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The Dimensional Anhedonia Rating Scale (DARS) is a novel questionnaire to assess anhedonia of recent validation. In this work, we aim to study the equivalence between the traditional paper-and-pencil and the digital format of DARS. Sixty-nine patients filled the DARS in a paper-based and digital versions. We assessed differences between formats (Wilcoxon test), validity of the scales [Kappa and intraclass correlation coefficients (ICCs)], and reliability (Cronbach's alpha and Guttman's coefficient). We calculated the comparative fit index and the root mean squared error (RMSE) associated with the proposed one-factor structure. Total scores were higher for paper-based format. Significant differences between both formats were found for three items. The weighted Kappa coefficient was approximately 0.40 for most of the items. Internal consistency was greater than 0.94, and the ICC for the digital version was 0.95 and 0.94 for the paper-and-pencil version (F = 16.7, p < 0.001). Comparative Adjustment Index was 0.97 for the digital DARS and 0.97 for the paper-and-pencil DARS, and RMSE was 0.11 for the digital DARS and 0.10 for the paper-and-pencil DARS. We concluded that the digital DARS is consistent in many respects with the paper-and-pencil questionnaire, but equivalence with this format cannot be assumed without caution. [ABSTRACT FROM AUTHOR]

The gold standard for measuring anhedonia is the Snaith-Hamilton Pleasure Scale (SHAPS). To date, there are no validated electronic versions of this questionnaire. We aim to study the equivalence between the traditional paper-and-pencil format and a digital version of the SHAPS. A group of 67 patients completed both SHAPS formats, and differences between formats were assessed. McNemar's test showed no significant differences between the two systems. The Kappa coefficient was over 40% for most items, and reliability was above 0.8, showing good to excellent levels of internal consistency. Thus, we have demonstrated a close equivalence between paper-and-pencil and electronic SHAPS. [ABSTRACT FROM AUTHOR]

This paper describes a sustainable structure to deliver the World Health Organization (WHO) endorsed group Interpersonal Psychotherapy (IPT-G) for Postpartum Adolescent (PPA) mothers living with HIV in Nairobi. It documents the process of mobilizing, training, and engaging Community Health Workers (CHWs) and Key Informants (health facility staff) involved in the Prevention of Mother-To-Child Transmission (PMTCT) in two Primary Health Care (PHC) facilities from informal settlements of Nairobi County. Mainly reporting experiences from the training process utilizing focused group discussions and in-depth interviews involving participants, IPT-G therapists and supervisors we present process findings and acceptability of our IPT-G implementation. [ABSTRACT FROM AUTHOR]

Background: Prehospital emergency staff usually encounter patients in situations that can affect the mental health of the medical staff and cause symptoms of depression, anxiety, and stress. This study aimed to determine depression, anxiety, and stress in prehospital emergency personnel during the COVID-19 epidemic in Ardabil City, Iran, 2020. Materials and Methods: A descriptive cross-sectional study was conducted from March 2020 to April 2020 with the participation of 138 working staff in the prehospital emergency department of Ardabil City. The samples were selected by the census method. Necessary information was collected with a two-part questionnaire: a demographic questionnaire and the DASS-21 standard questionnaire. DASS-21 is a 21-item questionnaire that consists of three subscales of 7 questions: depression, anxiety, and stress. The obtained data were analyzed using descriptive statistics, including mean and standard deviation, and inferential analysis, including analysis of variance, independent t test, and multiple regression using SPSS software v. 22 statistical software. Results: The results showed that 45.7% of the staff had moderate depression, 44.9% moderate anxiety, and 77.5% normal stress. There was a significant relationship between work experience and stress level (P=0.03). There were significant associations between age with depression (P=0.04), anxiety (P=0.00) and stress (P=0.01). There was also a significant relationship between gender and variables of stress (P=0.00) and anxiety (P=0.01). Multiple regression results showed that gender and education variables are predictors of anxiety and stress, and age and education variables are predictors of depression (P<0.05). Conclusion: More than half of the staff had moderate to severe depression and anxiety. Considering that prehospital emergency personnel has a vital role in improving and promoting people’s health in the community, eliminating the underlying factors that cause emotional reactions in them is considered a health priority. [ABSTRACT FROM AUTHOR]

