Telephone-Delivered Care For Treating Depression After Coronary Artery Bypass Graft Surgery Appears To Improve Outcomes
Patients who received telephone-delivered collaborative care for treatment of depression after coronary artery bypass graft surgery reported greater improvement in measures of quality of life, physical functioning and mood than patients who received usual care, according to a study in the November 18 issue of JAMA. The study is being released early online because of its presentation at an American Heart Association scientific conference. Coronary artery bypass graft (CABG) surgery is one of the most common and costly medical procedures performed in the United States. As many as half of CABG patients report depressive symptoms after surgery, and are also more likely to experience a decreased health-related quality of life (HRQL) and functional status, according to background information in the article. Several trials for treatment of depression have been conducted in cardiac populations, but most achieved less than anticipated benefits with regard to reducing mood symptoms. "Moreover, none used the proven effective collaborative care approach recently recommended by a National Institutes of Health expert consensus panel, " the authors write.
Asthma symptoms can worsen in children with depressed mothers, according to research from Johns Hopkins Children's Center published online in the Journal of Pediatric Psychology. Analyzing data from interviews with 262 mothers of African-American children with asthma - a population disproportionately affected by this inflammatory airway disorder - the Hopkins investigators found that children whose mothers had more depressive symptoms had more frequent asthma symptoms during the six-months of the study. Conversely, children whose mothers reported fewer depressive symptoms had less frequent asthma symptoms. Researchers tracked ups and downs in maternal depression as related to the frequency of symptoms among children. "Even though our research was not set up to measure just how much a mom's depression increased the frequency of her child's symptoms, a clear pattern emerged in which the latter followed the earlier, " says senior investigator Kristin Riekert, Ph.D., a pediatric psychologist and co-director of the Johns Hopkins Adherence Research Center.
Maternal depression can worsen asthma symptoms in their children, according to research from Johns Hopkins Children's Center published online in the Journal of Pediatric Psychology. Analyzing data from interviews with 262 mothers of African-American children with asthma a population disproportionately affected by this inflammatory airway disorder the Hopkins investigators found that children whose mothers had more depressive symptoms had more frequent asthma symptoms during the six-months of the study. Conversely, children whose mothers reported fewer depressive symptoms had less frequent asthma symptoms. Researchers tracked ups and downs in maternal depression as related to the frequency of symptoms among children. "Even though our research was not set up to measure just how much a mom's depression increased the frequency of her child's symptoms, a clear pattern emerged in which the latter followed the earlier, " says senior investigator Kristin Riekert, Ph.D., a pediatric psychologist and co-director of the Johns Hopkins Adherence Research Center.
Collective Depression Syndrome Among Asylum-Seeking Detainees Highlighted In New Paper Published By Dove Medical Press
A new paper by William W Bostock from the School of Government, University of Tasmania, analysing the debate between the psychiatric profession and the Australian government over collective depression syndrome found among asylum-seeking detainees, has been published in the Dove Medical Press journal: Psychology Research and Behavior Management. The open access publisher of medical and scientific journals has made the paper available here. Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities. Over several years there has been debate over the Australian Government's treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticising the Australian Government's policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees.
Falls among elderly people are significantly associated with several classes of drugs, including sedatives often prescribed as sleep aids and medications used to treat mood disorders, according to a study led by a University of British Columbia expert in pharmaceutical outcomes research. The study, published Nov. 23 in the Archives of Internal Medicine, provides the latest quantitative evidence of the impact of certain classes of medication on falling among seniors. Falling and fall-related complications such as hip fractures are the fifth leading cause of death in the developed world, the study noted. Antidepressants showed the strongest statistical association with falling, possibly because older drugs in this class have significant sedative properties. Anti-psychotics/neuroleptics often used to treat schizophrenia and other psychoses and benzodiazepines such as valium were also significantly associated with falls. "These findings reinforce the need for judicious use of medications in elderly people at risk of falling, " says principal investigator Carlo Marra, a UBC associate professor of Pharmaceutical Sciences.
