Awareness Of Depression Research Articles

A population survey of prevalence rates of antenatal depression in the Irish obstetric services using the Edinburgh Postnatal Depression Scale (EPDS).

Ireland has the second-highest birth rate in Europe and poorly developed perinatal psychiatry services. There are no screening services for antenatal depression and no data available on prevalence rates of depression among women attending the Irish obstetric services. The aim of this study was to assess the prevalence rates of depression during pregnancy in a population sample in Ireland using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool. Pregnant women during all stages of pregnancy were recruited from five maternity hospitals throughout the Republic of Ireland. Approximately 5000 EPDS questionnaires were collected. Information on the participant's age, gestational week, gravidity, parity, and level of education attained was also collected. A score of > 12 was used as a measure of probable depression. Overall, 15.8% of pregnant women scored > 12 in the EPDS. There was a significant association between gestational week and rates of depression, with increasing rates occurring with advancing pregnancy (p< 0.001). Overall, higher socioeconomic groups were over-represented in the sample although we replicated the well-established findings of higher EPDS scores in women with lower educational attainment (p< 0.005). This study demonstrates that prevalence rates of probable antenatal depression are high among women attending the obstetric services in Ireland and highlight the importance of increasing awareness of antenatal depression. These high rates of antenatal depression may be related to certain conditions that are specific to an Irish setting: the absence of screening for depression in the context of grossly under-resourced perinatal psychiatry services. These findings provide indirect confirmatory evidence for the need for streamlined mental health services within reproductive health services.

Who is coaching the coach? Knowledge of depression and attitudes toward continuing education in coaches

BackgroundThe rate of depression among collegiate athletes ranges from 16% to 23%, with particularly high findings of prevalence in track and field athletes (34%). Collegiate athletes have also been found...

Peer support in anesthesia: turning war stories into wellness.

Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery. As these are delineated, more targeted peer support models are being developed. One major change in 2017 is the institution of new Accreditation Council for Graduate Medical Education's Common Program Requirements, now including topics targeted on well being. Effective and accessible peer support is developing in many departments nationwide and can only be expected to continue, given new regulatory requirements. As these programs develop, and research on their effect continues, best practices will likely emerge.

Increasing Male Preponderance in Suicide Coinciding With a Reduction by Half in Total Suicides in the Danish Population Should Raise Awareness of Male Depression

Increasing Male Preponderance in Suicide Coinciding With a Reduction by Half in Total Suicides in the Danish Population Should Raise Awareness of Male Depression

Coping strategies of women with postpartum depression symptoms in rural Ethiopia: a cross-sectional community study

BackgroundMost women with postpartum depression (PPD) in low- and middle-income countries remain undiagnosed and untreated, despite evidence for adverse effects on the woman and her child. The aim of this study was to identify the coping strategies used by women with PPD symptoms in rural Ethiopia to inform the development of socio-culturally appropriate interventions.MethodsA population-based, cross-sectional study was conducted in a predominantly rural district in southern Ethiopia. All women with live infants between one and 12 months post-partum (n = 3147) were screened for depression symptoms using the validated Patient Health Questionnaire, 9 item version (PHQ-9). Those scoring five or more, ‘high PPD symptoms’, (n = 385) were included in this study. The Brief Coping with Problems Experienced (COPE-28) scale was used to assess coping strategies. Construct validity of the brief COPE was evaluated using confirmatory factor analysis.ResultsConfirmatory factor analysis of the brief COPE scale supported the previously hypothesized three dimensions of coping (problem-focused, emotion-focused, and dysfunctional). Emotion-focused coping was the most commonly employed coping strategy by women with PPD symptoms. Urban residence was associated positively with all three dimensions of coping. Women who had attended formal education and who attributed their symptoms to a physical cause were more likely to use both problem-focused and emotion-focused coping strategies. Women with better subjective wealth and those who perceived that their husband drank too much alcohol were more likely to use emotion-focused coping. Dysfunctional coping strategies were reported by women who had a poor relationship with their husbands.ConclusionsAs in high-income countries, women with PPD symptoms were most likely to use emotion-focused and dysfunctional coping strategies. Poverty and the low level of awareness of depression as an illness may additionally impede problem-solving attempts to cope. Prospective studies are needed to understand the prognostic significance of coping styles in this setting and to inform psychosocial intervention development.

