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Depression Severity (depression + severity)

Distribution by Scientific Domains

Medical Sciences	75%
Psychology	21%

Selected Abstracts

Do mood disorders alter crying? a pilot investigation

DEPRESSION AND ANXIETY, Issue 5 2008
Jonathan 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]

Serum adiponectin and resistin levels in major depressive disorder

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010
S. M. Lehto
Lehto SM, Huotari A, Niskanen L, Tolmunen T, Koivumaa-Honkanen H, Honkalampi K, Ruotsalainen H, Herzig K-H, Viinamäki H, Hintikka J. Serum adiponectin and resistin levels in major depressive disorder. Objective:, To examine the role of the adipose-tissue-derived low-grade inflammation markers adiponectin and resistin in major depressive disorder (MDD) in a population-based sample. Method:, Serum levels of adiponectin and resistin were measured from 70 DSM-IV MDD subjects and 70 healthy controls. Depression severity was assessed with the 29-item Hamilton Depression Rating Scale. Results:, The MDD group had lowered serum adiponectin levels. Regression modelling with adjustments for age, gender, overweight, several socioeconomic and lifestyle factors, coronary heart disease and metabolic syndrome showed that each 5.0 ,g/ml decrease in serum adiponectin increased the likelihood of MDD by approximately 20% (P = 0.01). The resistin levels correlated with atypical (P = 0.02), but not with typical depressive symptoms (P = 0.12). Conclusion:, Our findings suggest that the lowered adiponectin levels in MDD are depression-specific and not explained by conventional low adiponectin-related factors such as such as coronary heart disease and metabolic disorders. [source]

The effects of memory, attention, and executive dysfunction on outcomes of depression in a primary care intervention trial: the PROSPECT study

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2007
Hillary R. Bogner
Abstract Objective To describe the influence of domains of cognition on remission and response of depression in an intervention trial among older primary care patients. Methods Twenty primary care practices were randomly assigned to Usual Care or to an Intervention consisting of a depression care manager offering algorithm-based care for depression. In all, 599 adults 60 years and older with a depression diagnosis were included in these analyses. Depression severity and remission of depression were assessed by the 24-item Hamilton Depression Rating Scale. The Mini-Mental State Examination (MMSE) was our global measure of cognitive function. Verbal memory was assessed with the memory subscale of the Dementia Rating Scale. Attention was measured with the digit span from the Weschler Adult Intelligence Test. Response inhibition, one of the executive functions, was assessed with the Stroop Color-Word test. Results The intervention was associated with improved remission and response rates regardless of cognitive impairment. Response inhibition as measured by the Stroop Color-Word test appeared to significantly modify the intervention versus usual care difference in remission and response at 4 months. Patients in the poorest performance quartile at baseline on the Stroop Color-Word test in the Intervention Condition were more likely to achieve remission of depression at 4 months than comparable patients in Usual Care [odds ratio (OR),=,17.76, 95% Confidence Interval (CI), 3.06, 103.1]. Conclusions Depressed older adults in primary care with executive dysfunction have low remission and response rates when receiving usual care but benefit from depression care management. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Role of gender in depressive disorder outcome for individual and group cognitive,behavioral treatment,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2008
Hunna J. Watson
Abstract Gender in cognitive,behavioral therapy (CBT) for outcome for depression has been inadequately examined in previous research. Thirty-five men and 55 women diagnosed with a depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994) completed individual CBT at an outpatient community mental health clinic and 56 men and 105 women completed group CBT. Depression severity was measured before treatment and at endpoint using the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996) along with secondary outcomes of anxiety (Beck Anxiety Inventory; Beck, Epstein, Brown, & Steer, 1988) and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire; Endicott, Nee, Harrison, & Blumenthal, 1993). Men and women demonstrated equivalent pretreatment and posttreatment illness severity, a comparable gradient of improvement on outcomes, and attainment of clinically meaningful benchmarks. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1,15, 2008. [source]

The impact of panic-agoraphobic comorbidity on suicidality in hospitalized patients with major depression

