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Clinical Depression (clinical + depression)
Selected AbstractsThe relationships among clinical depression, suicide, and other actions that may hasten deathBEHAVIORAL SCIENCES & THE LAW, Issue 5 2004James L. Werth Jr. Ph.D. Clinical depression and other psychological disorders have been associated with suicidal ideation, attempts, and deaths. Because of the link between suicide and mental illness, whenever discussion of "assisted suicide" arises, the possibility that major depression is affecting the decision arises. This article examines the literature on clinical depression as it relates to suicide, "assisted suicide," and other decisions that will hasten death (i.e. withholding and withdrawing treatment, terminal sedation, and voluntarily stopping eating and drinking). Ethical and legal considerations when working with individuals who are considering taking an action that would hasten death are also briefly reviewed. The article ends with practice and policy recommendations. Copyright © 2004 John Wiley & Sons, Ltd. [source] Atypical depression: retrospective self-reporting of treatment effectivenessACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009G. Parker Objective:, Earlier studies demonstrated that those with atypical depression show a differentially superior response to monoamine oxidase inhibitor (MAOI) antidepressants. This study compares ratings of effectiveness for a range of treatments, amongst depressed subjects with and without atypical features. Method:, In an on-line survey, individuals experiencing likely clinical depression rated symptoms experienced when depressed, including ,atypical features' and the effectiveness of previous treatments. Mean treatment effectiveness ratings were compared amongst those with ,atypical depression' (n = 338) and ,non-atypical depression' (n = 377). Results:, There were few significant differences between the ,atypical depression' and ,non-atypical depression' groups in effectiveness ratings for drug treatments, and none for psychological treatments. The ,atypical depression' group had significantly lower mean effectiveness ratings for some selective serotonin reuptake inhibitor antidepressants. Few respondents had trialed MAOIs. Conclusion:, While MAOIs are rarely prescribed, a range of non-MAOI drug and psychological treatments are of some perceived benefit for depressed patients with atypical features. [source] Platelet hyperactivity in clinical depression and the beneficial effect of antidepressant drug treatment: how strong is the evidence?ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2004R. Von Känel Objective:, Platelet hyperactivity is thought to contribute to the increased coronary artery disease (CAD) risk in depression. This study reviewed the evidence for hyperactive platelets and for effects of antidepressant drug treatment on platelet ,stickiness' in clinical depression. Method:, By means of PubMed electronic library search, 34 studies in English were identified (1983,2003) and critically reviewed. Results:, In depression, flow cytometry studies allowing detection of subtle platelet activation states consistently found at least one platelet activation marker to be increased, while the bulk of platelet aggregation studies did not suggest increased platelet aggregability. Platelets seem to be more activated in depressed patients with CAD than in depressed individuals without CAD. The selective serotonin reuptake inhibitors normalized platelet hyperactivity in four studies. Conclusion:, Data on platelet activity in depression are inconclusive. To resolve this issue and its clinical implications, studies in larger sample sizes controlling for confounders of platelet functioning and prospectively designed are needed. [source] Depression in Croatian Type 2 diabetic patients: prevalence and risk factors.DIABETIC MEDICINE, Issue 7 2005A Croatian survey from the European Depression in Diabetes (EDID) Research Consortium Abstract Aims To determine the prevalence rate of and risk factors for depression in Croatian Type 2 diabetic patients. Methods Depressive mood was examined in 384 randomly selected outpatients with Type 2 diabetes. Center for Epidemiological Studies Depression Scale (CES-D) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) were used to identify depressive disturbances. The groups with CES-D , 16 and < 16 were compared with respect to demographic, psychological and clinical characteristics. Regression analysis was used to determine risk factors for depression. Results Of the examined patients, 22% had CES-D scores , 16, and in 33% of them clinical depression was confirmed by the psychiatric interview. Depressed patients compared with the non-depressed ones reported more diabetes-related problems and poorer well-being (t = 6.71, P < 0.001 and t = 11.98, P < 0.001, respectively). Multiple regression analysis indicated female gender, experienced support and the level of