Perinatal depression can have enduring adverse effects on women and their children and families, incurring substantial ongoing economic and personal costs. A significant proportion of the cost of perinatal depression relates to adverse impacts on the child, most likely mediated through impairment to the mother‐infant relationship. In recognition of this problem, Australia has invested in routine perinatal depression screening. Our previous research produced convergent findings suggesting that expected benefits for children have not yet been realised through perinatal depression screening. We question the potential of including a measure of personality in current perinatal depression screening for identifying maternal mental health problems and suboptimal mother‐infant relationships. This paper reviews our previous research findings within the broader context of perinatal depression screening. We propose a position, that perinatal depression screening in Australia should be redesigned to more precisely detect vulnerable mother‐infant relationships, parenting, maternal mental health, and infant psychosocial and psychological development. Practice change to appropriately target antenatal interventions may more efficiently improve both maternal and child outcomes, thereby contributing to greater efficiency and cost savings for the health system. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease 2019 (COVID-19) is a cluster of acute respiratory illnesses with unknown etiology, which firstly appeared in Wuhan, Hubei Province, China, in December 2019. All educational institutes of Pakistan were completely closed from March 13, 2020, to August 15, 2020. This condition disturbs the daily routines of children with mental health needs. This sudden closure limited their physical activities in their routine life. This study aims to observe the depression associated with COVID-19 and its impact on the physical activities of young adults of Pakistan. Materials and Methods: A web-based cross-sectional study was conducted on 384 young adults. A modified depression scale was used to assess depression, and the revised physical activity questionnaire was used to evaluate the physical activity of Pakistani young adults in the past month. Results: About 57.8% of the samples were sometimes sad; 44.5% sometimes felt grouchy in the mood; 43.8% never felt hopeless about the future. Also, 32.6% sometimes slept less or more than usual, 35.9% sometimes had difficulty concentrating on their work, 48.7% slept 6-8 hours per day. Besides, 49% engaged 1-3 hours in work or study per day; 43.2% watched TV, sat quietly, or listened to music for 1-3 hours. About 57.8% engaged less than 1 hour per week in light physical activities. Also, 77.9% engaged for less than 1 hour per week in moderately strenuous activities. Conclusion: Depression could be highly associated with the COVID-19 outbreak, and it might affect the physical activities of young adults. [ABSTRACT FROM AUTHOR]

Introduction: Patients with cancer may have many complications involving their psychosomatic systems, such as sleep disturbance, depression, and anxiety. Thus, many research studies were conducted to reduce these complications. Zolpidem, as a short-term non-benzodiazepine treatment of insomnia, and melatonin as a chronobiological functionregulatory hormone, are commonly used for improving sleep quality. This randomized clinical trial aims to compare the effects of zolpidem and melatonin on sleep quality, depression, and anxiety in patients with colorectal cancer. Methods: In this single-blinded trial, 90 patients with colorectal cancer undergoing chemotherapy who had obtained a score of 5 or higher on the Pittsburgh Sleep Quality Index (PSQI) were randomly divided into two groups (n=45). One group was treated with 10 mg zolpidem at bedtime, and the other group received 6 mg melatonin at bedtime for 30 days. PSQI on weeks 0, 4, 8, Groningen sleep quality scale, Hamilton rating scale for depression, and Hamilton anxiety rating scale questionnaires were performed to assess patients on weeks 0, 4, and 8. The outcome was then analyzed, and P=0.05 was considered statistically significant. Results: Both zolpidem and melatonin had significant impacts on sleep quality in week 4 (P<0.05). After stopping the treatments, the conditions were noticeably reversed on week 8 (P<0.05). Zolpidem and melatonin were relatively similar in affecting sleep duration, latency, efficiency, and disturbance. None of the two study medications had any considerable influence on anxiety and depression. Conclusion: Melatonin and zolpidem are promising agents for treating sleep complications and, to some extent, depression, and anxiety in cancer patients, according to the present study. However, further clinical trials are recommended to confirm the results of this study. [ABSTRACT FROM AUTHOR]