Public Awareness and Attitude Towards Depression: A Community Based Study Among an Adult Population in Ile-Ife South-Western Nigeria.

Depression has become a global health priority due to its associated burden. However, there is dearth of information regarding the public awareness and attitude towards depression in Nigeria. This study aimed to assess the level of public awareness and attitude towards depression in a semi-urban Nigerian community. A cross-sectional study conducted among 240 respondents with mean age of 34.7years (± 1.2years). A questionnaire assessed socio-demographic characteristics, level of awareness and attitude of people towards depression. While most respondents (72.5%) had heard about depression, it was less recognized as a major mental health problem. Also, most respondents (58.6%) had negative attitudes toward depression. There is low level of awareness of depression as a major health problem among community dwellers in South-western Nigeria and negative attitudes towards the illness also appear prevalent. Therefore, awareness should be improved through public health enlightenment programmes.

What is the prevalence of untreated depression and death ideation in older people? Data from the Irish Longitudinal Study on Aging.

Cross-sectional study ascertaining the prevalence of, and factors associated with, untreated depression and DI. This study, embedded within the Irish Longitudinal Study on Ageing, involves over 7,000 community-dwelling people aged ≥50 years. Depression was defined as Centre for Epidemiological Studies Depression scale ≥16 indicating current clinically relevant depressive symptoms or Composite International Diagnostic Interview indicative of major depressive episode within the last year. Participants not prescribed antidepressants/antipsychotics were defined as untreated. To define DI, participants were asked "In the last month, have you felt like you would rather be dead?" In total, 12% (839/7,055) met criteria for depression with 29% (241/839) on pharmacological therapy. Those with untreated depression were less likely to endorse symptoms of persistent low mood or worthlessness, but there was no difference in age or general practitioner (GP) visits compared to those on treatment. Over 3% (223/7,055) of participants had DI and less than one-third had visited their GP within the last year. This study demonstrates that two-thirds of depressed older people are not prescribed antidepressant/antipsychotic therapy. It is important to raise awareness of depression among older people and healthcare professionals, with particular focus on the fact that LLD is not an inevitable consequence of ageing and effective treatment is available.

Prevalence of depression in the elderly population of rural Puducherry: a community based cross sectional study

Background: Geriatric mental health is an important emerging public health concern. Although India is the second most populated country in the world in terms of elderly population it is yet to perceive geriatric depression as a public health problem. In spite of considerable disability and morbidity there is a dearth of community studies investigating geriatric depression and its associated risk factors from India. Considering this back ground, a community based cross sectional study was conducted in a rural setting of Puducherry to find out the disease burden of geriatric depression and to study the correlates of depression among the elderly in the community.Methods: A community based cross sectional study was done in a rural field practicing area of Sri Lakshmi Narayana Institute of Medical Science, Puducherry. The study was conducted in 640 elderly and geriatric depression was assessed with The Geriatric depression Scale – Short form.Results: Of the total elderly, only 42.34% were found to be normal while the remaining 57.66% of the elderly were suffering from some forms of depression. The major associated factors contributing to geriatric depression were found to be female sex, widowhood, illiteracy, living alone, presence of chronic diseases, lesser physical activity and inadequate sleep.Conclusions: A major proportion of the elderly in the study population were found to be suffering from depression. This high prevalence indicates an urgent need, both for great awareness of depression among the community members and to ensure availability and accessibility of appropriate health services to manage it.

