Results for Depression  
Title: Use of Antidepressants to Treat Postpartum Depression, During Breast Feeding
Abstract:

Postpartum depression affects approximately 14.5% of women and it can affect both mother and infant. Therefore, rapid attention and treatment are imperative. The pharmacological approach often represents one of the most realistic options of treatment. However, women may be reluctant to take antidepressants because of the fear of adverse effects for the infant, since that most drugs pass into breast milk. The use of pharmacotherapy has not been extensively documented in this population. The objective of this review is to evaluate the risk benefit of using antidepressants during breastfeeding to treat postpartum depression. An electronic search was performed by using PubMed database, from January 2001 through December 2010. The search was limited to articles in the English language and to articles that relate human’s research. Manual searches of bibliographies were also conducted to identify additional pertinent studies. The use of antidepressants that do not appear in infants’ plasma, for which use during breastfeeding is better documented and at standard therapeutic doses is recommended, such as sertraline and paroxetine. Fluoxetine has a long half-life which can lead to a long infant exposition through breast milk and citalopram can cause adverse effects in infants exposed through breast milk. Therefore, citalopram and fluoxetine should not be used as first-line treatments. More information is needed about the use of the other antidepressants referred in this study. This study aims to emphasize the importance of postpartum depression treatment, always considering its repercussions for the breastfed infants. Studies are needed with larger samples to properly evaluate the short and long-term effects of antidepressants on infants exposed through breast milk, so that clinicians can create standard decisions regarding the treatment of postpartum depression, without putting infants at risk.


Sources: Omics Online
Keywords: Antidepressants,Antidepressive agents,Breastfeeding,Breast milk,Bupropion,Citalopram,Drug milk level,Duloxetine, Escitalopram,Fluoxetine,Fluvoxamine,Lactation,Mirtazapine,Paroxetine,Postpartum depression,Reboxetine,Sertraline,Venlafaxine ,
Title: Rationale and Methods of a Trial to Evaluate a Depression Telemonitoring Program that Includes a Patient-Selected Support Person
Abstract:

Objective: To test the effectiveness of an automated telemonitoring program for patients with depression that
includes feedback to clinicians and support for a family member or friend serving as a non-professional caregiver.
Methods: Prior to being randomized to receive one year of either the Care Partners for Depression (CP-D)
intervention or usual care alone, depressed patients from primary care clinics serving primarily low-income populations
in rural and urban Michigan select a supportive adult from outside their home (their “Care Partner;” CP) to assist
them in their depression self-management. In the CP-D arm, patients receive weekly automated telephone calls that
provide monitoring and self-management guidance, CPs receive emailed guidance on supporting the patient’s selfmanagement
based on patient-reported information, and primary care providers receive notifications about any urgent
issues. At Baseline, Month 6, and Month 12, we assess depressive symptom severity (primary outcome) and several
secondary outcomes.
Conclusion: To date, this is the only mHealth intervention for any psychiatric condition that involves a patientselected
support person. If it proves effective and cost-efficient, a new sustainable intervention would be available to
patients with significant depressive symptoms, providing new management alternatives for patients who are medically
underserved or socially isolated.


Sources: Omics Online
Keywords: Depression; Telemonitoring; Illness self-management,
Title: Clinical evaluation of a self-rating scale for depressive disorder in childhood (Depression Self-Rating Scale).
Abstract:
The many conceptual and methodological difficulties involved in evaluating depression rating scales for children are discussed. A clinical validation of the Depression Self-Rating Scale for Children (DSRSC) is described. The instrument is easy to use and has a predictive value comparable with that of a psychiatric global rating of depressed appearance and history of depression obtained at interview. There was confirmation that the DSRSC can tap an internal dimension of depression and that children are able to evaluate their feeling states. An examination of misclassified children pointed to diagnostic overlap and some unreliability of diagnosis by clinicians.

Sources: PubMed
Keywords: teenage behavior disorders,childhood depression,
Title: Relationships between Acculturative Stress, Depression, and Quality of Life on in North Korean Refugees Living in South Korea
Abstract:

Purpose

The aim of this study was to evaluate acculturative stress, depression, and quality of life, and investigate the relationship between these factors in North Korean refugees who settled in South Korea.

