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Which Depressive Symptoms and Medication Side Effects Are Perceived by Patients as Interfering Most with Occupational Functioning?  [PDF]
Raymond W. Lam,Erin E. Michalak,David J. Bond,Edwin M. Tam,Auby Axler,Lakshmi N. Yatham
Depression Research and Treatment , 2012, DOI: 10.1155/2012/630206
Abstract: Background. Major depressive disorder (MDD) is associated with significant impairment in occupational functioning. This study sought to determine which depressive symptoms and medication side effects were perceived by patients with MDD to have the greatest interference on work functioning. Methods. 164 consecutive patients with MDD by DSM-IV criteria completed a standard assessment that included a self-rated questionnaire about the degree to which symptoms and side effects interfered with work functioning. Results. The symptoms perceived by patients as interfering most with work functioning were fatigue and low energy, insomnia, concentration and memory problems, anxiety, and irritability. The medication side effects rated as interfering most with work functioning were daytime sedation, insomnia, headache, and agitation/anxiety. There were no differences between men and women in symptoms or side effects that were perceived as interfering with work functioning. Limitations. This was a cross-sectional study; only subjective assessments of work functioning were obtained; the fact that patients were using varied medications acts as a potential confound. Conclusions. Specific depressive symptoms and medication side effects were perceived by patients as interfering more with occupational functioning than others. These factors should be considered in treatment selection (e.g., in the choice of antidepressant) in working patients with MDD. 1. Introduction Unipolar major depressive disorder (MDD) is among the most common and disabling medical conditions. Many epidemiological studies have demonstrated the high prevalence of MDD in the general population. For example, the Canadian Community Health Survey (CCHS) recently reported a one-year prevalence rate of 4.5% for MDD, indicating that over 1.2 million Canadians suffer significant distress and impairment in functioning due to mood disorders [1]. Similar statistics are found for Europe [2] and the United States [3]. Depression is currently the fourth leading medical condition contributing to global burden of disease and is estimated to rise to second by the year 2030 [4]. Given the high prevalence of MDD, increasing attention is now being paid to the economic costs of depression. The economic burden is, in part, attributable to individuals with depression being unable to work, or absenteeism. For example, one study reported that workers with MDD missed an average of 32 days of work in a 12-month assessment period [5], while another found that about 30% of work disability claims in Canada were attributed to mental
Relationship between Pain Intensity, Depressive Symptoms, Disability Level and Physical Functioning in Chronic Low Back Pain Turkish Patients: Gender Differences  [PDF]
S. Sagmanli,N. Yagci,U. Cavlak,A. Cetun
Journal of Medical Sciences , 2009,
Abstract: This study was conducted to examine the relationship between pain intensity, disability, emotional status and physical functioning and compare this relationship in men and women with Chronic Low Back Pain (CLBP). This study included 118 subjects (73 women and 45 men), with a mean age of 43.16±8.74 years. A Visual Analog Scale (VAS) was used to detect pain intensity. Depressive symptoms were evaluated using by the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) was used to determine disability score of the subjects. Physical functioning was evaluated with the use of the Fifty-Foot Walk (FWS), the Sit to Stand (STS) and the Bend Forward Test (BFT). Significant differences were found between the females and males in all outcome measures (p≤0.05). The results showed that the women had higher pain intensity, depression and disability scores compared with men (p = 0.0001). On the other hand, the women had lower physical functioning test scores (p = 0.0001). The investigators detected the presence of a significant positive correlation between physical functioning measures and pain intensity, disability level and emotional status in both males and females.
