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Depressed Mood (depressed + mood)
Selected AbstractsThe Effect of Maternal Depressed Mood on Infant Emotional Reaction in a Surprise-Eliciting SituationINFANT MENTAL HEALTH JOURNAL, Issue 2 2006Nadja Reissland The purpose of this study is to examine the claim that an infant's ability to respond appropriately to an emotional situation varies according to the emotional state of the mother. Surprise expressions in mother and child were examined both in terms of paralinguistic aspects of surprise vocalizations as well as facial expressions. Seventy-two infants and their mothers (mean age=8 months, range=5,11 months) were video- and audiotaped in their homes. Half of the infants, matched for age and gender, had mothers who reported depressed mood. Infants of mothers with depressed mood showed significantly fewer components of facial expressions of surprise compared with infants of nondepressed mothers. Mothers with depressed mood exclaimed surprise with a significantly lower pitch (mean F0=386.13 Hz) compared to nondepressed mothers (mean F0=438.10 Hz). Furthermore, mothers with depressed mood showed fewer associations between elements of emotional expression than the nondepressed group. Infants' expressions of surprise are influenced by maternal mood, resulting in reduced expression of the emotion in infants of mothers with depressed mood. These results are discussed in terms of coordination of vocal parameters in mother,infant dyadic interaction. [source] Sleep Apnea, Delirium, Depressed Mood, Cognition, and ADL Ability After StrokeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2001Olov Sandberg MD OBJECTIVES: The incidence of sleep apnea and stroke increases with age. The aim of this study was to investigate the presence of sleep apnea after stroke and its relationship to delirium, depressed mood, cognitive functioning, ability to perform activities of daily living (ADLs), and psychiatric and behavior symptoms. DESIGN:Cross-sectional study. SETTING:Geriatric stroke rehabilitation unit. PARTICIPANTS:133 patients (78 women and 55 men, mean age 77.1 ± 7.7 years) consecutively admitted to a geriatric stroke rehabilitation unit. MEASUREMENTS: All patients underwent overnight respiratory sleep recordings at 23 ± 7 days (range 11 to 41 days) after suffering a stroke. The patients were assessed using the Organic Brain Syndrome Scale, Montgomery-Ĺsberg-Depression-Rating Scale, Mini-Mental State Examination (MMSE), and Barthel-ADL Index. Sleep apnea was defined as an apnea-hypopnea index (AHI) of 10 or more. RESULTS: The median of the AHI for the studied sample (N = 133) was 13 (range 0,79; interquartile range 6,28). Fifty-nine percent fulfilled the criteria for sleep apnea; 52% with first-ever stroke had sleep apnea. More patients with sleep apnea than without were delirious, depressed, or more ADL-dependent. Sleep apnea patients also had a higher frequency of ischemic heart disease and had more often suffered from an earlier cerebral infarction. Multivariate analysis showed that obesity, low ADL scores, ischemic heart disease, and depressed mood were independently associated with sleep apnea. Low ADL scores, apnea-related hypoxemia, body mass index ,27, and impaired vision were independently associated with delirium. The presence of sleep apnea was not associated with any specific type of stroke or location of the brain lesion. CONCLUSIONS:Sleep apnea is common in stroke patients and is associated with delirium, depressed mood, latency in reaction and in response to verbal stimuli, and impaired ADL ability. We suggest a trial investigating whether delirium, depressed mood, and ADL ability improve with nasal continuous positive airway pressure treatment of sleep apnea in stroke patients. [source] Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free dietALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2009C. HALLERT Summary Background, Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status. Aim, To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease. Methods, In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45,64 years on a strict gluten-free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status. Results, Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 ,mol/L (7.4,23.0), significantly higher than in matched population controls [10.2 ,mol/L (6.7,22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well-being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well-being. Conclusions, Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet. [source] The Relationship Between Emotional Resources and Emotional Labor: An Exploratory StudyJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 10 2008Yongmei Liu The study examines the effects of a subtype of personal resources (i.e., emotional resources) on emotional labor strategies. We examined 2 variables, emotional intelligence and negative affectivity, as proxies for emotional resources. Largely consistent with predictions, results indicated that individuals with a high level of emotional resources (indicated by high emotional intelligence) are more likely than others to deep act, and individuals with comparatively low emotional resources (indicated by high negative affectivity) are more likely than others to surface act. The differential effects of surface acting and deep acting on strain and job satisfaction were examined. Depressed mood was found to mediate the relationship between surface acting and job satisfaction. [source] Evaluation of a group cognitive behavioural intervention for women suffering from menopausal symptoms following breast cancer treatmentPSYCHO-ONCOLOGY, Issue 5 2009Myra S. Hunter Abstract Objective: To evaluate a group cognitive behavioural intervention to alleviate menopausal symptoms in women who have had treatment for breast cancer. Methods: A single group design was used with pre- and post-treatment assessment and a 3-months follow-up. Seventeen women who had completed active breast cancer treatment were treated. Following a 2-week daily diary assessment they were offered 6 (90,min) weekly sessions of Group cognitive behaviour therapy (CBT). The CBT included information and discussion, relaxation and paced