A BRIEF COGNITIVE-BEHAVIORAL INTERVENTION for TREATING DEPRESSION and PANIC DISORDER in PATIENTS WITH NONCARDIAC CHEST PAIN: A 24-WEEK RANDOMIZED CONTROLLED TRIAL.

A BRIEF COGNITIVE-BEHAVIORAL INTERVENTION FOR TREATING DEPRESSION AND PANIC DISORDER IN PATIENTS WITH NONCARDIAC CHEST PAIN: A 24-WEEK RANDOMIZED CONTROLLED TRIAL.

Depress Anxiety. 2013 Apr 26;
van Beek MH, Oude Voshaar RC, Beek AM, van Zijderveld GA, Visser S, Speckens AE, Batelaan N, van Balkom AJ

BACKGROUND: Most patients with noncardiac chest pain experience anxiety and depressive symptoms. Commonly they are reassured and referred back to primary care, leaving them undiagnosed and untreated. Some small studies have suggested efficacy of 12 cognitive behavioral therapy (CBT) sessions. Our aim was to examine efficacy of brief CBT in reducing anxiety and depressive symptoms in patients with noncardiac chest pain and comorbid panic and/or depressive disorders. METHODS: In this 24-week randomized controlled trial comparing CBT (n = 60) versus treatment as usual (TAU, n = 53), we included all adults who presented at the cardiac emergency unit of a university hospital with noncardiac chest pain, scored ?8 on the hospital anxiety and depression scale (HADS) and were diagnosed with a comorbid panic and/or depressive disorder with the Mini International Neuropsychiatric Interview. CBT consisted of six individual sessions. Main outcome was disease severity assessed with the clinical global inventory (CGI) by a blinded independent rater. RESULTS: ANCOVA in the intention-to-treat and completer sample showed that CBT was superior to TAU after 24 weeks in reducing disease severity assessed with CGI (P < .001). Secondary outcomes on anxiety (HADS-anxiety, state trait anxiety inventory (STAI)-trait) and depressive symptoms (Hamilton depression rating scale) were in line with these results except for HADS-depression (P = .10), fear questionnaire (P = .13), and STAI-state (P = .11). CONCLUSIONS: Brief CBT significantly reduces anxiety and depressive symptoms in patients with noncardiac chest pain who are diagnosed with panic and/or depressive disorders. Patients presenting with noncardiac chest pain should be screened for psychopathology and if positive, CBT should be considered. HubMed – depression

Utility of the PedsQL™ family impact module: assessing the psychometric properties in a community sample.

Qual Life Res. 2013 Apr 27;
Medrano GR, Berlin KS, Hobart Davies W

PURPOSE: Research on families coping with pediatric chronic illnesses has established that children and parents are affected by the illness. Therefore, optimal assessment of parent and family functioning is clinically important. The PedsQL™ family impact module (FIM) assesses parents’ health-related quality of life (HRQOL) and family functioning. While the FIM has been shown to be reliable and valid in multiple chronic illness groups, there is little data on its use in non-clinical groups. The study’s objective was to assess the reliability, validity, and factor structure of the FIM in a community sample. METHODS: Nine hundred and twenty-nine community parents of children 2-17 years old completed an anonymous online survey. The mean age of the participants was 37.6 years (SD = 8.6), and the majority were mothers (63.6 %), white (82.9 %), and married (74.8 %). The mean age of the children being reported on was 8.8 years (SD = 3.9), and the majority were female (52.3 %) and 41.2 % were reported as having at least one chronic condition. RESULTS: All of the FIM’s scales demonstrated excellent internal consistency reliability. Confirmatory factor analysis of the measure supported the current structure. The measure correlated in the expected direction with validated measures of anxiety, depression, child HRQOL, and number of chronic conditions endorsed. Independent t tests indicated that the measure has discriminant validity between parents who reported having a child with a chronic condition to those who did not. CONCLUSION: The results of this study suggest the FIM is a reliable and valid measure of parent HRQOL and family functioning within a community sample, and facilitate its use in comparative studies. HubMed – depression

Quality of life, health status and caregiver burden in Parkinson’s disease: relationship to executive functioning.

Int J Geriatr Psychiatry. 2013 Apr 29;
Kudlicka A, Clare L, Hindle JV

OBJECTIVE: High-quality person-centred care for people with Parkinson’s disease (PwPD) and their families relies on identifying and addressing factors that specifically impact on quality of life (QoL). Deficits in executive functions (EF) are common in Parkinson’s disease, but their impact on PwPD and their caregivers is not well understood. The present study evaluated how EF contributes to QoL and health status for the PwPD and caregiver burden. METHODS: Sixty-five PwPD completed measures of QoL, health status and EF, and 50 caregivers rated the EF of the PwPD and their own burden. Multiple regression analyses examined predictors of QoL (general life, health and movement disorders domains), health status and caregiver burden. RESULTS: Quality of life in the health and movement disorders domains was best explained by caregiver-rated EF, whereas QoL in the general life domain was best explained by level of depression. Health status was predicted by self-rated EF, with an objective EF measure also included in the regression model. Caregiver burden was best explained by caregiver-rated EF and disease severity, with general cognition and other factors also included in the regression model. CONCLUSIONS: Executive functions-related behavioural problems may contribute to QoL and health status in PwPD and affect caregiver burden. The findings support the view that the concepts of subjective QoL and self-assessed health status are only partially related and should not be seen as identical. Adequate strategies to reduce the impact of EF deficits are needed as this may have the potential to improve QoL in PwPD. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression

Reduced fasting plasma levels of diazepam-binding inhibitor in adolescents with anorexia nervosa.

Int J Eat Disord. 2013 Apr 29;
Conti E, Tremolizzo L, Bomba M, Uccellini O, Rossi MS, Raggi ME, Neri F, Ferrarese C, Nacinovich R

OBJECTIVE: Altered expression and/or function, both peripherally and centrally, of various neuropeptides is involved in the neurophysiology of anorexia nervosa (AN). Diazepam-binding inhibitor (DBI) is an interesting peptide for understanding this crosstalk. The aim of this work was to assess fasting plasma levels of DBI and leptin in patients with AN. METHOD: Twenty-four AN adolescents were recruited together with 10 age-comparable healthy controls. Neuropeptide determinations were performed on plasma samples by enzyme-linked immunosorbent assays. Patients with AN were further characterized for the presence of a depressive state or anxiety by using, respectively, the Children’s Depression Inventory or the State-Trait Anxiety Inventory form Y. RESULTS: Levels of both plasma DBI and leptin were reduced in patients with AN (?40 and ?70%, respectively). DBI levels displayed a tendency to increase in the presence of a depressive state, although not with anxiety, whereas leptin levels correlated exclusively with body mass index. DISCUSSION: These data further extend our knowledge of neuropeptide dysfunction in AN, and plasma DBI may represent a marker for this disease, in particular considering its correlation with comorbid mood disorders. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013). HubMed – depression