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Biomedical subjects

Gordon Parker

Publications and source records attributed to Gordon Parker.

At least 37 records · Page 2Linked to original sources
PubMed2005

Measuring a behaviorally inhibited temperament style: development and initial validation of new self-report measures.

An inhibited temperament early in life has been implicated as a risk factor for the later development of clinically meaningful anxiety and possibly depression. Most empirical investigations study young children, with fewer data obtained from older subjects. Two self-report measures, the Adult Measure of Behavioral Inhibition (AMBI) and the Retrospective Measure of Behavioral Inhibition (RMBI), were developed and evaluated psychometrically. Both instruments were multifactorial with satisfactory psychometric properties. Results indicated that the RMBI performed favorably as a measure of (retrospectively reported) childhood temperament, with good construct and discriminant validity. Designed as a measure of trait behavioral inhibition in adulthood, the AMBI also performed as a measure of contemporaneous anxiety proneness. Although the identified factor structure of both measures requires further examination in independent samples, current results support their use as valid measurement tools for studies examining the link between normal range temperament and psychopathology, especially where more rigorous prospective methods are unavailable. The RMBI may be a particularly useful instrument in this regard.

Adolescent↗
PubMed2005

Maternal trait anxiety, depression and life event stress in pregnancy: relationships with infant temperament.

AIMS: To assess whether links exist between maternal trait anxiety (STAI), perceived life event (LE) stress and depression (Edinburgh scale) and infant temperament. STUDY DESIGN AND SUBJECTS: Women in the third trimester of pregnancy returned psychological self-report questionnaires; infant temperament was evaluated at 4 and 6 months by maternal and paternal report, while depression (concurrent Edinburgh scale) was also assessed at four and six months. As data were returned inconsistently at 4 and 6 months, we combined these two time points for simplicity of reporting and optimisation of numbers. RESULTS: Univariate logistic regressions on 970 subjects indicated that the pregnancy STAI (>40) scores were associated with 2.56- and 1.57-fold increases (maternal and paternal, respectively), in the odds of "difficult" infant temperament at 4 or 6 months. Concurrent Edinburgh scores (OR of 3.06 and 2.64 for maternal reports, respectively) were also predictive of infant temperament. Age, education, income, marital status, obstetric complications, infant gender and prematurity were not predictive of infant temperament. In stepwise multiple logistic regression analyses, the antenatal trait STAI (odds ratio 1.96) significantly predicted maternal reports of "difficult" temperament at 4 or 6 months independent of both antenatal and postnatal depression scores. There were similar trends for paternal reports of "difficult" temperament but these were not significant. Antenatal depression and perceived LE stress were not predictive of temperament. Finally, women (N=14) reporting domestic violence (DV) in pregnancy had highly significant increased Edinburgh and STAI scores. CONCLUSIONS: Maternal trait anxiety was predictive of "difficult" infant temperament, independent of "concurrent" depression and key sociodemographic and obstetric risk factors. These findings, while needing replication using objective measures of infant temperament, suggest that antenatal psychological interventions aimed at minimising anxiety may optimize infant temperament outcomes. There may be some benefit in shaping specific interventions to women reporting specific risk factors such as DV or past abuse.

Anxiety Disorders↗
PubMed2005

Vascular risk and low serum B12 predict white matter lesions in patients with major depression.

BACKGROUND: While patients with depression have been shown to have a greater incidence of vascular risk factors and structural brain changes, any association with dietary co-factors is unclear. METHODS: Forty-seven patients with major depression (mean age = 52.8 years, SD = 12.6) and 21 healthy volunteers (mean age = 54.7 years, SD = 9.1) underwent high-resolution magnetic resonance imaging scanning. T2-weighted films were scored for deep white matter (DWM), periventricular (PV), and subcortical (SC) hyperintensities. RESULTS: There was no difference in lesion severity between patients and control subjects. After controlling for age, vitamin B12 levels were predictive of DWM lesions in patients. DWM and SC lesions were associated with histories of hypertension and diabetes. LIMITATIONS: A relatively small sample of patients were recruited from specialist services and the findings may not represent those observed in larger or community-based cohorts. CONCLUSIONS: In patients with major depression, vitamin B12 levels and histories of hypertension and/or diabetes are predictive of white matter lesions.

