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At least 685 records · Page 38Linked to original sources
PubMed2001

How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression.

OBJECTIVE: To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. SETTING: A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). PARTICIPANTS: The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. CONCLUSIONS: The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.

Aged↗
PubMed2000

The evaluation of the Center for Epidemiologic Studies Depression (CES-D) scale: Depressed and Positive Affect in cancer patients and healthy reference subjects.

This study examined the reliability and validity of a two-factor structure of the Center for Epidemiologic Studies Depression (CES-D) scale. The study was conducted in a large group of cancer patients (n = 475) and a matched reference group (n = 255). Both groups filled in a questionnaire at two points in time; patients 3 and 15 months after diagnosis. Factor analysis confirmed our hypothesis that the 16 negatively and four positively formulated items measure two relatively independent factors, i.e. Depressed Affect and Positive Affect. Therefore, these items should not be combined into an overall sumscore. In both groups, Depressed Affect proved to be a reliable and valid measure of depressive symptomatology, as indicated by its good internal consistency, its strong correlations with other measures of psychological distress and neuroticism, and its effectiveness in discriminating patients from the reference group on depressive symptomatology. In contrast, the validity of the Positive Affect factor could not be confirmed, since it was only weakly related to other measures of psychological distress and extraversion. Depressed and Positive Affect were about equally related to self-esteem, life satisfaction, and quality of life. These findings support the use of a sumscore based on the 16 negatively formulated CES-D items as a more valid measure of depressive symptomatology, in cancer patients and in healthy individuals from the general population.

Adult↗
PubMed2003

Affective (depressive) morbidity in puerperal Nigerian women: validation of the Edinburgh Postnatal Depression Scale.

OBJECTIVE: To determine the rate of depression in a group of postpartum Nigerian women and to validate the Edinburgh Postnatal Depression Scale (EPDS) in this group. METHOD: Between April and August 2000, all postpartum women who remained in the maternity ward for up to 7 days, and those who attended the postnatal clinics of Nnamdi Azikiwe University Teaching Hospital were recruited. Translated local language versions of the EPDS and the Zung Self-Rating Depression Scale were used to screen the subjects. A structured interview schedule was adapted from the depression section of the Composite International Diagnostic Interview and affective module of the ICD-10 Symptom Check List to assess screened subjects. RESULTS: The total rejection rate was 23%, with 225 women participating in the study. Twenty-four subjects (10.7%) had depression. At the optimal cut-off score of 9, the EPDS had a sensitivity of 0.75, and specificity of 0.97. CONCLUSION: The EPDS clearly distinguished between depressed and non-depressed postpartum mothers (t = 7.63, P < 0.001, df = 222). Because of its brevity and acceptability, it is recommended that the EPDS be used in routine postnatal screening.

Adolescent↗
PubMed1996

Depression and smoking cessation: characteristics of depressed smokers and effects of nicotine replacement.

Previous research has linked depression to difficulties in smoking cessation. The authors followed 269 smokers who attempted to quit smoking for 3 months. Participants were given nicotine gum (2 or 4 mg) or placebo gum and brief counseling. The study found that 34% of the smokers met the criterion for current depression using the Center for Epidemiological Studies Depression Scale. Depressed smokers relapsed significantly earlier than the nondepressed. Nicotine gum was significantly more effective than placebo gum among all smokers. The benefits of nicotine gum were particularly apparent among the depressed. Only 12.5% of depressed smokers quit successfully with placebo gum for 3 months, whereas 29.5% quit with nicotine gum. Depressed smokers reported more stress, less coping resources, more physical and psychological symptoms, and more frequent smoking in the presence of negative affect than did the nondepressed.

Adaptation, Psychological↗
PubMed1989

Processing of ambiguous and unambiguous feedback by depressed and nondepressed college students: schematic biases and their implications for depressive realism.

