The hypothesis that the S allele of the 5-HTTLPR serotonin transporter promoter region is associated with increased risk of depression, but only in individuals exposed to stressful situations, has generated much interest, research, and controversy since first proposed in 2003. Multiple meta-analyses combining results from heterogeneous analyses have not settled the issue. To determine the magnitude of the interaction and the conditions under which it might be observed, we performed new analyses on 31 datasets containing 38 802 European-ancestry subjects genotyped for 5-HTTLPR and assessed for depression and childhood maltreatment or other stressful life events, and meta-analyzed the results. Analyses targeted two stressors (narrow, broad) and two depression outcomes (current, lifetime). All groups that published on this topic prior to the initiation of our study and met the assessment and sample size criteria were invited to participate. Additional groups, identified by consortium members or self-identified in response to our protocol (published prior to the start of analysis1) with qualifying unpublished data were also invited to participate. A uniform data analysis script implementing the protocol was executed by each of the consortium members. Our findings do not support the interaction hypothesis. We found no subgroups or variable definitions for which an interaction between stress and 5-HTTLPR genotype was statistically significant. In contrast, our findings for the main effects of life stressors (strong risk factor) and 5-HTTLPR genotype (no impact on risk) are strikingly consistent across our contributing studies, the original study reporting the interaction, and subsequent meta-analyses. Our conclusion is that if an interaction exists in which the S allele of 5-HTTLPR increases risk of depression only in stressed individuals, then it is not broadly generalizable, but must be of modest effect size and only observable in limited situations.

The present study investigated a possible interaction between a functional polymorphism in the MAOA gene promoter (MAOA-VNTR) and childhood maltreatment in the prediction of adolescent male and female delinquency. A cohort of 1,825 high school students, 17-18 years old, completed an anonymous questionnaire during class hours which included questions on childhood maltreatment, sexual abuse, and delinquency. Saliva samples were collected for DNA isolation, and analyzed for the MAOA-VNTR polymorphism. Self-reported maltreatment was a strong risk factor for adolescent delinquent behavior. The MAOA genotype also showed a significant main effect when controlled for maltreatment. Boys with a short variant and girls with one or two long variants of the polymorphism showed a higher risk for delinquency when exposed to maltreatment. Our results confirm previous findings of an interaction between the MAOA-VNTR polymorphism and self-reported maltreatment. Results for boys and girls differ according to MAOA-VNTR genotype and direction of phenotypic expression.

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Serotonin plays a central role in mood regulation and the development of depressive disorders. The present study investigated whether a functional polymorphism (5HTTLPR) of the serotonin transporter gene interacts with maltreatment in the prediction of depression. A cohort of 17-18 years old students (n = 1,482) anonymously completed the Survey of Adolescent Life and Health in Vestmanland 2006 and gave a saliva sample for DNA extraction. An association between maltreatment and adolescent depression was found independent of sex. When the whole population was analyzed, no main effect of 5HTTLPR in association with depression was found. When separated by sex, a significant main effect and a G x E interaction effect of the SS allele was found among girls. No gene main effect or G x E interaction effect was found among boys. The present study confirms previous findings of sex differences in interaction effects between the 5HTTLPR polymorphism and maltreatment in the prediction of adolescent depression.

