It would make sense that teenage mothers have a lot of psychological stress in their lives, but a new study shows that the distress comes before the pregnancy, not because of it.
"Psychological distress does not appear to be caused by teen childbearing, nor does it cause teen childbearing, except apparently among girls from poor households," said Stefanie Mollborn, Ph.D., an assistant professor of sociology at the Institute of Behavioral Science of the University of Colorado at Boulder.
The study, published in the September issue of the Journal of Health and Social Behavior, used data from two large long-term U.S. surveys that followed thousands of teen girls and women. Participants responded to items on symptoms associated with depression, such as how often they found things that did not usually bother them to be bothersome, how easily they could shake off feeling blue or whether they had trouble concentrating. The researchers did not use the term "depression," which is a clinical diagnosis.
Only the combination of poverty and existing distress was a good predictor of teen pregnancy.
Previous studies had shown high levels of depression among teen mothers, but nationally representative studies had not examined if distress was present before the pregnancy and stresses of young motherhood.
"Psychologically distressed girls are at risk for teen childbearing and vice versa, even if the two things usually do not cause each other," Mollborn said. "This could help educators and clinicians identify at-risk adolescents."
Looking for symptoms of depression or distress should be part of normal health screening for all teenagers, said Diane Merritt, M.D., director of Pediatric and Adolescent Gynecology at the Washington University School of Medicine in St. Louis. "Talking to teenagers about their sexuality and responsible behavior is key," she said. Responsible behavior would include the use of birth control if the teenager were sexually active.
One of the best ways to prevent teen pregnancy is for teens to have long-term goals and good self-esteem, Merritt added.
High levels of depression have long-term negative consequences for both mothers and children, Mollborn said. The higher levels of psychological distress in women who had teenage pregnancies continued well into adulthood, she added.
The Journal of Health and Social Behavior is a quarterly journal of the American Sociological Association.
Source
Health Behavior News Service
среда, 31 августа 2011 г.
воскресенье, 28 августа 2011 г.
Sudden Death Of A Parent Raises Risk Of Depression, Post-Traumatic Stress Disorder For Surviving Children, Pitt Researchers Find
The children of parents who die suddenly - whether by suicide, accident or natural causes - are three times more likely to develop depression and are at higher risk for post-traumatic stress disorder (PTSD) than children who don't face such a difficult life event, according to a University of Pittsburgh School of Medicine study published in the current issue of the Archives of Pediatric & Adolescent Medicine, one of the JAMA/Archives journals.
In the first controlled, population-based study of its kind, the team of Pitt and University of Pittsburgh Medical Center (UPMC) researchers also found that parents who died of suicide had higher rates of bipolar disorder, alcohol and substance abuse disorders and personality disorders. Higher rates of these disorders are expected in suicide victims; however, those who died accidentally or from sudden natural death also had higher rates of psychiatric disorders, specifically, alcohol and substance abuse and personality disorders, and showed a trend toward higher rates of bipolar disorder.
While the death of a parent is consistently rated as one of the most stressful events that a child can experience, little has been known about the psychiatric outcomes in bereaved children until now. "Our study shows that when premature parental death occurs, physicians should be alert to the increased risk for depression and post-traumatic stress disorder in bereaved offspring and in their surviving caregivers," said David A. Brent, M.D., academic chief of child and adolescent psychiatry at Western Psychiatric Institute and Clinic and professor of psychiatry, pediatrics and epidemiology at the University of Pittsburgh School of Medicine. "Not surprisingly, we found that bereaved offspring are at increased risk for adverse outcomes in part because of factors that may have contributed to the parent's death."
The study involved 140 families in which one parent had died of either suicide, accidental death - such as drug overdoses and car accidents - or sudden natural death, while a control group consisted of 99 families with two living biological parents who were matched to the deceased parents in the study group based on sex, age and neighborhood. Ages of the children at their parents' deaths ranged from seven to 25 years.
Other factors that affected outcomes included the nature of the last conversation with the deceased. Researchers found that a caregiver's recollection of a supportive conversation led to a higher risk of depression. "Understanding the effects of bereavement is essential to identifying those at highest risk who should be targeted for future prevention and intervention efforts," noted Nadine Melhem, Ph.D., first author and assistant professor of psychiatry at the University of Pittsburgh School of Medicine.
These findings point out the importance of improving the detection and treatment of bipolar illness, substance and alcohol abuse, and personality disorders, as well as the significance of addressing the lifestyle associations of these illnesses that lead to premature deaths, according to Dr. Brent.
"The caregivers should be monitored for depression and PTSD because restoring their normal mental functioning could lead to more positive outcomes for the children," said Dr. Brent. "However, given the increased risk of depression and PTSD, the bereaved children also should be monitored and, if necessary, referred and treated for their psychiatric disorders."
Co-authors of the study include Monica Walker, M.A., Western Psychiatric Institute and Clinic, and the Department of Psychiatry, University of Pittsburgh School of Medicine; and Grace Moritz, M.S.W., Division of Collaborative Care Medicine, UPMC.
Drs. Brent and Melhem were supported by funding provided by the National Institute of Mental Health and the American Foundation for Suicide Prevention.
The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in National Institutes of Health (NIH) grant support, which has more than doubled since 1998. For fiscal year 2006, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. The majority of these grants were awarded to the faculty of the medical school. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center. Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.
University of Pittsburgh Medical Center
In the first controlled, population-based study of its kind, the team of Pitt and University of Pittsburgh Medical Center (UPMC) researchers also found that parents who died of suicide had higher rates of bipolar disorder, alcohol and substance abuse disorders and personality disorders. Higher rates of these disorders are expected in suicide victims; however, those who died accidentally or from sudden natural death also had higher rates of psychiatric disorders, specifically, alcohol and substance abuse and personality disorders, and showed a trend toward higher rates of bipolar disorder.
While the death of a parent is consistently rated as one of the most stressful events that a child can experience, little has been known about the psychiatric outcomes in bereaved children until now. "Our study shows that when premature parental death occurs, physicians should be alert to the increased risk for depression and post-traumatic stress disorder in bereaved offspring and in their surviving caregivers," said David A. Brent, M.D., academic chief of child and adolescent psychiatry at Western Psychiatric Institute and Clinic and professor of psychiatry, pediatrics and epidemiology at the University of Pittsburgh School of Medicine. "Not surprisingly, we found that bereaved offspring are at increased risk for adverse outcomes in part because of factors that may have contributed to the parent's death."
The study involved 140 families in which one parent had died of either suicide, accidental death - such as drug overdoses and car accidents - or sudden natural death, while a control group consisted of 99 families with two living biological parents who were matched to the deceased parents in the study group based on sex, age and neighborhood. Ages of the children at their parents' deaths ranged from seven to 25 years.
Other factors that affected outcomes included the nature of the last conversation with the deceased. Researchers found that a caregiver's recollection of a supportive conversation led to a higher risk of depression. "Understanding the effects of bereavement is essential to identifying those at highest risk who should be targeted for future prevention and intervention efforts," noted Nadine Melhem, Ph.D., first author and assistant professor of psychiatry at the University of Pittsburgh School of Medicine.
These findings point out the importance of improving the detection and treatment of bipolar illness, substance and alcohol abuse, and personality disorders, as well as the significance of addressing the lifestyle associations of these illnesses that lead to premature deaths, according to Dr. Brent.
"The caregivers should be monitored for depression and PTSD because restoring their normal mental functioning could lead to more positive outcomes for the children," said Dr. Brent. "However, given the increased risk of depression and PTSD, the bereaved children also should be monitored and, if necessary, referred and treated for their psychiatric disorders."
Co-authors of the study include Monica Walker, M.A., Western Psychiatric Institute and Clinic, and the Department of Psychiatry, University of Pittsburgh School of Medicine; and Grace Moritz, M.S.W., Division of Collaborative Care Medicine, UPMC.
Drs. Brent and Melhem were supported by funding provided by the National Institute of Mental Health and the American Foundation for Suicide Prevention.
The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in National Institutes of Health (NIH) grant support, which has more than doubled since 1998. For fiscal year 2006, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. The majority of these grants were awarded to the faculty of the medical school. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center. Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.
