Men, depression and masculinities: A review and recommendations

Background: Major depression (MD) and anxiety disorders such as panic disorder (PD), agoraphobia (AG), and social phobia (SP) are heritable and highly co-morbid. However, the relative importance of genetic and environmental etiology of the covariation between these disorders, particularly the relationship between PD and AG, is less clear. Methods: This study measured MD, PD, and AG in a population sample of 5,440 twin pairs and 1,245 single twins, about 45% of whom were also scored for SP. Prevalences, within individual co-morbidity and twin odds ratios for co-morbidity, are reported. A behavioral genetic analysis of the four disorders using the classical twin design was conducted. Results: Odds ratios for MD, PD, AG, and SP in twins of individuals diagnosed with one of the four disorders were increased. Heritability estimates under a threshold-liability model for MD, PD, AG, and SP respectively were .33 (CI: 0.30–0.42), .38 (CI: 0.24–0.55), .48 (CI: 0.37–0.65), and .39 (CI: 0.16–0.65), with no evidence for any variance explained by the common environment shared by twins. We find that a common genetic factor explains a moderate proportion of variance in these four disorders. The genetic correlation between PD and AG was .83. Conclusion: MD, PD, AG, and SP strongly co-aggregate within families and common genetic factors explain a moderate proportion of variance in these four disorders. The high genetic correlation between PD and AG and the increased odds ratio for PD and AG in siblings of those with AG without PD suggests a common genetic etiology for PD and AG. Depression and Anxiety 26:1004–1011, 2009. Published 2009 Wiley-Liss, Inc. y

/pdf/genetic-and-environmental-influences-on-the-co-morbidity-2c44ibhc0m.pdf

Genetic and environmental influences on the co-morbidity between depression, panic disorder, agoraphobia, and social phobia: a twin study.

Background 
Social rhythm refers to the regularity with which one engages in social activities throughout the week, and has established links with bipolar disorder, as well as some links with depression and anxiety. The aim of the present study is to examine social rhythm and its relationship to various aspects of health, including physical health, negative mental health, and positive mental health.


Method 
Questionnaire data were obtained from a large-scale multi-national sample of 8095 representative participants from the U.S., Russia, and Germany.


Results 
Results indicated that social rhythm irregularity is related to increased reporting of health problems, depression, anxiety, and stress. In contrast, greater regularity is related to better overall health state, life satisfaction, and positive mental health. The effects are generally small in size, but hold even when controlling for gender, marital status, education, income, country, and social support. Further, social rhythm means differ across Russia, the U.S., and Germany. Relationships with mental health are present in all three countries, but differ in magnitude.


Conclusions 
Social rhythm irregularity is related to mental health in Russia, the U.S., and Germany.

/pdf/social-rhythm-and-mental-health-a-cross-cultural-comparison-2e1ii6457d.pdf

Social Rhythm and Mental Health: A Cross-Cultural Comparison

International university students can experience isolation amid academic pressures. Such circumstances can manifest as or exacerbate depression. This qualitative study involved 15 international male students at a Canadian university who were diagnosed or self-identified as having depression. Individual interviews revealed men’s perspectives about causes, implications, and management of depression. Participants intertwined sex- and gender-based factors in detailing causes, and emphasized the potential for parents to impact depression. Implications of depression for embodying traditional masculine roles of breadwinner and career man influenced many men to filter details about their illness within “home” cultures. This practice often prevailed within Canada despite the men’s perceptions that greater societal acceptance existed. Masculine ideals underpinned self-management strategies to fight depression and regain control. Counter to men’s reluctance to disclose illness details were participants’ self-management preference for peer-based support. Study findings highlight how masculine ideals and cultural constructs can influence depression experiences and expressions.

Connecting Masculinity and Depression Among International Male University Students

Abstract Vortioxetine is a novel antidepressant with two mechanisms of action – direct effect on several serotonin receptors and serotonin re-uptake inhibition. It shows antidepressant, anxiolytic and cognitive effects during the treatment of major depressive disorder (MDD). The aim of this article was to summarize the use of vortioxetine in clinical studies and assess the efficacy and tolerability. Most of the studies reported a statistically significant efficacy for vortioxetine versus placebo. In addition, vortioxetine showed efficacy in patients with an inadequate response to selective serotonin re-uptake inhibitors (SSRI) or serotonin-noradrenaline re-uptake inhibitors (SNRI) monotherapy and improved cognitive function in patients with MDD. In these studies, vortioxetine was well tolerated – most common observed adverse effect was nausea – and it was not associated with clinically important changes in laboratory test results or vital signs. Vortioxetine showed a relatively low incidence of sexual dysfunction.

/pdf/review-of-a-new-multimodal-antidepressant-vortioxetine-2e2p1ood3j.pdf

ESEMed Mhedea investigators

Papers

The European study of the epidemiology of mental disorders (ESEMedD) project: rationale and methods (vol 11, pg 55, 2002)

Impact of mental disorders on disability and quality of life in Europe