Introduction: One of the vital skills which has an impact on emotional health and well-being is the regulation of emotions. In recent years, the neural basis of this process has been considered widely. One of the powerful tools for eliciting and regulating emotion is music. The Anterior Cingulate Cortex (ACC) is part of the emotional neural circuitry involved in Major Depressive Disorder (MDD). The current study uses functional Magnetic Resonance Imaging (fMRI) to examine how neural processing of emotional musical auditory stimuli is changed within the ACC in depression. Statistical inference is conducted using a Bayesian Generalized Linear Model (GLM) approach with an Integrated Nested Laplace Approximation (INLA) algorithm. Methods: A new proposed Bayesian approach was applied for assessing functional response to emotional musical auditory stimuli in a block design fMRI data with 105 scans of two healthy and depressed women. In this Bayesian approach, Unweighted Graph-Laplacian (UGL) prior was chosen for spatial dependency, and autoregressive (AR) (1) process was used for temporal correlation via pre-weighting residuals. Finally, the inference was conducted using the Integrated Nested Laplace Approximation (INLA) algorithm in the R-INLA package. Results: The results revealed that positive music, as compared to negative music, elicits stronger activation within the ACC area in both healthy and depressed subjects. In comparing MDD and Never-Depressed (ND) individuals, a significant difference was found between MDD and ND groups in response to positive music vs negative music stimuli. The activations increase from baseline to positive stimuli and decrease from baseline to negative stimuli in ND subjects. Also, a significant decrease from baseline to positive stimuli was observed in MDD subjects, but there was no significant difference between baseline and negative stimuli. Conclusion: Assessing the pattern of activations within ACC in a depressed individual may be useful in retraining the ACC and improving its function, and lead to more effective therapeutic interventions. [ABSTRACT FROM AUTHOR]

Introduction: Stress predisposes organisms to depression and cognitive impairments, and seems to interact with metabolic homeostasis. The inflammatory response and the upregulation of proinflammatory cytokines are some of the consequences related to chronic stress. In this study, we investigated the preventive effect of chronic administration of ibuprofen, as an inhibitor of cyclooxygenases, on the cognitive and behavioral alterations and the weight gain reduction induced by simultaneous chronic restraint stress in rats. Materials and Methods: Male Wistar rats were subjected to chronic restraint stress and injected daily with the variable doses of ibuprofen or vehicle, for 21 consecutive days. Then, all animals were tested with the forced swim test and passive avoidance conditioning. Also, the weight of the animals was recorded before and after the interventions. Ultimately, plasma interleukin 6 (IL-6) levels were measured. Results: Chronic stress increased depressive-like behaviors, impaired learning, and disrupted the normal weight gain. However, the animals that received the highest dose of ibuprofen showed less depressive-like behaviors, a better avoidance memory, and a higher weight gain. However, the level of plasma IL-6 did not differ significantly between the study groups. Conclusion: The administration of ibuprofen prevents the cognitive and behavioral consequences of chronic stress. During the recovery, the plasma levels of IL-6 were not elevated by stress, and the IL-6 levels did not predict the behavioral performance of the stressed animals. The exact mechanisms of the protective effects of ibuprofen against chronic stress need to be further investigated. [ABSTRACT FROM AUTHOR]

The discussion notes the extreme sensitivity of the technique with a despairing deprived girl with a deep dread of the future and of adulthood. Where defenses are identified, caring alternatives are always on offer, and gradually the patient's hope, curiosity, and sense of agency are freed up and fired up. [ABSTRACT FROM AUTHOR]

