Allen Morris-Yates

Evidence of a genetic contribution to functional bowel disorder.

Objective:Anecdotally, functional bowel disorders (FBD) such as the irritable bowel syndrome appears to cluster in some families, but no studies have investigated the heritability of FBD. We aimed to investigate the influence of heritable factors in FBD.Methods:Same sex twin pairs enrolled in the Australian Twin Registry completed a structured interview that included questions related to symptoms consistent with FBD: abdominal pain, diarrhea, constipation, excessive gas or bloating, and nausea. Reasons for the occurrence of each symptom, including their physicians’ diagnoses, were recorded. Lisrel 7.16 software was used to fit genetic models following standard procedures.Results:Of the 686 individual twins from same-sex pairs, 33 (4.8%) had one or more symptoms diagnosed by a medical practitioner as functional bowel disorder. Complete data on this symptom scale was available for 186 monozygotic and 157 same sex dizygotic twin pairs. A model in which 56.9% (95% CI: 40.6–75.9%) of the variance was attributed to additive genetic variance, with the remaining 43.1% attributed to the individuals unique environment, closely fitted the data (χ2= 0.01, df = 4, p= 1.0).Conclusion:Our results suggest that a substantial proportion of the liability for FBD may be under genetic control. Whether this liability is related to the disorder itself or to other potential predisposing factors requires clarification.

Obstetric risk factors for postnatal depression in urban and rural community samples

Objective: The objective of this study was to examine obstetric risk factors for postnatal depression in an urban and rural community sample, with concurrent consideration of personality, psychiatric history and recent life events. Methods: This was a prospective study with women planning to give birth in one of the four participating hospitals recruited antenatally. Obstetric information was obtained from the New South Wales Midwives Data Collection, completed shortly after delivery. Personality, psychiatric history and life-events information were obtained from a questionnaire, administered within 1 week postpartum. Depression status was assessed at 8 weeks postpartum using the Edinburgh Postnatal Depression Scale. Results: Complete data were obtained from 490 women. Several non-obstetric risk factors for the development of postnatal depression at 8 weeks postpartum were reported including: sociodemographic (up to technical college level education, rented housing, receiving a pension/benefit), personality (those who described themselves as either nervy, shy/selfconscious, obsessional, angry or a worrier), psychiatric history (familial history of mental illness, personal history of depression or anxiety or a history of depression in the participants mother) and recent life-events (major health problem, arguments with partner and friends/relatives). None of the obstetric variables were significantly associated with increased risk for postnatal depression, but several showed marginally significant increases (multiparous women, antepartum haemorrhage, forceps and caesarean section deliveries). Conclusions: The results emphasize the importance of psychosocial risk factors for postnatal depression and suggest that most obstetric factors during pregnancy and birth do not significantly increase risk for this depression. Early identification of potential risk for postnatal depression should include assessment of sociodemography, personality, psychiatric history and recent life events, as well as past and present obstetric factors.

Parent-Child Agreement on Children's Behaviours Reported by the Child Behaviour Checklist (CBCL).

The authors examined agreement between parent and child ratings on the Child Behaviour Checklist in a sample of 1299 referred adolescents over a period of three years. Correlations ranged between 0.72 and 0.08 (mean = 0.28), while agreement using kappa was similar but slightly lower (mean = 0.24; range 0.71-0.07). Agreement on externalizing was higher than on internalizing items, and concordance increased with age for boys, while there were no differences in parent-child agreement between boys and girls. Agreement was higher for dimensions of behaviour, e.g. depression (r = 0.40).

Twins: a test of the equal environments assumption.

We asked a sample of 343 adult same‐sex twin pairs a number of questions about the similarity of their social environment during childhood and early adolescence. A factor analysis of their responses indicated that their common environment was derived from two sources, one being similar treatment “imposed” upon them by their parents, the other being “elicited” by the twins’ similar interests and behavior. Monozygotic (MZ) twins reported experiencing more similar “imposed” and “elicited” environments than dizygotic (DZ) twins. The extent of imposed similar treatment received during childhood and early adolescence was unrelated to either MZ or DZ twins’ current behavioral similarity, as indicated by absolute intrapair differences in their Neuroticism, Anxiety, and Depression scores. Similar treatment imposed upon MZ twins on the basis of their zygosity alone is therefore not a threat to the validity of the twin method.;

Functioning and well-being at 24 weeks postpartum of women with postnatal depression