The Impact of Individual Depressive Symptoms on Impairment of Psychosocial Functioning  [PDF]
Eiko I. Fried, Randolph M. Nesse
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0090311
Abstract: Previous studies have established that scores on Major Depressive Disorder scales are correlated with measures of impairment of psychosocial functioning. It remains unclear, however, whether individual depressive symptoms vary in their effect on impairment, and if so, what the magnitude of these differences might be. We analyzed data from 3,703 depressed outpatients in the first treatment stage of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Participants reported on the severity of 14 depressive symptoms, and stated to what degree their depression impaired psychosocial functioning (in general, and in the five domains work, home management, social activities, private activities, and close relationships). We tested whether symptoms differed in their associations with impairment, estimated unique shared variances of each symptom with impairment to assess the degree of difference, and examined whether symptoms had variable impacts across impairment domains. Our results show that symptoms varied substantially in their associations with impairment, and contributed to the total explained variance in a range from 0.7% (hypersomnia) to 20.9% (sad mood). Furthermore, symptoms had significantly different impacts on the five impairment domains. Overall, sad mood and concentration problems had the highest unique associations with impairment and were among the most debilitating symptoms in all five domains. Our findings are in line with a growing chorus of voices suggesting that symptom sum-scores obfuscate relevant differences between depressed patients and that substantial rewards will come from close attention to individual depression symptoms.
Depressive Symptoms and Psychosocial Functioning in Preadolescent Children  [PDF]
Marita McCabe,Lina Ricciardelli,Sophie Banfield
Depression Research and Treatment , 2011, DOI: 10.1155/2011/548034
Abstract: The current study was designed to determine the percentage of children “at-risk” of depression or evidencing clinical levels of depression. In addition, the study examined how the “at-risk” and the clinical groups differed from children who demonstrated no depressive symptoms on positive and negative affect, four aspects of self-concept, and peer ratings of popularity. Respondents were 510 children (270 boys 240 girls) who ranged in age from 7 to 13 years (mean?=?9.39). The results demonstrated that 23% of children were either in the “at-risk” or clinical range of depression. Children in both the clinical and the “at-risk” range demonstrated higher negative affect but lower positive affect and lower self-concepts than children in the normal range. However, children's peers only differentiated between the “clinical” and “normal” groups. It is harder for peers, and other informants such as teachers and parents, to detect the problems of children with elevated depressive symptoms but who do not meet the diagnostic criteria. It is important to implement intervention programs for children who evidence depression symptoms, as well as “at-risk” children. “At-risk” children with elevated levels of depressive symptoms may be more disadvantaged, as their problems are less likely to be detected and treated. 1. Introduction The clinical presentation of depressive symptoms in children largely parallels that of adults [1, 2]. However, as outlined below, there are some differences in the presentation of these symptoms across the life span [3]. The diagnostic and statistical manual of mental disorders [4] provides a summary of the most widely accepted constellation of depressive symptoms associated with each depressive disorder. The two most prevalent in childhood, and therefore most relevant to the current research, are major depressive disorder (mdd) and dysthymic disorder (DD) [4]. It is important to obtain a better understanding of the prevalence of depressive disorders in childhood, the prevalence of those at-risk of developing depression, and the factors in childhood that are associated with these depressive symptoms. Epidemiological studies of community samples have reported the prevalence of MDD in children to range from 0.4–2.5%, while the prevalence of DD has been reported to range from 0.6–1.7% (e.g., [5–7]). However, the number of children exceeding cutoff scores for clinically significant levels of depressive symptoms as assessed by the children’s depression inventory (CDI) has been shown to range from 20 to 24% [8, 9]. Symptoms associated with depression
Cognitive functioning and depressive symptoms in adolescents with inflammatory bowel disease  [cached]
Anu E Castaneda,Annamari Tuulio-Henriksson,Eeva T Aronen,Mauri Marttunen
World Journal of Gastroenterology , 2013, DOI: 10.3748/wjg.v19.i10.1611
