Depression Treatment: Cognitive and Interpersonal Moderators of Daily Co-Occurrence of Anxious and Depressed Moods in Generalized Anxiety Disorder.

Cognitive and Interpersonal Moderators of Daily Co-Occurrence of Anxious and Depressed Moods in Generalized Anxiety Disorder.

Filed under: Depression Treatment

Cognit Ther Res. 2012 Dec 1; 36(6): 655-669
Starr LR, Davila J

Anxiety and depression co-occur, both at the disorder and symptom levels, and within anxiety disorders, fluctuations in daily anxious mood correspond temporally to fluctuations in depressed mood. However, little is known about the factors or conditions under which anxiety and depressive symptoms are most likely to co-occur. The current study investigated the role of cognitive factors (daily rumination and cognitive attributions about anxiety symptoms) and interpersonal functioning (daily perceived rejection, support, criticism, and interpersonal problems) as moderators of the daily association between anxious and depressed moods. Fifty-five individuals with generalized anxiety disorder completed a 21-day diary assessing daily mood and cognitive and interpersonal functioning. Ratings of anxious and depressed mood were more closely associated on days when participants ruminated about their anxiety or viewed anxiety symptoms more negatively. Furthermore, anxious mood predicted later depressed mood on days when participants reported greater interpersonal problems and more perceived rejection. Results suggest that cognitive and interpersonal factors may elevate the likelihood of anxiety-depression co-occurrence.
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Obstructive sleep apnoea in adults.

Filed under: Depression Treatment

Postgrad Med J. 2012 Nov 17;
Usmani ZA, Chai-Coetzer CL, Antic NA, McEvoy RD

Obstructive sleep apnoea (OSA) is characterised by repetitive closure of the upper airway, repetitive oxygen desaturations and sleep fragmentation. The prevalence of adult OSA is increasing because of a worldwide increase in obesity and the ageing of populations. OSA presents with a variety of symptoms the most prominent of which are snoring and daytime tiredness. Interestingly though, a significant proportion of OSA sufferers report little or no daytime symptoms. OSA has been associated with an increased risk of cardiovascular disease, cognitive abnormalities and mental health problems. Randomised controlled trial evidence is awaited to confirm a causal relationship between OSA and these various disorders. The gold standard diagnostic investigation for OSA is overnight laboratory-based polysomnography (sleep study), however, ambulatory models of care incorporating screening questionnaires and home sleep studies have been recently evaluated and are now being incorporated into routine clinical practice. Patients with OSA are very often obese and exhibit a range of comorbidities, such as hypertension, depression and diabetes. Management, therefore, needs to be based on a multidisciplinary and holistic approach which includes lifestyle modifications. Continuous positive airway pressure (CPAP) is the first-line therapy for severe OSA. Oral appliances should be considered in patients with mild or moderate disease, or in those unable to tolerate CPAP. New, minimally invasive surgical techniques are currently being developed to achieve better patient outcomes and reduce surgical morbidity. Successful long-term management of OSA requires careful patient education, enlistment of the family’s support and the adoption of self-management and patient goal-setting principles.
HubMed – depression


The Effects of an Aerobic and Resistance Exercise Training Program on Cognition Following Stroke.

Filed under: Depression Treatment

Neurorehabil Neural Repair. 2012 Nov 16;
Marzolini S, Oh P, McIlroy W, Brooks D

BACKGROUND: . Cognitive benefits obtained from exercise in healthy populations support the idea that aerobic and resistance training (AT+RT) would confer benefit for poststroke recovery. However, there is little evidence regarding the effectiveness of such programs. OBJECTIVE: . To evaluate the effects of a 6-month exercise program of AT+RT on cognition in consecutively enrolled patients with motor impairments ?10 weeks poststroke. METHODS: . Outcomes were measured before and after 6 months of AT+RT on 41 patients. Cognition was measured by the Montreal Cognitive Assessment (MoCA). Secondary measures included evaluation of gas exchange anaerobic threshold (ATge), body composition by dual energy X-ray absorptiometry, and depressive symptoms by questionnaire. RESULTS: . There were significant improvements in overall MoCA scores (22.5 ± 4.5 to 24.0 ± 3.9, P < .001) as well as in the subdomains of attention/concentration (4.7 ± 1.7 to 5.2 ± 1.3, P = .03) and visuospatial/executive function (3.4 ± 1.1 to 3.9 ± 1.1, P = .002). There was a significant reduction in the proportion of patients meeting the threshold criteria for mild cognitive impairment (MCI) at baseline compared with posttraining (65.9% vs 36.6%, P < .001). In a linear regression model, there was a positive association between change in cognitive function and change in fat-free mass of the nonaffected limbs (? = .002; P = .005) and change in attention/concentration and change in ATge (? = .383; P ? .001), independent of age, sex, time from stroke, and change in fat mass and depression score. CONCLUSION: . A combined training model (AT+RT) resulted in improvements in cognitive function and a reduction in the proportion of patients meeting the threshold criteria for MCI. Change in cognition was positively associated with change in fat-free mass and ATge. HubMed – depression


Active Treatment of Depression (Norton Professional Books)-ExLibrary

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Cognitive-Behavioral Treatment of Depression (Clinical Application of Evidence-B
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Major Depression: Prevention and Treatment by Michael R. Lowry (1984, Hardcover)
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