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Sample records for internalizing depression generalized

  1. Consensus statement on generalized anxiety disorder from the International Consensus Group on Depression and Anxiety.

    Science.gov (United States)

    Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Borkovec, T D; Rickels, K; Stein, D J; Wittchen, H U

    2001-01-01

    To provide primary care clinicians with a better understanding of management issues in generalized anxiety disorder (GAD) and guide clinical practice with recommendations on the appropriate treatment strategy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R.T. Davidson, Yves Lecrubier, and David J. Nutt. Four additional faculty members invited by the chair were Karl Rickels, Hans-Ulrich Wittchen, Dan J. Stein, and Thomas D. Borkovec. The consensus statement is based on the 6 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Group meetings were held over a 2-day period. On day 1, the group discussed the review articles and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. GAD is the most common anxiety disorder in primary care and is highly debilitating. Furthermore, it is frequently comorbid with depression and other anxiety disorders, which exacerbates functional impairment. Antidepressants (serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and nonsedating tricyclic antidepressants) are generally the most appropriate first-line pharmacotherapy for GAD, since they are also effective against comorbid psychiatric disorders and are suitable for long-term use. Cognitive-behavioral therapy is the preferred form of psychotherapy for GAD, although when GAD is comorbid with depression, pharmacotherapy is increasingly indicated.

  2. Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Saitoh Akiyoshi

    2010-04-01

    Full Text Available Abstract Background A general internist has an important role in primary care, especially for the elderly in rural areas of Japan. Although effective intervention models for depressed patients in general practice and primary care settings have been developed in the US and UK medical systems, there is little information regarding even the recognition rate and prescription rate of psychotropic medication by general internists in Japan. The present study surveyed these data cross-sectionally in a general internal medicine outpatient clinic of a Japanese rural hospital. Methods Patients were consecutively recruited and evaluated for major depressive disorder or any mood disorder using the Patient Health Questionnaire (PHQ. Physicians who were blinded to the results of the PHQ were asked to diagnose whether the patients had any mental disorders, and if so, whether they had mood disorders or not. Data regarding prescription of psychotropic medicines were collected from medical records. Results Among 312 patients, 27 (8.7% and 52 (16.7% were identified with major depressive disorder and any mood disorder using the PHQ, respectively. Among those with major depressive disorder, 21 (77.8% were recognized by physicians as having a mental disorder, but only three (11.1% were diagnosed as having a mood disorder. Only two patients with major depressive disorder (7.4% had been prescribed antidepressants. Even among those (n = 15 whom physicians diagnosed with a mood disorder irrespective of the PHQ results, only four (26.7% were prescribed an antidepressant. Conclusions Despite a high prevalence of depression, physicians did not often recognize depression in patients. In addition, most patients who were diagnosed by physicians as having a mood disorder were not prescribed antidepressants. Multiple barriers to providing appropriate care for depressed patients exist, such as recognizing depression, prescribing appropriate medications, and appropriately referring

  3. Depression in general practice

    African Journals Online (AJOL)

    Most persons with emotional disorders are evaluated and treated by primary health ... the full clinical picture has emerged, and in most of their patients the .... Depression is common in attention deficit disorder where hyperactivity ... tncyclic antidepressants, SSRls ; selective serotonin re-uptake inhibitors; SNRls ; serotonin ...

  4. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain

    2014-12-04

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

  5. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

    2014-01-01

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

  6. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, M. A. H.

    2014-08-05

    Internal multiples deteriorate the image when the imaging procedure assumes only single scattering, especially if the velocity model does not have sharp contrasts to reproduce such scattering in the Green’s function through forward modeling. If properly imaged, internal multiples (internally scattered energy) can enhance the seismic image. Conventionally, to image internal multiples, accurate, sharp contrasts in the velocity model are required to construct a Green’s function with all the scattered energy. As an alternative, we have developed a generalized internal multiple imaging procedure that images any order internal scattering using the background Green’s function (from the surface to each image point), constructed from a smooth velocity model, usually used for conventional imaging. For the first-order internal multiples, the approach consisted of three steps, in which we first back propagated the recorded surface seismic data using the background Green’s function, then crosscorrelated the back-propagated data with the recorded data, and finally crosscorrelated the result with the original background Green’s function. This procedure images the contribution of the recorded first-order internal multiples, and it is almost free of the single-scattering recorded energy. The cost includes one additional crosscorrelation over the conventional single-scattering imaging application. We generalized this method to image internal multiples of any order separately. The resulting images can be added to the conventional single-scattering image, obtained, e.g., from Kirchhoff or reverse-time migration, to enhance the image. Application to synthetic data with reflectors illuminated by multiple scattering (double scattering) demonstrated the effectiveness of the approach.

  7. Rating scales in general practice depression

    DEFF Research Database (Denmark)

    Bech, Per; Paykel, Eugene; Sireling, Lester

    2015-01-01

    BACKGROUND: Our objective was to investigate to what extent the Clinical Interview for Depression (CID) used in the general practice setting covers clinically valid subscales (depression, anxiety, and apathy) which can measure outcome of antidepressant therapy as well as identifying subsyndromes...... within major depressive disorder. The CID was compared to the Hamilton Depression Rating Scale (HAM-D17). METHODS: 146 patients from a previous study in general practice with the CID were investigated. The item response theory model established by Rasch was used to investigate the scalability (a scale...... (approximately 20%) had an atypical depression. LIMITATIONS: The samples were derived from a single study and were all rated by a single rater. CONCLUSION: The CID contains subscales of depression, anxiety, and apathy with an acceptable scalability for use in general practice. A subsyndrome of atypical...

  8. Collaborative care for depression in general practice

    DEFF Research Database (Denmark)

    Brinck-Claussen, Ursula Ødum; Curth, Nadja Kehler; Davidsen, Annette Sofie

    2017-01-01

    Background: Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish...... context. We therefore developed a model for CC (the Collabri model) to treat people with depression in general practice in Denmark. Since systematic identification of patients is an “active ingredient” in CC and some literature suggests case finding as the best alternative to standard detection, the two...... detection methods are examined as part of the study. The aim is to investigate if treatment according to the Collabri model has an effect on depression symptoms when provided to people with depression in general practice in Denmark, and to examine if case finding is a better method to detect depression...

  9. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, M. A. H.; Alkhalifah, Tariq Ali

    2014-01-01

    Internal multiples deteriorate the image when the imaging procedure assumes only single scattering, especially if the velocity model does not have sharp contrasts to reproduce such scattering in the Green’s function through forward modeling

  10. Depression in focal, segmental and generalized dystonia.

    Science.gov (United States)

    Lewis, L; Butler, A; Jahanshahi, M

    2008-11-01

    Dystonia causes body disfigurement in the majority of those affected. Our aim was to test the hypothesis that low self-esteem resulting from the sense of disfigurement is an important component of self-reported depression in focal, segmental and generalized dystonia. Questionnaires to assess self-reported depression, self-esteem, body concept, disfigurement, disability and quality of life were completed by 329 community based dystonia patients. Moderate to severe depression was reported by 30 %. Self-reported depression had a strong somatic component, but patients also showed a specific concern with self-image. Extent of dystonia, body parts affected and marital status influenced self-reported depression in dystonia. Self esteem, body concept, disfigurement and quality of life emerged as factors which accounted for the variance of self-reported depression in dystonia. These results suggest that in dystonia, disfigurement, negative body concept, low self-esteem, and the impact of the disease on quality of life make important contributions to depression. However, longitudinal followup is required to firmly establish the direction of causality between depression and these psychosocial variables in dystonia.

  11. The care provided by general practitioners for persistent depression

    NARCIS (Netherlands)

    Van Os, TWDP; Van den Brink, RHS; Van der Meer, K; Ormel, J

    Purpose. - To examine the care provided by general practitioners (GPs) for persistent depressive illness and its relationship to patient, illness and consultation characteristics. Subjects and method. - Using the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) a

  12. Prevalence of depression in a general hospital in Izhevsk, Russia.

    Science.gov (United States)

    Pakriev, Sergei; Kovalev, Juri; Mozhaev, Mikhail

    2009-11-01

    There are a lot of studies on depressive disorders in a general hospital done across the world, but no data from Russia on this subject was found in international psychiatric journals or MEDLINE. to determine the prevalence of depressive disorders in medical inpatients in Izhevsk, the capital of the Udmurt Republic, a region in Russia, and to identify associated factors. A sample of 323 adult medical inpatients was composed. The Russian version of the MINI 5.0.0 was used. The prevalence of lifetime and current depressive disorders was 30% and 20.7%, respectively. Depression was more common in women, widowed or divorced, retired or disabled, with low income and bad family relationships, and among respondents with a chronic somatic illness. Depression had a high comorbidity with organic mental and anxiety disorders. Only 40.3% of the individuals with depression had referred for psychiatric consultations, most of them being treated with fluvoxamine. Prevalence of depression was substantial but consistent with other studies. Taking into consideration associated factors, physicians can improve recognition and treatment of depression in medical inpatients.

  13. Generalized Anxiety and Major Depressive syndrome ...

    Science.gov (United States)

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if levels of Mn exposure were associated with levels of GA and MD.Participants and methods: 186 participants (Mean age: 55.0 ± 10.80) were examined. Levels of air-Mn were assessed over a period of ten years using U.S. EPA’s AERMOD dispersion model. Average air-Mn exposure was 0.53 μg/m3 in the two towns. The GA syndrome was comprised of anxiety, obsessive-compulsive, and phobic scales from the Symptom Checklist (SCL-90-R). The MD syndrome was comprised of depression, anxiety, and psychoticism scales also from the SCL-90-R. Linear regression models were used to determine the relationship between Mn and GA, MD and the specific components of each.Results: Elevated air-Mn was associated with GA (β= 0.240, p=0.002), and MD (β= 0.202, p=0.011). Air-Mn was associated with specific components of GA anxiety (β= 0.255, p=0.001), phobic anxiety (β= 0.159, p=0.046), and obsessive-compulsive (β= 0.197, p=0.013). Similarly, components of MD syndrome suggested an association as well: depression (β= 0.180, p=0.023), anxiety (β= 0.255, p=0.001), and psychoticism (β= 0.188, p=0.018). Conclusions: The results suggest that residents with elevated exposure to environmental Mn have elevated levels of

  14. Maternal Depression and Youth Internalizing and Externalizing Symptomatology: Severity and Chronicity of Past Maternal Depression and Current Maternal Depressive Symptoms

    Science.gov (United States)

    O’Connor, Erin E.; Langer, David A.; Tompson, Martha C.

    2017-01-01

    Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58% male) ages 8 to 12 over a span of three years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed. PMID:27401880

  15. Depressive cognition: a test of depressive realism versus negativity using general knowledge questions.

    Science.gov (United States)

    Stone, E R; Dodrill, C L; Johnson, N

    2001-11-01

    This research is an examination of whether cognition in depressed individuals incorporates a realistic view of the world or a general tendency toward negativity. Participants provided two types of probability judgments of the likelihood that they correctly answered general knowledge questions: the probability that they correctly answered each of the individual questions and an aggregate judgment, after completing the questionnaire, of the percentage of all the questions they thought they had correctly answered. These tasks generally elicit overconfidence and accuracy in nondepressives. In accord with theories of both depressive realism and general negativity, in their item-by-item assessments of their answers to the individual questions, depressed participants demonstrated less overconfidence than nondepressed participants. In accord with the theory of general negativity but not with the theory of depressive realism, however, depressed participants demonstrated underconfidence in their aggregate judgments. The implications of these findings on theories of depressive cognition are discussed.

  16. Philanthropic endowments in general internal medicine.

    Science.gov (United States)

    Murden, R A; Lamb, J F

    1999-04-01

    We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine.

  17. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study

    Institute of Scientific and Technical Information of China (English)

    Cui-Bai Wei; Jian-Ping Jia; Fen Wang; Ai-Hong Zhou; Xiu-Mei Zuo; Chang-Biao Chu

    2016-01-01

    Background:Many studies have reported that depression and anxiety have bidirectional relationship with headache.However,few researches investigated the roles of depression or anxiety in patients with headache.We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals.Additional risk factors for depression and anxiety were also analyzed.Methods:A cross-sectional study was conducted at 11 general neurological clinics.All consecutive patients with a chief complaint of headache were enrolled.Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview,and those for headache were made according to the International Classification of Headache Disorders,2nd Edition.The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity.Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety.Results:A total of 749 outpatients with headache were included.Among them,148 (19.7%) were diagnosed with depression and 103 (13.7%) with anxiety.Further analysis showed that 114 (15.2%) patients complaining headache due to somatic symptoms of psychiatric disorders and 82 (10.9%) had a depression or anxiety comorbidity with headache.Most patients with depression or anxiety manifested mild to moderate headaches.Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety.Conclusion:Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.

  18. Chronic depression : Determinants and consequences of chronic major depression in the general population

    NARCIS (Netherlands)

    Spijker, Jan

    2002-01-01

    The subject of this thesis is chronicity of major depressive disorder (MDD). The main aims of the study are to examine: 1. the duration of a major depressive episode (MDE) and the rate of a chronic duration of MDE in the general population, 2. the determinants of (chronic) duration of

  19. Individual and organizational predictors of depression in general practitioners.

    OpenAIRE

    Firth-Cozens, J

    1998-01-01

    BACKGROUND: High levels of stress and depression are seen in both general practitioners (GPs) and hospital doctors, and this has implications for patient care. It is therefore important to discover the individual and organizational causes of elevated symptoms so they can be tackled. AIM: To discover the relative importance of individual characteristics measured 10 years earlier compared with current organizational stressors in predicting depression in GPs. METHOD: Longitudinal questionnaire s...

  20. Depression in general practice | Lans | South African Medical Journal

    African Journals Online (AJOL)

    Abstract. The object of this study is to increase the general practitioner's awareness of the prevalence of depression, its multifaceted presentation in all age groups and the concomitant danger of suicide. It highlights the vital role the general practitioner can play in the early diagnosis and adequate treatment of this disorder.

  1. Hospital Anxiety and Depression Scale (HADS: validation in a Greek general hospital sample

    Directory of Open Access Journals (Sweden)

    Patapis Paulos

    2008-03-01

    Full Text Available Abstract Background The Hospital Anxiety and Depression Scale (HADS has been used in several languages to assess anxiety and depression in general hospital patients with good results. Methods The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens. The Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI were used as 'gold standards' for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression and stability (test-retest intraclass correlation coefficient 0.944. Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749. Conclusion The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.

  2. Individual and organizational predictors of depression in general practitioners.

    Science.gov (United States)

    Firth-Cozens, J

    1998-10-01

    High levels of stress and depression are seen in both general practitioners (GPs) and hospital doctors, and this has implications for patient care. It is therefore important to discover the individual and organizational causes of elevated symptoms so they can be tackled. To discover the relative importance of individual characteristics measured 10 years earlier compared with current organizational stressors in predicting depression in GPs. Longitudinal questionnaire study, using data from those of the original cohort of 318 medical students who are now GPs (n = 131), considering perceptions of current stressors and comparing through regression analyses the relative strength of early personality and mood with current organizational factors of sleep, hours worked, and practice size in predicting current depression levels. There were 22 (17%) stressors scoring above threshold for depression. Relationships with senior doctors and patients are the main reported stressors, followed by making mistakes and conflict of career with personal life. The predictors of symptom levels varied for men and women. In men, depression and self-criticism as students, and current sleep levels; and in women, sibling rivalry and current alcohol use, were the main predictors: in men, 27% of the variance was accounted for by early dispositional factors alone compared with 14% in women. A model is suggested linking sleep loss with workplace stressors, self-critical cognitions, and depression. Interventions can be made throughout training, targeting self-criticism and recognizing early depression, while later addressing the organizational stressors, particularly work relationships and sleep patterns.

  3. Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder.

    Science.gov (United States)

    Beesdo, Katja; Pine, Daniel S; Lieb, Roselind; Wittchen, Hans-Ulrich

    2010-01-01

    Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD). To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder. Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers. Munich, Germany. A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up. Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia). Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles. Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories.

  4. The Interrelations Between Internalized Homophobia, Depressive Symptoms, and Suicidal Ideation Among Australian Gay Men, Lesbians, and Bisexual Women.

    Science.gov (United States)

    McLaren, Suzanne

    2016-01-01

    Internalized homophobia has been linked to depression among gay men, lesbians, and bisexuals. Relatively little research has investigated the link between internalized homophobia and suicidal thoughts and behaviors. The current research investigated the interrelations among internalized homophobia, depressive symptoms, and suicidal ideation by testing additive, mediation, and moderation models. Self-identified Australian gay men (n = 360), lesbians (n = 444), and bisexual women (n = 114) completed the Internalized Homophobia Scale, the Center for Epidemiological Studies Depression Scale, and the suicide subscale of the General Health Questionnaire. Results supported the additive and partial mediation models for gay men and the mediation and moderation models for lesbians. None of the models were supported for bisexual women. The findings imply that clinicians should focus on reducing internalized homophobia and depressive symptoms among gay men and lesbians, and depressive symptoms among bisexual women, to reduce suicidal ideation.

  5. Highlights of the international consensus statement on major depressive disorder.

    Science.gov (United States)

    Nutt, David J

    2011-06-01

    The International Consensus Group on Depression gathered to outline a universal treatment algorithm for depression with the purpose of merging the evidence base and standards of clinical practice from various countries, including the United States, Europe, the Middle East, China, and Japan. This brief summary includes the following recommendations made by the consensus group: periodically screen all patients for depression, use measurement-based tools and full psychiatric assessments to complete differential diagnoses, refer patients to psychiatric specialists when appropriate, establish a therapeutic alliance with patients and their families, begin treatment with an antidepressant for moderate or severe depression, treat patients to remission, and continually monitor patients' symptomatic improvement. © Copyright 2011 Physicians Postgraduate Press, Inc.

  6. Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors.

    Science.gov (United States)

    Vafai, Yassaman; Steinberg, Julia R; Shenassa, Edmond D

    2016-02-01

    Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (β=0.082, SE=0.032, p=0.012) and internalizing behaviors (β=0.111, SE=0.037, p=0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (β=0.051, SE=0.034, p=0.138) and internalizing behaviors (β=0.077, SE=0.040, p=0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (pexternalizing behaviors and 10.5% (pexternalizing behaviors was maternal age (β=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (β=-1.33, SE=0.378, p=0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on Depression and Anxiety.

    Science.gov (United States)

    Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Kirmayer, L J; Lépine, J P; Lin, K M; Tajima, O; Ono, Y

    2001-01-01

    To provide primary care physicians with a better understanding of transcultural issues in depression and anxiety. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Five faculty invited by the chair also participated: Laurence J. Kirmayer, Jean-Pierre Lepine, Keh-Ming Lin, Osamu Tajima, and Yutaka Ono. The consensus statement is based on the 5 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Group meetings were held over a 2-day period. On day 1, the group discussed the review articles, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. The consensus statement underlines the prevalence of depression and anxiety disorders across all cultures and nations while recognizing that cultural differences exist in symptom presentation and prevalence estimates. In all countries, the recognition of depression by clinicians in the primary care setting is low (generally less than 50%), and the consensus group recommends a 2-step process to aid the recognition and diagnosis of depression. In line with the low recognition of depression and anxiety disorders is the finding that only a small proportion of patients with depression or anxiety are receiving appropriate treatments for their condition. Biological diversity across ethnic groups may account for the differential sensitivity of some groups to psychotropic medication, but this area requires further investigation.

  8. 6th International Conference on General Inequalities

    CERN Document Server

    1992-01-01

    The sixthInternational Conference on General Inequalities was held from Dec. 9 to Dec. 15, 1990, at the Mathematisches Forschungsinstitut Oberwolfach (Black Fa­ rest, Germany). The organizing committee was composed of W.N. Everitt (Birm­ ingham), L. Losonczi (Debrecen) and W. Walter (Karlsruhe). Dr. A. Kovacec ( Coimbra) served cheerfully and efficiently as secretary of the meeting. The con­ ference was attended by 44 participants from 20 countries. Yet again the importance of inequalities in both pure and applied mathematics was made evident from the wide range of interests of the individual participants, and from the wealth of new results announced. New inequalities were presented in the usual spread of the subject areas now expected for these meetings: Classical and functional analysis, existence and boundary value problems for both ordinary and partial differential equations, with special contributions to computer science, quantum holography and error analysis. More strongly than ever, the role played ...

  9. The relationship between generalized anxiety disorder, depression and mortality in old age.

    NARCIS (Netherlands)

    Holwerda, T.J.; Schoevers, R.A.; Dekker, J.J.M.; Deeg, D.J.H.; Jonker, C.; Beekman, A.T.F.

    2007-01-01

    after adjustment for the different variables. Conclusions In elderly persons depression increases the risk of death in men. Neither generalized anxiety nor mixed anxiety-depression are associated with excess mortality. Generalized anxiety disorder may even predict less mortality in depressive

  10. [Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities].

    Science.gov (United States)

    Li, Guo; Jiang, Ronghuan; Guo, Chengjun; Liu, Meiyan; Zhang, Lijun

    2014-12-01

    To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities. A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up. A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123). There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.

  11. Personal stigma and use of mental health services among people with depression in a general population in Finland

    Directory of Open Access Journals (Sweden)

    Tuulari Jyrki

    2011-03-01

    Full Text Available Abstract Background A minority of people suffering from depression seek professional help for themselves. Stigmatizing attitudes are assumed to be one of the major barriers to help seeking but there is only limited evidence of this in large general population data sets. The aim of this study was to analyze the associations between mental health attitude statements and depression and their links to actual use of mental health services among those with depression. Methods We used a large cross-sectional data set from a Finnish population survey (N = 5160. Attitudes were measured by scales which measured the belief that people with depression are responsible for their illness and their recovery and attitudes towards antidepressants. Desire for social distance was measured by a scale and depression with the Composite International Diagnostic Interview Short Form (CIDI-SF instrument. Use of mental health services was measured by self-report. Results On the social discrimination scale, people with depression showed more social tolerance towards people with mental problems. They also carried more positive views about antidepressants. Among those with depression, users of mental health services, as compared to non-users, carried less desire for social distance to people with mental health problems and more positive views about the effects of antidepressants. More severe depression predicted more active use of services. Conclusions Although stronger discriminative intentions can reduce the use of mental health services, this does not necessarily prevent professional service use if depression is serious and views about antidepressant medication are realistic.

  12. Age and sex dependencies of anxiety and depression in cardiologic patients compared with the general population

    OpenAIRE

    Hinz, A; Kittel, J; Karoff, M; Schwarz, R

    2004-01-01

    Objective: The aim of this study was to test age and sex effects on anxiety and depression using the Hospital Anxiety and Depression Scale HADS. Method: Sample 1 consisted of 2037 subjects of the German general population, and sample 2 comprised 2696 cardiologic patients. Results: In the group of the general population we observed a linear increase of depression and (to a lower extent) of anxiety with age. In contrast to that, the patients reached their anxiety and depression maxima in the ra...

  13. Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms.

    Science.gov (United States)

    Earnshaw, Valerie A; Smith, Laramie R; Cunningham, Chinazo O; Copenhaver, Michael M

    2015-08-01

    We adopted an intersectionality framework and examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. A total of 85 people living with HIV with a history of substance use in the Bronx, New York, completed a survey. Results revealed evidence of moderation: Participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma. Researchers should examine stigma associated with multiple socially devalued characteristics to best understand how stigma impacts mental health among people living with HIV. Healthcare providers should address stigma associated with the full range of socially devalued characteristics with which people living with HIV live. © The Author(s) 2013.

  14. Comparison of automatical thoughts among generalized anxiety disorder, major depressive disorder and generalized social phobia patients.

    Science.gov (United States)

    Gül, A I; Simsek, G; Karaaslan, Ö; Inanir, S

    2015-08-01

    Automatic thoughts are measurable cognitive markers of the psychopathology and coping styles of individuals. This study measured and compared the automatic thoughts of patients with generalized anxiety disorder (GAD), major depressive disorder (MDD), and generalized social phobia (GSP). Fifty-two patients with GAD, 53 with MDD, and 50 with GSP and 52 healthy controls completed the validated Automatic Thoughts Questionnaire (ATQ) and a structured psychiatric interview. Patients with GAD, MDD, and GSP also completed the validated Generalized Anxiety Disorder-7 questionnaire, the Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS) to determine the severity of their illnesses. All scales were completed before treatment and after diagnosis. The ATQ scores of all pairs of groups were compared. The ATQ scores of the GAD, MDD, and GSP groups were significantly higher than were those of the control group. We also found significant correlations among scores on the GAD-7, BDI, and LSAS. The mean age of patients with GSP was lower than was that of the other groups (30.90 ± 8.35). The significantly higher ATQ scores of the MDD, GAD, and GSP groups, compared with the control group, underscore the common cognitive psychopathology characterizing these three disorders. This finding confirms that similar cognitive therapy approaches should be effective for these patients. This study is the first to compare GAD, MDD, and GSP from a cognitive perspective.

  15. 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...

  16. 49 CFR 192.475 - Internal corrosion control: General.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Internal corrosion control: General. 192.475... Control § 192.475 Internal corrosion control: General. (a) Corrosive gas may not be transported by... taken to minimize internal corrosion. (b) Whenever any pipe is removed from a pipeline for any reason...

  17. The effects of brief individual cognitive behavioural therapy for depression and homesickness among international students in Malaysia.

    Science.gov (United States)

    Saravanan, Coumaravelou; Alias, Alizi; Mohamad, Mardiana

    2017-10-01

    Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression. The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression. Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores. The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months. Overall, homesickness is considered a normal reaction. Brief

  18. Ecstasy use and depression: a 4-year longitudinal study among an Australian general community sample.

    Science.gov (United States)

    George, Amanda M; Olesen, Sarah; Tait, Robert J

    2013-10-01

    Longitudinal, population-based studies can better assess the relationship of ecstasy use with depression. We examined whether change in ecstasy use was associated with change in depressive symptoms/probable depression over a 4-year period, among a large Australian sample. The Personality and Total Health project is a longitudinal general community study of Australians from Canberra and Queanbeyan. Data from the youngest cohort when aged 24-30 (N = 2, 128) and 4 years later (N = 1, 977) was included. The Goldberg depression scale and the Brief Patient Health Questionnaire measured depressive symptoms and probable depression, respectively. Multilevel growth models also considered demographics, psychosocial characteristics, and other drug use. Ecstasy use was not associated with long-term depressive symptoms or greater odds of depression in multivariate analyses. Users had more self-reported depressive symptoms when using ecstasy compared to not using. However, differences between people who had and had not ever used ecstasy largely accounted for this. Other factors were more important in the prediction of depression. It would be premature to conclude that ecstasy use is not related to the development of long-term depressive symptoms, given the relatively low level of ecstasy and other drug use in this community sample. Results showed that other factors need to be considered when investigating ecstasy use and depression.

  19. Screening for depression in patients with myocardial infarction by general practitioners

    DEFF Research Database (Denmark)

    Larsen, K. K.; Vestergaard, M.; Sondergaard, J.

    2013-01-01

    Background: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners' practice of screening for post-MI depression and analysed whether...... the screening rate varied among subgroups of MI patients with a particular high risk of depression. Design: Population-based cohort study in the Central Denmark Region. Methods: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included...... information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders' general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information...

  20. Screening for depression in patients with myocardial infarction by general practitioners

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær; Vestergaard, Mogens; Christensen, Bo

    2013-01-01

    information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders’ general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information......Background: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners’ practice of screening for post-MI depression and analysed whether...... the screening rate varied among subgroups of MI patients with a particular high risk of depression. Design: Population-based cohort study in the Central Denmark Region. Methods: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included...

  1. The effects of Nordic and general walking on depression disorder patients’ depression, sleep, and body composition

    Science.gov (United States)

    Park, Seong Doo; Yu, Seong Hun

    2015-01-01

    [Purpose] This study examined Nordic walking as an exercise intervention for the elderly with depression. [Subjects] Twenty-four patients who were diagnosed with depression were randomly selected and divided into two groups, an experimental group which performed Nordic walking, and a control group, which performed normal walking. [Methods] Both groups practiced their respective walking exercise for 50 minutes per day, three times a week for eight weeks. To compare the effects of the intervention, psychological factors using the Beck depression inventory and sleep quality was assessed using the Korean version Pittsburgh sleep quality index. Skeletal muscle mass, fat free mass, body mass index, body fat percentage, and basal metabolism were estimated three times by a body composition analyzer, before the intervention, four weeks after the intervention, and eight weeks after the intervention. [Results] There was a significant difference in depression with a main effect of time in both groups. There was also a significant difference in sleep in over time and interaction. The differences over time between the two groups were significant for depression, sleep, and skeletal muscle mass. [Conclusion] The results suggests that Nordic walking has a positive effect on depression and sleeping disorders of the elderly, suggesting that Nordic walking based exercise programs should be developed for the elderly who suffer from depression or a sleeping disorder. PMID:26357429

  2. Role of vision loss, functional limitations and the supporting network in depression in a general population.

    Science.gov (United States)

    van Nispen, Ruth M A; Vreeken, Hilde L; Comijs, Hannie C; Deeg, Dorly J H; van Rens, Ger H M B

    2016-02-01

    Although the prevalence of depression in visually impaired older persons is high, the association between vision loss and depression seems to be influenced by factors other than visual impairment. In this study, the role of vision loss, functional limitations and social network characteristics in relation to depressive symptoms was investigated. Cross-sectional data (N = 1237) from the Longitudinal Aging Study Amsterdam were used to investigate the prevalence of depression (Center of Epidemiological Studies-Depression scale) within subgroups with increasing vision loss. In linear regression models, functional limitations and social network characteristics were examined as possible mediators in the association between vision loss and depression. Having a partner was considered to be a potential moderator. Although a significant linear trend was found in the presence of depressive symptoms with 14% in normally sighted, 23% in mild and 37% in severe vision loss (χ(2)(1) = 14.9; p depression. Mediators were functional limitations (p depression, a trend was found with increasing severity of vision loss, indicating the need for more attention in (mental) health care and low-vision rehabilitation. In the general older population, vision loss was not an independent determinant of depression but was mediated by functional limitations and social network size. Rather than receiving actual social support, the idea of having a social network to rely on when needed seemed to be associated with lower levels of depression. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  3. General health and well-being in outpatients with depressive and bipolar disorders

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Bech, Per

    2006-01-01

    -VAS) and well-being (WHO (Five) well-being index) and more depressive and anxiety symptoms compared with bipolar disorder. Similarly, more psychiatric admissions were associated with poorer general health and well-being and more depressive and anxiety symptoms. However, when adjusting for the effect...... of depressive symptoms, the associations between number of admissions and general health, and between numbers of admissions and well-being, lost significance. Thus, depressive symptoms seem to be the strongest predictor of general health and well-being in both disorders. As the response rate......Prior studies have found contradictory results regarding the association between course of illness and quality of life among patients with depressive disorder or bipolar disorder. Questionnaires about quality of life and affective symptoms (the EQ-5D, EQ-5D-VAS, WHO (Five) well-being index...

  4. Mapping selected general literature of international nursing.

    Science.gov (United States)

    Shams, Marie-Lise Antoun; Dixon, Lana S

    2007-01-01

    This study, part of a wider project to map the literature of nursing, identifies core journals cited in non-US nursing journals and determines the extent of their coverage by indexing services. Four general English-language journals were analyzed for format types and publication dates. Core titles were identified and nine bibliographic databases were scanned for indexing coverage. Findings show that 57.5% (13,391/23,271) of the cited references from the 4 core journals were to journal articles, 27.8% (6,471/23,271) to books, 9.5% (2,208/23,271) to government documents, 4.9% (1,131/23,271) to miscellaneous sources, and less than 1% (70/23,271) to Internet resources. Eleven journals produced one-third of the citations; the next third included 146 journals, followed by a dispersion of 1,622 titles. PubMed received the best database coverage scores, followed by CINAHL and Science Citation Index. None of the databases provided complete coverage of all 11 core titles. The four source journals contain a diverse group of cited references. The currency of citations to government documents makes these journals a good source for regulatory and legislative awareness. Nurses consult nursing and biomedical journals and must search both nursing and biomedical databases to cover the literature.

  5. Neighborhood-Specific and General Social Support: Which Buffers the Effect of Neighborhood Disorder on Depression?

    Science.gov (United States)

    Kim, Joongbaeck; Ross, Catherine E.

    2009-01-01

    Is neighborhood-specific social support the most effective type of social support for buffering the effect of neighborhood disorder on depression? Matching theory suggests that it is. The authors extend the research on neighborhood disorder and adult depression by showing that individuals who have higher levels of both general and…

  6. Autistic Traits in the General Population: What Mediates the Link with Depressive and Anxious Symptomatology?

    Science.gov (United States)

    Rosbrook, Ainslie; Whittingham, Koa

    2010-01-01

    The high prevalence of anxiety disorders and depression within the autism spectrum disorder (ASD) population is widely recognised. This study examined the role of three potential mediating variables in the relationship between autistic traits and depressive/anxious symptomatology in the general population. Participants included 231 university…

  7. The relationship between generalized anxiety disorder, depression and mortality in old age.

    NARCIS (Netherlands)

    Holwerda, T.J.; Schoevers, R.A.; Dekker, J.J.M.; Deeg, D.J.H.; Jonker, C.; Beekman, A.T.F.

    2007-01-01

    Background: The association between depression and in increased risk of death in elderly persons has been established in both clinical and community studies. Co-occurence of depression and generalized anxiety has been shown to represent more severe and more chronic physopathology. However, little is

  8. Delivering stepped care for depression in general practice : Results of a survey amongst general practitioners in the Netherlands

    NARCIS (Netherlands)

    Sinnema, Henny; Franx, Gerdien; Spijker, Jan; Ruiter, Marijke; van Haastrecht, Harry; Verhaak, Peter; Nuyen, Jasper

    2013-01-01

    Background: Revised guidelines for depression recommend a stepped care approach. Little is known about the implementation of the stepped care model by general practitioners (GPs) in daily practice. Objectives: To evaluate the performance of Dutch GPs in their general practice regarding important

  9. Relationship between occupational stress and depressive mood among interns and residents in a tertiary hospital, Seoul, Korea.

    Science.gov (United States)

    Kim, Keon; Lee, Sunhwa; Choi, Yoon Hee

    2015-06-01

    Occupational stress can have a harmful effect on the individual both physically and psychologically. In Korea, occupational stress of physician is rarely demonstrated. Although it is well reported that physicians tend to have a high incidence of minor psychiatric disorders, the magnitude of the problem remains unclear. Interns and residents are thought to be under substantial amount of stress, and tend to have psychiatric disorder. In this paper, we aimed to evaluate the relationship between the occupational stress and depression of residents. The participants of this study were surgical and medical residents in a tertiary hospital in Korea. For measurement of occupational stress, we used an occupational stress scale. In addition, to evaluate the prevalence of depression, we used the Beck Depression Inventory. Female doctors showed higher degree of occupational stress than the males. The interns and chief residents showed higher degree of occupational stress than the other residents. Interestingly, in this study, most of the participants experienced a depressive mood. Compared with the general population, job demand and culture of workplace were high. Occupational stress was the only significant predictor of a depressive mood. Hospital residents experience a high degree of occupational stress leading to a depressed mood due to various risk factors. Therefore, it is essential to recognize the occupational stress of residents early, to encourage positive competition and peer and social support, and to help improve the residents' ability to cope with stress.

  10. Shoaling internal solitary waves of depression over gentle slopes

    Science.gov (United States)

    Rivera, Gustavo; Diamessis, Peter

    2017-11-01

    The shoaling of an internal solitary wave (ISW) of depression over gentle slopes is explored through fully nonlinear and non-hydrostatic simulations using a high resolution/accuracy deformed spectral multidomain penalty method. During shoaling, the wave does not disintegrate as in the case of steeper slope but, instead, maintains its symmetric shape. At the core of the wave, an unstable region forms, characterized by the entrapment of heavier-over-light fluid. The formation of this convective instability is attributed to the vertical stretching by the ISW of the near-surface vorticity layer associated with the baroclinic background current. According to recent field observations in the South China Sea, the unstable region drives localized turbulent mixing within the wave, estimated to be up to four times larger than that in the open ocean, in the form of a recirculating trapped core. In this talk, emphasis is placed on the structure of the unstable region and the persistence of a possible recirculating core using simulations which capture 2D wave propagation combined with 3D representation of the transition to turbulence. As such, a preliminary understanding of the underlying fluid mechanics and the potential broader oceanic significance of ISWs with trapped cores is offered. Financial support gratefully acknowledged to NSF OCE Grant 1634257.

  11. General practitioners’ and psychiatrists’ responses to emotional disclosures in patients with depression

    DEFF Research Database (Denmark)

    Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

    2014-01-01

    OBJECTIVE: To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression. METHODS: Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysi...... approach. As most patients with depression are treated in primary care, developing GPs' mentalizing capacity instead of offering didactic training could have a substantial effect in the population.......OBJECTIVE: To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression. METHODS: Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysis...

  12. Role of Internal and External Religious Beliefs in Mental Health and Rate of Depression in Elderly People

    Directory of Open Access Journals (Sweden)

    Fazel Bahrami

    2007-09-01

    Full Text Available Objectives: The present research is aimed at surveying the role of (internal and external religious orientation in the mental health and the extent of depression in elderly people residing in welfare centers and the society. Methods: The study has been conducted through post-event and correlation method by using stochastic and cluster sampling in 230 cases of elderly people at senior citizens` homes, affiliated with the Welfare Organization, and public places (mosques and parks which are gathering centers for the elderly people of society, both male and female. The cases were initially screened in terms of recognition complications. Then 28-question tests on general health and depression of Beck and Alport`s test on religious approach were completed and the results were analyzed by using Pierson and Manvitni`s dependent statistical tests. Results: Results showed that there is a significant correlation between the religious orientation and depression of the elderly people. That is, the more the scores of external religious orientation rise, the more the scores of disorder in mental health and depression increase. There is also a meaningful difference between mental health, depression and religious orientation of the elderly people who are residence and non-residence of the society. That is, the elderly people who live in the centers enjoy a more external religious orientation and disorder of mental health and more depression as compared to the group of the elderly people residing in the society. Discussion: The external religious belief has a correlation with disorder in the mental health and depression as well as internal religious belief. Moreover, mental disorders and depression among the resident elderly people are higher than non residents, while resident elderly people have a more external religious approach.

  13. Depression in cystic fibrosis; Implications of The International Depression/Anxiety Epidemiological Study (TIDES) in cystic fibrosis.

    Science.gov (United States)

    Duff, Alistair J A

    2015-10-01

    Children and adults with chronic diseases, as well as their parents, are at increased risk for depression. Where people with CF do exhibit psychological distress it is linked to poorer adherence and pulmonary function, increased hospitalisations and healthcare costs and decreased quality of life. The International Depression Epidemiological Study (TIDES) evaluated depression and anxiety in CF patients and parent caregivers across eight European countries and the USA. Two national and one international data sets have been published. This paper summarises the findings, offers explanations for differences in results, and outlines the clinical implications with consideration given to if and how recommendations could be integrated into managing CF in the UK. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Depression among Collage Students; The Role of General Self-Efficacy and Perceived Social Support

    Directory of Open Access Journals (Sweden)

    F. Jalilian

    2012-01-01

    Full Text Available Introduction & Objective: Depression is the most common psychiatric disorder reported among college students. Evidence suggests that depression rate is especially high among medical students. The goal of this study was to examine the relationship of general self-efficacy and social support with depression levels of university students.Materials & Methods: This was a descriptive analytic study carried out among 235 students in Hamadan University of medical sciences. Samples were classified with the appropriate assignment done and gathering information from standard questionnaires (Beck Depression Inventory test & General Self Efficacy Scale & Perceived Social Support Scale. The data were analyzed by SPSS-13.Results: 37 percent of students showed different degrees of depression. A significant negative correlation was found among depression, self efficacy (P.value= 0.000, r= -0.581, and social support (P.value= 0.000, r= -0.617. Also the results showed that there was significant relationship between depression and student's dwelling (P<0.05.Conclusion: These findings also indicated the potential roles of social support in mediating depression. According to the results self efficacy strategies could improve the students' mental health.(Sci J Hamadan Univ Med Sci 2012;18(4:60-66

  15. The Role of Self-Compassion in Buffering Symptoms of Depression in the General Population.

    Directory of Open Access Journals (Sweden)

    Annett Körner

    Full Text Available Self-compassion, typically operationalized as the total score of the Self-Compassion Scale (SCS; Neff, 2003b, has been shown to be related to increased psychological well-being and lower depression in students of the social sciences, users of psychology websites and psychotherapy patients. The current study builds on the existing literature by examining the link between self-compassion and depressive symptomatology in a sample representative of the German general population (n = 2,404. The SCS subscales of self-judgment, isolation, and over-identification, and the "self-coldness", composite score, which encompass these three negative subscales, consistently differed between subsamples of individuals without any depressive symptoms, with any depressive syndromes, and with major depressive disorder. The contribution of the positive SCS subscales of self-kindness, common humanity, and mindfulness to the variance in depressive symptomatology was almost negligible. However, when combined to a "self-compassion composite", the positive SCS subscales significantly moderated the relationship between "self-coldness" and depressive symptoms in the general population. This speaks for self-compassion having the potential to buffer self-coldness related to depression--providing an argument for interventions that foster self-caring, kind, and forgiving attitudes towards oneself.

  16. Collaborative care for depression in general practice: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Brinck-Claussen, Ursula Ødum; Curth, Nadja Kehler; Davidsen, Annette Sofie; Mikkelsen, John Hagel; Lau, Marianne Engelbrecht; Lundsteen, Merete; Csillag, Claudio; Christensen, Kaj Sparle; Hjorthøj, Carsten; Nordentoft, Merete; Eplov, Lene Falgaard

    2017-07-21

    Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish context. We therefore developed a model for CC (the Collabri model) to treat people with depression in general practice in Denmark. Since systematic identification of patients is an "active ingredient" in CC and some literature suggests case finding as the best alternative to standard detection, the two detection methods are examined as part of the study. The aim is to investigate if treatment according to the Collabri model has an effect on depression symptoms when provided to people with depression in general practice in Denmark, and to examine if case finding is a better method to detect depression in general practice than standard detection. The trial is a cluster-randomised, clinical superiority trial investigating the effect of treatment according to the Collabri model for CC, compared to treatment as usual for 480 participants diagnosed with depression in general practice in the Capital Region of Denmark. The primary outcome is depression symptoms (Beck's Depression Inventory (BDI-II)) after 6 months. Secondary outcomes include depression symptoms (BDI-II) after 15 months, anxiety symptoms (Beck's Anxiety Inventory (BAI)), level of functioning (Global Assessment of Function (GAF)) and psychological stress (Symptom Checklist-90-Revised (SCL-90-R)). In addition, case finding (with the recommended screening tool Major Depression Inventory (MDI)) and standard detection of depression is examined in a cluster-randomized controlled design. Here, the primary outcome is the positive predictive value of referral diagnosis. If the Collabri model is shown to be superior to treatment as usual, the study will contribute with important knowledge on how to improve treatment of depression in

  17. Association of Parental ADHD and Depression with Externalizing and Internalizing Dimensions of Child Psychopathology

    Science.gov (United States)

    Humphreys, Kathryn L.; Mehta, Natasha; Lee, Steve S.

    2012-01-01

    Objective: To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. Method: Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were…

  18. Lesbian, gay, & bisexual older adults: linking internal minority stressors, chronic health conditions, and depression.

    Science.gov (United States)

    Hoy-Ellis, Charles P; Fredriksen-Goldsen, Karen I

    2016-11-01

    This study aims to: (1) test whether the minority stressors disclosure of sexual orientation; and (2) internalized heterosexism are predictive of chronic physical health conditions; and (3) depression; (4) to test direct and indirect relationships between these variables; and (5) whether chronic physical health conditions are further predictive of depression, net of disclosure of sexual orientation and internalized heterosexism. Secondary analysis of national, community-based surveys of 2349 lesbian, gay, and bisexual adults aged 50 and older residing in the US utilizing structural equation modeling. Congruent with minority stress theory, disclosure of sexual orientation is indirectly associated with chronic physical health conditions and depression, mediated by internalized heterosexism with a suppressor effect. Internalized heterosexism is directly associated with chronic physical health conditions and depression, and further indirectly associated with depression mediated by chronic physical health conditions. Finally, chronic physical health conditions have an additional direct relationship with depression, net of other predictor variables. Minority stressors and chronic physical health conditions independently and collectively predict depression, possibly a synergistic effect. Implications for depression among older sexual minority adults are discussed.

  19. International trade in carbon emission rights and basic materials: General equilibrium calculations for 2020

    International Nuclear Information System (INIS)

    Perroni, C.; Rutherford, T.F.

    1993-01-01

    Restrictions on CO 2 emissions affect international trade and the pattern of comparative advantage. This paper, based on calculations with a static general equilibrium model, suggests that international trade in carbon rights is a substitute for trade in energy-intensive goods, and thus international trading in carbon rights reduces sectoral effects of emission reductions. In our model, we surprisingly find that free riding by non-signatory countries may not render unilateral action ineffective. If the OECD unilaterally cuts global emissions by 5 per cent from 1990 levels by the year 2020, emission by non-OECD regions increase but offset less than 15 per cent of this cutback. Moreover, carbon taxes depress international oil prices and create incentives for increased trade in natural gas. 14 refs, 7 figs

  20. Hostility/anger as a mediator between college students' emotion regulation abilities and symptoms of depression, social anxiety, and generalized anxiety.

    Science.gov (United States)

    Asberg, Kia

    2013-01-01

    Internalizing problems are common among college students and have been linked consistently to deficits in emotion regulation (ER). Also, hostility/anger (animosity toward others, phenomenological aspect of anger) is an important feature of internalizing problems, but has received limited attention as a mediator between ER and outcomes. Results (N = 160) indicated that although college students' ER abilities corresponded with all three types of internalizing symptoms, hostility/anger mediated fully the relationship for symptoms of depression and social anxiety, but not generalized anxiety (GAD). The stronger interpersonal aspect inherent in depression and social anxiety relative to GAD may in part explain findings, but findings must be viewed in lieu of limitations, which include self-report, a non-clinical sample, and a cross-sectional design. Overall, hostility/anger may be important to address in interventions and programs aimed at reducing internalizing problems, especially among those who demonstrate ER deficits and are prone to depression and social anxiety.

  1. Depression and unemployment incidence rate evolution in Portugal, 1995-2013: General Practitioner Sentinel Network data.

    Science.gov (United States)

    Rodrigues, Ana Paula; Sousa-Uva, Mafalda; Fonseca, Rita; Marques, Sara; Pina, Nuno; Matias-Dias, Carlos

    2017-11-17

    Quantify, for both genders, the correlation between the depression incidence rate and the unemployment rate in Portugal between 1995 and 2013. An ecological study was developed to correlate the evolution of the depression incidence rates estimated by the General Practitioner Sentinel Network and the annual unemployment rates provided by the National Statistical Institute in official publications. There was a positive correlation between the depression incidence rate and the unemployment rate in Portugal, which was significant only for males (R2 = 0.83, p = 0.04). For this gender, an increase of 37 new cases of depression per 100,000 inhabitants was estimated for each 1% increase in the unemployment rate between 1995 and 2013. Although the study design does not allow the establishment of a causal association between unemployment and depression, the results suggest that the evolution of unemployment in Portugal may have had a significant impact on the level of mental health of the Portuguese, especially among men.

  2. The risk of being depressed is significantly higher in cancer patients than in the general population

    DEFF Research Database (Denmark)

    Hartung, T J; Brähler, E; Faller, H

    2017-01-01

    BACKGROUND: Depression is a common co-morbidity of cancer that has a detrimental effect on quality of life, treatment adherence and potentially survival. We conducted an epidemiological multi-center study including a population-based random comparison sample and estimated the prevalence...... of depressive symptoms by cancer site, thereby identifying cancer patients with the highest prevalence of depression. PATIENTS AND METHODS: We included 4020 adult cancer inpatients and outpatients from five distinct regions across Germany in a proportional stratified random sample based on the nationwide cancer......% participated (51% women, mean age = 58 years). We estimated that one in four cancer patients (24%) is depressed (PHQ-9 ≥ 10). The odds of being depressed among cancer patients were more than five times higher than in the general population (OR, 5.4; 95% CI, 4.6-6.2). Patients with pancreatic (M = 8.0, SD = 5...

  3. Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: the effect of eating disorders and past depression.

    Science.gov (United States)

    Micali, Nadia; Simonoff, Emily; Treasure, Janet

    2011-06-01

    This study investigated the effect of past depression, past and current eating disorders (ED) on perinatal anxiety and depression in a large general population cohort of pregnant women, the Avon Longitudinal Study of Parents and Children (ALSPAC). Anxiety and depression were measured during and after pregnancy in 10,887 women using the Crown-Crisp Experiential Inventory and Edinburgh Postnatal Depression Scale. Women were grouped according to depression and ED history: past ED with (n = 123) and without past depression (n = 50), pregnancy ED symptoms with (n = 77) and without past depression (n = 159), past depression only (n = 818) and controls (n = 9,660). We compared the course of depression and anxiety with linear mixed-effect regression models; and probable depressive and anxiety disorders using logistic regression. Women with both past depression and past/current ED had high anxiety and depression across time perinatally; this was most marked in the group with pregnancy ED symptoms and past depression (b coefficient:5.1 (95% CI: 4.1-6.1), p depressive and anxiety disorder compared to controls. At 8 months post-partum pregnancy ED symptoms and/or past depression conferred the highest risk for a probable depressive and anxiety disorder. Data were based on self-report. There was some selective attrition. Pregnancy ED symptoms and past depression have an additive effect in increasing the risk for depression and anxiety perinatally. Screening at risk women for anxiety and depression in the perinatal period might be beneficial. Copyright © 2010 Elsevier B.V. All rights reserved.

  4. Descriptive epidemiology of stigma against depression in a general population sample in Alberta

    Directory of Open Access Journals (Sweden)

    Wang JianLi

    2010-04-01

    Full Text Available Abstract Background Mental health illnesses, such as depression, are responsible for a growing disease burden worldwide. Unfortunately, effective treatment is often impeded by stigmatizing attitudes of other individuals, which have been found to lead to a number of negative consequences including reduced help-seeking behavior and increased social distance. Despite the high prevalence of depression in Canada, little research has been conducted to examine stigma against depression in the Canadian general population. Such information is crucial to understanding the current state of stigmatizing attitudes in the Canadian communities, and framing future stigma reduction initiatives. The objectives of this study were to estimate the percentages of various stigmatizing attitudes toward depression in a general population sample and to compare the percentages by demographics and socioeconomic characteristics. Methods We conducted a cross-sectional telephone survey in Alberta, Canada, between February and June 2006. Random digit dialing was used to recruit participants who were aged 18-74 years old (n = 3047. Participants were presented a case vignette describing a depressed individual, and responded to a 9-item Personal Stigma questionnaire. The percentages of stigmatizing attitudes were estimated and compared by demographic and socioeconomic variables. Results Among the participants, 45.9% endorsed that depressed individuals were unpredictable and 21.9% held the view that people with depression were dangerous. Significant differences in stigmatizing attitudes were found by gender, age, education, and immigration status. A greater proportion of men than women held stigmatizing views on each stigma item. No consistent trend emerged by age in stigma against depression. Participants with higher levels of education reported less stigmatizing attitudes than those with less education. Participants who were not born in Canada were more likely to hold

  5. Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea.

    Science.gov (United States)

    Kim, Ji-Hyun; Cho, Maeng Je; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Hahm, Bong-Jin; Lee, Dong-Woo; Park, Jong-Ik; Lee, Jun-Young; Jeon, Hong Jin; Chang, Sung Man

    2015-11-01

    This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.

  6. The Association of Parental Depressive Symptoms with Child Internalizing Problems: The Role of Parental Guilt Induction

    Science.gov (United States)

    Rakow, Aaron; Forehand, Rex; Haker, Kelly; McKee, Laura G.; Champion, Jennifer E.; Potts, Jennifer; Hardcastle, Emily; Roberts, Lorinda; Compas, Bruce E.

    2010-01-01

    This study builds on prior research by Rakow et al. (2009) by examining the role of parental guilt induction in the association between parent depressive symptoms and child internalizing problems in a sample of parents with a history of major depressive disorder. One hundred and two families with 129 children (66 males; Mage = 11.42 years) were studied. The association of parental depressive symptoms with child internalizing problems was accounted for by parental guilt induction, which was assessed by behavioral observations and child report. Implications of the findings for parenting programs are discussed and future research directions are considered. PMID:21355654

  7. Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder.

    Science.gov (United States)

    Marganska, Anna; Gallagher, Michelle; Miranda, Regina

    2013-01-01

    Differences in attachment style have been linked to both emotion regulation and psychological functioning, but the emotion regulatory mechanism through which attachment style might impact symptoms of depression and anxiety is unclear. The present study examined the explanatory role of emotion dysregulation in the relation between adult attachment style and symptoms of depression and generalized anxiety disorder (GAD) in a sample of 284 adults. Secure attachment was associated with lower depression and GAD symptoms and lower emotion dysregulation, whereas insecure attachment styles were generally associated with higher depression and GAD scores and higher emotion dysregulation. Perceived inability to generate effective emotion regulation strategies mediated the relation between insecure attachment and both depression and GAD symptoms. Nonacceptance of negative emotions and inability to control impulsive behaviors emerged as additional mediators of the relation between insecure attachment styles and GAD symptoms. The differential contribution of attachment style and emotion regulation to the prediction of depression and GAD symptoms may reflect differences in vulnerability to depression and GAD. © 2013 American Orthopsychiatric Association.

  8. Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Talati, Ardesheer; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2009-01-01

    Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major depressive disorder and were treated initially with citalopram; 33% of mothers experienced remission of depressive symptoms. Youth ranged in age from 7 to 17. Remission of maternal depression was associated with changes in children's reports of their mothers' warmth/acceptance, which in turn partially mediated the relation between maternal depression remission and youth internalizing symptoms, accounting for 22.9% of the variance. PMID:18991123

  9. General medicine vs subspecialty career plans among internal medicine residents.

    Science.gov (United States)

    West, Colin P; Dupras, Denise M

    2012-12-05

    Current medical training models in the United States are unlikely to produce sufficient numbers of general internists and primary care physicians. Differences in general internal medicine (GIM) career plans between internal medicine residency program types and across resident demographics are not well understood. To evaluate the general medicine career plans of internal medicine residents and how career plans evolve during training. A study of US internal medicine residents using an annual survey linked to the Internal Medicine In-Training Examination taken in October of 2009-2011 to evaluate career plans by training program, sex, and medical school location. Of 67,207 US eligible categorical and primary care internal medicine residents, 57,087 (84.9%) completed and returned the survey. Demographic data provided by the National Board of Medical Examiners were available for 52,035 (77.4%) of these residents, of whom 51,390 (76.5%) responded to all survey items and an additional 645 (1.0%) responded to at least 1 survey item. Data were analyzed from the 16,781 third-year residents (32.2%) in this sample. Self-reported ultimate career plans of internal medicine residents. A GIM career plan was reported by 3605 graduating residents (21.5%). A total of 562 primary care program (39.6%) and 3043 categorical (19.9%) residents reported GIM as their ultimate career plan (adjusted odds ratio [AOR], 2.76; 99% CI, 2.35-3.23; P international medical graduates (22.0% vs 21.1%, respectively; AOR, 1.76; 99% CI, 1.50-2.06; P international medical graduates (57.3% vs 27.3%, respectively; AOR, 3.48; 99% CI, 2.58-4.70; P internal medicine residents, including those in primary care training programs, and differed according to resident sex, medical school location, and program type.

  10. Factors associated with higher levels of depressive symptoms among international university students in the Philippines.

    Science.gov (United States)

    Lee, Romeo B; Maria, Madelene Sta; Estanislao, Susana; Rodriguez, Cristina

    2013-11-01

    Over the years, the number of international university students has been increasing in the Philippines. Depression tends to be common among this demographic sector, because of the varying challenges and expectations associated with studying abroad. Depression can be prevented if its symptoms, particularly those at higher levels, are identified and addressed early and effectively. This survey examined the social and demographic factors that are significantly associated with higher levels of depressive symptoms. One hundred twenty-six international university students were interviewed using the University Students Depression Inventory. Of the 13 factors analyzed, 3 were found with statistically significant associations with more intense levels of depressive symptoms. These factors were: level of satisfaction with one's financial condition, level of closeness with parents, and level of closeness with peers. In identifying international students with greater risk for depression, characteristics related to their financial condition and primary group relationships can be considered. There is a need to carry out more studies to confirm this initial evidence. The findings can help guide further discourse, research and program to benefit international students with higher levels of depressive symptoms.

