Analysis of depressive symptomatology in mood disorders

BACKGROUND: At this time little information is available about the relationship between glaucomatous visual field defects and impaired blood flow in the optic nerve head. The purpose of this study was to examine blood flow of the juxtapapillary retina and the rim area of the optic nerve head in primary open-angle glaucoma with a borderline visual defect. METHODS: Juxtapapillary retinal and neuroretinal rim area blood flow was measured by scanning laser Doppler flowmetry (SLDF). The visual field was evaluated by static perimetry (Octopus-G1). The optic nerve head was assessed on 15 degrees color stereo photographs. We examined 116 eyes of 91 patients with POAG with controlled IOP and 66 eyes of 44 healthy individuals. The POAG group was divided into eyes with a mean defect lower than 2 dB (POAG group I) and in eyes with a mean defect equal to or greater than 2 dB (POAG group II). The mean age of POAG group I and POAG group II was 55 +/- 11 years and 57 +/- 10 years, respectively. The mean age of the control group was 45 +/- 15 years. The eyes of POAG group I had an average C/D ratio of 0.71 +/- 0.18 with an average mean defect of the visual field of 0.97 +/- 0.68 dB; the eyes of POAG group II had an average C/D ratio of 0.80 +/- 0.17 with an average mean defect of the visual field of 8.2 +/- 6.0 dB. The intraocular pressure on the day of measurement in POAG group I was 18.2 +/- 3.7 mmHg, in POAG group II 17.6 +/- 4.0 mmHg, and in the control group 15.1 +/- 2.5 mmHg. For statistical analysis, age-matched groups of 32 normal eyes of 32 subjects (mean age 52 +/- 10 years) were compared to 18 glaucomatous eyes of 18 patients (POAG group I, mean age 55 +/- 11 years) and 59 glaucomatous eyes of 59 patients (POAG group II, mean age 55 +/- 10 years). RESULTS: In the eyes of POAG group I and POAG group II, both juxtapapillary retinal blood flow and neuroretinal rim area blood flow were significantly decreased compared to an age-matched control group: neuroretinal rim area "flow" POAG group I -65%, POAG group II -66%; juxtapapillary retina "flow" POAG group I -52%, POAG group II -44%. All eyes of the POAG group I (MD < 2 dB) and 56 of 61 eyes of the POAG group II (MD > = 2 dB) showed a retinal perfusion lower than the 90% percentile of normal blood flow. We found no correlation between reduction of juxtapapillary or papillary blood flow and mean defect in POAG eyes. CONCLUSION: Glaucomatous eyes with no defects or borderline visual field defects as well as glaucomatous eyes in an advanced disease stage show significantly decreased optic nerve head and juxtapapillary retinal capillary blood flow.     

Cognitive bibliotherapy for mild and moderate adolescent depressive symptomatology

OBJECTIVE: To compare patterns of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) mortality in 11 selected industrialized countries with highly developed death registration systems and a broad range of cumulative AIDS incidence rates. METHODS: Data on HIV/AIDS mortality were obtained from the World Health Organization (WHO) and Statistics Canada for the years 1987-1991. We obtained data for Australia, Canada, Denmark, France, the former Federal Republic of Germany, Italy, the Netherlands, New Zealand, Spain, Switzerland, and the US, stratified by sex and 5-year age groups. Population figures were obtained from national censal, post-censal or interpolated annual estimates compiled by WHO and from Statistics Canada. RESULTS: A total of 141534 deaths were attributed to HIV/AIDS (126224 in men and 15310 in women) in the 11 countries from 1987 to 1991. The majority of deaths (73.7%) occurred in the US. Other countries contributing substantially to the number of deaths were France (7.1%), Italy (4.9%), Spain (4.9%), former West Germany (3.5%), and Canada (3.0%). Age-specific death rates for men aged 25-44 years in 1991 were highest in the USA at 47.1 per 100000 population and highest for women in Switzerland at 7.7 per 100000 population. Potential years of life lost (PYLL) before age 75 years were highest for males in the US (2388 per 100000 population) and for females in Switzerland (373 per 100000 population). The lowest rates were in New Zealand (339 per 100000 population in men and 6.5 per 100000 population in women). CONCLUSIONS: This historical demographic analysis indicates that mortality resulting from HIV infection and AIDS among men and women varies considerable by country. Rates of death were highest in the US and lowest in Australia, the Netherlands, and New Zealand.     

