Depression Research and Treatment The latest articles from Hindawi © 2018 , Hindawi Limited . All rights reserved. A Psychometric Properties Evaluation of the Italian Version of the Geriatric Depression Scale Thu, 01 Mar 2018 00:00:00 +0000 Objective. The Geriatric Depression Scale (GDS) is an evaluation tool to diagnose older adult’s depression. This questionnaire was defined by Yesavage and Brink in 1982; it was designed expressly for the older person and defines his/her degree of satisfaction, quality of life, and feelings. The objective of this study is to evaluate the psychometric properties of the Italian translation of the Geriatric Depression Scale (GDS-IT). Methods. The Italian version of the Geriatric Depression Scale was administered to 119 people (79 people with a depression diagnosis and 40 healthy ones). We examined the following psychometric characteristics: internal consistency reliability, test-retest reliability, concurrent validity, and construct validity (factor structure). Results. Cronbach’s Alpha for the GDS-IT administered to the depressed sample was 0.84. Test-retest reliability was 0.91 and the concurrent validity was 0.83. The factorial analysis showed a structure of 5 factors, and the scale cut-off is between 10 and 11. Conclusion. The GDS-IT proved to be a reliable and valid questionnaire for the evaluation of depression in an Italian population. In the present study, the GDS-IT showed good psychometric properties. Health professionals now have an assessment tool for the evaluation of depression symptoms in the Italian population. Giovanni Galeoto, Julita Sansoni, Michela Scuccimarri, Valentina Bruni, Rita De Santis, Mariele Colucci, Donatella Valente, and Marco Tofani Copyright © 2018 Giovanni Galeoto et al. All rights reserved. The Effect of Interpersonal Counseling for Subthreshold Depression in Undergraduates: An Exploratory Randomized Controlled Trial Thu, 22 Feb 2018 00:00:00 +0000 Background. Subthreshold depression and poor stress coping strategies are major public health problems among undergraduates. Interpersonal counseling (IPC) is a brief structured psychological intervention originally designed for use in primary care to treat depressive patients whose symptoms arose from current life stress. Objectives. This study examined the efficacy of IPC in treating subthreshold depression and coping strategies among undergraduates in school counseling. Materials and Methods. We carried out an exploratory randomized controlled trial comparing the efficacy of IPC with counseling as usual (CAU). Participants were 31 undergraduates exhibiting depression without a psychiatric diagnosis. Results. The Zung Self-Rating Depression Scale total score decreased significantly in the IPC group (; , ), but not in the CAU group . The task-oriented coping score of the Coping Inventory for Stressful Situations showed a tendency towards a greater increase in the IPC group than in the CAU group (, , ). Conclusions. The IPC might be more useful for student counseling because it can teach realistic coping methods and reduce depressive symptoms in a short period. Further studies using more participants are required. Ami Yamamoto, Emi Tsujimoto, Reiko Taketani, Noa Tsujii, Osamu Shirakawa, and Hisae Ono Copyright © 2018 Ami Yamamoto et al. All rights reserved. Assigning Clinical Significance and Symptom Severity Using the Zung Scales: Levels of Misclassification Arising from Confusion between Index and Raw Scores Sun, 21 Jan 2018 08:16:04 +0000 Background. The Zung Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) are two norm-referenced scales commonly used to identify the presence of depression and anxiety in clinical research. Unfortunately, several researchers have mistakenly applied index score criteria to raw scores when assigning clinical significance and symptom severity ratings. This study examined the extent of this problem. Method. 102 papers published over the six-year period from 2010 to 2015 were used to establish two convenience samples of 60 usages of each Zung scale. Results. In those papers where cut-off scores were used (i.e., 45/60 for SDS and 40/60 for SAS), up to 51% of SDS and 45% of SAS papers involved the incorrect application of index score criteria to raw scores. Inconsistencies were also noted in the severity ranges and cut-off scores used. Conclusions. A large percentage of publications involving the Zung SDS and SAS scales are using incorrect criteria for the classification of clinically significant symptoms of depression and anxiety. The most common error—applying index score criteria to raw scores—produces a substantial elevation of the cut-off points for significance. Given the continuing usage of these scales, it is important that these inconsistencies be highlighted and resolved. Debra A. Dunstan and Ned Scott