Explored schematic processing as a mechanism for predicting (a) when depressed Ss would be negative relative to nondepressed Ss and (b) when depressed and nondepressed Ss would show biased or unbiased (i.e., "realistic") processing. Depressed and nondepressed Ss performed multiple trials of a task under conditions in which the two groups held either equivalent or different schemas regarding this task. Ss received either an unambiguous or objectively normed ambiguous feedback cue on each trial. In full support of schematic processing, depressed Ss showed negative encoding relative to nondepressed Ss only when their schemas were more negative, and both depressed and nondepressed Ss showed positively biased, negatively biased, and unbiased encoding depending on the relative feedback cue-to-schema match. Depressed and nondepressed Ss' response latencies to unambiguous feedback also supported the occurrence of schematic processing. We discuss the methodological, treatment, and "realism" implications of these findings and suggest a more precise formulation of Beck's schema theory of depression.

Adult↗
PubMed2004

Preferential 5-HT1A autoreceptor occupancy by pindolol is attenuated in depressed patients: effect of treatment or an endophenotype of depression?

Using positron emission tomography and the selective 5-HT1A receptor radioligand [11C]WAY100635, we previously demonstrated a preferential occupancy of 5-HT1A autoreceptors, compared to postsynaptic receptors by pindolol in healthy volunteers. We have speculated that preferential occupancy may be clinically important for the purported actions of pindolol in accelerating the antidepressant effects of selective serotonin re-uptake inhibitors (SSRIs). In this study, we have examined the preferential occupancy by pindolol of 5-HT1A autoreceptors, following three different pindolol regimes (10 mg single dose, 2.5 mg t.i.d., and 5 mg t.i.d., in 15 depressed patients on SSRIs. In addition, seven healthy volunteers were examined following a single 10 mg dose of pindolol. We found a preferential occupancy of 22.6+/-7.7% following a single dose of 10 mg of pindolol, in the healthy volunteers, which was attenuated in depressed patients on the same dose of pindolol to 2.9+/-10.8% (Student's t=3.94, df=12, p=0.002). In addition, we found a significant negative correlation between the degree of preferential occupancy and the severity of depression as assessed by the Hamilton depression rating score (HAM-D), Spearman's rho=-0.728, N=14, p=0.003, in the depressed sample. A possible mechanism underlying preferential occupancy and the attenuation of this phenomenon in depressed patients on SSRIs may include changes in the proportion of high affinity 5-HT1A sites in the autoreceptor region of the midbrain raphe. Speculatively, the degree of preferential occupancy may serve as a surrogate marker for depression, or the pharmacological effects of antidepressants.

Adrenergic beta-Antagonists↗
PubMed2001

Depression and smoking: examining correlates in a subset of depressed patients.

OBJECTIVE: The objective of this study was to examine for associations between depression and cigarette smoking. METHOD: A sample of 92 depressed smokers was compared with a control sample of depressed non-smokers, matched for age, gender and diagnostic variables. Comparisons were made across a range of demographic, depression, family history, developmental factors, anxiety and personality style variables, as well as use of alcohol and illicit drugs. RESULTS: We failed to find any difference between smokers and non-smokers in history or severity of depression. Cigarette smokers were distinguished principally by greater exposure to aversive experiences in childhood, disordered personality function, greater use of illicit drugs, anxiolytics and alcohol. Logistic regression identified dysfunctional personality 'domains', physical violence in childhood, long-term anxiolytic use and illicit drug use as the most significant predictor set. CONCLUSIONS: Results favour a model of cigarette smoking and depression as linked by shared early deprivational variables, rather than cigarette smoking causing depression or the converse.

Adult↗
PubMed2006

Changes in depression awareness and attitudes in Australia: the impact of beyondblue: the national depression initiative.

OBJECTIVE: To assess changes in depression awareness and attitudes in Australia and the effect that beyondblue: the national depression initiative has had on these. METHOD: Data from national surveys of mental health literacy in 1995 and 2003-2004 were analysed to see if states and territories that funded beyondblue (the high-exposure states) had greater changes than those that did not (the low-exposure states). In both surveys, participants were shown a depression vignette and asked whether they themselves or family or friends had ever had a similar problem, whether they thought the person would be discriminated against, and questions about the likelihood of long-term positive and negative outcomes for the person. Participants were also assessed for symptoms of psychological distress in the past month. RESULTS: There was an increase in the percentage of people who said that they or their family or friends had a problem like the person in the vignette. This increase was greater in the high-exposure states. However, there was no change in reports of current psychological distress, suggesting that there is greater depression awareness or openness rather than a real increase in symptoms. People in the high-exposure states also showed an increase in the belief that discrimination would occur. There was little change in beliefs about long-term outcomes, apart from people in high-exposure states believing that a depressed person would be more understanding of other people's feelings. CONCLUSIONS: The data are consistent with beyondblue having had an effect on awareness of depression and of discrimination against depressed people.