breathing and CBT to reduce stress and manage hot flushes (HF), night sweats (NS) and sleep. The primary outcome measure was Hot Flush Frequency and Hot Flush Problem Rating; secondary outcomes included the Women's Health Questionnaire (WHQ) and health-related quality of life (SF 36). Beliefs about HF were monitored in order to examine the effects of cognitive therapy. Results: HF and NS reduced significantly following treatment (38% reduction in frequency and 49% in problem rating) and improvements were maintained at 3 months follow-up (49% reduction in frequency and 59% in problem rating). Depressed mood, anxiety and sleep (WHQ) significantly improved, as did aspects of quality of life (SF 36) (emotional role limitation, energy/vitality and mental health). There was a significant reduction in negative beliefs about HF, NS and sleep following CBT. Conclusions: These results suggest that CBT delivered in groups might offer a viable option for women with troublesome menopausal symptoms following breast cancer treatment, but further controlled trials are needed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Inhibition deficits of serious delinquent boys of low intelligenceCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007Roos Koolhof Introduction,Studies have shown that low intelligence (IQ) and delinquency are strongly associated. This study focuses on inhibitory deficits as the source for the association between low IQ and delinquency. Further, the authors explore whether serious delinquent boys with a low IQ are exposed to more risk factors than serious delinquent boys with an average to high IQ. They also examine the extent to which low IQ and higher IQ serious delinquents incurred contact with the juvenile court because of their delinquent behaviour. Methods,Cross-sectional and longitudinal data from the Pittsburgh Youth Study were used to constitute four groups of boys: low IQ serious delinquents (n = 39), higher IQ serious delinquents (n = 149), low IQ non-to-moderate delinquents (n = 21) and higher IQ non-to-moderate delinquents (n = 219). Results,Low IQ serious delinquents committed more delinquent acts than higher IQ serious offenders. Low IQ serious delinquent boys also exhibited the highest levels of cognitive and behavioural impulsivity. There were no differences between low IQ and higher IQ serious delinquents on measures of empathy and guilt feelings. Instead, elevations on these characteristics were associated with serious offenders as a whole. Compared with higher IQ serious delinquents, low IQ serious delinquents were exposed to more risk factors, such as low academic achievement, being old for grade, depressed mood and poor housing. Conclusions,Inhibition deficits appear important in the aetiology of delinquency, especially among low IQ boys. Serious delinquent boys are all impulsive, but the higher IQ serious delinquents seem to have a better cognitive control system. Interventions aimed at low IQ boys should focus on the remediation of behavioural impulsivity as well as cognitive impulsivity. Copyright © 2007 John Wiley & Sons, Ltd. [source] Do mood disorders alter crying? a pilot investigationDEPRESSION AND ANXIETY, Issue 5 2008Jonathan Rottenberg Ph.D. Abstract Clinical commentators widely interpret crying as a sign of depressed mood. However, there is virtually no empirical data on this topic, and the evidence that mood disorders alter crying is surprisingly weak. This study compared mood disordered patients to a nonpsychiatric reference group on the frequency, antecedents, and consequences of crying behavior using a well-validated questionnaire measure of crying. Forty-four outpatients diagnosed with three forms of mood pathology were age and gender matched to a reference group of 132 participants sampled to be representative of the Dutch population. Both groups completed the Adult Crying Inventory, which provides estimates of the self-reported frequency, antecedents, and consequences of crying behavior. Depression severity and psychiatric symptom severity data were also collected from patients. Compared with the reference group, patients with mood pathology reported increased cry proneness to negative antecedents. By contrast, patients and controls did not differ in reported cry proneness to positive antecedents. Patients reported less mood improvement after crying than did controls. Among male patients, but not female patients, depression severity was associated with increased crying proneness and increased crying frequency. This pilot investigation suggests that mood disorders increase the frequency of negative emotional crying, and may also alter the functions of this behavior. Mood disorders may influence male crying to a greater extent than female crying. Future directions designed to clarify the causal pathways between mood disorders and alterations in crying behavior are discussed. Depression and Anxiety 0:1,7, 2007. © 2007 Wiley-Liss, Inc. [source] Hierarchical structures of affect and psychopathology and their implications for the classification of emotional disorders,DEPRESSION AND ANXIETY, Issue 4 2008David Watson Abstract The Diagnostic and Statistical Manual of Mental Disorders,IV groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." The current mood and anxiety disorders reflect the logic of older models emphasizing the existence of discrete emotions and, consequently, are based on a fundamental distinction between depressed mood (central to the mood disorders) and anxious mood (a core feature of the anxiety disorders). This distinction, however, ignores subsequent work that has established the existence of a general negative affect dimension that (a) produces strong correlations between anxious and depressed mood and (b) is largely responsible for the substantial comorbidity between the mood and anxiety disorders. More generally, there are now sufficient data to eliminate the current rational system and replace it with an empirically based taxonomy that reflects the actual,not the assumed,similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching superclass of emotional disorders, which can be decomposed into three subclasses: the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia), and the bipolar