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Sample records for depression diagnosis claims

  1. Effects of externally rated job demand and control on depression diagnosis claims in an industrial cohort.

    Science.gov (United States)

    DeSanto Iennaco, Joanne; Cullen, Mark R; Cantley, Linda; Slade, Martin D; Fiellin, Martha; Kasl, Stanislav V

    2010-02-01

    This study examined whether externally rated job demand and control were associated with depression diagnosis claims in a heavy industrial cohort. The retrospective cohort sample consisted of 7,566 hourly workers aged 18-64 years who were actively employed at 11 US plants between January 1, 1996, and December 31, 2003, and free of depression diagnosis claims during an initial 2-year run-in period. Logistic regression analysis was used to model the effect of tertiles of demand and control exposure on depression diagnosis claims. Demand had a significant positive association with depression diagnosis claims in bivariate models and models adjusted for demographic (age, gender, race, education, job grade, tenure) and lifestyle (smoking status, body mass index, cholesterol level) variables (high demand odds ratio = 1.39, 95% confidence interval: 1.04, 1.86). Control was associated with greater risk of depression diagnosis at moderate levels in unadjusted models only (odds ratio = 1.47, 95% confidence interval: 1.12, 1.93), while low control, contrary to expectation, was not associated with depression. The effects of the externally rated demand exposure were lost with adjustment for location. This may reflect differences in measurement or classification of exposure, differences in depression diagnosis by location, or other location-specific factors.

  2. Prevalence rates for depression by industry: a claims database analysis.

    Science.gov (United States)

    Wulsin, Lawson; Alterman, Toni; Timothy Bushnell, P; Li, Jia; Shen, Rui

    2014-11-01

    To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002-2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace.

  3. Prevalence rates for depression by industry: a claims database analysis

    Science.gov (United States)

    Alterman, Toni; Bushnell, P. Timothy; Li, Jia; Shen, Rui

    2015-01-01

    Purpose To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. Methods Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002–2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. Results Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. Conclusions Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. Clinical significance Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace. PMID:24907896

  4. Struggling with a depression diagnosis

    DEFF Research Database (Denmark)

    Rønberg, Mette

    2017-01-01

    In this article, I explore how an adult experiences and negotiates the process of being diagnosed with depression, and how she struggles to learn to live under this particular diagnostic descrip- tion. It is based on two interviews with one informant, Bridget, being part of a larger ethnograph- ic...... eldwork in Denmark among adults diagnosed with depression. Psychiatric diagnoses are the most common categories used when su ering and life problems are to be understood, interpret- ed, and acted upon in Denmark. Bridget’s story is a case in which resistance against, and ongoing negotiations...... and complicated struggles with, a psychiatric diagnosis stand out, as she continu- ously struggles to articulate an oppositional stance to the dominant diagnostic categories. The negotiations take place in a complex network where medical authorities, the workplace and the diagnostic cultures play a crucial part...

  5. CT diagnosis of occipital bone pacchionian depression

    International Nuclear Information System (INIS)

    Zhu Jianguo; Xu Xiaolin

    2004-01-01

    Objective: To improve the recognition of the CT findings of occipital bone pacchionian depression, in order to avoid misdiagnosis. Methods: occipital bone pacchionian depression underwent CT with plain scan and intravenous contrast enhancement in 11 cases, and then the CT findings were analyzed. Results: Occipital bone pacchionian depression situated beside the torcular herophilia in 11 cases. The depression or bone defect were found at occipital bone inner plate, they can reach diploe or outer plate and had no enhancement after contrast injection. Conclusions: CT scans play an important role in diagnosis and differential diagnosis of occipital bone pacchionian depression

  6. [Is the diagnosis 'depression' still useful?].

    Science.gov (United States)

    Terluin, Berend; Oud, Marian J T

    2012-01-01

    The DSM diagnosis of depression is based solely on the presence of symptoms, without taking into account the context in which these symptoms have occurred. For this reason, the DSM diagnosis does not distinguish between sadness as a normal reaction to a painful loss and pathologically depressive reactions that are disproportionate to personal life events and circumstances. According to a group of mental health expert general practitioners, a true depressive disorder is characterized by a depression that has acquired a life of its own and is hard to control. This depression is severe, and is recognized by the patient as alien to his or her character. Loss of the ability to experience pleasure in ordinary things (anhedonia) and thoughts about death as an alternative for the torment experienced are often present. We recommend the diagnosis of depression be reserved for clearly pathologically depressive reactions that are also recognized as such by the patient.

  7. Maternal Depressive Symptoms following Autism Spectrum Diagnosis

    Science.gov (United States)

    Taylor, Julie Lounds; Warren, Zachary E.

    2012-01-01

    The current study examined depressive symptoms, concerning the week following autism spectrum diagnosis and an average of 1.4 years later, in mothers (n = 75) of young children diagnosed with an autism spectrum disorder (ASD). Over three-quarters of mothers (78.7%) provided retrospective reports of clinically significant depressive symptoms…

  8. Undiagnosed depression: A community diagnosis

    Directory of Open Access Journals (Sweden)

    Sharifa Z. Williams

    2017-12-01

    Full Text Available Many large provider networks are investing heavily in preventing disease within the communities that they serve. We explore the potential benefits and challenges associated with tackling depression at the community level using a unique dataset designed for one such provider network. The economic costs of having depression (increased medical care use, lower quality of life, and decreased workplace productivity are among the highest of any disease. Depression often goes undiagnosed, yet many believe that depression can be treated or prevented altogether. We explore the prevalence, distribution, economic burden, and the psychosocial and economic factors associated with undiagnosed depression in a lower-income neighborhood in northern Manhattan. Even using state-of-the art data to “diagnose” the risk factors within a community, it can be challenging for provider networks to act against such risk factors.

  9. PRIMIPARA POST PARTUM DEPRESSION DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Esha Pradnyana

    2013-02-01

    Full Text Available Pregnancy and the first child birth is an influential complex event for a mother, which is where everything including phsycal and psyological aspects. This change can make mother psyological disorder, that can lead into depression after childbearing that call post childbearing depression or post partum depression. A wide review at 59 study make a result that 13% among primipara can suffer post partum depression 12 weeks after childbearing. Estabilishmet of this diagnosis, besides from history and symptoms, and can be supported through test Edinburgh Postnatal Depression Scale( EPDS . Patient with post partum depression, given treatment with antidepressant drug. Breastfeeding is not only to reduce stress for the mother, but also reduce the level of stress on a baby when his mother suffered depression

  10. Diagnosis of depression among adolescents

    DEFF Research Database (Denmark)

    Haavet, Ole Rikard; Christensen, Kaj Aage Sparle; Sirpal, Manjit

    2007-01-01

    BACKGROUND: The objective of the study is to improve general practitioners' diagnoses of adolescent depression. Major depression is ranked fourth in the worldwide disability impact. METHOD: Validation of 1) three key questions, 2) SCL-dep6, 3) SCL-10, 4) 9 other SCL questions and 5) WHO-5...... in a clinical study among adolescents. The Composite International Diagnostic Interview (CIDI) is to be used as the gold standard interview. The project is a GP multicenter study to be conducted in both Norway and Denmark. Inclusion criteria are age (14-16) and fluency in the Norwegian and Danish language...

  11. [Prevalence and diagnosis of depression in Mexico].

    Science.gov (United States)

    Belló, Mariana; Puentes-Rosas, Esteban; Medina-Mora, María Elena; Lozano, Rafael

    2005-01-01

    To present the prevalence of depressive episodes, as well as the percentage of the population with medical diagnosis. The definition of depression was based on a schedule with DSM IV diagnostic criteria. Using data from the 2002-2003 National Assessment Performance Survey, the prevalence of depression was estimated at the national level, by sex, age, education, size of residence community, and state. The percentage of individuals with medically diagnosed depression and the percentage of those under treatment were also estimated. The national prevalence of depression was 4.5%: 5.8% in women and 2.5% in men. The prevalence of depression increased with age and decreased with higher education. Among males, the prevalence was higher in rural than urban communities. A large percentage of affected individuals have no medical diagnosis. Depression is a frequent disease in adults.A higher prevalence is associated with social vulnerability. The low percentage of diagnosis represents a challenge for mental health service planning and provision.

  12. Does a Claims Diagnosis of Autism Mean a True Case?

    Science.gov (United States)

    Burke, James P.; Jain, Anjali; Yang, Wenya; Kelly, Jonathan P.; Kaiser, Marygrace; Becker, Laura; Lawer, Lindsay; Newschaffer, Craig J.

    2014-01-01

    The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis…

  13. Major depression in primary care: making the diagnosis

    Science.gov (United States)

    Ng, Chung Wai Mark; How, Choon How; Ng, Yin Ping

    2016-01-01

    Major depression is a common condition seen in the primary care setting, often presenting with somatic symptoms. It is potentially a chronic illness with considerable morbidity, and a high rate of relapse and recurrence. Major depression has a bidirectional relationship with chronic diseases, and a strong association with increased age and coexisting mental illnesses (e.g. anxiety disorders). Screening can be performed using clinical tools for major depression, such as the Patient Health Questionaire-2, Patient Health Questionaire-9 and Beck Depression Inventory, so that timely treatment can be initiated. An accurate diagnosis of major depression and its severity is essential for prompt treatment to reduce morbidity and mortality. This is the first of a series of articles that illustrates the approach to the management of major depression in primary care. Our next articles will cover suicide risk assessment in a depressed patient and outline the basic principles of management and treatment modalities. PMID:27872937

  14. Differential diagnosis of bipolar disorder and major depressive disorder.

    Science.gov (United States)

    Hirschfeld, R M

    2014-12-01

    Patients with bipolar disorder spend approximately half of their lives symptomatic and the majority of that time suffering from symptoms of depression, which complicates the accurate diagnosis of bipolar disorder. Challenges in the differential diagnosis of bipolar disorder and major depressive disorder are reviewed, and the clinical utility of several screening instruments is evaluated. The estimated lifetime prevalence of major depressive disorder (i.e., unipolar depression) is over 3 and one-half times that of bipolar spectrum disorders. The clinical presentation of a major depressive episode in a bipolar disorder patient does not differ substantially from that of a patient with major depressive disorder (unipolar depression). Therefore, it is not surprising that without proper screening and comprehensive evaluation many patients with bipolar disorder may be misdiagnosed with major depressive disorder (unipolar depression). In general, antidepressants have demonstrated little or no efficacy for depressive episodes associated with bipolar disorder, and treatment guidelines recommend using antidepressants only as an adjunct to mood stabilizers for patients with bipolar disorder. Thus, correct identification of bipolar disorder among patients who present with depression is critical for providing appropriate treatment and improving patient outcomes. Clinical characteristics indicative of bipolar disorder versus major depressive disorder identified in this review are based on group differences and may not apply to each individual patient. The overview of demographic and clinical characteristics provided by this review may help medical professionals distinguish between major depressive disorder and bipolar disorder. Several validated, easily administered screening instruments are available and can greatly improve the recognition of bipolar disorder in patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Dual diagnosis in Depression: treatment recommendations.

    Science.gov (United States)

    Tirado Muñoz, Judit; Farré, Adriana; Mestre-Pintó, Joan; Szerman, Nestor; Torrens, Marta

    2018-01-01

    Comorbidity between substance use disorders (SUD) and major depression (MD) is the most common dual pathology in the field of addiction to substances and has prevalence rates ranging between 12% and 80%, which complicates the response to treatment and worsens the prognosis of patients. Differentiating between diagnoses of induced depressive episodes and primary depressive episodes concurrent to substance use is especially relevant for therapeutic management. This article presents the state of the art of the currently available pharmacologic treatments of comorbid depression in patients with SUD, taking into account the safety and risk of abuse of antidepressant drugs. Due to the fact that comorbidity of MD and SUD is frequent and presents greater psychopathological and medical severity, as well as worse social functioning, it is crucial to treat MD and SUD simultaneously using the integrated treatment model and not to treat both conditions separately.

  16. Differential diagnosis of depression: relevance of positron emission tomography

    International Nuclear Information System (INIS)

    Schwartz, J.M.; Baxter, L.R. Jr.; Mazziotta, J.C.; Gerner, R.H.; Phelps, M.E.

    1987-01-01

    The proper differential diagnosis of depression is important. A large body of research supports the division of depressive illness into bipolar and unipolar subtypes with respect to demographics, genetics, treatment response, and neurochemical mechanisms. Optimal treatment is different for unipolar and bipolar depressions. Treating a patient with bipolar depression as one would a unipolar patient may precipitate a serious manic episode or possibly even permanent rapid cycling disorder. The clinical distinction between these disorders, while sometimes difficult, can often be achieved through an increased diagnostic suspicion concerning a personal or family history of mania. Positron emission tomography and the FDG method, which allow in vivo study of the glucose metabolic rates for discrete cerebral structures, provide new evidence that bipolar and unipolar depression are two different disorders

  17. Dementia and Depression: A Process Model for Differential Diagnosis.

    Science.gov (United States)

    Hill, Carrie L.; Spengler, Paul M.

    1997-01-01

    Delineates a process model for mental-health counselors to follow in formulating a differential diagnosis of dementia and depression in adults 65 years and older. The model is derived from empirical, theoretical, and clinical sources of evidence. Explores components of the clinical interview, of hypothesis formation, and of hypothesis testing.…

  18. Validity of the diagnosis of a single depressive episode in a case register

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

    2009-01-01

    .8% for severe type of a single depression, 76.0% for moderate type of a single depression and 65.2% for mild type of a single depression). CONCLUSION: The ICD-10 diagnosis of a single depressive episode can be used in daily clinical practice with sufficient precision. The validity of the diagnosis is highest...... for severe and moderate type of depression and decreases for mild depression....

  19. Diagnosis of depression in children and adolescents. Clinical pointers to a difficult diagnosis.

    Science.gov (United States)

    2010-04-01

    It is now accepted that depression can also affect children and adolescents, but its diagnosis is not straightforward. We examined review articles published on this subject over the last 15 years by large specialist groups and multidisciplinary teams. Most studies of symptoms of psychological distress and depression in children are mainly based on clinical experience of specialists and therefore provide only modest evidence. Isolated, transient unhappiness is not in itself a symptom of depression, but recurrent and persistent mood disorders constitute important warning signs. A French consensus jury recommended attentive listening to potentially depressed children, and those closest to them, focusing on phrases that might reflect a loss of interest, enjoyment, self-esteem and self-confidence; feelings of guilt, shame, loss of affection and hope; and morbid or suicidal ideas. British clinical practice guidelines recommend evaluating the severity of a depressive episode on the basis of the type and number of symptoms, and the family context. Scores designed to diagnose depression and assess its severity are controversial. In practice, diagnosis of depression in children and adolescents with persistent psychological distress is not based on a simple list of symptoms. In difficult cases, it is better to adopt a multidisciplinary approach in order to gauge severity and to determine the most appropriate treatment, which, in most cases, does not involve the use of drugs.

  20. DIAGNOSIS AND TREATMENT OF DEPRESSION IN PERSONS WITH INTELLECTUAL DISABILITY

    Directory of Open Access Journals (Sweden)

    Katarina Tomić1,

    2011-09-01

    Full Text Available This paper considers, from the theoretical point of view, the problem of diagnosing and treatment of depressive disorders in people with intellectual disability (ID, relying primarily on the results of previous researches, which stress the etiological, symptomatic, diagnostic and therapeutic specifics when it comes to depression and its correlates in this population. The interest in mental health and psychopathology of people with ID intensified during the seventh decade of the previous century, when it became clear that some cognitive and behavioral symptoms are not, as hitherto thought, only a part or a consequence of the syndrome of intellectual disability, but a sign of ongoing mental disorder. So, the idea of ''dual diagnosis'' was born, and now it provides guidelines for the growing number of studies which theoretically and empirically review different issues of mental health problems in people with ID. Likewise, the observation of syndrome groups of genetic disorders resulting in intellectual disability has led to the narrowing of the circle of genetic syndromes that carry increased risk for the onset of depression and its correlates, such as: Down syndrome, Fragile X syndrome and Prader-Willi syndrome. Potential diagnostic problem in people with ID, when it comes to depression, may arise from ''diagnostic overshadowing’’ of depression symptoms, which often remain hidden under abnormal behavior and adjustment disorders, especially in patients with severe forms of ID. As a possible way to overcome these problems some authors have proposed the concept of ''behavioral equivalents of depression'' or behavioral disorders that evidently can be associated with depression, such as social withdrawal, aggression, hostility, irritability, psychomotor agitation or retardation. Intensification of these forms of behavior may be a sign of developing depression, and in that sense, this view represents a useful starting point. When it comes to

  1. Missed Diagnosis of Cardiovascular Disease in Outpatient General Medicine: Insights from Malpractice Claims Data.

    Science.gov (United States)

    Quinn, Gene R; Ranum, Darrell; Song, Ellen; Linets, Margarita; Keohane, Carol; Riah, Heather; Greenberg, Penny

    2017-10-01

    Diagnostic errors are an underrecognized source of patient harm, and cardiovascular disease can be challenging to diagnose in the ambulatory setting. Although malpractice data can inform diagnostic error reduction efforts, no studies have examined outpatient cardiovascular malpractice cases in depth. A study was conducted to examine the characteristics of outpatient cardiovascular malpractice cases brought against general medicine practitioners. Some 3,407 closed malpractice claims were analyzed in outpatient general medicine from CRICO Strategies' Comparative Benchmarking System database-the largest detailed database of paid and unpaid malpractice in the world-and multivariate models were created to determine the factors that predicted case outcomes. Among the 153 patients in cardiovascular malpractice cases for whom patient comorbidities were coded, the majority (63%) had at least one traditional cardiac risk factor, such as diabetes, tobacco use, or previous cardiovascular disease. Cardiovascular malpractice cases were more likely to involve an allegation of error in diagnosis (75% vs. 47%, p <0.0001), have high clinical severity (86% vs. 49%, p <0.0001) and result in death (75% vs. 27%, p <0.0001), as compared to noncardiovascular cases. Initial diagnoses of nonspecific chest pain and mimics of cardiovascular pain (for example, esophageal disease) were common and independently increased the likelihood of a claim resulting in a payment (p <0.01). Cardiovascular malpractice cases against outpatient general medicine physicians mostly occur in patients with conventional risk factors for coronary artery disease and are often diagnosed with common mimics of cardiovascular pain. These findings suggest that these patients may be high-yield targets for preventing diagnostic errors in the ambulatory setting. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Support Tool in the Diagnosis of Major Depressive Disorder

    Science.gov (United States)

    Nunes, Luciano Comin; Pinheiro, Plácido Rogério; Pequeno, Tarcísio Cavalcante; Pinheiro, Mirian Calíope Dantas

    Major Depressive Disorder have been responsible for millions of professionals temporary removal, and even permanent, from diverse fields of activities around the world, generating damage to social, financial, productive systems and social security, and especially damage to the image of the individual and his family that these disorders produce in individuals who are patients, characteristics that make them stigmatized and discriminated into their society, making difficult their return to the production system. The lack of early diagnosis has provided reactive and late measures, only when the professional suffering psychological disorder is already showing signs of incapacity for working and social relationships. This article aims to assist in the decision making to establish early diagnosis of these types of psychological disorders. It presents a proposal for a hybrid model composed of expert system structured methodologies for decision support (Multi-Criteria Decision Analysis - MCDA) and representations of knowledge structured in logical rules of production and probabilities (Artificial Intelligence - AI).

  3. Symptoms associated with the DSM IV diagnosis of depression in pregnancy and post partum.

    Science.gov (United States)

    Kammerer, Martin; Marks, Maureen N; Pinard, Claudia; Taylor, Alyx; von Castelberg, Brida; Künzli, Hansjörg; Glover, Vivette

    2009-06-01

    Pregnancy and the postpartum may affect symptoms of depression. However it has not yet been tested how the symptoms used for the DSM IV diagnosis of depression discriminate depressed from non depressed women perinatally. A modified version of the Structured Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all associated DSM IV symptoms of depression with depressed and non depressed women in pregnancy and the postpartum period. Loss of appetite was not associated with depression either ante or postnatally. The antenatal symptom pattern was different from the postnatal. The sensitivity of the symptoms ranged from 0.7% to 51.6%, and specificity from 61.3% to 99.1%. The best discriminating symptoms were motor retardation/agitation and concentration antenatally, and motor retardation/agitation, concentration and fatigue postnatally. Depression in pregnancy and postpartum depression show significantly different symptom profiles. Appetite is not suitable for the diagnosis of depression in the perinatal period.

  4. Tree analysis modeling of the associations between PHQ-9 depressive symptoms and doctor diagnosis of depression in primary care.

    Science.gov (United States)

    Chin, Weng-Yee; Wan, Eric Yuk Fai; Dowrick, Christopher; Arroll, Bruce; Lam, Cindy Lo Kuen

    2018-04-26

    The aim of this study was to explore the relationship between patient self-reported Patient Health Questionnaire-9 (PHQ-9) symptoms and doctor diagnosis of depression using a tree analysis approach. This was a secondary analysis on a dataset obtained from 10 179 adult primary care patients and 59 primary care physicians (PCPs) across Hong Kong. Patients completed a waiting room survey collecting data on socio-demographics and the PHQ-9. Blinded doctors documented whether they thought the patient had depression. Data were analyzed using multiple logistic regression and conditional inference decision tree modeling. PCPs diagnosed 594 patients with depression. Logistic regression identified gender, age, employment status, past history of depression, family history of mental illness and recent doctor visit as factors associated with a depression diagnosis. Tree analyses revealed different pathways of association between PHQ-9 symptoms and depression diagnosis for patients with and without past depression. The PHQ-9 symptom model revealed low mood, sense of worthlessness, fatigue, sleep disturbance and functional impairment as early classifiers. The PHQ-9 total score model revealed cut-off scores of >12 and >15 were most frequently associated with depression diagnoses in patients with and without past depression. A past history of depression is the most significant factor associated with the diagnosis of depression. PCPs appear to utilize a hypothetical-deductive problem-solving approach incorporating pre-test probability, with different associated factors for patients with and without past depression. Diagnostic thresholds may be too low for patients with past depression and too high for those without, potentially leading to over and under diagnosis of depression.

  5. Depression management within GP-centered health care - A case-control study based on claims data.

    Science.gov (United States)

    Freytag, Antje; Krause, Markus; Lehmann, Thomas; Schulz, Sven; Wolf, Florian; Biermann, Janine; Wasem, Jürgen; Gensichen, Jochen

    For most patients with depression, GPs are the first and long-term medical providers. GP-centered health care (GPc-HC) programs target patients with chronic diseases. What are the effects of GPc-HC on primary care depression management? An observational retrospective case-control study was conducted using health insurance claims data of patients with depressive disorder from July 2011 to December 2012. From 40,298 patients insured with the largest health plan in Central Germany participating in the GPc-HC program (intervention group, IG), we observed 4645 patients with depression over 18months: 72.2% women; 66.6years (mean); multiple conditions (morbidity-weight 2.50 (mean), 86%>1.0). We compared them with 4013 patients who did not participate (control group). In participants we found lower number of incomplete/non-specified depression diagnoses (4.46vs.4.82;MD-0.36; pcare" (38.2%vs.30.2%;PP+8.0;pDepressive patients participating in a GPc-HC program may be more often diagnosed by a GP, receive symptom-monitoring and appropriate depression treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

    Science.gov (United States)

    Shin, Y S; Yeom, Y K; Hwang, H

    1993-02-01

    This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

  7. O diagnóstico de depressão Depression’s diagnosis

    Directory of Open Access Journals (Sweden)

    Maria Josefina Sota Fuentes Rodrigues

    2000-01-01

    Full Text Available Investiga-se o tema da depressão desde o referencial teórico psicanalítico, na obra de Sigmund Freud, Jacques Lacan e de alguns de seus comentadores. O tema é inicialmente introduzido a partir da psiquiatria, campo desde onde o conceito de depressão, tal como é concebido na atualidade, veio surgir. São abordados, criticamente, o diagnóstico atual, a fragilidade da hereditariedade como hipótese etiológica principal, a insuficiência de "marcadores biológicos" e os limites da quimioterapia. Em seguida, o tema é abordado na psicanálise, onde se conclui que a depressão como categoria diagnóstica que responderia a uma causalidade única, não existe. Em contrapartida, nesse campo reconhecem-se, por um lado, a universalidade dos fenômenos depressivos, passíveis de manifestação em qualquer categoria nosográfica e, por outro, a melancolia como um quadro que se fundamenta não a partir da tristeza, mas de mecanismos psicóticos específicos.The subject of depression is researched based on the theoretical psychoanalysis. In Sigmund Freud’s, Jacques Lacan’s and some of their critics’ works, the subject is - in the beginning - introduced from psychiatry-field from which the concept of depression, as it is understood nowadays, was born. The current diagnosis, the fragility of inherited genes as the main cause-effect hypothesis, the lack of sufficient "biological labels" and the limits of therapy through chemical means, are all critically approached. Immediately, the subject is approached in psychoanalysis, in which it is concluded that depression, as a category-subject to be diagnosed and derived from a unique cause - does not exist. As a counterpart, in this field it is recognised that - if on the one hand the universality of depression phenomena apt to appear in any diagnostic category - on the other hand, melancholy as a pathology which was not born from sadness but from specific psychotic mechanisms, is also recognised.

  8. Big Five personality and depression diagnosis, severity and age of onset in older adults.

    Science.gov (United States)

    Koorevaar, A M L; Comijs, H C; Dhondt, A D F; van Marwijk, H W J; van der Mast, R C; Naarding, P; Oude Voshaar, R C; Stek, M L

    2013-10-01

    Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, ppersonality measures. This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset. © 2013 Elsevier B.V. All rights reserved.

  9. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

    The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued......, that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression...

  10. Depressive symptoms in the first year from diagnosis of Type 2 diabetes

    DEFF Research Database (Denmark)

    Skinner, T. C.; Carey, M. E.; Cradock, S.

    2010-01-01

    the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic......Aims To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Methods Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed...... regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. Results The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18-22% over the year) was not significantly different from normative data for the general...

  11. Effect of depression before breast cancer diagnosis on mortality among postmenopausal women.

    Science.gov (United States)

    Liang, Xiaoyun; Margolis, Karen L; Hendryx, Michael; Reeves, Katherine; Wassertheil-Smoller, Sylvia; Weitlauf, Julie; Danhauer, Suzanne C; Chlebowski, Rowan T; Caan, Bette; Qi, Lihong; Lane, Dorothy; Lavasani, Sayeh; Luo, Juhua

    2017-08-15

    Few previous studies investigating depression before the diagnosis of breast cancer and breast cancer-specific mortality have examined depression measured at more than 1 time point. This study investigated the effect of depression (combining depressive symptoms alone with antidepressant use) measured at 2 time points before the diagnosis of breast cancer on all-cause mortality and breast cancer-specific mortality among older postmenopausal women. A large prospective cohort, the Women's Health Initiative, was used. The study included 3095 women with incident breast cancer who had measures of depressive symptoms and antidepressant use before their diagnosis at the baseline and at year 3. Multivariate Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) between depression at the baseline, depression at year 3, and combinations of depression at these time points and all-cause mortality and breast cancer-specific mortality. Depression at year 3 before a breast cancer diagnosis was associated with higher all-cause mortality after adjustments for multiple covariates (HR, 1.35; 95% confidence interval [CI], 1.02-1.78). There was no statistically significant association of baseline depression and all-cause mortality or breast cancer-specific mortality whether or not depression was also present at year 3. In women with late-stage (regional- or distant-stage) breast cancer, newly developed depression at year 3 was significantly associated with both all-cause mortality (HR, 2.00; 95% CI, 1.13-3.56) and breast cancer-specific mortality (HR, 2.42; 95% CI, 1.24-4.70). Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage. Cancer 2017;123:3107-15. © 2017 American Cancer Society. © 2017 American Cancer Society.

  12. DEPRESSION IN PRIMARY CARE. PART 1: SCREENING AND DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    XV Pereira

    2007-01-01

    Full Text Available One of the commonest psychological problems that a clinician would encounter in primary care is depression. Theprevalence of depression is high in women, the elderly and those with underlying physical problems or during the postpartumperiod. The spectrum of clinical presentations is wide and somatic complaints are more common in primary care clinics.Depression may present as a primary disorder and co-morbidity with other psychological problems or physical illnessesis high. A good clinical interview is an important form of assessment and a quick screening of depression can be donewith the administration of proper rating scales, such as the Patient Health Questionnaire, Hamilton Depression RatingScale or Geriatric Depression Scale. Repeated use of the same scale in a patient would help the clinician to monitor theprogress objectively.

  13. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?

    Directory of Open Access Journals (Sweden)

    Roshan Rasool

    2007-07-01

    Full Text Available Abstract Background Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress. Methods This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS. This is a widely used valid questionnaire to measure psychological distress in cancer patients. Demographic and clinical data also were collected to examine anxiety and depression in sub-group of patients especially in those who knew their cancer diagnosis and those who did not. Results In all 142 patients were studied. The mean age of patients was 54.1 (SD = 14.8, 56% were male, 52% did not know their cancer diagnosis, and their diagnosis was related to esophagus (29%, stomach (30%, small intestine (3%, colon (22% and rectum (16%. The mean anxiety score was 7.6 (SD = 4.5 and for the depression this was 8.4 (SD = 3.8. Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD anxiety score: knew diagnosis 9.1 (4.2 vs. 6.3 (4.4 did not know diagnosis, P Conclusion Psychological distress was higher in those who knew their cancer diagnosis. It seems that the cultural issues and the way we provide information for cancer patients play important role in their improved or decreased psychological well-being.

  14. Diagnosis and treatment of fatigue and depression in the patient treated with radiotherapy

    International Nuclear Information System (INIS)

    Greenberg, Donna B.; Piper, Barbara F.

    1995-01-01

    The purpose of this course is to clarify the diagnosis of when the diagnosis of major depressive disorder is appropriate for the cancer patient treated with radiotherapy. Specific anxiety syndromes and confounding differential diagnoses will be considered. We will consider the relationship between depression and anxiety and the symptom of radiation-induced fatigue. The review will also include the psychopharmacology of common antidepressants and antianxiety agents

  15. How family physicians address diagnosis and management of depression in palliative care patients.

    NARCIS (Netherlands)

    Warmenhoven, F.C.; Rijswijk, H.C.A.M. van; Hoogstraten, E. van; Spaendonck, K.P.M. van; Lucassen, P.L.B.J.; Prins, J.B.; Vissers, K.; Weel, C. van

    2012-01-01

    PURPOSE Depression is highly prevalent in palliative care patients. In clinical practice, there is concern about both insufficient and excessive diagnosis and treatment of depression. In the Netherlands, family physicians have a central role in delivering palliative care. We explored variation in

  16. Major depressive disorder as a co-morbid diagnosis in ...

    African Journals Online (AJOL)

    The purpose of this article is to focus on the importance of depressive symptoms in patients suffering from schizophrenia, and the dilemma posed by hierarchical classification methods, which exclude co-morbid diagnoses such as Major Depressive Disorder in patients with schizophrenia. The question arises that if Major ...

  17. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?

    Science.gov (United States)

    Tavoli, Azadeh; Mohagheghi, Mohammad Ali; Montazeri, Ali; Roshan, Rasool; Tavoli, Zahra; Omidvari, Sepideh

    2007-07-14

    Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress. This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). This is a widely used valid questionnaire to measure psychological distress in cancer patients. Demographic and clinical data also were collected to examine anxiety and depression in sub-group of patients especially in those who knew their cancer diagnosis and those who did not. In all 142 patients were studied. The mean age of patients was 54.1 (SD = 14.8), 56% were male, 52% did not know their cancer diagnosis, and their diagnosis was related to esophagus (29%), stomach (30%), small intestine (3%), colon (22%) and rectum (16%). The mean anxiety score was 7.6 (SD = 4.5) and for the depression this was 8.4 (SD = 3.8). Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD) anxiety score: knew diagnosis 9.1 (4.2) vs. 6.3 (4.4) did not know diagnosis, P < 0.001; mean (SD) depression score: knew diagnosis 9.1 (4.1) vs. 7.9 (3.6) did not know diagnosis, P = 0.05]. Performing logistic regression analysis while controlling for demographic and clinical variables studied the results indicated that those who knew their cancer diagnosis showed a significant higher risk of anxiety [OR: 2.7, 95% CI: 1.1-6.8] and depression [OR: 2.8, 95% CI: 1.1-7.2]. Psychological distress was

  18. Three-dimensional reconstruction used in the diagnosis and treatment of depressed fracture of skull

    International Nuclear Information System (INIS)

    Li Liang; Luo Zhikun; Lin Xiaohui; Liu Shuyi; Chen Xu; Liu Chenghui

    2005-01-01

    Objective: To evaluate three-dimensional reconstruction used in the diagnosis and management of depressed fracture of skull. Methods: The images of CT scan and three-dimensional reconstruction in 23 patients with depressed fracture of skull were studied. The clinical treatment was guided by the images. Results: The fracture site and depth in all 23 cases were well demonstrated in the imaging of three-dimensional reconstruction, which successfully guided the clinical management in every case. Conclusion: Three-dimensional reconstruction is a valuable modality for the diagnosis and management of depressed fracture of skull. (authors)

  19. Neurocognitive differential diagnosis of dementing diseases: Alzheimer's Dementia, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder.

    Science.gov (United States)

    Braaten, Alyssa J; Parsons, Thomas D; McCue, Robert; Sellers, Alfred; Burns, William J

    2006-11-01

    Similarities in presentation of Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder, pose differential diagnosis challenges. The current study identifies specific neuropsychological patterns of scores for Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. Neuropsychological domains directly assessed in the study included: immediate memory, delayed memory, confrontational naming, verbal fluency, attention, concentration, and executive functioning. The results reveal specific neuropsychological comparative profiles for Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. The identification of these profiles will assist in the differential diagnosis of these disorders and aid in patient treatment.

  20. Depression and dementia: taking a dual diagnosis approach.

    Science.gov (United States)

    Manthorpe, Jill; Iliffe, Steve

    2006-03-01

    This article explores dementia and depression, the relationship between them and ways of distinguishing between them in older patients. It also suggests ways in which nurses can offer support to people affected by both conditions.

  1. What is depression? Psychiatrists’ and GPs’ experiences of diagnosis and the diagnostic process

    Directory of Open Access Journals (Sweden)

    Annette S. Davidsen

    2014-11-01

    Full Text Available The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners’ (GPs’ treatment of depression is insufficient and a collaborative care (CC model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views on the usefulness of the concept of depression and in their language and narrative styles when telling stories about depressed patients. The differences were captured in three polarities which expressed the range of experiences in the two groups. Psychiatrists considered the diagnosis of depression as a pragmatic and agreed construct and they did not question its validity. GPs thought depression was a “gray area” and questioned the clinical utility in general practice. Nevertheless, GPs felt a demand from psychiatry to make their diagnosis based on instruments created in psychiatry, whereas psychiatrists based their diagnosis on clinical impression but used instruments to assess severity. GPs were wholly skeptical about instruments which they felt could be misleading. The different understandings could possibly lead to a clash of interests in any proposed CC model. The findings provide fertile ground for organizational research into the actual implementation of cooperation between sectors to explore how differences are dealt with.

  2. Symptom endorsement in men versus women with a diagnosis of depression: A differential item functioning approach.

    Science.gov (United States)

    Cavanagh, Anna; Wilson, Coralie J; Caputi, Peter; Kavanagh, David J

    2016-09-01

    There is some evidence that, in contrast to depressed women, depressed men tend to report alternative symptoms that are not listed as standard diagnostic criteria. This may possibly lead to an under- or misdiagnosis of depression in men. This study aims to clarify whether depressed men and women report different symptoms. This study used data from the 2007 Australian National Survey of Mental Health and Wellbeing that was collected using the World Health Organization's Composite International Diagnostic Interview. Participants with a diagnosis of a depressive disorder with 12-month symptoms (n = 663) were identified and included in this study. Differential item functioning (DIF) was used to test whether depressed men and women endorse different features associated with their condition. Gender-related DIF was present for three symptoms associated with depression. Depressed women were more likely to report 'appetite/weight disturbance', whereas depressed men were more likely to report 'alcohol misuse' and 'substance misuse'. While the results may reflect a greater risk of co-occurring alcohol and substance misuse in men, inclusion of these features in assessments may improve the detection of depression in men, especially if standard depressive symptoms are under-reported. © The Author(s) 2016.

  3. Etiology and Diagnosis of Major Depression - A Novel Quantitative Approach

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.

    2013-01-01

    Background: Classical psychiatric opinions are relative uncertain and treatment results are not impressive when dealing with major depression. Depression is related to the endocrine system, but despite much effort a good quantitative measure for characterizing depression has not yet emerged....... Methods: Based on ACTH and cortisol levels and using clustering analysis and mixture effect modeling we propose a novel and scientifically based quantitative index, denoted the O-index. The O-index combines a weighted and scaled deviation from normal values in both ACTH and cortisol. Results: Using ANOVA......-index may be used for diagnostic procedure. Discussion: The methods are discussed and based on the available data material we propose that the O-index may be used to improve the diagnostic procedure and consequently the follow-up treatment....

  4. Validation of laughter for diagnosis and evaluation of depression.

    Science.gov (United States)

    Navarro, J; del Moral, R; Alonso, M F; Loste, P; Garcia-Campayo, J; Lahoz-Beltra, R; Marijuán, P C

    2014-05-01

    In the medical field, laughter has been studied for its beneficial effects on health and as a therapeutic method to prevent and treat major medical diseases. However, very few works, if any, have explored the predictive potential of laughter and its potential use as a diagnostic tool. We registered laughs of depressed patients (n=30) and healthy controls (n=20), in total 934 laughs (517 from patients and 417 from controls). All patients were tested by the Hamilton Depression Rating Scale (HDRS). The processing was made in Matlab, with calculation of 8 variables per laugh plosive. General and discriminant analysis distinguished patients, controls, gender, and the association between laughter and HDRS test. Depressed patients and healthy controls differed significantly on the type of laughter, with 88% efficacy. According to the Hamilton scale, 85.47% of the samples were correctly classified in males, and 66.17% in women, suggesting a tight relationship between laughter and the depressed condition. (i) The compilation of humorous videos created to evoke laughter implied quite variable chances of laughter production. (ii) Some laughing subjects might not feel comfortable when recording. (iii) Evaluation of laughter episodes depended on personal inspection of the records. (iv) Sample size was relatively small and may not be representative of the general population afflicted by depression. Laughter may be applied as a diagnostic tool in the onset and evolution of depression and, potentially, of neuropsychiatric pathologies. The sound structures of laughter reveal the underlying emotional and mood states in interpersonal relationships. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Depression

    DEFF Research Database (Denmark)

    Pouwer, Frans

    2017-01-01

    There is ample evidence that depression is000  a common comorbid health issue in people with type 1 or type 2 diabetes. Reviews have also concluded that depression in diabetes is associated with higher HbA1c levels, less optimal self-care behaviours, lower quality of life, incident vascular...... complications and higher mortality rates. However, longitudinal studies into the course of depression in people with type 1 diabetes remain scarce. In this issue of Diabetologia, Kampling and colleagues (doi: 10.1007/s00125-016-4123-0 ) report the 5 year trajectories of depression in adults with newly diagnosed...... type 1 diabetes (mean age, 28 years). Their baseline results showed that shortly after the diagnosis of type 1 diabetes a major depressive episode was diagnosed in approximately 6% of participants, while 8% suffered from an anxiety disorder. The longitudinal depression data showed that, in a 5 year...

  6. [Diagnosis of depressive disorder and so-called exhaustion depression. Self-esteem--a central concept].

    Science.gov (United States)

    Beck-Friis, Johan

    2002-02-07

    Depressive disorders can be recognized by the loss of self-esteem; this contrasts with mourning and neurasthenic reactions, in which self-esteem remains intact. Just as depression can result from the gradual reduction and eventual loss of self-esteem, mourning and neurasthenic reactions can evolve into true depressive states. "Exhaustion depression", a new diagnostic category connected to "burnout" situations, should be applied only when criteria for depressive disorder are fulfilled, including loss of self-esteem. When these criteria are lacking we should refer only to an exhaustion state provoked by stress. Neurotic mechanisms may represent a special class of relevant stress factors, but are not seen in manifest neurasthenic reactions and exhaustion depression.

  7. Differential Diagnosis in Older Adults: Dementia, Depression, and Delirium.

    Science.gov (United States)

    Gintner, Gary G.

    1995-01-01

    Examines three common disorders, dementia, depression, and delirium, which can be particularly difficult to diagnose in older adults. Presents three aspects that are helpful in making a decision: age-related differences, medical issues that need to be ruled out, and assessment methods particularly useful in the diagnostic process. (JPS)

  8. The nature and correlates of change in depressive symptoms with cancer diagnosis: reaction and adaptation.

    Science.gov (United States)

    Infurna, Frank J; Gerstorf, Denis; Ram, Nilam

    2013-06-01

    Major life events trigger change processes in mental health. We examined how depressive symptoms change in conjunction with cancer diagnosis during adulthood and old age, and whether sociodemographic variables, cognitive and health resources, and cancer-specific mortality risks moderate event-related reaction and adaptation. Specifically, we applied multiphase growth models to prospective longitudinal data from 2,848 participants (age at diagnosis: M = 69, SD = 9.91; 46% women) in the Health and Retirement Study (HRS) who reported receiving a cancer diagnosis while enrolled in the study. On average, individuals experienced a significant increase in depressive symptoms within 2 years of cancer diagnosis, still-elevated levels 2 years postdiagnosis, and smaller increases in depressive symptoms postdiagnosis relative to the increases observed prediagnosis. Better memory and lower cancer-specific mortality risks were protective against increases in depressive symptoms within 2 years of diagnosis and were associated with reporting fewer depressive symptoms 2 years postdiagnosis. Findings suggest that diagnosis-related changes in depressive symptoms are typically characterized by a multiphase pattern, but tremendous between-person differences also emerged within each phase. Follow-up analyses comparing a matched group (N = 2,272) who did not experience cancer provided an additional layer of evidence supporting our inferences. Results indicate that, on average, people adapt and adjust to the challenges accompanying a cancer diagnosis, and illustrate the utility of using natural experiments such as major life events as a paradigm for studying developmental change processes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  9. Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors

    DEFF Research Database (Denmark)

    Schoormans, Dounya; van de Poll-Franse, Lonneke; Vissers, Pauline

    2017-01-01

    PURPOSE: To examine the associations between pharmaceutically treated anxiety and depression present in the year prior to breast cancer diagnosis and the risk of incident cardiovascular disease (CVD), while controlling for traditional cardiovascular risk factors and clinical characteristics...... adjustment for depression, traditional cardiovascular risk factors, and clinical characteristics......., anxiety, and depression. By multivariable Cox regression analysis, we examined the risk associated with pharmaceutically treated anxiety and depression for developing CVD after cancer diagnosis, adjusting for age, pharmaceutically treated hypertension, hypercholesterolemia, and diabetes mellitus...

  10. Determination of the optimal case definition for the diagnosis of end-stage renal disease from administrative claims data in Manitoba, Canada.

    Science.gov (United States)

    Komenda, Paul; Yu, Nancy; Leung, Stella; Bernstein, Keevin; Blanchard, James; Sood, Manish; Rigatto, Claudio; Tangri, Navdeep

    2015-01-01

    End-stage renal disease (ESRD) is a major public health problem with increasing prevalence and costs. An understanding of the long-term trends in dialysis rates and outcomes can help inform health policy. We determined the optimal case definition for the diagnosis of ESRD using administrative claims data in the province of Manitoba over a 7-year period. We determined the sensitivity, specificity, predictive value and overall accuracy of 4 administrative case definitions for the diagnosis of ESRD requiring chronic dialysis over different time horizons from Jan. 1, 2004, to Mar. 31, 2011. The Manitoba Renal Program Database served as the gold standard for confirming dialysis status. During the study period, 2562 patients were registered as recipients of chronic dialysis in the Manitoba Renal Program Database. Over a 1-year period (2010), the optimal case definition was any 2 claims for outpatient dialysis, and it was 74.6% sensitive (95% confidence interval [CI] 72.3%-76.9%) and 94.4% specific (95% CI 93.6%-95.2%) for the diagnosis of ESRD. In contrast, a case definition of at least 2 claims for dialysis treatment more than 90 days apart was 64.8% sensitive (95% CI 62.2%-67.3%) and 97.1% specific (95% CI 96.5%-97.7%). Extending the period to 5 years greatly improved sensitivity for all case definitions, with minimal change to specificity; for example, for the optimal case definition of any 2 claims for dialysis treatment, sensitivity increased to 86.0% (95% CI 84.7%-87.4%) at 5 years. Accurate case definitions for the diagnosis of ESRD requiring dialysis can be derived from administrative claims data. The optimal definition required any 2 claims for outpatient dialysis. Extending the claims period to 5 years greatly improved sensitivity with minimal effects on specificity for all case definitions.

  11. [Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part I: Risk Factors, Screening, Suicide Risk Diagnosis and Assessment in Patients with a Depression Diagnosis].

    Science.gov (United States)

    Gómez-Restrepo, Carlos; Peñaranda, Adriana Patricia Bohórquez; Valencia, Jenny García; Guarín, Maritza Rodríguez; Narváez, Eliana Bravo; Jaramillo, Luis Eduardo; Acosta, Carlos Alberto Palacio; Pedraza, Ricardo Sánchez; Díaz, Sergio Mario Castro

    2012-12-01

    Depression is an important cause of morbidity and disability in the world; however, it is under-diagnosed at all care levels. The purpose here is to present recommendations based on the evidence gathered to answer a series of clinical questions concerning risk factors, screening, suicide risk diagnosis and evaluation in patients undergoing a depressive episode and recurrent depressive disorder. Emphasis has been made upon the approach used at the primary care level so as to grant adult diagnosed patients the health care guidelines based on the best and more updated evidence available thus achieving minimum quality standards. A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from guides NICE90 and CANMAT were adopted and updated so as to answer the questions posed while de novo questions were developed. Recommendations 1-22 corresponding to screening, suicide risk and depression diagnosis were presented. The corresponding degree of recommendation is included. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Diagnosis and treatment of fatigue and depression in the patient treated with radiotherapy

    International Nuclear Information System (INIS)

    Greenberg, Donna B.; Piper, Barbara F.

    1996-01-01

    This course is designed to review what is currently known about depression and fatigue and their interrelationships in cancer patients receiving radiation therapy. Specific anxiety and confounding differential diagnoses will be considered in order to clarify when the diagnosis of major depressive disorder is appropriate in these patients. Psychopharmacology of common antidepressants and antianxiety agents will be reviewed. Similarly, the discussion will include how to make the differential diagnosis between tiredness and acute and chronic forms of fatigue; how to assess and measure fatigue multidimensionally; and how to target multimodal therapies to underlying fatigue mechanisms in these patients

  13. Is There Such a Diagnosis as an Early Onset Unipolar Depression?

    Directory of Open Access Journals (Sweden)

    Berta Ferreira

    2014-10-01

    Full Text Available According to Kraepelin, melancholia was part of manic-depressive psychosis. In the 60s however, other authors (Angst, 1966; Perris, 1966; Winokur, 1967 questioned this concept by considering unipolar depression a clinical entity, separated from bipolar disorders. Using strict bipolar disorders criteria, some prospective studies have shown a diagnosis switch from unipolar to bipolar disorders in up to 50% of the cases (Caryell, 1995; Goldberg, 2001; Angst, 2005. The existence of unipolar depression as a clinical entity is discussed, taking in consideration the “minor” bipolar symptoms that occur during the course of affective disorders.

  14. Does knowledge of diagnosis really affect rates of depression in cancer patients?

    Science.gov (United States)

    Kállay, Éva; Pintea, Sebastian; Dégi, Csaba L

    2016-12-01

    Significant levels of distress usually accompany the entire cancer experience, affecting the patients' general functioning and adaptation to illness. The major objective of the present study was to investigate potential demographic and intrapersonal moderators of the relationship between knowing the cancer diagnosis and the level of depression experienced. The present research has a transversal comparative repeated cross-sectional design (2006-2014), sampling following the proportional quota method. Research was conducted in the four major oncological institutes in Romania, obtaining a national sample of cancer patients, maintaining gender and ethnic rates, and permitting the investigation of the stability of the results from one assessment to the other. Results indicate that in the Romanian context, knowing the diagnosis is associated with a lower level of depression than not knowing the diagnosis, the results being similar in both assessments (2006-2014). Furthermore, from the explored demographic factors (gender, residence, age, and education), only age has a main effect upon depression (depression increasing with age), while education is the only factor from those analyzed, which has a moderator effect. Regarding the analyzed intra-individual variables, only dysfunctional attitudes, emotion-focused coping, and lack of emotional support from the family (loneliness) have main effects upon the level of depression (i.e., higher levels of dysfunctional attitudes, emotion-focused coping, and loneliness are associated with higher levels of depression), while neither of them has a moderator effect on the relationship between knowing the diagnosis and depression. These results are important in the improvement of the doctor-patient relationship, the management of cancer-related distress, and implicitly for the course of illness. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Health Care Engagement Among LGBT Older Adults: The Role of Depression Diagnosis and Symptomatology.

