Predicting female depression across puberty : a two-nation longitudinal study

Objective: To prospectively examine the relation between pubertal stage and the onset and course of depressive symptoms.

Method: The design was a three-wave longitudinal study of health and social development using statewide community samples in Washington, United States, and Victoria, Australia. Approximately 5,769 students initially ages 10 to 15 years were assessed for depressive symptoms with the Short Mood and Feelings Questionnaire. Pubertal status was assessed using a self-report version of the Pubertal Development Scale.

Results: Advancing pubertal stage carried higher risks for depressive symptoms in female subjects in all of the three study waves. The pubertal rise in female depressive symptoms was due to both higher risk for incident cases and an even greater effect on risks for persistence of depressive symptoms. Report of poor emotional control 12 months earlier carried a twofold higher risk for incident depressive symptoms and largely explained the pubertal rise in female incident cases. High family conflict and severity of bullying also predicted persistence of depressive symptoms. Preexisting depressive symptoms were not associated with later increases in the rate of pubertal transition.

Conclusions: Advancing pubertal stage carries risks for both the onset and persistence of depressive symptoms in females. Social adversity around puberty predicts the persistence of symptoms but does not account for a pubertal rise in female depression. A report of poor emotional control may be a useful marker of girls at risk for depressive symptoms and as a target for preventive intervention.

Professional carers' knowledge and response to depression among their aged-care clients : the care recipients' perspective

Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

Knowledge and skills of professional carers working with older people with depression

Objectives: The current study was designed to evaluate the knowledge, skills and self-efficacy of care providers from the perspective of professionals working in the aged-care industry.

Method: Participants were 21 professional carers, 10 General Practitioners and 7 aged-care managers. Focus groups, which involved the completion of a semi-structured interview related to knowledge, recognition, confidence, referral procedures and use of screening tools for the detection of depression, were conducted.

Results: The results showed that all groups of respondents recognised significant gap in the knowledge and awareness of depression among professional care staff working with older people in both the community and residential care-settings. Skills in the detection and monitoring of depression and the self-efficacy of these care staff were also seen to be a problem.

Discussion: The implications of these findings in terms of training programmes for professional carers working in the aged health care sector are discussed.

Depression training program for caregivers of elderly care recipients : implementation and qualitative evaluation

The prevalence of untreated depression is high among older adults who receive care in residential facilities or in their own omes and is associated with reduced quality of life and other medical conditions, Research has suggested a number of rea-p sons for the low detection and treatment rates for this problem, including lack of knowledge and efficacy among those who provide direct care and poor communication between these caregivers and senior staff, and between senior staff and genera practitioners. In this study, we report on the implementation of a training program for care staff that aims to address these issues. Focus groups with participants who completed the training indicated a high level of satisfaction with the program and reported improvements in knowledge, self-efficacy, and communication within services. It is recommended that the program be more systematically evaluated in relation to its longer term effects on care provider practices and the well-being of depressed elderly care recipients.

Effects of comorbid ADHD with learning disabilities on anxiety, depression, and aggression in adults

Objective: ADHD and learning disabilities (LD) frequently coexist and there are indications that comorbidity may increase the risk of psychopathology.

Method: The current study examined the gender distribution and frequency of comorbidity and its impact on the prevalence of symptoms of anxiety,  depression, and aggression in a clinic sample of 80 adults with ADHD, aged 18 to 58 years. More individuals were diagnosed with ADHD+LD than ADHD only, with no difference in this distribution according to gender.

Results: A factorial multivariate analysis of variance indicated that females with ADHD+LD displayed more cognitive depression than females with ADHD only and than males with ADHD+LD and ADHD only. However,individuals with ADHD only and individuals with ADHD+LD did not differ on overall anxiety, depression or aggression. Likewise, males and females did not differ on measures of psychopathology.

Conclusion: This study lays the foundation for continued research into the characteristics and comorbidities of adults with ADHD.

