Predictors of Recovery From Major Depression Among Geriatric Psychiatry Inpatients: The Importance of Caregivers' Beliefs

1999 ◽  
Vol 11 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Robin J. Casten ◽  
Barry W. Rovner ◽  
Yochi Shmuely-Dulitzki ◽  
Rona E. Pasternak ◽  
Rodney Pelchat ◽  
...  

Caregiver support is an important factor in recovery from depression among older patients. We examined whether caregivers' perceptions regarding patients' ability to control depressive symptoms were related to depression recovery. Depression treatment, demographics, number of depressive symptoms, and health were controlled. The sample comprised 51 geriatric psychiatry inpatients who met DSM-IV criteria for major depression and who had a primary caregiver. Depression was assessed at both admission and discharge. Caregivers were asked to indicate whether they believed their patient-relatives could control their depressive symptoms. At discharge, 33 patients (64.7%) were “remitted” and 18 (35.3%) were “nonremitted.” Multivariate analyses indicated that receiving electroconvulsive treatment, having fewer depressive symptoms caregivers perceived to be within patient control, and being female predicted depression remission at discharge. This study highlights the important relationship between family dynamics and course of depression.

2000 ◽  
Vol 12 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Emese Linka ◽  
György Bartkó ◽  
Tamás Agárdi ◽  
Katalin Kemény

The purpose of this study was to examine the prevalence and correlation of cognitive impairments, major depression, and depressive symptoms among elderly medical inpatients, and to compare the degree of depressive symptomatology as well as cognitive deterioration in possible vascular dementia and possible Alzheimer's disease. In a department of internal medicine, 100 (36 male, 64 female) 65-year-old or older patients were examined by a semistructured interview, and assessed by the Hachinski Ischemic Scale, the Hamilton Rating Scale for Depression (HDS), and the Modified Mini-Mental State (MMMS) Examination. In our total sample, the MMMS total score was (±SD) 76.0 ± 15.5 and the HDS total score was (±SD) 12.0 ± 6.1. Based on DSM-IV criteria, major depression was established in 11 patients. Deterioration of cognitive functions was seen in 66 patients; cognitive impairment was mild in 30 patients, moderate in 19, and severe in 17. Forty-six patients had mild depressive symptoms and 27 had severe depressive symptoms. In summary, a high prevalence of cognitive dysfunction and depressive symptomatology was detected in our study, illustrating the importance of psychiatric care in elderly medical inpatients.


1997 ◽  
Vol 27 (2) ◽  
pp. 137-157 ◽  
Author(s):  
Sergio Paradiso ◽  
Tatsunobu Ohkubo ◽  
Robert G. Robinson

Introduction: In patients with acute physical illness, symptoms used in the diagnosis of major depression such as sleep or appetite disturbance may be nonspecific for depression. This study was undertaken to examine the association of depressed mood with other depressive symptoms to determine which symptoms were most useful in the accurate diagnosis of major depression after stroke. Methods: Using a structured mental status examination, 142 patients with acute stroke were followed at three, six, twelve, and twenty-four months. Results: The median number of vegetative and psychological symptoms among patients with depressed mood was more than three times the respective rates among nondepressed patients at all time points over two years. Autonomic anxiety, morning depression, subjective anergia, worrying, brooding, loss of interest, hopelessness, and lack of self-confidence were significantly more frequent among depressed patients than nondepressed patients throughout the entire two-year period. Some symptoms such as anxious foreboding and loss of libido, as well as self-depreciation, feelings of guilt, and irritability were no longer significantly more common among depressed compared with nondepressed patients after six months. Standard DSM-IV diagnostic criteria and modified DSM-IV diagnostic criteria which included only specific symptoms of depression (i.e., symptoms which were significantly more frequent among depressed than nondepressed mood patients) yielded similar frequencies of major depression diagnosis. There were only a few patients (i.e., 2% to 3%) with depressive symptoms without a depressed mood (perhaps “masked” depressions). Conclusions: Vegetative and psychological depressive symptoms are significantly more common in depressed patients over the first two years after stroke and DSM-IV criteria do not overdiagnose major depression even in this population with chronic physical illness. The symptoms which characterize major depression appear to change between the subacute and chronic post-stroke periods.