Copyright © 2018 Debra A. Dunstan and Ned Scott. All rights reserved. Addressing Adolescent Depression in Tanzania: Positive Primary Care Workforce Outcomes Using a Training Cascade Model Sun, 26 Nov 2017 07:53:39 +0000 Background. This is a report on the outcomes of a training program for community clinic healthcare providers in identification, diagnosis, and treatment of adolescent Depression in Tanzania using a training cascade model. Methods. Lead trainers adapted a Canadian certified adolescent Depression program for use in Tanzania to train clinic healthcare providers in the identification, diagnosis, and treatment of Depression in young people. As part of this training program, the knowledge, attitudes, and a number of other outcomes pertaining to healthcare providers and healthcare practice were assessed. Results. The program significantly, substantially, and sustainably improved provider knowledge and confidence. Further, healthcare providers’ personal help-seeking efficacy also significantly increased as well as the clinicians’ reported number of adolescent patients identified, diagnosed, and treated for Depression. Conclusion. To our knowledge, this is the first study reporting positive outcomes of a training program addressing adolescent Depression in Tanzanian community clinics. These results suggest that the application of this training cascade approach may be a feasible model for developing the capacity of healthcare providers to address youth Depression in a low-income, low-resource setting. Stan Kutcher, Yifeng Wei, Heather Gilberds, Adena Brown, Omary Ubuguyu, Tasiana Njau, Norman Sabuni, Ayoub Magimba, and Kevin Perkins Copyright © 2017 Stan Kutcher et al. All rights reserved. Investigation of the Relationship between Psychological Variables and Sleep Quality in Students of Medical Sciences Thu, 28 Sep 2017 11:40:01 +0000 Objectives. Students of medical sciences are exposed to many emotional and mental problems. In light of the importance of sleep quality in learning and liveliness, this study was conducted to examine the relationship between psychological variables (stress, anxiety, and depression) and sleep quality of students. Design. This research is a cross-sectional analytical study, where all students studying at Fasa University of Medical Sciences in 2012-2013 year were selected. To examine the students’ stress, anxiety, and depression values, the standardized 21-item DASS-21 was used, and to examine their sleep quality, Pittsburgh Sleep Quality Index (PSQI) was used. Results. The results of the study demonstrated that 73% of the students have moderate and severe stress, and 46.4% of them have PSQ scores ≥ 5. The students’ mean sleep quality score was , and their stress score was . A statistically significant relationship was found between the students’ stress levels and sleep quality (). Conclusion. The high stress levels decrease students’ sleep quality. High stress levels and also the significant relationship between stress value and decrease in students’ sleep quality call for more attention to and care for students’ emotional and mental issues and timely proper interference on the part of authorities. Majid Najafi Kalyani, Nahid Jamshidi, Javad Salami, and Elahe Pourjam Copyright © 2017 Majid Najafi Kalyani et al. All rights reserved. Migration-Related Stressors and Their Effect on the Severity Level and Symptom Pattern of Depression among Vietnamese in Germany Tue, 22 Aug 2017 08:15:48 +0000 Objectives. Vietnamese in Germany represent a scarcely researched and vulnerable group for mental health problems, especially under exposure to migration-related stressors (MRS). This study analyzes the effect of those MRS on the severity level and symptom pattern of depression. Design. We analyzed the data of 137 depressed Vietnamese patients utilizing Germany’s first Vietnamese psychiatric outpatient clinic. Hierarchical linear regression models were applied to investigate how the quantity of MRS influenced (1) the overall severity of self-reported depression symptoms; (2) the cognitive, affective, and somatic BDI-II subscale; and (3) the single BDI-II items of these subscales. Results. A greater number of MRS were related to a higher severity level of depression in general, as well as to a higher level on the cognitive depression subscale in particular. The BDI-II single items pessimism, past failure, guilt feelings, punishment feelings, and suicidal thoughts were particularly associated with a higher quantity of perceived MRS. Conclusion. Among depressed Vietnamese migrants in Germany, a higher number of reported MRS were associated with higher overall depression severity. Within the domains of depression, particularly the cognitive domain was linked to perceived MRS. The association between MRS and suicidal thoughts is clinically