Depression Treatment: The Natural History of Depression Up to 15 Years After Stroke: The South London Stroke Register.

The Natural History of Depression up to 15 Years After Stroke: The South London Stroke Register.

Filed under: Depression Treatment

Stroke. 2013 Feb 12;
Ayerbe L, Ayis S, Crichton S, Wolfe CD, Rudd AG

BACKGROUND AND PURPOSE: Evidence on the natural history of depression after stroke is still insufficient to inform prognosis and treatment strategies. This study estimates the incidence, cumulative incidence, prevalence, time of onset, duration, and recurrence rate of depression up to 15 years after stroke. METHODS: Data from patients registered in the South London Stroke Register between 1995 and 2009 were used (N=4022 at registration. Maximum number of participants for these analyses n=1233). Depression was assessed in all patients with the Hospital Anxiety and Depression Scale (scores >7=depression) 3 months after stroke, 1 year after stroke, and annually thereafter up to 15 years after stroke. Inverse probability weighting was used to calculate the estimates accounting for missing data. RESULTS: The poststroke incidence of depression ranged from 7% to 21% in the 15 years after a stroke, with cumulative incidence of 55% and prevalence ranging from 29% to 39%. Most episodes of depression started within a year of stroke, with 33% of the cases starting in the 3 months after a stroke, and none from year 10 onward. Fifty percent of the patients with depression at 3 months had recovered 1 year after stroke. The proportion of recurrent episodes of depression after stroke increased gradually from 38% in year 2 to 100% in years 14 and 15. CONCLUSIONS: The natural history of depression after stroke is dynamic. Depression affects most of the stroke patients with episodes that have a short duration but a high risk of recurrence in the long term.
HubMed – depression


Caregiver Responsiveness to the Family Bereavement Program: What Predicts Responsiveness? What Does Responsiveness Predict?

Filed under: Depression Treatment

Prev Sci. 2013 Feb 13;
Schoenfelder EN, Sandler IN, Millsap RE, Wolchik SA, Berkel C, Ayers TS

The study developed a multidimensional measure to assess participant responsiveness to a preventive intervention and applied this measure to study how participant baseline characteristics predict responsiveness and how responsiveness predicts program outcomes. The study was conducted with caregivers who participated in the parenting-focused component of the Family Bereavement Program (FBP), a prevention program for families that have experienced parental death. The sample consisted of 89 caregivers assigned to the intervention condition in the efficacy trial of the FBP. Positive parenting, caregiver depression, and child externalizing problems at baseline were found to predict caregivers’ use of program skills outside the group, and more child internalizing problems predicted more positive perceptions of the group environment. Higher levels of skill use during the program predicted increased positive parenting at the 11-month follow-up, whereas positive perceptions of the group environment predicted decreased caregiver depressive symptoms at follow-up. Caregiver skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up, and skill use and perceived group environment mediated changes in caregiver depression from baseline to 11-month follow-up.
HubMed – depression


Comorbidity of depression with other psychiatric disorders in adolescents: about 77 cases.

Filed under: Depression Treatment

Tunis Med. 2013 Jan; 91(1): 33-7
Hadjkacem I, Ayadi H, Walha A, Moalla Y, Ghribi F

Background: In adolescents diagnosed with depressive disorders, psychiatric comorbidity is rather the rule than the exception. Aim: To find the prevalence of the association between depression in adolescents and other psychiatric disorders and second and to study the different mental disorders comorbid to depression. Methods: We conducted a descriptive, retrospective and analytic survey carried on 77 subjects having been followed in the child psychiatry department of Sfax for depressive disorders diagnosed according to the DSM-IV TR criteria during a period of 9 years (from January 1st 1998 till 31st December 2006) Results: 49.3% of the youths with depression had comorbid conditions: anxiety disorders in 23.37% of cases, disruptive disorders in 13% of cases (conduct disorders in 11.7 % of cases and oppositional defiant disorders in 1.3 % of cases), personality disorders in 13% of cases, substance abuse in 3.9% of cases and alimentary behavior disturbances in 2.6% of cases. A superimposed major depressive disorder in adolescents with dysthymia (« Double depression ») was present in 10.4 of cases. Conclusion: Throughout our study, we underline the frequency of the association between depression in teenagers and other mental disorders. The detection of this comorbidity has a great importance as it permits to understand the pathogenesis of depression in adolescents, to examine the implications of comorbidity for course and outcomes of this disorder and to elaborate the appropriate treatment.
HubMed – depression


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