Adolescent↗
PubMed2001

A longitudinal study of the relationship between levels of depression among persons with Alzheimer's disease and levels of depression among their family caregivers.

The purpose of this study was to examine the effects, over time, of depressive symptoms in persons with Alzheimer's disease on depression in their family caregivers. In a sample of 353 patients and caregivers, multilevel longitudinal analysis was used to accommodate an observational design in which the number of observation points and the intervals between points varied across caregivers. The rate of change (increase) in caregiver depression was predicted by the rate of change (increase) in patient depressive symptoms and by increase in patient dependency in instrumental activities of daily living (ADLs). Acceleration of the increase in caregiver depression was predicted by acceleration in patient dependency in instrumental and basic ADLs but not by acceleration in patient depressive symptoms. These findings indicate the importance of measuring the rate and acceleration of change in patient characteristics in order to understand caregiver depression. They also support early interventions for caregivers.

Activities of Daily Living↗
PubMed1998

Major depression: behavioral markers of depression and recovery.

The concepts of psychosocial and psychomotor inhibition characteristic of major depression are based primarily on clinical observations. It is possible to describe and define these two types of inhibition by means of a systematic, quantitative ethological (behavioral) approach, which singles out precise and significant behavior markers. This investigation focuses on the behavioral features of psychosocial and psychomotor inhibition in 11 hospitalized depressed subjects and their changes during clinical recovery. The hypothesis that major depression is characterized by a significant reduction of social interaction is tested (psycho-intellectual inhibition is not addressed). Results show significant behavioral differences between depressed and recovered subjects with depression being characterized by a significant reduction of social interaction, whereas self occupation and body mobility are reduced to a lesser degree. Behavior markers for depression include nonspecific gaze, withdrawal, no mouth movements, no eye region movements, and social inactivity. Behavior markers for recovery include socially interested, social smile, verbal social initiative, speech, nod, raised eyebrows, wrinkled eyebrows, social laughter, gesticulation, drum one's fingers, point, and help. Findings point to tendencies toward two types of major depression and two types of recovery. A companion paper (Schelde, this journal) addresses theoretical issues.

Adult↗
PubMedDate not supplied

Screening for depression in diabetes using the Beck Depression Inventory.

OBJECTIVE: The purpose of this study was to determine the utility of the Beck Depression Inventory (BDI) as a screening tool for major depression in diabetes. METHOD: One hundred seventy-two diabetic outpatients (insulin-dependent diabetes mellitus [IDDM] = 59, or non-insulin-dependent diabetes mellitus [NIDDM] = 113) being evaluated for a treatment trial were studied. BDI scores were calculated for the complete 21-item measure as well as for the cognitive (13 items) and somatic (eight items) symptom subgroups. The presence of depression was determined using the National Institute of Mental Health Diagnostic Interview Schedule in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. Receiver operating characteristic (ROC) analyses were used to evaluate the performance of the screening test in relation to the diagnostic standard. RESULTS: Depressed subjects were effectively discriminated from nondepressed subjects by using the full 21-item BDI, the cognitive items alone, or the somatic items alone (p < .001 for each comparison), although the cognitive items were more effective than the somatic items (p < .0005). BDI total scores between 12 and 14 inclusive displayed the best balance between sensitivity (0.90-0.82) and specificity (0.84-0.89), but a cutoff score > or = 16 for the entire 21-item measure exhibited the best balance between sensitivity and positive predictive value when prediction values were extrapolated to a diabetic population with a depression prevalence rate of 20%. This cutoff score would capture > 70% of the patients diagnosed with major depression yet provide > 70% certainty that a person screening positive actually has the psychiatric disorder. CONCLUSION: The BDI is an effective screening test for major depression in diabetic patients. Prospective studies are needed to confirm the test's precise performance characteristics in the general clinical setting.