DEPRESSION AND ANXIETY, Issue 3 2010
Lily A. Brown B.S.
Abstract Background: Previous research in outpatient samples suggests that panic and agoraphobic comorbidity is related to suicidality in outpatients with major depression. The purpose of the study was to further investigate this relationship specifically in a hospitalized sample. Method: This study examined the severity of current suicidal ideation and behaviors in a psychiatric hospital sample diagnosed with major depressive disorder alone (MDD; n=28) versus MDD plus panic-agoraphobic spectrum disorders (MDD+PAS; n=69). Results: Members of the MDD+PAS group were significantly more likely to have had a suicide attempt history, higher current depression severity, and higher current suicidal severity compared with individuals in the MDD alone group. The relationship between the current suicidality and comorbid PAS remained significant after controlling for the overall depression severity and other clinical factors. Conclusions: These findings suggest that panic-agoraphobic comorbidity is associated with a greater risk for suicidality in hospitalized patients, which cannot be adequately explained by the level of current depression alone. The clinical and research implications for these findings are discussed. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source]

Risk factors for relapse after remission with repetitive transcranial magnetic stimulation for the treatment of depression

DEPRESSION AND ANXIETY, Issue 7 2009
Roni B. Cohen M.D.
Abstract Background: Several studies have shown that repetitive transcranial magnetic stimulation (rTMS) treatment is associated with a significant antidepressant effect that can last for several months. Methods: To investigate the mean remission time and the predictors associated with its duration; we performed a large retrospective, naturalistic study with 204 patients who underwent treatment with rTMS. During the periods from 2000 to 2006, we identified and collected the data on 204 patients who underwent rTMS treatment for major depression and who remitted their depression (defined as Hamilton Depression Rating Scores less or equal to 7). Patients were followed up to 6 months after this therapy. Results: Event-free remission with the end point defined as relapse (Hamilton Depression Rating Scores higher than 8) was 75.3% (73.7) at 2 months, 60.0% (74.5) at 3 months, 42.7% (74.8) at 4 months, and 22.6% (74.5) at 6 months. According to a multivariate analysis, only the age and number of sessions were independent predictors of outcome. Although depression severity and use of tricyclics also showed a significant relationship with remission duration, the model including these variables was not adequate to explain our data. Conclusions: The results of this study suggest that young age and additional rTMS sessions are associated with a ong duration of rTMS effects and therefore future trials investigating the effects of maintenance rTMS treatment need to explore further the implication of these factors for depression remission. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source]

Do memory complaints represent impaired memory performance in patients with major depressive disorder?

DEPRESSION AND ANXIETY, Issue 10 2008
Arash Mowla M.D.
Abstract Memory complaints are found to be associated with depression. However, the question is, "How much these subjective complaints indicate objective memory impairments?" The aim of this study is to determine whether subjective memory complaints represent objective memory impairments and to establish the demographic and clinical characteristics of patients with major depressive disorder (MDD) and subjective memory complaints. Sixty-four patients with MDD were assessed for objective memory performance through subtests of the Wechsler Memory Scale-III. Memory complaints also were assessed in these patients with a structured interview. Thirty healthy controls were also included in the study to compare memory performance among groups. The Hamilton Rating Scale for Depression was used to measure the severity and characteristics of depression. Patients with MDD who had longer duration and earlier onset of depression reported more memory complaints. MDD patients with memory complaints had more hypochondriac concerns but not more depression severity compared with those without memory complaints. There was no relationship between subjective memory complaints and objective memory performance in MDD patients. Patients with MDD with and without memory complaints had lower scores on the Wechsler Memory Scale-III than the control group. Subjective memory complaints are not a valid indictor of objective memory impairments, and the diagnostic value of self-reported memory is being questioned in patients with MDD. The cognitive status of MDD patients should be assessed routinely, regardless of the patient awareness of his or her cognitive deficits. Depression and Anxiety, 2008. © 2007 Wiley-Liss, Inc. [source]

