Cambridge University Press



Supplementary Table SEQ Table \* ARABIC 1. Sociodemographic differences between persons with atypical depression versus depression with typical neurovegetative symptomsAtypical Depression Typical DepressionN=2,305N=12,660 n%n%OR (95% CI)P value Age 45to5455to64 65to74 75Plus 6251,0515854427.145.625.41.92,3245,0024,75757718.439.537.64.6Ref0.78(0.70-0.87)0.45(0.40-0.51)0.28(0.21-0.39)P < 0.001P < 0.001P < 0.001Gender FemaleMale1,73257375.124.99,5753,08575.624.4Ref1.03(0.92-1.14)P = 0.61EducationNoneOther(vocational)Secondary schoolA level Degree113897053979745.03.931.017.442.87947003,8951,7685,3786.35.631.114.142.9Ref0.89(0.66-1.20)1.27(1.03-1.57)1.57(1.26-1.98)1.27(1.03-1.57)P = 0.45P < 0.01P < 0.001P < 0.05Income<?18,000?18,000-30,000 ?30,000-52,000?52,000-100,000>?100,0004425115974579421.024.328.421.84.51,9442,7983,2702,70973317.024.428.623.76.4Ref0.80(0.69-0.92)0.80(0.70-0.92)0.74(0.64-0.85)0.56(0.44-0.71)P < 0.01P < 0.01P < 0.001P < 0.001House ownershipRent socialRent privateOwn mortgageOwn outright 1971201,0788398.85.448.337.64743665,4836,0623.83.044.349.0Ref0.78(0.61-1.02)0.47(0.39-0.56)0.33(0.27-0.40)P = 0.07P < 0.001P < 0.001Note: Atypical depression is defined as meeting the DSM-V criteria for MDD and reporting symptoms of hypersomnia and weight gain; depression with typical neurovegetative symptoms is defined as meeting the DSM-V criteria for MDD and reporting symptoms of hyposomnia and weight loss.Supplementary Table 2. Differences in depression age of onset, severity, recurrence, episode duration, and help seeking between persons with atypical depression versus depression with typical neurovegetative symptomsAtypical Depression Typical DepressionN=2,305N=12,660 NMean (SD)NMean (SD)OR (95% CI)P value Age depression onset2,12031.9(14.5)12,05136.1(14.1)0.99 (0.99-0.99)P < 0.001N%N%OR (95% CI)P value Severe depression91039.53,09024.41.89 (1.72-2.08)P < 0.001Recurrent depression 1,58374.96,78655.8 2.26 (2.04-2.52)P < 0.001Duration of worst episode<1 month763.36545.2Ref1 to 3 months43619.03,34726.61.14(0.88-1.46)P < 0.053 to 6 months44019.22,69321.41.43(1.10-1.85)P < 0.0016 to 12 months43418.92,60020.71.47(1.14-1.91)P < 0.0011 to 2 years35215.41,86414.81.74(1.33-2.27)P < 0.001>2 years55424.21,41011.23.56(2.74-4.61)P < 0.001Help seeking for depression2,07690.110,38782.21.94(1.67-2.25)P < 0.001Note: Models are adjusted for age and genderSupplementary Table 3. Differences in lifestyle factors and adverse life events between persons with atypical depression versus depression with typical neurovegetative symptomsAtypical DepressionTypical DepressionN=2,305N=12,660Lifestyle factorsn%n%OR (95% CI)P value Smoking NeverEver1,11748.75,96247.2Ref1.11(1.01-1.21)P < 0.05Social isolation NoYes29312.91,2339.8Ref1.37(1.20-1.58)P < 0.001LonelinessNoYes22310.16685.4Ref1.74(1.50-2.01)P < 0.001Moderate physical activityNoYes1,31256.98,24465.1Ref0.80(0.74-0.88)P < 0.001Childhood adversitiesFelt loved YesNo37816.51,31110.4Ref1.66 (1.46-1.88)P < 0.001Felt hated NoYes64528.12,20517.5Ref1.72(1.55-1.91)P < 0.001Physical abuse No Yes44919.61,76213.9Ref1.40(1.25-1.57)P < 0.001Sexual abuseNoYes25111.29717.8Ref1.42(1.22-1.65)P < 0.001Had someone to take to doctor when needed as a childYesNo26311.51,0218.1Ref1.50(1.-1.73)P < 0.001Adulthood adversitiesBeen in confiding relationship YesNo45019.91,79914.5Ref1.47(1.31-1.65)P < 0.001Physical violence by (ex)partnerNoYes39417.21,64113.0Ref1.33(1.18-1.50)P < 0.001Belittlement by (ex)partnerNo Yes83736.53,56228.2Ref1.41(1.28-1.55)P < 0.001Non-consensual sexual interference by (ex)partnerNoYes2018.87445.9Ref1.49(1.26-1.75)P < 0.001Unable to pay rent or mortgageNoYes31713.91,2269.8Ref1.46(1.28-1.67)P < 0.001Catastrophic traumaNoYes1,56267.87,23257.1Ref1.56(1.42-1.71)P < 0.001Note: Models are adjusted for age and gender. Catastrophic trauma is defined being attacked, mugged, robbed, exposed to violent crime, sexual assault, serious accidents, life-threatening illness, combat or war, violent death.Supplementary Table 4. Differences