Coping, self-efficacy and psychiatric history in patients with both chronic widespread pain and chronic fatigue
adolescent; Female; Humans; Male; Young Adult; Pain; Adult; Attitude to Health; Emotions; Questionnaires; Chronic disease; Aged; Middle Aged; Comorbidity; Self Efficacy; Fatigue; Problem Solving; Severity of Illness Index; Activities of Daily Living; Regression Analysis; Depressive Disorder; Adaptation; Psychological; Stress Disorders; Chronic; Fatigue Syndrome; Fibromyalgia; Major; Post-Traumatic
OBJECTIVE: To investigate the relationship of coping style and self-efficacy to functional impairment in a group of patients with both chronic widespread pain (CWP) and chronic fatigue, as well as the possible mediating role of psychiatric diagnosis. METHODS: We identified 138 consecutive clinic patients who met criteria for CWP and chronic fatigue. We collected demographic and clinical characteristics, as well as measures of emotion-focused and problem-focused coping styles, fatigue-related self-efficacy and self-reported general health. Psychiatric diagnoses were determined with a structured interview. Short Form-36 subscales of pain-related and fatigue-related functioning were the dependent variables in ordinal multiple regression analyses to identify the best-fit model for each. RESULTS: In the final model for pain, increased functional impairment was associated with increased emotion-focused coping as well as less education, lower general health scores and higher body mass index. Conversely, in the final model for fatigue, increased functional impairment was significantly associated with less emotion-focused coping, lower general health scores and lower self-efficacy. CONCLUSIONS: The unexpected finding that emotion-focused coping was associated differently with chronic pain and fatigue among patients who experience both symptoms is discussed in the context of the research on the effects of self-efficacy and possible treatment approaches.
2009-08
Smith WR; Strachan ED; Buchwald D
General Hospital Psychiatry
2009
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.genhosppsych.2009.03.012" target="_blank" rel="noreferrer">10.1016/j.genhosppsych.2009.03.012</a>
Depression and anxiety in children at the end of life
Child; Humans; Terminal Care; Prevalence; Drug Therapy; Psychotherapy; Depressive Disorder; Stress Disorders; Adjustment Disorders/epidemiology/psychology/therapy; Anxiety Disorders/epidemiology/psychology/therapy; Major/epidemiology/psychology/therapy; Post-Traumatic/epidemiology/psychology/therapy
A significant component of palliative care is the prompt diagnosis and management of distress, anxiety, and depression. This article reviews the symptoms and treatment of anxiety and depressive disorders in children at the end of life. Distinguishing between symptoms and disorders, the importance of open communication, consideration of the child's understanding of death, diagnostic challenges in chronically ill children, and suicidality are discussed. Because treatment options are available, it is imperative that symptoms are recognized and addressed. Understanding the issues involved in screening and diagnosis and the risks and benefits of available treatments can lead to an informed approach to the management of these disorders in the palliative care setting.
2007
Kersun LS; Shemesh E
Pediatric Clinics Of North America
2007
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.pcl.2007.06.003" target="_blank" rel="noreferrer">10.1016/j.pcl.2007.06.003</a>
Neurobiological mechanisms in major depressive disorder
Child; Humans; Psychotherapy; Environment; Depressive Disorder; Stress; Receptors; Atrophy; Hypothalamo-Hypophyseal System/physiology; Psychological/psychology; Genetic; Pituitary-Adrenal System/physiology; Polymorphism; Antidepressive Agents/therapeutic use; Brain-Derived Neurotrophic Factor/genetics; Brain/metabolism/pathology; Child Behavior/psychology; Corticotropin-Releasing Hormone/blood; Dopamine/genetics; Dopamine/metabolism; Major/genetics/metabolism/therapy; Serotonin Plasma Membrane Transport Proteins/genetics; Serotonin/metabolism
2009
aan het Rot M; Mathew SJ; Charney DS
Canadian Medical Association Journal
2009
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Journal Article
<a href="http://doi.org/10.1503/cmaj.080697" target="_blank" rel="noreferrer">10.1503/cmaj.080697</a>
Depression and anxiety in rheumatoid arthritis: the role of perceived social support
Female; Humans; Male; Middle Aged; social support; Anxiety Disorders; Sick Role; Depressive Disorder; Ireland; Arthritis; Social Perception; Rheumatoid; Social Support and Chronic Pain
BACKGROUND: Rheumatoid arthritis is a common, disabling, autoimmune disease with significant psychiatric sequelae. AIMS: We aimed to identify the prevalence of depression and anxiety in patients with rheumatoid arthritis attending hospitals, and to elucidate the role played by illness variables, disability variables and psychosocial variables in predicting levels of depression and anxiety. METHODS: We assessed depression, anxiety, arthritis-related pain, arthritis-related disability and perceived social support in 68 adults with rheumatoid arthritis. RESULTS: Sixty-five per cent of patients had evidence of depression (37.5% moderate or severe) and 44.4% had evidence of anxiety (17.8% moderate or severe). Both depression and anxiety were highly correlated with several measures of arthritis-related pain and functional impairment. After controlling for age, gender, marital status and duration of arthritis, perceived social support was a highly significant independent predictor of both depression and anxiety. CONCLUSIONS: These findings suggest that increasing social support may be particularly important in the management of depression and anxiety in rheumatoid arthritis.
