Para-chlorophenylalanine treatment inhibits the expression of vasoactive intestinal peptide messenger RNA in rat anterior pituitary.
alpha-Methyltyrosine; Animals; Anterior/*drug effects/metabolism; Chemical; Depression; Dopamine/metabolism; Fenclonine/*pharmacology; Gene Expression Regulation/drug effects; Male; Messenger/*biosynthesis; Methyltyrosines/pharmacology; Pituitary Gland; Prolactin/metabolism; Rats; RNA; Serotonin/metabolism; Sprague-Dawley; Tryptophan Hydroxylase/antagonists & inhibitors; Vasoactive Intestinal Peptide/*biosynthesis/genetics
Adult male Sprague-Dawley rats were treated with para-chlorophenylalanine (pCPA) or alpha-methyl tyrosine (alpha-MT) to study the effect of serotonin or catecholamine depletion on the expression of vasoactive intestinal peptide (VIP) messenger RNA in the anterior pituitary. Single injections of pCPA (300 mg/kg) for two consecutive days resulted on the third day in a dramatic depletion of serotonin in the medial basal hypothalamus, and a significant reduction in the pituitary content of VIP mRNA (1.0 and 1.7 kb). The effect of pCPA on VIP mRNA appeared to be relatively specific for the anterior pituitary since VIP message levels in the cerebral cortex did not decrease. alpha-MT treatment, (150 mg/kg) for 2 consecutive days, reduced dopamine concentrations in the MBH but had no significant effect on pituitary VIP levels. In a time-course study, hypothalamic serotonin and pituitary VIP mRNA levels were significantly depressed 1-3 days after initiation of pCPA treatment; however, 12 days after pCPA treatment, serotonin concentrations in the hypothalamus approached control values and pituitary VIP mRNA content increased an average of 2-fold over control levels in an apparent rebound effect. pCPA-treated rats injected i.p. twice a day with
Signs S A; Dluzen D E; Carrillo A J
Brain research. Molecular brain research
1993
1993-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/0169-328x(93)90070-6" target="_blank" rel="noreferrer noopener">10.1016/0169-328x(93)90070-6</a>
Depression screening using health questionnaires in patients receiving oral isotretinoin for acne vulgaris.
*Surveys and Questionnaires; Acne Vulgaris – Drug Therapy; Acne Vulgaris/drug therapy; Administration; depression; Depression – Diagnosis; Depression – Etiology; Depression/*diagnosis/etiology; Humans; iPLEDGE; isotretinoin; Isotretinoin – Adverse Effects; Isotretinoin – Therapeutic Use; Isotretinoin/*adverse effects/therapeutic use; Oral; patient health questionnaire-2; patient health questionnaire-9; Questionnaires; screening; suicidal ideation; Suicidal Ideation
Isotretinoin is used to treat severe and recalcitrant acne. Possible side effects include depression, suicide, and suicidal ideation; however, other studies suggest isotretinoin may improve mood and quality of life. Although iPLEDGE consenting warns about the risk of depression and suicidal ideation, there is no recommendation for screening tools. The patient health questionnaire-2 and the patient health questionnaire-9 are validated instruments that enable dermatologists to efficiently screen for depression before and after isotretinoin is initiated.
Schrom Kory; Nagy Terri; Mostow Eliot
Journal of the American Academy of Dermatology
2016
2016-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2016.02.1148" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2016.02.1148</a>
PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: a latent class analysis.
80 and over; Accidents; Adolescent; Adult; Aged; Alcoholism/alcohol use disorder; Depression; Depressive Disorder; Female; Humans; Intervention; Major/diagnosis/etiology; Male; Middle Aged; Motor Vehicles; Post-Traumatic/diagnosis/*etiology; PTSD/posttraumatic stress disorder; Stress Disorders; Substance use disorder; Substance-Related Disorders/etiology; Traffic/*psychology; Trauma; Young Adult
We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA.
Hruska Bryce; Irish Leah A; Pacella Maria L; Sledjeski Eve M; Delahanty Douglas L
Journal of anxiety disorders
2014
2014-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.janxdis.2014.06.009" target="_blank" rel="noreferrer noopener">10.1016/j.janxdis.2014.06.009</a>
The Indirect Effect of Positive Parenting on the Relationship Between Parent and Sibling Bereavement Outcomes After the Death of a Child.
*Bereavement; *Death; *Parent-Child Relations; Adolescence; Adolescent; Bereavement; Child; Death; Depression; family focused care; Female; Human; Humans; Male; parent distress; Parent-Child Relations; Parenting; Parenting/*psychology; Parents – Psychosocial Factors; Parents/*psychology; positive parenting; Post-Traumatic; Psychiatric Status Rating Scales; Psychological Tests; Siblings – Psychosocial Factors; Siblings/*psychology; Stress Disorders
CONTEXT: Families are referred to pediatric palliative care (PPC) programs when a child is diagnosed with a medical condition associated with less than a full life expectancy. When a child dies, PPC programs typically offer a range of bereavement interventions to these families, often focusing on parents. Currently, it is unclear which factors increase the likelihood that bereaved siblings will experience negative outcomes, limiting the development of empirically supported interventions that can be delivered in PPC programs. OBJECTIVES: The present study explored the relationship between parents' and surviving sibling's mental health symptoms (i.e., post-traumatic stress disorder [PTSD], prolonged grief disorder (PGD), and depression symptoms) after a child's death. Additionally, the extent to which parent functioning indirectly impacted sibling functioning through parenting behaviors (i.e., positive parenting and parent involvement) was also examined, with a specific focus on differences based on parent gender. METHODS: Sixty bereaved parents and siblings (aged 8-18) who enrolled in a PPC program from 2008 to 2013 completed measures of PTSD, PGD, and depression related to the loss of a child/sibling. Siblings also completed a measure of general parenting behaviors. RESULTS: Maternal, but not paternal, symptoms of PTSD and PGD were directly associated with sibling outcomes. Paternal symptoms were associated with sibling symptoms indirectly, through parenting behaviors (i.e., via decreasing positive parenting). CONCLUSION: These results underscore the importance of examining both maternal and paternal influences after the death of a child, demonstrate differential impact of maternal vs. paternal symptoms on siblings, and stress the importance of addressing postloss symptoms from a family systems perspective.
Morris Adam T; Gabert-Quillen Crystal; Friebert Sarah; Carst Nancy; Delahanty Douglas L
Journal of pain and symptom management
2016
2016-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jpainsymman.2015.08.011" target="_blank" rel="noreferrer noopener">10.1016/j.jpainsymman.2015.08.011</a>
The Role of Negative Affect on Headache-Related Disability Following Traumatic Physical Injury.