disorders (bipolar I, bipolar II, cyclothymia). An empirically based system of this type will facilitate differential diagnosis and encourage the ultimate development of an etiologically based taxonomy. Depression and Anxiety 25:282,288, 2008. Published 2008 Wiley-Liss, Inc. [source] Ruminative coping among patients with dysthymia before and after pharmacotherapyDEPRESSION AND ANXIETY, Issue 4 2007Owen Kelly Ph.D. Abstract The pivotal role of rumination in relation to other coping strategies was assessed in chronically depressed (dysthymic disorder) individuals versus nondepressed controls. Individuals with dysthymia demonstrated elevated use of rumination and other emotion-focused strategies (emotional expression, emotional containment, self- and other-blame). Among patients with dysthymia, rumination was linked to this limited array of emotion-focused efforts and diminished use of cognitive disengagement, whereas among controls, rumination was correlated with a broad constellation of problem- and emotion-focused strategies. Following 12 weeks of pharmacotherapy (sertraline), despite attenuation of depressed mood and reduced rumination, the limited relations between rumination and emotion-focused efforts persisted. Inflexibility in the ability to combine various coping efforts effectively may be characteristic of individuals with dysthymia, potentially increasing risk for recurrence. Depression and Anxiety 24:233,243, 2007. © 2006 Wiley-Liss, Inc. [source] How does premenstrual dysphoric disorder relate to depression and anxiety disorders?DEPRESSION AND ANXIETY, Issue 3 2003Mikael Landén M.D., Ph.D. Abstract Premenstrual dysphoric disorder (PMDD) is a severe variant of premenstrual syndrome that afflicts approximately 5% of all women of fertile age. The hallmark of this condition is the surfacing of symptoms during the luteal phase of the menstrual cycle, and the disappearance of symptoms shortly after the onset of menstruation. Whereas many researchers have emphasized the similarities between PMDD and anxiety disorders, and in particular panic disorder, others have suggested that PMDD should be regarded as a variant of depression. Supporting both these notions, the treatment of choice for PMDD, the serotonin reuptake inhibitors (SRIs), is also first line of treatment for depression and for most anxiety disorders. In this review, the relationship between PMDD on the one hand, and anxiety and depression on the other, is being discussed. Our conclusion is that PMDD is neither a variant of depression nor an anxiety disorder, but a distinct diagnostic entity, with irritability and affect lability rather than depressed mood or anxiety as most characteristic features. The clinical profile of SRIs when used for PMDD, including a short onset of action, suggests that this effect is mediated by other serotonergic synapses than the antidepressant and anti-anxiety effects of these drugs. Although we hence suggest that PMDD should be regarded as a distinct entity, it should be emphasized that this disorder does display intriguing similarities with other conditions, and in particular with panic disorder, which should be the subject of further studies. Also, the possibility that there are subtypes of PMDD more closely related to depression, or anxiety disorders, than the most common form of the syndrome, should not be excluded. Depression and Anxiety 17:122,129, 2003. © 2003 Wiley-Liss, Inc. [source] Achieving remission with venlafaxine and fluoxetine in major depression: its relationship to anxiety symptomsDEPRESSION AND ANXIETY, Issue 1 2002Jonathan R.T. Davidson M.D., M.B.A. Abstract Venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), produces significantly higher remission rates in depressed patients than do the selective serotonin reuptake inhibitors (SSRIs). In this analysis of pooled data, we explored the relationship between differences in treatment efficacy, early improvement of symptoms, and severity of baseline anxiety in depressed patients treated with either venlafaxine or fluoxetine. A pooled analysis was performed on data from 1,454 outpatients with major depression from five double-blind, randomized studies comparing the 6-week efficacy of venlafaxine (542 patients) with fluoxetine (555 patients). The Hamilton rating scale for depression (HAM-D) total and item scores were analyzed at different treatment times up to 6 weeks. Venlafaxine and fluoxetine both produced statistically significant higher response and remission rates compared with placebo starting from week 2 for response and weeks 3 to 4 for remission. Venlafaxine was statistically significantly superior to fluoxetine from week 3 until week 6 in respect of response rate, and from week 2 until week 6 for remission rate. After 1 week of treatment, greater improvement in individual symptoms was observed in the depressed mood, suicide, and psychic anxiety items of the HAM-D scale for both venlafaxine- and fluoxetine-treated patients compared with placebo. Improvement in psychic anxiety was statistically significantly greater with venlafaxine than with fluoxetine. The presence of baseline psychic anxiety correlated significantly to treatment outcome when analyzing the remission rates. In depressed patients with moderate anxiety (HAM-D psychic anxiety score ,2), venlafaxine statistically significantly increased remission rates compared with placebo from week 4 until week 6, while a significant effect of fluoxetine on remission rates was observed starting at week 6. Remission rates in the severely anxious depressed patients (score >2) were statistically significantly higher with venlafaxine than placebo starting from week 3 until the end of the study period, but no difference could be observed between fluoxetine and placebo. Baseline severity of psychic anxiety had a significant impact on remission rates after treatment of patients diagnosed with depression. Venlafaxine's superior remission rates in the more severely anxious patients and its ability to improve psychic anxiety as early as week 1 compared with fluoxetine suggest that venlafaxine's early efficacy on anxiety symptoms may be the basis for its superior efficacy in depression. Depression and Anxiety 16:4,13, 2002. © 2002 