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Background: We examined exposure to adulthood traumatic life events (TLEs) and their associations with depression in women and men. Then we examined whether those associations are independent of exposure loading and vulnerability including familial confounding., Methods: The fourth survey in 2011 of the population-based Finnish Twin Cohort had 8410 participants (45 % men, mean age 60 years). Using the Center for Epidemiologic Studies Depression (CES-D) scale, depression was defined using a cut-off value ≥20. Participants reported exposure to TLEs during adulthood. Logistic regression adjusted for multiple covariates was used as the individual-based analyses. Familial confounding was tested using conditional logistic regression in 399 twin pairs discordant for depression., Results: More women (15 %) than men (11 %) were depressed. Men reported more traffic accidents (men: 11.8 %, women: 7.4 %), other serious accidents (11.8 %, 5.8 %), and violent crime (3.1 %, 2.0 %) whereas women reported more sexual assault (0.7 %, 10.6 %). Violent crime (Odds Ratio 3.86; 95 % Confidence Intervals 2.59, 5.73), sexual assault (3.49; 2.67, 4.55), physical assault (3.10; 2.45, 3.93), and other serious accidents (1.36; 1.01, 1.85) were associated with depression. These associations, except other serious accidents, remained significant after adjusting for multiple covariates including shared familial factors. The associations did not differ by sex., Limitations: A relatively small set of relevant TLEs was reported retrospectively and the order of TLEs was not assessed., Conclusions: Women and men differ in exposure to TLEs but, if exposed, they are equally vulnerable for depression. Because traumatic life events are robustly associated with depression, they should be considered in treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Strategies of prevention for psychiatric disorders need a deep understanding of the aetiological factors involved in the psychopathological processes. Our twin study aims at disentangling the contributions of genes and environment to schizotypal and hypomanic dimensions, considering the role of stressful life events (LEs) and the quality of family relationships., Methods: The Magical Ideation Scale (MIS) and Perceptual Aberration Scale (PAS) were used to assess positive schizotypy, while Hypomanic Personality Scale (HPS) and its sub-scales were used to investigate proneness to affective disorders. 268 twins (54.5 % female; aged 18.0 ± 6.68) were included. Participants filled out a questionnaire on LEs and their parents provided an evaluation of intra-family relationship (Relationship Quality Index, RQI). Classic univariate twin models for quantitative traits were fitted for scales, and the effects of covariates (LEs and RQI) were assessed., Results: For MIS, HPS and its sub-scales, significant common and unique environmental effects were detected, with genetic factors affecting only HPS Social Vitality sub-scale. Unique environment was the only source of variance of PAS score. The number of recent LEs influenced MIS and PAS models, while RQI score affected MIS model., Limitations: The main limitation of the study is the small sample size, which reduces statistical power and may potentially lead to an underestimation of heritability. Additionally, the cross-sectional design limits the possibility to draw causal considerations., Conclusions: Findings provide preliminary evidence for a significant environmental role in modulating states of vulnerability. Moreover, the expression of positive schizotypy resulted influenced by recent stressors and intra-family relationships., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

Background: Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend., Methods: Data from the Finnish School Health Promotion study with 750,000 participants aged 13-20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression., Results: Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support., Limitations: The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes., Conclusions: Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Children with attention deficit hyperactivity disorder (ADHD) exhibit behavioral inhibition deficits, which often lead to emotional dysregulation (ED) affecting individual ability to control emotions and behavioral responses. In ADHD, ED is associated with poor outcomes and comorbidities, with both externalizing and internalizing disorders. This work aims to evaluate sensitivity to emotional stimuli in children with ADHD using functional Near Infrared Spectroscopy (fNIRS)., Methods: During frontal fNIRS recording, 20 children with ADHD and 25 typically developing (TD) peers performed a visual continuous performance task with stimuli of different emotional content (i.e., positive, negative, neutral, and control stimuli without emotional content). This is a cognitive task designed to evaluate the ability to recognize emotional stimuli and to deal with emotional interference., Results: The ADHD sample showed more variability in response time to stimuli and more false alarms compared to TD group. fNIRS data showed between-group differences in right prefrontal and frontal cortices, with wider hemoglobin concentration changes in the TD group, during positive, negative, and neutral conditions., Limitations: Owing to the limited possibility of near infrared light to penetrate tissue, fNIRS can only measure cortical activations, while it would be of interest to identify the subcortical areas linked to emotional processing, too., Conclusions: Findings suggest the presence of emotional processing deficits in children with ADHD, as suggested by poor performances on the e-CPT task, and of peculiar sensitivity to emotional stimuli, linked to atypical hemodynamics of right prefrontal and frontal areas., (Copyright © 2020. Published by Elsevier B.V.)