The relationship between interpersonal schemas and depressive symptomatology.

Turkish university students (187 men and 191 women), 17–27 years old, participated in this study. They completed the Interpersonal Schema Questionnaire (C. Hill & J. Safran, 1994) and the Beck Depression Inventory (A. Beck, A. Rush, B. Shaw, and G. Emery, 1979). This study extended the research that was conducted by Hill and Safran (1994). The results of this study revealed that individuals in the high-depressive symptomatology group expected less complementary responses from significant others in friendly, dominant, and submissive situations. They expected more complementary responses from them in hostile situations. They also rated their expected responses from others as more undesirable than did individuals in the low-depressive symptomatology group. These findings seem to be congruent with cognitive and interpersonal theories of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Addressing comorbid depressive symptomatology in alcohol treatment.

Clinicians often encounter patients who have comorbid alcoholism and depression. The presence of both disorders makes treatment especially challenging. Among individuals seeking treatment for alcohol dependence, depression and depressive symptoms are associated with poorer treatment outcomes, and depressed mood may play an important role in relapse to drinking. Results of a recent study suggest that adding cognitive-behavioral treatment of depression to alcohol treatment can be an effective means of reducing depressive symptoms and improving drinking outcomes in alcoholics with elevated levels of depressive symptoms. This approach may be particularly useful for clinicians seeking a nonmedical intervention to reduce depression during alcohol treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relations between observer-rating and self-report of depressive symptomatology.

Sources of discrepancy between the Hamilton Rating Scale for Depression (HRSD) and the Beck Depression Inventory (BDI) were investigated in 114 depressed inpatients treated with ECT. Three previously reported observations were found to occur within the same sample: (1) There was only a moderate baseline correlation between the measures; (2) this correlation improved markedly at later assessment; (3) the HRSD had a greater effect size for change. The modest baseline correlation was largely due to patients who rated themselves as substantially less depressed than clinicians had rated them. Improvement in the correlation with repeated assessment was due to the representation of clinical responders. The larger effect size with the HRSD was mainly attributable to a small subgroup that showed marked deterioration on the BDI, a phenomenon not observed with clinical evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting depressive symptomatology: Cognitive-behavioral models and postpartum depression.

170 women (mean age 26.6 yrs), seen in their 2nd trimester of pregnancy, were followed-up about 3 mo postpartum. Level of depression (Beck Depression Inventory) was just as high during pregnancy as during the postpartum period. Several variables assessed during pregnancy and during the postpartum period were significant predictors of postpartum depression level, including measures of prepartum depression, attributional style, delivery stress, and stressful life events. The predictor variables accounted for about 40% of the variance in level of postpartum depression. Predictor variables from earlier research such as history of menstrual problems, parity, education, and income did not account for significant variance in postpartum depression level. These findings provide some evidence for the role of cognitive-behavioral factors and stressful life events in depression. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric morbidity and depressive symptomatology in patients with permanent pacemakers

Implantation of a permanent pacemaker requires a psychological effort on the patient's part for adaptation in the acute term, and chronically, it restricts activities of the patient and may cause some psychiatric disturbances. To investigate psychiatric morbidity and depressive symptomatology of the patients with permanent pacemakers, 84 pacemaker patients were diagnosed using the DSM-III-R criteria and depressive symptoms were determined by modified Hamilton Depression Rating Scale (mHDRS). Sixteen (19.1%) patients had been given a psychiatric diagnosis. The most frequent diagnoses were adjustment disorder (5.9%) and major depressive episode (4.7%). Nine patients (10.7%) were diagnosed as having clinical depression (mHDRS > or = 17). The mean score of mHDRS was 7.57 +/- 7.46, and the severity of depression was significantly higher in females. The most frequent symptoms are difficulties in work and activities (53.6%), psychic anxiety (48.8%), loss of energy (42.9%), and hypochondriasis and insomnia (39.3%). Depressed mood, psychic anxiety, loss of energy, loss of interest, insomnia, and hypochondriasis were significantly more frequent in females. Uneducated patients had a more significant loss of energy than educated patients. Depressed mood, psychic anxiety, and somatic concerns and symptoms were more frequent in patients with permanent pacemakers than in the general population. These symptoms, resembling mixed anxiety-depression disorder, were related to fears of having a permanent pacemaker, since our series were composed of uneducated patients who did not have enough knowledge about the device.     