Depression in people with intellectual disability : an evaluation of a staff-administered treatment program

The prevalence of co-morbid depression in people with intellectual disability (ID) provides a strong rationale for the early identification and treatment of individuals at risk. The aim of this study was to evaluate a staff-administered group CBT program for the treatment of depression in people with mild ID. A sample of 13 staff employed at two community-based disability agencies were trained to deliver the program to 47 individuals with mild ID and symptoms of depression. A wait list control group comprised of 27 individuals subsequently completed the program. Compared to the control group, individuals who had participated in the treatment program showed lower depression scores, and fewer automatic negative thoughts. Furthermore, these changes were maintained at a 3-month follow-up. The results indicate that staff can be trained to deliver a CBT program within community settings that is effective in the reduction of depression symptomatology in people with mild ID.

Sleep quality and depression during pregnancy: a prospective study

For the first time, the relationship between depressive symptoms and sleep quality was explored prospectively during pregnancy. Participants (n = 273) completed the Pittsburgh Sleep Quality Index and Beck Depression Inventory at three 8-week intervals, starting from 15–23 weeks gestation. In addition to sleep quality and depression remaining relatively stable during pregnancy, findings revealed that sleep quality earlier in pregnancy predicted higher levels of depressive symptoms at later stage in pregnancy (after controlling for prior depression levels). In contrast, there was no evidence to suggest that depressive symptoms earlier in pregnancy impacted on sleep quality later on. Given that depressive symptomatology can lead to major depression and given the prevalence of pre- and postnatal depression, our findings suggest that screening for sleep problems during pregnancy may be of clinical significance.

Identifying the health and mental health information needs of people with coronary heart disease, with and without depression

Objective:
To identify the health and mental health information needs of people with coronary heart disease (CHD), with and without comorbid depression.

Design and setting:
A qualitative study conducted in Melbourne in 2006, using thematic analysis of semi-structured interviews on the types of health information that patients with CHD considered useful to assist with the management of their illness. Structured clinical interviews were used to assess current and prior depressive episodes in these patients.

Participants:
14 general practice patients (eight with current or prior history of major depression) who had experienced myocardial infarction, coronary artery bypass graft surgery, angioplasty or angina (confirmed via testing).

Results:
Four themes relating to information on how patients could manage their cardiovascular health and improve their psychosocial wellbeing emerged: psychosocial; physical activity; medical; and information for family. The most prominent information needs included identification and management of risk-related physical symptoms, and psychosocial information, most notably to enhance patients’ social support. Patients considered this information important for alleviating health anxiety and negative affect.

Conclusion:
This small patient sample endorsed the need for health and mental health information on a range of psychosocial and physical health topics. Participants desired specific types of information to assist with the self-management of their health and to assuage their health concerns.

What do general practitioners think depression is? A taxonomy of distress and depression for general practice

Objective:
To create a taxonomy of distress and depression for use in primary care, that mirrors the thinking and practice of experienced general practitioners.

Design:
Qualitative study, using an ethnomethodological approach, with observation of videotaped routine GP–patient consultations and in-depth interviews with GPs.

Setting and participants:
The study was conducted in metropolitan Melbourne in 2005. Fourteen GPs conducted 36 patient consultations where depression was a focus; nine GPs participated in in-depth interviews to elicit details of how they recognised and diagnosed depression in their patients.

Results:
GPs consider distress and depression in three steps. In the first step, a change in a group of symptoms and signs is observed (eg, facial expression, loss of drive). The second step categorises the syndrome according to whether or not there is an identifiable environmental cause (reactive or “endogenous”), with the final step categorising the reactive syndromes according to their most prominent symptoms: either anxiety and worry, or helplessness and hopelessness. The resulting taxonomy includes: endogenous depression (a chronic and perhaps characterological depression characterised by a lack of interest and motivation); anxious depressive reaction (stress or worry); and hopeless depressive reaction (demoralisation).

Conclusion:
This simple and parsimonious taxonomy has validity based on its derivation from within the primary care setting.

Physical activity and likelihood of depression in adults : a review

Objective : This review examines original research which has investigated associations between physical activity (PA) dose (i.e. frequency, intensity and duration) and domain and depression or symptoms of depression in adults.

Methods : A search of electronic databases and authors' own bibliographic libraries was performed between 2006 and 2007 for original research articles investigating associations between PA and depression in adults. A total of 27 observational and 40 intervention studies were included.