emotional well-being to predict depression (R = 0.74, F = 15.3, P < 0.001). Conclusions The obtained data indicate that the prevalence rate in Croatian Type 2 diabetic patients is comparable to findings from other cultural settings. Depressive symptoms can be predicted by psychological rather than disease-related variables. Psychological care for diabetic patients may be necessary to prevent depressive symptomatology. [source] Mixture and single-substance toxicity of selective serotonin reuptake inhibitors toward algae and crustaceansENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 1 2007Anne Munch Christensen Abstract Selective serotonin reuptake inhibitors (SSRIs) are used as antidepressant medications, primarily in the treatment of clinical depression. They are among the pharmaceuticals most often prescribed in the industrialized countries. Selective serotonin reuptake inhibitors are compounds with an identical mechanism of action in mammals (inhibit reuptake of serotonin), and they have been found in different aqueous as well as biological samples collected in the environment. In the present study, we tested the toxicities of five SSRIs (citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline) as single substances and of citalopram, fluoxetine, and sertraline in binary mixtures in two standardized bioassays. Test organisms were the freshwater algae Pseudokirchneriella subcapitata and the freshwater crustacean Daphnia magna. In algae, test median effect concentrations (EC50s) ranged from 0.027 to 1.6 mg/L, and in daphnids, test EC50s ranged from 0.92 to 20 mg/L, with sertraline being one of the most toxic compounds. The test design and statistical analysis of results from mixture tests were based on isobole analysis. It was demonstrated that the mixture toxicity of the SSRIs in the two bioassays is predictable by the model of concentration addition. Therefore, in risk assessment based on chemical analysis of environmental samples, it is important to include the effect of all SSRIs that are present at low concentrations, and the model of concentration addition may be used to predict the combined effect of the mixture of SSRIs. [source] Acute and chronic toxicity of five selective serotonin reuptake inhibitors in Ceriodaphnia dubiaENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 9 2004Theodore B. Henry Abstract Contamination of surface waters by pharmaceutical chemicals has raised concern among environmental scientists because of the potential for negative effects on aquatic organisms. Of particular importance are pharmaceutical compounds that affect the nervous or endocrine systems because effects on aquatic organisms are possible at low environmental concentrations. Selective serotonin reuptake inhibitors (SSRIs) are drugs used to treat clinical depression in humans, and have been detected in low concentrations in surface waters. In this investigation, the acute and chronic toxicity of five SSRIs (fluoxetine, Prozac®; fluvoxamine, Luvox®; paroxetine, Paxil®; citalopram, Celexa®; and sertraline, Zoloft®) were evaluated in the daphnid Ceriodaphnia dubia. For each SSRI, the 48-h median lethal concentration (LC50) was determined in three static tests with neonate C. dubia, and chronic (8-d) tests were conducted to determine no-observable-effect concentrations (NOEC) and lowest-observable-effect concentrations (LOEC) for reproduction endpoints. The 48-h LC50 for the SSRIs ranged from 0.12 to 3.90 mg/L and the order of toxicity of the compounds was (lowest to highest): Citalopram, fluvoxamine, paroxetine, fluoxetine, sertraline. Mortality data for the 8-d chronic tests were similar to the 48-h acute data. The SSRIs negatively affected C. dubia reproduction by reducing the number of neonates per female, and for some SSRIs, by reducing the number of broods per female. For sertraline, the most toxic SSRI, the LOEC for the number of neonates per female was 0.045 mg/L and the NOEC was 0.009 mg/L. Results indicate that SSRIs can impact survival and reproduction of C. dubia; however, only at concentrations that are considerably higher than those expected in the environment. [source] Naltrexone versus acamprosate in the treatment of alcohol dependence: a multi-centre, randomized, double-blind, placebo-controlled trialADDICTION, Issue 10 2006Kirsten C. Morley ABSTRACT Aim To compare the efficacy of acamprosate and naltrexone in the treatment of alcohol dependence., Design A double-blind, placebo-controlled trial., Setting Three treatment centres in Australia., Participants A total of 169 alcohol dependent subjects were given naltrexone (50 mg/day), acamprosate (1998 mg/day) or placebo for 12 weeks. Intervention All subjects were offered manualized compliance therapy, a brief intervention that targets problems that may affect treatment compliance such as ambivalence and misperceptions about medication. Measurements Time to the first drink, time to first relapse, drinks per drinking day and cumulative