Serotonergic function and negative and depressive symptomatology in schizophrenia and major depression

BACKGROUND: Serotonergic abnormalities are found in both major depressive disorder (MDD) and schizophrenia. Depressive symptoms commonly occur alongside the negative or defect symptoms in schizophrenia and antiserotonergic drugs may be particularly effective in their treatment. We wished to explore whether these symptoms could be distinguished biologically by directly comparing serotonergic function in these two illnesses. METHOD: Fifteen patients with MDD and 13 patients with schizophrenia underwent testing with the specific serotonin releasing agent D-fenfluramine (D-FEN). Prolactin and cortisol responses were measured to ascertain central serotonergic function. Individual patient results were compared with their own carefully matched control to correct for the effect of age, sex, weight and menstrual cycle, before the two patient groups were then compared. RESULTS: Prolactin responses differed significantly between the two patient groups, being lower in MDD patients and higher in schizophrenia patients than their individually matched controls. Cortisol responses did not differ. Within the schizophrenia group, increased serotonergic function correlated positively with depressive symptoms, but there was no such correlation with defect symptoms. Depressive scores were negatively correlated with the presence of negative symptoms in the schizophrenic group. CONCLUSIONS: Schizophrenia and MDD have distinct and opposite neuroendocrine responses to D-FEN. There is no evidence that depressive symptoms in these two conditions have a common serotonergic basis. Moreover, these responses distinguished between negative and depressive symptoms in our schizophrenic group.     

The composition and structure of depressive symptomatology in renal disease.

Renal disease is an increasingly common illness among middle-aged and older adults, and is often associated with depression. The Center for Epidemiologic Studies Depression Scale (CES–D) is a widely used self-report screening measure on which responses generally conform to a 4-factor structure, with each factor loading onto a higher-order Depression factor. The current study examines whether this structure is supported among individuals with renal disease (both predialysis and posttransplant kidney disease patients). Persons with renal disease (n = 225) and healthy control participants (n = 230) were recruited from Vancouver General Hospital and the community. Participants completed the CES–D as part of an extended assessment. Confirmatory factor analytic models were computed for the renal disease and healthy control groups. Results support a 4-factor structure for CES–D responses in persons with renal disease and healthy controls. The hierarchical structure of CES–D responses also appears invariant between groups. Factor structure was similar between groups; only for Depressive Affect was the strength of association with the second-order factor greater among the renal disease than healthy control participants. Findings support similarity of CES–D factor structures between patients with renal disease and healthy individuals. Results suggest that the CES–D's 4 factors contribute to measurement of a higher-order Depression factor in both groups; furthermore, 3 of 4 factors appear invariant between groups. As such, this measure can be used confidently to quantify depressive symptoms in individuals with renal disease. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Self-disgust mediates the relationship between dysfunctional cognitions and depressive symptomatology.

Disgust has been linked to several psychopathologies, although a role in depression has been questioned. However, it has recently been proposed that rather than general disgust sensitivity, disgust directed toward the self (self-disgust) may influence the development of depression, providing a causal link between dysfunctional cognitions and depressive symptomatology. This possibility was examined by developing a scale to measure self-disgust (the Self-Disgust Scale; SDS) and then using mediator analysis to determine if self-disgust was able to explain the relationship between dysfunctional cognitions (measured with the use of the Dysfunctional Attitudes Scale) and depressive symptomatology (measured with the use of the Beck Depression Inventory and the Depression, Anxiety and Stress Scale). The developed SDS was found to exhibit a high level of internal consistency, test-retest reliability, and concurrent validity. Principal-components analysis revealed two factors to underlie responses to SDS items: the 'Disgusting self,' concerned with enduring, context independent aspects of the self, and 'Disgusting ways,' concerned with behavior. Self-disgust was found to mediate the relationship between dysfunctional cognitions and depressive symptomatology, demonstrating for the first time that self-disgust plays a role in depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Word recognition, discrimination accuracy, and decision bias in schizophrenia: association with positive symptomatology and depressive symptomatology

The purpose of this experiment was to replicate and extend to a memory task Bentall and Slade's (1985) finding that hallucinations in schizophrenic patients were linked to a liberal decision bias. A word recognition task was administered to 40 schizophrenic patients and 40 normal controls that yielded two indices of performance: an index of discrimination accuracy (Pr) and one of decision bias (Br). Patients obtained a lower Pr than controls, whereas Br was similar in both groups. In patients, Br was selectively correlated with positive symptomatology: the more the positive symptoms, the more liberal the bias. In particular, there was a specific correlation between decision bias and hallucinations. Conversely, Pr was inversely correlated with severity of depression, but not with either positive or negative symptoms. Thus, positive symptomatology may be linked more to difficulties in distinguishing between representations of internal versus external events than to deficits in encoding external events.     