in psychiatric and physical comorbidities between persons with atypical depression versus depression with typical neurovegetative symptomsAtypical DepressionTypical DepressionN=2,305N=12,660Probable psychiatric diagnoses based on self-reported symptomsn%n%OR (95% CI)P valueWider Bipolar1667.45364.31.66(1.39-2.00)P < 0.001Bipolar I1185.33242.61.94(1.56-2.42)P < 0.001Bipolar II381.71541.21.32(1.92-1.89)P = 0.13GAD75460.22,88445.91.70(1.50-1.93)P < 0.001PTSD71731.31,97015.62.28(2.06-2.53)P < 0.001Self-reported psychiatric diagnosesSchizophrenia140.6250.22.79(1.43-5.44)P < 0.01Other psychosis502.21401.11.90(1.37-2.65)P < 0.001Panic attacks41317.91,66313.11.43(1.27-1.61)P < 0.001Agoraphobia401.71190.91.93(1.34-2.79)P < 0.001Social phobia1355.93382.72.12(1.72-2.61)P < 0.001Any other phobia833.62632.11.81(1.41-2.33)P < 0.001OCD753.31641.32.32(1.76-3.07)P < 0.001Anorexia nervosa180.82431.90.38(0.23-0.61)P < 0.001Bulimia nervosa241.01050.81.02(0.65-1.61)P = 0.90Binge-eating1165.0640.510.06(7.36-13.75)P < 0.001ADHD100.4190.22.65(1.22-5.77)P < 0.05Autism spectrum disorder160.7210.23.43(1.77-6.64)P < 0.001Personality disorder271.2880.71.49(0.96-2.31)P = 0.07Any addiction36016.31,2229.91.65(1.45-1.88)P < 0.001Substance Dependence23210.77596.001.65(1.41-1.93)P < 0.001Alcohol Dependence612.71781.41.79(1.32-2.42)P < 0.001Self-harm38516.81,39711.11.47(1.30-1.67)P < 0.001Suicidal intention among21959.580159.81.04(0.82-1.32)P = 0.21self-harmersPhysical comorbiditiesAny long-standing illness1,16950.74,03232.52.46(2.25-2.70)P < 0.001CVD65028.32,60820.61.92(1.72-2.13)P < 0.001Metabolic syndrome1948.44013.23.48(2.90-4.18)P < 0.001Body Mass Index (kg/m2)Normal (< 18.5)33414.55,90946.8Ref.Underweight (18.5–24.9)30.11160.90.44(0.14-1.40)P = 0.16Overweight (25.0–29.9)83436.24,61436.53.58(3.13-4.10)P < 0.001Obese (>30)1,13149.11,99815.811.34(9.91-12.99)P <0.001Note: Models are adjusted for age and gender Supplementary Table 5. Tetrachoric correlations between individual depressive symptoms among persons with lifetime probable MDDWeight gainHypersomniaWeight lossHyposomniaConcentrationTirednessInterest lossSadnessWorthlessnessDeath thoughtsWeight gain1.00Hypersomnia0.20***1.00Weight lossN/A-0.20***1.00Hyposomnia0.06***N/A-0.14***1.00Concentration -0.04*0.07***-0.04*-0.09***1.00Tiredness0.21***0.34***-0.18***0.010.22***1.00Interest loss0.06***0.26***-0.08***0.04**0.07***0.13***1.00Sadness-0.08**0.02-0.06*-0.020.01-0.13*N/A1.00Worthlessness0.13***0.20***-0.16***0.02*0.15***0.09***0.17***0.21***1.00Death thoughts0.010.04***0.02*-0.08***0.01-0.08***0.03*0.07**0.14***1.00* p < 0.05; ** p < 0.01; ***p < 0.001; the correlation between sadness and interest loss could not be computed because there are no depressed persons with a score of zero on both sadness and interest loss given that the MDD criteria require the presence of at least one of the two symptoms. Supplementary Table 6: Question and Answer Format of the UK Biobank Mental Health QuestionnaireVariableQuestion AskedPossible AnswersSociodemographic factorsAgePlease confirm your month & year ofmm yyyybirthGenderPlease confirm your sex0= Female1= MaleEducationWhich of the following qualifications0= None of the abovedo you have?1= Other2= GCSE3= A Level4= DegreeIncomeWhat is the average total income0= <?18,000before tax received by your household?1= ?18,000-30,0002= ?30,000-52,0003= ?52,000-100,0004= >?100,000UN = Do not knowDA = Prefer not to answerHouse ownershipDo you own or rent the1= Rent socialaccommodation that you live in?2= Rent private3= Own mortgage4= Own outrightUN = Do not knowDA = Prefer not to answerRisk factors and life eventsSmokingDo you smoke tobacco now? (i.e.,0= Noduring the baseline UKB assessments)1= Yes, on most or all days2= Only occasionally3= Prefer not to answerIn the past, how often have you0= I have never smokedsmoked tobacco?1= Just tried once or twice2= Smoked occasionally3= Smoked on most or all days4= Prefer not to answerA binary variable was derived forsmoking status:0= Never smoked, if current smoker = 0and past smoker < 2;1= Ever smoker, if current smoker = 1and/or past smoker > 1Moderate physicalIn a typical week, on how many daysA binary variable was generated:activitydid you do 10 minutes of moderate1= 10 minutes of moderate physicalphysical activities like carrying lightactivities at least 3 days a week;loads, cycling at normal pace? (do not0= 10 minutes of moderate physicalinclude walking)activities less than 3 days a week;6Social isolation(1) “Including yourself, how many1 point for living alonepeople are living together in yourhousehold? Include those who usuallylive in the house such as students livingaway from home during term time,partners in the armed forces orprofessions such as pilots”;(2) “How often do you visit friends or1 point for friends and family visit lessfamily or have them visit you?than once a month(3) “Which of the following1 point for no participation in social[leisure/social activities] do you engageactivities at least weeklyin once a week or more often?”.Total score 0=3A binary variable was derived:0= no social isolation, if total score ≤ 11= social isolation, if total score ≥ 2Loneliness(1) “Do you often feel lonely?”0= No1= Yes(2) “How often are you able to confide0= almost daily to once every fewin someone close to you?”months1= never or almost neverElovainio, M., C. Hakulinen, et al.A binary variable was derived."Contribution of risk factors to excessLonely|: total score = 2mortality in isolated and lonelyNot lonely|: total score < 2individuals: an analysis of data fromthe UK Biobank cohort study." TheLancet Public Health 2: e260-e266.Childhood adverseIncludes 1 question from each domain0= Never trueeventsof the Childhood Trauma1= Rarely trueQuestionnaire.2= Sometimes true3= OftenWalker, E. A., et al. (1999). "Adult4= Very often truehealth status of women with histories ofDA = Prefer not to answerchildhood abuse and neglect." TheAmerican Journal of Medicine 107(4):Binary variables were derived based on332-339the following thresholds:20489 Felt loved as a child < 2OR20488 Physically abused by family as achild ≥2OR20487 Felt hated by family member as achild ≥2OR20490 Sexually molested as a child ≥2OR20491 Someone to take to doctor whenneeded as a child < 3Adult adverse eventsBased on answers to the five questions0= Never trueof Adult Trauma Screen (written for1= Rarely truethis questionnaire).2= Sometimes true73= Often4= Very often trueDA = Prefer not to answerBinary variables were derived based onthe following thresholds:20522 Been in a confiding relationship asan adult < 220523 Physical violence by partner or ex-partner as an adult ≥ 220521 Belittlement by partner or ex-partner as an adult ≥220524 Sexual interference by partner orex-partner without consent as an adult ≥220525 Able to pay rent/mortgage < 3Catastrophic traumaIn your life, have you:Endorsed one or more events froma) Been a victim of a sexual assault,checklistwhether by a stranger or someone youknew?0= Neverb) Been attacked, mugged, robbed, or1= Yes, but not in the last 12 monthsbeen the victim of a physically violent2= Yes, within the last 12 monthscrime?DA = Prefer not to answerc) Been in a serious accident that youbelieved to be life-threatening at theA binary variable was derivedtime?0= Neverd) Witnessed a sudden violent death1= Ever (experienced 1 or several(eg. murder, suicide, aftermath of ancatastrophic events within the last 12accident)?months or before)e) Been diagnosed with a life-threatening illness?f) Been involved in combat or exposedto a war-zone (either in the military oras a civilian)?Depression FeaturesDepression age of onsetRegarding times in your life when youRecord years of age when first felt thishave had feelings of depression or losswayof interest:UN = Do not knowAbout how old were you the FIRSTDA = Prefer not to answertime you had a period of two weekslike this? (Whether or not you receivedany help for it.)Severe depressionMeets criteria for a lifetime diagnosisA binary variable was derived:of MDD (see Depression Ever below)1= severe MDDand reports all 8/8 symptoms