Do mood disorders alter crying? a pilot investigation

Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010
A. K. B. Van Reedt Dortland
van Reedt Dortland AKB, Giltay EJ, van Veen T, Zitman FG, Penninx BWJH. Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use. Objective:, The metabolic syndrome (MetSyn) predisposes to cardiovascular disease and diabetes mellitus. There might also be an association between the MetSyn and anxiety and depression, but its nature is unclear. We aimed to investigate whether diagnosis, symptom severity and antidepressant use are associated with the MetSyn. Method:, We addressed the odds for the MetSyn and its components among 1217 depressed and/or anxious subjects and 629 controls, and their associations with symptom severity and antidepressant use. Results:, Symptom severity was positively associated with prevalence of the MetSyn, [adjusted odds ratio (OR) 2.21 for very severe depression: 95% confidence interval (CI): 1.06,4.64, P = 0.04], which could be attributed to abdominal obesity and dyslipidemia. Tricyclic antidepressant (TCA) use also increased odds for the MetSyn (OR 2.30, 95% CI: 1.21,4.36, P = 0.01), independent of depression severity. Conclusion:, The most severely depressed people and TCA users more often have the MetSyn, which is driven by abdominal adiposity and dyslipidemia. [source]

Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder

ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009
R. H. Perlis
Objective:, Irritability is common during major depressive episodes, but its clinical significance and overlap with symptoms of anxiety or bipolar disorder remains unclear. We examined clinical correlates of irritability in a confirmatory cohort of Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study participants with major depressive disorder (MDD). Method:, Logistic regression was used to identify features associated with presence of irritability on the clinician-rated Inventory of Depressive Symptomatology. Results:, Of 2307 study participants, 1067(46%) reported irritability at least half the time during the preceding week; they were more likely to be female, to be younger, to experience greater depression severity and anxiety, and to report poorer quality of life, prior suicide attempts and suicidal ideation. Bipolar spectrum features were not more common among those with irritability. Conclusion:, Irritable depression is not a distinct subtype of MDD, but irritability is associated with greater overall severity, anxiety comorbidity and suicidality. [source]

Post-dexamethasone cortisol correlates with severity of depression before and during carbamazepine treatment in women but not men

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2001
Elizabeth A. Osuch
Objective: ,Previous studies show a state-dependent relationship between depression and post-dexamethasone suppression test (DST) cortisol level, as well as differences in DST response with age and gender. Method: ,In this study, 74 research in-patients with affective disorders were given the DST on placebo and in a subgroup following treatment with carbamazepine. Depression was evaluated twice daily with the Bunney,Hamburg (BH) rating scale. Data were examined for the total subject population, by gender and by menopausal status in women. Results: ,A robust positive correlation was observed between depression severity and post-DST cortisol in pre- and postmenopausal females, but not in males. This relationship persisted in women when restudied on a stable dose of carbamazepine (n=42). Conclusion: ,The pathophysiological implications of this selective positive relationship between severity of depression and post-DST cortisol in women, but not men, should be explored further. [source]

Lipoatrophy among HIV-infected patients is associated with higher levels of depression than lipohypertrophy

HIV MEDICINE, Issue 9 2008
HM Crane
Objectives We sought to determine the association between body morphology abnormalities and depression, examining lipoatrophy and lipohypertrophy separately. Methods An observational cross-sectional study of 250 patients from the University of Washington HIV Cohort was carried out. Patients completed an assessment including measures of depression and body morphology. We used linear regression analysis to examine the association between lipoatrophy or lipohypertrophy and depression. Analysis of variance was used to examine the relationship between mean depression scores and lipoatrophy and lipohypertrophy in 10 body regions. Results Of 250 patients, 76 had lipoatrophy and 128 had lipohypertrophy. Mean depression scores were highest among patients with moderate-to-severe lipoatrophy (16.4), intermediate among those with moderate-to-severe lipohypertrophy (11.7), mild lipohypertrophy (9.9) and mild lipoatrophy (8.5), and lowest among those without body morphology abnormalities (7.7) (P=0.002). After adjustment, mean depression scores for subjects reporting moderate-to-severe lipoatrophy were 9.2 points higher (P<0.001), scores for subjects with moderate-to-severe lipohypertrophy were 4.8 points higher (P=0.02), and scores for subjects with mild lipohypertrophy were 2.8 points higher (P=0.03) than those for patients without body morphology abnormalities. Facial lipoatrophy was the body region associated with the most severe depression scores (15.5 vs. 8.9 for controls; P=0.03). Conclusions In addition to long-term cardiovascular implications, body morphology has a more immediate effect on depression severity. [source]