University of Pittsburgh Medical Center
четверг, 25 августа 2011 г.
Depression Returns In About Half Of Treated Teens
Most depressed teens who receive treatment appear to recover, but the condition recurs in almost half of adolescent patients and even more often among females, according to a report posted online today that will appear in the March 2011 print issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Major depressive disorder affects approximately 5.9 percent of teen females and 4.6 percent of teen males, according to background information in the article. "It is associated with functional impairment, risk of suicide and risk of adult depression," the authors write. "Thus, it is important to investigate not only the efficacy of adolescent major depressive disorder treatments but also whether they reduce the risk of subsequent negative outcomes, especially depression recurrence."
John Curry, Ph.D., of Duke University Medical Center, Durham, N.C., and colleagues studied 196 adolescents (86 males and 110 females) who participated in the Treatment for Adolescents With Depression Study (TADS). The teens were randomly assigned to one of four short-term treatment interventions (medication with fluoxetine hydrochloride, cognitive behavioral therapy, a combination of the two or placebo) and followed up for five years.
Almost all participants (96.4 percent) recovered from their initial episode of depression during the follow-up period, including 88.3 percent who recovered within two years. Those who responded to a 12-week treatment session (short-term responders) were more likely to have recovered by two years (96.2 percent vs. 79.1 percent). However, two-year recovery was not associated with any particular type of treatment.
Of the 189 teens who recovered from depression, 88 (46.6 percent) experienced a recurrence. "Contrary to our hypotheses, neither full response to short-term treatment nor treatment with a combination of fluoxetine and cognitive behavioral therapy reduced the risk of recurrence," the authors write. "However, short-term treatment non-responders were more likely to experience recurrence than full and partial responders. Females were significantly more likely to have a recurrence than males."
Teens who also had an anxiety disorder were more likely to experience recurrence (61.9 percent vs. 42.2 percent of those without anxiety disorders). In addition, participants whose depression returned had higher scores on scales of suicidal thoughts and behaviors.
"Our results reinforce the importance of modifying a short-term treatment that leads to partial response or non-response because these were associated with less likelihood of recovery in two years," the authors write. "The finding that recurrence rates increased significantly from two to three years after baseline suggests that recurrence prevention efforts, such as symptom or medication monitoring or cognitive behavioral therapy booster sessions may be of value beyond the [18-week] maintenance period included in TADS."
"Female sex was the most robust predictor of recurrence, indicating the importance of understanding and reducing the vulnerabilities of female adolescents to recurrent episodes."
(Arch Gen Psychiatry. Published online November 1, 2010. doi:10.1001/archgenpsychiatry.2010.150.)
Major depressive disorder affects approximately 5.9 percent of teen females and 4.6 percent of teen males, according to background information in the article. "It is associated with functional impairment, risk of suicide and risk of adult depression," the authors write. "Thus, it is important to investigate not only the efficacy of adolescent major depressive disorder treatments but also whether they reduce the risk of subsequent negative outcomes, especially depression recurrence."
John Curry, Ph.D., of Duke University Medical Center, Durham, N.C., and colleagues studied 196 adolescents (86 males and 110 females) who participated in the Treatment for Adolescents With Depression Study (TADS). The teens were randomly assigned to one of four short-term treatment interventions (medication with fluoxetine hydrochloride, cognitive behavioral therapy, a combination of the two or placebo) and followed up for five years.
Almost all participants (96.4 percent) recovered from their initial episode of depression during the follow-up period, including 88.3 percent who recovered within two years. Those who responded to a 12-week treatment session (short-term responders) were more likely to have recovered by two years (96.2 percent vs. 79.1 percent). However, two-year recovery was not associated with any particular type of treatment.
Of the 189 teens who recovered from depression, 88 (46.6 percent) experienced a recurrence. "Contrary to our hypotheses, neither full response to short-term treatment nor treatment with a combination of fluoxetine and cognitive behavioral therapy reduced the risk of recurrence," the authors write. "However, short-term treatment non-responders were more likely to experience recurrence than full and partial responders. Females were significantly more likely to have a recurrence than males."
Teens who also had an anxiety disorder were more likely to experience recurrence (61.9 percent vs. 42.2 percent of those without anxiety disorders). In addition, participants whose depression returned had higher scores on scales of suicidal thoughts and behaviors.
"Our results reinforce the importance of modifying a short-term treatment that leads to partial response or non-response because these were associated with less likelihood of recovery in two years," the authors write. "The finding that recurrence rates increased significantly from two to three years after baseline suggests that recurrence prevention efforts, such as symptom or medication monitoring or cognitive behavioral therapy booster sessions may be of value beyond the [18-week] maintenance period included in TADS."
"Female sex was the most robust predictor of recurrence, indicating the importance of understanding and reducing the vulnerabilities of female adolescents to recurrent episodes."
(Arch Gen Psychiatry. Published online November 1, 2010. doi:10.1001/archgenpsychiatry.2010.150.)
понедельник, 22 августа 2011 г.
Depressed People Have High Rates Of Physical Illness
People with recurrent depression have high rates of many common physical illnesses, such as gastric ulcer, rhinitis/hay fever, osteoarthritis, thyroid disease, hypertension and asthma, a new study has found.
Published in the May 2008 issue of the British Journal of Psychiatry, the study compared 1546 people with recurrent depression with 884 psychiatrically healthy controls in terms of past treatment for 16 different physical disorders.
Since many medical disorders are related to obesity, the researchers also examined body mass index (BMI) in both groups.
It was found that 15 physical disorders were significantly more frequent in people with recurrent depression than in controls. However, when BMI, age and gender were taken into account, depression was found to predict 6 disorders - gastric ulcer, asthma, rhinitis, hypertension, thyroid disease and osteoarthritis.
For the remaining physical health problems - diabetes, epilepsy, hypercholesterolaemia (high blood fats), kidney disease, liver disease, heart attack, osteoporosis, rheumatoid arthritis and stroke - the difference between those with and without each disorder could be accounted for by BMI, age or gender.
Both men and women with recurrent depression had significantly higher BMIs than men and women in the control group.
Although the percentages of the two groups were similar in the overweight range, a greater proportion of people with depression were in the obese range, and substantially fewer were in the normal range, compared with controls.
Thus, around a quarter of the men and women with depression were obese, which increases their susceptibility to physical health problems. In this study, obesity was associated with an increase in self-reported rates of hypercholesterolaemia, type II diabetes and heart attack.
High rates of obesity may be caused by some antidepressant medications, or arise because people who are depressed take less exercise and/or 'comfort' eat. However, it is also possible that genetic factors may be involved.
Evidence from previous research, and from this study, lends some support to the hypothesis that there are shared causal factors between recurrent depression, obesity and certain physical disorders.
One possible explanation for this is the effect that stress, and stress hormones, have on the brain and body. For instance, high levels of the stress hormone cortisol may link both obesity and gastric ulcers with depression.
The researchers comment that inflammatory processes that activate stress hormones may also link depression with asthma, hay fever, osteoarthritis and hypertension. These are speculations, however, and need confirmation from further studies.
Although long neglected, the physical health of people with schizophrenia is starting to be addressed, particularly in relation to the weight gain caused by antipsychotic drugs. This study suggests that attention needs to be paid to the physical health needs of people with depression.
"Medical disorders in people with recurrent depression."
Farmer A. et al (2008)
British Journal of Psychiatry, 192, 5, pages 351-355.
Click here to view Abstract online
The Royal College of Psychiatrists
The Royal College of Psychiatrists is the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland. We promote mental health by:
-- Setting standards and promoting excellence in mental health care
-- Improving understanding through research and education
-- Leading, representing, training and supporting psychiatrists
-- Working with patients, carers and their organisations
As well as running its membership examination (MRCPsych), and visiting and approving hospitals for training purposes, the College organises scientific and clinical conferences and lectures and continuing professional development activities. The College publishes books, reports and educational material for professionals and the general public. It also publishes the British Journal of Psychiatry, Psychiatric Bulletin and Advances in Psychiatric Treatment, all of which are now available on-line.