abstinence. Findings In intention-to-treat analyses, there were no differences between groups on outcome measures of drinking, craving or biochemical markers. Similarly, analyses of the 94 subjects that completed the study in full and demonstrated 80% compliance, revealed no significant treatment effects. Differential treatment effects were identified after stratification according to scores on the Alcohol Dependence Scale (ADS) and Depression Anxiety and Stress Scale (DASS). A significant beneficial treatment effect on time to first relapse was revealed for subjects with ,no depression' allocated to naltrexone (n = 56; P < 0.01). In addition, a significant beneficial treatment effect was revealed in subjects with ,low dependence' allocated to naltrexone (n = 34; P < 0.05). Conclusions The results of this study support the efficacy of naltrexone in the relapse prevention of alcoholism amongst those with low levels of clinical depression and alcohol dependence severity. No effect of acamprosate was found in our sample. [source] Depressive symptoms among mothers of children with epilepsy: A review of prevalence, associated factors, and impact on childrenEPILEPSIA, Issue 11 2009Mark A. Ferro Summary The impact of epilepsy is not limited to the child experiencing seizures, but affects all members of the family. As primary caregivers, mothers are particularly at risk for experiencing increased depressive symptoms and risk for clinical depression. The objective of this systematic review was to critically assess available evidence regarding the prevalence, associated factors, and impact of maternal depressive symptoms on child outcomes in epilepsy. Using a modified version of the Quality Index, studies were rigorously evaluated in terms of reporting, external validity, and internal validity. Limitations in the study designs and analytic techniques of previous research are discussed, and study methods to overcome these barriers are presented in order to advance this research area. Up to 50% of mothers of children with epilepsy are at risk for clinical depression. Correlates of maternal depressive symptoms include a number of modifiable risk factors such as role ambiguity, worry, and satisfaction with relationships. In addition, studies suggest that depressive symptoms in mothers have a negative impact on child outcomes in epilepsy including behavior problems and health-related quality of life. The overall mean score on the Quality Index was 9.7, indicating a midrange quality score, suggesting a need for more methodologically robust studies. [source] The effects of physical exercise on depressive symptoms among the aged: a systematic reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2006Noora Sjösten Abstract Objective To determine the effects of physical exercise on depression or depressive symptoms among the aged. Method A literature search covering various medical databases was conducted to identify randomised controlled trials (RCT's) about the effects of exercise treatments on depression or depressive symptoms among the aged. The studies were classified according to the baseline depression status of participants and assessed in relation to allocation concealment, blinding at outcome assessment, follow-up and whether intention to treat analysis was used. Studies meeting the inclusion criteria were accepted. Results Exercise was effective in treating depression among those suffering from minor or major depression and in reducing depressive symptoms among those with a high amount of depressive symptoms at baseline. However, both the allocation concealment and the blinding method were adequately described in only four studies. Furthermore, intention-to-treat analysis was conducted in half of the studies and some follow-up information after the intervention has been published for five studies. Conclusions Physical exercise may be efficient in reducing clinical depression and depressive symptoms in the short-term among the aged suffering from depression or a high amount of depressive symptoms. More well controlled studies are needed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Risk Factors for Potentially Harmful Informal Caregiver BehaviorJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2005Scott R. Beach PhD Objectives: Caring for a sick or disabled relative has been linked to compromised caregiver health, and risk factors for negative caregiver outcomes have been studied extensively, but little attention has been given to care recipient and caregiver health as risk factors for potentially harmful behavior by informal caregivers. This article explores such risk factors. Design: Structured interviews from baseline assessment of the Family Relationships in Late Life Study. Setting: Three U.S. communities. Participants: Referred, volunteer sample of 265 caregiver/care recipient dyads. Caregivers were primarily responsible for care of an impaired, community-residing family member aged 60 and older and providing