Acute Disease – Etiology; ACUTE diseases; acute physical injury; Adult; Anxiety Disorders; ANXIETY disorders; Arousal; AROUSAL (Physiology); avoidance; Avoidance (Psychology); AVOIDANCE (Psychology); Chronic Pain; CHRONIC pain; Depression; Early Intervention; EARLY medical intervention; HEADACHE; Headache – Etiology; headache-related disability; Health Status; HEALTH status indicators; Human; hyperarousal; INJURY complications; Linear Regression; LONGITUDINAL method; MENTAL depression; negative affect; Nonexperimental Studies; OBSERVATION (Scientific method); Post-Traumatic; POST-traumatic stress disorder; Prospective Studies; PTSD symptoms; REGRESSION analysis; Secondary Analysis; SECONDARY analysis; Stress Disorders; Trauma – Complications
OBJECTIVE: Acute postinjury negative affect (NA) may contribute to headache pain following physical injury. Early psychiatric-headache comorbidity conveys increased vulnerability to chronic headache-related disability and impairment. Yet, it is unknown whether NA is involved in the transition to chronic headache related-disability after injury. This prospective observational study examined the role of acute postinjury NA on subacute and chronic headache-related disability above and beyond nonpsychiatric factors. METHODS: Eighty adult survivors of single-incident traumatic physical injury were assessed for negative affect (NA): a composite of depression and anxiety symptoms, and symptoms of posttraumatic stress disorder (PTSS) during the acute 2-week postinjury phase. NA was examined as the primary predictor of subacute (6-week) and chronic (3-month) headache-related disability; secondary analyses examined whether the individual NA components differentially impacted the outcomes. RESULTS: Hierarchical linear regression confirmed NA as a unique predictor of subacute (Cohen's f (2) = 0.130; P = .005) and chronic headache related-disability (Cohen's f (2) = 0.160; P = .004) beyond demographic and injury-related factors (sex, prior headaches, and closed head injury). Upon further analysis, PTSS uniquely predicted greater subacute (Cohen's f (2) = 0.105; P = .012) and chronic headache-related disability (Cohen's f (2) = 0.103; P = .022) above and beyond demographic and injury-related factors, depression, and anxiety. Avoidance was a robust predictor of subacute headache impairment (explaining 15% of the variance) and hyperarousal was a robust predictor of chronic headache impairment (10% of the variance). CONCLUSION: Although NA consistently predicted headache-related disability, PTSS alone was a unique predictor above and beyond nonpsychiatric factors, depression, and anxiety. These results are suggestive that early treatment of acute postinjury PTSS may correlate with reductions in disability and negative physical health sequelae associated with PTSS and chronic headache.
Pacella Maria L; Hruska Bryce; George Richard L; Delahanty Douglas L
Headache
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/head.13233" target="_blank" rel="noreferrer noopener">10.1111/head.13233</a>
Using established predictors of post-traumatic stress to explain variations in recovery outcomes among orthopedic patients.
*Recovery of Function; 80 and over; 80 and Over; activity; Adult; adults; Aged; Arthroplasty; Clinical Assessment Tools; Coefficient Alpha; Comorbidity; Depression; Descriptive Statistics; disability; Disabled; distress; Female; Funding Source; health care; Hip Fractures – Surgery; Hip/*psychology; Human; Humans; Knee; Knee/*psychology; Male; Middle Age; Middle Aged; Ohio; Orthopedic Surgery; outcomes; P-Value; Pain; Pain Measurement; Post-Traumatic – Risk Factors; Post-Traumatic/*etiology; Prospective Studies; Record Review; Recovery; Regression; Regression Analysis; Replacement; Risk Assessment; Scales; Stress Disorders; T-Tests; Treatment Outcomes; Walking
The present studies examine whether information contained in medical records can be used to predict outcomes following two orthopedic procedures: repair of hip fracture and total knee replacement. Study 1 reports the acute, in-hospital recovery data from the medical records of 119 hip fracture patients. Study 2 is a prospective, longitudinal investigation of 3-month postoperative recovery of 110 total knee replacement patients. Patients characterized by a greater number of post-traumatic stress risk factors experienced poorer outcomes following orthopedic surgery. Our results suggest that patients at risk for negative outcomes can be identified by information readily available to medical personnel.
Cremeans-Smith Julie K; Contrera Kevin; Speering Leann; Miller Eric T; Pfefferle Kiel; Greene Kenneth; Delahanty Douglas L
Journal of Health Psychology
2015
2015-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1359105313511135" target="_blank" rel="noreferrer noopener">10.1177/1359105313511135</a>
Age moderates the relationship between source of social support and mental health in racial minority lesbian, gay, and bisexual youth.
depression; sexuality; social support; trauma; youth
We examined the relationship between source of social support and mental health (and the moderating impact of age) in 64 low socioeconomic status, racial minority lesbian, gay, and bisexual adolescents/young adults. Social support from family ( beta = -.302, p = .03; beta = -.364, p = .008), but not friends or significant others, was independently related to posttraumatic stress disorder and depression symptoms, respectively. Family social support was associated with lower posttraumatic stress disorder and depression symptoms in participants aged
Wise Anna E; Smith Brian C; Armelie Aaron P; Boarts Jessica M; Delahanty Douglas L
Journal of Health Psychology
2017
2017-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1359105316686667" target="_blank" rel="noreferrer noopener">10.1177/1359105316686667</a>
Falls and cognitive decline in Mexican Americans 75 years and older.
Female; Humans; Male; Aged; United States/epidemiology; Sex Factors; depression; Neuropsychological Tests; Accidental Falls/*statistics & numerical data; cognition; Cognition Disorders/epidemiology/*etiology; Depression/epidemiology/etiology; Educational Status; elderly; Hand Strength; Mexican Americans/psychology/*statistics & numerical data; Psychiatric Status Rating Scales; 80 and over
BACKGROUND: Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls-cognition association among cognitively intact Hispanic Elders. METHODS: We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores \textgreater/=21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. RESULTS: At baseline, participants' mean age was 80.8 years (range, 74-109), mean education was 6.3 years (range, 0-17), and mean MMSE was 25.2 (range, 21-30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =-0.81, standard error =0.19, P\textless0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =-0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls-cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. CONCLUSION: Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls-cognition association.
Padubidri Anokha; Al Snih Soham; Samper-Ternent Rafael; Markides Kyriakos S; Ottenbacher Kenneth J; Raji Mukaila A
Clinical interventions in aging
2014
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2147/CIA.S59448" target="_blank" rel="noreferrer noopener">10.2147/CIA.S59448</a>
The Promoting Effective Advance Care for Elders (PEACE) Randomized Pilot Study: Theoretical Framework and Study Design.
Ohio; Aged; Quality of Life; Health Care Costs; Pilot Studies; Practice Guidelines; Study Design; Conceptual Framework; Collaboration; Palliative Care; Depression; Goal-Setting; Disease Management; Multidisciplinary Care Team; Anxiety; Home Health Care; Chronic Disease – In Old Age – Ohio; Health Promotion – In Old Age – Ohio
Practice guidelines are available for hospice and palliative medicine specialists and geriatricians. However, these guidelines do not adequately address the needs of patients who straddle the 2 specialties: homebound chronically ill patients. The purpose of this article is to describe the theoretical basis for the Promoting Effective Advance Care for Elders (PEACE) randomized pilot study. PEACE is an ongoing 2-group randomized pilot study ( n = 80) to test an in-home interdisciplinary care management intervention that combines palliative care approaches to symptom management, psychosocial and emotional support, and advance care planning with geriatric medicine approaches to optimizing function and addressing polypharmacy. The population comprises new enrollees into PASSPORT, Ohio's community-based, long-term care Medicaid waiver program. All PASSPORT enrollees have geriatric/palliative care crossover needs because they are nursing home eligible. The intervention is based on Wagner's Chronic Care Model and includes comprehensive interdisciplinary care management for these low-income frail elders with chronic illnesses, uses evidence-based protocols, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. Our model, with its standardized, evidence-based medical and psychosocial intervention protocols, will transport easily to other sites that are interested in optimizing outcomes for community-based, chronically ill older adults. ( Population Health Management 2012;15:71-77)
Allen Kyle R; Hazelett Susan E; Radwany Steven; Ertle Denise; Fosnight Susan M; Moore Pamela S
Population Health Management
2012
2012-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1089/pop.2011.0004" target="_blank" rel="noreferrer noopener">10.1089/pop.2011.0004</a>
Evaluation of dextromethorphan with select antidepressant therapy for the treatment of depression in the acute care psychiatric setting.
depression; NMDA; fluoxetine; bupropion; CYP2D6 inhibitor; dextromethorphan; paroxetine
Introduction: Dextromethorphan (DXM), an N-methyl-D-aspartate receptor antagonist, may have ketamine-like antidepressant effects. Dextromethorphan is extensively metabolized via cytochrome P450 (CYP) 2D6, and its half-life in extensive metabolizers is 2 to 4 hours. The purpose of this study was to evaluate the effects of DXM in combination with a moderate-to-strong CYP2D6 inhibitor antidepressant on depression in an acute care psychiatric setting. Methods: This was a single-center, retrospective chart review of adult patients with a depressive disorder diagnosis. Patients who received select antidepressant therapy with or without scheduled DXM were included. The primary outcome was the difference in time to improvement of depressive symptoms, which was an average composite of physician documentation, nurse documentation, and first time to 24 hours without as-needed anxiolytics or antipsychotics. The study group consisted of patients who received DXM with select antidepressant therapy, whereas the control group included those who received only select antidepressant therapy. Results: A total of 40 patients were included. The median time to clinical improvement was 3.00 days and 2.83 days for the study group and control group, respectively (P = .986). The incidence of perceptual disturbances and delusions was higher in the study group as compared with the control group (55% and 35% vs 30% and 25%, respectively). Discussion: Dextromethorphan was not associated with a rapid antidepressant effect. The commonly used dose of 30 mg daily may have been too low to have an effect; additionally, the most frequently utilized select antidepressant, bupropion, has moderately less CYP2D6 inhibition than fluoxetine and paroxetine.
