Depression Treatment: Psychological Symptoms of Family Members of High-Risk Intensive Care Unit Patients.

Psychological Symptoms of Family Members of High-Risk Intensive Care Unit Patients.

Filed under: Depression Treatment

Am J Crit Care. 2012 Nov; 21(6): 386-394
McAdam JL, Fontaine DK, White DB, Dracup KA, Puntillo KA

Background Family members of patients in intensive care are at increased risk for psychological symptoms. Objectives To compare levels of posttraumatic stress disorder, anxiety, and depression during and 3 months after the intensive care experience in family members of patients at high risk for dying and to determine if differences were related to the patient’s final disposition. Methods Longitudinal descriptive study of 41 family members in 3 tertiary care intensive care units. Results By repeated-measures analysis of variance, family members’ levels of posttraumatic stress disorder were significantly lower (P = .01) at 3 months after (mean score, 1.27; SD, 0.86) than during (mean, 1.61; SD, 0.81) the experience. Mean anxiety and depression scores were significantly lower (P < .001) after (anxiety: 7.35; SD, 3.91; depression: 5.63; SD, 4.58) than during (anxiety: 11.5; SD, 4.88; depression: 9.51; SD, 4.31) the experience. Scores for posttraumatic stress disorder, anxiety, and depression did not differ significantly between family members of patients who died and family members of patients who survived. Yet, all 13 family members of deceased patients and 42% of the total sample of 41 had traumatic stress scores of 1.5 or greater. Among the total sample, 44% had significant anxiety, and 27% were depressed. Conclusion Family members' symptoms of posttraumatic stress disorder, anxiety, and depression significantly decreased 3 months after the intensive care experience and did not differ according to the patients' final disposition. However, many family members still had significant risk for posttraumatic stress disorder and borderline anxiety and depression at 3 months. HubMed – depression

Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce.

Filed under: Depression Treatment

Arch Surg. 2012 Oct 1; 147(10): 933-9
Shanafelt TD, Balch CM, Sloan JA, Hanks JB, Satele DV, Oreskovich MR, Kaups KL, Freischlag J, Dyrbye LN

OBJECTIVE To evaluate factors associated with work-home conflicts (W-HCs) of US surgeons and their potential personal and professional consequences. DESIGN Cross-sectional study. PARTICIPANTS Members of the American College of Surgeons. MAIN OUTCOME MEASURES Burnout, depression, quality of life, alcohol use, career satisfaction, and career decisions (ie, reduce work hours or leave current practice). RESULTS Of 7197 participating surgeons, 3754 (52.5%) had experienced a W-HC in the previous 3 weeks. On multivariate analysis, hours worked per week, having children, sex, and work location (Veterans Administration or academic center) were independently associated with an increased risk for W-HC (all P < .01), while some factors (increased age and subspecialty field) reduced the risk. Surgeons with a recent W-HC were more likely to have symptoms of burnout (36.9% vs 17.1%; P < .001), depression (50.9% vs 28.1%; P < .001), alcohol abuse/dependency (17.2% vs 14.4%; P = .003), and were less likely to recommend surgery as a career option to their children (46.0% vs 54.4%; P < .001). Work-home conflicts were also independently associated with surgeons reporting a moderate or higher likelihood of planning to reduce clinical work hours (odds ratio, 1.769) and leave their current practice in the next 24 months for a reason other than retirement (odds ratio, 1.706) after controlling for other personal and professional factors. CONCLUSIONS Integrating personal and professional lives is a substantial challenge for US surgeons. Conflict in this balance appears to be a major factor in their decision to reduce work hours and/or move to a new practice, with potential substantive manpower implications for the surgical workforce.
HubMed – depression

Physical activity to combat depression in chronic heart failure-reply.

Filed under: Depression Treatment

JAMA. 2012 Nov 7; 308(17): 1738-9
Blumenthal JA, Babyak MA, Whellan DJ

HubMed – depression

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Treatment Of Depression In Managed Care (Mental Health Practice Under...

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