The young widow: depressive symptomatology throughout the grief process

The purpose of this investigation was to examine patterns of abatement of depressive symptomatology in 30 young widows at three time periods: immediately following the death of the husband, a year later, and at present. Data on all three time periods were gathered during one interview. The study thus provides retrospective information on patterns of depressive symptomatology. It was expected that such information would enhance understanding of the stages of the grief process described by Glick et al. and by Maddison.     

Behavioral correlates of maternal depressive symptomatology in conduct-disorder children.

We contrasted two predictive models of the impact of maternal depressive symptomatology on child behavior in a study of 51 mothers and their conduct-disorder children. Relations between global measures of maternal distress and child adjustment and observational measures of mother–child interaction were examined. Children of distressed mothers were more maladjusted than children of nondistressed mothers, when maladjustment was measured on the basis of a global rating, but "better" adjusted when measured on the basis of interactional measures. Measures of maternal indiscriminate responding to the child may account for these findings. Results suggest that (a) although conduct-disorder children are generally more maladjusted when their mothers are distressed, they display this maladjustment in a selective fashion, and (b) maternal distress acts as an adverse contextual factor that maintains mother–child interactional difficulties by disrupting the attentional and monitoring skills required for contingent responding. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Platelet serotonin measures in adolescents with conduct disorder

Dysregulation of serotonergic function has been associated with aggression in several studies involving children, adolescents, and adults. This study investigated the relationship of platelet serotonergic measures to conduct disorder type, severity of aggression, and social skills impairment. Standardized assessments of diagnosis, aggression, impulsivity, and social skills were obtained from 43 male adolescents (ages 13-17) incarcerated at an involuntary residential treatment facility for juvenile offenders. Blood samples were collected and assayed for whole blood serotonin (5-HT) and platelet [3H]-paroxetine-labeled 5-HT-transporter binding. Whole blood 5-HT was higher in adolescents with conduct disorder, childhood type than in subjects with conduct disorder, adolescent type. Whole blood 5-HT was positively correlated with violence rating of the current offense and total offense points, and staff ratings of social skills impairment. Our findings are consistent with a relationship between 5-HT dysregulation and aggressive behavior in incarcerated adolescent boys with conduct disorder, particularly of childhood onset.     

Correlates of change in depressive symptomatology among gay men with AIDS

The present experiment investigated the ability of the opiate receptor antagonist naltrexone to block the increased locomotion and rearing produced acutely by amphetamine as well as the sensitization of these responses produced when this drug is administered repeatedly. Rats in different groups received an injection of amphetamine (1.5 mg/kg, i.p.) or saline preceded 30 min earlier by an injection of naltrexone (0, 0.5, 1.0, 5.0 or 10.0 mg/kg, i.p.). Naltrexone dose-dependently reduced the rearing but had no effect on the locomotion produced by this dose of amphetamine. The locomotion and rearing observed following saline were not affected. This pattern of results was observed following each of six additional pairs of injections, one pair of injections given every third day. Once, soon (2-4 days) and once, long (9-12 days) after the last injection, all animals were injected with amphetamine (0.75 mg/kg, i.p.) in the absence of naltrexone (tests for sensitization). Animals having been pre-exposed to amphetamine preceded by naltrexone showed no evidence of sensitized rearing on either test, indicating that naltrexone blocked sensitization of this response to amphetamine. These animals, however, exhibited sensitized locomotion on both tests. These results suggest an important but complex role for dopamine-opioid interactions not only in the production of acute locomotor responding to amphetamine but also in the sensitization of locomotor responding when this drug is administered repeatedly. The present findings also suggest that amphetamine-induced rearing is more dependent than locomotion on neuronal mechanisms involving dopamine-opioid interactions.     

Patterns of relatedness, depressive symptomatology, and perceived competence in maltreated children.