Increased self-focus in major depressive disorder is related to neural abnormalities in subcortical-cortical midline structures

HUMAN BRAIN MAPPING, Issue 8 2009
Simone Grimm
Abstract Patients with major depressive disorder (MDD) often show a tendency to strongly introspect and reflect upon their self, which has been described as increased self-focus. Although subcortical-cortical midline structures have been associated with reflection and introspection of oneself in healthy subjects, the neural correlates of the abnormally increased attribution of negative emotions to oneself, i.e. negative self-attribution, as hallmark of the increased self-focus in MDD remain unclear. The aim of the study was, therefore, to investigate the neural correlates during judgment of self-relatedness of positive and negative emotional stimuli thereby testing for emotional self-attribution. Using fMRI, we investigated 27 acute MDD patients and compared them with 25 healthy subjects employing a paradigm that focused on judgment of self-relatedness when compared with mere perception of the very same emotional stimuli. Behaviourally, patients with MDD showed significantly higher degrees of self-relatedness of specifically negative emotional stimuli when compared with healthy subjects. Neurally, patients with MDD showed significantly lower signal intensities in various subcortical and cortical midline regions like the dorsomedial prefrontal cortex (DMPFC), supragenual anterior cingulate cortex, precuneus, ventral striatum (VS), and the dorsomedial thalamus (DMT). Signal changes in the DMPFC correlated with depression severity and hopelessness whereas those in the VS and the DMT were related to judgment of self-relatedness of negative emotional stimuli. In conclusion, we present first evidence that the abnormally increased negative self-attribution as hallmark of the increased self-focus in MDD might be mediated by altered neural activity in subcortical-cortical midline structures. Hum Brain Mapp, 2009. © 2008 Wiley-Liss, Inc. [source]

Depressive symptoms and suicidal ideation among older adults receiving home delivered meals

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2008
Jo Anne Sirey
Abstract Objective Homebound older adults may be vulnerable to the deleterious impact of untreated depression. Yet because these elders are difficult to reach, there is little data on the rates of depressive symptoms and suicidal ideation among this group. The objective of this study is to document the rates of depression and correlates among a population of homebound elders. Methods Using a community based participatory research partnership, we implemented a routine screening for depressive symptoms and suicidal ideation among older recipients of Westchester County's home meal program. Older adults enrolled in the home delivered meal program were administered the Physician Health Questionnaire,9 (PHQ-9), and questions to assess pain, falls, alcohol abuse and perceived emotional distress. Results In our sample of 403 meal recipients, 12.2% of older adults reported clinically significant depression (PHQ-9,>,9) and 13.4% reported suicidal thoughts. One-third of recipients with significant depressive symptoms were currently taking an antidepressant. Almost one-third of older adults who endorsed suicide ideation did not report clinically significant depressive symptoms. Among men, suicidal thoughts were associated with chronic pain and greater depression severity, whereas pain was not a predictor of suicidal thoughts among women. Conclusion More than one in nine elders suffer from depression; most are untreated with one-third undertreated. Through partnerships between public agencies that provide age related services and academic investigators there is an opportunity for improved detection of unmet mental health needs. Future research should explore innovative models to improve access to mental health services once unmet need is detected. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Suicidal ideation among elderly homecare patients

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2007
Patrick J. Raue
Abstract Objectives To identify the prevalence, correlates, and one-year naturalistic course of suicidal ideation in a representative sample of elderly adults newly admitted to visiting nurse homecare. Method Five hundred and thirty-nine participants (aged ,65), newly initiating homecare for skilled nursing services, were interviewed with the Structured Clinical Interview for DSM-IV (SCID-IV) and measures of depression severity, medical comorbidity, functional status, and social support. Participants were classified as having no suicidal ideation in the past month, passive ideation, active ideation, or active ideation with poor impulse control or suicide plan. Results Fifty-seven participants (10.6%) reported passive and six (1.2%) reported active suicidal ideation. Higher depression severity, greater medical comorbidity, and lower subjective social support were independently associated with the presence of any level of suicidal ideation. At one year, suicidal ideation persisted for 36.7% of those with ideation at baseline, and the incidence of suicide ideation was 5.4% Conclusions The high prevalence, persistence, and incidence of suicidal ideation in medically ill home healthcare patients underscore the relevance of this population for suicide prevention efforts. The clinical and psychosocial factors associated with suicidal ideation in this underserved, high-risk population are potentially modifiable, and thus useful targets for suicide prevention interventions. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Differential associations of Head and Body Symptoms with depression and physical comorbidity in patients with cognitive impairment