The Royal College of Psychiatrists has been in existence in some form since 1841. First as the "Association of Medical Officers of Asylums and Hospitals for the Insane" (later changed to the Medico Psychological Association) then, in 1926 receiving its Royal Charter to become the "Royal Medico Psychological Association, and finally, in 1971 receiving a Supplemental Charter to become the "Royal College of Psychiatrists" we know today.
rcpsych.ac.uk
Published in the May 2008 issue of the British Journal of Psychiatry, the study compared 1546 people with recurrent depression with 884 psychiatrically healthy controls in terms of past treatment for 16 different physical disorders.
Since many medical disorders are related to obesity, the researchers also examined body mass index (BMI) in both groups.
It was found that 15 physical disorders were significantly more frequent in people with recurrent depression than in controls. However, when BMI, age and gender were taken into account, depression was found to predict 6 disorders - gastric ulcer, asthma, rhinitis, hypertension, thyroid disease and osteoarthritis.
For the remaining physical health problems - diabetes, epilepsy, hypercholesterolaemia (high blood fats), kidney disease, liver disease, heart attack, osteoporosis, rheumatoid arthritis and stroke - the difference between those with and without each disorder could be accounted for by BMI, age or gender.
Both men and women with recurrent depression had significantly higher BMIs than men and women in the control group.
Although the percentages of the two groups were similar in the overweight range, a greater proportion of people with depression were in the obese range, and substantially fewer were in the normal range, compared with controls.
Thus, around a quarter of the men and women with depression were obese, which increases their susceptibility to physical health problems. In this study, obesity was associated with an increase in self-reported rates of hypercholesterolaemia, type II diabetes and heart attack.
High rates of obesity may be caused by some antidepressant medications, or arise because people who are depressed take less exercise and/or 'comfort' eat. However, it is also possible that genetic factors may be involved.
Evidence from previous research, and from this study, lends some support to the hypothesis that there are shared causal factors between recurrent depression, obesity and certain physical disorders.
One possible explanation for this is the effect that stress, and stress hormones, have on the brain and body. For instance, high levels of the stress hormone cortisol may link both obesity and gastric ulcers with depression.
The researchers comment that inflammatory processes that activate stress hormones may also link depression with asthma, hay fever, osteoarthritis and hypertension. These are speculations, however, and need confirmation from further studies.
Although long neglected, the physical health of people with schizophrenia is starting to be addressed, particularly in relation to the weight gain caused by antipsychotic drugs. This study suggests that attention needs to be paid to the physical health needs of people with depression.
"Medical disorders in people with recurrent depression."
Farmer A. et al (2008)
British Journal of Psychiatry, 192, 5, pages 351-355.
Click here to view Abstract online
The Royal College of Psychiatrists
The Royal College of Psychiatrists is the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland. We promote mental health by:
-- Setting standards and promoting excellence in mental health care
-- Improving understanding through research and education
-- Leading, representing, training and supporting psychiatrists
-- Working with patients, carers and their organisations
As well as running its membership examination (MRCPsych), and visiting and approving hospitals for training purposes, the College organises scientific and clinical conferences and lectures and continuing professional development activities. The College publishes books, reports and educational material for professionals and the general public. It also publishes the British Journal of Psychiatry, Psychiatric Bulletin and Advances in Psychiatric Treatment, all of which are now available on-line.
The Royal College of Psychiatrists has been in existence in some form since 1841. First as the "Association of Medical Officers of Asylums and Hospitals for the Insane" (later changed to the Medico Psychological Association) then, in 1926 receiving its Royal Charter to become the "Royal Medico Psychological Association, and finally, in 1971 receiving a Supplemental Charter to become the "Royal College of Psychiatrists" we know today.
rcpsych.ac.uk
пятница, 19 августа 2011 г.
New Study From University Of Leicester On Breast Feeding & Post Natal Depression, UK
The commonly held belief that mothers suffering from post natal depression will not be able to breastfeed has been challenged by research from the University of Leicester, which also suggests that the manner in which current breastfeeding promotion strategies are communicated may contribute to feelings of guilt and fears of inadequacy by mothers suffering from depression.
These results arise from research carried out by Ellen Homewood, Alison Tweed and Jon Crossley of the Department of Clinical Psychology at the University, and Michelle Cree of the Derbyshire Mental Health Services NHS Trust.
They found that mothers with post natal depression felt occluded in their attempts to meet their infants' demands for sustenance and nurturance. These feelings seemed to be triggered by experiences of feeding, as it represented a central aspect of the women's interaction with their infants.
In some cases, breastfeeding contributed to depression by increasing women's sense of being trapped by the dependency of their babies at the expense of their own well-being, and intensifying their feelings of responsibility for keeping their babies alive.
The authors concluded that the self-confidence of mothers with post natal depression could suffer as a result of perceived pressure to breastfeed, by prompting them to judge themselves as mothers on the basis of how successful their breast-feeding experiences were.
The research suggests that depressed mothers may well need individual, psychologically-based breastfeeding support to understand and manage their feelings of ambivalence in motherhood.
The findings on breastfeeding were not all negative, however, and for some mothers who had been diagnosed with postnatal depression, breastfeeding reassured them of their ability to satisfy, nurture and connect with their infants. Breastfeeding enabled them to feel more confident as mothers because they were fulfilling a maternal role that they valued, and consequently, this enhanced their ability to create more positive relationships with their babies.
Clinical Psychologist Ellen Homewood commented: "The findings of our study into breastfeeding experiences in women with postnatal depression highlight the effects of women's expectations about motherhood and breastfeeding on their behaviour and emotional experiences, and warn against the assumption that depressed mothers will not be able to breastfeed. The results also point to the need for further research into the potential benefits of breastfeeding for depressed mothers."
University Of Leicester
- A member of the 1994 Group of universities that share a commitment to research excellence, high quality teaching and an outstanding student experience.
-- Ranked joint top for two consecutive years for the quality of teaching and overall satisfaction amongst full-time students at English universities
-- Ranked as a Top 20 university by The Times Good University Guide and The Guardian University League Table
-- One of just 19 UK universities to feature in world's top 200- Shanghai Jiao Tong International Index, 2005 and 2006.
-- Short listed Higher Education Institution of the Year - THES awards 2005 and 2006
-- Students' Union of the Year award 2005, short listed 2006
Founded in 1921, the University of Leicester has 19,000 students from 136 countries. Teaching in 18 subject areas has been graded Excellent by the Quality Assurance Agency- including 14 successive scores - a consistent run of success matched by just one other UK University. Leicester is world renowned for the invention of DNA Fingerprinting by Professor Sir Alec Jeffreys and houses Europe's biggest academic Space Research Centre. 90% of staff are actively engaged in high quality research and 13 subject areas have been awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level. The University's research grant income places it among the top 20 UK research universities. The University employs over 3,000 people, has an annual turnover of ??173m, covers an estate of 94 hectares and is engaged in a ??300m investment programme- among the biggest of any UK university.
le.ac.uk
These results arise from research carried out by Ellen Homewood, Alison Tweed and Jon Crossley of the Department of Clinical Psychology at the University, and Michelle Cree of the Derbyshire Mental Health Services NHS Trust.
They found that mothers with post natal depression felt occluded in their attempts to meet their infants' demands for sustenance and nurturance. These feelings seemed to be triggered by experiences of feeding, as it represented a central aspect of the women's interaction with their infants.
In some cases, breastfeeding contributed to depression by increasing women's sense of being trapped by the dependency of their babies at the expense of their own well-being, and intensifying their feelings of responsibility for keeping their babies alive.
The authors concluded that the self-confidence of mothers with post natal depression could suffer as a result of perceived pressure to breastfeed, by prompting them to judge themselves as mothers on the basis of how successful their breast-feeding experiences were.
The research suggests that depressed mothers may well need individual, psychologically-based breastfeeding support to understand and manage their feelings of ambivalence in motherhood.
