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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study of 54 adolescent inpatient girls examined alcohol consumption in relation to depression severity and family dysfunction as predictors of suicidal ideation and behavior. Although alcohol consumption, depression severity, and family dysfunction were intercorrelated, regression analyses revealed their differential importance to the prediction of self-reported suicidal ideation and severity of clinician-documented suicidal ideation or behavior (none, ideation, intent, gesture, attempt). Self-reported ideation was strongly predicted by depression severity and family dysfunction; severity of clinician-documented suicidal ideation or behavior was predicted by alcohol consumption and family dysfunction. Implications for assessment and treatment are discussed.
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PMID:Alcohol consumption in relation to other predictors of suicidality among adolescent inpatient girls. 842 89

A cross-sectional survey of 304 young women about to undergo a 1st-trimester abortion at a Virginia clinic revealed a significant association between a pre-abortion depressive response and dissatisfaction with family relationships. The mean age of study participants was 24.3 years (range: 14-43 years); 83% were unmarried and 41% were Black. Depressive symptoms were measured by an abbreviated version of the Center for Epidemiologic Studies-Depression Scale (CES-D), while dissatisfaction with family relationships was assessed through use of the Family APGAR test. A researcher-designed questionnaire provided data on sociodemographic factors. The mean CES-D score was 16.82 (maximum possible score, 36), and the mean Family APGAR score was 6.63 (maximum possible, 10). Bivariate analysis revealed highly significant (p 0.001) associations between CES-D scores and Family APGAR scores, young age, lower educational attainment, and denial regarding the reality of the pregnancy. Also significantly correlated (p 0.01) with depression were poor subjective physical health and being unmarried. Lesser but significant (p 0.05) associations were found between depression and problems communicating with one's male partner, contraceptive use, dissatisfaction with the abortion decision, and the experience of symptoms of pregnancy. Multiple regression analysis indicated that increased depressive symptoms were independently predicted by low Family AGAR scores, young age, communication problems with the male partner, pregnancy symptoms, contraceptive use, and denial. The variables analyzed explained 25% of the variance in CES-D scores. Although long-term psychological adjustment to induced abortion is generally positive, over 50% of women are estimated to experience depressive symptoms prior to the procedure--a phenomenon that has not received adequate attention from family practitioners. Since problematic family relationships are often concealed from physicians, supportive exploration of the possibility of underlying family dysfunction should become a part of pre-abortion health care.
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PMID:Family relationships and depressive symptoms preceding induced abortion. 851 96

This study investigated associations between adolescents' perceptions of their family dynamics (McMaster Family Assessment Device, FAD) and depression, suicide thoughts and attempts. High school students (mean age 15.2 years) completed self-report questionnaires including the Beck Depression Inventory (BDI), the FAD, questions about suicidal thoughts, plans and attempts, deliberate self harm, and selected life experiences. Univariate analysis showed that family dysfunction measured on the FAD is associated with thinking and planning suicide, deliberate self harm, suicide attempts, as well as severe depression (BDI > or = 22). Despite this, stepwise regression indicated that family dysfunction influences suicide behaviors indirectly through other variables such as depression. The FAD is recommended as a useful addition to questionnaires seeking to identify vulnerability to both depression and adolescent attempted suicide in early detection studies.
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PMID:Adolescent suicide, depression and family dysfunction. 861 37

Sexual abuse consists of two discrete traumatic elements; the repeated infliction of sexual assault that is superimposed on a chronic background of pathological family interaction, including betrayal, stigmatization, role reversal, and violation of personal boundaries. The acute episodes of sexual assault may be overwhelming to the child and result in anxiety-related symptoms, including PTSD. The long-standing family dysfunction leads to a pathological defensive organization that becomes woven into the victim's personality structure, resulting in long-term characterological changes. As the sexually abused child progresses through adolescence into adulthood, and the immediacy of his or her victimization recedes to the background, the acute posttraumatic anxiety symptoms are gradually replaced by more enduring symptoms and characterological defenses. Traumatic memories of the abuse become repressed or dissociated from consciousness. Identifications, attitudes, and affects derived from the abusive environment are usually organized around victimization experiences, leading to identifications with the aggressor or victim, which contribute to sadomasochistic object relationships and problems with the regulation of sexual behavior. The repressed or dissociated traumatic memories of sexual abuse carry the potential for producing future psychopathology through displacement in the form of conversion symptoms or somatization, and by generating delayed PTSD when these memories are elicited by current experiences. Anxiety and depression triggered by the emergence of these traumatic memories often lead to alcohol and drug abuse. These substances may be used for their anxiolytic and antidepressant effects.
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PMID:Comparing child victims and adult survivors: clues to the pathogenesis of child sexual abuse. 880 26

Evidence in the medical literature suggests that patients with asthma who use antipsychotics or sedatives are at increased risk for serious complications of asthma. A number of mechanisms are potentially responsible for this observed association. The principle noncausal reasons for the increased risk of complications in this patient population include patient characteristics (such as the indication for antipsychotic use, noncompliance with asthma therapy, risk taking behaviour and family dysfunction) and treatment issues (including differential prescribing and the quality of medical care). The main causal mechanism involves depression of the CNS and impaired respiratory drive due to sedation during acute asthma attacks. Although it appears that most of the excess risk is a consequence of the noncausal mechanisms mentioned, physicians treating patients with asthma who have a history of antipsychotic use need to recognise the challenges inherent in managing such patients. Further research into the increased risk associated with sedative use is also warranted.
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PMID:Asthma mortality and antipsychotic or sedative use. What is the link? 924 89

