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We explored long-term employment status and income before and after depression diagnosis among men and women and at different working ages in Taiwan.
Data from 2006 to 2019 were obtained from the National Health Insurance Research Database (NHIRD). Individuals with newly diagnosed depressive disorder aged 15 to 64 years during the study period were identified. An equal number of individuals without depression were matched for their demographic and clinical characteristics. Employment outcomes included employment status, which was categorized into employed or unemployed, and annual income. Based on the occupation categories and monthly insurance salary recorded in the Registry for Beneficiaries of the NHIRD, a subject was defined as unemployed if he or she differed from the income earner or the occupation category was unemployed. Monthly income was defined as zero for unemployed subjects and proxied as monthly insurance salary for others. Annual income was the sum of monthly income in each observation year.
A total of 420,935 individuals with depressive disorder were included in the study, and an equal number of individuals with not diagnosed depression served as controls. Employment rate and income were lower in the depression group than in the control group before the year of diagnosis, with a difference of 5.7% in employment rate and USD 1,173 in annual income. This gap increased considerably after the year of diagnosis (7.3% in employment rate and USD 1,573 in annual incomes) and further widened in the subsequent years (8.1% in employment rate and USD 2,006 in annual incomes in the 5th following year). The drops in the employment rate and income caused by depression were more evident in men and older age groups than in women and younger age groups, respectively. However, the reduction in employment rate and income in the following years after the diagnosis was more considerable among younger age groups.
The effect of depression on employment status and income was significant during the year of diagnosis and continued afterwards. The effect on employment outcomes varied between genders and across all age groups.
People with major depressive disorder who fail to respond to adequate trials of antidepressant treatment may harbour hidden bipolar disorder.
We aimed to compare the rates of a change in diagnosis to bipolar disorder among people with major depressive disorder with stratified responses to antidepressants during an 8-year follow-up period.
Information on individuals with major depressive disorder identified during 2000 (cohort 2000, n = 1485) and 2003 (cohort 2003, n = 2459) were collected from a nationally representative cohort of 1 000 000 health service users in Taiwan. Participants responding well to antidepressants were compared with those showing poor responses to adequate trials of antidepressants.
In 7.6–12.1% of those with a diagnosis of unipolar major depressive disorder this diagnosis was subsequently changed to bipolar disorder, with a mean time to change of 1.89–2.98 years. Difficult-to-treat participants presented higher rates of change to a bipolar diagnosis (25.6% in cohort 2000; 26.6% in cohort 2003) than easy-to-treat participants (8.8–8.9% in cohort 2000; 6.8–8.6% in cohort 2003; P<0.0001). Regression analysis showed that the variable most strongly associated with the change in diagnosis was antidepressant use history. The difficult-to-treat participants were associated most with diagnostic changing (cohort 2000: odds ratio (OR) = 1.88 (95% CI 1.12–3.16); cohort 2003: OR = 4.94 (95% CI 2.81–8.68)).
This is the first large-scale study to report an association between antidepressant response history and subsequent change in diagnosis from major depressive disorder to bipolar disorder. Our findings support the view that a history of poor response to antidepressants in unipolar depression could be a useful predictor for bipolar diathesis.
Alpha quartz can be transformed to a metamict phase in a physical reaction such as irradiation with fast ions, neutrons and electrons. As truly inspired by this fact, we design a simple experiment to produce disordered silica and at the same time watch the transformation using a transmission electron microscope. This work simply presents electron-damaged silica in dark field at Bragg reflection. Since the transformation is not complete, disordered silica (at the sample edge) and retained quartz can be compared in each image. Not surprisingly, more speckles are found in the quartz than in the disordered structure. But it is too early to say no medium-range ordering in amorphous silica because the experiment only shows one Bragg diffraction. Systematic work to complete and measure the disordering again is being pursued.
For the first time we use fluctuation electron microscopy to study the effect of electron irradiation on amorphous silicon. Before showing the results, we compare two variable coherence methods, hollow cone and dark field. These techniques have been successfully implemented in the Philips CM12, JEOL 4000 and Hitachi 9000 microscopes. The image fluctuations for ion-implanted and vacuum-deposited amorphous silicon can be reliably measured under the conditions used in these microscopes.
Medium-range order in ion-implanted amorphous silicon has been observed using fluctuation electron microscopy. In fluctuation electron microscopy, variance of dark-field image intensity contains the information of high-order atomic correlations, primarily in medium-range order length scale (1–3 nm). Thermal annealing greatly reduces the order and leaves a random network. It appears that the free energy change previously observed on relaxation may therefore be associated with randomization of the network. In this paper, we discuss the origin of the medium-range order during implantation, which can be interpreted as a paracrystalline state, that is, a disordered network enclosing compacts of highly topologically ordered grains on the length scale of 1–3 nm with significant strain fields.
Medium-range order has been observed in ion-implanted amorphous silicon,
suggesting a paracrystalline structure for this material. The origin of a
paracrystalline structure may be due to an energy spike phenomenon. To
evaluate the influence of energy spikes on a particular process, we have
attempted to calculate the characteristic energy in a spike. However, the
observed depth dependence of amorphous structures in as-implanted silicon is
puzzling. To explain this, we simulated the depth distribution of cascade
events in a particular energy range. We found a great increase of point
defect concentration and cascade events as the depth increases. This result
could explain the experimental depth dependence.
Medium-range order has been observed in ion-implanted amorphous silicon, suggesting a paracrystalline structure for this material. The origin of a paracrystalline structure may be due to an energy spike phenomenon. To evaluate the influence of energy spikes on a particular process, we have attempted to calculate the characteristic energy in a spike. However, the observed depth dependence of amorphous structures in as-implanted silicon is puzzling. To explain this, we simulated the depth distribution of cascade events in a particular energy range. We found a great increase of point defect concentration and cascade events as the depth increases. This result could explain the experimental depth dependence.
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