Before organizing mixed-mode data collection for the self-administered questionnaire of the Belgian Health Interview Survey, measurement effects between the paper-and-pencil and the web-based questionnaire were evaluated. A two-period cross-over study was organized with a sample of 149 employees of two Belgian research institutes (age range 22–62 years, 72% female). Measurement agreement was assessed for a diverse range of health indicators related to general health, mental and psychosocial health, health behaviors and prevention with kappa coefficients and intraclass correlation (ICC). The quality of the data collected by both modes was evaluated by quantifying the missing, ‘don’t know’ and inconsistent values and data entry mistakes. Good to very good agreement was found for all categorical indicators with kappa coefficients superior to 0.60, except for two mental and psychosocial health indicators namely the presence of a sleeping disorder and of a depressive disorder (kappa≥0.50). For the continuous indicators high to acceptable agreement was observed with ICC superior to 0.70. Inconsistent answers and data-entry mistakes were only occurring in the paper-and-pencil mode. There were no less missing values in the web-based mode compared to the paper-and-pencil mode. The study supports the idea that web-based modes provide, in general, equal responses to paper-and-pencil modes. However, health indicators based upon factual and objective items tend to have higher measurement agreement than indicators requiring an assessment of personal subjective feelings. A web-based mode greatly facilitates the data-entry process and guides the completing of a questionnaire. However, item non-response was not positively affected. [ABSTRACT FROM AUTHOR]

The working environment may have a significant effect on response to treatment of depression and this issue has not yet been sufficiently addressed in the scientific literature. There is evidence showing that being engaged in high-level positions can be an obstacle to the success of treatment. This article discusses the few evidence in the literature and some of the possible mechanisms involved. Specific personality attributes and difficulties in adapting to depression may delay access to care and may also reduce treatment compliance. The presence of stress in jobs that require high cognitive function and lack of social support may be elements that hinder the recovery process. Residual symptoms that impact on cognitive functions may undermine adherence to treatment and adversely affect the response. The implications of these issues are potentially relevant for clinical practice in the treatment of depression and for future research. [ABSTRACT FROM AUTHOR]

Winnicott's unique contributions to a psychoanalytic theory of depression are not as familiar as Freud and Klein's writings. I concentrate on six areas: depression as a developmental achievement which denotes unit status; the role of destruction which arises from love (as opposed to hate which for Winnicott is a more mature affect); the importance of contributing‐in and the response of the (m)other in recovery from depression; the startling idea that the patient seeks out the analyst's depression; some thoughts on the differences between Winnicott and Freud and Klein; and lastly, the effect of depression on the development of self, creativity and the capacity to play. Winnicott does not shirk the darker side of being human, but at the same time he offers us a hopeful picture. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate and compare the executive functions of students with depression, anxiety, and stress symptoms with those functions in healthy ones. Methods: This study was a comparative and non-clinical analysis. The study population comprised all students of Shahid Beheshti University, Tehran, Iran. A total of 448 students were recruited using convenience sampling method. They were also screened using the Depression Anxiety Stress Scales (DASS) test comprising 21 items. Of study participants, 30 people were depressed, 27 had anxiety, and 15 suffered from stress. Then, 50 control people were matched with them. Next, both groups were compared using the Stroop test, Wisconsin card sorting, and cognitive ability test. Results: Using MANOVA test, data analysis revealed no significant differences among 4 groups with regard to selective attention and shifting attention. Depressed group reacted rapidly as opposed to the anxiety group with regard to measures of shifting attention and cognitive abilities; it was observed that the memory, inhibition control, planning, and flexibility of the healthy group were better than those of the 3 other groups. Conclusion: The findings of this research raised specific issues in relation to the role of depression, anxiety, and stress in the disruption of the executive functions of sufferers. Selective and shifting attention and cognitive abilities are specifically affected in this regard. Meanwhile, the role of stress in impairing decision making and the major role of anxiety in impairing sustained attention was shown to be considerable. [ABSTRACT FROM AUTHOR]

