Depression in Adults with Intellectual Disability. Part 2: A Pilot Study

1997 ◽  
Vol 31 (2) ◽  
pp. 243-251 ◽  
Author(s):  
Julian P. Davis ◽  
Fiona K. Judd ◽  
Helen Herrman
Keyword(s):  
Intellectual Disability ◽  
Depressive Disorder ◽  
Diagnostic Criteria ◽  
Patient Group ◽  
Depressive Disorders ◽  
Psychiatric Evaluation ◽  
Depressed Patients ◽  
Standard Assessment ◽  
Core Measure ◽  
Dsm Iv

Objectives: To identify adults with intellectual disability (ID) with a depressive disorder referred to a tertiary consultation clinic for psychiatric assessment; to investigate common presenting features of depression in adults with ID; to assess the utility of visual analogue scale (VAS) measures of emotion/behaviour, the CORE measure of psychomotor disturbance, and substitutive diagnostic criteria in the assessment of depressive disorders in this patient group. Method: Over a 6-month period 47 patients were seen for psychiatric evaluation. Patients in whom a diagnosis of depression was made were further assessed using: VAS measures of depression, irritability, verbal aggression, physical aggression, temper outbursts, regressed behaviour; CORE measure of psychomotor disturbance; and substitutive diagnostic criteria designed by the authors. Results: Ten patients were found to have a depressive disorder. Substitutive criteria resulted in a greater rate of diagnosis than standard DSM-IV criteria. The VAS measure of irritability was highly scored for all 10 depressed patients. All 10 depressed patients were assigned to the melancholic subgroup according to CORE score. Conclusions: Standard assessment measures and diagnostic criteria may require modification to enhance their utility in this patient group. Melancholic features require further investigation.

Depressed patients with incurable cancer: Which depressive symptoms do they experience?

2013 ◽  
Vol 11 (6) ◽  
pp. 491-501 ◽  
Author(s):  
Elisabeth Brenne ◽  
Jon Håvard Loge ◽  
Stein Kaasa ◽  
Ellen Heitzer ◽  
Anne Kari Knudsen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Social Withdrawal ◽  
Incurable Cancer ◽  
Cancer Symptoms ◽  
Depressed Patients ◽  
Symptom Experiences ◽  
Dsm Iv ◽  
Symptom Criteria

AbstractObjective:Diagnosing depressive disorders in palliative care is challenging because of the overlap between some depressive symptoms and cancer-related symptoms, such as loss of appetite and fatigue. In order to improve future assessment of depression in palliative care, depressive symptoms experienced by patients receiving pharmacological treatment for depression were assessed and compared to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder.Method:Thirty Norwegian (n = 20) and Austrian (n = 10) patients with advanced cancer were included. Semistructured interviews on symptom experiences were conducted and transcribed verbatim. By the phenomenographic method, patients' symptom experiences were extracted and sorted by headings, first individually and then across patients. The patients subsequently rated 24 symptoms numerically including the DSM-IV depression criteria.Results:Lowered mood and a diminished motivational drive were prominent and reflected the two main DSM-IV symptom criteria. A relentless focus on their actual situation, restlessness, disrupted sleep, feelings of worthlessness, feelings of guilt, and thoughts of death as a solution were variably experienced. Appetite and weight changes, fatigue and psychomotor retardation were indistinguishable from cancer symptoms. All these symptoms reflected DSM-IV symptom criteria. Some major symptoms occurred that are not present in the DSM-IV symptom criteria: despair, anxiety, and social withdrawal. The numerical ratings of symptoms were mainly in accordance with the findings from the qualitative analysis.Significance of results:Despair, anxiety, and social withdrawal are common symptoms in depressed patients with incurable cancer, and, therefore, hypothesized as candidate symptom criteria. Other symptom criteria might need adjustment for improvement of relevance in this group of patients.