highly relevant. Simon Wolf, Eric Hahn, Michael Dettling, Main Huong Nguyen, Katja Wingenfeld, Markus Stingl, Bernd Hanewald, and Thi Minh Tam Ta Copyright © 2017 Simon Wolf et al. All rights reserved. Expression of Concern on “Invisible Victims: Delayed Onset Depression among Adults with Same-Sex Parents” Tue, 22 Aug 2017 00:00:00 +0000 Depression Research and Treatment Copyright © 2017 Depression Research and Treatment. All rights reserved. A Review of the Conceptualisation and Risk Factors Associated with Treatment-Resistant Depression Thu, 03 Aug 2017 10:33:21 +0000 Major depression does not always remit. Difficult-to-treat depression is thought to contribute to the large disease burden posed by depression. Treatment-resistant depression (TRD) is the conventional term for nonresponse to treatment in individuals with major depression. Indicators of the phenomenon are the poor response rates to antidepressants in clinical practice and the overestimation of the efficacy of antidepressants in medical scientific literature. Current TRD staging models are based on anecdotal evidence without an empirical rationale to rank one treatment strategy above another. Many factors have been associated with TRD such as inflammatory system activation, abnormal neural activity, neurotransmitter dysfunction, melancholic clinical features, bipolarity, and a higher traumatic load. This narrative review provides an overview of this complex clinical problem and discusses the reconceptualization of depression using an illness staging model in line with other medical fields such as oncology. Jenifer A. Murphy, Jerome Sarris, and Gerard J. Byrne Copyright © 2017 Jenifer A. Murphy et al. All rights reserved. Spiritual Struggle in Parents of Children with Cystic Fibrosis Increases Odds of Depression Mon, 31 Jul 2017 00:00:00 +0000 Objective. Spiritual struggle (SS) is associated with poorer health outcomes including depression. The study’s main objectives were to characterize change in depression over time, examine longitudinal associations between SS and depression, and determine the extent to which experiencing SS at baseline was predictive of developing depression at follow-up. Methods. A two-site study collected questionnaire responses of parents (; 72% female) of children with cystic fibrosis followed longitudinally. Generalized linear mixed effects modeling examined the association between depression and SS over time and assessed potential mediators, moderators, and confounders. Results. Prevalence of depression increased from baseline to follow-up (OR: 3.6, ), regardless of degree of SS. Parents with Moderate/Severe SS were more likely to have depressive symptoms, compared to parents without SS (OR: 15.2, ) and parents who had Mild SS (OR: 10.2, ). Being female and feeling less “at peace” also significantly predicted increased depression (OR: 2.5, , and OR: 1.15, , resp.). Experiencing SS at baseline was not predictive of having depression subsequently at follow-up. Conclusions. Parents experiencing SS were significantly more likely to report depressive symptoms. Interventions to reduce SS have shown efficacy and may be considered. Rhonda D. Szczesniak, Yuanshu Zou, Sophia M. Stamper, and Daniel H. Grossoehme Copyright © 2017 Rhonda D. Szczesniak et al. All rights reserved. The Effect of Partnership Care Model on Mental Health of Patients with Thalassemia Major Wed, 21 Jun 2017 00:00:00 +0000 Background. Thalassemia major has become a public health problem worldwide, particularly in developing and poor countries, while the role of educating the family and community has not been considered enough in patients’ care. Objectives. This study examines the impact of partnership care model on mental health of patients with beta-thalassemia major. Materials and Methods. This experimental study, with pretest and posttest design, was performed on patients with beta-thalassemia major in Jiroft city. 82 patients with beta-thalassemia major were allocated randomly into two groups of intervention (41 patients) and control () groups. Mental health of the participants was measured using the standard questionnaire GHQ-28 before and after intervention in both groups. The intervention was applied to the intervention group for 6 months, based on the partnership care model. Results. There were significant differences between the scores of mental health and its subscales between two groups after the intervention (). Conclusions. The findings of the study revealed the efficacy and usefulness of partnership care model on mental health of patients with beta-thalassemia major; thus, implementation of this model is suggested for the improvement of mental health of patients with beta-thalassemia major. Afzal Shamsi, Fardin Amiri, Abbas Ebadi, and Musab Ghaderi Copyright © 2017 Afzal Shamsi et al. All