only by clients with both high neuroticism and an emotional disorder. CONCLUSIONS: It would be useful to incorporate personality characteristics into models to understand variations in service utilisation for mental health problems. The findings suggest that professionals would be wise to focus not just on their clients' emotional problems and disorders, but also on strengthening their problem-solving abilities through approaches like cognitive behavioural therapy.

Adolescent↗
PubMed2005

Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents.

Since non-response may jeopardize the validity of studies, comprehensive assessment of non-response is a prerequisite for proper interpretation of study findings. Recently, the baseline assessment of the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study among Dutch pre-adolescents, was completed. The aim of this report is to examine non-response bias by comparing responders and non-responders regarding mental health determinants (e.g., demographics and cognitive performance) and outcomes, as well as associations between the two. Furthermore, we examine whether extended efforts to recruit participants contribute to the prevention or reduction of non-response bias. Thanks to various recruitment procedures, the initial response rate of 66% increased to a final rate of 76%. The extended efforts to recruit participants prevented non-response bias in the prevalence rates of psychopathology. Although non-responders differed from responders with respect to several individual characteristics, no significant differences were found regarding associations between these characteristics and psychopathology. We conclude that TRAILS provides a solid basis to improve our understanding of the development of mental health during adolescence.

Adolescent↗
PubMed2005

Communicative skills of general practitioners augment the effectiveness of guideline-based depression treatment.

BACKGROUND: Although good physician communication is associated with positive patient outcomes, it does not figure in current depression treatment guidelines. We examined the effect of depression treatment, communicative skills and their interaction on patient outcomes for depression in primary care. METHODS: In a cohort of 348 patients with ICD-10 depression in primary care, patient outcomes were studied over 3- and 12-month follow-ups. The association of these outcomes with both depression-specific process of care variables and a nonspecific variable-communicative skillfulness of GP-was examined. Patient outcomes consisted of change from baseline in symptomatology, disability, activity limitation days, and duration of the depressive episode. RESULTS: In accordance with treatment guidelines, some main effects of depression treatment were found, in particular on symptomatology, but these remained small (effect size<0.50). A moderate effect was found for treatment with a sedative, which proved to be related to worse patient outcomes at 12 months. An accurate GP diagnosis of depression and adequate antidepressant treatment were associated with better patient outcomes, but only when provided by GPs with good communicative skills. In contrast to the main effects, these interactions were seen on disability and activity limitation days, not on symptomatology. LIMITATIONS: The study is observational and does not permit firm conclusions about causal relationships. Communicative skillfulness of the GP was assessed by patient report only. CONCLUSION: Neither depression-specific interventions nor good GP communication skills seem to be sufficient for optimal patient improvement. Only the combination of treatments according to guidelines and good communication skills results in an effective antidepressive treatment.

Adult↗
PubMed2005

Cognitive, physiological, and personality correlates of recurrence of depression.

BACKGROUND: The risk of recurrence in depressive disorder is high and increases with the number of episodes. We investigated whether individuals with a history of recurrent depression deviate from individuals with a single episode, as regards risk-related variables in 3 different domains of depression research. METHODS: Participants were 102 outpatients with major depressive disorder remitted from an episode (60 recurrent, 42 nonrecurrent). We assessed the perception of emotions from vocal stimuli, 24-h urinary free cortisol, and neuroticism. RESULTS: The recurrent group had higher cortisol levels than the nonrecurrent group, and recurrent women also had a more negative perception than nonrecurrent women. These results were independent of each other, and could also not be accounted for by neuroticism or residual symptoms. Gender differences were found in all 3 domains. LIMITATIONS: The cross-sectional design limits the possibility to draw conclusions on the causality of the observed effects. CONCLUSIONS: Remitted outpatients with recurrent depression deviate from remitted outpatients with single episode depression as regards physiology and social cognition, in a way that may increase their risk of the development of subsequent episodes. The results may have implications for prophylactic treatment strategies.

Adult↗