Background: Deficits in emotional processing and, in particular, in emotional self-regulation represent non-specific risk factors for transdiagnostic poor outcomes. Researches have been focusing on the investigation of possible emotional processing and regulation biomarkers. The present brief review of the literature aims to evaluate whether NIRS signal might be one of them., Methods: We reviewed 8 original articles investigating children's hemodynamic response to emotional tasks using NIRS, or exploring the association between NIRS response to cognitive tasks and behavioral emotional regulation., Results: All the works revised found significant associations between NIRS data and emotional indexes. Furthermore, significant hemodynamic response is found in different age-groups (3-12 years of age), suggesting that cortical response to emotional processing as measured by NIRS is a marker consistently recognizable throughout the development., Limitations: Given that the studies in this field were still limited and used heterogeneous protocols, addressed different functions or aspects of emotional processing, these results are preliminary., Conclusions: NIRS seems a reliable tool to describe brain activation during emotional processing and regulation. Moreover, it seems to be particularly useful in studies including either developmental-aged participants or clinical samples, due to its clear advantages and non-intrusiveness, offering a potential marker for deficits in emotional processing and regulation., Competing Interests: Declaration of Competing Interest None of the authors has conflicts of interest to declare in relation to the specific topic of the present manuscript., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: This study investigated the eight-year course and outcomes of depressive mood disorders and the key outcome predictors among adolescent outpatients., Methods: Depressive adolescent outpatients (N = 148) in a naturalistic clinical setting were assessed at baseline, six months, 12 months and eight years using diagnostic and self-report instruments. Baseline predictors covered selected sociodemographic, clinical and treatment-related characteristics. The outcomes were time to recovery, recurrence, time spent being ill and longitudinal latent profiles of depressive symptoms., Results: The recovery rate from any depressive mood disorder was 73% at two years, 91% at five years and 94% by the end of the eight-year follow-up. Two thirds (67%) of the subjects presented at least one recurrence and 57% of them were depressed for 25% or more of the follow-up period. At the eight-year follow-up, 36% had a mood disorder, 48% suffered from anxiety and 26% had a personality disorder. Less severe depression at baseline predicted a shorter time to recovery, whereas recurrence was predicted by a younger age. A latent profile with initially moderate-level depressive symptoms but a poor distal outcome was associated with being female and borderline personality disorder., Limitations: The female preponderance in the sample warrants caution when interpreting sex differences in the findings., Conclusions: Although the depression outcome for some adolescents making the transition to young adulthood is promising, many of them experience long, even chronic episodes, and recurrences are common. Personality-disorder characteristics appeared to be significant outcome predictors in this adolescent population., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020. Published by Elsevier B.V.)