  11. Academic general internal medicine: a mission for the future.

    Science.gov (United States)

    Armstrong, Katrina; Keating, Nancy L; Landry, Michael; Crotty, Bradley H; Phillips, Russell S; Selker, Harry P

    2013-06-01

    After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve health care delivery that is comprehensive, technologically advanced and individualized; instills trust within a culture of respect; is efficient in the use of time, people, and resources; is organized and financed to achieve optimal health outcomes; maximizes equity; and continually learns and adapts. This mission of health care transformation has implications for the clinical, educational, and research activities of divisions of general internal medicine over the next several decades.

  12. Testing specificity among parents' depressive symptoms, parenting, and child internalizing and externalizing symptoms.

    Science.gov (United States)

    Gruhn, Meredith A; Dunbar, Jennifer P; Watson, Kelly H; Reising, Michelle M; McKee, Laura; Forehand, Rex; Cole, David A; Compas, Bruce E

    2016-04-01

    The present study examined the specificity in relations between observed withdrawn and intrusive parenting behaviors and children's internalizing and externalizing symptoms in an at-risk sample of children (ages 9 to 15 years old) of parents with a history of depression (N = 180). Given past findings that parental depression and parenting behaviors may differentially impact boys and girls, gender was examined as a moderator of the relations between these factors and child adjustment. Correlation and linear regression analyses showed that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys and girls and to intrusive parenting for parents of boys only. When controlling for intrusive parenting, preliminary analyses demonstrated that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys, and this association approached significance for parents of girls. Specificity analyses yielded that, when controlling for the other type of problem (i.e., internalizing or externalizing), withdrawn parenting specifically predicted externalizing problems but not internalizing problems in girls. No evidence of specificity was found for boys in this sample, suggesting that impaired parenting behaviors are diffusely related to both internalizing and externalizing symptoms for boys. Overall, results highlight the importance of accounting for child gender and suggest that targeting improvement in parenting behaviors and the reduction of depressive symptoms in interventions with parents with a history of depression may have potential to reduce internalizing and externalizing problems in this high-risk population. (c) 2016 APA, all rights reserved).

  13. Testing Specificity Among Parents’ Depressive Symptoms, Parenting, and Child Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Gruhn, Meredith A.; Dunbar, Jennifer P.; Watson, Kelly H.; Reising, Michelle M.; McKee, Laura; Forehand, Rex; Cole, David A.; Compas, Bruce E.

    2016-01-01

    The present study examined the specificity in relations between observed withdrawn and intrusive parenting behaviors and children's internalizing and externalizing symptoms in an at risk sample of children (ages 9 to 15-years-old) of parents with a history of depression (N = 180). Given past findings that parental depression and parenting behaviors may differentially impact boys and girls, gender was examined as a moderator of the relations between these factors and child adjustment. Correlation and linear regression analyses showed that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys and girls and to intrusive parenting for parents of boys only. When controlling for intrusive parenting, preliminary analyses demonstrated that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys, and this association approached significance for parents of girls. Specificity analyses yielded that, when controlling for the other type of problem (i.e., internalizing or externalizing), withdrawn parenting specifically predicted externalizing problems but not internalizing problems in girls. No evidence of specificity was found for boys in this sample, suggesting that impaired parenting behaviors are diffusely related to both internalizing and externalizing symptoms for boys. Overall, results highlight the importance of accounting for child gender and suggest that targeting improvement in parenting behaviors and the reduction of depressive symptoms in interventions with parents with a history of depression may have potential to reduce internalizing and externalizing problems in this high-risk population. PMID:26882467

  14. Relationship Between Depression and Perception of Pain Severity in Patients Admitted to General Surgery Ward

    Directory of Open Access Journals (Sweden)

    Mehdi Samadzadeh

    2016-11-01

    Full Text Available Background Depression is considered as the most common psychological problem in individuals. Patients with persistent pain usually suffer from depression, disturbance in interpersonal relations, fatigue, and reduced physical and psychological performance. Objectives The aim of this study was to survey the relationship between depression and perception of pain severity in patients admitted to general surgery ward. Methods This research was a cross-sectional descriptive study. The study population included patients admitted to general surgery ward at hospitals of Ardabil city during 2010 - 2011. The study sample consisted of 168 individuals (male and female who were selected by nonrandomized convenience sampling method. The data were collected using a questionnaire on demographic information, the Beck depression inventory (BDI, and Toren questionnaire on pain beliefs and perceptions. The SPSS software was used for statistical analysis. Results The highest frequency of participants had moderate depression (44.1% while the lowest frequency belonged to healthy individuals (4.2%. The score of depression was higher in men (23.21 ± 7.56 than women (19.19 ± 6.84 as the same as the score of pain perception (8.91 ± 2.34 vs. 7.95 ± 1.87, respectively. The results indicated that there was a positive significant relationship between depression and perception of pain severity (P ≤ 0.01. This means that patients who have a history of depression feel much more pain during hospitalization and after the surgery. Conclusions Depressed or anguished patients report more pain compared to healthy ones.

  15. Psychological distress, depression, anxiety, and burnout among international humanitarian aid workers: a longitudinal study.

    Directory of Open Access Journals (Sweden)

    Barbara Lopes Cardozo

    Full Text Available BACKGROUND: International humanitarian aid workers providing care in emergencies are subjected to numerous chronic and traumatic stressors. OBJECTIVES: To examine consequences of such experiences on aid workers' mental health and how the impact is influenced by moderating variables. METHODOLOGY: We conducted a longitudinal study in a sample of international non-governmental organizations. Study outcomes included anxiety, depression, burnout, and life and job satisfaction. We performed bivariate regression analyses at three time points. We fitted generalized estimating equation multivariable regression models for the longitudinal analyses. RESULTS: Study participants from 19 NGOs were assessed at three time points: 212 participated at pre-deployment; 169 (80% post-deployment; and 154 (73% within 3-6 months after deployment. Prior to deployment, 12 (3.8% participants reported anxiety symptoms, compared to 20 (11.8% at post-deployment (p = 0.0027; 22 (10.4% reported depression symptoms, compared to 33 (19.5% at post-deployment (p = 0.0117 and 31 (20.1% at follow-up (p = .00083. History of mental illness (adjusted odds ratio [AOR] 4.2; 95% confidence interval [CI] 1.45-12.50 contributed to an increased risk for anxiety. The experience of extraordinary stress was a contributor to increased risk for burnout depersonalization (AOR 1.5; 95% CI 1.17-1.83. Higher levels of chronic stress exposure during deployment were contributors to an increased risk for depression (AOR 1.1; 95% CI 1.02-1.20 comparing post- versus pre-deployment, and increased risk for burnout emotional exhaustion (AOR 1.1; 95% CI 1.04-1.19. Social support was associated with lower levels of depression (AOR 0.9; 95% CI 0.84-0.95, psychological distress (AOR = 0.9; [CI] 0.85-0.97, burnout lack of personal accomplishment (AOR 0.95; 95% CI 0.91-0.98, and greater life satisfaction (p = 0.0213. CONCLUSIONS: When recruiting and preparing aid workers for deployment, organizations should

  16. Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety.

    Science.gov (United States)

    Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Foa, E B; Kessler, R C; McFarlane, A C; Shalev, A Y

    2000-01-01

    To provide primary care clinicians with a better understanding of management issues in posttraumatic stress disorder (PTSD) and guide clinical practice with recommendations on the appropriate management strategy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty invited by the chair were Edna B. Foa, Ronald C. Kessler, Alexander C. McFarlane, and Arieh Y. Shalev. The consensus statement is based on the 6 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Group meetings were held over a 2-day period. On day 1, the group discussed the review articles and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. PTSD is often a chronic and recurring condition associated with an increased risk of developing secondary comorbid disorders, such as depression. Selective serotonin reuptake inhibitors are generally the most appropriate choice of first-line medication for PTSD, and effective therapy should be continued for 12 months or longer. The most appropriate psychotherapy is exposure therapy, and it should be continued for 6 months, with follow-up therapy as needed.

  17. [Diagnosis and treatment in general internal medicine. Curriculum selection].

    Science.gov (United States)

    Casal, E R; Vázquez, E N; Husni, C

    1994-01-01

    In our country general internists are the providers of adult medical care in urban areas. In the past twenty years, with the increasing subspecialization within internal medicine and the development of advances in technology, the role of the general internist seems to be endangered. Recently much attention has been focused on this area and Divisions and Programs of General Internal Medicine have been established in most medical schools in the USA. The University of Buenos Aires instituted a Program of General Internal Medicine in its major teaching hospital in 1987. One of its purposes was to offer an educational experience to residents in the field of internal medicine primary care. This paper summarizes how this program was carried out and the subjects proposed in the area of Diagnosis and Treatment. The Program of General Internal Medicine is performed in the Outpatient Division and it is staffed by 3 faculty members and 4 fellows. Residents in Internal Medicine have a three month, full-time block rotation in the Program. A young, city dwelling, lower middle class population participates in the Program, with almost 10000 visits a year. The Program offers an experience that includes supervised patient care, an average of 100 office visits a month, and seminars and/or workshops covering topics of "Diagnosis and Treatment", "Case Presentations", "Clinical Epidemiology", "Prevention", and "Doctor-Patient Interview". In the area of Diagnosis and Treatment, the criteria used were: 1-frequency of diagnosis as determined by previous investigations, 2-relevant clinical conditions absent from the frequency list as determined by a consensus process by faculty members.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Unhealthy lifestyle factors and depressive symptoms: A Japanese general adult population survey.

    Science.gov (United States)

    Furihata, Ryuji; Konno, Chisato; Suzuki, Masahiro; Takahashi, Sakae; Kaneita, Yoshitaka; Ohida, Takashi; Uchiyama, Makoto

    2018-07-01

    To investigate the relationship between unhealthy lifestyles factors and depressive symptoms among the general adult population in Japan. Participants were randomly selected from the Japanese general adult population. Data from 2334 people aged 20 years or older were analyzed. This cross-sectional survey was conducted in August and September 2009. Participants completed a face-to-face interview about unhealthy lifestyle factors, including lack of exercise, skipping breakfast, a poorly balanced diet, snacking between meals, insufficient sleep, current smoking, alcohol drinking, and obesity. Presence of depressive symptoms was defined as a score of ≥ 16 on the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Relationships between unhealthy lifestyle factors and depressive symptoms were evaluated by multivariate logistic regression analysis adjusting for sociodemographic variables and other unhealthy lifestyle factors. Multivariate logistic regression analysis revealed that insufficient sleep, a poorly balanced diet, snacking between meals and lack of exercise were significantly associated with the prevalence of depressive symptoms, with odds ratios ranging from 1.56 for lack of exercise to 3.98 for insufficient sleep. Since this study was a cross-sectional study, causal relationships could not be determined. These results suggest that promoting a healthy lifestyle focused on sleep, food intake and exercise may be important for individuals with depressive symptoms. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Currency Hedging for International Stock Portfolios : A General Approach

    NARCIS (Netherlands)

    de Roon, F.A.; Nijman, T.E.; Werker, B.J.M.

    1999-01-01

    This paper tests whether hedging currency risk improves the performance of international stock portfolios. We use a generalized performance measure which allows for investor-dependencies such as different utility functions and the presence of nontraded risks. In addition we show that an auxiliary

  20. [Exploring the relationship between internalized stigma, insight and depression for inpatients with schizophrenia].

    Science.gov (United States)

    Bouvet, C; Bouchoux, A

    2015-10-01

    Recent studies on insight in people with schizophrenia showed that insight level is linked with treatment compliance. Therefore, many therapies are aimed at increasing the insight level, such as psycho-education. However, insight level is also probably linked with depression level. So, improving insight is at risk of increasing the level of depression. Nevertheless, results on this topic are not consensual in the scientific literature. Presumably, this could be due to the concept of insight itself, although we could hypothesise that some confounding variables are implied in the interaction between insight and depression, such as internalized stigma. to test the hypothesis that the relationship between insight and depression is mediated by internalized stigma in people with schizophrenia. Sixty-two patients with schizophrenia (DSM-IV or ICD-10) recruited in mental health services in Île de France (75% male), aged 20 to 64 years (m=38.71, σ=0. 43), filled in questionnaires assessing internalized stigma (ISMI), depression (CDSS and BDI) and insight (SAIQ, Q8, IS), after giving their written informed consent. Correlations between insight, depression and different variables were made (Hypothesis 1). Then we ran multiple regressions and partial correlations to test the internalized stigma mediation (Hypothesis 2). Insight, internalized stigma and depression are statistically significantly correlated with each scales used (except Q8). Insight is correlated with depressed mood (correlations between IS and CDSS: r=0.27, P=0.04, and BDI, r=0.40, P=0.001). We also found negative correlations between SAIQ and CDSS (r=-0.35, P=0.005) and the BDI (r=-0.4265, P=0.000) which means that good insight is linked with depression. This result validates our hypothesis 1. The statistic tests reveal other complementary results: the association between insight and depression is mediated by the level of internalized stigma: when ISMI is controlled, the correlation between insight and

  1. Metabolic syndrome and depressive symptoms among rural Northeast general population in China

    Directory of Open Access Journals (Sweden)

    Shasha Yu

    2017-01-01

    Full Text Available Abstract Background Previous researches aiming to estimate the association between metabolic syndrome and depressive symptoms come out with inconsistent results. Besides, most of them are conducted in the developed areas. There is lack of the data from rural China. The aim of this study is to confirm whether gender difference exists among the relationship between MetS, metabolic components and depressive symptoms in the rural Chinese population. Methods A cross-sectional analysis enrolled 11430 subjects’ aged ≥35 from rural Northeast China. Metabolic and anthropometric indicators were measured according to standard methods. Depressive symptoms were defined using the Patient Health Questionnaire-9 (PHQ-9. Results The prevalence of depressive symptoms was 6% among rural Northeast general population and the prevalence of MetS and its components were 39.0% for MetS, 42.9% for abdominal obesity, 67.1% for elevated blood pressure, 47.1% for hyperglycemia, 32.1% for hypertriglyceridemia, 29.5% for low HDL-C. Depressive symptoms were associated with triglyceride component (OR = 1.24, 95%CI: 1.05–1.46, P = 0.01 but not MetS (OR = 1.11, 95%CI: 0.94–1.30, P = 0.23. Moreover, depressive symptoms were associated with triglyceride component (OR = 1.21, 95% CI = 1.00–1.47, P = 0.05 in women only. But once adjusted for menopause status, depressive symptoms were no longer statically associated with triglyceride component (OR = 1.20, 95% CI = 0.99–1.46, P = 0.07. Conclusions Depressive symptoms were associated with triglyceride component but not MetS in rural Chinese population. Routine lipid screening should be recommended among rural depressed residents especially among female.

  2. Path Analysis of Acculturative Stress Components and Their Relationship with Depression Among International Students in China.

    Science.gov (United States)

    Liu, Yang; Chen, Xinguang; Li, Shiyue; Yu, Bin; Wang, Yan; Yan, Hong

    2016-12-01

    Acculturative stress prevents international students from adapting to the host culture, increasing their risk for depression. International students in China are a growing and at-risk population for acculturative stress and depression. With data from the International Student Health and Behaviour Survey (Yu et al., ) in China, seven acculturative stress components were detected in a previous study (Yu et al., ), including a central component (self-confidence), three distal components (value conflict, identity threat and rejection) and three proximal components (poor cultural competence, opportunity deprivation and homesickness). The current study extended the previous study to investigate the relationship between these components and depression with data also from International Student Health and Behaviour Survey. Participants were 567 students (59% male, 40.4% African, mean age = 22.75, SD = 4.11) recruited in Wuhan, China. The sample scored high on the Acculturative Stress Scale for International Students (M = 92.81, SD = 23.93) and Center for Epidemiologic Studies Short Depression Scale (M = 0.97, SD = 0.53). Acculturative stress was positively associated with depression; the association between the three distal stress components and depression was fully mediated through self-confidence, while the three proximal components had a direct effect and a self-confidence-mediated indirect effect. These findings extended the value of the previous study, highlighted the central role of self-confidence in understanding acculturative stress and depression and provided new data supporting more effective counselling for international students in China. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Generalized internal multiple imaging (GIMI) using Feynman-like diagrams

    KAUST Repository

    Zuberi, M. A. H.

    2014-05-19

    Single scattering events recorded in surface seismic data do not fully illuminate the subsurface structure, especially if it is complicated. In such cases, multiple internal scatterings (internal multiples) can help improve the illumination. We devise a generalized internal multiple imaging (GIMI) procedure that maps internal multiple energy to their true location with a relatively mild addition to the computational cost. GIMI theory relies heavily on seismic interferometry, which often involves cumbersome algebra, especially when one is dealing with high-order terms in the perturbation series. To make the derivations, and inference of the results easier, we introduce Feynman-like diagrams to represent different terms of the perturbation series (solution to the Lippman–Schwinger equation). The rules we define for the diagrams allow operations like convolution and cross-correlation in the series to be compressed in diagram form. The application of the theory to a double scattering example demonstrates the power of the method.

  4. Generalized internal multiple imaging (GIMI) using Feynman-like diagrams

    KAUST Repository

    Zuberi, M. A. H.; Alkhalifah, Tariq Ali

    2014-01-01

    Single scattering events recorded in surface seismic data do not fully illuminate the subsurface structure, especially if it is complicated. In such cases, multiple internal scatterings (internal multiples) can help improve the illumination. We devise a generalized internal multiple imaging (GIMI) procedure that maps internal multiple energy to their true location with a relatively mild addition to the computational cost. GIMI theory relies heavily on seismic interferometry, which often involves cumbersome algebra, especially when one is dealing with high-order terms in the perturbation series. To make the derivations, and inference of the results easier, we introduce Feynman-like diagrams to represent different terms of the perturbation series (solution to the Lippman–Schwinger equation). The rules we define for the diagrams allow operations like convolution and cross-correlation in the series to be compressed in diagram form. The application of the theory to a double scattering example demonstrates the power of the method.

  5. 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

  6. General health mediates the relationship between loneliness, life satisfaction and depression. A study with Malaysian medical students.

    Science.gov (United States)

    Swami, Viren; Chamorro-Premuzic, Tomas; Sinniah, Dhachayani; Maniam, Thambu; Kannan, Kumaraswami; Stanistreet, Debbi; Furnham, Adrian

    2007-02-01

    To examine the associations between life satisfaction, loneliness, general health and depression among 172 medical students in Malaysia. Participants completed a questionnaire battery, which included the 12-item General Health Questionnaire, Beck's Depression Inventory, the Revised UCLA Loneliness Scale and the Satisfaction With Life Scale. Life satisfaction was negatively and significantly correlated with suicidal attitudes, loneliness and depression; and positively with health, which was negatively and significantly correlated with depression and loneliness. Self-concept was negatively correlated with loneliness and depression, depression was positively and significantly correlated with loneliness. Mediational analyses showed that the effects of loneliness and life dissatisfaction on depression were fully mediated by health. Even though less satisfied, and particularly lonelier, individuals are more likely to report higher levels of depression, this is only the case because both higher loneliness and life dissatisfaction are associated with poorer health. These results are discussed in terms of their implications for the diagnosis and treatment of mental health disorders in developing nations.

  7. [A cross-sectional survey of the prevalence of depressive-anxiety disorders among general hospital outpatients in five cities in China].

    Science.gov (United States)

    He, Yan-ling; Ma, Hong; Zhang, Lan; Liu, Zhe-ning; Jia, Fu-jun; Zhang, Ming-yuan

    2009-09-01

    To find the prevalence of depressive and anxiety disorders among general hospital outpatients and to evaluate the diagnoses and treatment provided by physicians in China. A multi-center, hospital-based cross-sectional study was conducted. A total of 8478 subjects were screened by using HADS and PHQ-15 together with medical history review list and were followed by regular clinical visit process. Physician's diagnoses and management were recorded. Mini International Neuropsychiatric Interview (MINI) was used to evaluate by psychiatrists afterwards for 4172 subjects scored >or= 8 on HADS. The adjusted prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, depression and anxiety, depression or anxiety disorders were 12.0%, 8.6%, 4.1% and 16.5%, respectively. The prevalence of depressive and/or anxiety disorder in outpatients visiting department of neurology and digestive diseases were higher than that in patients visiting departments of cardiovascular diseases and gynecology with statistical significance (P depressive and/or anxiety disorders were found in the general hospitals. In order to improve the status quo, training program for physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.

  8. New insights into the correlation structure of DSM-IV depression symptoms in the general population v. subsamples of depressed individuals.

    Science.gov (United States)

    Foster, S; Mohler-Kuo, M

    2018-06-01

    Previous research failed to uncover a replicable dimensional structure underlying the symptoms of depression. We aimed to examine two neglected methodological issues in this research: (a) adjusting symptom correlations for overall depression severity; and (b) analysing general population samples v. subsamples of currently depressed individuals. Using population-based cross-sectional and longitudinal data from two nations (Switzerland, 5883 young men; USA, 2174 young men and 2244 young women) we assessed the dimensions of the nine DSM-IV depression symptoms in young adults. In each general-population sample and each subsample of currently depressed participants, we conducted a standardised process of three analytical steps, based on exploratory and confirmatory factor and bifactor analysis, to reveal any replicable dimensional structure underlying symptom correlations while controlling for overall depression severity. We found no evidence of a replicable dimensional structure across samples when adjusting symptom correlations for overall depression severity. In the general-population samples, symptoms correlated strongly and a single dimension of depression severity was revealed. Among depressed participants, symptom correlations were surprisingly weak and no replicable dimensions were identified, regardless of severity-adjustment. First, caution is warranted when considering studies assessing dimensions of depression because general population-based studies and studies of depressed individuals generate different data that can lead to different conclusions. This problem likely generalises to other models based on the symptoms' inter-relationships such as network models. Second, whereas the overall severity aligns individuals on a continuum of disorder intensity that allows non-affected individuals to be distinguished from affected individuals, the clinical evaluation and treatment of depressed individuals should focus directly on each individual's symptom profile.

  9. Validating the Beck Depression Inventory-II in Indonesia's general population and coronary heart disease patients

    NARCIS (Netherlands)

    Ginting, H.; Näring, G.W.B.; Veld, W.M. van der; Srisayekti, W.; Becker, E.S.

    2013-01-01

    This study assesses the validity and determines the cut-off point for the Beck Depression Inventory-II (the BDI-II) among Indonesians. The Indonesian version of the BDI-II (the Indo BDI-II) was administered to 720 healthy individuals from the general population, 215 Coronary Heart Disease (CHD)

  10. Changes in attachment security and mindfulness as predictors of changes in depression and general anxiety

    NARCIS (Netherlands)

    Martin, David; Gillath, Omri; Deboeck, Pascal; Lang, K.M.; Kerr, Barb

    2017-01-01

    Two studies examined the role short-term changes in adult attachment and mindfulness play in depression and general anxiety. Study 1, using a sample of college students (n = 121) who were not engaged in any clinical intervention, showed that changes in attachment anxiety and security, but not in

  11. Brief Cognitive Behavioural Therapy compared to optimised general practitioners’ care for depression : A randomised trial

    NARCIS (Netherlands)

    Schene, A.H.; Baas, K.D.; Koeter, M.W.J.; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K.A.; Huyser, J.; van Weert, H.C.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

  12. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    NARCIS (Netherlands)

    Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.|info:eu-repo/dai/nl/258267992; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

  13. Major Depressive Disorder, Obsessive-Compulsive Disorder, and Generalized Anxiety Disorder: Do the Sexual Dysfunctions Differ?

    OpenAIRE

    Kendurkar, Arvind; Kaur, Brinder

    2008-01-01

    Objectives: Major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) are known to have significant impact on sexual functioning. They have been studied individually. Therefore, this study was planned to compare the sexual dysfunction between MDD, OCD, and GAD with healthy subjects as controls.

  14. General, Specific and Unique Cognitive Factors Involved in Anxiety and Depressive Disorders

    NARCIS (Netherlands)

    Drost, J.; van der Does, A.; Antypa, N.; Zitman, F.G.; van Dyck, R.; Spinhoven, P.

    2012-01-01

    Comorbidity among anxiety and depressive disorders is the rule rather than the exception. The Integrative Hierarchical Model proposes that each of these disorders contains general (common to all), specific (common to some) and unique components. However, research into this model is limited and

  15. 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 ...

  16. 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 ...

  17. International Competition and Inequality: A Generalized Ricardian Model

    OpenAIRE

    Adolfo Figueroa

    2014-01-01

    Why does the gap in real wage rates persist between the First World and the Third World after so many years of increasing globalization? The standard neoclassical trade model predicts that real wage rates will be equalized with international trade, whereas the standard Ricardian trade model does not. Facts are thus consistent with the Ricardian model. However, this model leaves undetermined income distribution. The objective of this paper is to fill this gap by developing a generalized Ricard...

  18. Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

    Science.gov (United States)

    Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro

    2011-12-01

    The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

  19. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

    Science.gov (United States)

    Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

    2016-06-30

    We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.

  20. White matter alterations in the internal capsule and psychomotor impairment in melancholic depression.

    Science.gov (United States)

    Hyett, Matthew P; Perry, Alistair; Breakspear, Michael; Wen, Wei; Parker, Gordon B

    2018-01-01

    Emerging evidence suggests that structural brain abnormalities may play a role in the pathophysiology of melancholic depression. We set out to test whether diffusion-derived estimates of white matter structure were disrupted in melancholia in regions underpinning psychomotor function. We hypothesized that those with melancholia (and evidencing impaired psychomotor function) would show disrupted white matter organization in internal capsule subdivisions. Diffusion magnetic resonance imaging (dMRI) data were acquired from 22 melancholic depressed, 23 non-melancholic depressed, and 29 healthy control participants. Voxel-wise fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) values were derived for anterior, posterior, and retrolenticular limbs of the internal capsule and compared between groups. Neuropsychological (reaction time) and psychomotor functioning were assessed and correlated against FA. Fractional anisotropy was distinctly increased, whilst RD was decreased, in the right anterior internal capsule in those with melancholia, compared to controls. The right anterior limb of the internal capsule correlated with clinical ratings of psychomotor disturbance, and reduced psychomotor speed was associated with increased FA values in the right retrolenticular limb in those with melancholia. Our findings highlight a distinct disturbance in the local white matter arrangement in specific regions of the internal capsule in melancholia, which in turn is associated with psychomotor dysfunction. This study clarifies the contribution of structural brain integrity to the phenomenology of melancholia, and may assist future efforts seeking to integrate neurobiological markers into depression subtyping.

  1. Age-related differences in internalizing psychopathology amongst the Australian general population.

    Science.gov (United States)

    Sunderland, Matthew; Slade, Tim; Carragher, Natacha; Batterham, Philip; Buchan, Heather

    2013-11-01

    Two methodological criticisms have limited the reliability and validity of findings from previous studies that seek to examine change across the life span in levels of internalizing psychopathology using general population surveys. The first criticism involves the potential influence of cohort effects that confound true age-related changes whereas the second criticism involves the use of a single form of assessment to measure and compare levels of internalizing psychopathology. This study seeks to address these criticisms by modeling age-related change using multiple measures and multiple surveys. Data from 2 epidemiological surveys conducted 10 years apart in the Australian general population were combined and used for the current study. The latent construct of internalizing psychopathology was modeled using a combination of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) depression and anxiety diagnoses as well as items from the Kessler Psychological Distress scale (K10; Kessler et al., 2002). Confirmatory factor analysis (CFA) indicated that a single internalizing dimension provided good model fit to the data. Multigroup CFA indicated that strict measurement invariance of the model can be assumed across survey administrations and age bands, justifying comparisons of mean differences in latent trait levels. Significant changes in mean levels of latent internalizing psychopathology were evident between respondents aged 30-39 years old in 1997 and respondents aged 40-49 years old in 2007, suggesting a minor but significant increase in psychopathology across middle age. By contrast, a minor but significant decrease in psychopathology was noted when transitioning from late middle age (50-59 years old) to old age (60-69 years old). The majority of individuals in the general population will experience constant levels of internalizing psychopathology as they age, suggesting that the construct is relatively

  2. Parental Depression and Economic Disadvantage: The Role of Parenting in Associations with Internalizing and Externalizing Symptoms in Children and Adolescents.

    Science.gov (United States)

    Reising, Michelle M; Watson, Kelly H; Hardcastle, Emily J; Merchant, Mary Jane; Roberts, Lorinda; Forehand, Rex; Compas, Bruce E

    2013-04-01

    This study examined the effects of parental depression symptoms, economic disadvantage, and parenting behaviors in 180 children and adolescents of depressed parents (ages 9-15 years-old). Analyses revealed that while parental depression symptoms, economic disadvantage, and disrupted parenting behaviors were related to children's internalizing and externalizing symptoms, disrupted parenting (e.g., intrusive, neglectful parenting) accounted for the association of parental depressive symptoms and economic disadvantage with children's symptoms. This study provides evidence that disrupted parenting may be a common or shared process through which both parental depression and economic disadvantage are associated with children's internalizing and externalizing problems.

  3. 6th International Conference on the History of General Relativity

    CERN Document Server

    Eisenstaedt, Jean; The Universe of General Relativity; GR 6

    2005-01-01

    This volume from the Einstein Studies Series is based largely on papers presented at the Sixth International Conference on the History of General Relativity, held in Amsterdam on June 26-29, 2002. These contributions from notable experts offer both new and historical insights on gravitation, general relativity, cosmology, unified field theory, and the history of science. Topics discussed include the prehistory of special relativity, early attempts at a relativistic theory of gravitation, the beginnings of general relativity, the problem of motion in the context of relativity, conservation laws, the axiomatization of relativity, classical and contemporary cosmology, gravitation and electromagnetism, quantum gravity, and relativity as seen through the eyes of the public and renowned relativists. Contributors: K. Brading; G. Gale; H.F.M. Goenner; J. Goldberg; S. Katzir; D. Kennefick; H. Kragh; C. Lehner; U. Majer; J. Mattingly; E.T. Newman; J.D. Norton; J. Renn; R. Rynasiewicz; J.M. Sánchez-Ron; T. Sauer; C. Sm...

  4. Are Generalized Anxiety and Depression Symptoms Associated with Social Competence in Children with and without Autism Spectrum Disorder?

    Science.gov (United States)

    Johnston, Krista Haley Smith; Iarocci, Grace

    2017-01-01

    Generalized anxiety and depression symptoms may be associated with poorer social outcomes among children with Autism Spectrum Disorder (ASD) without intellectual disability. The goal of this study was to examine whether generalized anxiety and depression symptoms were associated with social competence after accounting for IQ, age, and gender in…

  5. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder.

    Science.gov (United States)

    White, Daniela; Tavakoli, Sason

    2015-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in treating individuals with behavioral disorders such as major depressive disorder (MDD), posttraumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. A number of applications of rTMS to different regions of the left and right prefrontal cortex have been used to treat these disorders, but no study of treatment for MDD with generalized anxiety disorder (GAD) has been conducted with application of rTMS to both the left and right prefrontal cortex. We hypothesized that applying low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) before applying it to the left DLPFC for the treatment of depression would be anxiolytic in patients with MDD with GAD. Thirteen adult patients with comorbid MDD and GAD received treatment with rTMS in an outpatient setting. The number of treatments ranged from 24 to 36 over 5 to 6 weeks. Response was defined as a ≥ 50% reduction in symptoms from baseline, and remission was defined as a score of anxiety symptoms on the 7-item Generalized Anxiety Disorder (GAD-7) scale and depressive symptoms on the 21-item Hamilton Rating Scale for Depression (HAM-D-21). At the end of the treatment period, for the GAD-7 scale, 11 out of 13 (84.6%) patients' anxiety symptoms were in remission, achieving a score of depressive symptoms. In this small pilot study of 13 patients with comorbid MDD and GAD, significant improvement in anxiety symptoms along with depressive symptoms was achieved in a majority of patients after bilateral rTMS application.

  6. 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...

  7. Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

    Science.gov (United States)

    Shea, Judy A.; Bellini, Lisa M.; Dinges, David F.; Curtis, Meredith L.; Tao, Yuanyuan; Zhu, Jingsan; Small, Dylan S.; Basner, Mathias; Norton, Laurie; Novak, Cristina; Dine, C. Jessica; Rosen, Ilene M.; Volpp, Kevin G.

    2014-01-01

    Background Patient safety and sleep experts advocate a protected sleep period for residents. Objective We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. Methods We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009–2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI). Results A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP. Conclusions A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores. PMID:24949128

  8. Parental Depression and Economic Disadvantage: The Role of Parenting in Associations with Internalizing and Externalizing Symptoms in Children and Adolescents

    OpenAIRE

    Reising, Michelle M.; Watson, Kelly H.; Hardcastle, Emily J.; Merchant, Mary Jane; Roberts, Lorinda; Forehand, Rex; Compas, Bruce E.

    2013-01-01

    This study examined the effects of parental depression symptoms, economic disadvantage, and parenting behaviors in 180 children and adolescents of depressed parents (ages 9–15 years-old). Analyses revealed that while parental depression symptoms, economic disadvantage, and disrupted parenting behaviors were related to children’s internalizing and externalizing symptoms, disrupted parenting (e.g., intrusive, neglectful parenting) accounted for the association of parental depressive symptoms an...

  9. A prediction algorithm for first onset of major depression in the general population: development and validation.

    Science.gov (United States)

    Wang, JianLi; Sareen, Jitender; Patten, Scott; Bolton, James; Schmitz, Norbert; Birney, Arden

    2014-05-01

    Prediction algorithms are useful for making clinical decisions and for population health planning. However, such prediction algorithms for first onset of major depression do not exist. The objective of this study was to develop and validate a prediction algorithm for first onset of major depression in the general population. Longitudinal study design with approximate 3-year follow-up. The study was based on data from a nationally representative sample of the US general population. A total of 28 059 individuals who participated in Waves 1 and 2 of the US National Epidemiologic Survey on Alcohol and Related Conditions and who had not had major depression at Wave 1 were included. The prediction algorithm was developed using logistic regression modelling in 21 813 participants from three census regions. The algorithm was validated in participants from the 4th census region (n=6246). Major depression occurred since Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-diagnostic and statistical manual for mental disorders IV. A prediction algorithm containing 17 unique risk factors was developed. The algorithm had good discriminative power (C statistics=0.7538, 95% CI 0.7378 to 0.7699) and excellent calibration (F-adjusted test=1.00, p=0.448) with the weighted data. In the validation sample, the algorithm had a C statistic of 0.7259 and excellent calibration (Hosmer-Lemeshow χ(2)=3.41, p=0.906). The developed prediction algorithm has good discrimination and calibration capacity. It can be used by clinicians, mental health policy-makers and service planners and the general public to predict future risk of having major depression. The application of the algorithm may lead to increased personalisation of treatment, better clinical decisions and more optimal mental health service planning.

  10. Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS).

    Science.gov (United States)

    Vafaei, Afshin; Ahmed, Tamer; Freire, Aline do N Falcão; Zunzunegui, Maria Victoria; Guerra, Ricardo O

    2016-01-01

    To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression. International cross-sectional study of adults between 65 and 74 years old (n = 1,967). Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). A validated 12-item Bem Sex Role Inventory (BSRI) was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR) of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions. Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16) were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93). In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated. Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

  11. Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS.

    Directory of Open Access Journals (Sweden)

    Afshin Vafaei

    Full Text Available To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression.International cross-sectional study of adults between 65 and 74 years old (n = 1,967. Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D. A validated 12-item Bem Sex Role Inventory (BSRI was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions.Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16 were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93. In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated.Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

  12. 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 ...

  13. Internal Migration and Depressive Symptoms among Migrant Factory Workers in Shenzhen, China

    Science.gov (United States)

    Mou, Jin; Cheng, Jinquan; Griffiths, Sian M.; Wong, Samuel Y. S.; Hillier, Sheila; Zhang, Dan

    2011-01-01

    There has been a dramatic increase in rural-urban migration in China over the last two decades but there are few studies on the mental health of Chinese internal migrants. This study assesses the prevalence of depressive symptoms (DS) and their associated factors among migrant factory workers in Shenzhen, China. A questionnaire survey was sent to…

  14. Intergenerational Transmission of Internalizing Problems: Effects of Parental and Grandparental Major Depressive Disorder on Child Behavior

    Science.gov (United States)

    Pettit, Jeremy W.; Olino, Thomas M.; Roberts, Robert E.; Seeley, John R.; Lewinsohn, Peter M.

    2008-01-01

    Effects of lifetime histories of grandparental (G1) and parental (G2) major depressive disorder (MDD) on children's (G3) internalizing problems were investigated among 267 G3 children (ages 2-18 years) who received Child Behavior Checklist (CBCL) ratings and had diagnostic data available on 267 biological G2 parents and 527 biological G1…

  15. Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety

    NARCIS (Netherlands)

    Ballenger, JC; Lecrubier, Y; Nutt, DJ; Baldwin, DS; den Boer, JA; Kasper, S; Shear, MK

    1998-01-01

    Objective: To provide primary care clinicians with a better understanding of management issues in panic disorder and guide clinical practice with recommendations for appropriate pharmacotherapy. Participants: The 4 members of the International Consensus Group on Depression and Anxiety were James C.

  16. The Impact of Supervision on Internal Medicine Residents' Attitudes and Management of Depression in Primary Care: A Pilot Study

    Science.gov (United States)

    Milone, Jennifer M.; Gottumukkala, Aruna; Ward, Christopher P.; York, Kaki M.

    2013-01-01

    Objective: The authors examined the effect of supervision on internal medicine residents' attitudes toward and management of depression. Method: Internal medicine residents completed a survey during preclinical conferences. The survey included a published, validated questionnaire, the Depression Attitude Questionnaire, and items developed by the…

  17. TRIGA International - History of Training Research Isotope production General Atomics

    International Nuclear Information System (INIS)

    2008-01-01

    TRIGA conceived at GA in 1956 by a distinguished group of scientists including Edward Teller and Freeman Dyson. First TRIGA reactor Mk-1 was commissioned on 3 may 1958 at G.A. Characteristic feature of TRIGA reactors is inherent safety: Sitting can be confinement or conventional building. TRIGA reactors are the most prevalent in the world: 67 reactors in 24 countries. Steady state powers up to 14 MWt, pulsing up to 22,000 MWt. To enlarge the scope of its manufactured products, CERCA engaged in a Joint Venture with General Atomics, and in July 1995 a new Company was founded: TRIGA INTERNATIONAL SAS (50% GA, 50% CERCA; Head Office: Paris (France); Sales offices: GA San Diego (Ca, USA) and CERCA Lyon (France); Manufacturing plant: CERCA Romans. General Atomics ID: founded in 1955 at San Diego, California, by General Dynamics; status: Privately held corporation; owners: Neal and Linden Blue; business: High technology research, design, manufacturing, and production for industry and Government in the U.S. and overseas; locations: U.S., Germany, Japan, Australia, Thailand, Morocco; employees: 5,000. TRIGA's ID: CERCA is a subsidiary of AREVA, born in November 05, 1957. Activities: fuel manufacture for research reactor, equipment and components for high-energy physics, radioactive sources and reference sources; plants locations: Romans and Pierrelatte (France); total strength: 180. Since the last five years TRIGA has manufactured and delivered more than 800 fuel elements with a door to door service. TRIGA International has the experience to manufacture all types of TRIGA fuel: standard fuel elements, instrumented fuel elements, fuel followed control rods, geometry: 37.3 mm (1.47 in.), 35.8 mm (1.4 in), 13 mm (0.5 in), chemical Composition: U w% 8.5, 12, 20, 30 and 45 w/o, erbium and no erbium. TRIGA International is on INL's approved vendor list (ISO 9000/NQA) and is ready to meet any TRIGA fuel needs either in the US or worldwide

  18. The Revised Child Anxiety and Depression Scale: A systematic review and reliability generalization meta-analysis.

    Science.gov (United States)

    Piqueras, Jose A; Martín-Vivar, María; Sandin, Bonifacio; San Luis, Concepción; Pineda, David

    2017-08-15

    Anxiety and depression are among the most common mental disorders during childhood and adolescence. Among the instruments for the brief screening assessment of symptoms of anxiety and depression, the Revised Child Anxiety and Depression Scale (RCADS) is one of the more widely used. Previous studies have demonstrated the reliability of the RCADS for different assessment settings and different versions. The aims of this study were to examine the mean reliability of the RCADS and the influence of the moderators on the RCADS reliability. We searched in EBSCO, PsycINFO, Google Scholar, Web of Science, and NCBI databases and other articles manually from lists of references of extracted articles. A total of 146 studies were included in our meta-analysis. The RCADS showed robust internal consistency reliability in different assessment settings, countries, and languages. We only found that reliability of the RCADS was significantly moderated by the version of RCADS. However, these differences in reliability between different versions of the RCADS were slight and can be due to the number of items. We did not examine factor structure, factorial invariance across gender, age, or country, and test-retest reliability of the RCADS. The RCADS is a reliable instrument for cross-cultural use, with the advantage of providing more information with a low number of items in the assessment of both anxiety and depression symptoms in children and adolescents. Copyright © 2017. Published by Elsevier B.V.

  19. Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles.

    Science.gov (United States)

    Keles, Serap; Friborg, Oddgeir; Idsøe, Thormod; Sirin, Selcuk; Oppedal, Brit

    2016-01-01

    This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma. The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway. Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression. The findings underscore the importance of current life conditions for unaccompanied refugees' mental health.

  20. Do depressive traits and hostility predict age-related decline in general intelligence?

    DEFF Research Database (Denmark)

    Mortensen, Erik Lykke; Barefoot, John Calvin; Avlund, Kirsten

    2012-01-01

    on decline in general intelligence over a 30-year period. The Minnesota Multiphasic Personality Inventory was administered at a 50-year baseline exam, and from this inventory the Obvious Depression Scale and an abbreviated version of the Cook-Medley Hostility Scale were derived. At the 50-year baseline...... and at the 60-, 70-, and 80-year followups the full version of Wechsler's Adult Intelligence Scale (WAIS) was administered to 673, 513, 136, and 184 participants. Mixed effects statistical models were used to evaluate both the effect of the personality scores on level of intelligence and the interaction between...... the personality scores and the time since followup. Analyses were adjusted for demographic background and a wide range of lifestyle factors. Both obvious depression and hostility were negatively associated with level of intelligence, but personality scores did not influence rate of decline in general intelligence....

  1. Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review.

    Science.gov (United States)

    Ford, Elizabeth; Shakespeare, Judy; Elias, Fatin; Ayers, Susan

    2017-02-01

    Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs' or Family Physicians' assessment, recognition and management of anxiety or depression in pregnancy or post-partum. Thirteen papers, reporting 10 studies, were identified from the United States, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counseling by GPs and referrals to specialists were common in the post-natal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training. Data on GPs' awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. 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....

  3. General, Specific and Unique Cognitive Factors Involved in Anxiety and Depressive Disorders

    OpenAIRE

    Drost, J.; Van der Does, A. J. W.; Antypa, N.; Zitman, F. G.; Van Dyck, R.; Spinhoven, Ph.

    2011-01-01

    Comorbidity among anxiety and depressive disorders is the rule rather than the exception. The Integrative Hierarchical Model proposes that each of these disorders contains general (common to all), specific (common to some) and unique components. However, research into this model is limited and hampered by small (clinical) sample sizes. The aim of the present study is to investigate the incremental validity of the cognitive constructs Anxiety Sensitivity, Pathological Worry and Cognitive React...

  4. International legal protection of environment in the system of fundamental generally recognized principles of international law

    International Nuclear Information System (INIS)

    Meherremov, A.A.

    2007-01-01

    The issue of international legal protection of environment in the system of fundamental, generally recognized principles of international law is analyzed in the article taking into consideration the different opinions in legal scientific researches and international practice. It is concluded that the protection of environment for the present and next generations - is a basic principle of international legal protection of environment. The meaning of this principleis that the countries will take all necessary measures for preservation and promotion of the quality of environment for the present and next generations, as well as rational management of natural resources. Adoption and national legal implementation of specific norms, in conformity with that basic principle, is a main factor in resolution of environmental problemsand ensuring environmental security

  5. NIDDK international conference report on diabetes and depression: current understanding and future directions.

    Science.gov (United States)

    Holt, Richard I G; de Groot, Mary; Lucki, Irwin; Hunter, Christine M; Sartorius, Norman; Golden, Sherita H

    2014-08-01

    Comorbid diabetes and depression are a major clinical challenge as the outcomes of each condition are worsened by the other. This article is based on the presentations and discussions during an international meeting on diabetes and depression convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the National Institute of Mental Health and the Dialogue on Diabetes and Depression. While the psychological burden of diabetes may contribute to depression in some cases, this explanation does not sufficiently explain the relationship between these two conditions. Shared biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors, are important to consider in understanding the link between depression and diabetes. Both individual psychological and pharmacological depression treatments are effective in people with diabetes, but the current range of treatment options is limited and has shown mixed effects on glycemic outcomes. More research is needed to understand what factors contribute to individual differences in vulnerability, treatment response, and resilience to depression and metabolic disorders across the life course and how best to provide care for people with comorbid diabetes and depression in different health care settings. Training programs are needed to create a cross-disciplinary workforce that can work in different models of care for comorbid conditions. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  6. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment.

    Science.gov (United States)

    2017-01-01

    Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Interpersonal therapy compared with usual care reduced posttreatment major depressive disorder

  7. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment

    Science.gov (United States)

    McMartin, Kristen; Gajic-Veljanoski, Olga; Wells, David; Higgins, Caroline; Walter, Melissa

    2017-01-01

    Background Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. Methods We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Results Interpersonal therapy compared with usual care reduced

  8. 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...

  9. The Evolution of General Internal Medicine (GIM)in Canada: International Implications.

    Science.gov (United States)

    Card, Sharon E; Clark, Heather D; Elizov, Michelle; Kassam, Narmin

    2017-05-01

    General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition. However, interest amongst trainees in GIM was declining, and the GIM workforce in Canada, like that in many other countries, was in danger of serious shortfalls. After much deliberation and consultation, in 2010, the RCPSC recognized GIM as a distinct subspecialty of internal medicine. Since this time, despite the challenges in the educational implementation of GIM as a distinct discipline, there has been a resurgence of interest in this field of medicine. This paper outlines the journey of the Canadian GIM to educational implementation as a distinct discipline, the impact on the discipline, and the implications for the international GIM community.

  10. Major depressive disorder and generalized anxiety disorder and response to treatment in hepatitis C patients in Egypt.

    Science.gov (United States)

    MM, Bassiony; A, Yousef; U, Youssef; GM, Salah El-Deen; M, Abdelghani; H, Al-Gohari; E, Fouad; MM, El-Shafaey

    2015-01-01

    The aim of the study was to estimate the prevalence and associated correlates of major depressive disorder and generalized anxiety disorder in hepatitis C virus patients before and after treatment and to investigate the relationship between major depressive disorder and generalized anxiety disorder and treatment response. A total of 116 consecutive hepatitis C virus patients from hepatitis C virus treatment center in Zagazig city, Egypt, were included in the study and divided into treated group (N = 58) and untreated group (N = 58). All hepatitis C virus patients were screened for major depressive disorder and generalized anxiety disorder using hospital anxiety and depression scale, and those who screened positive were interviewed to confirm the diagnosis of major depressive disorder and generalized anxiety disorder using DSM-IV-TR diagnostic criteria. These measures were done at baseline and after 12 weeks of treatment or observation. At baseline, 3.5% and 12.1% of hepatitis C virus patients (treated group) had major depressive disorder and generalized anxiety disorder, respectively. After 12 weeks of treatment 37.9% of hepatitis C virus patients (treated group) had major depressive disorder and 46.6% had generalized anxiety disorder. There was a significant statistical difference between hospital anxiety and depression scale scores for depression (3.3 ± 2.3 vs. 6.4 ± 3.2, t = 9.6, p = 0.001) and for anxiety (4.6 ± 2.4 vs. 7.3 ± 3.0, t = 10.2, p = 0.001) before and after treatment. There was also significant statistical difference between treated group and untreated group regarding hospital anxiety and depression scale scores after treatment and observation (depression, treated group 6.4 ± 3.2 vs. untreated group 4.0 ± 2.4, t = 3.7, p = 0.001; anxiety, treated group 7.3 ± 3.0 vs. untreated group 4.5 ± 2.3, t = 4.4, p = 0.001). There was no association between major depressive disorder

  11. 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...

  12. General Purpose Technologies and their Implications for International Trade

    Directory of Open Access Journals (Sweden)

    Petsas Iordanis

    2015-09-01

    Full Text Available This paper develops a simple model of trade and “quality-ladders” growth without scale effects to study the implications of general purpose technologies (GPTs for international trade. GPTs refer to a certain type of drastic innovations, such as electrification, the transistor, and the Internet, that are characterized by the pervasiveness in use, innovational complementarities, and technological dynamism. The model presents a two-country (Home and Foreign dynamic general equilibrium framework and incorporates GPT diffusion within Home that exhibits endogenous Schumpeterian growth. The model analyzes the long-run and transitional dynamic effects of a new GPT on the pattern of trade and relative wages. The main findings of the paper are: 1 when the GPT diffusion across industries is governed by S-curve dynamics, there are two steady-state equilibria: the initial steadystate arises before the adoption of the new GPT and the final one is reached after the GPT diffusion process has been completed, 2 when all industries at Home have adopted the new GPT, Home enjoys comparative advantage in a greater range of industries compared to Foreign, 3 during the transitional dynamics, Foreign gains back its competitiveness in some of the industries that lost its comparative advantage to Home.

  13. Prevalence of Depression among Type 2 Diabetic Outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Tesfa Dejenie Habtewold

    2015-01-01

    Full Text Available Background. The emotional consequences of diabetes have been scrutinized by a number of investigative teams and there are varying reports about the association of depression with type 2 diabetes mellitus. However, there is limited data about this in Ethiopia. Therefore, the purpose of this study was to assess the prevalence of comorbid depression among type 2 diabetic outpatients. Methods and Materials. Institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients from Black Lion General Specialized Hospital. Systematic random sampling technique was used to get these individual patients from 920 type 2 diabetic outpatients who have an appointment during the data collection period. Patients’ depression status was measured using Patient Health Questionnaire 9 (PHQ 9. Result. Totally 264 type 2 diabetic outpatients were interviewed with a response rate of 95.6%. The prevalence of depression among type 2 diabetic outpatients was 13%. Based on PHQ 9 score, 28.4% (75 fulfilled the criteria for mild depression, 12.1% (32 for moderate depression, 2.7% (7 for moderately severe depression, and 1.5% (4 for severe depression. But 45.8% (121 of patients had no clinically significant depression. Conclusion. This study demonstrated that depression is a common comorbid health problem in type 2 diabetic outpatients with a prevalence rate of 13%.

  14. Sample heterogeneity in unipolar depression as assessed by functional connectivity analyses is dominated by general disease effects.

    Science.gov (United States)

    Feder, Stephan; Sundermann, Benedikt; Wersching, Heike; Teuber, Anja; Kugel, Harald; Teismann, Henning; Heindel, Walter; Berger, Klaus; Pfleiderer, Bettina

    2017-11-01

    Combinations of resting-state fMRI and machine-learning techniques are increasingly employed to develop diagnostic models for mental disorders. However, little is known about the neurobiological heterogeneity of depression and diagnostic machine learning has mainly been tested in homogeneous samples. Our main objective was to explore the inherent structure of a diverse unipolar depression sample. The secondary objective was to assess, if such information can improve diagnostic classification. We analyzed data from 360 patients with unipolar depression and 360 non-depressed population controls, who were subdivided into two independent subsets. Cluster analyses (unsupervised learning) of functional connectivity were used to generate hypotheses about potential patient subgroups from the first subset. The relationship of clusters with demographical and clinical measures was assessed. Subsequently, diagnostic classifiers (supervised learning), which incorporated information about these putative depression subgroups, were trained. Exploratory cluster analyses revealed two weakly separable subgroups of depressed patients. These subgroups differed in the average duration of depression and in the proportion of patients with concurrently severe depression and anxiety symptoms. The diagnostic classification models performed at chance level. It remains unresolved, if subgroups represent distinct biological subtypes, variability of continuous clinical variables or in part an overfitting of sparsely structured data. Functional connectivity in unipolar depression is associated with general disease effects. Cluster analyses provide hypotheses about potential depression subtypes. Diagnostic models did not benefit from this additional information regarding heterogeneity. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The influence of specific chronic somatic conditions on the care for co-morbid depression in general practice

    NARCIS (Netherlands)

    Nuyen, J.; Spreeuwenberg, P.M.; Dijk, L. van; Bos, G.A.M. van den; Groenewegen, P.P.; Schellevis, F.G.

    Background. Limited information exists on the relationship between specific chronic somatic conditions and care for co-morbid depression in primary care settings. Therefore, the present prospective, general practice-based study examined this relationship. Method. Longitudinal data on morbidity,

  16. Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population.

    Science.gov (United States)

    Li, Haiyan; Luo, Xinni; Ke, Xiaoyin; Dai, Qing; Zheng, Wei; Zhang, Chanjuan; Cassidy, Ryan M; Soares, Jair C; Zhang, XiangYang; Ning, Yuping

    2017-01-01

    Somatic complaints are often the presenting symptoms of major depressive disorder (MDD) in the outpatient context, because this may go unrecognized. It is well understood that MDD carries an increased risk of suicide. This study aimed to identify the risk factors and association with both MDD and suicidality among Han Chinese outpatients. A multicenter study was carried out in 5189 outpatient adults (≥18 years old) in four general hospitals in Guangzhou, China. The 1392 patients who had the Patient Health Questionnaire-9 (PHQ-9) score ≥ 5, indicating depressive symptoms were offered an interview with a psychiatrist by the Mini International Neuropsychiatric Interview (MINI); 819 patients consented and completed the MINI interview. MINI module B was used to assess suicidality. Stepwise binary logistic models were used to estimate the relationship between a significant risk factor and suicide or MDD. According to with or without MDD, the secondary analysis was performed using the logistic regression model for the risk of suicidility. The current prevalence of MDD and the one month prevalence of suicidality were 3.7% and 2.3% respectively. The odds ratio of suicidality in women was more than twice that in men (OR = 2.62; 95% CI 1.45-4.76). Other risk factors which were significantly associated with suicidality were: living alone, higher education, self-reported depression, getting psychiatric diagnoses (MDD, anxiety disorders, and bipolar disorders). Significant risk factors for MDD were also noticed, such as comorbid anxiety disorders, self-reported anxiety, insomnia, suicidal ideation. It's a cross-sectional study in outpatient clinics using self-report questionnaires. This study provides valuable data about the risk factors and association of MDD and suicide risk in adult outpatients in Han Chinese. Those factors allow better the employment of preventative measures.

  17. Association between social support and depression in the general population: the HUNT study, a cross-sectional survey.

    Science.gov (United States)

    Grav, Siv; Hellzèn, Ove; Romild, Ulla; Stordal, Eystein

    2012-01-01

    The aim was to investigate the associations between perceived social support and depression in a general population in relation to gender and age. Social support is seen as one of the social determinants for overall health in the general population. Studies have found higher probability of experiencing depression among people who have a lack of social support; evidence from the general population has been more limited. Subjective perception that support would be available if needed may reduce and prevent depression and unnecessary suffering. A cross-sectional survey with self-reported health was used. A total of 40,659 men and women aged 20-89 years living in Nord-Trøndelag County of Norway with valid ratings of depression subscale of the Hospital Anxiety and Depression Scale in the The Nord-Trøndelag Health Study 3 were used. Logistic regression was used to quantify associations between two types of perceived support (emotional and tangible) and depression. Gender, age and interaction effects were controlled for in the final model. The main finding was that self-rated perceived support was significantly associated with Hospital Anxiety and Depression Scale-defined depression, even after controlling for age and gender; emotional support (OR = 3·14) and tangible support (OR = 2·93). The effects of emotional and tangible support differ between genders. Interaction effects were found for age groups and both emotional and tangible support. Self-rated perceived functional social support is associated with Hospital Anxiety and Depression Scale-defined depression. In the group of older people who have a lack of social support, women seem to need more emotional support and men tangible support. Health care providers should consider the close association between social support and depression in their continuing care, particularly in the older people. © 2011 Blackwell Publishing Ltd.

  18. Peer education as a strategy for reducing internalized stigma among depressed older adults.

    Science.gov (United States)

    Conner, Kyaien O; McKinnon, Symone A; Ward, Christine J; Reynolds, Charles F; Brown, Charlotte

    2015-06-01

    This article examines the mechanisms through which peer educator (PE) intervention targets and reduces internalized stigma. There is substantial evidence that internalized stigma negatively impacts the lives of those suffering with mental health concerns, and has been identified as 1 of the most significant barriers to seeking professional mental health services. There has been a push toward identifying interventions and programs that effectively reduce and mitigate the impact of internalized stigma. Research suggests that contact with other individuals who share a stigmatized condition may be a promising approach to targeting and reducing internalized stigma. However, there is a dearth of research that has identified the mechanism through which this contact impacts internalized stigma. Study participants (n = 19) completed a 3-month PE intervention. Each participant was matched with an older adult with a history of depression currently in recovery who provided psychoeducation, social support, and motivational interviewing. Participants completed a demographic questionnaire, public stigma (PDD), and internalized stigma (Internalized Stigma of Mental Illness, ISMI) scales pre- and post-PE intervention. They further participated in a brief semistructured qualitative interview to attain in-depth information about their perceptions of stigma and of working with a PE. Overall, internalized stigma scores were significantly reduced after participating in the PE intervention. In addition, participants identified 4 mechanisms through which contact with their PE impacted their stigmatized beliefs: age related concerns, shared understanding, improved mental health literacy, and mutual support. This study suggests that PE is a potentially valuable approach toward reducing internalized stigma among older adults with depression. (c) 2015 APA, all rights reserved).

