[Coping With Medical Residency: Depression Burnout].

[Coping with medical residency: depression burnout].

Gac Med Mex. 2013 Mar-Apr; 149(2): 183-95
Velásquez-Pérez L, Colin-Piana R, González-González M

Among the most prevalent psychiatric disorders, major depressive disorder is related with high incapacity levels, affecting also physical and mental health, and social, family, and work activities (burnout). Objectives: This study assessed possible damage and emotional changes in a cohort of recently incoming medical residents to the postgraduate courses of the National Institute of Neurology and Neurosurgery of Mexico City. Materials and methods: We collected information on sociodemographic data, and we applied two instruments: the scale of Maslach Burnout Inventory (MBI-HS) and the Beck Depression Inventory (BDI). Candidates were followed over time, at six and 12 months afterwards. Results: When the authors analyzed depressive symptoms, they found that the percentage of medical residents without depression at baseline was 97.7% and at the second application, this percentage decreased statistically (p = 0.008) and yet there was an increase in mild depressive symptoms (p = 0.017). With respect to MBI-HS, there was high emotional exhaustion with a significant increase at six months after arrival. The psychiatry residents were those more affected. Conclusions: Exploratory research is needed to be performed among residents to detect depressive symptoms and burnout syndrome, to act in a timely manner and prevent the progression of these diseases. HubMed – depression


[Medical treatment of neuropathic pain].

Tidsskr Nor Laegeforen. 2013 May 7; 133(9): 971-3
Slapø GD, Schjøtt J

Neuropathic pain represents a diagnostic challenge and is difficult to treat. In recent years, clinical trials have led to the development of a number of new treatment guidelines. The guidelines recommend drugs for the most important types of neuropathic pain and suggest alternatives in the event of lack of effect or intolerable adverse effects. Patients with this condition often suffer from anxiety, depression and insomnia, which influences the choice of drug. This article presents the most important drugs on which these guidelines concur. HubMed – depression


Residual Symptoms Related to Physical and Panic Symptoms at Baseline Predict Remission of Depression at Follow-Up.

Psychopathology. 2013 May 3;
Hung CI, Liu CY, Wang SJ, Yang CH

Aims: The study aimed to investigate whether common residual symptoms at baseline were able to predict full remission of depression at 6-month and 2-year follow-up examinations in patients with major depressive disorder (MDD). Methods: This study enrolled 135 outpatients with MDD. The depression (DS) and somatic subscales (SS) of the Depression and Somatic Symptoms Scale and the depression and anxiety (HADS-A) subscales of the Hospital Anxiety and Depression Scale were used to investigate residual symptoms, which were divided into the common residual part (CRP) and the other residual part (ORP). Multivariate logistic regression was used to compare the ability to predict full remission between the CRP and ORP scores at baseline. Results: One hundred and nineteen and 106 outpatients completed the two follow-up examinations. The CRP of the DS and the ORP of the SS and HADS-A at baseline had a good ability to predict full remission among patients without pharmacotherapy. The three residual parts included physical and anxiety symptoms of depression and panic symptoms. Conclusions: Physicians should pay attention to physical, anxiety, and panic symptoms, because these symptoms are related to remission of depression. Future studies should explore how these symptoms affect the prognosis of depression. HubMed – depression


Failing the failing heart: a review of palliative care in heart failure.

Rev Cardiovasc Med. 2013; 14(1): 41-8
Shah AB, Morrissey RP, Baraghoush A, Phan A, Hamilton M, Kobashigawa J, Schwarz ER, Bharadwaj P

Heart failure (HF) is the most common reason for hospital admission for patients older than 65 years. With an aging population and improving survival in heart failure patients, the number of people living with HF continues to grow. As this population increases, the importance of treating symptoms of fatigue, dyspnea, pain, and depression that diminish the quality of life in HF patients becomes increasingly important. Palliative care has been shown to help alleviate these symptoms and improve patients’ satisfaction with the care they receive. Despite this growing body of evidence, palliative care consultation remains underutilized and is not standard practice in the management of HF. With an emphasis on communication, symptom management, and coordinated care, palliative care provides an integrated approach to support patients and families with chronic illnesses. Early communication with patients and families regarding the unpredictable nature of HF and the increased risk of sudden cardiac death enables discussions around advanced care directives, health care proxies, and deactivation of permanent pacemakers or implantable cardioverter defibrillators. Cardiologists and primary care physicians who are comfortable initiating these discussions are encouraged to do so; however, many fear destroying hope and are uncertain how to discuss end-of-life issues. Thus, in order to facilitate these discussions and establish an appropriate relationship, we recommend that patients and families be introduced to a palliative care team at the earliest appropriate time after diagnosis. HubMed – depression