Wiley-Liss, Inc. [source] Identifying target groups for the prevention of anxiety disorders in the general populationACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010N. M. Batelaan Batelaan NM, Smit F, de Graaf R, van Balkom AJLM, Vollebergh WAM, Beekman ATF. Identifying target groups for the prevention of anxiety disorders in the general population. Objective:, To avert the public health consequences of anxiety disorders, prevention of their onset and recurrence is necessary. Recent studies have shown that prevention is effective. To maximize the health gain and minimize the effort, preventive strategies should focus on high-risk groups. Method:, Using data from a large prospective national survey, high-risk groups were selected for i) the prevention of first ever (n = 4437) and ii) either first-ever or recurrent incident anxiety disorders (n = 4886). Indices used were: exposure rate, odds ratio, population attributable fraction and number needed to be treated. Risk indicators included sociodemographic, psychological and illness-related factors. Results:, Recognition of a few patient characteristics enables efficient identification of high-risk groups: (subthreshold) panic attacks; an affective disorder; a history of depressed mood; a prior anxiety disorder; chronic somatic illnesses and low mastery. Conclusion:, Preventive efforts should be undertaken in the selected high-risk groups. [source] The association of physical activity and depression in Type 2 diabetesDIABETIC MEDICINE, Issue 10 2008Z. Lysy Abstract Aims Physical inactivity and depressed mood are both associated with a higher likelihood of diabetes-related complications; the association between physical activity and depressed mood in Type 2 diabetes has not been reviewed previously. We have reviewed (i) the strength of this association and (ii) the impact of depression-specific management and physical activity interventions on mood and activity levels in overweight adults with Type 2 diabetes. Methods Studies published between January 1996 and September 2007 were identified (Ovid - medline, Psych- Info and embase) using pertinent search terms (keyword/title). Results Of the 12 studies included (10 cross-sectional, two trials), most employed a standardized questionnaire for depressed mood but only one item for physical activity. In adults with Type 2 diabetes, the inactive are 1.72 to 1.75 times more likely to be depressed than the more active; the depressed are 1.22 to 1.9 times more likely to be physically inactive than the non-depressed. Two randomized trials demonstrated that a depression management programme improved mood, but only one demonstrated increased physical activity. Conclusions Studies to date suggest an association between depressed mood and physical inactivity in adults with Type 2 diabetes, although objective measures of physical activity have not been employed. Depression-specific management may improve mood and possibly activity. A trial comparing the impact of depression-specific management compared with exercise intervention on depressed mood and activity in Type 2 diabetes is justified. [source] Differential diagnosis of depressed mood in patients with schizophrenia: a diagnostic algorithm based on a reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2002A. Hausmann Objective:,To review the available literature on depressive symptomatology in schizophrenia in order to establish a diagnostic algorithm of depressive syndromes in schizophrenia. Method:,A literature search was performed using PubMed and Medline. Additional information was gained by cross-referencing from papers found in the database. Data from controlled studies as well as supplementary information from review articles and psychiatric manuals pertinent to the topic were used. Depressive symptoms were classified with respect to their temporal relationship to acute psychotic symptoms before the background of nosological entities as operationalized by Diagnostic Statistical Manual IV (DSM IV). Results:,Depression is a common and devastating comorbid syndrome in patients suffering from schizophrenic disorder. The paper summarizes the relevant diagnostic steps to guide the clinician towards therapeutic interventions, which differ depending on the nature of the depressive syndrome. Conclusion:,Differentiating depressives states in schizophrenia has consequences in terms of choosing therapeutic strategies. An algorithm which leads the practitioner to a reliable diagnosis and in consequence to a valid therapy is presented. [source] At-risk mental state (ARMS) detection in a community service center for early attention to psychosis in BarcelonaEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2010Yanet Quijada Abstract Aim: To describe the strategy and some results in at-risk mental state (ARMS) patient detection as well as some of the ARMS clinical and socio-demographical characteristics. The subjects were selected among the patients visited by an Early Care Equipment for patients at high risk of psychoses, in Barcelona (Spain) during its first year in operation. Methods: Descriptive study of the community,team relations, selection criteria and intervention procedure. Description of patient's socio-demographic and symptomatic characteristics according to the different instruments used in detection and diagnoses, taking account of four principal origins of referrals: mental health services, primary care services, education services and social services. Results: Twenty of 55 referred people fulfilled the at-risk mental state criteria, showing an incidence of 2.4 cases per 10 000 inhabitants. They were mainly adolescent males referred from health, education and social services. Overall, negative symptoms were predominant symptoms and the more frequent specific symptoms were decrease of motivation and poor work and school performance, decreased ability to maintain or initiate social relationships, depressed mood and withdrawal. Conclusions: It is possible to detect and to provide early treatment to patients with prodromal symptoms if the whole matrix of the community , including the social services , contributes to the process. The utilization of a screening instrument and a two-phase strategy , the second carried out by the