Percentage of Americans Taking Antidepressants Climbs

Back to table of contents Previous article Next article PsychopharmacologyFull AccessPercentage of Americans Taking Antidepressants ClimbsJun Yan,Pharm.D.Jun Yan,Search for more papers by this authorPharm.D.Published Online:15 Sep 2017https://doi.org/10.1176/appi.pn.2017.pp9b2AbstractOne contributing factor to the growth of patients taking antidepressants may be that they are being prescribed the medications for non-depression diagnoses, such as anxiety, sleep, and neuropathic pain. Between 2011 and 2014, approximately one in nine Americans of all ages reported taking at least one antidepressant medication in the past month, according to national survey data released by the Centers for Disease Control and Prevention (CDC). Three decades ago, less than one in 50 people did. The use of antidepressants increased with age and reached nearly 19 percent in adults 65 years and older (see bar chart). From 1988 to 1994, only 3 percent of older adults were taking antidepressants. The data were collected in the National Health and Nutrition Examination Survey (NHANES) by the CDC. The sharp rise of antidepressants in all age groups, except children and adolescents, followed the introduction of the first selective serotonin reuptake inhibitor (SSRI), fluoxetine (Prozac). Prozac was first approved in the United States in 1987 and entered the market in 1988. Since then, many more SSRIs and other types of antidepressants have become available. The rise of direct-to-consumer marketing since the 1990s further pushed antidepressants into the public consciousness. Because SSRIs do not carry the potentially life-threatening cardiac risks associated with tricyclic antidepressants, they are considered safer and easy to manage, particularly for elderly patients who often have coexisting cardiovascular diseases. While the current prevalence of antidepressant use in older people is more than twice of that in adults under 45, this does not mean older people are more likely to have depressive disorders. Epidemiological research has shown that depression is not more common in older adults than in younger adults and antidepressants tend to be less efficacious for older patients. One reason contributing to the popularity of antidepressants is the expansion of their indications. “Many patients are given antidepressants for non-depression diagnoses, such as anxiety, sleep, and neuropathic pain,” Donovan Maust, M.D., M.S., a geriatric psychiatrist and assistant professor of psychiatry at the University of Michigan, told Psychiatric News. Since older adults tend to have more contact with the health care system than younger adults, they may be more likely to be given an antidepressant prescription by their family physician, internist, or other specialist. iStock/smartstock“There has been more recognition and awareness of major depression, along with more willingness to prescribe drug therapy,” Maust added. The increase in antidepressants is, therefore, partially justified, he stated.Overtreatment with antidepressants remains a concern, as geriatric patients are far more likely to suffer side effects and drug interactions from the many more medications they take than younger adults. “[SSRIs] may be safer than tricyclics, but they still have side effects, particularly in older patients, such as hyponatremia and risk of falling. Meanwhile, there is limited evidence to support their effectiveness for [treating] subsyndromal depression,” said Maust. For example, antidepressants are frequently prescribed to older patients with dementia to treat mood symptoms, but there is no solid evidence that they are effective for this purpose. Rather than immediately reaching for the prescription pad, physicians should first clearly establish the diagnosis that may require an antidepressant and plan to measure and monitor the effectiveness, Maust recommended. “Such prescriptions are often motivated by the [physician’s] desire to help patients, especially when resources for psychosocial intervention are not available.” Even without psychosocial resources, however, watchful waiting by scheduling an early return visit may be enough for some patients and help reduce unnecessary prescribing, he suggested. ■Back to Psychopharmacology Newsletter Table of Contents ISSUES NewArchived

Factors associated with general practitioners\u2019 awareness of depression in primary care patients with heart failure: baseline-results from the observational RECODE-HF study

BackgroundDepression is more prevalent in patients with heart failure (HF) than in those without, but its detection is complicated by the symptom overlap between the two diseases. General practitioners (GPs) are the first point of contact for patients with HF. Therefore, this study aims to investigate GPs’ awareness of depression in their HF patients and factors associated with this awareness.MethodsIn this cross-sectional, observational study 3224 primary care patients with HF were screened for depressive symptomatology using an algorithm based on the Hospital Anxiety and Depression Scale, the 9-item subscale on Depression of the Patient Health Questionnaire, and selected items from the PROMIS Depression and Anxiety scales. The 272 GPs of all patients involved in the study were interviewed by telephone regarding their patients’ somatic and psychological comorbidities. The awareness rates of depressive symptomatology by the patients’ GPs are analyzed using descriptive statistics. Logistic regression analyses are applied to investigate the patient- and GP-based factors associated with the GPs’ awareness of depressive symptomatology.ResultsGPs were aware of their patients’ depressive symptomatology in 35% of all cases. Factors associated with the awareness of depressive symptomatology were: higher patient education levels, a history of depression known to the GP, GP-consultations due to emotional distress within the last 6 months, a higher frequency of GP-contacts within the last 6 months, a higher New York Heart Association (NYHA) classification and more severe depressive symptomatology. The GPs’ characteristics, including further education in psychology/psychiatry, were not associated with GP awareness.ConclusionsMany aspects, including the definition of awareness and the practical issues in primary care, may contribute to the unexpectedly low awareness rates of depressive symptomatology in HF patients in primary care. Awareness rates might increase, if GPs encouraged their patients to talk about emotional distress, held detailed medical interviews including a patient’s history of depression and payed special attention to HF patients with low education levels. However, it remains to be investigated whether GPs’ judgement of depressive symptomatology is a better or worse indicator for the future prognosis and quality of life of HF patients than psychiatry based diagnostic criteria.