Adolescent↗
PubMed1999

Cerebrovascular risk factors and depression in older primary care patients: testing a vascular brain disease model of depression.

The authors examined whether cerebrovascular risk factors (CVRFs) are associated with depressive diagnoses and symptoms in 303 primary-care patients age >/=60 years, as would be consistent with a small-vessel brain disease model of later-life depression. CVRFs were not significantly independently associated with major, minor, or subsyndromal depression, late-onset major depression, or overall depressive symptom severity. These data did not support the notion that a small-vessel brain disease model of depression might apply to the majority of older persons with depressive symptoms and syndromes in primary-care settings. Future work should include longitudinal study with larger sample sizes.

Aged↗
PubMed2006

Test characteristics of the 15-item geriatric depression scale and Hamilton depression rating scale in Parkinson disease.

OBJECTIVE: The objective of this study was to compare the sensitivity, specificity, and diagnostic accuracy of the 15-item Geriatric Depression Scale (GDS-15) and the Hamilton Depression Rating Scale (HDRS) in patients with Parkinson disease (PD). METHOD: A convenience sample of 148 outpatients with idiopathic PD receiving specialty care completed the GDS-15 and were administered the HDRS and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID) depression module by a research psychiatrist or trained research assistant. Receiver-operating characteristic (ROC) curves were plotted for the GDS-15 and HDRS scores with a SCID diagnosis of a depressive disorder as the state variable. RESULTS: Thirty-two subjects (22%) were diagnosed with a depressive disorder. The discriminant validity of the GDS-15 and HDRS were both high (ROC area under the curve: 0.92 and 0.91, respectively), with greatest dichotomization for the GDS-15 at a cutoff of 4/5 (87% accuracy, 88% sensitivity, 85% specificity) and the HDRS at a cutoff of 9/10 (83% accuracy, 88% sensitivity, 78% specificity). CONCLUSIONS: The GDS-15 performs well as a screening instrument and in distinguishing depressed from nondepressed patients in PD. Its test characteristics are comparable to the HDRS. Because it is a brief instrument and can be self-administered, it is an excellent depression screening tool in this population.

Adult↗
PubMed2004

Depression in France and Brazil: factorial structure of the 17-item Hamilton Depression Scale in inpatients.

Among various research strategies for depression, the cross-cultural approach is a useful tool to investigate depressive disorders. The Hamilton Rating Scale for Depression was applied to 130 depressed inpatients in France and Brazil. Items were factorized by principal component analysis with Varimax rotation using the Kaiser or simulation method for factor sorting. Three factors were obtained in France, and four in Brazil. The first factor includes the core symptoms of depression in both samples. Qualitative and quantitative differences appeared in the anxiety factor between Brazilian and French samples. Insomnia items appeared as another factor for both groups. A limitation of this study is that it was conducted with small inpatient samples. Principal component analysis of the Hamilton Rating Scale for Depression for depressive inpatients in these two countries showed a similar structure. Differences observed were in the way anxiety items were distributed.

Adult↗
PubMed2006

Negative bias in the perception of others' facial emotional expressions in major depression: the role of depressive rumination.

Depressed individuals display a negative bias in the perception of others' facial emotional expressions. The extent of this selective processing, moreover, has proven predictive of a poor outcome in depression. However, to date, little is known about the possible mechanisms that may account for this bias. This study examined the hypothesis that rumination--an analytical type of self-focused attention--would be associated with higher levels of perception of negative facial emotions in major depression. Twenty-six depressed patients (17 women) completed the Perception of Facial Expressions Questionnaire, the Ruminative Response Scale, and other measures assessing depression-related constructs. Consistent with prediction, rumination was positively related to a negative bias in the judgment of facial expressions, even when controlling for other depression-related variables. Although the correlational design of the present study limits the extent to which conclusions can be drawn on the directionality of the observed relationship, the present study reveals self-focused rumination as a possibly important causal mechanism in explaining depressed persons' negative bias in the perception of others' facial emotions.

Adult↗
PubMed1988

Infants of depressed mothers show "depressed" behavior even with nondepressed adults.