Methods

A total of 232 North Korean refugees residing in South Korea participated in the study. Participants completed a series of questionnaires, including measures of acculturative stress, depression, and quality of life. Data were analyzed using SPSS WIN 20.0.

Results

The results showed that Acculturative stress, depression, and quality of life were interrelated. In our sample, 40.9% of participants scored ≥ 16 on the BDI-II, and the mean depression score was 15.42 (range 0-55), which indicates mild depressive symptoms. The mean total acculturative stress score was 2.88 (SD=0.02). The mean total QOL total score was 3.02 (SD=0.03). The most powerful predictor of quality of life was depression in North Korean refugees. Conclusion: The results suggest that acculturative stress is a factor in preventing depression and promoting quality of life, especially mental health, in North Korean refugees.


Sources: Omics Online
Keywords: Acculturative stress; Depression; Quality of life; Refugee,
Title: Parental Depression Risk: Comparing Youth with Depression, Attention Deficit Hyperactivity Disorder and Community Controls
Abstract:

Objective: Family studies of youth with depression are reviewed and new data presented. Past studies suggest strong familiality of youth depression. However, few studies included direct interviews with fathers and both psychiatric and normal control groups. In this study, lifetime prevalences of parental Major Depressive Disorder (MDD), Recurrent Depression, Dysthymic Disorder (DD), Double Depression (MDD/DD) and Bipolar Disorder were compared for 6-18 year old youth with depression (n = 127), youth with ADHD without a depression history (n = 116), and community control youth (n = 78).

Method: Parental diagnoses were made by diagnosticians blind to child diagnostic status using best estimate procedures based on the parent-interview SADS and the Family History Interview of Psychiatric Status from the other parent. Child diagnoses were based on K-SADS interviews conducted with both parent and child separately.

Results: Both mothers and fathers of depressed probands were significantly more likely than mothers and fathers of the other proband groups to have a history of MDD and DD. Mothers of probands with MDD/DD had higher rates of MDD compared to mothers of other depressed probands. There were few cases of parental Bipolar Disorder and most occurred in parents of probands with depression.

Conclusion: The current findings provide further evidence of the strong familiality of youth depression and highlight the need to evaluate parents when treating depressed youth. A comprehensive treatment approach may need to include a focus on obtaining treatment for and enhancing coping with parental depression.


Sources: Omics Online
Keywords: Depression; Bipolar disorder; Mood disorders; Youth; Family; Genetics; Familial risk; Parental depression,
Title: Late Life Depression and Anxiety in Four Types of Medicare Advantage Plans: Comorbidity with other Medical Diseases and Resource Utilization
Abstract:

Background: The prevalence of anxiety and depression and associated medical co-morbidities and costs has not been studied across different types of Medicare Advantage plans that vary in their level of utilization management and patient costs. Methods: A cross-sectional study of 74,290 older adults belonging to four different Universal American Medicare Advantage Plans was conducted, to estimate the period prevalence of depression and anxiety, the comorbidity between these disorders and major medical illnesses and associated costs. Results: The prevalence of anxiety or depression ranged from 14.5% to 18.8% across four types of Medicare Advantage plans, with HMO members less likely to be identified than members from fee-for-service or preferred provider organizations. Regardless of the type of plan, there was a high degree of comorbidity between depression and anxiety and other medical conditions, and higher utilization of services and costs in members with these disorders. Conclusions: A substantial prevalence of depression and anxiety disorders is present among older adult members of Medicare Advantage Plans and the presence of both disorders is associated with substantial medical comorbidity and costs. Clinicians in all care settings will encounter a substantial number of medically complex older adults with depression and anxiety, requiring close follow-up and coordination of care.


