Depression Treatment: Childhood and Adult Stressors and Major Depression Risk: Interpreting Interactions With the Sufficient-Component Cause Model.

Childhood and adult stressors and major depression risk: interpreting interactions with the sufficient-component cause model.

Filed under: Depression Treatment

Soc Psychiatry Psychiatr Epidemiol. 2012 Nov 1;
Patten SB

PURPOSE: Using a representative longitudinal cohort consisting of more than 8,000 community residents, this study sought to evaluate patterns of interaction between childhood adversity and adult stressors in relation to MDE. The goal was to interpret the interactions using epidemiologic theory. METHODS: A Canadian longitudinal study called the National Population Health Survey (NPHS) was the data source. This NPHS began in 1994 and the cohort has subsequently been interviewed every 2 years. Childhood adversities were assessed retrospectively and adult stressors and MDE were evaluated during follow-up. Interactions between various potential MDE risk factors were assessed on an additive scale using linear regression and on a multiplicative scale using logistic regression. RESULTS: Hypothesized interactions between negative childhood experiences and more recent stressors were apparent in statistical models adopting an additive (linear regression), but not multiplicative (logisitic), perspective. According to the component-cause model of etiology, this pattern suggests shared causal mechanisms. There was no general tendency for such interactions to occur with other risk factors. CONCLUSIONS: Biological mechanisms responsible for early life calibration of stress response systems may generate persistent sensitization to stressors, thereby increasing the risk of MDE following exposure to stressful events later in life. Reliance on multiplicative models such as logistic regression and log-binomial regression in psychiatric epidemiological studies may render etiologically important interactions more difficult to identify.
HubMed – depression


Do behavioral disturbances predict falls among nursing home residents?

Filed under: Depression Treatment

Aging Clin Exp Res. 2012 Jun; 24(3): 251-6
Sylliaas H, Selbæk G, Bergland A

The purpose of our study was to examine whether severity of dementia, behavioral and psychological symptoms and depression can predict falls among nursing home residents, such as demographic variables, activities of daily living, and use of psychotropic drugs, when potential confounders are controlled for.1147 nursing home residents were examined in this one-year follow-up study. All residents were examined with the Physical Self-Maintenance scale (Activities of Daily Living – ADL), Clinical Dementia Rating Scale (CDR), Neuropsychiatric Inventory (NPI) and Cornell Scale for Depression in Dementia. Demographic data, gender, education, physical health and use of medication were collected from medical records.40% of participants had at least one fall during the one-year follow-up period. Bivariate survival analysis revealed that low level of education, severe dementia, severe behavioral and psychological symptoms, severe depression, greater functional impairment, age, worsening in physical health, and use of sedatives, significantly predict one or more falls. Multivariate Cox regression analyses showed that age, higher scores on NPI and CDR, use of sedatives and dependency in ADL were all, independently of each other, predictors of an increased risk of falling.Having a high NPI score was identified as a significant and independent predictor of falls. Since falling is a common event which causes considerable morbidity and mortality in older people, these findings are important for healthcare and for the individuals concerned. To prevent falling in nursing homes, special attention must be paid to residents with severe dementia, to behavioral symptoms and use of sedatives.
HubMed – depression


Work-related orthopaedic injury and feelings of depression: the potential role of physical therapy.

Filed under: Depression Treatment

J Orthop Sports Phys Ther. 2012; 42(11): 968

Feelings or thoughts of depression may be associated with a muscle or joint injury. When pain and depressive symptoms occur together, they can produce long-lasting problems. It can be difficult to know if these thoughts and feelings are caused by the pain or some other issue. Physical therapists focus on treating musculoskeletal problems; however, for some patients, depressed feelings may ease with treatment designed to decrease pain and improve function. Other patients may require specialized treatment for symptoms of depression in addition to physical therapy. This is especially true when depressed thoughts and feelings persist, pain has not resolved, and return to work has not been achieved. A study published in the November 2012 issue of JOSPT evaluated the change in feelings or thoughts of depression during physical therapy and how it relates to a person’s work status 1 year later.J Orthop Sports Phys Ther 2012;42(11):968. doi:10.2519/jospt.2012.0507.
HubMed – depression



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