Abstract: AIM: To investigate cognitive functioning and depressive symptoms in adolescents with inflammatory bowel disease (IBD). METHODS: A neuropsychological test battery, including subtests of the Wechsler Adult Intelligence Scale-Revised and III, Wechsler Memory Scale-Revised, California Verbal Learning Test (CVLT), Stroop Color-Word Test, and Trail Making Test, which assessed verbal and visual short- and long-term memory, processing speed, logical reasoning, verbal intelligence, attention, and executive functioning, was administered to 13- to 19-year-old patients with IBD (n = 34; active disease n = 20). Depressive symptoms were measured with the Beck Depression Inventory. The findings were compared with peers with non-acute juvenile idiopathic arthritis (JIA; n = 23). Patients with coexisting psychiatric disorders were excluded. RESULTS: The IBD group, especially patients in the acute phase, made more perseverative errors in the CVLT test that assessed verbal memory than the JIA group (6.0 ± 4.3 vs 3.3 ± 2.9, P < 0.01), but no other differences between the IBD and JIA groups were observed in the neuropsychological tests. The difference was close to statistical significance, even when glucocorticoid medication was controlled for (P < 0.052). The IBD group had more depressive symptoms than the JIA group (7.9 ± 7.6 vs 4.0 ± 4.0, P < 0.05). Approximately one third of the IBD group had at least mild depressive symptoms, and those with acute illness had the highest scores. However, depressive symptoms were not related to the difference in the verbal memory test (perseverative errors in the CVLT) between the IBD and JIA groups. CONCLUSION: Adolescents with acute IBD may have mild verbal memory problems but no major cognitive deficits compared to peers with JIA.
Cognitive Functioning in Patients with Bipolar Disorder: Association with Depressive Symptoms and Alcohol Use  [PDF]
Marieke J. van der Werf-Eldering,Huibert Burger,Esther A. E. Holthausen,André Aleman,Willem A. Nolen
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0013032
Abstract: Cognitive dysfunction is clearly recognized in bipolar patients, but the degree of impairment varies due to methodological factors as well as heterogeneity in patient populations. The goal of this study was to evaluate cognitive functioning in bipolar patients and to assess its association with depressive symptoms. Post hoc the relationship with lifetime alcohol use disorder was explored.
The Relationship between Parental Depressive Symptoms, Family Type, and Adolescent Functioning  [PDF]
Dominik Sebstian Sieh, Johanna Maria Augusta Visser-Meily, Anne Marie Meijer
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0080699
Abstract: It is evident that parental depressive symptoms negatively influence adolescent behavior and various psychosocial outcomes. Certain family types like families with a chronically ill parent and single parent families are more vulnerable to parental depressive symptoms. However, the relationship between these symptoms, family type, and adolescent functioning remains largely unclear. This study examined relations between self-report of parental depressive symptoms and adolescent functioning in 86 two-parent families including a parent with a chronic medical condition, 94 families with healthy single parents, and 69 families with 2 healthy parents (comparison group). Parents completed the Beck Depression Inventory. Adolescents filled in the Youth Self-Report measuring problem behavior, and other instruments measuring psychosocial outcomes (stress, grade point average, school problems, and self-esteem). Multilevel analyses were used to examine the effects of family type, parental depressive symptoms, adolescents' gender and age, and interaction effects on adolescent functioning. The results indicated that adolescents with chronically ill and single parents had a lower grade point average (p<.01) than the comparison group. Adolescents of single parents reported more internalizing problems (p<.01) and externalizing problems (p<.05) than children from the other family types. Parental depressive symptoms were strongly related to child report of stress (p<.001). Adolescents of depressed chronically ill parents were particularly vulnerable to internalizing problems (interaction effect, p<.05). Older children and girls, and especially older girls, displayed more internalizing problems and stress. It can be concluded that growing up with a chronically ill parent in a family with 2 parents may have less impact on adolescent problem behavior than growing up in a single parent family. Health practitioners are encouraged to be attentive to the unique and combined influence of family type and parental depressive symptoms on adolescent functioning. Older and female adolescents deserve particular attention.
Alcohol Use is Not Directly Related to the Perceived Control of Depressive Symptoms in Patients with Depressive Symptoms  [PDF]
P?l Ulleberg,Jens Egeland,Nils Inge Landr?