  19. Guidelines on treatment of perinatal depression with antidepressants: An international review.

    Science.gov (United States)

    Molenaar, Nina M; Kamperman, Astrid M; Boyce, Philip; Bergink, Veerle

    2018-04-01

    Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries. Only Clinical Practice Guidelines adhering to quality criteria of the Appraisal of Guidelines for Research and Evaluation instrument and including a systematic review of evidence were included. Data extraction focussed on recommendations regarding continuation or withdrawal of antidepressants and preferred treatment in newly depressed patients. Our initial search resulted in 1094 articles. After first screening, 40 full-text articles were screened. Of these, 24 were excluded for not being an official Clinical Practice Guidelines. In total, 16 Clinical Practice Guidelines were included originating from 12 countries. Eight guidelines were perinatal specific and eight were general guidelines. During pregnancy, four guidelines advise to continue antidepressants, while there is a lack of evidence supporting this recommendation. Five guidelines do not specifically advise or discourage continuation. For new episodes, guidelines agree on psychotherapy (especially cognitive behavioural therapy) as initial treatment for mild to moderate depression and antidepressants for severe depression, with a preference for sertraline. Paroxetine is not preferred treatment for new episodes but switching antidepressants for ongoing treatment is discouraged (three guidelines). If mothers use antidepressants, observation of the neonate is generally recommended and breastfeeding encouraged.

  20. Spiritual and religious beliefs as risk factors for the onset of major depression : an international cohort study

    NARCIS (Netherlands)

    Leurent, B.; Nazareth, I.; Bellon-Saameno, J.; Geerlings, M. -I.; Maaroos, H.; Saldivia, S.; Svab, I.; Torres-Gonzalez, F.; Xavier, M.; King, M.

    2013-01-01

    Background. Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the USA, limiting inference about generalizability. An international longitudinal study of incidence of major depression gave

  1. Sex Differences in the Relationship between Sleep Behavior, Fish Consumption, and Depressive Symptoms in the General Population of South Korea.

    Science.gov (United States)

    Supartini, Atin; Oishi, Taro; Yagi, Nobuyuki

    2017-07-14

    Sleep, fish consumption, and depression have a close relationship; however, the role of sex differences in sleep, fish consumption, and depression research is not yet well-established. This study aimed to examine whether the impact of bedtime, sleep-onset latency, sleep duration, sleep quality, and fish consumption on depressive symptoms differed in women and men. An online survey was conducted in South Korea with a stratified random sample of 600 participants between the ages of 20 and 69, whose gender and age were proportional to estimates of Korea's general population. The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms with a cut-off score of 16. The Pittsburgh Sleep Quality Index (PSQI) was applied to evaluate sleep timing, sleep-onset latency, sleep duration, and sleep quality. Our results indicated that late bedtime and short sleep duration were independently associated with depressive symptoms in women. Sleep-onset latency and poor sleep quality were independently associated with increased prevalence of depressive symptoms in both men and women. Higher fish consumption was significantly associated with decreased prevalence of depressive symptoms in men only. Our findings suggested the importance of a different approach for men and women in terms of promoting healthy sleep habits. In addition, higher fish consumption may be beneficial in the primary prevention of depression in Korean men. Further research is needed to confirm the findings from this cross-sectional study.

  2. International VLBI Service for Geodesy and Astrometry: General Meeting Proceedings

    Science.gov (United States)

    Vandenberg, Nancy R. (Editor); Baver, Karen D. (Editor)

    2002-01-01

    This volume contains the proceedings of the second General Meeting of the International VLBI Service for Geodesy and Astrometry (IVS), held in Tsukuba, Japan, February 4-7, 2002. The contents of this volume also appear on the IVS Web site at http://ivscc.gsfc.nasa.gov/publications/gm2002. The key-note of the second GM was prospectives for the future, in keeping with the re-organization of the IAG around the motivation of geodesy as 'an old science with a dynamic future' and noting that providing reference frames for Earth system science that are consistent over decades on the highest accuracy level will provide a challenging role for IVS. The goal of the meeting was to provide an interesting and informative program for a wide cross section of IVS members, including station operators, program managers, and analysts. This volume contains 72 papers and five abstracts of papers presented at the GM. The volume also includes reports about three splinter meetings held in conjunction with the GM: a mini-TOW (Technical Operations Workshop), the third IVS Analysis Workshop and a meeting of the analysis working group on geophysical modeling.

  3. Anxiety, Depression, and General Psychological Distress in Patients with Coronary Slow Flow

    Directory of Open Access Journals (Sweden)

    Mehmet Baran Karataş

    2015-10-01

    Full Text Available AbstractBackground:The relationship between psychiatric illness and heart disease has been frequently discussed in the literature. The aim of the present study was to investigate the relationship between anxiety, depression and overall psychological distress, and coronary slow flow (CSF.Methods:In total, 44 patients with CSF and a control group of 50 patients with normal coronary arteries (NCA were prospectively recruited. Clinical data, admission laboratory parameters, and echocardiographic and angiographic characteristics were recorded. Symptom Checklist 90 Revised (SCL-90-R, Beck Depression Inventory (BDI, and Beck Anxiety Inventory (BAI scales were administered to each patient.Results:The groups were comparable with respect to age, sex, and atherosclerotic risk factors. In the CSF group, BAI score, BDI score, and general symptom index were significantly higher than controls (13 [18.7] vs. 7.5 [7], p = 0.01; 11 [14.7] vs. 6.5 [7], p = 0.01; 1.76 [0.81] vs. 1.1[0.24], p = 0.01; respectively. Patients with CSF in more than one vessel had the highest test scores. In univariate correlation analysis, mean thrombolysis in myocardial infarction (TIMI frame counts were positively correlated with BAI (r = 0.56, p = 0.01, BDI (r = 0.47, p = 0.01, and general symptom index (r = 0.65, p = 0.01. The psychiatric tests were not correlated with risk factors for atherosclerosis.Conclusion:Our study revealed higher rates of depression, anxiety, and overall psychological distress in patients with CSF. This conclusion warrants further studies.

  4. Anxiety, Depression, and General Psychological Distress in Patients with Coronary Slow Flow

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    Mehmet Baran Karataş

    2015-01-01

    Full Text Available Abstract Background: The relationship between psychiatric illness and heart disease has been frequently discussed in the literature. The aim of the present study was to investigate the relationship between anxiety, depression and overall psychological distress, and coronary slow flow (CSF. Methods: In total, 44 patients with CSF and a control group of 50 patients with normal coronary arteries (NCA were prospectively recruited. Clinical data, admission laboratory parameters, and echocardiographic and angiographic characteristics were recorded. Symptom Checklist 90 Revised (SCL-90-R, Beck Depression Inventory (BDI, and Beck Anxiety Inventory (BAI scales were administered to each patient. Results: The groups were comparable with respect to age, sex, and atherosclerotic risk factors. In the CSF group, BAI score, BDI score, and general symptom index were significantly higher than controls (13 [18.7] vs. 7.5 [7], p = 0.01; 11 [14.7] vs. 6.5 [7], p = 0.01; 1.76 [0.81] vs. 1.1[0.24], p = 0.01; respectively. Patients with CSF in more than one vessel had the highest test scores. In univariate correlation analysis, mean thrombolysis in myocardial infarction (TIMI frame counts were positively correlated with BAI (r = 0.56, p = 0.01, BDI (r = 0.47, p = 0.01, and general symptom index (r = 0.65, p = 0.01. The psychiatric tests were not correlated with risk factors for atherosclerosis. Conclusion: Our study revealed higher rates of depression, anxiety, and overall psychological distress in patients with CSF. This conclusion warrants further studies.

  5. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress

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    Gulliver Amelia

    2012-07-01

    Full Text Available Abstract Background Depression and anxiety are treatable disorders, yet many people do not seek professional help. Interventions designed to improve help-seeking attitudes and increase help-seeking intentions and behaviour have been evaluated in recent times. However, there have been no systematic reviews of the efficacy or effectiveness of these interventions in promoting help-seeking. Therefore, this paper reports a systematic review of published randomised controlled trials targeting help-seeking attitudes, intentions or behaviours for depression, anxiety, and general psychological distress. Methods Studies were identified through searches of PubMed, PsycInfo, and the Cochrane database in November 2011. Studies were included if they included a randomised controlled trial of at least one intervention targeting help-seeking for depression or anxiety or general psychological distress, and contained extractable data on help-seeking attitudes or intentions or behaviour. Studies were excluded if they focused on problems or conditions other than the target (e.g., substance use, eating disorder. Results Six published studies of randomised controlled trials investigating eight different interventions for help-seeking were identified. The majority of trials targeted young adults. Mental health literacy content was effective (d = .12 to .53 in improving help-seeking attitudes in the majority of studies at post-intervention, but had no effect on help-seeking behaviour (d = −.01, .02. There was less evidence for other intervention types such as efforts to destigmatise or provide help-seeking source information. Conclusions Mental health literacy interventions are a promising method for promoting positive help-seeking attitudes, but there is no evidence that it leads to help-seeking behaviour. Further research investigating the effects of interventions on attitudes, intentions, and behaviour is required.

  6. Do Depressive Traits and Hostility Predict Age-Related Decline in General Intelligence?

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    Erik Lykke Mortensen

    2012-01-01

    Full Text Available Certain personality traits are likely to be associated with stress and distress through the lifespan, and as a consequence these traits may influence the rate of age-related cognitive decline. The present study uses data from the Glostrup 1914 cohort to analyze potential effects of personality on decline in general intelligence over a 30-year period. The Minnesota Multiphasic Personality Inventory was administered at a 50-year baseline exam, and from this inventory the Obvious Depression Scale and an abbreviated version of the Cook-Medley Hostility Scale were derived. At the 50-year baseline and at the 60-, 70-, and 80-year followups the full version of Wechsler's Adult Intelligence Scale (WAIS was administered to 673, 513, 136, and 184 participants. Mixed effects statistical models were used to evaluate both the effect of the personality scores on level of intelligence and the interaction between the personality scores and the time since followup. Analyses were adjusted for demographic background and a wide range of lifestyle factors. Both obvious depression and hostility were negatively associated with level of intelligence, but personality scores did not influence rate of decline in general intelligence.

  7. Sex- and age-specific associations between major depressive disorder and metabolic syndrome in two general population samples in Germany.

    Science.gov (United States)

    Block, Andrea; Schipf, Sabine; Van der Auwera, Sandra; Hannemann, Anke; Nauck, Matthias; John, Ulrich; Völzke, Henry; Freyberger, Harald Jürgen; Dörr, Marcus; Felix, Stephan; Zygmunt, Marek; Wallaschofski, Henri; Grabe, Hans Jörgen

    2016-11-01

    Major depressive disorder (MDD) has been associated with the Metabolic Syndrome (MetS). As previous data strongly suggested sex and age effects on this association, this study aimed to analyse the association between MDD and MetS in two general population samples under explicit consideration of sex and age. This study analysed cross-sectional data based on two independent general population samples: SHIP-0 (n = 4083; 20-81 years; 49.4% male) and SHIP-TREND-0 (n = 3957; 20-83 years; 49.0% male) that were part of the Study of Health in Pomerania. MDD (SHIP-0: 12.6%; SHIP-TREND-0: 27.2%) was assessed using the Composite International Diagnostic-Screener (CID-S) in both samples. Interview assessment of MDD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria was performed in SHIP-TREND-0 (18.1% MDD). MetS was defined by abdominal obesity, elevated blood pressure, elevated glucose, elevated triglycerides and reduced high-density lipoprotein cholesterol according to established criteria. Data analysis was performed sex- and age-stratified. Prevalence of MetS was high in both samples: 19.4% of females and 30.2% of males in SHIP-0 and 22.1% and 33.2% in SHIP-TREND-0, respectively. Effect modifications were observed by sex and age on the association between MDD and MetS. Particularly, younger females (20-49 years) with MDD were more often affected by MetS than younger females without MDD: OR = 2.21 (95% CI = 1.39-3.50). This association vanished in elderly participants (50-82 years). The data suggest that especially younger (presumably pre-menopausal) females with MDD are more likely to have MetS than those without major depressive disorders, and that age extenuates this association.

  8. Numbing of Positive, Negative, and General Emotions: Associations With Trauma Exposure, Posttraumatic Stress, and Depressive Symptoms Among Justice-Involved Youth.

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    Kerig, Patricia K; Bennett, Diana C; Chaplo, Shannon D; Modrowski, Crosby A; McGee, Andrew B

    2016-04-01

    Increasing attention has been drawn to the symptom of emotional numbing in the phenomenology of posttraumatic stress disorder (PTSD), particularly regarding its implications for maladaptive outcomes in adolescence such as delinquent behavior. One change in the definition of emotional numbing according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) was the limitation to the numbing of positive emotions. Previous research with youth, however, has implicated general numbing or numbing of negative emotions in PTSD, whereas numbing of positive emotions may overlap with other disorders, particularly depression. Consequently, the goal of this study was to investigate whether numbing of positive emotions was associated with PTSD symptoms above and beyond numbing of negative emotions, general emotional numbing, or depressive symptoms among at-risk adolescents. In a sample of 221 detained youth (mean age = 15.98 years, SD = 1.25; 50.7% ethnic minority), results of hierarchical multiple regressions indicated that only general emotional numbing and numbing of anger accounted for significant variance in PTSD symptoms (total R(2) = .37). In contrast, numbing of sadness and positive emotions were statistical correlates of depressive symptoms (total R(2) = .24). Further tests using Hayes' Process macro showed that general numbing, 95% CI [.02, .45], and numbing of anger, 95% CI [.01, .42], demonstrated indirect effects on the association between trauma exposure and PTSD symptoms. Copyright © 2016 International Society for Traumatic Stress Studies.

  9. Perceived loneliness and general cognitive status in community-dwelling older adults: the moderating influence of depression.

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    Lam, Charlene L M; Yu, Junhong; Lee, Tatia M C

    2017-09-01

    The relationship between depression, loneliness, and cognitive functioning among the elderly is not well understood in the literature. In the present study, we tested the moderating influence of depressive symptoms on loneliness and cognitive functioning. We recruited 100 community-dwelling older adults in Hong Kong. Demographic information, perceived loneliness, depressed mood, and general cognitive status were assessed. Results indicated that married participants reported lower levels of perceived loneliness (t (96) = 2.26, p = .03). We found a significant moderating effect of depressive symptoms on the relationship between perceived loneliness and general cognitive status (B = -.05, p = .002). Perceived loneliness correlated negatively with general cognitive status only in participants with higher levels of depressed mood (B = -.16, p = .01). Together, these findings suggest that perceived loneliness combined with depressed mood is related to poorer general cognitive status in older adults. The implications of these findings are discussed.

  10. Generalized internal model robust control for active front steering intervention

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    Wu, Jian; Zhao, Youqun; Ji, Xuewu; Liu, Yahui; Zhang, Lipeng

    2015-03-01

    Because of the tire nonlinearity and vehicle's parameters' uncertainties, robust control methods based on the worst cases, such as H ∞, µ synthesis, have been widely used in active front steering control, however, in order to guarantee the stability of active front steering system (AFS) controller, the robust control is at the cost of performance so that the robust controller is a little conservative and has low performance for AFS control. In this paper, a generalized internal model robust control (GIMC) that can overcome the contradiction between performance and stability is used in the AFS control. In GIMC, the Youla parameterization is used in an improved way. And GIMC controller includes two sections: a high performance controller designed for the nominal vehicle model and a robust controller compensating the vehicle parameters' uncertainties and some external disturbances. Simulations of double lane change (DLC) maneuver and that of braking on split- µ road are conducted to compare the performance and stability of the GIMC control, the nominal performance PID controller and the H ∞ controller. Simulation results show that the high nominal performance PID controller will be unstable under some extreme situations because of large vehicle's parameters variations, H ∞ controller is conservative so that the performance is a little low, and only the GIMC controller overcomes the contradiction between performance and robustness, which can both ensure the stability of the AFS controller and guarantee the high performance of the AFS controller. Therefore, the GIMC method proposed for AFS can overcome some disadvantages of control methods used by current AFS system, that is, can solve the instability of PID or LQP control methods and the low performance of the standard H ∞ controller.

  11. Sickness absence among depressed patients attending the General Out Patients Department of the Jos University Teaching Hospital, Jos, Nigeria.

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    Goar, G S; Moses, D A; Micheal, T A

    2013-01-01

    Depression has been associated with low productivity and long absence from work. This has a serious consequence for the individuals, the employer and the society. The objectives of this study were to determine sickness absence from work among depressed patients attending General Out Patients Department (GOPD) in the preceding 12 months, to assess socio-demographic correlates of sickness absence in these patients and lastly, to determine the effect of depression on perception of work performance. This was a cross-sectional descriptive study among 200 consecutive patients attending the General Out Patients Department of the Jos University Teaching Hospital from November 2006 to March 2007. A semi-structured questionnaire designed by the authors was used to collect socio-demographic variables, self-reported perception of work and sickness absence days in the 12 months prior to the study. Depression was assessed using Structured clinical Interview for DSM- IV (SCID) axis 1 disorder. A total of 51(25.4%) of the 200 patients met the DSM IV diagnostic criteria for major depression. The depressed respondents significantly had higher mean and cumulative days of sickness absence compared to the non-depressed (p marital status (p = 0.867) were associated with sickness absence. Older age (P = 0.001) was associated with sickness absence in the non-depressed while gender (p = 0.117), and marital status (p = 0.752) were not. Having a diagnosis of depression was associated with poor work performance compared with the non-depressed (p productivity and toprevent long spells of sickness absence.

  12. Maternal cognitions and mother-infant interaction in postnatal depression and generalized anxiety disorder.

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    Stein, Alan; Craske, Michelle G; Lehtonen, Annukka; Harvey, Allison; Savage-McGlynn, Emily; Davies, Beverley; Goodwin, Julia; Murray, Lynne; Cortina-Borja, Mario; Counsell, Nicholas

    2012-11-01

    Postnatal depression and anxiety have been shown to increase the risk of disturbances in mother-child interaction and child development. Research into mechanisms has focused on genetics and maternal behavior; maternal cognitions have received little attention. Our aim was to experimentally determine if worry and rumination in mothers with generalized anxiety disorder (GAD) and major depressive disorder (MDD), diagnosed in the postnatal 6 months, interfered with maternal responsiveness to their 10-month old infants. Mothers (N = 253: GAD n = 90; MDD n = 57; control n = 106) and their infants were randomized to either a worry/rumination prime (WRP) or a neutral prime (NP); mother-infant interactions were assessed before and after priming. Type of priming was a significant predictor of maternal cognitions, with WRP resulting in more negative thoughts, higher thought recurrence and more self-focus relative to NP across the entire sample. Interaction effects between group and priming were significant for two parenting variables: Compared with controls, WRP had a more negative impact on maternal responsiveness to infant vocalization for GAD, and to a lesser extent for MDD; WRP led to decreased maternal vocalization for GAD. Also, mothers with GAD used stronger control after the NP than WRP, as well as compared with other groups, and overall post-priming, their children exhibited lower emotional tone and more withdrawal. Across the entire sample, WRP was associated with increased child vocalization relative to NP. This study demonstrated that disturbances in maternal cognitions, in the context of postnatal anxiety and to a lesser degree depression, play a significant role in mother-child interaction. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  13. Maternal Cognitions and Mother–Infant Interaction in Postnatal Depression and Generalized Anxiety Disorder

    Science.gov (United States)

    Stein, Alan; Craske, Michelle G.; Lehtonen, Annukka; Harvey, Allison; Savage-McGlynn, Emily; Davies, Beverley; Goodwin, Julia; Murray, Lynne; Cortina-Borja, Mario; Counsell, Nicholas

    2012-01-01

    Postnatal depression and anxiety have been shown to increase the risk of disturbances in mother–child interaction and child development. Research into mechanisms has focused on genetics and maternal behavior; maternal cognitions have received little attention. Our aim was to experimentally determine if worry and rumination in mothers with generalized anxiety disorder (GAD) and major depressive disorder (MDD), diagnosed in the postnatal 6 months, interfered with maternal responsiveness to their 10-month old infants. Mothers (N = 253: GAD n = 90; MDD n = 57; control n = 106) and their infants were randomized to either a worry/rumination prime (WRP) or a neutral prime (NP); mother–infant interactions were assessed before and after priming. Type of priming was a significant predictor of maternal cognitions, with WRP resulting in more negative thoughts, higher thought recurrence and more self-focus relative to NP across the entire sample. Interaction effects between group and priming were significant for two parenting variables: Compared with controls, WRP had a more negative impact on maternal responsiveness to infant vocalization for GAD, and to a lesser extent for MDD; WRP led to decreased maternal vocalization for GAD. Also, mothers with GAD used stronger control after the NP than WRP, as well as compared with other groups, and overall post-priming, their children exhibited lower emotional tone and more withdrawal. Across the entire sample, WRP was associated with increased child vocalization relative to NP. This study demonstrated that disturbances in maternal cognitions, in the context of postnatal anxiety and to a lesser degree depression, play a significant role in mother–child interaction. PMID:22288906

  14. Changes in major depressive and generalized anxiety disorders in the national French working population between 2006 and 2010.

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    Malard, Lucile; Chastang, Jean-François; Niedhammer, Isabelle

    2015-06-01

    This study aimed at assessing the changes in mental disorders in the French working population between 2006 and 2010, using nationally representative prospective data and a structured diagnostic interview for major depressive episode (MDE) and generalized anxiety disorder (GAD), and also at exploring the differential changes in mental disorders according to age, origin, occupation, public/private sector, self-employed/employee status and work contract. The data came from the prospective national representative Santé et Itinéraire Professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The Mini International Neuropsychiatric Interview (MINI) was used to measure MDE and GAD. Analyses were performed using weighted generalized estimation equations, and were stratified by gender. No changes in MDE and GAD were observed for both genders among the working population. No differential changes were observed, except one: the prevalence of GAD increased among women working in the public sector while there was no change among women in the private sector. Two data collections over a 4-year period may not capture the effects of the crisis on mental disorders properly. No changes in mental disorders between 2006 and 2010 were found but the increase in the prevalence of anxiety among women in the public sector may be of particular interest for prevention policies. High levels of social protection in France might contribute to explain these non-significant results. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Patterns of Alcohol and Other Drug Use Associated with Major Depression among Gay Men Attending General Practices in Australia

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    Holt, Martin; Bryant, Joanne; Newman, Christy E.; Paquette, Dana M.; Mao, Limin; Kidd, Michael R.; Saltman, Deborah C.; Kippax, Susan C.

    2012-01-01

    Our aim was to clarify the role of alcohol and other drug (AOD) use in major depression among gay men attending general medical practices. A secondary analysis was conducted on survey data collected from 531 gay men attending high-HIV-caseload general practices in Adelaide and Sydney, Australia. The survey contained demographic, social,…

  16. General practitioners' and psychiatrists' responses to emotional disclosures in patients with depression.

    Science.gov (United States)

    Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

    2014-04-01

    To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression. Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysis (CA). Psychiatrists responded to patients' emotional disclosures by attempting to clarify symptoms, by rational argumentation, or by offering an interpretation of the emotions from their own perspectives. GPs responded by claiming to understand the emotions or by formulating the patients' statements, but without further exploring the emotions. GPs displayed a greater engagement with patients' emotions than psychiatrists. Their approach could be described as empathic, corresponding to a mentalizing stance. The different approaches taken by psychiatrists could represent conceptual differences and might affect fruitful interdisciplinary work. Psychiatric nurses' responses to patients' emotions must also be studied to complete our knowledge from psychiatry. Experiences from training in mentalization could be used to develop physicians' empathic or mentalizing approach. As most patients with depression are treated in primary care, developing GPs' mentalizing capacity instead of offering didactic training could have a substantial effect in the population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer's disease.

    Science.gov (United States)

    Huang, Chiung-Yu; Sousa, Valmi D; Perng, Shao-Jen; Hwang, Mei-Yi; Tsai, Chun-Ching; Huang, Mei-Huang; Yao, Shu-Ying

    2009-02-01

    This study examined the relationships among stressors, social support, depressive symptoms and the general health status of Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Caring for a disabled or cognitively impaired person can be extremely stressful and often has adverse effects on caregivers' health. While research on caregiving in Taiwan has examined caregivers' characteristics, caregivers' need and caregivers' burden in caring for older people in general, little is known about Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Cross-sectional, descriptive correlation design. Data were obtained from a convenience sample of 103 Taiwanese informal caregivers in the South of Taiwan and analysed using descriptive statistics, Pearson's correlations, multiple and hierarchical regressions and t-tests. Caregivers who had lower household incomes and were taking care of individuals with more behaviour problems had more depressive symptoms. In addition, caregivers who were older and were taking care of individuals with more behaviour problems had worse general health. Caregivers who had more emotional support had less depressive symptoms. Caregivers of persons with Alzheimer's disease had more depressive symptoms and worse general health than caregivers of persons with stroke. Only emotional support moderated the relationship between one of the stressors (household income) and depressive symptoms. The findings of this study may be helpful for nurses and other health care professionals in designing effective interventions to minimise the negative impacts of stressors on the psychological and general health of caregivers in Taiwan.

  18. Brief cognitive behavioral therapy compared to general practitioners care for depression in primary care: a randomized trial

    Science.gov (United States)

    2010-01-01

    Background Depressive disorders are highly prevalent in primary care (PC) and are associated with considerable functional impairment and increased health care use. Research has shown that many patients prefer psychological treatments to pharmacotherapy, however, it remains unclear which treatment is most optimal for depressive patients in primary care. Methods/Design A randomized, multi-centre trial involving two intervention groups: one receiving brief cognitive behavioral therapy and the other receiving general practitioner care. General practitioners from 109 General Practices in Nijmegen and Amsterdam (The Netherlands) will be asked to include patients aged between 18-70 years presenting with depressive symptomatology, who do not receive an active treatment for their depressive complaints. Patients will be telephonically assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to ascertain study eligibility. Eligible patients will be randomized to one of two treatment conditions: either 8 sessions of cognitive behavioral therapy by a first line psychologist or general practitioner's care according to The Dutch College of General Practitioners Practice Guideline (NHG- standaard). Baseline and follow-up assessments are scheduled at 0, 6, 12 and 52 weeks following the start of the intervention. Primary outcome will be measured with the Hamilton Depression Rating Scale-17 (HDRS-17) and the Patient Health Questionnaire-9 (PHQ-9). Outcomes will be analyzed on an intention to treat basis. Trial Registration ISRCTN65811640 PMID:20939917

  19. 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.

  20. Interpersonal sensitivity mediates the effects of child abuse and affective temperaments on depressive symptoms in the general adult population

    Directory of Open Access Journals (Sweden)

    Otsuka A

    2017-10-01

    Full Text Available Ayano Otsuka,1 Yoshikazu Takaesu,1 Mitsuhiko Sato,1 Jiro Masuya,1 Masahiko Ichiki,1 Ichiro Kusumi,2 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo, 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan Background: Recent studies have suggested that multiple factors interact with the onset and prognosis of major depressive disorders. In this study, we investigated how child abuse, affective temperaments, and interpersonal sensitivity are interrelated, and how they affect depressive symptoms in the general adult population. Subjects and methods: A total of 415 volunteers from the general adult population completed the Patient Health Questionnaire-9, the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire version, the Child Abuse and Trauma Scale, and the Interpersonal Sensitivity Measure, which are all self-administered questionnaires. Data were subjected to structural equation modeling (Mplus, and single and multiple regression analyses. Results: The effect of child abuse on depressive symptoms was mediated by interpersonal sensitivity and 4 affective temperaments, including depressive, cyclothymic, anxious, and irritable temperaments. In addition, the effect of these temperaments on depressive symptoms was mediated by interpersonal sensitivity, indicating the indirect enhancement of depressive symptoms. In contrast to these 4 temperaments, the hyperthymic temperament did not mediate the effect of child abuse on depressive symptoms; its effect was not mediated by interpersonal sensitivity. However, a greater hyperthymic temperament predicted decreased depressive symptoms and interpersonal sensitivity, independent of any mediation effect. Limitations: Because this is a cross-sectional study, long-term prospective studies are necessary to confirm its findings. Therefore, recall bias should be considered when interpreting the results. As the subjects were

  1. GENERAL ASPECTS REGARDING THE MANAGEMENT ACTIVITY IN INTERNATIONAL BUSINESS

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    Mihaela Loredana LĂPĂDUŞI

    2010-09-01

    Full Text Available The strategy of penetrating and developing the external markets is an important objective of the international enterprises management. This involves a specific analysis of the business environment for illustrating the opportunities of business and risks and the business potential of a particular enterprise in order to establish the internalisation objectives and types. The international management is individualised by the environment where the enterprises develop their economical activity, supposing that the world market of international business involves the access to new markets and the enterprises must adapt to the specific needs and opportunities.

  2. Risky music listening, permanent tinnitus and depression, anxiety, thoughts about suicide and adverse general health.

    Science.gov (United States)

    Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

    2014-01-01

    To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people's health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed.

  3. Risky music listening, permanent tinnitus and depression, anxiety, thoughts about suicide and adverse general health.

    Directory of Open Access Journals (Sweden)

    Ineke Vogel

    Full Text Available OBJECTIVE: To estimate the extent to which exposure to music through earphones or headphones with MP3 players or at discotheques and pop/rock concerts exceeded current occupational safety standards for noise exposure, to examine the extent to which temporary and permanent hearing-related symptoms were reported, and to examine whether the experience of permanent symptoms was associated with adverse perceived general and mental health, symptoms of depression, and thoughts about suicide. METHODS: A total of 943 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their sociodemographics, music listening behaviors and health. Multiple logistic regression analyses were used to examine associations. RESULTS: About 60% exceeded safety standards for occupational noise exposure; about one third as a result of listening to MP3 players. About 10% of the participants experienced permanent hearing-related symptoms. Temporary hearing symptoms that occurred after using an MP3 player or going to a discotheque or pop/rock concert were associated with exposure to high-volume music. However, compared to participants not experiencing permanent hearing-related symptoms, those experiencing permanent symptoms were less often exposed to high volume music. Furthermore, they reported at least two times more often symptoms of depression, thoughts about suicide and adverse self-assessed general and mental health. CONCLUSIONS: Risky music-listening behaviors continue up to at least the age of 25 years. Permanent hearing-related symptoms are associated with people's health and wellbeing. Participants experiencing such symptoms appeared to have changed their behavior to be less risky. In order to induce behavior change before permanent and irreversible hearing-related symptoms occur, preventive measurements concerning hearing health are needed.

  4. Depression during pregnancy: views on antidepressant use and information sources of general practitioners and pharmacists

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    Schobben Fred

    2009-07-01

    Full Text Available Abstract Background The use of antidepressants during pregnancy has increased in recent years. In the Netherlands, almost 2% of all pregnant women are exposed to antidepressants. Although guidelines have been developed on considerations that should be taken into account, prescribing antidepressants during pregnancy is still a subject of debate. Physicians and pharmacists may have opposing views on using medication during pregnancy and may give contradictory advice on whether or not to take medication for depression and anxiety disorders during pregnancy. In this study, we investigated information sources used by general practitioners (GPs and pharmacists and their common practices. Methods A questionnaire on the use of information sources and the general approach when managing depression during pregnancy was sent out to 1400 health care professionals to assess information sources on drug safety during pregnancy and also the factors that influence decision-making. The questionnaires consisted predominantly of closed multiple-choice questions. Results A total of 130 GPs (19% and 144 pharmacists (21% responded. The most popular source of information on the safety of drug use during pregnancy is the Dutch National Health Insurance System Formulary, while a minority of respondents contacts the Dutch national Teratology Information Service (TIS. The majority of GPs contact the pharmacy with questions concerning drug use during pregnancy. There is no clear line with regard to treatment or consensus between GPs on the best therapeutic strategy, nor do practitioners agree upon the drug of first choice. GPs have different views on stopping or continuing antidepressants during pregnancy or applying alternative treatment options. The debate appears to be ongoing as to whether or not specialised care for mother and child is indicated in cases of gestational antidepressant use. Conclusion Primary health care workers are not univocal concerning therapy for

  5. The Role of Attachment, Travel Experiences and English Proficiency in International Students' Acculturative Stress and Depressive Symptoms

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    Smiljanic, Iskra

    2017-01-01

    This study examined the relationship between attachment, travel experiences, and English proficiency and international students' acculturative stress and depressive symptoms. A total of 91 graduate international students completed online surveys. Pearson correlations showed that both attachment anxiety and avoidance were positively correlated with…

  6. The Cost of Being Mother's Ideal Child: The Role of Internalization in the Development of Perfectionism and Depression

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    Tong, Ying; Lam, Shui-fong

    2011-01-01

    The study investigated how children's willingness to internalize mothers' values affected the associations between mothers' performance goals for their children and the development of children's perfectionism and depression. The participants were 59 Hong Kong fifth graders and their mothers. The results showed that internalization, as a child…

  7. Interparental conflict, parenting, and childhood depression in a diverse urban population: the role of general cognitive style.

    Science.gov (United States)

    O'Donnell, Ellen H; Moreau, Melissa; Cardemil, Esteban V; Pollastri, Alisha

    2010-01-01

    Research on the mechanisms by which interparental conflict (IPC) affects child depression suggests that both parenting and children's conflict appraisals play important roles, but few studies have explored the role of general cognitive style or included both parenting and cognitions in the same design. Moreover, the effects of IPC on minority children are not well understood. In this longitudinal study, parenting was examined as a mediator of the relation between increasing IPC and change in depression. General cognitive style was included as a moderator. The combined influence of parenting and cognitions was also explored. A racially and ethnically diverse sample of 88 fifth and sixth graders from two urban schools reported their cognitive style, depressive symptoms, and perceptions of conflict and parenting at two time points separated by one year. Parental warmth/rejection mediated the relation between IPC and depression, and general cognitive style acted as a moderator. Parenting, cognitive style, and IPC did not significantly interact to predict change in depression over time. Findings indicate that both parenting and children's general cognitive style play a role in understanding the impact of increasing IPC on children's well-being.

  8. Minor and major depression in the general population: does dysfunctional thinking play a role?

    NARCIS (Netherlands)

    Graaf, LE.; Huibers, M.J.H.; Cuijpers, P.; Arntz, A.

    2010-01-01

    Background: Although most research suggests that minor depression is part of a depression continuum, conflicting results have also been found. Moreover, little is known about dysfunctional thinking in minor depression and how this varies along the continuum. Especially, research on the form of

  9. Interpersonal psychotherapy (IPT for late-life depression in general practice: uptake and satisfaction by patients, therapists and physicians

    Directory of Open Access Journals (Sweden)

    de Haan Marten

    2007-09-01

    Full Text Available Abstract Background Interpersonal Psychotherapy (IPT is recommended in most depression treatment guidelines and proved to be a suitable treatment for elderly depressed patients. Despite the favorable results of IPT in research populations, the dissemination to general practice is surprisingly limited. Little is known about uptake and satisfaction when this therapy is introduced into real-life general practice. Methods Motivation and evaluation of patients, GPs and therapists were recorded and organizational barriers described alongside a randomized controlled trial. IPT, given by mental health workers, was compared with usual general practitioner (GP care. Included were patients (≥55 years who met the DSM-IV criteria for major depressive disorder. Results Patients were motivated for the psychotherapy intervention: of the 205 eligible patients, 143 (70% entered the study, and of the 69 patients who were offered IPT, 77% complied with the treatment. IPT proved to be an attractive therapy for patients as well as for therapists from mental health organizations. General practitioners evaluated the intervention positively afterwards, mainly because of the time-limited and structured approach. Organizational barriers: no IPT therapists were available; an IPT trainer and supervisor had to be trained and training materials had to be developed and translated. Additionally, there was a lack of office space in some general practices; for therapists from private practices it was not feasible to participate because of financial reasons. IPT was superior to usual care in patients with moderate to severe depression. Conclusion As we succeeded in delivering IPT in primary care practice, and as IPT was superior to usual care, there are grounds to support the implementation of IPT for depressed elderly patients within general practice, as long as the practices have room for the therapists and financial barriers can be overcome. Consolidation may be achieved by

  10. Consensus statement update on posttraumatic stress disorder from the international consensus group on depression and anxiety.

    Science.gov (United States)

    Ballenger, James C; Davidson, Jonathan R T; Lecrubier, Yves; Nutt, David J; Marshall, Randall D; Nemeroff, Charles B; Shalev, Arieh Y; Yehuda, Rachel

    2004-01-01

    To provide an update to the "Consensus Statement on Posttraumatic Stress Disorder From the International Consensus Group on Depression and Anxiety" that was published in a supplement to The Journal of Clinical Psychiatry (2000) by presenting important developments in the field, the latest recommendations for patient care, and suggestions for future research. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty who were invited by the chair were Randall D. Marshall, Charles B. Nemeroff, Arieh Y. Shalev, and Rachel Yehuda. The consensus statement is based on the 7 review articles in this supplement and the related scientific literature. Group meetings were held over a 2-day period. On day 1, the group discussed topics to be represented by the 7 review articles in this supplement, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all faculty. There have been advancements in the science and treatment of posttraumatic stress disorder. Attention to this disorder has increased with recent world events; however, continued efforts are needed to improve diagnosis, treatment, and prevention of posttraumatic stress disorder.

  11. Maternal depression and trajectories of child internalizing and externalizing problems: the roles of child decision making and working memory.

    Science.gov (United States)

    Flouri, E; Ruddy, A; Midouhas, E

    2017-04-01

    Maternal depression may affect the emotional/behavioural outcomes of children with normal neurocognitive functioning less severely than it does those without. To guide prevention and intervention efforts, research must specify which aspects of a child's cognitive functioning both moderate the effect of maternal depression and are amenable to change. Working memory and decision making may be amenable to change and are so far unexplored as moderators of this effect. Our sample was 17 160 Millennium Cohort Study children. We analysed trajectories of externalizing (conduct and hyperactivity) and internalizing (emotional and peer) problems, measured with the Strengths and Difficulties Questionnaire at the ages 3, 5, 7 and 11 years, using growth curve models. We characterized maternal depression, also time-varying at these ages, by a high score on the K6. Working memory was measured with the Cambridge Neuropsychological Test Automated Battery Spatial Working Memory Task, and decision making (risk taking and quality of decision making) with the Cambridge Gambling Task, both at age 11 years. Maternal depression predicted both the level and the growth of problems. Risk taking and poor-quality decision making were related positively to externalizing and non-significantly to internalizing problems. Poor working memory was related to both problem types. Neither decision making nor working memory explained the effect of maternal depression on child internalizing/externalizing problems. Importantly, risk taking amplified the effect of maternal depression on internalizing problems, and poor working memory that on internalizing and conduct problems. Impaired decision making and working memory in children amplify the adverse effect of maternal depression on, particularly, internalizing problems.

  12. Acculturation, Acculturative Stress, and Depressive Symptoms in International Migrants: A Study with Vietnamese Women in South Korea.

    Science.gov (United States)

    Cho, Yong Ju; Jang, Yuri; Ko, Jung Eun; Lee, Sun Hae; Moon, Soo Kyung

    2017-10-10

    Globally, there have been increasing numbers of migrant women; these women are at an increased risk for depressive symptoms. The purpose of this study was to examine the associations among acculturation, acculturative stress and depressive symptoms in Vietnamese women who migrated to South Korea through marriages. We hypothesized that acculturative stress would serve as a mediator in the relationship between acculturation and depressive symptoms. Our findings from surveys with 217 Vietnamese immigrant women showed that the indirect effect of acculturation on depressive symptoms, mediated through acculturative stress [- .15 (.04)], was significant (bias corrected 95% confidence interval for the indirect effect = - .25, - .08). Low levels of acculturation increased acculturative stress, which in turn led to the elevated symptoms of depression. Our findings not only illuminate the adaptation processes of international, female migrants but also suggest avenues to protect and promote their mental well-being.

  13. Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

    Science.gov (United States)

    Merino, Hipólito; Ferreiro, Fátima

    2016-01-01

    This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms. PMID:27243462

  14. Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

    Science.gov (United States)

    Merino, Hipólito; Senra, Carmen; Ferreiro, Fátima

    2016-01-01

    This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

  15. Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

    Directory of Open Access Journals (Sweden)

    Hipólito Merino

    Full Text Available This study examines the relationships between neuroticism (higher-order vulnerability factor, the cognitive styles of worry, brooding and reflection (second-order vulnerability factors and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD, with Major Depressive Disorder (MDD and with Mixed Anxiety-Depressive Disorder (MADD. One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection, anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

  16. An association between the internalization of body image, depressive symptoms and restrictive eating habits among young males.

    Science.gov (United States)

    Fortes, Leonardo de Sousa; Meireles, Juliana Fernandes Filgueiras; Paes, Santiago Tavares; Dias, Fernanda Coelho; Cipriani, Flávia Marcele; Ferreira, Maria Elisa Caputo

    2015-11-01

    The scope of this study was to analyze the relationship between the internalization of body image and depressive symptoms with restrictive eating habits among young males. Three hundred and eighty-three male adolescents, aged between twelve and seventeen, took part in this survey. The "Overall Internalization" and "Athletic Internalization" sub-scales taken from the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) were used to evaluate the internalization of body images. The Major Depression Inventory (MDI) was used to evaluate depressive symptoms. The "Diet" sub-scale from the Eating Attitudes Test (EAT-26) was used to evaluate restrictive eating habits. The logistic regression findings indicated 2.01 times greater chances of youngsters with a high level of overall internalization adopting restrictive eating habits (Wald = 6.16; p = 0.01) when compared with those with low levels. On the other hand, the regression model found no significant association between "Athletic Internalization" (Wald = 1.16; p = 0.23) and depressive symptoms (Wald = 0.81; p = 0.35) with eating restrictions. The findings made it possible to conclude that only overall internalization was related to eating restrictions among young males.

  17. Factorial Validity and Internal Consistency of Malaysian Adapted Depression Anxiety Stress Scale - 21 in an Adolescent Sample

    OpenAIRE

    Hairul Anuar Hashim; Freddy Golok; Rosmatunisah Ali

    2011-01-01

    Background: Psychometrically sound measurement instrument is a fundamental requirement across broad range of research areas. In negative affect research, Depression Anxiety Stress Scale (DASS) has been identified as a psychometrically sound instrument to measure depression, anxiety and stress, especially the 21-item version. However, its psychometric properties in adolescents have been less consistent. Objectives: Thus, the present study sought to examine the factorial validity and internal c...

  18. A general model for use in internal dosimetry

    International Nuclear Information System (INIS)

    Johnson, J.R.; Carver, M.B.

    1981-01-01

    A model is described that combines the International Commission on Radiological Protection's Task Group on Lung Dynamics' Model, Eve's model for transport of material through the gastro-intestinal tract and a compartment model for the organs. Differential equations for this model are given, which include urinary and fecal excretion rates, and the method used to obtain solutions to these equations is described. (author)

  19. UFOs, NGOs, or IGOs: Using International Documents for General Reference.

    Science.gov (United States)

    Shreve, Catherine

    1997-01-01

    Discusses accessing and using documents from international (intergovernmental) organizations. Profiles the United Nations, the European Union and other Intergovernmental Organizations (IGOs). Discusses the librarian as "Web detective," notes questions to focus on, and presents examples to demonstrate navigation of IGO sites. Lists basic…

  20. Nineteenth International Cosmic Ray Conference papers. General index, volume 10

    International Nuclear Information System (INIS)

    Jones, F.C.

    1986-07-01

    These volumes contain papers submitted for presentation at the 19th International Cosmic Ray Conference held on the campus of the University of California, San Diego, in La Jolla, CA, Aug. 11-23, 1985. The present volume contains a complete author index for volumes 1 through 9 and a list of the names and addresses of all those who attended the conference

  1. Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

    Science.gov (United States)

    Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

    2015-07-03

    Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

  2. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    Science.gov (United States)

    Leontjevas, Ruslan; Gerritsen, Debby L; Koopmans, Raymond T C M; Smalbrugge, Martin; Vernooij-Dassen, Myrra J F J

    2012-06-01

    A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). Before effect analyses, to evaluate AiD process data on sampling quality (recruitment and randomization, reach) and intervention quality (relevance and feasibility, extent to which AiD was performed), which can be used for understanding internal and external validity. In this article, a model is presented that divides process evaluation data into first- and second-order process data. Qualitative and quantitative data based on personal files of residents, interviews of nursing home professionals, and a research database were analyzed according to the following process evaluation components: sampling quality and intervention quality. Nursing home. The pattern of residents' informed consent rates differed for dementia special care units and somatic units during the study. The nursing home staff was satisfied with the AiD program and reported that the program was feasible and relevant. With the exception of the first screening step (nursing staff members using a short observer-based depression scale), AiD components were not performed fully by NH staff as prescribed in the AiD protocol. Although NH staff found the program relevant and feasible and was satisfied with the program content, individual AiD components may have different feasibility. The results on sampling quality implied that statistical analyses of AiD effectiveness should account for the type of unit, whereas the findings on intervention quality implied that, next to the type of unit, analyses should account for the extent to which individual AiD program components were performed. In general, our first-order process data evaluation confirmed internal and external validity of the AiD trial, and this evaluation enabled further statistical fine tuning. The importance of

  3. Socialization of Emotion and Offspring Internalizing Symptoms in Mothers with Childhood-Onset Depression

    Science.gov (United States)

    Silk, Jennifer S.; Shaw, Daniel S.; Prout, Joanna T.; O'Rourke, Flannery; Lane, Tonya J.; Kovacs, Maria

    2011-01-01

    This study examines how mothers with and without a history of childhood-onset depression respond to their 3-9 year-old children's emotions. Mother-child dyads included 55 offspring of mothers with a history of childhood-onset depressive disorders and 57 offspring of never-depressed mothers. Mothers with a history of childhood depression were less…

  4. Generalized Anxiety and Major Depressive syndrome measured by the SCL-90-R in Two Manganese (Mn) Exposed Ohio Towns

    Science.gov (United States)

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if l...

  5. Is suppressed thyroid-stimulating hormone (TSH) associated with subclinical depression in the Danish General Suburban Population Study?

    DEFF Research Database (Denmark)

    Kvetny, Jan; Ellervik, Christina; Bech, Per

    2015-01-01

    BACKGROUND: The first phase of the Danish General Suburban Population Study (GESUS) including 8214 individuals was an attempt to evaluate the association between subclinical hypothyroidism without or with elevated peroxidase antibodies and depression. No such association was found. In the second...

  6. Interparental Conflict, Parenting, and Childhood Depression in a Diverse Urban Population: The Role of General Cognitive Style

    Science.gov (United States)

    O'Donnell, Ellen H.; Moreau, Melissa; Cardemil, Esteban V.; Pollastri, Alisha

    2010-01-01

    Research on the mechanisms by which interparental conflict (IPC) affects child depression suggests that both parenting and children's conflict appraisals play important roles, but few studies have explored the role of general cognitive style or included both parenting and cognitions in the same design. Moreover, the effects of IPC on minority…

  7. Associations among depressive symptoms, childhood abuse, neuroticism, and adult stressful life events in the general adult population

    Directory of Open Access Journals (Sweden)

    Ono K

    2017-02-01

    Full Text Available Kotaro Ono,1 Yoshikazu Takaesu,1 Yukiei Nakai,2 Akiyoshi Shimura,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Yasunori Matsumoto,1 Hajime Tanabe,3 Ichiro Kusumi,2 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo, 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, 3Department of Clinical Human Sciences, Graduate school of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. Subjects and methods: A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire – Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3 and single and multiple regressions were used to analyze the data. Results: Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. Limitations: There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. Conclusion: This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms

  8. Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder.

    Science.gov (United States)

    Brook, Judith S; Zhang, Chenshu; Rubenstone, Elizabeth; Primack, Brian A; Brook, David W

    2016-11-01

    To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. A random community-based sample [X̅ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. International Atomic Energy Agency thirty-third general conference

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    A brief account is given of the 33rd session of IAEA General Conference held in Vienna from 25 to 29 September 1989. The Minister for Primary Industry and Energy, Mr John Kerin, led the Australian delegation. His statement to the General Conference highlighted Australia's role as a major uranium exporter, its committment to the Non-Proliferation of Nuclear Weapon Treaty and support for the role which the Agency plays in it. The major Australian policy initiatives in environmental areas were also outlined. Australia continues to make a substantial extra-budgetary contribution to the Regional Cooperation Agreement for Asia and Pacific (RCA), and it has recently expanded its committment by agreeing to support a series of new RCA projects. In this context, the role played by the Australian Nuclear Science and Technology Organization for the provision of technical assistance and cooperation in many areas of the Agency's activities is discussed. ills

  10. Updating and using the international non-neutron experimental nuclear data base in ''Generalized EXFOR'' format

    International Nuclear Information System (INIS)

    Zhuravleva, G.M.; Chukreev, F.E.

    1985-10-01

    A software system for the automatic preparation of non-formalized textual information for the international exchange of nuclear data in the ''Generalized Exchange Format (EXFOR)'' is described. The ''Generalized EXFOR'' format is briefly outlined and data are given on the size of the international non-neutron experimental data base in this format. (author)

  11. Associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder among men and women.

    Science.gov (United States)

    Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W

    2016-01-01

    The objective of this study was to examine the associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder at the mean age of 43. Participants came from a community-based random sample of residents in 2 New York counties in 1975 (N = 548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (standard deviation = 2.8). Of the participants, 55% were females. Over 90% of the participants were Caucasian. The prevalence of substance dependence/abuse, major depressive episodes, and generalized anxiety disorder (during the past 5 years before the interviews) was 6.6, 13.7, and 11.5%, respectively. Logistic regression analyses showed that compulsive buying was significantly associated with substance dependence/abuse (adjusted odds ratio = 1.60), major depressive episodes (adjusted odds ratio = 1.70), and generalized anxiety disorder (adjusted odds ratio = 1.63), despite controlling for substance dependence/abuse, major depressive episodes, and generalized anxiety disorder, respectively, at the mean age of 37, and demographic factors. Since the study sample is limited to predominantly Caucasian participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, major depressive episodes, and generalized anxiety disorder consider the role of compulsive buying.

  12. Clinical phenotypes of perinatal depression and time of symptom onset: analysis of data from an international consortium

    Science.gov (United States)

    Putnam, Karen T; Wilcox, Marsha; Robertson-Blackmore, Emma; Sharkey, Katherine; Bergink, Veerle; Munk-Olsen, Trine; Deligiannidis, Kristina M; Payne, Jennifer; Altemus, Margaret; Newport, Jeffrey; Apter, Gisele; Devouche, Emmanuel; Viktorin, Alexander; Magnusson, Patrik; Penninx, Brenda; Buist, Anne; Bilszta, Justin; O’Hara, Michael; Stuart, Scott; Brock, Rebecca; Roza, Sabine; Tiemeier, Henning; Guille, Constance; Epperson, C Neill; Kim, Deborah; Schmidt, Peter; Martinez, Pedro; Di Florio, Arianna; Wisner, Katherine L; Stowe, Zachary; Jones, Ian; Sullivan, Patrick F; Rubinow, David; Wildenhaus, Kevin; Meltzer-Brody, Samantha

    2018-01-01

    Summary Background The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods. Methods Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19–40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes. Findings Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe

  13. Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

    Science.gov (United States)

    Lindelow, M; Hardy, R; Rodgers, B

    1997-01-01

    OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity. PMID:9425466

  14. General dosimetry model for internal contamination with radioisotopes

    International Nuclear Information System (INIS)

    Nino, L.

    1989-01-01

    Radiation dose by inner contamination with radioisotopes is not measured directly but evaluated by the application of mathematical models of fixation and elimination, taken into account biological activity of each organ with respect to the incorporated material. Models proposed by ICRP for the respiratory and gastrointestinal tracts (30) seems that they should not be applied independently because of the evident correlation between them. In this paper both models are integrated in a more general one with neither modification nor limitation of the starting models. It has been applied to some patients in the Instituto Nacional de Cancerologia, who received some I-131 dose via oral and results are quite similar to dose experimentally obtained via urine spectrograms. Based on this results the method was formalized and applied to professional exposed personnel of the medical staff at the same Institute; due to high doses found in some of the urine samples, probable I-131 air contamination could be supposed

  15. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

    NARCIS (Netherlands)

    Toorn, S.L.M. van der; Huizink, A.C.; Utens, E.M.W.J.; Verhulst, F.C.; Ormel, J.; Ferdinand, R.F.

    2010-01-01

    Maternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study sample

  16. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

    NARCIS (Netherlands)

    S.L.M. van der Toorn; A.C. Huizink (Anja); E.M.W.J. Utens (Elisabeth); F.C. Verhulst (Frank); J. Ormel (Johan Hans); R.F. Ferdinand (Robert)

    2010-01-01

    textabstractMaternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study

  17. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS study

    NARCIS (Netherlands)

    van der Toorn, Sonja L. M.; Huizink, Anja C.; Utens, Elisabeth M. W. J.; Verhulst, Frank C.; Ormel, Johan; Ferdinand, Robert F.

    2010-01-01

    Maternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study sample

  18. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children : a report on the TRAILS Study

    NARCIS (Netherlands)

    van der Toorn, Sonja L. M.; Huizink, Anja C.; Utens, Elisabeth M. W. J.; Verhulst, Frank C.; Ormel, Johan; Ferdinand, Robert F.

    Maternal internalizing problems affect reporting of child's problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child's internalizing problems. The study sample

  19. General relativistic study of astrophysical jets with internal shocks

    Science.gov (United States)

    Vyas, Mukesh K.; Chattopadhyay, Indranil

    2017-08-01

    We explore the possibility of the formation of steady internal shocks in jets around black holes. We consider a fluid described by a relativistic equation of state, flowing about the axis of symmetry (θ = 0) in a Schwarzschild metric. We use two models for the jet geometry: (I) a conical geometry and (II) a geometry with non-conical cross-section. A jet with conical geometry has a smooth flow, while the jet with non-conical cross-section undergoes multiple sonic points and even standing shock. The jet shock becomes stronger, as the shock location is situated farther from the central black hole. Jets with very high energy and very low energy do not harbour shocks, but jets with intermediate energies do harbour shocks. One advantage of these shocks, as opposed to shocks mediated by external medium, is that these shocks have no effect on the jet terminal speed, but may act as possible sites for particle acceleration. Typically, a jet with specific energy 1.8c2 will achieve a terminal speed of v∞ = 0.813c for jet with any geometry, where, c is the speed of light in vacuum. But for a jet of non-conical cross-section for which the length scale of the inner torus of the accretion disc is 40rg, then, in addition, a steady shock will form at rsh ˜ 7.5rg and compression ratio of R ˜ 2.7. Moreover, electron-proton jet seems to harbour the strongest shock. We will discuss possible consequences of such a scenario.

  20. The Role of Parents' Attachment Orientations, Depressive Symptoms, and Conflict Behaviors in Children's Externalizing and Internalizing Behavior Problems

    Science.gov (United States)

    Marchand, Jennifer F.; Schedler, Steven; Wagstaff, David A.

    2004-01-01

    The present study examined links among parents' attachment orientations, depressive symptoms, and conflict behaviors (attacking and compromising) and children's externalizing and internalizing behavior problems in a sample of 64 nonclinical, Caucasian families. Correlational analyses showed that all three parent attributes were significantly…

  1. The Effect of Perfectionism and Acculturative Stress on Levels of Depression Experienced by East Asian International Students

    Science.gov (United States)

    Hamamura, Toshitaka; Laird, Philip G.

