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Severe Depressive Symptoms (severe + depressive_symptom)
Selected AbstractsCaregiver Depressive Symptoms and Observed Family Interaction in Low-Income Children with Persistent AsthmaFAMILY PROCESS, Issue 1 2008MARIANNE CELANO PH.D. This study examined the relationship between caregiver depressive symptoms and observed parenting behaviors and family processes during interactions among 101 urban, low-income Africtan American families with children with persistent asthma. Caregivers (primarily female) were assessed on four dimensions (i.e., warmth/involvement, hostility, consistent discipline, relationship quality) in three videotaped interaction tasks (loss, conflict, cohesion). The results indicated that increased depressive symptoms were significantly associated with lower warmth/involvement and synchrony scores and greater hostility scores during the loss and conflict tasks. In the total sample, the highest levels of hostility and the lowest levels of warmth/involvement were found for the conflict task; nevertheless, caregivers with moderate/severe depressive symptoms showed a significantly greater increase in hostility from the loss to the conflict task than caregivers with minimal/mild depressive symptoms. The findings highlight the salience of considering task content in family observational process research to expand our understanding of depressed and nondepressed caregivers' abilities to modulate appropriately their behaviors and affect across various family interactions. Implications for improving asthma management for low-income children with persistent asthma are discussed, including the utility of multidisciplinary interventions that combine asthma education with family therapy. RESUMEN Síntomas de depresión en los responsables de los niños e interacción familiar observada en niños de familias de bajos ingresos que padecen asma crónica Este estudio examinó la relación entre los síntomas de depresión de los responsables de los niños y los comportamientos paternos y dinámicas familiares observados durante interacciones entre 101 familias afronorteamericanas, urbanas y de bajos recursos, con niños que padecen asma crónica. Los responsables de los niños (la mayoría mujeres) fueron evaluados en base a cuatro criterios: calidez/implicación, hostilidad, disciplina constante, y calidad de la relación) en tres tareas de interacción grabadas en cinta de video (pérdida, conflicto y cohesión). Los resultados demostraron que el aumento de los síntomas de depresión estaban relacionados de forma significativa con una menor puntuación en calidez/implicación y comprensión mutua, y una mayor puntuación en hostilidad durante las tareas de pérdida y conflicto. En la muestra total, los mayores niveles de hostilidad y menores niveles de calidez/implicación se encontraron en la tarea de conflicto; sin embargo, los responsables con síntomas de depresión de moderados a severos mostraron un aumento mucho mayor de la hostilidad, de la tarea de pérdida a la de conflicto, que los responsables con síntomas de mínimos a leves. Los resultados enfatizan la importancia de considerar el contenido de la tarea en la investigación observacional de familias para aumentar nuestra comprensión de las habilidades de los responsables de los niños, con o sin depresión, con el fin de modular de una manera apropiada su comportamiento y afecto en diferentes interacciones familiares. Las medidas para mejorar el control del asma en niños que padecen asma crónica y provienen de familias de bajos ingresos están en debate, incluida la utilidad de intervenciones multidisciplinarias que combinen formación sobre el asma con terapia familiar. [source] Screening for Adolescent Depression in a Pediatric Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 5 2006Emily Gale Scott MD Abstract Objectives: To describe the prevalence of depressive symptoms in adolescents presenting to the emergency department (ED) and to describe their demographics and outcomes compared with adolescents endorsing low levels of depressive symptoms. Methods: The Beck Depression Inventory,2nd edition (BDI-II) was used to screen all patients 13,19 years of age who presented to the ED during the period of study. The BDI-II is a 21-item self-report instrument used to measure the presence and severity of depressive symptoms in adolescents and adults. Demographics and clinical outcomes of screening-program participants were abstracted by chart review. Patients were categorized into one of four severity categories (minimal, mild, moderate, or severe) and one of three presenting complaint categories (medical, trauma, mental health). Results: Four hundred eighty-seven patients were approached, and 351(72%) completed the screening protocol. Participants endorsed minimal (n= 192, 55%), mild (n= 52, 15%), moderate (n= 41, 11%), or severe depressive symptoms (n= 66, 19%). Those with moderate or severe depressive