help with at least one activity of daily living (ADL) or two instrumental activities of daily living (IADLs). Measurements: Self-reported care recipient demographics, cognitive status, need for care, and self-rated health; self-reported caregiver demographics, cognitive status, amount of care provided, self-rated health, physical symptoms, and depression. Care recipient reports of potentially harmful caregiver behavior, including screaming and yelling, insulting or swearing, threatening to send to a nursing home, and withholding food, were the main outcome variable. Results: The following were significant risk factors for potentially harmful caregiver behavior: greater care recipient ADL/IADL needs (odds ratio (OR)=1.12, 95% confidence interval (CI)=1.03,1.22), spouse caregivers (vs others; OR=8.00, 95% CI=1.71,37.47), greater caregiver cognitive impairment (OR=1.20, 95% CI=1.04,1.38), more caregiver physical symptoms (OR=1.07, 95% CI=1.01,1.13), and caregivers at risk for clinical depression (OR=3.47, 95% CI=1.58,7.62). Conclusion: Potentially harmful caregiver behavior is more likely in spouse caregiving situations and when care recipients have greater needs for care and caregivers are more cognitively impaired, have more physical symptoms, and are at risk for clinical depression. This risk profile is similar to that for negative caregiver outcomes. [source] Depressive Symptoms and Associated Factors in Children With Attention Deficit Hyperactivity DisorderJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 2 2004Nancy LeBlanc PhD(c) PROBLEM To compare depressive symptoms in children with attention deficit hyperactivity disorder (ADHD) to those in healthy children, and to explore the influence of individual and family factors on level of depression. METHODS Individual interviews with 68 children, ages 7 to 12 years, in order to complete the Children's Depression Inventory. FINDINGS Children with ADHD reported significantly more depressive symptoms than did children without ADHD; 14.7% of children with ADHD reached the threshold of a 19 point score, which suggests clinical depression. No significant effects of individual and family factors on level of depression were found. CONCLUSIONS Children with ADHD are more inclined to experience depressive symptoms than are healthy children. To plan appropriate interventions, nurses evaluating and working with children with ADHD should always consider a possible coexistence of depressive symptoms. [source] Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trialsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2010Luke G. Perraton BPT MPT Abstract Rationale, aims and objectives, Previous systematic reviews have concluded that exercise programmes are effective in the management of clinical depression. The aim of this review was to analyse the parameters of exercise programmes reported in the primary research, in order to provide clinicians with evidence-based recommendations for exercise prescription for clinical depression. Methods, A systematic review of randomized controlled trials was undertaken. Only trials that reported exercise to be effective in treating depression were included and our review was limited to adults. Appropriate databases and reference lists were searched using established keywords. Data relating to the type, intensity, frequency, duration, mode of exercise and mode of application of exercise was extracted and collated. Results, A total of 14 randomized controlled trials were included in this review and from these trials 20 intervention arms were analysed. The majority of trials used an aerobic exercise intervention and were supervised. The most common exercise parameters were 60,80% of maximum heart rate for 30 minutes three times per week for an overall duration of 8 weeks. There is an equal volume of evidence supporting group as opposed to individually completed exercise programmes and no trends were identified which would support one mode of exercise over another. Conclusions, Currently the primary research on this topic supports the use of aerobic exercise which is supervised in some capacity. The current evidence base supports a prescription of three 30-minute sessions per week of aerobic exercise at 60,80% of maximum heart rate for at least 8 weeks. [source] Chronic Pain, Chronic Stress and Depression: Coincidence or Consequence?JOURNAL OF NEUROENDOCRINOLOGY, Issue 12 2001G. Blackburn-Munro Abstract Chronic pain and depressive illness are debilitating disease states that are variably resistant to currently available therapeutic agents. Animal models of chronic pain are associated with activation of the hypothalamo-pituitary-adrenal (HPA) axis, upon which chronic pain acts as an inescapable stressor. Inescapable stress is also associated with ,depressive-like' symptoms in experimental animals. Based on reports of the comorbidity between chronic pain and depressive illness in human patients, it is possible that these disease states