The world's children comprise: (i) those in wealthy, industrialized countries; (ii) those from rapidly industrializing countries; (iii) minority groups including recently arrived immigrants in otherwise affluent and healthy societies; (iv) previously traditional people in rapid transition to urbanized, Western lifestyles; and (v) many millions living in grinding poverty in overcrowded, unhygienic conditions where child mortality is high and often due to malnutrition and infections. Industrialization, affluence, better housing, hygiene and nutrition, better clinical care and disease prevention have helped enhance child health in many countries over the past century. However, this is being offset by obesity, smoking, alcohol and drug abuse and social disruption, mental disease and high rates of violence including homicide and suicide. These 'new morbidities' are worse among minorities and in populations undergoing rapid social change. Social pressures including unemployment, depression and family dysfunction are important. Pediatricians must become active in decisions about the use of public resources in disease prevention, health education and more rational and equitable use of high technology. They should also be active advocates for children and their rights and advise governments about all issues that affect child health, protection and well-being. This is particularly so in the poorest and developing countries. There is a need for better international collaboration, training and exchange programs involving the International Pediatric Association, United Nations International Children's Emergency Fund, World Health Organization and other local, national and regional organizations to help overcome these problems as the next century draws near.
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PMID:The pediatrician's role in the twenty-first century. 982 96

More than a decade of research has characterized the families of individuals with bulimia and bulimia anorexia (Anorexia Nervosa, Binge/Purging Type) as less expressive, less cohesive, and experiencing more conflicts than normal control families. This two-part study investigated variables believed more directly related to disturbed eating and bulimia as contributing to a "family climate for eating disorders." In Study 1. a nonclinical sample of 324 women who had just left home for college and a sample of 121 mothers evaluated their families. Principal-components analyses revealed the same factor structure for both students and mothers, with Family Body Satisfaction, Family Social Appearance Orientation, and Family Achievement Emphasis loading together, representing the hypothesized family climate for eating disorders: the remaining variables loaded with the more traditional family process variables (conflict, cohesion, expressiveness), representing a more general family dysfunction. As predicted, the family climate for eating disorders factor score was a more powerful predictor of disturbed eating. Study 2 extended these findings into a clin ical population, examining whether the family climate for eating disorders variables would distinguish individuals with bulimia from both depressed and healthy controls. Groups of eating-disordered patients (n = 40) and depressed (n = 17) and healthy (n = 27) controls completed family measures. The eating-disordered group scored significantly higher on family climate variables than control groups. Family process variables distinguished clinical groups (depressed and eating disordered) from healthy controls, but not from one another. Controlling for depression removed group differences on family process variables, but family climate variables continued to distinguish the eating-disordered group from both control groups. Indications for further research are discussed.
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PMID:Family climates: family factors specific to disturbed eating and bulimia nervosa. 1057 18

This study investigated the relationship between the perception of family functioning and depressive symptomatology in individuals with eating disorders (EDs). Subjects were evaluated by diagnostic clinical interview using DSM-III-R criteria for EDs, the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L), and two self-report measures, the Beck Depression Inventory (BDI) and the Family Assessment Device (FAD). A significant association was found between self-reported depressive symptomatology and perceived poor family functioning. Subjects with bulimia nervosa (BN) reported a significantly more dysfunctional family background than subjects with anorexia nervosa (AN). In our sample, the presence of self-reported depressive symptomatology was a more powerful predictive variable for perceived family dysfunction than the diagnosis of affective disorder. Also, the diagnosis of BN was a more consistent predictor of dysfunctional family interaction than the diagnosis of affective disorder. Depressive symptoms and EDs seem to play different roles in the way in which they contribute to dysfunctional family patterns.
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PMID:Perception of family functioning and depressive symptomatology in individuals with anorexia nervosa or bulimia nervosa. 1057 75

This article reviews the literature on the risk factors related to teen suicide in the United States and Puerto Rico. Findings indicate the interplay of multifactors including depression, homosexuality--due to the hostility that is often experienced by the person--, sexual abuse, lack of coping, social and problem-solving skills stemming from family dysfunction, feelings of isolation and helplessness, contagion, gender differences, alcohol and drug abuse, psychiatric disorders, biological factors, as well as natural disasters. Included in this report are some statistics on the prevalence of suicide among teens and in the military.
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PMID:Adolescent suicide: a review of the literature. 1084 86

Obsessive compulsive disorder (OCD) affects the lives of patients as well as their relatives. Calvocoressi et al. (1995) suggested that accommodation (e.g., participating in the patient's rituals) by relatives of patients with OCD was related to global family dysfunction and distress. These investigators did not, however, examine the relationship between family accommodation and severity of the patients' OCD symptoms. In the present study we examined the relationship between families' reactions to the patient's illness (e.g., assistance with rituals, modification of family routine, rejection of the patient, etc.) and the patient's Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score and Hamilton Depression scale ratings. We also examined the effects of family accommodation and rejection on treatment outcome. Results revealed that family distress, accommodation, and rejection were related to depression and anxiety in the family members, but not to severity of the patients' OCD. At posttreatment, family accommodation and modification of routine was related to the severity of patients' OCD. These results remained significant when the effect of pretreatment OCD severity was partialled out.
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PMID:Family distress and involvement in relatives of obsessive-compulsive disorder patients. 1086 80


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