DEPRESSION and SMOKING: A 5-YEAR PROSPECTIVE STUDY of PATIENTS WITH MAJOR DEPRESSIVE DISORDER.

DEPRESSION AND SMOKING: A 5-YEAR PROSPECTIVE STUDY OF PATIENTS WITH MAJOR DEPRESSIVE DISORDER.

Depress Anxiety. 2013 Apr 19;
Holma IA, Holma KM, Melartin TK, Ketokivi M, Isometsä ET

BACKGROUND: Major depressive disorder (MDD) and smoking are major public health problems and epidemiologically strongly associated. However, the relationship between smoking and depression and whether this is influenced by common confounding factors remain unclear, in part due to limited longitudinal data on covariation. METHODS: In the Vantaa Depression Study, psychiatric out- and inpatients with DSM-IV MDD and aged 20-59 years at were followed from baseline to 6 months, 18 months, and 5 years. We investigated course of depression, smoking, and comorbid alcohol-use disorders among the 214 patients (79.6% of 269) participating at least three time points; differences between smoking versus nonsmoking patients, and covariation of MDD, smoking, and alcohol-use disorders. RESULTS: Overall, 31.3% of the patients smoked regularly, 41.1% intermittently, and 27.6% never. Smokers were younger, had more alcohol-use disorders and Cluster B and C personality disorder symptoms, a higher frequency of lifetime suicide attempts, higher neuroticism, smaller social networks, and lower perceived social support than never smokers. Smoking and depression had limited longitudinal covariation. Depression, smoking, and alcohol-use disorders all exhibited strong autoregressive tendencies. CONCLUSIONS: Among adult psychiatric MDD patients, smoking is strongly associated with substance-use and personality disorders, which may confound research on the impact of smoking. Rather than depression or smoking covarying or predicting each other, depression, smoking, and alcohol-use disorders each have strong autoregressive tendencies. These findings are more consistent with common factors causing their association than either of the conditions strongly predisposing to the other. HubMed – depression

Steroid-responsive depression.

BMJ Case Rep. 2013; 2013:
Normann C, Frase L, Berger M, Nissen C

A 48-year-old man presented with long-standing symptoms of major depression in the absence of markedly abnormal neurological findings or structural brain alterations. Antidepressive treatment, including medication and psychotherapy, had not led to significant improvement. The EEG, cerebrospinal fluid (CSF) analysis, fluorodeoxyglucose-positron emission tomography and neuropsychological testing showed pathological findings. An epileptic state provided further evidence for an organic encephalopathy. Extensively elevated thyroid-antibodies in the serum and CSF, as well as the rapid and sustained recovery after intravenous treatment with prednisolone, pointed to the diagnosis of a primarily psychiatric manifestation of a steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT). HubMed – depression

Psychometric properties of the Norwegian version of the Audit of Diabetes-Dependent Quality of Life.

Qual Life Res. 2013 Apr 19;
Iversen MM, Espehaug B, Rokne B, Haugstvedt A, Graue M

PURPOSE: To examine the psychometric properties of the Norwegian version of the Audit of Diabetes-Dependent Quality of Life version 18 (ADDQoL-18). METHODS: We assessed the reliability (Cronbach’s alpha and intraclass correlations) and construct validity (confirmatory factor analysis and Pearson’s correlation coefficients) of the instrument in a sample of 292 adults in Norway aged 42.3 (SD 14.2) years. RESULTS: Internal consistency (Cronbach’s alpha 0.88) and 4-week test-retest stability (intraclass correlations = 0.87) were satisfactory. Confirmatory factor analysis indicated that the one-factor structure of the ADDQoL-18 fits moderately (? (2)/df ratio = 3.846, comparative fit index = 0.792, root mean square error of approximation = 0.099). Standardized coefficients showed that all domains loaded >0.4, except for one item. We found a satisfactory correlation between the ADDQoL-18 and the SF-36 Health Survey summary scales (physical health and mental health summary scales) and the Hospital Anxiety and Depression Scale. The total score was negatively associated with HbA1c (r = -0.18; P < 0.002), indicating that lower scores on the ADDQoL-18 were related to poorer glycemic control. Analysis regarding discriminant validity showed that the average weighted impact scores were mostly reduced among those reporting neuropathy and foot problems. CONCLUSIONS: The Norwegian version of the ADDQoL-18 showed high internal consistency, good test-retest reliability, and similar construct validity as the original instrument. Overall, the results supported the ADDQoL-18 being feasible for use in Norway. HubMed – depression

In Search of Serenity: Religious Struggle Among Patients Hospitalized for Suspected Acute Coronary Syndrome.

J Relig Health. 2013 Apr 19;
Magyar-Russell G, Brown IT, Edara IR, Smith MT, Marine JE, Ziegelstein RC

Hospitalization for a sudden cardiac event is a frightening experience, one that is often marked by uncertainty about health status, fear of recurrent cardiac problems, and related existential, religious, and spiritual concerns. Religious struggle, reflecting tension and strain regarding religious and spiritual issues, may arise in response to symptoms of acute coronary syndrome (ACS). The present study examined the prevalence and types of religious struggle using the Brief RCOPE, as well as associations between religious struggle, psychological distress, and self-reported sleep habits among 62 patients hospitalized with suspected ACS. Fifty-eight percent of the sample reported some degree of religious struggle. Questioning the power of God was the most frequently endorsed struggle. Those struggling religiously reported significantly more symptoms of anxiety, depression, and sleep disturbance. Non-White participants endorsed greater use of positive religious coping strategies and religious struggle. Results suggest that patients hospitalized for suspected ACS experiencing even low levels of religious struggle might benefit from referral to a hospital chaplain or appropriately trained mental health professional for more detailed religious and spiritual assessment. Practical means of efficiently screening for religious struggle during the often brief hospitalization period for suspected ACS are discussed. HubMed – depression