Browsing by Subject "depression"

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Anti-depressants are not first-line therapy for mild to moderate depression
(2010-07-29) Koch, Lisa
Anti-depressants do not treat mild to moderate depression better than placebo. They also have potential side effects and significant costs. For patients with mild to moderate depression, psychotherapy should be the first choice for treatment. Psychotherapy, or counseling, has been shown to be effective for depression and does not have the side effects associated with anti-depressants. For treating more severe depression, anti-depressants are more effective than placebo and should remain a first choice for therapy.
Anxiety and Depression: What if I have both?
(2009-09-18) Ho, Sing-Wei
The addition of a benzodiazepine to an SSRI provides more rapid global improvement of generalized anxiety disorder and depression than an SSRI alone. Patients are less likely to discontinue treatment and more likely to show improvement than those receiving antidepressant monotherapy. In addition, the risks of benzodiazepine abuse are low outside of the setting of polysubstance abuse. Overall, patients with co-existing depression and anxiety should be treated in the initial few weeks with combination therapy to prevent premature drop-out from treatment.
Assessment of Community Pharmacists Willingness and Barriers of Medication Therapy Management (MTM) focused on Pain Management and Mental Health
(University of Minnesota, College of Pharmacy, 2014) Keller, Megan E.; Bright, David R.; Sullivan, Donald L.; Cornelius, Doug C.
Objectives: To determine the willingness and barriers of community pharmacists to provide pain management and depression MTM services. Methods: An anonymous, self-administered survey was distributed electronically to 350 licensed pharmacists in a supermarket pharmacy chain. The survey consisted of a 40 question, Likert-type scale, where strongly disagree was assigned a value of one and strongly agree a value of seven. Constructs measured included: MTM interest, comfort with MTM, confidence with appropriate medication use and adjustment, educational needs, training required, time constraints, and work-related factors. Demographic data was also collected. Results: A total of 186 (53%) community pharmacists completed the survey. These pharmacists worked in an environment where MTM was currently being provided. Ninety percent of respondents averaged 0-5 MTM sessions per 4 week period. Pharmacists agreed that patients would benefit from MTM focused on pain (median 6 IR[5-7]) and/or depression (median 6 IR[5-7]) and agreed pharmacists can have positive interventions in these situations (pain: median 6 IR[5-7]; depression: median 6 IR[5-7]). Pharmacists surveyed were interested in continuing education and live presentation as preferred methods to improve knowledge of pain management and depression. Conclusion: Pharmacists are interested in and believe patients would benefit from MTM specifically for pain management and depression. Barriers to MTM focused on pain and depression were pharmacist training and workflow issues with the MTM process.
Associations between Depressive Symptoms and Relationship Satisfaction among Military Couples after Deployments
(2018-06) Cheng, Cheuk
Research traditionally has focused on associations between Post-Traumatic Stress Disorder (PTSD) symptoms and couple relationship satisfaction in military populations. Less research has been conducted on other mental health problems, particularly depression, given the high comorbidity between depression and PTSD. The purpose of the present study was to understand the associations between depressive symptoms and couple relationship satisfaction among post-deployed military couples, after controlling for combat exposure and life event stress. The actor-partner interdependence model (APIM) was used to measure inter and intra-spousal associations among 228 couples. Men had experienced at least one deployment to recent conflicts in the Middle East. The results show both actor effects and partner effects for negative associations between depressive symptoms and relationship satisfaction. Moreover, consistent with the Military Family Stress model, the results show that depressive symptoms are uniquely associated with relationship satisfaction. The results of the current study highlight the importance of focusing on depressive symptoms in both intervention and prevention programs for military families, especially for members of the National Guard and Reserves (NG/R).
Children and Depression
(2009-05-04) Goulet, Bridgette
Studies have shown that children and adolescents with depression who are treated with antidepressants show a significant improvement in their depressive symptoms. In addition, although the FDA found that children have a higher rate of suicidal thoughts when treated with antidepressants, this article found no difference in the amount of suicidal thoughts/attempts between children treated with antidepressant medication and children treated with placebo. This indicates that the benefits of antidepressants in children outweigh the risks in most cases.
Crossing Paths: A Study of the Interaction Between Law Enforcement and the Mentally Ill.
(2004) Conroy, Regan
Depression
(2009-05-04) Yang, Lao
Depression is a commonly encountered medical condition. This patient education tool is a brochure in both English and Hmong that details the basic information on depression.
Design and Implementation of Antidepressant Decision Making Aids
(University of Minnesota, College of Pharmacy, 2012-07) DeJongh, Beth; Haight, Robert
Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness. Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient’s medication adherence needs to be addressed in future studies.