are linked, via chronic stress-induced HPA dysfunction. Here, we discuss the possible involvement of the HPA axis in the aetiology of both chronic pain and clinical depression, and suggest a strategy for the development of novel pharmacotherapies. [source] Upregulation of Serotonin Transporter by Alcohol in Human Dendritic Cells: Possible Implication in Neuroimmune DeregulationALCOHOLISM, Issue 10 2009Dakshayani Kadiyala Babu Background:, Alcohol is the most widely abused substance and its chronic consumption causes neurobehavioral disorders. It has been shown that alcohol affects the function of immune cells. Dendritic cells (DC) serve as the first line of defense against infections and are known to accumulate neurotransmitters such as 5-hydroxytryptamine (5-HT). The enzyme monoamine oxidase-A (MAO-A) degrades 5-HT that is associated with clinical depression and other neurological disorders. 5-HT is selectively transported into neurons through the serotonin transporter (SERT), which is a member of the sodium- and chloride-dependent neurotransmitter transporter (SLC6) family. SERT also serves as a receptor for psychostimulant recreational drugs. It has been demonstrated that several drugs of abuse such as amphetamine and cocaine inhibit the SERT expression; however, the role of alcohol is yet to be elucidated. We hypothesize that alcohol can modulate SERT and MAO-A expression in DC, leading to reciprocal downregulation of 5-HT in extracellular medium. Methods:, Dendritic cells were treated with different concentrations (0.05% to 0.2%v/v) of alcohol for 24,72 hours and processed for SERT and MAO-A expression using Q-PCR and Western blots analysis. In addition, SERT function in DC treated with alcohol both in the presence and absence of imipramine, a SERT inhibitor was measured using 4-[4-(dimethylamino)styryl]-1-methylpyridinium iodide uptake assay. 5-HT levels in culture supernatant and intracellular 5-hydroxy indole acetic acid (5-HIAA) and cyclic AMP were also quantitated using ELISA. Results:, Dendritic cells treated with 0.1% alcohol for 24 hours showed significant upregulation of SERT and MAO-A expression compared with untreated DC. We also observed that 0.1% alcohol enhanced the function of SERT and decreased extracellular 5-HT levels compared with untreated DC cultures, and this was associated with the elevation of intracellular 5-HIAA and cyclic AMP levels. Conclusions:, Our study suggests that alcohol upregulates SERT and MAO-A by elevating cyclic AMP, which may lead to decreased concentration of 5-HT in the extracellular medium. As 5-HT is a major neurotransmitter and an inflammatory mediator, its alcohol-mediated depletion may cause both neurological and immunological deregulation. [source] Psychosocial well-being of patients with skin diseases in general practiceJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2007EWM Verhoeven Abstract Background, Skin diseases are a substantial part of the problems dealt with by general practitioners. Although the psychosocial consequences of skin diseases in secondary care has been extensively studied, little is known about the psychosocial well-being of patients with skin diseases in primary care. Objective, To investigate the psychosocial well-being of patients with skin diseases in primary care. Patients/methods, Questionnaires about the psychosocial consequences of skin diseases were sent to patients with a skin disease who were registered within a research network (continuous morbidity registration) of general practices that continuously have recorded morbidity data since 1971. Questionnaires completed by 532 patients were eventually suitable for analyses. Results, Compared with the general population, patients with skin diseases reported significantly lower scores for psychosocial well-being. Furthermore, a lower psychosocial wellbeing was significantly related with higher levels of disease-severity, lower disease-related quality of life, longer disease duration, more comorbidity and more physical symptoms of itch, pain and fatigue. After demographic variables and comorbidity were controlled for, sequential regression analyses showed that disease duration, disease severity and physical symptoms (itch, pain and fatigue) were significant predictors of psychosocial well-being. Conclusion, The psychosocial well-being of patients with skin diseases in primary care is lower than that of the general population. Special attention has to be directed to those patients with lowered psychosocial well-being who might be at risk of developing severe psychosocial impairments such as clinical depression. [source] Interaction between psychiatric and autoimmune disorders in coeliac disease patients in the Northeastern United StatesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2009S. GARUD Summary Background, Previous studies yielded conflicting results regarding the presence of an association between coeliac disease (CD) and psychiatric disorders including