symptoms were more likely to be hospitalized. Of patients completing the BDI-II, 72% with psychiatric, 12% with traumatic, and 19% with medical chief complaints endorsed either moderate or severe depressive symptoms. Conclusions: Depressive symptoms are prevalent in this screening sample, regardless of presenting complaint. A substantial proportion of patients with nonpsychiatric chief complaints endorsed moderate or severe depressive symptoms. A screening program might allow earlier identification and referral of patients at risk for depression. [source] Infant colic and maternal depressionINFANT MENTAL HEALTH JOURNAL, Issue 1 2005Aimee E. Maxted The combined impact of infant colic and maternal depression on infant, parent, and family difficulties was examined. The sample included 93 consecutive patients seen at an outpatient Colic Clinic. Most mothers had private insurance and completed high school. Infants were approximately 2 months of age. Questionnaires completed by the mother prior to treatment onset were used to measure depressive symptoms in the mothers, infant cry, sleep and temperament, characteristics, parenting stress, maternal self-esteem, social support, and family function. Moderate to severe depressive symptoms were reported by 45.2% of the mothers. More severe depressive symptoms in the mothers were related to fussy/difficult infant temperament, more parenting stress, lower parental self-esteem, and more family-functioning problems. Pediatric health care providers need to be aware that the combined effects of colic and maternal depression can be problematic for the family. ©2005 Michigan Association for Infant Mental Health. [source] Correlates of smoking among adolescents with asthmaJOURNAL OF CLINICAL NURSING, Issue 5-6 2010Su-Er Guo Aims and objective., This study examined the correlates of smoking among asthmatic adolescents to gain a better understanding of who is at particular risk. Background., Smoking is especially harmful to individuals with asthma. However, smoking is surprisingly prevalent among asthmatic individuals, with prevalence rates similar to or higher than those of the general adult or adolescent populations. Despite this notable finding, there has been little research about factors (i.e. biophysical, psychosocial and behavioural) influencing asthmatic adolescents' tobacco use patterns. Design., A Canadian provincial cross-sectional survey. Method., The study about adolescents' tobacco use and health status was conducted in secondary schools in 2004, 608 asthmatic adolescents participated. Demographic factors, biophysical (body mass index and physical health), psychosocial factors (parents' and peers' smoking, environmental tobacco smoke exposure and depression) and behavioural factors (marijuana use, alcohol use and exercise frequency) were explored. Multinomial logistic regression analyses were conducted to identify risk factors associated with tobacco use. Results and conclusions., Of the 608 asthmatic adolescents, 17·4% currently smoked and 12·0% formerly smoked. Girls, compared with boys, were more likely to smoke (OR: 3·34, 95% CI: 1·62,6·96) after adjusting for differences in the other demographic, biophysical, psychosocial and behavioural factors. Asthmatic girls who had relatively higher body mass index, were in the higher school grades, used marijuana or alcohol, had minor to severe depressive symptoms, had environmental tobacco smoke exposure in their homes and had friends who smoked or were currently more likely to smoke. The former smokers had similar risk factors including higher body mass index, environmental tobacco smoke exposure at home, friends who smoked and marijuana use. Relevance to clinical practice., Despite their health condition, asthmatic adolescents continue currently or formerly to smoke. Gender appropriate prevention and cessation interventions for asthmatic adolescents may need to address important psychosocial and environmental factors that increase the risk of these adolescents initiating and maintaining tobacco use. [source] Chronic pain in Parkinson's disease: The cross-sectional French DoPaMiP surveyMOVEMENT DISORDERS, Issue 10 2008Laurence Nègre-Pagès PhD Abstract Pain is a frequent, but poorly studied symptom of Parkinson's disease (PD). DoPaMiP survey aimed to assess the prevalence of chronic pain in PD, to describe PD patients with chronic pain, and to record analgesic consumption. About 450 parkinsonian patients underwent structured standardized clinical examination and completed self-reported questionnaires in a cross sectional survey. Pains related or unrelated to PD were identified according to predefined criteria. About 98 patients with other chronic disorders than PD were examined to assess if pain was more frequent in PD than in this population. Two thirds parkinsonian patients (278 of 450) had chronic pain. Twenty-five patients with non-chronic pain (<3-month duration) were excluded from