The findings on breastfeeding were not all negative, however, and for some mothers who had been diagnosed with postnatal depression, breastfeeding reassured them of their ability to satisfy, nurture and connect with their infants. Breastfeeding enabled them to feel more confident as mothers because they were fulfilling a maternal role that they valued, and consequently, this enhanced their ability to create more positive relationships with their babies.
Clinical Psychologist Ellen Homewood commented: "The findings of our study into breastfeeding experiences in women with postnatal depression highlight the effects of women's expectations about motherhood and breastfeeding on their behaviour and emotional experiences, and warn against the assumption that depressed mothers will not be able to breastfeed. The results also point to the need for further research into the potential benefits of breastfeeding for depressed mothers."
University Of Leicester
- A member of the 1994 Group of universities that share a commitment to research excellence, high quality teaching and an outstanding student experience.
-- Ranked joint top for two consecutive years for the quality of teaching and overall satisfaction amongst full-time students at English universities
-- Ranked as a Top 20 university by The Times Good University Guide and The Guardian University League Table
-- One of just 19 UK universities to feature in world's top 200- Shanghai Jiao Tong International Index, 2005 and 2006.
-- Short listed Higher Education Institution of the Year - THES awards 2005 and 2006
-- Students' Union of the Year award 2005, short listed 2006
Founded in 1921, the University of Leicester has 19,000 students from 136 countries. Teaching in 18 subject areas has been graded Excellent by the Quality Assurance Agency- including 14 successive scores - a consistent run of success matched by just one other UK University. Leicester is world renowned for the invention of DNA Fingerprinting by Professor Sir Alec Jeffreys and houses Europe's biggest academic Space Research Centre. 90% of staff are actively engaged in high quality research and 13 subject areas have been awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level. The University's research grant income places it among the top 20 UK research universities. The University employs over 3,000 people, has an annual turnover of ??173m, covers an estate of 94 hectares and is engaged in a ??300m investment programme- among the biggest of any UK university.
le.ac.uk
вторник, 16 августа 2011 г.
Study Finds Primary Care Depression Treatment Often Does Not Follow Quality Guidelines
Most patients with depression who are treated by primary care physicians do not receive care consistent with quality standards, according to a new RAND Corporation study.
Physicians had high rates of adherence to just one third of the 20 measures of quality that researchers examined and had low rates of adherence to nearly half of the treatment recommendations studied, according to the report in the September 4 edition of the Annals of Internal Medicine.
"These findings are important for patients since most cases of depression are diagnosed and treated in primary care settings," said senior author Dr. Lisa V. Rubenstein, the study's senior author, and a senior scientist at RAND, a nonprofit research organization, and a physician at the Veterans Affairs Greater Los Angeles Healthcare System. "This shows that additional efforts are needed to improve the treatment of depression."
The study also found that patients who received better-quality care reported fewer symptoms of depression up to two years after the start of treatment. The findings are among the first linking quality guidelines for depression treatment with improved patient outcomes in community settings.
"These are initial findings, but they suggest that programs that encourage doctors to follow treatment guidelines can help improve the long-term outlook for people with depression," said Rubenstein, who also is affiliated with the David Geffen School of Medicine at UCLA.
Previous studies have shown that primary care providers do a poor job following guidelines for antidepressant use or psychotherapy. The RAND study is one of the first to assess primary care providers' adherence to a comprehensive set of treatment guidelines for depression.
Researchers from RAND Health examined the experiences of health care providers and patients who took part from 1996 to 1998 in the Quality Improvement for Depression collaboration, which was designed to encourage primary care providers to adopt comprehensive depression treatment guidelines developed by the U.S. Agency for Healthcare Research and Quality.
The RAND study examined the experiences of 1,131 patients with depression who were treated in 45 primary care practices across 13 states. Study sites ranged from small private practices to large managed care organizations. About 10 percent of patients in the study were from Veterans Affairs practices.
Researchers examined whether physicians and other health providers followed 20 different measures of quality, as well as analyzing patients' reports about the status of their depression at 12, 18 and 24 months after starting treatment.
The study found that most primary care physicians did a good job of diagnosing and beginning treatment for depression, with guidelines aimed at these issues followed more than 70 percent of the time. These guidelines includes items such as talking to patients about depression and closely monitoring patients newly placed on antidepressant medication.
But researchers found that primary care clinicians did less well following up with treatment over time. Fewer than half of the patients in the study completed the minimal course of treatment for either antidepressant drugs or psychotherapy, and only slightly more than half the depressed patients who were not treated were monitored closely.
The lowest quality of care occurred among the patients who exhibited the most serious symptoms, including patients who showed evidence of suicide or substance abuse. For example, among patients who had a previous suicide attempt, just 35 percent were referred to a mental health specialist over the next six months
"Primary care physicians were good at diagnosing depression, but they did not do as good a good job of managing the sickest patients," Rubenstein said. "Right now, primary care physicians don't have the tools necessary to decide which patients to treat and which to refer on to specialized mental health care."
Receiving higher quality care did not appear to significantly impact the long-term functioning of less-sick patients, according to the study. But sicker patients who received better quality care were significantly less likely to report continuing symptoms of depression on surveys taken up to two years after their treatment began.
"For the people who were sicker, there was a closer relationship between quality and their symptoms over the long term," Rubenstein said. "This is among the first evidence that following treatment guidelines can help patients over the long term."
Other authors of the report are Kimberly A. Hepner, Melissa Rowe, Scot C. Hickey, Cathy D. Sherbourne and Lisa S. Meredith of RAND, Kathryn Rost of Florida State University, Dr. Daniel E. Ford of Johns Hopkins School of Medicine.
The research was supported by the National Institute of Mental Health, the Agency for Healthcare Research and Quality, the John D. and Catherine T. MacArthur Foundation and the Veterans Affairs Health Services Research and Development Service Center of Excellence for the Study of Healthcare Provider Behavior.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care quality, costs and delivery, among other topics.
Contact: Warren Robak
RAND Corporation
Physicians had high rates of adherence to just one third of the 20 measures of quality that researchers examined and had low rates of adherence to nearly half of the treatment recommendations studied, according to the report in the September 4 edition of the Annals of Internal Medicine.
"These findings are important for patients since most cases of depression are diagnosed and treated in primary care settings," said senior author Dr. Lisa V. Rubenstein, the study's senior author, and a senior scientist at RAND, a nonprofit research organization, and a physician at the Veterans Affairs Greater Los Angeles Healthcare System. "This shows that additional efforts are needed to improve the treatment of depression."
The study also found that patients who received better-quality care reported fewer symptoms of depression up to two years after the start of treatment. The findings are among the first linking quality guidelines for depression treatment with improved patient outcomes in community settings.
"These are initial findings, but they suggest that programs that encourage doctors to follow treatment guidelines can help improve the long-term outlook for people with depression," said Rubenstein, who also is affiliated with the David Geffen School of Medicine at UCLA.
Previous studies have shown that primary care providers do a poor job following guidelines for antidepressant use or psychotherapy. The RAND study is one of the first to assess primary care providers' adherence to a comprehensive set of treatment guidelines for depression.
Researchers from RAND Health examined the experiences of health care providers and patients who took part from 1996 to 1998 in the Quality Improvement for Depression collaboration, which was designed to encourage primary care providers to adopt comprehensive depression treatment guidelines developed by the U.S. Agency for Healthcare Research and Quality.
The RAND study examined the experiences of 1,131 patients with depression who were treated in 45 primary care practices across 13 states. Study sites ranged from small private practices to large managed care organizations. About 10 percent of patients in the study were from Veterans Affairs practices.
Researchers examined whether physicians and other health providers followed 20 different measures of quality, as well as analyzing patients' reports about the status of their depression at 12, 18 and 24 months after starting treatment.
The study found that most primary care physicians did a good job of diagnosing and beginning treatment for depression, with guidelines aimed at these issues followed more than 70 percent of the time. These guidelines includes items such as talking to patients about depression and closely monitoring patients newly placed on antidepressant medication.
But researchers found that primary care clinicians did less well following up with treatment over time. Fewer than half of the patients in the study completed the minimal course of treatment for either antidepressant drugs or psychotherapy, and only slightly more than half the depressed patients who were not treated were monitored closely.
