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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to explore sleep satisfaction and its related factors among 130 older adults living in the community. Descriptive analyses indicated a small proportion of participants (n = 20, 15.4%) were not satisfied with sleep. Best descriptors of sleep satisfaction were the total amount of sleep, number of awakenings, depth of sleep, and overall quality of sleep. Regression analysis showed depression was negatively related to sleep satisfaction after controlling for age and number of illnesses (p < .05). Findings indicate the need for nurses to assess for factors such as depressive symptoms and anxiety associated with sleep satisfaction.
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PMID:Sleep satisfaction of older adults living in the community: identifying associated behavioral and health factors. 1704 51

Apart from causing emotional suffering, postnatal depression strains marriage, undermines the mother's confidence, impairs her social functioning and quality of life, and in serious cases contributes to infant abuses, infanticides and suicidal behaviour. Recent studies also show that postnatal depression adversely affects emotional, behavioural and cognitive development of the newborn. In addition, there is growing awareness that depression can occur during pregnancy, and antenatal depression can adversely affect obstetric and neonatal outcomes. Antenatal depressive symptoms are also the strongest predictor of postnatal depression. This paper reviews the epidemiology, clinical presentation, risk factors, prevention and treatment of perinatal depression. The latest development in research and practice related to this condition are also highlighted.
Best Pract Res Clin Obstet Gynaecol 2007 Apr
PMID:Postnatal depression: an update. 1715 72

Perimenopause represents a significant transition in a woman's life. The evidence to support an association between perimenopause and depression is mixed, yet recent prospective studies have provided stronger evidence to support such an association. Interpretation of study data are complicated by methodological issues, such as a lack of standard definition for perimenopause or depression, reducing comparability. A variety of causal factors, including psychological, genetic and physiological, have been implicated in depression during perimenopause, which lends weight to a multifactorial model. Physicians should consider initiating dialogue about menopause and symptom relief at age 40 and screening perimenopausal women for depressive symptoms. Selective serotonin reuptake inhibitors are a first line of treatment for depression, but hormone therapy could be considered for women experiencing menopausal symptoms unless there are contraindications. Future research should focus on establishing temporality and studying these potential relationships among women of different ethnicities.
Best Pract Res Clin Obstet Gynaecol 2007 Apr
PMID:Perimenopause and depression: strength of association, causal mechanisms and treatment recommendations. 1716 71

Routine screening was introduced as a joint research/public-health initiative across 43 health services in Australia, funded by beyondblue, the National Australian Depression Initiative. This program included assessing risk factors and prevalence of depression in perinatal women. Other objectives included increasing awareness of the condition, training of relevant staff, and assessing the feasibility of a screening program. Women were screened antenatally and postnatally with a demographic questionnaire and the Edinburgh Postnatal Depression Scale. A subgroup of women and health professionals was surveyed. Over 40,000 women participated directly in the program. Data and issues for specific groups are presented. There was a high level of acceptability to women and health professionals involved. Screening is acceptable and feasible as part of the mental-health management of perinatal women. It needs to be supplemented with information for women and education and support for staff.
Best Pract Res Clin Obstet Gynaecol 2007 Apr
PMID:National program for depression associated with childbirth: the Australian experience. 1717 98

After perinatal loss, parents experience painful grief. Fathers and mothers show the same pattern of symptoms, but generally mothers' distress is more intense. Grief should be sympathetically acknowledged by health professionals, and parents should be reassured that their feelings are normal and that recovery may take many months. Intense depression lasting more than 6 months may require psychological treatment. There is some evidence that delaying conception for a year may allow an easier pregnancy psychologically. The common practice of encouraging parents to have contact with a dead infant is not evidence-based and may have adverse effects, including inducing symptoms of post-traumatic stress disorder. A protocol of postnatal follow-up allows parents to get appropriate information about the loss, including possible problems and timing of another pregnancy. The subsequent pregnancy is stressful, and health professionals should recognize that parents may suffer significant anxiety.
Best Pract Res Clin Obstet Gynaecol 2007 Apr
PMID:Psychological aspects of perinatal loss. 1719 34