SummaryBackground: Postnatal depression, an episode of major depression occurring within six months postpartum, occurs in 10–15% of mothers. Previous research has focussed on prevalence, risk factors, treatment, and impact, with little emphasis on assessment of functioning and well-being in women with this depression. Our aim was to examine the effect of postnatal depression, age, and parity on eight indicators of functional status, using the SF-36 self-report questionnaire, at 24 weeks postpartum. Methods: The study used a prospective cohort design. 424 postpartum women, recruited from Nepean, Cowra, Dudley and Orange Hospitals (New South Wales, Australia) completed questionnaires assessing functioning and well-being (SF-36), and postnatal depression (EPDS). Results: Compared to age-appropriate Australian normative data, women with postnatal depression (n = 54, 12.7%) were impaired on five of eight SF-36 dimensions at twenty four weeks postpartum (i.e. Role Limitations due to Physical and Emotional Problems, Social Functioning, Mental Health, and Vitality), while women without this depression (n = 370) were impaired on two dimensions only (i.e. Role Limitations due to Emotional Problems and Vitality). Women with and without postnatal depression differed on six SF-36 dimensions (i.e. Role Limitations due to Physical and Emotional Problems, Social Functioning, Bodily Pain, Mental Health, and Vitality). Role Limitations due to Physical Problems were more impaired in depressed first-time than multiparous mothers, with no parity difference for women without postnatal depression. Conclusion: Some declines in functioning and well-being are associated with the postpartum period generally, but postnatal depression detrimentally effects other specific aspects of the postpartum womens functional status.

The effects of questionnaire length and lottery ticket inducement on the response rate in mail surveys

Abstract As part of a study on functional gastrointestinal disorders in the Australian community, we surveyed 500 subjects to test the effects of questionnaire length and lottery inducement on the response rate in mail surveys. By random allocation, n = 124 subjects received a short form questionnaire (28 pages) with a lottery ticket, n = 126 received a short form with no lottery ticket, n= 124 received a long form (32 pages) with a lottery ticket and n= 126 received a long form with no lottery ticket. The overall response rate for the study was 74%. The response rates for the short (76.8%) versus long (71.2%) form and lottery ticket (74.2%) versus no lottery ticket (73.8%) were not significantly different. Significantly more short forms compared with longer forms were received after each stage of the follow-up protocol. A long questionnaire can however be successfully used in survey research.

Are Oppositional and Conduct Disorders of Adolescents Separate Conditions

This study explores the factor structure of behaviours that correspond to symptoms of DSM-III-R oppositional defiant (OD) and conduct disorder (CD). It also seeks to clarify how those hypothetical factors may relate to diagnoses of OD and CD. Using exploratory factor analysis and cluster analysis of parent questionnaire data from group of referred adolescents (N=528) diagnosed according to DSM-III criteria the authors extracted four factors. One of them corresponded closely to DSM-III-R OD, while the others comprised different aspects of the CD construct. The findings suggest there are subtypes of conduct problems in adolescents, and give some support to the distinction between conduct and oppositional disorders.

Adolescent depression and the Child Behavior Checklist.

Using receiver operating characteristic methods, the authors planned to assess the diagnostic accuracy of a measure of depression extracted from the Child Behavior Checklist in a group of 667 referred adolescents with DSM-III diagnoses. This depression scale was based on a depression factor found by Nurcombe et al. in Child Behavior Checklists from adolescent inpatients. Receiver operating characteristic analysis showed that Child Behavior Checklist-Nurcombe scores were able to discriminate between subjects with and without major depression with an accuracy comparable to that reported for the Dexamethasone Suppression Test (area under the receiver operating characteristic curve = 0.78).

An examination of defense style in parents who abuse children

The study aimed to determine the predominant defense style in parents who abuse their children, at least as determined by a new defense style questionnaire. The scores of 32 parents who had physically abused their young children and had been assessed after court proceedings were compared with a normal population sample and with patients with anxiety disorders who were equally symptomatic. Parents who had abused their children identified themselves as being particularly likely to use projection, displacement, passive-aggressiveness denial, and splitting to a degree greater than normal persons or patients with anxiety disorders. We would caution that, although the differences remained after statistical control of age and sex differences, a firm conclusion that such defenses are germane to child abuse will have to await replication of these findings with a study using a control group of young parents who do not abuse their children matched for social class and family structure.

Referred Adolescents as Young Adults: The Relationship between Psychosocial Functioning and Personality Disorder

Objective: To examine the functioning of young adults who had been referred for psychiatric treatment during adolescence. Method: A group of 145 adolescents referred at a mean age of 14 years were interviewed at a mean age of 20 years to ascertain their functioning and whether they suffered from a personality disorder. Results: Having a personality disorder was associated with poor functioning at follow-up independently of adolescent diagnosis. Antisocial personalities were typified by problems with the law, a poor work record and early cohabitation, while other personality disorders were characterised by social isolation and problems in interpersonal relationships. Poor quality of the family environment and having received treatment during the follow-up period were the only developmental variables associated with poor functioning. Conclusions: Developing a personality disorder and having a poor family environment, rather than having an adolescent disorder, appear to be the factors that result in poor functioning in young adults.