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Understanding depression from different paradigms: toward an eclectic social work approach
- Authors:
- HUANG Yu-Te, FANG Lin
- Journal article citation:
- British Journal of Social Work, 46(3), 2016, pp.756-772.
- Publisher:
- Oxford University Press
Depression is a significant mental health issue that many social workers encounter in their practice. There is great deal of theoretical and empirical knowledge concerning depression that stems from different paradigms. In this paper, the authors argue for the importance of understanding depression from four paradigms, post-positivism, social constructivism, critical theory and Eastern paradigm, and they illuminate how depression would be known and dealt with by these paradigmatic approaches. Given multiple paradigms available in understanding depression, the authors argue that social workers need to have the ability to appreciate and discern these different paradigms. Such ability can help strengthen social work practice. The authors further illustrate an eclectic approach that not only allows social workers to recognise the utilities and limitations of different paradigms, but also enables them to be dynamic, effectively addressing a range of issues when working with a service user who has depression. (Edited publisher abstract)
The impact of executive function on response to cognitive behavioral therapy in late-life depression
- Authors:
- GOODKIND Madeleine S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(4), 2016, pp.334-339.
- Publisher:
- Wiley
Objective: Late-life depression (LLD) is a common and debilitating condition among older adults. Cognitive behavioural therapy (CBT) has strong empirical support for the treatment of depression in all ages, including in LLD. In teaching patients to identify, monitor, and challenge negative patterns in their thinking, CBT for LLD relies heavily on cognitive processes and, in particular, executive to CBT. Results: When using three baseline measures of executive functioning that quantify set shifting, cognitive flexibility, and response inhibition to predict treatment response, only baseline Wisconsin Card Sort Task performance was associated with a significant drop in depression symptoms after CBT. Specifically, worse performance on the Wisconsin Card Sort Task was associated with better (Publisher abstract)
Young people's narratives of depression
- Authors:
- ISSAKAINEN Mervi, HANNINEN Vilma
- Journal article citation:
- Journal of Youth Studies, 19(2), 2016, pp.237-250.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reports on findings from a study, which aimed to gain insight into young people's depression as a part of their life course by analysing written accounts of 81 young Finnish people who self-identified as having been depressed. The participants’ accounts were seen as reflecting both their actual life and their narrative interpretations of it in relation to the prevailing normative conceptions regarding youth. The accounts can be grouped into four main story types. The story type referred to as growing up on a sidetrack depicts depression as having its origins in childhood adversities that hinder the realisation of normative goals. Falling off the track depicts how a young person's life can be derailed as a result of experiences that cause or exacerbate depression. In the story missing the track, depression is intertwined with one's experience of failure in meeting normative expectations, whereas the story questioning the track features the problematisation of such expectations. The results underscore the importance of tackling different adverse conditions in childhood, adolescence and young adulthood in a timely fashion, as well as the importance of therapy, counselling and guidance, which help young people to manage difficulties and depression in their life. (Publisher abstract)
Screening for depression in older adults on an acute medical ward: the validity of NICE guidance in using two questions
- Authors:
- ESIWE Collins, et al
- Journal article citation:
- Age and Ageing, 44(5), 2015, pp.771-775.
- Publisher:
- Oxford University Press
Background: Depression is common in older people in general hospital settings and associated with poor outcomes. This study aimed to evaluate the validity of two screening questions recommended by the UK National Institute for Health and Clinical Excellence (NICE). Methods: One hundred and eighteen patients aged over 65 years, admitted to acute medical wards at a teaching hospital, were interviewed in a standardised manner using relevant sections of the Present State Examination—Schedules for Clinical Assessment in Neuropsychiatry to identify depression according to ICD-10 criteria. Subsequently, participants completed the two depression screening questions and the 15-item version of the Geriatric Depression Scale (GDS-15). Results: A threshold of one or more positive responses to the two NICE depression screening questions gave a sensitivity of 100%, specificity of 71%, positive predictive value (PPV) of 49% and negative predictive value (NPV) of 100%. The GDS-15 optimal cut-off was 6/7 with a sensitivity of 80%, specificity of 86%, PPV of 62% and NPV of 94%. A two-stage screening process utilising the NICE two questions followed by the GDS-15 with these cut-offs gave a sensitivity of 80%, specificity of 91%, PPV of 71% and NPV of 94%. Conclusion: The two depression questions perform well as an initial screening process for non-cognitively impaired older people in the acute medical setting. A positive response to either question would indicate that further assessment is required by a clinician competent in diagnosing depression in this population, or the possible use of a more (Publisher abstract)
Normal aging or depression? A qualitative study on the differences between subsyndromal depression and depression in very old people
- Authors:
- LUDVIGSSON Mikael, et al
- Journal article citation:
- Gerontologist, 55(5), 2015, pp.760-769.
