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

Depression is a common psychiatric disorder that can disrupt a person's health, work, and relationships, and--in some cases--lead to suicide. Disparity between the prevalence of depression and diagnosis and treatment of the disorder led to the creation in 1991 of National Depression Screening Day (NDSD), an annual nationwide screening program for depression. By raising awareness and reducing the stigma of depression, the national screening program addresses the problems of underdiagnosis and lack of treatment in persons suffering from the depressive disorder. Mental health professionals and colleagues in other specialties must reach out to depressed individuals and make it easier for them to access the health care system. This article discusses the origin and goals of NDSD, the NDSD model for the current community-based program, the results of NDSD screening, and the proposed future expansion of NDSD and the voluntary screening concept.
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PMID:Depression screening as an intervention against suicide. 1007 86

Depression tends not to be accurately identified and treated in primary care settings. Women of color are especially likely to use these settings for mental health issues but are less likely to be diagnosed appropriately. A study was conducted within four Florida primary care clinics serving primarily low-income families. Participants included 321 women (Black, 22%, Hispanic, 23.5%, White, 38.6%) who completed a confidential questionnaire while waiting to be seen by clinic staff. Ten percent reported recent major depression, with 26.7% indicating depressive symptoms during the past two years. Depressed women were significantly more likely to report physical violence during the past year. Respondents turned primarily to family, friends, and medical clinics for their depression. They found turning to clinic staff to be helpful and described psychosocial interventions as useful. Members of all ethnic/racial groups reported barriers to seeking help, including perceived separation between mental health and general health and stigma. Implications are discussed in terms of appropriate community education and screening procedures.
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PMID:Women's help-seeking patterns for depression. 1048 27

The burden of depression is increased by the stigma of mental illness and the widely held idea that psychoactive medication is useless and addictive. These preconceptions may delay and obscure diagnosis and reduce treatment adherence. A sensitive clinician should be able to recognise the difficulties in the individual patient and overcome them.
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PMID:Stigma and depression: a double whammy. 1062 77

This study explored the multidimensional outcome of three neurosurgical interventions for Parkinson's disease (PD): pallidotomy (N = 23), pallidal deep brain stimulation (DBS) (N = 9), and thalamic DBS (N = 7). All patients completed the Sickness Impact Profile (SIP) and the Beck Depression Inventory. Pallidotomy patients also completed the Profile of Mood States, the Beck Anxiety Inventory, and a disease-specific quality of life (QOL) measure, the Parkinson's Disease Questionnaire (PDQ-39). Three months after surgery, all neurosurgical groups showed significant improvements in mood and function, including physical, psychosocial, and overall functioning. Pallidal DBS and pallidotomy patients who completed additional QOL measures reported decreased anxiety and tension, increased vigor, improved mobility and ability to perform activities of daily living, and decreased perceived stigma. Psychosocial dysfunction scores from the SIP were related to depressed mood both at baseline (r = .42) and at followup (r = .45), but the physical dysfunction subscale was not related to mood at either time point, suggesting that disruption of social relationships due to PD may have more impact on affective distress than physical symptoms alone. Results suggest that neurosurgical interventions for PD improve disabling PD motor symptoms and also improve several domains of quality of life.
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PMID:Health-related quality of life in Parkinson's disease after pallidotomy and deep brain stimulation. 1075 87

Depression is encountered frequently in the primary care setting. Its appearance is dominated by the physical symptoms of the syndrome. This factor, when combined with the residual stigma that mitigates against acceptance of the diagnosis, probably accounts for how often the diagnosis is missed. The depressive illnesses are serious, disrupting occupational and social functioning to a significant degree. They are life-threatening for some in the short-term, but for many more over a lifetime, as depression is more often recurrent or chronic than a one time experience. With a psychiatric nomenclature now available that is user-friendly, screening tests that are available and easy to administer, and treatments that are successful, it is important that the physician learn to recognize and manage this common set of problems. Depression is typically co-morbid with serious medical illness, and often co-morbid with complicating emotional disorders. It may appear in a form that takes a bipolar course, including episodes of mania and hypomania. The physician in practice must decide which patients with depression he or she will treat, and who to refer for specialty care. The SSRI anti-depressants are usually the frontline treatment of choice. Bipolar, treatment-resistant, and difficult patients with co-morbid psychiatric illnesses should be referred to psychiatrists. It is valuable for the physician to have psychiatrists he or she knows to facilitate consultation, communication and coordination. The value of brief psychotherapy in the treatment of a depressive episode underlines the need for a psychiatrist with whom the physician can work collaboratively. The depressed patient presents the physician with a situation in which he or she can make a positive difference in the life of a person and his or her family. The need to model and teach the treatment of depression in primary care is evident, with the likelihood that this will be the arena in which these patients will continue to receive care.
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PMID:Depression comes in many disguises to the providers of primary care: recognition and management. 1090 22