The Evaluation of the Effectiveness of Relaxation Training and Sleep Hygiene Education for Insomnia of Depressed Patients

2013 ◽  
Vol 6 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Deora Johnson ◽  
Anthony Roberson
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Relaxation Training ◽  
Sleep Hygiene ◽  
Psychiatric Evaluation ◽  
Major Depressive ◽  
Convenience Sample ◽  
Depressed Patients ◽  
Initial Session ◽  
Hygiene Education

Background: Insomnia is a frequent complaint of patients with major depressive disorder. The lifetime prevalence rate of major depressive disorder is 17% (Sadock & Sadock, 2007). Studies have found that a significantly higher percentage of women than men aged 20–55 years report difficulty maintaining sleep (Soares, 2005). Purpose: This scholarly project involved the implementation and evaluation of a relaxation training and sleep hygiene education intervention for female patients who experience major depressive disorder and insomnia. Theoretical Model: Middle-range theory of unpleasant symptoms (Lenz, Pugh, Milligan, Gift, & Suppe, 1997). Sample: A convenience sample of 10 female participants was recruited from an outpatient psychiatric private practice. Methods: Participants attended 4 consecutive, weekly outpatient sessions lasting approximately 1 hr. The initial session consisted of conducting a psychiatric evaluation and administration of the Pittsburgh Sleep Quality Index to measure rating of sleep quantity and quality. Principles of sleep hygiene and relaxation exercises were introduced during the initial session. Subsequent sessions focused on reinforcement of the principles of sleep hygiene and relaxation training. Results: Sleep hygiene education and relaxation training were effective in treating insomnia of depressed patients. Implications for Nursing: Implementation of sleep hygiene education and relaxation training provides nurses with evidence-based treatment alternatives or complements to pharmacotherapy in depressed patients.

Prevalence of depressive disorders in shanghai children aged 8∼12 years

2011 ◽  
Vol 26 (S2) ◽  
pp. 623-623
Author(s):  
J. Fan ◽  
H.-L. Gu ◽  
H.-L. Yang ◽  
W.-Y. Wang ◽  
J. Yi ◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Prevalence Rate ◽  
Primary Schools ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Cluster Sampling ◽  
Significant Difference ◽  
Prevalence Of Depression ◽  
Dsm Iv

ObjectiveThe purpose of this study was to investigated the prevalence child depression in primary schools.Methods3685 students from Grade 3 to Grade 5 were selected from 7 primary schools of Pudong district in Shanghai by random and cluster sampling. The study design consisted of a screening stage in which the Center for Epidemiological Studies Depression Scale for Children(CES-DC) were used, and a clinical interview stage in which the K-SADS-present state version (K-SADS) and DSM-IV were used. The diagnoses of depressive disorder were made according the DSM-IV criteria.ResultsThe prevalence of children depression was 1.60% (95%CI = 1.19%∼2.00%). The prevalence rate of male(2.08%) was significant higher than that of female (1.09%)(X2=5.40, P = 0.02). The rate of depressive disorder increased with age from 0.57% (8 years old) to 2.47% (12 years old). The prevalence of depression was no significant difference between ages from 8 to 12 years old (X2 = 4.49, P = 0.34).ConclusionThe prevalence rate of children depression in Shanghai is low. The prevalence of depression among boys is much higher than that of girls.It shows the prevalence of depression is no significant difference between ages from 8 to 12 years old.

Perceived Depriving Parental Rearing and Depression

1986 ◽  
Vol 148 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Carlo Perris ◽  
W. A. Arrindell ◽  
Hjördis Perris ◽  
Martin Eisemann ◽  
J. van der Ende ◽  
...  
Keyword(s):  
Risk Factor ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Healthy Individuals ◽  
Reactive Depression ◽  
Depressed Patients ◽  
Parental Rearing ◽  
Psychological Risk

Four groups of depressed patients 47 unipolars, 21 bipolars, 34 with neurotic-reactive depression, and 39 with unspecified depressive disorder completed, after recovery, the EMBU, a Swedish instrument aimed at assessing the experience of parental rearing practices. The results for three factors: “rejection”, “emotional warmth” and “over-protection” and the global judgement scores of “severity” and “consistency” in rearing attitudes were compared with those obtained from 205 healthy individuals. Depressed patients, particularly in the unipolar unspecified groups rated both parents lower than the controls on emotional warmth. Patients tended also to rate their parents as less consistent in their rearing attitudes. The variables emotional warmth and overprotection allowed 64% of the patients and 72 of the unipolar depressives to be classified correctly. These results, like those of previous studies, support the hypothesis that deprivation of love during childhood represents an important psychological risk factor in the background of depressive disorders.