Angst could be more than a rite of passage for insecure teenagers, according to a study published in The Journal of Pain. Researchers from the UniversitÃ de MontrÃ al, the Sainte-Justine University Hospital Center and McGill University have discovered that insecure adolescents experience more intense pain in the form of frequent headaches, abdominal pain and joint pain. These teens are also more likely to be depressed than peers with secure attachments. Dr. Isabelle Tremblay, a researcher at the UniversitÃ de MontrÃ al and its affiliated Sainte-Justine University Hospital Center, and Dr. Michael Sullivan, a psychology professor at McGill University, launched this study to build on previous findings that childhood experiences play a major role in the relationships people develop in later life. Simply put: insecure infants grow up to be insecure adolescents, and later, insecure adults. "Although previous studies in adults found that an individual's security level was influenced by painful experiences, it was not clear why relationship security should be related to pain, " says Dr.
Surgeons who are burned out or depressed are more likely to say they had recently committed a major error on the job, according to the largest study to date on physician burnout. The new findings suggest that the mental well-being of the surgeon is associated with a higher rate of self-reported medical errors, something that may undermine patient safety more than the fatigue that is often blamed for many of the medical mistakes. Although surgeons do not appear more likely to make mistakes than physicians in other disciplines, surgical errors may have more severe consequences for patients due to the interventional nature of the work. Some estimate that as many as 10 percent of hospitalized patients are impacted by medical errors. "People have talked about fatigue and long working hours, but our results indicate that the dominant contributors to self-reported medical errors are burnout and depression, " said Charles M. Balch, M.D., a professor of surgery at the Johns Hopkins University School of Medicine and one of the study's leaders.
People with Multiple Sclerosis (MS) feel more than twice as much withheld anger as the general population and this could have an adverse effect on their relationships and health, according to a study published in the December issue of the European Journal of Neurology. Italian researchers assessed 195 patients with MS, using a range of scales that measure anger, depression and anxiety, and then compared them with the general population. They were surprised by the results, which showed that while patients experienced almost twice the normal level of withheld anger and exerted low levels of control on their anger, their expressed anger levels were similar to the general population. This, together with the fact that the elevated withheld anger levels were not related to the severity of the patients' MS, suggests that these inconsistent changes were caused by nervous system damage, rather than an emotional reaction to the stress of the disease. "We believe that the higher levels of withheld anger shown by the study subjects is due to demyelination, loss of the substance in the white matter that insulates the nerve endings and helps people receive and interpret messages from the brain" explains lead researcher Dr Ugo Nocentini from the IRCCS S Lucia Foundation in Rome.
There is no scientific proof that people suffering from depression can benefit from taking reboxetine. However, clinical trials do provide proof of benefit of bupropion XL and mirtazapine: both agents can alleviate symptoms. This is the conclusion of the final report of the Institute for Quality and Efficiency in Health Care (IQWiG) published on 24 November 2009. The final evaluation of reboxetine and mirtazapine was only possible after manufacturers disclosed data that had previously been concealed. This case re-emphasizes the need for a mandatory regulation, which would require all clinical trials to be registered at the start and to have their results published after study completion. Manufacturers only release data when public pressure mounts In its preliminary report published at the beginning of June 2009, the only results IQWiG could present without reservation were those for bupropion XL. It was forced to add a caveat to the results for mirtazapine, because the fact could not be ignored that study data not provided by Essex Pharma might seriously bias the result.
A supplement in this edition of the Medical Funny book of Australia examines the multiplying effect of depression and physical illness. Supported by "beyondblue: the civic depression initiative", the supplement includes proof and commentary from leading mental health experts from throughout Australia. Professor of Psychological Medicine at Monash University, David Clarke, said the supplement addresses the complex relationship between depression and physical illness. " Every clinician knows that depression is common in tribe with a physical illness, " Prof Clarke said. "But the huge crunch of depression has been freshly highlighted over recent years. "Recent World Health Organization (WHO) earth health surveys indicated that depression produced the greatest decrement in health of any chronic disease, and the comorbid state of depression incrementally worsened health more than any other disease combination." Studies published in the supplement present evidence establishing a capable connection between physical illness and depression and anxiety, including baggage on outcomes.