McCARTHY Michael J., POWERS Laurie E., LYONS Karen S.
Journal article citation:
Health and Social Work, 36(2), May 2011, pp.139-148.
Publisher:
Oxford University Press
Previous research has demonstrated that depression is the most common psychological challenge experienced by stroke survivors, affecting approximately 33% of these individuals. Depression among informal caregivers of stroke survivors, many of whom are spouses, is also a significant problem. The main aim of this article is to raise awareness among social workers and other rehabilitation practitioners about the strong potential for depression following stroke for survivors and their spouses. This discussion includes a review of common measures for assessment of poststroke depression and resources for accessing these measures for use in social work practice. A second purpose of this article is to underscore the need for social workers to view survivors in the context of their committed relationships. Assessing poststroke depression from a couple-level perspective is justified in view of growing evidence of the interconnectedness of couples' emotional well-being and the significance of couples-level factors like relationship quality and coping in the well-being of couples experiencing stroke. It is also in line with the values of the social work profession in viewing stroke survivors
Previous research has demonstrated that depression is the most common psychological challenge experienced by stroke survivors, affecting approximately 33% of these individuals. Depression among informal caregivers of stroke survivors, many of whom are spouses, is also a significant problem. The main aim of this article is to raise awareness among social workers and other rehabilitation practitioners about the strong potential for depression following stroke for survivors and their spouses. This discussion includes a review of common measures for assessment of poststroke depression and resources for accessing these measures for use in social work practice. A second purpose of this article is to underscore the need for social workers to view survivors in the context of their committed relationships. Assessing poststroke depression from a couple-level perspective is justified in view of growing evidence of the interconnectedness of couples' emotional well-being and the significance of couples-level factors like relationship quality and coping in the well-being of couples experiencing stroke. It is also in line with the values of the social work profession in viewing stroke survivors in their physical, social and emotional contexts.
British Journal of Clinical Psychology, 46(4), November 2007, pp.491-495.
Publisher:
Wiley
This study assessed the association between self-ratings and key-worker ratings of depression in people with mild learning disabilities. The Zung Depression Scale was completed by 74 adults with mild learning disabilities and a modified version of the questionnaire was completed by two key-workers at two periods in time. The correlations between ratings of depression by key-workers were high and key-worker ratings correlated significantly with self-rating. The depression scores were found to be temporally stable. The findings suggest that proxy raters appear to be able to make reliable and valid judgements about other people's self-reported levels of depression.
This study assessed the association between self-ratings and key-worker ratings of depression in people with mild learning disabilities. The Zung Depression Scale was completed by 74 adults with mild learning disabilities and a modified version of the questionnaire was completed by two key-workers at two periods in time. The correlations between ratings of depression by key-workers were high and key-worker ratings correlated significantly with self-rating. The depression scores were found to be temporally stable. The findings suggest that proxy raters appear to be able to make reliable and valid judgements about other people's self-reported levels of depression.
British Journal of General Practice, 58(546), January 2008, pp.32-36.
Publisher:
Royal College of General Practitioners
This study aimed to assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) and the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for measuring depression severity in primary care in 32 general practices in Grampian, Scotland. Consecutive patients referred to a primary care mental health worker completed the PHQ-9 and HADS at baseline (n = 1063) anxiety (HADS-A) subscale at baseline and at end of treatment. Responsiveness to change was similar: effect size for PHQ-9 = 0.99 and for the HADS-D = 1. The HADS-D and PHQ-9 differed significantly in categorising severity of depression, with the PHQ-9 categorising a greater proportion of patients with moderate/severe depression (P<0.001). The study concludes the HADS-D and PHQ-9 demonstrated
This study aimed to assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) and the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for measuring depression severity in primary care in 32 general practices in Grampian, Scotland. Consecutive patients referred to a primary care mental health worker completed the PHQ-9 and HADS at baseline (n = 1063) and at the end of treatment (n = 544). Data were analysed to assess reliability, robustness of factor structure, convergent/discriminant validity, convergence of severity banding, and responsiveness to change. Both scales demonstrated high internal consistency at baseline and end of treatment. One factor emerged each for the PHQ-9 and HADS-D. Both scales converged more with each other than with the HADS anxiety (HADS-A) subscale at baseline and at end of treatment. Responsiveness to change was similar: effect size for PHQ-9 = 0.99 and for the HADS-D = 1. The HADS-D and PHQ-9 differed significantly in categorising severity of depression, with the PHQ-9 categorising a greater proportion of patients with moderate/severe depression (P<0.001). The study concludes the HADS-D and PHQ-9 demonstrated reliability, convergent/discriminant validity, and responsiveness to change. However, they differed considerably in how they categorised severity. Given that treatment decisions are made on the basis of severity, further work is needed to assess the validity of the scales' severity cut-off bands.