Vegetative and Psychological Symptoms Associated with Depressed Mood over the First Two Years after Stroke

1997 ◽  
Vol 27 (2) ◽  
pp. 137-157 ◽  
Author(s):  
Sergio Paradiso ◽  
Tatsunobu Ohkubo ◽  
Robert G. Robinson
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Diagnostic Criteria ◽  
Depressed Mood ◽  
Psychological Symptoms ◽  
Median Number ◽  
Physical Illness ◽  
Depressed Patients ◽  
Self Confidence ◽  
Dsm Iv

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.

Depressive Disorders, Comorbidity Issues, and Assessment Strategies

2013 ◽  
Author(s):  
Nicholas R. Eaton ◽  
Robert F. Krueger
Keyword(s):  
Depressive Disorder ◽  
Clinical Assessment ◽  
Depressive Disorders ◽  
Latent Structure ◽  
Adjustment Disorders ◽  
Dsm 5 ◽  
Structure Framework ◽  
Dsm Iv ◽  
Assessment Strategies ◽  
Internalizing Disorder

Assessment is at the very core of clinical and research endeavors to understand and ameliorate depressive disorders. In the current chapter, we discuss pressing issues in assessment of depressive disorders beginning with the definitional: how these disorders are conceptualized and classified. We highlight theDSM-IV-TRnosological organization of depressive disorders, and those disorders that are closely related (e.g., anxiety and adjustment disorders), as well as current depressive disorder proposals for the upcomingDSM-5. The high rates of comorbidity among the depressive and related disorders are discussed as an assessment challenge, and we propose a unified latent structure framework to supplement clinical assessment that involves characterizing individuals’ levels of underlying internalizing disorder liability. We discuss how disorders, and the latent internalizing liability, may manifest differently across subpopulations, such as age and ethnicity/culture. Finally, we discuss psychometric issues and conclude with a list of critical unanswered questions in depressive disorder assessment.

scholarly journals Multiple Comorbidity Profile of Psychiatric Disorders in Epilepsy

2021 ◽  
Vol 10 (18) ◽  
pp. 4104
Author(s):  
Agata M. Grzegorzewska ◽  
Mariusz S. Wiglusz ◽  
Jerzy Landowski ◽  
Katarzyna Jakuszkowiak-Wojten ◽  
Wiesław J. Cubała ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Depressive Disorders ◽  
Self Report ◽  
Major Depressive ◽  
Comorbid Anxiety ◽  
Axis I ◽  
Dsm Iv

The co-occurrence of psychiatric disorders in people with epilepsy (PWE) is not well documented or studied. Anxiety and depressive disorders are the most frequent comorbid disorders in PWE. In this paper, we characterized the rates of multiple psychiatric disorder comorbidity by reanalyzing data from a study sample of PWE. A total of 96 outpatient PWE completed the self-report symptom scale, and were diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Axis I disorders (SCID-I). For analyses, patients were assigned to a comprehensive diagnostic group of anxiety and depressive disorders. In order to determine comorbidity across psychiatric diagnoses for the DSM-IV categories, Pearson’s chi-squared test (χ2) was used. In the study sample, eight patients (8.3% of the study sample, n = 96) had comorbid major depressive disorder and anxiety disorder. When looking at comorbidity of each diagnosis separately, it was determined that 50% of individuals with an anxiety disorder had comorbid Major Depressive Disorder (MDD) and 38% patients with MDD had comorbid anxiety disorder. This finding encourages a more systematic reporting of psychiatric prevalence data in epilepsy, especially taking into account the high ratio of multiple comorbid anxiety and depressive disorders in PWE.

