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Biomedical subjects

P M Altham

Publications and source records attributed to P M Altham.

14 recordsLinked to original sources
PubMed2000

First-episode major depression in adolescents. Affective, cognitive and endocrine characteristics of risk status and predictors of onset.

BACKGROUND: There is little information on whether patterns of steroids precede and are associated with depressive onset. AIMS: To establish whether there is an association between salivary cortisol and/or dihydroepiandrosterone (DHEA) levels and depression independent of psychosocial risk. METHOD: Two subgroups of adolescents in the community at high (n = 181) and low (n = 65) risk for psychopathology were interviewed for recent psychiatric disorder at entry and again at 12 months. Salivary samples (08.00 and 20.00 h) for hormone estimations and self-reports on current mood and cognitive style were obtained at both assessments. RESULTS: Neither hormone was associated with risk status, current mood or cognitive style at entry. Of 31 onsets of major depression that occurred over the next 12 months, 30 came from the high-risk group but were not associated with any particular pattern of risk. Increased negative mood and feelings and DHEA (08.00 h) hypersecretion at entry were associated with subsequent major depression. CONCLUSIONS: Both negative mood and feelings and alterations in adrenal steroid function precede the onset of first-episode major depression in adolescents. Variation in levels of hormones may arise from more distal origins than recent life events and current ongoing difficulties.

Adolescent↗
PubMed2000

Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents.

BACKGROUND: It is not clear whether cortisol or dehydroepiandrosterone (DHEA) hypersecretion increases the risk for major depression in the presence of undesirable life events. AIMS: To determine whether there is a specific pattern of psychoendocrine factors that predicts the onset of major depressive disorder. METHOD: 180 adolescents (73 boys, 107 girls) at high risk for psychopathology were assessed for cortisol, DHEA, depressive symptoms, life events and psychiatric disorder at entry and 12 months later. RESULTS: Major depression was predicted for both genders by the additive effects of: higher depressive symptoms; personal disappointments and losses only in the month before onset; one or more daily levels of cortisol at 08.00 h or DHEA at 20.00 h greater than the 80th percentile of the daily mean. CONCLUSIONS: A subgroup of adolescents may carry a physiological risk for major depression which may be either of genetic and/or earlier psychosocial origin.

Adolescent↗
PubMed1998

Adrenal steroid secretion and major depression in 8- to 16-year-olds, III. Influence of cortisol/DHEA ratio at presentation on subsequent rates of disappointing life events and persistent major depression.

BACKGROUND: An investigation of the association between diurnal changes in cortisol and DHEA levels, or in the cortisol/DHEA ratio at five different time points at presentation, and the occurrence of undesirable life events (losses, dangers to self and others, disappointments) during follow-up, and the outcome of major depression at 36 weeks were investigated. METHODS: Psychosocial and endocrine assessment of a consecutive cohort (N = 68) of 8- to 16-year-old subjects with first episode major depression reassessed 12 months after presentation using a repeat measures design. RESULTS: Higher cortisol/DHEA ratios at 20.00 or 24.00 h predicted persistent major depression. Basal levels of either hormone alone or cortisol/DHEA ratios at the other three time points (08.00, 12.00 or 16.00 h) did not. High cortisol/DHEA ratios (i.e. values greater than the 60th percentile) at both evening points (20.00 and 24.00 h) also predicted the occurrence of subsequent disappointing life events but no other category of undesirable event. Both high evening cortisol/DHEA ratio at 20.00 h and one or more severely disappointing life events between presentation and follow-up predicted persistent major depression: 86% of subjects with both of these factors were still depressed at 36 weeks whereas 81% with neither factor were not. CONCLUSIONS: The finding that it is depressed subjects with high cortisol/DHEA ratios at presentation who are specifically at risk for subsequent disappointing life events suggests a putative role for these adrenal steroids in abnormal cognitive or emotional processes associated with disturbed interpersonal behaviour.

Adolescent↗
PubMed1998

Analysis of the human sex ratio by using overdispersion models.

Data from nineteenth-century Germany are reanalyzed to determine how the probability for having a child of each sex changes with family size. The data, collected by A. Geissler, concern some 1 million birth registrations and 3.7 million births occurring in Saxony between 1876 and 1885. Three models are fitted to the data. "The multiplicative and beta-binomial models provide similar fits, substantially better than that of the double-binomial model. All models show that both the probability that the child is a boy and the dispersion are greater in larger families. There is also some indication that a point probability mass is needed for families containing children uniquely of one sex."

Demography↗
PubMed1996

Adrenal secretion during major depression in 8- to 16-year-olds, I. Altered diurnal rhythms in salivary cortisol and dehydroepiandrosterone (DHEA) at presentation.

The association between basal cortisol, dehydroepiandrosterone (DHEA), its sulphate (DHEAS) and major depression was investigated in 8- to 16-year-olds. Eighty-two subjects with major depression, 25 non-depressed psychiatric cases and 40 community controls were systematically assessed for current mental state and hormone levels at 08.00, 12.00 and 20.00 h, assayed from salivary samples collected over a 48 h period. The average mean of the two time points was compared between the three groups. Evening cortisol hypersecretion and morning DHEA hyposecretion were significantly, and independently, associated with major depression. High evening cortisol (> 0.594 ng/mL) and low morning DHEA (< 0.200 ng/mL) identified subgroups of depressives with different types of adrenal hormone dysregulation. The association between high evening cortisol or low morning DHEA and MDD was not affected by either age or gender.