Results : Of the studies that focused on the association between duration of PA and likelihood of depression, all five observational studies, and five of the seven intervention studies found both shorter and longer durations of PA were associated with reduced likelihood of depression. Of the studies that focused on the association between intensity of PA and likelihood of depression, four of the six observational studies found that vigorous-intensity PA was more strongly associated with decreased likelihood of depression than lower intensities. Most intervention studies showed that both intensities were effective in reducing the likelihood of depression. Two observational studies found a stronger inverse relationship of leisure-time PA with depression than PA in other domains. There is insufficient evidence regarding the importance of the PA setting on depression.

Conclusion : Although the dose and domain of physical activity varied across studies reviewed, evidence suggests that even low doses of PA may be protective against depression. Further studies examining the optimal domain of PA for reducing the likelihood of depression are needed.

Depression : an important comorbidity with metabolic syndrome in a general population

OBJECTIVE—There is a recognized association among depression, diabetes, and cardiovascular disease. The aim of this study was to examine in a sample representative of the general population whether depression, anxiety, and psychological distress are associated with metabolic syndrome and its components.

RESEARCH DESIGN AND METHODS—Three cross-sectional surveys including clinical health measures were completed in rural regions of Australia during 2004–2006. A stratified random sample (n = 1,690, response rate 48%) of men and women aged 25–84 years was selected from the electoral roll. Metabolic syndrome was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III (NCEP ATP III), and International Diabetes Federation (IDF) criteria. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale and psychological distress by the Kessler 10 measure.

RESULTS—Metabolic syndrome was associated with depression but not psychological distress or anxiety. Participants with the metabolic syndrome had higher scores for depression (n = 409, mean score 3.41, 95% CI 3.12–3.70) than individuals without the metabolic syndrome (n = 936, mean 2.95, 95% CI 2.76–3.13). This association was also present in 338 participants with the metabolic syndrome and without diabetes (mean score 3.37, 95% CI 3.06–3.68). Large waist circumference and low HDL cholesterol showed significant and independent associations with depression.

CONCLUSIONS—Our results show an association between metabolic syndrome and depression in a heterogeneous sample. The presence of depression in individuals with the metabolic syndrome has implications for clinical management.

Active support, participation and depression

Background
Staff training in Active Support is designed to enable direct support staff to increase the engagement and participation of people with intellectual disabilities in a range of daily activities.

Method
Residents (n = 41) and staff of nine group homes participated. The effectiveness of Active Support was evaluated with a pre-test:post-test design, using a number of standardized assessments and other questionnaires, with group home staff as informants. These assessments were conducted before Active Support training and an average of 6.5 months later.

Results
Following implementation of Active Support residents experienced significant increases in domestic participation and adaptive behaviour. There were significant decreases in internalized challenging behaviour, overall challenging behaviour and depression. There was no significant pre–post change in other forms of challenging behaviour.

Conclusions
Our findings confirm and extend previous Active Support research showing that implementation of Active Support is followed by increased resident participation in activities. The significant improvements in adaptive behaviour, challenging behaviour and depression are of particular interest as the present study is among the first to report such effects. The study’s limitations are discussed.

The impact of workload on wellbeing, mental health and depression : a longitudinal study of work perception

This paper explores the relationships between characteristics of the job (workload, control and support) and organizational justice (distributive, procedural, interpersonal and informational) at Time 1, onto three indicators of psychological health at Time 2 (psychological wellbeing, distress and depression). The sample consisted of sworn members of a state-based police force (n=143). Hierarchical regression analyses indicated that workload was associated with psychological wellbeing, distress and depression at the one-year follow-up. Specifically, high workload at Time 1 was associated with psychological distress and depression at Time 2, and low workload was associated with psychological wellbeing at Time 2. Further, there was a significant relationship between perceived informational justice at Time 1 and psychological wellbeing at Time 2. No significant interaction effects were demonstrated for the job characteristics or organizational justice onto psychological health status. That is, longitudinally, workload directly influences both positive and negative mental health, and informational justice is related to psychological wellbeing. The implications for the demand-control-support model are discussed. The injustice-as-stressor argument was generally not supported.