Nofziger Jill L; Paxos Chris; Emshoff Jessica; Mullen Chanda
The mental health clinician
2019
2019-03
<a href="http://doi.org/10.9740/mhc.2019.03.076" target="_blank" rel="noreferrer noopener">10.9740/mhc.2019.03.076</a>
Perceptions of Residents and Their Training Directors Regarding Wellness Education, Program Support, and Access to Depression Treatment: the DEPRESS-Ohio Study
Depression; Medical licensure; Program director; Residency; Wellness
OBJECTIVE: This study determines the extent to which residents and their program directors have discordant perceptions regarding wellness, support, and treatment opportunities for trainees. In addition, the authors examined whether psychiatry residents differed in their perceptions compared with residents in other specialties. METHODS: Residents and their program directors from each of 10 specialties were electronically surveyed after IRB approval and giving informed consent. RESULTS: Of 42 program directors responding, over 92% indicated they provided wellness education and programming; however, a significantly lower percentage of 822 trainees were aware of this (81.2% and 74.9%, respectively). A similar disparity existed between program directors (PDs) who knew where to refer depressed residents for help (92.9%) and residents who knew where to seek help (71%). Moreover, 83.3% of program directors believed they could comfortably discuss depression with a depressed resident, but a lower percentage of their trainees (69.1%) felt their training directors would be supportive. A significantly greater percentage of program directors (40.5%) believed seeking treatment for depression might compromise medical licensure than did residents (13.0%). Psychiatry residents were significantly more aware of wellness, support, and access than were residents from other specialties. CONCLUSIONS: The availability of wellness education, programming, program director accessibility, and knowing where to ask for help if depressed does not seem to be adequately communicated to many residents. Moreover, program directors disproportionately see depression treatment as a risk to medical licensure compared with their residents. Psychiatry residents seem to be more aware of program director support and access to care than their colleagues.
Levy Alan B; Nahhas Ramzi W; Sampang Suzanne; Jacobs Karen; Weston Christina; Cerny-Suelzer Cathleen; Riese Amy; Niedermier Julie; Munetz Mark R; Shaw Janet; Mast Ryan
Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2019
2019-04
<a href="http://doi.org/10.1007/s40596-019-01067-1" target="_blank" rel="noreferrer noopener">10.1007/s40596-019-01067-1</a>
Age moderates the relationship between source of social support and mental health in racial minority lesbian, gay, and bisexual youth
Depression; sexuality; social support; trauma; youth
We examined the relationship between source of social support and mental health (and the moderating impact of age) in 64 low socioeconomic status, racial minority lesbian, gay, and bisexual adolescents/young adults. Social support from family ( β = -.302, p = .03; β = -.364, p = .008), but not friends or significant others, was independently related to posttraumatic stress disorder and depression symptoms, respectively. Family social support was associated with lower posttraumatic stress disorder and depression symptoms in participants aged 16-19 years, while friend social support was associated with lower symptoms for participants aged over 20 years. Friend social support was also associated with lower posttraumatic stress disorder symptoms in participants aged 16-17 years. Interventions should target age-appropriate sources of social support.
Wise Anna E; Smith Brian C; Armelie Aaron P; Boarts Jessica M; Delahanty Douglas L
Journal of Health Psychology
2019
2019-06
<a href="http://doi.org/10.1177/1359105316686667" target="_blank" rel="noreferrer noopener">10.1177/1359105316686667</a>
Characteristics Associated with Depression and Suicidal Thoughts Among Medical Residents: Results from the DEPRESS-Ohio Study
depression; Licensure; No terms assigned; Residents; Treatment; Wellness
OBJECTIVE: This study describes the characteristics that are associated with depression in residents and also examines resident perception of available mental health support. METHODS: Residents and their program directors from each of 10 specialties across all academic training institutions in Ohio were electronically surveyed over a 2-month period. Generalized logistic regression was used to test for association between risk factors and depression and, among depressed residents, with suicidal thoughts. RESULTS: Using the PHQ-9, 19% of residents met criteria for at least moderate depression and 31.1% of depressed residents had suicidal thoughts. Over 70% of depressed residents were not receiving treatment, including 70% of depressed residents with suicidal thoughts. Residents who were unaware of wellness programming or did not believe their program director would be supportive of a depressed resident were significantly more likely to be depressed. Residents who believed depression treatment would negatively impact medical licensure were significantly more likely to be depressed. Male program directors and those in their position for fewer than 5 years were significantly more likely to have depressed residents in their program. CONCLUSIONS: A substantial proportion of depressed residents have suicidal thoughts, and most are not receiving treatment. Depressed residents may perceive the availability of support from their program director differently than their non-depressed colleagues, and may perceive greater risk to medical licensure if they seek treatment.
Levy Alan B; Nahhas Ramzi W; Sampang Suzanne; Jacobs Karen; Weston Christina; Cerny-Suelzer Cathleen; Riese Amy; Munetz Mark R; Shaw Janet
Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2019
2019-07
<a href="http://doi.org/10.1007/s40596-019-01089-9" target="_blank" rel="noreferrer noopener">10.1007/s40596-019-01089-9</a>
RECOGNITION OF EMOTIONAL DISTRESS IN PHYSICALLY HEALTHY PRIMARY-CARE PATIENTS WHO PERCEIVE POOR PHYSICAL HEALTH
depression; mortality; perceptions; Psychiatry; somatization disorder
This study examines the recognition and treatment of emotional distress in physically healthy primary cave patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three private primary cave practices completed a mental health screening form prior to their medical visit which included an overall assessment of their physical health (1 = excellent, 2 = good, 3 = fair, 4 = poor). Following the visit, their physicians completed a questionnaire that included the same physical health assessment item. The study group, physically healthy patients who perceive poor physical health (HPPPH), included those patients who rated their physical health as 2 or 3 points more impaired than it was rated by their physician. HPPPH (N = 39) were significantly more likely than other patients (N = 853) to report a prior psychiatric hospitalization (p < 0.05), marital difficulties (p < 0.01), recent missed work due to a mental health problem (p < 0.001), and a range of anxiety, depressive, and psychosomatic symptoms. However, HPPPH were also significantly more likely than other patients to receive excellent emotional health ratings (p < 0.001) from their physicians and were less likely to receive mental health treatment (p < 0.05). Detection of emotional distress may be particularly difficult in physically healthy patients who have low physical health perceptions. Identification of pessimistic physical health perceptions may serve as an indicator for underlying emotional distress.
