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

We examined the impact of the subthalamic nuclei (STN) deep brain stimulation (DBS) on the health-related quality of life (QoL) of patients with advanced Parkinson's disease (PD). Seventeen consecutive patients with refractory motor fluctuations and dyskinesia were included in the study (mean age, 60.9 +/- 7.7 years [range, 43-74 years]; disease duration, 16.4 +/- 8.5 years [range, 7-38 years]; mean off-medication Hoehn and Yahr stage, 4.23 +/- 0.66 [range, 2.5-5]). Each patient's assessment was carried out using common rating scales, following the Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol. Dyskinesia and emotional state were evaluated through the Abnormal Involuntary Movement Scale (AIMS) and the Hospital Anxiety and Depression Scale (HAD). QoL was assessed by means of the Parkinson's Disease Questionnaire Spanish version (PDQ-39). Significant benefit was obtained in the motor manifestations and complications of disease, as well as in the functional state and mood (P < 0.001). Some QoL dimensions (mobility and activities of daily living) and the PDQ-39 Summary Index (PDQ-39SI) showed a significant improvement (P < 0.001). Benefit was modest (P < 0.05) for three other domains (emotional well-being, stigma, bodily discomfort) and nil for the rest. There was no correlation between the change obtained in the QoL (PDQ-39SI) and in the other variables. As measured by the PDQ-39, STN-DBS significantly improves important aspects of QoL in patients with advanced PD.
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PMID:Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's disease. 1192 Nov 26

The core findings of the GAD-P study (Generalized anxiety and depression in primary care) are summarized and measures to improve the quality of care of patients with generalized anxiety disorders are discussed. In addition to the identification of core research deficits the paper emphasizes the standard use of time-efficient diagnostic screening instruments, because urgently needed improved recognition and diagnosis is the prerequisite for appropriate treatment. Further the role of the media to combat stigma processes, as well as patient education materials to improve compliance and to enhance treatment outcome effects for this neglected disorder that frequently runs a chronic course are highlighted.
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PMID:[Problems and deficiencies in family physician's management of generalized anxiety disorders. Results of the GAD-P study and priorities for an improved care]. 1193 67

Although persons 50 years of age and older account for 10% of all US AIDS cases, the mental health needs of this growing group remain largely overlooked. The current study delineated patterns and predictors of psychological symptoms amongst late middle-aged and older adults living with HIV/AIDS in two large US cities. In late 1998, 83 HIV-infected individuals 50-plus years of age (M = 55.2, Range = 50-69) completed self-report surveys eliciting data on psychological symptomatology, HIV-related life-stressor burden, social support, barriers to health care and social services, and sociodemographic characteristics. Based on the Beck Depression Inventory, 25% of participants reported 'moderate' or 'severe' levels of depression. HIV-infected older adults also evidenced an elevated number of symptoms characteristic of somatization. A hierarchical multiple regression analysis revealed that HIV-infected older adults who endorsed more psychological symptoms also reported more HIV-related life-stressor burden, less support from friends, and reduced access to health care and social services due to AIDS-related stigma. As the impact of HIV on older communities continues to increase, geropractitioners must be prepared to provide care to greater numbers of HIV-infected older adults, a substantial minority of whom will present with complex comorbid physical and mental health conditions.
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PMID:Psychological symptoms among persons 50 years of age and older living with HIV disease. 1202 80

Psychiatric diagnosis and classification reflect the social and political context of an era and are embedded in it. In the last few decades, culture-bound syndromes reported in non-Western societies constituted the major focus of contention over the validity and universality of psychiatric diagnosis. In contemporary times, social, economic, and political factors, such as the hegemony of the DSM discourse, the managed care culture, pharmaceutical forces, and the global burden of disease study, have virtually made culture-bound syndromes 'disappear'. Once widely believed to be rare outside of the developed West, depression has rapidly become the master narrative of mental health worldwide. In the context of global mental health, the field of psychiatric classification must go beyond routine debates over categories. In order to address the growing discrepancy between needs and services, international cultural psychiatry must engage key social forces, such as psychiatric epidemiology, primary care psychiatry, integration of diagnostic systems, stigma, and advocacy.
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PMID:Socio-cultural and global health perspectives for the development of future psychiatric diagnostic systems. 1214 1

In the mid-1980s, research reported that people living with HIV were viewed differently on measures of competence, dependence, morbidity, depression, and moral worth from those living with other chronic illnesses. 443 students were surveyed to evaluate present attitudes in comparison to this earlier research. The usefulness of imaginal exposure, i.e., imagining a loved one living with HIV, in reducing stigma toward people with HIV was also investigated. Analysis indicated no difference in the rating of AIDS and cancer patients on measures of competence, depression, and morbidity and patients with heart disease, the latter being rated significantly less competent and more depressed than AIDS or cancer patients. AIDS patients were rated significantly less dependent than cancer and heart disease patients. While these results suggest that stigma associated with an HIV/AIDS diagnosis, in general, may have decreased over the years, ratings of moral worth were still lower for AIDS patients than for patients with cancer and heart disease. Robustness of this specific aspect of stigma may be associated with sexual prejudice. Also, an imagined loved one who lives with HIV was rated significantly more favorably on all 5 composite scales than a generic person living with HIV, suggesting the usefulness of exposure as an intervention for attitude change. Limitations of the research are discussed.
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PMID:Stigma directed toward chronic illness is resistant to change through education and exposure. 1215 Apr 1

