Disparate Rates of New-Onset Depression During the Menopausal Transition in 2 Community-Based Populations: Real, or Really Wrong?
Disparate Rates of New-Onset Depression During the Menopausal Transition in 2 Community-based Populations: Real, or Really Wrong?
Am J Epidemiol. 2013 Apr 14;
Harlow BL, Maclehose RF, Smolenski DJ, Soares CN, Otto MW, Joffe H, Cohen LS
This study took place in eastern Massachusetts and included respondents from the Harvard Study of Moods and Cycles Cohort 1, enrolled between 1995 and 1997, and the Harvard Study of Moods and Cycles Cohort 2, enrolled between 2005 and 2009. In prospectively assessing rates of new-onset depression in 2 populations of late-reproductive-aged women with no Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) lifetime history of depression, we were surprised to find far lower rates of depression in the population with greater racial diversity and lower socioeconomic status, contrary to what had been reported in the scientific literature. To better understand why these disparate results occurred, we assessed confounding and outcome misclassification as potential explanations for the discrepancy. After determining that these were unlikely explanations for the findings, we explored 2 potential sources of selection bias: one induced by self-referral of healthy participants into the study and the other induced by the design of the study itself. We concluded that both types of selection bias were likely to have occurred in this study and could account for the observed difference in rates. HubMed – depression
The Spanish translation of the Edinburgh Postnatal Depression Scale and the use of the word “desgraciada”.
Transcult Psychiatry. 2013 Feb; 50(1): 152-4
Wojcicki JM, Geissler J
Contribution of psychiatric illness and substance abuse to 30-day readmission risk.
J Hosp Med. 2013 Apr 16;
Burke RE, Donzé J, Schnipper JL
BACKGROUND: Little is known about the contribution of psychiatric illness to medical 30-day readmission risk. OBJECTIVE: To determine the independent contribution of psychiatric illness and substance abuse to all-cause and potentially avoidable 30-day readmissions in medical patients. DESIGN: Retrospective cohort study. SETTING: Patients discharged from the medicine services at a large teaching hospital from July 1, 2009 to June 30, 2010. MEASUREMENTS: The main outcome of interest was 30-day all-cause and potentially avoidable readmissions; the latter determined by a validated algorithm (SQLape) in both bivariate and multivariate analysis. Readmissions were captured at 3 hospitals where the majority of these patients are readmitted. RESULTS: Of 6987 discharged patients, 1260 were readmitted within 30 days (18.0%); 388 readmissions were potentially avoidable (5.6%). In multivariate analysis, 2 or more prescribed outpatient psychiatric medications (odds ratio [OR]: 1.1, 95% confidence interval [CI]: 1.01-1.20) or any prescription of anxiolytics (OR: 1.16, 95% CI: 1.00-1.35) were associated with increased all-cause readmissions, whereas discharge diagnoses of anxiety (OR: 0.82, 95% CI: 0.68-0.99) or substance abuse (OR: 0.80, 96% CI: 0.65-0.99) were associated with fewer all-cause readmissions. These findings were not replicated as predictors of potentially avoidable readmissions; rather, patients with discharge diagnoses of depression (OR: 1.49, 95% CI: 1.09-2.04) and schizophrenia (OR: 2.63, 95% CI: 1.13-6.13) were at highest risk. CONCLUSIONS: Our data suggest that patients treated during a hospitalization for depression and for schizophrenia are at higher risk for potentially avoidable 30-day readmissions, whereas those prescribed more psychiatric medications as outpatients are at increased risk for all-cause readmissions. These populations may represent fruitful targets for interventions to reduce readmission risk. Journal of Hospital Medicine 2013. © 2013 Society of Hospital Medicine. HubMed – depression
Barriers to Mental Health Care Utilization in Parkinson’s Disease.
J Geriatr Psychiatry Neurol. 2013 Apr 15;
Dobkin RD, Rubino JT, Friedman J, Allen LA, Gara MA, Menza M
Background: Parkinson’s disease (PD) is frequently complicated by co-occurring psychiatric problems such as depression and anxiety that negatively affect the course and management of the illness. Yet, in most cases, these psychiatric comorbidities are neither recognized nor treated to remission. The primary purpose of this study was to identify and describe barriers to mental health care utilization for people with PD. Secondary objectives included the assessment of attitudes and preferences regarding the need for mental health services in the PD community and the acceptability of telehealth interventions as a method for improving access and quality of care. Methods: A total of 769 people with PD completed an anonymous cross-sectional questionnaire assessing barriers to mental health care utilization in this medical population. Respondents were drawn from a national sample.Results: Commonly endorsed barriers to mental health care utilization in PD reflect the patients’ incomplete understanding of mental health problems, access issues, and illness-specific concerns, as well as the inadequate screening and detection of psychiatric complications by medical providers and the need for more effective treatments in this medical population. Several demographic, medical, and psychiatric variables also influenced the likelihood of accessing mental health care. Interest in telehealth approaches to mental health treatment was high and, in several instances, correlated with perceived barriers to mental health care utilization. Conclusions: People with PD may encounter a multitude of barriers that impede their pursuit of mental health care. Clinical implications are discussed and further research is needed to replicate and extend these findings. HubMed – depression
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