    Science.gov (United States)

    Shiu, Chengshi; Kim, Hyun-Jun; Fredriksen-Goldsen, Karen

    2017-02-01

    Optimal engagement in health care plays a critical role in the success of disease prevention and treatment, particularly for older adults who are often in greater need of health care services. However, to date, there is still limited knowledge about the relationship between depression and health care engagement among lesbian, gay, bisexual, and transgender (LGBT) older adults. This study utilized data from Aging with Pride: National Health, Aging, Sexuality/Gender Study, from the 2014 survey with 2,450 LGBT adults 50 years old and older. Multiple-variable regression was utilized to evaluate relationships between three indicators of health care engagement and four depression groups after controlling for background characteristics and discrimination in health care. Health care engagement indicators were "not using preventive care," "not seeking care when needed," and "difficulty in adhering to treatments." Depression groups were defined by depression diagnosis and symptomatology, including Diagnosed-Symptomatic group (Diag-Sympt), Diagnosed-Nonsymptomatic group (Diag-NoSympt), Nondiagnosed-Symptomatic group (NoDiag-Sympt), and Nondiagnosed-Nonsymptomatic group (NoDiag-NoSympt). Depression groups displayed different patterns and levels of health care engagement. The Diag-Sympt group displayed the highest "difficulty in adhering to treatments." Diag-NoSympt group displayed the lowest "not using preventive care." The NoDiag-Sympt group reported the highest "not using preventive care" and "not seeking care when needed." The NoDiag-NoSympt group had the lowest "not seeking care when needed" and "difficulty in adhering to treatments." Depression diagnosis and symptomatology are jointly associated with health care engagement among LGBT older adults. Interventions aiming to promote health care engagement among this population should simultaneously consider both depression diagnosis and symptomatology. © The Author 2017. Published by Oxford University Press on behalf of The

  16. Anxiety/aggression--driven depression. A paradigm of functionalization and verticalization of psychiatric diagnosis.

    Science.gov (United States)

    Van Praag, H M

    2001-05-01

    A new subtype of depression is proposed, named: anxiety/aggression-driven depression. The psychopathological, psychopharmacological and biochemical evidence on which this construct is based, is being discussed. Selective postsynaptic 5-HT1A agonists together with CRH and/or cortisol antagonists are hypothesized to be a specific biological treatment for this depression type, in conjunction with psychological interventions to raise the stressor-threshold and to increase coping skills. The development of this depression construct has been contingent on the introduction of two new diagnostic procedures, called functionalization and verticalization of psychiatric diagnosis. These procedures are explained and it is stressed that they are essential to psychiatric diagnosing, in order to put this process on a scientific footing.

  17. DESPERATELY SEEKING HAPPINESS: VALUING HAPPINESS IS ASSOCIATED WITH SYMPTOMS AND DIAGNOSIS OF DEPRESSION.

    Science.gov (United States)

    Ford, Brett Q; Shallcross, Amanda J; Mauss, Iris B; Floerke, Victoria A; Gruber, June

    Culture shapes the emotions people feel and want to feel. In Western cultures, happiness is an emotion that many people want to feel. Although experiencing happiness is associated with increased well-being and psychological health, recent evidence suggests wanting to feel happy to an extreme degree, or, highly valuing happiness, leads to decreased well-being. To examine whether these effects of valuing happiness might extend to clinical outcomes, we examined the hypothesis that depression is associated with highly valuing happiness. To do so, we examined the relationship between valuing happiness and depression in two U.S. samples. As hypothesized, valuing happiness was associated with increased depressive symptoms in a community sample with remitted major depressive disorder (MDD), even when controlling for social desirability and neuroticism (Study 1). Furthermore, valuing happiness was elevated in a remitted MDD sample (vs. healthy controls), even when controlling for current depressive symptoms, general affect valuation, and extreme goal pursuit (Study 2). Taken together, these findings suggest that the culturally-pervasive value placed on attaining happiness can represent a risk factor for symptoms and a diagnosis of depression. More broadly, they indicate that a cultural approach can meaningfully extend our understanding of clinical phenomena.

  18. Was Queen Victoria depressed? 1. Natural history and differential diagnosis of presenting problem.

    Science.gov (United States)

    Powles, W E; Alexander, M G

    1987-02-01

    For some years we have speculated as to whether Queen Victoria suffered a definable psychiatric illness in her notorious and prolonged seclusion after the Prince Consort's death. We here summarize criteria for grief and depression from three authorities. Against these, we examine the natural history of the Queen's bereavement and restitution. We find that her suffering and her portrayal of the role of widow were related to her personal style and were culturally accepted. Her self-esteem, ego functions, and object relatedness were preserved. While some clinicians might favour a diagnosis of Dysthymic Disorder, we find the evidence strongly in favour of an intense, prolonged, normal human grief (Uncomplicated Bereavement of DSM III) coloured by a romantic and histrionic personal style. Intensity and duration do not, in this case, establish a diagnosis of depression.

  19. Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

    Directory of Open Access Journals (Sweden)

    Yamada Kenshi

    2008-09-01

    Full Text Available Abstract Aim The aim of this survey was to assess the accuracy of a family physician's diagnosis of depression and alcoholism. Methods Consecutive new adult patients attending a family practice in Japan between April 2004 and August 2006 were enrolled. Excluded were those with dementia or visual disturbance, and emergency cases. Participants completed a questionnaire regarding their complaints and socio-demographics. A research nurse conducted the Japanese version of the Mini-International Neuropsychiatric Interview (J-MINI in the interview room. The doctor independently performed usual practice and recorded his own clinical diagnoses. A researcher listed the clinical diagnoses and complaints, including J-MINI or clinically-diagnosed alcoholism and depression, using the International Classifications for Primary Care, Second Edition (ICPC-2 and calculated kappa statistics between the J-MINI and clinical diagnoses. Results Of the 120 adult first-visit patients attending the clinics, 112 patients consented to participate in the survey and were enrolled. Fifty-one subjects were male and 61 female, and the average age was 40.7 ± 13.2 years. Eight alcohol-related disorders and five major depressions were diagnosed using the J-MINI, whereas no cases of alcoholism and eight depressions were diagnosed by the physician. Clinically overlooked patients tended to have acute illnesses like a common cold. Concordance between the clinical and research diagnosis was achieved only for three episodes of Major depression, resulting in a kappa statistic of 0.43. Conclusion Although almost half of the major depressions were identified, all alcoholism was missed. A mental health screening instrument might be beneficial in family practice, especially to detect alcoholism.

  20. Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors

    NARCIS (Netherlands)

    Schoormans, Dounya; Van De Poll-franse, Lonneke; Vissers, Pauline; Van Herk-sukel, Myrthe P. P.; Pedersen, Susanne S.; Rottmann, Nina; Horsbøl, Trine; Dalton, Susanne; Denollet, Johan

    2017-01-01

    PURPOSE: To examine the associations between pharmaceutically treated anxiety and depression present in the year prior to breast cancer diagnosis and the risk of incident cardiovascular disease (CVD), while controlling for traditional cardiovascular risk factors and clinical characteristics in a

  1. Costs by industry and diagnosis among musculoskeletal claims in a state workers compensation system: 1999-2004.

    Science.gov (United States)

    Dunning, Kari K; Davis, Kermit G; Cook, Chad; Kotowski, Susan E; Hamrick, Chris; Jewell, Gregory; Lockey, James

    2010-03-01

    Musculoskeletal disorders (MSDs) are a tremendous burden on industry in the United States. However, there is limited understanding of the unique issues relating to specific industry sectors, specifically the frequency and costs of different MSDs. Claim data from 1999 to 2004 from the Ohio Bureau of Workers' Compensation were analyzed as a function of industry sector (NAICS industry-sector categories) and anatomical region (ICD-9 codes). Almost 50% of the claims were lumbar spine (26.9%) or hand/wrist (21.7%). The majority of claims were from manufacturing (25.1%) and service (32.8%) industries. The industries with the highest average costs per claim were transportation, warehouse, and utilities and construction. Across industries, the highest costs per claim were consistently for the lumbar spine, shoulder, and cervical spine body regions. This study provides insight into the severity (i.e., medical and indemnity costs) of MSDs across multiple industries, providing data for prioritizing of resources for research and interventions. 2009 Wiley-Liss, Inc.

  2. Analysis of treatment patterns and persistence on branded and generic medications in major depressive disorder using retrospective claims data

    Directory of Open Access Journals (Sweden)

    Solem CT

    2016-10-01

    Full Text Available Caitlyn T Solem,1 Ahmed Shelbaya,2,3 Yin Wan,1 Chinmay G Deshpande,1 Jose Alvir,2 Elizabeth Pappadopulos2 1Pharmerit International, Real World Evidence/Data Analytics, Bethesda, MD, 2Pfizer, Inc., Global Health Outcomes, New York, NY, 3Epidemiology Department of Mailman’s School of Public Health, Columbia University Mailman School of Public Health, New York, NY, USA Background: In major depressive disorder (MDD, treatment persistence is critical to optimize symptom remission, functional recovery, and health care costs. Desvenlafaxine tends to have fewer drug interactions and better tolerability than other MDD drugs; however, its use has not been assessed in the real world.Objective: The aim of the present study is to compare medication persistence and concomitant MDD drug use with branded desvenlafaxine (Pristiq® compared with antidepressant drug groups classified as 1 branded selective serotonin reuptake inhibitors (SSRIs; ie, escitalopram [Lexapro™] and selective serotonin–norepinephrine reuptake inhibitors (SNRIs; ie, venlafaxine [Effexor®], duloxetine [Cymbalta®] and 2 generic SSRIs/SNRIs (ie, escitalopram, citalopram, venlafaxine, fluvoxamine, fluoxetine, sertraline, paroxetine, and duloxetine.Patients and methods: MDD patients (ICD-9-CM codes 296.2, 296.3, with ≥2 prescription fills for study drugs and 12-month preindex continuous enrollment from the MarketScan Commercial Claims and Encounters Database (2009–2013, were included. Time-to-treatment discontinuation (prescription gap ≥45 days was assessed using the Kaplan–Meier curve and Cox model. Concomitant MDD drug use was compared.Results: Of the 273,514 patients included, 14,379 patients were initiated with branded desvenlafaxine, 50,937 patients with other branded SSRIs/SNRIs, and 208,198 patients with generic SSRIs/SNRIs. The number of weeks for treatment discontinuation for branded desvenlafaxine were longer (40.7 [95% CI: 39.3, 42.0] compared with other branded

  3. Outpatient costs in pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting

    Directory of Open Access Journals (Sweden)

    Bosmans Judith E

    2012-02-01

    Full Text Available Abstract Background To assess differences in outpatient costs among pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting. Methods A retrospective case control study over 3 years (2002-2004. Data on 7128 depressed patients and 23772 non-depressed matched controls were available from the electronic medical record system of 20 general practices organized in one large primary care organization in the Netherlands. A total of 393 depressed patients with diabetes and 494 non-depressed patients with diabetes were identified in these records. The data that were extracted from the medical record system concerned only outpatient costs, which included GP care, referrals, and medication. Results Mean total outpatient costs per year in depressed diabetes patients were €1039 (SD 743 in the period 2002-2004, which was more than two times as high as in non-depressed diabetes patients (€492, SD 434. After correction for age, sex, type of insurance, diabetes treatment, and comorbidity, the difference in total annual costs between depressed and non-depressed diabetes patients changed from €408 (uncorrected to €463 (corrected in multilevel analyses. Correction for comorbidity had the largest impact on the difference in costs between both groups. Conclusions Outpatient costs in depressed patients with diabetes are substantially higher than in non-depressed patients with diabetes even after adjusting for confounders. Future research should investigate whether effective treatment of depression among diabetes patients can reduce health care costs in the long term.

  4. Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Høgh (Hogh), Annie; Nabe-Nielsen, Kirsten

    2018-01-01

    to depressive symptoms and diagnosis of depression. Methods The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9–45) and a one-item measure applying the self-labelling method with a definition to assess occasional...... its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844). Results The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification.......44–1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98–6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93–11.88) were significantly associated with diagnosis of depression. Conclusions...

  5. Aberrant functional connectivity for diagnosis of major depressive disorder: a discriminant analysis.

    Science.gov (United States)

    Cao, Longlong; Guo, Shuixia; Xue, Zhimin; Hu, Yong; Liu, Haihong; Mwansisya, Tumbwene E; Pu, Weidan; Yang, Bo; Liu, Chang; Feng, Jianfeng; Chen, Eric Y H; Liu, Zhening

    2014-02-01

    Aberrant brain functional connectivity patterns have been reported in major depressive disorder (MDD). It is unknown whether they can be used in discriminant analysis for diagnosis of MDD. In the present study we examined the efficiency of discriminant analysis of MDD by individualized computer-assisted diagnosis. Based on resting-state functional magnetic resonance imaging data, a new approach was adopted to investigate functional connectivity changes in 39 MDD patients and 37 well-matched healthy controls. By using the proposed feature selection method, we identified significant altered functional connections in patients. They were subsequently applied to our analysis as discriminant features using a support vector machine classification method. Furthermore, the relative contribution of functional connectivity was estimated. After subset selection of high-dimension features, the support vector machine classifier reached up to approximately 84% with leave-one-out training during the discrimination process. Through summarizing the classification contribution of functional connectivities, we obtained four obvious contribution modules: inferior orbitofrontal module, supramarginal gyrus module, inferior parietal lobule-posterior cingulated gyrus module and middle temporal gyrus-inferior temporal gyrus module. The experimental results demonstrated that the proposed method is effective in discriminating MDD patients from healthy controls. Functional connectivities might be useful as new biomarkers to assist clinicians in computer auxiliary diagnosis of MDD. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

  6. Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players.

    Science.gov (United States)

    Kerr, Zachary Y; Marshall, Stephen W; Harding, Herndon P; Guskiewicz, Kevin M

    2012-10-01

    Concussions may accelerate the progression to long-term mental health outcomes such as depression in athletes. To prospectively determine the effects of recurrent concussions on the clinical diagnosis of depression in a group of retired football players. Cohort study; Level of evidence, 2. Members of the National Football League Retired Players Association responded to a baseline General Health Survey (GHS) in 2001. They also completed a follow-up survey in 2010. Both surveys asked about demographic information, number of concussions sustained during their professional football career, physical/mental health, and prevalence of diagnosed medical conditions. A physical component summary (Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being [SF-36 PCS]) was calculated from responses for physical health. The main exposure, the history of concussions during the professional playing career (self-report recalled in 2010), was stratified into 5 categories: 0 (referent), 1 to 2, 3 to 4, 5 to 9, and 10+ concussions. The main outcome was a clinical diagnosis of depression between the baseline and follow-up GHS. Classic tabular methods computed crude risk ratios. Binomial regression with a Poisson residual and robust variance estimation to stabilize the fitting algorithm estimated adjusted risk ratios. χ(2) analyses identified associations and trends between concussion history and the 9-year risk of a depression diagnosis. Of the 1044 respondents with complete data from the baseline and follow-up GHS, 106 (10.2%) reported being clinically diagnosed as depressed between the baseline and follow-up GHS. Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their professional careers. The 9-year risk of a depression diagnosis increased with an increasing number of self-reported concussions, ranging from 3.0% in the "no concussions" group to 26.8% in the "10+" group (linear trend: P football and 2001 SF-36 PCS

  7. What Is Being Measured? A Comparison of Two Depressive Symptom Severity Instruments with a Depression Diagnosis in Low-Income High-Risk Mothers.

    Science.gov (United States)

    Yang, Jenny; Martinez, Maria; Schwartz, Todd A; Beeber, Linda

    2017-06-01

    Adequate assessment of depressive symptomatology is a necessary step toward decreasing income-related mental health treatment inequity. No studies have focused on comparing instruments used to detect depression in women from low-income backgrounds who are mothers of young children-a period of increased risk for depressive symptoms. To address this gap, two commonly used instruments (Center for Epidemiologic Studies Depression Scale [CES-D] and Hamilton Rating Scale for Depression [Hamilton]) were compared with a depression diagnosis (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-V]) in a sample (n = 251) of mothers from low-income backgrounds with children ranging from 1 to 54 months old. Diagnostic utility was examined in light of contextual factors associated with maternal depressive symptoms. In this sample, CES-D had better screening sensitivity and specificity than Hamilton. Our results suggest that Hamilton may underdiagnose cases of major depressive episodes (MDE) as defined by DSM-V among black and low-income mothers compared with CES-D. In addition, we identify items in CES-D, which do not contribute to alignment with DSM-V and are appropriate targets for future improvements. Our analysis identifies interpersonal relationships and mother's age as the primary risk factors, which differentiate between CES-D and Hamilton determinations versus MDE diagnosis. In addition, we find regional differences in CES-D and Hamilton. It is important to tailor the measure to the context, and a calibration sample should be considered for studies of sufficient size.

  8. Variability in Depressive Symptoms of Cognitive Deficit and Cognitive Bias During the First 2 Years After Diagnosis in Australian Men With Prostate Cancer.

    Science.gov (United States)

    Sharpley, Christopher F; Bitsika, Vicki; Christie, David R H

    2016-01-01

    The incidence and contribution to total depression of the depressive symptoms of cognitive deficit and cognitive bias in prostate cancer (PCa) patients were compared from cohorts sampled during the first 2 years after diagnosis. Survey data were collected from 394 patients with PCa, including background information, treatments, and disease status, plus total scores of depression and scores for subscales of the depressive symptoms of cognitive bias and cognitive deficit via the Zung Self-Rating Depression Scale. The sample was divided into eight 3-monthly time-since-diagnosis cohorts and according to depression severity. Mean scores for the depressive symptoms of cognitive deficit were significantly higher than those for cognitive bias for the whole sample, but the contribution of cognitive bias to total depression was stronger than that for cognitive deficit. When divided according to overall depression severity, patients with clinically significant depression showed reversed patterns of association between the two subsets of cognitive symptoms of depression and total depression compared with those patients who reported less severe depression. Differences in the incidence and contribution of these two different aspects of the cognitive symptoms of depression for patients with more severe depression argue for consideration of them when assessing and diagnosing depression in patients with PCa. Treatment requirements are also different between the two types of cognitive symptoms of depression, and several suggestions for matching treatment to illness via a personalized medicine approach are discussed. © The Author(s) 2014.

  9. Depression, pregnancy-related anxiety and parental-antenatal attachment in couples using preimplantation genetic diagnosis.

    Science.gov (United States)

    Winter, C; Van Acker, F; Bonduelle, M; Van Berkel, K; Belva, F; Liebaers, I; Nekkebroeck, J

    2016-06-01

    Do preimplantation genetic diagnosis (PGD) couples experience higher levels of stress during pregnancy and the perinatal period compared with couples who conceive spontaneously (SC) or with ICSI? PGD couples did not experience more psychological stress during pregnancy and beyond than ICSI or SC couples. Previous studies have shown that assisted reproduction technology (ART) couples are more prone to pregnancy-related anxieties than SC couples, but display depressed feelings to an equal or lesser extent. However, only one study has focused on a female PGD sample, which may be a more vulnerable group than other ART groups, due to the potentially complex hereditary background, adverse childhood experiences and losses. In that study, PGD women experienced a reduction in state anxiety, and maternal-antenatal attachment did not differ from normative data. Unfortunately, no data exist on pregnancy-related anxiety, depression and parental-antenatal attachment. Valuable information from both parents (e.g.: couples) is also lacking. For this longitudinal prospective study questionnaire, data from 185 women and 157 men (157 couples) were collected between February 2012 until April 2014. Data were analysed using multilevel analysis. The couples conceiving after PGD, ICSI or SC were followed from the first trimester of the pregnancy until the third month post-partum. A total of 60 PGD, 58 ICSI and 69 SC couples were initially recruited by various departments of Universitair Ziekenhuis Brussel (UZ Brussel). At each trimester (T1: 12-14 weeks, T2: 20-22 weeks, T3: 30-32 weeks) of pregnancy, depression (EPDS), pregnancy-related anxieties (PRAQ) and parental-antenatal attachment (M/PAAS) were recorded. At T4 (3 months post-partum), depression (EPDS) was assessed again. In the first trimester (T1) broad socio-demographic data and at T4 perinatal health data of both mother and child were recorded. Differences between conception groups over time were analysed using multilevel

  10. Depression

    Science.gov (United States)

    ... in the winter. Depression is one part of bipolar disorder. There are effective treatments for depression, including antidepressants, talk therapy, or both. NIH: National Institute of Mental Health

  11. Variations in the Reported Age of a Patient: A Source of Bias in the Diagnosis of Depression and Dementia.

    Science.gov (United States)

    Perlick, Deborah; Atkins, Alvin

    1984-01-01

    Varied the reported age of patients (N=36) presented to clinicians for diagnosis. Results indicated the presence of a bias, with a greater attributon of organic symptoms reflective of senile dementia and fewer judgments of depression when a patient is described as elderly as opposed to middle-aged. (LLL)

  12. Pharmaceutically treated anxiety but not depression prior to cancer diagnosis predicts the onset of cardiovascular disease among breast cancer survivors.

    Science.gov (United States)

    Schoormans, Dounya; van de Poll-Franse, Lonneke; Vissers, Pauline; van Herk-Sukel, Myrthe P P; Pedersen, Susanne S; Rottmann, Nina; Horsbøl, Trine; Dalton, Susanne; Denollet, Johan

    2017-11-01

    To examine the associations between pharmaceutically treated anxiety and depression present in the year prior to breast cancer diagnosis and the risk of incident cardiovascular disease (CVD), while controlling for traditional cardiovascular risk factors and clinical characteristics in a population-based observational study. Adult 1-year breast cancer survivors (n = 7227), diagnosed between 01-01-1999 and 12-31-2010, with no history of CVD, were selected from the Netherlands Cancer Registry. Drug dispensing data were derived from the PHARMO Database Network and used as proxy for CVD, anxiety, and depression. By multivariable Cox regression analysis, we examined the risk associated with pharmaceutically treated anxiety and depression for developing CVD after cancer diagnosis, adjusting for age, pharmaceutically treated hypertension, hypercholesterolemia, and diabetes mellitus in the year prior to cancer diagnosis, tumor stage, and cancer treatment. During the 13-year follow-up period, 193 (3%) breast cancer survivors developed CVD. Women pharmaceutically treated for anxiety in the year prior to their cancer diagnosis had a 48% increased hazard for CVD [HR = 1.48; 95% CI 1.05-1.08] after full adjustment. This association was restricted to breast cancer survivors who were 65 years or younger. Depression was not associated with CVD risk [HR = 0.89; 95% CI 0.52-1.53]. Older age [HR = 1.06; 95% CI 1.05-1.08], hypertension [HR = 1.80; 95% CI 1.32-2.46], and hypercholesterolemia [HR = 1.63; 95% CI 1.15-2.33] were associated with an increased hazard for incident CVD, whereas hormone therapy [HR = 0.59; 95% CI 0.42-0.83] was protective. Anxiety present in the year prior to breast cancer diagnosis increases the risk of incident CVD in 1-year breast cancer survivors, after adjustment for depression, traditional cardiovascular risk factors, and clinical characteristics.

  13. Depression

    Science.gov (United States)

    ... reasons why a woman may have depression: Family history . Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression. Brain changes. The brains of people ...

  14. Psychiatric co-morbidity in multiple sclerosis: The risk of depression and anxiety before and after MS diagnosis.

    Science.gov (United States)

    Hoang, Huong; Laursen, Bjarne; Stenager, Elsebeth N; Stenager, Egon

    2016-03-01

    Studies of depression and anxiety in multiple sclerosis (MS) patients have reported higher rates in MS patients than the general population. To estimate the risk of depression and anxiety and the use of tricyclic antidepressant and selective serotonin reuptake inhibitors (SSRI) prescriptions, in the pre-diagnostic and the post-diagnostic period of MS compared to the background population. A cohort of 5084 MS patients was included and matched with a control population of 24,771 persons linked to nationwide registers. Logistic regression analyses were performed estimating odds ratios (OR). In the pre-diagnostic period, the OR for having a diagnosis of depression and anxiety is 1.4 (95% confidence interval (CI) =1.05-1.88), and the OR of redemption prescriptions of TCAs is 1.90 (CI=1.54-2.34) and OR is 1.34 (CI= 1.20-1.51) for SSRI. In the post-diagnostic period the OR is 1.23 (CI= 0.92-1.64) for depression and anxiety diagnosis. The OR is 6.70 (CI=5.81-7.72) for TCA and OR is 2.46 (CI= 2.25-2.69) for SSRI. During both the pre- diagnostic and post-diagnostic period, MS patient have increased risk of depression and anxiety diagnoses and redemption of antidepressant and anxiolytic prescriptions, compared to the background population. © The Author(s), 2015.

  15. Health care costs before and after diagnosis of depression in patients with unexplained pain: a retrospective cohort study using the United Kingdom General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Reed C

    2013-01-01

    Full Text Available Catherine Reed,1 Jihyung Hong,2 Diego Novick,1 Alan Lenox-Smith,3 Michael Happich41Global Health Outcomes, Eli Lilly and Company, Windlesham, Surrey, UK; 2Personal Social Services Research Unit, London School of Economics and Political Science, London, UK; 3Eli Lilly UK, Basingstoke, UK; 4Eli Lilly and Company, Bad Homburg, GermanyPurpose: To assess the impact of pain severity and time to diagnosis of depression on health care costs for primary care patients with pre-existing unexplained pain symptoms who subsequently received a diagnosis of depression.Patients and methods: This retrospective cohort study analyzed 4000 adults with unexplained pain (defined as painful physical symptoms [PPS] without any probable organic cause and a subsequent diagnosis of depression, identified from the UK General Practice Research Database using diagnostic codes. Patients were categorized into four groups based on pain severity (milder or more severe; based on number of pain-relief medications and use of opioids and time to diagnosis of depression (≤1 year or >1 year from PPS index date. Annual health care costs were calculated (2009 values and included general practitioner (GP consultations, secondary care referrals, and prescriptions for pain-relief medications for the 12 months before depression diagnosis and in the subsequent 2 years. Multivariate models of cost included time period as a main independent variable, and adjusted for age, gender, and comorbidities.Results: Total annual health care costs before and after depression diagnosis for the four patient groups were higher for the groups with more severe pain (£819–£988 versus £565–£628; P < 0.001 for all pairwise comparisons and highest for the group with more severe pain and longer time to depression diagnosis in the subsequent 2 years (P < 0.05. Total GP costs were highest in the group with more severe pain and longer time to depression diagnosis both before and after depression diagnosis (P

  16. Depressants

    Science.gov (United States)

    ... For Teens / Depressants Print en español Depresores del sistema nervioso What They Are: Tranquilizers and other depressants ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  17. Effect of informing the diagnosis on depressive state in patients with non-small cell lung cancer of stage Ⅲ

    Directory of Open Access Journals (Sweden)

    Wei WANG

    2008-10-01

    Full Text Available Background and objective As other tumors, unresectabe lung cancer can cause many psychological problems to the patients, such as depression and anxiety. The present paper aims to evaluate the status of depression before and after knowing the state of illness in patients with non-small cell lung cancer of stage Ⅲ. Methods 43 casesof newly diagnosed non-small cell lung cancer (NSCLC with stage Ⅲ were enrolled in the study. All the patients were distributed into three groups and given different intervention, that was completely unknowing the state of illness (group A, partly knowing the state of illness (group B and completely knowing the state of illness (group C. Before and after knowing the state of illness, the depression status was assessed with the Hamilton depression rating scale for depression(HAMD. Results The mean total score of HAMD was unchanged both in group A and C, while significantly reduced in group B. The scores of anxiety somatization, cognitive disorder, retardation and feeling of despair were all significant lower in the group B after the patients partly knowing the state of illness, while the scores of sleep disorder was obviously higher in group C after the patients completely knowing the state of illness. The hypochondriasis was much severer in the group A, and in the group C, the score of suicidal idea became significantly higher after the patient knowing the diagnosis.Conclusion Depression is very common in the NSCLC patients with stage Ⅲ. Partly knowing the state of illness can obviously ameliorate the symptoms of depression, while completely knowing or completely unknowing the state of illness have no effect on relieving the patients' depression.

  18. Depression

    DEFF Research Database (Denmark)

    Cizza, G; Ravn, Pernille; Chrousos, G P

    2001-01-01

    Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Nevertheless, these studies reveal...... a strong association between depression and osteoporosis. Endocrine factors such as depression-induced hypersecretion of corticotropin-releasing hormone and hypercortisolism, hypogonadism, growth hormone deficiency and increased concentration of circulating interleukin 6, might play a crucial role...... in the bone loss observed in subjects suffering from major depression....

  19. The diagnosis of depression and use of antidepressants in nursing home residents with and without dementia.

    Science.gov (United States)

    van Asch, Iris F M; Nuyen, Jasper; Veerbeek, Marjolein A; Frijters, Dinnus H M; Achterberg, Wilco P; Pot, Anne Margriet

    2013-03-01

    To compare the prevalence of diagnosed depressive disorders, depressive symptoms and use of antidepressant medication between nursing home residents with and without dementia. This cross-sectional study used Minimal Data Set of the Resident Assessment Instrument 2.1 data collected in seven nursing homes located in an urbanized region in the Netherlands. Trained nurse assistants recorded all medical diagnoses made by a medical specialist, including dementia and depressive disorder, and medication use. Depressive symptoms were measured with the Depression Rating Scale. Multivariate logistic regression analysis was used to compare data between residents with and without dementia. Included in the study were 1885 nursing home residents (aged 65 years or older), of which 837 had dementia. There was no significant difference in the prevalence of diagnosed depressive disorder between residents with (9.6%) and without dementia (9.8%). Residents with dementia (46.4%) had more depressive symptoms than residents without dementia (22.6%). Among those with depressive symptoms, residents with dementia had the same likelihood of being diagnosed with a depressive disorder as residents without dementia. Among residents with a diagnosed depressive disorder, antidepressant use did not differ significantly between residents with dementia (58.8%) and without dementia (57.3%). The same holds true for residents with depressive symptoms, where antidepressant use was 25.3% in residents with dementia and 24.6% in residents without dementia. Regarding the prevalence rates of diagnosed depressive disorder and antidepressant use found in this study, our findings demonstrate that there is room for improvement not only for the detection of depression but also with regard to its treatment. Copyright © 2012 John Wiley & Sons, Ltd.

  20. Ratio of mBDNF to proBDNF for Differential Diagnosis of Major Depressive Disorder and Bipolar Depression.

    Science.gov (United States)

    Zhao, Guoqing; Zhang, Chen; Chen, Jun; Su, Yousong; Zhou, Rubai; Wang, Fan; Xia, Weiping; Huang, Jia; Wang, Zuowei; Hu, Yingyan; Cao, Lan; Guo, Xiaoyun; Yuan, Chengmei; Wang, Yong; Yi, Zhenghui; Lu, Weihong; Wu, Yan; Wu, Zhiguo; Hong, Wu; Peng, Daihui; Fang, Yiru

    2017-09-01

    There is a high rate of misdiagnosis between major depressive disorder (MDD) and bipolar disorder (BD) in clinical practice. Our previous work provided suggestive evidence for brain-derived neurotrophic factor (BDNF) in differentiating BD from MDD. In this study, we aimed to investigate the role of mature BDNF (mBDNF) and its precursor (proBDNF) in distinguishing bipolar depression (BP) from MDD during acute depressive episode. A total of 105 participants, including 44 healthy controls, 37 MDD patients and 24 BP patients, were recruited. Enzyme-linked immunosorbent assay kits were applied to measure plasma mBDNF levels and proBDNF levels of all participants. Plasma mBDNF levels were significantly decreased in BP group than those in MDD group (P = 0.001) and healthy controls (P = 0.002). Significantly higher ratio of mBDNF to proBDNF (M/P) at baseline was showed in MDD group than those in BP group as well as in healthy controls (P = 0.000 and P = 0.000, respectively). The optimal model for discriminating BP was the M/P ratio (area under the ROC curve = 0.858, 95 % CI 0.753-0.963). Furthermore, the M/P ratio was restored to normal levels after antidepressants treatment in MDD group. In summary, our data demonstrated that both plasma mBDNF levels and M/P ratio were lower in BP compared with MDD. These findings further support M/P ratio as a potential differential diagnostic biomarker for BP among patients in depressive episodes.

  1. [Diagnosis and treatment of anxiety-depressive disorders in patients with myocardial infarction].

    Science.gov (United States)

    Semiglazova, M V; Krasnov, V N; Dovzhenko, T V; Lebedev, A V

    2012-01-01

    The results of the study of psychopathological, somatic and functional characteristics of anxiety-depressive disorders in patients with acute myocardial infarction are presented. The authors confirmed the wide prevalence of these disorders in acute myocardial infarction and described the features of their diagnostics, dynamics and response to complex treatment. The impact of anxiety-depressive disorders on the clinical and functional state of the cardiovascular system and the dynamics of the patient's status due the concomitant anxiety-depressive disorder are considered.

  2. Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up

    NARCIS (Netherlands)

    Korfage, I. J.; Essink-Bot, M.-L.; Janssens, A. C. J. W.; Schröder, F. H.; de Koning, H. J.

    2006-01-01

    To document anxiety and depression from pretreatment till 5-year follow-up in 299 men with localized prostate cancer. To assess, if baseline scores were predictive for anxiety and depression at 1-year follow-up. Respondents completed four assessments (pretreatment, at 6 and 12 months, and at 5-year

  3. The diagnosis and management of depression in the era of the DSM-5

    African Journals Online (AJOL)

    Depressive disorders comprise a range of conditions that can be viewed along many dimensions. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) introduced several changes to the chapter on depressive disorders largely informed by advances in neuroscience, clinical and public health ...

  4. The Diagnosis of Depression in People with Severe Limitations in Intellectual Functioning

    Science.gov (United States)

    Scott, Haleigh; Havercamp, Susan M.

    2015-01-01

    People with intellectual disability (ID) were once considered immune to developing psychopathology, including affective disorders such as depression. Now research has shown that people with ID do suffer from depression, and the focus is on understanding how to best diagnose and provide treatment. Research has come a long way in adapting the…

  5. Depression

    DEFF Research Database (Denmark)

    Johansen, Jon O. J.

    2013-01-01

    Nyhederne er fulde af historier om depression. Overskrifter som: ’Danskerne propper sig med lykkepiller’ eller ‘depression er stadigvæk tabu’ går tit igen i dagspressen. Men hvor er nuancerne, og hvorfor gider vi læse de samme historier igen og igen? Måske er det fordi, vores egne forestillinger er...

  6. Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies.

    Science.gov (United States)

    Ford, Elizabeth; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

    2017-08-01

    Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. Meta-synthesis of the available published qualitative evidence on GPs' recognition and management of perinatal anxiety and depression. A systematic search was conducted on Embase, Medline, PsycInfo, Pubmed, Scopus, and Web of Science, and grey literature was searched using Google, Google Scholar, and British Library EThOS. Papers and reports were eligible for inclusion if they reported qualitatively on GPs' diagnosis or treatment of perinatal anxiety or depression. The synthesis was constructed using meta-ethnography. Five themes were established from five eligible papers: labels: diagnosing depression; clinical judgement versus guidelines; care and management; use of medication; and isolation: the role of other professionals. GPs considered perinatal depression to be a psychosocial phenomenon, and were reluctant to label disorders and medicalise distress. GPs relied on their own clinical judgement more than guidelines. They reported helping patients make informed choices about treatment, and inviting them back regularly for GP visits. GPs sometimes felt isolated when dealing with perinatal mental health issues. GPs often do not have timely access to appropriate psychological therapies and use several strategies to mitigate this shortfall. Training must focus on these issues and must be evaluated to consider whether this makes a difference to outcomes for patients. © British Journal of General Practice 2017.

  7. An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan

    Directory of Open Access Journals (Sweden)

    Weiner Jonathan P

    2010-01-01

    Full Text Available Abstract Background Diagnosis-based risk adjustment is becoming an important issue globally as a result of its implications for payment, high-risk predictive modelling and provider performance assessment. The Taiwanese National Health Insurance (NHI programme provides universal coverage and maintains a single national computerized claims database, which enables the application of diagnosis-based risk adjustment. However, research regarding risk adjustment is limited. This study aims to examine the performance of the Adjusted Clinical Group (ACG case-mix system using claims-based diagnosis information from the Taiwanese NHI programme. Methods A random sample of NHI enrollees was selected. Those continuously enrolled in 2002 were included for concurrent analyses (n = 173,234, while those in both 2002 and 2003 were included for prospective analyses (n = 164,562. Health status measures derived from 2002 diagnoses were used to explain the 2002 and 2003 health expenditure. A multivariate linear regression model was adopted after comparing the performance of seven different statistical models. Split-validation was performed in order to avoid overfitting. The performance measures were adjusted R2 and mean absolute prediction error of five types of expenditure at individual level, and predictive ratio of total expenditure at group level. Results The more comprehensive models performed better when used for explaining resource utilization. Adjusted R2 of total expenditure in concurrent/prospective analyses were 4.2%/4.4% in the demographic model, 15%/10% in the ACGs or ADGs (Aggregated Diagnosis Group model, and 40%/22% in the models containing EDCs (Expanded Diagnosis Cluster. When predicting expenditure for groups based on expenditure quintiles, all models underpredicted the highest expenditure group and overpredicted the four other groups. For groups based on morbidity burden, the ACGs model had the best performance overall. Conclusions Given the

  8. An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan.

    Science.gov (United States)

    Chang, Hsien-Yen; Weiner, Jonathan P

    2010-01-18

    Diagnosis-based risk adjustment is becoming an important issue globally as a result of its implications for payment, high-risk predictive modelling and provider performance assessment. The Taiwanese National Health Insurance (NHI) programme provides universal coverage and maintains a single national computerized claims database, which enables the application of diagnosis-based risk adjustment. However, research regarding risk adjustment is limited. This study aims to examine the performance of the Adjusted Clinical Group (ACG) case-mix system using claims-based diagnosis information from the Taiwanese NHI programme. A random sample of NHI enrollees was selected. Those continuously enrolled in 2002 were included for concurrent analyses (n = 173,234), while those in both 2002 and 2003 were included for prospective analyses (n = 164,562). Health status measures derived from 2002 diagnoses were used to explain the 2002 and 2003 health expenditure. A multivariate linear regression model was adopted after comparing the performance of seven different statistical models. Split-validation was performed in order to avoid overfitting. The performance measures were adjusted R2 and mean absolute prediction error of five types of expenditure at individual level, and predictive ratio of total expenditure at group level. The more comprehensive models performed better when used for explaining resource utilization. Adjusted R2 of total expenditure in concurrent/prospective analyses were 4.2%/4.4% in the demographic model, 15%/10% in the ACGs or ADGs (Aggregated Diagnosis Group) model, and 40%/22% in the models containing EDCs (Expanded Diagnosis Cluster). When predicting expenditure for groups based on expenditure quintiles, all models underpredicted the highest expenditure group and overpredicted the four other groups. For groups based on morbidity burden, the ACGs model had the best performance overall. Given the widespread availability of claims data and the superior explanatory

  9. Impact of the QOF and the NICE guideline in the diagnosis and management of depression: a qualitative study.

    Science.gov (United States)

    Mitchell, Caroline; Dwyer, Rachel; Hagan, Teresa; Mathers, Nigel

    2011-05-01

    The National Institute for Health and clinical Excellence (NICE) depression guideline (2004) and the updated Quality and Outcomes Framework (QOF) (2006) in general practice have introduced the concepts of screening severity assessment, for example using the Patient Health Questionnaire 9 (PHQ-9), and 'stepped care' for depression. To explore primary care practitioner perspectives on the clinical utility of the NICE guideline and the impact of the QOF on diagnosis and management of depression in routine practice. Qualitative study using focus groups from four multidisciplinary practice teams with diverse populations in south Yorkshire. Four focus groups were conducted, using a topic guide and audiotaping. There were 38 participants: GPs, nurses, doctors in training, mental health workers, and a manager. Data analysis was iterative and thematic. The NICE guideline, with its embedded principles of holism and evidence-based practice, was viewed positively but its impact was compromised by resource and practitioner barriers to implementation. The perceived imposition of the screening questions and severity assessments (PHQ-9) with no responsive training had required practitioners to work hard to minimise negative impacts on their work, for example: constantly adapting consultations to tick boxes; avoiding triggering open displays of distress without the time to offer appropriate care; positively managing how their patients were labelled. Further confusion was experienced around the evolving content of psychological interventions for depression. Organisational barriers to the implementation of the NICE guideline and the limited scope of the QOF highlight the need for policy makers to work more effectively with the complex realities of general practice in order to systematically improve the quality and delivery of 'managed' care for depression.

  10. Beyond Depression: Towards a Process-Based Approach to Research, Diagnosis, and Treatment

    Science.gov (United States)

    Forgeard, Marie J. C.; Haigh, Emily A. P.; Beck, Aaron T.; Davidson, Richard J.; Henn, Fritz A.; Maier, Steven F.; Mayberg, Helen S.; Seligman, Martin E. P.

    2012-01-01

    Despite decades of research on the etiology and treatment of depression, a significant proportion of the population is affected by the disorder, fails to respond to treatment and is plagued by relapse. Six prominent scientists, Aaron Beck, Richard Davidson, Fritz Henn, Steven Maier, Helen Mayberg, and Martin Seligman, gathered to discuss the current state of scientific knowledge on depression, and in particular on the basic neurobiological and psychopathological processes at play in the disorder. These general themes were addressed: 1) the relevance of learned helplessness as a basic process involved in the development of depression; 2) the limitations of our current taxonomy of psychological disorders; 3) the need to work towards a psychobiological process-based taxonomy; and 4) the clinical implications of implementing such a process-based taxonomy. PMID:22509072

  11. [Recurrent depressive disorder in Caspar David Friedrich. A pathographical approach with operationalized diagnosis].

    Science.gov (United States)

    Spitzer, C; Dahlenburg, B; Freyberger, H J

    2006-07-01

    Caspar David Friedrich (1774 - 1840) is one of the most important German Romantic painters. In his paintings, he prototypically represents the melancholy, which has been mentioned by his contemporaries and later biographers. Art scientists have also referred to his melancholy for the interpretation of his work. From a medical point of view, there are only two pathographies which remain inconclusive. Having applied diagnostic criteria for psychiatric disorders to his letters and publications, to statements of his contemporaries and to his art, we propose that he had suffered from a recurrent major depression which occurred in 1799 for the first time. At least three depressive episodes followed before he was struck by a stroke in 1835. There are epidemiological, psychodynamic and personality-typological reasons supporting our diagnostic assumption. The course of his depression corresponds to phases of reduced creativity, to the chosen techniques and motives. Finally we discuss the implications of our approach for the pathographical method in general.

  12. Depression and Suicide Risk

    Science.gov (United States)

    ... due to another medical disorder Relationship Between Depression & Suicide: 1. Depression is the psychiatric diagnosis most commonly associated with ... of patients with treated depression eventually die by suicide. xiv 4. Depression is present in at least 50 percent of ...

  13. [Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part III: Treatment of Resistant Depression and Psychotic Depression, Occupational Therapy and Day Hospital Treatment].

    Science.gov (United States)

    Gómez-Restrepo, Carlos; Peñaranda, Adriana Patricia Bohórquez; Valencia, Jenny García; Guarín, Maritza Rodríguez; Ángel, Juliana Rodríguez; Jaramillo, Luis Eduardo; Acosta, Carlos Alberto Palacio; Pedraza, Ricardo Sánchez; Díaz, Sergio Mario Castro; de la Hoz Bradford, Ana María

    2012-12-01

    This article presents recommendations based on the evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder. Emphasis was given to general treatment issues of resistant depression and psychotic depression, occupational therapy and day hospital treatment so as to grant diagnosed adult patients the health care parameters based on the best and more updated evidence available and achieve minimum quality standards. A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. Recommendations 23-25 corresponding to the management of depression are presented. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  14. [Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part II: General Aspects of Treatment, Management of the Acute Phase, Continuation and Maintenance of Patients with a Depression Diagnosis].

    Science.gov (United States)

    Peñaranda, Adriana Patricia Bohórquez; Valencia, Jenny García; Guarín, Maritza Rodríguez; Borrero, Álvaro Enrique Arenas; Díaz, Sergio Mario Castro; de la Hoz Bradford, Ana María; Riveros, Patricia Maldonado; Jaramillo, Luis Eduardo; Brito, Enrique; Acosta, Carlos Alberto Palacio; Pedraza, Ricardo Sánchez; González-Pacheco, Juan; Gómez-Restrepo, Carlos

    2012-12-01

    This article presents recommendations based on evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder, with emphasis on general treatment aspects, treatment in the acute phase and management of the continuation/maintenance, all intended to grant health care parameters based on the best and more updated available evidence for achieving minimum quality standards with adult patients thus diagnosed. A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. Recommendations 5-22 corresponding to management of depression are presented. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  15. Patient specific modeling of the HPA axis related to clinical diagnosis of depression

    DEFF Research Database (Denmark)

    Bangsgaard, Elisabeth; Ottesen, Johnny T.

    2017-01-01

    A novel model of the hypothalamic-pituitary-adrenal axis is presented. The axis is an endocrine system responsible for coping with stress and it is likely to be involved in depression. The dynamics of the system is studied and existence, uniqueness and positivity of the solution and the existence...... of an attracting trapping region are proved. The model is calibrated and compared to data for healthy and depressed subjects. A sensitivity analysis resulting in a set of identifiable physiological parameters is provided. A subset is selected for parameter estimation and a reduced version of the model is stated...... and an approximated version is discussed. The model is physiologically based, thus parameters are representative for gland functions or elimination processes. Hence the model may be used for pointing out pathologies by parameter estimation and hypothesis testing whereby it may be used as an objective and refined...

  16. DESPERATELY SEEKING HAPPINESS: VALUING HAPPINESS IS ASSOCIATED WITH SYMPTOMS AND DIAGNOSIS OF DEPRESSION

    OpenAIRE

    Ford, Brett Q.; Shallcross, Amanda J.; Mauss, Iris B.; Floerke, Victoria A.; Gruber, June

    2014-01-01

    Culture shapes the emotions people feel and want to feel. In Western cultures, happiness is an emotion that many people want to feel. Although experiencing happiness is associated with increased well-being and psychological health, recent evidence suggests wanting to feel happy to an extreme degree, or, highly valuing happiness, leads to decreased well-being. To examine whether these effects of valuing happiness might extend to clinical outcomes, we examined the hypothesis that depression is ...

  17. A spectroscopic approach toward depression diagnosis: local metabolism meets functional connectivity.

    Science.gov (United States)

    Demenescu, Liliana Ramona; Colic, Lejla; Li, Meng; Safron, Adam; Biswal, B; Metzger, Coraline Danielle; Li, Shijia; Walter, Martin

    2017-03-01

    Abnormal anterior insula (AI) response and functional connectivity (FC) is associated with depression. In addition to clinical features, such as severity, AI FC and its metabolism further predicted therapeutic response. Abnormal FC between anterior cingulate and AI covaried with reduced glutamate level within cingulate cortex. Recently, deficient glial glutamate conversion was found in AI in major depression disorder (MDD). We therefore postulate a local glutamatergic mechanism in insula cortex of depressive patients, which is correlated with symptoms severity and itself influences AI's network connectivity in MDD. Twenty-five MDD patients and 25 healthy controls (HC) matched on age and sex underwent resting state functional magnetic resonance imaging and magnetic resonance spectroscopy scans. To determine the role of local glutamate-glutamine complex (Glx) ratio on whole brain AI FC, we conducted regression analysis with Glx relative to creatine (Cr) ratio as factor of interest and age, sex, and voxel tissue composition as nuisance factors. We found that in MDD, but not in HC, AI Glx/Cr ratio correlated positively with AI FC to right supramarginal gyrus and negatively with AI FC toward left occipital cortex (p family wise error). AI Glx/Cr level was negatively correlated with HAMD score (p disintegration of insula toward low level and supramodal integration areas, in MDD. While causality cannot directly be inferred from such correlation, our finding helps to define a multilevel network of response-predicting regions based on local metabolism and connectivity strength.

  18. Psychological turmoil: Anxiety and depression in individuals after receiving a breast cancer diagnosis

    International Nuclear Information System (INIS)

    Fraim, N. L.

    2006-01-01

    A possible diagnosis of any form of cancer is every person's worst nightmare. Primarily among women, the most feared cancer diagnosis is breast cancer. With the development of modern technology, a variety of treatments are available; however, these treatments are not without side effects. Receiving the diagnosis initiates the development of psychological upheaval within the person. The modality and amount of treatment of treatment as well as the amount of social support the individual receives plays an important role in the person's survival throughout this disease. The purpose of this paper is to provide the reader with an overview of the psychological turmoil experienced by individual's diagnosed with breast cancer. Data for this paper was collected via electronic databases and internet sources

  19. A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

    Science.gov (United States)

    Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

    2015-03-15

    The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Prevalence, correlates and under-diagnosis of clinical depression among adults on highly active antiretroviral therapy in a Tertiary Health Institution in northeastern Nigeria

    Directory of Open Access Journals (Sweden)

    Abdu Wakawa Ibrahim

    2014-11-01

    Full Text Available Clinical depression is a highly debilitating illness, which is often under-diagnosed and negatively impacts on the quality of life of its sufferers. When it co-exists with other medical conditions, its effect is even more incapacitating. Undiagnosed depression in the context of HIV infection leads to accelerated decline in CD4+ cell counts with concomitant increase in the viral load and poor adherence to the antiretroviral medications which lead to viral mutation and the evolution of resistant strains. This study examined the prevalence of depression, its correlates and the frequency of the diagnosis of the condition among HIV+ subjects on highly active antiretroviral therapy (HAART by the internists and general physicians at the University of Maiduguri Teaching Hospital in Northeastern Nigeria. Three hundred and fifty representative samples of HIV+ adults on HAART were drawn from the Antiretroviral Therapy Clinic of the Institution. Diagnosis of depression was made using the International Classification of Diseases-10 criteria based on Composite International Diagnostic Interview generated data. Socio-demographic and clinical variables were also analyzed for their correlation with depression in the subjects. About 20% of the respondents were diagnosed with clinical depression and no diagnosis of the condition was hitherto entertained in all the respondents. The independent determinants of depression in the participants were: female gender [odds ratio (OR=3.87 (95% confidence interval, CI: 2.089-7.183], past history of psychiatric illness [OR=43.81 (95% CI: 9.731-197.30] and family history of psychiatric illness in first-degree relatives of the subjects [OR=14.364 (95% CI=5.327- 38.729]. Depression is a relatively common psychiatric condition among adults on HAART, there is therefore the need for routine screening of this condition among HIV+ subjects in order to optimize patient care and improve clinical outcomes.