of0= non-severe MDDdepression assessed with CIDI-SF andreports a lot of impairment.Recurrent depressionRegarding times in your life when youText box for number.have had feelings of depression or loss1= single depression episodeof interest:2 and above = recurrent depressionHow many periods did you have inepisodesyour life lasting two or more weekswhere you felt like this?Depression durationPlease think of the two-week period in1= less than a monthyour life when your feelings of2= between one and three months8depression or loss of interest were3= over three months, but less than sixworst. About how long did you feelmonthsthis way?4= over six months, but less than 12months5= one to two years6= over two yearsHelp seeking forRegarding times in your life when you0= Nodepressionhave had feelings of depression or loss1= Yesof interest:UN = Do not knowDid you ever tell a professional aboutDA = Prefer not to answerthese problems (medical doctor,psychologist, social worker, counsellor,nurse, clergy, or other helpingprofessional)Psychiatric comorbidities based on self-reported diagnosesClinical diagnosesHave you been diagnosed with one or[Select up to seven from]based on self–reportsmore of the following mental health0= None of the above(A)problems by a professional, even if you1= Depressiondon’t have it currently? (tick all that2= Mania, hypomania, bipolar or manic-apply):depression3= Anxiety, nerves or generalizedBy professional we mean: any doctor,anxiety disordernurse or person with specialist training4= Social anxiety or social phobia(such as a psychologist or therapist).5= Agoraphobia6= Any other phobia (e.g. disabling fearPlease include disorders even if youof heights or spidersdid not need treatment for them or if7= Panic attacksyou did not agree with the diagnosis8= Obsessive compulsive disorder(OCD)DA = Prefer not to answerClinical diagnosesHave you been diagnosed with one or[Select up to eight from]based on self–reportsmore of the following; mental health0= None of the above(B)problems by a professional, even if you1= Anorexia nervosadon’t have it currently? (tick all that2= Bulimia nervosaapply):3= Psychological over-eating or binge-eatingBy professional we mean: any doctor,4= Schizophrenianurse or person with specialist training5= Any other type of psychosis or(such as a psychologist or therapist).psychotic illnessPlease include disorders even if you6= A personality disorderdid not need treatment for them or if7= Autism, Asperger’s or autisticyou did not agree with the diagnosis.spectrum disorder8= Attention deficit or attention deficitand hyperactivity disorder (ADD/ADHD)DA = Prefer not to answerAny addictionHave you ever been addicted to or1= Yesdependent on one or more things,0= Noincluding substances (notUN = Do not knowcigarettes/coffee) or behaviors (such asDA = Prefer not to answergambling)?Substance Dependence:Have you been addicted to or1= Yesdependent on prescription or over-the-0= Nocounter medication?UN = Do not knowDA = Prefer not to answerHave you been addicted to illicit or1= Yesrecreational drugs?0= No9UN = Do not knowDA = Prefer not to answerNote: Substance dependence is asubcategory of any addictionAlcohol Dependence:Have you been physically dependent1= Yeson alcohol?0= NoThis means experiencing withdrawalUN = Do not knowsymptoms, such as sweating, shakingDA = Prefer not to answerand nausea, if you didn’t drink.Note: Alcohol dependence is asubcategory of substance dependenceSelf-harm behavioursHave you contemplated harming0= Noyourself (for example by cutting,1= Yes, oncebiting, hitting yourself or taking an2= Yes, more than onceoverdose)?DA = Prefer not to answerHave you deliberately harmed yourself,0= Nowhether or not you meant to end your1= Yeslife?DA = Prefer not to answerSelf-harm with suicideHave you harmed yourself with the0= Noattemptintention to end your life?1= YesDA = Prefer not to answerPhysical comorbiditiesLong-standing illnessDo you have any long-standing illness,0= Nodisability or infirmity?1= YesUN = Do not knowDA = Prefer not to answerMetabolic