Becoming Ellis

Author(s):  
Bonnie Carter King

The chapter describes the author's experience as a counselor working with a transgender-identifying teenager named Ellis. The goals of the counseling relationship included exploring transgender identity, managing feelings of depression and anxiety connected to gender dysphoria, and helping Ellis process and cope with life struggles that he experienced. The author provides an in-depth description of Ellis's experience in counseling, as well as a follow-up interview conducted five years after termination of the counseling relationship. This chapter depicts the experience of Ellis's transition and his perspectives about what his transgender identity means to him. The author provides insights on how to best work with transgender clients that emerged from her experience of working with Ellis.

Author(s):  
Bonnie Carter King

The chapter describes the author's experience as a counselor working with a transgender-identifying teenager named Ellis. The goals of the counseling relationship included exploring transgender identity, managing feelings of depression and anxiety connected to gender dysphoria, and helping Ellis process and cope with life struggles that he experienced. The author provides an in-depth description of Ellis's experience in counseling, as well as a follow-up interview conducted five years after termination of the counseling relationship. This chapter depicts the experience of Ellis's transition and his perspectives about what his transgender identity means to him. The author provides insights on how to best work with transgender clients that emerged from her experience of working with Ellis.


2020 ◽  
Vol 17 (3) ◽  
pp. 218-223
Author(s):  
Haichao Wang ◽  
Li Gong ◽  
Xiaomei Xia ◽  
Qiong Dong ◽  
Aiping Jin ◽  
...  

Background: Depression and anxiety after stroke are common conditions that are likely to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke anxiety (PSA) has not been sufficiently investigated. Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow- up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3, and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder 7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First, we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using multivariate Cox regression analysis. Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6 months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate Cox regression analysis indicated independent positive associations between PSD risk and higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63, 95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99) and PSA. Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of the RBC indices, higher MCV, showed an independent positive association with PSD.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Célestin Kaputu-Kalala-Malu ◽  
Eric Mafuta Musalu ◽  
Tim Walker ◽  
Olga Ntumba-Tshitenge ◽  
Steve Ahuka-Mundeke

Abstract Background Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town’s general hospital. Methods A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors who came for follow up from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics were used to summarized data and Pearson’s or likelihood chi-square were used to test association between psychiatric disorders and associated factors. Results The prevalence of PTSD, depression and anxiety was 24.3, 24.3 and 33.3% respectively. Being male (OR = 0.42, 95% CI: 0.16, 0.95, p = 0.049), suffering from persistent headache (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014), losing a loved one because of EVD (OR: 2.60, 95% CI: 1.11, 6.15, p = 0. 015) and being young − 18-24 years - (OR: 0. 261, 95% CI: 0. 08, 0.82, p = 0,026) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (OR = 2.44, 95% CI: 1.03, 5.82, p = 0.026); (OR = 2.24, 95% CI: 1.04, 4.85, p = 0.025); (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014); (OR = 2.31, 95% CI: 1.06, 5.01, p = 0.020). Conclusion The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC.


Author(s):  
D. Devi ◽  
V. Monica ◽  
Ravi Santhosh ◽  
Vijaya Raghavan ◽  
P. Poornachandrika

Background: The COVID-19 pandemic is a global health threat and is by far the largest outbreak of atypical pneumonia, since the SARS outbreak in 2003. A range of psychiatric morbidities such as persistent depression, anxiety, panic attacks, delirium and suicidality were observed in the post infectious state across the world. Hence, the aim of the study was to understand the psychological status of the patients affected by COVID during their post-COVID follow-up period and to examine the socio-demographic and clinical factors associated with high psychological morbidity. Materials and Methods: A cross sectional study conducted in the post-COVID follow up clinic, at a tertiary care hospital between the months of August - November 2020, using a semi structured proforma and rating scales such as Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) for depression, anxiety and insomnia, respectively. Results: The study results indicate that the prevalence of depression and anxiety among post-COVID-19 patients was 21.9% and 11.9%, respectively. Insomnia was observed among 21.7%Among various sociodemographic and clinical variables examined, it was observed that female gender, patients with ongoing stressors and patients with post-COVID-19 persistent physical symptoms were found to be associated with greater depression and anxiety among the study population. Conclusions: Persistent physical symptoms and ongoing life stressors are found to be associated with depression and anxiety among post-COVID-19 patients. Hence, periodic screening for individuals with persisting physical symptoms and care for the vulnerable population such as those with ongoing stressors will provide a significant advantage in the follow up of the mental health of the patients affected with COVID-19.


2016 ◽  
Vol 208 (1) ◽  
pp. 62-68 ◽  
Author(s):  
F. Lamers ◽  
A. T. F. Beekman ◽  
A. M. van Hemert ◽  
R. A. Schoevers ◽  
B. W. J. H. Penninx

BackgroundClinical and aetiological heterogeneity have impeded our understanding of depression.AimsTo evaluate differences in psychiatric and somatic course between people with depression subtypes that differed clinically (severity) and aetiologically (melancholic v. atypical).MethodData from baseline, 2-, 4- and 6-year follow-up of The Netherlands Study of Depression and Anxiety were used, and included 600 controls and 648 people with major depressive disorder (subtypes: severe melancholic n = 308; severe atypical n = 167; moderate n = 173, established using latent class analysis).ResultsThose with the moderate subtype had a significantly better psychiatric clinical course than the severe melancholic and atypical subtype groups. Suicidal thoughts and anxiety persisted longer in those with the melancholic subtype. The atypical subtype group continued to have the highest body mass index and highest prevalence of metabolic syndrome during follow-up, although differences between groups became less pronounced over time.ConclusionsCourse trajectories of depressive subtypes mostly ran parallel to each other, with baseline severity being the most important differentiator in course between groups.