depression. This association has not been studied in the United States. Aim, To determine the prevalence of psychiatric and autoimmune disorders in patients with CD in the US compared with control groups. Methods, In a case control study, the prevalence of psychiatric and autoimmune disorders was compared in 600 CD patients, 200 irritable bowel syndrome (IBS) patients and 200 healthy controls. Results, The prevalence of depression in CD was 17.2% and was similar to that in IBS (18.5%, P = 0.74) and controls (16.0%, P = 0.79). Among CD patients, type I diabetes mellitus (DM) was identified as a significant risk factor for depression (P < 0.01) with 37% of patients with both CD and type I DM having clinical depression. Conclusion, The prevalence of depression in CD is similar to that in other chronic gastrointestinal diseases and healthy controls. However, there is a markedly elevated risk of depression in patients with both type I DM and CD. Differing rates of type 1 DM among coeliac populations may account for disparity in published rates of depression in patients with CD. [source] Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer carePSYCHO-ONCOLOGY, Issue 1 2009David Kissane The psychotherapy and cancer survival debate generated great interest in the psychoneuroimmunological and bio-behavioral mechanisms that might mediate any gain in survival. Recent methodologically-improved cognitive-existential, supportive-expressive and psycho-educational group interventions for patients with breast cancer and melanoma have not extended survival times. Shorter survival has been associated with social disparity and untreated clinical depression, potentially mediated by poorer adherence to anti-cancer treatments. Group therapy both prevents and treats depression. Future research could address these bio-behavioral mechanisms. Copyright © 2008 John Wiley & Sons, Ltd. [source] The validity of the family relationships index as a screening tool for psychological risk in families of cancer patientsPSYCHO-ONCOLOGY, Issue 7 2005Ben Edwards The Family Relationships Inventory (FRI) has been proposed as a measure of psychological risk however its validity has only been tested in one cross-sectional study against another measure of family functioning where patients had less than six months to live. The current study presented longitudinal data on the validity of the FRI in identifying family dysfunction, and clinical levels of depression and anxiety in 48 families where the patient had been recently diagnosed. Over the three phases, the FRI identified all families at risk of family dysfunction, 88% or more families with one or more members with clinical depression and 78% or more with a member with clinical levels of anxiety. The FRI was also far more sensitive in identifying families with a member with clinical levels of depression and anxiety than the General Functioning (FAD-GF) scale of the Family Assessment Device. Although other measures of screening adequacy (such as specificity), suggested that the FRI identified too many false positives, the higher sensitivity of the FRI makes it preferable to the FAD-GF as a screening measure for families at risk of a poor psychological outcome in the oncology setting. However, because of the FRI's poor specificity, further follow-up of those families that are identified as being at some risk of a poor psychological outcome should be undertaken before referral to a mental health professional is warranted. Copyright © 2004 John Wiley & Sons, Ltd. [source] Correlates of fatigue in critical care nurses,,RESEARCH IN NURSING & HEALTH, Issue 6 2003Jeanne S. Ruggiero Abstract The purposes of this study were to examine shift-related differences in chronic fatigue and the contributions of sleep quality, anxiety, and depression to chronic fatigue among a random nationwide sample (N,=,142) of female critical care nurses. Twenty-three percent of this sample met criteria for clinical depression. Day and night nurses did not differ in their reports of chronic fatigue. Night nurses reported more depression and poorer sleep quality than did day nurses. Regression analyses indicated that among the variables of global sleep quality, depression, and anxiety, depression and sleep quality were the most relevant to the explanation of chronic fatigue. These findings suggest the need for studies of strategies to promote sleep and improve mood in critical care nurses. