Depression Treatment: Caregivers of Patients With Cancer: Anxiety, Depression and Distribution of Dependency.

Caregivers of patients with cancer: anxiety, depression and distribution of dependency.

Filed under: Depression Treatment

Psychooncology. 2013 Jan; 22(1): 133-9
Cipolletta S, Shams M, Tonello F, Pruneddu A

Assisting a patient with cancer implies assuming a role that may fit in with the previous role of the person or that may contrast with it, thereby provoking suffering. This research explores if it is possible to identify different profiles of caregivers on the basis of different levels of anxiety and depression as well as on different ways of distributing one’s own dependency.There were 50 Italian primary caregivers of patients with cancer who completed the Beck Anxiety Inventory, the Beck Depression Inventory-II, and Kelly’s Dependency Grids. Cluster analysis was conducted on the indices derived from the three instruments.Three profiles were found on the basis of how the caregivers used their resources to give and to receive help. If there was congruence between the situation of giving help that the caregivers experienced and their personal role, then anxiety and depression decreased, otherwise, they increased. The implications of the balance/imbalance between the usual and the present role depended also on the typicality of the caregivers’ experience, as related to their caring role.These results suggest the usefulness of planning different kinds of support for different experiences of caregiving. Copyright © 2011 John Wiley & Sons, Ltd.
HubMed – depression

Depression, anxiety and alexithymia symptoms are major determinants of health related quality of life (HRQoL) in cirrhotic patients.

Filed under: Depression Treatment

Metab Brain Dis. 2013 Jan 8;
Nardelli S, Pentassuglio I, Pasquale C, Ridola L, Moscucci F, Merli M, Mina C, Marianetti M, Fratino M, Izzo C, Merkel C, Riggio O

HRQoL is impaired in cirrhosis. Establishing the relevance of depression, anxiety, alexithymia and cirrhosis stage on the patients’ HRQoL. Sixty cirrhotics underwent a neuropsychological assessment, including ZUNG-SDS, STAI Y1-Y2 and TAS-20. Minimal hepatic encephalopathy (MHE) was detected by PHES, HRQoL by Short-Form-36 (SF-36). Depression was detected in 34 patients (57 %, 95%CI?=?44-70 %), state-anxiety in 16 (27 %, 95%CI?=?15-38 %), trait-anxiety in 17 (28 %, 95%CI?=?17-40 %), alexithymia in 14 (31 % 95%CI?=?16-46 %) and MHE in 22 (37 %, 95%CI?=?24-49 %). Neuropsychological symptoms were unrelated to cirrhosis stage, hepatocellular carcinoma or MHE. A significant correlation was observed among psychological test scores and summary components of SF-36. At multiple linear regression analysis including Child-Pugh and MELD scores, previous-HE and the psychological test scores as possible covariates, alexithymia and depression as well as to the Child-Pugh score were significantly related to the SF-36 mental component; while trait-anxiety was the only variable significantly and independently related to the SF-36 physical component. Depression, state and trait-anxiety and alexithymia symptoms are frequent in cirrhotics and are among the major determinants of the altered HRQoL.
HubMed – depression

The Practice of Electroconvulsive Therapy in Greece.

Filed under: Depression Treatment

J ECT. 2013 Jan 4;
Kaliora SC, Braga RJ, Petrides G, Chatzimanolis J, Papadimitriou GN, Zervas IM

OBJECTIVE: To describe the practice of electroconvulsive therapy (ECT) in Greece. METHODS: A survey was conducted during the academic year 2008-2009. Electroconvulsive therapy use was investigated for 2007. All civilian institutions providing inpatient care were included. Centers that provided ECT completed a 57-item questionnaire. Centers that did not offer ECT completed a 13-item questionnaire. RESULTS: Fifty-five (82.1%) of 67 institutions responded. Electroconvulsive therapy was offered in 18 hospitals. Only 2 of 10 university hospitals offered ECT. Overall, 137 patients were treated with 1271 sessions in 2007. Only 1.47% discontinued treatment owing to adverse events. There were no deaths. Schizophrenia was the most common diagnosis (41.3%) among those receiving ECT, followed by major depression (28.9%), bipolar depression (9.1%), catatonia (4.1%), suicidal ideation (3.3%), and schizoaffective disorder (2.5%). Physicians considered major depression (93.8%), catatonia (86.5%), schizophrenia (56.3%), and mania (50%) the most appropriate indications. Written informed consent was required in 77.8% of the institutions, whereas the rest required verbal consent. Bilateral ECT was the preferred electrode placement (88.9%). Modified ECT was used exclusively. Propofol was the preferred anesthetic (44.4%), followed by thiopental (38.9%). Seven (38.9%) of 18 hospitals used a fixed stimulus dose at first treatment. Five (27.8%) of 18 hospitals used the half-age method. Continuation/maintenance ECT was used in 33.3% of the hospitals. Outpatient ECT was seldom used. Lack of training, difficult access to anesthesiology, billing issues, and stigma were cited as the main impediments to the practice of ECT. CONCLUSIONS: Electroconvulsive therapy is practiced in moderate numbers in Greece and almost exclusively on an inpatient basis. Lack of training and lack of availability of anesthesiologists were cited as the most common obstacles to providing ECT.
HubMed – depression

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