    2014-01-01

    This study examined relationships among acculturative stress, grade point average satisfaction, maladaptive perfectionism, and depression in 52 East Asian international students and 126 North American students. Results indicated that a combined effect of perfectionism and acculturative stress accounted for more than 30% of the variance related to…

  2. Generally Applicable Transformation Protocols for Fluorescent Nanodiamond Internalization into Cells.

    Science.gov (United States)

    Hemelaar, Simon R; van der Laan, Kiran J; Hinterding, Sophie R; Koot, Manon V; Ellermann, Else; Perona-Martinez, Felipe P; Roig, David; Hommelet, Severin; Novarina, Daniele; Takahashi, Hiroki; Chang, Michael; Schirhagl, Romana

    2017-07-19

    Fluorescent nanodiamonds (FNDs) are promising nanoprobes, owing to their stable and magnetosensitive fluorescence. Therefore they can probe properties as magnetic resonances, pressure, temperature or strain. The unprecedented sensitivity of diamond defects can detect the faint magnetic resonance of a single electron or even a few nuclear spins. However, these sensitivities are only achieved if the diamond probe is close to the molecules that need to be detected. In order to utilize its full potential for biological applications, the diamond particle has to enter the cell. Some model systems, like HeLa cells, readily ingest particles. However, most cells do not show this behavior. In this article we show for the first time generally applicable methods, which are able to transport fluorescent nanodiamonds into cells with a thick cell wall. Yeast cells, in particular Saccharomyces cerevisiae, are a favored model organism to study intracellular processes including aging on a cellular level. In order to introduce FNDs in these cells, we evaluated electrical transformation and conditions of chemical permeabilization for uptake efficiency and viability. 5% DMSO (dimethyl sulfoxide) in combination with optimized chemical transformation mix leads to high uptake efficiency in combination with low impact on cell biology. We have evaluated all steps in the procedure.

  3. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: a comparative study between men and women.

    Science.gov (United States)

    El Kissi, Yousri; Romdhane, Asma Ben; Hidar, Samir; Bannour, Souhail; Ayoubi Idrissi, Khadija; Khairi, Hedi; Ben Hadj Ali, Bechir

    2013-04-01

    To compare measures of psychological distress between men and women undergoing ART in the Unit of Reproductive Medicine "UMR" in the Department of Obstetrics and Gynecology at "Farhat Hached" Hospital in Sousse, Tunisia. We conducted a gender comparative study of psychological profile in infertile couples. Recruitment was done during period from January to May 2009. 100 infertile couples with primary infertility were recruited. Scores of general psychopathology, depression, anxiety and self-esteem were evaluated. We administrated questionnaires on psychological factors among infertile couples before starting a new infertility treatment cycle. Psychological factors included the symptom check-list (SCL-90-R), the hospital anxiety and depression scale (HAD-S) and the Rosenberg self-esteem scale (RSE). Infertile women had higher scores than their spouses in the three global scores of the SCL-90-R and in several items such as somatisation, obsessive symptoms, interpersonal sensitivity and phobias. Scores of HADS were higher among women for both depression and anxiety. Scores of self-esteem were lower among women. Women endorsed higher psychological distress than men across multiple symptoms domains: general psychopathology, anxiety, depression and self esteem. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Parenting and Early Adolescent Internalizing: The Importance of Teasing Apart Anxiety and Depressive Symptoms

    Science.gov (United States)

    Johnson, Lesley E.; Greenberg, Mark T.

    2013-01-01

    This community-based study examined differences in parenting quality and parent symptoms for youth in four categories: anxious (elevated anxiety symptoms), depressed (elevated depressive symptoms), comorbid (elevated anxiety and depressive symptoms), and nonelevated (elevations of neither type). Respondents were 976 young adolescents (mean age =…

  5. Depression, anxiety and glucose metabolism in the general dutch population: the new Hoorn study.

    Directory of Open Access Journals (Sweden)

    Vanessa Bouwman

    Full Text Available BACKGROUND: There is a well recognized association between depression and diabetes. However, there is little empirical data about the prevalence of depressive symptoms and anxiety among different groups of glucose metabolism in population based samples. The aim of this study was to determine whether the prevalence of increased levels of depression and anxiety is different between patients with type 2 diabetes and subjects with impaired glucose metabolism (IGM and normal glucose metabolism (NGM. METHODOLOGY/PRINCIPAL FINDINGS: Cross-sectional data from a population-based cohort study of 2667 residents, 1261 men and 1406 women aged 40-65 years from the Hoorn region, the Netherlands. Depressive symptoms and anxiety were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D, score >or=16 and the Hospital Anxiety and Depression Scale--Anxiety Subscale (HADS-A, score >or=8, respectively. Glucose metabolism status was determined by oral glucose tolerance test. In the total study population the prevalence of depressive symptoms and anxiety for the NGM, IGM and type 2 diabetes were 12.5, 12.2 and 21.0% (P = 0.004 and 15.0, 15.3 and 19.9% (p = 0.216, respectively. In men, the prevalence of depressive symptoms was 7.7, 9.5 and 19.6% (p<0.001, and in women 16.4, 15.8 and 22.6 (p = 0.318, for participants with NGM, IGM and type 2 diabetes, respectively. Anxiety was not associated with glucose metabolism when stratified for sex. Intergroup differences (NGM vs. IGM and IGM vs. type 2 diabetes revealed that higher prevalences of depressive symptoms are mainly manifested in participants with type 2 diabetes, and not in participants with IGM. CONCLUSIONS: Depressive symptoms, but not anxiety are associated with glucose metabolism. This association is mainly determined by a higher prevalence of depressive symptoms in participants with type 2 diabetes and not in participants with IGM.

  6. TIME Of Diabetic Ulcer Foot Suffering And Depression Symptoms In Ulin General Hospital Banjarmasin

    OpenAIRE

    Puteri, Rizka Dwi; Darwis, Yulizar; Heriyani, Farida

    2017-01-01

    Diabetic foot ulcers are one kind of chronic complication of diabetes mellitus in the form of an open wound on the skin's surface and may be accompanied by local tissue death. Long term suffering of diabetic foot ulcers with physical and psychological changes may cause symptoms of depression. The aim of this study was to determine the correlation between long term suffering of diabetic foot ulcers and symptoms of depression in RSUD Ulin Banjarmasin. This was an analytic observational study w...

  7. The effects of depression and electroconvulsive therapy on retrospective memory and general cognition : a longitudinal study

    OpenAIRE

    Noone, Martha

    2012-01-01

    The objectives of this work were to investigate the effects of depression on retrospective memory, in addition to attention, psychomotor and executive function, in depressed patients receiving pharmacotherapy treatment compared to heahhy controls (The Mem-Dep Study). The second objective was to examine retrograde memory function in patients in a randomised controlled non-inferiority trial investigating the effectiveness and side-effects of high-dose Right Unilateral (RUL) ECT and standard Bit...

  8. Depression is a major determinant of quality of life in patients with chronic systolic heart failure in general practice.

    Science.gov (United States)

    Müller-Tasch, Thomas; Peters-Klimm, Frank; Schellberg, Dieter; Holzapfel, Nicole; Barth, Annika; Jünger, Jana; Szecsenyi, Joachim; Herzog, Wolfgang

    2007-12-01

    Quality of life (QoL) is severely restricted in patients with chronic heart failure (CHF). Patients frequently suffer from depressive comorbidity. It is not clear, to what extent sociodemographic variables, heart failure severity, somatic comorbidities and depression determine QoL of patients with CHF in primary care. In a cross-sectional analysis, 167 patients, 68.2 +/- 10.1 years old, 68.9% male, New York Heart Association (NYHA) functional class II-IV, Left ventricular ejection fraction (LVEF) < or = 40%, were recruited in their general practitioner's practices. Heart failure severity was assessed with echocardiography and N-terminal brain natriuretic peptide (NT-proBNP); multimorbidity was assessed with the Cumulative Illness Rating Scale (CIRS-G). QoL was measured with the Short Form 36 Health Survey (SF-36) and depression with the depression module of the Patient Health Questionnaire (PHQ-9). Significant correlations with all SF-36 subscales were only found for the CIRS-G (r = -0.18 to -0.36; P < .05) and the PHQ-9 (r = -0.26 to -0.75; P < .01). In multivariate forward regression analyses, the PHQ-9 summary score explained the most part of QoL variance in all of the SF-36 subscales (r2 = 0.17-0.56). LVEF and NT-proBNP did not have significant influence on QoL. Depression is a major determinant of quality of life in patients with chronic systolic heart failure, whereas somatic measures of heart failure severity such as NT-proBNP and LVEF do not contribute to quality of life. Correct diagnosis and treatment of depressive comorbidity in heart failure patients is essential.

  9. 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.

  10. Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern

    Directory of Open Access Journals (Sweden)

    Ulrika Heu

    2018-06-01

    Full Text Available Objective: Additional and comorbid diagnoses are common among suicide victims with major depressive disorder (MDD and have been shown to increase the suicide risk. The aim of the present study was first, to investigate whether patients with severe depression/melancholia who had died by suicide showed more additional psychiatric disorders than a matched control group. Second, general rates of comorbid and additional diagnoses in the total group of patients were estimated and compared with literature on MDD. Method: A blind record evaluation was performed on 100 suicide victims with severe depression/melancholia (MDD with melancholic and/or psychotic features: MDD-M/P and matched controls admitted to the Department of Psychiatry, Lund, Sweden between 1956 and 1969 and monitored to 2010. Diagnoses in addition to severe depression were noted. Results: Less than half of both the suicides and controls had just one psychiatric disorder (47% in the suicide and 46% in the control group. The average number of diagnoses was 1.80 and 1.82, respectively. Additional diagnoses were not related to an increased suicide risk. Anxiety was the most common diagnosis. Occurrence of suspected schizophrenia/schizotypal or additional obsessive-compulsive symptoms were more common than expected, but alcohol use disorders did not appear very frequent. Conclusions: The known increased risk of suicide in MDD with comorbid/additional diagnoses does not seem to apply to persons with MDD-M/P (major depressive disorder-depression/Melancholia. Some diagnoses, such as schizophrenia/schizotypal disorders, were more frequent than expected, which is discussed, and a genetic overlap with MDD-M/P is proposed.

  11. The Role of University Students' General Self-Efficacy, Depression and Psychological Well-Being in Predicting Their Exercise Behavior

    Science.gov (United States)

    Ersöz, Gözde

    2017-01-01

    The aim of this research is to examine the relationship between exercise and general self-efficacy, depression, and psychological well-being of college students. Five hundred and twenty-two university students (n[subscript male] = 273; X[subscript age] = 23.33 ± 4.36 and n[subscript female] = 279; X[subscript age] = 25.91 ± 7.11) have participated…

  12. Roles and practices of general practitioners and psychiatrists in management of depression in the community

    Directory of Open Access Journals (Sweden)

    Blin Patrick

    2006-01-01

    Full Text Available Abstract Background Little is known about depressed patients' profiles and how they are managed. The aim of the study is to compare GPs and psychiatrists for 1° sociodemographic and clinical profile of their patients considered as depressed 2° patterns of care provision. Methods The study design is an observational cross-sectional study on a random sample of GPs and psychiatrists working in France. Consecutive inclusion of patients seen in consultation considered as depressed by the physician. GPs enrolled 6,104 and psychiatrists 1,433 patients. Data collected: sociodemographics, psychiatric profile, environmental risk factors of depression and treatment. All clinical data were collected by participating physicians; there was no direct independent clinical assessment of patients to check the diagnosis of depressive disorder. Results Compared to patients identified as depressed by GPs, those identified by psychiatrists were younger, more often urban (10.5% v 5.4% – OR = 2.4, educated (42.4% v 25.4% – OR = 3.9, met DSM-IV criteria for depression (94.6% v 85.6% – OR = 2.9, had been hospitalized for depression (26.1% v 15.6% – OR = 2.0 and were younger at onset of depressive problems (all adjusted p Compared to GPs, psychiatrists more often prescribed tricyclics and very novel antidepressants (7.8% v 2.3% OR = 5.0 and 6.8% v 3.0% OR = 3.8 with longer duration of antidepressant treatment. GPs' patients received more "non-conventional" treatment (8.8% v 2.4% OR = 0.3 and less psychotherapy (72.2% v 89.1% OR = 3.1 (all adjusted p Conclusion Differences between patients mainly concerned educational level and area of residence with few differences regarding clinical profile. Differences between practices of GPs and psychiatrists appear to reflect more the organization of the French care system than the competence of providers.

  13. A sex-specific comparison of major depressive disorder symptomatology in the canadian forces and the general population.

    Science.gov (United States)

    Erickson, Julie; Kinley, D Jolene; Bolton, James M; Zamorski, Mark A; Enns, Murray W; Sareen, Jitender

    2014-07-01

    To compare major depressive disorder (MDD) symptomatology within men and women in a large, representative sample of Canadian military personnel and civilians. We used the Canadian Community Health Survey: Mental Health and Well-Being (Cycle 1.2 and Canadian Forces Supplement) (n = 36 984 and n = 8441, respectively) to compare past-year MDD symptomatology among military and civilian women, and military and civilian men. Logistic regression models were used to determine differences in the types of depressive symptoms endorsed in each group. Men in the military with MDD were at lower odds than men in the general population to endorse numerous symptoms of depression, such as hopelessness (adjusted odds ratio [AOR] 0.44; 99% CI 0.23 to 0.83) and inability to cope (AOR 0.53; 99% CI 0.31 to 0.92). Military women with MDD were at lower odds of thinking about their death (AOR 0.52; 99% CI 0.32 to 0.86), relative to women with MDD in the general population. Different MDD symptomatology among males and females in the military, compared with those in the general population, may reflect selection effects (for example, personality characteristics and patterns of comorbidity) or occupational experiences unique to military personnel. Future research examining the mechanisms behind MDD symptomatology in military personnel and civilians is required.

  14. Update in outpatient general internal medicine: practice-changing evidence published in 2014.

    Science.gov (United States)

    Sundsted, Karna K; Wieland, Mark L; Szostek, Jason H; Post, Jason A; Mauck, Karen F

    2015-10-01

    The practice of outpatient general internal medicine requires a diverse and evolving knowledge base. General internists must identify practice-changing shifts in the literature and reflect on their impact. Accordingly, we conducted a review of practice-changing articles published in outpatient general internal medicine in 2014. To identify high-quality, clinically relevant publications, we reviewed all titles and abstracts published in the following primary data sources in 2014: New England Journal of Medicine, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, JAMA Internal Medicine, and the Cochrane Database of Systematic Reviews. All 2014 primary data summaries from Journal Watch-General Internal Medicine and ACP JournalWise also were reviewed. The authors used a modified Delphi method to reach consensus on inclusion of 8 articles using the following criteria: clinical relevance to outpatient internal medicine, potential for practice change, and strength of evidence. Clusters of important articles around one clinical question were considered as a single-candidate series. The article merits were debated until consensus was reached on the final 8, spanning a variety of topics commonly encountered in outpatient general internal medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. International Law, Cultural Diversity, and The Environment: the Case of the General Forestry Law in Colombia

    OpenAIRE

    Bonilla-Maldonado, Daniel Eduardo; Universidad de los Andes

    2015-01-01

    International law has been repeatedly challenged for its exclusionary character and its imperial uses. These critiques describe many of its structures and dynamics in a precise manner. However, international law may be a useful instrument for protecting the legitimate interests of the States of the Global South in general, and of the distinct social and cultural groups that form them, in particular. Yet, in order to understand international law's potential for emancipation or social resistanc...

  16. Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder.

    Science.gov (United States)

    Yook, Keunyoung; Kim, Keun-Hyang; Suh, Shin Young; Lee, Kang Soo

    2010-08-01

    Intolerance of uncertainty (IU) can be defined as a cognitive bias that affects how a person perceives, interprets, and responds to uncertain situations. Although IU has been reported mainly in literature relating to worry and anxiety symptoms, it may be also important to investigate the relationship between IU, rumination, and depression in a clinical sample. Furthermore, individuals who are intolerant of uncertainty easily experience stress and could cope with stressful situations using repetitive thought such as worry and rumination. Thus, we investigated whether different forms of repetitive thought differentially mediate the relationship between IU and psychological symptoms. Participants included 27 patients with MDD, 28 patients with GAD, and 16 patients with comorbid GAD/MDD. Even though worry, rumination, IU, anxiety, and depressive symptoms correlated substantially with each other, worry partially mediated the relationship between IU and anxiety whereas rumination completely mediated the relationship between IU and depressive symptoms. (c) 2010 Elsevier Ltd. All rights reserved.

  17. Dimorphic anemia and mental depression as a result of systemic manifestations of generalized aggressive periodontitis: A pioneer case report

    Directory of Open Access Journals (Sweden)

    Ajay Mahajan

    2017-01-01

    Full Text Available Generalized aggressive periodontitis (GAP is a rare form of periodontitis resulting in early loss of teeth. Most of the clinical evidence available in literature focuses on the diagnosis and management aspects of GAP. Systemic manifestations of GAP have been reported infrequently. To the best of our knowledge, the present case report is the first-ever evidence providing a possible mechanism and link between GAP, dimorphic anemia, and mental depression suggesting that dimorphic anemia and mental depression are probable systemic manifestations of GAP. A young female reported with her father to the hospital with a complaint of pain in her oral cavity and lack of desire to eat. On thorough examination, GAP with dimorphic anemia and mental depression were diagnosed. Periodontal treatment along with nutritional supplements was prescribed. An improvement was noticed in the patient's condition after a follow-up period of 6 months. Systemic manifestations of GAP should include the diagnoses of dimorphic anemia and mental depression and should be treated accordingly.

  18. Latent profile analyses of posttraumatic stress disorder, depression and generalized anxiety disorder symptoms in trauma-exposed soldiers.

    Science.gov (United States)

    Contractor, Ateka A; Elhai, Jon D; Fine, Thomas H; Tamburrino, Marijo B; Cohen, Gregory; Shirley, Edwin; Chan, Philip K; Liberzon, Israel; Galea, Sandro; Calabrese, Joseph R

    2015-09-01

    Posttraumatic stress disorder (PTSD) is comorbid with major depressive disorder (MDD; Kessler et al., 1995) and generalized anxiety disorder (GAD; Brown et al., 2001). We aimed to (1) assess discrete patterns of post-trauma PTSD-depression-GAD symptoms using latent profile analyses (LPAs), and (2) assess covariates (gender, income, education, age) in defining the best fitting class solution. The PTSD Checklist (assessing PTSD symptoms), GAD-7 scale (assessing GAD symptoms), and Patient Health Questionnaire-9 (assessing depression) were administered to 1266 trauma-exposed Ohio National Guard soldiers. Results indicated three discrete subgroups based on symptom patterns with mild (class 1), moderate (class 2) and severe (class 3) levels of symptomatology. Classes differed in symptom severity rather than symptom type. Income and education significantly predicted class 1 versus class 3 membership, and class 2 versus class 3. In conclusion, there is heterogeneity regarding severity of PTSD-depression-GAD symptomatology among trauma-exposed soldiers, with income and education predictive of class membership. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Spared internal but impaired external reward prediction error signals in major depressive disorder during reinforcement learning.

    Science.gov (United States)

    Bakic, Jasmina; Pourtois, Gilles; Jepma, Marieke; Duprat, Romain; De Raedt, Rudi; Baeken, Chris

    2017-01-01

    Major depressive disorder (MDD) creates debilitating effects on a wide range of cognitive functions, including reinforcement learning (RL). In this study, we sought to assess whether reward processing as such, or alternatively the complex interplay between motivation and reward might potentially account for the abnormal reward-based learning in MDD. A total of 35 treatment resistant MDD patients and 44 age matched healthy controls (HCs) performed a standard probabilistic learning task. RL was titrated using behavioral, computational modeling and event-related brain potentials (ERPs) data. MDD patients showed comparable learning rate compared to HCs. However, they showed decreased lose-shift responses as well as blunted subjective evaluations of the reinforcers used during the task, relative to HCs. Moreover, MDD patients showed normal internal (at the level of error-related negativity, ERN) but abnormal external (at the level of feedback-related negativity, FRN) reward prediction error (RPE) signals during RL, selectively when additional efforts had to be made to establish learning. Collectively, these results lend support to the assumption that MDD does not impair reward processing per se during RL. Instead, it seems to alter the processing of the emotional value of (external) reinforcers during RL, when additional intrinsic motivational processes have to be engaged. © 2016 Wiley Periodicals, Inc.

  20. Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety.

    Science.gov (United States)

    Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Baldwin, D S; den Boer, J A; Kasper, S; Shear, M K

    1998-01-01

    To provide primary care clinicians with a better understanding of management issues in panic disorder and guide clinical practice with recommendations for appropriate pharmacotherapy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Four faculty invited by the chairman also participated: David S. Baldwin, Johan A. den Boer, Siegfried Kasper, and M. Katherine Shear. The consensus statement is based on the 6 review papers that are published in this supplement and on the scientific literature relevant to these issues. There were group meetings held during a 2-day period. On day 1, the group discussed each review paper and the chairman and discussant (Dr. Kasper) identified key issues for further debate. On day 2, the group discussed these key issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chairman and approved by all attendees. The consensus statement provides standard definitions for response and remission and identifies appropriate strategy for the management of panic disorder in a primary care setting. Serotonin selective reuptake inhibitors are recommended as drugs of first choice with a treatment period of 12 to 24 months. Pharmacotherapy should be discontinued slowly over a period of 4 to 6 months.

  1. Consensus statement on social anxiety disorder from the International Consensus Group on Depression and Anxiety.

    Science.gov (United States)

    Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Bobes, J; Beidel, D C; Ono, Y; Westenberg, H G

    1998-01-01

    The goal of this consensus statement is to provide primary care clinicians with a better understanding of management issues in social anxiety disorder (social phobia) and guide clinical practice with recommendations for appropriate pharmacotherapy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty invited by the chair were Julio Bobes, Deborah C. Beidel, Yukata Ono, and Herman G. M. Westenberg. The consensus statement is based on the 7 review papers published in this supplement and on the scientific literature relevant to the issues reviewed in these papers. The group met over a 2-day period. On day 1, the group discussed each review paper, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. The consensus statement underlines the importance of recognizing social anxiety disorder and provides recommendations on how it may be distinguished from other anxiety disorders. It proposes definitions for response and remission and considers appropriate management strategies. Selective serotonin reuptake inhibitors are recommended as first-line therapy, and effective treatment should be continued for at least 12 months. Long-term treatment is indicated if symptoms are unresolved, the patient has a comorbid condition or a history of relapse, or there was an early onset of the disorder.

  2. A national comparison of burnout and work-life balance among internal medicine hospitalists and outpatient general internists.

    Science.gov (United States)

    Roberts, Daniel L; Shanafelt, Tait D; Dyrbye, Liselotte N; West, Colin P

    2014-03-01

    General internists suffer higher rates of burnout and lower satisfaction with work-life balance than most specialties, but the impact of inpatient vs outpatient practice location is unclear. Physicians in the American Medical Association Physician Masterfile were previously surveyed about burnout, depression, suicidal ideation, quality of life, fatigue, work-life balance, career plans, and health behaviors. We extracted and compared data for these variables for the 130 internal medicine hospitalists and 448 outpatient general internists who participated. Analyses were adjusted for age, sex, hours worked, and practice setting. There were 52.3% of the hospitalists and 54.5% of the outpatient internists affected by burnout (P = 0.86). High scores on the emotional exhaustion subscale (43.8% vs 48.1%, P = 0.71) and on the depersonalization subscale (42.3% vs 32.7%, P = 0.17) were common but similar in frequency in the 2 groups. Hospitalists were more likely to score low on the personal accomplishment subscale (20.3% vs 9.6%, P = 0.04). There were no differences in symptoms of depression (40.3% for hospitalists vs 40.0% for outpatient internists, P = 0.73) or recent suicidality (9.2% vs 5.8%, P = 0.15). Rates of reported recent work-home conflict were similar (48.4% vs 41.3%, P = 0.64), but hospitalists were more likely to agree that their work schedule leaves enough time for their personal life and family (50.0% vs 42.0%, P = 0.007). Burnout was common among both hospitalists and outpatient general internists, although hospitalists were more satisfied with work-life balance. A better understanding of the causes of distress and identification of solutions for all internists is needed. © 2014 Society of Hospital Medicine.

  3. New Deal Policies and the Persistence of the Great Depression: A General Equilibrium Analysis.

    Science.gov (United States)

    Cole, Harold L.; Ohanian, Lee E.

    2004-01-01

    There are two striking aspects of the recovery from the Great Depression in the United States: the recovery was very weak, and real wages in several sectors rose significantly above trend. These data contrast sharply with neoclassical theory, which predicts a strong recovery with low real wages. We evaluate the contribution to the persistence of…

  4. Who is MADD? Mixed anxiety depressive disorder in the general population

    NARCIS (Netherlands)

    Spijker, J.; Batelaan, N.M.; de Graaf, R.; Cuijpers, P.

    2010-01-01

    Background: Diagnostic criteria for (subthreshold) mixed anxiety depression (MADD) were proposed in DSM-IV. Yet the usefulness of this classification is questioned. We therefore assessed the prevalence of MADD, and investigated whether MADD adds to separate classifications of pure subthreshold

  5. Who is MADD? Mixed anxiety depressive disorder in the general population

    NARCIS (Netherlands)

    Spijker, J.; Batelaan, N.M.; Graaf, R. de; Cuijpers, P.

    2010-01-01

    Background: Diagnostic criteria for (subthreshold) mixed anxiety depression (MADD) were proposed in DSM-IV. Yet the usefulness of this classification is questioned. We therefore assessed the prevalence of MADD, and investigated whether MADD adds to separate classifications Of pure subthreshold

  6. Endothelial dysfunction is associated with a greater depressive symptom score in a general elderly population

    DEFF Research Database (Denmark)

    van Sloten, T T; Schram, Miranda T; Adriaanse, M C

    2014-01-01

    ), soluble vascular cell adhesion molecule 1, soluble thrombomodulin and soluble endothelial selectin], LGI [C-reactive protein, tumour necrosis factor-α, interleukin 6, interleukin 8, serum amyloid A, myeloperoxidase (MPO) and sICAM-1] and OxS (oxidized low density lipoprotein and MPO). Depressive symptoms...

  7. Relationship between Maternal General and Specific-Pregnancy Stress, Anxiety, and Depression Symptoms and Pregnancy Outcome.

    Science.gov (United States)

    Hasanjanzadeh, Parvin; Faramarzi, Mahbobeh

    2017-04-01

    Despite scientific advances in the field of physical problems during pregnancy, the effect of mental problems on the health of pregnant women is still an important issue that needs further research. To determine the association of symptoms of stress, anxiety and depression during pregnancy and there effect on the pregnancy outcome. This was a descriptive correlational study. The population included 200 pregnant women of the urban and rural health centers affiliated with Babol University of Medical Sciences. There were 100 each in second and third trimester. Convenience multi stage cluster sampling was performed. Data collection was received through the Hospital Anxiety Depression Scale (HADS), Pregnancy Distress Questionnaire (PDQ), and Perceived Stress Scale (PSS-14) questionnaires. The correlation results showed a significant difference between variables of depression, stress, and anxiety with birth weight, birth height and head circumference and infants' APGAR score (prelationships on prediction of infant weight (B=-0.324), anxiety on prediction of infant height (B=-0.197), stress on prediction of head circumference (B=-0.350) and depression on prediction of APGAR score (B=-0.323) are effective (pdepression, anxiety and stress in pregnancy, and scheduling to avoid adverse consequences of the pregnancy outcome.

  8. Generalized Anxiety Disorder and Major Depressive Disorder in Pregnant and Postpartum Women: Maternal Quality of Life and Treatment Outcomes.

    Science.gov (United States)

    Misri, Shaila; Swift, Elena

    2015-09-01

    Comorbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) in perinatal women is often under-diagnosed, resulting in suboptimal treatment and leading to significant maternal dysfunction. We describe a prospective, longitudinal study of the course, treatment outcomes, and quality of life (QoL) in pregnant and postpartum women with MDD and anxiety disorders. Two separate cohorts of women were recruited through the Reproductive Mental Health Program, Women's and Children's Hospital, Vancouver, British Columbia, for pharmacotherapy of depressed mood. One cohort was recruited during pregnancy and followed to one month postpartum; the other cohort was recruited postpartum and followed for 12 weeks. All women met the DSM-5 criteria for MDD and anxiety disorders. This non-lactating perinatal population completed measures of depression, anxiety, worry symptoms, and QoL at multiple study visits. Depressed women with GAD or excessive worry were compared to those without GAD in each cohort. Analysis revealed that despite the majority of women with MDD having remission of symptoms with treatment, those with postpartum GAD displayed a poorer quality of life, with persistent worry symptoms, and their illness was slower to remit. Pregnant depressed women with uncontrollable worry (a GAD indicator) showed a lower probability of achieving remission of symptoms with treatment than those without uncontrollable worry. All pregnant and postpartum women with GAD and MDD responded to pharmacotherapy, and the majority attained complete remission of MDD. However, their GAD symptoms persisted, and their QoL was compromised. Given the chronic debilitating course of concomitant MDD and GAD in the perinatal population, it is essential to focus on adjunctive therapies to aim for full recovery.

  9. Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Talati, Ardesheer; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2008-01-01

    Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major…

  10. Internalized weight bias mediates the relationship between depressive symptoms and disordered eating behavior among women who think they are overweight.

    Science.gov (United States)

    Sienko, Rachel M; Saules, Karen K; Carr, Meagan M

    2016-08-01

    This study tested the potential mediating role of Internalized Weight Bias (IWB) in the relationship between depressive symptoms (DEP-SX) and disordered eating behavior. In particular, we hypothesized that IWB may be an intervening variable in the well documented association between depression and disordered eating. College women (N=172) who were taking undergraduate psychology courses and who endorsed thinking they were overweight completed the Patient Health Questionnaire depression screener (PHQ-9), the Weight Bias Internalization Scale (WBIS), and the Eating Disorder Examination Questionnaire (EDE-Q). Bootstrapping mediation analyses were conducted to explore the relationships between these variables. IWB was significantly correlated with eating disorder symptoms and DEP-SX, but not Body Mass Index. Mediation analyses supported a model in which IWB mediated the relationship between DEP-SX and disordered eating behavior. Results indicate that individuals with elevated DEP-SX may be likely to internalize weight bias, which may in turn lead to maladaptive approaches to eating and weight control, regardless of one's actual weight status. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis.

    Science.gov (United States)

    Deady, M; Choi, I; Calvo, R A; Glozier, N; Christensen, H; Harvey, S B

    2017-08-29

    Anxiety and depression are associated with a range of adverse outcomes and represent a large global burden to individuals and health care systems. Prevention programs are an important way to avert a proportion of the burden associated with such conditions both at a clinical and subclinical level. eHealth interventions provide an opportunity to offer accessible, acceptable, easily disseminated globally low-cost interventions on a wide scale. However, the efficacy of these programs remains unclear. The aim of this study is to review and evaluate the effects of eHealth prevention interventions for anxiety and depression. A systematic search was conducted on four relevant databases to identify randomized controlled trials of eHealth interventions aimed at the prevention of anxiety and depression in the general population published between 2000 and January 2016. The quality of studies was assessed and a meta-analysis was performed using pooled effect size estimates obtained from a random effects model. Ten trials were included in the systematic review and meta-analysis. All studies were of sufficient quality and utilized cognitive behavioural techniques. At post-treatment, the overall mean difference between the intervention and control groups was 0.25 (95% confidence internal: 0.09, 0.41; p = 0.003) for depression outcome studies and 0.31 (95% CI: 0.10, 0.52; p = 0.004) for anxiety outcome studies, indicating a small but positive effect of the eHealth interventions. The effect sizes for universal and indicated/selective interventions were similar (0.29 and 0.25 respectively). However, there was inadequate evidence to suggest that such interventions have an effect on long-term disorder incidence rates. Evidence suggests that eHealth prevention interventions for anxiety and depression are associated with small but positive effects on symptom reduction. However, there is inadequate evidence on the medium to long-term effect of such interventions, and importantly, on

  12. [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.

  13. A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS.

    Science.gov (United States)

    Zeng, Chengbo; Li, Linghua; Hong, Yan Alicia; Zhang, Hanxi; Babbitt, Andrew Walker; Liu, Cong; Li, Lixia; Qiao, Jiaying; Guo, Yan; Cai, Weiping

    2018-01-15

    Previous studies have shown positive association between HIV-related stigma and depression, suicidal ideation, and suicidal attempt among people living with HIV/AIDS (PLWH). But few studies have examined the mechanisms among HIV-related stigma, depression, and suicidal status (suicidal ideation and/or suicidal attempt) in PLWH. The current study examined the relationships among perceived and internalized stigma (PIS), depression, and suicidal status among PLWH in Guangzhou, China using structural equation modeling. Cross-sectional study by convenience sampling was conducted and 411 PLWH were recruited from the Number Eight People's Hospital from March to June, 2013 in Guangzhou, China. Participants were interviewed on their PIS, depressive symptoms, suicidal status, and socio-demographic characteristics. PLWH who had had suicidal ideation and suicidal attempts since HIV diagnosis were considered to be suicidal. Structural equation model was performed to examine the direct and indirect associations of PIS and suicidal status. Indicators to evaluate goodness of fit of the structural equation model included Chi-square Statistic, Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Weighted Root Mean Square Residual (WRMR). More than one-third (38.4%) of the PLWH had depressive symptoms and 32.4% reported suicidal ideation and/or attempt since HIV diagnosis. The global model showed good model fit (Chi-square value = 34.42, CFI = 0.98, RMSEA = 0.03, WRMR = 0.73). Structural equation model revealed that direct pathway of PIS on suicidal status was significant (standardized pathway coefficient = 0.21), and indirect pathway of PIS on suicidal status via depression was also significant (standardized pathway coefficient = 0.24). There was a partial mediating effect of depression in the association between PIS and suicidal status. Our findings suggest that PIS is associated

  14. International Study to Predict Optimized Treatment for Depression (iSPOT-D, a randomized clinical trial: rationale and protocol

    Directory of Open Access Journals (Sweden)

    Cooper Nicholas J

    2011-01-01

    Full Text Available Abstract Background Clinically useful treatment moderators of Major Depressive Disorder (MDD have not yet been identified, though some baseline predictors of treatment outcome have been proposed. The aim of iSPOT-D is to identify pretreatment measures that predict or moderate MDD treatment response or remission to escitalopram, sertraline or venlafaxine; and develop a model that incorporates multiple predictors and moderators. Methods/Design The International Study to Predict Optimized Treatment - in Depression (iSPOT-D is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65 from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls. Study-eligible patients are antidepressant medication (ADM naïve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary. Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm. Discussion First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide. Trial registration International Study to Predict Optimised Treatment - in Depression (iSPOT-D ClinicalTrials.gov Identifier

  15. Using a hybrid subtyping model to capture patterns and dimensionality of depressive and anxiety symptomatology in the general population.

    Science.gov (United States)

    Wardenaar, Klaas J; Wanders, Rob B K; Ten Have, Margreet; de Graaf, Ron; de Jonge, Peter

    2017-06-01

    Researchers have tried to identify more homogeneous subtypes of major depressive disorder (MDD) with latent class analyses (LCA). However, this approach does no justice to the dimensional nature of psychopathology. In addition, anxiety and functioning-levels have seldom been integrated in subtyping efforts. Therefore, this study used a hybrid discrete-dimensional approach to identify subgroups with shared patterns of depressive and anxiety symptomatology, while accounting for functioning-levels. The Comprehensive International Diagnostic Interview (CIDI) 1.1 was used to assess previous-year depressive and anxiety symptoms in the Netherlands Mental Health Survey and Incidence Study-1 (NEMESIS-1; n=5583). The data were analyzed with factor analyses, LCA and hybrid mixed-measurement item response theory (MM-IRT) with and without functioning covariates. Finally, the classes' predictors (measured one year earlier) and outcomes (measured two years later) were investigated. A 3-class MM-IRT model with functioning covariates best described the data and consisted of a 'healthy class' (74.2%) and two symptomatic classes ('sleep/energy' [13.4%]; 'mood/anhedonia' [12.4%]). Factors including older age, urbanicity, higher severity and presence of 1-year MDD predicted membership of either symptomatic class vs. the healthy class. Both symptomatic classes showed poorer 2-year outcomes (i.e. disorders, poor functioning) than the healthy class. The odds of MDD after two years were especially increased in the mood/anhedonia class. Symptoms were assessed for the past year whereas current functioning was assessed. Heterogeneity of depression and anxiety symptomatology are optimally captured by a hybrid discrete-dimensional subtyping model. Importantly, accounting for functioning-levels helps to capture clinically relevant interpersonal differences. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Depressive disorder in the last phase of life in patients with cardiovascular disease, cancer, and COPD: data from a 20-year follow-up period in general practice.

    Science.gov (United States)

    Warmenhoven, Franca; Bor, Hans; Lucassen, Peter; Vissers, Kris; van Weel, Chris; Prins, Judith; Schers, Henk

    2013-05-01

    Depression is assumed to be common in chronically ill patients during their last phase of life and is associated with poorer outcomes. The prevalence of depression is widely varying in previous studies due to the use of different terminology, classification, and assessment methods. To explore the reported incidence of depressive disorder, as registered in the last phase of life of patients who died from cardiovascular disease, cancer or COPD, in a sample of primary care patients. A historic cohort study, using a 20-year period registration database of medical records in four Dutch general practices (a dynamic population based on the Continuous Morbidity Registration database). Medical history of the sample cohort was analysed for the diagnosis of a new episode of depressive disorder and descriptive statistics were used. In total 982 patients were included, and 19 patients (1.9%) were diagnosed with a new depressive disorder in the last year of their life. The lifetime prevalence of depressive disorder in this sample was 8.2%. The incidence of depressive disorder in the last phase of life is remarkably low in this study. These data were derived from actual patient care in general practice. Psychiatric diagnoses were made by GPs in the context of both patient needs and delivered care. A broader concept of depression in general practice is recommended to improve the diagnosis and treatment of mood disorders in patients in the last phase of life.

  17. A Randomized, Placebo-Controlled Pilot Study of Quetiapine-XR Monotherapy or Adjunctive Therapy to Antidepressant in Acute Major Depressive Disorder with Current Generalized Anxiety Disorder.

    Science.gov (United States)

    Li, Ranran; Wu, Renrong; Chen, Jun; Kemp, David E; Ren, Ming; Conroy, Carla; Chan, Philip; Serrano, Mary Beth; Ganocy, Stephen J; Calabrese, Joseph R; Gao, Keming

    2016-03-01

    To pilot efficacy and safety data of quetiapine-XR monotherapy or adjunctive therapy to antidepressant(s) in the acute treatment of MDD with current generalized anxiety disorder (GAD). The Mini International Neuropsychiatric Interview was used to ascertain the diagnosis of DSM-IV Axis I disorders. Eligible patients were randomly assigned to quetiapine-XR or placebo for up to 8 weeks. Changes from baseline to endpoint in Hamilton Depression Rating Scale-17 items (HAMD-17), Hamilton Anxiety Rating Scale (HAM-A), Clinical Global Impression-Severity (CGI-S), Quick Inventory of Depression Symptomatology-16 items Self-Report (QIDS-16-SR) total scores, and other outcome measures were analyzed with the last observation carried forward strategy and/or mixed-effects modeling for repeated measures. Of the 34 patients screened, 23 patients were randomized to receive quetiapine-XR (n = 11) or placebo (n = 12), with 5 and 4 completing the study, respectively. The mean dose of quetiapine-XR was 154 ± 91 mg/d. The change from baseline to endpoint in the total scores of HAMD-17, HAM-A, QIDS-16-SR, and CGI-S were significant in the quetiapine-XR group, but only the change in HAM-A total score was significant in the placebo group. The differences in these changes between the two groups were only significant in CGI-S scores, with the rest of numerical larger in the quetiapine-XR group. The most common side effects from quetiapine-XR were dry mouth, somnolence/sedation, and fatigue. In this pilot study, quetiapine-XR was numerically superior to placebo in reducing depressive and anxiety symptoms in patients with MDD and current GAD. Large sample studies are warranted to support or refute these preliminary findings.

  18. Maternal Depressive Symptoms and At-Risk Young Children's Internalizing Problems: The Moderating Role of Mothers' Positivity

    Science.gov (United States)

    Goodlett, Benjamin D.; Trentacosta, Christopher J.; McLear, Caitlin; Crespo, Laura; Wheeler, Rebecca; Williams, Alexis; Chaudhry, Kiren; Smith-Darden, Joanne

    2017-01-01

    Maternal depressive symptoms predict negative child behaviors, including internalizing problems. However, protective factors, such as positive emotionality and positive parenting behaviors, may play an important a role in attenuating associations between maternal depressive symptoms and child behavior problems. This article presents two studies…

  19. Physicians' characteristics associated with exploring suicide risk among patients with depression: a French panel survey of general practitioners.

    Science.gov (United States)

    Bocquier, Aurélie; Pambrun, Elodie; Dumesnil, Hélène; Villani, Patrick; Verdoux, Hélène; Verger, Pierre

    2013-01-01

    General practitioners (GPs) have a key role to play in suicide prevention, but the rates at which they question patients with depression about suicidal thoughts and plans are rather low. Little is known about GPs' characteristics associated with such inquiries. Our objectives were to describe GPs' attitudes, perceived barriers, and self-reported practices in this questioning of these patients and to analyze factors associated with these practices. This cross-sectional survey was conducted among participants in a panel of randomly selected French GPs (1249/1431 participated: 87.3%). GPs were interviewed with a standardized questionnaire covering their professional and personal characteristics, attitudes, and practices in exploring the suicide risk of their patients with depression. We built a suicide inquiry score by summing the responses to 5 items and used a multiple linear regression analysis to explore the characteristics associated with this score. Most GPs reported inquiring about the presence of suicidal ideation often or very often; less than 30% reported that they frequently explored signs of a specific suicide plan. The mean suicide inquiry score was 12.4 (SD, 2.9; range, 5-20). False ideas, such as thinking that patients who report suicidal ideas do not often commit suicide, were frequent (42.3%). Previous continuing medical education on suicide, participation in a formal mental health network, and patients who committed suicide in the past 5 years were associated with a higher score. Reluctance to question patients about suicide and perception of insufficient skill were associated with a lower score. This study showed great variability in French GPs' practices in exploring suicide risk in patients with depression. Interventions aiming at improving GPs' initial training and continuing medical education in suicide and/or depression, and their collaboration with mental health specialists should be developed, and their impacts assessed.

  20. Suicidal risk, depression, and religiosity: a study of women in a general hospital in Santiago de Chile.

    Science.gov (United States)

    Florenzano, Ramón; Rodríguez, Jorge; Sieverson, Catalina; Cataldo, Eny; Pastorino, Sol; Fernández, Loreto

    2014-03-01

    The purpose of the present study is to compare the role of spiritual and religious beliefs in the prevention of suicidal risk among depressive women with suicidal ideation or attempts, treated in the psychiatric unit of a general hospital in Santiago de Chile (Servicio de Psiquiatría del Hospital del Salvador) between 2010 and 2011. The relationship among severity of depression, suicidal risk, and religiosity is explored in women treated in Servicio de Psiquiatría del Hospital del Salvador. The sociodemographic and clinical characteristics of believers (n = 121) and nonbelievers (n = 22) were compared, and their global mental health was assessed, as well as their rating in scales for depression, anxiety, aggressivity, and impulsivity. Most of the patients self-reported to belong to Catholic or other Christian churches. There were few statistically significant differences between them and nonbelievers, who were younger, had more years of education, were more frequently employed, and lived alone or with their parents. When comparing the least religious and the most religious quartiles, there were no differences in the type of affective disorder, attendance to temples, or self-appraisal of religiosity. Nonbelievers had more history of previous suicidal attempts and had more relatives committing suicide. In a country where most of the population is believer, self-reported religiosity seems to have a nonsignificant association with suicidality and severity of depression. Our results could be biased given the small number of nonbelievers in the sample. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  1. Physicians' characteristics associated with exploring suicide risk among patients with depression: a French panel survey of general practitioners.

    Directory of Open Access Journals (Sweden)

    Aurélie Bocquier

    Full Text Available BACKGROUND: General practitioners (GPs have a key role to play in suicide prevention, but the rates at which they question patients with depression about suicidal thoughts and plans are rather low. Little is known about GPs' characteristics associated with such inquiries. Our objectives were to describe GPs' attitudes, perceived barriers, and self-reported practices in this questioning of these patients and to analyze factors associated with these practices. METHODOLOGY: This cross-sectional survey was conducted among participants in a panel of randomly selected French GPs (1249/1431 participated: 87.3%. GPs were interviewed with a standardized questionnaire covering their professional and personal characteristics, attitudes, and practices in exploring the suicide risk of their patients with depression. We built a suicide inquiry score by summing the responses to 5 items and used a multiple linear regression analysis to explore the characteristics associated with this score. PRINCIPAL FINDINGS: Most GPs reported inquiring about the presence of suicidal ideation often or very often; less than 30% reported that they frequently explored signs of a specific suicide plan. The mean suicide inquiry score was 12.4 (SD, 2.9; range, 5-20. False ideas, such as thinking that patients who report suicidal ideas do not often commit suicide, were frequent (42.3%. Previous continuing medical education on suicide, participation in a formal mental health network, and patients who committed suicide in the past 5 years were associated with a higher score. Reluctance to question patients about suicide and perception of insufficient skill were associated with a lower score. CONCLUSIONS/SIGNIFICANCE: This study showed great variability in French GPs' practices in exploring suicide risk in patients with depression. Interventions aiming at improving GPs' initial training and continuing medical education in suicide and/or depression, and their collaboration with mental

  2. Migration and depressive symptoms in migrant-sending areas: findings from the survey of internal migration and health in China.

    Science.gov (United States)

    Lu, Yao; Hu, Peifeng; Treiman, Donald J

    2012-08-01

    China has experienced large-scale internal migration and growing mental health disorders. Limited research has examined the relationship between the two processes. We examined the association between labor out-migration and depressive symptoms of family members left behind in migrant-sending areas. We conducted a multistage probability sample survey of Chinese adults in 2008 ("Internal Migration and Health in China"), including 787 people in rural migrant-sending areas. To study whether adults in out-migrant households were more likely to experience depressive symptoms (CES-D) than were adults in non-migrant households, we used multivariate regressions and adjusted for a wide range of confounding factors and for the complex sampling design. Adults in households with labor out-migrants were more likely to report depressive symptoms than those in households without out-migrants, presumably a result of the absence of family members. However, monetary remittances from labor migrants buffered the mental health costs of out-migration. Labor out-migration has important consequences for the mental health in migrant-sending communities. There is an urgent need to address the psychological costs of migration and to promote regular remittances.

  3. International Workshop on “Generalized Concavity, Fractional Programming and Economic Applications”

    CERN Document Server

    Castagnoli, Erio; Martein, Laura; Mazzoleni, Piera; Schaible, Siegfried

    1990-01-01

    Generalizations of convex functions have been used in a variety of fields such as economics. business administration. engineering. statistics and applied sciences.· In 1949 de Finetti introduced one of the fundamental of generalized convex functions characterized by convex level sets which are now known as quasiconvex functions. Since then numerous types of generalized convex functions have been defined in accordance with the need of particular applications.· In each case such functions preserve soine of the valuable properties of a convex function. In addition to generalized convex functions this volume deals with fractional programs. These are constrained optimization problems which in the objective function involve one or several ratios. Such functions are often generalized convex. Fractional programs arise in management science. economics and numerical mathematics for example. In order to promote the circulation and development of research in this field. an international workshop on "Generalized Concavi...

  4. Gender, age, and place of residence as moderators of the internalized homophobia-depressive symptoms relation among Australian gay men and lesbians.

    Science.gov (United States)

    McLaren, Suzanne

    2015-01-01

    Internalized homophobia is a risk factor for depression among gay men and lesbians. The aim of the study was to test whether the internalized homophobia-depression relation was moderated by gender (stronger among gay men compared with lesbians), age (stronger among younger compared with older gay men and lesbians), and place of residence (stronger among gay men and lesbians who live in rural areas compared with those who live in urban areas). An Australian sample of 311 self-identified gay men and 570 self-identified lesbians, aged 18 to 70 years, completed the Internalized Homophobia Scale and the Centre for Epidemiological Studies Depression Scale. Results indicated that age and gender did not moderate the internalized homophobia-depressive symptoms relation. Place of residence was a significant moderator for gay men but not lesbians. In contrast to the hypothesis, the internalized homophobia-depression relation was significant only among gay men who resided in urban areas. Those who work with gay men should be particularly aware of the significant relationship between internalized homophobia and depressive symptoms among gay men who reside in urban areas.

  5. Sintomas depressivos entre internos de medicina em uma universidade pública brasileira Depressive symptoms among medical intern students in a Brazilian public university

    Directory of Open Access Journals (Sweden)

    Edméa Fontes de Oliva Costa

    2012-02-01

    Full Text Available OBJETIVO: Estimar entre internos de medicina a prevalência de sintomas depressivos e sua intensidade, além dos fatores associados. MÉTODOS: Estudo transversal, em maio de 2008, com amostra representativa dos internos de medicina (n = 84 da Universidade Federal de Sergipe (UFS. Foram utilizados o Inventário de Depressão de Beck (IDB e um questionário estruturado contendo informações sobre variáveis sociodemográficas, processo ensino-aprendizagem e aspectos pessoais. A análise exploratória dos dados foi realizada através de Estatística Descritiva e Inferencial. Finalmente foi realizada a análise de múltiplas variáveis através de regressão logística e cálculo das OR simples e ajustadas com seus respectivos intervalos de 95% de confiança. RESULTADOS: A prevalência geral foi de 40,5%, dos quais: 1,2% (IC 95% 0,0-6,5 foram de sintomas depressivos graves; 4,8% (IC 95% 1,3-11,7 de moderados; e 34,5% de leves (IC 95% 24,5-45,7. A regressão logística revelou as variáveis de maior impacto associadas ao aparecimento de sintomas depressivos: pensamento de abandonar o curso (OR 6,24; p = 0,002; tensão emocional (OR 7,43; p = 0,0004; e desempenho acadêmico regular (OR 4,74; p = 0,0001. CONCLUSÃO: A elevada prevalência de sintomas depressivos na população estudada esteve associada com variáveis relacionadas ao processo ensino-aprendizagem e aspectos pessoais, sugerindo a necessidade de medidas preventivas imediatas referentes à formação médica e à assistência ao estudante.OBJECTIVE: To estimate, among Medical School intern students, the prevalence of depressive symptoms and their severity, as well as associated factors. METHODS: Cross-sectional study in May 2008, with a representative sample of medical intern students (n = 84 from Universidade Federal de Sergipe (UFS. Beck Depression Inventory (BDI and a structured questionnaire containing informationon sociodemographic variables, teaching-learning process, and personal

  6. Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care.

    Science.gov (United States)

    Bellos, Stefanos; Skapinakis, Petros; Rai, Dheeraj; Zitko, Pedro; Araya, Ricardo; Lewis, Glyn; Lionis, Christos; Mavreas, Venetsanos

    2013-12-15

    Alcohol consumption is associated with several complications of both physical and mental health. Light or moderate alcohol consumption may have beneficial effects on physical or mental health but this effect is still controversial and research in the mental health field is relatively scarce. Our aim was to investigate the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety in a large international primary care sample. The sample consisted of 5438 primary care attenders from 14 countries who participated in the WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT) and the mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). Light to moderate alcohol consumption was associated with a lower prevalence of depression and generalized anxiety disorder compared to abstinence while excessive alcohol consumption was associated with a higher prevalence of depression. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables, including the presence of chronic disease and the current physical status of participants and was evident in different drinking cultures. The study confirms that excessive drinking is associated with an increased prevalence of depression, but also raises the possibility that light/moderate drinking may be associated with a reduced prevalence of both depression and anxiety. Any causal interpretation of this association is difficult in the context of this cross-sectional study and further longitudinal studies are needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda

    Directory of Open Access Journals (Sweden)

    Oyok Thomas

    2008-05-01

    Full Text Available Abstract Background The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD and depression amongst these internally displaced persons (IDPs, and investigate associated demographic and trauma exposure risk factors. Methods A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version, and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression. Results Over half (54% of the respondents met symptom criteria for PTSD, and over two thirds (67% of respondents met symptom criteria for depression. Over half (58% of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure. Conclusion This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.

  8. Generalized internal long wave equations: construction, hamiltonian structure and conservation laws

    International Nuclear Information System (INIS)

    Lebedev, D.R.

    1982-01-01

    Some aspects of the theory of the internal long-wave equations (ILW) are considered. A general class of the ILW type equations is constructed by means of the Zakharov-Shabat ''dressing'' method. Hamiltonian structure and infinite numbers of conservation laws are introduced. The considered equations are shown to be Hamiltonian in the so-called second Hamiltonian structu

  9. Practical and General Palladium-Catalyzed Synthesis of Ketones from Internal Olefins

    KAUST Repository

    Morandi, Bill; Wickens, Zachary K.; Grubbs, Robert H.

    2013-01-01

    Make it simple! A convenient and general palladium-catalyzed oxidation of internal olefins to ketones is reported. The transformation occurs at room temperature and shows wide substrate scope. Applications to the oxidation of seed-oil derivatives and a bioactive natural product (see scheme) are described, as well as intriguing mechanistic features.

  10. Practical and General Palladium-Catalyzed Synthesis of Ketones from Internal Olefins

    KAUST Repository

    Morandi, Bill

    2013-01-16

    Make it simple! A convenient and general palladium-catalyzed oxidation of internal olefins to ketones is reported. The transformation occurs at room temperature and shows wide substrate scope. Applications to the oxidation of seed-oil derivatives and a bioactive natural product (see scheme) are described, as well as intriguing mechanistic features.

  11. Datasets collected in general practice: an international comparison using the example of obesity.

    Science.gov (United States)

    Sturgiss, Elizabeth; van Boven, Kees

    2018-06-04

    International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not

  12. European project for developing general guidelines for harmonising internal dose assessment procedures (IDEAS)

    International Nuclear Information System (INIS)

    Andrasi, A.; Bailey, M.; Puncher, M.; Berkovski, V.; Eric Blanchardon, E.; Jourdain, J.-R.; Carlo-Maria Castellani, C.-M.; Doerfel, H.; Christian Hurtgen, Ch.; Le Guen, B.

    2003-01-01

    Several international intercomparison exercises on intake and internal dose assessments from monitoring data led to the conclusion that the results calculated by different participants varied significantly mainly because of the wide variety of methods and assumptions applied in the assessment procedure. Based on these experiences the need for harmonisation of the procedures has been formulated as an EU research project under the 5 th Framework Programme (2001-2005), with the aim of developing general guidelines for standardising assessments of intakes and internal doses. In the IDEAS project eight institutions from seven European countries are participating using inputs also from internal dosimetry professionals from across Europe to ensure broad consensus in the outcome of the project. The IDEAS project is explained

  13. Comparison of non-directive counselling and cognitive behaviour therapy for patients presenting in general practice with an ICD-10 depressive episode: a randomized control trial.

    Science.gov (United States)

    King, M; Marston, L; Bower, P

    2014-07-01

    Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode. Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months. A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies. We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.

  14. Reducing symptoms of major depressive disorder through a systematic training of general emotion regulation skills: protocol of a randomized controlled trial.

    Science.gov (United States)

    Ehret, Anna M; Kowalsky, Judith; Rief, Winfried; Hiller, Wolfgang; Berking, Matthias

    2014-01-27

    Major Depressive Disorder is one of the most challenging mental health problems of our time. Although effective psychotherapeutic treatments are available, many patients fail to demonstrate clinically significant improvements. Difficulties in emotion regulation have been identified as putative risk and maintaining factors for Major Depressive Disorder. Systematically enhancing adaptive emotion regulation skills should thus help reduce depressive symptom severity. However, at this point, no study has systematically evaluated effects of increasing adaptive emotion regulation skills application on symptoms of Major Depressive Disorder. In the intended study, we aim to evaluate stand-alone effects of a group-based training explicitly and exclusively targeting general emotion regulation skills on depressive symptom severity and assess whether this training augments the outcome of subsequent individual cognitive behavioral therapy for depression. In the evaluation of the Affect Regulation Training, we will conduct a prospective randomized-controlled trial. Effects of the Affect Regulation Training on depressive symptom severity and outcomes of subsequent individual therapy for depression will be compared with an active, common factor based treatment and a waitlist control condition. The study sample will include 120 outpatients meeting criteria for Major Depressive Disorder. Depressive symptom severity as assessed by the Hamilton Rating Scale will serve as our primary study outcome. Secondary outcomes will include further indicators of mental health and changes in adaptive emotion regulation skills application. All outcomes will be assessed at intake and at 10 points in time over the course of the 15-month study period. Measures will include self-reports, observer ratings, momentary ecological assessments, and will be complemented in subsamples by experimental investigations and the analysis of hair steroids. If findings should support the hypothesis that enhancing

  15. Specificity of the Association between Marital Discord and Longitudinal Changes in Symptoms of Depression and Generalized Anxiety Disorder in the Irish Longitudinal Study on Ageing.