Examining differences in cognitive and affective theory of mind between persons with high and low extent of somatic symptoms: an experimental study

BackgroundMedically unexplained somatic symptoms are common, associated with disability and strongly related to depression and anxiety disorders. One interesting, but to date rarely tested, hypothesis is that deficits in both theory of mind (ToM) and emotional awareness may undergird the phenomenon of somatization. This study sought to investigate whether or not differences in ToM functioning and self-reported emotional awareness are associated with somatic symptoms in a sample from the general population.MethodsThe sample consisted of 50 healthy participants (37 females, 13 males) aged between 22 and 64 years (46.8 ± 11.7) of whom 29 reported a high extent of somatic symptoms (HSR), whereas 21 reported a low extent of somatic symptoms (LSR) based on the 30 highest and lowest percentiles of the Symptom List norms. The participants’ affective and cognitive ToM were assessed with two experimental paradigms by experimenters who were blind to the participants’ group membership. In addition, self-reports regarding emotional awareness, alexithymia, depressive and anxiety symptoms and current affect were collected.ResultsIn the experimental tasks, HSR showed lower affective ToM than LSR but the groups did not differ in cognitive ToM. Although HSR reported lower emotional awareness than LSR in the self-report measure, this group difference vanished when we controlled for anxiety and depression. Depression, anxiety, emotional awareness and alexithymia were correlated positively.ConclusionsThe data supported the hypothesis that deficits in affective ToM are related to somatic symptoms. Neither cognitive ToM nor self-reported emotional awareness were associated with somatic symptoms. Self-reported emotional awareness, alexithymia and symptoms of depression and anxiety shared a considerable amount of variance.

The prevalence and correlates of depression awareness in patients with alcohol use disorder

IntroductionAlcoholic use disorder is a big problem in every country. It is the leading factor causing high disability-adjusted life year (DALYs). The National Institute of Mental Health Epidemiology Cathchment Area found that 37% of people with alcoholic use disorder had comorbid along with psychiatric disorder especially depression. In order to successfully treat patients with alcoholic use disorder, we have to treat their comorbidity along as well.AimTo examine the prevalence and correlation of depression awareness in patients with alcoholic use disorder.MethodsInpatients and outpatients who were diagnosed with alcoholic use disorder and alcohol dependence were invited to participate in this research. Subjects who had any history of depressive disorder treatment before were excluded. The awareness of depression was determined by the Illness Perception Questionnaire-Revised, IPQ-R. Depressive disorder was determined by the Thai version of the nine-item Patient Health Questionnaire (PHQ-9).ResultsNinety subjects with alcoholic use disorder agreed to join this research. Twenty-nine of the 90 (32.2%) had depression due to the PHQ-9 scale. Twenty-three were aware that they had depression and that was related to alcohol use. Using the logistic regression analysis, there were no significant factors related to this awareness.ConclusionThere is high prevalence of depression in patients with alcoholic use disorder and most of them have awareness did not receive treatment for depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Synthetic Oxytocin May Increase Risk of Postpartum Depression, Anxiety