rights reserved. Response to: Comment on “Invisible Victims: Delayed Onset Depression among Adults with Same-Sex Parents” Mon, 19 Dec 2016 11:19:19 +0000 D. Paul Sullins Copyright © 2016 D. Paul Sullins. All rights reserved. Comment on “Invisible Victims: Delayed Onset Depression among Adults with Same-Sex Parents” Mon, 19 Dec 2016 08:22:28 +0000 Nathaniel Frank Copyright © 2016 Nathaniel Frank. All rights reserved. The Effects of Mindfulness-Based Cognitive Therapy on Depression and Anxiety in Women with Premenstrual Syndrome Tue, 29 Nov 2016 10:03:58 +0000 Objective. Little research has been done regarding the role of psychotherapy in the treatment of Premenstrual Syndrome (PMS). The aim of this study was to examine the effect of mindfulness-based cognitive therapy (MBCT) on the PMS symptoms and depression and anxiety symptoms in women with PMS. Design. In a randomized controlled trial, a total of 60 students at Mazandaran University with mild to moderate PMS who had depressive symptoms (Beck depression scores 16–47) were randomly allocated to either an experimental () or a control () group. The experimental group received MBCT in eight group sessions (120 min each) over 8 weeks. The control group received no intervention. All participants completed the Premenstrual Assessment Scale (PAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at the beginning and the end of the study. Repeated-measure ANOVA was used to analyze the data. Results. At the end of study, the experimental and control groups showed the following scores, respectively (mean ± SD): depression, and ; anxiety, and ; and total PAS, and . MBCT improved depression and anxiety symptoms and total PAS score. Conclusion. MBCT intervention is acceptable and potentially beneficial in women with PMS symptoms. Psychotherapy should be considered as a treatment option for mild to moderate PMS in women with depressive symptoms. Faeze Panahi and Mahbobeh Faramarzi Copyright © 2016 Faeze Panahi and Mahbobeh Faramarzi. All rights reserved. The Connections of Pregnancy-, Delivery-, and Infant-Related Risk Factors and Negative Life Events on Postpartum Depression and Their Role in First and Recurrent Depression Wed, 26 Oct 2016 16:36:00 +0000 Introduction. The aim of this study is to assess how negative life events and adverse experiences with pregnancy, delivery, the infant(s), and breastfeeding cessation impact on postpartum depression (PPD), specifically in first lifetime and recurrent depression. Method. The study group comprised 104 mothers with a current episode of PPD and a control group of 104 mothers who did not have current PPD. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The course of the depression, adverse experiences, and breastfeeding were assessed by self-reports. Results. In age-adjusted multivariate analyses, mental and physical problems during pregnancy or delivery, postpartum problems with the infant and breastfeeding cessation, and negative life events during the previous 12 months were associated with postpartum depression. Eighteen percent (18%) of the mothers had first depression and 82% recurrent depression. Mental and physical problems during pregnancy or delivery were associated with both first lifetime and recurrent depression. Nevertheless, negative life events and infant/breastfeeding issues associated only with recurrent depression. Conclusion. Factors associated with pregnancy and delivery have an impact on PPD, but in recurrent depression other postnatal and psychosocial factors are also important risk factors. Pirjo Kettunen, Eeva Koistinen, and Jukka Hintikka Copyright © 2016 Pirjo Kettunen et al. All rights reserved. Suicidal Ideation, Attempt, and Determining Factors among HIV/AIDS Patients, Ethiopia Thu, 22 Sep 2016 09:35:15 +0000 Background. Suicide is a serious cause of mortality worldwide and is considered as a psychiatric emergency. Suicide is more frequent in peoples living with HIV/AIDS than in general population. Objective. To assess the proportion and determining factors of suicidal ideation and attempt among peoples living with HIV/AIDS in Ethiopia. Methods. Institutional based cross-sectional study was conducted from May to June 2015 by selecting 393 participants using systematic random sampling technique. Suicide manual of Composite International Diagnostic Interview (CIDI) was used to collect data. Logistic regression was carried out and odds ratio with 95% confidence intervals was computed. Results. The proportion of suicidal ideation and attempt was 33.6% and 20.1%, respectively. Female sex (AOR = 2.6, 95%CI: 1.27–5.22), marital status (AOR = 13.5, 95%CI: 4.69–39.13), depression (AOR = 17.0, 95%CI: 8.76–33.26), CD4 level (AOR = 2.57, 95%CI: 1.34–4.90), and presence of opportunistic infection (AOR = 5.23, 95%CI: 2.51–10.88) were associated with