    Science.gov (United States)

    Whisman, Mark A; Robustelli, Briana L; Labrecque, Lindsay T

    2018-03-25

    This longitudinal study was conducted to evaluate actor and partner effects of marital discord on changes in symptoms of depression and generalized anxiety disorder (GAD) in a large population sample of Irish adults (N = 1,445 couples), adjusting for the potential confounds of quality of other social relationships and other psychopathology symptoms. The Actor-Partner Interdependence Model was used to examine actor and partner effects of marital discord on changes in symptoms of depression and GAD at a 2-year follow-up. Additional models examined these associations adjusting for family and friend discord and symptoms of the other type of psychopathology (depressive or GAD symptoms). Actor effects of marital discord on depressive and anxiety symptoms were greater for men than for women. There were significant, positive actor effects of marital discord on depressive symptoms for husbands and wives, which remained significant when adjusting for family and friend discord and GAD symptoms. There were significant, positive actor effects of marital discord on GAD symptoms for husbands, which remained significant when adjusting for family and friend discord and depressive symptoms. Results demonstrate that longitudinal associations between marital discord and depressive symptoms (for wives and husbands) and GAD symptoms (for husbands) are incremental to other rival explanations (family and friend discord and the other set of symptoms). Findings provide evidence for a potential causal association leading from marital discord to symptoms of depression and GAD. © 2018 Family Process Institute.

  16. The general functional fitness index and symptoms of depression in older adults. DOI:10.5007/1980-0037.2012v14n2p125

    Directory of Open Access Journals (Sweden)

    Danielle Ledur Antes

    2012-02-01

    Full Text Available Depression is considered the most common mental health disorder in older adults. Studies have shown that physical activity can reduce depressive symptoms in this population with immediate clinical effects. The objective of this study was to analyze the association between symptoms of depression and General Functional Fitness Index (GFFI in elderly physical exercise practitioners. The Geriatric Depression Scale of Yesavage (GDS-15 was used to evaluate the presence of depressive symptoms, and the AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance fitness test battery for assessment of GFFI. We used descriptive statistics and Pearson correlation with 95% confidence intervals. The population consisted of 146 elderly participants of the Floripa Ativa Program - Phase B, with the sample consisting of 77 older adults with a mean age of 67.9 (SD 5.7 years. Among them, 13 exhibited symptoms of depression and 33 were fit, with the GFFI within normal range. We found a negative (r = -0.307 and significant (p = 0.007 correlation between GDS and GFFI. This inversely proportional relationship demonstrates that subjects with a better GFFI had a lower incidence of depressive symptoms. As the GFFI value is obtained through physical tests, it can be suggested that physical exercise supported the reduction of depressive symptoms in the study group.

  17. [Internal Medicine in the curriculum of General Medicine at Universities of Mexico, 2014].

    Science.gov (United States)

    Maldonado, Jesús Adrián; Peinado, José María

    2017-01-01

    The aim of this study was to analyze Internal Medicine as a subject and its requirement in each of the Universities curriculum in Mexico that offers a degree in General Medicine. By the end of the first quarter of 2014, the research was closed and 81 campuses were studied. This research was quantitative, using an analytical technique, written discourse, exploratory and purposive sampling not random and homogeneous type. The Likert questionnaire was used in this study to analyse the following variables: the record of Internal Medicine as a subject, the burden of credit, and the location of the program. The procedure consisted of three phases. First obtaining an official list of all the Universities in the Mexican Association of Colleges and Schools of Medicine. Second, obtaining an analysis of each of the Universities' curriculums, and lastly gathering each variable of the study. The results of the Universities were 63% were public and 37% private. Internal Medicine as a subject in the curriculum was 37.1%, and 20% of the universities include it for six months and 9% offer it the whole year. However, the undergraduate internship in Internal Medicine offers it 100%. In conclusion, Internal Medicine as a subject could disappear from the curriculum in General Medicine before coming to the undergraduate internship, even though the latter is declared required in hospital shifts.

  18. General guidelines for the assessment of internal dose from monitoring data: Progress of the IDEAS project

    International Nuclear Information System (INIS)

    Doerfel, H.; Andrasi, A.; Bailey, M.; Blanchardon, E.; Cruz-Suarez, R.; Berkovski, V.; Castellani, C. M.; Hurtgenv, C.; Leguen, B.; Malatova, I.; Marsh, J.; Stather, J.; Zeger, J.

    2007-01-01

    In recent major international intercomparison exercises on intake and internal dose assessments from monitoring data, the results calculated by different participants varied significantly. Based on this experience the need for harmonisation of the procedures has been formulated within an EU 5. Framework Programme research project. The aim of the project, IDEAS, is to develop general guidelines for standardising assessments of intakes and internal doses. The IDEAS project started in October 2001 and ended in June 2005. The project is closely related to some goals of the work of Committee 2 of the ICRP and since 2003 there has been close cooperation between the two groups. To ensure that the guidelines are applicable to a wide range of practical situations, the first step was to compile a database of well-documented cases of internal contamination. In parallel, an improved version of an existing software package was developed and distributed to the partners for further use. A large number of cases from the database was evaluated independently by the partners and the results reviewed. Based on these evaluations, guidelines were drafted and discussed with dosimetry professionals from around the world by means of a virtual workshop on the Internet early in 2004. The guidelines have been revised and refined on the basis of the experiences and discussions in this virtual workshop. The general philosophy of the Guidelines is presented here, focusing on the principles of harmonisation, optimisation and proportionality. Finally, the proposed Levels of Task to structure the approach of internal dose evaluation are reported. (authors)

  19. Evaluating the factor structure, item analyses, and internal consistency of hospital anxiety and depression scale in Iranian infertile patients

    Directory of Open Access Journals (Sweden)

    Payam Amini

    2017-09-01

    Full Text Available Background: The hospital anxiety and depression scale (HADS is a common screening tool designed to measure the level of anxiety and depression in different factor structures and has been extensively used in non-psychiatric populations and individuals experiencing fertility problems. Objective: The aims of this study were to evaluate the factor structure, item analyses, and internal consistency of HADS in Iranian infertile patients. Materials and Methods: This cross-sectional study included 651 infertile patients (248 men and 403 women referred to a referral infertility Center in Tehran, Iran between January 2014 and January 2015. Confirmatory factor analysis was used to determine the underlying factor structure of the HADS among one, two, and threefactor models. Several goodness of fit indices were utilized such as comparative, normed and goodness of fit indices, Akaike information criterion, and the root mean squared error of approximation. In addition to HADS, the Satisfaction with Life Scale questionnaires as well as demographic and clinical information were administered to all patients. Results: The goodness of fit indices through CFAs exposed that three and onefactor model provided the best and worst fit to the total, male and female datasets compared to the other factor structure models for the infertile patients. The Cronbach’s alpha for anxiety and depression subscales were 0.866 and 0.753 respectively. The HADS subscales significantly correlated with SWLS, indicating an acceptable convergent validity. Conclusion: The HADS was found to be a three-factor structure screening instrument in the field of infertility.

  20. Perseverative thought: a robust predictor of response to emotional challenge in generalized anxiety disorder and major depressive disorder.

    Science.gov (United States)

    Ruscio, Ayelet Meron; Seitchik, Allison E; Gentes, Emily L; Jones, Jason D; Hallion, Lauren S

    2011-12-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur, yet the reasons for their comorbidity remain poorly understood. In the present experiment, we tested whether a tendency to engage in negative, repetitive thinking constitutes a common risk process for the two disorders. A mixed sample of adults with comorbid GAD-MDD (n=50), GAD only (n=35), MDD only (n=34), or no lifetime psychopathology (n=35) was administered noncontingent failure and success feedback on consecutive performance tasks. Perseverative thought (PT), measured by negative thought intrusions during a baseline period of focused breathing, emerged as a powerful prospective predictor of responses to this experimental challenge. Participants reporting more frequent negative thought intrusions at baseline, irrespective of thought content or diagnostic status, exhibited a stronger negative response to failure that persisted even after subsequent success. Higher PT over the course of the experiment was associated with later behavioral avoidance, with negative affect and other traits closely linked to anxiety and depression, and with the presence and severity of GAD and MDD. These findings provide evidence for a broadly-defined PT trait that is shared by GAD and MDD and contributes to adverse outcomes in these disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Increased error-related brain activity distinguishes generalized anxiety disorder with and without comorbid major depressive disorder.

    Science.gov (United States)

    Weinberg, Anna; Klein, Daniel N; Hajcak, Greg

    2012-11-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are so frequently comorbid that some have suggested that the 2 should be collapsed into a single overarching "distress" disorder. Yet there is also increasing evidence that the 2 categories are not redundant. Neurobehavioral markers that differentiate GAD and MDD would be helpful in ongoing efforts to refine classification schemes based on neurobiological measures. The error-related negativity (ERN) may be one such marker. The ERN is an event-related potential component presenting as a negative deflection approximately 50 ms following an erroneous response and reflects activity of the anterior cingulate cortex. There is evidence for an enhanced ERN in individuals with GAD, but the literature in MDD is mixed. The present study measured the ERN in 26 GAD, 23 comorbid GAD and MDD, and 36 control participants, all of whom were female and medication-free. Consistent with previous research, the GAD group was characterized by a larger ERN and an increased difference between error and correct trials than controls. No such enhancement was evident in the comorbid group, suggesting comorbid depression may moderate the relationship between the ERN and anxiety. The present study further suggests that the ERN is a potentially useful neurobiological marker for future studies that consider the pathophysiology of multiple disorders in order to construct or refine neurobiologically based diagnostic phenotypes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  2. A study of depression and anxiety, general health, and academic performance in three cohorts of veterinary medical students across the first three semesters of veterinary school.

    Science.gov (United States)

    Reisbig, Allison M J; Danielson, Jared A; Wu, Tsui-Feng; Hafen, McArthur; Krienert, Ashley; Girard, Destiny; Garlock, Jessica

    2012-01-01

    This study builds on previous research on predictors of depression and anxiety in veterinary medical students and reports data on three veterinary cohorts from two universities through their first three semesters of study. Across all three semesters, 49%, 65%, and 69% of the participants reported depression levels at or above the clinical cut-off, suggesting a remarkably high percentage of students experiencing significant levels of depression symptoms. Further, this study investigated the relationship between common stressors experienced by veterinary students and mental health, general health, and academic performance. A factor analysis revealed four factors among stressors common to veterinary students: academic stress, transitional stress, family-health stress, and relationship stress. The results indicated that both academic stress and transitional stress had a robust impact on veterinary medical students' well-being during their first three semesters of study. As well, academic stress negatively impacted students in the areas of depression and anxiety symptoms, life satisfaction, general health, perception of academic performance, and grade point average (GPA). Transitional stress predicted increased depression and anxiety symptoms and decreased life satisfaction. This study helped to further illuminate the magnitude of the problem of depression and anxiety symptoms in veterinary medical students and identified factors most predictive of poor outcomes in the areas of mental health, general health, and academic performance. The discussion provides recommendations for considering structural changes to veterinary educational curricula to reduce the magnitude of academic stressors. Concurrently, recommendations are suggested for mental health interventions to help increase students' resistance to environmental stressors.

  3. Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study

    NARCIS (Netherlands)

    van der Toorn, S.L.M.; Huizink, A.C.; Utens, E.M.W.J.; Verhulst, F.C.; Ormel, J.; Ferdinand, R.F.

    2010-01-01

    Maternal internalizing problems affect reporting of child’s problem behavior. This study addresses the relative effects of maternal depressive symptoms versus anxiety symptoms and the association with differential reporting of mother and child on child’s internalizing problems. The study sample

  4. Cooccurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study.

    Science.gov (United States)

    Bienvenu, O Joseph; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A; Shanholtz, Carl; Dennison-Himmelfarb, Cheryl R; Pronovost, Peter J; Needham, Dale M

    2015-03-01

    To evaluate the cooccurrence, and predictors of remission, of general anxiety, depression, and posttraumatic stress disorder symptoms during 2-year follow-up in survivors of acute lung injury treated in an ICU. Prospective cohort study, with follow-up at 3, 6, 12, and 24 months post-acute lung injury. Thirteen medical and surgical ICUs in four hospitals. Survivors among 520 patients with acute lung injury. The outcomes of interest were measured using the Hospital Anxiety and Depression Scale anxiety and depression subscales (scores ≥ 8 indicating substantial symptoms) and the Impact of Event Scale-Revised (scores ≥ 1.6 indicating substantial posttraumatic stress disorder symptoms). Of the 520 enrolled patients, 274 died before 3-month follow-up; 186 of 196 consenting survivors (95%) completed at least one Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised assessment during 2-year follow-up, and most completed multiple assessments. Across follow-up time points, the prevalence of suprathreshold general anxiety, depression, and posttraumatic stress disorder symptoms ranged from 38% to 44%, 26% to 33%, and 22% to 24%, respectively; more than half of the patients had suprathreshold symptoms in at least one domain during 2-year follow-up. The majority of survivors (59%) with any suprathreshold symptoms were above threshold for two or more types of symptoms (i.e., general anxiety, depression, and/or posttraumatic stress disorder). In fact, the most common pattern involved simultaneous general anxiety, depression, and posttraumatic stress disorder symptoms. Most patients with general anxiety, depression, or posttraumatic stress disorder symptoms during 2-year follow-up had suprathreshold symptoms at 24-month (last) follow-up. Higher Short-Form-36 physical functioning domain scores at the prior visit were associated with a greater likelihood of remission from general anxiety and posttraumatic stress disorder symptoms during follow-up. The majority

  5. Discrimination, internalized racism, and depression: A comparative study of African American and Afro-Caribbean adults in the US

    Science.gov (United States)

    Molina, Kristine M.; James, Drexler

    2016-01-01

    Emerging research suggests that both perceptions of discrimination and internalized racism (i.e., endorsement of negative stereotypes of one’s racial group) are associated with poor mental health. Yet, no studies to date have examined their effects on mental health with racial/ethnic minorities in the US in a single study. The present study examined: (a) the direct effects of everyday discrimination and internalized racism on risk of DSM-IV criteria of past-year major depressive disorder (MDD); (b) the interactive effects of everyday discrimination and internalized racism on risk of past-year MDD; and (c) the indirect effect of everyday discrimination on risk of past-year MDD via internalized racism. Further, we examined whether these associations differed by ethnic group membership. We utilized nationally representative data of Afro-Caribbean (N = 1,418) and African American (N = 3,570) adults from the National Survey of American Life. Results revealed that experiencing discrimination was associated with increased odds of past-year MDD among the total sample. Moreover, for Afro-Caribbeans, but not African Americans, internalized racism was associated with decreased odds of meeting criteria for past-year MDD. We did not find an interaction effect for everyday discrimination by internalized racism, nor an indirect effect of discrimination on risk of past-year MDD through internalized racism. Collectively, our findings suggest a need to investigate other potential mechanisms by which discrimination impacts mental health, and examine further the underlying factors of internalized racism as a potential self-protective strategy. Lastly, our findings point to the need for research that draws attention to the heterogeneity within the U.S. Black population. PMID:28405176

  6. A longitudinal study of posttraumatic stress disorder, depression, and generalized anxiety disorder in Israeli civilians exposed to war trauma.

    Science.gov (United States)

    Neria, Yuval; Besser, Avi; Kiper, Dasha; Westphal, Maren

    2010-06-01

    This 3-wave longitudinal study examined the mental health consequences of the Israel-Gaza 2008-2009 war among young Israeli civilians. Data on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD), and their predictors were collected during the war, and 2 and 4 months after cease fire. Results showed a sharp decline in symptom levels of PTSD, MDD, and GAD over time. Perceived social support during the war moderated the effects of immediate emotional response on subsequent levels of PTSD, MDD, and GAD. These findings underscore the importance of social support and immediate emotional response to trauma in predicting trauma-related psychopathology, and highlight the potential need for providing early care to exposed individuals exhibiting immediate and severe emotional responses.

  7. 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

  8. Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Beekman Aartjan TF

    2007-02-01

    Full Text Available Abstract Background Depressive disorder is one of the most common disorders, and is highly prevalent in chronically ill patients. The presence of comorbid depression has a negative influence on quality of life, health care costs, self-care, morbidity, and mortality. Early diagnosis and well-organized treatment of depression has a positive influence on these aspects. Earlier research in the USA has reported good results with regard to the treatment of depression with a collaborative care approach and an antidepressant algorithm. In the UK 'Problem Solving Treatment' has proved to be feasible. However, in the general hospital setting this approach has not yet been evaluated. Methods/Design CC: DIM (Collaborative Care: Depression Initiative in the Medical setting is a two-armed randomised controlled trial with randomisation at patient level. The aim of the trial is to evaluate the treatment of depressive disorder in general hospitals in the Netherlands based on a collaborative care framework, including contracting, 'Problem Solving Treatment', antidepressant algorithm, and manual-guided self-help. 126 outpatients with diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular diseases will be randomised to either the intervention group or the control group. Patients will be included if they have been diagnosed with moderate to severe depression, based on the DSM-IV criteria in a two-step screening method. The intervention group will receive treatment based on the collaborative care approach; the control group will receive 'care as usual'. Baseline and follow-up measurements (after 3, 6, 9, and 12 months will be performed by means of questionnaires. The primary outcome measure is severity of depressive symptoms, as measured with the PHQ-9. The secondary outcome measure is the cost-effectiveness of these treatments according to the TiC-P, the EuroQol and the SF-36. Discussion Earlier research has indicated that depressive disorder is

  9. Correlation functions for the fractional generalized Langevin equation in the presence of internal and external noise

    International Nuclear Information System (INIS)

    Sandev, Trifce; Metzler, Ralf; Tomovski, Živorad

    2014-01-01

    We study generalized fractional Langevin equations in the presence of a harmonic potential. General expressions for the mean velocity and particle displacement, the mean squared displacement, position and velocity correlation functions, as well as normalized displacement correlation function are derived. We report exact results for the cases of internal and external friction, that is, when the driving noise is either internal and thus the fluctuation-dissipation relation is fulfilled or when the noise is external. The asymptotic behavior of the generalized stochastic oscillator is investigated, and the case of high viscous damping (overdamped limit) is considered. Additional behaviors of the normalized displacement correlation functions different from those for the regular damped harmonic oscillator are observed. In addition, the cases of a constant external force and the force free case are obtained. The validity of the generalized Einstein relation for this process is discussed. The considered fractional generalized Langevin equation may be used to model anomalous diffusive processes including single file-type diffusion

  10. WIPO Director-General introduces WIPO to the CERN internal audience

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    This is the third in the “International Geneva comes to CERN” series of seminars, which aims to present other Geneva-based international organisations to CERN’s internal audience. At his seminar, Francis Gurry, the WIPO Director-General, will discuss the many fields of activity of WIPO. WIPO (World Intellectual Property Organization) is the UN agency for intellectual property services, policy, information and cooperation. CERN People are *not* required to register for the event. Participants coming from outside CERN are required to register on the link below. On this page you will find information on how to get to CERN. Upon arrival, please go to CERN's Main Reception. The security guard will check that your name is on the list and will let you in. Inside CERN, please follow the directions to the MAIN AUDITORIUM/RESTAURANT.

  11. Student performance of the general physical examination in internal medicine: an observational study

    Science.gov (United States)

    2014-01-01

    Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

  12. Domestic Environmental Policy and International Factor Mobility: A General Equilibrium Analysis

    OpenAIRE

    Stefan Felder; Reto Schleiniger

    1995-01-01

    This paper studies the conditions under which a green tax reform not only benefits the environment but also enhances the efficiency of the tax system. The focus is on the consequences of international factor mobility for the scope of a double dividend. The investigation of the double-dividend claim is based on a general equilibrium model of a stylised small open economy. The simulations of equal-yield tax reform scenarios indicate that an environmental tax on consumption yields a double divid...

  13. Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2017.

    Science.gov (United States)

    Wieland, Mark L; Szostek, Jason H; Wingo, Majken T; Post, Jason A; Mauck, Karen F

    2018-02-26

    Clinicians are challenged to identify new practice-changing articles in the medical literature. To identify the practice-changing articles published in 2017 most relevant to outpatient general internal medicine, 5 internists reviewed the following sources: 1) titles and abstracts from internal medicine journals with the 7 highest impact factors, including New England Journal of Medicine, Lancet, Journal of the American Medical Association, British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine; 2) synopses and syntheses of individual studies, including collections in the American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine; 3) databases of synthesis, including Evidence Updates and the Cochrane Library. Inclusion criteria were perceived clinical relevance to outpatient general medicine, potential for practice change, and strength of evidence. This process yielded 140 articles. Clusters of important articles around one topic were considered as a single-candidate series. A modified Delphi method was utilized by the 5 authors to reach consensus on 7 topics to highlight and appraise from the 2017 literature. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Trajectories of maternal depressive symptoms during pregnancy and the first 12 months postpartum and child externalizing and internalizing behavior at three years

    Science.gov (United States)

    Kehler, Heather; Austin, Marie-Paule; Mughal, Muhammad Kashif; Wajid, Abdul; Vermeyden, Lydia; Benzies, Karen; Brown, Stephanie; Stuart, Scott; Giallo, Rebecca

    2018-01-01

    Background Most evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in preschool children. The objectives of this study were to: 1) identify distinct groups of women defined by their trajectories of depressive symptoms across four time points from mid-pregnancy to one year postpartum; and 2) examine the associations between these trajectories and child internalizing and externalizing behaviors. Methods We analyzed data from the All Our Families (AOF) study, a large, population based pregnancy cohort of mother-child dyads in Alberta, Canada. The AOF study is an ongoing pregnancy cohort study designed to investigate relationships between the prenatal and early life period and outcomes for children and mothers. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Children’s behavioral functioning at age 3 was assessed using the Behavior Scales developed for the Canadian National Longitudinal Survey of Children and Youth. Longitudinal latent class analysis was conducted to identify trajectories of women’s depressive symptoms across four time points from pregnancy to 1 year postpartum. We used multivariable logistic regression to assess the relationship between trajectories of maternal depressive symptoms and children’s behavior, while adjusting for other significant maternal, child and psychosocial factors. Results 1983 participants met eligibility criteria. We identified four distinct trajectories of maternal depressive symptoms: low level (64.7%); early postpartum (10.9%); subclinical (18.8%); and persistent high (5.6%). In multivariable models, the proportion of children with elevated behavior symptoms was highest for children whose mothers had

  15. Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries.

    Science.gov (United States)

    Lloyd, C E; Nouwen, A; Sartorius, N; Ahmed, H U; Alvarez, A; Bahendeka, S; Basangwa, D; Bobrov, A E; Boden, S; Bulgari, V; Burti, L; Chaturvedi, S K; Cimino, L C; Gaebel, W; de Girolamo, G; Gondek, T M; de Braude, M Guinzbourg; Guntupalli, A; Heinze, M G; Ji, L; Hong, X; Khan, A; Kiejna, A; Kokoszka, A; Kamala, T; Lalic, N M; Lecic Tosevski, D; Mankovsky, B; Li, M; Musau, A; Müssig, K; Ndetei, D; Rabbani, G; Srikanta, S S; Starostina, E G; Shevchuk, M; Taj, R; Vukovic, O; Wölwer, W; Xin, Y

    2018-06-01

    To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes. © 2018 Diabetes UK.

  16. Internalized Racism and Past-Year Major Depressive Disorder Among African-Americans: the Role of Ethnic Identity and Self-Esteem.

    Science.gov (United States)

    James, Drexler

    2017-08-01

    Although a large body of research focuses on discrimination as a risk for depression among African-Americans, only a dearth of research focuses on internalized racism (i.e., endorsement of negative stereotypes of one's racial group) as a risk factor. In addition, no studies have yet to examine mediators and/or moderators of the relationship between internalized racism and depression. To this end, the present study examined the mediating and moderating roles of (a) self-esteem and (b) ethnic identity on the relationship between internalized racism and past-year major depressive disorder (MDD), in a nationally representative sample of African-American adults (N = 3570) from the National Survey of American Life. Results from this study revealed an indirect association between internalized racism and past-year MDD via self-esteem, but no indirect relationship via ethnic identity. Further, results show that both self-esteem and ethnic identity individually moderate the relationship between internalized racism and past-year MDD. Collectively, these findings suggest a need to further investigate mechanisms through which internalized racism impacts mental health and factors that strengthen and/or weaken the association between internalized racism and depression.

  17. 'It's really a myriad of different signals, not just the textbook': the complexities of diagnosing depression in gay men in general practice.

    Science.gov (United States)

    Körner, Henrike; Newman, Christy; Mao, Limin; Kippax, Susan; Kidd, Michael R; Saltman, Deborah

    2008-09-01

    This paper reports on in-depth interviews with general practitioners (GPs) about their views and experiences of diagnosing depression in gay men - some of whom are living with HIV - and the broader social contexts in which such a diagnosis is located. This analysis is a key outcome of a collaboration between social researchers, primary healthcare researchers, GPs and community partners, to investigate the management of depression in gay men in primary care settings. As the qualitative component of this project, semi-structured in-depth interviews were conducted with 16 GPs with high caseloads of gay men, in three geographical settings in Australia: Sydney, Adelaide and a rural-coastal town. GPs considered the diagnosis and management of depression to be an integral part of primary care, especially in gay male patients. They had a heightened sense of awareness that depression was common in the group of patients they were seeing. Central to diagnosing depression was the ongoing, long-term relationship GPs had with their gay male patients. GPs were vigilant and proactively inquired about depression, taking into account somatic, social and psychological indicators. In their approach to diagnosing depression, GPs considered not only the life circumstances of individual patients but also the broader social context of stigma related to homosexuality, and the effects that the HIV epidemic has had on individuals, especially on gay men who have been living with HIV for a long time.

  18. Co-occurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study

    Science.gov (United States)

    Bienvenu, O. Joseph; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A.; Shanholtz, Carl; Dennison-Himmelfarb, Cheryl R.; Pronovost, Peter J.; Needham, Dale M.

    2014-01-01

    Objective To evaluate the co-occurrence, and predictors of remission, of general anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms during 2-year follow-up in survivors of acute lung injury (ALI) treated in an intensive care unit (ICU). Design, Setting, and Patients This prospective cohort study enrolled 520 patients from 13 medical and surgical ICUs in 4 hospitals, with follow-up at 3, 6, 12, and 24 months post-ALI. Measurements and Main Results The outcomes of interest were measured using the Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales (scores ≥8 indicating substantial symptoms) and the Impact of Event Scale-Revised (IESR, scores ≥1.6 indicating substantial PTSD symptoms). Of the 520 enrolled patients, 274 died before 3-month follow-up; 186/196 consenting survivors (95%) completed at least one HADS and IESR assessment during 2-year follow-up, and most completed multiple assessments. Across follow-up time points, the prevalence of supra-threshold general anxiety, depression, and PTSD symptoms ranged from 38–44%, 26–33%, and 22–24%, respectively; more than half of the patients had supra-threshold symptoms in at least one domain during 2-year follow-up. The majority (59%) of survivors with any supra-threshold symptoms were above threshold for 2 or more types of symptoms (i.e., of general anxiety, depression, and/or PTSD). In fact, the most common pattern involved simultaneous general anxiety, depression, and PTSD symptoms. Most patients with general anxiety, depression, or PTSD symptoms during 2-year follow-up had supra-threshold symptoms at 24-month (last) follow-up. Higher SF-36 physical functioning domain scores at the prior visit were associated with a greater likelihood of remission from general anxiety and PTSD symptoms during follow-up. Conclusions The majority of ALI survivors had clinically significant general anxiety, depressive, or PTSD symptoms, and these symptoms tended to co-occur across

  19. The validity and internal structure of the Bipolar Depression Rating Scale: data from a clinical trial of N-acetylcysteine as adjunctive therapy in bipolar disorder.

    Science.gov (United States)

    Berk, Michael; Dodd, Seetal; Dean, Olivia M; Kohlmann, Kristy; Berk, Lesley; Malhi, Gin S

    2010-10-01

    Berk M, Dodd S, Dean OM, Kohlmann K, Berk L, Malhi GS. The validity and internal structure of the Bipolar Depression Rating Scale: data from a clinical trial of N-acetylcysteine as adjunctive therapy in bipolar disorder. The phenomenology of unipolar and bipolar disorders differ in a number of ways, such as the presence of mixed states and atypical features. Conventional depression rating instruments are designed to capture the characteristics of unipolar depression and have limitations in capturing the breadth of bipolar disorder. The Bipolar Depression Rating Scale (BDRS) was administered together with the Montgomery Asberg Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) in a double-blind randomised placebo-controlled clinical trial of N-acetyl cysteine for bipolar disorder (N = 75). A factor analysis showed a two-factor solution: depression and mixed symptom clusters. The BDRS has strong internal consistency (Cronbach's alpha = 0.917), the depression cluster showed robust correlation with the MADRS (r = 0.865) and the mixed subscale correlated with the YMRS (r = 0.750). The BDRS has good internal validity and inter-rater reliability and is sensitive to change in the context of a clinical trial.

  20. Maternal Depression, Locus of Control, and Emotion Regulatory Strategy as Predictors of Preschoolers' Internalizing Problems

    Science.gov (United States)

    Coyne, Lisa W.; Thompson, Alysha D.

    2011-01-01

    Childhood internalizing problems may occur as early as preschool, tend to be stable over time, and undermine social and academic functioning. Parent emotion regulatory behaviors may contribute to child internalizing problems and may be especially important during the preschool years when parents model emotion coping and regulation for their…

  1. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population.

    Science.gov (United States)

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A; Ono, Yutaka

    2016-01-01

    Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern.

  2. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    Directory of Open Access Journals (Sweden)

    Shinichiro Tomitaka

    2016-10-01

    Full Text Available Background Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Methods Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items. The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. Results The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. Discussion The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an

  3. Occupational factors and subsequent major depressive and generalized anxiety disorders in the prospective French national SIP study.

    Science.gov (United States)

    Niedhammer, Isabelle; Malard, Lucile; Chastang, Jean-François

    2015-02-28

    The literature has been extensive on the associations between psychosocial work factors and mental health. Nevertheless, the studies using prospective design, various concepts and more than one measurement point in time for these factors and diagnostic interview to assess mental disorders remain seldom in the literature. This study is an attempt to fill the gap in this topic. The study was based on a national representative sample of 4717 workers of the French working population (SIP survey), interviewed in 2006 and reinterviewed again in 2010 and free of mental disorders at baseline. Psychosocial work factors, measured in both 2006 and 2010, included: psychological demands, decision latitude, social support, reward, emotional demands, role conflict, ethical conflict, tensions with the public, job insecurity and work-life imbalance. Other occupational factors related to working time/hours and physical work environment were also studied. Major depressive (MDD) and generalized anxiety disorders (GAD) were measured using a standardised diagnostic interview (MINI). Covariates were age, occupation, marital status, having a child under 3 y, social support outside work and stressful life events. Multivariate analyses were performed using weighted logistic regression models. Using models taking all occupational factors into account simultaneously, low reward and job insecurity predicted MDD. Psychological demands, low reward, emotional demands and job insecurity were predictive of GAD. The more frequent the exposure to job insecurity, the higher the risk of MDD and GAD, and the more frequent the exposure to psychological demands and low reward, the higher the risk of GAD. No effect was observed for repeated exposure to occupational factors. Classical and emergent psychosocial work factors were predictive factors of depression and anxiety with dose-response associations in terms of frequency of exposure. More attention may be needed on emergent psychosocial work factors and

  4. Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING]: study protocol of a non-inferiority randomized trial.

    Science.gov (United States)

    Massoudi, Btissame; Blanker, Marco H; van Valen, Evelien; Wouters, Hans; Bockting, Claudi L H; Burger, Huibert

    2017-06-13

    The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients' own GP or general practice mental health worker (MHW) in routine primary care is unknown. We aim to demonstrate non-inferiority of blended care compared with usual care in patients with depressive symptoms or a depressive disorder in general practice. Additionally, we will explore the real-time course over the day of emotions and affect, and events within individuals during treatment. This is a pragmatic non-inferiority trial including 300 patients with depressive symptoms, recruited by collaborating GPs and MHWs. After inclusion, participants are randomized to either blended care or usual care in routine general practice. Blended care consists of the 'Act and Feel' treatment: an eight-week web-based program based on behavioral activation with integrated monitoring of depressive symptomatology and automatized feedback. GPs or their MHWs coach the participants through regular face-to-face or telephonic consultations with at least three sessions. Depressive symptomatology, health status, functional impairment, treatment satisfaction, daily activities and resource use are assessed during a follow-up period of 12 months. During treatment, real-time fluctuations in emotions and affect, and daily events will be rated using ecological momentary assessment. The primary outcome is the reduction of depressive symptoms from baseline to three months follow-up. We will conduct intention-to-treat analyses and supplementary per-protocol analyses. This trial will show whether blended care might be an

  5. Self-rated health, symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke: a municipality-based study in Sweden

    Directory of Open Access Journals (Sweden)

    Hassler Ejda

    2007-10-01

    Full Text Available Abstract Background Self-rated health is an important indicator of quality of life as well as a good predictor of future health. The purpose of the study was to follow up the self-rated health and the prevalence of symptoms of depression and general symptoms in a population of first-ever stroke patients 3 and 12 months after stroke. Methods All patients surviving their first-ever stroke and residing in Nacka municipality in Stockholm County Council were included using a multiple overlapping search strategy during an 18-month period (n = 187. Our study group comprised the 145 patients who survived the first 3 months after stroke. Three and 12 months after their stroke, the patients were assessed regarding self-rated health and general symptoms using parts of the Göteborg Quality of Life Instrument (GQLI, and regarding symptoms of depression using the Montgomery Asberg Depression Scale (MADRS-S. Results Self-rated health was rated as very good or rather good by 62% at 3 months after stroke and by 78% at 12 months after stroke. More than half of the patients suffered from symptoms of depression, with no significant improvement at 12 months. The most common general symptoms at 3 months after stroke were fatigue, sadness, pain in the legs, dizziness and irritability. Fatigue and sadness were still common at 12 months. Twelve months after stroke the prevalences of crying easily, irritability, impaired concentration, nausea and loss of weight were significantly lower. Conclusion The majority of patients rated their health as rather good or very good at 3 and 12 months after stroke. However, the majority suffered from fatigue and from symptoms of depression after both 3 and 12 months. In continued care of stroke survivors, it is important to consider the fact that many patients who rate their health as good may nevertheless have symptoms of depression, and some of them may benefit from anti-depressive treatment.

  6. General Principles of the WTO and European Community Laws in Building International Competition Norms

    Directory of Open Access Journals (Sweden)

    Chan Mo Chung

    2002-12-01

    Full Text Available The World Trade Organization (WTO established a Working Group on the interaction between trade and competition policy in 1996. By the Doha Ministerial Declaration, it recognized the case for international competition policy framework and agreed that the relevant negotiations take place after the Fifth Session of the Ministerial Conference. The Working Group is meant to focus on the clarification of: core principles, including transparency, non-discrimination and procedural fairness among others in the period until the Fifth Session. This article attempts to clarify the implications of the core (WTO principles to the would-be international competition laws and practices. It further tries to get lessons from competition law and practices of the European Community. Protection of fundamental rights, proportionality, non-discrimination, transparency, supremacy, subsidiarity and direct effect are the general principles of the European Community law to be discussed in relation to the competition law and policy. It concludes that the general principles of the WTO and EC laws provide guiding principles for the future international competition norms, and makes some preliminary assessment of the present Korean competition law and policy in the light of those principles.

  7. General guidelines for the Assessment of Internal Dose from Monitoring Data (Project IDEAS)

    International Nuclear Information System (INIS)

    Doerfel, H.; Andrasi, A.; Bailey, M.; Blanchardon, E.; Berkovski, V.; Castellani, C. M.; Hurtgen, C.; Jourdain, J. R.; LeGuen, B.; Puncher, M.

    2004-01-01

    In recent major international intercomparison exercises on intake and internal dose assessments from monitoring data the results calculated by different participants varied significantly. This was mainly due to the broad variety of methods and assumptions applied in the assessment procedure. Based on these experiences the need for harmonisation of the procedures has been formulated within an EU research project under the 5th Framework Programme. The aim of the project, IDEAS, is to develop general guidelines for standardising assessments of intakes and internal doses. The IDEAS project started in October 2001 and will end in March 2005. Eight institutions from seven European countries are participating. Inputs from internal dosimetry professionals from across Europe are also being used to ensure a broad consensus in the outcome of the project. The IDEAS project is closely related to some goals of the work of Committee 2 of the ICRP and since 2003 there has been close cooperation between the two groups. To ensure that the guidelines are applicable to a wide range of practical situations, the first step has been to compile a database of well-documented cases of internal contamination. In parallel, an improved version of an existing software package has been developed and distributed to the partners for further use. A large number of cases from the database have been evaluated independently by partners in the project using the same software and the results have been reviewed. Based on these evaluations guidelines are being drafted and will be discussed with dosimetry professionals from around the world by means of a virtual workshop on the Internet early in 2004. The guidelines will be revised and refined on the basis of the experiences and discussions of this virtual workshop and the outcome of an intercomparison exercise organised as part of the project. This will be open to all internal dosimetry professionals. (Author) 10 refs

  8. International migration of partner, autonomy and depressive symptoms among women from a mexican rural area.

    Science.gov (United States)

    Bojorquez, Ietza; Salgado de Snyder, Nelly; Casique, Irene

    2009-07-01

    The emigration of Mexicans to the USA has increased in the last decades, and little is known about the effect of this on the mental health of those who stay behind. To evaluate the association of emigration of husband and depressive symptoms (DS) among women who stay in Mexico. We also tested the hypothesis that the husband's migration would increase the woman's autonomy, which in turn would decrease DS. A survey was conducted in a rural area in Mexico. Participants (n = 418) were selected through probabilistic sampling in three stages: localities, households and individuals. DS were evaluated using the Centre for Epidemiological Studies-Depression (CES-D) scale. Having a partner in the USA was associated with higher odds of scoring above the cut-off point in CES-D (OR 3.77, 95% CI 1.92-7.43). Economic autonomy was also associated with DS (OR 1.45, 95% CI 1.04-2.02). Migration of husband was associated with DS among women. The construct of autonomy and its operational definition should be further explored.

  9. Bismuth as a general internal standard for lead in atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Bechlin, Marcos A.; Fortunato, Felipe M.; Ferreira, Edilene C.; Neto, José A. Gomes; Nóbrega, Joaquim A.; Donati, George L.; Jones, Bradley T.

    2014-01-01

    Highlights: • Single internal standard is commonly proposed for definite application in AAS. • Internal standard for general use in AAS techniques is original. • Bi showed efficiency as internal standard for Pb determinations by FAAS and GFAAS. • Assorted samples were analyzed and accurate results were found. - Abstract: Bismuth was evaluated as internal standard for Pb determination by line source flame atomic absorption spectrometry (LS FAAS), high-resolution continuum source flame atomic absorption spectrometry (HR-CS FAAS) and line source graphite furnace atomic absorption spectrometry (LS GFAAS). Analysis of samples containing different matrices indicated close relationship between Pb and Bi absorbances. Correlation coefficients of calibration curves built up by plotting A Pb /A Bi versus Pb concentration were higher than 0.9953 (FAAS) and higher than 0.9993 (GFAAS). Recoveries of Pb improved from 52–118% (without IS) to 97–109% (IS, LS FAAS); 74–231% (without IS) to 96–109% (IS, HR-CS FAAS); and 36–125% (without IS) to 96–110% (IS, LS GFAAS). The relative standard deviations (n = 12) were reduced from 0.6–9.2% (without IS) to 0.3–4.3% (IS, LS FAAS); 0.7–7.7% (without IS) to 0.1–4.0% (IS, HR-CS FAAS); and 2.1–13% (without IS) to 0.4–5.9% (IS, LS GFAAS)

  10. Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2015.

    Science.gov (United States)

    Szostek, Jason H; Wieland, Mark L; Post, Jason A; Sundsted, Karna K; Mauck, Karen F

    2016-08-01

    Identifying new practice-changing articles is challenging. To determine the 2015 practice-changing articles most relevant to outpatient general internal medicine, 3 internists independently reviewed the titles and abstracts of original articles, synopses of single studies and syntheses, and databases of syntheses. For original articles, internal medicine journals with the 7 highest impact factors were reviewed: New England Journal of Medicine, Lancet, Journal of the American Medical Association (JAMA), British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine. For synopses of single studies and syntheses, collections in American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine were reviewed. For databases of synthesis, Evidence Updates and the Cochrane Library were reviewed. More than 100 articles were identified. Criteria for inclusion were as follows: clinical relevance, potential for practice change, and strength of evidence. Clusters of important articles around one topic were considered as a single-candidate series. The 5 authors used a modified Delphi method to reach consensus on inclusion of 7 topics for in-depth appraisal. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Psychological Distress, Depression, Anxiety, and Burnout among International Humanitarian Aid Workers: A Longitudinal Study

    NARCIS (Netherlands)

    Lopes Cardozo, Barbara; Gotway Crawford, Carol; Eriksson, Cynthia; Zhu, Julia; Sabin, Miriam; Ager, Alastair; Foy, David; Snider, Leslie; Scholte, Willem; Kaiser, Reinhard; Olff, Miranda; Rijnen, Bas; Simon, Winnifred

    2012-01-01

    Background: International humanitarian aid workers providing care in emergencies are subjected to numerous chronic and traumatic stressors. Objectives: To examine consequences of such experiences on aid workers' mental health and how the impact is influenced by moderating variables. Methodology: We

  12. International VLBI Service for Geodesy and Astrometry 2004 General Meeting Proceedings

    Science.gov (United States)

    Vandenberg, Nancy R. (Editor); Baver, Karen D. (Editor)

    2004-01-01

    This volume is the proceedings of the third General Meeting of the International VLBI Service for Geodesy and Astromctry IVS), held in Otlawa, Canada, February 9-11,2004. The keynote of the third GM was visions for the next decade following the main theme of "Today's Results and Tomorrow's Vision". with a recognition that the outstanding VLBI results available today are the foundation and motivation for the next generation VLBI system requirements. The goal of the meeting was to provide an interesting and informative program for a wide cross section of IVS members, including station operators, program managers, and analysts.

  13. Energy policy of the International Energy Agency (IEA) countries. General review of the year 1990

    International Nuclear Information System (INIS)

    1992-01-01

    This book is a general review on energy policy leaded by Members countries of International Energy Agency (IEA) during the year 1990. This book describes also the trends and the recent events which have affected energy demand, energy conservation, energy efficiency, energy supply and energy source development. This annual review gives the IEA energy forecasting for the next years, till year 2001. A detailed study of energy policy in Federal Republic of Germany, Austria, Denmark, Greece, Ireland and Japan is given. The policy of fifteen another Members countries, which have been analyzed the previous years, is recapitulated and briefly brought up to date

  14. Relationship between late-life depression and life stressors: large-scale cross-sectional study of a representative sample of the Japanese general population.

    Science.gov (United States)

    Kaji, Tatsuhiko; Mishima, Kazuo; Kitamura, Shingo; Enomoto, Minori; Nagase, Yukihiro; Li, Lan; Kaneita, Yoshitaka; Ohida, Takashi; Nishikawa, Toru; Uchiyama, Makoto

    2010-08-01

    The purpose of the present study was to clarify the relationship between late-life depression and daily life stress in a representative sample of 10 969 Japanese subjects. Data on 10 969 adults aged > or =50 who participated in the Active Survey of Health and Welfare in 2000, were analyzed. The self-administered questionnaire included items on 21 reasons for life stressors and the magnitude of stress, as well as the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). The relationship between the incidence of life stressors and mild-moderate (D(16)) and severe (D(26)) depressive symptoms was examined using logistic regression analysis. A total of 21.9% of subjects had D(16) symptoms, and 9.3% had D(26) symptoms. Further, increased age and being female were associated with more severe depressive state. Logistic regression analysis indicated that the strongest relationship between both the incidence of D(16) and D(26) symptoms and life stressors stemmed from 'having no one to talk to' (odds ratio = 3.3 and 5.0, respectively). Late-life depression was also associated with 'loss of purpose in life', 'separation/divorce', 'having nothing to do', 'health/illness/care of self', and 'debt'. There is a relationship between late-life depression and diminished social relationships, experiences involving loss of purpose in life or human relationships, and health problems in the Japanese general population.

  15. 自我效能感、应付方式和犯罪青少年抑郁的相关研究%Depression and Its Relation to General Self-efficacy and Coping Styles in Delinquent Teenagers

    Institute of Scientific and Technical Information of China (English)

    王才康

    2002-01-01

    Objective: To explore the characteristic of depression and its relationship with general self-efficacy and coping styles in delinquent teenagers. Methods: 228 delinquent teenagers in jail completed a battery of questionnaires consisted of General Self-Efficacy Scale (GSES), Short Coping Style Scale (SCSS), and Center for Epidemiological, Depression Scale (CES-D).Results: Mean scores of depression of delinquent teenagers were found to be highly elevated. A total of 52.6% of the subjects showed depression. Depression as assessed by CES-D was found to correlate with General self-efficacy (r=-0.162) and Negative Coping Styles (r=0.177). No significant relationship was found between Positive Coping Styles and depression. Conclusion: Depression of delinquent teenagers was related to low self-efficacy and negative coping styles.

  16. Male depression in females?

    Science.gov (United States)

    Möller-Leimkühler, Anne Maria; Yücel, Mete

    2010-02-01

    Scientific evidence for a male-typed depression ("male depression") is still limited, but mainly supports this concept with respect to single externalizing symptoms or symptom clusters. In particular, studies on non-clinical populations including males and females are lacking. The present study aims at assessing general well-being, the risk and the symptoms of male depression dependent on biological sex and gender-role orientation on instrumental (masculine) and expressive (feminine) personality traits in an unselected community sample of males and females. Students (518 males, 500 females) of the Ludwig-Maximilians-University of Munich, Germany, were asked to participate in a "stress study" and complete the following self-report questionnaires: the WHO-5 Well-being Index [Bech, P., 1998. Quality of Life in the Psychiatric Patient. Mosby-Wolfe, London], the Gotland Scale for Male Depression [Walinder, J., Rutz, W., 2001. Male depression and suicide. International Clinical Psychopharmacology 16 (suppl 2), 21-24] and the German Extended Personal Attribute Questionnaire [Runge, T.E., Frey, D., Gollwitzer, P.M., et al., 1981. Masculine (instrumental) and feminine (expressive) traits. A comparison between students in the United States and West Germany. Journal of Cross-Cultural Psychology 12, 142-162]. General well-being of the students was significantly lower compared to population norms. Contrary to expectations, female students had a greater risk of male depression than male students (28.9% vs. 22.4%; p<0.05). Overall, prototypic depressive symptoms as well as externalizing symptoms were more pronounced in females. In the subgroup of those at risk for male depression, biological sex and kind of symptoms were unrelated. Principal component analyses revealed a similar symptom structure for males and females. Low scores on masculinity/instrumentality significantly predicted higher risk of male depression, independent of biological sex. The study sample is not

  17. Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING] : study protocol of a non-inferiority randomized trial

    NARCIS (Netherlands)

    Massoudi, Btissame; Blanker, Marco H; van Valen, Evelien; Wouters, Hans; Bockting, Claudi L H; Burger, Huibert

    2017-01-01

    BACKGROUND: The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to

  18. Examination of the decline in symptoms of anxiety and depression in generalized anxiety disorder: Impact of anxiety senstivity on response to pharmacotherapy

    NARCIS (Netherlands)

    Olatunji, B.O.; Feldman, G.; Smits, J.A.J.; Christian, K.M.; Zalta, A.K.; Pollack, M.H.; Simon, N.M.

    2008-01-01

    Pharmacotherapy is an effective treatment for generalized anxiety disorder (GAD), but few studies have examined the nature of decline of anxiety and depression during pharmacotherapy for GAD and even fewer studies have examined predictors of symptom decline. This study examined the decline in

  19. The development of adolescent generalized anxiety and depressive symptoms in the context of adolescent mood variability and parent-adolescent negative interactions

    NARCIS (Netherlands)

    Maciejewski, D.F.; van Lier, P.A.C.; Neumann, A.; van der Giessen, D.; Branje, S.T.J.; Meeus, W.H.J.; Koot, H.M.

    2014-01-01

    This study explored the influence of adolescent mood variability on the symptom development of generalized anxiety and depression in the context of parent-adolescent negative interactions. Participants were 456 adolescents (55.7 % male) from a community sample, who were followed from age 13 to 16

  20. Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING] : Study protocol of a non-inferiority randomized trial

    NARCIS (Netherlands)

    Massoudi, Btissame; Blanker, Marco H.; van Valen, Evelien; Wouters, Hans; Bockting, Claudi L. H.; Burger, Huibert

    2017-01-01

    BACKGROUND: The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to

  1. Predictors of suicidality in depressive spectrum disorders in the general population : results of the Netherlands Mental Health Survey and Incidence Study

    NARCIS (Netherlands)

    Spijker, Jan; de Graaf, Ron; ten Have, Margreet; Nolen, Willem A.; Speckens, Anne

    The aim was to assess determinants of suicidality (suicidal ideation and suicide attempts) in a general population cohort with depressive spectrum disorders, and to compare determinants for suicidal ideation and determinants for suicide attempts in this cohort. The Netherlands Mental Health Survey

  2. Case management for the treatment of patients with major depression in general practices – rationale, design and conduct of a cluster randomized controlled trial – PRoMPT (Primary care Monitoring for depressive Patient's Trial [ISRCTN66386086] – Study protocol

    Directory of Open Access Journals (Sweden)

    Krauth Christian

    2005-10-01

    Full Text Available Abstract Background Depression is a disorder with high prevalence in primary health care and a significant burden of illness. The delivery of health care for depression, as well as other chronic illnesses, has been criticized for several reasons and new strategies to address the needs of these illnesses have been advocated. Case management is a patient-centered approach which has shown efficacy in the treatment of depression in highly organized Health Maintenance Organization (HMO settings and which might also be effective in other, less structured settings. Methods/Design PRoMPT (PRimary care Monitoring for depressive Patients Trial is a cluster randomised controlled trial with General Practice (GP as the unit of randomisation. The aim of the study is to evaluate a GP applied case-management for patients with major depressive disorder. 70 GPs were randomised either to intervention group or to control group with the control group delivering usual care. Each GP will include 10 patients suffering from major depressive disorder according to the DSM-IV criteria. The intervention group will receive treatment based on standardized guidelines and monthly telephone monitoring from a trained practice nurse. The nurse investigates the patient's status concerning the MDD criteria, his adherence to GPs prescriptions, possible side effects of medication, and treatment goal attainment. The control group receives usual care – including recommended guidelines. Main outcome measure is the cumulative score of the section depressive disorders (PHQ-9 from the German version of the Prime MD Patient Health Questionnaire (PHQ-D. Secondary outcome measures are the Beck-Depression-Inventory, self-reported adherence (adapted from Moriskey and the SF-36. In addition, data are collected about patients' satisfaction (EUROPEP-tool, medication, health care utilization, comorbidity, suicide attempts and days out of work. The study comprises three assessment times: baseline

  3. International VLBI Service for Geodesy and Astrometry: 2000 General Meeting Proceedings

    Science.gov (United States)

    Vandenberg, Nancy R. (Editor); Baver, Karen D. (Editor)

    2000-01-01

    This volume is the proceedings of the first General Meeting of the International Very Long Base Interferometry (VLBI) Service for Geodesy and Astrometry (IVS), held in Koetzting, Germany, February 21-24, 2000. The content of this volume also appears on the IVS web site at: http://ivscc.gsfc.nasa.gov/publications/gm2000. The goal of the program committee for the General Meeting was to provide an interesting and informative program for a wide cross section of IVS members, including station operators, program managers, and analysts. The program included reports, tutorials, invited and contributed papers, and poster presentations. The tutorial papers should be particularly useful references because each one provides an overview and introduction to a topic relevant to VLBI.

  4. Pitfalls in Using Limitation Clauses in the International General Conditions ECE 188 and Orgalime S 2000

    DEFF Research Database (Denmark)

    Henschel, Rene Franz

    2008-01-01

    various individual provisions contained in the general conditions - for example limitation of the right to require repair and further limitation of liability. If this is not motivated by the circumstances surrounding the particular contract, the parties risk creating imbalances in the otherwise well-balanced......The article centers on the rules on the limitation of liability in the general conditions ECE 188 and Orgalime S 2000. ECE 188 differ considerably from S 2000, as the provisions in ECE 188 do not give the necessary consideration to the development in industry practices and legal rules, including...... the approximation and harmonization of legal systems that have taken place during the last 50 years. S 2000 reflects an international trend that increasingly recognizes the importance of striking a balance between the interests of the parties. However, in practice the parties often derogate considerably from...

  5. Examining reward-seeking, negative self-beliefs and over-general autobiographical memory as mechanisms of change in classroom prevention programs for adolescent depression.

    Science.gov (United States)

    Rice, Frances; Rawal, Adhip; Riglin, Lucy; Lewis, Gemma; Lewis, Glyn; Dunsmuir, Sandra

    2015-11-01

    Effective methods to prevent adolescent depressive symptoms could reduce suffering and burden across the lifespan. However, psychological interventions delivered to adolescents show efficacy only in symptomatic or high-risk youth. Targeting causal risk factors and assessing mechanistic change can help devise efficacious universal or classroom based prevention programs. A non-randomized longitudinal design was used to compare three classroom-based prevention programs for adolescent depression (Behavioral Activation with Reward Processing, "Thinking about Reward in Young People" (TRY); Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT)), and determine cognitive mechanisms of change in these programs. Cognitive mechanisms examined were reward-seeking, negative self-beliefs (assessed with behavioral tasks) and over-general autobiographical memory. 256 healthy adolescents aged 13-14 participated with 236 (92%) and 227 (89%) completing the pre- and post-assessments. TRY was the only intervention associated with a reduction in depressive symptoms at follow-up. Reward-seeking increased following TRY. In the other programs there were non-significant changes in cognitive mechanisms, with more reflective negative self-beliefs in CBT and fewer over-general autobiographical memories in MBCT In the TRY program, which focused on increasing sensitivity to rewarding activities, reward seeking increased and this was associated with decreased depressive symptoms. Due to the infeasibility of a cluster randomized controlled trial, a non-randomized design was used. Increased reward-seeking was associated with decreased depressive symptoms and may be a mechanism of depressive symptom change in the intervention with a focus on enhancing sensitivity and awareness of reward. This study provides preliminary evidence to suggest that incorporating activities to enhance reward sensitivity may be fruitful in randomized controlled trials of universal prevention

  6. General Principles and Convention on Contracts for the International Sale of Goods (CISG – Uniformity under an Interpretation Umbrella?

    Directory of Open Access Journals (Sweden)

    Laura Lassila

    2017-01-01

    Full Text Available Globalization and digitalization of international sales creates needs to harmonize rules of international commercial contracts. The question is whether the harmonization should be done by binding rules or using soft law tools or through digitalization. In this article I argue on favor of harmonization through international contracts law rules’ international interpretation.The international interpretation principles used in this article are found from on Art. 7(1 of the Convention on Contracts for the International Sale of Goods (CISG which sets three interpretation rules: international character; promoting uniformity; and observance of good faith in international trade. These principles are not only principles of the CISG, but also principles commonly recognized in international commercial practice and also in domestic contract rules. I argue that by adopting an international interpretation umbrella – the meta-principle of international interpretation, cross-border contracts could be interpreted under the same principle no matter applicable substantial law. The meta-principle functions as an interpretation umbrella covering general principles and Articles of the CISG, general principles of international commercial contracts, Lex Mercatoria, and cross-border contract provision under national law.The outcomes points out that arbitral tribunals have interpreted general principles of the CISG and Lex Mercatoria in various ways. General principles and their application in case law is analyzed in connection with the Civil Code of the Russian Federation. Tribunals found that general principles of the CISG are applicable even if the CISG is not. It follows Art.’s 7(2 logic to promote international standard to cross-border contracts where the closes connection is international commercial practice rather than any national jurisdiction.

  7. Comparison of General Health and Depression in the People Covered With the Community-Based Rehabilitation Program (CBR With the Non-Covered

    Directory of Open Access Journals (Sweden)

    Karim Ayoubi Avaz

    2018-04-01

    Conclusion  Implementing the CBR programs in rural and remote areas can be effective in reducing the depression of people with physical disabilities. These programs can create meaningful change and a more comprehensive framework for people with physical disabilities and can have positive effects on the general health. Further studies are required to collect more data about the general health and the quality of life of these groups of patients. 

  8. 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 ...

  9. Investigating the influence of shame, depression, and distress tolerance on the relationship between internalized homophobia and binge eating in lesbian and bisexual women.

    Science.gov (United States)

    Bayer, Vanessa; Robert-McComb, Jacalyn J; Clopton, James R; Reich, Darcy A

    2017-01-01

    There is limited research evidence about the specific factors influencing disordered eating for lesbian and bisexual women. Therefore, this study investigated relationships among binge eating, internalized homophobia, shame, depression, and distress tolerance in a sample of lesbian (n=72) and bisexual women (n=66). Two hypotheses were tested. First, it was hypothesized that shame and depression would mediate the relationship between internalized homophobia and binge eating. Second, it was hypothesized that distress tolerance would moderate the relationship between shame and binge eating and the relationship between depression and binge eating in the mediation relationships proposed in the first hypothesis. Results indicated that shame was a significant mediator for the relationship between internalized homophobia and binge eating, that depression was not a significant mediator, and that distress tolerance did not moderate the significant mediation relationship between shame and binge eating. The data in this study also indicated that the proportions of lesbian and bisexual participants who reported binge eating and compensatory behavior did not differ significantly, but that bisexual participants reported significantly more depression and shame than lesbian participants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Associations Between Compulsive Buying and Substance Dependence/Abuse, Major Depressive Episode, and Generalized Anxiety Disorder Among Men and Women

    Science.gov (United States)

    Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.