This article discusses the Best Pharmaceuticals for Children Act and the FDA's request for placebo-controlled studies of drugs to treat OCD and depression in children. First, the article explains the need to test drugs in children and examines the reasons this testing has not occurred. Next, the article describes the legislative and administrative responses to remedy this lack of research and assesses the ethics and legality of their implementation. The article concludes that these initiatives are legally and ethically acceptable until a safe and effective treatment is determined--at which point the use of placebos in pediatric testing must be replaced with active controls.
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PMID:Give them what they want? The permissibility of pediatric placebo-controlled trials under the best pharmaceuticals for children act. 1755 29

Patients with widespread pain or fibromyalgia syndrome have many symptoms besides musculoskeletal pain: e.g. fatigue, sleep difficulties, a swollen feeling in tissues, paresthesia, cognitive dysfunction, dizziness, and symptoms of overlapping conditions such as irritable bowel syndrome, headaches and restless legs syndrome. There is evidence for central sensitization in these conditions, but further studies are needed. Anxiety, stress and depression are also present in 30-45% of patients. Other factors that may contribute to symptoms include endocrine dysfunction, psychosocial distress, trauma, and disrupted sleep. Evaluation of a patient presenting with widespread pain includes history and physical examination to diagnose both fibromyalgia and associated or concomitant conditions. Fibromyalgia should be diagnosed by its own characteristic features. Some patients with otherwise typical symptoms of fibromyalgia may have as few as four to six tender points in clinical practice. Patients with rheumatoid arthritis and systemic lupus erythematosus should be evaluated for fibromyalgia, since 20-30% of them have associated fibromyalgia, requiring a different treatment approach.
Best Pract Res Clin Rheumatol 2007 Jun
PMID:Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. 1760 95

Treatment-resistant depression (TRD) is a major public health problem in terms of its prevalence and in terms of individual suffering and cost to society. Best estimates indicate 12-month prevalence rates of approximately 3% for Stage 1 TRD (failure to respond to 1 adequate trial of an antidepressant) and approximately 2% for Stage 2 TRD (failure to respond to 2 adequate trials). The current article provides a brief review of the definitions, prevalence, and various treatment options for TRD, including switching, augmentation, and combination therapies and use of nonpharmacologic treatments. Given the public health importance of TRD, the relative absence of adequately powered, double-blind trials is striking.
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PMID:Prevalence and management of treatment-resistant depression. 1764 Jan 54

There is a paucity of literature on direct treatment outcomes for impoverished minority populations. The current study supports the feasibility of successfully treating women for depressive symptoms in community settings where they typically seek care, adding to the small but growing direct knowledge base in this area. The sample of the 2-site study consisted of 91 women seeking treatment for depressive complaints at a homeless shelter program and a municipal hospital psychiatric clinic for Latino patients. Participants were randomly assigned to either a 16-week cognitive-behavioral group or a 16-week supportive/exploratory group for depression. Best-practice features with this population were integrated throughout. Findings showed that both treatment conditions were equally effective in decreasing depressive symptoms (BDI, CES-D) up to 4 months after treatment termination. These changes were paralleled by improvements in self-reported physical health (Duke Physical Profile). No significant differences between treatment conditions were found. Directives for next steps in the current research agenda are offered in efforts to broaden the direct evidence base for treating vulnerable urban women at high risk for depression and other forms of mental illness.
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PMID:Treating depression in vulnerable urban women: a feasibility study of clinical outcomes in community service settings. 1769 73

Rheumatoid arthritis (RA) is often characterized by the burden of swollen joints, pain, and decreased physical function, but less understood are the many manifestations of additional health conditions that are associated with RA and its treatments. First brought to light with observations of increased mortality in RA, studies noted the increased rates of cardiovascular and infection events. The chronic, debilitating, autoimmune nature of RA affects the patient directly or indirectly in almost all organ systems, from cardiovascular problems and infections to depression and gastrointestinal ulcers. On average, the established RA patient has two or more comorbid conditions. It should be the responsibility of the rheumatologist to take these and the risk of additional conditions into account when treating the patient. This chapter reviews important comorbidities in patients with RA, their prevalence, and their relation to RA.
Best Pract Res Clin Rheumatol 2007 Oct
PMID:Comorbidities in rheumatoid arthritis. 1787 34


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