suicidal ideation, whereas marital status (AOR = 8.44, 95%CI: 3.117–22.84), perceived HIV stigma (AOR = 2.9, 95%CI: 1.45–5.99), opportunistic infection (AOR = 2.37, 95%CI: 1.18–4.76), and poor social support (AOR = 2.9, 95%CI: 1.58–5.41) were significantly associated with suicidal attempt. Conclusion. Suicidal ideation and attempt were high among HIV positive patients. Therefore early screening, treatment, and referral of suicidal patients are necessary in HIV clinics. Huluagresh Bitew, Gashaw Andargie, Agitu Tadesse, Amsalu Belete, Wubalem Fekadu, and Tesfa Mekonen Copyright © 2016 Huluagresh Bitew et al. All rights reserved. Depressive Symptoms among Latino Sexual Minority Men and Latina Transgender Women in a New Settlement State: The Role of Perceived Discrimination Wed, 14 Sep 2016 13:17:06 +0000 Background. Little is known about the role of discrimination on depression among Latino sexual and gender identity minorities. This manuscript examined the relationship between ethnic/racial discrimination and sexual discrimination on clinically significant depressive symptoms among Latino sexual minority men (i.e., gay and bisexual men and other men who have sex with men) and Latina transgender women. Methods. A community-based participatory research partnership recruited participants ( = 186; 80.6% cisgender men) in North Carolina to a social network-based HIV intervention. Using baseline data, we quantified the amount of perceived discrimination and conducted mixed-effects logistic regression analyses to examine correlates of clinically significant depressive symptoms. Results. A high percentage of participants reported ethnic/racial discrimination (73.7%) and sexual discrimination (53.8%). In the multivariable models, ethnic/racial discrimination, sexual discrimination, masculinity, fatalism, and social support were significantly associated with clinically significant depressive symptoms. Discussion. Improving mental health requires multilevel interventions that address pertinent individual, interpersonal, and system level factors. Christina J. Sun, Alice Ma, Amanda E. Tanner, Lilli Mann, Beth A. Reboussin, Manuel Garcia, Jorge Alonzo, and Scott D. Rhodes Copyright © 2016 Christina J. Sun et al. All rights reserved. Prevalence of Antenatal Depression and Associated Risk Factors among Pregnant Women Attending Antenatal Clinics in Abeokuta North Local Government Area, Nigeria Thu, 18 Aug 2016 11:52:52 +0000 Objective. The prevalence of antenatal depression (AD) and associated risk factors among pregnant women attending antenatal clinics in Abeokuta North Local Government Area, Nigeria, was determined. Methods. A descriptive cross-sectional survey was conducted, interviewing 314 pregnant women selected by multistage sampling technique from among those attending antenatal clinics. Information was collected using structured questionnaire and a screening tool, Edinburgh Postnatal Depression Scale (EPDS), to assess probable depression. Results. The prevalence of antenatal depression was 24.5%. There were significant associations between antenatal depression and attending public health facility (), young maternal age (), single marital status (), not having formal education (), large family size (), planned pregnancy (), coexisting medical conditions (), history of previous caesarian section (), drinking alcohol during pregnancy (), and gender based abuse (). On health seeking behaviour for antenatal depression among depressed pregnant women, most, 68.9%, consulted their husbands about their symptoms; 57.3% took the decision to get treatment from doctors, and 52% sought prayer in the church. Conclusion. Antenatal depression is prevalent in this study population. Interventions to address its risk factors should be carried out and physicians should suspect depression in pregnant women reporting alcohol use and gender abuse. Okechukwu Thompson and IkeOluwapo Ajayi Copyright © 2016 Okechukwu Thompson and IkeOluwapo Ajayi. All rights reserved. Invisible Victims: Delayed Onset Depression among Adults with Same-Sex Parents Sun, 29 May 2016 07:58:09 +0000 The relationship of elevated depression risk recently discovered among adult persons raised by same-sex parents with possible precipitating conditions in childhood has not previously been acknowledged. This study tests whether such inattention is supportable. Logistic regression based risk ratios were estimated from longitudinal measures of mental health outcomes observed in three waves (at ages 15, 22, and 28) of the US National Survey of Adolescent to Adult Health (,701). At age 28, the adults raised by same-sex parents were at over twice the risk of depression (CES-D: risk ratio 2.6, 95% CI 1.4–4.6) as persons raised by man-woman parents. These findings should be interpreted with caution. Elevated risk was associated