Evidence-Based Guidance for Culturally Sensitive Assessment and Interventions for Perinatal Depression in Black American Women: A Synthesis of Published Research, 2008-2011.

Evidence-based guidance for culturally sensitive assessment and interventions for perinatal depression in black american women: a synthesis of published research, 2008-2011.

J Prim Care Community Health. 2012 Oct 1; 3(4): 278-84
Cruser dA, Asante-Ackuayi L, Brown S, Cardenas E, Lee D

This article provides a review of published evidence-based guidance about culturally sensitive assessment and treatment intervention strategies addressing perinatal depression in black American women. Culturally sensitive approaches focus more on the woman’s environment than on her race and thus may improve access to treatment for perinatal depression by increasing health literacy.The authors abstracted evidence-based guidance from articles published between November 2005 and September 2011, including only articles specifically analyzing a discrete sample of black American women during pregnancy or within 6 months postpartum. They also examined research on unique cultural characteristics of black American women. To obtain relevant studies, the authors searched for research literature indexed in PubMed, using key terms associated with 2 systematic reviews of prevalence and risk factors for perinatal depression and additional keywords as used in the articles found. They abstracted the focus, design and methods, population, and results for each article in a table; discussed the findings; and suggested assessment and intervention strategies based on the studies’ results.Sixteen articles from 13 journals provide compelling evidence of culture-based risk factors for perinatal depression for black American women and information to guide culturally sensitive assessments and interventions. The literature provides a rich compendium of relevant and useful implications for clinical practice in assessing and addressing depression among pregnant black American women.Primary care providers may want to incorporate culturally sensitive screening questions to early identify and facilitate treatment interventions for depressive symptoms in their pregnant black American patients. HubMed – depression treatment


[The Discussion about the Application and Impact of Music on Depressive Diseases throughout History and at Present.]

Fortschr Neurol Psychiatr. 2013 Jun 26;
Heise S, Steinberg H, Himmerich H

Music therapy is the customised application of music for therapeutic use. For the treatment of depression it is mostly applied within a multimodal therapeutic approach. Since music was already used in prehistoric societies to cure diseases, it can be considered as a traditional therapy. As early as the antiquity physicians discussed the kind of music, the duration and frequency of its application. In the 19th century the pioneers of modern scientific psychiatry began to follow these questions with empirical experimental research. Since the 20th century, research has been investigating the influence of music on biological and psychological parameters. Current studies show that music therapy appears to improve symptoms of depression, especially in combination with antidepressants. Due to the limited number of randomised studies, the validity of its efficiency is limited. Further research is necessary to provide evidence-based recommendations regarding music therapy for the treatment of depression. HubMed – depression treatment


Self-stigmatization in patients with bipolar disorder.

Neuro Endocrinol Lett. 2013 Jun 27; 34(4):

Background: Prejudicial beliefs, emotions, and behaviours cause discrimination against people labeled as mentally ill. This stigmatization is sometimes internalized by the patients, leading to self-stigmatization. Specific features and impacts of stigmatization and self-stigmatization in patients with bipolar illness are the subjects of this review. Method: Studies were identified through PUBMED, Web of Science and Scopus databases as well as existing reviews. The search terms included “bipolar disorder”, “stigma”, “self-stigma” psychoeducation”, “psychotherapy”, “psychosocial treatment”. Key articles listed in reference lists were searched. Results: Considerable recent evidence indicates that bipolar patients and their families are stigmatized, and that this stigmatization affects their quality of life as well as social functioning. The severity of stigmatization in bipolar disorder is greater than that in people with depression. There is also evidence of self-stigmatization which further decreases the quality of life. Stigmatization and self-stigmatization were shown to be one of the barriers that delay or prevent effective treatment, and thus exert adverse effects on the outcomes of bipolar disorder. Conclusion: Stigma affects the experience of illness as well as social functioning in patients with bipolar disorder. The impact of stigma on the lives and treatment outcomes of patients with bipolar disorder mandates intensive effort of mental health research and policy to address this problem. Much has been done against the stigmatization of the mentally ill. But the fight against stigma remains a fundamental objective of health programs for mental health. HubMed – depression treatment


PHQ-9 Response Curve: Rate of Improvement for Depression Treatment With Collaborative Care Management.

J Prim Care Community Health. 2012 Jul 1; 3(3): 155-8
Angstman KB, Rohrer JE, Rasmussen NH

Major depressive disorder is common in primary care. Depression Improvement Across Minnesota-Offering a New Direction (DIAMOND), using a collaborative care model, was first implemented in March 2008 starting with 5 clinics and expanding to more than 70 clinics statewide by 2010. This was intended to improve depression management and to augment the relationship between the patient, the primary care provider, and the psychiatrist. Prior retrospective studies have demonstrated the clinical effectiveness of our program. This study was designed to examine those patients who were in clinical remission (defined as a Patient Health Questionnaire-9 [PHQ-9] score <5) at 6 months (180 days) after enrollment in collaborative care management. By determining the subsequent PHQ-9 data that were obtained, a PHQ-9 response curve was developed for those patients who did improve. The pilot study demonstrated that there appeared to be rapid response to depression treatment, evident by the first month of treatment and more pronounced in severely depressed patients. Also, it demonstrated that in the patients who did respond, there was no any difference in the remission rates over the study period when evaluated by the initial severity of the depression. HubMed – depression treatment



Dr Safiullah Afghan on clinical depression (Urdu) – For more information contact: safiafghan@btinternet.com.