Adult↗
PubMed2005

Great expectations: factors influencing patient expectations and doctors recommendations at a Mood Disorders Unit.

BACKGROUND: Literature about expectations and management of depression within community samples reflects attitudes of people who have generally not received treatment. We examined the factors influencing treatment expectations and psychiatrists' treatment recommendations for patients referred to a mood disorders unit with identified episodes of major depression. METHODS: Prior to attending a mood disorders unit, 182 men and women who met DSM-III-R or DSM-IV criteria for current major depression provided data on sociodemographic details, history of medical and psychiatric illness and expectations of treatment. Psychiatrists' treatment recommendations to the referring clinician were assessed to determine whether the patients' initial expectations were met. RESULTS: Data analyses revealed three factors relating to patients' expectations: "enhanced coping", "providing fresh ideas for the referring doctor" and "providing fresh ideas to self". Patients' expectations were influenced by sociodemographic and illness-related characteristics. In particular, young female patients typically expected to receive strategies to enhance coping, while those with lifetime anxiety expected less active involvement on their part. Some clinicians' recommendations were dependent upon depression type and patient factors. Women and those with a history of anxiety disorders received more education and recommendations for relationship counselling and support groups. LIMITATIONS: The study design did not allow determination of the impact of patients' expectations on the psychiatrists' recommendations. CONCLUSIONS: Individual and illness characteristics are important predictors of treatment expectations prior to specialist care. It appears that doctors take these factors into account with implications for patients' satisfaction with the type of care recommended.

Adaptation, Psychological↗
PubMed2005

The stability of the Parental Bonding Instrument over a 20-year period.

BACKGROUND: The Parental Bonding Instrument (PBI) measures the perception of being parented to the age of 16 years. Low scores on the care dimension and high scores on the overprotection dimension are considered to be risk factors of depression. While the PBI has been shown to be a reliable and valid instrument, the stability of the PBI over extended periods (taking into account individual characteristics and life experience) needs to be demonstrated. METHOD: The PBI was measured in a non-clinical cohort on four waves between 1978 and 1998, along with a series of self-report measures including state depression and neuroticism. Differences in PBI change over time were examined by gender, lifetime major depression diagnosis, and life event variables, as well as by scores on neuroticism and state depression. RESULTS: Acceptable retest coefficients on PBI scores over the 20-year study were found for the cohort. No differences were found in PBI scores over time on the variables examined, including sex and depression measures. CONCLUSIONS: The results indicate long-term stability of the PBI over time. The influences of mood state and life experience appear to have little effect on the stability of the perception of parenting as measured by the PBI. The present study increases confidence in the PBI as a valid measure of perceived parenting over extended time periods.

Adolescent↗
PubMed2005

Beyond major depression.

BACKGROUND: The DSM concept of 'major depression' has accrued increased status but demonstrated limited utility since inception. METHOD: An historical overview of models of depression and the initially perceived advantages presented by the concept of 'major depression' are presented before detailing its limitations in application. RESULTS: Challenges to the utility of 'major depression' are provided by examining its conceptual model, its validity, its utility and the limited information generated in aetiological and treatment efficacy studies. CONCLUSION: It is argued that the concept of 'major depression' has led to sterility in depression research and clinical practice, and that there is a need for a paradigm shift in modelling and classifying the depressive disorders.

Depressive Disorder↗
PubMed2005

Depression in the Chinese: the impact of acculturation.

BACKGROUND: Studies of depression in the Chinese have long identified low rates and a greater likelihood of somatization, findings which could reflect cultural influences or real differences. We report a study from a western region examining the impact of acculturation on depression to clarify the role of cultural factors. METHOD: In a Sydney-based study, Chinese subjects (n = 385) and a matched control group of 143 non-Chinese subjects completed either a Chinese or English questionnaire assessing state and lifetime depression, attributional style, depression recognition and help-seeking. The impact of acculturation was examined by several strategies. RESULTS: Any tendency by the Chinese to somatize depression appeared to be attenuated by acculturation. State depression levels countered the view that Chinese necessarily deny depression. Lifetime depression rate differences were also attenuated by acculturation, with Chinese subjects being less likely than controls to judge episodes as a distinct disorder and to seek professional help. CONCLUSIONS: Results suggest that Australian Chinese do not differ intrinsically in recognizing and ascribing depressive symptoms, and that the greater the degree of acculturation, the greater the tendency for reporting persistent and impairing depressive episodes.