Sources: Omics Online
Keywords: Depression,Anxiety,Prevalence,Co-morbidity,Costs,Utilization,
Title: Prevalence of Depression in Port Harcourt Prison
Abstract:

Background/Objectives: Imprisonment has been associated with mental illness, especially depression.
Aims/objectives: To investigate the prevalence of depressive disorders among inmates of Port Harcourt Prisons, South, Nigeria.
Methods: Through stratified random sampling, 400 prisoners were interviewed using the Depression component of WHO SCAN in a 2-stage design after having been screened with the Beck Depression Inventory (BDI). The study was descriptive in nature and used psychometric evaluation. A questionnaire with socio- demographic was administered along with the Beck Depression Inventory. The author performed bivariate and multivariate analysis regarding depression. SPSS Version 17, was used for analysis and test of significance was set at p<0.05.
Findings: 169 subjects presented with depression according to the BDI. However SCAN revealed a prevalence of 59 (14.8%) for mild depression with somatic features, 57 (14.2%) for moderate depression with somatic features, 25 (6.2%) severe depression without psychotic features, while 18 (4.5%) had severe depression with psychotic features. The overall true prevalence of depression was 37%. Socio-demographic factors were found to be statistically significant included age (with being older acting as a protective factor), marital status, and place of living. Multiple Logistic regression analysis, however, revealed that the strongest predictors of depression among the subjects, were living in the urban area (OR: 0.31, CI=0.14-0.68, p<0.01), when correcting for confounders.
Discussion/Conclusions: The prevalence of depression was found to be high. Most of those identified were neither diagnosed nor received treatment. Undetected, under-detected and under-treated depression in the prisoners is an increasing public health problem.


Sources: Omics Online
Keywords: Prevalence,Prison,Penal,Depression,
Title: Optimal Concentration of Sevoflurane to Prevent Cardiovascular Depression after Induction of General Anesthesia with Remifentanil and Propofol
Abstract:

Background: We examined the optimal concentration of sevoflurane to prevent cardiovascular depression after induction of general anesthesia with remifentanil and propofol. Methods: Seventy-five adult patients were randomized to one of three groups (n = 25). Midazolam (0.025 mg/kg) and remifentanil (0.5 ?g/kg/min) were administered to all patients, followed by propofol (1.0 mg/kg) and rocuronium (0.6 mg/kg) after 2 min. The lungs were ventilated manually with sevoflurane and oxygen via a tightly fitted face mask. The trachea was intubated when end-tidal sevoflurane concentration reached 1%, 1.5%, and 2% in each group, respectively. Three min after the start of administration, remifentanil was decreased to 0.25 ?g/kg/min. The effect-site concentration of remifentanil was 6.0 ng/ml for 4 min after it was started. Hemodynamic variables were recorded from before induction of anesthesia to 15 min after tracheal intubation. Results: There were no serious adverse events such as severe bradycardia or asystole. Relative change of mean arterial pressure after induction of general anesthesia in the end-tidal sevoflurane 1% group was smaller than that of the end-tidal sevoflurane 1.5% and end-tidal sevoflurane 2% groups. Conclusion: An end-tidal sevoflurane concentration of 1% was sufficient when general anesthesia was induced with an effect-site concentration of remifentanil of 6.0 ng/mL and propofol of 1 mg/kg.


Sources: Omics Online
Keywords: Sevoflurane,Cardiovascular depression,Induction of general anesthesia.,
Title: Therapeutic Approaches for Depression During Pregnancy and Lactation
Abstract:

Objectives: The pregnancy and postpartum period appear to be a time of heightened vulnerability for the development of major depression in some women. The treatment of depressive disorder during pregnancy is an important but complex clinical topic. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation: Psychotherapy, Pharmacotherapy, Electroconvulsive therapy and other effective treatments.

Methods: PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner.

Results: The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed.

Conclusion: Treatments during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. As the research knowledge is limited, the recommendations should based on the best judgment of clinicians.