    2016-01-01

    Aims The objective of this study was to examine the associations between compulsive buying (CB) and substance dependence/abuse, major depressive episode (MDE), and generalized anxiety disorder (GAD) at mean age 43. Methods Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. The prevalence of substance dependence/abuse, MDE, and GAD (during the past 5 years before the interviews) was 6.6%, 13.7, and 11.5%, respectively. Results Logistic regression analyses showed that CB was significantly associated with substance dependence/abuse [Adjusted Odds Ratio (A.O.R.) = 1.60], MDE (A.O.R. = 1.70), and GAD (A.O.R. = 1.63), despite controlling for substance dependence/abuse, MDE, and GAD, respectively, at mean age 37, and demographic factors. Discussion Since the study sample is limited to predominantly white participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, MDE, and GAD consider the role of CB. PMID:27215919

  11. The Relations among Maternal Depression, Maternal Criticism, and Adolescents' Externalizing and Internalizing Symptoms.

    Science.gov (United States)

    Frye, Alice A.; Garber, Judy

    2005-01-01

    This study examined the relations between maternal criticism and externalizing and internalizing symptoms in adolescents who varied in their risk for psychopathology. Both maternal-effects and child-effects models were examined. The sample consisted of 194 adolescents (mean age = 11.8 years) and their mothers: 146 mothers had a history of…

  12. Self-Critical Perfectionism, Acculturative Stress, and Depression among International Students

    Science.gov (United States)

    Rice, Kenneth G.; Choi, Chun-Chung; Zhang, Yanmei; Morero, Yanina Ines; Anderson, Debra

    2012-01-01

    The authors tested a classic diathesis-stress, stress-enhancement model of perfectionism with subgroups of Chinese (N = 129) and Asian Indian (N = 166) international graduate students attending a major U.S. university. More specifically, the authors tested whether self-critical perfectionism, acculturative stress, and their interaction accounted…

  13. General guidelines for safe and expeditious international transport of samples subjected to biological dosimetry assessment.

    Science.gov (United States)

    Di Giorgio, Marina; Radl, Analía; Taja, María R; Bubniak, Ruth; Deminge, Mayra; Sapienza, Carla; Vázquez, Marina; Baciu, Florian; Kenny, Pat

    2014-06-01

    It has been observed that victims of accidental overexposures show better chance of survival if they receive medical treatment early. The increased risk of scenarios involving mass casualties has stimulated the scientific community to develop tools that would help the medical doctors to treat victims. The biological dosimetry has become a routine test to estimate the dose, supplementing physical and clinical dosimetry. In case of radiation emergencies, in order to provide timely and effectively biological dosimetry assistance it is essential to guarantee an adequate transport of blood samples in principal, for providing support to countries that do not have biodosimetry laboratories. The objective of the present paper is to provide general guidelines, summarised in 10 points, for timely and proper receiving and sending of blood samples under National and International regulations, for safe and expeditious international transport. These guidelines cover the classification, packaging, marking, labelling, refrigeration and documentation requirements for the international shipping of blood samples and pellets, to provide assistance missions with a tool that would contribute with the preparedness for an effective biodosimetric response in cases of radiological or nuclear emergencies. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Proposal to change General Consideration 5 and Principle 2 of the International Code of Nomenclature of Prokaryotes.

    Science.gov (United States)

    Oren, Aharon; Garrity, George M

    2014-01-01

    A proposal is submitted to the ICSP to change the wording of General Consideration 5 of the International Code of Nomenclature of Prokaryotes (ICNP), deleting the words Schizophycetes, Cyanophyceae and Cyanobacteria from the groups of organisms whose nomenclature is covered by the Code. It is further proposed to change the terms Zoological Code and International Code of Botanical Nomenclature in General Consideration 5 and in Principle 2 to International Code of Zoological Nomenclature and International Code of Nomenclature for algae, fungi and plants, respectively.

  15. The role of international institutions in the formation of international bioethical law: UNESCO and the United Nations General Assembly attempt to govern human cloning.

    Science.gov (United States)

    Kuppuswamy, Chamundeeswari

    2007-01-01

    This article analyses the international governance of human reproductive cloning. Noting that bioethics is a new field of engagement for international lawyers, it recounts some of the institutional developments in bioethical law making. The role of UNESCO and the United Nations General Assembly is scrutinized and the author discusses the relative merits of the institutions' governance of human reproductive cloning. The author suggests that some international institutions and mechanisms are better suited than others for bioethical law making. The 2005 General Assembly resolution on human cloning is analysed in this context.

  16. Phenomena Conflict, Anxiety, and Depression for Cancer Survivor One Year and After Have Therapy in General Hospital

    Directory of Open Access Journals (Sweden)

    Maria Turnip

    2016-03-01

    Full Text Available Introduction. Psychosocial distress emerges in cancer disease. This research explores experience of conflict, anxiety, and depression in one year cancer survivor. Methods. Data were collected through in-depth semi structured interviews with fifteen participants when seeking treatment at a public hospital in Bandung. Result. There nine themes emerge: anxiety about cancer’s spread and recurrence, changing relationships with a partner, 'labeling' from oneself and others, physical discomfort along treatment, psychological discomfort along treatment, self-concept, religious/spiritual, hiding diagnose and complain, and deficit information about cancer. But, four themes among were not characterized with conflict, anxiety, and depression. Conflict, anxiety, and depression impact condition of the client cancer. Discussion. Experience of conflict, anxiety, and depression became the basis for the development of management system service and provision of facilities for integrated mental health nursing therapy. Key word: cancer, conflict, anxiety, depression

  17. Reactor building with internal structure of which the movements are independent of those of the general raft and process for building these internal structures

    International Nuclear Information System (INIS)

    Hista, J.C.

    1982-01-01

    This reactor building includes a containment enclosure for the internal structures composed of a slab wedged on its periphery against the containment enclosure gusset and resting on the general raft by means of a peripheral bearing ring, a compressible layer being provided between the general raft and the slab [fr

  18. The Impact of Social Support on the Relation between Stress from Daily Life Issues and Depression among East Asian International Students in the United States

    Science.gov (United States)

    Fang, Hong-Ning

    2013-01-01

    Moderation effects of social support on the relation between stress resulting from five daily life issues (i.e., acculturation, second language, academic performance, interpersonal relationships, and financial concerns) and psychological distress (i.e., the level of depression) among China, South Korea, Taiwan, and Japan international students…

  19. Metabolic syndrome, major depression, generalized anxiety disorder, and ten-year all-cause and cardiovascular mortality in middle aged and elderly patients.

    Science.gov (United States)

    Butnoriene, Jurate; Bunevicius, Adomas; Saudargiene, Ausra; Nemeroff, Charles B; Norkus, Antanas; Ciceniene, Vile; Bunevicius, Robertas

    2015-01-01

    Studies investigating specifically whether metabolic syndrome (MetS) and common psychiatric disorders are independently associated with mortality are lacking. In a middle-aged general population, we investigated the association of the MetS, current major depressive episode (MDE), lifetime MDE, and generalized anxiety disorder (GAD) with ten-year all-cause and cardiovascular disease mortality. From February 2003 until January 2004, 1115 individuals aged 45 years and older were randomly selected from a primary care practice and prospectively evaluated for: (1) MetS (The World Health Organization [WHO], National Cholesterol Education Program/Adult Treatment Panel III and International Diabetes Federation [IDF] definitions); (2) current MDE and GAD, and lifetime MDE (Mini International Neuropsychiatric Interview); and (3) conventional cardiovascular risk factors. Follow-up continued through January, 2013. During the 9.32 ± 0.47 years of follow-up, there were 248 deaths, of which 148 deaths were attributed to cardiovascular causes. In women, WHO-MetS and IDF-MetS were associated with greater all-cause (HR-values range from 1.77 to 1.91; p-values ≤ 0.012) and cardiovascular (HR-values range from 1.83 to 2.77; p-values ≤ 0.013) mortality independent of cardiovascular risk factors and MDE/GAD. Current GAD predicted greater cardiovascular mortality (HR-values range from 1.86 to 1.99; p-values ≤ 0.025) independently from MetS and cardiovascular risk factors. In men, the MetS and MDE/GAD were not associated with mortality. In middle aged women, the MetS and GAD predicted greater 10-year cardiovascular mortality independently from each other; 10-year all-cause mortality was independently predicted by the MetS. MetS and GAD should be considered important and independent mortality risk factors in women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Divisions of general practice in Australia: how do they measure up in the international context?

    Science.gov (United States)

    Smith, Judith; Sibthorpe, Beverly

    2007-07-13

    Since the late 1980s, there has been evidence of an international trend towards more organised primary care. This has taken a number of forms including the emergence of primary care organisations. Underpinning such developments is an inherent belief in evidence that suggests that well-developed primary care is associated with improved health outcomes and greater cost-effectiveness within health systems. In Australia, primary care organisations have emerged as divisions of general practice. These are professionally-led, regionally-based, and largely government-funded voluntary associations of general practitioners that seek to co-ordinate local primary care services, and improve the quality of care and health outcomes for local communities. In this paper, we examine and debate the development of divisions in the international context, using six roles of primary care organisations outlined in published research. The six roles that are used as the basis for the critique are the ability of primary care organisations to: improve health outcomes; manage demand and control costs; engage primary care physicians; enable greater integration of health services; develop more accessible services in community and primary care settings; and enable greater scrutiny and assurance of quality of primary care services. We conclude that there has been an evolutionary approach to divisions' development and they now appear embedded as geographically-based planning and development organisations within the Australian primary health care system. The Australian Government has to date been cautious in its approach to intervention in divisions' direction and performance. However, options for the next phase include: making greater use of contracts between government and divisions; introducing and extending proposed national quality targets for divisions, linked with financial or other incentives for performance; government sub-contracting with state-based organisations to act as purchasers of

  1. Perceived social support and its impact on depression and health-related quality of life: a comparison between cancer patients and general population.

    Science.gov (United States)

    Yoo, Hyosang; Shin, Dong Wook; Jeong, Ansuk; Kim, So Young; Yang, Hyung-Kook; Kim, Jun Suk; Lee, Ji Eun; Oh, Jae Hwan; Park, Eun-Cheol; Park, Keeho; Park, Jong-Hyock

    2017-08-01

    It is well known that cancer patients' perception of social support is associated with their depressive symptoms and health-related quality of life. However, there have been little studies that compared the variates of cancer patients with the general population. We sought to compare differences in the level of perceived social support and the impact of perceived social support on depressive symptoms and health-related quality of life between cancer survivors and the general population. Data were collected from 1818 cancer patients treated at the National Cancer Center and regional cancer centers in South Korea. The control group of the general population was composed of 2000 individuals without cancer from community. Cancer patients reported significantly higher level of perceived social support than the general population, while they reported lower health-related quality of life and were more susceptible to depression. The positive associations of higher perceived social support with lower depressive symptoms, as well as with higher health-related quality of life, were stronger among cancer patients than among the general population. The interaction effect suggests that the impact of social support would be stronger among cancer patients than the general public. Thus, it would be beneficial to pay attention to providing social support to cancer patients, particularly to those who are more vulnerable. Furthermore, investigation of the most effective and efficient methods to deliver social support interventions would be worthwhile. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. The influence of parental care and overprotection, neuroticism and adult stressful life events on depressive symptoms in the general adult population.

    Science.gov (United States)

    Ono, Yasuyuki; Takaesu, Yoshikazu; Nakai, Yukiei; Ichiki, Masahiko; Masuya, Jiro; Kusumi, Ichiro; Inoue, Takeshi

    2017-08-01

    The quality of parenting, neuroticism, and adult stressful life events are reportedly associated with depressive symptoms. However, previous studies have not examined the complex interaction between these three factors. In this study, we hypothesized that the quality of parenting (care and overprotection) acts on depressive symptoms through 'neuroticism' and the appraisal of adult stressful life events, and this hypothesis was verified by structural equation modeling. Four hundred one participants from the general adult population were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9 (PHQ-9), Parental Bonding Instrument (PBI), neuroticism subscale of the short version of the Eysenck Personality Questionnaire-revised (EPQ-R), and Life Experiences Survey (LES). The data were analyzed with single and multiple regression analyses and covariance structure analyses. In the covariance structure analysis, neuroticism scores and negative change scores on the LES acted on the depressive symptoms (PHQ-9 scores) directly, but care or overprotection in childhood on the PBI did not act on them directly. Low care and high overprotection of the PBI increased depressive symptoms and negative change scores on the LES through enhanced neuroticism, which is regarded as a mediator in these effects. The subjects of this study were nonclinical volunteers; the findings might not be generalizable to psychiatric patients. This research showed that low care and high overprotection of maternal and paternal parenting in childhood influence depressive symptoms indirectly through enhanced neuroticism in general adults. These findings suggest that neuroticism mediates the long-term effect of the quality of parenting on depression in adulthood. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Effects on work ability, job strain and quality of life of monitoring depression using a self-assessment instrument in recurrent general practitioner consultations: A randomized controlled study.

    Science.gov (United States)

    Petersson, E-L; Wikberg, C; Westman, J; Ariai, N; Nejati, S; Björkelund, C

    2018-05-01

    Depression reduces individuals' function and work ability and is associated with both frequent and long-term sickness absence. Investigate if monitoring of depression course using a self-assessment instrument in recurrent general practitioner (GP) consultations leads to improved work ability, decreased job strain, and quality of life among primary care patients. Primary care patients n = 183, who worked. In addition to regular treatment (control group), intervention patients received evaluation and monitoring and used the MADRS-S depression scale during GP visit at baseline and at visits 4, 8, and 12 weeks. Work ability, quality of life and job strain were outcome measures. Depression symptoms decreased in all patients. Significantly steeper increase of WAI at 3 months in the intervention group. Social support was perceived high in a significantly higher frequency in intervention group compared to control group. Monitoring of depression course using a self-assessment instrument in recurrent GP consultations seems to lead to improved self-assessed work ability and increased high social support, but not to reduced job strain or increased quality of life compared to TAU. Future studies concerning rehabilitative efforts that seek to influence work ability probably also should include more active interventions at the workplace.

  4. Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

    Science.gov (United States)

    Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

    2017-12-11

    The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

  5. Proceedings of the Sixth General Meeting of the International VLBI Service for Geodesy and Astrometry

    Science.gov (United States)

    Behrend, Dirk (Editor); Baver, Karen D. (Editor)

    2010-01-01

    This volume is the proceedings of the sixth General Meeting of the International VLBI Service for Geodesy and Astrometry (IVS), held in Hobart, Tasmania, Australia, February 7-13, 2010. The contents of this volume also appear on the IVS Web site at http://ivscc.gsfc.nasa.gov/publications/gm2010. The keynote of the sixth GM was the new perspectives of the next generation VLBI system under the theme "VLBI2010: From Vision to Reality". The goal of the meeting was to provide an interesting and informative program for a wide cross-section of IVS members, including station operators, program managers, and analysts. This volume contains 88 papers. All papers were edited by the editors for usage of the English language, form, and minor content-related issues.

  6. [The new postgraduate training program in general internal medicine: implications for the primary care physician].

    Science.gov (United States)

    Monti, Matteo; Gachoud, David

    2010-11-03

    The Swiss postgraduate training program in general internal medicine is now designed as a competency-based curriculum. In other words, by the end of their training, the residents should demonstrate a set of predefined competences. Many of those competences have to be learnt in outpatient settings. Thus, the primary care physicians have more than ever an important role to play in educating tomorrows doctors. A competency-based model of training requires a regular assessment of the residents. The mini-CEX (mini-Clinical Evaluation eXercise) is the assessment tool proposed by the Swiss institute for postgraduate and continuing education. The mini-CEX is based on the direct observation of the trainees performing a specific task, as well as on the ensuing feedback. This article aims at introducing our colleagues in charge of residents to the mini-CEX, which is a useful tool promoting the culture of feedback in medical education.

  7. International trade in oil, gas and carbon emission rights: An intertemporal general equilibrium model

    International Nuclear Information System (INIS)

    Manne, A.S.; Rutherford, T.F.

    1994-01-01

    This paper employs a five-region intertemporal model to examine three issues related to carbon emission restrictions. First, we investigate the possible impact of such limits upon future oil prices. We show that carbon limits are likely to differ in their near- and long-term impact. Second, we analyze the problem of open-quotes leakageclose quotes which could arise if the OECD countries were to adopt unilateral limits upon carbon emissions. Third, we quantify some of the gains from trade in carbon emission rights. Each of these issues have been studied before, but to our knowledge this is the first study based on a multi-regional, forward-looking model. We show that sequential joint maximization can be an effective way to compute equilibria for intertemporal general equilibrium models of international trade. 18 refs., 10 figs

  8. Early experience in establishing and evaluating an ACGME-approved international general surgery rotation.

    Science.gov (United States)

    Tarpley, Margaret; Hansen, Erik; Tarpley, John L

    2013-01-01

    In 2011, the Accreditation Council for Graduate Medical Education Surgery Residency Review Committee first provided guidelines for elective international general surgery rotations. The Vanderbilt general surgery residency program received Surgery Residency Review Committee approval for a fourth-year elective in Kenya beginning in the 2011-2012 academic year. Because this rotation would break ground culturally and geographically, and as an educational partnership, a briefing and debriefing process was developed for this ground-breaking year. Our objectives were to prepare residents to maximize the experience without competing for cases with local trainees or overburdening the host institution and to perform continuous quality assessment and improvement as each resident returned back. Briefing included health protection strategies, a procedures manual containing step-by-step preparation activities, and cultural-sensitivity training. Institutional Review Board exemption approval was obtained to administer a questionnaire created for returning residents concerning educational value, relations with local trainees, physical environment, and personal perceptions that would provide the scaffold for the debriefing conference. The questionnaire coupled with the debriefing discussion for the first 9 participants revealed overall satisfaction with the rotation and the briefing process, good health, and no duty hours or days-off issues. Other findings include the following: (1) emotional effect of observing African families weigh cost in medical decision making; (2) satisfactory access to educational resources; (3) significant exposure to specialties such as urology and radiology; and (4) toleration of 4 weeks as a single and expressed need for leisure activity materials such as books, DVDs, or games. The responses triggered adjustments in the briefing sessions and travel preparation. The host institution invited the residents to return for the 2012-2013 year as well as 2013

  9. Separating generalized anxiety disorder from major depression using clinical, hormonal, and structural MRI data: A multimodal machine learning study.

    Science.gov (United States)

    Hilbert, Kevin; Lueken, Ulrike; Muehlhan, Markus; Beesdo-Baum, Katja

    2017-03-01

    Generalized anxiety disorder (GAD) is difficult to recognize and hard to separate from major depression (MD) in clinical settings. Biomarkers might support diagnostic decisions. This study used machine learning on multimodal biobehavioral data from a sample of GAD, MD and healthy subjects to differentiate subjects with a disorder from healthy subjects (case-classification) and to differentiate GAD from MD (disorder-classification). Subjects with GAD ( n  = 19), MD without GAD ( n  = 14), and healthy comparison subjects ( n  = 24) were included. The sample was matched regarding age, sex, handedness and education and free of psychopharmacological medication. Binary support vector machines were used within a nested leave-one-out cross-validation framework. Clinical questionnaires, cortisol release, gray matter (GM), and white matter (WM) volumes were used as input data separately and in combination. Questionnaire data were well-suited for case-classification but not disorder-classification (accuracies: 96.40%, p   .22). The opposite pattern was found for imaging data (case-classification GM/WM: 58.71%, p  = .09/43.18%, p  > .66; disorder-classification GM/WM: 68.05%, p  = .034/58.27%, p  > .15) and for cortisol data (38.02%, p  = .84; 74.60%, p  = .009). All data combined achieved 90.10% accuracy ( p  < .001) for case-classification and 67.46% accuracy ( p  = .0268) for disorder-classification. In line with previous evidence, classification of GAD was difficult using clinical questionnaire data alone. Particularly cortisol and GM volume data were able to provide incremental value for the classification of GAD. Findings suggest that neurobiological biomarkers are a useful target for further research to delineate their potential contribution to diagnostic processes.

  10. Views of the Scottish general public on community pharmacy weight management services: international implications.

    Science.gov (United States)

    Weidmann, Anita Elaine; Cunningham, Scott; Gray, Gwen; Hansford, Denise; Bermano, Giovanna; Stewart, Derek

    2012-04-01

    Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of community pharmacy services in other parts of the UK and internationally. To describe the views of the Scottish general public on the provision of weight management services via community pharmacies. General public in Scotland. A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Views on community pharmacy led weight management services. Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through community pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists' specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Overall, respondents appear to be receptive to the idea of accessing weight management services through community pharmacy but a perceived lack of privacy, poor knowledge of pharmacists' skill level and of public health services available to

  11. GENERAL GUIDELINES CONCERNING THE RELATION INTERNATIONAL INTELLECTUAL PROPERTY BUSINESS VERSUS HUMAN RIGHTS AND CIVIL LIBERTIES

    Directory of Open Access Journals (Sweden)

    Speriusi-Vlad Alin

    2014-07-01

    Full Text Available Today, the intellectual property protection is no longer an absolute social and legal that justifies adoption of any measures necessary to protect it. Initially seen as the prerequisite for sustainable development, implementation of new technologies, and encouragement of international trade, the intellectual property, especially prior to ACTA (Anti-Counterfeiting Trade Agreement international trial implementation, and also thereafter, was increasingly identified as a source of violation of fundamental rights and civil liberties, i.e. the right to protection of personal data, the right to privacy, freedom to send and receive information freedom of information, freedom to contract, and freedom to carry out economic activities (freedom of commerce. As far as international trade transactions have often a component of intellectual property that requires to be protected, it is necessary to identify the landmarks, the rules establishing de facto limits in order to protect the intellectual property without risk of infringement of fundamental rights and civil liberties of other persons, in particular users or potential users of goods and services incorporating intellectual property. The best guidelines in this regard may be provided by the CJEU (Court of Justice of the European Union case-law both due to its reasoning underlying the decision of the Parliament to reject ACTA ratification and the fact that the case-law of this Court, especially the most recent one, is highly complex and nuanced, not denying in any way the importance of intellectual property, and identifying certain cases where their primacy persist and whose analysis leads to laying down some general rules in the field.

  12. Looking beyond general metrics for model comparison - lessons from an international model intercomparison study

    Science.gov (United States)

    de Boer-Euser, Tanja; Bouaziz, Laurène; De Niel, Jan; Brauer, Claudia; Dewals, Benjamin; Drogue, Gilles; Fenicia, Fabrizio; Grelier, Benjamin; Nossent, Jiri; Pereira, Fernando; Savenije, Hubert; Thirel, Guillaume; Willems, Patrick

    2017-01-01

    International collaboration between research institutes and universities is a promising way to reach consensus on hydrological model development. Although model comparison studies are very valuable for international cooperation, they do often not lead to very clear new insights regarding the relevance of the modelled processes. We hypothesise that this is partly caused by model complexity and the comparison methods used, which focus too much on a good overall performance instead of focusing on a variety of specific events. In this study, we use an approach that focuses on the evaluation of specific events and characteristics. Eight international research groups calibrated their hourly model on the Ourthe catchment in Belgium and carried out a validation in time for the Ourthe catchment and a validation in space for nested and neighbouring catchments. The same protocol was followed for each model and an ensemble of best-performing parameter sets was selected. Although the models showed similar performances based on general metrics (i.e. the Nash-Sutcliffe efficiency), clear differences could be observed for specific events. We analysed the hydrographs of these specific events and conducted three types of statistical analyses on the entire time series: cumulative discharges, empirical extreme value distribution of the peak flows and flow duration curves for low flows. The results illustrate the relevance of including a very quick flow reservoir preceding the root zone storage to model peaks during low flows and including a slow reservoir in parallel with the fast reservoir to model the recession for the studied catchments. This intercomparison enhanced the understanding of the hydrological functioning of the catchment, in particular for low flows, and enabled to identify present knowledge gaps for other parts of the hydrograph. Above all, it helped to evaluate each model against a set of alternative models.

  13. German National Proficiency Scales in Biology: Internal Structure, Relations to General Cognitive Abilities and Verbal Skills

    Science.gov (United States)

    KÖLLER, OLAF

    2016-01-01

    ABSTRACT National and international large‐scale assessments (LSA) have a major impact on educational systems, which raises fundamental questions about the validity of the measures regarding their internal structure and their relations to relevant covariates. Given its importance, research on the validity of instruments specifically developed for LSA is still sparse, especially in science and its subdomains biology, chemistry, and physics. However, policy decisions for the improvement of educational quality based on LSA can only be helpful if valid information on students’ achievement levels is provided. In the present study, the nature of the measurement instruments based on the German Educational Standards in Biology is examined. On the basis of data from 3,165 students in Grade 10, we present dimensional analyses and report the relationship between different subdimensions of biology literacy and cognitive covariates such as general cognitive abilities and verbal skills. A theory‐driven two‐dimensional model fitted the data best. Content knowledge and scientific inquiry, two subdimensions of biology literacy, are highly correlated and show differential correlational patterns to the covariates. We argue that the underlying structure of biology should be incorporated into curricula, teacher training and future assessments. PMID:27818532

  14. GENERAL INFORMATION MEETING on the European Co-operative Association of International Civil Servants (AMFIE)

    CERN Multimedia

    HR Department

    2010-01-01

    Wednesday 29 September 2010 at 11h (160/1-009) Mr. Dimitri ARGYROPOULOS, Chairman of AMFIE's*) Board of Directors and Mrs. Janine RIVALS, Member of AMFIE's Board of Directors, will make a general presentation on AMFIE's personal financial services and how they may benefit international civil servants. They will also focus on the particular financial challenges faced by expatriate civil servants and on the solutions AMFIE can offer. The presentation will be followed by a question and answer session. Private consultations - 9:00 to 11:00 and 14:00 to 17:30 (5/1-030) Participants who wish to meet AMFIE's representatives for one-to-one private consultations are invited to contact directly Mrs. Janine Rivals (+33/1 45 35 70 79, GSM +33/6 63 58 36 62 or jr@amfie.org) or AMFIE's Secretariat in Luxembourg (+352/42 36 61-1 or amfie@amfie.org). A dedicated form will also be available for this purpose in the meeting room during the presentation. *)\tAMFIE is a cooperative society open exclusively to international ...

  15. General Information Meeting on the European Co-operative Association of International Civil Servants (AMFIE)

    CERN Multimedia

    HR Department

    2011-01-01

    Monday 28 November 2011 at 12h (61/1-009 – Pas Perdus, room C) Mrs. Janine RIVALS, Vice-Chairwoman of AMFIE's* Board of Directors and Mrs. Hélène ECKERT, coordinator for all international organisations in Switzerland, will make a general presentation on AMFIE's personal financial services and how they may benefit international civil servants. They will also focus on the particular financial challenges faced by expatriate civil servants and on the solutions AMFIE can offer. The presentation will be followed by a question and answer session. Private consultations – from 11:00 to 12:00 and from 14:00 to 17:30 (61/1-009 and 61/0-006) Participants who wish to meet AMFIE's representatives for one-to-one private consultations are invited to contact directly Mrs. Janine Rivals (+33/1 45 35 70 79, GSM +33/6 63 58 36 62 or jr@amfie.org) or AMFIE's Secretariat in Luxembourg (+352/42 36 61-1 or amfie@amfie.org). It will be possible to make an ...

  16. Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey.

    Directory of Open Access Journals (Sweden)

    Hélène Dumesnil

    Full Text Available French general practitioners (GPs refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates.This qualitative study aims to explore general practitioners' (GP opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression.In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content.We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists.Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area.

  17. Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey

    Science.gov (United States)

    Dumesnil, Hélène; Apostolidis, Thémis; Verger, Pierre

    2018-01-01

    Background French general practitioners (GPs) refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates. Objectives This qualitative study aims to explore general practitioners' (GP) opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression. Methods In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content. Results We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists, Conclusion Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area. PMID:29385155

  18. Using an Adoption–Biological Family Design to Examine Associations Between Maternal Trauma, Maternal Depressive Symptoms, and Child Internalizing and Externalizing Behaviors

    Science.gov (United States)

    Grabow, Aleksandria Perez; Khurana, Atika; Natsuaki, Misaki N.; Neiderhiser, Jenae M.; Harold, Gordon T.; Shaw, Daniel S.; Ganiban, Jody M.; Reiss, David; Leve, Leslie D.

    2017-01-01

    Maternal trauma is a complex risk factor that has been linked to adverse child outcomes, yet the mechanisms underlying this association are not well understood. This study, which included adoptive and biological families, examined the heritable and environmental mechanisms by which maternal trauma and associated depressive symptoms are linked to child internalizing and externalizing behaviors. Path analyses were used to analyze data from 541 adoptive mother–adopted child (AM–AC) dyads and 126 biological mother–biological child (BM–BC) dyads; the two family types were linked through the same biological mother. Rearing mother’s trauma was associated with child internalizing and externalizing behaviors in AM–AC and BM–BC dyads, and this association was mediated by rearing mothers’ depressive symptoms, with the exception of biological child externalizing behavior, for which biological mother trauma had a direct influence only. Significant associations between maternal trauma and child behavior in dyads that share only environment (i.e., AM–AC dyads) suggest an environmental mechanism of influence for maternal trauma. Significant associations were also observed between maternal depressive symptoms and child internalizing and externalizing behavior in dyads that were only genetically related, with no shared environment (i.e., BM–AC dyads), suggesting a heritable pathway of influence via maternal depressive symptoms. PMID:29162177

  19. NATO International Conference on Applied General Systems Research : Recent Developments and Trends

    CERN Document Server

    1978-01-01

    This volume consists of a selection of papers presented at the International Conference on Applied General Systems Research: Recent Developments and Trends which was held on the campus of the State University of New York at Binghamton in August 15-19, 1977, under the sponsorship of the Special Panel on Systems Science of the NATO Scientific Affairs Division. General systems research is a fairly new field which has been developing in the course of the last two or three decades. In my op~n10n, it can be best described as a movement which involves the study of all structural and context independent aspects of problem solving. As such, it is cross-disciplinary in nature and, in this sense, it might seem similar to mathematics. There is a consid­ erable difference, however, between the two. While pure mathe­ matics is basically oriented to the development of various axiomatic theories, regardless of whether or not they have any real world meaning, applied mathematics explores the applicability of some of these t...

  20. Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center.

    Science.gov (United States)

    Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah

    2015-09-01

    Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values quality measures in cancer hospitals. Copyright © 2015 by American Society of Clinical Oncology.

  1. Validity of the brief Zung's scale for screening major depressive episode among the general population from Bucaramanga, Colombia Validez de la escala breve de Zung para tamizaje del episodio depresivo mayor en la población general de Bucaramanga, Colombia

    OpenAIRE

    Luis Alfonso Díaz; Adalberto Campo; Germán Eduardo Rueda

    2011-01-01

    Introduction. Brief scales for identiying depressive disorder are as useful as long scales for screening. However, a validated scale with these characteristics is not avalaible in Colombia.
    Objective. To design a brief Zung's self-rating depression scale in order to screen major depressive episodes among adults dwelling in the general community.
    Materials and methods. After filling-out the 20-item Zung's self-rating depression scale, the ten items with the higher correl...

  2. Perspectiva internacional del uso de la teoría general de Orem International perspective relative to Orem General Theory

    Directory of Open Access Journals (Sweden)

    Alba Lucero López Díaz

    2006-09-01

    Full Text Available Objetivos: caracterizar y analizar artículos que utilizan la Teoría General de Enfermería de Orem en el período de 1992 a 2001. Diseño y metodología: estudio documental sobre 108 artículos encontrados en las bases de datos: MEDLINE, OVID, PROQUEST y el Catálogo Colectivo Nacional de Publicaciones Seriadas- Hemeroteca Nacional (Colombia. Fueron seleccionados 74 artículos que utilizaron alguna de las teorías de Orem o conceptos de la Teoría General de Orem. Resultados: la Teoría General de Orem ha sido utilizada en cuatro continentes; 38 (51,3% estudios la aplican en el ámbito institucional y 21 (28,4% en la comunidad. Los adultos y ancianos son los grupos de edad con mayor reporte en los estudios (47,3%. Los métodos cuantitativos de investigación son los más utilizados (69 estudios, 93,2%. Conclusión: los estudios exploran o correlacionan conceptos de la Teoría General de Orem, el desarrollo de instrumentos y la validación de constructos teóricos. La evidencia empírica sobre la aplicación de la Teoría General de Orem muestra su importancia en el desarrollo del conocimiento en enfermería e indica su gran utilidad para la investigación y práctica de enfermería.Objective: analysis and characterization of articles about Orem General Theory used between 1992 to 2001. Methodology and Materials: documental study about 108 articles recorded in Medline, Ovid, Proquest databases and in the National Colective Catalogue of Periodicals Colombian newspapers library. Seventy four articles using some Orem’s General Theory were selected. Results: Orem’s General Theory has been applied in four continents. Thirty eight studies (51.3% use it in the institutional environment and 21 (28.4% in the community. Adults and senior citizens are the age groups more reported (47.3%. Quantitative research methods are the most common. Conclusions: sixty nine studies explore or correlate concepts from Orem’s General Theory, the development of

  3. Validity of the brief Zung's scale for screening major depressive episode among the general population from Bucaramanga, Colombia Validez de la escala breve de Zung para tamizaje del episodio depresivo mayor en la población general de Bucaramanga, Colombia

    Directory of Open Access Journals (Sweden)

    Luis Alfonso Díaz

    2011-05-01

    Full Text Available Introduction. Brief scales for identiying depressive disorder are as useful as long scales for screening. However, a validated scale with these characteristics is not avalaible in Colombia.
    Objective. To design a brief Zung's self-rating depression scale in order to screen major depressive episodes among adults dwelling in the general community.
    Materials and methods. After filling-out the 20-item Zung's self-rating depression scale, the ten items with the higher correlation with total score were selected. Construct and criterion validity were computed for these ten items.
    Results. The ten chosen items showed an internal consistency of 0,803, one factor that accounted for 36,6% of the variance; sensitivity was 95,5%; specificity, 70,3%; Cohen's kappa, 0,415; and area under receptor-operator curve, 0,898.
    Conclusions. The brief Zung's self-rating depression scale exhibits psychometric properties similar to the long version. This brief scale can be used as a screening device in the general population.

    Introducción. Las escalas breves para identificar trastornos depresivos conservan la utilidad de las escalas extensas como instrumentos para tamizaje. Sin embargo, no se cuenta con una escala de estas características validada en población general colombiana.
    Objetivo. Diseñar una escala abreviada de la escala de Zung para depresión para tamizaje de episodio depresivo mayor en adultos residentes en la comunidad general.
    Materiales y métodos. A partir de la aplicación de la escala de Zung de veinte items se tomaron los diez items que mostraron la mayor correlación con la puntuación total. A estos items escogidos se les determinó la validez de constructo y la validez de criterio.
    Resultados. Los diez items escogidos mostraron una consistencia interna de 0,803, un único factor principal que explicaba el 36,6% de la varianza y sensibilidad de 95,5%, especificidad de 70,3%, kappa media de Cohen de 0

  4. Influences of general self-efficacy and weight bias internalization on physical activity in bariatric surgery candidates.

    Science.gov (United States)

    Hübner, Claudia; Baldofski, Sabrina; Zenger, Markus; Tigges, Wolfgang; Herbig, Beate; Jurowich, Christian; Kaiser, Stefan; Dietrich, Arne; Hilbert, Anja

    2015-01-01

    Physical activity (PA) seems to be important for long-term weight loss after bariatric surgery; however, studies provide evidence for insufficient PA levels in bariatric patients. Research found self-efficacy to be associated with PA and weight bias internalization, for which an influence on mental and physical health has been shown in recent studies. The purpose of the present study was to investigate the influence of general self-efficacy on PA, mediated by weight bias internalization. In 179 bariatric surgery candidates, general self-efficacy, weight bias internalization, and different intensities of PA were assessed by self-report questionnaires. Structural equation modeling was used to analyze the assumed mediational relationship. After controlling for sociodemographic variables, weight bias internalization fully mediated the association between general self-efficacy and moderate-intense as well as vigorous-intense PA. Lower general self-efficacy predicted greater weight bias internalization, which in turn predicted lower levels of moderate-intense and vigorous-intense PA. The results suggest an influence of weight bias internalization on preoperative PA in bariatric surgery candidates. Subsequently, implementation of interventions addressing weight bias internalization in the usual treatment of bariatric surgery candidates might enhance patients' preoperative PA, while longitudinal analyses are needed to further examine its predictive value on PA after bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  5. The responsiveness of the International Prostate Symptom Score, Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scale-21 in patients with lower urinary tract symptoms.

    Science.gov (United States)

    Choi, Edmond P H; Chin, Weng Yee; Lam, Cindy L K; Wan, Eric Y F

    2015-08-01

    To examine the responsiveness of a combined symptom severity and health-related quality of life measure, condition-specific health-related quality of life measure and mental health measure in patients with lower urinary tract symptoms. To establish the responsiveness of measures that accurately capture the change in health status of patients is crucial before any longitudinal studies can be appropriately planned and evaluated. Prospective longitudinal observational study. 402 patients were surveyed at baseline and 1-year using the International Prostate Symptom Score, the Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scales-21. The internal and external responsiveness were assessed. Surveys were conducted from March 2013-July 2014. In participants with improvements, the internal responsiveness for detecting positive changes was satisfactory in males and females for all scales, expect for the Depression subscale. The health-related quality of life question of the International Prostate Symptom Score was more externally responsive than the Incontinence Impact Questionnaire-7. The International Prostate Symptom Score and Anxiety and Stress subscales were more responsive in males than in females. The symptom questions of the International Prostate Symptom Score and Anxiety and Stress subscales were not externally responsive in females. The health-related quality of life question of the International Prostate Symptom Score outperformed the Incontinence Impact Questionnaire-7 in both males and females, in terms of external responsiveness. © 2015 John Wiley & Sons Ltd.

  6. Statement of the Director General to the forty-third regular session of the General Conference of the International Atomic Energy Agency

    International Nuclear Information System (INIS)

    ElBaradei, M.

    1999-01-01

    In his Statement on the forty-third regular session of the General Conference of the IAEA, the Director General of the Agency presented the past, present and future programme of the Agency in terms of the three 'pillars' that constitute its mandate: Nuclear technology (with emphasis on nuclear power and nuclear applications); Nuclear, radiation and waste safety (with emphasis on international conventions prescribing the basic legal norms for the safe use of nuclear energy, internationally accepted safety standards, and measures to assist Member States in the implementation of these conventions and standards, including technological solutions for improving safety); Nuclear verification and the security of material (with emphasis on IAEA safeguards, and physical protection of nuclear material), including possible new verification activities and specific verification issues (Iraq, DPRK, Middle East region). The Director General also touched in his Statement on two supporting elements that undergird these 'pillars': effective interaction with partners and the public, and achieving excellence in management

  7. Association of oral health related quality of life with dental anxiety and depression along with general health among people of Bhopal district, Madhya Pradesh

    Science.gov (United States)

    Shet, RGK; Jain, Gaurvi; Maroli, Sohani; Srivastava, Kirti Jajoo; Kasina, Sitaram Prasad; Shwetha, GS

    2013-01-01

    Background: To associate oral health related quality of life with dental anxiety and depression along with general health among people of Bhopal district, Madhya Pradesh. Materials & Methods: A cross sectional questionnaires based survey was conducted among the subjects of Bhopal district, Madhya Pradesh. The survey was carried among 101 subjects aging from 20-40 years. Subjects under investigation were belonging to various occupations. They were assigned a questionnaire. Questionnaire consisted of four parts, first part consists of socio-demographic data along with dental visiting habits, second part has OHqOL-questionnaire, third part has general health (sf-12) and fourth part has hospital anxiety and depression questionnaire. Questionnaire was used for assessment of OHqOL. It consists of 16 questions which takes into account both effect and impact of oral health on quality of life. Dental anxiety and depression was measured by Hospital Anxiety and Depression Scale. Each question was provided with four options and numbering ranging from 0-3. For general health consideration sf-12 v2 was being used, which calculates two values PCS and MCS giving result in percentage. Results: A large proportion of respondent perceived oral health as having an enhanced effect on their quality of life in all three aspects that is general health, social and psychological. This is in stark contrast to other studies, where only physical aspects of oral health were more frequently considered to have the greatest overall impact of life quality compared with items relating to social, psychological and general health aspects. Conclusion: Gender variations were not apparent in the study. Both genders were likely to perceive oral health as it is impacting strongly on their quality of life. No significant gender variations are seen. But both have specific oral health needs and are most likely to utilize dental services which may be the key in understanding oral health behavior, including

  8. Major depression and first-time hospitalization with ischemic heart disease, cardiac procedures and mortality in the general population

    DEFF Research Database (Denmark)

    Gasse, Christiane; Laursen, Thomas M; Baune, Bernhard T

    2014-01-01

    -59 years of age and during the first weeks following psychiatric admission. Our findings support recent cardiovascular disease prevention guidelines on assessing depression among other psychosocial factors in patients at increased cardiovascular disease (CVD) risk.......Objective: We investigated the association between unipolar depression and incident hospital admissions due to ischemic heart disease, invasive cardiac procedures and mortality independent of other medical illnesses.Methods: A population-based cohort of 4.6 million persons aged 15 years or older...... with depression (women: IRR: 1.38; MRR: 2.35; men: IRR: 1.42; MRR: 2.67). One-year mortality after new ischemic heart disease was elevated by 34% in women and men. By contrast, overall rates of invasive cardiac procedures following cardiac hospitalizations were significantly decreased by 34% in persons...

  9. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery.

    Science.gov (United States)

    Matini, Diana; Ghanbari Jolfaei, Atefeh; Pazouki, Abdolreza; Pishgahroudsari, Mohadeseh; Ehtesham, Mehdi

    2014-01-01

    Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery. This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded. In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (pdepression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period. Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.

  10. Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey.

    Science.gov (United States)

    Linzer, Mark; Poplau, Sara; Babbott, Stewart; Collins, Tracie; Guzman-Corrales, Laura; Menk, Jeremiah; Murphy, Mary Lou; Ovington, Kay

    2016-09-01

    General internal medicine (GIM) careers are increasingly viewed as challenging and unsustainable. We aimed to assess academic GIM worklife and determine remediable predictors of stress and burnout. We conducted an email survey. Physicians, nurse practitioners, and physician assistants in 15 GIM divisions participated. A ten-item survey queried stress, burnout, and work conditions such as electronic medical record (EMR) challenges. An open-ended question assessed stressors and solutions. Results were categorized into burnout, high stress, high control, chaos, good teamwork, high values alignment, documentation time pressure, and excessive home EMR use. Frequencies were determined for national data, Veterans Affairs (VA) versus civilian populations, and hospitalist versus ambulatory roles. A General Linear Mixed Model (GLMM) evaluated associations with burnout. A formal content analysis was performed for open-ended question responses. Of 1235 clinicians sampled, 579 responded (47 %). High stress was present in 67 %, with 38 % burned out (burnout range 10-56 % by division). Half of respondents had low work control, 60 % reported high documentation time pressure, half described too much home EMR time, and most reported very busy or chaotic workplaces. Two-thirds felt aligned with departmental leaders' values, and three-quarters were satisfied with teamwork. Burnout was associated with high stress, low work control, and low values alignment with leaders (all p less burnout than civilian counterparts (17 % vs. 40 %, p stress and burnout, division rates vary widely. Sustainability efforts within GIM could focus on visit length, staff support, schedule control, clinic chaos, and EMR stress.

  11. Genetic moderation of child maltreatment effects on depression and internalizing symptoms by 5-HTTLPR, BDNF, NET, and CRHR1 genes in African-American children

    Science.gov (United States)

    Cicchetti, Dante; Rogosch, Fred A.

    2014-01-01

    Genetic moderation of the effects of child maltreatment on depression and internalizing symptoms was investigated in a sample of low-income maltreated and nonmaltreated African-American children (N = 1,096). Lifetime child maltreatment experiences were independently coded from Child Protective Services records and maternal report. Child depression and internalizing problems were assessed in the context of a summer research camp by self-report (Children’s Depression Inventory, CDI) and adult counselor-report (Teacher Report Form, TRF). DNA was obtained from buccal cell or saliva samples and genotyped for polymorphisms of the following genes: 5-HTTLPR, BDNF, NET, and CRHR1. ANCOVAs with age and gender as covariates were conducted, with maltreatment status and respective polymorphism as main effects and their GxE interactions. Maltreatment consistently was associated with higher CDI and TRF symptoms. Results for child self-report symptoms indicated a GxE interaction for BDNF and maltreatment. Additionally, BDNF and tri-allelic 5-HTTLPR interacted with child maltreatment in a GxGxE interaction. Analyses for counselor-report of child anxiety/depression symptoms on the TRF indicated moderation of child maltreatment effects by tri-allelic 5-HTTLPR. These effects were elaborated based on variation in developmental timing of maltreatment experiences. NET was found to further moderate the GxE interaction of 5-HTTLPR and maltreatment status revealing a GxGxE interaction. This GxGxE was extended by consideration of variation in maltreatment subtype experiences. Finally, GxGxE effects were observed for the co-action of BDNF and the CRHR1 haplotype. The findings illustrate the variable influence of specific genotypes in GxE interactions based on variation in maltreatment experiences and the importance of a multi-genic approach for understanding influences on depression and internalizing symptoms among African-American children. PMID:25422957

  12. A scientometric study of general internal medicine domain among muslim countries of middle East (1991 - 2011).

    Science.gov (United States)

    Hodhodinezhad, Niloofar; Zahedi, Razieh; Ashrafi-rizzi, Hassan; Shams, Asadollah

    2013-03-01

    The position of General Internal Medicine in the Islamic countries in the Middle East has been investigated in the present study. The scientific productions of the countries in the area on Web of science database during 1990-2011 constitute were examined. The result of the survey showed that the share of these countries in world scientific productions is very low. Turkey, Saudi Arabia and Iran are the first to third ones in this domain in order. In view of annual growth rate, Kuwait having high growth rate, is the first one. Libya and Syria are the next ones. The scientific poverty line of Islamic countries in the area was surveyed. The result showed that in view of the scientific poverty line, the highest is Kuwait with the population of 0.04 percent of the world. Next to it, Saudi Arabia and Bahrain are the second and third ones. The results of this research showed that the share of Islamic countries in the Middle East in scientific production of this medicine domain is very low. It needs to be paid more attention by the countries in the area.

  13. Diagnosing somatisation disorder (P75) in routine general practice using the International Classification of Primary Care.

    Science.gov (United States)

    Schaefert, Rainer; Laux, Gunter; Kaufmann, Claudia; Schellberg, Dieter; Bölter, Regine; Szecsenyi, Joachim; Sauer, Nina; Herzog, Wolfgang; Kuehlein, Thomas

    2010-09-01

    (i) To analyze general practitioners' diagnosis of somatisation disorder (P75) using the International Classification of Primary Care (ICPC)-2-E in routine general practice. (ii) To validate the distinctiveness of the ICD-10 to ICPC-2 conversion rule which maps ICD-10 dissociative/conversion disorder (F44) as well as half of the somatoform categories (F45.0-2) to P75 and codes the other half of these disorders (F45.3-9), including autonomic organ dysfunctions and pain syndromes, as symptom diagnoses plus a psychosocial code in a multiaxial manner. Cross-sectional analysis of routine data from a German research database comprising the electronic patient records of 32 general practitioners from 22 practices. For each P75 patient, control subjects matched for age, gender, and practice were selected from the 2007 yearly contact group (YCG) without a P75 diagnosis using a propensity-score algorithm that resulted in eight controls per P75 patient. Of the 49,423 patients in the YCG, P75 was diagnosed in 0.6% (302) and F45.3-9 in 1.8% (883) of cases; overall, somatisation syndromes were diagnosed in 2.4% of patients. The P75 coding pattern coincided with typical characteristics of severe, persistent medically unexplained symptoms (MUS). F45.3-9 was found to indicate moderate MUS that otherwise showed little clinical difference from P75. Pain syndromes exhibited an unspecific coding pattern. Mild and moderate MUS were predominantly recorded as symptom diagnoses. Psychosocial codes were rarely documented. ICPC-2 P75 was mainly diagnosed in cases of severe MUS. Multiaxial coding appears to be too complicated for routine primary care. Instead of splitting P75 and F45.3-9 diagnoses, it is proposed that the whole MUS spectrum should be conceptualized as a continuum model comprising categorizations of uncomplicated (mild) and complicated (moderate and severe) courses. Psychosocial factors require more attention. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  14. Are Canadian General Internal Medicine training program graduates well prepared for their future careers?

    Directory of Open Access Journals (Sweden)

    Snell Linda

    2006-11-01

    Full Text Available Abstract Background At a time of increased need and demand for general internists in Canada, the attractiveness of generalist careers (including general internal medicine, GIM has been falling as evidenced by the low number of residents choosing this specialty. One hypothesis for the lack of interest in a generalist career is lack of comfort with the skills needed to practice after training, and the mismatch between the tertiary care, inpatient training environment and "real life". This project was designed to determine perceived effectiveness of training for 10 years of graduates of Canadian GIM programs to assist in the development of curriculum and objectives for general internists that will meet the needs of graduates and ultimately society. Methods Mailed survey designed to explore perceived importance of training for and preparation for various aspects of Canadian GIM practice. After extensive piloting of the survey, including a pilot survey of two universities to improve the questionnaire, all graduates of the 16 universities over the previous ten years were surveyed. Results Gaps (difference between importance and preparation were demonstrated in many of the CanMEDS 2000/2005® competencies. Medical problems of pregnancy, perioperative care, pain management, chronic care, ambulatory care and community GIM rotations were the medical expert areas with the largest gaps. Exposure to procedural skills was perceived to be lacking. Some procedural skills valued as important for current GIM trainees and performed frequently (example ambulatory ECG interpretation had low preparation ratings by trainees. Other areas of perceived discrepancy between training and practice included: manager role (set up of an office, health advocate (counseling for prevention, for example smoking cessation, and professional (end of life issues, ethics. Conclusion Graduates of Canadian GIM training programs over the last ten years have identified perceived gaps

  15. Anhedonia in depressed patients on treatment with selective serotonin reuptake inhibitor anti-depressant--A two-centered study in Malaysia.

    Science.gov (United States)

    Yee, Anne; Chin, Soo Cheng; Hashim, Aili Hanim bt; Harbajan Singh, Manveen Kaur A P; Loh, Huai Seng; Sulaiman, Ahmad Hatim; Ng, Chong Guan

    2015-01-01

    Anhedonia is the reduced ability to experience pleasure. It is a core symptom of depression and is particularly difficult to treat. This study aims to compare the level of anhedonia between depressed patients on anti-depressants and healthy subjects. A total of 111 depressed patients on selective serotonin reuptake inhibitor (SSRI) and 82 healthy subjects were recruited from the outpatient psychiatric services at two major general hospitals in a cross-sectional study. Subjects were assessed using the Mini International Neuropsychiatric Interview 5.0.0 or MINI, Beck's Depression Index (BDI), and Snaith-Hamilton Pleasure Scale (SHAPS). Relevant personal and sociodemographic information were also collected. There was a significant association between educational level and SHAPS-M scores (P depressed subjects treated with anti-depressant compared with the healthy subjects, after adjusting the confounding factors, BDI score, and educational level. Anhedonia often persists in depressed patients despite on SSRI anti-depressant treatment.

  16. Dietary sodium, added salt, and serum sodium associations with growth and depression in the U.S. general population.

    Science.gov (United States)

    Goldstein, Pavel; Leshem, Micah

    2014-08-01

    It is not known why salt is so attractive to humans. Here, guided by hypotheses suggesting that the attraction of salt is conditioned by postingestive benefits, we sought to establish whether there are such benefits in a population by analyzing the National Health and Nutrition Examination Survey (NHANES) 2007-2008 database (n = ~ 10,000). We focus on two potential benefits supported by the literature, growth and moderation of depression, and examine their relationship to sodium, dietary, added at table, and serum. We find that during growth (sodium intake, independent of caloric or other electrolyte intakes. We find that adding salt and depression are related. In contrast, and in women only, dietary sodium and depression are inversely related. The relationships are correlational, but we speculate that this constellation may reflect self-medication for depression by adding salt, and that men may be protected by their higher dietary sodium intake. Additional findings are that women add more salt than men below age ~30, after which men add more, and below 40 years of age, serum sodium is lower in women than in men. It remains possible that small but beneficial effects of sodium could condition salt preference and thus contribute to population-wide sodium intake. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Anxiety and depression in breast cancer patients at low risk of recurrence compared with the general population: a valid comparison?

    NARCIS (Netherlands)

    Groenvold, M.; Fayers, P. M.; Sprangers, M. A.; Bjorner, J. B.; Klee, M. C.; Aaronson, N. K.; Bech, P.; Mouridsen, H. T.

    1999-01-01

    Breast cancer and its treatment have been associated with psychological morbidity. In this study our aim was to quantify the excess anxiety and depression resulting from breast cancer. We compared 538 newly diagnosed breast cancer patients at low risk of recurrence (87.0% responded) to 872 women

  18. The association of depressive symptoms and physical diseases in Switzerland: a cross-sectional general population study

    Directory of Open Access Journals (Sweden)

    Donja eRodic

    2015-03-01

    Full Text Available Objective: To estimate the association between depressive symptoms and physical diseases in Switzerland, as respective findings might inform about future estimates of mental and physical health care costs.Methods: A population-based study, using data from the Swiss Health Survey collected by computer assisted telephone interviews and additional written questionnaires during the year 2007 (n = 18,760 in Switzerland. The multistage stratified random sample included subjects aged 15 and older, living in a private Swiss household with a telephone connection. Complete data was available for 14,348 subjects (51% of all subjects reached by telephone. Logistic regression analyses were used to estimate the associations between depressive symptoms and any physical disease, or a specific physical disease out of 13 non-communicable physical diseases assessed with a self-report checklist on common physical diseases. Analyses were adjusted for sex, age, education, occupation and household income. Results: In the adjusted models depressive symptoms were associated with arthrosis and arthritis (Odds Ratio [OR] = 1.79, 95% Confidence Interval [CI] = 1.28−2.50 and any physical disease (OR = 1.67, 95% CI = 1.33−2.10 after controlling for multiple testing.Conclusion: Our findings contribute to a better understanding of the comorbidity of depressive symptoms and arthrosis and arthritis in Switzerland and might have implications for more precise future estimates of mental and physical health care costs.

  19. Using a hybrid subtyping model to capture patterns and dimensionality of depressive and anxiety symptomatology in the general population

    NARCIS (Netherlands)

    Wardenaar, Klaas J.; Wanders, Rob B. K.; ten Have, Margreet; de Graaf, Ron; de Jonge, Peter

    Background: Researchers have tried to identify more homogeneous subtypes of major depressive disorder (MDD) with latent class analyses (LCA). However, this approach does no justice to the dimensional nature of psychopathology. In addition, anxiety and functioning-levels have seldom been integrated

  20. General internal medicine at the crossroads of prosperity and despair: caring for patients with chronic diseases in an aging society.

    Science.gov (United States)

    Larson, E B

    2001-05-15

    During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice becomes increasingly effective, it has become much more difficult for them to earn a living. General internists find themselves at the crossroads of prosperity and despair. Although general medicine research leads the research agenda in many departments of medicine, it is particularly vulnerable. The necessary multidisciplinary "programmatic" infrastructure is expensive, and results often take many years to obtain, particularly in the study of chronic disease. The educational environment in many institutions is particularly difficult for general medicine, both because the current emphasis on technical skills obscures patients' and learners' real needs and because complex patients on general medicine services are now so ill and their turnover so rapid. General internal medicine and geriatrics are synergistic, especially in today's marketplace. A focus on geriatric medicine could help general medicine continue to flourish. General internists are ideally suited to the integrated care of elderly patients with multiple problems, research opportunities are enormous in the geriatric population, and the teaching of geriatrics requires a high level of generalist skills. Problems that plague current generalist practice have unique significance to older patients. Organizations that represent general internists would do well to join forces with many other advocacy groups, especially those representing the interests of elderly patients and geriatric medicine.

  1. Process Evaluation to Explore Internal and External Validity of the "Act in Case of Depression" Care Program in Nursing Homes

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.F.J.

    2012-01-01

    Background: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): " Act in case of Depression" (AiD). Objective: Before effect analyses, to evaluate AiD

  2. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD

  3. 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...