with imbalanced parental closeness and parental child abuse in family of origin; depression, suicidality, and anxiety at age 15; and stigma and obesity. More research and policy attention to potentially problematic conditions for children with same-sex parents appears warranted. D. Paul Sullins Copyright © 2016 D. Paul Sullins. All rights reserved. Breastfeeding and Postpartum Depression: An Overview and Methodological Recommendations for Future Research Mon, 11 Apr 2016 13:02:14 +0000 Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1) use standardized assessment protocols; (2) confirm diagnosis through established clinical interview when possible; (3) provide a clear operationalized definition for breastfeeding variables; (4) clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5) be prospective or longitudinal in nature; and (6) take into consideration other potential risk factors identified in the empirical literature. Carley J. Pope and Dwight Mazmanian Copyright © 2016 Carley J. Pope and Dwight Mazmanian. All rights reserved. Prevalence and Severity of Depression and Its Association with Substance Use in Jimma Town, Southwest Ethiopia Wed, 16 Mar 2016 07:26:13 +0000 Background. Depression is a significant contributor to the global burden of disease and affects 350 million people worldwide. Substance use could be the risk factor for depression. Objective. We aim to determine the prevalence and severity of depression and its association with substance use. Methods. A cross-sectional study was conducted on a sample of 650 respondents in Jimma town in March 2014. A multistage stratified sampling method was conducted. Structured questionnaire and Beck’s Depression Inventory (BDI-II) scale were used for data collection. Data analysis was done using the SPSS Version 20.0 for Windows. Results. The participation rate of respondents was 590/650 (90.77%). The proportion of females was 300 (50.9%). The current prevalence of depression was 171 (29.0%). Based on the BDI-II grading of the severity of depression, 102 (59.6%) had mild, 56 (32.7%) had moderate, 13 (7.6%) had severe depression. In the present study, age of 55 years and above [OR = 5.94, CI: 2.26–15.58], being widowed [OR = 5.18, CI: 1.18–22.76], illiterates [OR = 9.06, CI: 2.96–27.75], khat chewing [OR = 10.07, CI: 5.57–18.25], cigarette smoking [OR = 3.15, CI: 1.51–6.58], and shisha usage [OR = 3.04, CI: 1.01–9.19] were significantly and independently associated with depression. Conclusion. The finding depicted that depression was a moderate public health problem. Advanced age, being widowed, illiterate, khat chewing, and cigarette and shisha smocking could be the potential risk factors for depression. Risk reduction is recommended. Andualem Mossie, Dagmawi Kindu, and Alemayehu Negash Copyright © 2016 Andualem Mossie et al. All rights reserved. Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis Thu, 03 Mar 2016 15:14:29 +0000 The Center for Epidemiological Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its psychometric properties have not been adequately evaluated among adults with HIV/AIDS. This study used an item response theory approach (Rasch analysis) to evaluate the CES-D’s validity and reliability in relation to key demographic and clinical variables in adults with HIV/AIDS. A convenience sample of 347 adults with HIV/AIDS (231 males, 93 females, and 23 transgenders; age range 22–77 years) completed the CES-D. A Rasch model application was used to analyze the CES-D’s rating scale functioning, internal scale validity, person-response validity, person-separation validity, internal consistency, differential item functioning (DIF), and differential test functioning. CES-D scores were generally high and associated with several demographic and clinical variables. The CES-D distinguished 3 distinct levels of depression and had acceptable internal consistency but lacked unidimensionality, five items demonstrated poor fit to the model, 15% of the respondents demonstrated poor fit, and eight items demonstrated DIF related to gender, race, or AIDS diagnosis. Removal of misfitting items resulted in minimal improvement in the CES-D’s substantive and structural validity. CES-D scores should be interpreted with caution in adults with HIV/AIDS, particularly when comparing scores across gender and racial groups. Caryl L. Gay, Anders Kottorp, Anners Lerdal, and Kathryn A. Lee Copyright © 2016 Caryl L. Gay et al. All rights reserved. A Possible Role of Anhedonia as Common Substrate for Depression and Anxiety Wed, 02 Mar 2016 06:49:28 +0000 Depression and anxiety are often comorbid, in up to 70% of cases, and the level of one or the other may fluctuate, leading now to a diagnosis of depression, now to a diagnosis of anxiety. For these reasons, and for the presence of many other common factors, it