An attachment theory framework is applied toward understanding the emergence of depressive symptomatology and lower perceived competence in maltreated and nonmaltreated children. Hypotheses that maltreated children with nonoptimal patterns of relatedness evidence elevated depressive symptomatology and lower competence, whereas nonmaltreated children with optimal or adequate patterns of relatedness exhibit the least depressive symptomatology and higher competence, were confirmed. Additionally, differentiations between maltreated children with and without optimal or adequate patterns of relatedness emerged, suggesting that relatedness may mitigate against the adverse effects of maltreatment. Moreover, sexually abused children with confused patterns of relatedness evidenced clinically significant depressive symptomatology. Results are discussed with regard to mechanisms that contribute to adaptation or maladaptation in children with negative caregiving histories (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social relations and depressive symptomatology in a sample of community-dwelling French older adults.

This study examined the association between social relations and mental health, specifically the relative contribution of social networks and social support to depressive symptomatology. The culturally unique representative sample consisted of 3,777 noninstitutionalized older persons living in southwestern France. The findings indicated that French older adults generally had more than 8 people in their networks, their networks consisted mostly of family members, and they felt understood by most of their network members. These older adults reported being satisfied with their social relations. Sociodemographic variables contribute (R–2?=?.143) to depressive symptomatology, as did social network (incremented R–2?=?.033) and social support (incremented R–2?=?.09) variables. Sociodemographic, social network, and social support variables together increased the variance explained still further (incremented R–2?=?.108). Results were consistent with similar analyses in the US and indicated that social support variables account for more variance in depressive symptomatology than social network variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of control, burnout, and depressive symptomatology: A replication and extension.

100 nurses were observed for burnout and depressive symptomatology. Analysis of change scores and structural equations suggested that the variance shared by burnout and depression (20%) may be attributable to their codevelopment. A definitive temporal sequence among measures of burnout and depressive affect was not obtained. At initial assessment and follow-up, burned-out nurses displayed accurate perceptions of job uncontrollability, whereas non-burned-out nurses overestimated job control. Perceptual accuracy increased in linear fashion with degree of burnout, irrespective of depressive symptomatology. Frequency of threats to job control predicted a significant amount of the variance in perceptual accuracy, supporting the view that "burnout realism" is reality driven. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of depressive symptomatology among adult daughter caregivers of a parent with cancer

BACKGROUND: As a consequence of advances and changes in the detection and treatment of cancer, increasing demands are being placed on familial caregivers of elderly cancer patients. Understanding the factors that place familial caregivers at risk of poor psychological outcomes and threaten their ability to provide adequate care is important for maintaining chronically ill patients in the community. METHODS: Dyads comprised of 164 cancer outpatients (ages 60-90 years) and their adult caregiving daughter completed structured telephone interviews. Hierarchical regression was used to determine the individual and cumulative effect of five domains of potential predictors on the daughters' depressive symptomatology (Center for Epidemiologic Studies Depression Scale [CES-D]). RESULTS: The domains that were shown to be significantly predictive of a daughter's level of depressive symptomatology were daughter sociodemographics, constraints on/facilitators of caregiving, and caregiver burden. The domains of disease/patient characteristics and the daughter's appraisal of the caregiving situation were not found to be significant. The total model suggests that having a health-limiting condition, a greater sense of filial obligation, and greater caregiver burden were correlated with higher CES-D scores, whereas having graduated college, having other social roles, having favorable attitudes regarding her caregiving experience, and providing care in a greater number of domains of care were correlated with lower scores. CONCLUSIONS: These findings demonstrate the importance of focusing on situational factors that may function to constrain or facilitate caregiving when investigating caregiver depression.     

Weight, self-esteem, ethnicity, and depressive symptomatology during pregnancy among inner-city women.

The relationship of weight and self-esteem to depressive symptomatology was examined among 36 African American and 96 European American pregnant inner-city women. Lower self-esteem and higher deviations from medically ideal weight predicted increased dysphoria during the 3rd trimester for European American women, but only lower self-esteem predicted increased dysphoria for African American women. These results support the hypothesis that African Americans are less likely than European Americans to experience negative psychological repercussions of greater weight. Consistent with findings among nonpregnant middle-class samples, these results extend the association between heavier weight and increased risk for psychological distress to pregnant women of European American descent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)