subsequent analysis. Twenty six percent (111 of 425) parkinsonian patients had pain unrelated to PD ("non-PD-pain", caused mainly by osteoarthritis), while 39.3% (167 of 425) had chronic pain related to PD ("PD-pain"). In this last group, PD was the sole cause of pain in 103 and indirectly aggravated pain of another origin (mainly osteoarthritis) in 64. Parkinsonian patients with "PD-pain" were younger at PD onset, had more motor complications, more severe depressive symptoms than those without pain or with "non-PD pain." "PD-pain" was more intense (P = 0.03), but was less frequently reported to doctors (P = 0.02), and was associated with less frequent analgesic consumption than "non-PD-pain." Pain was twice more frequent in PD patients than in patients without PD after adjustment for osteo-articular comorbidities (OR = 1.9; 95% CI 1.2,3.2). Chronic pain is frequent but underreported in PD. Awareness of this problem should be increased and the assessment of analgesic strategies improved. © 2008 Movement Disorder Society [source] Unsuspected or Unacknowledged Depressive Symptoms in Young Adult Emergency Department PatientsACADEMIC EMERGENCY MEDICINE, Issue 4 2009Michelle H. Biros MD Abstract Objectives:, The objective was to determine the frequency of unsuspected or unacknowledged depressive symptoms among young adult emergency department (ED) patients. Methods:, The Beck Depression Inventory-II (BDI-II) and a demographic/lifestyle questionnaire were administered to a cross-section of medically stable, English-speaking young adult ED patients (aged 18,23 years) with nonpsychiatric chief complaints. The frequency of moderate to severe depressive symptoms was determined. Group results were analyzed with descriptive statistics; multivariate analysis assessed for patient characteristics associated with depressive symptoms. Results:, A total of 2,898 patients were screened; 2,255 were eligible for enrollment, and 1,264 enrolled (56%; 64% female, 42% African American; mean age = 21 [±1.7] years). Twenty-nine percent had BDI-II scores consistent with moderate to severe depressive symptoms. Patient characteristics associated with depressive symptoms included knowledge of someone who had intentionally hurt him- or herself (odds ratio [OR] = 2) or died a violent nonaccidental death (OR = 1.4), low personal income (OR = 1.8), chronic health issues (OR = 1.7), cigarette smoking (OR = 1.6), and African American race (OR = 1.5). Those who attended school (OR = 0.5), engaged in frequent social activities (OR = 0.5), or drove a car (OR = 0.7) were less likely to have depressive symptoms. Patients lacked insight into their depressive symptoms. Conclusions:, There is a high prevalence of depressive symptoms in young adult ED patients. Young adults often do not recognize, or are reluctant to acknowledge, depressive symptoms. Specific patient characteristics may be useful in deciding which young adults should undergo ED screening for depression. [source] Medication adherence skills training for middle-aged and elderly adults with bipolar disorder: development and pilot studyBIPOLAR DISORDERS, Issue 6 2007Colin A Depp Objectives:, To present the rationale, development, and pilot study of a medication adherence skills training (MAST-BD) intervention for older adults with bipolar disorder (BPD). We developed a 12-week manualized group intervention that combined educational, motivational, medication management skills and symptom management training adapted for older adults. Methods:, Among 21 older outpatients with BPD (mean age = 60 years; SD = 6), the feasibility and acceptability of MAST-BD were assessed in a quasi-experimental clinical trial. We also obtained preliminary effect sizes associated with pre,post change on measures of self-reported adherence to psychiatric medications, performance-based medication management ability, attitudes toward medication, depressive and manic symptoms, and health-related quality of life. Results:, At baseline, 55% of participants reported recent non-adherence to psychiatric medications and were, on average, suffering from moderately severe depressive symptoms and minimal symptoms of mania. A total of 76% of participants completed the intervention, and 86% of sessions were attended by completers. Participants reported high levels of satisfaction with the intervention and manual. Pre,post improvement by small to medium effect sizes (Cohen's d = 0.30,0.57) was seen in medication adherence, medication management ability, depressive symptoms, and selected indices of health-related quality of life. Conclusions:, Notwithstanding the limitations of this small preliminary study, the results are encouraging in that the MAST-BD intervention was feasible, acceptable to patients, and associated with improvement in key outcomes. Suggestions for further development of medication adherence interventions for this neglected group of patients are discussed. [source] | |||||||||||||