The Syndemic Effects of Intimate Partner Violence, HIV/AIDS, and Substance Abuse on Depression Among Low-Income Urban Women.

The Syndemic Effects of Intimate Partner Violence, HIV/AIDS, and Substance Abuse on Depression among Low-Income Urban Women.

J Urban Health. 2013 Mar 26;
Illangasekare S, Burke J, Chander G, Gielen A

Intimate partner violence (IPV), HIV/AIDS, and substance use are epidemics among low-income urban women that have been described together as the “SAVA syndemic” because of their co-occurring nature. This study examines the synergistic or “syndemic” effect of these three health issues on depression among urban women and evaluates social support as a protective factor that might reduce depressive symptoms associated with the Substance Abuse, Violence, and AIDS (SAVA) syndemic. Data from 445 urban women were collected through in-person interviews. All women were over the age of 18, not pregnant, English speaking, and reported having a main partner in the past year. Twenty-five percent had experienced all three factors of the SAVA syndemic (were HIV-positive, had experienced IPV in the past year, and had used cocaine or heroin in their lifetime). HIV-positive status, hard drug use, IPV, and low levels of social support were all individually associated with greater depressive symptoms. When controlling for demographics and other SAVA factors, IPV and hard drug use in the past 30 days remained associated with depressive symptoms, as did low social support. However, social support did not modify the effect of the SAVA factors on depression. Compared to women who experienced no SAVA factors, women who had experienced all three factors were 6.77 times more likely to have depressive symptoms. These findings confirm that IPV is significantly associated with depressive symptoms and that the syndemic impact of IPV, substance use, and HIV could have even more extreme effects on depression outcomes. HubMed – depression

[Prevalence of Personal Exhaustion in the General Population in Germany and its Coherences towards Further Psychosomatic Disorders].

Psychother Psychosom Med Psychol. 2013 Mar; 63(3-4): 109-14
Stöbel-Richter Y, Daig I, Brähler E, Zenger M

The delineated mental and somatic symptoms in the context of burnout have to be seen as serious health complaints. Exhaustion is one of the symptoms in this context. The present study focuses the prevalence of exhaustion symptoms (assessed with a screeninger for mental wellbeing) in the German general population and the correlation with anxiety and depression as well as further symptoms that co-occur. For this purpose, data of 2 433 persons from a population-based representative sample were analysed. After setting a cut-off point the results reveal that 6% of the population show serious mental impairments, which can be interpreted as a exhaustion prevalence rate. Moreover, the results imply clear relationships of exhaustion and other symptoms as well as mental and somatic impairments and the intake of pharmaceuticals. HubMed – depression

Mind-body therapies – Use in chronic pain management.

Aust Fam Physician. 2013 Mar; 42(3): 112-7
Hassed C

Chronic pain is a common presentation to general practice.This article explores the role of the mind in the experience of pain and describes how mind-body techniques can be used in the management of chronic pain.The mind, emotions and attention play an important role in the experience of pain. In patients with chronic pain, stress, fear and depression can amplify the perception of pain. Mind-body approaches act to change a person’s mental or emotional state or utilise physical movement to train attention or produce mental relaxation. They are occasionally used as a sole treatment, but more commonly as adjuncts to other therapies. Mind-body approaches include progressive muscle relaxation, meditation, laughter, mindfulness based approaches, hypnosis, guided imagery, yoga, biofeedback and cognitive behavioural therapy. Studies have shown that mind-body approaches can be effective in various conditions associated with chronic pain, however levels of evidence vary. Group delivered courses with healthcare professional input may have more beneficial effects than individual therapy. General practitioners are well placed to recommend or learn and provide a range of mind-body approaches to improve outcomes for patients with chronic pain. HubMed – depression

Common general practice presentations and publication frequency.

Aust Fam Physician. 2013 Jan-Feb; 42(1-2): 65-8
Cooke G, Valenti L, Glasziou P, Britt H

As first point-of-contact, general practitioners see the widest range of conditions of any specialty and this has consequences for continuing medical education. It follows that GPs need to know a lot about the conditions they see daily or weekly, less about those they see monthly or yearly, and little or nothing about rarities until they are encountered.General practitioners see the widest range of conditions of any specialty. It is unclear if the most commonly managed problems in general practice are reflected in the volume of published general practice research, or in guidelines produced for general practice.The 200 most commonly managed problems in general practice were sought from the BEACH database. For the 10 most often managed, we searched Australian Family Physician in MEDLINE (2005-10) for articles and the National Health and Medical Research Council Clinical Practice Guidelines Portal for guidelines, to determine publication frequency.The 10 most commonly managed problems were hypertension, immunisation, upper respiratory tract infection, depression, diabetes, lipid disorder, general check-up, osteoarthritis, back complaint, and prescription request. The top 30 problems accounted for approximately 48% of GP problems managed. To cover 75% of problems managed, GPs need to have knowledge of more than 100 problems.While GPs are required to have a working knowledge of numerous conditions, almost half of problems managed fall within the top 30 problem areas. Research published in Australian Family Physician and published clinical guidelines do not align with the problems most frequently encountered by GPs. HubMed – depression

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