Aim. To investigate whether adolescent online gaming time and the additive effect of gaming motives were associated with depressive, musculoskeletal, and psychosomatic symptoms. The hypothesis was that adolescents who engage in online gaming with escape motives and increased online gaming time have higher probability for depressive, musculoskeletal, and psychosomatic symptoms compared to adolescents with other online gaming motives and/or less online gaming time.Method. An anonymous and voluntary questionnaire was completed during class hours by 7,757 Swedish adolescents aged 13–18 years. The questionnaire included demographic background, gaming habits, and depressive, musculoskeletal, and psychosomatic symptoms.Results. It was found that increased online gaming time during weekdays increased the probability of having depressive, musculoskeletal, and psychosomatic symptoms. However, these relations with time spent gaming were further explained by online gaming motives. Weekday online gaming for more than five hours a day, in combination with escape motives, was associated with an increased probability of depressive symptoms (odds ratio (OR) 4.614, 95% CI 3.230–6.590), musculoskeletal symptoms (OR 2.494, 95% CI 1.598–3.892), and psychosomatic symptoms (OR 4.437, 95% CI 2.966–6.637). The probability of ill health decreased when gaming was for fun or had social motives.Conclusion. Excessive gaming time and escape motives were found to be associated with increased probability of ill health among adolescents. Gaming motives may identify gamers in need of support to reduce unhealthy gaming behaviour as well as identify individuals at risk for ill health.

BackgroundSocial capital has lately received much attention in health research. The present study investigated whether two measures of subjective social capital were related to psychosomatic symptoms, musculoskeletal pain, and depression in a large population of Swedish adolescents.MethodsA total of 7757 13-18 year old students anonymously completed the Survey of Adolescent Life in Vestmanland 2008 which included questions on sociodemographic background, neighbourhood social capital, general social trust, and ill health.ResultsLow neighbourhood social capital and low general social trust were associated with higher rates of psychosomatic symptoms, musculoskeletal pain, and depression. Individuals with low general social trust had more than three times increased odds of being depressed, three times increased odds of having many psychosomatic symptoms, and double the odds of having many symptoms of musculoskeletal pain.ConclusionsThe findings make an important contribution to the social capital - health debate by demonstrating relations between social capital factors and self-reported ill health in a young population.

IntroductionFinancial stress is an important source of distress and is related to poor mental and physical health outcomes. The present study investigated whether tangible social support could buffer the effect of financial stress on psychological and psychosomatic health.MethodsTwo separate postal surveys were sent to random samples in five counties in Sweden in 2004 and 2008, with a total of 84 263 respondents. The questionnaires included questions about financial stress, tangible social support, psychosomatic symptoms, and psychological well-being (General Health Questionnaire-12).ResultsIndividuals with high financial stress and low tangible social support had six to seven times increased odds ratios for low psychological well-being and many psychosomatic symptoms. By contrast, individuals with high financial stress and high tangible social support had only two to three times increased odds ratios for low psychological well-being and three to four times increased odds ratios for many psychosomatic symptoms, suggesting a buffering effect of tangible social support. Consistent with the buffering hypothesis, there were significant interactions between financial stress and social support, particularly in relation to low psychological well-being.ConclusionsSocial support had its strongest effect at high levels of financial stress. The question whether the altering of our social networks may improve physical health is important for the prevention of ill health in people experiencing financial stress. Strengthening social networks may have the potential to influence health-care costs and improve quality of life.

BackgroundSocial capital has lately received much attention in public health research. However, few studies have examined the influence of social capital on alcohol consumption, smoking and drug use which have strong influence on public health. The present cross-sectional study investigated whether two measures of social capital were related to substance use in a large population of Swedish adolescents.MethodsA total of 7757 13–18 year old students (participation rate: 78.2%) anonymously completed the Survey of Adolescent Life in Vestmanland 2008 which included questions on sociodemographic background, neighbourhood social capital, general social trust, alcohol consumption, smoking, and illicit drug use.ResultsIndividuals within the group with low neighbourhood social capital had an approximately 60% increased odds of high alcohol consumption, more than three times increased odds of smoking and more than double the odds of having used illicit drugs compared with individuals with high neighbourhood social capital. Individuals within the group with low general social trust had approximately 50% increased odds of high alcohol consumption and double the odds of smoking and having used illicit drugs compared with individuals with high general social trust. However, social capital at the contextual level showed very weak effects on alcohol consumption, smoking, and illicit drug use.ConclusionsSocial capital may be an important factor in the future development of prevention programs concerning adolescent substance use. However, further replications of the results as well as identifications of direction of causality are needed.