has been suggested that both are part of the same continuum of problems and that they have a common substrate. This paper proposes the possibility that anhedonia may be an important component of this possible common substrate, and it tries to identify the mechanism with which anhedonia could contribute to causing both depression and anxiety. It also proposes an explanation why an intense pleasure could improve both depression and anxiety. Luigi Grillo Copyright © 2016 Luigi Grillo. All rights reserved. Symptom Endorsement and Sociodemographic Correlates of Postnatal Distress in Three Low Income Countries Mon, 15 Feb 2016 13:15:57 +0000 Background. Maternal mental illness has been implicated in adverse child development outcomes. Factors such as context and culture may influence experiences of maternal distress and explain differences in outcomes across settings. Methods. We analyzed baseline data from 5,647 mothers in Ethiopia, India (Andhra Pradesh), and Vietnam participating in an ongoing cohort study (Young Lives) to compare symptom endorsement and sociodemographic correlates of distress. Maternal distress was assessed using the Self-Reporting Questionnaire-20 Items (cutoff: ≥8). Logistic regressions were stratified by sample to identify correlates of distress. Results. Symptom endorsement was similar among distressed women, particularly with regard to feeling unhappy (76%, 80%, and 79%). Notable differences were observed in three items assessing Depressive Thoughts, which were most highly endorsed in Ethiopia (49%–56%). Having a child experiencing a life-threatening event was correlated with distress in all three samples. A variety of correlates were unique to only one sample. Conclusions. There were multiple similarities but also notable differences across sites in the expression and correlates of maternal distress. Feeling unhappy appears to be a hallmark feature of distress. Correlates highlight the relationship between distress and indicators of poverty, child wellbeing, and economic shocks. Differences demonstrate the value of further exploration of cross-cultural differences. Amanda J. Nguyen, Emily E. Haroz, Tamar Mendelson, and Judith Bass Copyright © 2016 Amanda J. Nguyen et al. All rights reserved. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features Tue, 05 Jan 2016 14:00:42 +0000 Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state. Miguel Palma, Berta Ferreira, Nuno Borja-Santos, Bruno Trancas, Céu Monteiro, and Graça Cardoso Copyright © 2016 Miguel Palma et al. All rights reserved. Perinatal Depression and Patterns of Attachment: A Critical Risk Factor? Sun, 20 Dec 2015 13:05:16 +0000 Background. This study aims to verify if the presence and severity of perinatal depression are related to any particular pattern of attachment. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, who were administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS) and the Experience in Close Relationship (ECR). A clinical group of subjects with perinatal depression (PND, 89 subjects) was selected and compared with a control group (C), regarding psychopathological variables and attachment patterns. Results. The ECR showed a prevalence of “Fearful-Avoidant” attachment style in PND group (29.2% versus 1.1%, ); additionally, the EPDS average score increases with the increasing of ECR dimensions (Avoidance and Anxiety). Conclusion. The severity of depression increases proportionally to attachment disorganization; therefore, we consider attachment as both an important risk factor as well as a focus for early psychotherapeutic intervention. Valentina Meuti, Franca Aceti, Nicoletta Giacchetti, Giuseppe Mattia Carluccio, Michela Zaccagni, Isabella Marini, Orazio Giancola, Paola Ciolli, and Massimo Biondi Copyright © 2015 Valentina Meuti et al. All rights reserved. Illness Attitudes Associated with Seasonal Depressive Symptoms: An Examination Using a Newly Developed Implicit Measure Thu, 10 Dec 2015 06:47:41 +0000 The Dual Vulnerability Model of seasonal depression posits that seasonal vegetative symptoms are due to a physiological vulnerability, but cognitive and mood symptoms are the result of negative appraisal of vegetative changes. In addition, rumination may be associated with stronger negative attitudes toward vegetative symptoms. This is the first study to examine implicit attitudes toward vegetative symptoms. We hypothesized that illness attitudes about fatigue moderate the relationship between the severity of vegetative symptoms and the severity of cognitive symptoms and that the illness attitudes are associated with rumination. This study also developed an implicit method to assess the appraisal of fatigue as indicating illness. Results supported both hypotheses. Illness attitudes toward fatigue moderated the relationship between vegetative