The lowest quality of care occurred among the patients who exhibited the most serious symptoms, including patients who showed evidence of suicide or substance abuse. For example, among patients who had a previous suicide attempt, just 35 percent were referred to a mental health specialist over the next six months
"Primary care physicians were good at diagnosing depression, but they did not do as good a good job of managing the sickest patients," Rubenstein said. "Right now, primary care physicians don't have the tools necessary to decide which patients to treat and which to refer on to specialized mental health care."
Receiving higher quality care did not appear to significantly impact the long-term functioning of less-sick patients, according to the study. But sicker patients who received better quality care were significantly less likely to report continuing symptoms of depression on surveys taken up to two years after their treatment began.
"For the people who were sicker, there was a closer relationship between quality and their symptoms over the long term," Rubenstein said. "This is among the first evidence that following treatment guidelines can help patients over the long term."
Other authors of the report are Kimberly A. Hepner, Melissa Rowe, Scot C. Hickey, Cathy D. Sherbourne and Lisa S. Meredith of RAND, Kathryn Rost of Florida State University, Dr. Daniel E. Ford of Johns Hopkins School of Medicine.
The research was supported by the National Institute of Mental Health, the Agency for Healthcare Research and Quality, the John D. and Catherine T. MacArthur Foundation and the Veterans Affairs Health Services Research and Development Service Center of Excellence for the Study of Healthcare Provider Behavior.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care quality, costs and delivery, among other topics.
Contact: Warren Robak
RAND Corporation
суббота, 13 августа 2011 г.
Unintended Racism, Depression And Problem Gambling In Elderly Stem From Brain Atrophy
As we age, our brains slowly shrink in volume and weight. This includes significant atrophy within the frontal lobes, the seat of executive functioning. Executive functions include planning, controlling, and inhibiting thought and behavior. In the aging population, an inability to inhibit unwanted thoughts and behavior causes several social behaviors and cognitions to go awry.
In a study appearing in the October issue of Current Directions in Psychological Science, University of Queensland psychologist, Bill von Hippel, reports that decreased inhibitory ability in late adulthood can lead to unintended prejudice, social inappropriateness, depression, and gambling problems.
Regarding prejudice, von Hippel and colleagues found that older white adults showed greater stereotyping toward African Americans than younger white adults did, despite being more motivated to control their prejudices. Von Hippel suggests that "because prejudice toward African Americans conflicts with prevailing egalitarian beliefs, older adults attempt to inhibit their racist feelings, but fail."
Age-related inhibitory losses have also been implicated in social appropriateness. Von Hippel found that older adults were more likely than younger adults were to inquire about private issues (e.g. weight gain, family problems) in public settings. Furthermore, these age differences emerged even though older and younger adults both agreed that it is inappropriate to inquire about such issues in public settings. The older adults seemed to know the social rules but failed to follow them, which is consistent with diminished frontal lobe functioning.
In late-onset depressed older adults, poor inhibition predicted increased rumination, which in turn predicted increased depression. This finding suggests that people who struggle to control their rumination begin to lose that battle as they age, with the end result being the emergence of depression late in life.
Von Hippel also found that a penchant for gambling can be toxic for older adults, as those with poor executive functioning are particularly likely to have gambling problems. Interestingly, these problems are exacerbated in the afternoon, when older adults are less mentally alert. Older adults were more likely to get into an unnecessary argument and were also more likely to gamble all their money away later rather than earlier in the day. These findings suggest a possible avenue for intervention, by scheduling their important social activities or gambling excursions earlier in the day.
While social changes commonly occur with age, they are widely assumed a function of changes in preferences and values as people get older. Von Hippel argues that there may be more to the story and that some of the changes may be unintended and brought about by losses in executive control.
Author Contact: Bill von Hippel
Current Directions in Psychological Science publishes concise reviews on the latest advances in theory and research spanning all of scientific psychology and its applications.
In a study appearing in the October issue of Current Directions in Psychological Science, University of Queensland psychologist, Bill von Hippel, reports that decreased inhibitory ability in late adulthood can lead to unintended prejudice, social inappropriateness, depression, and gambling problems.
Regarding prejudice, von Hippel and colleagues found that older white adults showed greater stereotyping toward African Americans than younger white adults did, despite being more motivated to control their prejudices. Von Hippel suggests that "because prejudice toward African Americans conflicts with prevailing egalitarian beliefs, older adults attempt to inhibit their racist feelings, but fail."
Age-related inhibitory losses have also been implicated in social appropriateness. Von Hippel found that older adults were more likely than younger adults were to inquire about private issues (e.g. weight gain, family problems) in public settings. Furthermore, these age differences emerged even though older and younger adults both agreed that it is inappropriate to inquire about such issues in public settings. The older adults seemed to know the social rules but failed to follow them, which is consistent with diminished frontal lobe functioning.
In late-onset depressed older adults, poor inhibition predicted increased rumination, which in turn predicted increased depression. This finding suggests that people who struggle to control their rumination begin to lose that battle as they age, with the end result being the emergence of depression late in life.
Von Hippel also found that a penchant for gambling can be toxic for older adults, as those with poor executive functioning are particularly likely to have gambling problems. Interestingly, these problems are exacerbated in the afternoon, when older adults are less mentally alert. Older adults were more likely to get into an unnecessary argument and were also more likely to gamble all their money away later rather than earlier in the day. These findings suggest a possible avenue for intervention, by scheduling their important social activities or gambling excursions earlier in the day.
While social changes commonly occur with age, they are widely assumed a function of changes in preferences and values as people get older. Von Hippel argues that there may be more to the story and that some of the changes may be unintended and brought about by losses in executive control.
Author Contact: Bill von Hippel
Current Directions in Psychological Science publishes concise reviews on the latest advances in theory and research spanning all of scientific psychology and its applications.
среда, 10 августа 2011 г.
Connection Between A Mother's Mood And Her Baby's Sleep
If there's one thing that everyone knows about newborn babies, it's that they don't sleep through the night, and neither do their parents. But in fact, those first six months of life are crucial to developing the regular sleeping and waking patterns, known as circadian rhythms, that a child will need for a healthy future.
Some children may start life with the sleep odds stacked against them, though, say University of Michigan sleep experts who study the issue. They will present data from their study next week at the European Sleep Research Society meeting in Glasgow, Scotland.
Babies whose mothers experienced depression any time before they became pregnant, or developed mood problems while they were pregnant, are much more prone to having chaotic sleep patterns in the first half-year of life than babies born to non-depressed moms, the team has found.
For instance, infants born to depressed mothers nap more during the day, take much longer to settle down to sleep at night, and wake up more often during the night. It's a baby form of the insomnia that millions of adults know all too well.
Not only does this add to parents' sleepless nights, but it may help set these children up for their own depression later in life.
But this doesn't mean that babies born to depressed mothers are doomed to follow in their mothers' shoes, even though depression does tend to run in families, says Roseanne Armitage, Ph.D., the leader of the U-M Sleep & Chronophysiology Laboratory team at the U-M Depression Center.
Nor does it mean that parents who haven't suffered depression can ignore the importance of their babies' sleep.
Rather, it means that all parents -especially ones with a history of depression - must pay close attention to the conditions they create for their infant's sleep, from birth.
"Keeping a very regular sleep schedule is incredibly important," says Armitage. "We know that for both children and adults, and from this study we now know that for infants, the more stable the bedtime the less chaotic sleep is during the night."
Armitage and her team have devoted years to studying the links between sleep and depression, and the circadian rhythms, light-dark exposure, and other factors that appear to make a difference in sleep and mood. Over the past decade, they've shown that all are strongly linked.
Recently, their research in depressed adults, teenagers and pre-teens led them to wonder if the links were as strong among babies. Infants need a lot more sleep than grownups, but tend to get it in shorter chunks of time throughout the day and night, at least for the first months of life.
The research that Armitage and her colleagues will present next week, and also this fall at the American Academy of Child & Adolescent Psychiatry annual meeting, is based on sleep studies involving two groups of new mothers and their babies. It's funded by the Cohen Sleep Research Fund and the Drs. Jack and Barbara Berman Depression Research Fund at the U-M Depression Center.
