The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) Study: Cluster Randomised Trial of Humour Therapy in Nursing Homes.

The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) study: cluster randomised trial of humour therapy in nursing homes.

Filed under: Depression Treatment

BMJ Open. 2013; 3(1):
Low LF, Brodaty H, Goodenough B, Spitzer P, Bell JP, Fleming R, Casey AN, Liu Z, Chenoweth L

To determine whether humour therapy reduces depression (primary outcome), agitation and behavioural disturbances and improves social engagement and quality-of-life in nursing home residents.The Sydney Multisite Intervention of LaughterBosses and ElderClowns study was a single-blind cluster randomised controlled trial of humour therapy.35 Sydney nursing homes.All eligible residents within geographically defined areas within each nursing home were invited to participate.Professional ‘ElderClowns’ provided 9-12 weekly humour therapy sessions, augmented by resident engagement by trained staff ‘LaughterBosses’. Controls received usual care.Depression scores on the Cornell Scale for Depression in Dementia, agitation scores on the Cohen-Mansfield Agitation Inventory, behavioural disturbance scores on the Neuropsychiatric Inventory, social engagement scores on the withdrawal subscale of Multidimensional Observation Scale for Elderly Subjects, and self-rated and proxy-rated quality-of-life scores on a health-related quality-of-life tool for dementia, the DEMQOL. All outcomes were measured at the participant level by researchers blind to group assignment. RANDOMISATION: Sites were stratified by size and level of care then assigned to group using a random number generator.Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Groups did not differ significantly over time on the primary outcome of depression, or on behavioural disturbances other than agitation, social engagement and quality of life. The secondary outcome of agitation was significantly reduced in the intervention group compared with controls over 26 weeks (time by group interaction adjusted for covariates: p=0.011). The mean difference in change from baseline to 26 weeks in Blom-transformed agitation scores after adjustment for covariates was 0.17 (95% CI 0.004 to 0.34, p=0.045).Humour therapy did not significantly reduce depression but significantly reduced agitation.Australian New Zealand Clinical Trials Registry -ACTRN12611000462987.
HubMed – depression

Longitudinal neuropsychological test performance among HIV seropositive individuals in Uganda.

Filed under: Depression Treatment

J Neurovirol. 2013 Jan 12;
Sacktor N, Nakasujja N, Okonkwo O, Skolasky RL, Robertson K, Musisi S, Katabira E

This study was conducted to evaluate longitudinal neuropsychological testing performance over a 12-month period among HIV?+?individuals, and to evaluate the impact of antiretroviral therapy (ART) initiation on neuropsychological test changes in Uganda. The study examined 77 HIV?+?individuals recruited from the Infectious Diseases Clinic at Makerere University, Uganda. They underwent detailed sociodemographic, medical history, immune status, functional, neurologic, and neuropsychological evaluations at baseline and 12 months later. Thirty-one individuals initiated ART (ART group) after their baseline visit, whereas 46 individuals were not placed on ART (no-ART group) during those 12 months. Paired samples t-tests were used to evaluate longitudinal changes in neuropsychological test performance for the entire sample, as well as for groups defined by ART initiation and baseline neurocognitive status. The study evaluated 77 HIV individuals (62 % women, mean age?=?37 years, mean education?=?8 years, mean CD4 count?=?235 cells/?l). Both the ART and no-ART groups showed significant improvements in tests of verbal memory, executive functioning, motor, and psychomotor speed performance, as well as depression symptoms. The ART group had significant improvements in CD4 count over the 12-month period (p?HubMed – depression

Depression, Constraint, and the Liver: (Dis)assembling the Treatment of Emotion-Related Disorders in Chinese Medicine.

Filed under: Depression Treatment

Cult Med Psychiatry. 2013 Jan 12;
Scheid V

Traditional Chinese medicine (TCM) is today practiced worldwide, rivaling biomedicine in terms of its globalization. One of the most common TCM diagnoses is “Liver qi constraint,” which, in turn, is commonly treated by an herbal formula dating back to the 10th century. In everyday TCM practice, biomedical disease categories such as depression or anxiety and popular disease categories such as stress are often conflated with the Chinese medical notion of constraint. Medical anthropologists, meanwhile, argue that constraint reveals to us a distinctive aesthetics of constructing body/persons in Chinese culture, while psychologists seek to define constraint as a distinctive psychiatric disorder distinctive from depression and anxiety. All of these actors agree in defining constraint as a concept dating back two thousand years to the very origins of Chinese medicine. This article disassembles the articulations by means of which these different facts about constraint are constructed. It shows how ideas about constraint as a disorder caused by the penetration of external pathogens into the body were gradually transformed from the eleventh century onward into constraint as an emotion-related disorder, while treatment strategies were adjusted to match perceptions about body/self that developed among the gentry elite of southeast China in late imperial China.
HubMed – depression

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