2006-06
Zyrianova Y; Kelly BD; Gallagher C; McCarthy C; Molloy MG; Sheehan J; Dinan TG
Irish Journal Of Medical Science
2006
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Journal Article
<a href="http://doi.org/10.1007/bf03167946" target="_blank" rel="noreferrer">10.1007/bf03167946</a>
A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression
Child; Female; Humans; Male; Double-Blind Method; Depressive Disorder; Diagnostic and Statistical Manual of Mental Disorders; adolescent; Non-U.S. Gov't; Research Support; PedPal Lit; N.I.H.; Extramural; Citalopram/therapeutic use; Major/diagnosis/drug therapy; Serotonin Uptake Inhibitors/therapeutic use
OBJECTIVE: Escitalopram is a selective serotonin reuptake inhibitor antidepressant indicated for use in adults. This trial examined the efficacy and safety of escitalopram in pediatric depression. METHOD: Patients (6-17 years old) with major depressive disorder were randomized to receive 8 weeks of double-blind flexibly dosed treatment with escitalopram (10-20 mg/day; n = 131) or placebo (n = 133). Randomization was not stratified by age. The primary efficacy measure was the mean change from baseline to endpoint in Children's Depression Rating Scale-Revised (CDRS-R) scores, using the last observation carried forward approach. RESULTS: A total of 82% of patients completed treatment. Escitalopram did not significantly improve CDRS-R scores compared to placebo at endpoint (least squares mean difference = -1.7, p = .31; last observation carried forward). In a post hoc analysis of adolescent (ages 12-17 years) completers, escitalopram significantly improved CDRS-R scores compared with placebo (least squares mean difference = -4.6, p = .047). Headache and abdominal pain were the only adverse events in >10% of patients in the escitalopram group. Discontinuation rates caused by adverse events were 1.5% for both groups. Potential suicide-related events were observed in one escitalopram- and two placebo-treated patients. There were no completed suicides. CONCLUSIONS: Although there were no significant differences between escitalopram and placebo in the total population, the data suggest that escitalopram may have beneficial effects in adolescent patients. Escitalopram appeared to be well tolerated.