Frontiers in Psychiatry , 2014, DOI: 10.3389/fpsyt.2014.00031
Abstract: Treatment-seeking patients (N = 233) were recruited as they started a course of relapse prevention and coping with depression. The mean Beck depression inventory (BDI-II) score was 26 points, indicating a moderate degree of depression. The sample was recruited from different outpatient clinics and screened for alcohol-related problems with the alcohol use disorders identification test (AUDIT). Almost half of the total sample had a score on AUDIT >8 indicating an alcohol problem. The participants in this study did not undergo a clinical interview to check out if their symptoms, as assessed with BDI-II and AUDIT, were part of a formal diagnosis in accordance with the criteria in ICD 10 or DSM IV. A specific instrument, perceived uncontrollability of depression (UNCONTROL), was used to measure the persons’ perceived control of depressive symptoms; a set of statements about coping with depressive symptoms where high scores indicate lack of coping with the symptoms. Alcohol problems were not found to be significantly associated with the perceived control of ongoing depressive symptoms and did not moderate the relationship between depressive symptoms and the perceived control of depressive symptoms. The results question the assumption that alcohol use is related to coping with depressive symptoms in patients with alcohol abuse and depressive symptoms.
Relation Between Depressive Symptoms and Physical Functioning in a Sample Based on Turkish Institutionalized Elderly: Exploring Sex Differences  [PDF]
Ugur Cavlak,Mustafa Ahmet Dirik,Beyza Akdag
Journal of Medical Sciences , 2005,
Abstract: The purpose of this study was to explore how depressive symptoms affect physical functioning in the institutionalized elderly and to show gender differences. One hundred and thirty-three subjects aged 65 and older living rest home (60 women and 73 men) with mean age of 75.27 6.71 years were included in the study and were examined using Beck Depression Inventory and depression was defined as a score of >13 on the inventory. Physical functioning level of the elderly was evaluated by using Functional Independence Measure and Rivermead Mobility Index. Women in the study pool suffered from more depressive symptoms than men. The older women and men with a high Beck Depression Inventory score showed a decreased physical functioning (p<0.05). Among variables, such as age, duration of stay, duration of work, marital status, education level, occupation and regular exercise, a significant correlation was detected with depression scores (p<0.05). Depression scores were found to be important correlates of the diagnosis of depression. There was some evidence of possible gender in the diagnosis of depression. Physical functioning scores decreased with depressive symptoms.
Depressive symptoms and perceived burdens related to being a student: Survey in three European countries  [cached]
Mikolajczyk Rafael T,Maxwell Annette E,Naydenova Vihra,Meier Sabine
Clinical Practice and Epidemiology in Mental Health , 2008, DOI: 10.1186/1745-0179-4-19
Abstract: Background Despite a high prevalence of depressive symptoms among university students, few studies have examined how this mental health problem is associated with perceived stress and perceived burdens related to being a student. Methods We conducted a cross-sectional study of 2,103 first year students from one western (Germany), one central (Poland), and one south-eastern European country (Bulgaria). The self-administered questionnaires included the modified Beck Depression Inventory and Cohen's Perceived Stress Scale. A 13 item scale measured perceived burdens related to being a student with four subscales: "Course work", "Relationships", "Isolation", and "Future". Results Depressive symptoms were highly prevalent in all three countries (M-BDI ≥35: 34% in Poland, 39% in Bulgaria, and 23% in Germany). Students felt more burdened by course work and bad job prospects ("Future") than by relationship problems or by feelings of isolation. The perceived burdens subscales "Future", "Relationship" and "Isolation" remained associated with depressive symptoms after adjusting for perceived stress, which displayed a strong association with depressive symptoms. The association between perceived stress and depressive symptoms differed by gender. These findings were similar in all three countries. Conclusion Perceived burdens related to studying are positively associated with higher depression scores among students, not only by mediation through perceived stress but also directly. While the strong association between perceived stress and depressive symptoms suggests the need for interventions that improve stress management, perceived burdens should also be addressed.
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