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Keywords: Antidepressants, Personality, Emotionalprocessing, Genetics

doi:10.1016/j.jad.2007.12.011

[O1.3] Sense of coherence and recovery from majordepression: A four-year follow-up

I. Skärsäter*,a,b,c, M.K. Rayensb,d, A. Pedenb,d,L. Hallb,d, M. Zhangb,d,H. Agrenb,e, H. Prochazkaa,b

aSahlgrenska Academy at Göteborg University, SwedenbThe Swedish Institute for Health Sciences, SwedencPsychiatric Services in Halland, SwedendUniversity of Kentucky College of Nursing, USAeCentre for Defence Medicine, Swedish Armed Forces,SwedenfSwedish Armed Forces, Sweden

Objective: The aim of this exploratory study was toidentify and follow persons with a first episode of majordepression to determine whether sense of coherencechanges over time. An additional purpose was to assesswhether sense of coherence relates to depressive symp-toms, aggression, and functional status either immedi-ately following diagnosis or at four years post-diagnosis.

Methods: The study design was longitudinal; subjectsparticipated in semi-structured interviews and completedsurveys every 6 months starting at diagnosis and con-cluding 4 years later. The sample consisted of thirty-threeadult patients who were being treated for first episode ofmajor depression (DSM-IV). Sense of coherence wasmeasured using Sense of Coherence Scale (SOC),depressive symptoms using the Montgomery ÅsbergDepression Rating Scale, aggression, including a totalscore and subscales of anger and hostility, using the AQAggression Questionnaire — revised Swedish Version,and functional status using Global Assessment of Func-tioning scale and SF-36 Health Survey. The data wereanalyzed using Pearson's productmoment correlation andrepeated measures analysis of variance.Results: At baseline, SOC was significantly correlatedwith total aggression (r=−45) and the hostility subscale(r=− .73); baseline SOC was unrelated to depressivesymptoms or functional status. SOC increased signif-icantly over the time ( pb .0001). At the four-year follow-up, SOCwas significantly related to depressive symptoms(r=− .60), the aggression summary score (r=− .65), theanger subscale (r=− .52), the hostility subscale (r=− .77),the GAF (r=.64), and the physical and mental healthcomponents of the SF-36 (r=.74 and .72, respectively).Conclusion: The finding that SOC increases as patientsrecover from MD suggests that treatment for depressionmay also bolster the patient's ability to cope, in additionto lowering depressive symptoms. The relationship be-tween SOC and aggression in MD, with higher SOCcorrelated with lower aggression, needs to be examinedfurther.

Keywords: Major depression, Sense of coherence,Recovery

doi:10.1016/j.jad.2007.12.012

[O1.4] Antenatal depression predicts depression inadolescent offspring: Prospective longitudinalcommunity-based study

S.J. Pawlby*,a, D.J. Sharpb, D.F. Hayc, V. O'Keanea

aKing's College London, UKbUniversity of Bristol, UKcCardiff University, UK

Data from a prospective, longitudinal community-based study was used to determine whether maternaldepression in pregnancy predicts offspring depression at16 years.

S54 Abstracts / Journal of Affective Disorders 107 (2008) S53–S122

The sample was recruited from two general practiceantenatal clinics. Of 151 mother–child dyads followed upfrom pregnancy to 16 years, information on maternaldepression and on depression in adolescent offspring wasavailable for 127 (84%). Seven interviews and diagnosticassessments were conducted with the mothers over thisperiod. At 16 years diagnoses of adolescent depressionwere computer-generated from information obtainedfrom the Child and Adolescent Psychiatric Assessment.

Two-thirds (82/125) of the women had been depressedduring the 16-year period, with the majority (54/82)experiencing more than one episode. The point preva-lence of depression was highest during pregnancy and thepostnatal periodwith rates of 20.5% at 20weeks, 21.3% at36 weeks and 21.1% at 3 months postpartum. Almost halfof the women (20/41) depressed during pregnancy hadconsulted a GP about a mental health problem prior tobecoming pregnant and almost 90% (35/39) had furtherepisodes during the child's lifetime. 14% (18/127) of theadolescent offspring were diagnosed with a depressivedisorder at 16 years. Every depressed adolescent had beenexposed to maternal depression. There was a 4.7-foldgreater odds of depression among the 16-year-olds whohad been exposed to maternal antenatal depression thanfor offspring who were not so exposed (CI 1.60 to 13.86;pb .01). Adolescent offspring depression was predictedmost accurately by first exposure to maternal depressionin utero and was accounted for by recurrent episodes ofmaternal depression throughout the following 16 years.

Antenatal depression is highly predictive of subse-quent depression. Detection of maternal depressionduring pregnancy, rather than the postnatal period, is theoptimal time for identifying children at risk ofdepression in adolescence.

Keywords: Antenatal maternal depression, Adolescentoffspring depression, Longitudinal study, Clinicaldiagnoses

doi:10.1016/j.jad.2007.12.013

[O1.5] Clinical relevance of subthreshold mood andanxiety disorders

M. Preisig*

University Hospital Center and University of Lausanne,Switzerland

Introduction: As a consequence of recent epidemiologi-cal studies that argued for a dimensional rather than acategorical approach to the classification of mood and

anxiety disorders, studies focusing on the clinical conse-quences of subthreshold syndromes have gained increas-ing interest. The goal of the present paper was to assess theclinical relevance of both subthreshold mood and anxietydisorders in a sample recruited from the general popula-tion. The occurrence of comorbid disorders, health seek-ing, suicidal attempts and social disability were assessedas indicators of the clinical relevance of syndromes.Method: The sample stems from a large community sur-vey on cardio-vascular risk factors and psychiatric dis-orders carried out in Lausanne, Switzerland. The presentanalysis is based on the first half of investigated subjectsaged from 35 to 65 years (n=2153, mean age: 49 years).Diagnostic assessment was based on the semi-structuredDiagnostic Interview for Genetic Studies (DIGS), whichwas modified in order to allow the assignment of bothdiagnoses according to DSM-IV and algorithmicallydefined subthreshold syndromes.Results: Ten percent of the sample presented a syndromeof the bipolar and 50% of the unipolar spectrum. More-over, 2% revealed subthreshold generalized anxietydisorder and 6% subthreshold panic disorder. Regardingthe occurrence of comorbid disorders, health seekingbehaviors, suicidal attempts and social disability, subjectssuffering from subthreshold depression occupied anintermediate position between those who met criteria formajor depressive disorder (MDD) and those who had nodepressive syndromes. A similar picture was also ob-served for subthreshold anxiety syndromes.Conclusion: Our results support the clinical significanceof subthreshold depressive and anxiety syndromes. Thefact that their clinical impact is less than that of syndromesmeeting the DSM-IV threshold is compatible with thehypothesis that subthreshold mood and anxietysyndromes reflect the continuum between “normality”and threshold mood and anxiety syndromes.

Keywords: Mood disorders, Anxiety disorders,Subthreshold syndromes, Epidemiology

doi:10.1016/j.jad.2007.12.014

[O1.6] Long-term outcome of major depressivedisorder in psychiatric patients is variable

E.T. Isometsä*, K.M. Holma, I.A.K. Holma,T.K. Melartin, H.J. Rytsälä

Helsinki University, Finland

Objective: The prevailing view of outcome of majordepressive disorder (MDD), based on mostly inpatient

S55Abstracts / Journal of Affective Disorders 107 (2008) S53–S122