Despite ample research on depression after stroke, the debate continues regarding whether symptoms such as sleep disturbances, loss of energy, changes in appetite and diminished concentration should be considered to be consequences of stroke or general symptoms of depression. By comparing symptoms in depressed and non-depressed stroke patients with patients in general practice and patients with symptomatic atherosclerotic diseases, we aim to further clarify similarities and distinctions of depression after stroke and depression in other patient populations. Based on this, it is possible to determine if somatic symptoms should be evaluated in stroke patients in diagnosing depression after stroke. An observational multicenter study is conducted in three hospitals and seven general prac- tices including 382 stroke patients admitted to hospital with a clinical diagnosis of intracere- bral hemorrhage or ischemic infarction, 1160 patients in general practice (PREDICT-NL), and 530 patients with symptomatic atherosclerotic diseases (SMART-Medea).
DOCUMENT
Background: Depression and being overweight are correlated health problems in adulthood. Adolescence is a significant period for the onset and increase of depression and obesity, especially among girls. Pubertal development also occurs with concomitant increases in weight. Thus, it is not yet clear whether the association between depression and being overweight can be explained by pubertal development. Purpose: We examined the association between depressive mood, body weight, and pubertal status in adolescent girls. Method: The design was cross-sectional. In 962 young adolescent Dutch girls (age range: 11.9 - 15.9) weight and height measurements were used to calculate height, age and gender standardized body weight (zBMI). Questionnaires assessed depressive mood (the Centre for Epidemiological Studies-Depression, CES-D, inventory) and menarcheal status (pre or post). Results: The correlation between menarcheal status and body weight (r = .34, p < .001) was not affected by depressive mood, and the correlation between menarcheal status and depressive mood (r = .20, p < .001) was not affected by body weight. A small correlation between depressive mood and body weight (r = .12, p < .001) largely disappeared after controlling for menarche. Conclusion: Menarcheal status does explain the association between weight and depression. Pubertal status is independently associated with both BMI and depression, suggesting that different mechanisms underlie the post-menarcheal increased prevalence of depression and overweight.
DOCUMENT
Research on psychological treatment of depression in inpatients is not conclusive,with some studies finding clear positive effects and other studies finding no significant benefit compared to usual care or structured pharmacotherapy. The results of a meta-analysis investigating how effective psychological treatment is for depressed inpatients are presented. A systematic search in bibliographical databases resulted in 12 studieswith a total of 570 respondents. This set of studies had sufficient statistical power to detect small effect sizes. Psychological treatments had a small (g=0.29), but statistically significant additional effect on depression compared to usual care and structured pharmacological treatments only. This corresponded with a numbersneeded- to-be-treated of 6.17. Heterogeneity was zero inmost analyses, and not significant in all analyses. There wasno indication for significant publication bias. Effectswere not associatedwith characteristics of the population, the interventions and the design of the studies. Although the number of studieswas small, and the quality ofmany studieswas not optimal, it seems safe to conclude that psychological treatments have a small but robust effect on depression in depressed inpatients. More high-quality research is needed to verify these results.
DOCUMENT
Research shows that most of the variance in depression severity levels in late life can be explained by the unmet psychological needs of patients, more in particular the care needs of patients related with psychological distress. This case report describes the treatment of an 84-year-old patient suffering from depression. Her complaints faded upon the use of nursing interventions that were defined on the basis of a systematic assessment of her care needs with the Camberwell Assessment of Needs for the Elderly. The methodical attention to her needs for care and the interventions carried out led to the patient feeling acknowledged and to a diminished need for care and a better quality of life. Although there is no scientific evidence to date, a systematic assessment of care needs may well be a meaningful addition to the nursing diagnostic process. Moreover, alleviating distress in patients by fulfilling unmet care needs through tailored interventions can be seen as an essential element of an effective multidisciplinary depression treatment process.
DOCUMENT
The timely detection of post-stroke depression is complicated by a decreasing length of hospital stay. Therefore, the Post-stroke Depression Prediction Scale was developed and validated. The Post-stroke Depression Prediction Scale is a clinical prediction model for the early identification of stroke patients at increased risk for post-stroke depression. he study included 410 consecutive stroke patients who were able to communicate adequately. Predictors were collected within the first week after stroke. Between 6 to 8 weeks after stroke, major depressive disorder was diagnosed using the Composite International Diagnostic Interview. Multivariable logistic regression models were fitted. A bootstrap-backward selection process resulted in a reduced model. Performance of the model was expressed by discrimination, calibration, and accuracy.
LINK
Objective: To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision. Methods: The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test–retest reliability were also assessed. Results: Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08–1.00), Standardized Root Mean Square Residual = 0.09 ($2 = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> a = 0.75) and test–retest reliability (ICC > 0.75). Discussion: The first statistical evaluation of the ASAD indicated a high level of internal consistency and test–retest reliability, and identified three distinctive factors. This could aid patients and professionals’ assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.
DOCUMENT
Successfully introducing care innovations depends on the type of care setting, the intervention and specific circumstances. In this study the factors influencing the introduction of an evidence based nursing guideline on depression in psychogeriatric nursing home residents were studied.