One group was made up of mothers who sought help for depression during pregnancy from the U-M Depression Center's Women's Mood Disorders Program. The other group was mothers who had no past or current depression. Each group agreed to wear wristwatch-like devices called actigraphs, which measure sleep time at night, light exposure and daytime activity/rest patterns.
The mothers began wearing the devices during the last trimester of pregnancy, and then after their babies were born the team fitted each child with a tiny actigraph at the age of two weeks. Then, the team downloaded the information from the devices every month until the babies were eight months old.
So far, the analysis of the data they collected show that babies born to depressed mothers had little or no evidence of an in-born 24-hour circadian rhythm soon after they were born - unlike the babies born to women who weren't depressed. This irregular pattern continued until the study ended in the babies' eighth month.
"We think we've identified one of the risk factors that may contribute to these infants' going on to develop depression later in life," says Armitage. "Not everybody who has poor sleep or weak circadian rhythms will develop depression, but if sleep stays consistently disrupted and circadian rhythms are weak, the risk is significantly elevated."
That's why, she says, it's so crucial to help all babies - and new parents - get the sleep they need.
Those first few months, in fact, are a kind of training camp for the baby's sleep in the future, Armitage says. Babies' bodies and brains need to be trained to understand that they should sleep when it's dark, and be awake when it's light - the basic circadian rhythm that governs sleep patterns for a person's entire life. This sets the baby's "body clock" right from the start.
Of course, infants and toddlers need to nap during the daytime to get all the sleep they need -11 to 18 hours for newborns in the first two months, 11 to 15 hours for the next ten months, and 12 to 14 hours from ages 1 to 3 years. And, newborns wake up in the night when they need food.
"But going to bed at the same time, getting up at the same time, establishing rituals around the bedtime helps infants begin to distinguish between night sleep and day sleep," says Armitage. "Put the baby in day clothes for naps, and in night clothes for night sleep - babies pick up these cues."
Parents can also make sure that babies are regularly around bright light during the day, which helps the body develop circadian rhythms linked to light cycles. Of course, the bright light shouldn't shine directly in babies' eyes, and they should be shielded from direct sunlight or wear sunscreen outside.
By four months of age, a baby's sleep schedule should have become regular, more focused on nighttime sleep, and their blocks of sleep more "consolidated" or longer - especially at night.
The main thing, she says, is to make sure babies and small children get enough sleep on an increasingly regular schedule - and that their moms do too.
The period immediately after giving birth is a high-risk time for depression, even in women who have never had depression before. Those who have had depression, or have relatives who have suffered depression, are most at risk. This "postpartum depression" as it is called can be worsened by lack of sleep - or perhaps even partly triggered by it.
"Chronic sleep deprivation is associated with an elevated risk for depression in everybody, at all stages of life, but in new moms, because of the hormonal changes and the need to recover from the pregnancy and birth, sleep deprivation can really be a problem," says Armitage, a professor of psychiatry at the U-M Medical School. "It can interfere with the social rhythms that are important for keeping the circadian clock in the brain in sync, it can minimize the amount of energy moms have to care for their infants, and it can contribute to the development of depression."
Find out more on the World Wide Web at:
Sleep and Chronophysiology Laboratory, University of Michigan Depression Center: depressioncenter/sleeplab/
U-M Health System: Sleep Patterns in Babies
med.umich/1libr/pa/pa_sleepbab_hhg.htm
Some children may start life with the sleep odds stacked against them, though, say University of Michigan sleep experts who study the issue. They will present data from their study next week at the European Sleep Research Society meeting in Glasgow, Scotland.
Babies whose mothers experienced depression any time before they became pregnant, or developed mood problems while they were pregnant, are much more prone to having chaotic sleep patterns in the first half-year of life than babies born to non-depressed moms, the team has found.
For instance, infants born to depressed mothers nap more during the day, take much longer to settle down to sleep at night, and wake up more often during the night. It's a baby form of the insomnia that millions of adults know all too well.
Not only does this add to parents' sleepless nights, but it may help set these children up for their own depression later in life.
But this doesn't mean that babies born to depressed mothers are doomed to follow in their mothers' shoes, even though depression does tend to run in families, says Roseanne Armitage, Ph.D., the leader of the U-M Sleep & Chronophysiology Laboratory team at the U-M Depression Center.
Nor does it mean that parents who haven't suffered depression can ignore the importance of their babies' sleep.
Rather, it means that all parents -especially ones with a history of depression - must pay close attention to the conditions they create for their infant's sleep, from birth.
"Keeping a very regular sleep schedule is incredibly important," says Armitage. "We know that for both children and adults, and from this study we now know that for infants, the more stable the bedtime the less chaotic sleep is during the night."
Armitage and her team have devoted years to studying the links between sleep and depression, and the circadian rhythms, light-dark exposure, and other factors that appear to make a difference in sleep and mood. Over the past decade, they've shown that all are strongly linked.
Recently, their research in depressed adults, teenagers and pre-teens led them to wonder if the links were as strong among babies. Infants need a lot more sleep than grownups, but tend to get it in shorter chunks of time throughout the day and night, at least for the first months of life.
The research that Armitage and her colleagues will present next week, and also this fall at the American Academy of Child & Adolescent Psychiatry annual meeting, is based on sleep studies involving two groups of new mothers and their babies. It's funded by the Cohen Sleep Research Fund and the Drs. Jack and Barbara Berman Depression Research Fund at the U-M Depression Center.
One group was made up of mothers who sought help for depression during pregnancy from the U-M Depression Center's Women's Mood Disorders Program. The other group was mothers who had no past or current depression. Each group agreed to wear wristwatch-like devices called actigraphs, which measure sleep time at night, light exposure and daytime activity/rest patterns.
The mothers began wearing the devices during the last trimester of pregnancy, and then after their babies were born the team fitted each child with a tiny actigraph at the age of two weeks. Then, the team downloaded the information from the devices every month until the babies were eight months old.
So far, the analysis of the data they collected show that babies born to depressed mothers had little or no evidence of an in-born 24-hour circadian rhythm soon after they were born - unlike the babies born to women who weren't depressed. This irregular pattern continued until the study ended in the babies' eighth month.
"We think we've identified one of the risk factors that may contribute to these infants' going on to develop depression later in life," says Armitage. "Not everybody who has poor sleep or weak circadian rhythms will develop depression, but if sleep stays consistently disrupted and circadian rhythms are weak, the risk is significantly elevated."
That's why, she says, it's so crucial to help all babies - and new parents - get the sleep they need.
Those first few months, in fact, are a kind of training camp for the baby's sleep in the future, Armitage says. Babies' bodies and brains need to be trained to understand that they should sleep when it's dark, and be awake when it's light - the basic circadian rhythm that governs sleep patterns for a person's entire life. This sets the baby's "body clock" right from the start.
Of course, infants and toddlers need to nap during the daytime to get all the sleep they need -11 to 18 hours for newborns in the first two months, 11 to 15 hours for the next ten months, and 12 to 14 hours from ages 1 to 3 years. And, newborns wake up in the night when they need food.
"But going to bed at the same time, getting up at the same time, establishing rituals around the bedtime helps infants begin to distinguish between night sleep and day sleep," says Armitage. "Put the baby in day clothes for naps, and in night clothes for night sleep - babies pick up these cues."
Parents can also make sure that babies are regularly around bright light during the day, which helps the body develop circadian rhythms linked to light cycles. Of course, the bright light shouldn't shine directly in babies' eyes, and they should be shielded from direct sunlight or wear sunscreen outside.
By four months of age, a baby's sleep schedule should have become regular, more focused on nighttime sleep, and their blocks of sleep more "consolidated" or longer - especially at night.
The main thing, she says, is to make sure babies and small children get enough sleep on an increasingly regular schedule - and that their moms do too.
The period immediately after giving birth is a high-risk time for depression, even in women who have never had depression before. Those who have had depression, or have relatives who have suffered depression, are most at risk. This "postpartum depression" as it is called can be worsened by lack of sleep - or perhaps even partly triggered by it.