La medicalizzazione della tristezza: come la psichiatria ha trasformato una semplice emozione in un disturbo mentale

2009 ◽  
pp. 56-74
Author(s):  
Jerome C. Wakefield ◽  
Allan V. Horwitz
Keyword(s):  
Depressive Disorder ◽  
Diagnostic Criteria ◽  
Depressive Disorders ◽  
Mental Disease ◽  
Keywords Depression ◽  
Sociology Of Health

- This essay argues that changes in the diagnostic criteria of depression that occurred with the introduction of the DSM-III have resulted in the treatment of normal emotions of sadness as well as of depressive disorders. In fact, the new symptoms-based definition no longer allows the distinction of common states of unhappiness from mental disease. The authors explain, first, the reasons for this change and, second, the reasons for the desirability of reversing this trend and restoring the conception distinction between depressive disorder and normal sadness.Keywords: depression, DSM, medicalization, psychiatry, sadness, sociology of health.Parole chiave: depressione, DSM, medicalizzazione, psichiatria, tristezza, sociologia della salute.

The Medicalization of Sadness: How Psychiatry Transformed a Natural Emotion into a Mental Disorder

2009 ◽  
pp. 49-66
Author(s):  
Jerome C. Wakefield ◽  
Allan V. Horwitz
Keyword(s):  
Depressive Disorder ◽  
Mental Disorder ◽  
Diagnostic Criteria ◽  
Depressive Disorders ◽  
Mental Disease ◽  
Keywords Depression ◽  
Sociology Of Health ◽  
Natural Emotion

- This essay argues that changes in the diagnostic criteria of depression that occurred with the introduction of the DSM-III have resulted in the treatment of normal emotions of sadness as well as of depressive disorders. In fact, the new symptoms-based definition no longer allows the distinction of common states of unhappiness from mental disease. The authors explain, first, the reasons for this change and, second, the reasons for the desirability of reversing this trend and restoring the conception distinction between depressive disorder and normal sadness.Keywords: depression, DSM, medicalization, psychiatry, sadness, sociology of health.Parole chiave: depressione, DSM, medicalizzazione, psichiatria, tristezza, sociologia della salute.

Incidence and predictors of suicide attempts among primary-care patients with depressive disorders: a 5-year prospective study

2013 ◽  
Vol 44 (2) ◽  
pp. 291-302 ◽  
Author(s):  
K. Riihimäki ◽  
M. Vuorilehto ◽  
T. Melartin ◽  
J. Haukka ◽  
E. Isometsä
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Substance Abuse ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Major Depressive ◽  
Primary Care Patients ◽  
Dsm Iv

BackgroundNo previous study has prospectively investigated incidence and risk factors for suicide attempts among primary care patients with depression.MethodIn the Vantaa Primary Care Depression Study, a stratified random sample of 1119 patients was screened for depression, and Structured Clinical Interviews for DSM-IV used to diagnose Axis I and II disorders. A total of 137 patients were diagnosed with a DSM-IV depressive disorder. Altogether, 82% of patients completed the 5-year follow-up. Information on timing of suicide attempts, plus major depressive episodes (MDEs) and partial or full remission, or periods of substance abuse were examined with life charts. Incidence of suicide attempts and their stable and time-varying risk factors (phases of depression/substance abuse) were investigated using Cox proportional hazard and Poisson regression models.ResultsDuring the follow-up there were 22 discrete suicide attempts by 14/134 (10.4%) patients. The incidence rates were 0, 5.8 and 107 during full or partial remission or MDEs, or 22.2 and 142 per 1000 patient-years during no or active substance abuse, respectively. In Cox models, current MDE (hazard ratio 33.5, 95% confidence interval 3.6–309.7) was the only significant independent risk factor. Primary care doctors were rarely aware of the suicide attempts.ConclusionsOf the primary care patients with depressive disorders, one-tenth attempted suicide in 5 years. However, risk of suicidal acts was almost exclusively confined to MDEs, with or without concurrent active substance abuse. Suicide prevention among primary care patients with depression should focus on active treatment of major depressive disorder and co-morbid substance use, and awareness of suicide risk.

Sign in / Sign up

Export Citation Format

Share Document