This article discusses the extent of child rape in India, case studies of girl children in legal procedures, rape settings and perpetrators, public morality, and the nature of rape laws in India. It is concluded that there is no safe place for children. Currently, rapists are allowed to go free or are acquitted. Prevention and control of child rape must involve punishment of rapists. It is not appropriate that society ostracize the victim and her family. Victims should not remain silent. National Crime Records Bureau statistics reveal increases in rape during 1986-91. State figures are given for 1986-88. Madhya Pradesh had the highest reported incidence of rape in 1988. In 1993, Madhya Pradesh had a total of 2459 rapes. Nationally, 10,425 women were reported as raped in 1991. 51.7% were 16-30 years old. There were 1099 cases of pedophilia in 1991, which was an increase over 1990. Over 50% of the pedophilia cases were reported in Uttar Pradesh. The record of convictions shows very low figures. 1992 trial results of 276 rape cases indicated that only 46 persons were convicted. Victims suffer from psychological effects of embarrassment, disgust, depression, guilt, and even suicidal tendencies. There is police and prosecution indifference as well as social stigma and social ostracism of the victim and her family. Many cases go unreported. The case studies illustrate the difficulties for the victim of experiencing the rape and the social responses: police harassment, shame and fear, and occasionally public outrage. The case studies illustrate rape in familiar settings, such as schools, family homes, and neighbors and friends' homes; rape by policemen; and rape by political influentials. Most offenders are young, married, and socioeconomically poor. Mass media portrayals fuel the frustrations of poor and lonely men in cities. Rapists exhibit anti-social behavior or psychopathology. Sexual offenses are related to society's moral values.
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PMID:Child rape: facets of a heinous crime. 1215 4

Mental health services in the treatment of late-life depression are critical in the primary care arena. A significant proportion of elderly patients experience depression, a problem causing a far-reaching impact on morbidity, mortality, and quality of life. A number of barriers may prevent effective depression treatment including negative physician and patient attitudes toward the stigma of depression, somatically focused clinical presentations, health care plan constraints, and competing medical demands, as well as gender and geographic isolation. Screening for depression in primary care settings is not always standard fare as physicians may feel confident in their diagnostic abilities. Research addressing effective depression treatment in the primary care setting has been limited to few clinical trials and physician-focused academic detailing. Future research should address real-world scenarios encountered by the primary care physician in their treatment of the "old-old" patient with complex medical comorbidities and functional decline.
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PMID:Late-life depression and mental health services in primary care. 1223 83

AIDS is steeped in moral judgments about who becomes infected with HIV. Consequently, an AIDS diagnosis inevitably brings with it feelings of shame, guilt, loss, depression, fear of disclosure and some form of self-imposed isolation. Because of the stigma of an HIV-positive diagnosis, people are often reluctant to come forward and be tested, which makes it difficult for them to make informed decisions about their own future and that of their family. Nevertheless, since early in the epidemic, people living with HIV/AIDS have spoken out to present their personal perspectives on living with HIV and to challenge perceptions about who can and cannot become infected. However, there has been little research to explore their role in the global response to AIDS and the impact of public HIV disclosure on the HIV-positive persons themselves.
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PMID:Public disclosure of serostatus -- the impact on HIV-positive people. 1229 87

Over the past two decades there have been great advances in the understanding of depression and in the development of pharmacological agents and psychosocial treatments that have demonstrated efficacy in the treatment of this common and disabling illness. Unfortunately, this knowledge and evidence is not consistently translated into actual treatment, and depression remains undiagnosed in a large percentage of patients, and when it is accurately diagnosed, it often is suboptimally treated.The frequent failure to properly diagnose depression may be due to the continuing stigma of mental illness, the persistence of the biomedical, rather than the biopsychosocial, paradigm of illness and treatment, educational issues and the time constraints in the typical medical practice. The suboptimal treatment may be due to all of these issues plus the difficulty in changing physician behaviours even when there exists much evidence that would seem to dictate such a change. The development of a criteria-based nomenclature and the subsequent development and dissemination of evidence-based practice guidelines addresses some of these issues. Copyright 2001 John Wiley & Sons, Ltd.
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PMID:Depression and practice guidelines. 1240 6

Fifty clients and providers narrated their experiences with the stigma associated with seeking care for depression and/or suicidal ideation. Participants also shared their perspectives on ways to minimize stigma. The narrative interviews were audiotaped, transcribed into text, and then interpreted using an interpretive phenomenological method. Open communication; community awareness, education, and prevention; as well as community-centered and in-home services were identified as ways to minimize stigma and enhance the care available to depressed or suicidal individuals. The importance of modifying health care providers' attitudes and changing the climate of inpatient services were also highlighted as priorities by the participants.
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PMID:Client and provider perspectives regarding the stigma of and nonstigmatizing interventions for depression. 1243 25


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