Olfson M; Gilbert T; Weissman M M; Blacklow R S; Broadhead W E
General Hospital Psychiatry
1995
1995-05
Journal Article
<a href="http://doi.org/10.1016/0163-8343(95)00023-k" target="_blank" rel="noreferrer noopener">10.1016/0163-8343(95)00023-k</a>
The Impact of Prolonged Exposure on PTSD Symptoms and Associated Psychopathology in People Living with HIV: A Randomized Test of Concept
antiretroviral; Biomedical Social Sciences; comorbidity survey; depression; depressive symptoms; disease progression; disorder; Environmental & Occupational Health; human-immunodeficiency-virus; intervention; medication adherence; national; People living with HIV; Posttraumatic stress; posttraumatic-stress-disorder; Prolonged exposure; psychiatric-disorders; Public; substance use; therapy; traumatic events
People living with HIV (PLWH) report elevated levels of posttraumatic stress disorder symptoms (PTSS) and associated comorbidities. The present study tested the efficacy of prolonged exposure (PE) at reducing PTSS, depression, negative posttraumatic cognitions, and substance use in PLWH. Participants were randomly assigned to receive PE ( = 40) or to a weekly monitoring control group ( = 25). Assessments occurred at baseline, post-intervention and 3-months post-treatment. Following the 3-month assessment, controls were offered the intervention. All PE recipients (whether originally from the PE or control group) completed a 6-month assessment. Intent-to-treat mixed model repeated measures ANOVAs were conducted through 3-months post-treatment; within group analyses were conducted through 6-months. PE recipients reported fewer PTSS and negative posttraumatic cognitions and were more likely to achieve good end-state functioning; gains were maintained at 6-months. No between-group differences emerged for substance use. Overall, results support the efficacy of PE in PLWH.
Pacella M L; Armelie A; Boarts J; Wagner G; Jones T; Feeny N; Delahanty D L
Aids and Behavior
2012
2012-07
Journal Article
<a href="http://doi.org/10.1007/s10461-011-0076-y" target="_blank" rel="noreferrer noopener">10.1007/s10461-011-0076-y</a>
Neural Network-Based Real-Time Prediction of Glucose in Patients with Insulin-Dependent Diabetes
blood-glucose; circadian rhythmicity; cortisol; depression; Endocrinology & Metabolism; glycemic control; mellitus; resistance; stress
Background: Continuous glucose monitoring (CGM) technologies report measurements of interstitial glucose concentration every 5 min. CGM technologies have the potential to be utilized for prediction of prospective glucose concentrations with subsequent optimization of glycemic control. This article outlines a feed-forward neural network model (NNM) utilized for real-time prediction of glucose. Methods: A feed-forward NNM was designed for real-time prediction of glucose in patients with diabetes implementing a prediction horizon of 75 min. Inputs to the NNM included CGM values, insulin dosages, metered glucose values, nutritional intake, lifestyle, and emotional factors. Performance of the NNM was assessed in 10 patients not included in the model training set. Results: The NNM had a root mean squared error of 43.9 mg/dL and a mean absolute difference percentage of 22.1. The NNM routinely overestimates hypoglycemic extremes, which can be attributed to the limited number of hypoglycemic reactions in the model training set. The model predicts 88.6% of normal glucose concentrations (>70 and <180mg/dL), 72.6% of hyperglycemia (>= 180mg/dL), and 2.1% of hypoglycemia (<= 70mg/dL). Clarke Error Grid Analysis of model predictions indicated that 92.3% of predictions could be regarded as clinically acceptable and not leading to adverse therapeutic direction. Of these predicted values, 62.3% and 30.0% were located within Zones A and B, respectively, of the error grid. Conclusions: Real-time prediction of glucose via the proposed NNM may provide a means of intelligent therapeutic guidance and direction.
Pappada S M; Cameron B D; Rosman P M; Bourey R E; Papadimos T J; Olorunto W; Borst M J
Diabetes Technology & Therapeutics
2011
2011-02
Journal Article
<a href="http://doi.org/10.1089/dia.2010.0104" target="_blank" rel="noreferrer noopener">10.1089/dia.2010.0104</a>
Repeated stressor exposure regionally enhances beta-adrenergic receptor-mediated brain IL-1 beta production
Anhedonia; antidepressant treatments; Chronic mild stress; chronic psychosocial stress; Cytokine; depression; depressive-like behavior; hippocampal neurogenesis; Immunology; inflammatory cytokines; ligand-binding; messenger-rna; Neurosciences & Neurology; Norepinephrine; paraventricular nucleus; prefrontal cortex; Psychiatry; rat; rat-brain; Receptor binding; Sensitization
It has been proposed that increased brain cytokines during repeated stressor exposure can contribute to neuropathological changes that lead to the onset of depression. Previous studies demonstrate that norepinephrine acting via beta-adrenergic receptors (beta-ARs) mediate brain IL-1 production during acute stressor exposure. The aim of the current studies was to examine how the regulation of brain cytokines by adrenergic signaling might change following repeated stressor exposure. Fischer rats were exposed to four days of chronic mild stress and 24 h after the last stressors beta-AR expression, norepinephrine turnover, and beta-AR-mediated induction of brain IL-1 were measured in limbic areas (e.g. hypothalamus, hippocampus, amygdala, and prefrontal cortex) and brainstem. Repeated stressor exposure resulted in decreases in beta-AR expression (B-max) measured by saturation binding curves in many limbic brain areas, while an increase was observed in the brainstem. This coincided with significant increases in norepinephrine turnover in the prefrontal cortex, hypothalamus, and amygdala, a significant increase in norepinephrine turnover was not observed in the hippocampus or brainstem. Stress increased overall IL-1 production in the amygdala (both basal and stimulated). While stress did not affect basal IL-1 levels in any other brain area, central administration of isoproterenol (a beta-AR agonist) augmented IL-1 production in the hypothalamus of stressed animals. These data indicate that repeated stressor exposure results in brain area specific enhancements in beta-AR-mediated IL-1 production and extends current knowledge of stress-induced enhancement of brain cytokine beyond sensitized response to immunological stimuli. (C) 2012 Elsevier Inc. All rights reserved.
Porterfield V M; Gabella K M; Simmons M A; Johnson J D
Brain Behavior and Immunity
2012
2012-11
Journal Article
<a href="http://doi.org/10.1016/j.bbi.2012.08.001" target="_blank" rel="noreferrer noopener">10.1016/j.bbi.2012.08.001</a>
Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women
birth outcomes; depression; differentials; Health; mortality; multivariate; nonpsychotic postpartum depression; prevalence; Psychology; psychosocial resources; satisfaction; self-esteem; social support; stress; weight
The authors examined the prospective influence of stress, self-esteem, and social support on the postpartum depressive symptoms of 191 inner-city women (139 European Americans and 52 African Americans) over 3 waves of data collection. Depressive symptomatology was measured by multiple indicators, including self-report and clinical scales. Women became less depressed as they move from prenatal to postpartum stages and adjusted to their pregnancy and its consequences. LISREL and regression analyses indicated that stress was related to increased depression, whereas greater income and social support were related to decreased depression. Self-esteem was related to lower depression at the prenatal and postpartum periods but not to change in depression from the prenatal to the postpartum period. The results also indicated that self-esteem and social support did not have additional stress-buffering effects over and above their direct effects on depression. Finally, African American women did not differ from European American women terms of depression or in terms of how they were impacted by stress or psychosocial resources.