  1. Unrecognized bipolar disorder in patients with a diagnosis of unipolar depression%诊断为单相抑郁症者中未识别的双相障碍

    Institute of Scientific and Technical Information of China (English)

    David L.DUNNER

    2011-01-01

    @@ The diagnosis of bipolar rather than unipolar depression is currently a clinicaI diagnosis which cannot be validated by specific biological measures,such as laboratory tests.Certainly the characteristics of bipolar depression frequently differ from unipolar major depression in that patients with bipolar depression generally have an earlier age of onset and more frequent episodes than individuals with unipolar major depression[1]Some,but not all,studies support an increase in suicidal behaviors among bipolar as compared with unipolar major depression[2],and"atypical features"such as hypersomnia and hyperphagia also may be found more frequently among individuals with bipolar depression.Furthermore family histories of subjects with bipolar disorders more frequently reveal relatives with bipolar disorder.In contrast,relatives of patients with unipolar depression's family history generally reflects major depression but not bipolar disorder[3].

  2. ClaimAssociationService

    Data.gov (United States)

    Department of Veterans Affairs — Retrieves and updates a veteranÆs claim status and claim-rating association (claim association for current rating) from the Corporate database for a claim selected...

  3. Claiming Community

    DEFF Research Database (Denmark)

    Jensen, Steffen Bo

    As its point of departure this working paper takes the multitude of different uses and meanings of the concept of community in local politics in Cape Town. Instead of attempting to define it in substantive terms, the paper takes a social constructivist approach to the study of community...... is termed community work. First, the paper explores how community has become a governmental strategy, employed by the apartheid regime as well, although in different ways, as post-apartheid local government. Secondly, the paper explores the ways in which community becomes the means in which local residents...... lay claim on the state, as well as how it enters into local power struggles between different political groups within the township. In the third part, the paper explores how the meanings of community and the struggles to realise it have changed as South Africa, nationally and locally, has become...

  4. Toward Probabilistic Diagnosis and Understanding of Depression Based on Functional MRI Data Analysis with Logistic Group LASSO.

    Directory of Open Access Journals (Sweden)

    Yu Shimizu

    Full Text Available Diagnosis of psychiatric disorders based on brain imaging data is highly desirable in clinical applications. However, a common problem in applying machine learning algorithms is that the number of imaging data dimensions often greatly exceeds the number of available training samples. Furthermore, interpretability of the learned classifier with respect to brain function and anatomy is an important, but non-trivial issue. We propose the use of logistic regression with a least absolute shrinkage and selection operator (LASSO to capture the most critical input features. In particular, we consider application of group LASSO to select brain areas relevant to diagnosis. An additional advantage of LASSO is its probabilistic output, which allows evaluation of diagnosis certainty. To verify our approach, we obtained semantic and phonological verbal fluency fMRI data from 31 depression patients and 31 control subjects, and compared the performances of group LASSO (gLASSO, and sparse group LASSO (sgLASSO to those of standard LASSO (sLASSO, Support Vector Machine (SVM, and Random Forest. Over 90% classification accuracy was achieved with gLASSO, sgLASSO, as well as SVM; however, in contrast to SVM, LASSO approaches allow for identification of the most discriminative weights and estimation of prediction reliability. Semantic task data revealed contributions to the classification from left precuneus, left precentral gyrus, left inferior frontal cortex (pars triangularis, and left cerebellum (c rus1. Weights for the phonological task indicated contributions from left inferior frontal operculum, left post central gyrus, left insula, left middle frontal cortex, bilateral middle temporal cortices, bilateral precuneus, left inferior frontal cortex (pars triangularis, and left precentral gyrus. The distribution of normalized odds ratios further showed, that predictions with absolute odds ratios higher than 0.2 could be regarded as certain.

  5. Risk for Hospitalization With Depression After a Cancer Diagnosis: A Nationwide, Population-Based Study of Cancer Patients in Denmark From 1973 to 2003

    DEFF Research Database (Denmark)

    Dalton, S.O.; Laursen, T.M.; Nylandsted, Lone Ross

    2009-01-01

    for both men and women surviving hormone-related cancers, for women surviving smoking-related cancers, and for men surviving virus- and immune-related cancers. Conclusion This study confirms an increased risk for depression in patients facing a disruptive event like cancer. Early recognition and effective......Purpose As more people survive cancer, it is necessary to understand the long-term impact of cancer. We investigated whether cancer survivors are at increased risk for hospitalization for depression. Methods We linked data on all 5,703,754 persons living in Denmark on January 1, 1973, or born...... thereafter to the Danish Cancer Registry and identified 608,591 adults with a diagnosis of cancer. Follow-up for hospitalization for depression in the Danish Psychiatric Central Register from 1973 through 2003 yielded 121,227,396 person-years and 121,304 hospitalizations for depression. The relative risk (RR...

  6. Flourishing or floundering? Prevalence and correlates of anxiety and depression among a population-based sample of adult cancer survivors 6months after diagnosis.

    Science.gov (United States)

    Boyes, Allison W; Girgis, Afaf; D'Este, Catherine; Zucca, Alison C

    2011-12-01

    To describe the prevalence of anxiety, depression and comorbid anxiety-depression among adult cancer survivors six months following diagnosis, and identify the individual, disease, health behaviour, psychological and social factors associated with psychological morbidity. A population-based sample of adult cancer survivors was recruited from two state-based cancer registries in Australia. Data for 1323 survivors were obtained by self-report questionnaire and linkage with registry data. Anxiety and depression were assessed by the 14-item Hospital Anxiety and Depression Scale (HADS). The prevalence of psychological morbidity was 28% (95% CI: 23%-33%). Specifically, 24% (95% CI: 19%-29%) of survivors were identified as cases on anxiety (irrespective of depression), 14% (95% CI: 9%-19%) as cases on depression (irrespective of anxiety) and 10% (95% CI: 5%-15%) as cases on comorbid anxiety-depression. In addition to mental health history prior to cancer, modifiable health behaviours (physical activity, smoking status), psychological (helplessness-hopelessness, anxious preoccupation coping) and social (low positive social interaction) characteristics were stronger indicators of psychological morbidity than survivors' individual or disease characteristics. Psychological morbidity was assessed by self-report screening instrument rather than clinical interview. The extent to which psychological morbidity is age-related versus cancer-related cannot be determined without a gender- and age-matched control group. Although lower than previously reported, psychological morbidity is prevalent six months after a cancer diagnosis and emphasises the need for routine psychosocial assessment throughout the cancer trajectory to identify those at increased risk or in need of immediate intervention. Physical activity, smoking cessation and coping skills training interventions warrant further exploration. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Health-related quality of life, anxiety and depression in the diagnostic phase of suspected cancer, and the influence of diagnosis

    DEFF Research Database (Denmark)

    Larsen, Ellen Frøsig Moseholm; Rydahl Hansen, Susan; Overgaard, Dorthe

    2016-01-01

    suspected to have cancer based on non-specific symptoms was performed. Participants completed the EORTC-QLQ-C30 quality of life scale, HADS, SOC-13 and self-rated health before and after completing diagnostic evaluations. Intra- and inter-group differences between patients diagnosed with cancer versus......-specific symptoms experience a high prevalence of anxiety and affected quality of life prior to knowledge of the diagnosis. The predictive value of the baseline scores is important when assessing the psychological impact of undergoing diagnostic evaluations for cancer.......Background Undergoing diagnostic evaluation for cancer has been associated with a high prevalence of anxiety and depression and affected health-related quality of life (HRQoL). The aims of this study were to assess HRQoL, anxiety, and depression pre- and post-diagnosis in patients undergoing...

  8. The relationship between health locus of control, depression, and sociodemographic factors and amount of time breast cancer patients wait before seeking diagnosis and treatment.

    Science.gov (United States)

    Marijanović, Inga; Pavleković, Gordana; Buhovac, Teo; Martinac, Marko

    2017-09-01

    In the Federation of Bosnia and Herzegovina, the prevalence and incidence of breast cancer has been increasing, and the national programme of early prevention, administered locally, is sporadic and without quality assurance. While many factors may influence women's decision to adopt prevention-oriented behaviours regarding breast cancer, this study has emphasised the importance of sociodemographic factors, psychological factors and mental wellbeing. Participants in the study were all patients who, during one year, were admitted for the first time for diagnosis and treatment in the biggest Clinical hospitals of the Herzegovina-Neretva region Patients were divided into two groups based on their TNM classification: "early stage" and "late stage". Three instruments were used in this study: an individual questionnaire about demographic and socioeconomic characteristics of the woman, the Multidimensional Health Locus of Control scales, and the Hamilton Depression Rating Scale. The majority of patients diagnosed with advanced disease were admitted to hospital in the late/advanced stages of the disease. Multi-variant analysis showed that the most statistically significant positive predictor for early admittance in hospital is living with family and marital status while religiosity has a negative predictive value. The results indicate that 59.7% of respondents do not have depression, while the remainder do have some degree of depression. There was no statistically significant difference in the degree of depression between women who were diagnosed and treated early and those who were not. The employment status of the respondents was the only significant factor related to degree of depression. Although health locus of control and depression are not statistically significant predictors of early hospital treatment, the recommendation is that further studies focus on the implementation of MHLC and HDRS scales within the community. This could be useful in planning appropriate and

  9. Depressive Symptoms, Emotion Dysregulation, and Bulimic Symptoms in Youth With Type 1 Diabetes: Varying Interactions at Diagnosis and During Transition to Insulin Pump Therapy.

    Science.gov (United States)

    Young-Hyman, Deborah L; Peterson, Claire M; Fischer, Sarah; Markowitz, Jessica T; Muir, Andrew B; Laffel, Lori M

    2016-07-01

    This study evaluated the associations between depressive symptoms, emotion dysregulation and bulimic symptoms in youth with type 1 diabetes (T1D) in the context of the diagnosis and treatment of T1D. Study participants were 103 youth in 2 distinct groups: newly diagnosed (New) or transitioning to pump therapy (continuous subcutaneous insulin infusion [CSII]; "Pump"), who completed questionnaires regarding symptoms of depression, emotion dysregulation, and bulimia. Glycemic control (A1c), height, weight, and questionnaires were evaluated within 10 days of diagnosis (n = 58) or at education/clinic visit before starting insulin utilizing CSII (n = 45). In the newly diagnosed group, only depression accounted for significant variance in bulimia scores (β = .47, P symptoms and emotion dysregulation were associated with greater bulimic symptoms. Depressive symptoms and emotion dysregulation, an indicator of poor coping/behavioral control, could help explain adoption of disordered eating behaviors in youth with T1D who are transitioning to pump therapy. © 2016 Diabetes Technology Society.

  10. Survey of malpractice claims in dermatology

    International Nuclear Information System (INIS)

    Altman, J.

    1975-01-01

    A statistical survey of malpractice claims asserted against dermatologists was made. The subject matter of the claims was divided into eight major categories: drug reactions, x-ray burns, poor cosmetic result following surgery, poor cosmetic result following medication, failure to diagnose cancer, improper diagnosis, infection from treatment, and miscellaneous. The study showed that a group of ''serious'' damage cases, which accounted for 34 percent of total claims, generated 94 percent of total dollar losses. The problem areas for malpractice claims appeared to be drug reactions, cosmetic chemosurgery, and failure to diagnose cancer. (U.S.)

  11. O conhecimento do diagnóstico de câncer não leva à depressão em pacientes sob cuidados paliativos Awareness of cancer diagnosis does not lead to depression in palliative care patients

    Directory of Open Access Journals (Sweden)

    Renata Wanderley Diniz

    2006-10-01

    Full Text Available OBJETIVOS: Traçar o perfil e identificar a prevalência de depressão nos pacientes sob cuidados paliativos no Serviço de Oncologia da Faculdade de Medicina do ABC. MÉTODOS: Entrevistamos 62 pacientes oncológicos em cuidados paliativos que responderam a três questionários: questionário geral contendo variáveis demográficas, questionário estruturado para pacientes oncológicos em cuidados terminais para avaliação de sua qualidade de vida e inventário de depressão de Beck. RESULTADOS: Observamos que 68% dos pacientes tinham algum grau de depressão. A maioria dos pacientes sabia seu diagnóstico (87,1%, estava satisfeito com o tratamento (93,33%, sentia-se satisfeito com o apoio recebido (95,7% e referiu não conversar com seus médicos sobre outros assuntos além de sua saúde (81,18%. Os sintomas mais freqüentes foram dor, cansaço, fraqueza e alterações do sono. Encontramos que o fato de não saber o diagnóstico (p=0,008, estar internado (p=0,0019 e não ter recebido tratamento oncológico (p=0,007 se correlacionam significativamente com níveis mais altos de depressão. CONCLUSÃO: Pacientes sob cuidados paliativos em nosso meio, apesar de geralmente satisfeitos com seu cuidado, relatam pobre comunicação com seu médico e apresentam uma alta taxa de depressão. Saber o seu diagnóstico e ter recebido tratamento oncológico se correlacionam inversamente com a presença de depressão.OBJECTIVE: Characterize the profile of patients under palliative care at this institution and evaluate the prevalence of depression in these patients. METHODS: Sixty two cancer patients under palliative care, who had answered three questionnaires: one regarding their demographic characteristics, another to evaluate their quality of life and the Beck's depression inventory were surveyed. RESULTS: Of these patients, 68% presented with some degree of depression. Most of them were aware of their diagnosis (87.1%, did not talk to their physicians on

  12. Comparison of the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in emergency departments of general hospitals in China.

    Science.gov (United States)

    Wei, Shengnan; Li, Haiyan; Hou, Jinglin; Chen, Wei; Chen, Xu; Qin, Xiaoxia

    2017-01-01

    Major depressive disorder (MDD) is a known major risk factor for suicide due to the high suicide mortality. However, studies comparing the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in China are very limited. This study examined and compared the sociodemographic and psychological characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in emergency departments of general hospitals to better understand the risk factors for suicide attempts in China. All subjects were enrolled in the study between June 2007 and January 2008. A total of 127 suicide attempters-54 with MDD and 73 with no psychiatric diagnosis-were enrolled. The sociodemographic and clinical characteristics were compared between two groups using the statistical analysis performed using frequency distribution, Student's t test, Chi-square test, and Fisher's exact test and a logistic regression model. Suicide attempters with MDD were more likely to be more depressive, older, divorced or separated, unemployed, and living alone, and more likely to write a suicide note, have suicide ideation, and be motivated by reducing pain and burden. Suicide attempters with no psychiatric diagnosis were more likely to be younger and more impulsive, have self-rescue, and be motivated by threatening or taking revenge on others. Multivariate logistic regression analysis identified the following independent predictors of suicide attempts in individuals with MDD: a lower score on the quality of life scale, more years of education, and suicide ideation. The present study found both similarities and differences in the sociodemographic and clinical characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in the emergency departments of general hospitals in China. These findings will help us to recognize the characteristics of suicide attempters in both groups and develop specific interventions for the two

  13. High heterogeneity and low reliability in the diagnosis of major depression will impair the development of new drugs.

    Science.gov (United States)

    Lieblich, Samuel M; Castle, David J; Pantelis, Christos; Hopwood, Malcolm; Young, Allan Hunter; Everall, Ian P

    2015-10-01

    Major depressive disorder is a common diagnosis associated with a high burden of disease that has proven to be highly heterogeneous and unreliable. Treatments currently available demonstrate limited efficacy and effectiveness. New drug development is urgently required but is likely to be hindered by diagnostic limitations. D.J.C. has received grants and personal fees from Eli Lilly, Janssen-Cilag, Roche, Allergen, Bristol-Myers Squibb, Pfizer, Lundbeck, AstraZeneca, Hospira, Organon, Sanofi-Aventis, and Wyeth during the writing of this review. C.P. has received grant support from Janssen-Cilag, Eli Lilly, Hospira (Mayne), AstraZeneca, and received honoraria for consultancy to Janssen-Cilag, Eli Lilly, Hospira (Mayne), AstraZeneca, Pfizer, Schering Plough, and Lundbeck. Over the past 2 years he has participated on advisory boards for Janssen-Cilag and Lundbeck, and received honoraria for talks presented at educational meetings organised by AstraZeneca, Janssen-Cilag and Lundbeck. M.H. has received personal fees or grants from Lundbeck, AstraZeneca and Servier during the writing of this review. A.H.Y. reports personal fees from Lundbeck, Sunovion, AstraZeneca and Janssen outside the submitted work. I.P.E. has received personal fees or grants from Lundbeck, AstraZeneca, and Abbvie during the writing of this review. © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

  14. Differentiating maternal fatigue and depressive symptoms at six months and four years post partum: Considerations for assessment, diagnosis and intervention.

    Science.gov (United States)

    Giallo, Rebecca; Gartland, Deirdre; Woolhouse, Hannah; Brown, Stephanie

    2015-02-01

    fatigue and depressive symptoms are common among women in the postpartum period, and it has been proposed that fatigue is a risk factor for later depression. To progress this research, there is a need to clarify the conceptual and measurement issue of whether these two sets of symptoms are distinct constructs. There is also a need to determine whether they are distinct constructs beyond the postnatal period. The aim of the study was to assess the construct and discriminant validity of fatigue and depressive symptoms as measured by the SF-36 Vitality subscale (SF-36) and the Edinburgh Postnatal Depression Scale (EPDS) at six months and at four years post partum. data from over 1000 women participating in the Maternal Health Study, a longitudinal study of women׳s physical and psychological health and recovery after childbirth were used. confirmatory factor analysis revealed a two-factor model of fatigue and depressive symptoms represented as distinct but related constructs was a better fit to the data than a one-factor model of fatigue and depression sharing the same underlying construct at both six months and four years post partum. this study provides empirical evidence that maternal fatigue and depression in the first year after having a baby and at four years post partum are best understood as separate psychological constructs or experiences. The findings have important implications for clinical practice, in particular underlining the importance of differentiating tiredness from depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Depressive Disorders

    Science.gov (United States)

    Brown, Jacqueline A.; Russell, Samantha; Rasor, Kaitlin

    2017-01-01

    Depression is among the most common mental disorders in the United States. Its diagnosis is often related to impairment of functioning across several domains, including how an individual thinks, feels, and participates in daily activities. Although depression has a relatively high prevalence among adults, the rate is alarmingly higher among…

  16. Prevalence of Depressive Disorder in Persons With Type 2 Diabetes: A National Population-Based Cohort Study 2000-2010.

    Science.gov (United States)

    Tu, Hung-Pin; Hsieh, Hui-Min; Liu, Tai-Ling; Jiang, He-Jiun; Wang, Peng-Wei; Huang, Chun-Jen

    Diabetes mellitus, a chronic and disabling disease, is epidemic worldwide. Depressive disorder affects the productivity of workers and leads to disability. This study investigated the prevalence of depressive disorder among persons with type 2 diabetes in Taiwan. We extracted service claims data for subjects who had at least 2 ambulatory care service claims or 1 inpatient service claim with a principal diagnosis of type 2 diabetes and at least 1 ambulatory or inpatient service claim with a principal diagnosis of depressive disorder from Taiwan's National Health Insurance Database. From 2000-2010, the prevalence of depressive disorder increased from 3.50-4.07% in people with type 2 diabetes, and from 1.05-2.27% in the general population. The higher prevalence of depressive disorder in persons with type 2 diabetes was associated with being female; residence in central, southern, and eastern Taiwan; residence in urban areas; the comorbidities of hemiplegia or paraplegia, cerebrovascular disease, and anxiety disorder; Charlson Comorbidity Index scores ≥1; diabetes duration >9 years; and the use of rapid-acting insulin injection therapy. The prevalence of depressive disorder is higher among persons with type 2 diabetes than the general population. Consequently, more public health attention should be devoted to the prevention and treatment of this debilitating disease in persons with type 2 diabetes, especially those with the earlier mentioned risk factors. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  17. 32 CFR 536.120 - Claims payable as maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable as maritime claims. 536.120... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.120 Claims payable as maritime claims. A claim is cognizable under this subpart if it arises in or on a maritime location, involves some...

  18. Effect of informing the diagnosis on depressive state in patients with non-small cell lung cancer of stage Ⅲ

    OpenAIRE

    Wei WANG; Ping CHEN; Xianglin PI; Anlan WANG; Xiaoping WEN; Dong HUANG

    2008-01-01

    Background and objective As other tumors, unresectabe lung cancer can cause many psychological problems to the patients, such as depression and anxiety. The present paper aims to evaluate the status of depression before and after knowing the state of illness in patients with non-small cell lung cancer of stage Ⅲ. Methods 43 casesof newly diagnosed non-small cell lung cancer (NSCLC) with stage Ⅲ were enrolled in the study. All the patients were distributed into three groups and given different...

  19. SyncClaimService

    Data.gov (United States)

    Department of Veterans Affairs — Provides various methods to sync Claim related data for NWQ processing. It includes web operations to get Claims, get Unique Contention Classifications, get Unique...

  20. IBO Claim Taking Project

    Data.gov (United States)

    Social Security Administration — IBO manually tracks all Canadian Claims and DSU claims via this report. It also provides a summary for each region and office of origin that the DSU works with. This...

  1. Workers Compensation Claim Data -

    Data.gov (United States)

    Department of Transportation — This data set contains DOT employee workers compensation claim data for current and past DOT employees. Types of data include claim data consisting of PII data (SSN,...

  2. Medicaid Drug Claims Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid Drug Claims Statistics CD is a useful tool that conveniently breaks up Medicaid claim counts and separates them by quarter and includes an annual count.

  3. Evaluation of the utility of Liebowitz Social Anxiety Scale and Barratt Impulsiveness Scale in the diagnosis of social anxiety, impulsivity and depression.

    Science.gov (United States)

    Tyrała, Kinga; Seweryn, Mariusz; Bonk, Magdalena; Bulska, Weronika; Orszulak, Kamila; Bratek, Agnieszka; Krysta, Krzysztof

    2015-09-01

    Often mental disorders are serious problems concerning psychological well-being. They require comprehensive and specialized psychiatric and psychological help, but there are no public methods of controlling your mental state. The aim of study was the evaluation of the utility of Liebowitz Social Anxiety Scale and Barratt Impulsiveness Scale in the diagnosis of social anxiety, impulsivity and depression. The study included 85 persons. The study group had 34 patients treated in an open ward of the Department of Psychiatry and Psychotherapy of Medical University of Silesia in Katowice. The control group included 51 persons without mental disorders. Three self-rating questionnaires were used: Beck Depression Inventory, Barratt Impulsiveness Scale and Liebowitz Social Anxiety Scale. Statistica v10 Statsoft software was used for statistical analysis. The analyzed groups had significant differences in terms of Beck Scale (U Mann-Whitney test p=0.000001). Average score in study group: 22.94±12.50; in control group: 7.15±6.44. Groups had significant differences in terms of Liebowitz Scale (U test Mann-Whitney test, p=0.000164). Average score in the study group: 60.41±30.30; in control group: 35.01±23.94. Groups had significant differences in terms of Barratt Scale (t-student test p=0.000601). Average in study group: 66.35±9,49; in control group: 59.54±7.87. Significant positive correlation was observed between the results of Beck Scale and Liebowitz Scale (r=0.64465). Correlation was not observed between the results of the Liebowitz and Barrat (r=0.12091 and Beck and Barrat (r=0.21482). The intensity of the Liebowitz Social Anxiety Scale is directly proportional to the severity of depression according to the Beck Depression Inventory. The degree of impulsivity by Barrat Impulsiveness Scale does not correlate with the level of depression according to Beck Depression Inventory. The analyzed scales are relevant in the diagnosis of mental disorders.

  4. Diagnosis of depressed young people-criterion validity of WHO-5 and HSCL-6 in Denmark and Norway

    DEFF Research Database (Denmark)

    Christensen, Kaj Sparle; Haugen, Wenche; Sirpal, Manjit K

    2015-01-01

    Ifølge WHO bidrager depression væsentligt til den globale sygdomsbyrde. Depressioner hos voksne har ofte deres debut i ungdomsårene. Korte, pålidelige depressionsskalaer er fremmende for tidlig identifikation af depressioner. Formålet med denne undersøgelse var at validere WHO-5 og HSCL-6...... spørgeskemaer til opsporing af depression blandt unge. Projektet blev gennemført som et multicenter-studie i almen praksis i Danmark og Norge. I alt 294 unge i alderen 14-16 år deltog ved at besvare et papir- eller webbaseret spørgeskema og gennemførte efterfølgende et Composite International Diagnostic...... Interview (CIDI), som blev brugt som diagnostisk standard. Depression blev i undersøgelsen defineret ud fra ICD-10 kriterier. Kriterievaliditeten blev undersøgt i form af Receiver Operating Curve analyser og cut-offs for depression blev beregnet ved anvendelse af Youden-indekset. Forekomsten af depression...

  5. [Suicide Risk Assessment in the Clinical Practice Guidelines for the Diagnosis and Management of Depression in Colombia].

    Science.gov (United States)

    Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Gil Lemus, Laura Marcela; Jaramillo, Luis Eduardo; García Valencia, Jenny; Bravo Narváez, Eliana; de la Hoz Bradford, Ana María; Palacio, Carlos

    2013-01-01

    Suicide is the most serious complications of depression. It has high associated health costs and causes millions of deaths worldwide per year. Given its implications, it is important to know the factors that increase the risk of its occurrence and the most useful tools for addressing it. To identify the signs and symptoms that indicate an increased risk of suicide, and factors that increase the risk in patients diagnosed with depression. To establish the tools best fitted to identify suicide risk in people with depression. Clinical practice guidelines were developed, following those of the methodmethodological guidelines of the Ministry of Social Protection, to collect evidence and to adjust recommendations. Recommendations from the NICE90 and CANMAT guidelines were adopted and updated for questions found in these guidelines, while new recommendations were developed for questions not found in them. Basic points and recommendations are presented from a chapter of the clinical practice guidelines on depressive episodes and recurrent depressive disorder related to suicide risk assessment. Their corresponding recommendation levels are included. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Transdiagnostic and diagnosis-specific dynamic functional connectivity anchored in the right anterior insula in major depressive disorder and bipolar depression.

    Science.gov (United States)

    Pang, Yajing; Chen, Heng; Wang, Yifeng; Long, Zhiliang; He, Zongling; Zhang, Huangbin; Liao, Wei; Cui, Qian; Chen, Huafu

    2018-07-13

    Dysfunctional and abnormal functional connectivity in the right anterior insula (rAI) may underlie the pathophysiology of depression episode in bipolar disorder (BD) and of major depressive disorder (MDD). In this study, we examined the dynamic functional connectivity (dFC) of the rAI of 30 patients with BD, 30 patients with MDD, and 30 healthy controls. In the functional separation of rAI, the right dorsal AI (rdAI) and ventral AI (rvAI) were defined as seed regions. Sliding-window correlation of rAI subregions was implemented to measure the variance of dFC. BD and MDD shared abnormality in dFC, such as the decreased dFC between the rvAI and right ventrolateral prefrontal cortex. Others were disorder-specific and included MDD-related increases in dFC between the rvAI and right precuneus, temporal pole, and left dorsolateral prefrontal cortex. This observation is in stark contrast to BD-related increases in the dFC between the rdAI and left inferior parietal lobule and right middle occipital gyrus. The abnormal dFC of rAI shared by BD and MDD supports the importance of rAI in the common pathophysiology of these disorders. Meanwhile, disorder-specific abnormalities that attribute to the dorsal and ventral divisions of rAI can be used as biomarkers to differentiate BD from MDD. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Behandlingsresistent depression kan behandles

    DEFF Research Database (Denmark)

    Vinberg, Maj; Levinsen, Mette Frandsen; Kessing, Lars Vedel

    2011-01-01

    Depression is considered resistant when two treatment attempts with antidepressants from different classes fail to produce significant clinical improvement. In cases of treatment-resistant depression, it is recommended to reevaluate the diagnosis, clarify comorbidity, substance abuse and lack of ...

  8. Differential diagnosis of depression and Alzheimer's disease with the Addenbrooke's Cognitive Examination-Revised (ACE-R).

    Science.gov (United States)

    Rotomskis, Augustinas; Margevičiūtė, Ramunė; Germanavičius, Arūnas; Kaubrys, Gintaras; Budrys, Valmantas; Bagdonas, Albinas

    2015-04-17

    One of the usual problems psychologists and clinicians face in clinical practice is differential diagnostics of Alzheimer's disease and depression. It has been reported that the ACE and ACE-R could discriminate the cognitive dysfunctions due to depression from that due to dementia, although this is not uniform in all studies. The current study aimed to evaluate the utility of the ACE-R to differentiate late-life onset depression (with severe episode) from mild-moderate Alzheimer's Disease (AD). This study received approval from the Lithuanian Bioethics Committee. All participants were older than 50 years (mean age = 66.52 (±8.76) years). The study sample consisted of 295 individuals: 117 with severe depression, 85 with mild-moderate Alzheimer's disease (AD), and 94 age, gender and education matched participants of control group. The ACE-R had high sensitivity (100%) and specificity (81%) at detecting cognitive impairments related to AD. Patients with late-life onset depression (ACE-R mean 76.82, SD = 7.36) performed worse than controls (ACE-R mean 85.08, SD = 7.2), but better than the AD group (ACE-R mean 54.74, SD = 12.19). Participants with late-life onset depression were differentiated by mild impairment in the ACE-R total score with mild memory (13.79, SD = 6.29) and greater deficits in letter fluency (3.65, SD = 1.21) than in semantic fluency (4.68, SD = 1.23). Participants with AD were differentiated by severely impaired performance on attention and orientation (11.80, SD = 2.93), memory (8.25, SD = 3.47) and language subtests (17.21, SD = 4.04), and moderately impaired performance on verbal fluency (6.07, SD = 2.74). ACE-R has diagnostic accuracy in detecting people with AD and can be used in differential diagnostics of late-life onset depression (severe episode) and AD. Diagnostic accuracy may be improved by analyzing the neuropsychological profiles and using lower cutoffs for different age groups.

  9. Relations of mindfulness facets with psychological symptoms among individuals with a diagnosis of obsessive-compulsive disorder, major depressive disorder, or borderline personality disorder.

    Science.gov (United States)

    Didonna, Fabrizio; Rossi, Roberta; Ferrari, Clarissa; Iani, Luca; Pedrini, Laura; Rossi, Nicoletta; Xodo, Erica; Lanfredi, Mariangela

    2018-03-25

    To explore differences in mindfulness facets among patients with a diagnosis of either obsessive-compulsive disorder (OCD), major depressive disorder (MDD), or borderline personality disorder (BPD), and healthy controls (HC), and their associations with clinical features. One hundred and fifty-three patients and 50 HC underwent a clinical assessment including measures of mindfulness (Five Facets Mindfulness Questionnaire - FFMQ), psychopathological symptoms (Symptom Check List-90-R), dissociation (Dissociative Experience Scale), alexithymia (Alexithymia Scale 20), and depression (Beck Depression Inventory-II). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were performed to assess differences in mindfulness scores and their associations with clinical features. The three diagnostic groups scored lower on all mindfulness facets (apart from FFMQobserving) compared to the HC group. OCD group had a significant higher FFMQ total score (FFMQ-TS) and FFMQacting with awareness compared to the BPD group, and scored higher on FFMQdescribing compared to BPD and MDD groups. The scores in non-judging facet were significantly lower in all the three diagnostic groups compared to the HC group. Interestingly, higher FFMQ-TS was inversely related to all psychological measures, regardless of diagnostic group. Deficits in mindfulness skills were present in all diagnostic groups. Furthermore, we found disease-specific relationships between some mindfulness facets and specific psychological variables. Clinical implications are discussed. The study showed deficits in mindfulness scores in all diagnostic groups compared to a healthy control group. Overall, mindfulness construct has a significantly negative association with indexes of global distress, dissociative symptoms, alexithymia, and depression. Mindfulness-based interventions in clinical settings should take into account different patterns of mindfulness skills and their impact on disease-specific maladaptive

  10. Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims

    International Nuclear Information System (INIS)

    Breen, Micheal A.; Taylor, George A.; Dwyer, Kathy; Yu-Moe, Winnie

    2017-01-01

    Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in

  11. Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal A.; Taylor, George A. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dwyer, Kathy; Yu-Moe, Winnie [CRICO Risk Management Foundation, Boston, MA (United States)

    2017-06-15

    Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality

  12. Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims.

    Science.gov (United States)

    Breen, Micheál A; Dwyer, Kathy; Yu-Moe, Winnie; Taylor, George A

    2017-06-01

    Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in

  13. Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses

    Directory of Open Access Journals (Sweden)

    Schultz Jennifer F

    2010-06-01

    Full Text Available Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1 to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2 to assess the increased cost associated with this potential misdiagnosis. Methods This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1 at least 2 bipolar diagnoses in 2002, 2 continuous enrollment during 2002 and 2003, 3 a pharmacy benefit, and 4 age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models. Results Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400 had an incongruent depression diagnosis (IDD. After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD. Conclusions A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression after being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar

  14. Comparison of depression symptoms between primary depression and secondary-to-schizophrenia depression.

    Science.gov (United States)

    Rahim, Twana; Rashid, Roshe

    2017-11-01

    This study exclusively aimed to clinically assess which symptom pattern discriminates primary depression from depression-secondary to-schizophrenia. A total of 98 patients with primary depression and 71 patients with secondary-to-schizophrenia depression were assessed for identifying the clinical phenomena of depression. Diagnosis of schizophrenia was confirmed by Mini International Neuropsychiatric Interview. Each participant was, however, assessed by Patient Health Questionnaire-9 as well as Calgary Depression Scale for Schizophrenia (CDSS) for possible concurrent depressive symptoms. Depressed mood, loss of interest, reduced energy and pathological guilt were more common in primary depression, whereas sleep disturbance and guilty ideas of reference were more amounting towards the diagnosis of depression secondary-to-schizophrenia. It is clinically hard to differentiate primary from secondary-to-schizophrenia depression, especially in the absence of obvious psychotic symptoms. However, the classical symptoms of depression like subjective depressed mood, anhedonia, reduced energy and pathological guilt are more prominent in the primary depression.

  15. Information about diagnosis and prognosis related to anxiety and depression in children with cancer aged 8-16 years

    NARCIS (Netherlands)

    Last, B. F.; van Veldhuizen, A. M.

    1996-01-01

    The aim of this study was to test the hypothesis that being openly informed about the diagnosis and prognosis benefits the emotional well-being of children with cancer. A stratified sample of 56 children with cancer aged 8-16 years and their parents participated. The parents were interviewed about

  16. Formalizing Probabilistic Safety Claims

    Science.gov (United States)

    Herencia-Zapana, Heber; Hagen, George E.; Narkawicz, Anthony J.

    2011-01-01

    A safety claim for a system is a statement that the system, which is subject to hazardous conditions, satisfies a given set of properties. Following work by John Rushby and Bev Littlewood, this paper presents a mathematical framework that can be used to state and formally prove probabilistic safety claims. It also enables hazardous conditions, their uncertainties, and their interactions to be integrated into the safety claim. This framework provides a formal description of the probabilistic composition of an arbitrary number of hazardous conditions and their effects on system behavior. An example is given of a probabilistic safety claim for a conflict detection algorithm for aircraft in a 2D airspace. The motivation for developing this mathematical framework is that it can be used in an automated theorem prover to formally verify safety claims.

  17. [Age 89 years, depression, fall with pelvic fracture, severe confusion - serotonin syndrome : Differential diagnosis, importance of CYP450 and economic considerations].

    Science.gov (United States)

    Weinrebe, W; Moutaouakil, A; Risz, K; Martin, M; Jeckelmann, K; Goetz, S

    2017-04-18

    A case study of an 89-year-old patient is reported, who was admitted to hospital because of immobility due to pain. After the cause of the pain could initially be clarified and treated, the further clinical course in this very old woman showed an alarming symptom complex of agitation, confusion and cognitive deterioration, which took on grave forms. The work-up of this case showed a typical constellation of pain and depression in old age; however, the pharmaceutical treatment in this case is not atypical and could lead to a severe serotonin syndrome. The interaction, diagnostics, differential diagnosis, pharmacological, functional, codification and economic aspects of the course of the disease are discussed.

  18. Relationship between working hours and power of attention, memory, fatigue, depression and self-efficacy one year after diagnosis of clinically isolated syndrome and relapsing remitting multiple sclerosis.

    Science.gov (United States)

    Jongen, Peter Joseph; Wesnes, Keith; van Geel, Björn; Pop, Paul; Sanders, Evert; Schrijver, Hans; Visser, Leo H; Gilhuis, H Jacobus; Sinnige, Ludovicus G; Brands, Augustina M

    2014-01-01

    The role of cognitive domain dysfunction with respect to vocational changes in persons with Clinically Isolated Syndrome (CIS) and early Relapsing Remitting Multiple Sclerosis (eRRMS) is insufficiently known. We investigated thirty-three patients--14 CIS, 19 eRRMS -, mean (standard deviation [SD]) time since diagnosis 13.5 (4.8) months and mean (SD) Expanded Disability Status Scale (EDSS) score 1.3 (1.1). Patients were assessed on the CDR System, a set of automated tests of cognitive function, which yielded scores for Power of Attention (ms), Continuity of Attention (#), Working Memory (SI), Episodic Memory (#) and Speed of Memory (ms). Work-related items and the confounding variables fatigue, depression, disease impact and self-efficacy, were assessed by self-report questionnaires. Patients had poorer Power of Attention compared to normative data (1187 [161.5] vs. 1070 [98.6]; PMemory (4043 [830.6]) vs. 2937 [586.1]; PAttention (Pearson r =  -0.42; PMemory (r = 0.42; PAttention (1247 vs. 1116 ms; PMemory (1.35 vs. 1.57; pAttention and Speed of Memory are reduced, that Power of Attention and Memory are associated with a capability of working less hours, and that fatigue, depression and disease impact may negatively, and self-efficacy positively affect working hours.

  19. A Randomised Controlled Experimental Study on the Influence of Patient Age on Medical Decisions in Respect to the Diagnosis and Treatment of Depression in the Elderly

    Directory of Open Access Journals (Sweden)

    Michael Linden

    2009-01-01

    Full Text Available Background. Elderly patients are often treated differently than younger patients, even when suffering from the same disorder. Objective. The study examines the influence of “patient age” on the perception of symptoms and conclusions of physicians in respect to diagnosis and treatment. Methods. In a randomised controlled experimental study on medical decision-making, 121 general practitioners were given two case vignettes which contained all the criteria for major depression according to ICD-10, but differed in respect to the age of the patient (39 or 81. Reaction time, diagnostic conclusions and therapeutic recommendations were assessed by computer. Results. Depression and anxiety were significantly seen as more probable in the young cases and dementia and physical illness in the old. In young age, psychotherapy, pharmacotherapy and referral to a specialist or inpatient treatment were significantly more recommended than in old age, for whom supportive counselling was significantly more recommended. The time needed for a decision was significantly longer in the older patients. Conclusion. Ageing stereotypes can also form medical illness concepts and have a significant influence on diagnostic and therapeutic decisions.

  20. Major depression

    Science.gov (United States)

    Depression - major; Depression - clinical; Clinical depression; Unipolar depression; Major depressive disorder ... providers do not know the exact causes of depression. It is believed that chemical changes in the ...

  1. Diagnosis of major depressive disorder by combining multimodal information from heart rate dynamics and serum proteomics using machine-learning algorithm.

    Science.gov (United States)

    Kim, Eun Young; Lee, Min Young; Kim, Se Hyun; Ha, Kyooseob; Kim, Kwang Pyo; Ahn, Yong Min

    2017-06-02

    Major depressive disorder (MDD) is a systemic and multifactorial disorder that involves abnormalities in multiple biochemical pathways and the autonomic nervous system. This study applied a machine-learning method to classify MDD and control groups by incorporating data from serum proteomic analysis and heart rate variability (HRV) analysis for the identification of novel peripheral biomarkers. The study subjects consisted of 25 drug-free female MDD patients and 25 age- and sex-matched healthy controls. First, quantitative serum proteome profiles were analyzed by liquid chromatography-tandem mass spectrometry using pooled serum samples from 10 patients and 10 controls. Next, candidate proteins were quantified with multiple reaction monitoring (MRM) in 50 subjects. We also analyzed 22 linear and nonlinear HRV parameters in 50 subjects. Finally, we identified a combined biomarker panel consisting of proteins and HRV indexes using a support vector machine with recursive feature elimination. A separation between MDD and control groups was achieved using five parameters (apolipoprotein B, group-specific component, ceruloplasmin, RMSSD, and SampEn) at 80.1% classification accuracy. A combination of HRV and proteomic data achieved better classification accuracy. A high classification accuracy can be achieved by combining multimodal information from heart rate dynamics and serum proteomics in MDD. Our approach can be helpful for accurate clinical diagnosis of MDD. Further studies using larger, independent cohorts are needed to verify the role of these candidate biomarkers for MDD diagnosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. SSA Disability Claim Data

    Data.gov (United States)

    Social Security Administration — The dataset includes fiscal year data for initial claims for SSA disability benefits that were referred to a state agency for a disability determination. Specific...

  3. Health Claims Data Warehouse (HCDW)

    Data.gov (United States)

    Office of Personnel Management — The Health Claims Data Warehouse (HCDW) will receive and analyze health claims data to support management and administrative purposes. The Federal Employee Health...

  4. Borderline personality disorder, bipolar disorder, depression, attention deficit/hyperactivity disorder, and narcissistic personality disorder: Practical differential diagnosis.

    Science.gov (United States)

    Kernberg, Otto F; Yeomans, Frank E

    2013-01-01

    The challenge of accurate diagnosis remains at the heart of good psychiatric treatment. In the current state of psychiatry, a confluence of forces has increased this challenge for the clinician. These include practical pressures-such as limited time for diagnostic evaluation, the question of what is reimbursed by insurance, and the issue of directing patients to acute treatments-and also trends in nosology, such as the descriptive focus on signs and symptoms in the current official diagnostic system. The authors offer observations that we hope will help clinicians who have to make difficult diagnostic differentiations often under pressured circumstances. The paper is motivated both by the high frequency of diagnostic errors observed under such conditions and also by the belief that considering symptoms in the context of the patient's sense of self, quality of interpersonal relations, and level of functioning over time will help guide the diagnostic process.

  5. 32 CFR 536.129 - Claims cognizable as UCMJ claims.

    Science.gov (United States)

    2010-07-01

    ... Personnel Claims Act and chapter 11 of AR 27-20, which provides compensation only for tangible personal... 32 National Defense 3 2010-07-01 2010-07-01 true Claims cognizable as UCMJ claims. 536.129 Section 536.129 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS...

  6. Genetic variants in 5-HTTLPR, BDNF, HTR1A, COMT, and FKBP5 and risk for treated depression after cancer diagnosis

    DEFF Research Database (Denmark)

    Suppli, Nis P; Bukh, Jens D; Moffitt, Terrie E

    2017-01-01

    BACKGROUND: The role of gene-environment interactions in the pathogenesis of depression is unclear. Previous studies addressed vulnerability for depression after childhood adversity and stressful life events among carriers of numerous specific genetic variants; however, the importance of individual...

  7. Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.

    Science.gov (United States)

    Ryu, Euijung; Chamberlain, Alanna M; Pendegraft, Richard S; Petterson, Tanya M; Bobo, William V; Pathak, Jyotishman

    2016-04-26

    Major depressive disorder (MDD) is often comorbid with other chronic mental and physical health conditions. Although the literature widely acknowledges the association of many chronic conditions with the risk of MDD, the relative importance of these conditions on MDD risk in the presence of other conditions is not well investigated. In this study, we aimed to quantify the relative contribution of selected chronic conditions to identify the conditions most influential to MDD risk in adults and identify differences by age. This study used electronic health record (EHR) data on patients empanelled with primary care at Mayo Clinic in June 2013. A validated EHR-based algorithm was applied to identify newly diagnosed MDD patients between 2000 and 2013. Non-MDD controls were matched 1:1 to MDD cases on birth year (±2 years), sex, and outpatient clinic visits in the same year of MDD case diagnosis. Twenty-four chronic conditions defined by Chronic Conditions Data Warehouse were ascertained in both cases and controls using diagnosis codes within 5 years of index dates (diagnosis dates for cases, and the first clinic visit dates for matched controls). For each age group (45 years or younger, between 46 and 60, and over 60 years), conditional logistic regression models were used to test the association between each condition and subsequent MDD risk, adjusting for educational attainment and obesity. The relative influence of these conditions on the risk of MDD was quantified using gradient boosting machine models. A total of 11,375 incident MDD cases were identified between 2000 and 2013. Most chronic conditions (except for eye conditions) were associated with risk of MDD, with different association patterns observed depending on age. Among 24 chronic conditions, the greatest relative contribution was observed for diabetes mellitus for subjects aged ≤ 60 years and rheumatoid arthritis/osteoarthritis for those over 60 years. Our results suggest that specific chronic

  8. Pain, depressive symptoms and medication in German patients with rheumatoid arthritis-results from the linking patient-reported outcomes with claims data for health services research in rheumatology (PROCLAIR) study.

    Science.gov (United States)

    Jobski, Kathrin; Luque Ramos, Andres; Albrecht, Katinka; Hoffmann, Falk

    2017-07-01

    Pain and depressive symptoms are common in patients with rheumatoid arthritis (RA). Information on the prevalence and treatment of both conditions in German RA patients is scarce. Using data from a nationwide statutory health insurance fund (BARMER GEK), 6193 RA patients aged 18 to 79 years were provided with a questionnaire covering a variety of items such as demographics, medical condition and quality of life in 2015. Pain caused by the joint disorder (11-point scale) was classified as none existent/mild, moderate or severe. Depressive symptoms were determined using the World Health Organization's five-item Well-being Index and categorized as none existent, mild or moderate/severe. Another item covered additional use of over-the-counter drugs. Data were linked to dispensation records. A total of 3140 RA patients were included. Median age was 66 years (79% female). About 70% of patients were classified as having moderate or severe pain. Depressive symptoms were found in 52% and were far more common among patients with higher pain levels. Analgesic treatment ranged from 45% to 76% (non-opioid analgesics) and from 6% to 33% (opioids) in patients with no/mild pain and those reporting severe pain, respectively. In patients reporting moderate or severe pain, substantially higher prevalences of opioid use were observed among those with depressive symptoms. Depending on depressive symptoms, antidepressant use ranged from 7% to 37%. Overall, over-the-counter drug use varied between 30% and 59%. Pain and depressive symptoms are highly prevalent in German RA patients, often present together and influence each other's treatment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Experiences of depression

    DEFF Research Database (Denmark)

    Rønberg, Mette

    In this thesis, I examine the complex experiences of what we call depression in everyday life, the multifaceted and ambiguous experiences of getting a depression diagnosis, and the in-depth processes involved in learning to live under the description of depression. The thesis is based......-and-for-all-dealt-with matters but rather messy and complicated processes, that involve several actors and multiple relations to the diagnosis. The thesis furthermore challenges the dominant diagnostic understanding depression as a neurobiological, and individual disorder in present-day diagnostic cultures, by arguing...

  10. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... generally miserable or unhappy without really knowing why. Depression symptoms in children and teens Common signs and ... in normal activities, and avoidance of social interaction. Depression symptoms in older adults Depression is not a ...

  11. BenefitClaimWebServiceBean/BenefitClaimWebService

    Data.gov (United States)

    Department of Veterans Affairs — A formal or informal request for a type of monetary or non-monetary benefit. This service provides benefit claims and benefit claim special issues data, allows the...

  12. Legal Services: Claims

    Science.gov (United States)

    1997-12-31

    waive such exemp- tions or privileges and direct release of the protected documents, upon balancing all pertinent factors, including finding that...injury causing death until expiration of decedent’s worklife ex- pectancy. When requested, the previous five years Federal income tax forms must be...knowing at all times how much of the CEA has been obligated, its remaining balance , and assessing each month whether the balance will cover claims

  13. Claims-based definition of death in Japanese claims database: validity and implications.

    Science.gov (United States)

    Ooba, Nobuhiro; Setoguchi, Soko; Ando, Takashi; Sato, Tsugumichi; Yamaguchi, Takuhiro; Mochizuki, Mayumi; Kubota, Kiyoshi

    2013-01-01

    For the pending National Claims Database in Japan, researchers will not have access to death information in the enrollment files. We developed and evaluated a claims-based definition of death. We used healthcare claims and enrollment data between January 2005 and August 2009 for 195,193 beneficiaries aged 20 to 74 in 3 private health insurance unions. We developed claims-based definitions of death using discharge or disease status and Charlson comorbidity index (CCI). We calculated sensitivity, specificity and positive predictive values (PPVs) using the enrollment data as a gold standard in the overall population and subgroups divided by demographic and other factors. We also assessed bias and precision in two example studies where an outcome was death. The definition based on the combination of discharge/disease status and CCI provided moderate sensitivity (around 60%) and high specificity (99.99%) and high PPVs (94.8%). In most subgroups, sensitivity of the preferred definition was also around 60% but varied from 28 to 91%. In an example study comparing death rates between two anticancer drug classes, the claims-based definition provided valid and precise hazard ratios (HRs). In another example study comparing two classes of anti-depressants, the HR with the claims-based definition was biased and had lower precision than that with the gold standard definition. The claims-based definitions of death developed in this study had high specificity and PPVs while sensitivity was around 60%. The definitions will be useful in future studies when used with attention to the possible fluctuation of sensitivity in some subpopulations.

