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

In order to determine whether a decrease in the amplitude of heart rate circadian rhythm (HRCR) could represent a chronobiological marker of depression and to answer the question of the possible role of this alteration in the reduction of rapid eye movement sleep latency (REM latency) observed in depression, 22 major depressed patients (DSM III R, Montgomery Asberg Depression Rating Scale) and 11 healthy volunteers entered this study, which included the simultaneous recordings of sleep and heart rate (HR) during two consecutive 24-h periods. After a smoothing procedure, the HR data, obtained from a portable device providing mean HR/min, were computed with the single cosinor method for the classical circadian parameters. We also determined the cosinor fitting index (CFI = percentage to fit). When studied as a single group and compared to the control group, the depressed patients, who had difficulties in sleep initiation and whose REM latencies were within normal limits, were characterized by a dampening of the amplitude HRCR and of the day-night HR difference. This was linked to a lesser increase of HR during the day and a reduced decrease at night. No significant phase modification of HRCR was observed in this group of depressives. In a second step, the depressives were divided into a depressed arrhythmic group (DAG, CFI < 50%, 11 patients) and a depressed rhythmic group (DRG, CFI > 50%, 11 patients) who did not differ on MADRS scores. Even though the amplitude of HRCR was reduced in the DAG only, with HR higher at night and lower during the daytime than for controls, both DAG and DRG significantly differed from controls on those items related to sleep induction and maintenance. In the DAG only was there a tendency toward a reduction of total sleep time and REM sleep time while REM latency was normal. This finding suggests that sleep problems are not responsible for the differences in HRCR parameters between the two depressed groups. These differences in HR and sleep parameters between two groups of similarly depressed patients also suggest that a short REM latency does not systematically imply a disruption of all circadian clocks.
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PMID:Sleep and heart rate circadian rhythm in depression: the necessity to separate. 844 45

Depressive symptoms in psychotic disorders are of high relevance but seem to be heterogeneous when assessed with a standard rating scale. The present analysis is a replication study on the dimensionality of the Bech-Rafaelsen Melancholia Scale (BRMES) in acutely psychotic patients with substantial depression defined according to a functional approach across the nosological borders of schizophrenia with major affective symptoms, schizoaffective disorder, depressed subtype, and major depression with psychotic features. The baseline data of 123 patients participating in a multicenter pharmacological trial were evaluated with structural equation models. A previously reported three-dimensional model of the BRMES comprising the facets retardation, depressive core symptoms, and accessory depressive symptoms was cross-validated by confirmatory factor analysis (CFA). The three-dimensional model proved to be superior to one-, two-, or four-factor models with respect to goodness-of-fit (goodness-of-fit index [GFI] = 0.91 and comparative fit index [CFI] = 0.89) and parsimony (adjusted GFI [AGFI] = 0.85). When comparing the present model with the previously reported model, a highly satisfactory correspondence emerged (CFI = 0.87). The results corroborate our previous findings that depression-like symptoms in acutely psychotic patients assessed by the BRMES can best be represented by a three-dimensional model and should not be treated as a homogeneous syndrome.
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PMID:Three dimensions of depression in patients with acute psychotic disorders: a replication study. 1057 77

Our objectives were to determine the extent to which symptoms in the schizophrenia patient and personality in the mother lead to a sense of subjective burden in the mother, and to explain variance in two components of Expressed Emotion. Data on symptom severity (PANSS), mothers' personality (NEO-PI), subjective burden (SBAS), and Expressed Emotion (CFI) were gathered from 41 schizophrenia outpatients and their mothers. Approximately one quarter of the variance in Critical Comments (CCs) and Emotional Overinvolvement (EOI) was explained using path analysis. Mothers' CCs were associated with more severe excitement in the patient, with lower Neuroticism, and greater burden in the mother. Higher EOI was explained by greater Conscientiousness and burden in the mother; patient depression had a weak indirect effect on maternal EOI. These results characterize the high EE mother as low in neuroticism and high in conscientiousness with a particular sensitivity to excitement and depression in the patient.
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PMID:Determinants of expressed emotion in mothers of schizophrenia patients. 1268 64

Despite mounting evidence that depression increases risk for cardiovascular morbidity and mortality, little is known about the mechanisms responsible for this association. The current study examined the inter-relationships between depression, adiposity, and inflammatory molecules implicated in the pathogenesis of coronary heart disease. One hundred adults were enrolled. Half were clinically depressed; the others were matched controls with no history of psychiatric illness. All subjects were in excellent health, defined as having no acute infectious disease, chronic medical illness, or prescribed medication regimen. Structural equation modeling yielded support for a model in which depressive symptoms promote weight accumulation, which in turn activates an inflammatory response through two distinct pathways: expanded adipose tissue release of interleukin-6 and leptin-induced upregulation of interleukin-6 release by white blood cells (CFI =.99; NNFI =.99; RMSEA =.05). It did not support a sickness behavior model in which the inflammatory molecules arising from expanded adipose tissue promote depressive symptoms.
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PMID:Pathways linking depression, adiposity, and inflammatory markers in healthy young adults. 1283 30

