Nine-Year Follow-Up of a Home-Visitation Program: A Randomized Trial.

Nine-Year Follow-up of a Home-Visitation Program: A Randomized Trial.

Filed under: Depression Treatment

Pediatrics. 2013 Jan 28;
Fergusson DM, Boden JM, Horwood LJ

OBJECTIVE:To evaluate the extent to which a home-visitation program (Early Start) had benefits for child abuse, child behavior, and parental- and family-level benefits to the 9-year follow-up.METHODS:A randomized controlled trial in which 220 families receiving Early Start were contrasted with a control series of 223 families not receiving the program. Families were enrolled in the program for up to 5 years. Outcomes were assessed at 6 months, annually from 1 year to 6 years, and at 9 years after trial entry.RESULTS:Comparisons between the Early Start and control series showed that families in the Early Start program showed significant (P < .05) benefits in reduced risk of hospital attendance for unintentional injury, lower risk of parent-reported harsh punishment, lower levels of physical punishment, higher parenting competence scores, and more positive child behavioral adjustment scores. Effect sizes (Cohen's "d") ranged from 0.13 to 0.29 (median = 0.25). There were no significant differences (all P values > .05) between the Early Start and control series on a range of measures of parental behavior and family outcomes, including maternal depression, parental substance use, intimate partner violence, adverse economic outcomes, and life stress.CONCLUSIONS:The Early Start program was associated with small to moderate benefits in a range of areas relating to child abuse, physical punishment, child behavior, and parenting competence. There was little evidence to suggest that the Early Start program had benefits that extended to the level of parents or family overall.
HubMed – depression


Psychiatric manifestations, personality traits and health-related quality of life in cancer of unknown primary site.

Filed under: Depression Treatment

Psychooncology. 2013 Jan 29;
Hyphantis T, Papadimitriou I, Petrakis D, Fountzilas G, Repana D, Assimakopoulos K, Carvalho AF, Pavlidis N

OBJECTIVE: Psychiatric manifestations and personality traits are known to influence cancer patients. We aimed to assess psychological distress symptoms, psychosocial factors and health-related quality of life (HRQoL) in cancer of unknown primary site (CUP) and to test whether these parameters differ between CUP and Metastatic (MKPC) or Non-Metastatic Known Primary Cancers (N-MKPC) after controlling for demographics and clinical variables. METHODS: In this cross-sectional study, we recruited 50 CUP, 264 N-MKPC and 52 MKPC participants. We assessed depressive symptoms (Center for Epidemiologic Studies-Depression [CES-D]), psychological distress symptoms (Symptom Distress Checklist-90 Revised), sense of coherence (SOC), ego defense mechanisms (Life Style Index) and HRQoL (World Health Organization Quality of Life Instrument, Short Form). RESULTS: The prevalence of clinically significant depressive symptoms (CES-D???23) was 40.0% in CUP, 28.8% in MKPC and 23.5% N-MKPC (p?=?0.037). Multivariate logistic regression analysis showed that N-MKPC patients were 5 times less likely (p?=?0.028) and MKPC patients 3.3 times less likely (p?=?0.05) to be assessed with probable depression compared with CUP patients after controlling for the major demographic and clinical variables studied. CUP patients presented also higher levels of somatization, anxiety and depressive symptoms; they also had more impaired Physical (p?=?0.005), Mental (p?=?0.041) and Social Relations (p?=?0.044) HRQoL, along with lower scores on SOC and intellectualization defense and higher scores on repression defense, compared with MKPC and N-MKPC patients. CONCLUSIONS: These findings suggest that psychiatric manifestations are frequent in CUP, and the patients’ resources to cope with the burden of their illness are limited. Attention to CUP patients’ psychological distress and coping resources and capacities may enable oncologists to identify and manage modifiable aspects of HRQoL. Copyright © 2013 John Wiley & Sons, Ltd.
HubMed – depression


Four-Year Analysis of Cardiovascular Disease Risk Factors, Depression Symptoms, and Antidepressant Medicine Use in the Look AHEAD (Action for Health in Diabetes) Clinical Trial of Weight Loss in Diabetes.

Filed under: Depression Treatment

Diabetes Care. 2013 Jan 28;
Rubin RR, Peyrot M, Gaussoin SA, Espeland MA, Williamson D, Faulconbridge LF, Wadden TA, Ewing L, Safford M, Evans-Hudnall G, Wing RR, Knowler WC,

OBJECTIVETo study the association of depressive symptoms or antidepressant medicine (ADM) use with subsequent cardiovascular disease (CVD) risk factor status in the Look AHEAD (Action for Health in Diabetes) trial of weight loss in type 2 diabetes.RESEARCH DESIGN AND METHODSParticipants (n = 5,145; age [mean ± SD] 58.7 ± 6.8 years; BMI 35.8 ± 5.8 kg/m(2)) in two study arms (intensive lifestyle [ILI], diabetes support and education [DSE]) completed the Beck Depression Inventory (BDI), reported ADM use, and were assessed for CVD risk factors at baseline and annually for 4 years. Risk factor-positive status was defined as current smoking, obesity, HbA(1c) >7.0% or insulin use, and blood pressure or cholesterol not at levels recommended by expert consensus panel or medicine to achieve recommended levels. Generalized estimating equations assessed within-study arm relationships of elevated BDI score (?11) or ADM use with subsequent year CVD risk status, controlled for demographic variables, CVD history, diabetes duration, and prior CVD risk status.RESULTSPrior year elevated BDI was associated (odds ratio [95% CI]) with subsequent CVD risk factor-positive status for the DSE arm (A1C [1.30 (1.09-1.56)]; total cholesterol [0.80 (0.65-1.00)]; i.e., protective from high total cholesterol) and the ILI arm (HDL [1.40 (1.12-1.75)], triglyceride [1.28 (1.00-1.64)]). Prior year ADM use predicted subsequent elevated CVD risk status for the DSE arm (HDL [1.24 (1.03-1.50)], total cholesterol [1.28 (1.05-1.57)], current smoking [1.73 (1.04-2.88)]) and for the ILI arm (A1C [1.25 (1.08-1.46)], HDL [1.32 (1.11-1.58)], triglycerides [1.75 (1.43-2.14)], systolic blood pressure [1.39 (1.11-1.74)]), obesity [1.46 (1.22-2.18)]).CONCLUSIONSAggressive monitoring of CVD risk in diabetic patients with depressive symptoms or who are treated with ADM may be warranted.
HubMed – depression


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