specialized team , seems to be an appropriate approach for early psychosis and ARMS detection. [source] A review of the clinical pharmacology of methamphetamineADDICTION, Issue 7 2009Christopher C. Cruickshank ABSTRACT Aims To examine the literature regarding clinical pharmacokinetics, direct effects and adverse clinical outcomes associated with methamphetamine use. Methods Relevant literature was identified through a PubMed search. Additional literature was obtained from relevant books and monographs. Findings and conclusions The mean elimination half-life for methamphetamine is approximately 10 hours, with considerable inter-individual variability in pharmacokinetics. Direct effects at low-to-moderate methamphetamine doses (5,30 mg) include arousal, positive mood, cardiac stimulation and acute improvement in cognitive domains such as attention and psychomotor coordination. At higher doses used typically by illicit users (,50 mg), methamphetamine can produce psychosis. Its hypertensive effect can produce a number of acute and chronic cardiovascular complications. Repeated use may induce neurotoxicity, associated with prolonged psychiatric symptoms, cognitive impairment and an increased risk of developing Parkinson's disease. Abrupt cessation of repeated methamphetamine use leads to a withdrawal syndrome consisting of depressed mood, anxiety and sleep disturbance. Acute withdrawal lasts typically for 7,10 days, and residual symptoms associated with neurotoxicity may persist for several months. [source] REVIEW: Acute withdrawal, protracted abstinence and negative affect in alcoholism: are they linked?ADDICTION BIOLOGY, Issue 2 2010Markus Heilig ABSTRACT The role of withdrawal-related phenomena in the development and maintenance of alcohol addiction remains under debate. A ,self-medication' framework postulates that emotional changes are induced by a history of alcohol use, persist into abstinence, and are a major factor in maintaining alcoholism. This view initially focused on negative emotional states during early withdrawal: these are pronounced, occur in the vast majority of alcohol-dependent patients, and are characterized by depressed mood and elevated anxiety. This concept lost popularity with the realization that in most patients, these symptoms abate over 3,6 weeks of abstinence, while relapse risk persists long beyond this period. More recently, animal data have established that a prolonged history of alcohol dependence induces more subtle neuroadaptations. These confer altered emotional processing that persists long into protracted abstinence. The resulting behavioral phenotype is characterized by excessive voluntary alcohol intake and increased behavioral sensitivity to stress. Emerging human data support the clinical relevance of negative emotionality for protracted abstinence and relapse. These developments prompt a series of research questions: (1) are processes observed during acute withdrawal, while transient in nature, mechanistically related to those that remain during protracted abstinence?; (2) is susceptibility to negative emotionality in acute withdrawal in part due to heritable factors, similar to what animal models have indicated for susceptibility to physical aspects of withdrawal?; and (3) to what extent is susceptibility to negative affect that persists into protracted abstinence heritable? [source] Autonomic symptoms in patients and pre-manifest mutation carriers of Huntington's diseaseEUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2010N. A. Aziz Background and purpose:, Although autonomic function tests have revealed abnormalities of the autonomic nervous system in Huntington's disease (HD), autonomic symptoms and their association with other symptoms and signs of HD have not yet been assessed in large groups of patients or pre-manifest mutation carriers. Therefore, we aimed at delineating the characteristics and correlates of autonomic symptoms in HD. Methods:, Using the scales for outcomes in Parkinson's disease-autonomic symptoms (SCOPA-AUT) and Beck Depression Inventory questionnaires, autonomic symptoms and depressed mood were assessed in 63 patients with HD, 21 pre-manifest mutation carriers, and 85 controls. The Unified Huntington's Disease Rating Scale was used to assess other HD symptoms and signs. Results:, Relative to controls, patients with HD experienced significantly more gastrointestinal, urinary, cardiovascular and, in men, sexual problems. The most prevalent symptoms were swallowing difficulties, erection and ejaculation problems, dysphagia, sialorrhea, early abdominal fullness, straining for defecation, fecal and urinary incontinence, urgency, incomplete bladder emptying, and light-headedness whilst standing. Pre-manifest mutation carriers experienced significantly more swallowing difficulties and light-headedness on standing up compared with controls. In patients with HD, autonomic symptoms were associated with a greater degree of functional disability, more severe depression, and antidepressant drugs use. However, depression was the only independent predictor of autonomic dysfunction. Conclusions:, Autonomic symptoms are highly prevalent in patients with HD and may even precede the onset of motor signs. Moreover, autonomic dysfunction is related to functional disability and depression in HD. [source] Neuropsychiatric disturbances in SLE are associated with antibodies against NMDA receptorsEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2005R. Omdal To determine whether neuropsychiatric manifestations in patients with systemic lupus erythematosus (SLE) are influenced by antibodies against the human N-methyl- d -aspartate (NMDA) receptor types NR2a or NR2b. A decapeptide was synthesized containing a sequence motif present in the extracellular ligand-binding domain of NMDA receptors NR2a and NR2b, bound by the monoclonal murine anti-DNA antibody R4A. In an ELISA with the murine monoclonal R4v as positive control, plasma samples of 57 patients with SLE were examined for the anti-peptide (anti-NR2) antibody after the patients had been subjected to comprehensive psychological and cognitive testing. Poor performance on the Visual Paired Associates test (immediate), the Grooved Pegboard test, as well as high