syndromeParticipants were classified as havingmetabolic syndrome if:- Their waist circumference was:≥ 102 cm for males and≥ 88 cm for females;- They had any two of thefollowing: diabetes, hypertension,hypercholesterolemia.DiabetesQ1: Has a doctor ever told you that0= Noyou have diabetes?1= YesUN = Do not knowDA = Prefer not to answerQ2: Do you regularly take any of the1= cholesterol lowering medicationfollowing medications? (you can select2= blood pressure medicationmore than one answer)3= insulinUN = Do not knowDA = Prefer not to answerParticipants were considered as diabetescases if they answeredQ1 = 1 and/or Q2 = 3.10HypertensionQ1: Has a doctor ever told you that0= Noyou have high blood pressure?1= YesUN = Do not knowDA = Prefer not to answerQ2: Do you regularly take any of the1= cholesterol lowering medicationfollowing medications? (you can select2= blood pressure medicationmore than one answer)3= insulinUN = Do not knowDA = Prefer not to answerParticipants were considered ashypertension cases if they answeredQ1 = 1 and/or Q2 = 2.HypercholesterolemiaQ1: Has a doctor ever told you that0= Noyou have hypercholesterolemia1= YesUN = Do not knowQ2: Do you regularly take any of theDA = Prefer not to answerfollowing medications? (you can selectmore than one answer)1= cholesterol lowering medication2= blood pressure medication3= insulinUN = Do not knowDA = Prefer not to answerParticipants were considered ashypertension cases if they answeredQ1 = 1 and/or Q2 = 1.Cardiovascular diseaseHas a doctor ever told you that you1= Heart attackhave had any of the following2= Anginaconditions? (You can select more than3= Strokeone answer)4= High blood pressure0= None of the aboveDA = Prefer not to answerA binary variable was derived:0= None1= any of the above11Supplementary Table 7. Case and control criteria derived from the UK Biobank Mental Health QuestionnaireDisorder - case and controlFields and codesNotes and referencesdefinitionsCase: Lifetime depressionAt least one core symptom ofdepression, most or all of the day onCIDI-SF (Composite Internationalmost or all days for a two-weekDiagnostic Interview – Short Form),period, with at least five depressivedepression module, lifetime version.symptoms that represent a changeScored based on DSM definition offrom usual occurring over the samemajor depressive disordertime-scale, with some or a lot ofimpairment.Kessler RC, Andrews G, Mroczek D,Persistent sadness (20446) = Yes ORUstun B, Wittchen HU (1998). TheLoss of interest (20441) = YesWorld Health Organization compositeANDinternational diagnostic interviewHow much of day (20436) = Most ofshort‐form (CIDI‐SF). Int J Methodsday or All day longPsychiatr Res, 7(4):171-85.ANDDid you feel this way (20439) =Almost every day or Every day ANDImpairment (20440) = Somewhat or AlotANDTotal number of symptoms endorsed(core and others) >= 5Persistent sadness (core) 20446; Lossof interest (core) 20441; Tired or lowenergy 20449; Gain or loss of weight20536 = Gain, Loss or Gain and loss;Sleep change 20532; Troubleconcentrating 20435; Feelingworthless 20450; Thinking aboutdeath 20437Control: LifetimeNot endorsing depression or screeningCase plus control plus subthresholddepressionpositive on PHQ or CIDIshould include all participants withNOT (reported diagnosis of depressionvalid responses. By excluding20544 or 20002)subthreshold symptoms, we can beANDconfident that this group has notNOT Core symptoms from aboveexperienced a classical depressiveANDepisodePHQ score ≤5Case: Lifetime bipolarEver manic/hyper or irritable, plus atCase for depression is not required indisorder type I:least three other features (four if neverDSM-IV diagnostic criteria, but it ismanic/hyper), plus duration a week oradded here to improve the positivemore, plus symptoms causedpredictive value of the test (see textsignificant problems. Requires also toand references). This definition doesbe case for depression ever.not exclude antidepressant-inducedCase {depression ever}mania.ANDHigh/Hyper 20501 = 01 OR IrritableCerimele et al. (2014). The