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessSynthetic Oxytocin May Increase Risk of Postpartum Depression, AnxietyNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:17 Mar 2017https://doi.org/10.1176/appi.pn.2017.3a17AbstractWomen with no history of pre-pregnancy depression or anxiety who were exposed to synthetic oxytocin during or shortly after delivery had a 32 percent increased risk of postpartum depression or anxiety compared with women who were not administered the synthetic hormone.Synthetic oxytocin (Pitocin) is widely used in obstetric medicine to induce and/or augment labor and reduce post-delivery bleeding. A study published January 30 in Depression and Anxiety now suggests women who receive synthetic oxytocin during childbirth may be more likely to experience postpartum depression or anxiety.Kristina Deligiannidis, M.D., and her colleagues found that the elevated risks posed by synthetic oxytocin were not influenced by the mother’s depression or anxiety history, nor by the method of delivery.Northwell HealthThe findings came as a surprise to lead author Kristina Deligiannidis, M.D., who noted that oxytocin is known to promote positive feelings and strengthen the bond between a mother and child. She said the study demonstrates how much remains unknown about the role of oxytocin in the body.“We know how oxytocin affects uterine contraction, which is what it is used for during labor. But so many other tissues including the brain have oxytocin receptors, which can lead to a range of unintended consequences when we manipulate this hormone system during delivery,” said Deligiannidis, who is an associate professor of psychiatry and obstetrics and gynecology at Hofstra Northwell School of Medicine in Glen Oaks, N.Y.Deligiannidis and her colleagues used data available through the Massachusetts Integrated Clinical Academic Research Database (MiCARD) to analyze postpartum outcomes for all women who had a live birth at University of Massachusetts Memorial Health Care between January 2005 and April 2014. The sample included 9,684 deliveries with peripartum synthetic oxytocin exposure (defined as within two weeks of delivery date) and 37,048 deliveries without peripartum synthetic oxytocin exposure. Depressive or anxiety disorders, defined as a record of diagnosis and/or receipt of antidepressant or anxiolytic medication prescription, were divided into three timeframes: pre-pregnancy (diagnosis/prescriptions more than one year before delivery), pregnancy (diagnosis/prescription during pregnancy or 40 weeks ahead of delivery date), and postpartum (diagnosis/prescription one year following delivery). The analysis showed that women with no history of pre-pregnancy depression or anxiety who were exposed to synthetic oxytocin had a 32 percent increased risk of postpartum depression or anxiety compared with non-exposed women, while women with pre-pregnancy symptoms had a 36 percent increased risk.Deligiannidis and her colleagues also explored whether multiple births altered the depression/anxiety risk following Pitocin exposure by comparing outcomes following the first birth (index birth) or one birth at random from women with multiple births. Both approaches yielded roughly similar results: when analyzing only index deliveries, oxytocin exposure resulted in a 35 percent increased risk of postpartum depression or anxiety, and among all random births the risk was 39 percent.The researchers also found that the oxytocin-related risks were elevated in both vaginal and caesarian births, and that excluding all pre-term births did not change the results. Deligiannidis, who is also director of Women’s Behavioral Health at Hofstra’s Zucker Hillside Hospital, told Psychiatric News that limitations of the study mean many unanswered questions remain. For example, because the investigators lumped all oxytocin exposure into one category there was no way of knowing whether risks were higher for women exposed to the synthetic hormone for longer periods during labor induction and augmentation. It was also not possible for the researchers to determine whether the relationship between peripartum synthetic oxytocin administration and postpartum depression and anxiety is causal.“Before we can make any firm conclusions, we need to better understand how these different indications for oxytocin might affect risk,” Deligiannidis said. Until there is more evidence to suggest oxytocin is driving postpartum depression and anxiety, Deligiannidis said she believes it is too early to suggest that women who receive synthetic oxytocin during childbirth should receive extra monitoring for postpartum depression or anxiety. Fortunately, the overall awareness of postpartum depression has grown to the point where most doctors do already discuss it during postpartum visits, she added. This study was funded by grants from the National Center for Advancing Translational Sciences and the National Institute of Mental Health. ■An abstract of “Association of Peripartum Synthetic Oxytocin Administration and Depressive and Anxiety Disorders Within the First Post-partum Year” can be accessed here. ISSUES NewArchived

Awareness, Access and Use of Internet Self-Help Websites for Depression by University Students.

BackgroundUniversity students have a higher prevalence rate of depression than the average 18 to 24 year old. Internet self-help has been demonstrated to be effective in decreasing self-rated measures of depression in this population, so it is important to explore the awareness, access and use of such self-help resources in this population.ObjectiveThe objective of this study is to explore university students’ awareness, access and use of Internet self-help websites for depression and related problems.MethodsA total of 2691 university students were surveyed at 3 time points.ResultsWhen asked about browsing behavior, 69.6% (1494/2146) of students reported using the Internet for entertainment. Most students were not familiar with self-help websites for emotional health, although this awareness increased as they completed further assessments. Most students considered user-friendliness, content and interactivity as very important in the design of a self-help website. After being exposed to a self-help website, more students reported visiting websites for emotional health than those who had not been exposed.ConclusionsMore students reported visiting self-help websites after becoming aware of such resources. Increased awareness of depression and related treatment resources may increase use of such resources. It is important to increase public awareness with the aim of increasing access to targeted strategies for young people.