scores on the Beck Depression Inventory, and scales D-2 (depression), Pd-4 (psychopathic deviate), Sc-8 (schizophrenia), and Ma-9 (hypomania) of the MMPI-2 were significantly associated with elevated levels of anti-NR2 antibodies. The findings in several domains indicate an association between anti-NR2 antibodies and depressed mood in addition to decreased short-time memory and learning. Antibodies to NMDA receptors thus may represent one of several mechanisms for cerebral dysfunction in patients with SLE. [source] The importance of dental beliefs for the outcome of dental-fear treatmentEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2003Kajsa Henning Abrahamsson This study investigated the importance of dental beliefs and the predictive value of the Dental Belief Survey (DBS) in dental-fear treatment. The sample comprised 117 adult patients seeking treatment at a dental-fear clinic. Pretreatment data were collected during a screening procedure, including two visits to the dentist. Outcome measurements were completed after treatment. The dentist rated successful/unsuccessful treatment outcome. Patients unsuccessful in treatment (n = 48) reported more initial negative dental beliefs, while patients successful in treatment (n = 69) showed a larger decrease in negative beliefs between the first and second visit to the dentist. However, these differences were small. There was a significant difference between the groups at visit two. Thus, patients unsuccessful in treatment reported more negative beliefs about how dentists communicate. Regression analyses showed that improved dental beliefs during the first two visits to the dentist predicted dental-fear reduction, while longer avoidance time, female gender, low engagement in treatment, and depressed mood increased the risk of unsuccessful treatment outcome. Our results suggest that the DBS provides valuable information, and that patients' subjective perceptions about how dentists communicate are important for treatment outcome. However, initial dental beliefs were not found to predict clinical treatment outcome. [source] Sleep apnea and dialysis therapies: Things that go bump in the night?HEMODIALYSIS INTERNATIONAL, Issue 4 2007Mark L. UNRUH Abstract Sleep apnea has been linked to excessive daytime sleepiness, depressed mood, hypertension, and cardiovascular disease in the general population. The prevalence of severe sleep apnea in the conventional thrice-weekly hemodialysis population has been estimated to be more than 50%. Sleep apnea leads to repetitive episodes of hypoxemia, hypercapnia, sleep disruption, and activation of the sympathetic nervous system. The hypoxemia, arousals, and intrathoracic pressure changes associated with sleep apnea lead to sympathetic activation, endothelial dysfunction, oxidative stress, and inflammation. Because sleep apnea has been shown to be widespread in the conventional dialysis population, it may be that sleep apnea contributes substantially to the sleepiness, poor quality of life, and cardiovascular disease found in this population. The causal links between conventional dialysis and sleep apnea remain speculative, but there are likely multiple factors related to volume status and azotemia that contribute to the high rate of severe sleep apnea in dialysis patients. Both nocturnal automated peritoneal dialysis and nocturnal hemodialysis have been associated with reduced severity of sleep apnea. Nocturnal dialysis modalities may provide tools to increase our understanding of the uremic sleep apnea and may also provide therapeutic alternatives for end-stage renal disease patients with severe sleep apnea. In conclusion, sleep apnea is an important, but overlooked, public health problem for the dialysis population. The impact of sleep apnea treatment in this high-risk population may include reduced sleepiness, better mood and blood pressure, and lowered risk of cardiovascular disease. [source] The psychiatrist confronted with a fibromyalgia patientHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue S1 2009Siegfried Kasper Abstract Fibromyalgia is usually treated by rheumatologists but since co-morbid depression and anxiety are frequent, psychiatrists are likely to be confronted with patients suffering from the syndrome. The symptoms associated with fibromyalgia vary from patient to patient but there is one common symptom,they ache all over. In addition to pain, patients report headaches, poor sleep, fatigue, depressed mood and irregular bowel habits, which are also all symptoms of depression. For a formal diagnosis of fibromyalgia, the American College of Rheumatology (ACR) criteria require the patient to have widespread pain for at least 3 months together with tenderness at 11 or more of 18 specific tender points. Treatment of fibromyalgia requires a comprehensive approach involving education, aerobic exercise and cognitive behavioural therapy in addition to pharmacotherapy. The most effective drugs available for the treatment for fibromyalgia, the serotonin noradrenaline reuptake inhibitors, milnacipran and duloxetine and the anti-epileptic, pregabalin, are well known to psychiatrists. Thus the psychiatrist is well placed to initiate treatment in these patients. Copyright © 2009 John Wiley & Sons, Ltd. [source] Parental representations and subclinical changes in postpartum moodINFANT MENTAL HEALTH JOURNAL, Issue 3 2007Linda C. Mayes Parents commonly experience a depressed mood in the immediate postpartum period, and a smaller proportion experience clinical postpartum depression. Among other factors, mental representations of early parenting experience appear to contribute to the development of major depressive disorder. The present study examines the role of mental representations of early parenting in subclinical fluctuations of parental mood in the peripartum period. Forty-one middle-class mothers and thirty-six fathers were interviewed on three occasions from late in their pregnancy until three months postpartum. Ratings of social support and past history of depression were obtained along with ratings of parents' perceptions of their early parenting experiences. Parents' perception of their own maternal care was significantly predictive of peripartum fluctuations in