Objectives: This study investigated trajectories of mothers' and fathers' depressive symptoms from prenatal to 24 months postpartum. Prenatal correlates of the trajectories were also examined., Methods: Mothers (N = 1670) and fathers (N = 1604) from the Finnish CHILD-SLEEP birth cohort, reported depressive symptoms at 32nd pregnancy week and 3, 8, and 24 months postpartum using the Center for Epidemiologic Studies Depression Scale (CES-D, 10-item). Profile analysis was used to group participants according to their longitudinal patterns of depressive symptoms. Prenatal predictors (sociodemographic, health, substance use, sleep, and stress related factors, family atmosphere) of depressive symptom trajectories as well as association between parents' trajectories were analyzed using multinomial logistic regression., Results: For both mothers and fathers, a solution with three stable depressive symptom trajectories (low: 63.1% mothers and 74.9% fathers; moderate: 28.1% and 22.6%; high: 8.8% and 2.6%) was considered the best fitting and most informative. Insomnia, earlier depression, anxiousness, stressfulness, and poor family atmosphere predicted the moderate and high (compared to low) depressive symptom trajectories among both mothers and fathers in multivariate analyses. Mother's higher depressive symptom trajectory was significantly associated with father's higher symptom trajectory (p < 0.001)., Limitations: Number of cases in the high depressive symptom trajectory group among fathers was low., Conclusions: Maternal and paternal depressive symptom trajectories from prenatal period up to two years postpartum seem stable, indicating the chronic nature of perinatal depressive symptoms. Mothers' and fathers' trajectories are associated with each other and their strongest predictors are common to both., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by deficits in self-controlling attention, behavior, and emotions. In recent years, noninvasive optical techniques, such as near infrared spectroscopy (NIRS), have been used to measure the neural correlates of pharmacological-therapy outcomes in children and adolescents with ADHD., Methods: We reviewed a short series of articles that investigated the results of functional NIRS (fNIRS) on developmental-age ADHD. The review was limited to fNIRS studies that investigated the cortical responses that occurred during neuropsychological tasks in ADHD patients who received methylphenidate or atomoxetine., Results: The majority of the reviewed studies revealed the presence of increased oxygenated hemoglobin concentrations in the prefrontal cortex following pharmacotherapy in ADHD samples. A higher frequency of right-lateralized results was found., Limitations: The considered studies are characterized by substantial methodological heterogeneity in terms of the patients' medication status and washout period, explored cerebral regions, and neuropsychological tasks., Conclusions: fNIRS seems to be a promising tool for the detection of pharmacological-treatment biomarkers in samples of children and adolescents with ADHD., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by deficits in cognitive and emotional self-control. Optical technique acquisitions, such as near infrared spectroscopy (NIRS), seem to be very promising during developmental ages, as they are non- invasive techniques and less influenced by body movements than other neuroimaging methods. Recently, these new techniques are being widely used to measure neural correlates underlying neuropsychological deficits in children with ADHD., Methods: In a short series of articles, we will review the results of functional NIRS (fNIRS) studies in children with ADHD. The present brief review will focus on the results of the fNIRS studies that investigate cortical activity during neuropsychological and/or emotional tasks., Results: According to the reviewed studies, children and adolescents with ADHD show peculiar cortical activation both during neurological and emotional tasks, and the majority of the reviewed studies revealed lower prefrontal cortex activation in patients compared to typically developmental controls., Limitations: a consistent interpretation of these results is limited by the substantial methodological heterogeneity including patients' medication status and washout period, explored cerebral regions, neuropsychological tasks, number of channels and sampling temporal resolutions., Conclusions: fNIRS seems to be a promising tool for investigating neural substrates of emotional dysregulation and executive function deficits in individuals with ADHD during developmental ages., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: Recent research indicates that Heart Rate Variability (HRV) is affected in Bipolar Disorders (BD) patients. To determine whether such alterations are a mere expression of the current mood state or rather contain longitudinal information on BD course, we examined the potential influence of states adjacent in time upon HRV features measured in a target mood state., Methods: Longitudinal evaluation of HRV was obtained in eight BD patients by using a wearable monitoring system developed within the PSYCHE project. We extracted time-domain, frequency-domain and non-linear HRV-features and trained a Support Vector Machine (SVM) to classify HRV-features according to mood state. To evaluate the influence of adjacent mood states, we trained SVM with different HRV-feature sets: 1) belonging to each mood state considered alone; 2) belonging to each mood state and normalized using information from the preceding mood state; 3) belonging to each mood state and normalized using information from the preceding and subsequent mood states; 4) belonging to each mood state and normalized using information from two randomly chosen states., Results: SVM classification accuracy within a target state was significantly greater when HRV-features from the previous and subsequent mood states were considered., Conclusions: Although preliminary and in need of replications our results suggest for the first time that psychophysiological states in BD contain information related to the subsequent ones. Such characteristic may be used to improve clinical management and to develop algorithms to predict clinical course and mood switches in individual patients., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Clinically derived follow-up studies examining the predictors of suicide attempts (SA) and non-suicidal self-injury (NSSI) among adolescents are scarce. The aims were to study SA and NSSI as predictors of future NSSI and SA, and to study the role of other risk and protective factors, especially alcohol use, and perceived social support from family and peers during a 1-year follow-up and between the 1-year and 8-year follow-ups among consecutively referred depressed adolescent outpatients., Methods: The Adolescent Depression Study (ADS) is a longitudinal study of depressed adolescent outpatients (mean age at baseline 16.5 years, 81.8% females). The subjects of the present study (n=139, 63.8% of the original study population) were assessed at baseline, at 1-year and 8-year follow-ups using semi-structured diagnostic interviews (K-SADS-PL) for DSM-IV diagnoses, and structured self-report scales for clinical risk factors., Results: In multivariate comparisons, SAs were predicted both in the 1-year follow-up and in the period between the 1- and 8-year follow-ups by alcohol use and low perceived peer support. NSSI in the 1-year of follow-up was predicted by baseline NSSI, younger age and alcohol use, whereas the only significant predictor for NSSI between the 1- and 8-year follow-ups was NSSI., Limitations: A large majority of the sample were females, limiting the possibility to analyze gender differences., Conclusions: Among depressed outpatients NSSI is a strong predictor of suicidal behavior, and other factors beyond depression, such as alcohol use and availability of social support, must also be addressed to prevent the recurrence of suicidal behavior., (© 2013 Published by Elsevier B.V.)

