Gender differences in depression in relation to life events.
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Adult↗
Biomedical subjects
S Saxena
Publications and source records attributed to S Saxena.
Treatment-resistant depression: clinical significance, concept and management.
Depression is a common disorder which causes intense personal suffering and socio-occupational dysfunction. It also imposes a heavy economic burden on society. It has been shown that between 29% and 46% of depressed patients fail to respond adequately to antidepressant medication. Treatment-resistant depression may contribute to the morbidity and mortality associated with affective illness. When treatment resistance is suspected, the patient's history should be reevaluated particularly regarding diagnostic subtypes and comorbidity. An assessment of treatment adequacy in terms of dose, duration and compliance should also be made. Treatment strategies for treatment-resistant depression should be systematic and empirically grounded because of the risk of increased resistance and loss of time in case of a random trial-and-error approach, and the inherent risks in certain novel strategies. A stepped care approach to treatment-resistant depression involves optimization of the current drug under trial, augmentation with drugs such as lithium and triiodothyronine, and switching to other somatic therapies such as electroconvulsive therapy and monoamine inhibitors. Only if these strategies fail, should novel treatments such as the use of venlafaxine, antidepressant combinations and augmentation with sleep deprivation be considered. Experimental strategies such as the use of antiglucocorticoids and sex hormones, which carry considerable risk, should be restricted to research settings. Somatotherapy should be combined in all cases with depression-specific psychotherapy. Psychosurgery should be considered only in truly intractable cases. Rational and energetic treatment can adequately help a large majority of patients with treatment-resistant depression.
Adolescent↗
WHOQOL-Hindi: a questionnaire for assessing quality of life in health care settings in India. World Health Organization Quality of Life.
BACKGROUND: Quality of life is becoming an important component of overall assessment in health care settings. However, satisfactory instruments are not available for use in India. METHODS: Qualitative and quantitative work was conducted at the Delhi centre as a part of the WHOQOL (World Health Organization Quality of Life) project at 15 centres in developing and developed countries to construct a new quality of life instrument (WHOQOL). The pilot field trial at Delhi was conducted on 304 adult subjects using the 236-item questionnaire. RESULTS: Based on the pilot field trial data, item reduction could be done to develop a 100-item version (WHOQOL-100, Hindi). The items are distributed into 4 domains (physical; psychological, social and environmental health) and 25 facets. Each facet has four items, rated on a five-point scale. The initial psychometric properties of this instrument are satisfactory. A 26-item short version has also been developed (WHOQOL-Bref, Hindi). CONCLUSION: The WHOQOL-100, Hindi appears to be a suitable instrument for comprehensively assessing quality of life in health care settings. WHOQOL-Bref, Hindi can be used for intervention studies including drug trials.
Factor Analysis, Statistical↗