mood. Parents who perceived their own mothers as less caring showed more dysphoria at 8 months gestation, and at 2 weeks and 3 months postpartum. Perceptions of maternal protectiveness or fathers' caring and protectiveness were not related to prenatal or postpartum mood fluctuations. Both mothers and fathers who perceived their mothers as affectionless and/or controlling were more likely to experience fluctuations in mood in the peripartum period. A past history of one or more episodes of major depression and ratings of perceived social support were also associated with more peripartum mood fluctuation. These findings suggest that early parenting experiences set the threshold for how vulnerable parents are in the peripartum period to the depressive costs of engaging with a new infant. [source] The Effect of Maternal Depressed Mood on Infant Emotional Reaction in a Surprise-Eliciting SituationINFANT MENTAL HEALTH JOURNAL, Issue 2 2006Nadja Reissland The purpose of this study is to examine the claim that an infant's ability to respond appropriately to an emotional situation varies according to the emotional state of the mother. Surprise expressions in mother and child were examined both in terms of paralinguistic aspects of surprise vocalizations as well as facial expressions. Seventy-two infants and their mothers (mean age=8 months, range=5,11 months) were video- and audiotaped in their homes. Half of the infants, matched for age and gender, had mothers who reported depressed mood. Infants of mothers with depressed mood showed significantly fewer components of facial expressions of surprise compared with infants of nondepressed mothers. Mothers with depressed mood exclaimed surprise with a significantly lower pitch (mean F0=386.13 Hz) compared to nondepressed mothers (mean F0=438.10 Hz). Furthermore, mothers with depressed mood showed fewer associations between elements of emotional expression than the nondepressed group. Infants' expressions of surprise are influenced by maternal mood, resulting in reduced expression of the emotion in infants of mothers with depressed mood. These results are discussed in terms of coordination of vocal parameters in mother,infant dyadic interaction. [source] An integration of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa: A case study using the case formulation methodINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2005Peter S. Hendricks MA Abstract Objective The current study provides an illustration of an integration of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for the treatment of bulimia nervosa (BN), based on the case formulation strategy. Method A 25-year-old Hispanic female referred herself for the treatment of eating difficulties and depressed mood. Diagnostic criteria were met for BN, major depressive episode, and alcohol abuse. Components of both CBT and IPT were utilized throughout the course of treatment. Results CBT techniques appeared to be most effective in eliminating binge eating and binge drinking behavior, whereas IPT techniques seemed to be most effective in reducing purging behavior. Results revealed that the client was no longer experiencing clinically significant symptoms of BN, depression, or alcohol abuse at end of treatment and follow-up (18 months after treatment onset). Discussion Findings support the integration of CBT and IPT for the treatment of BN and, potentially, other eating disorders. © 2005 by Wiley Periodicals, Inc. [source] Sociotropy and bulimic symptoms in clinical and nonclinical samplesINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2003Jumi Hayaki Abstract Objective The purpose of this study is to examine the relation between sociotropy and bulimic symptoms. Studies of interpersonal functioning among individuals with bulimia nervosa consistently reveal issues of social dependency, need for approval, and fear of rejection. These themes are conceptually related to sociotropy, a cognitive-personality factor that has been implicated in the development and maintenance of depression. Individuals high in sociotropy are keenly invested in attaining others' approval and avoiding social rejection. Methods The relationship between sociotropy and bulimic symptoms was examined in two samples of women: undergraduate women and community women seeking treatment at a private eating disorder facility. Results In both samples, sociotropy was significantly associated with bulimic symptoms beyond the shared relation with depressed mood. Discussion Findings are discussed in terms of the maintenance and treatment of bulimia nervosa. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 172,176, 2003. [source] Factor structure of the Cornell Scale for Depression in Dementia among Japanese poststroke patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2002Andrea S. Schreiner Abstract Background The present study reports on the first translation and use of the Cornell Scale for Depression in Dementia (CSDD) (Alexopoulos, Abrams, Young, & Shamoian, 1988) among poststroke patients (n,=,101) in Japan. Objectives The study had three main purposes: 1. To examine the factor structure of the CSDD among Japanese poststroke patients; 2. To compare this with the factor structure identified for Anglo-American Alzheimer's (AD) patients; and 3. To examine the prevalence and covariates of depressive symptoms among the Japanese stroke survivors. Methods Poststroke patients and their caregivers (n,=,202), at a random sample of neurological hospitals in western Japan, were interviewed using the study instruments. Data was also collected from patient charts. All subjects at each site who met the study criteria participated in the study. Results The four-factor solution for poststroke subjects was analogous to that found among AD patients with 2 main exceptions. In contrast to AD patients: 1. Physical complaints were unrelated to depressed mood in stroke patients; and 2. Agitation and psychosis loaded with depressed mood in stroke patients rather than as a separate unique factor as in AD patients. However, in the exploratory 5-factor model, agitation and suicidal ideation comprised a unique factor. Using standard cutoff scores for the CSDD, 58.2% of poststroke patients had scores suggesting possible