To determine whether the "depressed" behavior (e.g., less positive affect and lower activity level) of infants noted during interactions with their "depressed" mothers generalizes to their interactions with nondepressed adults, 74 3-6-month-old infants of "depressed" and nondepressed mothers were videotaped in face-to-face interactions with their mothers and with nondepressed female strangers. "Depressed" mothers and their infants received lower ratings on all behaviors than nondepressed mothers and infants. Although the infants of "depressed" versus nondepressed mothers also received lower ratings with the stranger adult, very few differences were noted between those infants' ratings when interacting with their mother versus the stranger, suggesting that their "depressed" style of interacting is not specific to their interactions with depressed mothers but generalizes to their interactions with nondepressed adults as early as 3 months of age.

Adolescent↗
PubMed1989

Depressed mothers' judgments about their children: an examination of the depression-distortion hypothesis.

The belief that depressed mothers have distorted perceptions of their children's problems has gained considerable currency in recent years. The empirical basis for this belief at present amounts to little more than reliable demonstrations that depressed mothers tend to report more behavior problems in their children than do nondepressed mothers. An obvious alternative to the distortion interpretation is that depressed mothers are accurate about their children's behavior problems. We examined these competing models by comparing teachers' ratings of children with ratings provided by their mothers, who varied on the dimensions of depressed mood, depressed clinical state, and history of depression. Mothers' and teachers' ratings yielded substantially similar portraits of child behavior problems at the group level, with children of in-remission and in-episode mothers manifesting significantly higher levels of behavior problems than children of control mothers. Moreover, agreement between mothers and teachers was in the moderate range for all index groups and did not differ significantly from the mean level of mother-teacher agreement reported by other investigators based on unselected samples. The limitations of these findings and of earlier reports for assessing a depression----distortion influence on mothers' ratings of their children are considered.

Adult↗
PubMed2007

Onset of depression in elderly persons after hip fracture: implications for prevention and early intervention of late-life depression.

OBJECTIVES: To identify predictors of onset of major depressive disorder (MDD) and of depressive symptoms in subjects who suffered a hip fracture. DESIGN: Prospective naturalistic study. SETTING: University of Pittsburgh Medical Center-Shadyside, a large urban hospital in Pittsburgh, Pennsylvannia. PARTICIPANTS: One hundred twenty-six elderly patients who received surgical fixation for hip fracture and who were not experiencing a major depressive episode at the time of the fracture; severely cognitively impaired persons were excluded. MEASUREMENTS: Subjects were evaluated at the time of hospital discharge using a battery of clinical measures (including apathy measured using the Apathy Evaluation Scale (AES), delirium, cognitive measures, social support, and disability level). Depression was assessed at the end of the surgical stay, 2 weeks later, and then monthly for 6 months, using the Hamilton Rating Scale for Depression (Ham-D) to evaluate symptomatology and the Primary Care Evaluation of Mental Disorders to evaluate diagnosis of MDD. RESULTS: Eighteen of 126 subjects (14.3%) developed MDD after hip fracture. Of these, 11 developed MDD by the end of the hospitalization, and seven developed MDD between 2 and 10 weeks later. Logistic regression showed that baseline apathy score, as measured using the AES, was the only clinical measure associated with the development of MDD (odds ratio=1.09, 95% confidence interval=1.03-1.16, P=.003); 46.2% of those with high AES scores developed MDD, versus 10.9% of those with lower scores. In contrast, cognitive variables, delirium, disability after hip fracture, and other factors related to the fracture (e.g., fracture type) were not associated with MDD. A repeated-measures analysis with Ham-D over time as a dependent variable generally confirmed these findings; depressive symptoms were highest immediately after the fracture, and apathy and delirium scores were associated with higher depressive symptom levels. CONCLUSION: The onset of MDD is common after hip fracture, and the greatest period of risk is immediately after the fracture. Individuals with clinical evidence of apathy are at high risk for developing MDD, and evaluation and close follow-up of such individuals is warranted. However, further research is needed to examine other candidate variables (e.g., clinical measures or biomarkers) to model adequately the risk for MDD after hip fracture and other disabling medical events.

Affect↗