“Too Blessed to Be Stressed”: A Rural Faith Community’s Views of African-American Males and Depression.

“Too Blessed to be Stressed”: A Rural Faith Community’s Views of African-American Males and Depression.

Filed under: Depression Treatment

J Relig Health. 2013 Jan 4;
Bryant K, Haynes T, Greer-Williams N, Hartwig MS

Among African-Americans, the faith community has a long history of providing support to its members. Because African-American men tend to delay and decline traditional depression treatment, the faith community may be an effective source of support. The aim of this study was to determine how a rural African-American faith community describes and perceives experiences of depression among African-American males. A convenience sample of 24 men and women participated in focus groups and interview. Four themes were identified: defining depression, etiology of depression, denial of depression, and effect of masculine roles on depression experience.
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Complex challenges in treating depression during pregnancy.

Filed under: Depression Treatment

Am J Psychiatry. 2013 Jan 1; 170(1): 12-20
Chaudron LH

The treatment of depression during pregnancy can be challenging for patients and providers alike. An increasing attention to perinatal mood disorders has led to an expanding literature that is often difficult for providers to navigate. It can be a challenge for providers to feel comfortable reviewing the broad scope of the risks and benefits of treatments in the context of the limitations of the literature. Women who are depressed during pregnancy have been found to have an elevated risk of poor obstetrical outcomes, although studies of the relationship between depression and outcomes are limited. Women who are treated with antidepressants during pregnancy are also at risk for a host of poor obstetrical and fetal outcomes. The risks for these outcomes are often confused by confounding factors and study design limitations. Understanding the current data and their limitations will allow providers to guide their patients in choosing treatment options. Consistent and simple strategies should be used when discussing the risk-benefit analysis with the patient.
HubMed – depression

Patient Activation and Improved Outcomes in HIV-Infected Patients.

Filed under: Depression Treatment

J Gen Intern Med. 2013 Jan 4;
Marshall R, Beach MC, Saha S, Mori T, Loveless MO, Hibbard JH, Cohn JA, Sharp VL, Korthuis PT

BACKGROUND: The Patient Activation Measure (PAM) assesses several important concepts in chronic care management, including self-efficacy for positive health behaviors. In HIV-infected populations, better self-efficacy for medication management is associated with improved adherence to antiretroviral medications (ARVs), which is critically important for controlling symptoms and slowing disease progression. OBJECTIVE: To determine 1) characteristics associated with patient activation and 2) associations between patient activation and outcomes in HIV-infected patients. DESIGN: Cross-sectional survey. PARTICIPANTS: 433 patients receiving care in four HIV clinics. METHODS: An interviewer conducted face-to-face interviews with patients following their HIV clinic visit. Survey data were supplemented with medical record abstraction to obtain most recent CD4 counts, HIV viral load and antiretroviral medications. MAIN MEASURES: Patient activation was measured using the 13-item PAM (possible range 0-100). Outcomes included CD4 cell count?>?200 cells/mL(3), HIV-1 RNA??200 cells/mL(3) (aOR 1.10 [95 % CI 1.01, 1.21]), adherence (aOR 1.18 [95 % CI 1.09, 1.29]) and viral suppression (aOR 1.08 [95 % CI 1.00, 1.17]). The association between PAM and viral suppression was mediated through adherence. CONCULSIONS: Higher patient activation was associated with more favorable HIV outcomes. Interventions to improve patient activation should be developed and tested for their ability to improve HIV outcomes.
HubMed – depression

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