  4. International recommendations[General radiation protection background to protective measures against foodstuffs contaminated with radioactive substances

    Energy Technology Data Exchange (ETDEWEB)

    Lindell, Bo [Swedish National Institute of Radiation Protection (Sweden)

    1986-07-01

    Full text: This short presentation will indicate the general radiation protection background to protective measures against foodstuffs contaminated with radioactive substances. A number of international organizations are involved in various aspects of radiation protection, for example, the International Atomic Energy Agency (IAEA), the United Nations Food and Agriculture Organization (FAO), the United Nations Environment Programme (UNEP), and the World Health Organization (WHO). Two international organizations, however, provide the basic background. These are the International Commission on Radiological Protection (ICRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). UNSCEAR provides the scientific information on radiation levels and effects. It consists of 21 member countries, with truly international coverage. It issues reports to the UN General Assembly, including comprehensive scientific annexes. Its latest comprehensive report was issued in 1982, the next is expected to be published in 1988. That report will include an assessment of the radiological consequences of the Chernobyl accident. The ICRP is a non-governmental organization. It has issued recommendations on radiation protection since 1928. The postulated biological basis for radiation protection recommendations involves two types of biological effects. The so-called non-stochastic effects, mainly due to cell death, appear only when the radiation doses exceed a certain threshold value. These effects, therefore, can only appear after high accidental exposures. After the Chernobyl accident, they only affected about 200 individuals involved in fire extinction and rescue work at the damaged nuclear power plant. Stochastic effects, with some simplification, may be seen as the result of initial changes in the genetic code of some surviving cells. If these cells are germ cells, this may lead to hereditary harm. If they are somatic cells, the result could be cancer

  5. Female residents experiencing medical errors in general internal medicine: a qualitative study.

    Science.gov (United States)

    Mankaka, Cindy Ottiger; Waeber, Gérard; Gachoud, David

    2014-07-10

    Doctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today's approach to errors emphasizes systemic factors. Doctors' individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital. Within a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed. Seven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one's own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience. This study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our interviews with female residents convey the

  6. The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care

    DEFF Research Database (Denmark)

    Nielsen, Marie Germund; Ørnbøl, Eva; Bech, Per

    2017-01-01

    the web-based MDI in a primary care setting. The validation was based on the Munich-Composite International Diagnostic Interview (M-CIDI) by phone. GPs in the 22 practices in our study included 132 persons suspected of depression. Depression was rated as yes/no according to the MDI and M-CIDI. Sensitivity......BACKGROUND: The Major Depression Inventory (MDI) is widely used in Danish general practice as a screening tool to assess depression in symptomatic patients. Nevertheless, no validation studies of the MDI have been performed. The aim of this study was to validate the web-based version of the MDI...... against a fully structured telephone interview in a population selected on clinical suspicion of depression (ie, presence of two or three core symptoms of depression) in general practice. MATERIALS AND METHODS: General practitioners (GPs) invited consecutive persons suspected of depression to complete...

  7. Cortisol in the morning and dimensions of anxiety, depression, and aggression in children from a general population and clinic-referred cohort: An integrated analysis. The TRAILS study.

    Science.gov (United States)

    Dietrich, Andrea; Ormel, Johan; Buitelaar, Jan K; Verhulst, Frank C; Hoekstra, Pieter J; Hartman, Catharina A

    2013-08-01

    Anxiety and depressive problems have often been related to higher hypothalamic-pituitary-adrenal (HPA)-axis activity (basal morning cortisol levels and cortisol awakening response [CAR]) and externalizing problems to lower HPA-axis activity. However, associations appear weaker and more inconsistent than initially assumed. Previous studies from the Tracking Adolescents Individual Lives Study (TRAILS) suggested sex-differences in these relationships and differential associations with specific dimensions of depressive problems in a general population sample of children (10-12 years). Using the TRAILS population sample (n=1604), we tested hypotheses on the association between single day cortisol (basal morning levels and CAR) and specifically constructed dimensions of anxiety (cognitive versus somatic), depressive (cognitive-affective versus somatic), and externalizing problems (reactive versus proactive aggression), and explored the modifying role of sex. Moreover, we repeated analyses in an independent same-aged clinic-referred sample (n=357). Structural Equation Modeling was used to investigate the association between cortisol and higher- and lower-order (thus, broad and specific) problem dimensions based on self-reports in an integrated model. Overall, findings were consistent across the population and clinic-referred samples, as well as with the existing literature. Most support was found for higher cortisol (mainly CAR) in relation to depressive problems. However, in general, associations were weak in both samples. Therefore, the present results shed doubt on the relevance of single day cortisol measurements for problem behaviors in the milder range. Associations may be stronger in more severe or persistent psychopathology. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

    Science.gov (United States)

    Ruangkriengsin, Darat; Phisalprapa, Pochamana

    2014-03-01

    Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

  9. International common-cause failure data exchange. ICDE general coding guidelines - Technical note

    International Nuclear Information System (INIS)

    Johanson, Gunnar; Werner, Wolfgang; Concepcion Capote, Marina; Kreuser, Albert; Rasmuson, Dale; Jonsson, Esther; Pereira Pagan, Begona; Tirira, Jorge; Morris, Ian; Morales, Rosa; Oxberry, Anna; Kreuser, Albert

    2004-01-01

    Several Member countries of the Nuclear Energy Agency of the Organisation for Economic Co-operation and Development (OECD/NEA) have established the International Common-Cause Failure Data Exchange Project (ICDE Project) to encourage multilateral co-operation in the collection and analysis of data relating to Common-Cause Failure (CCF) events. The objectives of the ICDE Project are to: a) Collect and analyse CCF events over the long term so as to better understand such events, their causes, and their prevention; b) Generate qualitative insights into the root causes of CCF events which can then be used to derive approaches or mechanisms for their prevention or for mitigating their consequences; c) Establish a mechanism for the efficient feedback of experience gained in connection with CCF phenomena, including the development of defences against their occurrence, such as indicators for risk based inspections; and d) Record event attributes to facilitate quantification of CCF frequencies when so decided by the Project Working Group. The ICDE Project is envisaged to comprise all possible events of interest, including both complete and partial ICDE events. The ICDE Project will cover the key components of the main safety systems. Presently, the components listed below are included in the ICDE Project. Data have been collected for the six first components in the list: Centrifugal pumps, Diesel generators, Motor operated valves, Safety relief valves/power operated relief valves, Check valves, Batteries, Level measurement, Breakers, Control rod drive assemblies. Others will be added to this list later on. In this component coding guidelines, explanations on the ICDE General coding format are given. The guide reflects present experience with the data format and with the collected data. Further interpretations and clarifications will be added, should they become necessary. For each component analysed in the ICDE project, separate coding guidance is provided in the appendices

  10. International Common Cause Failure Data Exchange (ICDE). General Coding Guidelines - Updated Version, October 2011

    International Nuclear Information System (INIS)

    Johanson, Gunnar; Werner, Wolfgang; Capote, Marina Concepcion; Kreuser, Albert

    2012-01-01

    Several OECD/NEA member countries have established the International Common-Cause Failure Data Exchange Project ('ICDE Project') to encourage multilateral cooperation in the collection and analysis of data relating to Common-Cause Failure (CCF) events. The objectives of the ICDE Project are to: a) Collect and analyse CCF events over the long term so as to better understand such events, their causes, and their prevention. b) Generate qualitative insights into the root causes of CCF events which can then be used to derive approaches or mechanisms for their prevention or for mitigating their consequences. c) Establish a mechanism for the efficient feedback of experience gained in connection with CCF phenomena, including the development of defenses against their occurrence, such as indicators for risk based inspections. d) Record event attributes to facilitate quantification of CCF frequencies when so decided by the Project Working Group. The ICDE Project is envisaged to comprise all possible events of interest, including both complete and partial ICDE events. The ICDE Project will cover the key components of the main safety systems. Presently, the components listed below are included in the ICDE Project. Data have been collected for the six first components in the list: Centrifugal pumps, Diesel generators, Motor operated valves, Safety relief valves/power operated relief valves, Check valves, Batteries, Level measurement, Breakers, Control rod drive assemblies. Others will be added to this list later on. In this component coding guidelines, explanations on the ICDE general coding format are given. The guide reflects present experience with the data format and with the collected data. Further interpretations and clarifications will be added, should they become necessary. For each component analysed in the ICDE project, separate coding guidance is provided in the appendices ICDECG 01-06, specifying details relevant to the respective components

  11. The Koukopoulos Mixed Depression Rating Scale (KMDRS): An International Mood Network (IMN) validation study of a new mixed mood rating scale.

    Science.gov (United States)

    Sani, Gabriele; Vöhringer, Paul A; Barroilhet, Sergio A; Koukopoulos, Alexia E; Ghaemi, S Nassir

    2018-05-01

    It has been proposed that the broad major depressive disorder (MDD) construct is heterogenous. Koukopoulos has provided diagnostic criteria for an important subtype within that construct, "mixed depression" (MxD), which encompasses clinical pictures characterized by marked psychomotor or inner excitation and rage/anger, along with severe depression. This study provides psychometric validation for the first rating scale specifically designed to assess MxD symptoms cross-sectionally, the Koukopoulos Mixed Depression Rating Scale (KMDRS). 350 patients from the international mood network (IMN) completed three rating scales: the KMDRS, Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). KMDRS' psychometric properties assessed included Cronbach's alpha, inter-rater reliability, factor analysis, predictive validity, and Receiver Operator Curve analysis. Internal consistency (Cronbach's alpha = 0.76; 95% CI 0.57, 0.94) and interrater reliability (kappa = 0.73) were adequate. Confirmatory factor analysis identified 2 components: anger and psychomotor excitation (80% of total variance). Good predictive validity was seen (C-statistic = 0.82 95% CI 0.68, 0.93). Severity cut-off scores identified were as follows: none (0-4), possible (5-9), mild (10-15), moderate (16-20) and severe (> 21) MxD. Non DSM-based diagnosis of MxD may pose some difficulties in the initial use and interpretation of the scoring of the scale. Moreover, the cross-sectional nature of the evaluation does not verify the long-term stability of the scale. KMDRS was a reliable and valid instrument to assess MxD symptoms. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Internalized Homophobia and Drug Use in a National Cohort of Gay and Bisexual Men: Examining Depression, Sexual Anxiety, and Gay Community Attachment as Mediating Factors.

    Science.gov (United States)

    Moody, Raymond L; Starks, Tyrel J; Grov, Christian; Parsons, Jeffrey T

    2018-05-01

    The minority stress process of internalized homophobia (IH) has been associated with a range of adverse health outcomes among gay and bisexual men (GBM). However, evidence is mixed regarding the effect of IH on drug use, suggesting the potential role of multiple mediated pathways. Researchers have linked depression, sexual anxiety, and gay community attachment with IH. Depression, sexual anxiety, and gay community attachment have also been linked with drug use and drug-related problems suggesting potential mediating roles. A U.S. national sample of 1071 HIV-negative GBM completed at-home surveys, including measures of sociodemographic characteristics, IH, depression, sexual anxiety, gay community attachment, and drug use and associated problems. Adjusting for sociodemographic characteristics, depression mediated the association between IH and recent drug use. IH was positively associated with depression, and depression was positively associated with recent drug use. Gay community attachment partially mediated drug-related problems. IH had a positive direct association with drug-related problems and a negative direct association with gay community attachment. Gay community attachment had a positive association with drug-related problems. IH was positively associated with sexual anxiety, but sexual anxiety was not associated with either drug outcome. Efforts to reduce IH among HIV-negative GBM are likely to have a positive impact on mental health problems, as well as reduce risk for drug use and drug-related problems. Gay communities could provide the social support necessary for reducing IH; however, emphasis on community level interventions that address factors that increase risk for drug-related problems remains important.

  13. Evaluations of treatment efficacy of depression from perspective of both patients' symptoms and general sense of mental health and wellbeing: A large scale, multi-centered, longitudinal study in China.

    Science.gov (United States)

    Zeng, Qingzhi; Wang, Wei Chun; Fang, Yiru; Mellor, David; Mccabe, Marita; Byrne, Linda; Zuo, Sai; Xu, Yifeng

    2016-07-30

    Relying on the absence, presence of level of symptomatology may not provide an adequate indication of the effects of treatment for depression, nor sufficient information for the development of treatment plans that meet patients' needs. Using a prospective, multi-centered, and observational design, the present study surveyed a large sample of outpatients with depression in China (n=9855). The 17-item Hamilton Rating Scale for Depression (HRSD-17) and the Remission Evaluation and Mood Inventory Tool (REMIT) were administered at baseline, two weeks later and 4 weeks, to assess patients' self-reported symptoms and general sense of mental health and wellbeing. Of 9855 outpatients, 91.3% were diagnosed as experiencing moderate to severe depression. The patients reported significant improvement over time on both depressive symptoms and general sense after 4-week treatment. The effect sizes of change in general sense were lower than those in symptoms at both two week and four week follow-up. Treatment effects on both general sense and depressive symptomatology were associated with demographic and clinical factors. The findings indicate that a focus on both general sense of mental health and wellbeing in addition to depressive symptomatology will provide clinicians, researchers and patients themselves with a broader perspective of the status of patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  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. Evaluation of the effect of Spiritual care on patients with generalized anxiety and depression: a randomized controlled study.

    Science.gov (United States)

    Sankhe, A; Dalal, K; Save, D; Sarve, P

    2017-12-01

    The present study was conducted to assess the effect of spiritual care in patients with depression, anxiety or both in a randomized controlled design. The participants were randomized either to receive spiritual care or not and Hamilton anxiety rating scale-A (HAM-A), Hamilton depression rating scale-D (HAM-D), WHO-quality of life-Brief (WHOQOL-BREF) and Functional assessment of chronic illness therapy - Spiritual well-being (FACIT-Sp) were assessed before therapy and two follow-ups at 3 and 6 week. However, with regard to the spiritual care therapy group, statistically significant differences were observed in both HAM-A and HAM-D scales between the baseline and visit 2 (p scales during the follow-up periods for the control group of participants. When the scores were compared between the study groups, HAM-A, HAM-D and FACIT-Sp 12 scores were significantly lower in the interventional group as compared to the control group at both third and sixth weeks. This suggests a significant improvement in symptoms of anxiety and depression in the spiritual care therapy group than the control group; however, large randomized controlled trials with robust design are needed to confirm the same.

  16. The Generalized Internal/External Frame of Reference Model: An Extension to Dimensional Comparison Theory

    Science.gov (United States)

    Möller, Jens; Müller-Kalthoff, Hanno; Helm, Friederike; Nagy, Nicole; Marsh, Herb W.

    2016-01-01

    The dimensional comparison theory (DCT) focuses on the effects of internal, dimensional comparisons (e.g., "How good am I in math compared to English?") on academic self-concepts with widespread consequences for students' self-evaluation, motivation, and behavioral choices. DCT is based on the internal/external frame of reference model…

  17. Maternal depression and trajectories of child internalizing and externalizing problems: the roles of child decision making and working memory

    OpenAIRE

    Flouri, E.; Ruddy, A.; Midouhas, E.

    2017-01-01

    BACKGROUND: Maternal depression may affect the emotional/behavioural outcomes of children with normal neurocognitive functioning less severely than it does those without. To guide prevention and intervention efforts, research must specify which aspects of a child's cognitive functioning both moderate the effect of maternal depression and are amenable to change. Working memory and decision making may be amenable to change and are so far unexplored as moderators of this effect. METHOD: Our samp...

  18. Attributional Style and Depression in Multiple Sclerosis

    Science.gov (United States)

    Arnett, Peter A.

    2013-01-01

    Several etiologic theories have been proposed to explain depression in the general population. Studying these models and modifying them for use in the multiple sclerosis (MS) population may allow us to better understand depression in MS. According to the reformulated learned helplessness (LH) theory, individuals who attribute negative events to internal, stable, and global causes are more vulnerable to depression. This study differentiated attributional style that was or was not related to MS in 52 patients with MS to test the LH theory in this population and to determine possible differences between illness-related and non-illness-related attributions. Patients were administered measures of attributional style, daily stressors, disability, and depressive symptoms. Participants were more likely to list non-MS-related than MS-related causes of negative events on the Attributional Style Questionnaire (ASQ), and more-disabled participants listed significantly more MS-related causes than did less-disabled individuals. Non-MS-related attributional style correlated with stress and depressive symptoms, but MS-related attributional style did not correlate with disability or depressive symptoms. Stress mediated the effect of non-MS-related attributional style on depressive symptoms. These results suggest that, although attributional style appears to be an important construct in MS, it does not seem to be related directly to depressive symptoms; rather, it is related to more perceived stress, which in turn is related to increased depressive symptoms. PMID:24453767

  19. The disarmament agenda of the international community in 1994 and beyond. Statements of the Secretary-General

    International Nuclear Information System (INIS)

    Boutros Ghali, B.

    1994-04-01

    The document comprises two statements of the Secretary-General delivered in January 1994, conveys present thinking on possible approaches to be taken in the light of the events of the past year and views on a number of specific tasks that the international community must now carry out with a sense of urgency.

  20. Resident Advisor General Intelligence, Emotional Intelligence, Personality Dimensions, and Internal Belief Characteristics as Predictors of Rated Performance

    Science.gov (United States)

    Wu, Max B.; Stemler, Steven

    2008-01-01

    Resident Advisors (RAs) have a significant hand in helping students adjust and thrive in college life. Given the importance of selecting high-performing RAs, this study sought to examine how well various measures of intelligence (e.g., general, emotional) in addition to personality and additional "internal belief" characteristics predict…

  1. “Strength of Weak Ties,” Neighborhood Ethnic Heterogeneity, and Depressive Symptoms among Adults: A Multilevel Analysis of Korean General Social Survey (KGSS 2012

    Directory of Open Access Journals (Sweden)

    Harris Hyun-soo Kim

    2017-06-01

    Full Text Available A substantial body of research, based largely on North American and European contexts, demonstrates that social networks play a critical role in protecting and promoting mental, as well as physical, health. The purpose of this study is to examine how “weak” and “strong” network relations are differentially related to individual mental health (depressive symptoms based on a nationally representative sample of South Korean adults. Using multilevel analysis, the current research also investigates the extent to which contextual or neighborhood-level factors moderate the associations between depression and social network. Findings show that regular interaction with weaker ties (acquaintances, neighbors, coworkers, etc. are associated with better mental health. The number of strong ties (family members and friends, on the other hand, is not a significant predictor of psychological distress. In addition, a cross-level interaction term is observed: The negative relationship between weak ties and depressive symptoms is diminished in neighborhoods with more foreign-born residents or immigrants. General implications beyond the empirical case under investigation are discussed, as to why weak ties can be “strong” in relation to mental health and how this phenomenon can vary according to residential characteristics such as ethnic heterogeneity.

  2. Interprofessional communication with hospitalist and consultant physicians in general internal medicine: a qualitative study

    Directory of Open Access Journals (Sweden)

    Gotlib Conn Lesley

    2012-11-01

    Full Text Available Abstract Background Studies in General Internal Medicine [GIM] settings have shown that optimizing interprofessional communication is important, yet complex and challenging. While the physician is integral to interprofessional work in GIM there are often communication barriers in place that impact perceptions and experiences with the quality and quantity of their communication with other team members. This study aims to understand how team members’ perceptions and experiences with the communication styles and strategies of either hospitalist or consultant physicians in their units influence the quality and effectiveness of interprofessional relations and work. Methods A multiple case study methodology was used. Thirty-one semi-structured interviews were conducted with physicians, nurses and other health care providers [e.g. physiotherapist, social worker, etc.] working across 5 interprofessional GIM programs. Questions explored participants’ experiences with communication with all other health care providers in their units, probing for barriers and enablers to effective interprofessional work, as well as the use of communication tools or strategies. Observations in GIM wards were also conducted. Results Three main themes emerged from the data: [1] availability for interprofessional communication, [2] relationship-building for effective communication, and [3] physician vs. team-based approaches. Findings suggest a significant contrast in participants’ experiences with the quantity and quality of interprofessional relationships and work when comparing the communication styles and strategies of hospitalist and consultant physicians. Hospitalist staffed GIM units were believed to have more frequent and higher caliber interprofessional communication and collaboration, resulting in more positive experiences among all health care providers in a given unit. Conclusions This study helps to improve our understanding of the collaborative environment

  3. Mechanisms for the Negative Effects of Internalized HIV-Related Stigma on Antiretroviral Therapy Adherence in Women: The Mediating Roles of Social Isolation and Depression.

    Science.gov (United States)

    Turan, Bulent; Smith, Whitney; Cohen, Mardge H; Wilson, Tracey E; Adimora, Adaora A; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L; Foster, Antonina G; Metsch, Lisa; Tien, Phyllis C; Weiser, Sheri D; Turan, Janet M

    2016-06-01

    Internalization of HIV-related stigma may inhibit a person's ability to manage HIV disease through adherence to treatment regimens. Studies, mainly with white men, have suggested an association between internalized stigma and suboptimal adherence to antiretroviral therapy (ART). However, there is a scarcity of research with women of different racial/ethnic backgrounds and on mediating mechanisms in the association between internalized stigma and ART adherence. The Women's Interagency HIV Study (WIHS) is a multicenter cohort study. Women living with HIV complete interviewer-administered questionnaires semiannually. Cross-sectional analyses for the current article included 1168 women on ART for whom data on medication adherence were available from their last study visit between April 2013 and March 2014, when the internalized stigma measure was initially introduced. The association between internalized stigma and self-reported suboptimal ART adherence was significant for those in racial/ethnic minority groups (AOR = 0.69, P = 0.009, 95% CI: 0.52 to 0.91), but not for non-Hispanic whites (AOR = 2.15, P = 0.19, 95% CI: 0.69 to 6.73). Depressive symptoms, loneliness, and low perceived social support mediated the association between internalized stigma and suboptimal adherence in the whole sample, as well as in the subsample of minority participants. In serial mediation models, internalized stigma predicted less-perceived social support (or higher loneliness), which in turn predicted more depressive symptoms, which in turn predicted suboptimal medication adherence. Findings suggest that interconnected psychosocial mechanisms affect ART adherence, and that improvements in adherence may require multifaceted interventions addressing both mental health and interpersonal factors, especially for minority women.

  4. Bullying perpetration and victimization as externalizing and internalizing pathways: A retrospective study linking parenting styles and self-esteem to depression, alcohol use, and alcohol-related problems

    Science.gov (United States)

    Patock-Peckham, Julie A; Medina, Mia; Terrell, Nathan; Belton, Daniel; King, Kevin M

    2016-01-01

    Emerging research suggests significant positive associations between bullying and substance use behaviors. However, these studies typically focused either on the link between substance use and bullying perpetration or victimization, and few have conceptualized bullying perpetration and/or victimization as mediators. In this study, we simultaneously tested past bullying perpetration and victimization as mediational pathways from retrospective report of parenting styles and global self-esteem to current depressive symptoms, alcohol use and alcohol-related problems. Data were collected from a college sample of 419 drinkers. Mediation effects were conducted using a bias-corrected bootstrap technique in structural equation modeling. Two-path mediation analyses indicated that mother and father authoritativeness were protective against bully victimization and depression through higher self-esteem. Conversely, having a permissive or authoritarian mother was positively linked to bullying perpetration, which in turn was associated with increased alcohol use, and to a lesser degree, more alcohol-related problems. Mother authoritarianism was associated with alcohol-related problems through depressive symptoms. Three-path mediation analyses suggested a trend in which individuals with higher self-esteem were less likely to report alcohol-related problems through lower levels of bullying victimization and depression. Results suggested that bullying perpetration and victimization may respectively serve as externalizing and internalizing pathways through which parenting styles and self-esteem are linked to depression and alcohol-related outcomes. The present study identified multiple modifiable precursors of, and mediational pathways to, alcohol-related problems which could guide the development and implementation of prevention programs targeting problematic alcohol use. PMID:26757486

  5. Bullying Perpetration and Victimization as Externalizing and Internalizing Pathways: A Retrospective Study Linking Parenting Styles and Self-Esteem to Depression, Alcohol Use, and Alcohol-Related Problems.

    Science.gov (United States)

    Luk, Jeremy W; Patock-Peckham, Julie A; Medina, Mia; Terrell, Nathan; Belton, Daniel; King, Kevin M

    2016-01-02

    Emerging research suggests significant positive associations between bullying and substance use behaviors. However, these studies typically focused either on the link between substance use and bullying perpetration or victimization, and few have conceptualized bullying perpetration and/or victimization as mediators. In this study, we simultaneously tested past bullying perpetration and victimization as mediational pathways from retrospective report of parenting styles and global self-esteem to current depressive symptoms, alcohol use, and alcohol-related problems. Data were collected from a college sample of 419 drinkers. Mediation effects were conducted using a bias-corrected bootstrap technique within a structural equation modeling framework. Two-path mediation analyses indicated that mother and father authoritativeness were protective against bully victimization and depression through higher self-esteem. Conversely, having a permissive or authoritarian mother was positively linked to bullying perpetration, which in turn, was associated with increased alcohol use, and to a lesser degree, more alcohol-related problems. Mother authoritarianism was associated with alcohol-related problems through depressive symptoms. Three-path mediation analyses suggested a trend in which individuals with higher self-esteem were less likely to report alcohol-related problems through lower levels of bullying victimization and depression. Results suggested that bullying perpetration and victimization may, respectively, serve as externalizing and internalizing pathways through which parenting styles and self-esteem are linked to depression and alcohol-related outcomes. The present study identified multiple modifiable precursors of, and mediational pathways to, alcohol-related problems which could guide the development and implementation of prevention programs targeting problematic alcohol use.

  6. Is a history of work-related low back injury associated with prevalent low back pain and depression in the general population?

    Directory of Open Access Journals (Sweden)

    Cassidy J David

    2008-02-01

    Full Text Available Abstract Background Little is known about the role of prior occupational low back injury in future episodes of low back pain and disability in the general population. We conducted a study to determine if a lifetime history of work-related low back injury is associated with prevalent severity-graded low back pain, depressive symptoms, or both, in the general population. Methods We used data from the Saskatchewan Health and Back Pain Survey – a population-based cross-sectional survey mailed to a random, stratified sample of 2,184 Saskatchewan adults 20 to 69 years of age in 1995. Information on the main independent variable was gathered by asking respondents whether they had ever injured their low back at work. Our outcomes, the 6-month period prevalence of severity-graded low back pain and depressive symptoms during the past week, were measured with valid and reliable questionnaires. The associations between prior work-related low back injury and our outcomes were estimated through multinomial and binary multivariable logistic regression with adjustment for age, gender, and other important covariates. Results Fifty-five percent of the eligible population participated. Of the 1,086 participants who responded to the question about the main independent variable, 38.0% reported a history of work-related low back injury. A history of work-related low back injury was positively associated with low intensity/low disability low back pain (OR, 3.66; 95%CI, 2.48–5.42, with high intensity/low disability low back pain (OR, 4.03; 95%CI, 2.41–6.76, and with high disability low back pain (OR, 6.76; 95%CI, 3.80–12.01. No association was found between a history of work-related low back injury and depression (OR, 0.85; 95%CI, 0.55–1.30. Conclusion Our analysis shows an association between past occupational low back injury and increasing severity of prevalent low back pain, but not depression. These results suggest that past work-related low back injury

  7. [Is the orientation of patients suffering from depressive disorder to the psychiatric emergencies by a general practitioner associated with the decision to hospitalize?

    Science.gov (United States)

    Chrétien, P; Caillet, P; Bouazzaoui, F; Kaladjian, A; Younes, N; Sanchez, S

    2018-03-02

    Depressive disorders affect nearly 350 million people worldwide and are the world's leading cause of incapacity. Patients who are depressed preferentially approach their general practitioner (GP), who is their first point of contact, in 50-60% of cases. The aim of our study is to assess whether the orientation of patients suffering from anxiety-depressive disorder towards a GP in a general emergency is a factor associated with hospitalization when compared to patients who present themselves spontaneously for the same disorders. Our secondary objective was to identify the different profiles of patients who were hospitalized for these disorders as an emergency. We conducted a cross-sectional study for the year 2015, targeting patients who presented as general emergencies at the centre hospitalier de Troyes and who had received a psychiatric diagnosis in the context of an anxiety or depressive disorder. Five hundred and twenty four patients were included. A univariate analysis showed that referral by the attending physician was associated with hospitalization in 57.9% vs. 42.1% cases (P=0.007), at an odds ratio at 1.98 [1.22-3.21] by multivariate analysis. Analysis by ascending hierarchical classification made it possible to identify 3 profiles for hospitalized patients: 1) patients with a known psychiatric history, a history of past or current follow-ups directed by a psychiatrist, with at least one psychotropic treatment, the presence of psychotic symptoms and a low suicidal risk compared to the rest of the study population; 2) patients without a psychiatric history, or a history of past or ongoing psychiatric follow-up and the absence of ongoing psychotropic treatment. These patients were referred by a GP (67% vs 23%, P<0.001) and their suicidal risk was higher (59% vs 26%, P<0.001); 3) patients about whom the psychiatrist had little information at the time of the emergency consultation. The relevance of GPs in orientation towards emergencies pleads in favor of a

  8. 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

  9. Plasma fluoxetine concentrations and clinical improvement in an adolescent sample diagnosed with major depressive disorder, obsessive-compulsive disorder, or generalized anxiety disorder.

    Science.gov (United States)

    Blázquez, Ana; Mas, Sergi; Plana, Maria Teresa; Gassó, Patricia; Méndez, Iria; Torra, Mercè; Arnaiz, Joan Albert; Lafuente, Amàlia; Lázaro, Luisa

    2014-06-01

    Fluoxetine (FLX) has been one of the most widely studied selective serotonin reuptake inhibitors in adolescents. Despite its efficacy, however, 30% to 40% of patients do not respond to treatment. The aim of this study was to evaluate whether clinical improvement or adverse events are related to the corrected dose of FLX at 8 and 12 weeks after starting treatment in a sample of adolescents diagnosed with major depressive disorder, obsessive-compulsive disorder, or generalized anxiety disorder. Seventy-four subjects aged between 10 and 17 years participated in the study. Clinical improvement was measured with the Clinical Global Impression-Improvement Scale, whereas the UKU (Udvalg for Klinske Undersogelser) scale was administered to assess adverse effects of treatment. Fluoxetine per kilograms of body weight was related to serum concentration of FLX, NORFLX (norfluoxetine), FLX + NORFLX, and FLX/NORFLX. No relationship was found between dose-corrected FLX levels and therapeutic or adverse effects. No differences in serum concentrations were found between responders and nonresponders to treatment. Sex differences were observed in relation to dose and FLX serum concentration. The analysis by diagnosis revealed differences in FLX dose between obsessive-compulsive disorder patients and both generalized anxiety disorder and major depressive disorder patients. Fluoxetine response seems to be influenced by factors such as sex, diagnosis, or certain genes that might be involved in the drug's pharmacokinetics and pharmacodynamics. Clinical and pharmacogenetic studies are needed to elucidate further the differences between treatment responders and nonresponders.

  10. Pattern of cognitive impairment after giving total intravenous anaesthesia vs general anesthesia for electroconvulsive therapy in patients with depressive episode severe

    International Nuclear Information System (INIS)

    Malik, U.E.; Ahmed, N.; Hyder, R.R.

    2017-01-01

    To study the pattern of cognitive impairment after giving total intravenous anesthesia Vs general anesthesia for ECT for patients of Depressive Episode Severe. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Skardu, from 15 Jul 2015 till 15 Jan 2016. Material and Methods: Hundred patients fulfilling the inclusion criteria were included by consecutive sampling technique for this study and divided in to two groups of 50 each. Patients of group A were given TIVA (propofol + succinylcholine). Patients in group B received GA (propofol + succinylcholine + isoflurane). Cognitive functions of patient were assessed by psychiatrist via mini mental state examination (MMSE) test before ECT and two weeks after ECT respectively. Results: Both the groups were assessed for cognitive impairment after TIVA Vs GA. In group A the MMSE showed less cognitive impairment as compared to group B (p<0.05). Conclusion: Cognitive impairment is less in total intravenous anesthesia as compared to general anesthesia for ECT in patients of depressive episode severe. (author)

  11. Pathways from assaultive violence to post-traumatic stress, depression, and generalized anxiety symptoms through stressful life events: longitudinal mediation models.

    Science.gov (United States)

    Lowe, S R; Joshi, S; Galea, S; Aiello, A E; Uddin, M; Koenen, K C; Cerdá, M

    2017-10-01

    Assaultive violence events are associated with increased risk for adverse psychiatric outcomes, including post-traumatic stress (PTS), depression, and generalized anxiety. Prior research has indicated that economic, legal, and social stressors that could follow assaultive events may explain the increased risk for adverse psychiatric outcomes, yet longitudinal studies have not adequately examined this pathway. In the current study, we aimed to address this limitation. Participants (N = 1360) were part of a longitudinal population-based study of adults living in Detroit. At three waves, participants indicated their exposure to assaultive violence and economic, legal, and social stressors, and completed inventories of PTS, depression, and generalized anxiety. Longitudinal mediation models were used to test the hypothesized pathway from assaultive violence to each psychiatric outcome. The hypothesized models evidenced good fit with the data and, in each, the paths from Wave 1 (W1) assaultive violence to W2 stressors, and from W2 stressors to W3 symptoms were significant (range of Standardized Estimates: 0.09-0.15, all p violence to W3 symptoms were significant (range of Standardized Estimates: 0.01-0.02, all p violence increase risk for a range of psychiatric symptoms. Although future research is needed, the results suggest that investment in interventions that prevent and mitigate assaultive violence survivors' exposure to such stressors may be an effective way to prevent mental illness in the aftermath of violent assaults.

  12. Generalized role for the cerebellum in encoding internal models: evidence from semantic processing.

    Science.gov (United States)

    Moberget, Torgeir; Gullesen, Eva Hilland; Andersson, Stein; Ivry, Richard B; Endestad, Tor

    2014-02-19

    The striking homogeneity of cerebellar microanatomy is strongly suggestive of a corresponding uniformity of function. Consequently, theoretical models of the cerebellum's role in motor control should offer important clues regarding cerebellar contributions to cognition. One such influential theory holds that the cerebellum encodes internal models, neural representations of the context-specific dynamic properties of an object, to facilitate predictive control when manipulating the object. The present study examined whether this theoretical construct can shed light on the contribution of the cerebellum to language processing. We reasoned that the cerebellum might perform a similar coordinative function when the context provided by the initial part of a sentence can be highly predictive of the end of the sentence. Using functional MRI in humans we tested two predictions derived from this hypothesis, building on previous neuroimaging studies of internal models in motor control. First, focal cerebellar activation-reflecting the operation of acquired internal models-should be enhanced when the linguistic context leads terminal words to be predictable. Second, more widespread activation should be observed when such predictions are violated, reflecting the processing of error signals that can be used to update internal models. Both predictions were confirmed, with predictability and prediction violations associated with increased blood oxygenation level-dependent signal in the posterior cerebellum (Crus I/II). Our results provide further evidence for cerebellar involvement in predictive language processing and suggest that the notion of cerebellar internal models may be extended to the language domain.

  13. The international project of radiation and hydrochemical investigation and monitoring of general Caspian rivers

    International Nuclear Information System (INIS)

    Passell, H.D.; Barber, D.S.; Kadyrzhanov, K.K; Solodukhin, V.P.; Chernykh, E.E.; Arutyunyan, R.V.; Valyaev, A.N.; Kadik, A.A.; Stepanetts, O.V; Vernadsky, V.I.; Alizade, A.A.; Gutiev, I.S.; Mamedov, R.F.; Nadareishvili, K.S.; Chkhartishvili, A.G.; Tsitskishvili, M.S.; Chubaryan, E. V; Gevorgyan, R.G.; Puskyulyan, K.I.

    2005-01-01

    Full text: The scientific community of six countries (USA, Kazakhstan, Russia, Georgia, Armenia, and Azerbaijan) has developed the ecological project 'Joint International Researches and Creation of the General System of Radiation and Hydro-chemical Monitoring of Rivers of the Caspian Sea Basin.' The purpose of this project is to investigate and characterized contamination by radionuclides and toxic and chemically hazardous elements and create a valid system of radiation and hydro-chemical monitoring of the main river basins of the Caspian region: the Volga, Ural, Emba and Kura. The basins of these rivers cover large parts of Europe and Asia, including parts of Russia, West Kazakhstan and the South Caucasus and including territories of Georgia, Armenia and Azerbaijan. The total area of the basins of these rivers exceeds combined area of such large European states as France, Spain and Germany, and comprises 1631 sq. km. All these rivers are the main life-supporting water arteries for the region's inhabitants, a population that comprises tens of millions of people Also, the outlets of these rivers determine the condition of the aquatic environment of the Caspian Sea. The ecological condition of the aquatic environment of all the rivers of the Caspian Sea is to a great extent due to contamination, the main components of which are anthropogenic radioactive elements, heavy metals and oil products. At present, information about contamination levels of these rivers is not known and is occasionally contradictory. In this connection there is an obvious need of qualified investigation of contamination levels and its character in the basins of these rivers and in creating a common monitoring system to assess the quality of the aquatic environment. The present project is devoted to this matter. 1. The project provides for the following main tasks: 1. Wide-ranging investigation of the level and character of contamination by radionuclides and toxic elements of the river basins

  14. The Depression Inventory Development Workgroup: A Collaborative, Empirically Driven Initiative to Develop a New Assessment Tool for Major Depressive Disorder.

    Science.gov (United States)

    Vaccarino, Anthony L; Evans, Kenneth R; Kalali, Amir H; Kennedy, Sidney H; Engelhardt, Nina; Frey, Benicio N; Greist, John H; Kobak, Kenneth A; Lam, Raymond W; MacQueen, Glenda; Milev, Roumen; Placenza, Franca M; Ravindran, Arun V; Sheehan, David V; Sills, Terrence; Williams, Janet B W

    2016-01-01

    The Depression Inventory Development project is an initiative of the International Society for CNS Drug Development whose goal is to develop a comprehensive and psychometrically sound measurement tool to be utilized as a primary endpoint in clinical trials for major depressive disorder. Using an iterative process between field testing and psychometric analysis and drawing upon expertise of international researchers in depression, the Depression Inventory Development team has established an empirically driven and collaborative protocol for the creation of items to assess symptoms in major depressive disorder. Depression-relevant symptom clusters were identified based on expert clinical and patient input. In addition, as an aid for symptom identification and item construction, the psychometric properties of existing clinical scales (assessing depression and related indications) were evaluated using blinded datasets from pharmaceutical antidepressant drug trials. A series of field tests in patients with major depressive disorder provided the team with data to inform the iterative process of scale development. We report here an overview of the Depression Inventory Development initiative, including results of the third iteration of items assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain and appetite. The strategies adopted from the Depression Inventory Development program, as an empirically driven and collaborative process for scale development, have provided the foundation to develop and validate measurement tools in other therapeutic areas as well.

  15. Global Modeling of Internal Tides Within an Eddying Ocean General Circulation Model

    Science.gov (United States)

    2012-05-31

    paper aooo not violate: any Oisclosur~,;·of trade• secrets or suggestions of outside individuals on::oncams whiCh have· beE !n communicated 1.o...fully three- dimensional global ocean circulation model, we will provide an internal tide capability everywhere, and allow nested models to include

  16. International Comparisons through Simultaneous and Conjunct Analysis: A Search for General Relationships across Countries.

    Science.gov (United States)

    Lietz, Petra

    1996-01-01

    The six chapters of this theme issue explore data collected by the International Association for the Evaluation of Educational Achievement to investigate crucial issues in reading comprehension. Simultaneous analysis and conjunct analysis are used to examine models as structured combinations of factors in the search for relationships among…

  17. Good quality of oral anticoagulation treatment in general practice using international normalised ratio point of care testing

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent

    2015-01-01

    INTRODUCTION: Oral anticoagulation treatment (OACT)with warfarin is common in general practice. Increasingly,international normalised ratio (INR) point of care testing(POCT) is being used to manage patients. The aim of thisstudy was to describe and analyse the quality of OACT withwarfarin...... in the management of patients in warfarintreatment provided good quality of care. Sampling intervaland diagnostic coding were significantly correlated withtreatment quality. FUNDING: The study received financial support from theSarah Krabbe Foundation, the General Practitioners’ Educationand Development Foundation...

  18. 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/ ...

  19. Impact of deep brain stimulation of the ventral anterior limb of the internal capsule on cognition in depression

    NARCIS (Netherlands)

    Bergfeld, Isidoor O.; Mantione, Mariska; Hoogendoorn, M L C; Ruhe, H. G.; Horst, Ferdinand; Notten, P; van Laarhoven, J; van den Munckhof, M. P.; Beute, G. N.; Schuurman, P R; Denys, D

    Background. Preliminary studies report no negative and a possible positive impact of deep brain stimulation (DBS) on cognition of patients with treatment-resistant depression (TRD). However, these studies neither controlled for practice effects nor compared active with sham stimulation. Method. To

  20. Impact of deep brain stimulation of the ventral anterior limb of the internal capsule on cognition in depression

    NARCIS (Netherlands)

    Bergfeld, I O; Mantione, M; Hoogendoorn, M L C; Ruhé, H G; Horst, F; Notten, P; van Laarhoven, J; van den Munckhof, P; Beute, G; Schuurman, P R; Denys, D

    2017-01-01

    BACKGROUND: Preliminary studies report no negative and a possible positive impact of deep brain stimulation (DBS) on cognition of patients with treatment-resistant depression (TRD). However, these studies neither controlled for practice effects nor compared active with sham stimulation. METHOD: To

  1. Impact of deep brain stimulation of the ventral anterior limb of the internal capsule on cognition in depression

    NARCIS (Netherlands)

    Bergfeld, I. O.; Mantione, M.; Hoogendoorn, M. L. C.; Ruhé, H. G.; Horst, F.; Notten, P.; van Laarhoven, J.; van den Munckhof, P.; Beute, G.; Schuurman, P. R.; Denys, D.

    2017-01-01

    Background. Preliminary studies report no negative and a possible positive impact of deep brain stimulation (DBS) on cognition of patients with treatment-resistant depression (TRD). However, these studies neither controlled for practice effects nor compared active with sham stimulation. Method. To

  2. Good quality of oral anticoagulation treatment in general practice using international normalised ratio point of care testing

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent

    2015-01-01

    INTRODUCTION: Oral anticoagulation treatment (OACT) with warfarin is common in general practice. Increasingly, international normalised ratio (INR) point of care testing (POCT) is being used to manage patients. The aim of this study was to describe and analyse the quality of OACT with warfarin...... practices using INR POCT in the management of patients in warfarin treatment provided good quality of care. Sampling interval and diagnostic coding were significantly correlated with treatment quality....

  3. The role of unhealthy lifestyles in the incidence and persistence of depression: a longitudinal general population study in four emerging countries.

    Science.gov (United States)

    Cabello, Maria; Miret, Marta; Caballero, Francisco Felix; Chatterji, Somnath; Naidoo, Nirmala; Kowal, Paul; D'Este, Catherine; Ayuso-Mateos, Jose Luis

    2017-03-20

    Unhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time. However, few longitudinal evidence of these relationships has been collected in emerging countries. The present study aims i) to analyse whether people with unhealthy lifestyles are more likely to develop depression, and ii) to examine whether depressed people with unhealthy lifestyles are more likely to remain depressed. A total of 7908 participants from Ghana, India, Mexico and Russia were firstly evaluated in the World Health Organization's Study on Global AGEing and Adult Health (SAGE) Wave 0 (2002-2004) and re-evaluated in 2007-2010 (Wave 1). Data on tobacco use, alcohol drinking and physical activity, were collected. Logistic regressions models were employed to assess whether baseline unhealthy lifestyles were related to depression in Wave 1, among people without 12-month depression in Wave 0 and any previous lifetime diagnosis of depression, and to 12-month depression at both study waves (persistent depression). Baseline daily and non-daily smoking was associated with depression in Wave 1. Low physical activity and heavy alcohol drinking were associated with persistent depression. Unhealthy lifestyles and depression are also positively related in emerging countries. Smoking on a daily and non-daily basis was longitudinally related to depression. Depressed people with low physical activity and with heavy drinking patterns were more likely to become depressed over time. Several interpretations of these results are given. Further studies should check whether a reduction of these unhealthy lifestyles leads to lower depression rates and/or to a better clinical prognosis of depressed people.

  4. 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 ...

  5. Statement to the 40th session of the General Conference of the International Atomic Energy Agency 16 September 1996; Statement to the 51st session of the United Nations General Assembly 28 October 1996

    International Nuclear Information System (INIS)

    Blix, H.

    1996-11-01

    In the Statement to the 40th Session of the General Conference of the International Atomic Energy Agency main directions of the IAEA activities and plans for the future are outlined. In the Statement to the 51th Session of the United Nations General Assembly main achievements and challenge facing the international community in the field of IAEA competence are discussed

  6. 17th General Conference of the International Association for Research in Income and Wealth

    CERN Document Server

    1982-01-01

    Those familiar with input-output analysis know well that compilation of input-output tables is a difficult statistical work. The very first input-output tables (e.g. such as those for the United States economy in 1919 and 1929 or for the Federal Republic of Germany in the fifties) were the results of applied economic research. But soon after, official statistical bodies, who understood that input-output tables consistent with national accounts can very much improve the quality of economic statistics, started systematic work in this field. It was also obvious that international exchange of experience can be useful. The two main internatio­ nal fora in which discussion of input-output compilation took place were the international input-out­ put conferences and United Nations bodies. Already at the First International Conference on Input-Output Techniques (Driebergen 1950) several authors analysed the relations between input-output tables and national accounts. The topic was also on the programme of the Second...

  7. Depression, alcohol use disorders and nicotine dependence among patients at a general hospital Depressão, transtornos decorrentes do uso de álcool e dependência de nicotina no hospital geral

    Directory of Open Access Journals (Sweden)

    Neury José Botega

    2010-09-01

    Full Text Available OBJECTIVE: To determine prevalence rates and identify patient characteristics associated with depression, alcohol use disorders and nicotine dependence among individuals admitted to a general teaching hospital. METHOD: Using the Hospital Anxiety and Depression Scale and Alcohol Use Disorder Identification Test, we assessed 4,352 consecutive medical and surgical patients admitted over a 13-month period. The patients were also asked to report their daily cigarette smoking habits during the last month. Multiple logistic regression analyses were performed, and odds ratios (ORs were calculated. RESULTS: The mean age of the sample was 49.3 years, and 56.6% were male. Prevalence rates of depression, alcohol use disorders and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis, depression was associated with previous suicide attempts (OR = 8.7, lower level of education (OR = 3.6, prior use of psychotropic medications (OR = 3.1, cancer (OR = 1.7 and pain (OR = 1.7. Alcohol use disorders were associated with male sex (OR = 6.3, smoking (OR = 3.5, admission for an external cause of injury, such as a traffic accident (OR = 2.4, and previous suicide attempts (OR = 2.3. Nicotine dependence was associated with alcohol use disorders (OR = 3.4, young adulthood (OR = 2.3, widowhood (OR = 2.2 and previous suicide attempts (OR = 1.8. CONCLUSION: This is the largest sample of medical and surgical patients ever surveyed with standardized screening instruments in a general hospital in Brazil. The high prevalence rates of psychiatric disorders and the profiles of the patients evaluated in this study underscore the need to develop methods that are more effective for detecting and managing such disorders. Hospital admission should be considered a major opportunity for the detection of psychiatric disorders and the subsequent implementation of the appropriate specific treatment strategies.OBJETIVO: Identificar taxas de prevalência e

  8. Exploring the Educational Value of Clinical Vignettes from the Society of General Internal Medicine National Meeting in the Internal Medicine Clerkship

    Science.gov (United States)

    Wofford, James L; Singh, Sonal

    2006-01-01

    INTRODUCTION Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE To explore the relevance and learning value of clinical vignettes from the SGIM national meeting in the Internal Medicine clerkship. SETTING Third year Ambulatory Internal Medicine clerkship at one academic medical center (academic year 2005 to 2006). METHODS Students were introduced to the clinical vignette and oriented to the database of clinical vignettes available through the SGIM annual meeting website. Students then reviewed 5 to 10 clinical vignettes using a worksheet, and rated the learning value of each vignette using a 5-point Likert scale (1 = least, 5 = greatest). A single investigator evaluated congruence of the vignette with the Clerkship Directors of Internal Medicine (CDIM)-SGIM curriculum to assess relevance. MAIN RESULTS A total of 42 students evaluated 371 clinical vignettes from the 2004 and 2005 meetings. The clinical vignettes were curriculum-congruent in 42.6% (n = 175), and clearly incongruent in 40.4% (n = 164). The mean rating for learning value was 3.8 (±1.0) (5 signifying greatest learning value). Curriculum-congruent vignettes had a higher mean learning value compared with curriculum-incongruent vignettes (4.0 vs 3.6, Student's t-test, P =.017). CONCLUSION The clinical vignettes presented at the national SGIM meeting offer clinical content that is relevant and of some educational value for third year clerkship students. Based on this pilot study, the educational value and strategies for their use in the clinical clerkships deserve further study. PMID:17026730

  9. How people evaluate others with social anxiety disorder: A comparison to depression and general mental illness stigma.

    Science.gov (United States)

    Anderson, Kristin N; Jeon, Andrew B; Blenner, Jordan A; Wiener, Richard L; Hope, Debra A

    2015-03-01

    Despite the availability of effective interventions, most individuals with social anxiety disorder do not seek treatment. Given their fear of negative evaluation, socially anxious individuals might be especially susceptible to stigma concerns, a recognized barrier for mental health treatment. However, very little is known about the stigma specific to social anxiety disorder. In a design similar to Feldman and Crandall (2007), university undergraduate students read vignettes about target individuals with a generic mental illness label, major depressive disorder, and social anxiety disorder. Subjects rated each of 3 people in the vignettes on social distance and 17 dimensions including dangerousness, heritability and prevalence of the disorder, and gender ratio. Results indicated that being male and not having experience with mental health treatment was associated with somewhat greater preferred social distance. Multiple regression analyses revealed that being embarrassed by the disorder and dangerousness predicted social distance across all 3 vignettes. The vignette for social anxiety disorder had the most complex model and included work impairment, more common among women, and more avoidable. These results have implications for understanding the specific aspects of the stigma associated with social anxiety disorder. Public service messages to reduce stigma should focus on more accurate information about dangerousness and mental illness, given this is an established aspect of mental illness stigma. More nuanced messages about social anxiety might be best incorporated into the treatment referral process and as part of treatment. (c) 2015 APA, all rights reserved).

  10. Attributional Style and Depression in Multiple Sclerosis: The Learned Helplessness Model

    OpenAIRE

    Vargas, Gray A.; Arnett, Peter A.

    2013-01-01

    Several etiologic theories have been proposed to explain depression in the general population. Studying these models and modifying them for use in the multiple sclerosis (MS) population may allow us to better understand depression in MS. According to the reformulated learned helplessness (LH) theory, individuals who attribute negative events to internal, stable, and global causes are more vulnerable to depression. This study differentiated attributional style that was or was not related to MS...

  11. Effects of duty hour restrictions on core competencies, education, quality of life, and burnout among general surgery interns.

    Science.gov (United States)

    Antiel, Ryan M; Reed, Darcy A; Van Arendonk, Kyle J; Wightman, Sean C; Hall, Daniel E; Porterfield, John R; Horvath, Karen D; Terhune, Kyla P; Tarpley, John L; Farley, David R

    2013-05-01

    To measure the implications of the new Accreditation Council for Graduate Medical Education duty hour regulations for education, well-being, and burnout. Longitudinal study. Eleven university-based general surgery residency programs from July 2011 to May 2012. Two hundred thirteen surgical interns. Perceptions of the impact of the new duty hours on various aspects of surgical training, including the 6 Accreditation Council for Graduate Medical Education core competencies, were measured on 3-point scales. Quality of life, burnout, balance between personal and professional life, and career satisfaction were measured using validated instruments. Half of all interns felt that the duty hour changes have decreased the coordination of patient care (53%), their ability to achieve continuity with hospitalized patients (70%), and their time spent in the operating room (57%). Less than half (44%) of interns believed that the new standards have decreased resident fatigue. In longitudinal analysis, residents' beliefs had significantly changed in 2 categories: less likely to believe that practice-based learning and improvement had improved and more likely to report no change to resident fatigue (P life. Compared with the normal US population, 50 interns (32%) were 0.5 SD less than the mean on the 8-item Short Form Health Survey mental quality of life score. Approximately one-third of interns demonstrated weekly symptoms of emotional exhaustion (28%) or depersonalization (28%) or reported that their personal-professional balance was either "very poor" or "not great" (32%). Although many interns (67%) reported that they daily or weekly reflect on their satisfaction from being a surgeon, 1 in 7 considered giving up their career as a surgeon on at least a weekly basis. The first cohort of surgical interns to train under the new regulations report decreased continuity with patients, coordination of patient care, and time spent in the operating room. Furthermore, suboptimal quality of

  12. Depression, Somatization, and Posttraumatic Stress Disorder in Children Born of Occupation After World War II in Comparison With a General Population.

    Science.gov (United States)

    Kaiser, Marie; Kuwert, Philipp; Braehler, Elmar; Glaesmer, Heide

    2015-10-01

    At the end of World War II and during the first decade after the war, roughly 200,000 children were fathered in intimate contacts between German women and foreign soldiers. The experiences of these German occupation children (GOC) have been so far described in case reports and from historical perspective only. Research on psychosocial consequences of growing up as a GOC has been missing so far. This study examined traumatic experiences, posttraumatic stress disorder, somatization, and depression in GOC (N = 146) using self-report instruments: Posttraumatic Diagnostic Scale and Patient Health Questionnaire. Findings have then been compared with a representative birth cohort-matched sample from the German general population (N = 977). German occupation children showed significantly higher prevalence rates of most traumatic experiences, higher point prevalence rates of full and partial posttraumatic stress disorder, depression, and somatization than the control group. In summary, GOC often grew up under difficult conditions (e.g., poverty, single mothers, and stigmatization). Even decades later, they showed higher rates of different mental disorders and higher comorbidity. These findings underline the complex and long-term impact of their burdened social, financial, and familial conditions. The results underpin the importance of conceptualizing occupation children as a vulnerable group in postconflict settings.

  13. 成都市综合医院门诊患者抑郁焦虑障碍诊治状况研究%Prevalence of Depression and (or) Anxiety Disorders among Outpatients in General Hospitals in Chengdu

    Institute of Scientific and Technical Information of China (English)

    李晓靖; 张岚; 李斌

    2011-01-01

    Objective To investigate the prevalence of depressive disorders and (or) anxiety disorders and physicians' detection rate of these disorders in general hospitals in Chengdu. Methods From April to May, 2007, a hospital-based cross-sectional survey was conducted in neurology, gastrointestinal, gynecology and vasculocardiology departments in West China Hospital and West China Second Hospital. Outpatients were screened by using Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire 15-Item (PHQ-15). Psychiatrists interviewed subjects whose score of HADS were 8 and above and made diagnoses by using Mini International Neuropsychiatric Interview (MINI) according to the criteria of Diagnostic and Statistical Manual of Mental Health Disorders 4th Edition (DSM-IV). Results The adjusted current and lifetime prevalence of depressive disorders were 19. 26% and 22. 32%, respectively, and those of anxiety disorders were 9. 16% and 9. 63%, respectively. The prevalence of depressive disorders and/or anxiety disorders among four departments had statistically significant difference. The detection rate of these disorders by outpatient physicians was 10. 57%. Conclusion Prevalence of depressive disorders and anxiety disorders among outpatients in West China Hospital and West China Women and Children Hospital is high, and the rate of physicians' detection needs to be improved.%目的 了解成都市综合医院门诊患者抑郁障碍和焦虑障碍的患病率及门诊医生的识别率.方法 2007年4-5月应用医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)、患者健康问卷(PatientHealth Questionnaire 15-Item,PHQ-15)对在四川大学华两医院和华两第二医院神经内科、消化内科、妇科和心血管内科门诊就诊的685例患者进行筛杳.HADS≥8分者进入精神科访谈,南精神科医牛使朋国际神经精神科简式访谈问卷进行诊断.结果 综合医院门诊患者抑郁障碍校正后的现

  14. International developments in revenues and incomes of general practitioners from 2000 to 2010.

    NARCIS (Netherlands)

    Kroneman, M.; Meeus, P.; Kringos, D.S.; Groot, W.; Zee, J. van der

    2013-01-01

    Background: The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Methods: Annual GP revenue and

  15. International developments in revenues and incomes of general practitioners from 2000 to 2010

    NARCIS (Netherlands)

    Kroneman, Madelon; Meeus, Pascal; Kringos, Dionne Sofia; Groot, Wim; van der Zee, Jouke

    2013-01-01

    The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Annual GP revenue and practice costs were

  16. Professional reimbursement and management of time in general practice: A international comparison

    NARCIS (Netherlands)

    Calnan, M.; Groenewegen, P.P.; Hutten, J.