"Chronic sleep deprivation is associated with an elevated risk for depression in everybody, at all stages of life, but in new moms, because of the hormonal changes and the need to recover from the pregnancy and birth, sleep deprivation can really be a problem," says Armitage, a professor of psychiatry at the U-M Medical School. "It can interfere with the social rhythms that are important for keeping the circadian clock in the brain in sync, it can minimize the amount of energy moms have to care for their infants, and it can contribute to the development of depression."
Find out more on the World Wide Web at:
Sleep and Chronophysiology Laboratory, University of Michigan Depression Center: depressioncenter/sleeplab/
U-M Health System: Sleep Patterns in Babies
med.umich/1libr/pa/pa_sleepbab_hhg.htm
воскресенье, 7 августа 2011 г.
Adolescents From Certain Races Participating In Religion May Become More Depressed
One of the few studies to look at the effects of religious participation on the mental health of minorities suggests that for some of them, religion may actually be contributing to adolescent depression.
Previous research has shown that teens who are active in religious services are depressed less often because it provides these adolescents with social support and a sense of belonging.
But new research has found that this does not hold true for all adolescents, particularly for minorities and some females. The study found that white and African-American adolescents generally had fewer symptoms of depressive at high levels of religious participation. But for some Latino and Asian-American adolescents, attending church more often was actually affecting their mood in a negative way.
Asian-American adolescents who reported high levels of participation in their church had the highest number of depressive symptoms among teens of their race.
Likewise, Latino adolescents who were highly active in their church were more depressed than their peers who went to church less often. Females of all races and ethnic groups were also more likely to have symptoms of depression than males overall.
Setting all other factors aside, the results suggest that participating in religion at high levels may be detrimental to some teens because of the tensions they face in balancing the conflicting ideals and customs of their religion with those of mainstream culture, said Richard Petts, co-author of the study, who did the work as a doctoral student in sociology at Ohio State University.
"Most research has shown that religious participation, for the most part, is good and can be very helpful for battling depression. But our research has shown that this relationship does not hold true in all instances," he said.
While the study shows that females and males from certain groups may be more inclined to become depressed, involvement in religious services still had an overall positive affect for many youth in the study. The results do provide important insight into the impact of religious participation on teenage depression, but race and gender may only be part of the reason certain youth were more depressed, Petts said.
"The study shows that we need to consider the broader social aspects of institutions such as religion on an individual's well being, both good and bad. We focus specifically on race and gender, but these are not the only two factors that may be contributing to higher and lower depression among youth," he said.
Petts, who is now an assistant professor of sociology at Ball State University, conducted the study with Anne Jolliff when they were both doctoral students at Ohio State. Jolliff is now a research coordinator at Indiana University-Purdue University Indianapolis. The pair based the study on data from the National Longitudinal Study of Adolescent Health, a study surveying middle and high school students throughout the United States.
Adolescents in grades 7 through 12 were initially interviewed in school and a random number of students were again interviewed at home. Students were asked to identify the positive and negative feelings they had experienced in the preceding week such as depression, loneliness, isolation, happiness, or excitement. They were also asked about their behavior in the last year and asked to identify their race, religious preference, and how often they attended services during the same period of time.
Adolescents were then interviewed a second time one year later at home about the same topics. Parents of these adolescents were also asked about their child's moods and behaviors. Only the 12,155 adolescents who participated in both parts of the study and had information from their parents were included in this study.
The results were recently published in the journal Review of Religious Research.
Among adolescents who never attended church, Asian-American adolescents reported 4 percent fewer symptoms of depression in the preceding week than did their African-American peers.
In comparison, Asian-American youth who attended church at least once a week reported 20 to 27 percent more symptoms of depression than their white and African-American peers who attended at the same level.
Latino adolescents fared about the same as Asian Americans, reporting 6 to 14 percent higher rates of depression symptoms than did African-American and white teens when attending church at least once a week.
The results showed that in stark contrast to the findings for white and African-American adolescents, Asian-American adolescents who never attended services and Latinos attending at intermediate levels were the least likely to be depressed within their groups.
The results suggest that something unique was affecting adolescents within these two groups when they went to church often. Petts believes that the traditional nature of religion for these two groups may be conflicting with the ideals and customs of mainstream American society. This conflict may be putting additional stress on these youth as they try to balance competing principles and traditions, he said.
"Asian and Latino youth who are highly involved in a culturally distinct church may have a more difficult time balancing the beliefs of their family and their traditional culture with mainstream society. Their religious institution is telling them what should be important in their lives and how to behave, and mainstream society is saying something else," he said.
At higher levels of participation, Asian-American and Latino adolescents had a harder time juggling which set of ideals to adopt because they were more involved and committed to their religion.
Meanwhile, Asian-American adolescents who had lower levels of involvement in church were able to focus more on life without worrying about conflicting ideals, resulting in lower depression. At lower levels of involvement, adolescents still gained the social support of their religious community while also feeling in touch with mainstream society, Petts said.
The results also showed that the problem for Latino adolescents may be two-fold. At high levels of involvement in their religious community, Latino teens experienced the same tension between culture and society as some Asian-American teens. This led to higher reports of depression symptoms among these youth.
But Latino teens who never attended church reported high levels of depression as well, reporting 26 to 28 percent higher rate of depression symptoms than did white and African-American American youth. Religion is often an important part of social support for these adolescents and no involvement in their religion may leave these teens without a sense of connection to their community and culture, he said.
"Participating to a certain extent may enable these youth to balance their lives better. They have a connection with a religious community and all the benefits it offers, but they are not so immersed that they're out of touch with mainstream society. So they're sort of getting the best of both worlds," Petts said.
The tension between society and religion may also help explain why females who were sexually active report higher levels of depression than do sexually active males. The disconnect between how their religion told them to act and what they chose to do may cause these females to have higher emotional distress and increased depression, he said.
In addition, Latina females who participated heavily in their religion were more likely to become depressed then Latino males. Not only were these young women more at risk for feeling depressed than were their male counterparts, but they were also more depressed then Latina females who attended church at intermittent levels.
"Females in these religious institutions often have subordinate status and if females feel that they don't have equal say in that religious institution, that may contribute to higher levels of depression," Petts said.
This may also explain why attending church at intermediate levels resulted in lower depression for these females. Latina females who attend at moderate levels may benefit from the social support of the religious community, while avoiding the patriarchal tensions experienced by those who attend services weekly.
Written by Jenna McGuire
Previous research has shown that teens who are active in religious services are depressed less often because it provides these adolescents with social support and a sense of belonging.
But new research has found that this does not hold true for all adolescents, particularly for minorities and some females. The study found that white and African-American adolescents generally had fewer symptoms of depressive at high levels of religious participation. But for some Latino and Asian-American adolescents, attending church more often was actually affecting their mood in a negative way.
Asian-American adolescents who reported high levels of participation in their church had the highest number of depressive symptoms among teens of their race.
Likewise, Latino adolescents who were highly active in their church were more depressed than their peers who went to church less often. Females of all races and ethnic groups were also more likely to have symptoms of depression than males overall.
Setting all other factors aside, the results suggest that participating in religion at high levels may be detrimental to some teens because of the tensions they face in balancing the conflicting ideals and customs of their religion with those of mainstream culture, said Richard Petts, co-author of the study, who did the work as a doctoral student in sociology at Ohio State University.
"Most research has shown that religious participation, for the most part, is good and can be very helpful for battling depression. But our research has shown that this relationship does not hold true in all instances," he said.
While the study shows that females and males from certain groups may be more inclined to become depressed, involvement in religious services still had an overall positive affect for many youth in the study. The results do provide important insight into the impact of religious participation on teenage depression, but race and gender may only be part of the reason certain youth were more depressed, Petts said.
"The study shows that we need to consider the broader social aspects of institutions such as religion on an individual's well being, both good and bad. We focus specifically on race and gender, but these are not the only two factors that may be contributing to higher and lower depression among youth," he said.
