Beliefs about Depression in Patients and Their Partners

2005 ◽  
Vol 33 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Peter L. Cornwall ◽  
Jan Scott ◽  
Anne Garland ◽  
Ben R. Pollinger
Keyword(s):  
Major Depression ◽  
Clinical Outcome ◽  
Caregiver Burden ◽  
Symptom Severity ◽  
Caregiver Distress ◽  
Marital Functioning ◽  
Major Depressive ◽  
Severity Of Depression ◽  
Functioning Level ◽  
The Impact

We examined beliefs about depression in patients and their partners and explored the impact of beliefs on perceptions of marital functioning, level of distress and caregiving in partners, and clinical outcome of major depression. Fifteen patients meeting criteria for major depressive disorder and their co-habiting spouses were interviewed at baseline using the Reasons for Depression Questionnaire (Addis, Truax and Jacobson, 1995) and measures of symptom severity, distress, caregiver consequences and marital satisfaction. Outcome was assessed at 6 months. Identifying biological reasons for depression was significantly associated with patient severity of depression and with caregiver burden. Caregiver distress was significantly associated with endorsement of interpersonal reasons for depression. Concordance in reason giving between patients and partners was significantly associated with a good outcome. This is the first study to show that beliefs about depression held by patients and their partners may have an impact on the clinical outcome of major depression.

scholarly journals Cognition and Its Association with Psychosocial and Occupational Functioning during Treatment with Escitalopram in Patients with Major Depressive Disorder: A CAN-BIND-1 Report: La Cognition Et Son Association Avec Le Fonctionnement Psychosocial Et Professionnel Durant Le Traitement Par Escitalopram Chez Des Patients Souffrant De Trouble Dépressif Majeur: Une Étude Can-Bind-1

2020 ◽  
pp. 070674372097482
Author(s):  
Shane J. McInerney ◽  
Trisha Chakrabarty ◽  
Malgorzata Maciukiewicz ◽  
Benicio N. Frey ◽  
Glenda M. MacQueen ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Functioning ◽  
Symptom Severity ◽  
Cognitive Change ◽  
Cognitive Domain ◽  
Depression Symptom ◽  
Major Depressive ◽  
Occupational Functioning ◽  
The Impact

Objectives: Major depressive disorder (MDD) is associated with impairments in both cognition and functioning. However, whether cognitive deficits significantly contribute to impaired psychosocial and occupational functioning, independent of other depressive symptoms, is not well established. We examined the relationship between cognitive performance and functioning in depressed patients before and after antidepressant treatment using secondary data from the first Canadian Biomarker Integration Network in Depression-1 study. Methods: Cognition was assessed at baseline in unmedicated, depressed participants with MDD ( n = 207) using the Central Nervous System Vital Signs computerized battery, psychosocial functioning with the Sheehan Disability Scale (SDS), and occupational functioning with the Lam Employment Absence and Productivity Scale (LEAPS). Cognition ( n = 181), SDS ( n = 175), and LEAPS ( n = 118) were reassessed after participants received 8 weeks of open-label escitalopram monotherapy. A series of linear regressions were conducted to determine (1) whether cognitive functioning was associated with psychosocial and occupational functioning prior to treatment, after adjusting for overall depressive symptom severity and (2) whether changes in cognitive functioning after an 8-week treatment phase were associated with changes in psychosocial and occupational functioning, after adjusting for changes in overall symptom severity. Results: Baseline global cognitive functioning, after adjusting for depression symptom severity and demographic variables, was associated with the SDS work/study subscale (β = −0.17; P = 0.03) and LEAPS productivity subscale (β = −0.17; P = 0.05), but not SDS total (β = 0.19; P = 0.12) or LEAPS total (β = 0.41; P = 0.17) scores. Although LEAPS and SDS scores showed significant improvements after 8 weeks of treatment ( P < 0.001), there were no significant associations between changes in cognitive domain scores and functional improvements. Conclusion: Cognition was associated with occupational functioning at baseline, but changes in cognition were not associated with psychosocial or occupational functional improvements following escitalopram treatment. We recommend the use of more comprehensive functional assessments to determine the impact of cognitive change on functional outcomes in future research.