Abstract: Internet based data collection methods have many advantages for psychological assessment when compared with more traditional paper formats, including, reduced costs, and greater convenience for both the researcher and the participant. However, prior to the wide-spread adoption of these methods, equivalence with paper tests formats must be established. The present study compared questionnaire data from the computer with that from a traditional paper format in a sample of college students both directly and through an opinion survey. Three types of questionnaires that represent distinct areas commonly assessed in psychological research included: quality of life (SF-36), depression (BDI-II) and personality (NEO). A within-subjects design counterbalanced order across the computer and paper formats. Overall the findings showed no differences for the Neuroticism and Extraversion facts of the NEO, for the BDI and for the subscales and composite scores of the SF-36. Significant differences were found between the paper and computer formats for the Openness, Agreeableness, and Conscientiousness facets of the NEO. Additionally, the computer was perceived to be convenient, user-friendly, comfortable, and secure. Results suggest that a computerized format is an efficient way to conduct quality of life research, especially for the assessment of distress levels and quality of life. [Copyright &y& Elsevier]

Background Stress, depression, and anxiety affect 15% to 25% of pregnant women. However, substantial barriers to psychosocial assessment exist, resulting in less than 20% of prenatal care providers assessing and treating mental health problems. Moreover, pregnant women are often reluctant to disclose their mental health concerns to a healthcare provider. Identifying screening and assessment tools and procedures that are acceptable to both women and service providers, cost-effective, and clinically useful is needed. Methods/design The primary objective of this randomized, parallel-group, superiority trial is to evaluate the feasibility and acceptability of a computer tablet-based prenatal psychosocial assessment (escreening) compared to paper-based screening. Secondary objectives are to compare the two modes of screening on: (1) the level of detection of prenatal depression and anxiety symptoms and psychosocial risk; (2) the level of disclosure of symptoms; (3) the factors associated with feasibility, acceptability, and disclosure; (4) the psychometric properties of the e-version of the assessment tools; and (5) cost-effectiveness. A sample of 542 women will be recruited from large, primary care maternity clinics and a high-risk antenatal unit in an urban Canadian city. Pregnant women are eligible to participate if they: (1) receive care at one of the recruitment sites; (2) are able to speak/read English; (3) are willing to be randomized to e-screening; and (4) are willing to participate in a follow-up diagnostic interview within 1 week of recruitment. Allocation is by computer-generated randomization. Women in the intervention group will complete an online psychosocial assessment on a computer tablet, while those in the control group will complete the same assessment in paperbased form. All women will complete baseline questionnaires at the time of recruitment and will participate in a diagnostic interview within 1 week of recruitment. Research assistants conducting diagnostic interviews and physicians will be blinded. A qualitative descriptive study involving healthcare providers from the recruitment sites and women will provide data on feasibility and acceptability of the intervention. We hypothesize that mental health escreening in primary care maternity settings and high-risk antenatal units will be as or more feasible, acceptable, and capable of detecting depression, anxiety, and psychosocial risk compared to paper-based screening. Trial registration ClinicalTrials.gov Identifier: NCT01899534 [ABSTRACT FROM AUTHOR]

Purpose: Chronic inflammation is one of the key mechanisms of depression. Wenyang-Tianjin-Jie Decoction (WTJD) is an effective antidepressant found in the course of diagnosis and treatment, but the mechanism of therapeutic effect is not clear. The study aimed to evaluate the efficacy of WTJD in the kidney yang deficiency (KYD) type of depression rats and reveal its mechanisms. Materials and Methods: We selected forty 6-week-old male Sprague-Dawley rats for the study. We established a KYD [Phellodendron amurense Rupr (Huangbai) solution oral gavage and 4°C environments; 8 weeks] type of depression (chronic unpredictable mild stimulus; 6 weeks) rat model first. After successful modeling, we used WTJD or fluoxetine on rats for 3 weeks. Then we evaluated the depression and KYD behavior. Finally, we observed the expression of key inflammatory factors and proteins in peripheral blood and hippocampus, and further investigated the immune balance of Th17/Treg and Th1/Th2 cells and the activity of their main regulatory pathways JAK2/STAT3 and TLR4/TRAF6/NF-κB. Results: The imbalance of Th17/Treg and Th1/Th2 cells in rats were related to KYD and depressive symptoms. Through this study, we found that WTJD can inhibit the activity of JAK2/STAT3 and TLR4/TRAF6/NF-κB pathways, balance Th17/Treg and Th1/Th2 cell homeostasis, regulate the levels of inflammatory factors in the hippocampus and peripheral blood, and reverse KYD and depression. Conclusion: This study confirmed that WTJD had a reliable effect on depression rats with KYD, and its mechanism was to regulate the immune homeostasis of hippocampal T cells and related inflammatory factors to improve KYD and depression symptoms in rats. [ABSTRACT FROM AUTHOR]