  14. Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications

    Science.gov (United States)

    Ooba, Nobuhiro; Setoguchi, Soko; Ando, Takashi; Sato, Tsugumichi; Yamaguchi, Takuhiro; Mochizuki, Mayumi; Kubota, Kiyoshi

    2013-01-01

    Background For the pending National Claims Database in Japan, researchers will not have access to death information in the enrollment files. We developed and evaluated a claims-based definition of death. Methodology/Principal Findings We used healthcare claims and enrollment data between January 2005 and August 2009 for 195,193 beneficiaries aged 20 to 74 in 3 private health insurance unions. We developed claims-based definitions of death using discharge or disease status and Charlson comorbidity index (CCI). We calculated sensitivity, specificity and positive predictive values (PPVs) using the enrollment data as a gold standard in the overall population and subgroups divided by demographic and other factors. We also assessed bias and precision in two example studies where an outcome was death. The definition based on the combination of discharge/disease status and CCI provided moderate sensitivity (around 60%) and high specificity (99.99%) and high PPVs (94.8%). In most subgroups, sensitivity of the preferred definition was also around 60% but varied from 28 to 91%. In an example study comparing death rates between two anticancer drug classes, the claims-based definition provided valid and precise hazard ratios (HRs). In another example study comparing two classes of anti-depressants, the HR with the claims-based definition was biased and had lower precision than that with the gold standard definition. Conclusions/Significance The claims-based definitions of death developed in this study had high specificity and PPVs while sensitivity was around 60%. The definitions will be useful in future studies when used with attention to the possible fluctuation of sensitivity in some subpopulations. PMID:23741526

  15. Medico-legal claims against English radiologists: 1995–2006

    Science.gov (United States)

    Halpin, S F S

    2009-01-01

    A list of claims against radiologists from 1995–2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under £8.5 million has so far been paid in damages, with a further £5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of £464 000 (£673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was £300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future. PMID:19470570

  16. Medico-legal claims against English radiologists: 1995-2006.

    Science.gov (United States)

    Halpin, S F S

    2009-12-01

    A list of claims against radiologists from 1995-2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under pound8.5 million has so far been paid in damages, with a further pound5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of pound464 000 ( pound673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was pound300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future.

  17. Depression - resources

    Science.gov (United States)

    Resources - depression ... Depression is a medical condition. If you think you may be depressed, see a health care provider. ... following organizations are good sources of information on depression : American Psychological Association -- www.apa.org/topics/depression/ ...

  18. Contested Property Claims

    DEFF Research Database (Denmark)

    Property relations are such a common feature of social life that we can sometimes forget the immense complexity of the web of laws, practices, and ideas that allow a property regime to function smoothly. But we are quickly reminded of this complexity when social conflict over property erupts. When...... social actors confront a property regime – for example by squatting – they enact what can be called ‘contested property claims’. These confrontations raise crucial issues of social justice and show the ways in which property conflicts often reflect wider social conflicts. Through a series of case studies...... from across the globe, this multidisciplinary anthology exploring contested property claims brings together works from anthropologists, legal scholars, and geographers, who show how disagreements give us a privileged window onto how property regimes function and illustrates the many ways...

  19. Contested Property Claims

    DEFF Research Database (Denmark)

    Property relations are such a common feature of social life that the complexity of the web of laws, practices, and ideas that allow a property regime to function smoothly are often forgotten. But we are quickly reminded of this complexity when conflict over property erupts. When social actors...... confront a property regime – for example by squatting – they enact what can be called ‘contested property claims’. As this book demonstrates, these confrontations raise crucial issues of social justice and show the ways in which property conflicts often reflect wider social conflicts. Through a series...... of case studies from across the globe, this multidisciplinary anthology brings together works from anthropologists, legal scholars, and geographers, who show how exploring contested property claims offers a privileged window onto how property regimes function, as well as an illustration of the many ways...

  20. Characteristics of claims in the management of septic arthritis in Japan: Retrospective analyses of judicial precedents and closed claims.

    Science.gov (United States)

    Otaki, Yasuhiro; DaSilva, Makiko Ishida; Saito, Yuichi; Oyama, Yasuaki; Oiso, Giichiro; Yoshida, Tomohiko; Fukuhara, Masakazu; Moriyama, Mitsuru

    2018-03-01

    Septic arthritis (SA) cases can result in claims or litigation because of poor prognosis even if it is unavoidable. Although these claims or litigation are useful for understanding causes and background factors of medical errors, the characteristics of malpractice claims associated with SA remain undetermined in Japan. This study aimed to increase our understanding of malpractice claims in the clinical management of SA. We analyzed 6 civil precedents and 16 closed claims of SA from 8530 malpractice claims processed between July 2004 and June 2014 by the Tokyo office of Sompo Japan Nipponkoa Insurance, Incorporated. We also studied 5 accident and 21 incident reports of SA based on project data compiled by the Japan Council for Quality Health Care. The rate of negligence was 83.3% in the precedents and 75.0% in closed claims. Two main malpractice claim patterns were revealed: SA in a lower extremity joint following sepsis caused by methicillin-resistant Staphylococcus aureus in newborns and SA in an injection site following joint injection. These two patterns accounted for 83.3% and 56.3% of judicial cases and closed claim cases, respectively. Breakdowns in care process of accident and incident reports were clearly differentiated from judicial cases or closed claim cases (Fisher's exact test, p < 0.001). It is important to pay particular attention to SA following sepsis in newborns and to monitor for any signs of SA after joint injection to ensure early diagnosis. Analysis of both malpractice claims and accident and incident reports is essential to ensure a full understanding of the situation in Japan. Copyright © 2017. Published by Elsevier Taiwan LLC.

  1. Claiming health in food products

    DEFF Research Database (Denmark)

    Lähteenmäki, Liisa

    2013-01-01

    Health-related information is increasingly used on food products to convey their benefits. Health claims as a subcategory of these messages link the beneficial component, functions or health outcomes with specific products. For consumers, health claims seem to carry the message of increased...... healthiness, but not necessarily making the product more appealing. The wording of the claim seems to have little impact on claim perception, yet the health image of carrier products is important. From consumer-related factors the relevance and attitudes towards functional foods play a role, whereas socio......-demographic factors have only minor impact and the impact seems to be case-dependent. Familiarity with claims and functional foods increase perceived healthiness and acceptance of these products. Apparently consumers make rather rational interpretations of claims and their benefits when forced to assess...

  2. Claims in civil engineering contracts

    CERN Document Server

    Speirs, N A

    1999-01-01

    This paper considers claims arising during civil engineering construction contracts. The meaning of the word 'claim' is considered and its possible implications for additional cost and time to completion. The conditions of the construction contract selected will influence the risk apportionment between contractor and client and the price offered by the contractor for the work. Competitive bidding constraints and profit margins in the construction industry, however, may also influence the price offered. This in turn can influence the likelihood of claims arising. The client from his point of view is concerned to complete the work within an agreed time and budget. The circumstances under which claims may arise are reviewed in relation to typical conditions of contract. These circumstances are then related to the CERN LHC civil works. Ways of avoiding claims, where this is possible, are considered. Finally, the means of evaluation of claims and their settlement are considered.

  3. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... your mood. Chronic pain causes a number of problems that can lead to depression, such as trouble sleeping and stress. Disabling pain can cause low self-esteem due to work, legal or financial issues. Depression ...

  4. Claim prevention at reactor facilities

    International Nuclear Information System (INIS)

    Colby, B.P.

    1987-01-01

    Why does a radiation worker bring a claim alleging bodily injury from radiation exposure? Natural cancer, fear of radiation induced cancer, financial gain, emotional distress and mental anguish are some reasons for workers' claims. In this paper the author describes what power reactor health physicists are doing to reduce the likelihood of claims by establishing programs which provide sound protection of workers, prevent radiological events, improve workers' knowledge of radiological conditions and provide guidance for radiological incident response

  5. Analysis of 11 years of clinical negligence claims in esophagogastric cancer in England.

    Science.gov (United States)

    Ratnasingham, K; Stroud, L; Knight, J; Preston, S R; Sultan, J

    2017-04-01

    In the National Health Service (NHS), clinical negligence claims and associated compensations are constantly rising. The aim of this study is to identify the size, trends, and causes of litigations claims in relation to esophagogastric (EG) cancer in the NHS. Data requests were submitted to the NHS Litigation Authority (NHSLA) for the period of January 2003 to December 2013. Data were reviewed, categorized clinically, and analyzed in terms of causes and costs behind claims. In this time period, there were 163 claims identified from the NHSLA database. Ninety-five (58.3%) claims were successful with a pay out of £6.25 million. An increasing overall claim frequency and success rate were found over the last few years. Majority of the claims were from gastric cancer 84 (88.4%). The commonest cause of complaint in successful claims was delay or failure in diagnosis (21.1%) and treatment (17.9%). There were only 10.5% successful intraoperative claims, of which 50% were due to unnecessary or additional procedures. The frequency and success rates of malpractice claims in EG cancer are rising. The failure or delay in diagnosing and treatment in EG malignancy are the common cause for successful litigation claims. The findings further reinforce the need to improve early diagnosis. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Agreement for depression diagnosis between DSM-IV-TR criteria, three validated scales, oncologist assessment, and psychiatric clinical interview in elderly patients with advanced ovarian cancer

    Directory of Open Access Journals (Sweden)

    Rhondali W

    2015-07-01

    Full Text Available Wadih Rhondali,1 Gilles Freyer,2 Virginie Adam,3 Marilène Filbet,4 Martine Derzelle,5 Gaelle Abgrall-Barbry,6 Sophie Bourcelot,7 Jean-Louis Machavoine,8 Muriel Chomat-Neyraud,9 Olivier Gisserot,10 Rémi Largillier,11 Annick Le Rol,12 Frank Priou,13 Pierre Saltel,14 Claire Falandry15 1Clinique Mon Repos, Clinea, Marseille, France; 2Medical Oncology Unit, Centre Hospitalier Lyon Sud, Université Lyon 1, Pierre-Benite, France; 3Institut de Cancérologie de Lorraine Alexis Vautrin, Vandoeuvre-lès-Nancy, France; 4Palliative Unit, Centre Hospitalier Lyon Sud, Université Lyon 1, Pierre-Benite, France; 5Institut Jean Godinot, Reims, France; 6Tenon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; 7Centre Léon Bérard, Lyon, France; 8Centre François Baclesse, Caen, France; 9Centre Hospitalier de la région d’Annecy, Pringy, France; 10Hôpital d’Instruction des Armées Sainte-Anne, Toulon, France; 11Centre Azuréen de Cancérologie, Mougins, France; 12Medical Oncology, Hôpital Perpétuel Secours, Levallois-Perret, France; 13Medical Oncology, Centre Hospitalier Départemental Les Oudairies, La Roche-sur-Yon, France; 14Supportive Care Department, Centre Léon Bérard, Lyon, France; 15Geriatrics and Oncology Unit, Centre Hospitalier Lyon Sud, Université Lyon 1, Pierre-Bénite, France Background: Depression, a major outcome in cancer patients, is often evaluated by physicians relying on their clinical impressions rather than patient self-report. Our aim was to assess agreement between patient self-reported depression, oncologist assessment (OA, and psychiatric clinical interview (PCI in elderly patients with advanced ovarian cancer (AOC.Methods: This analysis was a secondary endpoint of the Elderly Women AOC Trial 3 (EWOT3, designed to assess the impact of geriatric covariates, notably depression, on survival in patients older than 70 years of age. Depression was assessed using the Geriatric Depression Scale-30 (GDS, the Hospital

  7. What is depression?

    DEFF Research Database (Denmark)

    Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

    2014-01-01

    of depression is insufficient and a collaborative care (CC) model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed......The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners' (GPs') treatment...... to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views...

  8. Depression and anxiety are associated with a diagnosis of hypertension 5 years later in a cohort of late middle-aged men and women

    NARCIS (Netherlands)

    Ginty, A. T.; Carroll, D.; Roseboom, T. J.; Phillips, A. C.; de Rooij, S. R.

    2013-01-01

    The aim of this study is to examine the association between symptoms of depression and anxiety and hypertension status. Participants (n=455, 238 women) were drawn from the Dutch Famine Birth Cohort Study. In 2002-2004, they attended a clinic assessment during which socio-demographics,

  9. Characteristics of claims in the management of septic arthritis in Japan: Retrospective analyses of judicial precedents and closed claims

    Directory of Open Access Journals (Sweden)

    Yasuhiro Otaki

    2018-03-01

    Conclusion: It is important to pay particular attention to SA following sepsis in newborns and to monitor for any signs of SA after joint injection to ensure early diagnosis. Analysis of both malpractice claims and accident and incident reports is essential to ensure a full understanding of the situation in Japan.

  10. Self-compassion in depression: associations with depressive symptoms, rumination, and avoidance in depressed outpatients.

    Science.gov (United States)

    Krieger, Tobias; Altenstein, David; Baettig, Isabelle; Doerig, Nadja; Holtforth, Martin Grosse

    2013-09-01

    Self-compassion involves being kind to oneself when challenged with personal weaknesses or hardship and has been claimed to be associated with resilience in various areas. So far, there are only a handful of studies that investigate self-compassion and its relation to clinical depression. Therefore, the principal goals of the present study were (a) to compare self-compassion in clinically depressed patients and never-depressed subjects, (b) to investigate self-compassion and its relation to cognitive-behavioral avoidance and rumination in depressed outpatients, and (c) to investigate rumination and avoidance as mediators of the relationship between self-compassion and depressive symptoms. One hundred and forty-two depressed outpatients and 120 never-depressed individuals from a community sample completed a self-report measure of self-compassion along with other measures. Results indicate that depressed patients showed lower levels of self-compassion than never-depressed individuals, even when controlled for depressive symptoms. In depressed outpatients, self-compassion was negatively related to depressive symptoms, symptom-focused rumination, as well as cognitive and behavioral avoidance. Additionally, symptom-focused rumination and cognitive and behavioral avoidance mediated the relationship between self-compassion and depressive symptoms. These findings extend previous research on self-compassion, its relation to depression, as well as processes mediating this relationship, and highlight the importance of self-compassion in clinically depressed patients. Since depressed patients seem to have difficulties adopting a self-compassionate attitude, psychotherapists are well advised to explore and address how depressed patients treat themselves. Copyright © 2013. Published by Elsevier Ltd.

  11. Primary care closed claims experience of Massachusetts malpractice insurers.

    Science.gov (United States)

    Schiff, Gordon D; Puopolo, Ann Louise; Huben-Kearney, Anne; Yu, Winnie; Keohane, Carol; McDonough, Peggy; Ellis, Bonnie R; Bates, David W; Biondolillo, Madeleine

    Despite prior focus on high-impact inpatient cases, there are increasing data and awareness that malpractice in the outpatient setting, particularly in primary care, is a leading contributor to malpractice risk and claims. To study patterns of primary care malpractice types, causes, and outcomes as part of a Massachusetts ambulatory malpractice risk and safety improvement project. Retrospective review of pooled closed claims data of 2 malpractice carriers covering most Massachusetts physicians during a 5-year period (January 1, 2005, through December 31, 2009). Data were harmonized between the 2 insurers using a standardized taxonomy. Primary care practices in Massachusetts. All malpractice claims that involved primary care practices insured by the 2 largest insurers in the state were screened. A total of 551 claims from primary care practices were identified for the analysis. Numbers and types of claims, including whether claims involved primary care physicians or practices; classification of alleged malpractice (eg, misdiagnosis or medication error); patient diagnosis; breakdown in care process; and claim outcome (dismissed, settled, verdict for plaintiff, or verdict for defendant). During a 5-year period there were 7224 malpractice claims of which 551 (7.7%) were from primary care practices. Allegations were related to diagnosis in 397 (72.1%), medications in 68 (12.3%), other medical treatment in 41 (7.4%), communication in 15 (2.7%), patient rights in 11 (2.0%), and patient safety or security in 8 (1.5%). Leading diagnoses were cancer (n = 190), heart diseases (n = 43), blood vessel diseases (n = 27), infections (n = 22), and stroke (n = 16). Primary care cases were significantly more likely to be settled (35.2% vs 20.5%) or result in a verdict for the plaintiff (1.6% vs 0.9%) compared with non-general medical malpractice claims (P < .001). In Massachusetts, most primary care claims filed are related to alleged misdiagnosis. Compared with malpractice

  12. Depressive disorder due to craniopharyngioma.

    Science.gov (United States)

    Spence, S A; Taylor, D G; Hirsch, S R

    1995-01-01

    Secondary causes of depression are legion, and must always be considered in patients presenting with features atypical of primary idiopathic depressive disorder. The case described is that of a middle-aged woman presenting initially with a major depressive disorder who was subsequently found to have a craniopharyngioma, leading to a revised diagnosis of mood disorder due to the tumour. Some features of the presentation might have led to earlier diagnosis had their localizing significance been recognized. Diencephalic lesions should always be considered in patients presenting with the hypersomnic-hyperphagic variant of depressive disorder. Images Figure 1 PMID:8544149

  13. Differences in the ICD-10 diagnostic subtype of depression in bipolar disorder compared to recurrent depressive disorder

    DEFF Research Database (Denmark)

    Jensen, H.M.; Christensen, E.M.; Kessing, Lars Vedel

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective...... disorder, current episode of depression, or a diagnosis of recurrent depressive disorder, current episode of depression, in a period from 1994 to 2002 at the first outpatient treatment or at the first discharge from psychiatric hospitalization in Denmark were identified in a nationwide register. Results......: Totally, 389 patients got a diagnosis of bipolar disorder, current episode of depression, and 5.391 patients got a diagnosis of recurrent depressive disorder, current episode of depression, at first contact. Compared with patients with a diagnosis of recurrent depressive disorder, patients with bipolar...

  14. Clinical negligence claims in pediatric surgery in England: pattern and trends.

    Science.gov (United States)

    Thyoka, Mandela

    2015-02-01

    We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims. Georg Thieme Verlag KG Stuttgart · New York.

  15. Epidemic Depression and Burtonian Melancholy | Radden ...

    African Journals Online (AJOL)

    Data indicate the ubiquity and rapid increase of depression wherever war, want and social upheaval are found. The goal of this paper is to clarify such claims and draw conceptual distinctions separating the depressive states that are pathological from those that are normal and normative responses to misfortune. I do so by ...

  16. BLM Colorado Mining Claims Closed

    Data.gov (United States)

    Department of the Interior — Shapefile Format –This data set consists of closed mining claim records extracted from BLM’s LR2000 database. These records contain case attributes as well as legal...

  17. BLM Colorado Mining Claims Active

    Data.gov (United States)

    Department of the Interior — Shapefile Format –This data set consists of active mining claim records extracted from BLM’s LR2000 database. These records contain case attributes as well as legal...

  18. Medicare Part D Claims Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page contains information on Part D claims data for the purposes of research, analysis, reporting, and public health functions. These data will also be used to...

  19. Transtornos depressivos na doença de Alzheimer: diagnóstico e tratamento Depressive disorders in Alzheimer's disease: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Orestes V Forlenza

    2000-06-01

    Full Text Available Transtornos do humor afetam uma porcentagem considerável de indivíduos com doença de Alzheimer, em algum ponto da evolução da síndrome demencial. Pode ser uma condição difícil de se detectar, dependendo da gravidade do acometimento cognitivo. Na presença de manifestações depressivas leves ou atípicas, a observação da evolução, associada ou não ao emprego de técnicas não-farmacológicas, é a abordagem inicial mais recomendável; na vigência de depressão moderada a grave, o emprego de psicofármacos pode fazer-se necessário. Embora haja evidências dos benefícios advindos do tratamento da depressão em pacientes com demência, avaliações formais da sua eficácia nesses pacientes são limitadas. A escolha do antidepressivo depende muito mais do seu perfil de tolerabilidade, das condições clínicas associadas e das características individuais do paciente. Os inibidores seletivos da recaptação de serotonina são usualmente as drogas de primeira opção, pelo perfil mais adequado de segurança, tolerabilidade e facilidade posológica. Em situações especiais, devem ser considerados os potenciais terapêuticos das novas drogas ou mesmo dos medicamentos tradicionais. O artigo revê a literatura dos últimos dez anos, enfocando particularidades do diagnóstico da depressão em pacientes com doença de Alzheimer, bem como diretrizes para uma prescrição segura.Depressive symptoms frequently arise in the course of dementia, imposing additional limitations to both cognitive performance and quality of life. Diagnosing depression in these cases can be difficult, especially in patients with moderate and severe Alzheimer's disease. In general, non-pharmacological approaches are the first-line treatment for mild depressive symptoms, but medication is clearly indicated for moderate and severe cases. However, age-and disease-related changes make the pharmacological management of such patients particularly complex and hazardous. In

  20. A cena constituinte da psicose maníaco-depressiva no Brasil The emergence of manic depressive psychosis as a diagnosis in Brazil

    Directory of Open Access Journals (Sweden)

    Joel Birman

    2010-12-01

    Full Text Available A intenção deste ensaio é esboçar a leitura da psicose maníaco-depressiva no Brasil, no começo do século XX. Destaca a transformação teórica ocorrida na psiquiatria brasileira, que se deslocou da tradição francesa para a alemã. Sublinha o modo como a problemática da histeria foi substituída pela da psicose maníaco-depressiva nesse contexto histórico.This essay examines the early twentieth-century interpretation of manic depressive psychosis in Brazil, during a moment when Brazilian psychiatry witnessed a theoretical shift from the French to German traditions. It calls special attention to how the problem of hysteria was replaced by manic depressive psychosis within this historical context.

  1. Treinamento de clínicos para o diagnóstico e tratamento da depressão An educational training program for physicians for diagnosis and treatment of depression

    Directory of Open Access Journals (Sweden)

    Willians Valentini

    2004-08-01

    Full Text Available OBJETIVO: Avaliar os resultados da aplicação de programa de treinamento da Organização Mundial de Saúde, voltado para diagnóstico e tratamento da depressão, dirigido a médicos clínicos gerais. MÉTODOS: Dezessete clínicos e 1.224 pacientes da cidade de Campinas, SP, participaram do estudo. Um mês antes e um após o treinamento, foram avaliados o conhecimento dos médicos, suas atitudes e o atendimento prestado aos pacientes; esses, por sua vez, completaram escalas de auto-avaliação de sintomas depressivos: Zung e um "checklist" para depressão maior do manual para diagnóstico e estatística em saúde mental (DSM-IV/CID-10. A mudança de conhecimento e atitude dos clínicos entre as fases 1 e 2 foi avaliada pelos testes t de Student. Mudanças com relação ao conhecimento de cada indivíduo foram mensuradas pelo teste de qui-quadrado de McNemar. As diferenças entre o modo de atender os pacientes entre as duas fases foram determinadas pelo teste de qui-quadrado de Pearson. A concordância diagnóstica foi analisada utilizando o Kappa, com o intuito de corrigir a concordância ao acaso. RESULTADOS: O programa mostrou benefícios limitados nessa amostra de clínicos gerais. Não foi capaz de mostrar aumento do conhecimento sobre a depressão e nem quanto à atitude dos médicos com relação a esse transtorno. Não houve modificação no número de casos diagnosticados antes ou após o programa. Existiram algumas evidências com relação à melhora no manejo psicofarmacológico. Aparentemente, o programa tornou os clínicos mais confiantes para o tratamento da depressão, diminuindo o número de encaminhamentos feitos aos profissionais da área de saúde mental. Porém, um baixo poder estatístico não permitiu que os dois últimos achados atingissem significância. CONCLUSÕES: A inclusão de clínicos gerais é um componente central de qualquer iniciativa para melhorar a detecção e o tratamento da depressão, porém faz

  2. Neonatal hypoglycaemia: learning from claims

    OpenAIRE

    Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

    2016-01-01

    Objectives Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. Design The NHS Litigation Authority (NHS LA) Claims Management Syste...

  3. [Usefulness of the 10 pictures reminding test for memory assessment for the diagnosis of Alzheimer's disease, mild cognitive impairment and anxiety/depression].

    Science.gov (United States)

    Federico, D; Thomas-Anterion, C; Borg, C; Foyatier Michel, N; Dirson, S; Laurent, B

    2008-10-01

    Episodic memory is often considered to be essential in the neuropsychological examination of elderly people consulting in the memory clinics. Therefore, the performance of three different episodic memory tests were compared in Alzheimer's disease (AD), mild cognitive impairment (MCI) and anxiety/depression. Seventy-six patients with AD, 46 with MCI, and 36 with anxiety/depression performed three memory tests: (1) three-words immediate and delayed recall of the MMSE test; (2) 10-pictures reminding test; (3) 16-items free and cued reminding test. Patients with AD and MCI differed from the depressed/anxious participants on all subcomponents of the memory tests. Only the three-words immediate and delayed recall in the MMSE test as well as the immediate recall (encoding) of the free and cued reminding test (16-items) did not differ between AD and MCI. Significant correlations were also evidenced between the free and cued recall of the 10 pictures and the score of the 16-items for all patients. Scores of total and free recalls distinguished the three group of patients; also, a trend was observed for the free recall between the patients with AD and MCI. The three-words immediate and delayed recall of the MMSE test is linked with hippocampic dysfunction. Also, the present study suggests that the 10-pictures reminding test, is a simple and reliable test for investigating memory, in addition to other evaluation tests. Finally, further studies would be necessary to assess the sensitivity and specificity of the tests.

  4. Application of positron emission tomography with 18ffdg in combined diagnosis of anxiety and depressive disorders in elderly patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    A. A. Stanzhevsky

    2013-01-01

    Full Text Available 35 patients with chronic cardiac failure of the third functional class and anxiety depressive disorders were examined. The screening group consisted of 35 patients with chronic cardiac insufficiency without affective disorders. Evaluation of the clinical state was carried out by echocardiography, 6 minute walk and estimation of therapy compliance. Severity of the symptoms of anxiety and depressive disorders were studied by MMPI test, Beck`s test, Hamilton`s scale, Spielberg scale. PET with 18FFDG was carried out on PET tomographs «EcatExact 47» and «Ecat Exact HR+» (Siemens, Germany. It was found that anxiety depressive disorders have negative effect on the clinical state and the therapy compliance in the patients with chronic cardiac failure. Significant correlation between the clinical data and the brain 18FFDG PET results was seen in most cases.

  5. 32 CFR 536.121 - Claims not payable as maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims not payable as maritime claims. 536.121... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.121 Claims not payable as maritime claims... (except at (e) and (k)), and 536.46; (b) Are not maritime in nature; (c) Are not in the best interests of...

  6. Depression following acute coronary syndrome

    DEFF Research Database (Denmark)

    Joergensen, Terese Sara Hoej; Maartensson, Solvej; Ibfelt, Else Helene

    2016-01-01

    PURPOSE: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk...... factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations. METHODS: The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period...... 2001-2009 in Denmark. Cox regression models were used to analyse hazard ratios (HRs) for depression. RESULTS: 1.5 and 9.5 % develop early (≤30 days) and later (31 days-2 years) depression after the acute coronary syndrome. Among all patients with depression, 69.2 % had first onset depression, while 30...

  7. Behandlingsresistent depression kan behandles

    DEFF Research Database (Denmark)

    Vinberg, Maj; Levinsen, Mette Frandsen; Kessing, Lars Vedel

    2011-01-01

    Depression is considered resistant when two treatment attempts with antidepressants from different classes fail to produce significant clinical improvement. In cases of treatment-resistant depression, it is recommended to reevaluate the diagnosis, clarify comorbidity, substance abuse and lack...... of compliance. Regarding treatment, evidence is sparse, but switching to a different antidepressant, and combination or augmentation with another agent, admission and treatment with ECT are the options. The choice of treatment must be based on the characteristics of the depression, the severity of treatment...

  8. Severity of depressive episodes during the course of depressive disorder

    DEFF Research Database (Denmark)

    Kessing, L.V.

    2008-01-01

    Background It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. Aims To investigate whether the severity of depressive episodes increases during the course of illness. Method Using a Danish nationwide case register, all psychiatric inpatients...... and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. Results A total of 19 392 patients received a diagnosis of a single depressive episode at first...... contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact...

  9. Severity of depressive episodes during the course of depressive disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

    BACKGROUND: It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. AIMS: To investigate whether the severity of depressive episodes increases during the course of illness. METHOD: Using a Danish nationwide case register, all psychiatric in......-patients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. RESULTS: A total of 19 392 patients received a diagnosis of a single depressive episode at first...... contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact...

  10. [Primary headache and depression].

    Science.gov (United States)

    Gesztelyi, Gyöngyi

    2004-11-28

    Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

  11. Anxious-retarded depression: relation to family history of depression

    NARCIS (Netherlands)

    de Winter, Remco F. P.; Zwinderman, Koos H.; Goekoop, Jaap G.

    2004-01-01

    Anxious-retarded depression is a two-dimensionally defined subcategory of depression based on high scores for both anxiety and retardation. The anxious-retarded subcategory is related to melancholia as defined by DSM-IV. Patients with this diagnosis exhibit elevated plasma arginine vasopressin (AVP)

  12. Early perinatal diagnosis of mothers at risk of developing post-partum depression--a concise guide for obstetricians, midwives, neonatologists and paediatricians.

    Science.gov (United States)

    Ambrosini, Alessandra; Donzelli, Gianpaolo; Stanghellini, Giovanni

    2012-07-01

    In this article, we tried to provide all those involved in perinatal medicine with a concise guide to detect mothers at risk of developing post-partum depression. Motherhood is a critical situation characterized by role conflicts because conflicts among the role of mother, worker and wife are the norm in the post-partum period and may jeopardize the mother's existence. We have described a kind of personality that is at great risk of developing post-partum depression because of the incapacity to creatively manage situations of role conflict. This personality structure is called typus melancholicus, and we operationally defined its main features: orderliness, conscientiousness, hypernomia/heteronomia and intolerance of ambiguity. We have shown how these mothers may typically behave during pregnancy and early motherhood: they cannot avoid behaving with feverish perfectionism, developing an exaggerated preoccupation towards the unborn child and hostility towards persons and events that are experienced as an obstacle to their search for perfection. They ultra-carefully follow all the steps concerning paediatric check-ups and feel all the responsibility relating to the care of the child, without being able to delegate to someone else or share their feelings. We hope to provide those clinicians who are engaged in the care of pregnant women and their children with a valuable and user-friendly instrument for understanding and making a timely diagnoses of at-risk psychopathological phenomena.

  13. Double blinding requirement for validity claims in cognitive-behavioral therapy intervention trials for major depressive disorder. Analysis of Hollon S, et al., Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Douglas Berger

    2015-08-01

    Full Text Available This paper will focus on problems in the inability to double-blind cognitive-behavioral therapy (CBT studies for major depressive disorder (MDD, and provides an analysis of a recently published study to show how this problem can lead to faulty conclusions. A study by Hollon et al. published in JAMA Psychiatry that compared an antidepressant medication-only arm with a combined CBT/antidepressant arm concluded that the cognitive therapy/antidepressant combination enhanced the recovery rates compared with antidepressant alone, and that the magnitude of this increment nearly doubled for patients with more severe depression. We propose that for subjects with greater severity, there could have been both antidepressant efficacy as well as more hope and expectation in the group who knew they had received combined cognitive therapy/medication, leading to an erroneous conclusion of greater efficacy for the combined group. The large subject number in this study could easily lead to an erroneous finding on statistical testing as a small amount of bias in the subjects adds-up. We opine that the conclusions of unblind CBT outcome research in conditions with subjective endpoints such as MDD need to be given with great caution. The validity of CBT (and its derivatives such as dialectical behavioral therapy for indications other than MDD is also part of a larger problem in  the inability to blind outcome studies for these interventions.

  14. Postpartum depression in older women.

    Science.gov (United States)

    Strelow, Brittany; Fellows, Nicole; Fink, Stephanie R; OʼLaughlin, Danielle J; Radke, Gladys; Stevens, Joy; Tweedy, Johanna M

    2018-03-01

    Postpartum depression, which affects 10% to 20% of women in the United States, can significantly harm the health and quality of life for mother, child, and family. This article reviews the risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment of postpartum depression with specific focus on women of advanced maternal age.

  15. 32 CFR 842.94 - Assertable claims.

    Science.gov (United States)

    2010-07-01

    ..., against a tort-feasor when: (a) Damage results from negligence and the claim is for: (1) More than $100... ADMINISTRATIVE CLAIMS Property Damage Tort Claims in Favor of the United States (31 U.S.C. 3701, 3711-3719) § 842.... (The two claims should be consolidated and processed under subpart N). (d) The Tort-feasor or his...

  16. Caregiver Depression

    Science.gov (United States)

    ... will not sell or share your name. Caregiver Depression Tweet Bookmark this page | Email | Print Many caregivers ... depression See your doctor Treatment Coping Symptoms of depression Caregiving is hard — and can lead to feelings ...

  17. Depression FAQs

    Science.gov (United States)

    Depression affects about 15 million American adults every year. Women are more likely to get depression than men. In general, about one out of every four women will get depression at some point in her life.

  18. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  19. Exaggerated Claims for Interactive Stories

    Science.gov (United States)

    Thue, David; Bulitko, Vadim; Spetch, Marcia; Webb, Michael

    As advertising becomes more crucial to video games' success, developers risk promoting their products beyond the features that they can actually include. For features of interactive storytelling, the effects of making such exaggerations are not well known, as reports from industry have been anecdotal at best. In this paper, we explore the effects of making exaggerated claims for interactive stories, in the context of the theory of advertising. Results from a human user study show that female players find linear and branching stories to be significantly less enjoyable when they are advertised with exaggerated claims.

  20. Reserving by detailed conditioning on individual claim

    Science.gov (United States)

    Kartikasari, Mujiati Dwi; Effendie, Adhitya Ronnie; Wilandari, Yuciana

    2017-03-01

    The estimation of claim reserves is an important activity in insurance companies to fulfill their liabilities. Recently, reserving method of individual claim have attracted a lot of interest in the actuarial science, which overcome some deficiency of aggregated claim method. This paper explores the Reserving by Detailed Conditioning (RDC) method using all of claim information for reserving with individual claim of liability insurance from an Indonesian general insurance company. Furthermore, we compare it to Chain Ladder and Bornhuetter-Ferguson method.

  1. Army Blast Claims Evaluation Procedures

    Science.gov (United States)

    1994-03-01

    ATIN: AFZX-JA Building 4551 Fort Polk, LA 71459-5000 Commander U.S. Army Engineer Center and Fort Leonard Wood ATIN: AlZT-JA Building 1706 East...U.S. Armed Forces Claims Service, Korea APO AP 96205-0084 No. of Copies Organization 1 Commander U.S. Army South ATI’N: SOJA Building 154 APO

  2. Nordic scepticism towards health claims

    DEFF Research Database (Denmark)

    Pedersen, Susanne; Grunert, Klaus G.

    2008-01-01

    Imagine that you are shopping in a supermarket and find a package of pork chops labelled "omega-3 added" or that the yogurt "contains phosphatidylserine, which can improve your memory"; would you buy these pork chops or this yogurt? Most Nordic consumers would choose products without health claims....

  3. Entrepreneurial Crowdfunding without Private Claims

    DEFF Research Database (Denmark)

    Boudreau, Kevin J.; Jeppesen, Lars Bo; Reichstein, Toke

    Today's crowdfunding raises funds for tiny, private entrepreneurial ventures without granting funders private claims to a project's future value. Rather than “investments,” these are “contributions.” This paper argues that for such crowdfunding neither producer nor consumer surplus – i.e., project...

  4. Severity of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2004-01-01

    BACKGROUND: The ICD-10 categorisation of severity of depression into mild, moderate and severe depressive episodes has not been validated. AIMS: To validate the ICD-10 categorisation of severity of depression by estimating its predictive ability on the course of illness and suicidal outcome. METHOD......: All psychiatric in-patients in Denmark who had received a diagnosis of a single depressive episode at their first discharge between 1994 and 1999 were identified. The risk of relapse and the risk of suicide were compared for patients discharged with an ICD-10 diagnosis of a single mild, moderate...... or severe depressive episode. RESULTS: At their first discharge, 1103 patients had an ICD-10 diagnosis of mild depressive episode, 3182 had a diagnosis of moderate depressive episode and 2914 had a diagnosis of severe depressive episode. The risk of relapse and the risk of suicide were significantly...

  5. Rates, Amounts, and Determinants of Ambulatory Blood Pressure Monitoring Claim Reimbursements Among Medicare Beneficiaries

    Science.gov (United States)

    Kent, Shia T.; Shimbo, Daichi; Huang, Lei; Diaz, Keith M.; Viera, Anthony J.; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    Ambulatory blood pressure monitoring (ABPM) can be used to identify white coat hypertension and guide hypertensive treatment. We determined the percentage of ABPM claims submitted between 2007–2010 that were reimbursed. Among 1,970 Medicare beneficiaries with submitted claims, ABPM was reimbursed for 93.8% of claims that had an ICD-9 diagnosis code of 796.2 (“elevated blood pressure reading without diagnosis of hypertension”) versus 28.5% of claims without this code. Among claims without an ICD-9 diagnosis code of 796.2 listed, those for the component (e.g., recording, scanning analysis, physician review, reporting) versus full ABPM procedures and performed by institutional versus non-institutional providers were each more than two times as likely to be successfully reimbursed. Of the claims reimbursed, the median payment was $52.01 (25–75th percentiles: $32.95–$64.98). In conclusion, educating providers on the ABPM claims reimbursement process and evaluation of Medicare reimbursement may increase the appropriate use of ABPM and improve patient care. PMID:25492833

  6. Depression and cardiovascular disease.

    Science.gov (United States)

    Elderon, Larkin; Whooley, Mary A

    2013-01-01

    Approximately one out of every five patients with cardiovascular disease (CVD) suffers from major depressive disorder (MDD). Both MDD and depressive symptoms are risk factors for CVD incidence, severity and outcomes. Great progress has been made in understanding potential mediators between MDD and CVD, particularly focusing on health behaviors. Investigators have also made considerable strides in the diagnosis and treatment of depression among patients with CVD. At the same time, many research questions remain. In what settings is depression screening most effective for patients with CVD? What is the optimal screening frequency? Which therapies are safe and effective? How can we better integrate the care of mental health conditions with that of CVD? How do we motivate depressed patients to change health behaviors? What technological tools can we use to improve care for depression? Gaining a more thorough understanding of the links between MDD and heart disease, and how best to diagnose and treat depression among these patients, has the potential to substantially reduce morbidity and mortality from CVD. Published by Elsevier Inc.

  7. Should the District Courts Have Jurisdiction Over Pre-Award Contract Claims? A Claim for the Claims Court

    National Research Council Canada - National Science Library

    Short, John J

    1987-01-01

    This thesis briefly examines the jurisdiction of the federal district courts and the United States Court of Claims over pre-award contract claims before the Federal Courts Improvement Act of October 1...

  8. Political liberalism and religious claims

    Science.gov (United States)

    2016-01-01

    This article gives an overview of 4 important lacunae in political liberalism and identifies, in a preliminary fashion, some trends in the literature that can come in for support in filling these blind spots, which prevent political liberalism from a correct assessment of the diverse nature of religious claims. Political liberalism operates with implicit assumptions about religious actors being either ‘liberal’ or ‘fundamentalist’ and ignores a third, in-between group, namely traditionalist religious actors and their claims. After having explained what makes traditionalist religious actors different from liberal and fundamentalist religious actors, the author develops 4 areas in which political liberalism should be pushed further theoretically in order to correctly theorize the challenge which traditional religious actors pose to liberal democracy. These 4 areas (blind spots) are: (1) the context of translation; (2) the politics of exemptions; (3) the multivocality of theology; and (4) the transnational nature of norm-contestation. PMID:28344375

  9. Second WCB claims: who is at risk?

    Science.gov (United States)

    Cherry, Nicola M; Sithole, Fortune; Beach, Jeremy R; Burstyn, Igor

    2010-01-01

    Many workers with one Workers' Compensation Board (WCB) claim make further claims. If the characteristics of the job, initial injury or worker were predictive of an early second claim, interventions at the time of return to work after the first claim might be effective in reducing the burden of work-related injury. This report explores the characteristic of those who make a second claim. Records of all Alberta WCB claims from January 1, 1995, to December 31, 2004, for individuals 18 to claim, sex and age of claimant, type of injury, type of accident, occupation, industry, an indicator of company size, and industry claim rate were extracted, as well as the date of any second claim. The likelihood of second claim and mean time to second claim were estimated. Multivariate analyses were performed using Cox regression. 1,047,828 claims were identified from 490,230 individuals. Of these, 49.2% had at least two claims. In the multivariate model a reduced time to second claim was associated with male sex, younger age and some types of injury and accident. Machining trades were at highest risk of early second claim (hazard ratio [HR] 2.54 compared with administration), and of the industry sectors manufacturing was at highest risk (HR 1.37 compared with business, personal and professional services). Some caution is needed in interpreting these data as they may be affected by under-reporting and job changes between claims. Nonetheless, they suggest that there remains room for interventions to reduce the considerable differences in risk of a second claim among workers, jobs and industries.

  10. Sovereignty Frames and Sovereignty Claims

    OpenAIRE

    Walker, Neil

    2013-01-01

    This essay argues that much of the contemporary confusion and controversy over the meaning and continuing utility of the concept of sovereignty stems from a failure to distinguish between sovereignty as a deep framing device for making sense of the modern legal and political word on the one hand, and the particular claims which are made on behalf of particular institutions, agencies, rules or other entities to possess sovereign authority on the other. The essay begins by providing a basic acc...

  11. Diagnosis and treatment delays among elderly breast cancer patients with pre-existing mental illness.

    Science.gov (United States)

    Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw

    2017-11-01

    This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.

  12. Stigma towards depression in primary care

    OpenAIRE

    Sinkevičius, Kasparas; Jaraitė, Goda

    2018-01-01

    Introduction. Depression is a common mental disorder, more than 300,000,000 people affected by this disease, which is either the leading cause of disability worldwide. Depression can be treated effectively, however, there are a lot of obstacles that can interfere with it. Stigma towards depression is one of causes leading to under-diagnosis and under-treatment. Aim. This study aims to describe the attitudes of general practitioners towards misleading statements about depression in Lithuania. ...

  13. Risk of Contractors’ Claims On the Example of Road Works

    Science.gov (United States)

    Rybka, Iwona; Bondar-Nowakowska, Elżbieta; Pawluk, Katarzyna; Połoński, Mieczysław

    2017-10-01

    The aim of the study is to analyse claims filed by building contractors during the project implementation. The work is divided into two parts. In the first part problems associated with the management of claims in the construction process were discussed. Bearing in mind that claims may result in prolongation of the investment or exceeding planned budget, possibilities of applying information included in documents connected with claims procedure to risk management was analysed in the second part of the study. The basis of the analysis is a review of 226 documents. They originate from 8 construction sites completed in the last 5 years in southwestern Poland. In each case, these were linear road projects, executed by different contractors, according to conditions in the contract set out in the “Yellow Book” FIDIC. In the study, other documents relating events that according to contractors entitled them to claim were also analysed. They included among others: project documentation, terms of reference, construction log, reports and correspondence under the contract. The events constituting the reason for contractors` claims were classified according to their sources. 8 areas of potential threats were distinguished. They were presented in the form of a block diagram. Most events initiating the claims were reported in the following group - adverse actions of third parties, while the fewest were recorded in the group - the lack of access to the construction site. Based on calculated similarity indicators it was found that considered construction sites were diversified in terms of the number of the events occurrence that generated the claim and their sources. In recent years, many road projects are completed behind the schedule and their initially planned budgets are significantly exceeded. Conducted research indicated that data derived from the analysis of documents connected with claims can be applied to identify and classify both cost and schedule risk factors

  14. Determinants of consumer understanding of health claims

    DEFF Research Database (Denmark)

    Grunert, Klaus G; Scholderer, Joachim; Rogeaux, Michel

    2011-01-01

    as safe, risky or other. In addition to the open questions on claim understanding, respondents rated a number of statements on claim interpretation for agreement and completed scales on interest in healthy eating, attitude to functional foods, and subjective knowledge on food and health. Results showed......The new EU regulation on nutrition and health claims states that claims can be permitted only if they can be expected to be understood by consumers. Investigating determinants of consumer understanding of health claims has therefore become an important topic. Understanding of a health claim...... on a yoghurt product was investigated with a sample of 720 category users in Germany. Health claim understanding was measured using open answers, which were subsequently content analysed and classified by comparison with the scientific dossier of the health claim. Based on this respondents were classified...

  15. 40 CFR 35.6600 - Contractor claims.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Contractor claims. 35.6600 Section 35... Actions Procurement Requirements Under A Cooperative Agreement § 35.6600 Contractor claims. (a) General... prepared by the contractor to support a claim against the recipient; and (4) The award official determines...

  16. PS2-15: Coding for Obesity in a Health Plan Claims Database

    OpenAIRE

    Shainline, Michael; Carter, Shelley; Von Worley, Ann; Gunter, Margaret

    2010-01-01

    Background and Aims: The Centers for Disease Control estimated the obesity rate in New Mexico for 2008 to be 25.2%. Sources estimate the following associations between obesity and type 2 diabetes (80%); cardiovascular disease (70%); hypertension (26 %). Yet obesity is infrequently coded as a secondary diagnosis among providers submitting claims. This study examines the frequency with which obesity is documented on claims forms, the relationship between age, gender, and obesity coding, and the...

  17. Depression (PDQ)

    Science.gov (United States)

    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... that may also cause depression. There are many medical conditions that can cause depression. Medical conditions that ...

  18. Postpartum Depression

    Science.gov (United States)

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  19. Depression Treatment

    Science.gov (United States)

    ... 3286 After hours (404) 639-2888 Contact Media Depression Treatment Recommend on Facebook Tweet Share Compartir On ... How Do I Know if I Am Experiencing Depression? The following questions may help you determine if ...

  20. An Individual Claims History Simulation Machine

    Directory of Open Access Journals (Sweden)

    Andrea Gabrielli

    2018-03-01

    Full Text Available The aim of this project is to develop a stochastic simulation machine that generates individual claims histories of non-life insurance claims. This simulation machine is based on neural networks to incorporate individual claims feature information. We provide a fully calibrated stochastic scenario generator that is based on real non-life insurance data. This stochastic simulation machine allows everyone to simulate their own synthetic insurance portfolio of individual claims histories and back-test thier preferred claims reserving method.

  1. Using Self-reports or Claims to Assess Disease Prevalence: It's Complicated.

    Science.gov (United States)

    St Clair, Patricia; Gaudette, Étienne; Zhao, Henu; Tysinger, Bryan; Seyedin, Roxanna; Goldman, Dana P

    2017-08-01

    Two common ways of measuring disease prevalence include: (1) using self-reported disease diagnosis from survey responses; and (2) using disease-specific diagnosis codes found in administrative data. Because they do not suffer from self-report biases, claims are often assumed to be more objective. However, it is not clear that claims always produce better prevalence estimates. Conduct an assessment of discrepancies between self-report and claims-based measures for 2 diseases in the US elderly to investigate definition, selection, and measurement error issues which may help explain divergence between claims and self-report estimates of prevalence. Self-reported data from 3 sources are included: the Health and Retirement Study, the Medicare Current Beneficiary Survey, and the National Health and Nutrition Examination Survey. Claims-based disease measurements are provided from Medicare claims linked to Health and Retirement Study and Medicare Current Beneficiary Survey participants, comprehensive claims data from a 20% random sample of Medicare enrollees, and private health insurance claims from Humana Inc. Prevalence of diagnosed disease in the US elderly are computed and compared across sources. Two medical conditions are considered: diabetes and heart attack. Comparisons of diagnosed diabetes and heart attack prevalence show similar trends by source, but claims differ from self-reports with regard to levels. Selection into insurance plans, disease definitions, and the reference period used by algorithms are identified as sources contributing to differences. Claims and self-reports both have strengths and weaknesses, which researchers need to consider when interpreting estimates of prevalence from these 2 sources.

  2. The association between depression and mortality

    DEFF Research Database (Denmark)

    Christensen, Gunhild Tidemann; Maartensson, Solvej; Osler, Merete

    2017-01-01

    survey- and register-based measures of depression were associated with 7-year mortality in a cohort of middle-aged Danish men. METHODS: The study was based on 10,517 men born in 1953. Depression was assessed through hospital diagnosis for the period from 1969 to 2004 and by self-reported information...... on depression, use of antidepressants and the Major Depression Inventory (MDI) from a survey in 2004, in which 58.8% (n=6292) of the men participated. Information on mortality and cause of death was retrieved from registers for the period between 2004 and 2011. RESULTS: Depression diagnosis from hospital...... reflecting past depression, but the strongest association was found for current depression as assessed by the MDI-score. LIMITATIONS: The study population consists almost exclusively of white men and the findings may not be generalizable to female populations or other races and ethnicities. CONCLUSIONS...

  3. Teen Depression

    Science.gov (United States)

    What is depression in teens? Teen depression is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. It is ... trouble focusing and have no motivation or energy. Depression can make you feel like it is hard ...