Acculturation↗
PubMed2005

Role of omega-3 fatty acids as a treatment for depression in the perinatal period.

OBJECTIVES: To consider the possible rationale and utility of omega-3 fatty acids as a treatment for depression in the perinatal period. METHOD: A review of published and unpublished research was undertaken, using electronic databases, conferences proceedings and expert informants. RESULTS: Relevant bodies of evidence include an epidemiological link between low fish intake and depression. Laboratory studies show correlations between low omega-3 fatty acid levels and depression, as well as reduced levels of omega-3 in non-depressed women during the perinatal period. Treatment studies using omega-3 in patients with mood disorders further support an omega-3 contribution, as do neuroscientific theories. Research into omega-3 and infant development also highlights potential effects of depletion in the perinatal period and supports infant safety and benefits of supplementation. CONCLUSIONS: There is a relative lack of knowledge about the safety of standard antidepressants in the perinatal period. There is a clear need for more research into alternative treatments, such as omega-3 fatty acids, in the management of depression in the perinatal period.

Cross-Sectional Studies↗
PubMed2005

Falls and fractures in women at work.

BACKGROUND: Older women have been observed to have more serious injury particularly fractures after slips, trips or falls at the workplace. It is unclear whether this excess reflects a greater likelihood of falling or a greater proportion presenting with fractures once the fall has occurred. METHODS: Two studies were carried out: Study A, of 130 women who fell at work and matched referents, and Study B, of 120 women who fell at work and sustained a major fracture and 314 matched referents who fell but for whom no fracture was recorded. In Study A, the workplace of the case and referent was observed, questionnaires completed and objective health measures carried out. Study B relied on information obtained from the subject by postal questionnaire. RESULTS: Women who fell were older than referents matched on workplace and occupation, but age did not continue to be a significant factor after allowing for bodyweight and use of spectacles. Fractures were more common in older women who fell, particularly post-menopausal women with low body mass. The risk of fracture increased steadily with age without an obvious discontinuity around the likely age of menopause. CONCLUSIONS: The observed excess of fractures in older women falling at work appeared to be explained by the greater risk of fracture among those who fell.

Accidental Falls↗
PubMed2005

Age and gender in the phenomenology of depression.

OBJECTIVE: Authors investigated the effects of current age, age at onset, and gender on the phenomenology of depression. METHODS: A mixed-age sample of 810 Mood Disorders Unit attendees with a diagnosis of unipolar major depressive episode at or near its nadir were interviewed by clinician-rated and self-report instruments assessing symptoms and severity of depression. RESULTS: Differences were found in depressive phenomenology according to current age but not age at onset, confirming previous findings. Age differences on several variables were found in women only. Subjective ratings of depression severity decreased with age, whereas objective, clinician-rated severity increased. CONCLUSIONS: The pattern and severity of depression change with increasing age. Longitudinal prospective studies would further elucidate this age-gender relationship. Clinicians should be aware of the decreased likelihood of older patients' reporting of depressive symptoms themselves.

Adolescent↗
PubMed2005

Is combination olanzapine and antidepressant medication associated with a more rapid response trajectory than antidepressant alone?