Objective: The aim of the present study was to identify different clinical subtypes in severe, treatment resistant bipolar mixed state (MS)., Method: The sample comprised 202 Bipolar I patients currently in MS referred for an Electro-convulsive Therapy (ECT) trial and evaluated in the first week of hospitalization and one week after the ECT course. Principal component factor analysis (PCA) followed by Varimax rotation was performed on 21 non-overlapping items selected from Hamilton rating-scale for depression (HAMD) and from Young mania rating-scale (YMRS) at baseline evaluation. Cluster subtypes derived from the factor scores were compared in clinical variables and final HAMD, YMRS, Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) scores., Results: The principal-component analysis extracted 6 interpretable factors explaining 55.9% of the total variance. Cluster analysis identified four groups, including respectively 63 (31.2%) subjects with Agitated-Irritable Mixed-Depression, 59 (29.2%) with Psychotic Mixed-Mania, 17 (8.5%) with Anxious-Irritable-Psychotic Mixed-Mania, and 63 (31.2%) with Retarded-Psychotic Mixed-Depression. The four clusters were statistically distinct and did not show significant overlap in the main symptomatological presentation. Cluster subtypes reported differences in number of past mood episodes, duration of the current episode, suicide attempts, lifetime comorbidity with panic and eating disorders, baseline and final rating-scale scores and rate of remission after ECT trial., Conclusions: Our study indicates that, at least in severe treatment resistant MS, multiple depressive and manic subtypes can be observed with substantial differences in terms of clinical presentation, course, associated comorbidities and treatment response., (© 2013 Elsevier B.V. All rights reserved.)

Background: Recent epidemiological studies indicate that separation anxiety disorder occurs more frequently in adults than children. Data from literature suggest that Adult Separation Anxiety Disorder (ASAD) may develop after a bereavement or threat of loss. Research has demonstrated that bereaved persons may present a clinically significant grief reaction, defined as Complicated Grief (CG) that causes a severe impairment in the quality of life. The aim of this study was to evaluate the relationship between ASAD and CG in a large cohort of outpatients with mood and anxiety disorders., Methods: Study participants comprised 454 adult psychiatric outpatients with DSM-IV mood or anxiety disorders diagnoses. Diagnostic assessments were performed using the SCID-I; ASAD was assessed using an adapted version of the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS-adult). Complicated grief symptoms were assessed by the Inventory of Complicated Grief (ICG). Social and work impairments were evaluated using the Sheehan Disability Scale (SDS). Adult attachment styles were assessed by the Relationship Questionnaire (RQ)., Results: The overall frequency of ASAD in our sample was 43% and that of CG was 23%. Individuals with CG had a greater frequency of ASAD (56%) with respect to those without CG (40%). Subjects with CG plus ASAD reported higher scores on ICG and greater impairment on quality of life, as measured with SDS, than CG patients without ASAD., Conclusions: Adult separation anxiety disorder occurs in a high proportion of adult psychiatric outpatients with complicated grief. The association between these two conditions should be further investigated in light of their clinical implications., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: Earlier studies suggest that social phobia (SP) and depression (DEP) often have their onset in adolescence, and are highly comorbid, with SP mainly preceding depression. There is a lack of population-based prospective studies among adolescents vulnerable to both disorders, taking into account possible gender differences in the relationship between the two., Methods: This study is part of a prospective Adolescent Mental Health Cohort (AMHC) study. Subjects are 9th grade pupils (mean age 15.5 years (sd 0.39)) responding to a survey conducted 2002-2003 (T1) and a 2-year follow-up 2004-2005 (T2) (N=2038). Social phobia was measured by the Social Phobia Inventory (SPIN) and depression by the 13-item Beck Depression Inventory (BDI-13)., Results: Risk for depression at T2 by SP at T1 was elevated only among boys (OR 3.6, 95% C.I. 1.507-8.579, p=0.004), whereas among girls, risk for SP at T2 by DEP at T1 was elevated (OR 7.8, 95% CI 4.529-13.391, p<0.001). The course of both disorders was unstable and recovery was common., Limitations: Lack of diagnostic interviews and fairly high drop-out rate (36.9%) in follow-up., Conclusions: The relationship between SP and depression in adolescence seems different for boys and girls. Further studies are needed to explore factors explaining the different course of these disorders among boys and girls. Clinicians need to be alert to comorbidity when examining an adolescent with SP or depression., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Background: Although highly structured diagnostic interview instruments are reportedly reliable, it has been suggested that even small changes in the diagnostic threshold or wording of the questions may substantially affect the results. General population data on this topic are scarce., Methods: A random sample of 15-75-year-old Finnish men and women was interviewed in 1996 (N=5993). The diagnosis of DSM-III-R major depressive episode (MDE) was made by using the Composite International Diagnostic Interview Short Form (CIDI-SF). Prevalence estimates derived by using three different thresholds for the intensity of the depressed mood ("depressed mood all day" vs. "most of the day" vs. "half of the day") are compared., Results: The use of the threshold "depressed mood all day", yielded the prevalence estimate of 4.67% [95% CI 4.12, 5.22] for MDE, while according to the thresholds of "depressed mood most time of the day" and "at least half of the day" the prevalences were 9.23% [95% CI 8.47, 9.99] and 11.9% [95% CI 11.0, 12.8], respectively. A consistent female to male ratio was observed across the categories, while an age effect was noted so that younger age associated with less frequent depressed mood. The diagnostic thresholds associated with impairment, episode duration, treatment need and use., Conclusions: Minor changes in case definition within the same measuring instrument may produce major differences in prevalence estimates. The categories defined for the purposes of this study were on a continuum where the frequency of depressed mood associated with other measures of the depressive episode., (Copyright 2009 Elsevier B.V. All rights reserved.)