prevalence20502 = 01of bipolar disorder in primary careANDsamples: a systematic review, GeneralFour features from:Hospital Psychiatry 36: 19-25? High/Hyper 20501; Active20548(01); TalkativeCarvalho, A. F., Y. Takwoingi, et al.20548(02); Less sleep(2015). "Screening for bipolar20548(03); Creative/ideasspectrum disorders: a comprehensive20548(04); Restless1220548(5); Confidentmeta-analysis of accuracy studies."20548(55); Thoughts racingJournal of affective disorders 172:20548(7); Easily distracted337-34620548(8)ANDDuration 20492 = A week or moreANDSymptoms caused problem 20493 =yesVariant: Lifetime bipolarAs above, without disruption fromThere is less agreement over thetype II:symptomsdefinition of bipolar affective disorderCase {depression ever}type II. DSM-IV criteria requireANDsymptoms for four days or more. HereHigh/Hyper 20501 = 01 OR Irritableis one week, so could be predicted to20502 = 01miss some cases.ANDFour features as aboveANDDuration 20492 = A week or moreControl: Hypomania /NOT {hypomania/mania} AND NOTMania{categorised bipolar on last UKBcategorisation 20126 = 1 or 2} ANDNOT {self-reported bipolar20544=10}Case: Lifetime GADExcessive worrying about a number ofCIDI-SF (Composite Internationalissues, occurring most days for sixDiagnostic Interview – Short Form),months and difficult to control, withGAD module, lifetime version. Scoredthree or more somatic symptoms andbased on DSM definition of GADfunctional impairment.Worried tense of anxious (20421) =Kessler RC, Andrews G, Mroczek D,YesUstun B, Wittchen HU. The WorldANDHealth Organization compositeDuration (20420) >= 6 months or Allinternational diagnostic interviewmy lifeshort‐form (CIDI‐SF). Int J MethodsANDPsychiatr Res. 1998;7(4):171-85.Most days (20538) = YesANDNational Institute for Health andExcessive: More than most (20425)Clinical Excellence. GeneralisedOR Stronger than most (20542)anxiety disorder and panic disorder inANDadults: management. NICE ClinicalNumber of issues: More than oneGuideline CG113 (available atthing (20543) OR Different worries(20540)13) 2011ANDDifficult to control: Difficult to stopworrying (20541) OR Couldn’t put itout of mind (20539) OR Difficult tocontrol (20537)ANDFunctional impairment: Roleinterference (20418) = Some or A lotAND3 somatic symptoms out of:Restless. 20426; Keyed up oron edge. 20423; Easily tired.20429; Having difficultykeeping your mind on whatyou were doing. 20419; More13irritable than usual. 20422;Having tense, sore, or achingmuscles. 20417; Often havingtrouble falling or stayingasleep. 20427Control: Lifetime GADNot meeting criteria for GAD ever norExcluding those that screen positivescoring over low cut-off for GAD-7for mild anxiety means that there isNOT case {GAD ever}greater confidence that this group haveANDnot had anxiety disorderGAD-7 score < 5Case: Current PTSDCase: PCL-6 sum of scores ≥ 14Does not currently require catastrophictrauma, but it refers to “stressfulSum of scores on questionsevent” in the text of the questions asrepresenting the core symptoms ofthis is not an exhaustive list ofPTSD (scored 1-5)possible traumatic events.{20497Repeated disturbing thoughtsof stressful experience in past monthUsing PHQ item for concentration,20498Felt very upset when remindedscores out of 29 (conventionallyof stressful experience in past monthscores out of 30), and will make it20495Avoided activities or situationsslightly harder to reach conventionalbecause of previous stressfulthreshold.experience in past month20496Felt distant from other people inLang AJ, Stein MB (2005).Anpast monthabbreviated PTSD checklist for use as20494Felt irritable or had angrya screening instrument in primaryoutbursts in past month}care. Behaviour Research and+ 20508 Trouble concentratingTherapy,43(5):585-94(scored 1-4)(nb biobank coded 0-4, subtract 5 toadjust)Control: Current PTSDPCL-6 sum of scores 13 or less.Note: “Current” PTSD refers topersons meeting the criteria for PTSDwhen completing the MHQassessments. ................
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