Examining the Effects of the Creativity Camp Intervention on Depression and Suicidality in Depressed Adolescents
(2023) Frederiksen, Jordan; Nair, Aparna U; DiMaggio-Potter, Michaelle E; Klimes-Dougan, Bonnie; Cullen, Kathryn R.
Many adolescents experience depression and, sometimes in tandem, suicidality. Unfortunately, not all depression and suicidality can treated using the same methods, as it is often the case they may be resistant to common techniques such as Cognitive Behavioral Therapy or SSRIs. Using a novel Creativity Camp intervention, we analyzed the effects on suicidality, and found a statistically significant reduction in depression symptoms using the CDI-2, and a reduction in adolescents reporting suicidality from pre-camp to post-camp.
Examining the Role of Aggression and Victimization in the Development of Psychopathology in Ugandan Adolescents
(2015-06) Hecht, Kathryn
Positive peer relationships play an important role in child development, serving not only as protective factors during and after exposure to adversity such as war or armed conflict, but also providing a training ground to develop the wide range of social skills and behaviors necessary for effective functioning within any given cultural context. Alternately, negative peer experiences such as relational and physical aggression and victimization can serve as powerful risk factors for later psychopathology; in particular, research supports a link between depression and forms of aggression as well as victimization. However, this relation has primarily been explored in North American and European contexts. Further, child aggressive behavior and depressive symptoms both appear to be more prevalent in contexts where children have been exposed to armed conflict. Little information is available on how different forms of aggression and victimization relate to depression in youth in more diverse cultural contexts, particularly in war-affected populations. The present study addresses this gap through examinations exploring the prevalence and gender differences of different forms of aggression as well as the relationship between relational and overt forms aggression/victimization and depression in a sub-Saharan, war-affected setting. Participants include a cross-sectional sample of 258 adolescents (M=16.26 years of age) to examine prevalence and gender differences in forms of aggression and victimization, as well as 96 adolescents (M=15.71 years of age) studied longitudinally over one calendar year to examine the relation between aggression, victimization and depression. Findings indicate that self-reported relational aggression as well as overt aggression each uniquely predicts depression symptoms, controlling for the alternate form of aggression. Relational victimization also uniquely predicts depression symptoms after controlling for overt victimization. Overt victimization did not significantly predict depression after controlling for the contribution of relational victimization. Implications of findings, limitations and future directions are discussed.
Fish Oil
(2010-10-29) Dickmann, Patty
Fish oil is obtained in the human diet by eating oily fish such as salmon, herring, trout, mackerel, albacore tuna, and sardines, or by consuming fish oil supplements. Contrary to popular belief, fish do not naturally produce these oils; instead, they acquire them through the ocean food chain when they consume algae, the original sources of the omega-3 fatty acids found in fish oils. Evidence from several studies suggests that omega-3 fatty acids from fish or fish oil supplements have positive effects on heart health, mental health, and infant development. It may even reduce the risk of some types of cancer. While fish oil has few reported side effects, it is important to talk to your doctor before starting fish oil supplements.
Intergenerational Relationships across the Life Course: Links with Adolescent Well-Being
(2015-08) Doty, Jennifer
Grounded in the life course perspective, the author used data from three generations of the Youth Development Study (YDS) to conduct two studies on intergenerational relationships between parents and children. Using growth mixture modeling, Study 1 identified prospective patterns of perceived closeness with fathers (n = 913) and mothers (n = 966) from adolescence into adulthood over 24 years in the first generation (G1 -- G2). Analyses identified a continuous, slightly increasing pattern of perceived closeness with fathers. Three quadratic, latent class patterns of perceived closeness with mothers fit the data best: high closeness over time, average but decreased closeness in adulthood, and low but increased closeness in adulthood. Demographic and family correlates are discussed. In a subset of second generation, parent-adolescent dyads (n =262), Study 2 examined the relationship between G1- G2 patterns of perceived closeness and G3 well-being and perceived closeness with parents in adolescence. The mean trajectory of G2 perceived closeness with grandfathers did not predict perceived closeness with parents, depression, or well-being in G3 adolescents; nor did patterns of G2 perceived closeness with grandmothers differentiate levels of depressed mood, self-esteem, or closeness with mother in G3 adolescents. A marginal difference in G3 closeness with fathers was found by G2 patterns of closeness with mothers, such that those in families with G2 low but increased closeness reported lower closeness with fathers compared to those in families with high G2 closeness over time.