Inbreeding depression is a general phenomenon that is well documented in many plants and animals. Furthermore, it is generally considered to be the driving force behind mating-system evolution. Traditionally, the focus has been on the mean level of inbreeding depression in populations. However, more recently, the variation in inbreeding depression among individuals within populations has been shown to be influential in mating-system evolution. One set of theories predicts that genetic associations will develop between a mating-system locus and loci causing inbreeding depression, whereas another suggests either that no such association will occur or that it will be difficult to detect empirically. Here, we focus on variation in inbreeding depression among individuals and present empirical evidence of a genetic association between genes causing inbreeding depression and a floral trait influencing the mating system (i.e., selfing rate). We found a positive association between inbreeding depression and herkogamy (the degree to which the stigma and anthers are separated) in an annual plant, Gilia achilleifolia. These results are consistent with theory predicting that an individual's history of inbreeding will affect its level of inbreeding depression and highlight the potential importance of genetic associations between selfing-modifier traits and viability in mating-system evolution.
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PMID:An association between a floral trait and inbreeding depression. 1093 57

Stigma is a social devaluation of a person because of personal attribute leading to an experience of sense of shame, disgrace and social isolation. The nature of stigma in schizophrenia and its relationship to attribution was studied in one hundred and fifty-nine urban patients of Madras, India who fulfilled DSM-IV criteria for schizophrenia. The response of the primary care givers to fourteen questions on stigma and 14 on what they thought attributed to the illness was elicited. Based on the mean stigma score, the entire sample was divided into two groups- those with high and low stigma. Marriage, fear of rejection by neighbour, and the need to hide the fact from others were some of the more stigmatising aspects. Many care givers reported feelings of depression and sorrow. Discriminant function analysis showed that female sex of the patient and a younger age of both patient and caregiver were related to higher stigma. Among attribution items, having no explanation to offer, and attributions to faulty biological functioning, character of life style, substance abuse and intimate interpersonal relationship discriminated between the two groups. The relevance of stigma in the cultural context is described.
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PMID:How stigmatising is schizophrenia in India? 1095 Mar 61

This study examines depression among HIV infected AIDS caregivers, documenting and explaining variation in health within a stress proliferation framework. Longitudinal data for 376 HIV- and HIV+ caregiving men who self-identify as gay are analyzed to establish how changes in depression are influenced by care-related stressors and by being a member of the gay, HIV-affected community. This research identifies the mechanisms by which the caregiver stress process unfolds distinctively among caregivers with AIDS-related health problems, in comparison to HIV- caregivers. Three waves of data are analyzed using longitudinal multiple regression models. Among HIV infected caregivers, mental health is affected by deteriorating health, perceptions of AIDS alienation/stigma, internalized homophobia, role overload, and financial worry. For both groups, depression is a function of social constriction and AIDS-related bereavement. The precursive nature of caregiving among these HIV infected men may magnify the stress of being in poor health, gay, and stigmatized.
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PMID:Precursive depression among HIV infected AIDS caregivers over time. 1097 35

This paper describes the needs assessment phase of a mental health promotion programme for rural communities in Ireland. As part of a larger study encompassing four rural communities, a cross-sectional study of the mental health beliefs and perceptions of 1014 people was carried out. Employing a combination of interviewer-administered questionnaire and the vignette method, the needs assessment explores the levels of awareness, current practices, attitudes and stigma concerning depression and suicide among a randomly selected quota sample of community members. Lower levels of awareness, less confidence in dealing with mental health issues, negative attitudes to help-seeking and social stigma emerge as particular issues for men and the under 40 age group. Women were found to have more positive attitudes generally, were more likely to use informal social support networks and were more open about discussing mental health matters. The predominant interpretation of the depression vignette was to view it as a mental health problem with good prospects for recovery given appropriate help. Social relationships, negative thinking patterns and social stresses were perceived as being particularly important in explaining the origins of depression. The implications of the findings for planning the intervention phase of the project are considered.
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PMID:A community needs assessment for rural mental health promotion. 1097 77

Major depression is a widespread, often chronic disorder affecting the individual, his or her family, and society as a whole. It incurs tremendous social and financial costs in the form of impaired relationships, lost productivity, and lost wages. Although chronic major depression is eminently treatable, it continues to be undertreated and underrecognized. This is particularly true in primary care settings, where physicians are usually the first to encounter chronic depression but are seldom trained to distinguish depression from other medical illnesses with similar symptoms. In addition, because of the stigma attached to depression, patients often characterize their symptoms as part of a physical illness or fail to report them to a clinician at all. This article discusses the epidemiology of depression, its impact and burden on society, and its special character (including diagnosis and treatment) as a chronic illness.
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PMID:The societal costs of chronic major depression. 2212


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