Canadian Men’s Perspectives of Depression: Awareness and Intention to Seek Help

It is often presumed that men are generally unaware of depression being a serious health issue and are unlikely to seek professional help if they became depressed. To test this presumption, Canadian men’s (N = 452) perspectives regarding awareness of depression and likelihood of seeking help for depression were solicited. While 78.7% of respondents recognized depression as a significant health issue for men, only 58.5% felt fairly or very well informed about depression. In terms of help-seeking intentions, 82.6% of respondents indicated that they probably or definitely would seek professional help if depressed. Contrary to popular depictions, the findings suggest that Canadian men are indeed aware of the seriousness of depression as a health issue, yet many are poorly informed about it. Furthermore, most men are well intentioned when it comes to seeking help if they became depressed. The findings imply that greater efforts are required to improve men’s understanding of depression (symptoms, triggers, approaches to care), which may help translate intentions to seek help into concrete action.

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review

Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs' or Family Physicians' assessment, recognition and management of anxiety or depression in pregnancy or post-partum. Thirteen papers, reporting 10 studies, were identified from the United States, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counseling by GPs and referrals to specialists were common in the post-natal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training. Data on GPs' awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices.

The awareness of depression and anxiety in cancer patients.

e21550Background: Depression and anxiety is prevalent among cancer patients and show serious impact. This study was conducted to investigate the knowledge of and attitude to depression and anxiety ...

Awareness of Subjective Fatigue After Moderate to Severe Traumatic Brain Injury.

As measurements of subjective fatigue after traumatic brain injury (TBI) rely on self-assessment, deficits in self-awareness after TBI may distort subjective fatigue reports. This study investigates awareness of subjective fatigue after TBI using self- and informant reports. Fourteen adults with moderate to severe TBI and 7 healthy controls (HCs). Modified Fatigue Impact Scale (MFIS) and battery of cognitive and emotional tests. Informants completed an "other-report," rating their perception of participant's fatigue. Subjective fatigue awareness was defined as discrepancy between self- and other-MFIS scores. Adults with TBI showed greater discrepancies between self- and other-MFIS scores than did HCs. Negative relations were found between fatigue awareness and symptoms of depression, but there were no relationships between fatigue awareness and cognitive performance. Results indicate that adults with TBI have poorer awareness of subjective fatigue than HCs. Correlations between subjective fatigue awareness and depression support existing literature implicating strong emotional components in the experience of subjective fatigue postinjury. Findings suggest cautious interpretation of subjective fatigue, as responses may not reflect fatigue symptoms exclusively.

Time trend in depression diagnoses among acute coronary syndrome patients and a reference population from 2001 to 2009 in Denmark

Introduction In the last decade a range of recommendations to increase awareness of depression in acute coronary syndrome patients have been published. To test the impact of those recommendations we examine and compare recent time trends in depression among acute coronary syndrome patients and a reference population.Methods 87 218 patients registered with acute coronary syndrome from 2001–2009 in Denmark and a match reference population were followed through hospital registries and medication prescriptions for early (≤30 days), intermediate (31 days to 6 months) and later (6 months to 2 years) depression in the acute coronary syndrome population and overall depression in the reference population. Cox regression models were used to compare hazard ratios (HRs) for depression over calendar years.Results During the study period, 11.0% and 6.2% were diagnosed with depression in the acute coronary syndrome population and in the reference population, respectively. For the acute coronary syndrome population, the adjusted HRs increased for early (HR (95% CI) 1.04 (1.01–1.06)) and intermediate depression (HR (95% CI) 1.01 (1.00–1.03)), whereas the adjusted HRs did not change for later depression (HR (95% CI) 0.99 (0.98–1.00)). For the reference population the adjusted HRs for depression increased through the study period (HR (95% CI) 1.01 (1.01–1.03)).Conclusion Increase in diagnoses of depressions within 6 months of acute coronary syndrome may be explained by increased focus on depression in this patient group in combination with increased awareness of depression in the general population.

Screening for Postpartum Depression and Anxiety in a Primary Pediatric Clinic

Abstract This presentation aims to increase awareness of postpartum depression, provide a successful model for postpartum depression screening in a pediatric primary care clinic, and provoke discus...