DOCUMENT
OBJECTIVE: This work aims to gain insight into the long-term impact of depression course on social network size and perceived loneliness in older people living in the community. METHODS: Within a large representative sample of older people in the community (Longitudinal Aging Study Amsterdam (LASA)), participants with clinically relevant levels of depressive symptoms (scores >16 on the Center for Epidemiological Studies Depression Scale) were followed up over a period of 13 years of the LASA study (five waves). General estimating equations were used to estimate the impact of depression course on network size and loneliness and the interaction with gender and age. RESULTS: An unfavorable course of depression was found to be associated with smaller network sizes and higher levels of loneliness over time, especially in men and older participants. CONCLUSIONS: The findings of this study stress the importance of clinical attention to the negative consequences of chronicity in depressed older people. Clinicians should assess possible erosion of the social network over time and be aware of increased feelings of loneliness in this patient group.
DOCUMENT
It is by no means uncommon that academic scholars, journalists and even poets use the epi-thet ‘age of’ to signal how a certain feature is particularly characteristic of the times in which we live. In this chapter, we argue that it makes sense to address our current epoch as an ‘age of emotions’. Broadly speaking this entails that emotions, in many shapes and forms, have been widely recognized as decisive factors in social, cultural, economic and political realms in ways that were not the case before. For example, emotions are proven to play a key role in otherwise rational aspects of life such as political orientation and elections, as Arlie R. Hochschild so forcefully has demonstrated in her account of how people’s deep emotions are decisive when constructing their political identity and casting their vote (Hochschild 2016). In a more specific sense, emotions have historically been singled out as particularly informative about the psychic constitution of the times in which we live. W. H. Auden in 1947 famously declared that this epoch was an ‘age of anxiety’ (Auden 1948). Written in the aftermath of World War II, this pessimistic statement is not surprising: Anxiety was a normal human response to extraordinary circumstances. Recently, journalist of The Guardian, Oli-ver Burkeman, has pondered whether we currently live in an ‘age of rage’, in which people are – simply put – angrier than before, and in which social media is supporting and encourag-ing the ventilation of people’s rage and fury in a hitherto unseen manner. In relation to this chapter, the statement made by Allan V. Horwitz and Jerome C. Wakefield, based on an in-creasing prevalence of the phenomenon in question, that contemporary society should be understood as an ‘age of depression’, is noteworthy (Horwitz and Wakefield 2005). This characteristic begs the questions of how depression has become such an influential and prev-alent disorder in our times and how – even if – we should understand the phenomenon as an indicatory emotion of our epoch? Both as a sign of our times and as an emotion, depression is a particularly interesting phenomenon to study. This is not least due to its long and prolific history. As literary scholar Clark Lawlor has stated, it seems as if depression has been around forever and that depres-sion has been ‘fashionable throughout its history’ (Lawlor 2012:2). For centuries, Lawlor explains, depression has been a socio-cultural weighty condition that a significant amount of people has been emotionally affected by. Similarly, however, he also implies that the under-standing of depression – as a fashionable type of suffering – has changed proportionate to various socio-historical transformations. That is, depression is by no means a static descrip-tion of a specific type of human suffering. Depression changes and ‘relates’ to the societal circumstances it is situated in. If we focus on contemporary late modern society, two things hold true. First of all, there seems to be no doubt about the fact that the dominating under-standing of depression, by and large, is equivalent with the medically informed definition of Major Depression Disorder found in the DSM (Diagnostic and Statistical Manual of Mental Disorders). In here, depression is perceived as a biomedical disease that people suffer from. Secondly, we are witnessing a societal proliferation of the diagnosis of depression unseen in history. WHO has expressed that a veritable depression alarm is ringing loudly worldwide, and that more than 264 million people of all ages now suffer from depression (www.who.int). The combination of these facts is interesting. It informs us about a situation in which a biomedical understanding of depression has inserted itself in the societal discourse about what depression is, and that this understanding has internalized itself in the lives of many people. How are we to fathom this? In this chapter, we shall address this by following four main steps. First, we shall explore how depression has come to be understood as a biomedical disorder that is treated as a specific diagnosable disease, and then show how this understand-ing has been criticized. Second, we elucidate how – and against the backdrop of what – con-temporary depression can be understood as an emotion. Third, we will attempt to nuance the understanding of depression as emotion by arguing that when one zooms in on the phenome-non – that is on the experience of depression – one comes to understand depression as ele-mentary disconnection. Fourth, and based on this deepened understanding, we shall show how the alleged ‘depression epidemic’ can be sensibly linked to a certain subject-position in contemporary culture. Lastly, we will discuss some important implications of this nuanced understanding of depression. This is an Accepted Manuscript of a book chapter published by Routledge/CRC Press in "Emotions in Culture and Everyday Life Conceptual, Theoretical and Empirical Explorations". on 27.05.2024, available online: https://www.routledge.com/Emotions-in-Culture-and-Everyday-Life-Conceptual-Theoretical-and-Empirical-Explorations/Jacobsen/p/book/9781032077314?srsltid=AfmBOop3BqR29YtXXk7FrP4zXPX2BNdx5XizlZGoNZo4fDYC9HJ9OwQE
DOCUMENT
Research has shown that some 30% of total care needs in people with late-life depression (LLD) are unmet. It is not known to what extent patients actually don’t receive any care for these needs or consider the care to be insufficient and their satisfaction with the provided care. Results: In 67% of patients, at least one unmet need was ascertained. In most cases (80%) care was actually provided for those needs by professionals and/or informal caregivers. Patients were satisfied with the care delivered for 81% of the reported care needs. Satisfaction was lowest for social care needs (67%). For six specific care needs it was demonstrated that dissatisfied patients were significantly more depressed than satisfied patients. Conclusion: Even though patients might receive care for certain needs, this does not mean that their needs are met. A substantial proportion of patients with LDD feel that they need additional help for unmet needs.
DOCUMENT