Abstract: This study reports results from a format comparison between Web-based and pencil and paper questionnaires measuring two well-validated measures of psychological distress among 530 frequent Internet users studying at an on-line University (Open University of Catalonia, UOC). A four-item version of the Perceived Stress Scale (PSS) and a seven-item version of the Center for Epidemiological Studies-Depression Scale (CESD) were randomly administered in Web-based and pencil and paper format. Internal consistency analyses showed that these two brief versions were reliable for on-line assessment. Also, no differences in Cronbach αs were found between formats. Exploratory as well as multigroup factor analysis techniques showed that factor structures were invariant across formats. Overall, results revealed that respondents did not bias their responses in the Web-based condition. As these findings suggest, when familiarity with technology is high among respondents and sample procedures are followed to maximize control for potential participants, Web-based and paper and pencil formats are virtually equivalent, as in the two brief measures of psychological distress used in this study. [Copyright &y& Elsevier]

Objectives To examine the acceptability of fluoxetine in elderly depressed patients with chronic obstructive pulmonary disease (COPD). Setting A university teaching hospital. Method Single-blinded (open) study. One hundred and thirty-seven outpatients (69 male) with symptomatic irreversible, moderate to severe COPD were recruited. Major depression was diagnosed using the Geriatric Mental State Schedule. Quality of life was assessed by the Breathing Problems Questionnaire, physical disability by the Manchester Respiratory Activities of Daily Living Questionnaire and severity of depression using the Montgomery Asberg Depression Rating Scale. Exclusion criteria were: use of oral steroids within 6 weeks, acute or chronic confusion, known cancer and known psychosis. Results Fifty-seven patients (42%) (25 males) with a mean age of 72 years (range 60–89 years) were depressed. Fourteen (six male) agreed to undergo therapy with fluoxetine 20 mg/day for 6 months, while 36 (72%) refused antidepressant drug therapy. Only seven subjects completed the trial; of these, four (57%) responded to fluoxetine therapy. Five subjects withdrew because of side-effects. Twenty-two of those who refused treatment (61%) agreed to be interviewed, and of these 19 (86%) were still depressed. Conclusion Patient acceptance of fluoxetine was poor. The reasons for refusing treatment varied but were largely due to misapprehension by the patient. Untreated depression became chronic. Offering antidepressants to COPD patients with depression is not an effective strategy. Why this might be so is discussed. Copyright © 2001 John Wiley & Sons, Ltd [ABSTRACT FROM AUTHOR]

The ability to critically read a research paper is a skill that all postgraduate students and academicians require because the findings of a study must be interpreted in the context of its strengths and limitations. This article summarizes a recent study on continuation vs. discontinuation of antidepressants during pregnancy; preterm birth and low-birth weight were the outcomes of interest. The strengths and limitations of the study are considered, as are the best and worst case scenarios related to antidepressant use during pregnancy. It is hoped that this exercise will increase the reader's awareness of statistical and methodological issues that emerge when a study is critically examined. [ABSTRACT FROM AUTHOR]