The purpose of the present study was to examine whether gender moderates the relationship between mood and attitudes toward eating disorders in athletes. 165 athletes (Male = 99; Female = 66) completed the Eating Attitudes Test (EAT), the Profile of Mood States-A (POMS-A), and the Hospital Anxiety Depression Scale (HADS). To test the proposed moderating effect, multisample structural equation modelling was used with equality constraints placed on relationships between mood and EAT scores. Results indicated that relationships between mood and EAT scores did not differ significantly between males and females (CFI = .988), thereby demonstrating that gender did not have a moderating effect. Mood significantly accounted for 38% of the variance in EAT scores in males and 29% of the variance in females, with depressed mood scores showing the strongest relationship with EAT scores. Findings support the use of mood profiling in applied work, and suggest negative mood, particular depressed mood, might be masking a disordered eating attitude. It is suggested that follow-up interviews should be conducted with athletes who report symptoms of depressed mood to ascertain its cause and that further research is needed to investigate the nature of disordered eating attitudes in athletes.
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PMID:Relationships between attitudes towards eating disorders and mood. 1294 21

The Obsessive Thoughts Checklist (OTC) differs from several other measures of obsessive-compulsive symptoms in its focus on obsessive thoughts instead of compulsive behaviour. The OTC has been used in several studies in France and abroad and support for the discriminant and convergent validity of the instrument has been gathered. The authors of the OTC recently reported 3 underlying factors in this instrument: a perfectionism/verification factor, a contamination factor and a responsibility factor. In an earlier study of the OTC a 2 factor solution was however suggested. It therefore seems important to further elucidate the factorial structure of this instrument using confirmatory factor analysis. In this study data on the Icelandic translation of the OTC from three samples of Icelandic college students were submitted first to an exploratory and then to a confirmatory factor analysis. The total number of subjects was 614 college students, 254 men and 360 women with a mean age of 24.4 (sd = 5.0). The results of the exploratory factor analysis (PCA) submitted to a varimax rotation are presented in table I. The 3 expected factors were reproduced with few cross-loadings. In the confirmatory factor analysis the fit of three models to the data were evaluated: a 1 factor model, the 2 factor model of Bouvard et al. and the 3 factor model of Bouvard et al.. An initial examination of the data led to logarithmic transformation of 18 items to reduce skewness in their distributions. The data was subsequently subjected to a confirmatory factor analysis to compare the three-factor model with the two-factor and one-factor models for the OTC. The factors for the three- and two-factor models were allowed to correlate freely. The data were analysed using the EQS procedure, and the models tested were covariance structure models. Table II presents the goodness of fit indices for all three models. The results show that none of the three models provide an overall appropriate fit for the data. However, the fit indices for the three-factor model were considerably higher than found for the two or one factor models and the RMSEA index for the three-factor model suggested an acceptable fit for that model. Although the three-factor model suggests the best fit of all three models, the fit indices were still unacceptably low. Further examination of the data revealed a pattern of standardized residuals suggesting that this might in part be attributable to three items from the responsibility factor (items 26, 19 and 15) not being well specified within the model. When the residuals for these items were allowed to correlate, the fit of the model was substantially improved (CFI = 0.85; GFI = 0.87; AGFI = 0.85; RMSEA = 0.062). This indicates that a revision of the responsibility scale might be appropriate. Table III provides the means, standard deviations and the alpha coefficients for the 3 subscales of the OTC as well as for the total scale. In one subsample of the study (sample 1, n = 169) the OTC was administered together with the Padua Inventory-Washington State Revision (PI-WSUR) measuring obsessive-compulsive symptoms, the Penn State Worry Questionnaire (PSWQ) and the Community Epidemiological Scale-Depression (CES-D) measuring depression. In order to investigate the convergent validity and divergent of the OTC its correlation with the PI-WSUR was compared with its correlations with PSWQ and CES-D. These correlations shown in table IV support the convergent and divergent validity of the OTC. In another subsample of the study (sample 2, n = 296) the OTC was administered together with the Maudsley Obsessive Compulsive Inventory (MOCI). For samples 1 and 2, zero order and partial correlations were calculated between the subscales of the OTC and the subscales of the other instruments. As shown in table V the strongest correlations between the checking/perfectionism and the contamination subscales of the OTC were with corresponding subscales of the PI-WSUR and the MOCI. It is concluded that the factorial, the convergent and the divergent validities of the Icelandic translation of the OTC are supported in a student population even though the somewhat suboptimal fit of the three-factor model may indicate that a revision of the responsibility factor might be in order. This should however be further studied in a clinical population.
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PMID:[A study of the psychometric properties of the Icelandic translation of Obsessive Thoughts Checklist (OTC) with confirmatory factor analysis]. 1595 41