Emotional availability in women with bipolar disorder and major depression: A longitudinal pregnancy cohort study

2021 ◽  
pp. 000486742199879
Author(s):  
Pavitra Aran ◽  
Andrew J Lewis ◽  
Stuart J Watson ◽  
Thinh Nguyen ◽  
Megan Galbally
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Depressive Disorder ◽  
Emotional Availability ◽  
Major Depressive ◽  
Interaction Quality ◽  
Pregnancy Cohort ◽  
The Impact

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.

scholarly journals Patient-reported outcomes before and after treatment of major depressive disorder

2014 ◽  
Vol 16 (2) ◽  
pp. 171-183 ◽  
Keyword(s):  
Depressive Symptom ◽  
Symptom Severity ◽  
Patient Reported Outcomes ◽  
Burden Of Illness ◽  
Major Depressive ◽  
Patient Reported ◽  
Before And After ◽  
Depressive Symptom Severity ◽  
The Impact ◽  
Level 2

Patient reported outcomes (PROs) of quality of life (QoL), functioning, and depressive symptom severity are important in assessing the burden of illness of major depressive disorder (MDD) and to evaluate the impact of treatment. We sought to provide a detailed analysis of PROs before and after treatment of MDD from the large Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. This analysis examines PROs before and after treatment in the second level of STAR*D. The complete data on QoL, functioning, and depressive symptom severity, were analyzed for each STAR*D level 2 treatment. PROs of QoL, functioning, and depressive symptom severity showed substantial impairments after failing a selective serotonin reuptake inhibitor trial using citalopram (level 1). The seven therapeutic options in level 2 had positive statistically (P values) and clinically (Cohen's standardized differences [Cohen's d]) significant impact on QoL, functioning, depressive symptom severity, and reduction in calculated burden of illness. There were no statistically significant differences between the interventions. However, a substantial proportion of patients still suffered from patient-reported QoL and functioning impairment after treatment, an effect that was more pronounced in nonremitters. PROs are crucial in understanding the impact of MDD and in examining the effects of treatment interventions, both in research and clinical settings.

The impact of neuroinflammation and inflammatory cytokines in depression and suicidal behavior

2016 ◽  
Vol 33 (S1) ◽  
pp. S160-S160
Author(s):  
G. Serafini ◽  
M. Pompili ◽  
P. Girardi ◽  
M. Amore
Keyword(s):  
Suicidal Ideation ◽  
Major Depression ◽  
Inflammatory Cytokines ◽  
Suicidal Behavior ◽  
Affective Disorders ◽  
Molecular Mechanisms ◽  
Major Depressive ◽  
Competing Interest ◽  
Activation Pathways ◽  
The Impact

IntroductionIt has been suggested that neuroinflammation and inflammatory mediators may play a crucial role in the pathophysiology of both major depression and suicidal behavior. Immunological differences have been reported between both subjects with major affective disorders and suicidal behavior.ObjectivesThe main objective of this review was to deeply investigate the nature of the association between inflammatory cytokines in depression and suicidal behavior. Aims: The study aimed to conduct a systematic review of the current literature to investigate the association between inflammatory cytokines, depression, and suicidal behavior.ResultsGenerally, an imbalance between pro-inflammatory and anti-inflammatory cytokines has been documented in both major depression and suicidal behavior. The presence of major depressive disorder (MDD) with suicidal ideation/attempts was associated with differences in inflammatory cytokine profile when compared to that without suicidal ideation/attempts. However, not all studies demonstrated a positive correlation between inflammatory cytokines and suicidal behavior.ConclusionsThe mentioned association between inflammatory cytokines, depression, and suicidal behavior does not imply the existence of a causal relationship. Further additional studies should clarify the molecular mechanisms of the immune activation pathways underlying depression and suicidality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Major Depressive Disorder and Health Care Costs in Multiple Sclerosis

2002 ◽  
Vol 32 (2) ◽  
pp. 167-178 ◽  
Author(s):  
Scott B. Patten ◽  
Philip Jacobs ◽  
Ruxandra Petcu ◽  
Marlene A. Reimer ◽  
Luanne M. Metz
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Statistical Tests ◽  
Composite International Diagnostic Interview ◽  
Major Depressive ◽  
The Impact

