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

Postpartum depression (PPD) affects nearly 1 in 8 mothers and has many negative implications. Studies show particular risk factors are linked with PPD. There are nearly 200,000 women serving in the U.S. Armed Forces, but little is known regarding PPD and active duty (AD) mothers. This study examined rates and risk factors for AD mothers and found that 19.5% were positive for PPD symptoms. Ten significant psychosocial factors were associated with PPD, including low self-esteem, prenatal anxiety, prenatal depression, history of previous depression, social support, poor marital satisfaction, life stress, child care stress, difficult infant temperament, and maternity blues. This study has implications for prevention, identification, and treatment of AD military women with PPD.
Mil Med 2008 Nov
PMID:Postpartum depression in a military sample. 1905 83

ABSTRACT Heart failure continues to be the leading cause of hospitalization among older adults. Noncompliance with medications, dietary indiscretion, failure to recognize symptoms, and failed social support systems contribute to increased morbidity. Multidisciplinary medical approaches have proven successful for heart failure. In 2004, the Naval Medical Center San Diego started a multidisciplinary shared medical appointment for patients with complicated cases of heart failure. Patients enrolled in the heart failure clinic were monitored prospectively for 6 months. Validated questionnaires concerning satisfaction with care, self-care management, depression, and quality-of-life measures were administered at baseline and 6 months after enrollment. Thirty-nine individuals were enrolled in the clinic, with 33 completing 6 months of follow-up monitoring to date. Hospital admissions for any cause decreased from 11 to eight, whereas congestive heart failure-related admissions decreased from four to two. There was a total of six deaths. During the 6 months of enrollment, use of angiotensin-converting enzyme inhibitors and beta-receptor blockers had absolute increases of 20% and 19%, respectively. Statistically significant improvements were seen in the Beck Depression Inventory and Self-Care Management Index results. A multidisciplinary approach to heart failure patients using the shared medical appointment model can improve patient satisfaction, enhance quality of life, and help reduce hospitalizations while improving provider efficiency.
Mil Med 2008 Dec
PMID:A pilot study: reports of benefits from a 6-month, multidisciplinary, shared medical appointment approach for heart failure patients. 1914 41

Mental health symptoms in military populations are rising and constitute a significant health concern. This study examined the prevalence of depression, anxiety, and suicidal ideation in soldiers (N = 3,792) undergoing combat medic training. At the start of training, 10.4%, 15.5%, and 4.1% of soldiers had clinically significant depression, anxiety, or suicidal ideation, respectfully. These percentages increased to 12.2%, 20.3%, and 5.7% at completion of training, respectfully. Worsening of depression, anxiety, and suicidal ideation occurred for 7.7%, 11.4%, and 4% of soldiers. Higher percentages of symptoms were associated with females, lower education, and lower income. Active duty personnel were more likely to worsen following training with respect to suicidal ideation (OR = 1.9, 95% CI = 1.2-2.9) compared to reservists. The identification of these significant predictors of mental health status may serve to identify individuals at risk. Additional work to examine the relative contribution of anticipatory (impending deployment) factors vs. training-related factors is warranted.
Mil Med 2009 Jun
PMID:Mental health symptoms in combat medic training: a longitudinal examination. 1958 67

Significant mental health symptoms are reported in troops deployed to Iraq and Afghanistan (OEF/OIF). Symptomatic troops are more likely to be discharged and become eligible for Department of Veterans Affairs (DVA) care. Prevalence and predictors of mental health symptoms were assessed in 339 OEF/OIF veterans and reservists registering at the San Diego DVA. Participants completed self-report questionnaires assessing combat exposure, posttraumatic stress disorder (PTSD) symptom frequency and severity, depression, and substance and alcohol abuse. A minority of participants (36%) did not screen positive for mental health symptoms; the remainder met threshold for caseness of PTSD, depression, or substance and alcohol abuse. Using a hierarchical logistic regression model, gender, age, race, and rank were not significantly related to PTSD caseness, whereas most recent branch of service and report of injury during combat were. Follow-up analyses revealed that trauma history and combat exposure varied by branch of service. Knowledge of base rates and vulnerability factors can aid in rapid detection of "at risk" individuals.
Mil Med 2009 Aug
PMID:Trauma exposure, branch of service, and physical injury in relation to mental health among U.S. veterans returning from Iraq and Afghanistan. 1974 29

Initial evaluation of an advanced access clinic developed at a VA medical center (VAMC) found decreased Mental Health wait times and improved quality of care for veterans with depression. Subsequently, modified advanced access models were implemented at affiliated community-based outreach clinics (CBOCs). By comparing each site, we sought to determine whether less resource-intensive models could improve care to the same degree. We assessed contributions of the model's components to the improvement of care (i.e., wait times and depression treatment adequacy). The modified advanced access models led to significant improvements, although no such improvements were seen at 2 control sites. Six features related to rapid access, short-term treatment, and barrier-free access to mental health services accounted for most of the observed improvements. CBOCs can implement limited advanced mental health access models and derive similar improvements to those seen in more extensive models at the VAMCs to which they are affiliated.
Mil Med 2009 Oct
PMID:Access to what? An evaluation of the key ingredients to effective advanced mental health access at a VA medical center and its affiliated community-based outreach clinics. 1989 Dec 13

