Depression Treatment: Depression in Medical Students: Cluster Symptoms and Management.

Depression in medical students: Cluster symptoms and management.

Filed under: Depression Treatment

J Affect Disord. 2012 Dec 24;
Baldassin S, Silva N, de Toledo Ferraz Alves TC, Castaldelli-Maia JM, Bhugra D, Nogueira-Martins MC, de Andrade AG, Nogueira-Martins LA

BACKGROUND: Rates of depression among medical students have been shown to be high and related to year of study and other factors. We report on cluster of symptoms related to depression and their association with other difficulties in specific domains. METHODS: 481 (Response rate=79.8%) medical students completed a questionnaire about areas of difficulty in the medical school (studies, leisure, colleagues, professors, and patients), and Beck Depression Inventory (BDI). We studied correlation among areas of difficulty and clusters of BDI along with year in the course. RESULTS: Two areas which contributed most difficulty were studies and leisure. The significant associations for studies were seen between somatic cluster of depressive symptoms and the level of the course. Difficulties associated with leisure activities and with colleagues were correlated with the affective cluster of symptoms of depression. Activities related to clinical matters especially working with patients in the internship year were associated with somatic clusters. The different associations confirmed that rather than relying on scores emphasis should be placed on clusters of symptoms. LIMITATIONS: Sample from a single medical school. CONCLUSIONS: Although the clusters are associated with specific difficulties, it is important that educators and health professionals are aware of streesors the medical students face. The correlations if confirmed in future studies with qualitative factors could guide the development of more specific therapeutic or curriculum interventions.
HubMed – depression

Abnormal functional connectivity of the default mode network in remitted late-onset depression.

Filed under: Depression Treatment

J Affect Disord. 2012 Dec 25;
Wu D, Yuan Y, Bai F, You J, Li L, Zhang Z

BACKGROUND: The functional neural network model has been a major method used to investigate mechanisms of neuropsychopathy. There is considerable evidence that late-onset depression (LOD) is the prodrome, or the early clinical manifestation, of Alzheimer’s disease (AD). The default mode network (DMN) is one of the neural networks that can be used to explore the complex relationships between depressive symptoms, episodic memory deficits and other cognitive impairments. To date, no study has directly linked the DMN to LOD while focusing on episodic memory and the influence of apolipoprotein E4 (APOE4), a major genetic risk factor for AD in LOD patients. METHODS: In total, 33 remitted LOD (rLOD) patients and 33 elderly controls underwent fMRI scanning using low-frequency BOLD signal imaging during the resting state and during an episodic memory task. Furthermore, function-based functional connectivities (FCs) in the region of interesting (ROI) (posterior cingulate cortex (PCC) of the DMN) were analysed to explore interactions between disease states, task states and genetic risk factors (APOE4). RESULTS: Compared to healthy control subjects (HC), the FCs between the PCC and the right medial temporal lobe of the rLOD patients were significantly stronger during rest (p<0.005) and significantly weaker (p<0.05) during performance of the task. The mode of change from rest to task performance in the HC was in contrast to the mode of change in the rLOD patients. The FCs of the rLOD patients without APOE4 were significantly increased (p<0.05) in the resting state, but the rLOD patients who carried APOE4 showed a trend toward decreased FCs. LIMITATIONS: The sample size was small. While the study was cross-sectional, we did not differentiate between the various types of antidepressants the patients used, which may have had different effects on cognitive function, especially on episodic memory. CONCLUSION: Our results suggested that rLOD might be the prodrome, or the early clinical manifestation, of AD and that rLOD patients with APOE4 showed an increased risk for episodic memory decline and AD. HubMed – depression

Intelligence, temperament, and personality are related to over- or under-reporting of affective symptoms by patients with euthymic mood disorder.

Filed under: Depression Treatment

J Affect Disord. 2012 Dec 24;
Kim EY, Hwang SS, Lee NY, Kim SH, Lee HJ, Kim YS, Ahn YM

BACKGROUND: Many patients with mood disorders report subjective indicators of depression that are inconsistent with clinicians’ objective ratings. This study used the self-report Beck Depressive Inventory (BDI) and the observer-rated Hamilton Depression Rating Scale (HAMD) to evaluate the extent to which temperament, personality traits, and clinical characteristics accounted for discrepancies between self-reports and clinician ratings of depressive symptoms in patients experiencing the euthymic period of a mood disorder. METHOD: The sample consisted of 100 individuals with bipolar disorder (n=72) or major depressive disorder (n=28). The HAMD and Young Mania Rating Scale were administered, and participants completed the BDI and Barratt Impulsivity Scale. Intelligence was assessed with the Korean Wechsler Adult Intelligence Scale. Patients completed the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire and the NEO-Five-Factor Inventory. RESULTS: The BDI and HAMD were significantly but modestly correlated with each other (r=0.319, p<0.001). Lower intelligence and a less conscientious personality were independent contributors to differences between Z-scores for the BDI and the HAMD. Higher impulsivity and a more anxious temperament were also observed in the group that self-reported more symptoms than were noted by clinicians. LIMITATIONS: Generalizability of results can be limited in ethnic difference. CONCLUSIONS: Subjective and objective assessments of the depressive symptoms of patients with mood disorders in a euthymic mood state are frequently discordant. Clinicians should consider the subjective aspects of depressive symptoms along with objective information about the influence of intelligence and personality on patients' self-reports. HubMed – depression

Depression Leeds & Homeopathy Sheffield & anxiety Wakefield, Pontefract – Naturally Homeopathic – Depression Leeds & Homeopathy Sheffield & anxiety Wakefield, Pontefract – Naturally Homeopathic www.naturallyhomeopathic.com Hello, Welcome to Naturally Homeopathic Thank you for taking the time to find out more about how homeopathy and can help you. Naturally Homeopathic, run by Sarah Johnston-Knight has been treating people with all kinds of challenges in their lives; physical, mental and emotional for a number of years. Have you ever been to the doctor only to feel like you haven’t been listened to or understood and come out feeling worse than before? Have you ever taken medicine prescribed by your doctor only to find that it hasn’t really worked? Conventional medicine teaches doctors to treat the symptoms of an illness in the body or mind, but not the root cause. Homeopathy is natural, gentle, has no side effects and treats the whole person, not just symptoms. As an expert homeopathic practitioner Sarah will take the time to really listen to you. Sarah is a fully qualified homeopath & lives near Pontefract in Yorkshire. She offers personal consultations, homeopathy treatment and homeopathic remedies to clients in the Pontefract, Castleford, Wakefield, Barnsley, Doncaster, Rotherham, Leeds, Sheffield & Bradford areas of Yorkshire. Sarah can also provide consultations by email, Skype and by phone… so you can be anywhere in the world! For more information or to book an appointment please call — 01977 620983 or vist our website at www.naturallyhomeopathic.com

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