Depression Treatment: Guilt Is More Strongly Associated With Suicidal Ideation Among Military Personnel With Direct Combat Exposure.

Guilt is more strongly associated with suicidal ideation among military personnel with direct combat exposure.

Filed under: Depression Treatment

J Affect Disord. 2012 Dec 8;
Bryan CJ, Ray-Sannerud B, Morrow CE, Etienne N

BACKGROUND: Suicide rates in the U.S. military have been rising rapidly in the past decade. Research suggests guilt is a significant predictor of suicidal ideation among military personnel, and may be especially pronounced among those who have been exposure to combat-related traumas. The current study explored the interactive effect of direct combat exposure and guilt on suicidal ideation in a clinical sample of military personnel. METHODS: Ninety-seven active duty U.S. Air Force personnel receiving outpatient mental health treatment at two military clinics completed self-report symptom measures of guilt, depression, hopelessness, perceived burdensomeness, posttraumatic stress disorder, and suicidal ideation. RESULTS: Generalized multiple regression analyses indicated a significant interaction of guilt and direct combat exposure (B=.124, SE=.053, p=.020), suggesting a stronger relationship of guilt with suicidal ideation among participants who had direct combat exposure as compared to those who had not. The interactions of direct combat exposure with depression (B=.004, SE=.040, p=.926), PTSD symptoms (B=.016, SE=.018, p=.382), perceived burdensomeness (B=.159, SE=.152, p=.300) and hopelessness (B=.069, SE=.036, p=.057) were nonsignificant. CONCLUSIONS: Although guilt is associated with more severe suicidal ideation in general among military personnel, it is especially pronounced among those who have had direct combat exposure.
HubMed – depression

Relationship between neurocognitive functioning and episode recurrences in bipolar disorder.

Filed under: Depression Treatment

J Affect Disord. 2012 Dec 8;
Martino DJ, Strejilevich SA, Marengo E, Igoa A, Fassi G, Teitelbaum J, Caravotta P

BACKGROUND: The relationship between neurocognitive impairment and clinical course in bipolar disorder (BD) is inconclusive. The aim of this study was to compare time to recurrence between patients with and without clinically significant cognitive impairment. METHODS: Seventy euthymic patients with BD were included. Based on baseline neurocognitive performance, patients were divided into those with (n=49) and those without (n=21) clinically significant cognitive impairment. Both groups of patients were prospectivelly assessed by a modified life chart method during a mean of 16.3 months. RESULTS: Patients with some cognitive domain compromised had an increased risk of suffering any recurrence (HR: 3.13; CI 95%: 1.64-5.96), hypo/manic episodes (HR: 2.42; CI 95%: 1.13-5.19), or depressive episodes (HR: 3.84, CI 95%: 1.66-8.84) compared with those patients without clinically significant cognitive impairment. These associations remained significant after adjusting for several potential counfounders such as number of previous episodes, time since last episode, clinical subtype of BD, exposure to antipsychotics, and subclinical symptoms. LIMITATIONS: We classified patients as with or without clinically significant cognitive impairment, although deficits in different cognitive domains may not be equivalent in terms of risk of recurrence. CONCLUSIONS: The results did not support the hypothesis that the experience of successive episodes is related to a progressive neurocognitive decline. On the contrary, cognitive impairment could be the cause more than the consequence of poorer clinical course. Alternatively, a specific subgroup of patients with clinically significant cognitive impairment and a progressive illness in terms of counts of recurrence and shortening of wellness intervals might explain the association showed in this study.
HubMed – depression

Job Stress and Physical Activity Related to Elevated Symptom Clusters in Breast Cancer Survivors at Work.

Filed under: Depression Treatment

J Occup Environ Med. 2012 Dec 10;
Moskowitz MC, Feuerstein M, Todd BL

OBJECTIVE:: To identify whether clusters of symptoms (depression, anxiety, fatigue, cognitive limitations) appear in employed breast cancer survivors, and whether clusters are related to job stress and aerobic activity. METHODS:: Employed breast cancer survivors (n = 94) and women without a history of cancer (n = 100) completed questionnaires online in a cross-sectional study. RESULTS:: A two-cluster solution of high or low symptom severity groups was observed. High symptom cluster was associated with breast cancer (odds ratio [OR] = 2.46; 95% confidence interval [CI], 1.22 to 4.93), more frequent job stress (OR = 1.78; 95% CI, 1.12 to 2.83), and lower levels of aerobic activity (OR = 0.55; 95% CI, 0.36 to 0.83). CONCLUSION:: Levels of anxiety, depression, cognitive limitations, and fatigue are expressed as clusters with varying severity. Clusters are related to job stress and aerobic activity in breast cancer survivors at work. Findings suggest avenues for clinical management and research.
HubMed – depression

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