  4. Occupational management in the workplace and impact on injury claims, duration, and cost: a prospective longitudinal cohort

    Directory of Open Access Journals (Sweden)

    Lemstra ME

    2016-07-01

    Full Text Available Mark E Lemstra Alliance Health Medical Clinic, Moose Jaw, SK, Canada Abstract: Few workplaces have prospectively reviewed workplace and worker issues simultaneously and assessed their impact on Workers’ Compensation Board (WCB claims. In January of 2014, each worker in a large workplace in Saskatchewan, Canada, was prospectively followed for 1 year to determine factors that impact injury claim incidence, recovery, and costs. In total, 207 out of 245 workers agreed to complete the baseline survey (84.5%. In 2014, 82.5% of workers had self-reported pain, but only 35.5% submitted a WCB claim. Binary logistic regression was used to compare those with pain who did not submit a WCB injury claim to those with pain who did initiate a WCB claim. Independent risk factors associated with WCB claim incidence included depressed mood (odds ratio [OR] =2.75, 95% confidence interval [CI] 1.44–9.78 and lower job satisfaction (OR =1.70, 95% CI 1.08–10.68. Higher disability duration was independently associated with higher depressed mood (OR =1.60, 95% CI 1.05–4.11 and poor recovery expectation (OR =1.31, 95% CI 1.01–5.78. Higher cost disability claims were independently associated with higher depressed mood (OR =1.51, 95% CI 1.07–6.87 and pain catastrophizing (OR =1.11, 95% CI 1.02–8.11. Self-reported pain, physically assessed injury severity, and measured ergonomic risk of workstation did not significantly predict injury claim incidence, duration, or costs. In January 2015, the workplace implemented a new occupational prevention and management program. The injury incidence rate ratio reduced by 58% from 2014 to 2015 (IRR =1.58, 95% CI =1.28–1.94. The ratio for disability duration reduced by 139% from 2014 to 2015 (RR =2.39, 95% CI =2.16–2.63. Costs reduced from $114,149.07 to $56,528.14 per year. In summary, WCB claims are complex. Recognizing that nonphysical factors, such as depressed mood, influence injury claim incidence, recovery, and

  5. Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study.

    Science.gov (United States)

    Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno

    2018-01-01

    Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.

  6. Mental health claims management and return to work: qualitative insights from Melbourne, Australia.

    Science.gov (United States)

    Brijnath, Bianca; Mazza, Danielle; Singh, Nabita; Kosny, Agnieszka; Ruseckaite, Rasa; Collie, Alex

    2014-12-01

    Mental health conditions (MHC) are an increasing reason for claiming injury compensation in Australia; however little is known about how these claims are managed by different gatekeepers to injury entitlements. This study, drawing on the views of four stakeholders-general practitioners (GPs), injured persons, employers and compensation agents, aims to describe current management of MHC claims and to identify the current barriers to return to work (RTW) for injured persons with a MHC claim and/or mental illness. Ninety-three in-depth interviews were undertaken with GPs, compensation agents, employers and injured persons. Data were collected in Melbourne, Australia. Thematic techniques were used to analyse data. MHC claims were complex to manage because of initial assessment and diagnostic difficulties related to the invisibility of the injury, conflicting medical opinions and the stigma associated with making a MHC claim. Mental illness also developed as a secondary issue in the recovery process. These factors made MHC difficult to manage and impeded timely RTW. It is necessary to undertake further research (e.g. guideline development) to improve current practice in order to enable those with MHC claims to make a timely RTW. Further education and training interventions (e.g. on diagnosis and management of MHC) are also needed to enable GPs, employers and compensation agents to better assess and manage MHC claims.

  7. A report on 15 years of clinical negligence claims in rhinology.

    Science.gov (United States)

    Geyton, Thomas; Odutoye, Tunde; Mathew, Rajeev

    2014-01-01

    This study was designed to determine the characteristics of medical negligence claims in rhinology. In 2010-2011 the National Health Service (NHS) litigation bill surpassed 1 billion Great British Pounds (GBP; 1.52 billion U.S. dollars [US$]). Systematic analysis of malpractice complaints allows for the identification of errors and can thereby improve patient safety and reduce the burden of litigation claims on health services. Claims relating to ear, nose, and throat between 1995 and 2010 were obtained from the NHS Litigation Authority and were analyzed. The series contains 65 closed claims that resulted in payment totaling 3.1 million GBP (US$4.7 million). Fifty claims were related to surgical complications. Functional endoscopic sinus surgery and septoplasty were the procedures most commonly associated with successful claims. There were 11 cases of orbital injury including 6 cases of visual loss and 5 cases of diplopia. The most common cause of a claim was failure to recognize the complication or manage it appropriately. Lack of informed consent was claimed in eight cases. Other claims arose because of errors in outpatient procedures (two), diagnosis (six), delayed surgery (one), and errors in medical management (three). This is the first study to report the outcomes of negligence claims in rhinology in the United Kingdom. Claims in rhinology are associated with a high success rate. Steps that can be taken to reduce litigation include careful patient workup and ensuring adequate informed consent. Where there is a suspicion of orbital damage early recognition and intervention is needed to reduce long-term injury to the patient.

  8. Warranty claim analysis considering human factors

    International Nuclear Information System (INIS)

    Wu Shaomin

    2011-01-01

    Warranty claims are not always due to product failures. They can also be caused by two types of human factors. On the one hand, consumers might claim warranty due to misuse and/or failures caused by various human factors. Such claims might account for more than 10% of all reported claims. On the other hand, consumers might not be bothered to claim warranty for failed items that are still under warranty, or they may claim warranty after they have experienced several intermittent failures. These two types of human factors can affect warranty claim costs. However, research in this area has received rather little attention. In this paper, we propose three models to estimate the expected warranty cost when the two types of human factors are included. We consider two types of failures: intermittent and fatal failures, which might result in different claim patterns. Consumers might report claims after a fatal failure has occurred, and upon intermittent failures they might report claims after a number of failures have occurred. Numerical examples are given to validate the results derived.

  9. Depression, women, and the workplace.

    Science.gov (United States)

    Wollersheim, J P

    1993-01-01

    Depression is a highly prevalent disorder that causes much personal distress and difficulties in functioning at home and in the workplace. In the workplace, as elsewhere, depression can manifest as a variation in normal mood, as a symptom, as a disorder, or as a disease. Occupational health professionals are more concerned with clinical depression, a term used to signify any type of depression that causes significant personal distress and/or problems in functioning. Clinical depression is manifest in the workplace and adversely affects the employee's work satisfaction and performance. For most types of depression, women are at a higher risk than men. A number of events and variables related to women and depression were reviewed. Although the effects of some of these events, such as menopause, can be manifest in the workplace, they are not associated with an increased incidence of clinical depression. Other events, such as victimization (e.g., childhood sexual abuse or battering by an intimate partner), are associated with higher risks of depression in women. Women derive substantial satisfaction from interpersonal relationships but also are at greater risk for depression when strains and conflicts in these relationships occur. In the workplace women who have no difficulty in arranging for child care and whose spouses share in the care of children show lower rates of depression. When marriages are unhappy, women are three times as likely as men to be depressed. These findings speak to the importance of relationships to women. In the workplace, when women are depressed, problems with relationships are likely to be involved. Clinically depressed women are not difficult to identify in work settings. Dejected mood and loss of interest in usual activities are noticeable, along with numerous other symptoms that accompany depression. The effective treatment of depression depends on careful diagnosis and assessment. Both drug therapy and the more structured psychotherapies

  10. Questioning the claims from Kaiser.

    Science.gov (United States)

    Talbot-Smith, Alison; Gnani, Shamini; Pollock, Allyson M; Gray, Denis Pereira

    2004-06-01

    The article by Feachem et al, published in the BMJ in 2002, claimed to show that, compared with the United Kingdom (UK) National Health Service (NHS), the Kaiser Permanente healthcare system in the United States (US) has similar healthcare costs per capita, and performance that is considerably better in certain respects. To assess the accuracy of Feachem et al's comparison and conclusions. Detailed re-examination of the data and methods used and consideration of the 82 letters responding to the article. Analyses revealed four main areas in which Feachem et al's methodology was flawed. Firstly, the populations of patients served by Kaiser Permanente and by the NHS are fundamentally different. Kaiser's patients are mainly employed, significantly younger, and significantly less socially deprived and so are healthier. Feachem et al fail to adjust adequately for these factors. Secondly, Feachem et al have wrongly inflated NHS costs by omitting substantial user charges payable by Kaiser members for care, excluding the costs of marketing and administration, and deducting the surplus from Kaiser's costs while underestimating the capital charge element of the NHS budget and other costs. They also used two methods of converting currency, the currency rate and a health purchasing power parity conversion. This is double counting. Feachem et al reported that NHS costs were 10% less per head than Kaiser. Correcting for the double currency conversion gives the NHS a 40% cost advantage such that per capita costs are 1161 dollars and 1951 dollars for the NHS and Kaiser, respectively. Thirdly, Feachem et al use non-standardised data for NHS bed days from the Organisation for Economic Cooperation and Development, rather than official Department of Health bed availability and activity statistics for England. Leaving aside the non-comparability of the population and lack of standardisation of the data, the result is to inflate NHS acute bed use and underestimate the efficiency of

  11. 32 CFR 842.129 - Settlement of claims against NAFIs.

    Science.gov (United States)

    2010-07-01

    ... LITIGATION ADMINISTRATIVE CLAIMS Nonappropriated Fund Claims § 842.129 Settlement of claims against NAFIs. (a) This subpart does not establish legal theories for adjudication of claims. Refer to the appropriate...

  12. Depression in CADASIL patients

    Directory of Open Access Journals (Sweden)

    Lačković Maja

    2014-01-01

    Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is a hereditary neurological disease accompanied by recurrent ischemic events, characterized by the presence of psychiatric disorders. The aim of this study was to examine the occurrence of depression and its severity among patients with CADASIL. Sixteen patients with diffuse white matter changes on MRI and clinical signs suggesting CADASIL were included in the study. Definitive diagnosis of CADASIL was obtained by electron microscopic analysis of skin biopsies. Testing of the patients’ affective status was primarily devoted to detecting depression. Electron microscopic examinations of all skin biopsies revealed numerous granular osmiophilic material (GOM deposits embedded into the basal lamina around altered or degenerated vascular smooth muscle cells (VSMCs. Clinical symptoms of depression were present in a great number of examined CADASIL patients. The frequency of depression was higher than previously reported. Psychiatric disturbances might also represent the onset of CADASIL, especially in young patients, and should be evaluated by differential diagnosis. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  13. Exploring the relationship between physical health, depressive symptoms, and depression diagnoses in Hispanic dementia caregivers.

    Science.gov (United States)

    Cucciare, Michael A; Gray, Heather; Azar, Armin; Jimenez, Daniel; Gallagher-Thompson, Dolores

    2010-04-01

    The present study examined the relationship between self-reported physical health, depressive symptoms, and the occurrence of depression diagnosis in Hispanic female dementia caregivers. Participants were 89 Hispanic female dementia caregivers. This study used a cross-sectional design. Baseline depression and physical health data were collected from participants enrolled in the 'Reducing Stress in Hispanic Anglo Dementia Caregivers' study sponsored by the National Institute on Aging. Physical health was assessed using the Medical Outcome Study Short Form-36 (SF-36), a one-item self-report health rating, body mass index, and the presence or history of self-reported physical illness. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D). The occurrence of depression diagnosis was assessed using the Clinical Interview for DSM-IV Axis I Disorders (SCID). Multiple linear and logistic regression analysis was used to examine the extent to which indices of physical health and depressive symptoms accounted for variance in participants' depressive symptoms and depressive diagnoses. Self-reported indices of health (e.g., SF-36) accounted for a significant portion of variance in both CES-D scores and SCID diagnoses. Caregivers who reported worsened health tended to report increased symptoms of depression on the CES-D and increased likelihood of an SCID diagnosis of a depressive disorder. Self-reported health indices are helpful in identifying Hispanic dementia caregivers at risk for clinical levels of depression.

  14. [Health claims for medical foods].

    Science.gov (United States)

    Katan, Martijn B

    2013-01-01

    Souvenaid (Nutricia, Zoetermeer, the Netherlands) is a medical food for the dietary management of early Alzheimer's disease. The mix of nutrients in this drink is suggested to have a beneficial effect on cognitive function; such implicit health claims for medical foods are not checked by government agencies. Souvenaid has been investigated in three clinical trials. The first trial showed that Souvenaid produced a significant improvement in delayed verbal recall, but not in other psychological tests. The second and largest trial showed no effect on any outcome. The third trial showed no significant effect at 12 or 24 weeks, but a significant difference in the 24-week time course of the composite memory score. None of these outcomes was clearly specified as a primary outcome at trial registration. In conclusion, there is no convincing proof that Souvenaid benefits cognitive function. Better scrutiny of the efficacy of medical foods is warranted.

  15. CLAIMS OF SUSTAINABLE FACILITIES MANAGEMENT

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev

    Purpose: The purpose of the paper is to provide an overview of current practices within the emergent management discipline: Sustainable Facilities Management (SFM). Background: To develop a sustainable society, facilities managers must become change agents for sustainability in the built...... environment. Facilities Management (FM) is contributing to the environmental, social and economical problems, but can at the same time also be a part of the solution. However, to integrate sustainability in FM is still an emergent niche within FM, and the examples of SFM so far seems to come out of very......-creating of new socio-technical services and technologies These SFM understandings are concluded to be coexisting claims of SFM definitions. Practical Implications: Facilities managers will be able to identify the mindset behind different services and technologies that are promoted as SFM. But maybe just...

  16. Depressive Symptoms and Clinical Status during the Treatment of Adolescent Suicide Attempters (TASA) Study

    Science.gov (United States)

    Vitiello, Benedetto; Brent, David A.; Greenhill, Laurence L.; Emslie, Graham; Wells, Karen; Walkup, John T.; Stanley, Barbara; Bukstein, Oscar; Kennard, Betsy D.; Compton, Scott; Coffey, Barbara; Cwik, Mary F.; Posner, Kelly; Wagner, Ann; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Capasso, Lisa; Mayes, Taryn; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake; Barnett, Shannon; Zelazny, Jamie

    2009-01-01

    Objective: To examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide. Method: Adolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating…

  17. Neurobiology of anxious depression: a review.

    Science.gov (United States)

    Ionescu, Dawn F; Niciu, Mark J; Mathews, Daniel C; Richards, Erica M; Zarate, Carlos A

    2013-04-01

    Anxious depression is a common, distinct clinical subtype of major depressive disorder (MDD). This review summarizes current neurobiological knowledge regarding anxious depression. Peer-reviewed articles, published January 1970 through September 2012, were identified via PUBMED, EMBASE, and Cochrane Library, using the following key words: anxious depression electroencephalography (EEG), anxious depression functional magnetic resonance imaging (fMRI), anxious depression genetics, anxious depression neurobiology, and anxious melancholia neurobiology. Despite a general dearth of neurobiological research, the results suggest that anxious depression-when defined either syndromally or dimensionally-has distinct neurobiological findings that separate it from nonanxious depression. Structural neuroimaging, EEG, genetics, and neuropsychiatric studies revealed differences in subjects with anxious depression compared to other groups. Endocrine differences between individuals with anxious depression and those with nonanxious depression have also been noted, as evidenced by abnormal responses elicited by exogenous stimulation of the system. Despite these findings, heterogeneity in the definition of anxious depression complicates the results. Because exploring the neurobiology of this depressive subtype is important for improving diagnosis, prognosis, and treatment, enrichment strategies to decrease heterogeneity within the field should be employed for future research. © 2013 Wiley Periodicals, Inc.

  18. 37 CFR 360.12 - Form and content of claims.

    Science.gov (United States)

    2010-07-01

    ... SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Satellite Claims § 360.12 Form and content of claims. (a) Forms. (1) Each claim to compulsory license royalty fees... owner entitled to claim the royalty fees. (ii) A general statement of the nature of the copyright owner...

  19. 37 CFR 360.3 - Form and content of claims.

    Science.gov (United States)

    2010-07-01

    ... SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Cable Claims § 360.3 Form and content of claims. (a) Forms. (1) Each claim to cable compulsory license royalty fees... copyright owner entitled to claim the royalty fees. (ii) A general statement of the nature of the copyright...

  20. 32 CFR 842.110 - Claims not payable.

    Science.gov (United States)

    2010-07-01

    ...) Claims for a maritime occurrence covered under U.S. admiralty laws. (o) Claims for: (1) Any tax or... International Agreements Claims Act. (4) The Air Force Admiralty Claims Act and the Admiralty Extensions Act. (5...) Claims from the combat activities of the armed forces during war or armed conflict. (c) Claims for...

  1. Burnout does not help predict depression among French school teachers.

    Science.gov (United States)

    Bianchi, Renzo; Schonfeld, Irvin Sam; Laurent, Eric

    2015-11-01

    Burnout has been viewed as a phase in the development of depression. However, supportive research is scarce. We examined whether burnout predicted depression among French school teachers. We conducted a 2-wave, 21-month study involving 627 teachers (73% female) working in French primary and secondary schools. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). The PHQ-9 grades depressive symptom severity and provides a provisional diagnosis of major depression. Depression was treated both as a continuous and categorical variable using linear and logistic regression analyses. We controlled for gender, age, and length of employment. Controlling for baseline depressive symptoms, linear regression analysis showed that burnout symptoms at time 1 (T1) did not predict depressive symptoms at time 2 (T2). Baseline depressive symptoms accounted for about 88% of the association between T1 burnout and T2 depressive symptoms. Only baseline depressive symptoms predicted depressive symptoms at follow-up. Similarly, logistic regression analysis revealed that burnout symptoms at T1 did not predict incident cases of major depression at T2 when depressive symptoms at T1 were included in the predictive model. Only baseline depressive symptoms predicted cases of major depression at follow-up. This study does not support the view that burnout is a phase in the development of depression. Assessing burnout symptoms in addition to "classical" depressive symptoms may not always improve our ability to predict future depression.

  2. Operating room fires: a closed claims analysis.

    Science.gov (United States)

    Mehta, Sonya P; Bhananker, Sanjay M; Posner, Karen L; Domino, Karen B

    2013-05-01

    To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. There were 103 OR fire claims (1.9% of 5,297 surgical claims). Electrocautery was the ignition source in 90% of fire claims. OR fire claims more frequently involved older outpatients compared with other surgical anesthesia claims (P fire claims (P fires (n = 93) increased over time (P fires occurred during head, neck, or upper chest procedures (high-fire-risk procedures). Oxygen served as the oxidizer in 95% of electrocautery-induced OR fires (84% with open delivery system). Most electrocautery-induced fires (n = 75, 81%) occurred during monitored anesthesia care. Oxygen was administered via an open delivery system in all high-risk procedures during monitored anesthesia care. In contrast, alcohol-containing prep solutions and volatile compounds were present in only 15% of OR fires during monitored anesthesia care. Electrocautery-induced fires during monitored anesthesia care were the most common cause of OR fires claims. Recognition of the fire triad (oxidizer, fuel, and ignition source), particularly the critical role of supplemental oxygen by an open delivery system during use of the electrocautery, is crucial to prevent OR fires. Continuing education and communication among OR personnel along with fire prevention protocols in high-fire-risk procedures may reduce the occurrence of OR fires.

  3. Radiation injury claims: an overview and update

    International Nuclear Information System (INIS)

    Schaffer, W.G.

    1984-01-01

    The author reviews the radiation injury claims problem and summarizes the legal framework in which the claims are presently brought. Two cases are reviewed in which the decisions are troubling. The implications of these decisions are discussed in the overall radiation injury claims problem. The author notes that in the largest radiation injury case tried in the United States, the court was unable to resolve the claims within the confines of the existing law. The disregard for established norms of adjudication and the resultant decline in predictability of outcome portends grave consequences, not only for the nuclear industry but for other industries involved with potentially toxic substances

  4. Missed diagnosis-persistent delirium

    Directory of Open Access Journals (Sweden)

    Aseem Mehra

    2014-01-01

    Full Text Available Delirium is in general considered as an acute short lasting reversible neuropsychiatric syndrome. However, there is some evidence to suggest that in a small proportion of cases delirium may be a chronic or persistent condition. However, making this diagnosis requires clinical suspicion and ruling other differential diagnosis. In this report, we present a case of a 55-year-old man who had cognitive symptoms, psychotic symptoms and depressive symptoms along with persistent hypokalemia and glucose intolerance. He was seen by 3 psychiatrists with these symptoms and was initially diagnosed as having depressive disorder and later diagnosis of bipolar affective disorder (current episode mania, and psychosis were considered by the third psychiatrist. However, despite the presence of persistent neurocognitive deficits, evening worsening of symptoms, hypokalemia and glucose intolerance diagnosis of delirium was not suspected.

  5. Depression in hemodialysis patients

    International Nuclear Information System (INIS)

    Anees, M.; Barki, H.; Masood, M.

    2008-01-01

    To measure the frequency of depression and its risk factors in patients under going hemodialysis. It is a cross-sectional prospective study conducted at Hemodialysis unit of Shalamar Hospital and Shaikh Zayed Hospital, Lahore from 1/sup st/ January 2006 to 30/sup th/ April 2006. All patients getting regular hemodialysis for more than three months were included. Beck's Depression Inventory- II (BDI-II; adapted in Urdu) was administered on all the patients who were able to read or understand it. Blood sample were drawn at the same time for routine hematological, biochemical parameters and viral markers (Anti HCV and HbsAg). Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) for correlation of psychological variables with clinical, hematological and biochemical parameters. Eighty nine patients were enrolled which included fifty two (58.4%) were male and seventy seven (86.5%) were married. Major causes of renal failure were diabetes, hypertension and chronic glomerulonephrotis. Duration of dialysis was from 03 to 49 months with mean of 19.64 +- 11.7 months. Severity of depression was categorized in to mild, moderate and severe on the basis of BDI score. Majority of the patients fifty (56.1%) were moderately to severely depressed and there was no gender difference in the prevalence of depression. Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status, illiteracy, number of children, socioeconomic factors, gender, hypertension and hypoalbuminemia. Patients with anemia, hyponatremia and hyperkalemia had suicidal tendency. Patients with hepatitis C and disturbed liver function have strong correlation with psychological parameters. (author)

  6. Depression After a Cardiac Event or Diagnosis

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  7. Subtypes of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2003-01-01

    a period from 1994 to 1999 were identified. The risk of relapse leading to readmission and the risk of committing suicide were compared for patients discharged with an ICD-10 diagnosis of a single depressive episode with and without melancholic syndrome and for patients with and without psychotic symptoms......BACKGROUND: The long-term predictive ability of the ICD-10 subtypes of depression with melancholic syndrome and depression with psychosis has not been investigated. SAMPLING AND METHODS: All patients in Denmark who had a diagnosis of a single depressive episode at their first ever discharge during......, respectively. RESULTS: In all, 1,639 patients had a diagnosis of depressive episode without psychotic symptoms, 1,275 patients a diagnosis with psychotic symptoms, 293 a diagnosis without melancholic syndrome, and 248 a diagnosis with melancholic symptoms at first discharge. The risk of relapse leading...

  8. Depressed suicide attempters with posttraumatic stress disorder.

    Science.gov (United States)

    Ramberg, Maria; Stanley, Barbara; Ystgaard, Mette; Mehlum, Lars

    2015-01-01

    Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.

  9. Sensitivity of Billing Claims for Cardiovascular Disease Events among Kidney Transplant Recipients

    Science.gov (United States)

    Lentine, Krista L.; Schnitzler, Mark A.; Abbott, Kevin C.; Bramesfeld, Kosha; Buchanan, Paula M.; Brennan, Daniel C.

    2009-01-01

    Background and objectives: Billing claims are increasingly examined beyond administrative functions as outcomes measures in observational research. Few studies have described the performance of billing claims as surrogate measures of clinical events among kidney transplant recipients. Design, setting, participants, & measurements: We investigated the sensitivity of Medicare billing claims for clinically verified cardiovascular diagnoses (five categories) and procedures (four categories) in a novel database linking Medicare claims to electronic medical records of one transplant program. Cardiovascular events identified in medical records for 571 Medicare-insured transplant recipients in 1991 through 2002 served as reference measures. Results: Within a claims-ascertainment period spanning ±30 d of clinically recorded dates, aggregate sensitivity of single claims was higher for case definitions incorporating Medicare Parts A and B for diagnoses and procedures (90.9%) compared with either Part A (82.3%) or Part B (84.6%) alone. Perfect capture of the four procedures was possible within ±30 d or with short claims window expansion, but sensitivity for the diagnoses trended lower with all study algorithms (91.2% with window up to ±90 d). Requirement for additional confirmatory diagnosis claims did not appreciably reduce sensitivity. Sensitivity patterns were similar in the early compared with late periods of the study. Conclusions: Combined use of Medicare Parts A and B billing claims composes a sensitive measure of cardiovascular events after kidney transplant. Further research is needed to define algorithms that maximize specificity as well as sensitivity of claims from Medicare and other insurers as research measures in this population. PMID:19541817

  10. Mood-congruent true and false memory: effects of depression.

    Science.gov (United States)

    Howe, Mark L; Malone, Catherine

    2011-02-01

    The Deese/Roediger-McDermott paradigm was used to investigate the effect of depression on true and false recognition. In this experiment true and false recognition was examined across positive, neutral, negative, and depression-relevant lists for individuals with and without a diagnosis of major depressive disorder. Results showed that participants with major depressive disorder falsely recognised significantly more depression-relevant words than non-depressed controls. These findings also parallel recent research using recall instead of recognition and show that there are clear mood congruence effects for depression on false memory performance. © 2011 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

  11. Cytokines in the physiopathology of depression

    OpenAIRE

    María Belén Paredes; María Eugenia Sulen

    2018-01-01

    This paper presents a bibliographical review on the relevance of the possible role of cytokines in depression. There is a consideration of the existing approaches to detection and diagnosis of depression; they are classified according to different criteria such as design methodologies and applications. Although the etiology of depression is still an issue, the focus of this paper is to highlight the various studies regarding the interactions of the immune system and brain activity linked to d...

  12. A retrospective claims analysis of combination therapy in the treatment of adult attention-deficit/hyperactivity disorder (ADHD

    Directory of Open Access Journals (Sweden)

    Pohl Gerhardt M

    2009-06-01

    Full Text Available Abstract Background Combination therapy in managing psychiatric disorders is not uncommon. While combination therapy has been documented for depression and schizophrenia, little is known about combination therapy practices in managing attention-deficit/hyperactivity disorder (ADHD. This study seeks to quantify the combination use of ADHD medications and to understand predictors of combination therapy. Methods Prescription dispensing events were drawn from a U.S. national claims database including over 80 managed-care plans. Patients studied were age 18 or over with at least 1 medical claim with a diagnosis of ADHD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 314.0, a pharmacy claim for ADHD medication during the study period July2003 to June2004, and continuous enrollment 6 months prior to and throughout the study period. Dispensing events were grouped into 6 categories: atomoxetine (ATX, long-acting stimulants (LAS, intermediate-acting stimulants (IAS, short-acting stimulants (SAS, bupropion (BUP, and Alpha-2 Adrenergic Agonists (A2A. Events were assigned to calendar months, and months with combined use from multiple categories within patient were identified. Predictors of combination therapy for LAS and for ATX were modeled for patients covered by commercial plans using logistic regression in a generalized estimating equations framework to adjust for within-patient correlation between months of observation. Factors included age, gender, presence of the hyperactive component of ADHD, prior diagnoses for psychiatric disorders, claims history of recent psychiatric visit, insurance plan type, and geographic region. Results There were 18,609 patients identified representing a total of 11,886 months of therapy with ATX; 40,949 months with LAS; 13,622 months with IAS; 38,141 months with SAS; 22,087 months with BUP; and 1,916 months with A2A. Combination therapy was present in 19.7% of continuing

  13. A retrospective claims analysis of combination therapy in the treatment of adult attention-deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Pohl, Gerhardt M; Van Brunt, David L; Ye, Wenyu; Stoops, William W; Johnston, Joseph A

    2009-06-08

    Combination therapy in managing psychiatric disorders is not uncommon. While combination therapy has been documented for depression and schizophrenia, little is known about combination therapy practices in managing attention-deficit/hyperactivity disorder (ADHD). This study seeks to quantify the combination use of ADHD medications and to understand predictors of combination therapy. Prescription dispensing events were drawn from a U.S. national claims database including over 80 managed-care plans. Patients studied were age 18 or over with at least 1 medical claim with a diagnosis of ADHD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 314.0), a pharmacy claim for ADHD medication during the study period July 2003 to June 2004, and continuous enrollment 6 months prior to and throughout the study period. Dispensing events were grouped into 6 categories: atomoxetine (ATX), long-acting stimulants (LAS), intermediate-acting stimulants (IAS), short-acting stimulants (SAS), bupropion (BUP), and Alpha-2 Adrenergic Agonists (A2A). Events were assigned to calendar months, and months with combined use from multiple categories within patient were identified. Predictors of combination therapy for LAS and for ATX were modeled for patients covered by commercial plans using logistic regression in a generalized estimating equations framework to adjust for within-patient correlation between months of observation. Factors included age, gender, presence of the hyperactive component of ADHD, prior diagnoses for psychiatric disorders, claims history of recent psychiatric visit, insurance plan type, and geographic region. There were 18,609 patients identified representing a total of 11,886 months of therapy with ATX; 40,949 months with LAS; 13,622 months with IAS; 38,141 months with SAS; 22,087 months with BUP; and 1,916 months with A2A. Combination therapy was present in 19.7% of continuing months (months after the first month of therapy

  14. When Stepfathers Claim Stepchildren: A Conceptual Analysis

    Science.gov (United States)

    Marsiglio, William

    2004-01-01

    Abstract Guided by social constructionist and symbolic interactionist perspectives and a grounded theory method, my conceptual analysis explores stepfathers experiences with claiming stepchildren as their own. Using indepth interviews with a diverse sample of 36 stepfathers, my analysis focuses on paternal claiming as a core category and generates…

  15. 49 CFR 22.69 - Claim process.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Claim process. 22.69 Section 22.69 Transportation Office of the Secretary of Transportation SHORT-TERM LENDING PROGRAM (STLP) Loan Administration § 22.69 Claim process. After reasonable efforts have been exhausted to collect on a delinquent debt, the...

  16. The Indirect Empathic Approach to Claim Letters.

    Science.gov (United States)

    Bell, James D.

    1985-01-01

    In discussing letter-writing methods for business communication classes, the article explains that claim letter formats other than the direct approach are not only legitimate, but also effective, and suggests that the approach selected should depend upon the circumstances surrounding the claim. (CT)

  17. 16 CFR 460.22 - Tax claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Tax claims. 460.22 Section 460.22 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.22 Tax claims. Do not say or imply that your product qualifies for a tax benefit unless it is true. ...

  18. 20 CFR 410.705 - Duplicate claims.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Duplicate claims. 410.705 Section 410.705 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Rules for the Review of Denied and Pending Claims Under the Black Lung...

  19. 78 FR 75944 - Commencement of Claims Program

    Science.gov (United States)

    2013-12-13

    ... Agreement Between the United States of America and the Great Socialist People's Libyan Arab Jamahiriya.... Simkin, Chief Counsel, Foreign Claims Settlement Commission of the United States, 600 E Street NW., Room... provided that (1) the claim was set forth by a claimant named in Abbott et al. v. Socialist People's Libyan...

  20. 76 FR 3156 - Alaska Native Claims Selection

    Science.gov (United States)

    2011-01-19

    ... located in: Seward Meridian, Alaska T. 26 N., R. 47 W., Sec. 3, those lands formerly within mining claim... claim recordation AA- 32365. Containing approximately 155 acres. T. 27 N., R. 47 W., Sec. 34, those... e-mail at ak[email protected] , or by telecommunication device (TTD) through the Federal...

  1. 32 CFR 842.31 - Claims payable.

    Science.gov (United States)

    2010-07-01

    ... which last for an extended period of time. The claimant must be free of negligence. (i) Claims for... hazards may be negligence. These types of claims would include pitted windshields, dents, chipped paint on..., or power outages which last for an extended period of time. The claimant must be free of negligence...

  2. Moral Minimalism in American Indian Land Claims

    Science.gov (United States)

    Hendrix, Burke A.

    2005-01-01

    This is an essay about Indian claims for the return of historically stolen lands, written from the perspective of a "Western" academic moral philosopher. I want to try to outline points of agreement and disagreement between Indian and Western moral conceptions and to seek common ground on which land claims can be more clearly evaluated…

  3. 32 CFR 536.77 - Applicable law for claims under the Military Claims Act.

    Science.gov (United States)

    2010-07-01

    ... contributory negligence be interpreted and applied according to the law of the place of the occurrence... 32 National Defense 3 2010-07-01 2010-07-01 true Applicable law for claims under the Military... Act § 536.77 Applicable law for claims under the Military Claims Act. (a) General principles—(1) Tort...

  4. Autism: Diagnosis

    Science.gov (United States)

    ... Information Publications Awards Partners Contact Us ¿Qué es Autismo? Donate Home What is Autism? What is Autism? ... Information Publications Awards Partners Contact Us ¿Qué es Autismo? Diagnosis Home / What is Autism? / Diagnosis Expand Medical ...

  5. Postpartum Depression

    Science.gov (United States)

    ... professionals for help. With support and treatment, new mothers with depression can go on to be healthy, happy parents. ... or two, talk to your doctor. A new mother who feels like giving up, who feels that life is not ... depression can last for several months or even longer ...

  6. Perception of health claims among Nordic consumers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Lähteenmäki, Liisa; Boztug, Yasemin

    2009-01-01

    . Claims were constructed from an underlying universe combining different active ingredients (familiar, unfamiliar), type of claim (combination of information about ingredient, physiological function and health benefit), framing (positive, negative) and use of qualifier (with, without 'may'). Across pairs...... of active ingredient, physiological function and health benefit, whereas the other prefers 'short' claims consisting of the health benefit only. Results also showed that the familiar ingredient is preferred to the unfamiliar one, whereas effects of positive vs. negative framing depended on the type......Health claim perception was investigated by a web-based instrument with a sample of 4612 respondents in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden). Respondents decided which of a pair of claims sounded better, was easier to understand, and was more convincing in their opinion...

  7. An Evaluation of Algorithms for Identifying Metastatic Breast, Lung, or Colorectal Cancer in Administrative Claims Data.

    Science.gov (United States)

    Whyte, Joanna L; Engel-Nitz, Nicole M; Teitelbaum, April; Gomez Rey, Gabriel; Kallich, Joel D

    2015-07-01

    Administrative health care claims data are used for epidemiologic, health services, and outcomes cancer research and thus play a significant role in policy. Cancer stage, which is often a major driver of cost and clinical outcomes, is not typically included in claims data. Evaluate algorithms used in a dataset of cancer patients to identify patients with metastatic breast (BC), lung (LC), or colorectal (CRC) cancer using claims data. Clinical data on BC, LC, or CRC patients (between January 1, 2007 and March 31, 2010) were linked to a health care claims database. Inclusion required health plan enrollment ≥3 months before initial cancer diagnosis date. Algorithms were used in the claims database to identify patients' disease status, which was compared with physician-reported metastases. Generic and tumor-specific algorithms were evaluated using ICD-9 codes, varying diagnosis time frames, and including/excluding other tumors. Positive and negative predictive values, sensitivity, and specificity were assessed. The linked databases included 14,480 patients; of whom, 32%, 17%, and 14.2% had metastatic BC, LC, and CRC, respectively, at diagnosis and met inclusion criteria. Nontumor-specific algorithms had lower specificity than tumor-specific algorithms. Tumor-specific algorithms' sensitivity and specificity were 53% and 99% for BC, 55% and 85% for LC, and 59% and 98% for CRC, respectively. Algorithms to distinguish metastatic BC, LC, and CRC from locally advanced disease should use tumor-specific primary cancer codes with 2 claims for the specific primary cancer >30-42 days apart to reduce misclassification. These performed best overall in specificity, positive predictive values, and overall accuracy to identify metastatic cancer in a health care claims database.

  8. Subsyndromal symptomatic depression: a new concept.

    Science.gov (United States)

    Sadek, N; Bona, J

    2000-01-01

    Although DSM-IV acknowledged the clinical significance of some subthreshold forms of unipolar depression, such as minor depression (MinD) and recurrent brief depression (RBD), clinicians continued to struggle with the concept of "subthreshold" depression. A substantial number of patients continued to present with depressive symptoms that still did not satisfy any DSM-IV diagnosis. Generally, these patients failed to complain of anhedonia and depressed mood, a criterion that DSM-IV mandates for any diagnosis of depression. Therefore, researchers reexamined the question of whether this cluster of depressive symptoms, in the absence of anhedonia and depressed mood, was clinically significant. Some researchers labeled this cluster of symptoms, "subsyndromal symptomatic depression" (SSD). Specifically, SSD is defined as a depressive state having two or more symptoms of depression of the same quality as in major depression (MD), excluding depressed mood and anhedonia. The symptoms must be present for more than 2 weeks and be associated with social dysfunction. Using Medline Search, the authors reviewed the literature on the epidemiology, demographics, clinical characteristics, and psychosocial impairment of SSD. SSD is found to be comparable in demographics and clinical characteristics to MD, MinD, and dysthymia. SSD is also associated with significant psychosocial dysfunction as compared with healthy subjects. Further; it has significant risk for suicide and future MD. Few studies have been conducted on the treatment of SSD. The high prevalence of SSD, the significant psychosocial impairment associated with it, and the chronicity of its course make subsyndromal symptomatic depression a matter for serious consideration by clinicians and researchers.

  9. Defining hip fracture with claims data: outpatient and provider claims matter.

    Science.gov (United States)

    Berry, S D; Zullo, A R; McConeghy, K; Lee, Y; Daiello, L; Kiel, D P

    2017-07-01

    Medicare claims are commonly used to identify hip fractures, but there is no universally accepted definition. We found that a definition using inpatient claims identified fewer fractures than a definition including outpatient and provider claims. Few additional fractures were identified by including inconsistent diagnostic and procedural codes at contiguous sites. Medicare claims data is commonly used in research studies to identify hip fractures, but there is no universally accepted definition of fracture. Our purpose was to describe potential misclassification when hip fractures are defined using Medicare Part A (inpatient) claims without considering Part B (outpatient and provider) claims and when inconsistent diagnostic and procedural codes occur at contiguous fracture sites (e.g., femoral shaft or pelvic). Participants included all long-stay nursing home residents enrolled in Medicare Parts A and B fee-for-service between 1/1/2008 and 12/31/2009 with follow-up through 12/31/2011. We compared the number of hip fractures identified using only Part A claims to (1) Part A plus Part B claims and (2) Part A and Part B claims plus discordant codes at contiguous fracture sites. Among 1,257,279 long-stay residents, 40,932 (3.2%) met the definition of hip fracture using Part A claims, and 41,687 residents (3.3%) met the definition using Part B claims. 4566 hip fractures identified using Part B claims would not have been captured using Part A claims. An additional 227 hip fractures were identified after considering contiguous fracture sites. When ascertaining hip fractures, a definition using outpatient and provider claims identified 11% more fractures than a definition with only inpatient claims. Future studies should publish their definition of fracture and specify if diagnostic codes from contiguous fracture sites were used.

  10. Effect of a health system's medical error disclosure program on gastroenterology-related claims rates and costs.

    Science.gov (United States)

    Adams, Megan A; Elmunzer, B Joseph; Scheiman, James M

    2014-04-01

    In 2001, the University of Michigan Health System (UMHS) implemented a novel medical error disclosure program. This study analyzes the effect of this program on gastroenterology (GI)-related claims and costs. This was a review of claims in the UMHS Risk Management Database (1990-2010), naming a gastroenterologist. Claims were classified according to pre-determined categories. Claims data, including incident date, date of resolution, and total liability dollars, were reviewed. Mean total liability incurred per claim in the pre- and post-implementation eras was compared. Patient encounter data from the Division of Gastroenterology was also reviewed in order to benchmark claims data with changes in clinical volume. There were 238,911 GI encounters in the pre-implementation era and 411,944 in the post-implementation era. A total of 66 encounters resulted in claims: 38 in the pre-implementation era and 28 in the post-implementation era. Of the total number of claims, 15.2% alleged delay in diagnosis/misdiagnosis, 42.4% related to a procedure, and 42.4% involved improper management, treatment, or monitoring. The reduction in the proportion of encounters resulting in claims was statistically significant (P=0.001), as was the reduction in time to claim resolution (1,000 vs. 460 days) (P<0.0001). There was also a reduction in the mean total liability per claim ($167,309 pre vs. $81,107 post, 95% confidence interval: 33682.5-300936.2 pre vs. 1687.8-160526.7 post). Implementation of a novel medical error disclosure program, promoting transparency and quality improvement, not only decreased the number of GI-related claims per patient encounter, but also dramatically shortened the time to claim resolution.

  11. Childhood depression: a systematic review

    Directory of Open Access Journals (Sweden)

    Lima NNR

    2013-09-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs

  12. Depressive realism and clinical depression.

    Science.gov (United States)

    Carson, Richard C; Hollon, Steven D; Shelton, Richard C

    2010-04-01

    Depressive realism suggests that depressed individuals make more accurate judgments of control than their nondepressed counterparts. However, most studies demonstrating this phenomenon were conducted in nonclinical samples. In this study, psychiatric patients who met criteria for major depressive disorder underestimated control in a contingent situation and were consistently more negative in their judgments than were nondepressed controls. Depressed patients were less likely than their nondepressed counterparts to overestimate control in a noncontingent situation, but largely because they perceived receiving less reinforcement. Depressed patients were no more likely to use the appropriate logical heuristic to generate their judgments of control than their nondepressed counterparts and each appeared to rely on different primitive heuristics. Depressed patients were consistently more negative than their nondepressed counterparts and when they did appear to be more "accurate" in their judgments of control (as in the noncontingent situation) it was largely because they applied the wrong heuristic to less accurate information. These findings do not support the notion of depressive realism and suggest that depressed patients distort their judgments in a characteristically negative fashion. 2009 Elsevier Ltd. All rights reserved.

  13. Depressive disorders and the menopause transition.

    Science.gov (United States)

    Llaneza, Plácido; García-Portilla, María P; Llaneza-Suárez, David; Armott, Begoña; Pérez-López, Faustino R

    2012-02-01

    needed to improve the early diagnosis of depression; it may be advisable to monitor a woman's mental health during the menopause transition to prevent a depressive disorder having long-term negative consequences. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Adherence to highly active antiretroviral therapy in depressed ...

    African Journals Online (AJOL)

    A sociodemographic and drug adherence questionnaire was administered. The Centre for Epidemiological Studies Depression Scale (CES-D) was used to screen for depressive symptoms while the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) was used to confirm the diagnosis of depressive disorder.

  15. Epidemiology and management of depression in cancer patients

    NARCIS (Netherlands)

    Ng, C.G.

    2012-01-01

    Depression is the most frequent psychiatric comorbidity in cancer patients especially those in terminal stage. Despite the large amount of studies on depression in cancer patients, there are a lot of unanswered questions with respect to diagnosis, prevalence and treatment. Diagnosing depression in

  16. Depression in the Workplace

    Science.gov (United States)

    ... You are here Home » Depression In The Workplace Depression In The Workplace Clinical depression has become one ... will die by suicide vi . Employees' Attitudes Towards Depression Often times a depressed employee will not seek ...

  17. Genetics Home Reference: depression

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Depression Depression Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Depression (also known as major depression or major depressive ...

  18. Mothers' Depressive State "Distorts" the Ratings of Depression They Give for Their Sons with an Autism Spectrum Disorder

    Science.gov (United States)

    Bitsika, Vicki; Sharpley, Christopher F.

    2016-01-01

    Depression is highly prevalent in children who have an Autism Spectrum Disorder (ASD), potentially confounding accurate diagnosis and treatment planning. Although information about the depressive status of a child is often collected from parents, there is evidence of distortion in parental assessments of their offspring's depression. This…

  19. 37 CFR 360.25 - Copies of claims.

    Science.gov (United States)

    2010-07-01

    ... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio Recording Devices and Media Royalty Claims § 360.25 Copies of claims. A claimant shall, for each claim...

  20. 32 CFR 536.117 - Statutory authority for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Statutory authority for maritime claims. 536.117... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.117 Statutory authority for maritime claims. The Army Maritime Claims Settlement Act (AMCSA) (10 U.S.C. 4801-04, 4806, as amended) authorizes the...

  1. 12 CFR 627.2750 - Priority of claims-banks.

    Science.gov (United States)

    2010-01-01

    ...) All claims for taxes. (f) All claims of creditors which are secured by specific assets or equities of... accordance with priorities of applicable Federal or State law. (g) All claims of holders of bonds issued by... claims of holders of consolidated and System-wide bonds and all claims of the other Farm Credit banks...

  2. Dual Diagnosis

    Science.gov (United States)

    ... tend to occur with Depression Anxiety disorders Schizophrenia Personality disorders Sometimes the mental problem occurs first. This can ... Treatments may include behavioral therapy, medicines, and support groups. NIH: National Institute on Drug Abuse

  3. The importance of subjective claims management.

    Science.gov (United States)

    Beger, C S

    1997-01-01

    This article discusses the causes and effects of "subjective disability" on today's workforce and employers. As employees feel out of control with both their careers and demands placed upon them, the number of claims characterized by self-reported symptoms are increasing. Subjective disabilities include chronic syndrome, fibromyalgia, psychiatric claims and chronic pain. The author discusses creative strategies in case studies that have helped employers contain the costs of disability claims, while empowering the employee to take control of their own situation and return to work sooner.

  4. Court rejects claim of mental illness from needlestick.

    Science.gov (United States)

    1998-05-29

    The Montana Supreme Court rejected the bid of a medical technician to remain on workers' compensation, based on his claims that he suffered from psychosis, depression, and hallucinations after pricking himself with a needle used on an HIV-positive patient. [Name removed], a respiratory therapist at Community Medical Center in Missoula, tested negative for HIV, but claimed that the psychological trauma from the needlestick injury caused him to become disabled. Based on expert testimony, the Workers' Compensation Court determined that [name removed] was faking his symptoms to collect benefits from his employer's insurer, EBI/Orion Group. [Name removed] appealed, and the Supreme Court remanded the case, stating that psychologists are not included among the medical professionals able to conduct medical reviews. The Workers' Compensation Court again found that [name removed] was faking his symptoms, and [name removed] unsuccessfully appealed. The compensation panel cited conflicting evidence from psychological tests, [name removed]'s friends' testimonies, and [name removed]'s personal diary. The Supreme Court upheld the verdict.

  5. Postpartum Depression

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne

    Background: In three academic articles, this PhD thesis investigates maternal postpartum depression (PPD) as a risk factor for the infant-mother attachment and infant development. Previous studies have been contradictory with respect to the question of whether PPD can have long term effects...... on offspring. This may be due to not differing between when PPD is only occurring in the postpartum period and when effects are also due to ongoing or recurrent depression. However, it may also be due to viewing maternal depression as a unitary construct, and not considering underlying maternal psychological...... difficulties which may moderate potential adverse effects. The present thesis investigates two potential maternal moderators of risk:. Comorbid personality disorder and adult attachment insecurity. Moreover, the question of early environmental effects of PPD versus effects of later or ongoing depression...

  6. Increased risk for depression after breast cancer

    DEFF Research Database (Denmark)

    Suppli, Nis P; Johansen, Christoffer; Christensen, Jane

    2014-01-01

    PURPOSE: To investigate the risk for first depression, assessed as incident hospital contacts for depression and incident use of antidepressants, among women with breast cancer. PATIENTS AND METHODS: Danish national registries were used to identify 1,997,669 women with no diagnosis of cancer...... or a major psychiatric disorder. This cohort was followed from 1998 to 2011 for a diagnosis of breast cancer and for the two outcomes, hospital contact for depression and redeemed prescriptions for antidepressants. Rate ratios for incident hospital contacts for depression and incident use of antidepressants...... were estimated with Poisson regression models. Multivariable Cox regression was used to evaluate factors associated with the two outcomes among patients with breast cancer. RESULTS: We identified 44,494 women with breast cancer. In the first year after diagnosis, the rate ratio for a hospital contact...

  7. Basic Stand Alone Medicare Inpatient Claims PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Inpatient Public Use Files (PUF) named CMS 2008 BSA Inpatient Claims PUF with information from 2008 Medicare...

  8. 5 CFR 180.107 - Claims procedure.

    Science.gov (United States)

    2010-01-01

    ... General Counsel, Office of Personnel Management, 1900 E Street NW., Washington, DC 20415. Claims shall be... the performance of official business at the request of, or with the knowledge and consent of, superior...

  9. 49 CFR 1018.7 - Conversion claims.

    Science.gov (United States)

    2010-10-01

    ... Conversion claims. These procedures are directed primarily to the recovery of money on behalf of the Government. The Board may demand: (a) The return of specific property; or (b) Either the return of property or the payment of its value. ...

  10. Must Metaethical Realism Make a Semantic Claim?

    Science.gov (United States)

    Kahane, Guy

    2013-02-01

    Mackie drew attention to the distinct semantic and metaphysical claims made by meta ethical realists, arguing that although our evaluative discourse is cognitive and objective, there are no objective evaluative facts. This distinction, however, also opens up a reverse possibility: that our evaluative discourse is antirealist, yet objective values do exist. I suggest that this seemingly far-fetched possibility merits serious attention; realism seems com mitted to its intelligibility, and, despite appearances, it isn't incoherent, ineffable, inherently implausible or impossible to defend. I argue that reflection on this possibility should lead us to revise our understanding of the debate between realists and antirealists. It is not only that the realist's semantic claim is insufficient for realism to be true, as Mackie argued; it's not even necessary. Robust metaethical realism is best understood as making a purely metaphysical claim. It is thus not enough for antirealists to show that our discourse is antirealist. They must directly attack the realist's metaphysical claim.