Sources: Omics Online
Keywords: Depression,Pregnancy,Lactation,Antidepressant,Therapeutic approach,
Title: Implementing an Educational Program to Enhance Identification, Diagnosis and Treatment of Adolescent Depression into Primary Care in Guatemala
Abstract:

Depression is projected to become the leading cause of disability and second leading contributor to the global burden of disease by the year 2020. Depression commonly has its onset in adolescence-early adulthood, affecting 6-8% of young people during that time span. Youth onset of Depression usually develops into a chronic condition with substantial morbidity and increased mortality. If untreated, depression can negatively impact the life of an adolescent and in some cases lead to suicide. Early identification and effective treatment provided in primary health care, can decrease depression related morbidity and mortality. “Identification, Diagnosis and Treatment of Adolescent Depression, A Package for Primary Health Care Providers” is an evidence-based educational program, designed to enhance the knowledge of primary health care providers to better identify, assess, diagnose and treat adolescent depression. This educational program has been field tested in Canada and is accredited as a Continuing Medical Education in Canada. The program has been translated into Spanish and culturally adapted for the Latin America context. The present article describes the process to establish a ‘Train the Trainers’ program to integrate the educational program into primary health care in Guatemala.


Sources: Omics Online
Keywords: Adolescent,Depression,Identification,Diagnosis,Treatment,,Mental Health,Primary Health Care,Educational Program,Guatemala,
Title: Don't overlook childhood depression.
Abstract:
Although depression is not uncommon among American children, clinicians often miss it. Because depression is associated with somatic complaints, social impairment, and suicide, health care providers must know the risk factors for depression and be able to recognize the symptoms and implement an effective treatment plan.

Sources: PubMed
Keywords: teenage behavior disorders,childhood depression,
Title: Major depression in childhood and adolescence.
Abstract:
Major depression in children and adolescents is diagnosed by the same criteria used in the adult disorder. There is a depth of knowledge regarding the childhood disorder in the areas of natural history, comorbidity, prognosis, epidemiology, and treatment. There are no controlled studies on the efficacy of psychotherapy for the treatment of childhood depression and only a few controlled studies on the efficacy of pharmacologic therapy. Current clinical practice combines individual psychotherapy, family intervention and education, and tricyclic antidepressant therapy in doses of 2 to 5 mg/kg to yield serum levels greater than 200 ng/ml for the treatment of major depression in children. Electrocardiograms should be performed prior to each increase in dose. Mood and cognitive functioning rapidly return to baseline levels following appropriate treatment but interpersonal difficulties tend to remain after resolution of the depression.

Sources: PubMed
Keywords: teenage behavior disorders,adult behavior disorders,childhood depression,
Title: Childhood depression.
Abstract:
This paper reviews the development of the current understanding of childhood depression. Psychoanalytic thought is briefly reviewed and recent studies regarding diagnosis, incidence, etiology, treatment, and prognosis are covered. The Diagnostic and Statistical Manual III is thought to adequately diagnose both adult and childhood depression. Depressive disorder in children is more frequently recognized and important studies are enhancing our knowledge of biologic, genetic, and psychological factors in depression. Treatment of depression is being refined and developed. The authors suggest that the understanding of childhood depression continues to be best conceptualized within a biopsychosocial model.

Sources: PubMed
Keywords: teenage behavior disorders,adult behavior disorders,bipolar disorder,bipolar disorder in children and teens,childhood depression,
Title: Depression in childhood: a survey of the literature.
Abstract:
Unlike adult depression, childhood depression is still a controversial concept in psychiatry. This paper explores and discusses the various issues involved in the controversy. Empirical evidence from epidemiological surveys and clinical studies is examined systematically. A brief survey of the literature over the last fifty years is given. The latest clinical study by Pearce (1974) is highlighted as it demonstrates how the condition can be systematically investigated. Despite conflicting findings, the available evidence, on balance, suggests that childhood depression does exist; it is rare in middle childhood, rarer still in the pre-school period of life but more common in adolescence. Although research findings have begun to give support to the diagnosis of childhood depression, its validity is far from being proven. Obviously, further research is needed.

Sources: PubMed
Keywords: teenage behavior disorders,adult behavior disorders,bipolar disorder,bipolar disorder in children and teens,childhood depression,
Title: Depression in the school-aged child: implications for primary care.
Abstract:
The diagnosis, classification and treatment of depression as a pediatric problem are receiving attention by an increasing number of clinicians and researchers today. Until recently skepticism concerning the emotional ability of a child to experience depressive feelings or illness resulted in a scarcity of research on the topic. A review of literature published in the last two decades reveals that depression can and does exist in children as young as six years. Furthermore, several studies suggest that it is underdiagnosed and underreported in pediatric clinical settings. Current literature provides pediatric practitioners with "at-risk" factors and symptoms of childhood depression to aid in casefinding, referral and treatment necessary to promote the emotional well-being of a child.