Ritter C; Hobfoll S E; Lavin J; Cameron R P; Hulsizer M R
Health Psychology
2000
2000-11
Journal Article
<a href="http://doi.org/10.1037//0278-6133.19.6.576" target="_blank" rel="noreferrer noopener">10.1037//0278-6133.19.6.576</a>
Castration differentially alters H-3 nisoxetine binding to norepinephrine uptake sites in olfactory bulb and frontal cortex of male rats
androgens; cerebral-cortex; chemical cues; conspecific odors; depression; dopamine; h-3 nisoxetine; hormone-releasing hormone; induced plasticity; locus-coeruleus; memory/recognition; Neurosciences & Neurology; norepinephrine transporter; olfaction; transporter; transporter messenger-rna; tyrosine-hydroxylase
In the present study, [H-3]nisoxetine binding to norepinephrine (NE) uptake sites and [H-3]norepinephrine uptake were investigated within olfactory bulb (OB) and frontal cortex homogenates from intact and castrated male rats. Statistically significant reductions in the number of [H-3] nisoxetine binding sites (B-max) were found in OB from the castrates, while significantly increased B-max values were obtained in the frontal cortex. Castration also significantly altered the affinity (K-d) of [H-3]nisoxetine binding in the frontal cortex, but not in the OB. Assessment of [H-3]norepinephrine uptake showed that in neither brain regions were there any statistically significant differences in K-m nor V-max between the castrated and intact male rats, indicating that the basal uptake process is not changed following castration in either of these brain areas. These results demonstrate the differential effects of castration upon [H-3]nisoxetine binding sites between the OB and frontal cortex. Such findings provide new evidence for one of the mechanisms by which androgens may modulate central noradrenergic activity. Synapse 31:250-255, 1999. (C) 1999 Wiley-Liss, Inc.
Shang Y L; Boja J W; Dluzen D E
Synapse
1999
1999-03
Journal Article
<a href="http://doi.org/10.1002/(sici)1098-2396(19990315)31:4%3C250::aid-syn2%3E3.3.co;2-q" target="_blank" rel="noreferrer noopener">10.1002/(sici)1098-2396(19990315)31:4%3C250::aid-syn2%3E3.3.co;2-q</a>
PTSD, Depression, and Substance Use in Relation to Suicidality Risk among Traumatized Minority Lesbian, Gay, and Bisexual Youth
adolescents; alcohol-consumption; behavior; bullying; depression; Health; LGB; posttraumatic-stress-disorder; Psychiatry; Psychology; PTSD; service use; sexual minority; substance use; suicide; united-states; victimization; young-adults
Youths who are lesbian, gay, or bisexual (LGB) are more likely than heterosexuals to commit suicide. Substance use, PTSD, and depression are independent risk factors for suicidality; however, the extent to which these factors interact to predict suicidality is unclear. The current study examined the association between substance use, PTSD symptoms (PTSS), depressive symptoms, and suicidality in a sample of 68 traumatized minority LGB youths. Participants were recruited from an LGBT community center and completed a packet of questionnaires. Substance use and depressive symptoms were positively associated with prior suicide attempts. A significant three-way interaction revealed that substance use interacted with both PTSS and depressive symptoms to increase the odds of attempted suicide. Results underscore the importance of integrating substance use components into PTSD/depression treatment to reduce suicide risk in LGB youth.
Smith B C; Armelie A P; Boarts J M; Brazil M; Delahanty D L
Archives of Suicide Research
2016
2016-01
Journal Article
<a href="http://doi.org/10.1080/13811118.2015.1004484" target="_blank" rel="noreferrer noopener">10.1080/13811118.2015.1004484</a>
Antidepressants in Bipolar Disorder: Caveats in Interpreting and Applying the Findings of Altshuler et al
depression; impact; Psychiatry; Psychology
Sparhawk R
Journal of Clinical Psychiatry
2010
2010-02
Journal Article
<a href="http://doi.org/10.4088/JCP.09lr05463gre" target="_blank" rel="noreferrer noopener">10.4088/JCP.09lr05463gre</a>
In Bipolar Disorder Beyond 10 Weeks of Treatment, the Term Antidepressants Is a Misnomer
depression; discontinuation; mania; Psychiatry; Psychology; step-bd
Sparhawk R
Journal of Clinical Psychiatry
2011
2011-06
Journal Article
<a href="http://doi.org/10.4088/JCP.11l06953" target="_blank" rel="noreferrer noopener">10.4088/JCP.11l06953</a>
Career decidedness as a predictor of subjective well-being
Big-five personality traits; Career decidedness; Career decision making; Career indecision; college-students; decisional process inventory; depression; happiness; indecision; model; personality; Psychology; satisfaction; Subjective well-being
Forming, pursing, and achieving life tasks constitute important determinants of subjective well-being (SWB). A principal life task for emerging adults involves deciding about career goals. Prior research indicates that depression predicts SWB and may be linked to lower levels of career decidedness. We tested whether or not career decidedness predicts SWB above and beyond the influence of depression and other personality traits. We also examined whether or not career decidedness partially mediates depression's influence on SWB when controlled for personality effects. Undergraduate students (N =181; 65% female, 52% Asian) responded to measures of career decidedness. SWB, and personality. Results largely confirmed predictions. A partial mediator model indicated a direct relationship between decidedness and SWB not moderated by grade level, and an inverse relationship between the depression facet of neuroticism and both career decidedness and SWB. Findings further support career interventions to increase decidedness during the first year of college. (C) 2010 Elsevier Inc. All rights reserved.
Uthayakumar R; Schimmack U; Hartung P J; Rogers J R
Journal of Vocational Behavior
2010
2010-10
Journal Article
<a href="http://doi.org/10.1016/j.jvb.2010.07.002" target="_blank" rel="noreferrer noopener">10.1016/j.jvb.2010.07.002</a>
When it rains, it pours: The greater impact of resource loss compared to gain on psychological distress
conservation; depression; gender; model; multiple roles; Psychology; social support; stress; symptoms; time; womens mental-health
The authors prospectively investigated stress in 71, mostly European American pregnant women. Conservation of Resources (COR) theory was applied to assess the impact of resource losses and gains that occur in women's lives. Resources were defined as those things that people value or that act as a means to obtaining that which they value and include social, personal, object, and condition resources. The authors hypothesized that women's resource losses would better predict postpartum anger and depression than their resource gains (in the opposite direction). They also predicted that earlier resource boss would accelerate the negative impact of later resource loss on postpartum distress. Resource gain was expected to be most salient when resource losses co-occurred, such that resource gains buffered the negative impact of resource loss. The hypotheses were generally supported and argue for the primacy of resource loss in the stress process.
Wells J D; Hobfoll S E; Lavin J
Personality and Social Psychology Bulletin
1999
1999-09
Journal Article
<a href="http://doi.org/10.1177/01461672992512010" target="_blank" rel="noreferrer noopener">10.1177/01461672992512010</a>
Physicians' attention to parents' concerns about the psychosocial functioning of their children
depression; dysfunction; epidemiology; General & Internal Medicine; Health; management; pediatric primary care; prevalence; psychiatric-disorders; psychopathology; service utilization
Background: Epidemiological data indicate that approximately 20% of children have psychosocial problems, yet less than 2% of children are seen by mental health specialists each year. Primary care physicians tend to identify children with psychosocial problems when parents discuss concerns with them. Objective: To examine factors related to physicians' attention to parental disclosures. Design: Parents reported the psychosocial functioning of themselves and their children. Physicians reported the psychosocial functioning of 75; children and whether the parent disclosed psychosocial concerns to them. Setting: Ambulatory care clinic of a community-based, university-affiliated, residency training program. Participants: Seventy-five parents of children aged 2 to 16 years who presented for routine primary care, and 26 physicians. Main Outcome Measures: Beck Depression Inventory (parental distress), Eyberg Child Behavior Inventory (child behavior problems) , physician and parent report. Results: Physicians identified 50.0% of children with clinically significant behavior problems. Logistic regression indicated that parental disclosure was the only significant predictor of physician identification (P<.002). When children had clinically significant behavior problems, physicians were more likely to report disclosures by parents (45.0% vs 5.7% for parents of children with and without behavior problems, respectively). Physicians were more likely to report parental disclosure when parents reported personal psychosocial distress (38.9% for distressed vs 5.7% nondistressed parents). Conclusions: Parental disclosure of concerns was a better predictor of physician identification of child psychosocial problems than was the presence of child behavior problems. Physicians responded more frequently to the disclosures of potential problems by parents of children with clinically significant psychosocial problems. They also attended more frequently to disclosures about behavior problems when the parent was also experiencing psychosocial distress.