2020 ◽  
Vol 129 (8) ◽  
pp. 788-798
Author(s):  
Lonneke A. van Tuijl ◽  
Elise C. Bennik ◽  
Brenda W. J. H. Penninx ◽  
Philip Spinhoven ◽  
Peter J. de Jong

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeeyeon Lee ◽  
Jin Hyang Jung ◽  
Wan Wook Kim ◽  
Byeongju Kang ◽  
Jungmin Woo ◽  
...  

Abstract Purpose The incidence of depression and anxiety is higher in patients with breast cancer than in the general population. We evaluated the degree of depression and anxiety and investigated the changes in patients with breast cancer during the treatment period and short-term follow-up period. Methods Overall, 137 patients with breast cancer were evaluated using the Patient Health Questionnaire 9-item depression scale (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7). The scales were developed as a web-based electronic patient-reported outcome measure, and serial results were assessed before the operation, after the operation, in the post-treatment period, and in the 6-month follow-up period after surgery. Results The degree of depression and anxiety increased during treatment and decreased at 6-month follow-up, even if there were no statistical differences among the four periods (PHQ-9: p = 0.128; GAD-7: p = 0.786). However, daily fatigue (PHQ-9 Q4) and insomnia (PHQ-9 Q3) were the most serious problems encountered during treatment and at 6-month follow-up, respectively. In the GAD-7, worrying too much (Q3) consistently showed the highest scores during the treatment and follow-up periods. Of the patients, 7 (5.11%) and 11 (8.03%) patients had a worsened state of depression and anxiety, respectively, after treatment compared with before treatment. Conclusion Most factors associated with depression and anxiety improved after treatment. However, factors such as insomnia and worrying too much still disturbed patients with breast cancer, even at 6-month follow-up. Therefore, serial assessment of depression and anxiety is necessary for such patients.


2020 ◽  
Vol 13 (1) ◽  
pp. 264-271
Author(s):  
Roberto Truzoli ◽  
Bruno Renzi ◽  
Marta Romanò ◽  
Ilaria Gremizzi ◽  
Veronica Pirola ◽  
...  

Background: There is evidence of hypnosis being effective in reducing both emotional distress, anxiety, and depression. Hypnosis as a technique promotes enhanced mental mastery over the body. This may result in hypnosis being particularly salient in treating distress associated with somatic and psychological symptoms. Objective: This research aims at verifying the effectiveness of a group treatment, which provides for the use of hypnosis-related techniques in mixed-group outpatients with anxiety or depression. Methods: Participants. 31 outpatients (average age= 49.005; DS =12.1) including 13 with mild-moderate depression (average age= 49.17; DS=12.20) and 18 with mild-moderate anxiety (average age=48.84; DS=13.02). Procedure. The group treatment comprised 8 sessions, during which a hypnotic state was induced, aimed at generating a sensation of profound wellbeing in the participants. They could share their experience in a penultimate group session, and were provided with individualised recommendations on nutrition and lifestyle in the last individual session. Patients were prescribed to practice self-hypnosis every day at home with the support of a CD-ROM. Psychopathological symptomatology (SCL-90R), depression (BDI), and anxiety (STAI-Y1, SAS) were assessed at pre, post, and 3-month follow-up. Statistical analysis. Friedman, Kruskal-Wallis and Mann-Whitey tests were used. The Bonferroni’s correction was applied as needed. The effect size (Cohen’s d) was also measured. Results: For the total sample, for all tests, significant differences were observed in the phases. The effect size was found to vary from “small” at pre to ”medium” at post. A “large” effect size was observed when comparing pre and follow-up phases. An overall reduction in the symptoms of distress measured by the SCL-90 R – with the anxiety group showing better outcomes – alongside with an improvement in the symptoms of depression and anxiety were observed in all participants. Conclusion: The clinical impact appears to be relevant, as shown by the values for d. The treatment is cost-effective for highly prevalent disorders in outpatients. The outcomes of this study support the effectiveness of hypnotic group treatment.


Author(s):  
Terry Robinson ◽  
Jane Scullion

Pulmonary rehabilitation (PR) is an important component in the management, care, and treatment of patients with chronic lung disease, particularly with COPD and increasingly in ILD. Breathlessness is a symptom of the underlying lung disease, and can result in reduced patient activity, which in turn reduces fitness, leads to social isolation, and can exacerbate depression and anxiety. PR is a multidisciplinary programme of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. This chapter describes the rationale for PR, how to set up an effective rehabilitation regime through education and physical exercise, and how to provide follow-up care.


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