symptoms and cognitive symptoms. Ruminative response style was positively associated with implicit illness attitudes towards fatigue. The study provides support for the role of negative appraisals of vegetative symptoms in the development of cognitive and mood seasonal depressive symptoms. Katherine Meyers and Michael A. Young Copyright © 2015 Katherine Meyers and Michael A. Young. All rights reserved. Cognitive Mechanisms Reciprocally Transmit Vulnerability between Depressive and Somatic Symptoms Wed, 09 Dec 2015 12:27:17 +0000 Despite high comorbidity between depressive and somatic symptoms, cognitive mechanisms that transmit vulnerability between symptom clusters are largely unknown. Dampening, positive rumination, and brooding are three cognitive predictors of depression, with rumination theoretically indicated as a transdiagnostic vulnerability through amplifying and diminishing affect in response to events. Specifically, the excess negative affect and lack of positive affect characteristic of depressive symptoms and underlying somatic symptoms may cause and be caused by cognitive responses to events. Therefore, the current study examined whether comorbidity between depressive and somatic symptoms may be explained by the cognitive mechanisms of dampening and positive rumination in response to positive events and brooding in response to negative events among adults () across eight weeks of assessment. We hypothesized that greater dampening and brooding would reciprocally predict greater depressive and somatic symptoms, while greater positive rumination would reciprocally predict fewer depressive and somatic symptoms. Mediation analyses in AMOS 22 indicated that dampening and brooding mediated reciprocal pathways between depressive and somatic symptoms, but positive rumination did not. Findings propose dampening and brooding as mechanisms of the reciprocal relationship between depressive and somatic symptoms through diminishing positive affect and amplifying negative affect in response to positive and negative events. Kaitlin A. Harding, Karly M. Murphy, and Amy Mezulis Copyright © 2015 Kaitlin A. Harding et al. All rights reserved. Childhood Trauma and Its Relation to Chronic Depression in Adulthood Sun, 29 Nov 2015 09:31:51 +0000 There is a large consensus indicating that childhood trauma is significantly involved in the development of depression. The aim of this study was to examine the prevalence of retrospectively recalled childhood trauma in chronically depressed patients and to investigate a more specific relationship between trauma type and depression. We further asked for the influence of multiple experiences of childhood trauma on the vulnerability to a chronic course of depression in adulthood. 349 chronically depressed patients of the German LAC Depression Study completed the Childhood Trauma Questionnaire, a self-report measure of traumatic experiences in childhood. 75.6% of the chronically depressed patients reported clinically significant histories of childhood trauma. 37% of the chronically depressed patients reported multiple childhood traumatization. Experiences of multiple trauma also led to significantly more severe depressive symptoms. Stepwise multiple regression analysis suggested that childhood emotional abuse and sexual abuse were significantly associated with a higher symptom severity in chronically depressed adults. Yet, expanding the regression model for multiple exposures showed that multiplicity was the only remaining significant predictor for symptom severity in chronically depressed patients. Clinical implications suggest a precise assessment of childhood trauma in chronically depressed patients with a focus on emotional abuse, sexual abuse, and multiple exposures to childhood trauma. This trial is registered with registration number ISRCTN91956346. Alexa Negele, Johannes Kaufhold, Lisa Kallenbach, and Marianne Leuzinger-Bohleber Copyright © 2015 Alexa Negele et al. All rights reserved. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches Wed, 25 Nov 2015 13:30:55 +0000 Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as “winter blues.” Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ). Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD. Sherri Melrose Copyright © 2015 Sherri Melrose. All rights reserved. Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates Wed, 18 Nov 2015 07:46:05 +0000 Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia. Method. 72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS). A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), was examined. Results. Eleven (15.3%) patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale. Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients. Ravi Philip Rajkumar Copyright © 2015 Ravi Philip Rajkumar. All rights reserved.