Objective: Multiple Sclerosis (MS) is associated with elevated levels of depressive symptoms and an elevated frequency of depressive disorders. Depressive disorders, in general, are associated with substantial direct and indirect economic costs, and have been shown to increase the costs associated with the management of medical conditions in a variety of clinical settings. However, the impact of depressive disorders on costs associated with MS have not been evaluated. The objective of this study was to evaluate this association. Methods: The Composite International Diagnostic Interview (CIDI) was used to identify subjects with major depressive disorder in a sample who had earlier been selected for a broader economic evaluation of the costs associated with MS. Costs were measured in two ways: retrospectively (by questionnaire covering a 2-year period) and prospectively (using a 6-month diary). The proportion of subjects reporting any costs and the proportion exceeding various cost thresholds were calculated in subjects with and without lifetime major depression. These proportions were compared using exact statistical tests and confidence intervals. Non-parametric (rank sum) tests were used to compare median costs. Results: Of 136 subjects, 31 had a lifetime history of major depression. MS-related expenses evaluated retrospectively (e.g., house and vehicle alterations and purchases) did not differ depending on major depression status. In the prospective analysis, subjects with lifetime major depression were more likely to purchase vitamins, herbs, and naturopathic remedies ( p < 0.01) and more likely to incur costs associated with utilization of services provided by alternative practitioners ( p = 0.04). Other differences (e.g., in mental health care, medical specialists, general practitioner visits) were not observed. Conclusions: Contrary to expectation, this study did not find increased direct medical costs in persons with comorbid major depressive disorder and multiple sclerosis. Persons with comorbid MS and (lifetime) major depression did not incur greater costs or utilize more services. The Canadian health care system is guided by principles of universality and is publicly funded and administered, however, the lack of an impact of major depression on utilization may reflect limited access to services. The lack of an association between costs and major depression may or may not be generalizable to health care systems in other countries.

scholarly journals Comparison of self-rating of cognition and depression in patients with major depressive disorder

2020 ◽  
Vol 12 (2) ◽  
pp. 31-33
Author(s):  
Kishen Berra ◽  
Charles Nguyen ◽  
Peter Bota
Keyword(s):  
Major Depression ◽  
Cognitive Dysfunction ◽  
Neuropsychological Testing ◽  
Health Clinic ◽  
Self Assessment ◽  
Major Depressive ◽  
Content Type ◽  
Clinical Support ◽  
Severity Of Depression ◽  
Equivalent Test

Purpose The purpose of this paper is to discover if there is a correlation between scores on the Beck’s Depression Inventory (BDI) and the Cognitive and Physical Functioning Questionnaire (CPFQ) scores of 43 patients with major depression. Design/methodology/approach In total, 43 adult patients with major depression were evaluated during their regularly scheduled outpatient appointment in a mental health clinic. Findings There was an R2 value of 0.6544 between the patients’ scores, a moderate-to-strong correlation which matches other observations that cognitive impairment increases in conjunction with severity of depression. This correlation lends further clinical support to the legitimacy of using the CPFQ as a simpler alternative to traditional neuropsychological testing, with further testing of the correlation between CPFQ and traditional neuropsychological testing results being a worthwhile potential field of study. Originality/value Cognitive dysfunction is a frequent comorbidity in patients with depression, but while there is a brief and effective self- assessment for depression, the BDI, in common use, there is no equivalent test for cognitive dysfunction, and physicians are forced to rely on less accessible methods of neuropsychological testing.

scholarly journals White matter abnormalities and illness severity in major depressive disorder

2012 ◽  
Vol 201 (1) ◽  
pp. 33-39 ◽  
Author(s):  
James Cole ◽  
Christopher A. Chaddock ◽  
Anne E. Farmer ◽  
Katherine J. Aitchison ◽  
Andrew Simmons ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
White Matter ◽  
Major Depression ◽  
Corpus Callosum ◽  
Depressive Disorder ◽  
Symptom Severity ◽  
White Matter Integrity ◽  
Control Group ◽  
Major Depressive ◽  
The Relationship