Petts, who is now an assistant professor of sociology at Ball State University, conducted the study with Anne Jolliff when they were both doctoral students at Ohio State. Jolliff is now a research coordinator at Indiana University-Purdue University Indianapolis. The pair based the study on data from the National Longitudinal Study of Adolescent Health, a study surveying middle and high school students throughout the United States.
Adolescents in grades 7 through 12 were initially interviewed in school and a random number of students were again interviewed at home. Students were asked to identify the positive and negative feelings they had experienced in the preceding week such as depression, loneliness, isolation, happiness, or excitement. They were also asked about their behavior in the last year and asked to identify their race, religious preference, and how often they attended services during the same period of time.
Adolescents were then interviewed a second time one year later at home about the same topics. Parents of these adolescents were also asked about their child's moods and behaviors. Only the 12,155 adolescents who participated in both parts of the study and had information from their parents were included in this study.
The results were recently published in the journal Review of Religious Research.
Among adolescents who never attended church, Asian-American adolescents reported 4 percent fewer symptoms of depression in the preceding week than did their African-American peers.
In comparison, Asian-American youth who attended church at least once a week reported 20 to 27 percent more symptoms of depression than their white and African-American peers who attended at the same level.
Latino adolescents fared about the same as Asian Americans, reporting 6 to 14 percent higher rates of depression symptoms than did African-American and white teens when attending church at least once a week.
The results showed that in stark contrast to the findings for white and African-American adolescents, Asian-American adolescents who never attended services and Latinos attending at intermediate levels were the least likely to be depressed within their groups.
The results suggest that something unique was affecting adolescents within these two groups when they went to church often. Petts believes that the traditional nature of religion for these two groups may be conflicting with the ideals and customs of mainstream American society. This conflict may be putting additional stress on these youth as they try to balance competing principles and traditions, he said.
"Asian and Latino youth who are highly involved in a culturally distinct church may have a more difficult time balancing the beliefs of their family and their traditional culture with mainstream society. Their religious institution is telling them what should be important in their lives and how to behave, and mainstream society is saying something else," he said.
At higher levels of participation, Asian-American and Latino adolescents had a harder time juggling which set of ideals to adopt because they were more involved and committed to their religion.
Meanwhile, Asian-American adolescents who had lower levels of involvement in church were able to focus more on life without worrying about conflicting ideals, resulting in lower depression. At lower levels of involvement, adolescents still gained the social support of their religious community while also feeling in touch with mainstream society, Petts said.
The results also showed that the problem for Latino adolescents may be two-fold. At high levels of involvement in their religious community, Latino teens experienced the same tension between culture and society as some Asian-American teens. This led to higher reports of depression symptoms among these youth.
But Latino teens who never attended church reported high levels of depression as well, reporting 26 to 28 percent higher rate of depression symptoms than did white and African-American American youth. Religion is often an important part of social support for these adolescents and no involvement in their religion may leave these teens without a sense of connection to their community and culture, he said.
"Participating to a certain extent may enable these youth to balance their lives better. They have a connection with a religious community and all the benefits it offers, but they are not so immersed that they're out of touch with mainstream society. So they're sort of getting the best of both worlds," Petts said.
The tension between society and religion may also help explain why females who were sexually active report higher levels of depression than do sexually active males. The disconnect between how their religion told them to act and what they chose to do may cause these females to have higher emotional distress and increased depression, he said.
In addition, Latina females who participated heavily in their religion were more likely to become depressed then Latino males. Not only were these young women more at risk for feeling depressed than were their male counterparts, but they were also more depressed then Latina females who attended church at intermittent levels.
"Females in these religious institutions often have subordinate status and if females feel that they don't have equal say in that religious institution, that may contribute to higher levels of depression," Petts said.
This may also explain why attending church at intermediate levels resulted in lower depression for these females. Latina females who attend at moderate levels may benefit from the social support of the religious community, while avoiding the patriarchal tensions experienced by those who attend services weekly.
Written by Jenna McGuire
четверг, 4 августа 2011 г.
For Patients With Bipolar Disorder - Getting More From Your Doctor's Appointment
Today patients are increasingly frustrated with the brevity of scheduled appointments with their doctors. Many physicians are constrained by outside factors, such as too few practitioners, too many patients, or restrictions from health insurance companies.
It is important for patients to use communications and organizational skills that will maximize the effectiveness of the visit. By bringing strong communication skills to your office visits, you can feel you have done all you can to get the help you need.
The article, appearing in the Spring 2006 issue of bp Magazine and written by author and patient, Julie Fast, suggests the following:
-- Prepare ahead for appointments.
-- Try to stay calm and focused.
-- Have a list of what you want to cover. Let the doctor read this list so you don't have to spend so much time talking.
-- Be clear on what you need.
-- Respect the fact that your doctor probably didn't choose this time limit and would also like to see you more.
-- Voice your concerns. Ask your doctor how your appointments might be more effective.
Finally, help your family and friends understand what you go through so that they can be a support between appointments.
bp Magazine (Bipolar Magazine)
bphope
It is important for patients to use communications and organizational skills that will maximize the effectiveness of the visit. By bringing strong communication skills to your office visits, you can feel you have done all you can to get the help you need.
The article, appearing in the Spring 2006 issue of bp Magazine and written by author and patient, Julie Fast, suggests the following:
-- Prepare ahead for appointments.
-- Try to stay calm and focused.
-- Have a list of what you want to cover. Let the doctor read this list so you don't have to spend so much time talking.
-- Be clear on what you need.
-- Respect the fact that your doctor probably didn't choose this time limit and would also like to see you more.
-- Voice your concerns. Ask your doctor how your appointments might be more effective.
Finally, help your family and friends understand what you go through so that they can be a support between appointments.
bp Magazine (Bipolar Magazine)
bphope
понедельник, 1 августа 2011 г.
Smoking And Depression Often Occur Together In New Mothers
Smoking and depression often go hand-in-hand for new mothers, according to a new study by Dr Robert Whitaker, a pediatrician and profressor of public health at Temple University.
He said, "While smoking and depression adversely affects a mother's health, the combination may also affect the health of her child."
For children, the potential consequences of maternal smoking include sudden infant death, asthma, ear infections and attention deficit/hyperactivity disorder, while the potential consequences of maternal depression include behaviour problems, language delay and childhood depression.
Dr Whitaker said that depression and addiction to tobacco should not be treated in isolation from each other as giving a mother who smokes a quit smoking helpline number is not going to be enough.
Data for the analysis came from the Fragile Families and Child Wellbeing Study. In 20 U.S. cities, 4,898 mothers were surveyed at the time of delivery, from 1998 to 2000. In a follow up survey 15 months later, 4,353 (89 percent) of mothers reported their smoking behaviour and symptoms of a major depressive episode during the prior 12 months.
The follow up survey showed that the 12 month prevalence of a major depressive episode was 46 percent higher among smokers and that the prevalence of smoking was 33 percent higher among those who had a major depressive episode in the prior 12 months.
"Most recently, healthcare policy has focused on children's access to healthcare, but we also have to keep the mother's health in the discussion," Dr Whitaker said.
ash.uk
He said, "While smoking and depression adversely affects a mother's health, the combination may also affect the health of her child."
For children, the potential consequences of maternal smoking include sudden infant death, asthma, ear infections and attention deficit/hyperactivity disorder, while the potential consequences of maternal depression include behaviour problems, language delay and childhood depression.
Dr Whitaker said that depression and addiction to tobacco should not be treated in isolation from each other as giving a mother who smokes a quit smoking helpline number is not going to be enough.
Data for the analysis came from the Fragile Families and Child Wellbeing Study. In 20 U.S. cities, 4,898 mothers were surveyed at the time of delivery, from 1998 to 2000. In a follow up survey 15 months later, 4,353 (89 percent) of mothers reported their smoking behaviour and symptoms of a major depressive episode during the prior 12 months.
The follow up survey showed that the 12 month prevalence of a major depressive episode was 46 percent higher among smokers and that the prevalence of smoking was 33 percent higher among those who had a major depressive episode in the prior 12 months.
"Most recently, healthcare policy has focused on children's access to healthcare, but we also have to keep the mother's health in the discussion," Dr Whitaker said.
ash.uk
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