Sources: PubMed
Keywords: childhood depression,
Title: Childhood depression and suicide.
Abstract:
Recent years have witnessed accumulating evidence that the disorders subsumed under the heading of childhood depression are much more prevalent than used to be believed; that these conditions in prepubertal youngsters are more similar to those disorders occurring in adolescents and adults than was previously believed; that childhood depression can co-exist with many other childhood conditions; and that, although a rare occurrence, suicide is committed by older children. To quote a professional in the child mental health field: It is difficult to see how depression could not be involved in almost every form of psychopathology. The various theories of personality speculate on the existence of unhappy and depressing feelings and cognitions at the core of human development, with ineffective means of dealing with these concerns expressed by abnormalities. . . . Thus it becomes reasonable to argue that depression is everywhere in childhood and adulthood and hence we must be careful to specify under what conditions it is to be regarded as pathological.

Sources: PubMed
Keywords: art,childhood depression,
Title: Use and abuse of the Children's Depression Inventory.
Abstract:
This study investigated current uses of the Children's Depression Inventory (CDI), a frequently cited self-report measure for children's depressive symptomatology. Recently published studies of "childhood depression" were reviewed: Half of them used the CDI. Of these studies, 68% did not use a clinical or structured interview to determine diagnostic status. When the CDI was used alone to assess depressive symptoms, 44% of studies referred to high CDI scorers as "depressed" without providing a clear cautionary statement (i.e., either stating that the CDI cannot be used to diagnose depression or clarifying limitations regarding generalization of findings from a nonclinical to a clinical sample). These results are similar to those previously published regarding the Beck Depression Inventory, and they suggest a need for caution in the administration and interpretation of results from self-report inventories for children's depressive symptoms.

Sources: PubMed
Keywords: childhood depression,
Title: Two different putative genetic animal models of childhood depression.
Abstract:
In an attempt to model childhood depression, we examined whether existing genetic animal models of depression in adult rats are also valid in prepubertal rats.

Sources: PubMed
Keywords: animal models,hormones,childhood depression,
Title: A cross-fostering study in a genetic animal model of depression: maternal behavior and depression-like symptoms.
Abstract:
Connections between maternal behavior and childhood depression were examined by using a "genetic animal model"; Flinder Sensitive Line--(FSL) rats, and cross-fostering the offspring with the control strain, Sprague Dawley (SD) rats. The control procedure was "in-fostering", where the foster dam and her pups were from the same strain. Contribution of pups' characteristics/genotype to maternal behavior was examined. After weaning, we measured male offspring's body weight, immobility in the swim test, and basal corticosterone (CORT) and adrenocorticotropin (ACTH) levels at the prepubertal age of 35 days. While maternal behavior (of "depressive-like" dams and their controls) was not altered significantly by the pups' strain, the adoption procedure per se appeared to have more adverse effects on "depressive-like" symptoms of the SD prepubertal rats than on the FSL pups. Nevertheless, the combination between abnormal maternal behavior and genetic predisposition affected the hormonal stress responses of the offspring in a more severe manner than genetic predisposition or abnormal maternal behavior per se.

Sources: PubMed
Keywords: adverse effects,hormones,childhood depression,
Title: Duloxetine for childhood depression with pain and dissociative symptoms.
Abstract:
Over two thirds of people suffering from depression complain of pain with or without reporting psychological symptoms. Physical symptoms are more prevalent among the women, the elderly, the poor, and in children population. Successful treatment of depression in children complicated by pain symptoms constitutes a great clinical challenge. Duloxetine has already emerged as a safe and effective treatment option for adult depressed patients with painful physical symptoms. However, no data exist in literature which suggests use of duloxetine in childhood and adolescent population for the same clinical indication. We report a case documenting successful use of duloxetine in a depressed girl child who also had severe pain and dissociative symptoms.

Sources: PubMed
Keywords: teenage behavior disorders,adult behavior disorders,childhood depression,antiemetics,