Citalopram Versus Sertraline in Late-Life Nonmajor Clinically Significant Depression

2005 ◽  
Vol 66 (03) ◽  
pp. 360-369 ◽  
Author(s):  
Paola Rocca ◽  
Paolo Calvarese ◽  
Fabrizio Faggiano ◽  
Livio Marchiaro ◽  
Federica Mathis ◽  
...  
Keyword(s):  
Late Life ◽  
Significant Depression ◽  
Clinically Significant

Clinicopathologic and Neurochemical Correlates of Major Depression and Psychosis in Primary Dementia

1997 ◽  
Vol 8 (S3) ◽  
pp. 219-223 ◽  
Author(s):  
George S. Zubenko
Keyword(s):  
Major Depression ◽  
Effective Means ◽  
Late Life ◽  
Significant Depression ◽  
Clinically Significant ◽  
Neurochemical Correlates ◽  
And Behavior

Disturbances of mood, thought content, perception, and behavior are common concomitants of dementia that often produce suffering and excess disability. These disturbances also interfere with caregiving, precipitate institutionalization, and hasten death. The current lack of an effective means of preventing or controlling the pathophysiologic events that lead to dementia in late life has stimulated efforts to understand and treat these phenomena. In particular, clinically significant depression and psychosis often emerge in patients with dementia, regardless of its origins, and are an important focus of treatment.

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Psychiatrists' accounts of clinical significance in depression

2012 ◽  
Vol 43 (2) ◽  
pp. 101-111
Author(s):  
Dariusz Galasiński
Keyword(s):  
Mental Illness ◽  
Discourse Analysis ◽  
Diagnostic Criteria ◽  
Clinical Significance ◽  
Psychiatric Diagnosis ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Discursive Space ◽  
Significant Depression ◽  
Clinically Significant

Psychiatrists' accounts of clinical significance in depression Clinical significance is a crucial element in the diagnosis of mental illness, yet, it is practically untheorised and significantly under-researched. This article takes up the question of how the criterion of clinical significance is translated into psychiatric practice. More particularly, it examines how psychiatrists account for the threshold between health and depression. The paper is anchored in the constructionist view of discourse underpinned by the assumptions of critically oriented discourse analysis. It is based upon a convenience sample of 39 semi-structured interviews with specialist-psychiatrists in south-western Poland. There is no discursive space for clinical significance in psychiatrists' accounts. There is no boundary, no decision to be taken as to whether the symptoms are clinically significant. Depression, invariably constructed in terms of diagnostic criteria, is always represented as fully developed, appearing out of thin air, with no period of falling ill. The article raises the issue of the validity and usefulness of psychiatric diagnosis.

Arthritis, Depression, and Falls Among Community-Dwelling Older Adults: Evidence From the Health and Retirement Study

2016 ◽  
Vol 37 (9) ◽  
pp. 1133-1149 ◽  
Author(s):  
Lien T. Quach ◽  
Jeffrey A. Burr
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Health And Retirement Study ◽  
Depression Symptoms ◽  
Care Providers ◽  
Significant Depression ◽  
Nationally Representative ◽  
Clinically Significant ◽  
Retirement Study

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study ( n = 7,715, M age = 75, 62% female, and 90% White). Among the respondents, 42% experienced at least one fall during the previous 2 years. About one third had some form of arthritis: 22% osteoarthritis (OA), 4.8% rheumatoid arthritis (RA), 2.3% both OA and RA, and 7.9% with other arthritis types. About one fifth of respondents had CSDS. OA and CSDS are associated with the odds of falling (17% and 29%, respectively), adjusting for socio-demographic characteristics, lifestyle, health conditions, and psychiatric medications. There was no statistically significant interaction between types of arthritis and CSDS. Health care providers should pay attention to managing arthritis, especially OA, and CSDS to prevent falls among older adults.

Depression in Schizophrenia: A Descriptive Study

1996 ◽  
Vol 30 (3) ◽  
pp. 354-357 ◽  
Author(s):  
Petros Markou
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
Structured Interview ◽  
Depression Score ◽  
Outcome Variable ◽  
Outpatient Group ◽  
Significant Difference ◽  
Significant Depression ◽  
Inpatient Group ◽  
Clinically Significant

Objective: To assess the level of depressive symptomatology among a group of patients with schizophrenia, both inpatients and outpatients, and speculate as to the reasons why differences among the groups may be occurring. Method: Fifty inpatients of Baillie Henderson Hospital, a chronic stay psychiatric hospital in Queensland, and 44 outpatients of this hospital were assessed on a number of measures including the Positive and Negative Syndrome Scale for Schizophrenia, Abnormal Involuntary Movements Scale, Hamilton Rating Scale for Depression and Beck Depression Inventory. All patients were assessed in a structured interview for 35–40 minutes by the same clinician. A chart review also occurred. The chief outcome variable was a Hamilton Depression Rating Scale of 17 or greater. Results: Clinically significant depression, as defined by a Hamilton Depression score of 17 or greater, was found in 10% (n = 5) of the inpatient sample. Of the outpatient sample, 4.5% (n = 2) showed a clinically significant depression, which was not significantly different to the inpatient group. The prevalence of mild to moderate depression, as defined by a Hamilton Depression score of between 10 and 17, was 42% in the inpatient group and 47.7% in the outpatient group. There was no significant difference between the two groups on the mean Hamilton Depression scores. Conclusions: The results suggest a high level of depressive symptomatology in patients with schizophrenia. As suicide is common in this group, this finding is important. Self-reporting of this problem by patients with schizophrenia, by means of questionnaire, is feasible and provides comparable results to objective clinician ratings.