OBJECTIVE: The authors' goal was to determine if prescription of antidepressant medication plus olanzapine initiates a more rapid response than prescription of antidepressant alone. METHOD: Twenty patients with major depression were studied. For 2 weeks the patients were blindly assigned to receive antidepressant plus olanzapine or antidepressant plus placebo. After 2 weeks, olanzapine augmentation was initiated for patients who did not improve with placebo augmentation. Response to medication was measured primarily by Hamilton Depression Rating Scale score. Other measures were the CORE, Clinical Global Impression, Beck Depression Inventory, and Daily Rating Schedule. RESULTS: Hamilton depression scores improved nonsignificantly in response to olanzapine combination therapy, but that trend was not evident on any secondary measure. Four patients who did not improve while receiving antidepressant and placebo showed rapid remission following late olanzapine augmentation. CONCLUSIONS: Failure to demonstrate any benefit from initial combination therapy may reflect an underpowered rather than a negative study. The distinct impact of late olanzapine augmentation suggests that pretreatment with an antidepressant may be required to facilitate a rapid antidepressant response to combined treatment.

Antidepressive Agents↗
PubMed2005

Melancholia.

Explore the source record for details and available documents.

Australia↗
PubMed2005

Reduced hippocampal volumes and memory loss in patients with early- and late-onset depression.

BACKGROUND: Hippocampal volume reduction has been reported inconsistently in people with major depression. AIMS: To evaluate the interrelationships between hippocampal volumes, memory and key clinical, vascular and genetic risk factors. METHOD: Totals of 66 people with depression and 20 control participants underwent magnetic resonance imaging and clinical assessment. Measures of depression severity, psychomotor retardation, verbal and visual memory and vascular and specific genetic risk factors were collected. RESULTS: Reduced hippocampal volumes occurred in older people with depression, those with both early-onset and late-onset disorders and those with the melancholic subtype. Reduced hippocampal volumes were associated with deficits in visual and verbal memory performance. CONCLUSIONS: Although reduced hippocampal volumes are most pronounced in late-onset depression, older people with early-onset disorders also display volume changes and memory loss. No clear vascular or genetic risk factors explain these findings. Hippocampal volume changes may explain how depression emerges as a risk factor to dementia.

Adult↗
PubMed2005

Atypical depression: Australian and US studies in accord.

PURPOSE OF REVIEW: A 2004 review of 'atypical depression' in Current Opinion in Psychiatry could be read as more reifying the Columbian and DSM-IV concept rather than considering an alternative model that has been supported by independent studies undertaken in Australia and North America. Additional analyses of the Australian data set are reported to examine inter-study agreement further and to consider the implications. RECENT FINDINGS: Both studies recruited patients meeting criteria for a major depressive episode, and then contrasted patients meeting or not meeting DSM-IV criteria for definite atypical depression. In both studies, those with atypical depression were comparable in terms of female preponderance, age, age at first episode and depression severity, but developed earlier and more persistent episodes, showed a slight female preponderance, and were more likely to meet criteria for panic disorder, social phobia and hypochondriasis, and of avoidant and dependent personality styles. In both, there was a lack of evidence suggesting that atypical depression differs in severity, in being clearly less likely to have certain 'endogeneity' symptoms, or in being more likely to be associated with bipolar disorder, while neither the centrality of mood reactivity nor interdependence of symptoms could be demonstrated. SUMMARY: Findings from both studies challenge the view that atypical depression is an entity and the current model of its constituent features. Both found support for primacy of personality style (rather than mood reactivity) and for certain expressions of anxiety. Both effectively argue for and assist shaping of a revisionist model for conceptualizing atypical depression as a syndrome or spectrum disorder.

Journal Article↗
PubMed2004

Capacity of the 10-item Depression in the Medically Ill screening measure to detect depression 'caseness' in psychiatric out-patients.

The 10-item Depression in the Medically Ill (DMI-10) screening measures has been demonstrated to be useful in medically ill and general practice patients. Its usefulness as a screening or monitoring measure in depressed psychiatric out-patients is now reported. One hundred subjects-currently depressed or recovered from a recent episode-completed the measure, with scores for those 69 currently meeting DSM-IV depression caseness criteria compared with 31 non-depressed subjects. A cut-off score of 10 or more had high sensitivity and specificity for discriminating between 'cases' and 'non-cases'. The discriminating capacity of each item was also quantified. We conclude that the DMI-10 is brief, gender non-specific and less intrusive than many depression screening measures in clinical practice with depressed patients, with the currently established cut-off score similar to that established in medically ill samples. Analyses suggest useful items for clinicians to determine depression caseness status.

Adult↗