2013 ◽  
Vol 43 (10) ◽  
pp. 2143-2151 ◽  
Author(s):  
R. E. Roberts ◽  
H. T. Duong

BackgroundOverweight/obesity and depression are both major public health problems among adolescents. However, the question of a link between overweight/obesity and depression remains unresolved in this age group. We examined whether obesity increases risk of depression, or depression increases risk of obesity, or whether there is a reciprocal effect.MethodA two-wave prospective cohort study of adolescents aged 11–17 years at baseline (n = 4175) followed up a year later (n = 3134) sampled from the Houston metropolitan area. Overweight was defined as 95th percentile >body mass index (BMI) ⩽85th percentile and obese as BMI >95th percentile. Three indicators of depression were examined: any DSM-IV mood disorder, major depression, and symptoms of depression.ResultsData for the two-wave cohort indicated no evidence of reciprocal effects between weight and depression. Weight status predicted neither major depression nor depressive symptoms. However, mood disorders generally and major depression in particular increased risk of future obesity more than twofold. Depressed males had a sixfold increased risk of obesity. Females with depressive symptoms had a marginally increased risk of being overweight but not obese.ConclusionsOur findings, combined with those of recent meta-analyses, suggest that obese youths are not more likely to become depressed but that depressed youths are more likely to become obese.


2013 ◽  
Vol 44 (7) ◽  
pp. 1391-1401 ◽  
Author(s):  
Y. Li ◽  
S. Aggen ◽  
S. Shi ◽  
J. Gao ◽  
Y. Li ◽  
...  

BackgroundThe symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?MethodSymptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.ResultsThe preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.ConclusionsMD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.


Author(s):  
Leah Sawyer Vanderwerp

Using data from the National Longitudinal Survey of Youth-Mother and Child samples, I investigated the relationships among child and adolescent depressive symptoms, having a chronically ill sibling, and other child and familial demographic variables. From research on social support and social role transitions, with the Stress Process as a theoretical model, I hypothesized that children with chronically ill siblings experience more depressive symptoms. Specifically, I looked at age, gender, birth order and family size as potentially reducing the effect size of having a chronically ill sibling. Findings showed that having a chronically ill sibling is associated with demonstrating more depressive symptoms both in the bivariate and multivariate analyses. Although age, gender, birth order and family size do not interact significantly with having a chronically ill sibling in predicting depressive symptoms, they do present interesting findings about childhood depressive symptoms in general. Thus, the results of this study suggest specific and meaningful paths for future research.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
T. Maria-Silvia

Depression is a disorder of representation and regulation of mood and emotion; it affects 5% of world population, in a year. Unlike normal loss and sadness feelings, major depression is persistant and it interferes significantly with thoughts, behaviour, emotions, activity and health of the individual. If untreated, depression can lead to suicide. Using family therapy in treating psychiatric patients is a must due to the significance that a family holds in individual and society life.Objective:Assesing family functionality in families with a member diagnosed according to DSM IV TR with depressive disorder; depression intensity was assesed with HDRS.Methods:A sample of 3o families (71 members); FFS assesses the most important and consistent five functioning areas: positive affect, comunication, conflicts, worries and rituals.Results:Values obtained in each of the 40 questions of the scale can give information on variables affecting the increase or decrease in subscales values. Positive affect 35,07, communication 37, conflicts 15,11, worries 40,77, rituals 45,03. The reuslts were compared to those obtained by assessin normal families from a control group of 132 families (323 members).Conclusions:Differences were noticed. Values obtained in our study represent the standard of functioning of families with a depressed member.


1997 ◽  
Vol 81 (2) ◽  
pp. 635-639
Author(s):  
Motoko Hayashi ◽  
Isao Fukunishi

This study examined what kinds of social support are related to mood states in a sample of 50 HIV-positive patients without AIDS (46 men and 4 women; M age 36.5 yr., SD = 9.8). In the early stage of HIV infection, HIV patients without AIDS may be prone to depressive symptoms although none of these HIV-positive patients' symptoms fulfilled the DSM-III-R Mood Disorders including Major Depression. The depressive symptoms were not significantly related to lack of ordinary social support such as friends and family but were significantly associated with dissatisfaction with HIV/AIDS-related medical support


2021 ◽  
pp. 000486742199879
Author(s):  
Pavitra Aran ◽  
Andrew J Lewis ◽  
Stuart J Watson ◽  
Thinh Nguyen ◽  
Megan Galbally

Objective: Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). Methods: Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder ( n = 60) and bipolar disorder ( n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant’s interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. Results: After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. Conclusions: Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring’s emotional availability at 6 months postpartum, particularly in maternal intrusiveness.


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