Background: The Internet and telephone are valuable resources for mental health practitioners when access to face-to-face assessment or therapy is difficult. However, despite the high stakes (such as access to medication or financial compensation) often involved in psychological testing, little is known about how test administration mode influences test scores when patients are malingering. The aim of this research was to examine for the first time the equivalence of a malingered measure of depression when administered over the Internet, over the telephone, and with pen and paper. Subjects and Methods: A mixed experimental design was used with participants (n =91) randomly allocated to Internet, telephone, or pen-and-paper groups. Participants completed the Edinburgh Depression Scale, first under standard instructions and then under instructions to fake as if experiencing severe depression. A manipulation check was included to ensure participants had understood and followed instructions to fake. Results: As predicted, participants were able to significantly increase their depression scores when asked to fake depression. Participants reported significantly lower faked depression scores over the telephone than in pen-and-paper format. Faked depression scores in the online group did not differ significantly from those in the telephone and pen-and-paper groups. However, participants in all groups met criteria indicative of a provisional diagnosis of depression. Conclusions: Overall, the results indicate that there may be no meaningful difference between malingering across administration modes. If an individual is malingering depression, administration mode has minimal influence. These findings provide preliminary support for the use of online/telephone technologies in the assessment of depression. [ABSTRACT FROM AUTHOR]

The development of new molecular and neurobiological methods, computer-assisted quantification techniques and neurobiological investigation methods which can be applied to the human brain, all have evoked an increased demand for post-mortem tissue in research. Psychiatric disorders are considered to be of neurobiological origin. Thus far, however, the etiology and pathophysiology of schizophrenia, depression and dementias are not well understood at the cellular and molecular level. The following will outline the consensus of the working group for neuropsychiatric brain banking organized in the Brainnet Europe II, on ethical guidelines for brain banking, clinical diagnostic criteria, the minimal clinical data set of retrospectively analyzed cases as well as neuropathological standard investigations to perform stageing for neurodegenerative disorders in brain tissue. We will list regions of interest for assessments in psychiatric disorder, propose a dissection scheme and describe preservation and storage conditions of tissue. These guidelines may be of value for future implementations of additional neuropsychiatric brain banks world-wide. [ABSTRACT FROM AUTHOR]

The article presents abstracts of psychophysiological research. They include "sLORETA Correlates of Memory Impairment," by Alicia Townsend and Leslie Sherlin, "Computer-Mediated Biofeedback in Managing Acute Post-Operative Pain," by Jonathan Woodhouse, Paul Lynch, Jae Park, Allen Lebortis and Douglas Gentile and "Assessment and Treatment of Emotional Trauma," by Paul G. Swingle.

Abstract: Background: In western countries, the yearly incidence of depression is estimated to be 3–5% and the lifetime prevalence is 17%. In patient populations with chronic diseases the point prevalence may be 20%. Depression is associated with increased risk for various conditions such as osteoporoses, cardiovascular diseases, and dementia. WHO stated in 2000 that depression was the fourth leading cause of disease burden in terms of disability. In 2000 the cost of depression in the US was estimated to 83 billion dollars. A predominance of trials suggests that physical exercise has a positive effect on depressive symptoms. However, a meta-analysis from 2001 stated: “The effectiveness of exercise in reducing symptoms of depression cannot be determined because of a lack of good quality research on clinical populations with adequate follow-up.” Objectives: The major objective for this randomized trial is to compare the effect of non-aerobic, aerobic, and relaxation training on depressive symptoms using the blindly assessed Hamilton depression scale (HAM-D17) as primary outcome. The secondary outcome is the effect of the intervention on working status (i.e., lost days from work, employed/unemployed) and the tertiary outcomes consist of biological responses. Design: The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are recruited through general practitioners and psychiatrist and randomized to three different interventions: 1) non-aerobic, — progressive resistance training, 2) aerobic training, — cardio respiratory fitness, and 3) relaxation training with minimal impact on strength or cardio respiratory fitness. Training for all three groups takes place twice a week for 4 months. Evaluation of patients'' symptoms takes place four and 12 months after inclusion. The trial is designed to include 45 patients in each group. Statistical analysis will be done as intention to treat (all randomized patients). Results from the DEMO trial will be reported according to the CONSORT guidelines in 2008–2009. [Copyright &y& Elsevier]