depression. CSDD scores were not related to functional ability, or stroke characteristics such as aphasia or right or left-sided paralysis. However, scores were significantly higher among subjects,2 years poststroke. Feelings of irritability, anxiety, sadness, and sleep problems were most prevalent. Discussion Despite the prevalence of depressive symptoms, none of the subjects were currently receiving any mental health treatment. Findings suggest that symptoms differ by poststroke duration, which may necessitate different treatment approaches. Copyright © 2002 John Wiley & Sons, Ltd. [source] Depressive symptoms among poststroke patients in Japan: frequency distribution and factor structure of the GDSINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2001Andrea S. Schreiner Abstract Objective The present study examined the nature, prevalence, and covariates of depressive symptoms among home-dwelling poststroke patients in Japan using the Geriatric Depression Scale Short Form (GDS-1). Poststroke results were compared with those of elderly with affective disorders and with those of healthy nonstroke elderly. Methods Poststroke patients (n,=,101) who did not also have a diagnosis of Alzheimer's dementia, were identified from patient records at seven randomly selected hospitals with outpatient rehabilitation clinics in a metropolitan area in western Japan and invited to participate in the study. All instruments were interview-administered. Results GDS scores did not correlate with age, sex, education, functional dependence, aphasia, paralysis or presence of other chronic illnesses. However, GDS scores did correlate significantly with self-rated general health and poststroke duration. Compared with the frequency distribution in a psychiatric sample, poststroke patients had higher positive affect and lower depressed mood but similar social withdrawal scores. The factor structure of the poststroke sample differed from that of nonstroke elderly in that depressed mood items loaded with items for energy loss and memory problems. Conclusion Despite the fact that 62% of subjects scored ,,6 on the GDS, none were currently receiving assessment and/or treatment for their depressive symptoms. The frequency distribution and factor structure suggest that poststroke GDS scores reflect endorsement of functional losses such as decreased energy and impaired memory and subsequent feelings of helplessness, boredom and social withdrawal rather than decreased positive affect. Treatment should focus on dealing with these issues. Copyright © 2001 John Wiley & Sons, Ltd. [source] Why do primary care doctors diagnose depression when diagnostic criteria are not met?INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000Michael Höfler Abstract This study examines predictors of false positive depression diagnoses by primary care doctors in a sample of primary care attendees, taking the patients' diagnostic status from a self-report measure (Depression Screening Questionnaire, DSQ) as a yardstick against which to measure doctors' correct and false positive recognition rates. In a nationwide study, primary care patients aged 15,99 in 633 doctors' offices completed a self-report packet that included the DSQ, a questionnaire that assesses depression symptoms on a three-point scale to provide diagnoses of depression according to the criteria of DSM-IV and ICD-10. Doctors completed an evaluation form for each patient seen, reporting the patient's depression status, clinical severity, and treatment choices. Predictor analyses are based on 16,909 patient-doctor records. Covariates examined included depression symptoms, the total DSQ score, number and persistence of depression items endorsed, patient's prior treatment, history of depression, age and gender. According to the DSQ, 11.3% of patients received a diagnosis of ICD-10 depression, 58.9% of which were correctly identified by the doctor as definite threshold, and 26.2% as definite subthreshold cases. However, an additional 11.7% of patients not meeting the minimum DSQ threshold were rated by their doctors as definitely having depression (the false positive rate). Specific DSQ depression items endorsed, a higher DSQ total score, more two-week depression symptoms endorsed, female gender, higher age, and patient's prior treatment were all associated with an elevated rate of false positive diagnoses. The probability of false positive diagnoses was shown to be affected more by doctors ignoring the ,duration of symptoms' criterion than by doctors not following the ,number of symptoms' criterion for an ICD or DSM diagnosis of depression. A model selection procedure revealed that it is sufficient to regress the ,false positive diagnoses' on the DSQ-total score, symptoms of depressed mood, loss of interest, and suicidal ideation; higher age; and patient's prior treatment. Further, the total DSQ score was less important in prediction if there was a prior treatment. The predictive value of this model was quite good, with area under the ROC-curve = 0.86. When primary care doctors use depression screening instruments they are oversensitive to the diagnosis of depression. This is due to not strictly obeying the two weeks duration required by the diagnostic criteria of ICD-10 and DSM-IV. False positive rates are further increased in particular by the doctor's knowledge of a patient's prior treatment history as well as the presence of a few specific depression symptoms. Copyright © 2000 Whurr Publishers Ltd. [source] Insomnia Severity Index: psychometric properties with Chinese community-dwelling older peopleJOURNAL OF ADVANCED NURSING, Issue 10 2010Doris S.F. Yu yu d.s.f. (2010) Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people. Journal of Advanced Nursing,66(10), 2350,2359. Abstract Aim., This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Background., Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. Methods., An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Results., Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item-to-total correlations in the range of 0·34,0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. Conclusion., The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. [source] | |||||||||||||||||||||||||||||||