Prevalence and Factors Associated With the Rates of Depression Among Elderly Residents in Rural Areas.

Prevalence and factors associated with the rates of depression among elderly residents in rural areas.

Rev Esc Enferm USP. 2013 Apr; 47(2): 401-407
Ferreira PC, Tavares DM

This study aimed to determine the prevalence of elderly patients with an indication of depression by sex and age group and to identify the factors associated with the indication of depression. Analytical, observational and cross studies were conducted with 850 elderly residents in the rural areas of the municipality of Minas Gerais. For data analysis, we applied the prevalence formula and logistic regression model (p<0.05). The project was approved by the Ethics in Research Human of the Triângulo Mineiro Federal University (Protocol No. 1477). The prevalence of the indicators of depression accounted for 22%, with a greater occurrence among females and individuals aged 60?70 years. In females, a higher number of comorbidities and higher functional disability with respect to performing the activities of daily living remained associated with the indication of depression. These results reinforce the need to implement actions to promote health and disease prevention, focusing on depression. HubMed – depression


Efficacy of a multicomponent support programme for the caregivers of disabled persons : A randomised controlled study.

Z Gerontol Geriatr. 2013 Jun 8;
Ryynänen OP, Nousiainen P, Soini EJ, Tuominen S

AIM: The goal of the present work was to measure the efficacy of a multicomponent programme designed to provide tailored support for the caregivers of disabled persons. SUBJECTS: A total of 135 caregivers-care receiver dyads were randomly divided into an intervention group (n?=?66) and a control group (n?=?69). One-third of the care receivers were demented, and two-thirds had other diseases. SETTING: Health centres (publicly funded primary health care systems) in 8 rural and urban communities in southeast Finland. INTERVENTION: The multicomponent support programme for the caregivers consisted of a 2-week rehabilitation period. The control group received standard care. OUTCOME MEASUREMENTS: Continuation of the caregiver and care receiver relationship, care receiver mortality at the 2-year follow-up as well as the health-related quality of life (15D scale) and Zung’s depression scale of the caregiver at the 1-year follow-up were evaluated. RESULTS: At the 2-year follow-up, the caregiver-care receiver relationship was terminated for any reason in 11 cases (17%) in the intervention group, and in 25 cases (36%) in the control group. After adjusting, the primary outcome (i.e., termination of care giving for any reason) indicated statistical significance (p?=?0.04) with a hazard rate of 1.83 (95% confidence interval 1.03-3.29). With a similar adjustment, the difference in mortality and placement to institutional care between the two groups demonstrated a trend towards statistical significance. The caregivers’ health, as related to quality of life and depressive symptoms, remained unchanged in both groups at the 1-year follow-up. CONCLUSION: These results indicate that a tailored support programme for caregivers may help the caregiver to continue the caregiver-care receiver relationship and delay institutionalization. HubMed – depression


Depression and painful conditions: patterns of association with health status and health utility ratings in the general population.

Qual Life Res. 2013 Jun 7;
Patten SB, Williams JV, Lavorato DH, Bulloch AG, Currie G, Emery H

PURPOSE: Preference-weighted HRQoL (utility) ratings are increasingly used to guide clinical and resource allocation decisions, but their performance has not always been adequately explored. We sought to examine patterns of health utility ratings in community populations with depressive disorders and painful conditions. METHODS: We used two Canadian cross-sectional health surveys that obtained Comprehensive Health Status Measurement System/Health Utilities Index Mark 3 (HUI3) ratings and identified people with painful conditions and major depression. We estimated the frequency of item endorsements and mean utility ratings in these groups. RESULTS: Interesting differences between health state ratings and diagnostic categories were noted. For example, 71 % of those professionally diagnosed with migraine reported that they usually have “no pain.” Despite this, utility ratings were lower in those respondents with depressive episodes and in those with painful conditions. Greater than additive reductions in HUI3 scores were noted in most instances where both depressive disorders and painful conditions were present. CONCLUSIONS: Health utility ratings confirm the clinical impression that painful conditions and depressive disorders magnify each other’s impact. Despite weak alignment between the health state definitions incorporated into utility ratings and the diagnostic concepts examined, the HUI3 appeared to capture HRQoL decrements and negative synergies associated with the co-occurrence of depressive episodes and painful conditions. HubMed – depression


A Multidimensional Measure of Sexual Orientation, Use of Psychoactive Substances, and Depression: Results of a National Survey on Sexual Behavior in France.

Arch Sex Behav. 2013 Jun 7;
Lhomond B, Saurel-Cubizolles MJ, Michaels S,

Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity. HubMed – depression


Mental Health Disorders and Solid-Organ Transplant Recipients.

Transplantation. 2013 Jun 5;
Corbett C, Armstrong MJ, Parker R, Webb K, Neuberger JM

Depression affects up to 60% of solid-organ recipients and is independently associated with both mortality (hazard ratio for death of ?2) and de novo malignancy after transplantation, although the mechanism is not clear. Both pretransplantation psychosis and depression occurring more than 2 years after transplantation are associated with increased noncompliance and graft loss. It remains to be shown that effective treatment of depression is associated with improved outcomes and quality of life. Immunosuppressive drugs (especially corticosteroids and calcineurin inhibitors) and physiologic challenges can precipitate deterioration in mental health. All potential transplant candidates should be assessed for mental health problems and preexisting medical conditions that can mimic mental health problems, such as uremic, hepatic, or hypoxic encephalopathy, should be identified and treated appropriately. Expert mental health review of those with identified risk factors (such as previous suicide attempts, history of mental illness or noncompliance with medications) is advisable early in the transplant assessment process to mitigate risk and support the patient. Patients with mental health disorders, when adequately controlled and socially supported, have outcomes similar to the general transplant population. Therefore, exclusion from transplantation based on the diagnosis alone is neither ethically nor medically justified. However, it is ethically and clinically justifiable to deny access to transplantation to those who, despite full support, would have a quality of life that is unacceptable to the candidate or are likely to be noncompliant with treatment or follow-up, which would lead to graft loss. HubMed – depression