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:434,444, 2003 [source] Modifying interpretation and imagination in clinical depression: A single case series using cognitive bias modificationAPPLIED COGNITIVE PSYCHOLOGY, Issue 3 2010Simon E. Blackwell The current cognitive bias modification (CBM) paradigm targets interpretation bias (CBM-I) in depression via promoting positive imagery. We investigated the impact of repeated sessions of this CBM-I on interpretation bias, mood and mental health in participants currently experiencing a major depressive episode. Seven participants completed daily sessions of CBM-I at home for one week in a single case series. Outcome measures were completed pre and post a one-week baseline period, and after the week of daily CBM-I. Depressive symptoms were also assessed at a 2-week follow-up. Four of seven participants demonstrated improvements in mood, bias and/or mental health after one week of CBM-I, with improvements in depressive symptoms maintained at follow-up. Discussion of the remaining three highlights difficulties involved in translating CBM-I interventions from the laboratory to the clinic. To bridge this gap, we suggest that it is critical to examine the failures as well as the successes. Copyright © 2010 John Wiley & Sons, Ltd. [source] Psychological Characteristics and Social Integration of Patients with Ischemic and Non-Ischemic Heart Failure Newly Listed for Heart Transplantation: The Waiting for a New Heart StudyAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 2 2009Heike Spaderna It is not known whether psychosocial risk factors for coronary artery disease (CAD) are present in patients listed for heart transplantation (HTx). The aim of this study was to examine whether HTx candidates with ischemic heart failure (due to CAD) have an adverse psychological risk profile and reduced social integration compared to patients with non-ischemic etiology. In the multi-site study "Waiting for a New Heart", waiting-list-related stressors, depression, anxiety, trait-anger, anger-expression, dispositional coping, social integration, and social support were assessed in 318 newly registered HTx candidates (53.5 ± 11.4 years, 18% female, left ventricular ejection fraction <25%). Medical parameters at time of listing were provided by Eurotransplant. Analyses revealed a high level of stress (on average 70% of 50 HTx-related stressors), and signs of clinical depression in 39 per cent of the sample. Social integration was correlated with reduced depression (p < .05). While ischemic and non-ischemic groups were comparable in terms of disease severity, men with CAD reported significantly more anxiety, anger, anger-in, and less social integration than non-ischemic men after adjusting for age and marital status (ps < .05). To conclude, psychosocial stress is common in HTx candidates, particularly in men with underlying CAD. Thus, targeting psychosocial stress and increasing social integration may enhance well-being in patients waiting for a new heart. [source] Prevalence of depression among adults in Oyo State, Nigeria: A comparative study of rural and urban communitiesAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2007Olorunfemi Amoran Abstract Objective:,This study was designed to assess the current prevalence of depression in Oyo State, Nigeria and the rural,urban variation in prevalence. Setting:,This is a two-phase community-based cross-sectional study. The urban areas selected for the study are the Ibadan North-West and Egbeda local government areas. The rural area selected was the Saki-East local government area. Participants:,A total of 1105 participants were recruited into the study. Multistage sampling technique was used to obtain a representative sample of the participants from the communities in Oyo State. The study was conducted using an interviewer-administered structured questionnaire, and the general health questionnaire (GHQ 12) as a screening tool. The second phase of the interview was conducted only for those participants with a score of more than 3 using the GHQ 12. These participants were then clinically examined using the Structured Clinical Interview DSM IV for assessment of clinical depression. Main outcome measure:,Prevalence of depression. Results:,A total of 721 (65.2%) were from urban communities, while 384 (34.8%) were from the rural community. The overall prevalence of depression was found to be 5.2%. Depression was more prevalent among women than men (5.7% vs 4.8%, ,2 = 0.36 P = 0.55), and among adolescents (9.6%, P = 0.04). Furthermore, depression was more common in the rural areas than in the urban areas (7.3% vs 4.2%, ,2 = 4.94 P = 0.02). Conclusion:,Depression is more common in rural than urban areas in the Nigerian population. Mental health education for adolescents and secondary school students should be encouraged in rural communities. [source] The relationships among clinical depression, suicide, and other actions that may hasten deathBEHAVIORAL SCIENCES & THE LAW, Issue 5 2004James L. Werth Jr. Ph.D. Clinical depression and other psychological disorders have been associated with suicidal ideation, attempts, and deaths. Because of the link between suicide and mental illness, whenever discussion of "assisted suicide" arises, the possibility that major depression is affecting the decision arises. This article examines the literature on clinical depression as it relates to suicide, "assisted suicide," and other decisions that will hasten death (i.e. withholding and withdrawing