Wildman B G; Kizilbash A H; Smucker W D
Archives of Family Medicine
1999
1999-09
Journal Article
<a href="http://doi.org/10.1001/archfami.8.5.440" target="_blank" rel="noreferrer noopener">10.1001/archfami.8.5.440</a>
Use of child reports of daily functioning to facilitate identification of psychosocial problems in children
agreement; behavioral-problems; care; community; depression; General & Internal Medicine; informants; management; parent; sample; symptoms
Background: Despite the availability of effective screening measures, physicians fail to identify and manage many children with psychosocial problems. Physicians are most likely to identify children with psychosocial problems when parents voice concerns about their child's functioning. However, few parents express concerns to their child's physician, and children's perspectives of their own functioning are rarely considered. This study evaluated the potential utility of children's reports of their own functioning. Methods: The Child Functioning Scale (CFS) was completed by 107 parents and children and compared with the Pediatric Symptom Checklist (PSC) and physician reports on the psychosocial status of each child. Results: Physicians identified 20% of the children identified by the PSC. Children's self-reported problems on the CFS would have identified 53.3% of these children. Additionally. 11.2% of children who did not meet criteria on the PSC self-reported problems in daily functioning. Conclusion: Collecting information about children's perceptions of their own daily functioning could provide physicians with an additional tool for the assessment of psychosocial problems.
Wildman B G; Kinsman A M; Smucher W D
Archives of Family Medicine
2000
2000-07
Journal Article
<a href="http://doi.org/10.1001/archfami.9.7.612" target="_blank" rel="noreferrer noopener">10.1001/archfami.9.7.612</a>
THE SDDS-PC(TM) - A DIAGNOSTIC-AID FOR MULTIPLE MENTAL-DISORDERS IN PRIMARY-CARE
anxiety; depression; Pharmacology & Pharmacy; providers; psychiatric-disorders; Psychiatry; recognition; structured clinical interview
The Symptom Driven Diagnostic System for Primary Care (SDDS-PCTM) is a new computerized clinical procedure to assist primary care physicians in diagnosing mental disorders during the course of routine practice, It has three components: (1) a 5-minute patient-administered 16-item screening questionnaire, (2) six 5-minute physician-administered diagnostic interview modules based on DSM-III-R criteria, and (3) a longitudinal tracking form, The SDDS-PCTM covers five disorders (major depression, panic disorder, alcohol abuse or dependence, generalized anxiety disorder, and obsessive compulsive disorder) as well as suicidal ideation. Patients who screen positive for a disorder receive the corresponding diagnostic interview module, Patients who meet mental disorder criteria on the diagnostic interview module are then followed with the longitudinal tracking form, Minor or subsyndromal conditions are also addressed at the physician's discretion, This article describes the development of SDDS-PCTM and summarizes results from two studies which involved comparisons between the SDDS-PCTM and independently administered full-length structured diagnostic interviews.
Olfson M; Leon A C; Broadhead W E; Weissman M M; Barrett J E; Blacklow R S; Gilbert T; Higgins E S
Psychopharmacology Bulletin
1995
1995
Journal Article
n/a
VISUAL DEPRIVATION DECREASES LONG-TERM POTENTIATION IN RAT VISUAL CORTICAL SLICES
cortex; rat; plasticity; depression; period; Neurosciences & Neurology; pathways; induction; long-term potentiation; organization; nmda receptors; evoked-potentials; visual cortex; critical; current source density; dark rearing; monocular deprivation; source density analysis
A major finding in the visual plasticity literature is that visual deprivation is effective only during an early 'sensitive' period, which is lengthened by dark rearing. Unresolved is whether the visual cortex is in a normally plastic state prior to light stimulation. This cannot be addressed using paradigms employing light exposure to assess plasticity. Several developmental studies have investigated a plastic phenomenon termed long-term potentiation (LTP) in slices from cat (J. Neurophysiol., 59 (1988) 124-141) and rat (Brain Res., 439 (1988) 222-229) visual cortex. Susceptibility to the induction of LTP parallels the period of sensitivity to visual deprivation. This suggests that slices can be used to assay visual cortical plasticity, avoiding light exposure. In the present study, field potentials were recorded from slices of the primary visual cortices of dark-reared (DR) and control (CONT) Long Evans hooded rats (17 to 21 days). Field potential profiles recorded before and 90 min following tetanic electrical stimulation were subjected to current source density analysis, yielding extracellular current sink amplitudes. Tetanus resulted in LTP in both CONT and DR slices, but DR slices were significantly less potentiated. These results indicate that the primary visual cortex of DR animals is not fully plastic, indicating a role for light stimulation in inducing visual cortical plasticity.
Berry R L; Perkins A T; Teyler T J
Brain Research
1993
1993-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/0006-8993(93)90943-h" target="_blank" rel="noreferrer noopener">10.1016/0006-8993(93)90943-h</a>
The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV
depression; social support; HIV; adherence; PTSD; Environmental & Occupational Health; Public; Biomedical Social Sciences; posttraumatic-stress-disorder; primary care; medication; drug-resistance; protease inhibitors; active antiretroviral therapy; CD4; cell count; outpatient clinics; viral load
Despite high rates of comorbidity, research has typically focused on the independent impact of posttraumatic stress disorder (PTSD) and depression symptoms in people living with HIV (PLWH). The present study examined the independent and comorbid influence of PTSD and depression symptoms on medication adherence, CD4 cell counts, and viral load, over the course of 3 months in 57 PLWH (82% men, 54% Caucasian, 44% African American) recruited from a clinic or social service agency. Both PTSD and depressive symptoms predicted lower subsequent adherence. However, only depressive symptoms predicted lower CD4 counts and presence of a detectable viral load. Participants reporting symptoms consistent with diagnostic levels of comorbid PTSD and depression were less likely to adhere to HAART and were more likely to have a detectable viral load. These results highlight the influences of PTSD and depression on adherence and HIV disease markers, and underscore the importance of examining comorbid symptomatology in PLWH.
Boarts J M; Sledjeski E M; Bogart L M; Delahanty D L
Aids and Behavior
2006
2006-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s10461-006-9069-7" target="_blank" rel="noreferrer noopener">10.1007/s10461-006-9069-7</a>
DEVELOPMENT OF A WEB-BASED SCALABLE INTERVENTION TO REDUCE MENTAL HEALTH RISKS IN MEDICAL EXAMINER PERSONNEL
education; depression; cognition; depression; PTSD; Psychology; Social; metaanalysis; model; posttraumatic-stress-disorder; workers; impact; instruction; public-health; 1st responders; Medical examiners; Web-based intervention
This paper describes the development of a scalable intervention to reduce risk for depression and posttraumatic stress among medical examiner employees. Medical examiners identify the deceased, determine the cause and manner of death, and communicate this information to various stakeholders including law enforcement, public health authorities, and families of victims. Basic research has revealed that aspects of their job responsibilities, including working on disturbing cases and interacting with highly distressed families of the deceased, are associated with symptoms of depression and posttraumatic stress, and these relationships are partly mediated by concerns about alienation and distress intolerance. However, employees do not receive systematic training in the skills needed to manage the emotional labor demands associated with work responsibilities. To address these unmet needs, a pilot study was conducted to develop a scalable, web-based intervention to decrease symptoms of depression and posttraumatic distress. The intervention consisted of self-paced programed intervention modules based on empirically validated treatments including psychoeducation, social modeling, values affirmation, exposure, and skills training tailored to the specific job demands of medical examiners. The program was delivered to personnel in nine offices in six states. Consumer satisfaction data indicate that participants found the intervention, including the exercises, clear and useful. Overall, 53% of the employees who consented to participate enrolled in at least one class and half of them completed eight or more of 16 classes. The program is feasible to administer in the workplace and shows preliminary evidence of efficacy. Employees demonstrated a reduction in depressive symptoms over time.