  11. Research progress of functional MRI in depression

    International Nuclear Information System (INIS)

    Xie Shenghui; Niu Guangming; Han Xiaodong; Qiao Pengfei

    2013-01-01

    The mood disorders of depression are associated with abnormalities of brain structure and function, and exploring their pathological mechanism has important significance for the choice of treatment and the curative effect evaluation. In recent years, the research of MRI on brain structure and function of depression has made great progress, especially in functional magnetic resonance imaging (fMRI). fMRI can detect the functional change in real time, and also can display the activity of brain and changes in the nerve pathways in patients with depression. This article summarizes the present research situation and progress of MRI in the diagnosis of depression. (authors)

  12. Reflection in Medical Diagnosis: A Literature Review

    OpenAIRE

    Mamede, Silvia; Schmidt, Henk G.

    2017-01-01

    Purpose: Reflection in medical diagnosis has been said to prevent errors by minimizing flaws in clinical reasoning. This claim, however, has been much disputed. While some studies show reflective reasoning to improve diagnostic performance, others find it to add nothing. This paper presents a narrative review of the literature on reflection in medical diagnosis aimed at addressing two questions: (1) how reflective reasoning has been conceived in this literature; and (2) what is the effect of ...

  13. Depression and Liver Transplant Survival.

    Science.gov (United States)

    Meller, William; Welle, Nicole; Sutley, Kristen; Thurber, Steven

    Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts. To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings. A total of 765 patients with liver transplants were scrutinized for complications following transplantation. Further, 104 patients experienced posttransplant depression as manifested by diagnosis and treatment by medical personnel. Survival analyses were conducted comparing hazard and survival curves for these selected individuals and the remainder of transplant patients. Contrary to prior data and consistent with the aforementioned hypothesis, median survival durations, survival curves, and hazard functions (controlling for age and prolonged posttransplant survival for the depressed patients were better. The improved survival for the depressed patients may simply be related to an amelioration of depressed symptoms via antidepressant medications. However, this interpretation would only be congruent with reduced hazard, not elevated survival, beyond the norm (median) for other transplant participants. Assuming the reliability and generalization of our findings, perhaps a reasonable and compelling interpretation is that combined with the effectiveness of antidepressant medications, the seeking and receiving treatment for depression is a type of proxy measure of a more global pattern of adherence to recommended posttransplant medical regimens. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  14. Depression, Obesity and Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Andreia Lopes

    2018-01-01

    Full Text Available Background:  Overweight is an increasing problem worldwide. Data from  2008 show that, in Portugal, 60% of the adult population was overweight and 25% was obese. The relation between mood disorders and obesity is well known and about 2/3 of those who search for bariatric surgery have a psychiatric diagnosis, being depression the most common. Aims: We reviewed the relation between depression and obesity before and after bariatric surgery and evaluated its impact in the pharmacokinetics of antidepressant medication and nutrients that influence depressive symptomatology. Methods: We conducted a non-systematic review of the literature published in English between 1988 and 2015, through research in MEDLINE with the keywords absorption, bioavailability, bariatric surgery, obesity, depression, antidepressants. Results: Depression and obesity potentiates each other in a bidirectional way and the strength of this association is modulated by gender, physical activity, diet and antidepressant medication usage. Bariatric surgery leads to changes in the pharmacokinetics of antidepressant medication and nutrients that have a regulatory role on mood symptomatology. Discussion and Conclusions: Available data show we need to pay special attention to obese depressive patients proposed for bariatric surgery. The existence of depressive symptoms leads to a greater risk of not losing weight after a bariatric surgery but, in the opposite direction, bariatric surgery leads to a lower bioavailability of antidepressant medication.

  15. 29 CFR 15.26 - Claims procedures.

    Science.gov (United States)

    2010-07-01

    ... forth in § 15.21(d) will be accepted and considered a claim under the Act if it constitutes a demand for compensation from the Department. A demand is not required to be for a specific sum of money. (c) Notification... 29 Labor 1 2010-07-01 2010-07-01 true Claims procedures. 15.26 Section 15.26 Labor Office of the...

  16. 46 CFR 327.4 - Claim requirements.

    Science.gov (United States)

    2010-10-01

    ... statements made in the claim are subject to the provision of 18 U.S.C. 287 and 1001 and all other penalty... Admiralty Act, as amended by Public Law 877, 81st Congress (64 Stat. 1112; 46 app. U.S.C. 745), shall not be... physicians and hospitals related to a seaman's claim for injury, illness, or death shall be attached. If the...

  17. 40 CFR 1620.2 - Administrative claim; when presented.

    Science.gov (United States)

    2010-07-01

    ... ADMINISTRATIVE CLAIMS ARISING UNDER THE FEDERAL TORT CLAIMS ACT § 1620.2 Administrative claim; when presented. (a... negligence or wrongful act or omission of the CSB or its employees must be mailed or delivered to the Office...

  18. 32 CFR 842.95 - Non-assertable claims.

    Science.gov (United States)

    2010-07-01

    ... ADMINISTRATIVE CLAIMS Property Damage Tort Claims in Favor of the United States (31 U.S.C. 3701, 3711-3719) § 842...) Reimbursement for military or civilian employees for their negligence claims paid by the United States. (b) Loss...

  19. Depressive Realism and Outcome Density Bias in Contingency Judgments: The Effect of the Context and Intertrial Interval

    Science.gov (United States)

    Msetfi, Rachel M.; Murphy, Robin A.; Simpson, Jane; Kornbrot, Diana E.

    2005-01-01

    The perception of the effectiveness of instrumental actions is influenced by depressed mood. Depressive realism (DR) is the claim that depressed people are particularly accurate in evaluating instrumentality. In two experiments, the authors tested the DR hypothesis using an action-outcome contingency judgment task. DR effects were a function of…

  20. Consumer understanding of sugars claims on food and drink products

    OpenAIRE

    Patterson, N J; Sadler, M J; Cooper, J M

    2012-01-01

    Consumer understanding of nutrition and health claims is a key aspect of current regulations in the European Union (EU). In view of this, qualitative and quantitative research techniques were used to investigate consumer awareness and understanding of product claims in the UK, focusing particularly on nutrition claims relating to sugars. Both research methods identified a good awareness of product claims. No added sugars claims were generally preferred to reduced sugars claims, and there was ...

  1. Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases.

    Science.gov (United States)

    Weycker, Derek; Sofrygin, Oleg; Seefeld, Kim; Deeter, Robert G; Legg, Jason; Edelsberg, John

    2013-02-13

    Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN) and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not been formally evaluated. Data comprised linked electronic medical records from Geisinger Health System and healthcare claims data from Geisinger Health Plan. Subjects were classified into subgroups based on whether or not they were hospitalized for FN per the presumptive "gold standard" (ANC based definition (diagnosis codes for neutropenia, fever, and/or infection). Accuracy was evaluated principally based on positive predictive value (PPV) and sensitivity. Among 357 study subjects, 82 (23%) met the gold standard for hospitalized FN. For the claims-based definition including diagnosis codes for neutropenia plus fever in any position (n=28), PPV was 100% and sensitivity was 34% (95% CI: 24-45). For the definition including neutropenia in the primary position (n=54), PPV was 87% (78-95) and sensitivity was 57% (46-68). For the definition including neutropenia in any position (n=71), PPV was 77% (68-87) and sensitivity was 67% (56-77). Patients hospitalized for chemotherapy-induced FN can be identified in healthcare claims databases--with an acceptable level of mis-classification--using diagnosis codes for neutropenia, or neutropenia plus fever.

  2. Using Data Mining to Predict Possible Future Depression Cases

    OpenAIRE

    Daimi, Kevin; Banitaan, Shadi

    2014-01-01

    Depression is a disorder characterized by misery and gloominess felt over a period of time. Some symptoms of depression overlap with somatic illnesses implying considerable difficulty in diagnosing it. This paper contributes to its diagnosis through the application of data mining, namely classification, to predict patients who will most likely develop depression or are currently suffering from depression. Synthetic data is used for this study. To acquire the results, the popular suite of mach...

  3. Bipolar disorder diagnosis: challenges and future directions

    Science.gov (United States)

    Phillips, Mary L; Kupfer, David J

    2018-01-01

    Bipolar disorder refers to a group of affective disorders, which together are characterised by depressive and manic or hypomanic episodes. These disorders include: bipolar disorder type I (depressive and manic episodes: this disorder can be diagnosed on the basis of one manic episode); bipolar disorder type II (depressive and hypomanic episodes); cyclothymic disorder (hypomanic and depressive symptoms that do not meet criteria for depressive episodes); and bipolar disorder not otherwise specified (depressive and hypomanic-like symptoms that do not meet the diagnostic criteria for any of the aforementioned disorders). Bipolar disorder type II is especially difficult to diagnose accurately because of the difficulty in differentiation of this disorder from recurrent unipolar depression (recurrent depressive episodes) in depressed patients. The identification of objective biomarkers that represent pathophysiologic processes that differ between bipolar disorder and unipolar depression can both inform bipolar disorder diagnosis and provide biological targets for the development of new and personalised treatments. Neuroimaging studies could help the identification of biomarkers that differentiate bipolar disorder from unipolar depression, but the problem in detection of a clear boundary between these disorders suggests that they might be better represented as a continuum of affective disorders. Innovative combinations of neuroimaging and pattern recognition approaches can identify individual patterns of neural structure and function that accurately ascertain where a patient might lie on a behavioural scale. Ultimately, an integrative approach, with several biological measurements using different scales, could yield patterns of biomarkers (biosignatures) to help identify biological targets for personalised and new treatments for all affective disorders. PMID:23663952

  4. Studying depression using imaging and machine learning methods

    Directory of Open Access Journals (Sweden)

    Meenal J. Patel

    2016-01-01

    Full Text Available Depression is a complex clinical entity that can pose challenges for clinicians regarding both accurate diagnosis and effective timely treatment. These challenges have prompted the development of multiple machine learning methods to help improve the management of this disease. These methods utilize anatomical and physiological data acquired from neuroimaging to create models that can identify depressed patients vs. non-depressed patients and predict treatment outcomes. This article (1 presents a background on depression, imaging, and machine learning methodologies; (2 reviews methodologies of past studies that have used imaging and machine learning to study depression; and (3 suggests directions for future depression-related studies.

  5. Studying depression using imaging and machine learning methods.

    Science.gov (United States)

    Patel, Meenal J; Khalaf, Alexander; Aizenstein, Howard J

    2016-01-01

    Depression is a complex clinical entity that can pose challenges for clinicians regarding both accurate diagnosis and effective timely treatment. These challenges have prompted the development of multiple machine learning methods to help improve the management of this disease. These methods utilize anatomical and physiological data acquired from neuroimaging to create models that can identify depressed patients vs. non-depressed patients and predict treatment outcomes. This article (1) presents a background on depression, imaging, and machine learning methodologies; (2) reviews methodologies of past studies that have used imaging and machine learning to study depression; and (3) suggests directions for future depression-related studies.

  6. 20 CFR 429.103 - Who may file my claim?

    Science.gov (United States)

    2010-04-01

    ... authorized agent, or your legal representative may file the claim. (c) Claims based on death. The executor or... behalf as agent, executor, administrator, parent, guardian or other representative. ...

  7. Sleep disorders and depressive feelings: a global survey with the Beck depression scale.

    Science.gov (United States)

    Vandeputte, Melissa; de Weerd, Al

    2003-07-01

    Patients with (chronic) sleep disorders are prone to depression. Until now studies on the prevalence of depression in the various sleep disorders focused mainly on obstructive sleep apnea patients and narcolepsy. Studies in other common sleep disorders are scarce. The aim of our study was to estimate the prevalence of depressive feelings in the various sleep disorders diagnosed in a Center for Sleep and Wake Disorders. We included 917 consecutive patients (age between 14 and 84 years, median age: 49, 396 male and 521 female), seen in our center for sleep and wake disorders during 2001 and first half of 2002. The diagnosis was based on the history taken at the outpatient-clinic and two consecutive 24-h polysomnographic recordings at home (APSG). The final decisions on the diagnosis were made according to the ASDA international classification of sleep disorders. The severity of depressive feelings was based on the Beck depression scale. Overall, the prevalence of depressive feelings was high. There were no significant differences in age and gender. In psychophysiological insomnia, inadequate sleep- and wake hygiene, sleep state misperception and periodic limb movement disorder/restless legs syndrome some form of depression occurred in more than half of the patients. Moderate to severe depression was found in 3.5% of the patients. The study suggests that the use of a depression scale in the daily routine of diagnosing and treating sleep disorders should be encouraged in order to optimise diagnosis and therapy in these patients.

  8. Framing and Claiming: How Information-Framing Affects Expected Social Security Claiming Behavior

    Science.gov (United States)

    Brown, Jeffrey R.; Kapteyn, Arie; Mitchell, Olivia S.

    2017-01-01

    This paper provides evidence that Social Security benefit claiming decisions are strongly affected by framing and are thus inconsistent with expected utility theory. Using a randomized experiment that controls for both observable and unobservable differences across individuals, we find that the use of a “breakeven analysis” encourages early claiming. Respondents are more likely to delay when later claiming is framed as a gain, and the claiming age is anchored at older ages. Additionally, the financially less literate, individuals with credit card debt, and those with lower earnings are more influenced by framing than others. PMID:28579641

  9. Framing and Claiming: How Information-Framing Affects Expected Social Security Claiming Behavior.

    Science.gov (United States)

    Brown, Jeffrey R; Kapteyn, Arie; Mitchell, Olivia S

    2016-03-01

    This paper provides evidence that Social Security benefit claiming decisions are strongly affected by framing and are thus inconsistent with expected utility theory. Using a randomized experiment that controls for both observable and unobservable differences across individuals, we find that the use of a "breakeven analysis" encourages early claiming. Respondents are more likely to delay when later claiming is framed as a gain, and the claiming age is anchored at older ages. Additionally, the financially less literate, individuals with credit card debt, and those with lower earnings are more influenced by framing than others.

  10. Accuracy of claims-based algorithms for epilepsy research: Revealing the unseen performance of claims-based studies.

    Science.gov (United States)

    Moura, Lidia M V R; Price, Maggie; Cole, Andrew J; Hoch, Daniel B; Hsu, John

    2017-04-01

    To evaluate published algorithms for the identification of epilepsy cases in medical claims data using a unique linked dataset with both clinical and claims data. Using data from a large, regional health delivery system, we identified all patients contributing biologic samples to the health system's Biobank (n = 36K). We identified all subjects with at least one diagnosis potentially consistent with epilepsy, for example, epilepsy, convulsions, syncope, or collapse, between 2014 and 2015, or who were seen at the epilepsy clinic (n = 1,217), plus a random sample of subjects with neither claims nor clinic visits (n = 435); we then performed a medical chart review in a random subsample of 1,377 to assess the epilepsy diagnosis status. Using the chart review as the reference standard, we evaluated the test characteristics of six published algorithms. The best-performing algorithm used diagnostic and prescription drug data (sensitivity = 70%, 95% confidence interval [CI] 66-73%; specificity = 77%, 95% CI 73-81%; and area under the curve [AUC] = 0.73, 95%CI 0.71-0.76) when applied to patients age 18 years or older. Restricting the sample to adults aged 18-64 years resulted in a mild improvement in accuracy (AUC = 0.75,95%CI 0.73-0.78). Adding information about current antiepileptic drug use to the algorithm increased test performance (AUC = 0.78, 95%CI 0.76-0.80). Other algorithms varied in their included data types and performed worse. Current approaches for identifying patients with epilepsy in insurance claims have important limitations when applied to the general population. Approaches incorporating a range of information, for example, diagnoses, treatments, and site of care/specialty of physician, improve the performance of identification and could be useful in epilepsy studies using large datasets. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  11. The Prevalence and Regional Variation of Major Depressive Disorder Among Patients With Peripheral Arterial Disease in the Medicare Population.

    Science.gov (United States)

    Columbo, Jesse A; Stone, David H; Goodney, Philip P; Nolan, Brian W; Stableford, Jennifer A; Brooke, Benjamin S; Powell, Richard J; Finn, Christine T

    2016-05-01

    Current evidence suggests an association between coronary artery disease and major depressive disorder (MDD). Data to support a similar association between peripheral arterial disease (PAD) and MDD are more limited. This study examines the prevalence and regional variation of both PAD and MDD in a large contemporary patient sample. All Medicare claims, part A and B, from January 2009 until December 2011 were queried using diagnosis codes specific for a previously validated clinical algorithm for PAD and major depression. Codes for PAD included those specific to cerebrovascular disease, abdominal aortic aneurysm, and peripheral vascular disease. Peripheral arterial disease prevalence, major depression prevalence, and coprevalence rates were determined, respectively. Regional variation of both conditions was determined using zip code data to identify potential endemic areas of disease intensity for both diagnoses. Over the study interval, the percentage of Medicare beneficiaries with a diagnosis of PAD remained relatively constant (3.0%-3.7%, n = 0.85-1.06 million in part A and 17.4%-17.5%, n = 4.82-4.93 million in part B), and MDD showed a similar trend (1.6%-2.7%, n = 0.46-0.79 million in part A and 6.1%-6.7%, n = 1.69-1.90 million in part B). The observed rate of MDD in those with an established diagnosis of PAD was 5-fold higher than those without PAD in part A claims (1.8-fold in part B claims). Moreover, there was a significant linear geographic correlation among patients with PAD and MDD (r = .54, P ≤ .01). This study documents a correlation between PAD and MDD and may, therefore, identify an at-risk population susceptible to inferior clinical outcomes. Significant regional variation exists in the prevalence of PAD and MDD, though there appear to be specific endemic regions notable for both disorders. Accordingly, health-care resource allocation toward endemic regions may help improve population health among this at-risk cohort. © The Author(s) 2016.

  12. A 12-year analysis of closed medical malpractice claims of the Taiwan civil court

    Science.gov (United States)

    Hwang, Chi-Yuan; Wu, Chien-Hung; Cheng, Fu-Cheng; Yen, Yung-Lin; Wu, Kuan-Han

    2018-01-01

    Abstract Malpractices lawsuits cause increased physician stress and decreased career satisfaction, which might result in defensive medicine for avoiding litigation. It is, consequently, important to learn experiences from previous malpractice claims. The aim of this study was to examine the epidemiologic factors related to medical malpractice claims, identify specialties at high risk of such claims, and determine clinical which errors tend to lead to medical malpractice lawsuits, by analyzing closed malpractice claims in the civil courts of Taiwan. The current analysis reviewed the verdicts of the Taiwan judicial system from a retrospective study using the population-based databank, focusing on 946 closed medical claims between 2002 and 2013. Among these medical malpractice claims, only 14.1% of the verdicts were against clinicians, with a mean indemnity payment of $83,350. The most common single specialty involved was obstetrics (10.7%), while the surgery group accounted for approximately 40% of the cases. In total, 46.3% of the patients named in the claims had either died or been gravely injured. Compared to the $75,632 indemnity for deceased patients, the mean indemnity payment for plaintiffs with grave outcomes was approximately 4.5 times higher. The diagnosis groups at high risk of malpractice litigation were infectious diseases (7.3%), malignancies (7.2%), and limb fractures (4.9%). A relatively low success rate was found in claims concerning undiagnosed congenital anomalies (4.5%) and infectious diseases (5.8%) group. A surgery dispute was the most frequent argument in civil malpractice claims (38.8%), followed by diagnosis error (19.3%). Clinicians represent 85.9% of the defendants who won their cases, but they spent an average of 4.7 years to reach final adjudication. Increased public education to prevent unrealistic expectations among patients is recommended to decrease frivolous lawsuits. Further investigation to improve the lengthy judicial process is

  13. Late onset depression: A recent update

    Directory of Open Access Journals (Sweden)

    Ananya Mahapatra

    2015-01-01

    Full Text Available Late onset depression has recently emerged as a serious mental health issue in the geriatric population with significant public health implications. It is often challenging to diagnose and treat this entity. Various theories have been postulated to elucidate the etiology of late onset depression, but a unifying hypothesis is lacking. Although the vascular hypothesis is most researched; a complex interaction of multiple vulnerability factors is the current focus of attention. Numerous psychosocial variables have been implicated to play a significant role in predicting the onset and severity of late-life depression. Phenomenological differences have been delineated from depression occurring at a younger age, but the findings are equivocal. A better understanding of the natural trajectory of depression in the elderly is required for early diagnosis and effective treatment. This review attempts to summarize the current status of evidence regarding epidemiology, etiology, clinical features, and treatment options available for late-onset depression.

  14. Addiction and depression comorbidity approaches

    Directory of Open Access Journals (Sweden)

    Crnić Katarina A.B.

    2016-01-01

    Full Text Available Topic: Comorbidities, simultaneous occurrence of two or more disorders are common in psychiatry; therefore the concept of dual diagnosis was established due to new ethiopatogenetic dilemmas and principles of diagnosis and treatment of these conditions. The most common are comorbid affective disorders and comorbidity of drug addictions and affective disorders. Topic position in medical public: Epidemiological studies show a high percentage of comorbidity of drug addictions and depression. Various studies show that about one-third of individuals with depression have addiction, and often some other psychiatric disorders are present, such as personality disorder, anxiety, and bipolar affective disorder. Comorbid disorders exacerbate one another; have tendencies to chronicity and treatment resistance. The problem of adequate diagnosis is common; other diagnosis is neglected, leading to inadequate treatment and poor outcomes. Researches of possible causes of addiction and depression comorbidity follow different theoretical assumptions. One favor genetically determined vulnerability, the others are addressing to the impact of trauma in the formative stages of personality development. Widespread is the theoretical assumption on the deficit functioning of the same regions of the CNS and the same neurotransmitters system. In previous studies the preclinical ones dominate, which are theoretically placed in the context of the CNS of a man. Most of the research are related to dysfunction of the serotonergic and dopaminergic systems, whose influence on addiction and depression are clear, and recent studies show the importance of neuromodulators and their receptors, for example, the role of natural opioid dynorphin and 'kappa' receptors in the mesolimbic reward system. Further action: The better diagnosis would require proper screening of patients entering addiction treatments for affective disorders and vice versa. Treatment have to be combined; in addition

  15. Everyday Citizenship: Identity Claims and Their Reception

    Directory of Open Access Journals (Sweden)

    Nick Hopkins

    2015-10-01

    Full Text Available Citizenship involves being able to speak and be heard as a member of the community. This can be a formal right (e.g., a right to vote. It can also be something experienced in everyday life. However, the criteria for being judged a fellow member of the community are multiple and accorded different weights by different people. Thus, although one may self-define alongside one’s fellows, the degree to which these others reciprocate depends on the weight they give to various membership criteria. This suggests we approach everyday community membership in terms of an identity claims-making process in which first, an individual claims membership through invoking certain criteria of belonging, and second, others evaluate that claim. Pursuing this logic we report three experiments investigating the reception of such identity-claims. Study 1 showed that in Scotland a claim to membership of the national ingroup was accepted more if couched in terms of place of birth and ancestry rather than just in terms of one’s subjective identification. Studies 2 and 3 showed that this differential acceptance mattered for the claimant’s ability to be heard as a community member. We discuss the implications of these studies for the conceptualization of community membership and the realization of everyday citizenship rights.

  16. CLAIMS FOR REINBURSEMENT OF EDUCATION FEES

    CERN Multimedia

    PE-ADS

    1999-01-01

    You are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:-\tthe academic year is defined as the period going from 1st September to 31st August,-\tonly paid bills can be subject to reimbursement,-\ta claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child,-\tbills for one child may be grouped on a claim by periods of term, semester or academic year,-\tthe months of July and August should be included in the third term, or the second semester, or the academic year,-\tfor each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have receive...

  17. CLAIMS FOR REIMBURSEMENT OF EDUCATION FEES

    CERN Multimedia

    Personnel Division

    1999-01-01

    REMINDERYou are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:the academic year is defined as the period going from 1st September to 31st August, only paid bills can be subject to reimbursement, a claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child, bills for one child may be grouped on a claim by periods of term, semester or academic year, the months of July and August should be included in the third term, or the second semester, or the academic year, for each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have received and paid all bills, including those for...

  18. [Preclinical horizon of depression in adults].

    Science.gov (United States)

    Jiménez-Báez, María Valeria; Márquez-González, Horacio; Monsreal-Góngora, Juan Leonardo; Góngora-González, Gonzalo; Sandoval-Jurado, Luis; Boquer-Hernández, Rubén

    2016-01-01

    Identify factors related to preclinical depression in healthy adults, their risk factors and concordance with family doctor diagnostic. Case-control study in adult from family medicine consulting room. Beck inventory for depression was applied. The correlation between depression and the diagnosis by the family physician was evaluated. Odds ratio (OR) was determined. Involved 138 patients randomly from four family medicine units (FMU) in the Northern Region of Quintana Roo, Mexico. The mean age 34.9 ± 11.4 years, 55.8% women, prevalence for depression was 26.1%. Being male OR: 3.76; 95% CI: 1.69-8.36, under 30 years OR: 2.76; 95% CI: 1.27-5.99, low socioeconomic status (SES) OR: 2.11; 95% CI: 0.97-4.59 and be married OR: 3.22; 95% CI: 1.41.-7.36 had depression risk. Diagnosis by the family physician and inventory Beck. Kappa Index 0.2, 95% CI: -0057-0176; p = 0.05. Almost a third of young adults have some depression degree in family medicine consulting room, it is necessary a depression screening for male patients, low SES, married, and under 30 years old, attending medical consultation familiar, for a early diagnosis and improve prognosis.

  19. Longitudinal Association of Dementia and Depression.

    Science.gov (United States)

    Snowden, Mark B; Atkins, David C; Steinman, Lesley E; Bell, Janice F; Bryant, Lucinda L; Copeland, Catherine; Fitzpatrick, Annette L

    2015-09-01

    Depression is an important precursor to dementia, but less is known about the role dementia plays in altering the course of depression. We examined whether depression prevalence, incidence, and severity are higher in those with dementia versus those with mild cognitive impairment (MCI), or normal cognition. Prospective cohort study using the longitudinal Uniform Data Set of the National Alzheimer's Coordinating Center (2005-2013). 34 Alzheimer Disease research centers. 27,776 subjects with dementia, MCI, or normal cognition. Depression status was determined by a clinical diagnosis of depression within the prior 2 years and by a Geriatric Depression Scale-Short Form score >5. Rates of depression were significantly higher in subjects with MCI and dementia compared with those with normal cognition at index visit. Controlling for demographics and common chronic conditions, logistic regression analysis revealed elevated depression in those with MCI (OR: 2.40 [95% CI: 2.25, 2.56]) or dementia (OR: 2.64 [95% CI: 2.43, 2.86]) relative to those with normal cognition. In the subjects without depression at the index visit (N = 18,842), those with MCI and dementia had higher probabilities of depression diagnosis 2 years post index visit than those with normal cognition: MCI = 21.7%, dementia = 24.7%, normal cognition = 10.5%. MCI and dementia were associated with significantly higher rates of depression in concurrent as well as prospective analyses. These findings suggest that efforts to effectively engage and treat older adults with dementia will need also to address co-occurring depression. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. 76 FR 36176 - Fully Developed Claim (Fully Developed Claims-Applications for Compensation, Pension, DIC, Death...

    Science.gov (United States)

    2011-06-21

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0747] Fully Developed Claim (Fully Developed Claims--Applications for Compensation, Pension, DIC, Death Pension, and/or Accrued Benefits); Correction AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice; correction...

  1. Depression and Multiple Sclerosis

    Science.gov (United States)

    ... Symptoms Depression Share this page Facebook Twitter Email Depression Depression Fatigue Walking (Gait) Difficulties Numbness or Tingling ... away from addictive substances such as alcohol. Clinical depression It’s important to distinguish between mild, everyday “blues” — ...

  2. Depression in Older Adults

    Science.gov (United States)

    ... here Home » Depression In Older Adults: More Facts Depression In Older Adults: More Facts Depression affects more ... combination of both. [8] Older Adult Attitudes Toward Depression: According to a Mental Health America survey [9] ...

  3. Older Adults and Depression

    Science.gov (United States)

    ... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...

  4. Depression and Caregiving

    Science.gov (United States)

    ... FCA - A A + A You are here Home Depression and Caregiving Order this publication Printer-friendly version ... a more serious depression over time. Symptoms of Depression People experience depression in different ways. Some may ...

  5. Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity--implications for diagnosis and ultra-high risk research.

    Science.gov (United States)

    Wigman, Johanna T W; van Nierop, Martine; Vollebergh, Wilma A M; Lieb, Roselind; Beesdo-Baum, Katja; Wittchen, Hans-Ullrich; van Os, Jim

    2012-03-01

    It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating. Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors. Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89-2.66, P illness course (P symptoms (P illness behavior (P illness (P disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.

  6. Anthrax: Diagnosis

    Science.gov (United States)

    ... Diagnosis Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir Doctors in the United States rarely see a patient with anthrax. CDC Guidance and case definitions are available to help doctors diagnose anthrax, take ...

  7. Postpartum Depression

    Science.gov (United States)

    ... or guilty. These emotions can affect a woman’s self-esteem and how she deals with stress. Fatigue—Many ... FAQs Exercise After Pregnancy (FAQ131) Depression (FAQ106) Patient Education FAQs Resources & Publications Committee Opinions Practice Bulletins Patient ...

  8. The comparison of postpartum with non-postpartum depression: a rose by any other name.

    OpenAIRE

    Whiffen, V E

    1991-01-01

    A strong tradition exists in the psychiatric literature to consider postpartum depression a distinct diagnosis. However, the empirical evidence indicates that, in terms of etiology and relapse rates, postpartum depression is indistinguishable from non-postpartum depression. Symptomatically, postpartum depression seems to involve a milder disturbance, suggesting that it is best seen as an adjustment disorder. This paper summarizes the empirical evidence relevant to the distinct diagnosis quest...

  9. 31 CFR 361.8 - Claim for replacement.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Claim for replacement. 361.8 Section... § 361.8 Claim for replacement. Claim for replacement shall be made in writing to the Secretary, to the..., Parkersburg, WV 26106-1328. The claim, accompanied by a recommendation regarding the manner of replacement...

  10. 32 CFR Appendix to Part 281 - Claims Description

    Science.gov (United States)

    2010-07-01

    ... advance decision functions for claims under the following statutes: (a) 31 U.S.C. 3702, concerning claims... SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS Pt. 281, App. Appendix to... Personnel Management performs these functions for claims involving civilian employees' compensation and...

  11. 32 CFR Appendix B to Part 282 - Claims Description

    Science.gov (United States)

    2010-07-01

    ... perform the claims settlement and advance decision functions for claims under the following statutes: (a...) MISCELLANEOUS PROCEDURES FOR SETTLING PERSONNEL AND GENERAL CLAIMS AND PROCESSING ADVANCE DECISION REQUESTS Pt... Director of the Office of Personnel Management performs these functions for claims involving civilian...

  12. 37 CFR 7.12 - Claim of color.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Claim of color. 7.12 Section... § 7.12 Claim of color. (a) If color is claimed as a feature of the mark in the basic application and/or registration, the international application must include a statement that color is claimed as a...

  13. 38 CFR 3.160 - Status of claims.

    Science.gov (United States)

    2010-07-01

    ..., Compensation, and Dependency and Indemnity Compensation Claims § 3.160 Status of claims. The following definitions are applicable to claims for pension, compensation, and dependency and indemnity compensation. (a... for a benefit received after final disallowance of an earlier claim, or any application based on...

  14. 40 CFR 14.12 - Principal types of unallowable claims.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Principal types of unallowable claims... PERSONAL PROPERTY CLAIMS § 14.12 Principal types of unallowable claims. Claims that ordinarily will not be... valid appraisal or authentication with the carrier prior to shipment of the item; (d) Loss of bankbooks...

  15. 37 CFR 360.5 - Copies of claims.

    Science.gov (United States)

    2010-07-01

    ... Section 360.5 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Cable Claims... hand delivery or by mail, file an original and one copy of the claim to cable royalty fees. ...

  16. 37 CFR 360.22 - Form and content of claims.

    Science.gov (United States)

    2010-07-01

    .... 360.22 Section 360.22 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio Recording Devices and Media Royalty Claims § 360.22 Form and content of claims. (a) Forms. (1...

  17. 20 CFR 410.232 - Withdrawal of a claim.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Withdrawal of a claim. 410.232 Section 410.232 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969... Claims and Evidence § 410.232 Withdrawal of a claim. (a) Before adjudication of claim. A claimant (or an...

  18. 49 CFR 1021.4 - Notice of claim and demand.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Notice of claim and demand. 1021.4 Section 1021.4... § 1021.4 Notice of claim and demand. Initiation of administrative collection of enforcement claims will be commenced by the enforcement collection designee mailing a letter of notice of claim and demand to...

  19. 32 CFR 536.19 - Disaster claims planning.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Disaster claims planning. 536.19 Section 536.19... AGAINST THE UNITED STATES The Army Claims System § 536.19 Disaster claims planning. All ACOs will prepare... requirements related to disaster claims planning. ...

  20. 32 CFR 842.43 - Filing a claim.

    Science.gov (United States)

    2010-07-01

    ... completed Standard Form 95 or other signed and written demand for money damages in a sum certain. A claim... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE CLAIMS AND LITIGATION ADMINISTRATIVE... amend a claim at any time prior to final action. To amend a claim, the claimant or his or her authorized...

  1. 32 CFR 536.118 - Related statutes for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Related statutes for maritime claims. 536.118... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.118 Related statutes for maritime claims... under the AMCSA is not mandatory for causes of action as it is for the SIAA or PVA. (b) Similar maritime...

  2. 32 CFR 537.16 - Scope for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for maritime claims. 537.16 Section 537.16... BEHALF OF THE UNITED STATES § 537.16 Scope for maritime claims. The Army Maritime Claims Settlement Act... claims for damage to: (1) DA-accountable properties of a kind that are within the federal maritime...

  3. 32 CFR 537.19 - Demands arising from maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Demands arising from maritime claims. 537.19 Section 537.19 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS ON BEHALF OF THE UNITED STATES § 537.19 Demands arising from maritime claims. (a) It is...

  4. 32 CFR 536.119 - Scope for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for maritime claims. 536.119 Section 536... CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.119 Scope for maritime claims. The AMCSA applies...) Damage that is maritime in nature and caused by tortious conduct of U.S. military personnel or federal...

  5. 32 CFR 536.124 - Settlement authority for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Settlement authority for maritime claims. 536.124 Section 536.124 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.124 Settlement authority for maritime...

  6. 32 CFR 537.18 - Settlement authority for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Settlement authority for maritime claims. 537.18 Section 537.18 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS ON BEHALF OF THE UNITED STATES § 537.18 Settlement authority for maritime claims. (a) The...

  7. 32 CFR 536.29 - Revision of filed claims.

    Science.gov (United States)

    2010-07-01

    ... AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.29 Revision of filed claims. (a... the writing alleges a new theory of liability, a new tortfeasor, a new party claimant, a different... amendment, not a new claim. Similarly, the addition of required information not on the original claim...

  8. Worst-Case-Optimal Dynamic Reinsurance for Large Claims

    DEFF Research Database (Denmark)

    Korn, Ralf; Menkens, Olaf; Steffensen, Mogens

    2012-01-01

    We control the surplus process of a non-life insurance company by dynamic proportional reinsurance. The objective is to maximize expected (utility of the) surplus under the worst-case claim development. In the large claim case with a worst-case upper limit on claim numbers and claim sizes, we fin...

  9. 42 CFR 456.722 - Electronic claims management system.

    Science.gov (United States)

    2010-10-01

    ... Electronic Claims Management System for Outpatient Drug Claims § 456.722 Electronic claims management system...'s Medicaid Management Information System (MMIS) applicable to prescription drugs. (ii) Notifying the... 42 Public Health 4 2010-10-01 2010-10-01 false Electronic claims management system. 456.722...

  10. 28 CFR 32.32 - Time for filing claim.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Time for filing claim. 32.32 Section 32.32 Judicial Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Educational Assistance Benefit Claims § 32.32 Time for filing claim. (a...

  11. 7 CFR 220.14 - Claims against school food authorities.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SCHOOL BREAKFAST PROGRAM § 220.14 Claims against school food authorities. (a) State agencies shall disallow any portion of a claim and recover any payment made... FNSRO, when FNSRO disallows a claim or a portion of a claim, or makes a demand for refund of an alleged...

  12. Music therapy for depression.

    Science.gov (United States)

    Aalbers, Sonja; Fusar-Poli, Laura; Freeman, Ruth E; Spreen, Marinus; Ket, Johannes Cf; Vink, Annemiek C; Maratos, Anna; Crawford, Mike; Chen, Xi-Jing; Gold, Christian

    2017-11-16

    Depression is a highly prevalent mood disorder that is characterised by persistent low mood, diminished interest, and loss of pleasure. Music therapy may be helpful in modulating moods and emotions. An update of the 2008 Cochrane review was needed to improve knowledge on effects of music therapy for depression. 1. To assess effects of music therapy for depression in people of any age compared with treatment as usual (TAU) and psychological, pharmacological, and/or other therapies.2. To compare effects of different forms of music therapy for people of any age with a diagnosis of depression. We searched the following databases: the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR; from inception to 6 May 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; to 17 June 2016); Thomson Reuters/Web of Science (to 21 June 2016); Ebsco/PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed (to 5 July 2016); the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, the National Guideline Clearing House, and OpenGrey (to 6 September 2016); and the Digital Access to Research Theses (DART)-Europe E-theses Portal, Open Access Theses and Dissertations, and ProQuest Dissertations and Theses Database (to 7 September 2016). We checked reference lists of retrieved articles and relevant systematic reviews and contacted trialists and subject experts for additional information when needed. We updated this search in August 2017 and placed potentially relevant studies in the "Awaiting classification" section; we will incorporate these into the next version of this review as appropriate. All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing music therapy versus treatment as usual (TAU), psychological therapies, pharmacological therapies, other therapies, or different forms of music therapy for reducing depression. Two review

  13. Major Depressive Disorder Definition, Etiology and Epidemiology: A Review

    Directory of Open Access Journals (Sweden)

    Fatmagul Helvaci Celik

    2016-03-01

    Full Text Available Depression is one of the most common psychiatric disorders influencing the all population. Untreated depression may lead to early death and worsening in general health. Depression has several clinically distinct subtypes which are sometimes difficult to diagnose. Diagnosis and treatment of these disorders are of concern to physicians other than psychiatrists, because of their effect on course and prognosis of general medical diseases. This is a concise and up to date overview of the epidemiology,etiology physiopathology and diagnosis of major depressive disorder. [J Contemp Med 2016; 6(1.000: 51-66

  14. Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases

    Directory of Open Access Journals (Sweden)

    Weycker Derek

    2013-02-01

    Full Text Available Abstract Background Healthcare claims databases have been used in several studies to characterize the risk and burden of chemotherapy-induced febrile neutropenia (FN and effectiveness of colony-stimulating factors against FN. The accuracy of methods previously used to identify FN in such databases has not been formally evaluated. Methods Data comprised linked electronic medical records from Geisinger Health System and healthcare claims data from Geisinger Health Plan. Subjects were classified into subgroups based on whether or not they were hospitalized for FN per the presumptive “gold standard” (ANC 9/L, and body temperature ≥38.3°C or receipt of antibiotics and claims-based definition (diagnosis codes for neutropenia, fever, and/or infection. Accuracy was evaluated principally based on positive predictive value (PPV and sensitivity. Results Among 357 study subjects, 82 (23% met the gold standard for hospitalized FN. For the claims-based definition including diagnosis codes for neutropenia plus fever in any position (n=28, PPV was 100% and sensitivity was 34% (95% CI: 24–45. For the definition including neutropenia in the primary position (n=54, PPV was 87% (78–95 and sensitivity was 57% (46–68. For the definition including neutropenia in any position (n=71, PPV was 77% (68–87 and sensitivity was 67% (56–77. Conclusions Patients hospitalized for chemotherapy-induced FN can be identified in healthcare claims databases--with an acceptable level of mis-classification--using diagnosis codes for neutropenia, or neutropenia plus fever.

  15. 32 CFR 537.15 - Statutory authority for maritime claims and claims involving civil works of a maritime nature.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Statutory authority for maritime claims and claims involving civil works of a maritime nature. 537.15 Section 537.15 National Defense Department of....15 Statutory authority for maritime claims and claims involving civil works of a maritime nature. (a...

  16. Early Maladaptive Schemas in Depressed Women and Its Relationship with Depression

    Directory of Open Access Journals (Sweden)

    Hacer Bolat KONUKÇU

    2013-07-01

    Full Text Available Objective: Objective: Schemas are deep enduring cognitive structures that are the source of dysfunctional cognitions, emotions and behaviors, activate after critical incidents in depression. A subset of schemas called Early Maladaptive Schemas (EMS which are hyphotised to arise from early traumatic and adverse life events are also claimed to be related with not only personality disorders but also mood disorders. In this study we aimed to investigate the relationship between early maladaptive schemas and depression and relationship between schema scores and depression severity in depressed women and compare it with non-depressed controls.Methods: 40 women attending to an outpatient psychiatry clinic and 30 healthy controls participated. All participants were assessed with SCID-1. Data were obtained by using a Sociodemographic Questionnaires, Young Schema Questionnaire-Short Form 3 (YSQ and Beck Depression Inventory (BDI.Results: All except one (enmeshment/undeveloped self maladaptive schema scores of depressed women were higher than controls. BDI was correlated to some schema and schema domain scores in both depressed and control groups but the correlations were stronger in control group. Mean emotional deprivation, negativism, abandonment and instability, failure EMS scores showed the highest difference between two groups. The schema domains most related to depression symptom severity were disconnection and rejection, impaired autonomy and performance.Conclusions: Almost all early maladaptive schemas are related to depression, and some schemas are related to depression symptom severity but these correlations are weaker in control group. This may mean that EMS are stable and mood independent structures. Although other schemas are related to depression, mostly related EMS in women might be emotional deprivation schema. These schemas may also overlap with Beck’s unlovability core belief or sociotropy dimension

  17. Fault diagnosis

    Science.gov (United States)

    Abbott, Kathy

    1990-01-01

    The objective of the research in this area of fault management is to develop and implement a decision aiding concept for diagnosing faults, especially faults which are difficult for pilots to identify, and to develop methods for presenting the diagnosis information to the flight crew in a timely and comprehensible manner. The requirements for the diagnosis concept were identified by interviewing pilots, analyzing actual incident and accident cases, and examining psychology literature on how humans perform diagnosis. The diagnosis decision aiding concept developed based on those requirements takes abnormal sensor readings as input, as identified by a fault monitor. Based on these abnormal sensor readings, the diagnosis concept identifies the cause or source of the fault and all components affected by the fault. This concept was implemented for diagnosis of aircraft propulsion and hydraulic subsystems in a computer program called Draphys (Diagnostic Reasoning About Physical Systems). Draphys is unique in two important ways. First, it uses models of both functional and physical relationships in the subsystems. Using both models enables the diagnostic reasoning to identify the fault propagation as the faulted system continues to operate, and to diagnose physical damage. Draphys also reasons about behavior of the faulted system over time, to eliminate possibilities as more information becomes available, and to update the system status as more components are affected by the fault. The crew interface research is examining display issues associated with presenting diagnosis information to the flight crew. One study examined issues for presenting system status information. One lesson learned from that study was that pilots found fault situations to be more complex if they involved multiple subsystems. Another was pilots could identify the faulted systems more quickly if the system status was presented in pictorial or text format. Another study is currently under way to

  18. Uncomplicated Depression, Suicide Attempt, and the DSM-5 Bereavement Exclusion Debate: An Empirical Evaluation

    Science.gov (United States)

    Wakefield, Jerome C.; Schmitz, Mark F.

    2014-01-01

    Purpose: To evaluate the claim, made repeatedly during "Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition debates over eliminating the bereavement exclusion (BE), that ''uncomplicated'' depressive reactions have elevated suicidality like other major depressive disorder (MDD), so exclusions risk…

  19. Depressive realism and outcome density bias in contingency judgments: the effect of the context and intertrial interval

    OpenAIRE

    Msetfi, Rachel M.; Murphy, Robin, A.; Simpson, Jane; Kornbrot, Diana E.

    2005-01-01

    peer-reviewed The perception of the effectiveness of instrumental actions is influenced by depressed mood. Depressive realism (DR) is the claim that depressed people are particularly accurate in evaluating instrumentality. In two experiments, the authors tested the DR hypothesis using an action–outcome contingency judgment task. DR effects were a function of intertrial interval length and outcome density, suggesting that depressed mood is accompanied by reduced contextual processing rather...

  20. Recent cold fusion claims: are they valid?

    International Nuclear Information System (INIS)

    Kowalski, Ludwik

    2006-01-01

    Cold fusion consists of nuclear reactions occurring in solid metals loaded with hydrogen. Considerable progress has been made in that area in the last ten years. This 2004 paper summarizes recent claims without attempting to evaluate their validity. The manuscript was submitted to seven physics journals. Unfortunately, the editors rejected it without the benefit of the usual peer-review process. (author)

  1. 27 CFR 70.413 - Claims.

    Science.gov (United States)

    2010-04-01

    ... file a bond in double the amount of the tax in order to insure collection of the tax if the claim is... 5620.8 for allowance of loss, credit of tax, or relief from tax liability, as applicable, on (1....413 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE...

  2. IDENTITY CLAIMS, TEXTS, ROME AND GALATIANS

    African Journals Online (AJOL)

    inform the identity claimed and negotiated by people and groups. When ..... 24 To some extent, going against the grain of Bourdieu' notion that “what exist in the social world are .... based on words and information that create reality” (Lampe 1995:940, emphasis ..... Jesus, the Early Church and the Roman superpower.

  3. 45 CFR 34.5 - Unallowable claims.

    Science.gov (United States)

    2010-10-01

    ... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CLAIMS FILED UNDER THE MILITARY... as jewelry, cameras, watches, and binoculars when they are shipped with household goods by a moving... exercise due care in protecting his or her property. (10) Sales Tax. Reimbursements for the payment of...

  4. CLAIMS IN INTERNATIONAL CONSTRUCTION PROJECTS IN ...

    African Journals Online (AJOL)

    The most significant effect-of claims in international projects in Ethiopia has ... however, do not accept the decision of the Engineer, then an .... The original design of the roof framing for the ..... have experienced tIus problem making it a prime.

  5. 33 CFR 25.507 - Claims payable.

    Science.gov (United States)

    2010-07-01

    ... property involved would be liable under local law. (b) The fact that the act giving rise to a claim may constitute a crime does not, by itself, bar relief. (c) Local law or custom pertaining to contributory or comparative negligence, and to joint tort-feasors, are applied to the extent practicable. ...

  6. 32 CFR 750.9 - Claims: Payments.

    Science.gov (United States)

    2010-07-01

    ... requires submission of the payment voucher to the General Accounting Office. All other field authorized payment vouchers are submitted directly to the servicing disbursing office for payment. ... 32 National Defense 5 2010-07-01 2010-07-01 false Claims: Payments. 750.9 Section 750.9 National...

  7. Consumer perceptions of nutrition and health claims

    NARCIS (Netherlands)

    Trijp, van H.C.M.; Lans, van der I.A.

    2007-01-01

    The number of food products containing extra or reduced levels of specific ingredients (e.g. extra calcium) that bring particular health benefits (e.g. stronger bones) is still increasing. Nutrition- and health-related (NH) claims promoting these ingredient levels and their health benefit differ in

  8. Quadratic Hedging Methods for Defaultable Claims

    International Nuclear Information System (INIS)

    Biagini, Francesca; Cretarola, Alessandra

    2007-01-01

    We apply the local risk-minimization approach to defaultable claims and we compare it with intensity-based evaluation formulas and the mean-variance hedging. We solve analytically the problem of finding respectively the hedging strategy and the associated portfolio for the three methods in the case of a default put option with random recovery at maturity

  9. Competing jurisdictions : settling land claims in Africa

    NARCIS (Netherlands)

    Evers, S.; Spierenburg, M.; Wels, H.

    2005-01-01

    The papers included in this volume were earlier presented at a conference on the settlement of land claims in Africa, which was held in Amsterdam in September 2003. The papers are written primarily from an anthropological perspective. Contributions: Introduction: competing jurisdictions: settling

  10. 32 CFR 750.43 - Claims payable.

    Science.gov (United States)

    2010-07-01

    ... in nature, having little parallel in civilian pursuits, and in which the U.S. Government has... agreement are payable under the MCA, even though legally enforceable against the U.S. Government as contract.... Claims filed under this paragraph may, if in the best interest of the U.S. Government, be referred to and...

  11. Archival claims in Southern Africa | Mnjama | Innovation

    African Journals Online (AJOL)

    The author examines the problem of archival claims in the region. He begins by defining the broad categories of archives that fall under the rubric of `migrated archives' and shows that virtually all states in the region are affected by problems related to this phenomenon. He argues that failure to distinguish the different ...

  12. 32 CFR 732.19 - Claims.

    Science.gov (United States)

    2010-07-01

    ... naval medical or dental officer is not on duty, or by the member receiving care when on detached duty...) and line of duty (LOD) determination. When a reservist claims benefits for care received totally after... Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical...

  13. Contested claims to gardens and land

    DEFF Research Database (Denmark)

    Obika, Julaina; Adol, Ben Otto; Babiiha, Sulayman Mpisi

    2018-01-01

    This chapter explores how, in a patrilineal and patriarchal society recovering from two decades of war, women and men frame arguments about entitlement. Here claims to gardens (plots of land for cultivation) become a contested conversation about women’s rights of belonging to family and community...