The Interpersonal-Psychological Theory of Suicide and Associated Family Factors in Clinically Suicidal and Depressed Adolescents
(2018-06) Hunt, Quintin
Suicide is a leading cause of death in adolescence. The mechanisms of adolescent suicidality, however, are not fully understood. Although the Interpersonal-Psychological Theory of Suicide, as assessed by the Interpersonal Needs Questionnaire-15 (INQ), may be a promising framework, systematic study of its utility during adolescence is lacking. To this end, I utilized factor analyses and hierarchical regression analyses to test the factor structure, correlates, and predictive validity of the INQ in a sample of clinically depressed and suicidal adolescents (N=120, aged 12-18, 81.9% female). Contrary to studies including adult samples in which a two-factor solution is identified, results within this sample indicated three factors: perceived burdensomeness, thwarted belongingness, and perceived isolation. Perceived burdensomeness and the interaction between perceived burdensomeness and perceived isolation predicted suicide ideation above and beyond depression, but thwarted belongingness and perceived isolation did not. Perceived burdensomeness appears to play a role in adolescent suicidality and may be a point of intervention, yet the notable deviation from previous findings and relative weakness of two of the factors warrant further study
Iron Deficiency, Depression, and Other Affective Disorders in Female State Fair Attendees
(2018-05) Price, Kathleen
Iron deficiency persists as the most prevalent nutrient deficiency on the planet, and women of menstruating age are at high risk due to menstrual blood loss. Recent data suggests that iron deficiency in the absence of anemia impacts quality of life, and currently the prevalence of menstruating females with inadequate ferritin values in the US is high. Although the literature on iron status and depression is conflicting, a relationship is suggested with a proposed mechanism of altered neurotransmitter functioning. This cross-sectional study gathered survey data and blood samples from 182 female subjects at the Minnesota State Fair in August of 2015. Whole blood hemoglobin, hematocrit, serum ferritin and serum TIBC were determined and correlated to survey data detailing reported iron deficiency symptoms and their severity, including the PHQ9, a validated depression screen. 15% of subjects were anemic as defined by a hematocrit value under 38% or a hemoglobin value below 12 g/dL. Additionally, 74% had low ferritin status as defined by a value less than 20 g/L. Overall, 10% of subjects reported moderate to severe depression as defined by the PHQ9. Although independent relationships between anemia, low ferritin values, or elevated TIBC values and depression were not seen, inclusion of symptomatic iron deficiency, a variable combining iron deficiency symptoms of dizziness and shortness of breath to assess whether deficiency was exerting a physiological effect, improved the correlation between the biochemical measures of iron status and depression (p < 0.0001), as well as self-reported incidence of other affective and executive functioning disorders, including stress or moodiness, ease of anger, emotional unresponsiveness, and alertness or concentration. This data suggests that iron deficiency must be symptomatic for the association with depression and other affective or executive functioning disorders to be apparent.
Personality and Psychopathology in Offspring of Mothers Diagnosed with Affective Illness
(2016-10) Allen, Timothy
Offspring of mothers diagnosed with an affective illness are at increased risk for developing an affective spectrum disorder. The overarching goal of the present study is to investigate whether individual differences in cognition and personality among at-risk offspring promote or prevent the development of affective symptomatology in adolescence and young adulthood. Participants included siblings drawn from 98 families participating in a longitudinal study of the offspring of depressed mothers (Radke-Yarrow, 1998). Forty-two of the mothers in the study were diagnosed with unipolar depression, 26 with bipolar disorder I or II, and 30 were healthy comparisons. Ratings of offspring personality, cognitive style, and psychopathology were obtained from multiple measures across two time points in adolescence and young adulthood. History of a maternal affective disorder and offspring Neuroticism independently predicted elevated depressive symptoms in adolescence, while high Neuroticism and Extraversion predicted offspring mania. Offspring Neuroticism interacted with maternal diagnosis to predict risk for depression in young adulthood. Lower-order traits comprising Neuroticism showed unique associations with offspring affective symptoms both concurrently and prospectively. Overall, findings suggest that high Neuroticism is associated with increased risk for depressive and manic symptoms in adolescence and young adulthood, and this effect may be partially moderated by maternal psychopathology.
Prenatal depressive symptoms and social support: An examination of their role in prenatal care adequacy, birth outcomes, and risk for postpartum depressive symptoms among low-income urban women
(2016-05) Sidebottom, Abbey
Background. Decreasing the prevalence of inadequate prenatal care, poor birth outcomes, and postpartum depression are public health priorities. Objectives. To examine, in a low-income, racially diverse, urban clinic-based sample the associations of: 1) Social support and depressive symptoms with prenatal care adequacy. 2) Social support and depressive symptoms with poor birth outcomes. 3) Prenatal and postpartum depressive symptoms, as well as their magnitude, and correlates of occurrence. Methods. The study sample was women who received prenatal care at five community health centers from 2005-2009. Maternal data from prenatal and postpartum risk screening tools were linked to data from their infants’ birth certificates. We examined the associations of social support and prenatal depressive symptoms with late and less than adequate prenatal care (Paper 1, n = 2,341) and preterm birth, low birthweight, and small size for gestational age (Paper 2, n = 2,868). We also characterized depressive symptoms in the prenatal and postpartum periods (Paper 3, n = 594). For all papers, multivariable analyses included personal, social, behavioral, and environmental risk factors associated with maternal and infant health. Results. Lack of social support was associated with inadequate prenatal care. Women with poor partner support and depressive symptoms were at the highest risk for starting care late. Neither prenatal depressive symptoms nor social support were independently associated with birth outcomes. There was an association between prenatal and postpartum depressive symptoms. Over half of women with postpartum symptoms had elevated symptoms prenatally. Variability in risk markers suggest unique risk factors are associated with experiencing depressive symptoms in either or both time periods. Conclusions. This study assessed understudied psychosocial risks with public health priority outcomes in a sample of women served by the public health system. Findings support efforts to increase screening for prenatal depression to better identify those at risk of postpartum depression.