Background: There is growing evidence for cognitive dysfunction in depressive and anxiety disorders. Nevertheless, the neuropsychological profile of young adult patients has not received much systematic investigation. The following paper reviews the existing literature on cognitive impairments in depressive and anxiety disorders particularly among young adults. Additionally, the focus of young adult age group and the effect of confounding variables on study results are discussed., Methods: Electronic database searches were conducted to identify research articles focusing on cognitive impairments in depressive or anxiety disorders among young adults published in English during years 1990-2006., Results: Cognitive impairments are common in young adults with major depression and anxiety disorders, although their nature remains partly unclear. Accordingly, executive dysfunction is evident in major depression, but other more specific deficits appear to depend essentially on disorder characteristics. The profile of cognitive dysfunction seems to depend on anxiety disorder subtype, but at least obsessive-compulsive disorder is associated with deficits in executive functioning and visual memory. The conflicting results may be explained by heterogeneity within study participants, such as illness status, comorbid mental disorders, and medication, and other methodological issues, including inadequate matching of study groups and varying testing procedures., Limitations: The study is a comprehensive review, but not a formal meta-analysis, due to methodological heterogeneity., Conclusions: Cognitive impairments are common in major depression and anxiety disorders. However, more research is needed to confirm and widen these findings, and to expand the knowledge into clinical practice. Controlling of confounding variables in future studies is highly recommended.

Background: We examined mid-adolescent psychosocial problems as risk factors for subsequent depression up to adulthood proper, and differences in these for episodic and persistent depression., Methods: In a 16-year follow-up of an urban Finnish community cohort (547 males and 714 females) from age 16 years risk factors for subsequent depression (S-BDI) were studied. Data were collected with a classroom questionnaire at 16 years and a postal questionnaire at 22 and 32 years. Differences in predictors for episodic depression (only at age of 22 or 32 y) and persistent depression (both at 22 and 32 y) were studied using logistic and multinomial regression analyses., Results: Mid-adolescent depressive symptoms predicted persistent and female sex episodic depression. Low self-esteem, dissatisfaction with academic achievement, problems with the law, having no dating experiences, and parental divorce all predicted both episodic and persistent depression., Limitations: We had two assessment points in adulthood, but no information about depression between these., Conclusions: The associations between mid-adolescent psychosocial problems and subsequent depression extended up to adulthood proper, somewhat differently for episodic and persistent depression. Preventive efforts should be focused towards young people at risk.