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2004
Roberta Riello
Abstract Objective To test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment. Methods Subjects were taken from those enrolled in ,The Mild Project' a prospective study on the natural history of mild dementia (Mini Mental State Examination,,,18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS). Results The number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel-Haenszel test,=,6.497, df,=,1, p,=,0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel-Haenszel test,=,4.726, df,=,1, p,=,0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis). Conclusions Head Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Apathy and cognitive performance in older adults with depression

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2003
Denise Feil
Abstract Objectives Recent studies have linked apathy to frontal lobe dysfunction in persons with dementia, but few studies have explored this relationship in older, depressed persons without dementia. We examined the association between apathy and cognitive function in a group of older persons with major depression using standardized neuropsychological tests. We hypothesized that presence of apathy in depression is associated with poorer frontal executive performance. Methods We analyzed data from 89 older adults with major depression. We defined apathy using four items from the Hamilton Psychiatric Rating Scale for Depression which reflect the clinical state of apathy, including ,diminished work/interest,' ,psychomotor retardation,' ,anergy' and ,lack of insight.' Results Apathy most strongly correlated with two verbal executive measures (Stroop C and FAS), a nonverbal executive measure (Wisconsin Card Sorting Test,Other Responses), and a measure of information processing speed (Stroop B). Apathy was not associated with age, sex, education, medical illness burden, Mini-Mental State Examination score and Full Scale IQ score. Stepwise regression analyses of significant cognitive tests showed that apathy alone or apathy plus depression severity, age, or education accounted for a significant amount of the variance. Conclusions The results of this study provide support for an apathy syndrome associated with poorer executive function in older adults with major depression. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Use of the Late-Life Function and Disability Instrument to Assess Disability in Major Depression

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2009
Jordan F. Karp MD
OBJECTIVES: To determine whether there was greater disability in subjects with depression than in those without, the correlation between disability and depression severity and quality of life, and whether improvement in disability after antidepressant pharmacotherapy was greater in those who responded to antidepressant treatment. DESIGN: Disability in subjects with and without depression from two different studies was compared for 22 weeks. Correlations were performed for the subjects with depression between disability and depression, anxiety, health-related quality of life (HRQOL), and medical comorbidity. T -tests were used to compare disability between subjects who did and did not respond to antidepressant treatment and change in disability after pharmacotherapy. SETTING: Late-life depression research clinic. PARTICIPANTS: The 313 subjects were recruited from primary care and the community and were aged 60 and older; 244 subjects were participants in a depression treatment protocol, and 69 subjects without depression participated in a separate longitudinal observational study of the mental and cognitive health of depression-free older adults. MEASUREMENTS: The Late-Life Function and Disability Instrument (LL-FDI), a measure of instrumental activity of daily living, personal role, and social role functioning. RESULTS: Subjects with depression scored lower than controls for domains measuring limitation (can do) and frequency (does do) of activities. Both disability domains correlated with depression severity, anxiety, HRQOL, and cognition. Disability improved with antidepressant treatment; for partial responders who continued to receive higher-dose antidepressant treatment out to 22 weeks, there was continued improvement, although not to the level of comparison subjects without depression. CONCLUSION: The LL-FDI appears to discriminate subjects with depression from those without, correlates with depression severity, and demonstrates sensitivity to antidepressant treatment response. We recommend further investigation of the LL-FDI and similar disability instruments for assessing depression-related disability. [source]

Effect of Psychiatric and Other Nonmotor Symptoms on Disability in Parkinson's Disease