    1992-01-01

    A hypothetical model was proposed for explaining the relationship between general practitioners' system of payment and the amount of time spent in patient and non-patient work. It was hypothesized that GPs reactions to higher workload vary according to the payment system. In this paper we compare

  17. Aftercare for prostate cancer survivors: information for General Practitioners in international guidelines.

    NARCIS (Netherlands)

    Spronk, I.; Schellevis, F.G.; Korevaar, J.C.

    2015-01-01

    Background: The number of prostate cancer survivors requiring aftercare is rising. This places extra burden on hospital care. Therefore there are increasing appeals for greater involvement of General Practitioners (GPs) in the aftercare of prostate cancer survivors. To date, there is little

  18. The construct validity of the Major Depression Inventory

    DEFF Research Database (Denmark)

    Nielsen, Marie Germund; Ørnbøl, Eva; Vestergaard, Mogens

    2017-01-01

    Objective We aimed to assess the measurement properties of the ten-item Major Depression Inventory when used on clinical suspicion in general practice by performing a Rasch analysis. Methods General practitioners asked consecutive persons to respond to the web-based Major Depression Inventory...... on clinical suspicion of depression. We included 22 practices and 245 persons. Rasch analysis was performed using RUMM2030 software. The Rasch model fit suggests that all items contribute to a single underlying trait (defined as internal construct validity). Mokken analysis was used to test dimensionality...... for gender, age, work status and education. The Rasch and Mokken analyses revealed two dimensions, but the Major Depression Inventory showed fit to one scale if items 9 and 10 were excluded. Conclusion Our study indicated scalability problems in the current version of the Major Depression Inventory...

  19. Lower urinary tract symptoms and erectile dysfunction associated with depression among Japanese patients with late-onset hypogonadism symptoms.

    Science.gov (United States)

    Takao, Tetsuya; Tsujimura, Akira; Okuda, Hidenobu; Yamamoto, Keisuke; Fukuhara, Shinichiro; Matsuoka, Yasuhiro; Miyagawa, Yasushi; Nonomura, Norio; Okuyama, Akihiko

    2011-06-01

    The aim of this study was to investigate the relation between lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and depression in Japanese patients with late-onset hypogonadism (LOH) symptoms. The study comprised 87 Japanese patients with LOH symptoms (>27 points on the Aging Males Symptoms Scale). Thirty-four patients were diagnosed as having depression and the remaining 53 patients were diagnosed as not having depression by the Mini International Neuropsychiatric Interview. We compared the International Index of Erectile Function (IIEF) 5, International Prostate Symptom Score (IPSS), IPSS quality-of-life (QOL) index, King's Health Questionnaire (KHQ), endocrinological data, and free uroflow study between depression and non-depression patients and performed multiple logistic regression analysis. IIEF5 scores of depression patients were significantly lower than those of non-depression patients. In KHQ, only the category of general health perceptions was significantly higher in depression patients than non-depression patients. However, IPSS, QOL index, and endocrinological and uroflowmetric data showed no significant difference between the groups. Multiple logistic regression analysis revealed moderate and severe ED to be risk factors for depression. However, LUTS are not related to depression. Moderate and severe ED is correlated with depression, whereas LUTS are not related to depression in Japanese LOH patients.

  20. Participating in Politics Resembles Physical Activity: General Action Patterns in International Archives, United States Archives, and Experiments

    Science.gov (United States)

    Noguchi, Kenji; Handley, Ian M.; Albarracín, Dolores

    2016-01-01

    A series of studies examined whether political participation can emerge from general patterns of indiscriminate activity. In the first two studies, general action tendencies were measured by combining national and state-level indicators of high activity (e.g., impulsiveness, pace of life, and physical activity) from international and U.S. data. This action-tendency index positively correlated with a measure of political participation that consisted of voting behaviors and participation in political demonstrations. The following two experimental studies indicated that participants exposed to action words (e.g., go, move) had stronger intentions to vote in an upcoming election and volunteered more time to make phone calls on behalf of a university policy than participants exposed to inaction words did (e.g., relax, stop). These studies suggest that political participation can be predicted from general tendencies toward activity present at the national and state levels, as well as from verbal prompts suggestive of activity. PMID:21177515

  1. Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period.

    Science.gov (United States)

    Simpson, William; Glazer, Melanie; Michalski, Natalie; Steiner, Meir; Frey, Benicio N

    2014-08-01

    About 24.1% of pregnant women suffer from at least 1 anxiety disorder, 8.5% of whom suffer specifically from generalized anxiety disorder (GAD). GAD is often associated with major depressive disorder (MDD). During the perinatal period, the presence of physical and somatic symptoms often makes differentiation between depression and anxiety more challenging. To date, no screening tools have been developed to detect GAD in the perinatal population. We investigated the psychometric properties of the GAD 7-item Scale (GAD-7) as a screening tool for GAD in pregnant and postpartum women. Two hundred and forty perinatal women (n = 155 pregnant and n = 85 postpartum) referred for psychiatric consultation were enrolled. On the day of initial assessment, all women completed the GAD-7 and the Edinburgh Postnatal Depression Scale (EPDS). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-based diagnoses were made by experienced psychiatrists. Scores from the GAD-7 and EPDS were compared with the clinical diagnoses to evaluate the psychometric properties of the GAD-7 and EPDS when used as a screening tool for GAD. The GAD-7 yielded a sensitivity of 61.3% and specificity of 72.7% at an optimal cut-off score of 13. Compared with the EPDS and the EPDS-3A subscale, the GAD-7 displayed greater accuracy and specificity over a greater range of cut-off scores and more accurately identified GAD in patients with comorbid MDD. Our findings suggest that the GAD-7 represents a clinically useful scale for the detection of GAD in perinatal women.

  2. The relationship between computer gaming hours and depression or social phobia in adults. An international online survey.

    OpenAIRE

    Tobias, Radeke

    2016-01-01

    Background: In the past decades, there was a worldwide increase in people playing video games. Researchers have started to conduct studies and identified positive and negative associations with video gaming. Comparable studies have been done.   Aim: The aim is to analyse, if there is an association between the average hours an adult participant has played computer games per day and depression or social phobia.   Methods: Data from 4,936 adults who voluntarily participated in an online survey ...

  3. [Community pharmacy and general internal medicine are at the same crossroads: some opportunities should be seized].

    Science.gov (United States)

    Bugnon, O; Buchmann, M

    2012-11-28

    The medicines give some symptoms relief and save lives every day. However, the responsible use of medicines is not definitively attained for the modern health systems. The shortcomings in this area are the cause of major negative clinical outcomes for the patients and the cause of additional cost for the health financing system. The two centenarians, as the International Pharmaceutical Federation (FIP) and the "Policlinique Médicale Universitaire (PMU)" in Lausanne, preview the solutions from now on for reversing this trend, such as the interdisciplinary collaborative approaches, the introduction of adequate financial incentives and the strengthening of education and research in community medicine, pharmacy and health.

  4. The 3rd international intercomparison on EPR tooth dosimetry: Part 1, general analysis

    International Nuclear Information System (INIS)

    Wieser, A.; Debuyst, R.; Fattibene, P.

    2005-01-01

    The objective of the 3rd International Intercomparison on Electron Paramagnetic Resonance (EPR) Tooth Dosimetry was the evaluation of laboratories performing tooth enamel dosimetry below 300 mGy. Participants had to reconstruct the absorbed dose in tooth enamel from 11 molars, which were cut into two halves. One half of each tooth was irradiated in a 60 Co beam to doses in the ranges of 30-100 mGy (5 samples), 100-300 mGy (5 samples), and 300-900 mGy (1 sample). Fourteen international laboratories participated in this intercomparison programme. A first analysis of the results and an overview of the essential features of methods applied in different laboratories are presented. The relative standard deviation of results of all methods was better than 27% for applied doses in the range of 79-704 mGy. In the analysis of the unirradiated tooth halves 8% of the samples were identified as outliers with additional absorbed dose above background dose

  5. International developments in revenues and incomes of general practitioners from 2000 to 2010

    OpenAIRE

    Kroneman, Madelon; Meeus, Pascal; Kringos, Dionne Sofia; Groot, Wim; van der Zee, Jouke

    2013-01-01

    Background: The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Methods: Annual GP revenue and practice costs were collected from national institutes in the eight countries included in our study (Belgium, Denmark, Finland, France, Germany, The Netherlands, Sweden, The United Kingdom (UK)) from 2000...

  6. Cholesterol levels in panic disorder, generalized anxiety disorder and major depression Níveis de colesterol no transtorno de pânico, transtorno de ansiedade generalizada e depressão maior

    Directory of Open Access Journals (Sweden)

    ACIOLY L.T. LACERDA

    2000-06-01

    Full Text Available Serum plasma total cholesterol levels were measured in 85 male or female outpatients with panic disorder (PD; N=41, generalized anxiety disorder (GAD; N=23 and major depression (MD; N=21 according to DSM-IV criteria. All the patients had a mean cholesterol level within the normal range; males (N=22 and females (N=63 had approximately the same serum cholesterol levels (p > .05. No significant differences in cholesterol levels emerged between PD, GAD and MD patient groups. Both female PD and female GAD subjects had a mean cholesterol level similar to their male counterparts (p>.05. It is concluded that both Hayward and colleagues and Bajwa et al. findings could not be replicated by our study.Foram medidos os níveis plasmáticos de colesterol total em 85 pacientes ambulatoriais com transtorno de pânico (TP; N = 41, transtorno de ansiedade generalizada (TAG; N = 23 e depressão maior (DM; N = 21, diagnosticados de acordo com os critérios do DSM-IV. O grupo de pacientes apresentou média do nível de colesterol dentro da faixa normal; homens (N = 22 e mulheres (N = 63 tiveram aproximadamente os mesmos níveis séricos de colesterol (p > 0,05. Não foram observadas diferenças nos níveis de colesterol entre os grupos de pacientes com TP, TAG e DM. Mulheres com TP e as com TAG apresentaram média dos níveis de colesterol semelhante aos seus pares masculinos (p > 0,05. Conclui-se que os resultados obtidos por Hayward et al. e por Bajwa et al. não foram replicados neste estudo.

  7. Unmet care needs of the oldest old with late-life depression: A comparison of patient, caring relative and general practitioner perceptions - Results of the AgeMooDe study.

    Science.gov (United States)

    Stein, Janine; Pabst, Alexander; Weyerer, Siegfried; Werle, Jochen; Maier, Wolfgang; Miebach, Lisa; Scherer, Martin; Stark, Anne; Kaduszkiewicz, Hanna; Wiese, Birgitt; Moor, Lilia; Bock, Jens-Oliver; König, Hans-Helmut; Riedel-Heller, Steffi G

    2016-11-15

    Research showed that the perception of unmet needs may differ between patients, caregivers and professionals. Lacking agreement with regard to unmet needs between raters involved may have a negative impact on treatment of late-life depression. As part of the multicenter German study "Late-life depression in primary care: needs, health care utilization and costs" (AgeMooDe), n=1188 primary care patients aged 75-98 with and without depression, relatives (n=366) and general practitioners (GPs, n=1152) were assessed using the German version of the Camberwell Assessment of Need for the Elderly (CANE) in order to identify patients' unmet needs from different perspectives. Kappa coefficients were computed to determine level of agreement between perspectives. Penalized likelihood logistic regression models were run in order to assess the association between depression severity and disagreement between perspectives with regard to unmet needs. The prevalence of unmet needs was higher in depressive patients. Kappa coefficients were on average higher for depressive patients ranging from poor to substantial. Severity of depression was significantly associated with disagreement regarding unmet needs between perspectives. The cross-sectional design of the study limits the results. Only a part of caring relatives was able to participate. Perceptions of unmet needs in the oldest old primary care patients suffering from depression strongly differ between raters. Severity of depression seems to exacerbate the discrepancy between involved perspectives. The negative impact that depression severity may have on the perception and assessment of unmet needs requires greater attention by GPs. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. DEP: A Depression Emulation Program*

    Science.gov (United States)

    Webster, Charles; Glass, Richard M; Banks, Gordon

    1988-01-01

    Cognitive deficits can be studied by “lesioning” computer simulations of normal cognitive processes. DEP (Depression Emulation Program) implements key aspects of a computational theory of “normal” adaptive reactive depression. A theory of “normal” depression is a step toward a theory of “pathological” depression. Transient depressed mood caused by an environmental event may be an example of fallure-triggered reprogramming of the self-schema. We normally generate responses to our environment in a fast and effortless “compiled” mode. After experiencing a stable, internal, and global failure, we debug our self-schema in a slow and effortful “interpreted” mode. During debugging, we experience a cognitive loop, increased objectivity, decreased motivation, and fluctuating self-generalizations. DEP exhibits analogous behavior and suggests vulnerability in an emotional operating system that normally, and periodically, adapts to a changing environment. Computer simulation of cognitive deficit may become a valuable research tool in psychiatry and neurology.

  9. Ways of Improving the Training of Interns Pediatricians and General Practitioners — Family Physicians in «Pediatrics» Discipline

    Directory of Open Access Journals (Sweden)

    S.A. Mokiia-Serbina

    2015-09-01

    Full Text Available Graduates of medical schools having sufficient theoretical and practical skills often have difficulty in communicating with patients — children and their parents, as well as with colleagues. Objective: improving the efficiency of the educational process in the training of interns pediatricians and general practitioners — family physicians in «Pediatrics» course. Methods of the study: theoretical analysis of gathered experience. Results and discussion. During internship at the department, there are used seminars-discussions, seminars — training conferences, seminars — round tables that allows you to work out the tactics of speech, methods of discussion, reasoning of judgments, review, assessment, analysis. Interns most of the time must participate in the examination of a sick child, discussions of the results, conversations with parents. Clinical analysis of patients should be carried out using the method of structured group discussion when each intern can express his views. Interns are involved in scientific work, speak at scientific conferences. The department created a series of ambulatory pediatrics, -during which the intern talks to a child, his parents and he must to conciliate them, to inspire confidence and to prove himself as a specialist. During this course, special attention is paid to the psychological component of medical trai-ning. Clas-ses are conducted by assistant pediatrician, a graduate majoring in «Practical Psychology». Conclusions. The use of interactive teaching methods at different stages of the educational process contributes not only to improvement of theoretical activity, but also the formation in interns of professional qualities of clinical and scientific thinking, competence in the construction and development of interpersonal relations, humanism.

  10. Barriers to Medical Compassion as a Function of Experience and Specialization: Psychiatry, Pediatrics, Internal Medicine, Surgery, and General Practice.

    Science.gov (United States)

    Fernando, Antonio T; Consedine, Nathan S

    2017-06-01

    Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialities and among physicians with differing degrees of experience, barriers to compassion are also likely to vary. We describe barriers to physician compassion as a function of specialization (psychiatry, general practice, surgery, internal medicine, and pediatrics) and physician experience. We used a cross-sectional study using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. Nonrandom convenience sampling was used to recruit 580 doctors, of whom 444 belonged to the targeted speciality groups. The sample was characterized before conducting a factorial Multivariate Analysis of Covariance and further post hoc analyses. A 5 (speciality grouping) × 2 (more vs. less physician experience) Multivariate Analysis of Covariance showed that the barriers varied as a function of both speciality and experience. In general, psychiatrists reported lower barriers, whereas general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors. Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  11. Vortex creep and the internal temperature of neutron stars. I - General theory

    Science.gov (United States)

    Alpar, M. A.; Pines, D.; Anderson, P. W.; Shaham, J.

    1984-01-01

    The theory of a neutron star superfluid coupled to normal matter via thermal creep against pinning forces is developed in some detail. General equations of motion for a pinned rotating superfluid and their form for vortex creep are given. Steady state creep and the way in which the system approaches the steady state are discussed. The developed formalism is applied to the postglitch relaxation of a pulsar, and detailed models are developed which permit explicit calculation of the postglitch response. The energy dissipation associated with creep and glitches is considered.

  12. General aviation internal-combustion engine research programs at NASA-Lewis Research Center

    Science.gov (United States)

    Willis, E. A.

    1978-01-01

    An update is presented of non-turbine general aviation engine programs. The program encompasses conventional, lightweight diesel and rotary engines. It's three major thrusts are: (1) reduced SFC's; (2) improved fuels tolerance; and (3) reduced emissions. Current and planned future programs in such areas as lean operation, improved fuel management, advanced cooling techniques and advanced engine concepts, are described. These are expected to lay the technology base, by the mid to latter 1980's, for engines whose life cycle fuel costs are 30 to 50% lower than today's conventional engines.

  13. General aviation internal combustion engine research programs at NASA-Lewis Research Center

    Science.gov (United States)

    Willis, E. A.

    1978-01-01

    An update is presented of non-turbine general aviation engine programs underway at the NASA-Lewis Research Center in Cleveland, Ohio. The program encompasses conventional, lightweight diesel and rotary engines. Its three major thrusts are: (a) reduced SFC's; (b) improved fuels tolerance; and (c) reducing emissions. Current and planned future programs in such areas as lean operation, improved fuel management, advanced cooling techniques and advanced engine concepts, are described. These are expected to lay the technology base, by the mid to late 1980's, for engines whose life cycle fuel costs are 30 to 50% lower than today's conventional engines.

  14. Statement to the 34th session of the general conference of the International Atomic Energy Agency, 17 September 1990. Statement to the 45th session of the United Nations general assembly, 23 October 1990

    International Nuclear Information System (INIS)

    Blix, H.

    1991-01-01

    The document contains the following two statements of Hans Blix, Director General of the IAEA: Statement to the 34th Session of the General Conference of the International Atomic Energy Agency, 17 September 1990; Statement to the 45th Session of the United Nations General Assembly, 23 October 1990. A separate abstract was prepared for each of these statements

  15. Statement to the 35th session of the General Conference of the International Atomic Energy Agency 16 September 1991; Statement to the 46th session of the United Nations General Assembly 21 October 1991

    International Nuclear Information System (INIS)

    Blix, H.

    1991-01-01

    The document contains the following two statements of Hans Blix, Director General of the IAEA: Statement to the 35th session of the General Conference of the International Atomic Energy Agency, 16 September 1991; Statement to the 46th session of the United Nations General Assembly, 21 October 1991. A separate abstract was prepared for each of these statements

  16. 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...

  17. A computational code for resolution of general compartment models applied to internal dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Claro, Thiago R.; Todo, Alberto S., E-mail: claro@usp.br, E-mail: astodo@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The dose resulting from internal contamination can be estimated with the use of biokinetic models combined with experimental results obtained from bio analysis and the knowledge of the incorporation time. The biokinetics models can be represented by a set of compartments expressing the transportation, retention and elimination of radionuclides from the body. The ICRP publications, number 66, 78 and 100, present compartmental models for the respiratory tract, gastrointestinal tract and for systemic distribution for an array of radionuclides of interest for the radiological protection. The objective of this work is to develop a computational code for designing, visualization and resolution of compartmental models of any nature. There are available four different techniques for the resolution of system of differential equations, including semi-analytical and numerical methods. The software was developed in C{ne} programming, using a Microsoft Access database and XML standards for file exchange with other applications. Compartmental models for uranium, thorium and iodine radionuclides were generated for the validation of the CBT software. The models were subsequently solved by SSID software and the results compared with the values published in the issue 78 of ICRP. In all cases the system is in accordance with the values published by ICRP. (author)

  18. A computational code for resolution of general compartment models applied to internal dosimetry

    International Nuclear Information System (INIS)

    Claro, Thiago R.; Todo, Alberto S.

    2011-01-01

    The dose resulting from internal contamination can be estimated with the use of biokinetic models combined with experimental results obtained from bio analysis and the knowledge of the incorporation time. The biokinetics models can be represented by a set of compartments expressing the transportation, retention and elimination of radionuclides from the body. The ICRP publications, number 66, 78 and 100, present compartmental models for the respiratory tract, gastrointestinal tract and for systemic distribution for an array of radionuclides of interest for the radiological protection. The objective of this work is to develop a computational code for designing, visualization and resolution of compartmental models of any nature. There are available four different techniques for the resolution of system of differential equations, including semi-analytical and numerical methods. The software was developed in C≠ programming, using a Microsoft Access database and XML standards for file exchange with other applications. Compartmental models for uranium, thorium and iodine radionuclides were generated for the validation of the CBT software. The models were subsequently solved by SSID software and the results compared with the values published in the issue 78 of ICRP. In all cases the system is in accordance with the values published by ICRP. (author)

  19. Bismuth as a general internal standard for lead in atomic absorption spectrometry.

    Science.gov (United States)

    Bechlin, Marcos A; Fortunato, Felipe M; Ferreira, Edilene C; Gomes Neto, José A; Nóbrega, Joaquim A; Donati, George L; Jones, Bradley T

    2014-06-11

    Bismuth was evaluated as internal standard for Pb determination by line source flame atomic absorption spectrometry (LS FAAS), high-resolution continuum source flame atomic absorption spectrometry (HR-CS FAAS) and line source graphite furnace atomic absorption spectrometry (LS GFAAS). Analysis of samples containing different matrices indicated close relationship between Pb and Bi absorbances. Correlation coefficients of calibration curves built up by plotting A(Pb)/A(Bi)versus Pb concentration were higher than 0.9953 (FAAS) and higher than 0.9993 (GFAAS). Recoveries of Pb improved from 52-118% (without IS) to 97-109% (IS, LS FAAS); 74-231% (without IS) to 96-109% (IS, HR-CS FAAS); and 36-125% (without IS) to 96-110% (IS, LS GFAAS). The relative standard deviations (n=12) were reduced from 0.6-9.2% (without IS) to 0.3-4.3% (IS, LS FAAS); 0.7-7.7% (without IS) to 0.1-4.0% (IS, HR-CS FAAS); and 2.1-13% (without IS) to 0.4-5.9% (IS, LS GFAAS). Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Good quality of oral anticoagulation treatment in general practice using international normalised ratio point of care testing

    DEFF Research Database (Denmark)

    Løkkegaard, Thomas; Pedersen, Tina Heidi; Lind, Bent

    2015-01-01

    collected retrospectively for a period of six months. For each patient, time in therapeutic range (TTR) was calculated and correlated with practice and patient characteristics using multilevel linear regression models. RESULTS: We identified 447 patients in warfarin treatment in the 20 practices using POCT......INTRODUCTION: Oral anticoagulation treatment (OACT) with warfarin is common in general practice. Increasingly, international normalised ratio (INR) point of care testing (POCT) is being used to manage patients. The aim of this study was to describe and analyse the quality of OACT with warfarin...

  1. Validating the Beck Depression Inventory-II in Indonesia’s general population and coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Henndy Ginting

    2013-01-01

    Full Text Available Este estudio evalúa la validez y determina los puntos de corte del Inventario de Depresión de Beck -II (BDI-II en Indonesia. La versión indonesia del BDI-II (BDI-II Indo se administró a 720 personas sanas de la población general, a 215 pacientes con Enfermedad Coronaria (EC y a 102 pacientes con depresión. El análisis factorial confirmatorio mostró similitud factorial de las tres muestras. Las correlaciones entre el Indo BDI-II y otras medidas de auto-percepción relacionadas con la depresión fueron significativas, mostrando la validez de constructo del Indo BDI-II. Además, la diferencia de puntuación del Indo BDI-II entre los participantes deprimidos y no deprimidos fue altamente significativa. La consistencia interna y la fiabilidad re- test fueron suficientemente altas. La curva ROC (receiver operating characteristic indicó que el punto de corte de la BDI-II para el nivel de gravedad leve de depresión la población de Indonesia es igual a 17. En conclusión, el Indo BDI-II es una medida válida de depresión, tanto para la población general indonesia como en pacientes con EC.

  2. Generalization of international centrifugal zone growth of metal-ceramic composites. Technical report

    Energy Technology Data Exchange (ETDEWEB)

    Sekerka, R.F.; Hartzell, R.A.

    1976-08-01

    The electric and temperature fields within inductively heated materials have been calculated in order to better understand the essential features of the crystal growth process called Internal Centrifugal Zone Growth (ICZG). A complicated two-dimensional problem has been studied via a simple one-dimensional model which applies to infinitely long samples heated by infinitely long induction coils. Two such one-dimensional models are presented. In the first model, all material properties of the sample are assumed to be independent of temperature. The coupled differential equations determining the electric field and temperature distributions within the sample are solved analytically. Resulting profiles of temperature and electromagnetic fields within the sample provide a basis for more sophisticated models. The second model deals with materials (e.g., oxides) whose electrical conductivities are very low at room temperature but increase significantly with temperature. The differential equations for electromagnetic and temperature fields are consequently strongly coupled, resulting in multiple steady state solutions, some of which are unstable. An understanding of this instability is of utmost importance with regard to crystal growth via ICZG, because it has been observed that an increase in the electrical conductivity of the sample when melting occurs can cause a catastrophic increase in surface temperature. The modeling predicts, however, that the instability can be controlled through a judicious choice of RF frequency, sample size, and sample alloying. Progress has been made in solving the two-dimensional differential equations. Many problems are encountered that are not present in one-dimensional modeling. The method of solution is outlined, but no solutions have yet been obtained.

  3. Unruptured internal carotid artery bifurcation aneurysms: general features and overall results after modern treatment.

    Science.gov (United States)

    La Pira, Biagia; Brinjikji, Waleed; Burrows, Anthony M; Cloft, Harry J; Vine, Roanna L; Lanzino, Giuseppe

    2016-11-01

    Internal carotid artery bifurcation aneurysms (ICAbifAs) present unique challenges to endovascular and surgical operators, and little is known about their natural history. We reviewed our institution's experience with ICAbifAs studying outcomes of surgical and endovascular management and natural history. Consecutive patients with unruptured ICAbifAs evaluated and/or treated over an 8-year interval were studied. Baseline demographics, neurovascular risk factors, aneurysm location and size, clinical presentation, treatment recommendations, and outcomes were prospectively collected and retrospectively analyzed. Continuous variables were compared with Student's t test and categorical variables with Chi-square tests. Fifty-nine patients with 61 unruptured ICAbifAs were included. Seven aneurysms were treated surgically (11.5 %), 22 underwent endovascular treatment (36 %), and 32 were managed conservatively (52.5 %). In the surgical group, short- and long-term complete aneurysm occlusion rates were 100 % with no cases of perioperative or long-term permanent morbidity or treatment-related mortality. In the endovascular group, two patients (11.7 %) with giant aneurysms had perioperative thromboembolic events with transient morbidity. There was one case of aneurysm rupture at follow-up in a giant aneurysm treated with partial coil embolization. Complete/near-complete occlusion rates were 63 %. There was one case of aneurysm rupture after 114 aneurysm-years of follow-up in the conservative management group (0.89 %/year), but no ruptures were observed in small aneurysms selected for conservative management. Unruptured small ICAbifAs have a benign natural history. In patients selected for treatment, excellent results can be achieved in the vast majority of patients with judicious use of endovascular and surgical therapy.

  4. Generalization of international centrifugal zone growth of metal-ceramic composites. Technical report

    International Nuclear Information System (INIS)

    Sekerka, R.F.; Hartzell, R.A.

    1976-08-01

    The electric and temperature fields within inductively heated materials have been calculated in order to better understand the essential features of the crystal growth process called Internal Centrifugal Zone Growth (ICZG). A complicated two-dimensional problem has been studied via a simple one-dimensional model which applies to infinitely long samples heated by infinitely long induction coils. Two such one-dimensional models are presented. In the first model, all material properties of the sample are assumed to be independent of temperature. The coupled differential equations determining the electric field and temperature distributions within the sample are solved analytically. Resulting profiles of temperature and electromagnetic fields within the sample provide a basis for more sophisticated models. The second model deals with materials (e.g., oxides) whose electrical conductivities are very low at room temperature but increase significantly with temperature. The differential equations for electromagnetic and temperature fields are consequently strongly coupled, resulting in multiple steady state solutions, some of which are unstable. An understanding of this instability is of utmost importance with regard to crystal growth via ICZG, because it has been observed that an increase in the electrical conductivity of the sample when melting occurs can cause a catastrophic increase in surface temperature. The modeling predicts, however, that the instability can be controlled through a judicious choice of RF frequency, sample size, and sample alloying. Progress has been made in solving the two-dimensional differential equations. Many problems are encountered that are not present in one-dimensional modeling. The method of solution is outlined, but no solutions have yet been obtained

  5. International developments in revenues and incomes of general practitioners from 2000 to 2010.

    Science.gov (United States)

    Kroneman, Madelon; Meeus, Pascal; Kringos, Dionne Sofia; Groot, Wim; van der Zee, Jouke

    2013-10-24

    The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Annual GP revenue and practice costs were collected from national institutes in the eight countries included in our study (Belgium, Denmark, Finland, France, Germany, The Netherlands, Sweden, The United Kingdom (UK)) from 2000-2010. The data were corrected for inflation and purchasing power. Data on the remuneration systems and changes herein were collected from the European Observatory Health Systems Reviews and country experts. Comprehensive changes in the remuneration system of GPs were associated with considerable changes in GP income. Incremental changes mainly coincided with a gradual increase in income after correction for inflation. Average GP income was higher in countries with a strong primary care structure. The gap between the countries where GPs have a lower income (Belgium, Sweden, France and Finland) and the countries where GPs have a higher income (Netherlands, Germany and the UK) continues to exist over time and appeared to be related to dimensions of primary care, such as governance and access. New payment forms, such as integrated care payment systems, and new health care professionals that are working for GPs, increasingly blur the line between practice costs and income, making it more and more important to clearly define expenditures on GPs, to remain sight on the actual income of GPs.

  6. Personality characteristics and attributes of international medical graduates in general practice training: Implications for supporting this valued Australian workforce.

    Science.gov (United States)

    Laurence, Caroline O; Eley, Diann S; Walters, Lucie; Elliott, Taryn; Cloninger, Claude Robert

    2016-10-01

    To describe the personality profiles of International Medical Graduates (IMGs) undertaking General Practice (GP) training in Australia. A better understanding of the personal characteristics of IMGs may inform their training and enhance support for their vital contribution to the Australian rural workforce. Cross-sectional self-report questionnaires. Independent variables included socio-demographics, prior training, the Temperament and Character Inventory, and the Resilience Scale. GP registrars (IMGs = 102; AMGs = 350) training in the Australian General Practice Training rural and general pathway and the Australian College of Rural and Remote Medicine independent pathway. Univariate analysis explored the differences in levels of traits between IMG and AMG registrars. Compared to the general population both groups have moderately high resilience, and well-organised characters with high Self-directedness, high Cooperativeness and low Self-transcendence, supported by temperaments which were high in Persistence and Reward Dependence. IMGs were different than AMGs in two temperament traits, Novelty Seeking and Persistence and two character traits, Self-directedness and Cooperativeness. Factors such as cultural and training backgrounds, personal and professional expectations, and adjustments necessary to assimilate to a new lifestyle and health system are likely to be responsible for differences found between groups. Understanding the personality profiles of IMGs provides opportunities for targeted training and support which may in turn impact on their retention in rural areas. © 2016 National Rural Health Alliance Inc.

  7. Conformity to the surviving sepsis campaign international guidelines among physicians in a general intensive care unit in Nairobi.

    Science.gov (United States)

    Mung'ayi, V; Karuga, R

    2010-08-01

    There are emerging therapies for managing septic critically-ill patients. There is little data from the developing world on their usage. To determine the conformity rate for resuscitation and management bundles for septic patients amongst physicians in a general intensive care unit. Cross sectional observational study. The general intensive care unit, Aga Khan University Hospital,Nairobi. Admitting physicians from all specialties in the general intensive care unit. The physicians had high conformity rates of 92% and 96% for the fluid resuscitation and use of va so pressors respectively for the initial resuscitation bundle. They had moderate conformity rates for blood cultures prior to administering antibiotics (57%) and administration of antibiotics within first hour of recognition of septic shock (54%). There was high conformity rate to the glucose control policy (81%), use of protective lung strategy in acute lung injury/Acute respiratory distress syndrome, venous thromboembolism prophylaxis (100%) and stress ulcer prophylaxis (100%) in the management bundle. Conformity was moderate for use of sedation, analgesia and muscle relaxant policy (69%), continuous renal replacement therapies (54%) and low for steroid policy (35%), administration ofdrotrecogin alfa (0%) and selective digestive decontamination (15%). There is varying conformity to the international sepsis guidelines among physicians caring for patients in our general ICU. Since increased conformity would improve survival and reduce morbidity, there is need for sustained education and guideline based performance improvement.

  8. An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study.

    Science.gov (United States)

    Mather, Lisa; Blom, Victoria; Bergström, Gunnar; Svedberg, Pia

    2016-12-01

    Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005-2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69-0.74) between MDD and GAD, 0.58 (0.56-0.60) between MDD and burnout, and 0.53 (0.50-0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.

  9. Common mental disorders and mortality in the West of Scotland Twenty-07 Study: comparing the General Health Questionnaire and the Hospital Anxiety and Depression Scale.

    Science.gov (United States)

    Hannah, Mary Kathleen; Batty, G David; Benzeval, Michaela

    2013-07-01

    While various measures of common mental disorders (CMD) have been found to be associated with mortality, a comparison of how different measures predict mortality may improve our understanding of the association. This paper compares how the Hospital Anxiety and Depression Scale (HADS) and the 30-item General Health Questionnaire (GHQ-30) predict all cause and cause-specific mortality. Data on 2547 men and women from two cohorts, aged approximately 39 and 55 years, from the West of Scotland Twenty-07 Study who were followed up for mortality over an average of 18.9 (SD 5.0) years. Scores were calculated for HADS depression (HADS-D), HADS Anxiety (HADS-A) and GHQ-30. Cox Proportional Hazards Models were used to determine how each CMD measure predicted mortality. After adjusting for serious physical illness, smoking, social class, alcohol, obesity, pulse rate and living alone, HRs (95% CI) per SD increase in score for all-cause mortality were: 1.15 (1.07 to 1.25) for HADS-D; 1.13 (1.04 to 1.23) for GHQ-30 and 1.05 (0.96 to 1.14) for HADS-A. After the same adjustments, cardiovascular disease mortality was also related to HADS-D (HR 1.24 (1.07 to 1.43)), to GHQ-30 (HR 1.24 (1.11 to 1.40)) and to HADS-A (HR 1.15 (1.01 to 1.32)); respiratory mortality to GHQ-30 (HR 1.33 (1.13 to 1.55)) and mortality from other causes, excluding injuries, to HADS-D (HR 1.28 (1.05 to 1.55)). There were associations between CMD and both all-cause and cause-specific mortality which were broadly similar for GHQ-30 and HADS-D and were still present after adjustment for important confounders and mediators.

  10. 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.

  11. Internationally Adopted Children from Non-European Countries: General Development during the First Two Years in the Adoptive Family

    Directory of Open Access Journals (Sweden)

    Monica Dalen

    2012-01-01

    Full Text Available Internationally adopted children are often delayed in their development and demonstrate more behaviour problems than nonadopted children due to adverse preadoption circumstances. This is especially true for children adopted from Eastern European countries. Few studies have focused on children adopted from non-European countries. This paper presents results from an ongoing longitudinal study of 119 internationally adopted children from non-European countries during their first two years in Norway. Several scales measuring different aspects of the children’s development are included in the study: communication and gross motor development, temperamental characteristics, and behaviour problems. The results show that internationally adopted children are delayed in their general development when they first arrive in their adoptive families. After two years the children have made significant progress in development. However, they still lag behind in communication and motor skills compared to non-adopted children. The temperamental characteristics seem very stable from time of adoption until two years after adoption. The children demonstrate a low frequency of behaviour problems. However, the behaviour problems have changed during the two years. At time of adoption they show more nonphysically challenging behaviour while after two years their physically challenging behaviour has increased.

  12. Internationally adopted children from non-European countries: general development during the first two years in the adoptive family.

    Science.gov (United States)

    Dalen, Monica; Theie, Steinar

    2012-01-01

    Internationally adopted children are often delayed in their development and demonstrate more behaviour problems than nonadopted children due to adverse preadoption circumstances. This is especially true for children adopted from Eastern European countries. Few studies have focused on children adopted from non-European countries. This paper presents results from an ongoing longitudinal study of 119 internationally adopted children from non-European countries during their first two years in Norway. Several scales measuring different aspects of the children's development are included in the study: communication and gross motor development, temperamental characteristics, and behaviour problems. The results show that internationally adopted children are delayed in their general development when they first arrive in their adoptive families. After two years the children have made significant progress in development. However, they still lag behind in communication and motor skills compared to non-adopted children. The temperamental characteristics seem very stable from time of adoption until two years after adoption. The children demonstrate a low frequency of behaviour problems. However, the behaviour problems have changed during the two years. At time of adoption they show more nonphysically challenging behaviour while after two years their physically challenging behaviour has increased.

  13. UNDERSTANDING REACTIVE DEPRESSION*

    African Journals Online (AJOL)

    1971-01-02

    Jan 2, 1971 ... ... repressed, internalized, tumed against the self and causes the patient to suffer. ... depression, and suicide) and analysed the Szondi profiles obtained upon a first ... causes resentment and loss of dependency and esteem."".

  14. Drug-related problems identification in general internal medicine: The impact and role of the clinical pharmacist and pharmacologist.

    Science.gov (United States)

    Guignard, Bertrand; Bonnabry, Pascal; Perrier, Arnaud; Dayer, Pierre; Desmeules, Jules; Samer, Caroline Flora

    2015-07-01

    Patients admitted to general internal medicine wards might receive a large number of drugs and be at risk for drug-related problems (DRPs) associated with increased morbidity and mortality. This study aimed to detect suboptimal drug use in internal medicine by a pharmacotherapy evaluation, to suggest treatment optimizations and to assess the acceptance and satisfaction of the prescribers. This was a 6-month prospective study conducted in two internal medicine wards. Physician rounds were attended by a pharmacist and a pharmacologist. An assessment grid was used to detect the DRPs in electronic prescriptions 24h in advance. One of the following interventions was selected, depending on the relevance and complexity of the DRPs: no intervention, verbal advice of treatment optimization, or written consultation. The acceptance rate and satisfaction of prescribers were measured. In total, 145 patients were included, and 383 DRPs were identified (mean: 2.6 DRPs per patient). The most frequent DRPs were drug interactions (21%), untreated indications (18%), overdosages (16%) and drugs used without a valid indication (10%). The drugs or drug classes most frequently involved were tramadol, antidepressants, acenocoumarol, calcium-vitamin D, statins, aspirin, proton pump inhibitors and paracetamol. The following interventions were selected: no intervention (51%), verbal advice of treatment optimization (42%), and written consultation (7%). The acceptance rate of prescribers was 84% and their satisfaction was high. Pharmacotherapy expertise during medical rounds was useful and well accepted by prescribers. Because of the modest allocation of pharmacists and pharmacologists in Swiss hospitals, complementary strategies would be required. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  15. Standardization of depression measurement

    DEFF Research Database (Denmark)

    Wahl, Inka; Löwe, Bernd; Bjørner, Jakob

    2014-01-01

    OBJECTIVES: To provide a standardized metric for the assessment of depression severity to enable comparability among results of established depression measures. STUDY DESIGN AND SETTING: A common metric for 11 depression questionnaires was developed applying item response theory (IRT) methods. Data...... of 33,844 adults were used for secondary analysis including routine assessments of 23,817 in- and outpatients with mental and/or medical conditions (46% with depressive disorders) and a general population sample of 10,027 randomly selected participants from three representative German household surveys....... RESULTS: A standardized metric for depression severity was defined by 143 items, and scores were normed to a general population mean of 50 (standard deviation = 10) for easy interpretability. It covers the entire range of depression severity assessed by established instruments. The metric allows...

  16. [Which route leads from chronic back pain to depression? A path analysis on direct and indirect effects using the cognitive mediators catastrophizing and helplessness/hopelessness in a general population sample].

    Science.gov (United States)

    Fahland, R A; Kohlmann, T; Hasenbring, M; Feng, Y-S; Schmidt, C O

    2012-12-01

    Chronic pain and depression are highly comorbid; however, the longitudinal link is only partially understood. This study examined direct and indirect effects of chronic back pain on depression using path analysis in a general population sample, focussing on cognitive mediator variables. Analyses are based on 413 participants (aged 18-75 years) in a population-based postal survey on back pain who reported chronic back pain at baseline. Follow-up data were collected after 1 year. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Fear-avoidance-beliefs (FABQ), catastrophizing and helplessness/hopelessness (KRSS) were considered as cognitive mediators. Data were analyzed using path analysis. Chronic back pain had no direct effect on depression at follow-up when controlling for cognitive mediators. A mediating effect emerged for helplessness/hopelessness but not for catastrophizing or fear-avoidance beliefs. These results support the cognitive mediation hypothesis which assumes that psychological variables mediate the association between pain and depression. The importance of helplessness/hopelessness is of relevance for the treatment of patients with chronic back pain.

  17. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    OpenAIRE

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

    2016-01-01

    [Background]Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item th...

  18. Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

    Science.gov (United States)

    Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John

    2008-01-01

    Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a "Pure" depression group, an "Internalizing" group (depression and co-occurring internalizing disorders), or an "Externalizing"…

  19. Perspectives on depressive realism: implications for cognitive theory of depression.

    Science.gov (United States)

    Haaga, D A; Beck, A T

    1995-01-01

    Beck's cognitive theory of depression has provided a successful description of depressive thinking, with one major exception. The hypothesis that depressed people show biased negative thinking seems contradicted by research indicating that Ss scoring 9 or above on the Beck Depression Inventory were more accurate than their nondepressed counterparts in judging contingencies between their responses and outcomes, seemingly showing "depressive realism". Depressive realism research has attracted attention in numerous areas of psychology, along with critical commentary focused on such issues as whether realism is limited to mild depressive states, whether laboratory tasks are sufficient to document realism, and whether realism is a general characteristic of either depressed or nondepressed people. We analyze the main critiques and show how debates about depressive realism can be heuristic for refinement of cognitive theory of depression.

  20. A model for predicting depression in victims of rape.

    Science.gov (United States)

    Regehr, C; Regehr, G; Bradford, J

    1998-01-01

    This article proposes a model for understanding the factors contributing to long-standing depression in women who have been raped. A path analysis of data obtained from 71 women who had been raped revealed that women with generalized beliefs that they could not control events in their lives were more likely to attribute responsibility for their rape to permanent intrapsychic factors and were more likely to be depressed. Women who perceived that they had higher levels of internal control tended to have higher levels of education, were more likely to be employed, and were less likely to be depressed more than one year after having been raped. Childhood sexual abuse was not associated with internal control or attributions of causality or depression in this analysis. Implications for the determination of prognosis and treatment recommendations in civil litigation assessments are discussed.

  1. Seasonality in depressive and anxiety symptoms among primary care patients and in patients with depressive and anxiety disorders; results from the Netherlands Study of Depression and Anxiety

    Science.gov (United States)

    2011-01-01

    Background Little is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder. Methods Data were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model. Results In the primary care population the severity of depressive and anxiety symptoms did not show a seasonal pattern. In the diagnostic groups healthy controls and patients with any anxiety disorder, but not patients with a major depressive disorder, showed a small rise in depressive symptoms in winter. Atypical and melancholic symptoms were both elevated in winter. No seasonal pattern for anxiety symptoms was found. There was a small gender related seasonal effect for fear symptoms. Conclusions Seasonal differences in severity or type of depressive and anxiety symptoms, as measured with a general screening instrument and symptom questionnaires, were absent or small in effect size in a primary care population and in patient populations with a major depressive disorder and anxiety disorders. PMID

  2. A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment

    Directory of Open Access Journals (Sweden)

    Tylee André

    2012-06-01

    Full Text Available Abstract Background Community studies reveal people with coronary heart disease (CHD are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings. Methods This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP care. 81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ≥8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant’s physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant’s mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient’s self efficacy to solve their

  3. Statement to the 41st session of the General Conference of the International Atomic Energy Agency 29 September 1997; Statement to the 52nd session of the United Nations General Assembly 12 November 1997

    International Nuclear Information System (INIS)

    Blix, H.

    1997-12-01

    The document presents Statement to the 41st Session of the General Conference of the International Atomic Energy Agency and Statement to the 52nd Session of the United Nations General Assembly made at the 40th anniversary of the IAEA

  4. Statement to the 39th session of the General Conference of the International Atomic Energy Agency 18 September 1995. Statement to the 50th session of the United Nations General Assembly 1 November 1995

    International Nuclear Information System (INIS)

    Blix, H.

    1995-11-01

    In the Statement to the 39th Session of the General Conference of the IAEA main directions of IAEA activities for 1994 and plans for the future are outlined. In the Statement to the 50th Session of the United Nations General Assembly main achievements and challenges facing the international community in the field of IAEA competence are discussed

  5. Statement to the 39th session of the General Conference of the International Atomic Energy Agency 18 September 1995. Statement to the 50th session of the United Nations General Assembly 1 November 1995

    Energy Technology Data Exchange (ETDEWEB)

    Blix, H

    1995-11-01

    In the Statement to the 39th Session of the General Conference of the IAEA main directions of IAEA activities for 1994 and plans for the future are outlined. In the Statement to the 50th Session of the United Nations General Assembly main achievements and challenges facing the international community in the field of IAEA competence are discussed.

  6. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder.

    Science.gov (United States)

    Gentes, Emily L; Ruscio, Ayelet Meron

    2011-08-01

    Intolerance of uncertainty (IU) has been suggested to reflect a specific risk factor for generalized anxiety disorder (GAD), but there have been no systematic attempts to evaluate the specificity of IU to GAD. This meta-analysis examined the cross-sectional association of IU with symptoms of GAD, major depressive disorder (MDD), and obsessive-compulsive disorder (OCD). Random effects analyses were conducted for two common definitions of IU, one that has predominated in studies of GAD (56 effect sizes) and another that has been favored in studies of OCD (29 effect sizes). Using the definition of IU developed for GAD, IU shared a mean correlation of .57 with GAD, .53 with MDD, and .50 with OCD. Using the alternate definition developed for OCD, IU shared a mean correlation of .46 with MDD and .42 with OCD, with no studies available for GAD. Post-hoc significance tests revealed that IU was more strongly related to GAD than to OCD when the GAD-specific definition of IU was used. No other differences were found in the magnitude of associations between IU and the three syndromes. We discuss implications of these findings for models of shared and specific features of emotional disorders and for future research efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria.

    Science.gov (United States)

    Price, Matthew; van Stolk-Cooke, Katherine

    2015-11-01

    Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Comparative cost analysis of generalized anxiety disorder and major depressive disorder patients in secondary care from a national hospital registry in Finland.

    Science.gov (United States)

    Kujanpää, Tero; Ylisaukko-Oja, Tero; Jokelainen, Jari; Linna, Miika; Timonen, Markku

    2014-07-01

    Major depressive disorder (MDD) has shown to cause high costs to society. Earlier research indicates that generalized anxiety disorder (GAD) also causes high costs, but only limited data is available in varying settings. To analyse the secondary care costs of GAD compared with those of MDD. Retrospective database analysis from Finnish Hospital Discharge Registers (FHDR). All GAD and MDD patients diagnosed between 1 January 2007 and 31 December 2007 in FHDR were recorded and individual-level secondary care costs during a 48-month follow-up period were measured. The total mean cost of GAD with history of MDD or some other anxiety disorder was significantly higher than that of MDD with history of GAD or some other anxiety disorder during the 48-month follow-up period. The costs of pure GAD were comparable with those of pure MDD, but after adjusting for age and sex, the costs of pure MDD were higher than those of pure GAD. The economic burden of individual GAD patients is comparable with that of MDD patients in secondary care.

  9. Sociodemographic, clinical, and psychosocial factors associated with depression among type 2 diabetic outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia : a cross-sectional study

    NARCIS (Netherlands)

    Habtewold, Tesfa; Alemu, Sisay Mulugeta; Haile, Yohannes Gebreegziabhere

    2016-01-01

    Background: Depression is a common comorbidity among patients with type 2 diabetes. There are several reports supporting a bidirectional association between depression and type 2 diabetes. However, there is limited data from non-western countries. Therefore, the aim of this study was to assess the

  10. Ethnic Variation in the Cross-sectional Association between Domains of Depressive Symptoms and Clinical Depression

    Directory of Open Access Journals (Sweden)

    Shervin eAssari

    2016-04-01

    Full Text Available BackgroundThe degree by which depressive symptoms and clinical depression reflect each other may vary across populations. The present study compared Blacks and Whites for the magnitude of the cross-sectional associations between various domains of depressive symptoms and endorsement of clinical disorders of depression. MethodsData came from the National Survey of American Life (NSAL, 2001–2003. We included 3,570 Black (African Americans, and 891 Non-Hispanic Whites. Predictors were positive affect, negative affect, and interpersonal problems measured using the 12-item Center for Epidemiologic Studies Depression Scale (CES-D. Outcomes were lifetime MDD, lifetime MDE, 12 month MDE, 30 days MDE, and 30 days MDDH based on the Composite International Diagnostic Interview (CIDI. Logistic regression models were applied in the pooled sample, as well as Blacks and Whites.ResultsRegarding CES-D, Blacks had lower total scores, positive affect, negative affect, and interpersonal problems compared to Whites (p < 0.05 for all comparisons. Blacks also had lower odds of meeting criteria for lifetime MDD and MDE, 12 month MDE, and 30 days MDE and MDDH (p < 0.05 for all comparisons. For most depressive diagnoses, ethnicity showed a positive and significant interaction with the negative affect and interpersonal domains, suggesting stronger associations for Blacks compared to Whites. CES-D total and CES-D positive affect did not interact with ethnicity on CIDI based diagnoses.ConclusionStronger associations between multiple domains of depressive symptoms and clinical MDD may be due to higher severity of depression among Blacks, when they endorse the disorder. This finding may explain some of previously observed ethnic differences in social, psychological, and medical correlates of depressive symptoms and clinical depression in the general population as well as clinical settings.

  11. International Classification of Primary Care-2 coding of primary care data at the general out-patients' clinic of General Hospital, Lagos, Nigeria.

    Science.gov (United States)

    Olagundoye, Olawunmi Abimbola; van Boven, Kees; van Weel, Chris

    2016-01-01

    Primary care serves as an integral part of the health systems of nations especially the African continent. It is the portal of entry for nearly all patients into the health care system. Paucity of accurate data for health statistics remains a challenge in the most parts of Africa because of inadequate technical manpower and infrastructure. Inadequate quality of data systems contributes to inaccurate data. A simple-to-use classification system such as the International Classification of Primary Care (ICPC) may be a solution to this problem at the primary care level. To apply ICPC-2 for secondary coding of reasons for encounter (RfE), problems managed and processes of care in a Nigerian primary care setting. Furthermore, to analyze the value of selected presented symptoms as predictors of the most common diagnoses encountered in the study setting. Content analysis of randomly selected patients' paper records for data collection at the end of clinic sessions conducted by family physicians at the general out-patients' clinics. Contents of clinical consultations were secondarily coded with the ICPC-2 and recorded into excel spreadsheets with fields for sociodemographic data such as age, sex, occupation, religion, and ICPC elements of an encounter: RfE/complaints, diagnoses/problems, and interventions/processes of care. Four hundred and one encounters considered in this study yielded 915 RfEs, 546 diagnoses, and 1221 processes. This implies an average of 2.3 RfE, 1.4 diagnoses, and 3.0 processes per encounter. The top 10 RfE, diagnoses/common illnesses, and processes were determined. Through the determination of the probability of the occurrence of certain diseases beginning with a RfE/complaint, the top five diagnoses that resulted from each of the top five RfE were also obtained. The top five RfE were: headache, fever, pain general/multiple sites, visual disturbance other and abdominal pain/cramps general. The top five diagnoses were: Malaria, hypertension

  12. Prevalence, stability, 1-year incidence and predictors of depressive symptoms among Norwegian adolescents in the general population as measured by the Short Mood and Feelings Questionnaire.

    Science.gov (United States)

    Larsson, Bo; Ingul, JoMagne; Jozefiak, Thomas; Leikanger, Einar; Sund, Anne Mari

    2016-01-01

    Background In numerous surveys the prevalence of depressive symptoms in adolescents has been examined in single sites and at one time point. Aims We examined depressive symptoms among adolescents aged 10-19 years in four different large school samples including two cohorts over a 10-year period in different locations in the same health region in central Norway including a total of 5804 adolescents. Two cohorts were retested within a 1-year time period to predict high versus low depressive symptom scores. Changes over a 6-year period in depressive symptom levels were examined in two of the samples of 12-14-year olds. Methods Depressive symptoms were estimated by the 13-item Short Mood and Feelings Questionnaire (SMFQ). Covariates were student age, sex, school size and location. Results "Miserable or unhappy", "Tired", "Restlessness" and "Poor concentration" were the most commonly reported depressive symptoms. Depressive symptom levels and proportions of high scoring students were consistently higher among girls, in particular in mid and late adolescence. Poisson regression analysis showed that all SMFQ items significantly predicted total scores for the whole sample, while sex (girls having a higher risk) emerged as a consistent 1-year predictor of high depressive symptom levels. Conclusions The SMFQ constitutes a short, practical and feasible measure. We recommend that this standardized measure should be used in the assessment of depressive symptoms among adolescents in school, primary care and clinical settings but also to evaluate treatment outcome. High scorers should be evaluated in subsequent clinical interviews for the presence of a depressive disorder.

  13. Preventing Depression in Adults With Subthreshold Depression

    DEFF Research Database (Denmark)

    Buntrock, Claudia; Berking, Matthias; Smit, Filip

    2017-01-01

    -based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs......BACKGROUND: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. OBJECTIVE: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD......) in people with subthreshold depression (sD). METHODS: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web...

  14. Smallest detectable change and test-retest reliability of a self-reported outcome measure: Results of the Center for Epidemiologic Studies Depression Scale, General Self-Efficacy Scale, and 12-item General Health Questionnaire.

    Science.gov (United States)

    Ohno, Shotaro; Takahashi, Kana; Inoue, Aimi; Takada, Koki; Ishihara, Yoshiaki; Tanigawa, Masaru; Hirao, Kazuki

    2017-12-01

    This study aims to examine the smallest detectable change (SDC) and test-retest reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), General Self-Efficacy Scale (GSES), and 12-item General Health Questionnaire (GHQ-12). We tested 154 young adults at baseline and 2 weeks later. We calculated the intra-class correlation coefficients (ICCs) for test-retest reliability with a two-way random effects model for agreement. We then calculated the standard error of measurement (SEM) for agreement using the ICC formula. The SEM for agreement was used to calculate SDC values at the individual level (SDC ind ) and group level (SDC group ). The study participants included 137 young adults. The ICCs for all self-reported outcome measurement scales exceeded 0.70. The SEM of CES-D was 3.64, leading to an SDC ind of 10.10 points and SDC group of 0.86 points. The SEM of GSES was 1.56, leading to an SDC ind of 4.33 points and SDC group of 0.37 points. The SEM of GHQ-12 with bimodal scoring was 1.47, leading to an SDC ind of 4.06 points and SDC group of 0.35 points. The SEM of GHQ-12 with Likert scoring was 2.44, leading to an SDC ind of 6.76 points and SDC group of 0.58 points. To confirm that the change was not a result of measurement error, a score of self-reported outcome measurement scales would need to change by an amount greater than these SDC values. This has important implications for clinicians and epidemiologists when assessing outcomes. © 2017 John Wiley & Sons, Ltd.

  15. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings - Report from the World Health Organization collaborative study on Psychological Problems in General Health Care

    NARCIS (Netherlands)

    Gater, R; Tansella, M; Korten, A; Tiemens, BG; Mavreas, VG; Olatawura, MO

    Background: Understanding the relevance of biological and social factors to sex differences in the prevalence and detection of depressive and anxiety disorders has been impaired by the lack of standardized research methods across cultures. Method: Prevalence rates of depressive and anxiety disorders

  16. Relapse prevention and residual symptoms: a closer analysis of placebo-controlled continuation studies with escitalopram in major depressive disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-01-01

    -Asberg Depression Rating Scale (MADRS) scores on items 1, 3, and 7 at randomization. RESULTS: All studies showed a statistically significant (P ...-Severity of Illness scores and relapse status in 4 studies published from 2005 to 2007, 1 each in major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD), were analyzed using mixed-effects model repeated measures as a function of Montgomery...... > 0) and without residual symptoms (MADRS score = 0) at the start of continuation treatment were defined by how patients scored on 3 core items of the MADRS: depressed mood (observed), inner or psychic tension, and lassitude. At randomization, patients with a residual symptom were globally more ill...

  17. Relapse prevention and residual symptoms: a closer analysis of placebo-controlled continuation studies with escitalopram in major depressive disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-01-01

    -Severity of Illness scores and relapse status in 4 studies published from 2005 to 2007, 1 each in major depressive disorder (MDD), generalized