- Publisher:
- Oxford University Press
Purpose of the Study: The aim of this study was to make a qualitative comparison of experiences of being in very old people with subsyndromal depression (SSD), in relation to the experiences of very old people with syndromal depression or nondepression. Through investigation and deeper understanding of the interface between depressive disease and normal aging, clinicians might give more accurate prevention or treatment to those very old persons who need such help. Design and Methods: Semistructured qualitative interviews were conducted for 27 individuals of 87–88 years of age, who were categorized in the 3 strata of nondepressive, SSD, and syndromal depression. Transcripts were analysed using qualitative content analysis within each stratum and later with a comparison between the strata.Results: The content analysis resulted in 4 themes in people with SSD, as defined by a self-report depression screening instrument, giving a comprehensive picture of SSD in very old people, and also showed qualitative differences between the SSD, syndromal depression, and nondepressive groups. A main finding was that SSD differs qualitatively from syndromal depression but not clearly from nondepression. (Edited publisher abstract)
Physical exercise for late-life major depression
- Authors:
- MURRI M. Belvederi, et al
- Journal article citation:
- British Journal of Psychiatry, 207(3), 2015, pp.235-242.
- Publisher:
- Cambridge University Press
Aims: Interventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available. This study aimed to investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression. Method: Primary care patients (465 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of ≤10 on the Hamilton Rating Scale for Depression). Results: A total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group. Conclusions: Physical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression. (Publisher abstract)
Down syndrome: systematic review of the prevalence and nature of presentation of unipolar depression
- Authors:
- WALTON Catherine, KERR Mike
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(4), 2015, pp.151-162.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to assess the prevalence and nature of presentation of unipolar depression in individuals with Down syndrome (DS). Design/methodology/approach: The PRISMA (2009) checklist for systematic review was followed where possible. Findings: Eight studies were included in the qualitative synthesis from a total of 634 records identified. The quality of the studies was then assessed: the studies all scored either 5 or 6 out of 6. The incidence of depression ranged between studies from 5 to 13 per cent. It was found that depression is more common in DS than the general intellectual disability population; this on a background of mental ill health of all causes being less common in DS. It was suggested that, excluding organic disorders, depression is the most common psychiatric problem in DS. In terms of the nature of depression, the evidence was less clear. Various “vegetative” and biological symptoms were observed, with no fixed pattern. There was evidence for withdrawal symptoms and psychosis. Research limitations/implications: The small number of studies included in this review, and their heterogeneity, highlights the need for further original research in this field.Practical implications: - An increased awareness of the frequency of depression in individuals with DS will aid in a timely diagnosis, therefore reduce psychiatric morbidity. Clinicians should be aware of the varied presentation, with no clear clinical picture, in order to maintain a high index of suspicion in an individual presenting with “atypical” symptoms. Originality/value This review has provided preliminary evidence that depression may be the most commonly experienced psychiatric disorder in DS. (Publisher abstract)
An exploratory analysis of the relations between the rate of physiological habituation, the acquired capability for suicide, and acute risk factors for suicide
- Authors:
- SMITH Phillip N., et al
- Journal article citation:
- Journal of Aggression Conflict and Peace Research, 7(3), 2015, pp.139-148.
- Publisher:
- Emerald
Purpose: The interpersonal theory of suicide proposes that an individual must acquire the capability for suicide to carry out a near-lethal or lethal suicide attempt. This capability develops via habituation in response to painful and provocative life events. Some individuals might be more vulnerable to developing the capability for suicide because they habituate more quickly to stimuli. The purpose of this paper is to examine the relations between the rate of physiological habituation and acquired capability, proxies for acquired capability, and acute risk factors for suicide. Design/methodology/approach: Depressed, suicidal individuals completed self-report assessments and a startle reflex task assessing the rate or speed of physiological habituation in response to repeated bursts of white noise. Findings: Slower habituation was associated with hopelessness and negative stressors. The rate of habituation was not associated with acquired capability. (Edited publisher abstract)
Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong
- Authors:
- CHAN Wallace Chi Ho, KWAN Chi Wai, CHI Iris
- Journal article citation:
- Aging and Mental Health, 19(9), 2015, pp.829-834.
- Publisher:
- Taylor and Francis
Objectives: This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. Method: Logistic regression was used to analyse secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Results: Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. Conclusion: The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophise their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty (Edited publisher abstract)
The relationship between depression and frailty syndrome: a systematic review
- Authors:
- BUIGUES Cristina, et al
- Journal article citation:
- Aging and Mental Health, 19(9), 2015, pp.762-772.
- Publisher:
- Taylor and Francis
Objectives: Frailty is a geriatric syndrome characterised by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve. Frailty and depressive symptoms are common issues facing older adults and may be associated. It is not clear if the depression facilitates the appearance of frailty syndrome or vice versa or these two coexist independently in the same individuals. Method: Searches were conducted in several databases (Embase, PubMed, CINAHL, Scopus, and PsycINFO) for papers published between November 2003 to February 2014 about frailty syndrome and depression in people aged 65 and older. The reference lists of from the articles retrieved were also pearled in order to identify any which may have been missed in the initial search. Two independent reviewers extracted descriptive information on the prevalence and co-occurrence of frailty and depression in older individuals and of frailty criteria among depressed patients. Results: Depression and frailty occur in a significant proportion of frail older individuals. Common pathophysiological alterations and biomarkers in the two (Edited publisher abstract)