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2004
Daniel Weintraub MD
Objectives: To examine the effect of depression and other nonmotor symptoms on functional ability in Parkinson's disease (PD). Design: A cross-sectional study of a convenience sample of PD patients receiving specialty care. Setting: The Parkinson's Disease Research, Education and Clinical Center at the Philadelphia Veterans Affairs Medical Center. Participants: One hundred fourteen community-dwelling patients with idiopathic PD. Measurements: The Unified Parkinson's Disease Rating Scale (UPDRS); Hoehn and Yahr Stage; Mini-Mental State Examination; Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, depression module; probes for psychotic symptoms; Hamilton Depression Rating Scale; Geriatric Depression Scale,Short Form; Apathy Scale; and Epworth Sleepiness Scale. Disability was rated using the UPDRS activity of daily living (ADL) score and the Schwab and England ADL score. Multivariate analysis determined effect of depression and other nonmotor symptoms on disability. Results: The presence of psychosis, depressive disorder, increasing depression severity, age, duration of PD, cognitive impairment, apathy, sleepiness, motor impairment, and percentage of time with dyskinesias were related to greater disability in bivariate analyses. Entering these factors into two multiple regression analyses, only the increasing severity of depression and worsening cognition were associated with greater disability using the UPDRS ADL score, accounting for 37% of the variance in disability (P<.001). These two factors plus increasing severity of PD accounted for 54% of the variance in disability using the Schwab and England ADL score (P<.001). Conclusion: Results support and extend previous findings that psychiatric and other nonmotor symptoms contribute significantly to disability in PD. Screening for nonmotor symptoms in PD is necessary to more fully explain functional limitations. Further study is required to determine whether identifying and treating these symptoms will improve function and quality of life. [source]

Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2009
Alice S. Carter
Abstract Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,11, 2009. [source]

Rumination: Relationship to depression and personality in a clinical sample

PERSONALITY AND MENTAL HEALTH, Issue 4 2009
Janet D. Carter
Numerous studies indicate rumination has a deleterious impact on the course of depressive symptoms. Very little is known about the factors that account for individual differences in the tendency to ruminate, particularly in clinical samples. The aim of this study was to examine the relationship between demographic factors, clinical characteristics of depression, personality and rumination in a clinical sample. Rumination was assessed with the Response Styles Questionnaire in 168 outpatients with a current diagnosis of major depression. Depression characteristics and personality were assessed with both structured clinical interviews and self-report measures. The results indicate that depression severity and personality predict rumination. Specifically, high initial depression severity, cluster B personality disorder symptoms and low self-directedness were significant predictors of rumination. There were no age or gender differences in the tendency to ruminate. Personality functioning appears to be an important dimension that may account for individual differences in the tendency to ruminate in depressed outpatients. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Influence of depression and HIV serostatus on the neuropsychological performance of injecting drug users

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2005
DRENNA WALDROP-VALVERDE phd
Abstract, Depression is common in injecting drug users (IDUs), a group at significant risk for HIV infection. Moreover, both HIV infection and depression have been shown to adversely effect neurocognitive abilities. Understanding the effects of depression and HIV infection on the neurocognitive functioning of drug users is essential for appropriate management and/or treatment of these deficits in this population. Therefore, the purpose of the present study was to investigate the effects of depression and HIV status on cognitive functioning in 100 male and female IDUs. Participants were categorized into three groups of depression severity based on their scores on the Beck Depression Inventory: no depression, mild depression, and moderate to severe depression. The effects of depression and HIV serostatus as well as their interaction were assessed. Results indicated that regardless of serostatus, those with moderate to severe depression had lower scores on cognitive measures. These findings suggest that although depression contributes to poor neuropsychological performance in IDUs, this effect was not exacerbated by HIV infection. The finding also illustrates the importance of addressing depression-related neurocognitive deficits in IDUs. [source]