Subject terms:
instruments, primary care, assessment, depression;
Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.384-390.
Publisher:
Wiley
There is a history of over-prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under-prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed. Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen’s kappa statistic and agreement proportion. Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement. Experienced clinicians achieved a high
There is a history of over-prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under-prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed. Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen’s kappa statistic and agreement proportion. Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement. Experienced clinicians achieved a high level of agreement as to whether a person with ID was psychotic or depressed similar to that found for those without ID. The findings provide some support for treatment interventions based on diagnosis.
... needed changes in any aspect of their family functioning. The authors conducted an open pilot trial of the Family Check-Up with 32 families. Data suggest that the Family Check-Up (1) is sought out by the target audience, namely those with family problems; (2) is sought out by people with elevated depression symptoms or a history of treatment for depression or anxiety; (3) is feasible to conduct; (4) is acceptable to families; and (5) may be associated with changes in family functioning and depression symptoms over time. These results suggest that further research, particularly a randomized clinical trial, is warranted.
Many barriers exist for families seeking appropriate treatment for family problems. The authors describe the development the Family Check-Up, a brief two-session family intervention. The Family Check-Up is based on the Drinker's Check-Up and consists of assessment, feedback, discussion, and goal setting. The purpose of the intervention is to help families identify and become motivated to make needed changes in any aspect of their family functioning. The authors conducted an open pilot trial of the Family Check-Up with 32 families. Data suggest that the Family Check-Up (1) is sought out by the target audience, namely those with family problems; (2) is sought out by people with elevated depression symptoms or a history of treatment for depression or anxiety; (3) is feasible to conduct; (4) is acceptable to families; and (5) may be associated with changes in family functioning and depression symptoms over time. These results suggest that further research, particularly a randomized clinical trial, is warranted.
Subject terms:
assessment, depression, families, family relations;
International Journal of Geriatric Psychiatry, 17(4), April 2002, pp.375-382.
Publisher:
Wiley
The 15-item Geriatric Depression Scale (GDS-15) is recommended for screening older people, but there are no large epidemiological studies using this instrument in the UK. This article describes the age and sex distribution of GDS-15 scores in the largest ever UK sample of people aged 75 and over. The GDS-15 was offered to a representative sample of UK people aged 75 and over. Proportions of people attaining thresholds on the GDS-15 were calculated by age group and sex. The data provides a national picture of the numbers of older people who will score positively for depression in health screens which include the GDS-15.
The 15-item Geriatric Depression Scale (GDS-15) is recommended for screening older people, but there are no large epidemiological studies using this instrument in the UK. This article describes the age and sex distribution of GDS-15 scores in the largest ever UK sample of people aged 75 and over. The GDS-15 was offered to a representative sample of UK people aged 75 and over. Proportions of people attaining thresholds on the GDS-15 were calculated by age group and sex. The data provides a national picture of the numbers of older people who will score positively for depression in health screens which include the GDS-15.
British Journal of Clinical Psychology, 36(4), November 1997, pp.489-503.
Publisher:
Wiley
Examines whether selective attentional and interpretative processing of emotional information occurs in depression, and if so, whether it depends on a close match between the material used and current concerns. Finds that depressed patients show evidence of cognitive biases favouring all negative self-related information, on both attentional and interpretative tasks. Suggests that such effects in depression may occur only under conditions allowing the elaborative processing of negative material related to oneself.