treatment, terminal sedation, and voluntarily stopping eating and drinking). Ethical and legal considerations when working with individuals who are considering taking an action that would hasten death are also briefly reviewed. The article ends with practice and policy recommendations. Copyright © 2004 John Wiley & Sons, Ltd. [source] Double trouble: maternal depression and alcohol dependence as combined factors in child and family social workCHILDREN & SOCIETY, Issue 4 2002Johanna Woodcock This study, part of a large programme of research incorporating four child and family care teams, focuses on the combined effects of alcohol dependence alongside clinical depression in mothers. A comparison is made between women who were clinically depressed and women who were both clinically depressed and alcohol dependent. The latter group had significantly higher levels of difficulty in social relationship, health, child, and particularly parenting problems. When considered alongside the intensity, duration and range of intervention required, the results indicated that there is considerable concern about the ,dangerousness' of this particular group with major implications for policy and practice. Copyright © 2002 John Wiley & Sons, Ltd. [source] Factitious panniculitis masquerading as pyoderma gangrenosumCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2005C. C. Y. Oh Summary We report a case of factitious panniculitis masquerading as florid pyoderma gangrenosum in a 35-year-old woman. At presentation, she had tender, ecchymotic plaques over the lower trunk and limbs, and several biopsies showed active lobular panniculitis. However, the extensive ulceration that ensued was clinically persuasive for pyoderma gangrenosum. We elected to treat the inflammatory element symptomatically with a range of topical and systemic medications including clobetasol propionate, tacrolimus 0.1% ointment, prednisolone, dapsone, cyclosporin A and mycophenolate mofetil, none of which effected an improvement. The possibility of a factitious aetiology had been suspected from the outset, and when signs of clinical depression emerged, antidepressant therapy was initiated and the ulcers were encased in fibreglass casts. Within a short period, healing commenced and slowly progressed with scar formation. In retrospect, we consider the diagnosis to have been factitious panniculitis on the basis of strong circumstantial evidence and the disparity between the histological and clinical features. [source] Depressive deficits and bias: a direct comparison of two implicit measures of memory,CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 1 2001Glenys Caseley-Rondi Repeated findings of depressive deficits and mood-congruent biases on explicit measures of memory have lent much support to cognitive models of depression. However, studies to date have been inconclusive with respect to such deficits or biases on implicit measures. Given current assertions that implicit use of memory is far more pervasive than explicit use, clarification of these issues has important implications for our understanding of cognitive factors in clinical depression and its treatment. We consider both these issues, and, in particular, we follow up the suggestion by Roediger and McDermott (1992) that conceptually driven implicit measures of memory are more appropriate to detect depressive bias than those that are typically used, which are perceptually driven. In this study we directly compare the memory performance of 24 clinically depressed patients with 24 nondepressed controls on a perceptually driven implicit task (fragment completion) and a comparable task that is more conceptually driven (cued fragment completion). Although depressive deficits were obtained on both these measures, no bias was revealed. We consider alternative research designs for clarification of these findings. Copyright © 2001 John Wiley & Sons, Ltd. [source] Elucidating the Relationship Between Obesity and Depression: Recommendations for Future ResearchCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2008Joshua I. Hrabosky The obese population is heterogeneous in its experiences of psychosocial disturbances, yet many obese individuals do experience such problems as body image disturbance, low self-esteem, diminished self-efficacy, and binge eating. Furthermore, recent research has repeatedly found obesity to correlate with negative affect, depressed mood, and clinical depression. In their comprehensive review, Markowitz, Friedman, and Arent (2008) identify numerous psychosocial and biological processes that they hypothesize to act as mediating factors in the relationship between obesity and depression. This commentary extends Markowitz and colleagues' review and proposed causal pathway model by (a) evaluating the specificity of the relationship between obesity and depression, and (b) providing recommendations for the empirical evaluation of causal hypotheses. [source] | |||||||||||||||||||||||||||||||