Intrusive cognitions and their appraisal in anxious cancer patients

PSYCHO-ONCOLOGY, Issue 11 2009
Katriina L. Whitaker
Abstract Objective: Previous research found that anxious cancer patients experience uncontrollable negative intrusive cognitions that have an impact on coping and are associated with significant psychological distress. This is the first study to examine the appraisal of intrusive cognitions in an anxious group of cancer patients. Methods: A sample of 139 anxious cancer patients was assessed for evidence of intrusive phenomena, including memories, images and thoughts. Patients completed the Response to Intrusions Questionnaire and the Impact of Event Scale in relation to intrusive cognitions. Results: Forty-eight percent (67/139) reported frequent, uncontrollable intrusive cognitions. Intrusive thoughts and images were equally as common and images were associated with increased distress and uncontrollability. A significant positive linear relationship was found between the number of intrusions and anxiety severity (P<0.05). Negative appraisal of intrusive cognitions was associated with anxiety (P<0.01) and depression severity (P<0.01), intrusion-specific distress (P<0.01), rumination (P<0.01) and cognitive avoidance (P<0.01), after controlling for intrusion frequency. Conclusion: Negative appraisal of intrusive cognitions plays a significant role in psychological distress and intrusion-specific distress in anxious cancer patients. Finding similarities in the types of intrusive cognitions reported by cancer patients and other anxious populations highlights the potential applicability of psychological therapies developed to reduce the frequency and impact of intrusive cognitions. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Stroop performance in bipolar disorder: further evidence for abnormalities in the ventral prefrontal cortex

BIPOLAR DISORDERS, Issue 1 2006
Dina M Kronhaus
Objectives:, Bipolar patients are impaired in Stroop task performance, a measure of selective attention. Structural and functional abnormalities in task-associated regions, in particular the prefrontal cortex (PFC), have been reported in this population. We aimed to examine the relationship between functional abnormalities, impaired task performance and the severity of depressive symptoms in bipolar patients. Methods:, Remitted bipolar patients (n = 10; all medicated), either euthymic or with subsyndromal depression, and age-matched control subjects (n = 11) viewed 10 alternating blocks of incongruent Stroop and control stimuli, naming the colour of the ink. Neural response was measured using functional magnetic resonance imaging. We computed between-group differences in neural response and within-group correlations with mood and anxiety. Results:, There were no significant between-group differences in task performance. During the Stroop condition, controls demonstrated greater activation of visual and dorsolateral and ventrolateral prefrontal cortical areas; bipolar patients demonstrated relative deactivation within orbital and medial prefrontal cortices. Depression scores showed a trend towards a negative correlation with the magnitude of orbitofrontal cortex deactivation in bipolar patients, whereas state anxiety correlated positively with activation of dorsolateral PFC and precuneus in controls. Conclusions:, Our findings confirm previous reports of decreased ventral prefrontal activity during Stroop task performance in bipolar patients, and suggest a possible negative correlation between this and depression severity in bipolar patients. These findings further highlight the ventromedial PFC as a potential candidate for illness related dysfunction in bipolar disorder. [source]

Early maladaptive schemas, temperament and character traits in clinically depressed and previously depressed subjects,

CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 5 2009
Marianne Halvorsen
Abstract The Young Schema Questionnaire (YSQ) and the Temperament and Character Inventory (TCI) have been suggested as vulnerability markers for depression. One- hundred forty clinically depressed subjects(CD), previously depressed subjects(PD) and never depressed (ND) controls completed the YSQ, the TCI and the Beck Depression Inventory. Results showed that CD and PD differed significantly on early maladaptive schemas, temperament and character traits compared with ND. In accordance with previous research, higher levels of harm avoidance and lower levels of self-directedness were found in CD and in recovered PD. Moreover, CD and PD showed substantial variability in the scores on the YSQ and the TCI when controlling for concurrent depression severity. In multiple regression analyses, YSQ domain scales of disconnection, impaired autonomy, restricted self-expression and impaired limits emerged as significant predictors of depression severity. Likewise, as concerns TCI higher order scales, high harm avoidance, low self-directedness and high persistence emerged as significant predictors of depression severity. Harm avoidance was positively related to several early maladaptive schemas (EMSs), whereas self-directedness was negatively related to a majority of the EMSs. Our findings indicate the presence of maladaptive personality characteristics in CD and PD. Longitudinal studies are needed to establish their causal role in relation to first-onset and recurrent depression.,Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: , Early maladaptive schemas, high harm [correction made here after initial online publication] avoidance and low self-directedness may be a part of vulnerability to depression. , The finding of these personality characteristics in subjects recovered from depression indicates malfunctioning to some degree. , Addressing such characteristics in therapy should be considered in order to prevent and treat depression from its relapsing and recurring course. [source]