Adolescent↗
PubMed1996

Adrenal secretion and major depression in 8- to 16-year-olds, II. Influence of co-morbidity at presentation.

The association between high evening cortisol and low morning DHEA and the pattern of co-morbid diagnoses in 82 cases of major depressive disorder in 8- to 16-year-olds has been analysed. There was a significant association between the presence of high evening cortisol and co-morbid dysthymia. This was independent of age or sex. No positive association was found between the presence of low morning DHEA and any co-morbid diagnosis. However, co-morbid panic or phobic disorder was significantly associated with the absence of this endocrine abnormality. These findings suggest that specific endocrine disturbances may be associated with different patterns of co-morbidity during an episode of major depression in this age group.

Adolescent↗
PubMed1996

Temperament and psychopathology amongst siblings of probands with depressive and anxiety disorders.

Thirteen (42%) of 31 siblings of 29 probands with depression (n = 21) or anxiety disorders (n = 8) attending a clinic met DSM-IIIR criteria for psychiatric disorder, a rate nearly three times greater than reported from community studies. The diagnoses were heterogeneous. Compared with probands, sibling cases had half the level of comorbidity and significantly lower levels of psychosocial impairment. Comparisons of temperamental characteristics showed that higher levels of emotionality, but no other aspect of temperament, was associated with an increased likelihood of a sibling being a case. Higher emotionally in all cases (sibs and probands) was associated with greater comorbidity in general and the diagnoses of dysthymia and separation anxiety in particular.

Adolescent↗
PubMed1993

Temperament and major depression in 11 to 16 year olds.

Temperament (EAS teacher and parent questionnaire) and mental state (modified DISC-C interview with adolescent) was systematically assessed in 193 11 to 16 year olds (112 girls, 81 boys) screened for major depression in the community. Sex differences in the structure of temperament were noted from both parent and teacher reports. High (negative) emotionality alone was associated with major depression, particularly (but not exclusively) in girls.

Adolescent↗
PubMed1991

Lifetime exit events and recent social and family adversities in anxious and depressed school-age children and adolescents--I.

The number of lifetime exit events occurring over the lives of 7-16-year-old children was compared between cases with new onset episodes of anxiety and depression (n = 100) and community controls (n = 100). The reporting of events by adult responders appears reliable and not subject to distortions of recall. Overall the likelihood of experiencing exit events increases with age. A significant association was found between current disorder and two or more previous lifetime exit events. There is, however, a non-significant trend for those cases who experience multiple lifetime exits to be younger than the controls and to be female rather than male. These findings are uninfluenced by pubertal stage at time of onset of disorder or by diagnosis.

Adolescent↗
PubMed1991

Lifetime exit events and recent social and family adversities in anxious and depressed school-age children and adolescents--II.

The relative contribution made by three sets of social adversities preceding the onset of anxiety and depression in 8-16-year-olds is reported. These three sets of adversities are (i) lifetime exit events over the whole of the subject's life excluding those in the 12 months before onset of disorder in cases or day of interview for controls; (ii) recent family adversities; (iii) recent friendship difficulties and an absence of social achievements. Three cases compared with 35 controls experienced none of these sets of adverse social variables. Lifetime exit events exert significant independent effects on the likelihood of being a case in the presence or absence of the other two sets of factors. This suggests that the impact of multiple lifetime exits is not explained by the presence of recent adversities measured in this study. Twenty controls however experienced two or more of these sets of adversities with four experiencing all three. This suggests that some children appear protected from the pathological effects of these social adversities. The findings are not influenced by the sex or pubertal stage of the subjects and appear with equal likelihood in both anxious and depressive cases.

Achievement↗
PubMed1989

Recent friendships in anxious and depressed school age children.

A consecutive series of school age children (7 to 16 years) with emotional disorders (N = 100) were compared with a series of community controls (N = 100) matched for age, sex and social class for the quality of their friendships. A semi-structured interview was developed to measure the quality of friendship for this purpose. Significantly more (48%) children with emotional disorder were likely to be rated as experiencing moderate to poor friendships in the 12 months prior to the onset of symptoms than were controls (16%) in the 12 months prior to interview. Prepubertal children with moderate to poor friendship patterns were classified as either predominantly anxious or depressed. Postpubertal children with moderate to poor friendships patterns were, in contrast, predominantly anxious. These findings suggest that puberty denotes a point of change for the impact of friendship deficits on the psychopathology of emotional disorder. There were no sex differences in the clinical classification of children with moderate or poor friendship patterns.

Adolescent↗
PubMed1988

Maternal adversity and recent stressful life events in anxious and depressed children.

Poor confiding relations in mothers' own lives, the presence of maternal distress and recent stressful life events focussed on children are all significantly and independently associated with emotional disorder in the school-age child. The probability of being a case is best predicted by considering the contribution of all three factors. When this is done, an additive rather than multiplicative interaction for the three variables is found. The association between these maternal factors and events focussed on the child varies with the presence or absence of caseness. There appears to be no greater probability of being anxious rather than depressed as a consequence of these three stressful factors occurring in the lives of school-age children.

Adaptation, Psychological↗