Unintended consequences of participating in research studies are not well characterized, particularly in veterans who are frequent study participants. Our objective, then, was to assess the rate of and variables associated with distress resulting from veterans' participation in a study on a sensitive subject. Veterans Administration (VA) hospital outpatients were administered questionnaires with three increasingly severe scenarios of a U.S. soldier abusing a detainee. Distress--upset requiring clinical intervention--was assessed, as were sociodemographic characteristics, post-traumatic stress disorder (PTSD), depression, and locus of control (LOC). Three hundred fifty-one veterans participated. Forty-three (12%) became distressed. Modeling indicated distress was associated with minority status (odds ratio [OR] = 5.72, 95% confidence interval [CI] = 1.59, 20.58), PTSD (OR = 2.66, 95% CI = 1.12, 6.29), and external LOC (OR = 6.27, 95% CI = 2.82, 13.90). Distress related to study participation was high in this veteran sample. Higher rates in some subgroups suggested that some individuals may not be able to accurately anticipate risk for harm in sensitive studies.
Mil Med 2009 Nov
PMID:Veterans' distress related to participation in a study about detainee abuse. 1996 Aug 21

A total of 675,626 active duty Army soldiers who were known to be at risk for deployment to the Persian Gulf were followed from 1980 through the Persian Gulf War. Hospitalization histories for the entire cohort and Health Risk Appraisal surveys for a subset of 374 soldiers were used to evaluate prewar distress, health, and behaviors. Deployers were less likely to have had any prewar hospitalizations or hospitalization for a condition commonly reported among Gulf War veterans or to report experiences of depression/suicidal ideation. Deployers reported greater satisfaction with life and relationships but displayed greater tendencies toward risk taking, such as drunk driving, speeding, and failure to wear safety belts. Deployed veterans were more likely to receive hazardous duty pay and to be hospitalized for an injury than nondeployed Gulf War-era veterans. If distress is a predictor of postwar morbidity, it is likely attributable to experiences occurring during or after the war and not related to prewar exposures or health status. Postwar excess injury risk may be explained in part by a propensity for greater risk taking, which was evident before and persisted throughout the war.
Mil Med 2010 Apr
PMID:Demographic, physical, and mental health factors associated with deployment of U.S. Army soldiers to the Persian Gulf. 2044 97

Stress and depression can adversely impact the performance of military personnel. Cognitive-behavioral (CBT) interventions for managing stress are efficacious in traditional face-to-face formats, but the Internet supports a broader reach of these programs. This study reports on the feasibility of using an Internet-based self-help stress-management intervention in military personnel. There were 142 officers/enlisted sailors at a Naval Medical Center who completed the program. Evaluation of the program titled "Stress Gym" was positive for the user interface, content, feasibility, and satisfaction. Positive evaluation was not influenced by rank/status, sex, or previous deployment. Stress ratings also decreased significantly while using the program. These data support Stress Gym as being an online CBT-based self-help intervention that is feasible to deploy, accepted by the intended end users, and demonstrates the intended goal of reducing stress.
Mil Med 2010 Jul
PMID:Stress Gym: Feasibility of deploying a web-enhanced behavioral self-management program for stress in a military setting. 2068 52

This investigation assessed the extent to which various health factors are associated with difficulties initiating and maintaining sleep (DIMS) and nightmares among Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans reporting a trauma (combat, noncombat, or a trauma before service). Veterans (N = 201, 88.1% male, mean age = 34.2, SD = 10.1) were referred by primary care for a behavioral health assessment upon evidence of psychiatric symptoms. Sleep problems were assessed using items from the PTSD checklist. After controlling for demographics and nonsleep PTSD symptoms, head injury with a loss of consciousness increased the likelihood of severe nightmares (OR = 3.77, p = 0.019), alcohol abuse or dependence increased the likelihood of moderate nightmares (OR = 4.80, p = 0.007), and greater nonsleep depression increased the likelihood of severe DIMS (OR = 1.20, p = 0.008). Thus, factors aside from PTSD severity are related to sleep disturbance in OIF/OEF veterans reporting a trauma.
Mil Med 2010 Aug
PMID:Predictors of sleep disturbances in Operation Iraqi Freedom/Operation Enduring Freedom veterans reporting a trauma. 2073 Dec 60

A meta-analysis was conducted to examine the relative effectiveness of the broad-based treatments for combat-related post-traumatic stress disorder (PTSD). The analysis includes 13 pharmacotherapy studies and 12 psychotherapy studies obtained from a PsychINFO database search and a reference search. Studies of pharmacotherapy treatment efficacy demonstrated a significantly greater decrease in reducing PTSD symptoms, t (22) = -2.74, p = 0.01, d = 0.05. A random coefficient analysis supports this finding with significance determined at p < 0.001 for the fixed effects in the models. A limited examination of depression as a frequently comorbid disorder indicated pharmacotherapy also demonstrated a significantly greater decrease than psychotherapy in depression symptoms, t (15.77) = -2.26, p = 0.04, d = 0.16. Differences between treatments are discussed as potentially reflective of assignment to treatments and assessment techniques as well as therapeutic effects.
Mil Med 2009 May
PMID:Evaluation of the efficacy of pharmacotherapy and psychotherapy in treatment of combat-related post-traumatic stress disorder: a meta-analytic review of outcome studies. 2073 Dec 75


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