About 10% of the US population suffers from depression (NIMH, 2000/2001) affecting both the client and his/her family members. This study applies Inconsistent Nurturing as Control Theory (Le Poire, 1994) to romantic relationships with depressed individuals (N=68 couples) and examines types and patterns of attempts to curtail depression. Results from in-depth interviews of depressed individuals and their partners suggest partners change their communication strategies over time such that they use more negative strategies before they label depression problematic, actively help and encourage depressed individuals more after the labeling, and revert to a less consistent sequence of positive and negative strategies after the initial control strategies have proven unsuccessful. Implications for health challenges in romantic relationships are discussed. [ABSTRACT FROM AUTHOR]

Family caregiving for those who suffer from Alzheimer's disease is an important but understudied area in Italian nursing. Population ageing and the existing burden of care for family caregivers indicate that there will be enormous pressure on families in the future to provide adequate and culturally appropriate care. This study attempted to redress this situation by examining anxiety and depression among 34 female Italian Alzheimer's caregivers over a total of 816 caregiving days. A descriptive, repeated measures design was used, using three instruments to survey caregiving: a General Questionnaire about Caregiving, the Spielberg State-Trait Anxiety Inventory and the Geriatric Depression Scale. Findings indicated that caregivers suffered high levels of anxiety (76%) and depression (42%). Statistical analyses showed that the anxiety and depression scores were positively correlated with hours of care, physical and psychological illness scores, and negatively correlated with level of education and time for leisure activities. However, no significant correlations were found with the Mini Mental State Examination scores, demonstrating that the burden of care is large, irrespective of the extent of mental impairment. Implications of the findings suggest that support and assistance given to Italian caregivers might be inadequate, particularly with respect to respite services and educational support. [ABSTRACT FROM AUTHOR]

This review considers evidence for the efficacy of pharmacotherapy among primary care patients with depressive disorders and reviews knowledge regarding the effectiveness of current practice. Strong evidence supports the efficacy of antidepressant pharmacotherapy for primary care patients with major depression and dysthymia with some evidence for pharmacotherapy of less severe depression. In general, available antidepressants appear equal in both efficacy and effectiveness. Treatment selection for any individual patient remains largely empirical, with few clinical characteristics predicting better or worse response to specific treatments. Strong evidence supports continuation treatment (i.e., at least six months of pharmacotherapy) for all patients and maintenance treatment (i.e., at least 24 months of pharmacotherapy) for those with chronic or recurrent depression. Unfortunately, few patients in primary care or specialty practice receive recommended levels of pharmacotherapy or recommended frequency of follow-up care. A number of recent studies have evaluated strategies to improve the quality of antidepressant treatment in primary care. Educational programs (including academic detailing and continuous quality improvement) have had little impact on patient outcomes. Key elements of effective care improvement programs include specific, evidence-based treatment protocols, organized patient education and active follow-up care. [Copyright &y& Elsevier]

Background: The serotonin system and hypothalamic pituitary-adrenal (HPA)-axis are each implicated in the pathway to depression; human and animal research support these systems' cross-talk. Our work implicates a 5-variant additive serotoninergic multilocus genetic profile score (MGPS) and separately the cortisol awakening response (CAR) in the prospective prediction of depression; other work has shown that the serotonin transporter polymorphism 5HTTLPR predicts CAR and interacts with the CAR to predict depression.Methods: We tested the hypothesis that a 6-variant MGPS (original plus 5HTTLPR) would interact with CAR to predict prospective depressive episode onsets in 201 emerging adults using four annual follow-up interviews. We also tested whether MGPS predicted CAR. We attempted replication of significant findings in a sample of 77 early adolescents predicting depression symptoms.Results: In sample 1, MGPS did not significantly predict CAR. MGPS interacted with CAR to predict depressive episodes; CAR slopes for depression steepened as MGPS increased, for risk or protection. No single variant accounted for results, though CAR's interactions with 5HTTLPR and the original MGPS were both significant. In sample 2, the 6-variant MGPS significantly interacted with CAR to predict depression symptoms.Conclusions: Higher serotonergic MGPS appears to sensitize individuals to CAR level-for better and worse-in predicting depression. [ABSTRACT FROM AUTHOR]