Relationships between Adolescent Stress, Depressive Symptoms, Social Support, Coping and Sexual Risk Behavior in Young Adulthood
(2017-01) Ghobadzadeh, Maryam
Objective To describe longitudinal associations among adolescent stressful life events, depressive symptoms, coping skills, social support, and young adult sexual risk behaviors and sexually transmitted infection (STI) in the United States. Design A total of 18,924 participants aged from 12 to 18 at baseline were included in the analysis. The study's design was a secondary analysis of three waves of longitudinal data utilized structural equation modeling (SEM) to test direct and indirect effects of adolescent stressful life events, depressive symptoms, problem-focused coping skills, unhealthy coping strategies, and social support on young adult sexual risk behavior. To examine the hypotheses of this study, three main structural models were evaluated. Model 1 explores the effects of depressive symptoms and stressful life events as the potential mediator of the association between mental health problems and sexual risk behavior, while Model 2 tests mediating effect of unhealthy coping strategies. Lastly, Model 3 examines the indirect effects of problem-focused coping skills and social support on sexual risk behavior. Results As anticipated, direct effects were found for adolescent stressful life events and unhealthy coping strategies on young adult sexual risk behavior. Adolescent stressful life events and unhealthy coping also significantly mediated the relationship between depressive symptoms and young adult sexual risk behavior. Higher social support from family and problem-focused coping strategies were associated with lower depressive symptoms and stressful life events in adolescence. Adolescent social support from family and problem-focused coping skills were shown to influence young adult sexual risk behavior indirectly through reducing stressful life events. Conclusions Given the associations between stressful life events, depressive symptoms, and sexual risk behavior, these findings highlight a need for screening for depression and stressful life events in adolescents. Findings may also be useful to inform interventions for high-risk adolescents facing psychological stressors and suggest that coping skills training and enhancing social support should be specific targets.
SSRIs (Selective Serotonin Reuptake Inhibitors) and Sexual Side Effects in Women
(2008-11-24) Swanson, Gloria
Women on SSRIs may experience sexual side effects. There are a variety of ways to deal with these effects. Sildenafil is one medication that may help ameliorate these side effects.
St. Johnʼs wort (Hypericum perforatum extract) is effective for treatment of mild to moderate major depression.
(2010-11-02) Wolbrink, Dan
A clinical trial found that St. John’s wort can be used to treat some forms of depression. The evidence holds open the possibility of effective herbal treatments for patients with mild to moderate depression.
Supporting Care Partner Mental Health: Feasibility of a Behavioral Intervention Tailored for Stroke Survivor-Care Partner Dyads
(2020-04) Hultman, Meghan
This dissertation begins with an introduction to the current state of the science in patient-caregiver dyad research. Current studies have largely focused on cancer and dementia, and additional research is needed in other chronic conditions. Evidence suggests that various factors may impact caregiver outcomes such as caregiver burden, depression, and quality of life (QOL), and these outcomes may improve with intervention. Three manuscripts are presented, the first presenting a review of the literature related to characteristics of stroke survivors that are associated with depressive symptoms in their caregivers. The findings offer support for dyad-focused interventions to manage depressive symptoms in stroke survivor-caregiver dyads. This led to development of a two-arm randomized feasibility study exploring the use of problem-solving therapy (PST) compared to stroke-related health education for depressive symptoms and QOL in stroke survivor-caregiver dyads. Dyad-focused PST is a novel approach. The second manuscript describes challenges and lessons learned tailoring PST to dyads. These include: personalizing the intervention, balancing participation, maintaining focus, managing conflict, and addressing ethical concerns. Considerations for future research involving dyad-focused interventions are presented. The third manuscript illustrates the design, methods and results of the study. Recruitment required substantial efforts, yielding a recruitment rate of 14.4%. Overall attrition was 25%. Dyads completing the study showed excellent protocol adherence and provided positive experiential feedback, especially for PST, supporting intervention acceptability. No significant changes in outcome measures were seen over time for care partners or stroke survivors. Finally, the work is synthesized, highlighting key takeaways and implications for research and practice.

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