The homeless have been identified as a group at risk of significant anxiety and depression and screening is therefore highly desirable to identify those needing psychological and psychiatric support. However, the psychometric properties of routine screening instruments have yet to be established in this group. This study sought to determine the psychometric properties of the widely used Hospital Anxiety and Depression Scale in this group. Using a cross-sectional design, 314 clients presenting at homelessness units (shelters) supported by The Salvation Army were administered the HADS. Confirmatory factor analysis revealed three-factor models offered the best fit to the data (best-fit model CFI = .98, RMSEA = .06, WRMR = .87). This investigation confirms contemporary research findings that the HADS comprises an underlying tri-dimensional factor structure. However, the internal consistency of the HADS anxiety (alpha = .81) and depression (alpha = .90) sub-scales was excellent. The findings of the current study suggest that the HADS is a suitable screening tool in this group.
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PMID:Factor structure and use of the hospital anxiety and depression scale in the homeless and socially marginalized. 1712 7

EuroQol-5D (EQ-5D) is a well-known generic instrument measuring quality of life in different diseases; it includes 5 dimensions (mobility, self-care, daily activities, pain-discomfort, anxiety and depression) and a Visual Analogue Scale that evaluates patients' perceived health status. The aim of this study was to verify the utility of the EQ-5D in the Italian Cardiac Rehabilitation setting. The study population consisted of 248 consecutive cardiac rehabilitation inpatients (176 males and 72 females, aged 65.3 +/- 10.75 years), 200 of whom had recently undergone cardiac surgery (aortocoronary by-pass and/or valve replacement). Patients filled in the EQ-5D and A-D schedule (on anxiety and depression) on their second day in hospital. Exploratory and Confirmatory Factor Analysis confirmed the robust nature of the EQ-5D and its mono-factorial structure (EFA: Total Variance 50.39% - CFA: chi2 = 3.596; p approximately equal .60; RMSEA = 00; CFI = 1.00; RMR = .007). The instrument showed a good internal consistency (a .73) despite the limited number of items. T test and ANOVA showed the independence of the EQ-5D dimensions and VAS evaluation with respect to patients' education level, but an influence of age and sex. In general, females reported a lower quality of life than males, and older patients a lower quality of life than younger. Furthermore, cardiac-surgery patients reported more problems in self-care and pain-discomfort than ischemic/heart failure patients, and patients in NYHA Classes III and IV reported more difficulties in mobility than patients in lower NYHA classes. In 15% of patients, of heterogeneous socio-demographic and clinical characteristics, no problems in any of the 5 EQ-5D dimensions were reported: this group was characterised by scores under the clinical cut-off on anxiety and depression and showed a better quality of life on the VAS. Results confirm the robustness of the EuroQol-SD psychometric properties and the instrument's utility for the routine assessment of quality of life in the Italian Cardiac Rehabilitation setting.
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PMID:[EuroQol-5D FOR quality of life assessment in cardiac rehabilitation]. 1857 59

This study sought to provide further information about the psychometric properties of the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), in a large, international, cross-culturally diverse sample. Six hundred and fourteen patients with PD participated in the study. Apart from the CISI-PD, assessments were based on Hoehn & Yahr (HY) staging, the Scales for Outcomes in PD-Motor (SCOPA-M), -Cognition (SCOPA-COG) and -Psychosocial (SCOPA-PS), the Cumulative Illness Rating Scale-Geriatrics, and the Hospital Anxiety and Depression Scale. The total CISI-PD score displayed no floor or ceiling effects. Internal consistency was 0.81, the test-retest intraclass correlation coefficient was 0.84, and item homogeneity was 0.52. Exploratory and confirmatory factor analysis (CFI = 0.99, RMSEA = 0.07) confirmed CISI-PD's unifactorial structure. The CISI-PD showed adequate convergent validity with SCOPA-COG and SCOPA-M (r(S) = 0.46-0.85, respectively) and discriminative validity for HY stages and disease duration (P < 0.0001). In a multiple regression model, main CISI-PD predictors were SCOPA-M, disease duration, and depression. The results obtained were not only comparable to but also extended those yielded by the preliminary validation study, thus showing that the CISI-PD is a valid instrument to measure clinical impression of severity in PD. Its simplicity and easy application make it an attractive and useful tool for clinical practice and research.
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PMID:The Clinical Impression of Severity Index for Parkinson's Disease: international validation study. 1897 56

To test the diathesis-stress model for family caregivers, two structural equation models were developed to explain depression measured by the Center for Epidemiologic Studies Depression Scale. A cross-sectional convenience sample of 112 caregivers completed questionnaires to measure burden, personality traits, dysfunctional attitudes, and depression. The final model included direct paths from caregiver burden to autonomy and sociotropy, and indirect paths from burden to depression through sociotropy and autonomy. The final model fit adequately (chi(2) [224, N = 112] = 308.60, p < .00; CFI = .951; RMSEA = .058). Levels of burden influenced caregiver depression scores. One pathway to depression was though the personality traits of sociotropy and autonomy; both had a larger influence on depression scores than burden alone.
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PMID:Depression in family caregivers of elders: a theoretical model of caregiver burden, sociotropy, and autonomy. 1991 1


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