2006
Wagner KD; Jonas J; Findling RL; Ventura D; Saikali K
Journal Of The American Academy Of Child And Adolescent Psychiatry
2006
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Journal Article
Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy
Female; Humans; Male; Adult; Follow-Up Studies; Middle Aged; Sensitivity and Specificity; Personality Inventory; Antidepressive Agents; Depressive Disorder; Ambulatory Care; Outcome and Process Assessment (Health Care); Non-U.S. Gov't; Research Support; Comparative Study; Blood Glucose/metabolism; Brain Mapping; Cerebral Cortex/physiopathology/radionuclide imaging; Cognitive Therapy; Emission-Computed; Energy Metabolism/physiology; Fluorodeoxyglucose F18/diagnostic use; Frontal Lobe/physiopathology/radionuclide imaging; Limbic System/physiopathology/radionuclide imaging; Major/physiopathology/radionuclide imaging/therapy; Nerve Net/physiopathology/radionuclide imaging; Neural Pathways/physiopathology/radionuclide imaging; Paroxetine/therapeutic use; Prefrontal Cortex/physiopathology/radionuclide imaging; Second-Generation/therapeutic use; Tomography
BACKGROUND: Functional imaging studies of major depressive disorder demonstrate response-specific regional changes following various modes of antidepressant treatment. OBJECTIVE: To examine changes associated with cognitive behavior therapy (CBT). METHODS: Brain changes underlying response to CBT were examined using resting-state fluorine-18-labeled deoxyglucose positron emission tomography. Seventeen unmedicated, unipolar depressed outpatients (mean +/- SD age, 41 +/- 9 years; mean +/- SD initial 17-item Hamilton Depression Rating Scale score, 20 +/- 3) were scanned before and after a 15- to 20-session course of outpatient CBT. Whole-brain, voxel-based methods were used to assess response-specific CBT effects. A post hoc comparison to an independent group of 13 paroxetine-treated responders was also performed to interpret the specificity of identified CBT effects. RESULTS: A full course of CBT resulted in significant clinical improvement in the 14 study completers (mean +/- SD posttreatment Hamilton Depression Rating Scale score of 6.7 +/- 4). Treatment response was associated with significant metabolic changes: increases in hippocampus and dorsal cingulate (Brodmann area [BA] 24) and decreases in dorsal (BA 9/46), ventral (BA 47/11), and medial (BA 9/10/11) frontal cortex. This pattern is distinct from that seen with paroxetine-facilitated clinical recovery where prefrontal increases and hippocampal and subgenual cingulate decreases were seen. CONCLUSIONS: Like other antidepressant treatments, CBT seems to affect clinical recovery by modulating the functioning of specific sites in limbic and cortical regions. Unique directional changes in frontal cortex, cingulate, and hippocampus with CBT relative to paroxetine may reflect modality-specific effects with implications for understanding mechanisms underlying different treatment strategies.
2004
Goldapple K; Segal Z; Garson C; Lau M; Bieling P; Kennedy S; Mayberg H
Archives Of General Psychiatry
2004
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Journal Article
<a href="http://doi.org/10.1001/archpsyc.61.1.34" target="_blank" rel="noreferrer">10.1001/archpsyc.61.1.34</a>
Functional ability, social support, and depression in rheumatoid arthritis
Humans; Adult; Aged; Middle Aged; social support; Netherlands; Longitudinal Studies; Activities of Daily Living; Regression Analysis; Sickness Impact Profile; Depressive Disorder; quality of life; Arthritis; Rheumatoid; Social Support and Chronic Pain
OBJECTIVE: First, to investigate the patterns of functional ability, depressive feelings, and social support in early stage rheumatoid arthritis (RA) patients. Second, to demonstrate the stress buffering effect of social support. Social support is thought to reduce the impact of chronic stress on psychological well-being; for patients without social support the impact of functional ability on depressive feelings will be stronger. METHODS: In 4 waves with an intervening period of 1 year, longitudinal data was collected of 264 Dutch RA patients, of which 65% was female. At T1, the mean age of these patients was 53 years, while their mean disease duration was 22 months. In an interview at the patients' homes, data was collected on functional ability, social support en psychological well-being. The buffering effect of social support was examined by testing the significance of the (computed) stressor by social support interaction term in a regression analysis on depressive feelings. RESULTS: Although large differences between subjects existed, the mean scores on functional ability, social support, and depressive feelings barely changed from year to year. Patients who deteriorated in functional ability during one year had the best chances to improve next year, and visa versa. Furthermore, the stress by support interaction terms had no significant effect on depressive feelings in a regression analysis. CONCLUSIONS: This study demonstrated clearly the fluctuating pattern of RA in the first years after onset. The patients' level of depressive feelings was linearly related to the level of functional ability. Like many other studies, also this study could not provide evidence for the stress buffering effect of social support.
2004-08
Doeglas DM; Suurmeijer Th PBM; van den Heuvel WJA; Krol B; van Rijswijk MH; van Leeuwen MA; Sanderman R
Quality of Life Research
2004
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1023/b:qure.0000031339.04589.63" target="_blank" rel="noreferrer">10.1023/b:qure.0000031339.04589.63</a>