Examines whether selective attentional and interpretative processing of emotional information occurs in depression, and if so, whether it depends on a close match between the material used and current concerns. Finds that depressed patients show evidence of cognitive biases favouring all negative self-related information, on both attentional and interpretative tasks. Suggests that such effects in depression may occur only under conditions allowing the elaborative processing of negative material related to oneself.
International Journal of Geriatric Psychiatry, 12(4), April 1997, pp.436-446.
Publisher:
Wiley
Examines the use of the Centre for Epidemiological Studies-Depression Scale (CES-D in a sample of elderly, medically ill inpatients. Seventy-six individuals completed the CES-D and a psychiatric interview, from which DSM-III-R diagnoses of depression were obtained. Analyses of sensitivity and specificity indicated that use of an alternative scoring method which more closely approximates current diagnostic criteria for depression may improve the predictive power of the test. Item analyses demonstrated that seven of the CES-D items failed to discriminate major, minor and non-depressed patients, and that several of these items tapped somatic symptoms. These findings suggest that the validity of the CES-D may be compromised when used with elderly medical patients, and modifications for its use
Examines the use of the Centre for Epidemiological Studies-Depression Scale (CES-D in a sample of elderly, medically ill inpatients. Seventy-six individuals completed the CES-D and a psychiatric interview, from which DSM-III-R diagnoses of depression were obtained. Analyses of sensitivity and specificity indicated that use of an alternative scoring method which more closely approximates current diagnostic criteria for depression may improve the predictive power of the test. Item analyses demonstrated that seven of the CES-D items failed to discriminate major, minor and non-depressed patients, and that several of these items tapped somatic symptoms. These findings suggest that the validity of the CES-D may be compromised when used with elderly medical patients, and modifications for its use are recommended.
British Medical Journal, 10.9.11, 2011, pp.527-531.
Publisher:
British Medical Association
This clinical review article focuses on cognitive assessment of older people (those aged over about 65 years) in the context of possible dementia, delirium, and depression. The article highlights the need for accurate assessments to include three components; observation of the patient, accounts from the carer, and the results of assessment instruments. It also describes some brief cognitive tests. The authors draw on their own experience; the guidelines on dementia, delirium, and depression published by the National Institute for Health and Clinical Excellence (NICE); and a systematic review of cognitive assessment instruments.
This clinical review article focuses on cognitive assessment of older people (those aged over about 65 years) in the context of possible dementia, delirium, and depression. The article highlights the need for accurate assessments to include three components; observation of the patient, accounts from the carer, and the results of assessment instruments. It also describes some brief cognitive tests. The authors draw on their own experience; the guidelines on dementia, delirium, and depression published by the National Institute for Health and Clinical Excellence (NICE); and a systematic review of cognitive assessment instruments.
British Journal of Psychiatry, 198(5), May 2011, pp.370-384.
Publisher:
Cambridge University Press
Screening for risk of suicide may have potential harms as well as benefits; observational studies support the idea that suicidal ideation can be transmitted by exposure to the subject. This multicentre, single-blind, randomised controlled study examined whether being screened for suicidal ideation when attending primary care services with signs of depression increased the short-term incidence
Screening for risk of suicide may have potential harms as well as benefits; observational studies support the idea that suicidal ideation can be transmitted by exposure to the subject. This multicentre, single-blind, randomised controlled study examined whether being screened for suicidal ideation when attending primary care services with signs of depression increased the short-term incidence of feeling that life is not worth living. Patients in four general practices in London were randomised to screening or control questions on health and lifestyle. Follow up interviews 10-14 days later measured “thinking that life is not worth living” and other aspects of suicidal ideation and behaviour in both groups. A total of 443 participants (mean age 48.5 years, 31% male) were randomised to early (n = 230) or delayed screening (n = 213). The adjusted odds of experiencing thoughts that life was not worth living at follow-up among those randomised to early compared with delayed screening was 0.88. No differences were seen in other aspects of suicidal ideation and behaviour. Among those randomised to early screening, 22.3% reported thinking about taking their life at baseline and 14.6% had this thought 2 weeks later. It appears that screening for suicidal ideation in depressive primary care patients does not induce suicidal ideation.
Subject terms:
primary care, screening, suicide, assessment, depression;