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

The relationship between family functioning and dementia caregiving is complex. The present study examined the interrelationships between family functioning, caregiver burden, and patient characteristics. Participants were 72 live-in, family caregivers of patients with mild (n = 47) or moderate dementia (n = 25). Caregivers completed measures of burden, family functioning, depression, and anxiety. Ratings of patients' memory/behavior problems and patients' activities of daily living were also collected. Results indicated that higher levels of caregiver burden were significantly associated with increased caregiver depression and anxiety, greater frequency of memory and behavior problems in the dementia patient, worse activities of daily living, and poorer family functioning. Even after controlling for caregiver depression, caregiver anxiety, and frequency of memory/behavior problems in dementia patients, poorer family functioning continued to be associated with higher levels of caregiver burden. Caregivers with high levels of burden reported greater family dysfunction in communication and roles, regardless of their relationship to the patient (i.e., spouse or child). These findings suggest that including a family systems component in caregiver interventions may be beneficial in reducing burden in these very distressed individuals.
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PMID:Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. 1639 97

Several factors influence dementia caregiver desire to institutionalize; however, little is known about differences in caregivers who desire institutionalization versus those who do not. The current study compares predictors of desire to institutionalize in dementia caregivers. Seventy-two caregivers completed the Desire to Institutionalize Scale (DIS) and several psychosocial measures, including burden, dementia knowledge, self-efficacy, depression, health, care recipient daily functioning and memory/behavior problems, family functioning, and social support. Based on DIS responses, caregivers were divided into No DI versus DI groups. DI caregivers had significantly higher burden, greater dementia knowledge, more family dysfunction, and decreased social support compared with No DI caregivers. Findings emphasize the importance of caregiver and family relationship variables in DIS, suggesting potentially modifiable targets for caregiver interventions. Dementia knowledge was associated with higher DIS, suggesting that educational programs alone may not be helpful to delay institutionalization.
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PMID:Psychosocial predictors of dementia caregiver desire to institutionalize: caregiver, care recipient, and family relationship factors. 1644 55

Emotional and behavioural problems were investigated in children who have a parent with multiple sclerosis (MS), in relation to factors such as family dysfunction, parental depression and illness-related characteristics. The participants were 56 MS patients, their spouses and one randomly selected child aged 4-17 years, and a comparison group of 64 children and both their parents, none of whom reported somatic illness. Emotional and behavioural problems in the children were identified by reporting of both parents and self-report using the Achenbach's Child Behaviour Checklist and Youth Self Report respectively. Parental depression and family dysfunction were explored using the Beck Depression Inventory and Family Assessment Device, respectively. The data were analysed using independent samples t-tests for between-group comparisons, Pearson r correlations between children's problems and family dysfunction or parental depression, and multiple regression analyses for identifying predictors for children's problems. Children whose parents, especially mothers, had MS presented greater emotional and behavioural problems than comparison children. Children's problems were positively associated with maternal depression and family dysfunction. Family dysfunction predicted children's overall and externalizing problems, while the severity of impairment of the ill mother predicted children's internalizing problems. Implications of these findings for clinical practice are discussed.
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PMID:Emotional and behavioural difficulties in children of parents with multiple sclerosis: a controlled study in Greece. 1661 88

This study investigated the relationship between activity of disease, mental health status, quality of life, and family dysfunction in northwestern Colombian patients with rheumatoid arthritis (RA). Seventy-nine patients completed a 2-phase study that included physical examination (objective measurement of disease activity according to adapted American College of Rheumatology criteria) and a pretested questionnaire that sought information on helplessness, disability, depression, anxiety, quality of life, arthritis self-efficacy for pain, and other symptoms, as well as family dysfunction and socioeconomic status. Nineteen patients (24%) had active RA, 48 (61%) had moderately active RA, and 12 (15%) were in remission. Symptoms of depression, helplessness, disability, pain, anxiety, lower quality of life, and self-efficacy were associated with RA activity regardless of age, sex, and duration of the disease. Symptoms of depression were directly correlated with anxiety, helplessness, pain, and disability and inversely correlated with quality of life and self-efficacy. Although family dysfunction was present in 39% of patients, no associations between family dysfunction, activity of RA, mental health variables, socioeconomical status or quality of life were observed. These results indicate that RA activity significantly influences mental health status and quality of life in this population. Accordingly, a holistic conception of therapy should guide the treatment of patients with RA.
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PMID:The impact of disease activity on the quality of life, mental health status, and family dysfunction in colombian patients with rheumatoid arthritis. 1704 49