Background: Few studies, to date, have investigated the relationship between self-damaging behavior and the presence of comorbid psychiatric diagnoses in eating disorders. The aim of the present study was to investigate the axis I and II comorbidity in subjects with bulimia nervosa who report self-injurious behavior and/or suicide attempt., Methods: The subjects were 95 patients with purging type bulimia nervosa who underwent a clinical evaluation assessing the presence of self-injurious behavior and suicide attempts, comorbidity for axis I and II psychiatric disorders and temperament., Results: No axis I diagnosis was associated with any type of self-injurious behavior, whereas social phobia and bipolar disorder were linked to attempted suicide. Significant independent predictors of impulsive self-injurious behavior were the presence of childhood sexual abuse, high harm avoidance scores, and high self-transcendence scores, whereas childhood sexual abuse, the presence of a cluster B personality disorder, and a low self-directedness were predictors of suicide attempts. Compulsive self-injurious behavior was significantly associated with harm avoidance and cluster C personality disorders. Harm avoidance was also associated with skin picking., Conclusions: Personality disorders are a frequent correlate of the presence of SIB in purging bulimia nervosa. However, temperament seems to play a more important role. Further studies on larger samples are necessary to confirm our findings in bulimia nervosa and to extend them to other patient populations.

Background: Depressions that fail to meet the diagnostic criteria for major depressive disorder (MDD) may be underdiagnosed and undertreated in adolescent population. Traditionally, they are not considered as serious conditions and the phenomenological nature and clinical correlates of these disorders are largely unknown. In the present study, we used a large, representative and age-standardized sample of adolescents to examine the phenomenology and clinical correlates of minor depression, a poorly understood condition included in the category of Depressive Disorder Not Otherwise Specified in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR)., Methods: 909 girls and 945 boys, with mean age of 14, were interviewed by professionals using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA)., Results: Although clearly milder condition than MDD, minor depression was associated with marked suicidal thoughts, plans and attempts, recurrences and a high degree of comorbidity. At this early age, despite that 14% of adolescents under 15 had suffered from depressive conditions with severe clinical implications, most of them failing to meet the diagnostic threshold for MDD, only 1.7% had received any psychiatric treatment. 40% of depressive adolescents who had attempted suicide had no contact with mental health services., Limitations: Analyzed in a cross-sectional setting, no conclusions about long-term implications could be made., Conclusions: The results highlight the clinical and public health significance of non-MDD depressions, e.g. minor depression, which need to be more carefully identified and treated at early age.

Background: Few longitudinal studies have attempted to identify risk factors in mid-adolescence for subsequent depression in young adulthood. Mid-adolescence is a critical developmental phase for studying vulnerability to depression due to high incidence and prevalence of depression., Methods: In a longitudinal study, following an urban Finnish community cohort (761 males and 887 females) from age 16, mid-adolescent risk factors for depression at age 22 years were studied. Data were collected by a questionnaire at school at age 16, and by a postal questionnaire at age 22., Results: Of the females 116 (13%) and of the males 69 (9%) had depression (S-BDI) in young adulthood. In multivariate analyses baseline depressive symptoms, low self-esteem, dissatisfaction with academic achievement, problems with the law, poor atmosphere at home and having no close friends predicted subsequent depression. Risk factors for males included more 'externalizing' aspects, for females more 'internalizing' factors., Conclusions: Mid-adolescence is an important age to study risk for depression, and self-reported perceptions of psychosocial well-being have predictive value. Preventive efforts can be selectively targeted at adolescents who have been exposed to identifiable risk factors.

Background: We report data on 1-year prevalence and comorbidity of depression, related impairment, treatment need, and psychiatric treatment among young adults., Methods: A sample of young urban adults (n=245) mean age 21.8 years was screened from a baseline population of 706 high-school students and given a semistructured clinical interview to evaluate 12-month prevalence of depression, psychosocial functioning according to DSM-IV GAF scale, need for psychiatric treatment, and use of mental health services., Results: One in 10 young adults suffered from depression with associated psychosocial impairment, the female-to-male-ratio being approximately 2:1. Most depressive disorders were comorbid with other DSM-IV disorders, depression usually occurring secondary to other disorders. Comorbidity was related to impairment, treatment need, and treatment contacts. Less than half of the depressed young adults had ever contacted mental health services, and less than one-third reported treatment contacts during the index episode. Males were less likely than females to report previous treatment contacts or intention to refer to mental health services for their problems, but treatment contacts during the index episode were reported equally often by both sexes., Conclusions: A minority of the severely depressed young adults with associated impairment had sought treatment. Except for subjects with dysthymia, no gender difference emerged in treatment contact rates during the 12-month depression episode. Comorbidity showed important clinical implications by its relation to severity of depression and treatment contacts.