  14. A retrospective study on the impact of comorbid depression or anxiety on healthcare resource use and costs among diabetic neuropathy patients

    Directory of Open Access Journals (Sweden)

    Bao Yanjun

    2009-06-01

    Full Text Available Abstract Background Diabetic neuropathy (DN is a common complication of diabetes that has significant economic burden, especially for patients with comorbid depression or anxiety. This study examines and quantifies factors associated with healthcare costs among patients diagnosed with diabetic neuropathy (DN with or without a comorbid diagnosis of depression or anxiety (DA using retrospective administrative claims data. No study has examined the differences in economic outcomes depending on the presence of comorbid DA disorders. Methods Over-age-18 individuals with 1+ diagnosis of DN in 2005 were selected. The first observed DN claim was considered the "index date." All individuals had a 12-month pre-index and follow-up period. For both under-age-65 commercially insured and over-age-65 individuals with employer-sponsored Medicare supplemental insurance, we constructed 2 subgroups for individuals with DA (DN-DA or without (DN-only. Patients' clinical characteristics over pre-index period were compared. Multivariate regressions were performed to assess whether DN-DA patients had higher utilization of healthcare resources and costs than DN-only patients, controlling for demographic and clinical characteristics. Results We identified 16,831 DN-only and 1,699 DN-DA patients in the Medicare supplemental cohort, as well as 17,205 and 3,105 in the commercially insured. DN-DA patients had higher prevalence of diabetes-related comorbidities for cardiovascular disease, cerebrovascular/peripheral vascular disease, nephropathy, obesity, and hypoglycemic events than DN-only patients (all p Conclusion These findings indicate that the healthcare costs were significantly higher for DN patients with depression or anxiety relative to those without such comorbid disorders.

  15. Prenatal Diagnosis

    Directory of Open Access Journals (Sweden)

    Ozge Ozalp Yuregir

    2012-02-01

    Full Text Available Prenatal diagnosis is the process of determining the health or disease status of the fetus or embryo before birth. The purpose is early detection of diseases and early intervention when required. Prenatal genetic tests comprise of cytogenetic (chromosome assessment and molecular (DNA mutation analysis tests. Prenatal testing enables the early diagnosis of many diseases in risky pregnancies. Furthermore, in the event of a disease, diagnosing prenatally will facilitate the planning of necessary precautions and treatments, both before and after birth. Upon prenatal diagnosis of some diseases, termination of the pregnancy could be possible according to the family's wishes and within the legal frameworks. [Archives Medical Review Journal 2012; 21(1.000: 80-94

  16. Stability and change in levels of depression and personality: a follow-up study of postpartum depressed mothers that were hospitalized in a mother-infant unit.

    Science.gov (United States)

    Vliegen, Nicole; Luyten, Patrick; Besser, Avi; Casalin, Sara; Kempke, Stefan; Tang, Eileen

    2010-01-01

    This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with previous research, a considerable subgroup of mothers (39%) reported moderate to severe symptoms of depression at time 2. In addition, although these mothers did not exhibit more depressive episodes during follow-up period compared with mothers with a less chronic course of depression, their depressive episodes were considerably longer, and they had higher levels of severity of depression as well as of dependency and self-criticism at Time 1. Finally, self-criticism, but not dependency, assessed at Time 1, predicted both depression diagnosis and levels of depression at follow-up, supporting a vulnerability model positing that self-criticism confers vulnerability for depression over time.

  17. Fewer self-reported depressive symptoms in young adults exposed to maternal depressed mood during pregnancy.

    Science.gov (United States)

    Zohsel, Katrin; Holz, Nathalie E; Hohm, Erika; Schmidt, Martin H; Esser, Günter; Brandeis, Daniel; Banaschewski, Tobias; Laucht, Manfred

    2017-02-01

    Depressed mood is prevalent during pregnancy, with accumulating evidence suggesting an impact on developmental outcome in the offspring. However, the long-term effects of prenatal maternal depression regarding internalizing psychopathology in the offspring are as yet unclear. As part of an ongoing epidemiological cohort study, prenatal maternal depressed mood was assessed at the child's age of 3 months. In a sample of n=307 offspring, depressive symptoms were obtained via questionnaire at the ages of 19, 22, 23 and 25 years. At age 25 years, diagnoses of depressive disorder were obtained using a diagnostic interview. In a subsample of currently healthy participants, voxel-based morphometry was conducted and amygdala volume was assessed. In n=85 young adults exposed to prenatal maternal depressed mood, no significantly higher risk for a diagnosis of depressive disorder was observed. However, they reported significantly lower levels of depressive symptoms. This association was especially pronounced when prenatal maternal depressed mood was present during the first trimester of pregnancy and when maternal mood was depressed pre- as well as postnatally. At an uncorrected level only, prenatal maternal depressed mood was associated with decreased amygdala volume. Prenatal maternal depressed mood was not assessed during pregnancy, but shortly after childbirth. No diagnoses of maternal clinical depression during pregnancy were available. Self-reported depressive symptoms do not imply increased, but rather decreased symptom levels in young adults who were exposed to prenatal maternal depressed mood. A long-term perspective may be important when considering consequences of prenatal risk factors. Copyright © 2016. Published by Elsevier B.V.

  18. “Being in a Funk”: Teens’ Efforts to Understand Their Depressive Experiences

    OpenAIRE

    Wisdom, Jennifer P.; Green, Carla A.

    2004-01-01

    Although there is literature about adults’ experiences of depression, little research has focused on teenagers’ experiences. In this article, the authors describe how a sample of adolescents makes sense of depression and responds to a depression diagnosis. Twenty-two adolescents participated in in-depth individual or focus group interviews. Teens discussed their experiences with depression and getting health care for depression, and described a trajectory similar to that found among adults: a...

  19. Quality of life, diagnosis, and treatment of patients with major depression: a prospective cohort study in primary care Qualidade de vida, diagnóstico e tratamento de pacientes com depressão maior: uma coorte prospectiva em cuidados primários

    Directory of Open Access Journals (Sweden)

    Ana Flávia Barros da Silva Lima

    2011-09-01

    Full Text Available OBJECTIVE: To describe the demographic and clinical characteristics, adequacy of antidepressant treatment, and changes in quality of life of patients with major depression receiving follow-up care from primary care centers. METHOD: A cohort study was performed in which major depression patients were followed-up over a nine-month period. Several evaluation instruments were used, including the World Health Organization Quality of Life and the Quality of Life-Depression, Centers for Epidemiologic Studies-Depression questionnaires. RESULTS: The sample comprised 179 individuals, mostly female (73%, with a mean age of 38 years and mean education of 9 years. At the end of the follow-up period, 42% of the individuals still presented with major depression, 25% had complete symptom remission, and only 9% were properly treated with antidepressants. In relation to quality of life, there were significant differences especially between baseline and after nine months in almost all measures. CONCLUSION: This study demonstrated that depressive symptoms are poorly recognized and that treatment is often inadequate for patients followed-up in primary care units in the south of Brazil. Most of the patients continued to have symptoms of depression over the nine-month period which were associated with impaired quality of life.OBJETIVO: Descrever o seguimento de usuários de serviços de cuidados primários com depressão maior em relação as suas características demográficas, clínicas, tratamento antidepressivo potencialmente adequado, assim como mudanças encontradas na qualidade de vida ao longo do acompanhamento. MÉTODO: Foi realizado um estudo de coorte, no qual os sujeitos com depressão maior foram acompanhados ao longo de nove meses. Foram incluídas diversas medidas de avaliação, como World Health Organization Quality of Life, Quality of Life-Depression, Centers for Epidemiologic Studies-Depression Instrument, entre outras. RESULTADOS: A amostra foi

  20. Falls and depression in older people.

    Science.gov (United States)

    Turcu, Alin; Toubin, Sandrine; Mourey, France; D'Athis, Philippe; Manckoundia, Patrick; Pfitzenmeyer, Pierre

    2004-01-01

    Depression is one of the most common risk factors for falls, but links between falls and depression are still unclear. Few studies have examined the relationship between depression and gait alteration, which may increase the risk of fall. This study aims to assess a possible relationship between depression, postural and gait abnormalities, and falls. We conducted a 1-year prospective study on patients >/=70 years who were admitted to a geriatric unit for 'spontaneous' unexplained falls. Patients were tested for depression using the 30-item Geriatric Depression Scale (GDS). Their motor performances were assessed using the Mini Motor Test (MMT), which is an easy direct-observation test, validated in France, for assessment of frail old people who present with severe postural and gait impairment. This scale is composed of 4 categories of items: (1) abilities in bed; (2) quality of the sitting position; (3) abilities in the standing position, and (4) quality of gait. Sixty-nine patients were included. Depression was found in 46 patients (66.7%). The MMT score was higher in the non-depressed fallers (NDF) group (GDS 10; p predispose to falls. In clinical practice, more attention should be given to old fallers concerning diagnosis and treatment of associated depression. Copyright 2004 S. Karger AG, Basel

  1. SARS - Diagnosis

    Indian Academy of Sciences (India)

    SARS - Diagnosis. Mainly by exclusion of known causes of atypical pneumonia; * X ray Chest; * PCR on body fluids- primers defined by WHO centres available from website.-ve result does not exclude SARS. * Sequencing of amplicons; * Viral Cultures – demanding; * Antibody tests.

  2. 32 CFR 536.93 - Claims not payable under the Non-Scope Claims Act.

    Science.gov (United States)

    2010-07-01

    ... agent or employee. The doctrine of comparative negligence does not apply. (b) Is for medical, hospital... recoverable by the claimant under an indemnifying law or indemnity contract. If the claim is in part legally...

  3. Masked depression: its interrelations with somatization, hypochondriasis and conversion.

    Science.gov (United States)

    Fisch, R Z

    1987-01-01

    Masked depression appears to be a common clinical phenomenon. Most depressions present with some somatic complaints in addition to affective and cognitive ones. About one half of all depressions seen by primary care physicians initially present predominantly or exclusively with somatic symptoms. Many of these depressions are not recognized or are misdiagnosed and mistreated. The possible reasons for this are discussed here. The phenomenon of somatization in depressions and other conditions is reviewed and the interface with other related clinical problems like hypochondriasis and conversion is delineated. It is hypothesized that the proportion of depressions that are masked is positively correlated to the patients' tendency to somatize and negatively correlated to the doctors' ability to recognize depressions that hide behind somatic complaints. Suggestions for the diagnosis and treatment of masked depressions are given.

  4. Sensitivity and specificity of the Major Depression Inventory in outpatients

    Directory of Open Access Journals (Sweden)

    Noteboom Annemieke

    2007-08-01

    Full Text Available Abstract Background The Major Depression Inventory (MDI is a new, brief, self-report measure for depression based on the DSM-system, which allows clinicians to assess the presence of a depressive disorder according to the DSM-IV, but also to assess the severity of the depressive symptoms. Methods We examined the sensitivity, specificity, and psychometric qualities of the MDI in a consecutive sample of 258 psychiatric outpatients. Of these patients, 120 had a mood disorder (70 major depression, 49 dysthymia. A total of 139 subjects had a comorbid axis-I diagnosis, and 91 subjects had a comorbid personality disorder. Results Crohnbach's alpha of the MDI was a satisfactory 0.89, and the correlation between the MDI and the depression subscale of the SCL-90 was 0.79 (p Conclusion The MDI is an attractive, brief depression inventory, which seems to be a reliable tool for assessing depression in psychiatric outpatients.

  5. Determinants of Depression in the ECLIPSE COPD Cohort

    DEFF Research Database (Denmark)

    Hanania, Nicola A; Müllerova, Hana; Locantore, Nicholas W

    2010-01-01

    RATIONALE: Depression is prevalent in patients with chronic obstructive pulmonary disease (COPD); however, its etiology and relationship to the clinical features of COPD are not well understood. Using data from a large cohort, we explored prevalence and determinants of depression in subjects...... the Center for Epidemiologic Studies of Depression Scale (CES-D). For the purposes of this analysis, depression was defined as a CES-D score of 16 and higher which reflects a high load of depressive symptoms and has a good correspondence with a clinical diagnosis of major depression. RESULTS: The study...... cohort consisted of 2118 subjects with COPD, 335 smokers without COPD (smokers) and 243 non-smokers without COPD (non-smokers). Twenty-six percent, 12% and 7% of COPD, smokers and non-smokers, respectively, suffered from depression. In subjects with COPD, higher depression prevalence was seen in females...

  6. A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole.

    Science.gov (United States)

    Hinz, Marty; Stein, Alvin; Uncini, Thomas

    2010-11-09

    A novel method for differentiating and treating bipolar disorder cycling on the depressive pole from patients who are suffering a major depressive episode is explored in this work. To confirm the diagnosis of type 1 or type 2 bipolar disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria require that at least one manic or hypomanic episode be identified. History of one or more manic or hypomanic episodes may be impossible to obtain, representing a potential blind spot in the DSM-IV diagnostic criteria. Many bipolar patients who cycle primarily on the depressive side for many years carry a misdiagnosis of recurrent major depression, leading to treatment with antidepressants that achieve little or no relief of symptoms. This article discusses a novel approach for diagnosing and treating patients with bipolar disorder cycling on the depressive pole versus patients with recurrent major depression. Patients involved in this study were formally diagnosed with recurrent major depression under DSM-IV criteria and had no medical history of mania or hypomania to support the diagnosis of bipolar disorder. All patients had suffered multiple depression treatment failures in the past, when evaluated under DSM-IV guidelines, secondary to administration of antidepressant drugs and/or serotonin with dopamine amino acid precursors. This study contained 1600 patients who were diagnosed with recurrent major depression under the DSM-IV criteria. All patients had no medical history of mania or hypomania. All patients experienced no relief of depression symptoms on level 3 amino acid dosing values of the amino acid precursor dosing protocol. Of 1600 patients studied, 117 (7.3%) nonresponder patients were identified who experienced no relief of depression symptoms when the serotonin and dopamine amino acid precursor dosing values were adjusted to establish urinary serotonin and urinary dopamine levels in the Phase III therapeutic ranges. All of the 117

  7. Ultra-processed family foods in Australia: nutrition claims, health claims and marketing techniques.

    Science.gov (United States)

    Pulker, Claire Elizabeth; Scott, Jane Anne; Pollard, Christina Mary

    2018-01-01

    To objectively evaluate voluntary nutrition and health claims and marketing techniques present on packaging of high-market-share ultra-processed foods (UPF) in Australia for their potential impact on public health. Cross-sectional. Packaging information from five high-market-share food manufacturers and one retailer were obtained from supermarket and manufacturers' websites. Ingredients lists for 215 UPF were examined for presence of added sugar. Packaging information was categorised using a taxonomy of nutrition and health information which included nutrition and health claims and five common food marketing techniques. Compliance of statements and claims with the Australia New Zealand Food Standards Code and with Health Star Ratings (HSR) were assessed for all products. Almost all UPF (95 %) contained added sugars described in thirty-four different ways; 55 % of UPF displayed a HSR; 56 % had nutrition claims (18 % were compliant with regulations); 25 % had health claims (79 % were compliant); and 97 % employed common food marketing techniques. Packaging of 47 % of UPF was designed to appeal to children. UPF carried a mean of 1·5 health and nutrition claims (range 0-10) and 2·6 marketing techniques (range 0-5), and 45 % had HSR≤3·0/5·0. Most UPF packaging featured nutrition and health statements or claims despite the high prevalence of added sugars and moderate HSR. The degree of inappropriate or inaccurate statements and claims present is concerning, particularly on packaging designed to appeal to children. Public policies to assist parents to select healthy family foods should address the quality and accuracy of information provided on UPF packaging.

  8. Helping your teen with depression

    Science.gov (United States)

    Teen depression - helping; Teen depression - talk therapy; Teen depression - medicine ... teen the most. The most effective treatments for depression are: Talk therapy Antidepressant medicines If your teen ...

  9. Comparison of escitalopram versus citalopram for the treatment of major depressive disorder in a geriatric population.

    Science.gov (United States)

    Wu, Eric; Greenberg, Paul E; Yang, Elaine; Yu, Andrew; Erder, M Haim

    2008-09-01

    To compare escitalopram versus citalopram for the treatment of major depressive disorder (MDD) in geriatric patients. Administrative claims data (2003-2005) were analyzed for patients aged > or =65 years with at least one inpatient claim or two independent medical claims associated with MDD diagnosis. Patients were continuously enrolled for at least 12 months, filled at least one prescription for citalopram or escitalopram and had no second generation antidepressant use during the 6-month pre-index date. Contingency table analysis and survival analysis were used to compare outcomes between the two treatment groups. Treatment persistence, hospitalization utilization, and prescription drug, medical, and total healthcare costs were analyzed. Outcomes were compared between patients initiated on escitalopram and those initiated on citalopram both descriptively and using multivariate analysis adjusting for baseline characteristics. Among 691 geriatric patients, escitalopram-treated patients (n=459) were less likely to discontinue treatment (hazard ratio [HR]=0.83, p=0.049) or switch to another second generation antidepressant (HR=0.62, p=0.001) compared to patients treated with citalopram (n=232). Patients treated with escitalopram had a significantly lower hospitalization rate (31.2% vs. 38.8%, p=0.045) and 66% fewer hospitalization days based on negative binomial regression (pescitalopram patients had comparable prescription drug costs, they had lower total medical service costs (regression: $9748 vs. $19,208, pescitalopram had better treatment persistence, fewer hospitalizations, and lower medical and total healthcare costs than patients treated with citalopram. Most of the cost reduction was attributable to significantly lower hospitalizations and total medical costs.

  10. Depressive symptoms in youth with type 1 or type 2 diabetes: Results of the Pediatric Diabetes Consortium screening assessment of depression in diabetes study

    Science.gov (United States)

    To evaluate the frequency of depressive symptoms and the diagnosis and management of depression in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium T1D and T2D registries. The Children's Depression Inventory (CDI) 2 Self-Report (Short) version ...

  11. The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression.

    Directory of Open Access Journals (Sweden)

    Chi Ming Leung

    Full Text Available Bipolar II (BP-II depression is often misdiagnosed as unipolar (UP depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8% were males and 233 (78.2% females. There were 112 (37.6% subjects with BP depression [BP-I = 42 (14.1%, BP-II = 70 (23.5%] and 182 (62.4% with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results.

  12. Birth dimensions and risk of depression in adulthood

    DEFF Research Database (Denmark)

    Osler, Merete; Nordentoft, Merete; Andersen, Anne-Marie Nybo

    2005-01-01

    of depression. RESULTS: A total of 190 men, corresponding to 1.8% of the cohort, had a discharge diagnosis of depression. The Cox's regression analyses failed to show any association between birth dimensions (birth weight and ponderal index) and risk of psychiatric ward diagnosis of depression in adult life......, before or after adjustment for social indicators at birth. CONCLUSIONS: This study does not support the existence of a relation between birth dimensions and psychiatric ward admission for depression in adult men.......BACKGROUND: Two British cohort studies have reported birth weight to be associated with self-reported depression in adulthood, even after adjustment for socio-economic factors. AIMS: To examine the relationship between birth dimensions and discharge from a psychiatric ward with a depression...

  13. 76 FR 16804 - Alaska Native Claims Selection

    Science.gov (United States)

    2011-03-25

    ... DEPARTMENT OF THE INTERIOR Bureau of Land Management [AA-8102-05, AA-8102-08, AA-8102-10, AA-8102-25, AA-8102-28, AA-8102- 37, AA-8102-47; LLAK965000-L14100000-KC0000-P] Alaska Native Claims... phone at 907-271-5960, by e-mail at ak[email protected] , or by telecommunication device (TTD...

  14. Rights as entitlements and rights as claims

    Directory of Open Access Journals (Sweden)

    Azevedo, Marco Antônio Oliveira de

    2010-01-01

    Full Text Available Há pelo menos dois registros diferentes sobre o significado de “direitos”. Segundo um deles, os direitos são relações entre dois termos: uma pessoa e um bem; para o outro, os direitos são relações entre três termos: um indivíduo, uma pessoa e uma ação ou algo. Os registros são diferentes, mas não são totalmente incompatíveis. De acordo com a interpretação de direitos como entitlements, trata-se de direitos morais ou legais, ou seja, as relações de ordem moral ou jurídica das pessoas com bens (de benefícios concedidos a pessoas por uma lei humana, moral ou legal. Como uma espécie de direitos, os direitos humanos são vistos como direitos (entitlements das pessoas ou dos indivíduos a bens essenciais, dos quais podem-se inferir reivindicações (claims contra outras pessoas ou contra governos e representantes. Falamos sobre direitos humanos geralmente desta forma. Mas de acordo com o outro registro, os direitos em sentido próprio têm que ser interpretados como claims. Neste artigo, pretendo apresentar alguns argumentos em favor da vantagem de expor todos os enunciados significativos dos direitos como entitlements em termos explícitos de claims

  15. Electronic Health Record-Related Events in Medical Malpractice Claims.

    Science.gov (United States)

    Graber, Mark L; Siegal, Dana; Riah, Heather; Johnston, Doug; Kenyon, Kathy

    2015-11-06

    There is widespread agreement that the full potential of health information technology (health IT) has not yet been realized and of particular concern are the examples of unintended consequences of health IT that detract from the safety of health care or from the use of health IT itself. The goal of this project was to obtain additional information on these health IT-related problems, using a mixed methods (qualitative and quantitative) analysis of electronic health record-related harm in cases submitted to a large database of malpractice suits and claims. Cases submitted to the CRICO claims database and coded during 2012 and 2013 were analyzed. A total of 248 cases (<1%) involving health IT were identified and coded using a proprietary taxonomy that identifies user- and system-related sociotechnical factors. Ambulatory care accounted for most of the cases (146 cases). Cases were most typically filed as a result of an error involving medications (31%), diagnosis (28%), or a complication of treatment (31%). More than 80% of cases involved moderate or severe harm, although lethal cases were less likely in cases from ambulatory settings. Etiologic factors spanned all of the sociotechnical dimensions, and many recurring patterns of error were identified. Adverse events associated with health IT vulnerabilities can cause extensive harm and are encountered across the continuum of health care settings and sociotechnical factors. The recurring patterns provide valuable lessons that both practicing clinicians and health IT developers could use to reduce the risk of harm in the future. The likelihood of harm seems to relate more to a patient's particular situation than to any one class of error.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share thework provided it is properly cited. The work cannot be changed in any way or used

  16. Depression and Anxiety Disorders among Hospitalized Women with Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Neomi Vin-Raviv

    Full Text Available To document the prevalence of depression and anxiety disorders, and their associations with mortality among hospitalized breast cancer patients.We examined the associations between breast cancer diagnosis and the diagnoses of anxiety or depression among 4,164 hospitalized breast cancer cases matched with 4,164 non-breast cancer controls using 2006-2009 inpatient data obtained from the Nationwide Inpatient Sample database. Conditional logistic regression models were used to compute odds ratios (ORs and 95% confidence intervals (CI for the associations between breast cancer diagnosis and diagnoses of anxiety or depression. We also used binary logistic regression models to examine the association between diagnoses of depression or anxiety, and in-hospital mortality among breast cancer patients.We observed that breast cancer cases were less likely to have a diagnosis of depression (OR=0.63, 95% CI: 0.52-0.77, and less likely to have a diagnosis of anxiety (OR=0.68, 95% CI: 0.52-0.90 compared with controls. This association remained after controlling for race/ethnicity, residential income, insurance and residential region. Breast cancer patients with a depression diagnosis also had lower mortality (OR=0.69, 95% CI: 0.52-0.89 compared with those without a depression diagnosis, but there was no significant difference in mortality among those with and without anxiety diagnoses.Diagnoses of depression and anxiety in breast cancer patients were less prevalent than expected based on our analysis of hospitalized breast cancer patients and matched non-breast cancer controls identified in the NIS dataset using ICD-9 diagnostic codes. Results suggest that under-diagnosis of mental health problems may be common among hospitalized women with a primary diagnosis of breast cancer. Future work may fruitfully explore reasons for, and consequences of, inappropriate identification of the mental health needs of breast cancer patients.

  17. Studying depression using imaging and machine learning methods

    OpenAIRE

    Patel, Meenal J.; Khalaf, Alexander; Aizenstein, Howard J.

    2015-01-01

    Depression is a complex clinical entity that can pose challenges for clinicians regarding both accurate diagnosis and effective timely treatment. These challenges have prompted the development of multiple machine learning methods to help improve the management of this disease. These methods utilize anatomical and physiological data acquired from neuroimaging to create models that can identify depressed patients vs. non-depressed patients and predict treatment outcomes. This article (1) presen...

  18. 12 CFR 793.3 - Administrative claim; who may file.

    Science.gov (United States)

    2010-01-01

    ... authorized agent, or his legal representative. (c) A claim based on death may be presented by the executor or... accompanied by evidence of his authority to present a claim on behalf of the claimant as agent, executor...

  19. 25 CFR 11.707 - Claims against estate.

    Science.gov (United States)

    2010-04-01

    ... executor or administrator within 60 days from official notice of the appointment of the executor or... appropriate notice for the filing of claims. (b) The executor or administrator shall examine all claims within...

  20. 40 CFR 10.3 - Administrative claims; who may file.

    Science.gov (United States)

    2010-07-01

    ...) A claim based on death may be presented by the executor or administrator of the decedent's estate or... to present a claim on behalf of the claimant as agent, executor, administrator, parent, guardian, or...

  1. 24 CFR 17.3 - Administrative claim; who may file.

    Science.gov (United States)

    2010-04-01

    ... representative. (c) A claim based on death may be presented by the executor or administrator of the decedent's... evidence of his authority to present a claim on behalf of the claimant as agent, executor, administrator...

  2. 29 CFR 15.3 - Administrative claim; who may file.

    Science.gov (United States)

    2010-07-01

    ... representative. (c) A claim for death may be presented by the executor or administrator of the decedent's estate... her authority to present a claim on behalf of the claimant as agent, executor, administrator, parent...

  3. 37 CFR 360.14 - Copies of claims.

    Science.gov (United States)

    2010-07-01

    ... Section 360.14 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Satellite... royalty fees. ...

  4. 32 CFR 750.10 - Claims: Settlement and release.

    Science.gov (United States)

    2010-07-01

    ... amount in full settlement and final satisfaction of the claim. In the latter instance, no payment will be... employee of the Government whose act or omission gave rise to the claim. [57 FR 4722, Feb. 7, 1992, as...

  5. 32 CFR 536.22 - Claims investigative responsibility-General.

    Science.gov (United States)

    2010-07-01

    ... involving serious injury or death or those in which property damage exceeds $50,000. A command claims... forwarded to the Commander USARCS. (d) Geographic concept of responsibility. A command claims service or an...

  6. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...

  7. 28 CFR 543.32 - Processing the claim.

    Science.gov (United States)

    2010-07-01

    ..., Central Office for their review. (f) Will appreciation or depreciation be considered? Yes. Staff will consider appreciation or depreciation of lost or damaged property in settling a claim. (g) If my claim is...

  8. 40 CFR 1620.3 - Administrative claim; who may file.

    Science.gov (United States)

    2010-07-01

    ...) A claim based on death may be presented by the executor or administrator of the decedent's estate... that the basis for the representation is documented in writing. (d) A claim for loss totally...

  9. Depression in Down Syndrome: A Review of the Literature

    Science.gov (United States)

    Walker, J. C.; Dosen, A.; Buitelaar, J. K.; Janzing, J. G. E.

    2011-01-01

    Background: Depression has been frequently reported in individuals with Down Syndrome (DS). The aim of this article is to provide a comprehensive, critical review of the clinically relevant literature concerning depression in DS, with a focus on epidemiology, potential risk factors, diagnosis, course characteristics and treatment. Methods: We…

  10. Relationship between quality of life and postpartum depression ...

    African Journals Online (AJOL)

    The Edinburgh Postnatal Depression Scale (EPDS), the World Health Organization Quality of Life-BREF-26 (WHOQoL-BREF-26) questionnaire and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis (SCID) were used. Results: The studied participants were 531 out which 21.8% with ...

  11. Prevalence of depression and socio-demographic characteristics of ...

    African Journals Online (AJOL)

    Background information: Various studies across the world have shown that depression is of high prevalence among people living with HIV/AIDS (PLWHA), and that it has lots of adverse effects on them. Diagnosis of depression among this group of people is however still very low in sub-Sahara Africa, particularly at primary ...

  12. Depressive scores in newly diagnosed HIV-infected and HIV ...

    African Journals Online (AJOL)

    Background: Prevalence rates of HIV infection in KwaZulu-Natal are high, with a significant amount of those infected being women of reproductive age. A diagnosis of HIV infection has been associated with an increased risk for the development of depression. Antenatal depression is a serious health concern, having the ...

  13. Postpartum Depression Among Igbo Women In An Urban Mission ...

    African Journals Online (AJOL)

    Context: Postpartum depression adversely affects mothers, their newborn infants, their partners and the society. Its timely diagnosis is highly desirable. Objective: To assess the prevalence and associated sociodemographic variables of Postpartum depression among women of Igbo Ethnic origin attending an urban mission ...

  14. The prevalence of depression in hereditary spastic paraplegia.

    Science.gov (United States)

    Vahter, L; Braschinsky, M; Haldre, S; Gross-Paju, K

    2009-09-01

    To evaluate the prevalence of depression and sensitivity and specificity of the single-item interview 'Are you depressed?' for people with hereditary spastic paraplegia in Estonia. Single-item interview 'Are you depressed?' was used as a screening question for depression; all participants then completed the Beck Depression Inventory. People with hereditary spastic paraplegia identified from the epidemiological database who agreed to participate in the study. Beck Depression Inventory, clinical interview. The epidemiological database consisted of 59 patients with clinically confirmed diagnosis of hereditary spastic paraplegia. Forty-eight of these consented to participate in the study. The Beck Depression Inventory score was higher than cut-off point in 58% (28/48) and lower in 42% (20/48). Of the study group, 44% (21/48) had mild, 13% (6/48) moderate and one person revealed severe depression. There was a statistically significant correlation between Beck Depression Inventory score and level of mobility; no other significant correlations with other measures were detected. Of the participants, 54% (26/48) had subjective complaints about depression and answered 'Yes' to the single-item interview 'Are you depressed?'. The sensitivity of the one-item interview in the hereditary spastic paraplegia group was 75% and specificity 75%. Our results show that mild depression is prevalent among people with hereditary spastic paraplegia. Although the single question may be helpful, it cannot be relied upon entirely when assessing a person for depression.

  15. Predicting Consumer Effort in Finding and Paying for Health Care: Expert Interviews and Claims Data Analysis.

    Science.gov (United States)

    Long, Sandra; Monsen, Karen A; Pieczkiewicz, David; Wolfson, Julian; Khairat, Saif

    2017-10-12

    For consumers to accept and use a health care information system, it must be easy to use, and the consumer must perceive it as being free from effort. Finding health care providers and paying for care are tasks that must be done to access treatment. These tasks require effort on the part of the consumer and can be frustrating when the goal of the consumer is primarily to receive treatments for better health. The aim of this study was to determine the factors that result in consumer effort when finding accessible health care. Having an understanding of these factors will help define requirements when designing health information systems. A panel of 12 subject matter experts was consulted and the data from 60 million medical claims were used to determine the factors contributing to effort. Approximately 60 million claims were processed by the health care insurance organization in a 12-month duration with the population defined. Over 292 million diagnoses from claims were used to validate the panel input. The results of the study showed that the number of people in the consumer's household, number of visits to providers outside the consumer's insurance network, number of adjusted and denied medical claims, and number of consumer inquiries are a proxy for the level of effort in finding and paying for care. The effort level, so measured and weighted per expert panel recommendations, differed by diagnosis. This study provides an understanding of how consumers must put forth effort when engaging with a health care system to access care. For higher satisfaction and acceptance results, health care payers ideally will design and develop systems that facilitate an understanding of how to avoid denied claims, educate on the payment of claims to avoid adjustments, and quickly find providers of affordable care. ©Sandra Long, Karen A. Monsen, David Pieczkiewicz, Julian Wolfson, Saif Khairat. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 12.10.2017.

  16. Postpartum Depression - Multiple Languages

    Science.gov (United States)

    ... Русский (Russian) Bilingual PDF Health Information Translations Postpartum Depression - English PDF Postpartum Depression - Русский (Russian) PDF Postpartum Depression - English MP3 ...

  17. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

  18. Recognizing teen depression

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000648.htm Recognizing teen depression To use the sharing features on this page, ... life. Be Aware of the Risk for Teen Depression Your teen is more at risk for depression ...

  19. Sadness and Depression

    Science.gov (United States)

    ... Videos for Educators Search English Español Sadness and Depression KidsHealth / For Kids / Sadness and Depression Print en ... big difference in your life. When Sadness Is Depression When you're in a sad mood, it ...

  20. Postpartum Depression Facts

    Science.gov (United States)

    ... Where can I find more information? Share Postpartum Depression Facts Download PDF Download ePub Download Mobi Order ... for herself or her family. What is postpartum depression? Postpartum depression is a mood disorder that can ...

  1. Depression and College Students

    Science.gov (United States)

    ... depression and other mental health issues? Reference Share Depression and College Students Download PDF Download ePub Order ... Answers to college students’ frequently asked questions about depression Feeling moody, sad, or grouchy? Who doesn’t ...

  2. Repeat workers' compensation claims: risk factors, costs and work disability

    Science.gov (United States)

    2011-01-01

    Background The objective of our study was to describe factors associated with repeat workers' compensation claims and to compare the work disability arising in workers with single and multiple compensation claims. Methods All initial injury claims lodged by persons of working age during a five year period (1996 to 2000) and any repeat claims were extracted from workers' compensation administrative data in the state of Victoria, Australia. Groups of workers with single and multiple claims were identified. Descriptive analysis of claims by affliction, bodily location, industry segment, occupation, employer and workplace was undertaken. Survival analysis determined the impact of these variables on the time between the claims. The economic impact and duration of work incapacity associated with initial and repeat claims was compared between groups. Results 37% of persons with an initial claim lodged a second claim. This group contained a significantly greater proportion of males, were younger and more likely to be employed in manual occupations and high-risk industries than those with single claims. 78% of repeat claims were for a second injury. Duration between the claims was shortest when the working conditions had not changed. The initial claims of repeat claimants resulted in significantly (p claims. Conclusions A substantial proportion of injured workers experience a second occupational injury or disease. These workers pose a greater economic burden than those with single claims, and also experience a substantially greater cumulative period of work disability. There is potential to reduce the social, health and economic burden of workplace injury by enacting prevention programs targeted at these workers. PMID:21696637

  3. Observer-rated depression in long-term care: frequency and risk factors.

    Science.gov (United States)

    McCusker, Jane; Cole, Martin G; Voyer, Philippe; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Vu, Minh; Dyachenko, Alina; Belzile, Eric

    2014-01-01

    The objectives of this study were: (1) to describe the prevalence and 6-month incidence of observer-rated depression in residents age 65 and over of long-term care (LTC) facilities; (2) to describe risk factors for depression, at baseline and over time. A multisite, prospective observational study was conducted in residents aged 65 and over of 7 LTC facilities. The Cornell Scale for Depression in Dementia (CSDD) was completed by nurses monthly for 6 months. We measured demographic, medical, and functional factors at baseline and monthly intervals, using data from research assessments, nurse interviews, and chart reviews. 274 residents were recruited and completed baseline depression assessments. The prevalence of depression (CSDD score of 6+) was 19.0%. The incidence of depression among those without prevalent depression was 73.3 per 100 person-years. A delirium diagnosis, pain, and diabetes were independently associated with prevalent depression. CSDD score at baseline and development of severe cognitive impairment at follow-up were independent risk factors for incident depression. A diagnosis of delirium and uncorrected visual impairment at follow-up occurred concurrently with incident depression. The results of this study have implications for the detection and prevention of depression in LTC. Delirium diagnosis, pain and diabetes at baseline were associated with prevalent depression; depression symptoms at baseline and development of severe cognitive impairment at follow-up were risk factors for incident depression. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. [Frequency of depression in patients with diabetes mellitus type 2].

    Science.gov (United States)

    Garduño-Espinosa, J; Téllez-Zenteno, J F; Hernández-Ronquillo, L

    1998-01-01

    To determine the prevalence of depression in Mexican adult diabetics and to identify factors associated to the depression. Prolective survey. Four Mexico City hospitals (Clinica San Pedro de los Pinos IMSS, Centro Medico Nacional Siglo XXI IMSS, Hospital Gea González SSa and Centro de Salud Margarita Chorne SSa). 79 patients with diabetes mellitus type 2. The Beck Depression Inventory was used as a measure of depression. We used sociodemographic variables (age, gender, marital status, religion, education, occupation, socioeconomic status) and disease variables (years of diagnosis, other chronic medical conditions and compliance with therapeutic regimens) as the independent variables of depression. Mean age was 59 +/- 11 years (SD) and 58 (73%) were females. The frequency of depression was 46%. Factors associated to depression were: females (OR = 3.67, CI = 1.07-13.3, p = 0.03) and years of diagnosis above 15 (OR = 3.08, CI = 0.91-10.8, p = 0.07). Frequency of depression was high (46%). Gender and years of diabetes diagnosis were factors associated to depression.

  5. 28 CFR 104.31 - Procedure for claims evaluation.

    Science.gov (United States)

    2010-07-01

    ... COMPENSATION FUND OF 2001 Claim Intake, Assistance, and Review Procedures § 104.31 Procedure for claims..., described herein as “Track A” and “Track B,” selected by the claimant on the Personal Injury Compensation Form or Death Compensation Form. (1) Procedure for Track A. The Claims Evaluator shall determine...

  6. Evaluation of Modified Risk Claim Advertising Formats for Camel Snus

    Science.gov (United States)

    Fix, Brian V.; Adkison, Sarah E.; O'Connor, Richard J.; Bansal-Travers, Maansi; Cummings, K. Michael; Rees, Vaughan W.; Hatsukami, Dorothy K.

    2017-01-01

    Objectives: The US Food and Drug Administration (FDA) has regulatory authority for modified risk tobacco product advertising claims. To guide future regulatory efforts, we investigated how variations in modified risk claim advertisements influence consumer perceptions of product risk claims for Camel Snus. Methods: Young people and adults (15-65),…

  7. 33 CFR 211.22 - Real estate Claims Officers.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Real estate Claims Officers. 211..., DEPARTMENT OF DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Real Estate Claims § 211.22 Real estate Claims Officers. In each Division Office the Division...

  8. 48 CFR 33.208 - Interest on claims.

    Science.gov (United States)

    2010-10-01

    ... otherwise would be due, if that date is later, until the date of payment. (b) Simple interest on claims... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Interest on claims. 33.208... REQUIREMENTS PROTESTS, DISPUTES, AND APPEALS Disputes and Appeals 33.208 Interest on claims. (a) The Government...

  9. 32 CFR 842.6 - Signature on the claim form.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Signature on the claim form. 842.6 Section 842.6... ADMINISTRATIVE CLAIMS General Information § 842.6 Signature on the claim form. The claimant or authorized agent... authorized agent signing for a claimant shows, after the signature, the title or capacity and attaches...

  10. 27 CFR 70.608 - Action on claims.

    Science.gov (United States)

    2010-04-01

    ... Section 70.608 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... appropriate TTB officer shall date stamp and examine each claim filed under this subpart and will determine the validity of the claim. Claims and supporting data involving customs duties will be forwarded to...

  11. 32 CFR 842.76 - Filing a claim.

    Science.gov (United States)

    2010-07-01

    ... by a demand for money damages in a sum certain. A claim incorrectly presented to the Air Force will... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE CLAIMS AND LITIGATION ADMINISTRATIVE.... A claim has been filed when a federal agency receives from a claimant or the claimant's duly...

  12. 32 CFR 842.24 - Filing a claim.

    Science.gov (United States)

    2010-07-01

    ... properly completed AF Form 180, DD Form 1842 or other written and signed demand for a specified sum of money. (b) Amending a claim. A claimant may amend a claim at any time prior to the expiration of the... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE CLAIMS AND LITIGATION ADMINISTRATIVE...

  13. 32 CFR 842.46 - Who may file a claim.

    Science.gov (United States)

    2010-07-01

    ... authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any other persons legally entitled to do so under applicable local law may file claims for minors' personal... action surviving an individual's death. (e) Insurers with subrogation rights may file claims for losses...

  14. 13 CFR 142.3 - What is a claim?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is a claim? 142.3 Section 142.3 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Overview and Definitions § 142.3 What is a claim? (a) Claim means any request, demand, or...

  15. 31 CFR 360.29 - Adjudication of claims.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Adjudication of claims. 360.29 Section 360.29 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... the ordinary course of business. (b) Claims filed 10 years after payment. Any claim filed 10 years or...

  16. 16 CFR 260.7 - Environmental marketing claims.

    Science.gov (United States)

    2010-01-01

    ... pieces if left uncovered in sunlight.” The claim is supported by competent and reliable scientific... sunlight and into sufficiently small pieces to become part of the soil. The qualified claim is not... time. The claim is not deceptive. Example 4: A plastic six-pack ring carrier is marked with a small...

  17. 27 CFR 70.123 - Claims for credit or refund.

    Science.gov (United States)

    2010-04-01

    ..., documentary evidence to establish the legal authority of the fiduciary need not accompany the claim, provided... necessary documentary evidence should accompany the claim. A claim may be executed by an agent of the person... Office of Management and Budget under control number 1512-0141) (26 U.S.C. 6402) [T.D. ATF-251, 52 FR...

  18. A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole

    OpenAIRE

    Hinz, Marty; Stein, Alvin; Uncini, Thomas

    2010-01-01

    Marty Hinz1, Alvin Stein2, Thomas Uncini31Clinical Research, NeuroResearch Clinics, Inc., Cape Coral, FL, USA; 2Stein Orthopedic Associates, Plantation, FL, USA; 3DBS Labs, Duluth, MN, USAPurpose: A novel method for differentiating and treating bipolar disorder cycling on the depressive pole from patients who are suffering a major depressive episode is explored in this work. To confirm the diagnosis of type 1 or type 2 bipolar disorder, the Diagnostic and Statistical Manual of Mental Disorder...

  19. Reiki for depression and anxiety.

    Science.gov (United States)

    Joyce, Janine; Herbison, G Peter

    2015-04-03

    Anxiety and depression affect many people. Treatments do not have complete success and often require people to take drugs for long periods of time. Many people look for other treatments that may help. One of those is Reiki, a 2500 year old treatment described as a vibrational or subtle energy therapy, and is most commonly facilitated by light touch on or above the body. There have been reports of Reiki alleviating anxiety and depression, but no specific systematic review. To assess the effectiveness of Reiki for treating anxiety and depression in people aged 16 and over. Search of the Cochrane Register of Controlled Trials (CENTRAL - all years), the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR - all years), EMBASE, (1974 to November 2014), MEDLINE (1950 to November 2014), PsycINFO (1967 to November 2014) and AMED (1985 to November 2014). Additional searches were carried out on the World Health Organization Trials Portal (ICTRP) together with ClinicalTrials.gov to identify any ongoing or unpublished studies. All searches were up to date as of 4 November 2014. Randomised trials in adults with anxiety or depression or both, with at least one arm treated with Reiki delivered by a trained Reiki practitioner. The two authors independently decided on inclusion/exclusion of studies and extracted data. A prior analysis plan had been specified but was not needed as the data were too sparse. We found three studies for inclusion in the review. One recruited males with a biopsy-proven diagnosis of non-metastatic prostate cancer who were not receiving chemotherapy and had elected to receive external-beam radiation therapy; the second study recruited community-living participants who were aged 55 years and older; the third study recruited university students.These studies included subgroups with anxiety and depression as defined by symptom scores and provided data separately for those subgroups. As this included only 25 people with

  20. Coping and cognition in schizophrenia and depression

    NARCIS (Netherlands)

    vandenBosch, RJ; Rombouts, RP

    1997-01-01

    We examined the stable relations between coping style and cognitive function in schizophrenic and depressed patients and in patient and normal controls on two test occasions. The results show that a poor self-report of coping style is independent of psychiatric diagnosis, but there are associations

  1. Postnatal depression, oxytocin and maternal sensitivity

    NARCIS (Netherlands)

    Mah, Beth Lynette

    2015-01-01

    Intra nasal oxytocin administered to a population of mothers with a diagnosis of postnatal depression: -lowers their current mood -causes mothers to report that their infants are more difficult but their relationship with them is more positive -increases their protective response towards them in the

  2. Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression

    Science.gov (United States)

    Walton, Catherine; Kerr, Mike

    2016-01-01

    Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and…

  3. Impact of comorbid depression or anxiety on patterns of treatment and economic outcomes among patients with diabetic peripheral neuropathic pain.

    Science.gov (United States)

    Boulanger, Luke; Zhao, Yang; Foster, Talia S; Fraser, Kimberly; Bledsoe, Stacey L; Russell, Mason W

    2009-07-01

    The objective of this retrospective analysis was to assess the correlation of comorbid depression and/or anxiety to patterns of treatment, healthcare utilization, and associated costs among diabetic peripheral neuropathic pain (DPNP) patients, employing a large US administrative claims database. Patients under age 65 with commercial insurance and patients aged 65 and older with employer-sponsored Medicare supplemental insurance were selected for the study if they had at least one diagnosis of DPNP in 2005. The first observed DPNP claim was considered the 'index date.' All individuals had a 12-month pre-index and 12-month follow-up period. For both populations, two subgroups were constructed for individuals with depression and/or anxiety (DPNP-DA cohort) or without these disorders (DPNP-only cohort). Patients' demographic characteristics, clinical characteristics, and medication use were compared over the pre-index period. Healthcare expenditures and resource utilization were measured for the post-index period. Two-part models were used to examine the impact of comorbid depression and/or anxiety on healthcare utilization and costs, controlling for demographic and clinical characteristics. The study identified 11,854 DPNP-only and 1512 DPNP-DA patients in the Medicare supplemental cohort, and 11,685 and 2728 in the commercially insured cohort. Compared to DPNP-only patients over the follow-up period, a significantly higher percentage of DPNP-DA patients were dispensed pain and DPNP-related medication. All components of healthcare utilization, except home healthcare visits and physician office visits, were more likely to be provided to DPNP-DA patients versus the DPNP-only cohort (all p bias between study cohorts, mis-identification of DPNP and/or depression, and inability to assess indirect costs as well as use and cost of over-the-counter medications. These findings indicate that the healthcare costs were significantly higher for DPNP patients comorbid with

  4. Psychological characteristics of chronic depression: a longitudinal cohort study.

    Science.gov (United States)

    Wiersma, Jenneke E; van Oppen, Patricia; van Schaik, Digna J F; van der Does, A J Willem; Beekman, Aartjan T F; Penninx, Brenda W J H

    2011-03-01

    Few studies have investigated the importance of psychological characteristics for chronicity of depression. Knowledge about psychological differences between chronically depressed persons and nonchronically depressed persons may help to improve treatment of chronic depression. This is the first study to simultaneously compare in large samples various psychological characteristics between chronically depressed and nonchronically depressed adults. Baseline data were drawn from the Netherlands Study of Depression and Anxiety (NESDA), an ongoing longitudinal cohort study aimed at examining the long-term course of depressive and anxiety disorders in different health care settings and phases of illness. Participants were aged 18 to 65 years at the baseline assessment in 2004-2007 and had a current diagnosis of DSM-IV major depressive disorder (N = 1,002). Chronicity of depression was defined as being depressed for 24 months or more in the past 4 to 5 years. The chronicity criterion was fulfilled by 31% (n = 312). The NEO Five-Factor Inventory measured the 5 personality domains, the Leiden Index of Depression Sensitivity-Revised was used to measure cognitive reactivity (eg, hopelessness, rumination), and the Mastery Scale measured external locus of control. Compared to the nonchronically depressed persons, the chronically depressed persons reported significantly higher levels of neuroticism (OR = 1.81; 95% CI, 1.55-2.12; P testing these variables multivariably, the odds of chronic depression were significantly increased among those with low extraversion (OR = 0.73; 95% CI, 0.61-0.88; P = .001), high rumination (OR = 1.24; 95% CI, 1.01-1.53; P = .04), and high external locus of control (OR = 1.48; 95% CI, 1.21-1.80; P psychological characteristics for chronicity of depression. These findings provide suggestions for more specific interventions, focused on extraversion, rumination, and external locus of control, in the treatment of chronic depression. © Copyright 2011

  5. Depression and Its Measurement in Verbal Adolescents and Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Gotham, Katherine; Unruh, Kathryn; Lord, Catherine

    2015-01-01

    In a sample of 50 verbally fluent adolescents and adults with autism spectrum disorders (age: 16-31 years; verbal IQ: 72-140), we examined the pattern of response and associations between scores on common measures of depressive symptoms, participant characteristics, and clinical diagnosis of depressive disorders. Beck Depression Inventory--Second…

  6. Evaluación del Programa para la Detección, Diagnóstico y Tratamiento Integral de la Depresión en atención primaria, en Chile Evaluation of the Program for Depression Detection, Diagnosis, and Comprehensive Treatment in primary care in Chile

    Directory of Open Access Journals (Sweden)

    Rubén Alvarado

    2005-11-01

    ón en el diagnóstico clínico y el cumplimiento de los tratamientos ofrecidos.OBJECTIVE: To conduct a preliminary evaluation of the Program for Depression Detection, Diagnosis, and Comprehensive Treatment, which was developed by the Ministry of Health of Chile. MATERIAL AND METHODS: A group of women who had entered the Depression Program in eight primary care centers in three regions of Chile were monitored for three months. The initial sample was made up of 229 women, of whom 169 were able to be interviewed at the end of the three months. Sociodemographic variables, psychosocial risk factors, anxiety and somatic symptoms, and the degree of satisfaction with the care received were studied. Depressive symptoms were evaluated with the Beck Depression Inventory (BDI. The treatments prescribed for the women were also analyzed. RESULTS: The clinicians' decision to enroll the patients in the Depression Program was appropriate, with 95.2% of the women having depressive symptoms, according to the BDI. The accuracy in the clinical assessment of the severity of the symptoms was around 50%, with a tendency to underestimate the severity of the depression. The dropout rate for the women was 19.5% at the end of three months of monitoring. Those who dropped out tended to present less severe clinical symptoms (less intense anxiety and somatic symptoms, a smaller number of psychosocial risk factors, and a lower level of satisfaction with the care received. The patients showed good adherence (73.3% with the pharmacological treatment, but less with the individual psychotherapy (47.4% and the group psychotherapy (37.8%. A significant decline was seen in the intensity of the depressive symptoms by the end of the three months, with the decline being greater among the women with more serious symptoms. There was also a significant decline in anxiety and somatic symptoms. CONCLUSIONS: The preliminary evaluation indicates that the Depression Program is meeting the proposed objectives, although

  7. Determinants of Depression in the ECLIPSE COPD Cohort

    DEFF Research Database (Denmark)

    Hanania, Nicola A; Müllerova, Hana; Locantore, Nicholas W

    2010-01-01

    , current smokers and those with severe disease (GOLD-defined). Multivariate modelling of depression determinants in subjects with COPD revealed that increased fatigue, higher SGRQ-C score, younger age, female gender, history of cardiovascular disease and current smoking status were all significantly......RATIONALE: Depression is prevalent in patients with chronic obstructive pulmonary disease (COPD); however, its etiology and relationship to the clinical features of COPD are not well understood. Using data from a large cohort, we explored prevalence and determinants of depression in subjects...... the Center for Epidemiologic Studies of Depression Scale (CES-D). For the purposes of this analysis, depression was defined as a CES-D score of 16 and higher which reflects a high load of depressive symptoms and has a good correspondence with a clinical diagnosis of major depression. RESULTS: The study...