Bipolar disorder is a chronic condition characterized by periods of mania, depression, or mixed states (co-occurring mania and depression). The postpartum period is associated with a high risk for symptom relapse or intensification, which can be reduced with the use of medications. Abrupt discontinuation of these medications increases the probability of relapse, which is associated with high-risk behaviors, significant family dysfunction, and suicide. Drugs used to treat patients with bipolar disorder vary in teratogenic potential. Although first trimester lithium use is associated with Ebstein's anomaly, the risk was overestimated in the past. Valproate and its derivatives and carbamazepine are human teratogens. Lamotrigine does not negatively impact major reproductive outcomes, but the data are limited. Typical antipsychotic medications are relatively well studied and the data do not identify major morphologic teratogenicity. There are fewer studies of newer atypical antipsychotic medications, and registries have been developed to collect prospective data. Clinical management of bipolar disorder during pregnancy, postpartum, and lactation requires a careful balancing of maternal and fetal risks and benefits. Communication and careful comanagement between the obstetric and psychiatric team is essential when treating women with bipolar disorder during the reproductive years.
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PMID:Collaborative management of women with bipolar disorder during pregnancy and postpartum: pharmacologic considerations. 1720 45

This paper reviews predictors of treatment response in open and controlled trials of cognitive-behavioral therapy for obsessive-compulsive disorder (OCD). We focus on demographic characteristics, aspects of OCD symptoms, comorbidity, family factors, cognitive influences, and treatment-specific characteristics as predictor variables. Although inconsistent findings characterize much of the literature, several relatively consistent and salient predictors have emerged, including symptom severity, symptom subtype, severe depression, the presence of comorbid personality disorders, family dysfunction, and the therapeutic alliance. Implications of findings and recommendations for future research are discussed.
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PMID:Clinical predictors of response to cognitive-behavioral therapy for obsessive-compulsive disorder. 1753 65

The hemodialysis regimen required to treat end stage renal disease (ESRD) can be extremely rigid, requiring individuals to adapt to and cope with multiple acute and chronic stressors. Stressors for individuals on hemodialysis can be treatment-related such as dietary and fluid restrictions and ingesting handfuls of medications, or psychosocial in nature such as alterations in sexual function, changes in self-perception, and fear of death. Coping for individuals with ESRD can be adaptive or maladaptive. Adaptive coping can produce desirable outcomes, such as employment and successfulf functioning within the family. If coping is maladaptive, however, marital and family dysfunction can occur, as well as depression, anxiety and loss of one's role and identity. ESRD is marked by extreme loss of personal control and the challenge of lifelong behavioural change. This paper explores and examines the concept of control and its relevance to coping for individuals with ESRD receiving hemodialysis. It also critically analyzes the research literature, and makes recommendations for clinical practice and future research.
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PMID:Control and coping for individuals with end stage renal disease on hemodialysis: a position paper. 1794 49

The phenomenon of auditory hallucinations in clinical populations of nonpsychotic children is an intriguing and little understood area. To date, investigations in this area have reported on a range of correlates, including family histories of psychiatric illness, family dysfunction, and significant levels of stress in the children themselves. The current study reported on 10 nonpsychotic children drawn from a number of community-based child and family agencies that provide therapeutic outpatient services. Consistent with previous studies, the present study found strong associations with family dysfunction, specifically family break-up, as well as significant levels of anxiety and depression in the presenting children. In addition, half the children reported the presence of imaginary companions. Despite confirmation of some previous findings, many other features of this phenomenon remain unanswered, including the different psychological functions that hallucinations and imaginary companions may serve for emotionally troubled children.
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PMID:Correlates of auditory hallucinations in nonpsychotic children. 1809 41

The present study used Canadian National Longitudinal data to examine a model of the mechanisms through which the effects of neighborhood socioeconomic conditions impact young children's verbal and behavioral outcomes (N= 3,528; M age = 5.05 years, SD= 0.86). Integrating elements of social disorganization theory and family stress models, and results from structural equation models suggest that both neighborhood and family mechanisms played an important role in the transmission of neighborhood socioeconomic effects. Neighborhood disadvantage manifested its effect via lower neighborhood cohesion, which was associated with maternal depression and family dysfunction. These processes were, in turn, related to less consistent, less stimulating, and more punitive parenting behaviors, and ultimately, poorer child outcomes.
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PMID:Neighborhood disadvantage: pathways of effects for young children. 1826 15

Latino adolescents report high levels of depression compared to other youth, yet little is known about how culture-specific factors contribute to risk (Blazer, Kessler, McGonagle, & Swartz, 1994; Roberts, Roberts, & Chen, 1997; Roberts & Sobhan, 1992; Twenge & Nolen-Hoeksema, 2002). In this study we evaluated the link between cultural discrepancy (i.e., perceived acculturation and gender role disparity between children and their parents) and depression among children of Latino immigrants. Compared to boys, Latina adolescents reported greater differences in traditional gender role beliefs between themselves and their parents and higher levels of depression. Gender role discrepancy was associated with higher youth depression, with this relationship mediated by increases in family dysfunction. Moreover, a moderator analysis suggested that gender role discrepancy effects may be most pronounced for Latina adolescents. Gender role discrepancy was associated with poorer family functioning for girls but not for boys, although the interaction effect was only marginally significant. These preliminary results point to the importance of considering cultural discrepancy as a contributing factor to youth depression.
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PMID:Depression in Latino adolescents: a cultural discrepancy perspective. 1842 90


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