Brondolo E; Kaur A; Brondolo T J; Schwartz J E; Delahanty D L
Tpm-Testing Psychometrics Methodology in Applied Psychology
2017
2017-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.4473/tpm24.3.7" target="_blank" rel="noreferrer noopener">10.4473/tpm24.3.7</a>
Weight, self-esteem, ethnicity, and depressive symptomatology during pregnancy among inner-city women
pregnancy; African Americans; depression; obesity; self-esteem; Psychology; weight; black-women; body-image; dysphoria; postpartum; white
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.
Cameron R P; Grabill C M; Hobfoll S E; Crowther J H; Ritter C; Lavin J
Health Psychology
1996
1996-07
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/0278-6133.15.4.293" target="_blank" rel="noreferrer noopener">10.1037/0278-6133.15.4.293</a>
Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: A randomized controlled trial of Acute Care for Elders (ACE) in a community hospital
depression; illness; program; Geriatrics & Gerontology; consultation; institutionalization; functional decline; aged; medical unit; comprehensive geriatric assessment; decline; hospital outcomes; quality of care
BACKGROUND: Older persons frequently experience a decline in function following an acute medical illness and hospitalization. OBJECTIVE: To test the hypothesis that a multicomponent intervention, called Acute Care for Elders (ACE), will improve functional outcomes and the process of care in hospitalized older patients. DESIGN: Randomized controlled trial. SETTING: Community teaching hospital. PATIENTS: A total of 1531 community-dwelling patients, aged 70 or older, admitted for an acute medical illness between November 1994 and May 1997. INTERVENTION: ACE includes a specially designed environment (with, for example, carpeting and uncluttered hallways); patient-centered care, including nursing care plans for prevention of disability and rehabilitation; planning for patient discharge to home; and review of medical care to prevent iatrogenic illness. MEASUREMENTS: The main outcome was change in the number of independent activities of daily living (ADL) from 2 weeks before admission (baseline) to discharge. Secondary outcomes included resource use, implementation of orders to promote function, and patient and provider satisfaction. RESULTS: Self-reported measures of function did not differ at discharge between the intervention and usual care groups by intention-to-treat analysis. The composite outcome of ADL decline from baseline or nursing home placement was less frequent in the intervention group at discharge (34% vs 40%; P =.027) and during the year following hospitalization (P = .022). There were no significant group differences in hospital length of stay and costs, home healthcare visits, or readmissions. Nursing care plans to promote independent function were more often implemented in the intervention group (79% vs 50%; P = .001), physical therapy consults were obtained more frequently (42% vs 36%; P = .027), and restraints were applied to fewer patients (2% vs 6%; r = .001). Satisfaction with care was higher for the intervention group than the usual care group among patients, caregivers, physicians, and nurses (P <.05). CONCLUSIONS: ACE in a community hospital improved the process of care and patient and provider satisfaction without increasing hospital length of stay or costs. A lower frequency of the composite outcome ADL decline or nursing home placement may indicate potentially beneficial effects on patient outcomes.
Counsell S R; Holder C M; Liebenauer L; Palmer R M; Fortinsky R H; Kresevic D M; Quinn L M; Allen K R; Covinsky K E; Landefeld C S
Journal of the American Geriatrics Society
2000
2000-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1532-5415.2000.tb03866.x" target="_blank" rel="noreferrer noopener">10.1111/j.1532-5415.2000.tb03866.x</a>
The Moderating Impact Of Interacting With Distressed Families Of Decedents On Trauma Exposure In Medical Examiner Personnel
comorbidity; compassion fatigue; depression; disaster; medical examiner; mental-health; posttraumatic stress; posttraumatic-stress-disorder; prevalence; professionals; Psychiatry; Psychology; ptsd symptoms; trauma exposure; workers
Coleman J A; Delahanty D L; Schwartz J; Murani K; Brondolo E
Psychological Trauma-Theory Research Practice and Policy
2016
2016-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/tra0000097" target="_blank" rel="noreferrer noopener">10.1037/tra0000097</a>
Predicting Ptsd Prospectively Based On Prior Trauma History And Immediate Biological Responses
autonomic responses; catecholamine excretion; catecholamines; cortisol; depression; developmental traumatology; excretion; heart rate; heart rate; holocaust survivors; major; motor-vehicle accident; plasma norepinephrine; posttraumatic-stress-disorder; predictors; PTSD; trauma history; urinary cortisol
Delahanty D L; Nugent N R
Psychobiology of Posttraumatic Stress Disorder: a Decade of Progress
2006
2006
Book Chapter
n/a
Patient-reported Outcomes And Health-care Resource Utilization In Patients With Psoriasis Treated With Etanercept: Continuous Versus Interrupted Treatment
arthritis; atopic-dermatitis; Business & Economics; clinical trial; depression; double-blind; efficacy; etanercept; Health Care Sciences & Services; health-care resource utilization; monotherapy; phase-iii trial; plaque psoriasis; psoriasis; quality-of-life; quality-of-life; therapy; tumor necrosis factor
Gelfand J M; Kimball A B; Mostow E N; Chiou C F; Patel V; Xia H A; Freundlich B; Stevens S R
Value in Health
2008
2008-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1524-4733.2007.00251.x" target="_blank" rel="noreferrer noopener">10.1111/j.1524-4733.2007.00251.x</a>
Different Mechanisms May Be Required For Maintenance Of Nimda Receptor-dependent And Independent Forms Of Long-term Potentiation
activation; area; ca1; calcium; calcium channels; calmodulin inhibitors; d-aspartate receptors; dentate gyrus; depression; glutamate; hippocampal slice; induction; Neurosciences & Neurology; protein kinase; protein-kinase-c; rat hippocampal slices
In hippocampal area CA1, long-term potentiation (LTP) is induced by tetanic stimulation protocols that activate N-methyl-D-aspartate (NMDA) receptors. In addition, some stimulation protocols can induce LTP during NMDA receptor blockade. An initial signal in both NMDA receptor-dependent and independent LTPs is increased intracellular Ca2+ concentration in postsynaptic neurons. It therefore seems possible that subsequent steps leading to expression and maintenance of potentiation are shared whether or not LTP is induced through NMDA receptor activation. We tested this hypothesis by applying a broad spectrum protein kinase inhibitor, previously shown to inhibit NMDA receptor-dependent LTP. In agreement with earlier reports, we found that H-7 inhibited NMDA receptor-dependent LTP when applied either during tetanic stimulation, or beginning 30 min following tetanic stimulation. In contrast, NMDA receptor-independent LTP was not inhibited by H-7 applied during or following tetanic stimulation. We also tested for mutual occlusion between NMDA receptor-dependent and independent LTPs. Although induction of NMDA receptor-independent LTP did not occlude later induction of NMDA receptor-dependent LTP, induction of NMDA receptor-dependent LTP did occlude NMDA receptor-independent LTP. While the kinase inhibitor experiment showed a clear difference between NMDA receptor-dependent and independent LTPs, the occlusion experiments suggest an interaction between the signalling pathways for the two LTPs. (C) 1995 Wiley-Liss, Inc.
Grover L M; Teyler T J
Synapse
1995
1995-02
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/syn.890190208" target="_blank" rel="noreferrer noopener">10.1002/syn.890190208</a>
Hemodynamic Status During Famotidine Infusion
antagonist; depression; double-blind; h2-receptor; histamine; hypotension; intensive-care unit; intravenous cimetidine; Pharmacology & Pharmacy; ranitidine; secretion; ym-11170
Histamine H2 antagonists, which reduce gastric acid secretion, are often used in the intensive care setting for the prophylaxis of stress ulcers. This double-blind, placebo-controlled study evaluated hemodynamic parameters in 11 stable, critically ill patients receiving famotidine. Repeated-measures ANOVA demonstrated that famotidine had no significant effect on baseline hemodynamic measurements and that there was no significant difference in hemodynamic values following the famotidine infusion as compared with NaCl 0.9% placebo (p > 0.05).