Origins of depression in later life

2005 ◽  
Vol 35 (9) ◽  
pp. 1241-1252 ◽  
Author(s):  
DAN G. BLAZER ◽  
CELIA F. HYBELS
Keyword(s):  
Older Adults ◽  
Stressful Life Events ◽  
Cognitive Distortions ◽  
Late Life ◽  
Later Life ◽  
Late Life Depression ◽  
Younger Adults ◽  
Social Risks ◽  
Clinically Significant ◽  
The Many

Background. Despite the burden of depression in late life, its origins present a paradox to investigators and clinicians alike.Method. We review biological (genetics and heredity factors, neurotransmitter dysfunction, endocrine changes, vascular disorders, and medical co-morbidities), psychological (personality attributes, neuroticism, cognitive distortions, and the lack of emotional control and self-efficacy) and social (stressful life events, bereavement, chronic stress or strain, socio-economic disadvantage and impaired social support) origins of late-life depression based upon an extensive though not exhaustive review of the extant literature. In addition, modifying psychological and social factors are discussed.Results. Older adults appear to be at greater risk for major depression biologically, such as depression resulting from vascular changes, yet the frequency of depression is lower compared to younger adults. Older adults may be protected psychologically due to factors such as socio-emotional selectivity and wisdom, compared to younger adults, and perhaps relatively protected from social risks.Conclusions. A biopsychosocial approach to evaluating the origins of late-life depression is heuristically valuable, a continual reminder of the many factors that contribute to the onset and persistence of clinically significant symptoms in late life.

scholarly journals Depression in Women with Spontaneous 46, XX Primary Ovarian Insufficiency

Endocrinology ◽  
2010 ◽  
Vol 151 (12) ◽  
pp. 5972-5972
Author(s):  
Peter J. Schmidt ◽  
Jamie A. Luff ◽  
Nazli A. Haq ◽  
Vien H. Vanderhoof ◽  
Deloris E. Koziol ◽  
...  
Keyword(s):  
Turner Syndrome ◽  
Ovarian Function ◽  
Primary Ovarian Insufficiency ◽  
Menstrual Irregularity ◽  
Ovarian Insufficiency ◽  
Cross Sectional ◽  
Clinical Research Center ◽  
Before And After ◽  
Significant Depression ◽  
Clinically Significant

Context: A high prevalence of depressive symptoms is observed in women with primary ovarian insufficiency (POI) compared with women in whom the menopause is normally timed. Indeed, studies suggest that depression and/or its pharmacological treatment contribute to the onset of POI. Objectives: We characterize the prevalence of psychiatric disorders and the timing of onset of clinically significant depression relative to both the diagnosis of POI and the onset of menstrual irregularity in women with POI. Design and Setting: We conducted a cross-sectional clinic-based study at the National Institutes of Health Clinical Research Center. Patients: A total of 174 women with spontaneous 46, XX POI and 100 women with Turner syndrome participated in the study. Main Outcome Measures: The structured clinical interview for DSM-IV was performed. Results: Lifetime histories of depression in POI exceeded rates of depression reported in women with Turner syndrome and community-based samples of women (P < 0.001). The onset of depression frequently preceded the diagnosis of POI but occurred after the onset of menstrual irregularity. Analyses standardizing the periods of risk for depression showed that similar numbers of depressions occurred before and after these events. Conclusions: POI is associated with an increased lifetime risk for major depression. Attention to the presence of depression in POI should become an important part of the care for these women. The onset of depression frequently occurs after signs of altered ovarian function but before the diagnosis of POI. Thus, in some women the association between POI and depression suggests an overlapping pathophysiology rather than a causal relationship.

scholarly journals Psychological Well-Being among Nursing Students

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Ali Sabri Radeef Al-Ani
Keyword(s):  
Nursing Students ◽  
Well Being ◽  
Emotional Disturbances ◽  
Depression Anxiety Stress Scale ◽  
Psychological Well Being ◽  
Academic Factors ◽  
Stress Symptoms ◽  
Significant Depression ◽  
Severity Of Depression ◽  
Clinically Significant

Introduction:  Nursing students are subjected to a variety of stressors during their study. Severe and prolonged stressors may affect the psychological well-being in the form of depression, anxiety and stress which may affect students’ academic performance, physical health and quality of life. Therefore, this study aimed to determine the rate and severity of depression, anxiety and stress symptoms and also to assess the relationship between these symptoms with stressors faced by the students. Materials and method: A sample of 174 nursing students from International Islamic University Malaysia participated in this study. Depression Anxiety, Stress Scale (DASS-21) was used to assess the psychological well-being by determining the prevalence and severity of depression, anxiety and stress (DAS) symptoms. The sources of stressors were identified by giving the students a list of the most possible source of stressors which were chosen depending on previous studies, and then the severity of stressors and their relationship with these symptoms were assessed. Results: The overall prevalence of depression, anxiety and stress symptoms was 51.7%, 81.6% and 43.1% respectively but it was found that 13.2%, 44.3% and 10.3% of nursing students have clinically significant depression, anxiety and stress respectively. No significant differences between the gender and age of students in relation to DAS symptoms. Regarding the source of stressors, the top five stressors decided by the students were fear of failing, examination and grades, study pressure and obligations, fear of unemployment after graduation and academic overload. Conclusion: Depression, anxiety and stress symptoms are present among nursing students which require early intervention. Academic factors can be considered as sources of stressors that may precipitate emotional disturbances among the nursing students.

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