Depression Treatment: Illness Attribution of Patients With Medically Unexplained Physical Symptoms in China.

Illness attribution of patients with medically unexplained physical symptoms in China.

Filed under: Depression Treatment

Transcult Psychiatry. 2012 Dec 21;
Fritzsche K, Anselm K, Fritz M, Wirsching M, Xudong Z, Schaefert R

The illness behavior of patients with medically unexplained physical symptoms (MUS) depends largely on what the patient believes to be the cause of the symptoms. Little data are available on the illness attributions of patients with MUS in China. This cross-sectional study investigated the illness attributions of 96 patients with MUS in the outpatient departments of Psychosomatic Medicine, biomedicine (Neurology, Gynecology), and Traditional Chinese Medicine in Shanghai. Patients completed the Illness Perception Questionnaire (IPQ) for illness attribution, the Screening Questionnaire for Somatoform Symptoms, the Hospital Anxiety and Depression Scale for emotional distress, and questionnaires on clinical and sociodemographic data. The physicians also filled out a questionnaire regarding the cause of the illness (IPQ). In contrast to previous research, both physicians and patients from all three areas of medicine most frequently reported “psychological attributions.” The concordance between the physicians’ and the patients’ illness attributions was low. Emotional distress was an important predictor of psychological attributions. Further research should include large-scale studies among patients from different regions of China and qualitative studies to deepen our understanding of cultural influences on illness attribution.
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The Longitudinal Relationship Between Depression and Walking Behavior in Older Latinos: The “{inverted exclamation}Caminemos!” Study.

Filed under: Depression Treatment

J Aging Health. 2012 Dec 21;
Hernandez R, Prohaska TR, Wang PC, Sarkisian CA

OBJECTIVE: This study sought to evaluate the relationship between baseline depression and prospective engagement in walking and exercise behavior after enrollment in an exercise intervention. METHODS: The study used baseline, 1-month, 12-month, and 24-month in-person interview and pedometer data collected from Latinos aged >60 years participating in an exercise intervention (¡Caminemos!) at 27 senior centers (n = 572). RESULTS: After joining an exercise intervention, and when using continuous pedometer data and scores from the Yale Physical Activity Survey (YPAS) as the outcomes of interest, older adults with baseline depression exhibited comparable levels of physical activity across time when compared to their nondepressed counterparts. Significant difference in physical activity levels between the depressed and nondepressed subgroups no longer existed within one month of initiating the exercise intervention. DISCUSSION: Among sedentary older Latino adults, having depression may not delay exercise initiation nor does it appear to prevent achievement or maintenance of an exercise program.
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Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study.

Filed under: Depression Treatment

Age Ageing. 2012 Dec 21;
Yan T, Escarce JJ, Liang LJ, Longstreth WT, Merkin SS, Ovbiagele B, Vassar SD, Seeman T, Sarkisian C, Brown AF

Objectives: to investigate whether psychosocial pathways mediate the association between neighbourhood socioeconomic disadvantage and stroke.Methods: prospective cohort study with a follow-up of 11.5 years.Setting: the Cardiovascular Health Study, a longitudinal population-based cohort study of older adults ?65 years.Measurements: the primary outcome was adjudicated incident ischaemic stroke. Neighbourhood socioeconomic status (NSES) was measured using a composite of six census-tract variables. Psychosocial factors were assessed with standard measures for depression, social support and social networks.Results: of the 3,834 white participants with no prior stroke, 548 had an incident ischaemic stroke over the 11.5-year follow-up. Among whites, the incident stroke hazard ratio (HR) associated with living in the lowest relative to highest NSES quartile was 1.32 (95% CI = 1.01-1.73), in models adjusted for individual SES. Additional adjustment for psychosocial factors had a minimal effect on hazard of incident stroke (HR = 1.31, CI = 1.00-1.71). Associations between NSES and stroke incidence were not found among African-Americans (n = 785) in either partially or fully adjusted models.Conclusions: psychosocial factors played a minimal role in mediating the effect of NSES on stroke incidence among white older adults.
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