Heiselman D E; Chapman J; Malik M; Riegnor E
Dicp-the Annals of Pharmacotherapy
1990
1990-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1177/106002809002401202" target="_blank" rel="noreferrer noopener">10.1177/106002809002401202</a>
Pain And Depression In A Cohort Of Underserved, Community-dwelling Primary Care Patients
anxiety; association; Community Medicine; comorbidity; depression; diagnostic-tests; disorders; General & Internal Medicine; Headache; life; Medically Underserved Area; Mental Health; methodology; operating characteristic curves; Pain; physical symptoms; Population Register; prevalence
Purpose: Almost 17% of the US population exhibits a major depressive disorder in their lifetimes. Prevalence data show that whites experience depression earlier than African Americans, and women have a higher prevalence than men. Less is known regarding depression among underserved minority populations. The goal of our study was to examine the relationship of depression and associated self-reported conditions in participants enrolled in a community-based research registry, a substantial number of whom were underrepresented minorities. Methods: This study used a research registry of community members who had expressed interest in participating in health education projects conducted by the Center for Primary Care Community-Based Research. The patients received care at 10 family health centers. Participants were surveyed regarding family history of depression/anxiety and associated symptoms. Descriptive analyses, univariate analyses, and logistic regressions were used. Results: The population (N = 2421) included women (72.2%), African Americans (54.9%), and reported good or very good general health (68.9%). Comorbid pain was found, with headache as the predominant complaint. Compared with nonwhites, whites had a significantly higher prevalence of current depression (26.3% vs. 23.8%; P = .01), current anxiety (25.5% vs. 16.6%), and current headache (14.2% vs. 11.2%). Whites also had a higher prevalence of a family history of depression (38.4% vs. 32.1%) and anxiety (8.9% vs. 7.7%) and of taking depression (22.4% vs. 14.8%) and anxiety (15.8% vs. 7.8%) medications. However, nonwhites had a higher prevalence of leg pain (18.8% vs. 14.9%) but a lower prevalence of headache (11.2% vs. 14.2%). Conclusions: Pain was common in patients with comorbid behavioral conditions. Headache was more common in whites, whereas leg pain was more common in nonwhites. Physicians should screen for depression and anxiety in patients with headache and other pain symptoms. (J Am Board Fam Med 2012;25:300-307.)
Janosky J E; South-Paul J E; Lin C J
Journal of the American Board of Family Medicine
2012
2012-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.3122/jabfm.2012.03.080138" target="_blank" rel="noreferrer noopener">10.3122/jabfm.2012.03.080138</a>
Brief Report: Parent Report About Health Care Use: Relationship To Child's And Parent's Psychosocial Problems
behavior problems; depression; disorder; family assessment device; health care utilization; inventory; management; parent; primary care; Psychology; psychopathology; psychosocial problems; reliability; report; services; validity
Objective: To investigate the potential utility of: asking parents about health care utilization as a means of identifying individuals at risk for psychosocial problems. Method: Parents of 366 children ages 2 to 16 completed questionnaires about their own, their child's, and their family's psychosocial functioning and health care utilization. Results: Children and parents with high health care utilization were more likely to have psychosocial problems than those with low health care utilization. Sensitivity and specificity of health care utilization as a marker for psychosocial problems ranged from 43.8% to 68.8%. Conclusions: Although high rates of child health care utilization are related to the presence of psychosocial problems, use of this measure alone could result in many false-positive and false-negative identifications. Rather, use of health care utilization data in conjunction with other screening measures may be useful for alerting physicians to the possibility of both child and parent psychosocial problems.
Kinsman A M; Wildman B G; Smucker W D
Journal of Pediatric Psychology
1999
1999-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1093/jpepsy/24.5.435" target="_blank" rel="noreferrer noopener">10.1093/jpepsy/24.5.435</a>
Hyperpolarizing And Depolarizing Gaba-a Receptor-mediated Dendritic Inhibition In Area Ca1 Of The Rat Hippocampus
activity-dependent disinhibition; cortical-neurons; depression; electrophysiology; gamma-aminobutyric acid; lacunosum-moleculare interneurons; morphology; Neurosciences & Neurology; Physiology; pyramidal cells-invitro; responses; voltage-clamp
1. Gamma-aminobutyric acid(A) (GABA(A)) receptor-mediated inhibition of pyramidal neuron dendrites was studied in area CA1 of the rat hippocampal slice preparation with the use of intracellular and extracellular recording and one-dimensional current source-density (CSD) analysis. 2. Electrical stimulation of Schaffer collateral/commissural fibers evoked monosynaptic excitatory postsynaptic potentials (EPSPs) and population EPSPs, which were followed by biphasic inhibitory postsynaptic potentials (IPSPs). In the presence of the excitatory amino acid receptor antagonists 6,7-dinitroquinoxaline-2,3-dione (DNQX) and D,L-2-amino-5-phosphonovalerate (APV), stimulation in stratum radiatum evoked monosynaptic fast, GABA(A) and late, GABA(B) receptor or-mediated IPSPs and fast and late positive field potentials recorded in s. radiatum. 3. Fast monosynaptic IPSPs and fast positive field potentials evoked in the presence of DNQX and APV were reversibly abolished by the GABA(A) receptor antagonist bicuculline methiodide (BMI; 30-mu-M) and were not changed by the GABA(B) receptor antagonist P-[3-aminopropyl]-P-diethoxymethylphosphinic acid (CGP 35 348; 0.1-1.0 mM). CGP 35 348 (0.1 mM) reversibly blocked late monosynaptic IPSPs and late positive field potentials. These results suggest that fast field potentials are GABA(A) receptor-mediated population IPSPs (GABA(A), fast pIPSPs) and that late field potentials are GABA(B) receptor-mediated population IPSPs (GABA(B), late pIPSPs). 4. Fast pIPSPs were reversibly abolished when the extracellular Cl- concentration ([Cl-1]o) was reduced from 132 to 26 mM in parallel with a depolarizing shift in the reversal potential of fast IPSPs. Paired or repetitive stimulation in s. radiatum reversibly depressed fast pIPSPs and fast IPSPs. Paired-pulse depression of fast pIPSPs was reversibly antagonized by CGP 35 348 (0.40. 8 mM). 5. Laminar analysis of s. radiatum-evoked fast pIPSPs and one-dimensional CSD analysis revealed active current sources in s. radiatum and passive current sinks in s. oriens and s. lacunosum moleculare. S. radiatum sources were abolished by pressure application of BMI in s. radiatum but not in s. oriens. Stimulation in s. oriens, s. pyramidale, or s. lacunosum moleculare evoked GABA(A) current sources horizontal to the stimulation site. Changes in the dendritic location of inhibitory current with changes in stimulus location paralleled changes in the distribution of excitatory current. 6. In the presence of 4-aminopyridine (50-100-mu-M), DNQX and APV long-lasting depolarizing GABA(A) receptor-mediated responses (LLDs) occurred spontaneously or could be evoked. Current sinks associated with s. radiatum-evoked LLDs were located in the same dendritic area as sources associated with hyperpolarizing fast IPSPs. 7. These results suggest that activation of GABA(A) receptors located on pyramidal neuron apical and basal dendrites produces outward Cl-1 current and hyperpolarizing IPSPs. This suggests that depolarizing responses to dendritic GABA application and orthodromic activation in area CA1 do not result from inward chloride current.
Lambert N A; Borroni A M; Grover L M; Teyler T J
Journal of Neurophysiology
1991
1991-11
Journal Article or Conference Abstract Publication
n/a