BackgroundWhite matter abnormalities have been implicated in the aetiology of major depressive disorder; however, the relationship between the severity of symptoms and white matter integrity is currently unclear.AimsTo investigate white matter integrity in people with major depression and healthy controls, and to assess its relationship with depressive symptom severity.MethodDiffusion tensor imaging data were acquired from 66 patients with recurrent major depression and a control group of 66 healthy individuals matched for age, gender and IQ score, and analysed with tract-based spatial statistics. The relationship between white matter integrity and severity of depression as measured by the Beck Depression Inventory was examined.ResultsDepressive illness was associated with widespread regions of decreased white matter integrity, including regions in the corpus callosum, superior longitudinal fasciculus and anterior corona radiata, compared with the control group. Increasing symptom severity was negatively correlated with white matter integrity, predominantly in the corpus callosum.ConclusionsWidespread alterations in white matter integrity are evident in major depressive disorder. These abnormalities are heightened with increasing severity of depressive symptoms.

scholarly journals 550 - Caregiver Burden and Geriatric Patients Undergoing Electroconvulsive Therapy in the COVID-19 Era

2021 ◽  
Vol 33 (S1) ◽  
pp. 92-92
Author(s):  
Valeriya Tsygankova ◽  
Maria A. Grullon ◽  
Bobbi Woolwine ◽  
Ashley Subler ◽  
Parker Schwab ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Caregiver Burden ◽  
Chart Review ◽  
Medical Providers ◽  
Disability Scale ◽  
Life Challenges ◽  
Geriatric Hospital ◽  
At Risk Populations ◽  
Severity Of Depression ◽  
The Impact

IntroductionCaregivers are essential in providing valuable patient information to medical providers. With limited available research investigating caregiver burden among those caring for patients receiving ECT and the new life challenges presented by the COVID-19 pandemic, it is more important now than ever to take a closer look at the caregivers’ experiences.MethodsEmory’s Wesley Woods Geriatric Hospital is one of the busiest ECT services in the country with around 2000 treatments completed every year. In this chart review, researchers are looking at caregivers’ responses to the Zarit Caregiver Burden Interview. This assessment includes 22 questions assessing the caregivers’ current emotional state in order to examine the impact of the patient’s condition oncaregiver wellbeing. The score ranges from 0 (no burden) to 88 (severe burden). Other objective assessments completed with ECT patients are BDI (Beck Depression Inventory), BDI Suicide, Sheehan Disability Scale, ECCA (Electrocompulsive Cognitive Assessment), GAD-7 (Generalized Anxiety Disorder Scale), and CGI (Clinical Global Impression). The purpose of this chart review is to investigate whether the higher severity of depression in patients correlates with higher levels of caregiver burden and whether the pandemic contributed to caregiver burden.ResultsThe Zarit Caregiver Burden Interview has been administered on twelve caregivers (n=12; 6 male and 6 female), all providing care for patients currently undergoing ECT for depressive symptoms. Out of the twelve caregivers, 66.6% reported little caregiver burden, 16.6% reported mild to moderate burden, and 16.6% reported moderate to severe burden. Additional patients are being interviewed in the ECT suite and further data collected will be presented at the 2021 IPA Virtual International Congress.ConclusionAs the world adjusts to life in the COVID-19 era, caregivers face new challenges in providing care for vulnerable, at-risk populations. Caregivers of patients receiving ECT facilitate frequent COVID testing and limited visitation policies while continuing to provide care and emotional support to patients with advanced age and a mental illness. Administrating the Zarit Caregiver Burden Interview can help providers look at the degree of burden in caregivers of patients receiving ECT for depressive symptoms and provide better caregiving strategies during and post pandemic.

scholarly journals The Symptom Structure of Postdisaster Major Depression: Convergence of Evidence from 11 Disaster Studies Using Consistent Methods

2021 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Carol S. North ◽  
David Baron
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Diagnostic Assessment ◽  
Self Report ◽  
Depression Symptoms ◽  
Symptom Scale ◽  
Major Depressive ◽  
Report Symptom ◽  
Symptom Patterns

Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grouping of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary.

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