  8. A content analysis of depression-related Tweets.

    Science.gov (United States)

    Cavazos-Rehg, Patricia A; Krauss, Melissa J; Sowles, Shaina; Connolly, Sarah; Rosas, Carlos; Bharadwaj, Meghana; Bierut, Laura J

    2016-01-01

    This study examines depression-related chatter on Twitter to glean insight into social networking about mental health. We assessed themes of a random sample (n=2,000) of depression-related tweets (sent 4-11 to 5-4-14). Tweets were coded for expression of DSM-5 symptoms for Major Depressive Disorder (MDD). Supportive or helpful tweets about depression was the most common theme (n=787, 40%), closely followed by disclosing feelings of depression (n=625; 32%). Two-thirds of tweets revealed one or more symptoms for the diagnosis of MDD and/or communicated thoughts or ideas that were consistent with struggles with depression after accounting for tweets that mentioned depression trivially. Health professionals can use our findings to tailor and target prevention and awareness messages to those Twitter users in need.

  9. Clinical negligence in foot and ankle surgery: A 17-year review of claims to the NHS Litigation Authority.

    Science.gov (United States)

    Ring, J; Talbot, C L; Clough, T M

    2014-11-01

    We present a review of litigation claims relating to foot and ankle surgery in the NHS in England during the 17-year period between 1995 and 2012. A freedom of information request was made to obtain data from the NHS litigation authority (NHSLA) relating to orthopaedic claims, and the foot and ankle claims were reviewed. During this period of time, a total of 10 273 orthopaedic claims were made, of which 1294 (12.6%) were related to the foot and ankle. 1036 were closed, which comprised of 1104 specific complaints. Analysis was performed using the complaints as the denominator. The cost of settling these claims was more than £36 million. There were 372 complaints (33.7%) involving the ankle, of which 273 (73.4%) were related to trauma. Conditions affecting the first ray accounted for 236 (21.4%), of which 232 (98.3%) concerned elective practice. Overall, claims due to diagnostic errors accounted for 210 (19.0%) complaints, 208 (18.8%) from alleged incompetent surgery and 149 (13.5%) from alleged mismanagement. Our findings show that the incorrect, delayed or missed diagnosis of conditions affecting the foot and ankle is a key area for improvement, especially in trauma practice. ©2014 The British Editorial Society of Bone & Joint Surgery.

  10. Disturbances of Embodiment as Core Phenomena of Depression in Clinical Practice.

    Science.gov (United States)

    Doerr-Zegers, Otto; Irarrázaval, Leonor; Mundt, Adrian; Palette, Virginie

    2017-01-01

    This paper proposes a phenomenological approach to the diagnosis of depression, with the aim of overcoming the broadness and nonspecificity of the concept of major depressive disorder (MDD) in current systems of diagnostic classification of mental disorders. Firstly, we outline the methodological limitations of the current classification systems for the diagnosis of MDD. Secondly, we offer a conceptual differentiation between a "symptomatological" versus a "phenomenological" diagnosis of depression. Thirdly, we propose characteristic "disturbances of embodiment" as the fundamental phenomena of "core depression", which manifest themselves in 3 dimensions: embodied self, embodied intentionality, and embodied time. A more useful diagnosis of depression may be achieved by describing the phenomena that constitute a core depression, in order to avoid the overdiagnosis of MDD and its negative consequences in clinical practice. © 2017 S. Karger AG, Basel.

  11. Continued antidepressant treatment and suicide in patients with depressive disorder

    DEFF Research Database (Denmark)

    Søndergård, Lars; Lopez, Ana Garcia; Andersen, Per Kragh

    2007-01-01

    1995 to 2000, we investigated the relation between continued treatment with antidepressants and suicide in a population of all patients discharged from hospital psychiatry with a diagnosis of depressive disorder. Patients discharged from hospital psychiatry with a diagnosis of depressive disorder had...... of prescriptions. On individualized data from a cohort of patients with a known history of depressive disorder, continued antidepressant treatment was associated with reduced risk of suicide.......Antidepressant use in Denmark, as in many developed countries, has substantially increased during recent years, coinciding with a decreasing suicide rate. In a nationwide observational cohort study with linkage of registers of all prescribed antidepressants and recorded suicides in Denmark from...

  12. [Differential diagnosis in potency disorders].

    Science.gov (United States)

    Kockott, G; Dittmar, F

    1976-12-02

    Disorders of sexual libido are seldom organic, in general they are of psychological origin. It is, however, difficult to obtain a differential diagnosis. One of the first diagnostic considerations must be the establishment of primary or secondary libidinal dificit, or indeed, whether there is no libido at all. In cases of libido disorders with primary libido dificit, depression, organic disease, or side effects of pharmaca may be the cause. Libido disorders in the presence of functional libido, however, must be regarded as primarily psychologically caused. An exception are libido problems in the presence of diabetes mellitus and peripheral vasculatory defeciencies. In these cases libido is either totally absent or appears only secondarily. The symptomatology of libido disorders in the presence of depression, diabetes melitus, and peripheral vasculatory disturbancies, as well as psychologically caused erectile and ejaculatory difficulties are discussed in detail. These groups are compared with respect to libido and behavior involving erection, ejaculation, anxiety and avoidance.

  13. [Clinical study of comparing comorbidity between depression and neurological disorder with depressive disorder].

    Science.gov (United States)

    Zhang, Jing; He, Mao-Lin; Li, Shun-Wei

    2010-01-26

    To compare the clinical traits in comorbidity between depression and neurological disorder with depressive disorder and explore the characteristic of the outpatients with neurological disorder comorbidity in depression. According to Diagnosis and Statistic Manual for Mental Disorder-IV (DSM-IV) criteria, outpatients were diagnosed as depressive disorder at Departments of Neurology and Psychology. We used HAMD-17 scale to evaluate the patient's severity. There was no statistical difference in severity of depression in two groups. But the clinical traits showed significant differences between two outpatient groups: the outpatients with neurological disorder comorbidity in depression were elder, had more somatic disorders and a higher retard symptom factor score while the other are relative younger, have less physical disorders and higher the core symptom factor score on the other hand. The patients of comorbidity between depression and neurological disorders have unique clinical traits. Thus it will be helpful to improve the identification of diagnosis and choose an appropriate treatment if we know the differences well.

  14. Food claims and nutrition facts of commercial infant foods.

    Science.gov (United States)

    Koo, Yu-Chin; Chang, Jung-Su; Chen, Yi Chun

    2018-01-01

    Composition claim, nutrition claim and health claim are often found on the commercial complementary food packaging. The introduction of complementary foods (CFs) to infants is a turning point in the development of their eating behavior, and their commercial use for Taiwanese infants is growing. In Taiwan, lots of the advertisements for CFs employed health or nutrition claims to promote the products, but the actual nutritional content of these CFs is not clear. The aim of this study was to compare the food claims of commercial complementary food products with their actual nutrition facts. A sample of 363 commercial CFs was collected from websites, local supermarkets, and other food stores, and their nutrition-related claims were classified into composition, nutrition, and health categories. Although the World Health Organization recommends that infants should be exclusively breastfed for the first 6 months, 48.2% of the commercial CFs were targeted at infants younger than 6 months. Therefore, marketing regulations should be implemented to curb early weaning as a result of products targeted at infants younger than 6 months. More than 50% of Taiwanese commercial CFs have high sugar content and more than 20% were high in sodium. Products with health claims, such as "provides good nutrition to children" or "improves appetite," have higher sodium or sugar content than do those without such claims. Moreover, products with calcium or iron content claims did not contain more calcium or iron than products without such claims. Additionally, a significantly greater proportion of the products with "no added sugar" claims were classified as having high sugar content as compared to those without such claims. Parents cannot choose the healthiest food products for their children by simply focusing on food claims. Government should regulate the labeling of nutrition facts and food claims for foods targeted at infants younger than 12 months.

  15. Global Warming: Claims, Science, and Consequences

    Science.gov (United States)

    Gould, Laurence I.

    2007-04-01

    Widespread (and seemingly dominant) claims about the dire consequences of anthropogenic global warming (AGW) have been propagated by both scientists and politicians and have been prominently featured by much of the mass media. This talk will examine some of those claims --- such as those made in the popular pro-AGW film, An Inconvenient Truth^1 --- from the perspectives of science^2 and scientific methodology^3. Some of the issues considered will be: What are the major ``greenhouse gases''? To what extent is global warming a result of human influences through an increase of ``greenhouse gases''? Is an increase in (1) global temperature and (2) carbon dioxide bad/good? What are some meanings that can be given to the term ``consensus'' in science? What are the estimated financial and other costs of governments implementing the Kyoto accords? Links to readings and videos will be given at the conclusion of the talk. ^1Gore, Al, An Inconvenient Truth: The Planetary Emergency of Global Warming and What We Can Do About It -- (Rodale Press, May, 2006). ^2Marlo Lewis, ``A Skeptic's Guide to An Inconvenient Truth'' http://www.cei.org/pages/aitresponse-book.cfm ^3Aaron Wildavsky, But Is It True? A Citizen's Guide to Environmental Health and Safety Issues (Harvard University Press, 1995), Intro. and Chap. 11. To cite this abstract, use the following reference: http://meetings.aps.org/link/BAPS.2007.NES07.C1.6

  16. Updates on nutrition and health claims

    Directory of Open Access Journals (Sweden)

    Alejandro Perales-Albert

    2013-12-01

    Full Text Available There is concern about the influence of social determinants related to advertising, communication and information on the selection of food for healthy eating and safe. From this point of view, Spain created the European Regulation 1924/2006 (ER1924/2006, its aim is to ensure and promote access to safe food that benefit health and prevent information received by consumers is inaccurate, ambiguous or misleading. The aims of regulation are to prevent nutritional and attributed health claims to food without reason or if there is sufficient scientific evidence. In this sense, a group of professionals from the University of Alicante in December 2012 performed the First Day of Food and Nutrition, organized by the Center Alinua of the Faculty of Health Sciences, University of Alicante, related to updates on nutrition and health claims and its implications public health.By the interest and importance of this topic, this is a summary of the position papers from agents involved: consumers, government, food business, the gremial’s dietitian, the Academy and public health.

  17. Attitudes toward the dubious compensation claim.

    Science.gov (United States)

    LEGGO, C

    1951-07-01

    Laws providing for compensation of workmen for occupational injury are a powerful socio-economic force. In settlement of compensation claims the goal, difficult to achieve, is fairness to employee, employer and insurance carrier. Often, medical, legal, economic and social considerations conflict with one another. A "fact" in one field may not be considered so in another. Since medical data and testimony often guide the ultimate decision of a compensation claim, the physician's attitude is a large factor not only immediately and directly in determination of the case at hand but, perhaps more important, in the ultimate direction of the socio-economic forces which spring from the sum of all such determinations. To perpetuate the good in workmen's compensation laws, the next generation of physicians-and of lawyers and business administrators as well, for they, too, are involved-ought to have basic training in the social sciences in order that they may have a broad rather than a segmental view of the problems with which they deal.

  18. A 12-year analysis of closed medical malpractice claims of the Taiwan civil court: A retrospective study.

    Science.gov (United States)

    Hwang, Chi-Yuan; Wu, Chien-Hung; Cheng, Fu-Cheng; Yen, Yung-Lin; Wu, Kuan-Han

    2018-03-01

    Malpractices lawsuits cause increased physician stress and decreased career satisfaction, which might result in defensive medicine for avoiding litigation. It is, consequently, important to learn experiences from previous malpractice claims. The aim of this study was to examine the epidemiologic factors related to medical malpractice claims, identify specialties at high risk of such claims, and determine clinical which errors tend to lead to medical malpractice lawsuits, by analyzing closed malpractice claims in the civil courts of Taiwan.The current analysis reviewed the verdicts of the Taiwan judicial system from a retrospective study using the population-based databank, focusing on 946 closed medical claims between 2002 and 2013.Among these medical malpractice claims, only 14.1% of the verdicts were against clinicians, with a mean indemnity payment of $83,350. The most common single specialty involved was obstetrics (10.7%), while the surgery group accounted for approximately 40% of the cases. In total, 46.3% of the patients named in the claims had either died or been gravely injured. Compared to the $75,632 indemnity for deceased patients, the mean indemnity payment for plaintiffs with grave outcomes was approximately 4.5 times higher. The diagnosis groups at high risk of malpractice litigation were infectious diseases (7.3%), malignancies (7.2%), and limb fractures (4.9%). A relatively low success rate was found in claims concerning undiagnosed congenital anomalies (4.5%) and infectious diseases (5.8%) group. A surgery dispute was the most frequent argument in civil malpractice claims (38.8%), followed by diagnosis error (19.3%).Clinicians represent 85.9% of the defendants who won their cases, but they spent an average of 4.7 years to reach final adjudication. Increased public education to prevent unrealistic expectations among patients is recommended to decrease frivolous lawsuits. Further investigation to improve the lengthy judicial process is also

  19. Depression After Heart Attack

    Science.gov (United States)

    ... Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health? There is some good news here. Depression is ... Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health? What Can I Do About the Depression I’ ...

  20. Exercise for patients with major depression

    DEFF Research Database (Denmark)

    Krogh, Jesper; Speyer, Helene; Gluud, Christian

    2015-01-01

    is to investigate the beneficial and harmful effects of exercise, in terms of severity of depression, lack of remission, suicide, and so on, compared with treatment as usual with or without co-interventions in randomized clinical trials involving adults with a clinical diagnosis of major depression. A meta......BACKGROUND: The lifetime prevalence of major depression is estimated to affect 17% of the population and is considered the second largest health-care problem globally in terms of the number of years lived with disability. The effects of most antidepressant treatments are poor; therefore, exercise...... has been assessed in a number of randomized clinical trials. A number of reviews have previously analyzed these trials; however, none of these reviews have addresses the effect of exercise for adults diagnosed with major depression. METHODS/DESIGN: The objective of this systematic review...

  1. Selvmordsforsøg og depression

    DEFF Research Database (Denmark)

    Stenager, E N; Christensen, Lard; Jepsen, I M

    1991-01-01

    The frequency of depressive illness was investigated in 195 patients who had been referred consecutively after attempted suicide during the period 15. February 1989-15, October 1989. A total of 130 of these patients were admitted to hospital while the remainder were treated in the psychiatric...... the hospitalized patients with attempted suicide. Approximately 10% were treated with antidepressives. Only 8% were discharged with the diagnoses of endogenic or reactive psychoses (ICD-8). It is concluded that depressive symptoms occur in the majority of patients with attempted suicide but that slight non......-endogenic depressive states are most commonly concerned and that many of these improve rapidly during hospitalization without medicinal treatment. Restraint should be observed in prescription of antidepressive medicine to patients with attempted suicide until the diagnosis of depressive disease is verified....

  2. Toward psychiatry as a ‘human’ science of mind. The Case of Depressive Disorders in DSM-5

    Directory of Open Access Journals (Sweden)

    Marco eCastiglioni

    2015-01-01

    Full Text Available The aim of this paper is to argue that a strictly reductionist approach to psychiatry represents a theoretical and clinical obstacle to a fruitful synthesis between neurobiological and sociocultural aspects of the sciences of mind. We examine the theoretical and practical motivations underlying this approach, by analyzing the case of depressive disorders, as defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, and the related removal of the bereavement exclusion clause. We first explore the claim that DSM is atheoretical, observing that, far from being atheoretical, DSM adopts an implicit, biologically-inspired view of the mind; we show that such a view leads to a sort of circularity in the definition of depressive disorders, in which psychopharmacology seems to play a key role. We then turn to further problems deriving from this a position, analyzing the issue of placebo effects in the treatment of depressive disorders and the philosophical question of normative preconditions for psychopathological diagnosis. Finally, we address the issue of subjectivity, which, together with the related aspect of the subject’s relational context, appears to be crucial to any scientific theorizing about mental disorders, despite DSM’s attempt to exclude it. Our defence of a non-reductionist view of mental disorders, however, does not imply that we endorse any sort of metaphysical dualism, or anti-diagnostic or anti-psychiatric positions. On the contrary, we argue that adoption of a reductionist position actually undermines theoretical and clinical accuracy in explaining depressive disorders.

  3. 77 FR 22204 - Administrative Claims Under the Federal Tort Claims Act and Related Statutes

    Science.gov (United States)

    2012-04-13

    ... relationship between the national government and the States, or on the distribution of power and... relationship between the Federal government and Indian tribes, or on the distribution of power and... claim for personal injury, including pain and suffering, the claimant is required to submit the...

  4. 77 FR 22236 - Administrative Claims Under the Federal Tort Claims Act and Related Statutes

    Science.gov (United States)

    2012-04-13

    ... between the national government and the States, or on the distribution of power and responsibilities among... relationship between the Federal government and Indian tribes, or on the distribution of power and... claim for personal injury, including pain and suffering, the claimant is required to submit the...

  5. 32 CFR 536.78 - Settlement authority for claims under the Military Claims Act.

    Science.gov (United States)

    2010-07-01

    ... compensation of federal employees for job-related injuries (see § 536.44), or untimely filing, TJAG or TAJAG... satisfaction of the claim. (6) Authority to further delegate payment authority is set forth in § 536.3(g)(1) of...

  6. 48 CFR 1652.204-72 - Filing health benefit claims/court review of disputed claims.

    Science.gov (United States)

    2010-10-01

    ... beyond his or her control from making the request within the time limit. (2) The Carrier has 30 days... information is required to make a decision on the claim; (iii) Specify the time limit (60 days after the date... that time and give a written notice of its decision to the covered individual and to the Carrier. (f...

  7. Depression associated with dementia.

    Science.gov (United States)

    Gutzmann, H; Qazi, A

    2015-06-01

    Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression is frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients and the severity of psychopathological and neurological impairments increases with increasing severity of depression. Depressive symptoms may be both a risk factor for, as well as a prodrome of dementia. Major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults. Treating depression is therefore a key clinical priority to improve the quality of life both of people with dementia as well as their carergivers. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate depression and dementia. In cases of severe depression or depression not able to be managed through nonpharmacological means, antidepressant therapy should be considered.

  8. Depression in pulmonary arterial hypertension: An undertreated comorbidity

    Directory of Open Access Journals (Sweden)

    Sameer Verma

    2016-01-01

    Full Text Available Pulmonary arterial hypertension (PAH is a debilitating condition leading to progressive decline in functional capacity. As a result, PAH can lead to psychological impairment that can impact the overall disease status. The medical community has developed several screening questionnaires in order to assess depression in their patients allowing physicians to be at the forefront of recognizing clinical depression. There is a suggestion that depression symptomatology is more prevalent in the PAH population. The aim of this article is to review the current thought process about diagnosis and management of depression in PAH patients.

  9. Development of an Adolescent Depression Ontology for Analyzing Social Data.

    Science.gov (United States)

    Jung, Hyesil; Park, Hyeoun-Ae; Song, Tae-Min; Jeon, Eunjoo; Kim, Ae Ran; Lee, Joo Yun

    2015-01-01

    Depression in adolescence is associated with significant suicidality. Therefore, it is important to detect the risk for depression and provide timely care to adolescents. This study aims to develop an ontology for collecting and analyzing social media data about adolescent depression. This ontology was developed using the 'ontology development 101'. The important terms were extracted from several clinical practice guidelines and postings on Social Network Service. We extracted 777 terms, which were categorized into 'risk factors', 'sign and symptoms', 'screening', 'diagnosis', 'treatment', and 'prevention'. An ontology developed in this study can be used as a framework to understand adolescent depression using unstructured data from social media.

  10. Dissociative depression among women in the community.

    Science.gov (United States)

    Sar, Vedat; Akyüz, Gamze; Oztürk, Erdinç; Alioğlu, Firdevs

    2013-01-01

    This study screened the prevalence and correlates of dissociative disorders among depressive women in the general population. The Dissociative Disorders Interview Schedule and the posttraumatic stress disorder (PTSD) and borderline personality disorder sections of the Structured Clinical Interview for DSM-IV were administered to 628 women in 500 homes. The prevalence of current major depressive episode was 10.0%. Of the women, 26 (40.6%) had the lifetime diagnosis of a DSM-IV, dissociative disorder, yielding a prevalence of 4.1% for dissociative depression. This group was younger (mean age = 30.7 years) than the nondissociative depression women (mean age = 39.6 years). There was no difference between the 2 groups on comorbid somatization disorder, PTSD, or borderline personality disorder. Besides suicide attempts, the dissociative group was characterized by secondary features of dissociative identity disorder; Schneiderian symptoms; borderline personality disorder criteria; and extrasensory perceptions, including possession experiences. They reported suicidality, thoughts of guilt and worthlessness, diminished concentration and indecisiveness, and appetite and weight changes more frequently than the nondissociative group. Early cessation of school education and childhood sexual abuse were frequently reported by the dissociative depression group. With its distinct features, the concept of dissociative depression may facilitate understanding of treatment resistance in, development of better psychotherapy strategies for, and new thinking on the neurobiology and pharmacotherapy of depressive disorders.

  11. Impact of corporate social responsibility claims on consumer food choice

    DEFF Research Database (Denmark)

    Mueller Loose, Simone; Remaud, Hervé

    2013-01-01

    Purpose - The study assesses the impact of two different corporate social responsibility (CSR) claims, relating to social and environmental dimensions, on consumers’ wine choice across international markets. It is analysed how point of purchase CSR claims compete with other food claims and their ......Purpose - The study assesses the impact of two different corporate social responsibility (CSR) claims, relating to social and environmental dimensions, on consumers’ wine choice across international markets. It is analysed how point of purchase CSR claims compete with other food claims...... Eastcoast, the US Midwest, Anglophone and Francophone Canada. Findings - CSR claims relating to social and environmental responsibility have a similar awareness, penetration and consumer trust, but differ in their impact on consumer choice, where environmental corporate responsibility claims benefit from...... a higher marginal willingness to pay. Consumer valuation of CSR claims significantly differs across international markets, but is consistently lower than for organic claims. Research limitations/implications - The study was limited to wine and future research is required to generalise findings to other...

  12. Degrees of Truthfulness in Accepted Scientific Claims.

    Directory of Open Access Journals (Sweden)

    Ahmed Hassan Mabrouk

    2008-12-01

    Full Text Available Normal 0 false false false EN-MY X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Abstract: Sciences adopt different methodologies in deriving claims and establishing theories. As a result, two accepted claims or theories belonging to two different sciences may not necessarily carry the same degree of truthfulness. Examining the different methodologies of deriving claims in the sciences of ʿaqīdah (Islamic Creed, fiqh (Islamic Jurisprudence and physics, the study shows that ʿaqīdah provides a holistic understanding of the universe. Physics falls short of interpreting physical phenomena unless these phenomena are looked at through the ʿaqīdah holistic view. Left to itself, error may creep into laws of physics due to the methodology of conducting the physical experiments, misinterpreting the experimental results, or accepting invalid assumptions. As for fiqh, it is found that apart from apparent errors, fiqh views cannot be falsified. It is, therefore, useful to consider ʿaqīdah as a master science which would permit all other sciences to live in harmony.

  13. European consumers and health claims: attitudes, understanding and purchasing behaviour.

    Science.gov (United States)

    Wills, Josephine M; Storcksdieck genannt Bonsmann, Stefan; Kolka, Magdalena; Grunert, Klaus G

    2012-05-01

    Health claims on food products are often used as a means to highlight scientifically proven health benefits associated with consuming those foods. But do consumers understand and trust health claims? This paper provides an overview of recent research on consumers and health claims including attitudes, understanding and purchasing behaviour. A majority of studies investigated selective product-claim combinations, with ambiguous findings apart from consumers' self-reported generic interest in health claims. There are clear indications that consumer responses differ substantially according to the nature of carrier product, the type of health claim, functional ingredient used or a combination of these components. Health claims tend to be perceived more positively when linked to a product with an overall positive health image, whereas some studies demonstrate higher perceived credibility of products with general health claims (e.g. omega-3 and brain development) compared to disease risk reduction claims (e.g. bioactive peptides to reduce risk of heart disease), others report the opposite. Inconsistent evidence also exists on the correlation between having a positive attitude towards products with health claims and purchase intentions. Familiarity with the functional ingredient and/or its claimed health effect seems to result in a more favourable evaluation. Better nutritional knowledge, however, does not automatically lead to a positive attitude towards products carrying health messages. Legislation in the European Union requires that the claim is understood by the average consumer. As most studies on consumers' understanding of health claims are based on subjective understanding, this remains an area for more investigation.

  14. Low rates of depressed mood and depression diagnoses in a clinic review of children and adolescents with autistic disorder.

    Science.gov (United States)

    Henry, Charles A; Nowinski, Lisa; Koesterer, Karmen; Ferrone, Christine; Spybrook, Jessaca; Bauman, Margaret

    2014-09-01

    The purpose of this study was to investigate the prevalence of depression diagnoses and related clinical data in an outpatient sample of youth with autistic disorder. Records of 123 psychiatrically referred children and adolescents with a Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR) diagnosis of autistic disorder were examined. Mood disorder diagnoses and chief complaints along with family mood disorder history were the primary variables analyzed. Four subjects (3%) presented with depressed mood. Irritability complaints were frequent (n=78, 63%). Six subjects (5%) received a mood disorder diagnosis; all with mood disorder, not otherwise specified. No subjects received a depressive disorder diagnosis. Family history of mood disorders was common. Findings raise questions about the appropriate characterization and potential misdiagnoses of depression in youth with autistic disorder.

  15. Recognition and treatment of depression: a comparison of Australian and Chinese medical students.

    Science.gov (United States)

    Rong, Ye; Luscombe, Georgina M; Davenport, Tracey A; Huang, Yueqin; Glozier, Nick; Hickie, Ian B

    2009-08-01

    Depression is a major public health problem in both China and Australia. To improve services, we need to ensure health professionals have an appropriate understanding of depression and its treatments. This study compares the level of awareness of depression between Chinese and Australian medical students. The International Depression Literacy Survey assessing the public health impact, recognition and treatment of depression was completed by pre-psychiatric training medical students in China (n = 220) and Australia (n = 177). Chinese students were far less likely to consider mental health conditions and depression as major public health problems (P Depression symptom recognition was similar with four of the top five symptoms of depression the same in both groups of students. Chinese students were more likely to consider some psychological symptoms such as "thinking life is not worth living", but less likely to consider somatic features such as "sleep disturbance" as typical for people with depression. Chinese students were more likely to claim that they would seek help from mental health professionals if experiencing depression whilst Australian students were more likely to seek help from a general or family doctor. Chinese medical students recognise depression similarly to Australian students but do not consider it a major public health problem. These results challenge the stereotype that depression is characterised by somatic symptoms in China. Increasing awareness of the public health impact of depression should be incorporated into the medical curriculum in China.

  16. Struggling for clarity : cultural context, gender and a concept of depression in general practice

    OpenAIRE

    Lehti, Arja

    2009-01-01

    Many depressed patients attend primary health care, and minority-group patients often see general practitioners for depressive symptoms. The diagnosis and classification criteria of depression and guidelines for management are based on symptoms. However,expressions of depression can vary with culture and gender but the diagnostic tools and guidelines are not adapted to gendered or cultural context and have shown to be poorly applicable in clinical practice. The purpose of this thesis was to a...

  17. The independence of physical attractiveness and symptoms of depression in a female twin population.

    Science.gov (United States)

    McGovern, R J; Neale, M C; Kendler, K S

    1996-03-01

    The relationship between physical attractiveness and symptoms of depression was investigated in a general population simple of 1,100 female twins. Photographs were rated by 4 raters. Symptoms of depression were measured by the Depression sub-scale of the SCL-54, by a self-rating based on the DSM-III-R, and by an MD diagnosis based on a structured interview (SCID). No relationships between ratings of physical attractiveness and symptoms of depression were found.

  18. Proof of payment for all reimbursement claims

    CERN Multimedia

    HR Department

    2006-01-01

    Members of the personnel are kindly requested to note that only documents proving that a payment has been made are accepted as proof of payment for any claims for reimbursement, including specifically the reimbursement of education fees. In particular, the following will be accepted as proof of payment: bank or post office bank statements indicating the name of the institution to which the payment was made; photocopies of cheques made out to the institution to which the payments were made together with bank statements showing the numbers of the relevant cheques; proof of payment in the form of discharged payment slips; invoices with acknowledgement of settlement, receipts, bank statements detailing operations crediting another account or similar documents. As a result, the following documents in particular will no longer be accepted as proof of payment: photocopies of cheques that are not submitted together with bank or post office bank statements showing the numbers of the relevant cheques; details of ...

  19. Prebiotics, Fermentable Dietary Fiber, and Health Claims.

    Science.gov (United States)

    Delcour, Jan A; Aman, Per; Courtin, Christophe M; Hamaker, Bruce R; Verbeke, Kristin

    2016-01-01

    Since the 1970s, the positive effects of dietary fiber on health have increasingly been recognized. The collective term "dietary fiber" groups structures that have different physiologic effects. Since 1995, some dietary fibers have been denoted as prebiotics, implying a beneficial physiologic effect related to increasing numbers or activity of the gastrointestinal microbiota. Given the complex composition of the microbiota, the demonstration of such beneficial effects is difficult. In contrast, an exploration of the metabolites of dietary fiber formed as a result of its fermentation in the colon offers better perspectives for providing mechanistic links between fiber intake and health benefits. Positive outcomes of such studies hold the promise that claims describing specific health benefits can be granted. This would help bridge the "fiber gap"-that is, the considerable difference between recommended and actual fiber intakes by the average consumer. © 2016 American Society for Nutrition.

  20. Depression in Parkinson's disease: A case-control study.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Wu

    Full Text Available To evaluate the association between Parkinson's disease (PD prognosis and the patient's onset of depression.A total of 353 patients with newly-diagnosed PD and a history of depression were enrolled. On the basis of the onset of depression before or after PD diagnosis, we divided participants into PD patients with pre- or post-diagnostic depression. Cox's regression analysis was used to detect risks between the onset of depression and outcomes (including death, accidental injury, dementia, and aspiration pneumonia. The association between the onset of depression and levodopa equivalent dosage (LED and cumulative equivalent dosage of antidepressants were assessed.PD patients with post-diagnostic depression were associated with significantly higher risks of dementia (adjusted HR = 2·01, p = 0·015, and were older (58·5 ± 17·7 vs. 53·7 ± 18·6, p = 0·020 at the time of PD diagnosis than PD patients with pre-diagnostic depression. The higher incident rate of accidental injury was also noted in PD patients with post-diagnostic depression (48·1 vs. 31·3/1000 person-years, HR = 1·60, p = 0·041, but no statistical significance was observed in the adjusted hazard ratio (HR (HR = 1·52, p = 0·069. Otherwise, mortality, motor condition and severity of depression revealed no significant difference between PD patients with pre-diagnostic and post-diagnostic depression.PD patients with post-diagnostic depression had higher incidence of dementia, implying different onset time of depression could be associated with different subtypes and spreading routes which should be examined in follow-up studies.

  1. The role of Melancholia in prostate cancer patients' depression

    Directory of Open Access Journals (Sweden)

    Sharpley Christopher F

    2011-12-01

    Full Text Available Abstract Background Although it is well established that prostate cancer (PCa patients are more likely to experience clinical depression than their age-matched non-prostate cancer peers, and that such depression can have negative effects upon survival, little is known about the underlying nature of the depressive symptomatology that these men experience. In particular, the incidence of melancholic symptoms of depression, which are signs of increased risk of suicide and resistance to treatment, has not previously been reported in PCa patients. The present study aimed to measure the incidence and nature of Melancholia in PCa depression. Method A sample of 507 PCa patients in Queensland, Australia, completed anonymous and confidential questionnaires about their background, treatment status, and depression. Data were analysed to select depressive symptoms that were part of the definition of Melancholia vs those which were not. Regression was used to determine the links between Melancholia and overall depressive status, and factor analysis revealed the underlying components of Melancholia, which were mapped over time since diagnosis for 3 years. Results Psychometric data were satisfactory. Melancholia significantly predicted depressive status for the most depressed subset of patients, but not for the total sample. Melancholia was factored into its components of Anhedonia and Agitation, and the first of these was more powerful in predicting Melancholia. Variability over the 3 years following diagnosis was noted for each of these two components of Melancholia. Conclusions The strong presence of Melancholia in the depressive symptomatology of this sample of PCa patients suggests that some forms of treatment for depression may be more likely to succeed than others. The dominance of Anhedonia and Agitation over other symptoms of Melancholia also holds implications for treatment options when assisting these men to cope with their depression.

  2. Are Claims of Global Warming Being Suppressed?

    Science.gov (United States)

    Crowley, Thomas J.

    2006-02-01

    Over the last few years, I have heard many rumors that climate science relevant to the global warming discussion is being suppressed by the Bush Administration. One cannot do much about third-hand information. However, on 29 January, the New York Times published a front page article on NASA efforts to suppress statements about global warming by James Hansen, director of the NASA Goddard Institute for Space Studies. A claim by one government scientist, though, no matter how distinguished, still requires examples from other scientists before a general conclusion can be drawn about the overall scope of the problem. But if the charges are more widespread, then some government scientists might be reluctant to make such claims, because they might feel that their positions were jeopardized. Therefore, an alternate way may be needed to determine the scope of the issue, while still safeguarding government workers from possible retaliation. -On 30 January, Rep. Sherwood Boehlert (R-N.Y.), chairman of the U.S. House of Representatives Committee on Science, wrote a letter to NASA Administrator Michael Griffin addressing many of the concerns Crowley has raised. Boehlert wrote,``It ought to go without saying that government scientists must be free to describe their scientific conclusions and the implications of those conclusions to their fellow scientists, policymakers and the general public.'' He continued,``Good science cannot long persist in an atmosphere of intimidation. Political figures ought to be reviewing their public statements to make sure they are consistent with the best available science; scientists should not be reviewing their statements to make sure they are consistent with the current political orthodoxy.'' I commend Rep. Boehlert for his quick and clear statement of the importance of unfettered communication of science. -FRED SPILHAUS, Editor

  3. Depression and anxiety in hyperthyroidism.

    Science.gov (United States)

    Demet, Mehmet Murat; Ozmen, Bilgin; Deveci, Artuner; Boyvada, Sibel; Adigüzel, Hakan; Aydemir, Omer

    2002-01-01

    Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients. Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features. Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group. Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation.

  4. Perceived relevance and foods with health-related claims

    DEFF Research Database (Denmark)

    Dean, M.; Lampila, P.; Shepherd, R.

    2012-01-01

    consumers’ responses to health claims that either promise to reduce a targeted disease risk or improve well-being in comparison to other types of health-related messages, and how attitudes towards nutritionally healthy eating, functional food and previous experience relating to products with health claims...... affect the consumers’ perceptions of nutrition and health claims. The data (N = 2385) were collected by paper and pencil surveys in Finland, the UK, Germany and Italy on a target group of consumers over 35 year old, solely or jointly responsible for the family’s food shopping. The results showed...... risk reduction with detailed information about function and health outcome. Previous experience with products with health claims and interest in nutritionally healthy eating promoted the utility of all claims, regardless of whether they were health or nutrition claims. However, to be influenced...

  5. General scientific guidance for stakeholders on health claim applications

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2016-01-01

    of Article 13.1 claims except for claims put on hold by the European Commission, and has evaluated additional health claim applications submitted pursuant to Articles 13.5, 14 and also 19. In addition, comments received from stakeholders indicate that general issues that are common to all health claims need...... based on the experience gained to date with the evaluation of health claims, and it may be further updated, as appropriate, when additional issues are addressed.......The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products Nutrition and Allergies (NDA) to update the General guidance for stakeholders on the evaluation of Article 13.1, 13.5 and 14 health claims published in March 2011. Since then, the NDA Panel has completed the evaluation...

  6. Obesity, metabolic syndrome and Mediterranean diet: Impact on depression outcome.

    Science.gov (United States)

    García-Toro, M; Vicens-Pons, E; Gili, M; Roca, M; Serrano-Ripoll, M J; Vives, M; Leiva, A; Yáñez, A M; Bennasar-Veny, M; Oliván-Blázquez, B

    2016-04-01

    Obesity, metabolic syndrome (MetS) and low adherence to Mediterranean diet are frequent in major depression patients and have been separately related with prognosis. The aim of this study is to analyse their predictive power on major depression outcome, at 6 and 12 months. 273 Major depressive patients completed the Beck Depression Inventory for depressive symptoms and the 14-item Mediterranean diet adherence score. MetS was diagnosed according to the International Diabetes Federation (IDF). At the baseline Mediterranean diet adherence was inversely associated with depressive symptoms (p=0.007). Depression response was more likely in those patients with normal weight (p=0.006) and not MetS (p=0.013) but it was not associated with Mediterranean diet adherence (p=0.625). Those patients with MetS and obesity were less likely to improve symptoms of depression than patients with obesity but not MetS. Obesity and MetS, but not low adherence to the Mediterranean diet at baseline, predicted a poor outcome of depression at 12 months. Our study suggests that MetS is the key factor that impacts negatively in depression prognosis, rather than obesity or diet. If this finding is confirmed, clinicians should be aware about MetS diagnosis and treatment in overweight depressed patients, especially if outcome is not being satisfactory enough. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Greater incidence of depression with hypnotic use than with placebo

    Directory of Open Access Journals (Sweden)

    Kripke Daniel F

    2007-08-01

    Full Text Available Abstract Background Although it has been claimed that insomnia causes an increased risk for depression, adequate controlled trials testing this hypothesis have not been available. This study contrasted the incidence of depression among subjects receiving hypnotics in randomized controlled trials versus those receiving placebo. Methods The incidence of depression among patients randomized to hypnotic drugs or placebo was compiled from prescribing information approved by the United States Food and Drug Administration (FDA and from FDA New Drug Application documents. Available data for zolpidem, zaleplon, eszopiclone, and ramelteon were accessed. Results Data for 5535 patients randomized to a hypnotic and for 2318 randomized to placebo were compiled. The incidence of depression was 2.0% among participants randomized to hypnotics as compared to 0.9% among those randomized in parallel to placebo (p Conclusion Modern hypnotics were associated with an increased incidence of depression in data released by the FDA. This suggests that when there is a risk of depression, hypnotics may be contra-indicated. Preventive treatments such as antidepressant drugs, cognitive-behavioral therapy, or bright light might be preferred. Limitations in the FDA data prevented a formal meta-analysis, and there was a lack of information about drop-out rates and definitions of depression. Trials specifically designed to detect incident depression when treating insomnia with hypnotic drugs and better summarization of adverse events in trials submitted to the FDA are both necessary.

  8. Depression in nursing homes: prevalence, recognition, and treatment.

    Science.gov (United States)

    Kramer, Dietmar; Allgaier, Antje-Kathrin; Fejtkova, Sabina; Mergl, Roland; Hegerl, Ulrich

    2009-01-01

    Depression is very common in people above 65 years living in long-term care. However, little is known about how well depression is recognized and how adequately it is treated. Therefore, the present study aimed at assessing accuracy of the unaided clinical diagnosis of the attending physicians, and the medical treatment situation in nursing home residents. A random sample of 97 residents of 10 nursing homes in Munich was examined with the Section A "Affective Syndrome" of the Structured Clinical Interview (SCID) for DSM-IV to detect depression. Information concerning clinical diagnosis and medication was obtained from the subjects' medical records. 14.4% suffered acutely from major depression, 14.4% suffered from minor depression, and 18.6% were diagnosed as depressive according to the physician and nursing records. In total, 27.8% received antidepressants. Merely 42.9% of the subjects with acute major depression were diagnosed by their attending physicians as depressive, and only half of them received an antidepressant; 17.5% received antidepressants without a diagnosis of depression in their physician and nursing records. In accordance with the guidelines, 73.3% of the antidepressants prescribed were SSRIs or newer antidepressants. Only 20.0% were tricyclic antidepressants. Findings show that depression is relatively frequent in residents of nursing homes. Moreover, it is insufficiently recognized by physicians and is even more seldom adequately treated. Also, a significant proportion of residents receive antidepressants without a documented associated indication. Therefore, the recognition and guideline-based treatment of depression should be improved in this high-risk group.

  9. Differential diagnosis

    Directory of Open Access Journals (Sweden)

    Abdallah Adra

    2016-09-01

    Full Text Available Abnormal uterine bleeding may be acute or chronic accounting for up to 30% of outpatient visits to gynecologists. Hyperprolactinemia is one of the most common endocrine disorders associated with ovulatory dysfunction that results in menstrual irregularities. Prior to initiating treatment, the various causes (physiologic, pathologic, pharmacologic, or idiopathic of hyperprolactinemia must be elucidated. Prolactin is a stress hormone that increases in response to stressful conditions; therefore, while collecting samples it is necessary to reduce venipuncture stress. A thorough patient history and physical examination will help to identify the cause and to direct therapy. Imaging results must always be assessed along with a patient’s clinical history and biochemical parameters when a pituitary tumor is suspected. Magnetic resonance imaging is the method of choice for the diagnosis of microprolactinomas and macroprolactinomas in both initial assessment and follow-up. Several drugs may cause a significant increase in serum prolactin concentration. If clinically feasible, the drug should be discontinued; if this is not possible, it should be substituted with a drug of similar action that does not cause hyperprolactinemia. Prolactinomas are the most common cause of pituitary adenomas affecting women of fertile age leading to significant elevations in prolactin that warrant treatment. Idiopathic hyperprolactinemia may be observed in the presence of elevated serum prolactin levels and in the absence of any other recognized cause of increased prolactin secretion. Dopamine agonists are the mainstay of therapy in prolactinomas and symptomatic idiopathic hyperprolactinemia because they normalize serum prolactin, effectively shrink prolactinomas and normalize gonadal function (i.e. menstruation.

  10. Pancreatic cancer and depression: myth and truth

    Directory of Open Access Journals (Sweden)

    Schmid Roland M

    2010-10-01

    Full Text Available Abstract Background Various studies reported remarkable high incidence rates of depression in cancer patients compared with the general population. Pancreatic cancer is still one of the malignancies with the worst prognosis and therefore it seems quite logical that it is one of the malignancies with the highest incidence rates of major depression. However, what about the scientific background of this relationship? Is depression in patients suffering from pancreatic cancer just due to the confrontation with a life threatening disease and its somatic symptoms or is depression in this particular group of patients a feature of pancreatic cancer per se? Discussion Several studies provide evidence of depression to precede the diagnosis of pancreatic cancer and some studies even blame it for its detrimental influence on survival. The immense impact of emotional distress on quality of life of cancer patients enhances the need for its early diagnosis and adequate treatment. Knowledge about underlying pathophysiological mechanisms is required to provide the optimal therapy. Summary A review of the literature on this issue should reveal which are the facts and what is myth.

  11. 29 CFR 15.4 - Administrative claim; where to file.

    Science.gov (United States)

    2010-07-01

    ... accompanied by a claim for money damages in a sum certain for injury to or loss of property or personal injury... hereunder to the Council for Claims and Compensation, Office of the Solicitor of Labor, U.S. Department of... 29 Labor 1 2010-07-01 2010-07-01 true Administrative claim; where to file. 15.4 Section 15.4 Labor...

  12. 36 CFR 1009.4 - Payment of claims.

    Science.gov (United States)

    2010-07-01

    ... TORT CLAIMS ACT § 1009.4 Payment of claims. (a) When an award of $2,500 or less is made, the voucher signed by the claimant shall be transmitted for payment to the Presidio Trust. When an award over $2,500... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Payment of claims. 1009.4...

  13. Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data

    Science.gov (United States)

    Guerino, Paul; Ewald, Erin; Laffan, Alison M.

    2017-01-01

    Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908

  14. Differences in depressive symptoms between Korean and American outpatients with major depressive disorder.

    Science.gov (United States)

    Jeon, Hong Jin; Walker, Rosemary S; Inamori, Aya; Hong, Jin Pyo; Cho, Maeng Je; Baer, Lee; Clain, Alisabet; Fava, Maurizio; Mischoulon, David

    2014-05-01

    Previous epidemiologic studies have revealed that East-Asian populations experience fewer depressive symptoms than American populations do. However, it is unclear whether this difference applies to clinical patients with major depressive disorder (MDD). This present study included 1592 Korean and 3744 American outpatients who were 18 years of age or older and met the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria for single or recurrent episodes of nonpsychotic MDD, and evaluated their symptoms of depression using the Hamilton Depression Rating Scale and the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form. Korean patients scored significantly lower for guilt and depressed mood items, and higher for hypochondriasis and suicidality items than American patients did, after adjusting for total Hamilton Depression Rating Scale scores. Conversely, no significant differences were found in quality and function of daily life between groups. Multivariate logistic regression analyses revealed that Korean patients experienced less frequent depressed mood and guilt, including verbal and nonverbal expression of depressed mood [adjusted odds ratio (AOR) = 0.14, 95% confidence interval (CI) 0.08-0.23] and feelings of punishment (AOR = 0.036, 95% CI 0.025-0.054) when compared with Americans after adjusting for age and sex. Conversely, Korean patients experienced more frequent suicidality and hypochondriasis, including suicidal ideas or gestures (AOR = 2.10, 95% CI 1.60-2.76) and self-absorption of hypochondriasis (AOR = 1.94, 95% CI 1.70-2.20). In conclusion, decreased expression of depressed mood and guilt may cause underdiagnosis of MDD in Korean patients. Early diagnosis of and intervention for depression and suicide may be delayed because of this specific cross-cultural difference in depression symptoms.

  15. Consumers’ willingness to pay for sustainable wine claims

    DEFF Research Database (Denmark)

    Mueller, Simone; Remaud, Hervé; Chabin, Yann

    attributes (price, brand, region of origin and appellation system, grape variety, alcohol level, medal, sensory style, bottling, and sustainable claim), considering the majority of attributes, which are known to be important to consumers and preventing an overestimation of the effect of sustainable claims......-choice reference alternative. Findings: Of all sustainable claims, organic had the highest impact on consumer choice, followed by a privately used claim ‘protect the planet’. Carbon zero wines were only significantly positively valued in the UK, where consumers were made aware of its meaning through national...

  16. Joint Asymptotic Distributions of Smallest and Largest Insurance Claims

    Directory of Open Access Journals (Sweden)

    Hansjörg Albrecher

    2014-07-01

    Full Text Available Assume that claims in a portfolio of insurance contracts are described by independent and identically distributed random variables with regularly varying tails and occur according to a near mixed Poisson process. We provide a collection of results pertaining to the joint asymptotic Laplace transforms of the normalised sums of the smallest and largest claims, when the length of the considered time interval tends to infinity. The results crucially depend on the value of the tail index of the claim distribution, as well as on the number of largest claims under consideration.

  17. Are the claims made in orthopaedic print advertisements valid?

    Science.gov (United States)

    Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P

    2014-05-01

    Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p advertisements. High-quality evidence is required by orthopaedic surgeons to influence clinical practice and this evidence should be sought by manufacturers wishing to market a successful product.

  18. FEMA Hazard Mitigation Assistance Repetitive Flood Claims (RFC) Data

    Data.gov (United States)

    Department of Homeland Security — This dataset contains closed and obligated projects funded under the following Hazard Mitigation Assistance (HMA) grant programs: Repetitive Flood Claims (RFC). The...

  19. 13 CFR 114.103 - Who may file a claim?

    Science.gov (United States)

    2010-01-01

    ... THE FEDERAL TORT CLAIMS ACT AND REPRESENTATION AND INDEMNIFICATION OF SBA EMPLOYEES Administrative.... Death The executor, administrator, or legal representative of the decedent's estate, or any other person...

  20. Artificial intelligence applied in claims management: Bet on the right customer with claims satisfaction predictive modeling

    OpenAIRE

    Lamarsaude, Benoit

    2017-01-01

    Insurance companies suffer from loss of customer consecutively to claims. Only a small portion of dissatisfied customer expresses themselves, creating difficulties in establishing a long term relationship. Increase customer loyalty is a major subject for insurers, because they have to maintain a minimum portfolio size and acquiring newclients is more expensive than retains the existing. In this work we use artificial intelligence techniques to assess and manage the customer satisfaction when ...