Cause Of Emotional Distress Research Articles

2608 – Screening for depression in elderly urban population

Introduction žDepression is a treatable medical condition and one of the most frequent causes of emotional distress in older adults žUntreated depression can delay recovery or worsen the outcome of other medical illnesses via increased morbidity or mortality žDepression is NOT a part of normal aging. Objectives žTo determine the prevalence of depression among the elderly population žTo identify the risk factors with respect to depression in elderly. Material and methods žStudy design: Cross sectional study žStudy setting: Community based žSample size: 216 žStudy area: Southern part of urban Pune city žInclusion criteria: Age more than 60 yrs of age žStudy tool: Predesigned Questionnaire including WHO 5 Well being index and Mastering depression in Primary care version 2.2 was administered. Results The prevalence of ndepression was 21.2% in the geriatric population. Widowed stae, financial dependancy,living in nuclear family and medical illnesses were the major stressors. Conclusion The present study found that widowed state,retirement,medical illness and residing in a nuclear family system are strong predictors of depression in the elderly. Recommendation žSocial support programs for the elderly must be developed to ensure their well-being. Awareness about risk factors would help in designing appropriate strategies for prevention of depressive disorders in geriatric population.

Uncovering Recovery: The Resistible Rise of Recovery and Resilience

Discourses of recovery and resilience have risen to positions of dominance in the mental health field. Models of recovery and resilience enjoy purchase, in both policy and practice, across a range of settings from self-described psychiatric survivors through to mental health charities through to statutory mental health service providers. Despite this ubiquity, there is confusion about what recovery means. In this article we problematize notions of recovery and resilience, and consider what, if anything, should be recovered from these concepts. We focus on three key issues, i) individualization, ii) the persistence of a deficit model, and iii) collective approaches to recovery. Through documentary analysis we consider these issues across third sector organizations, and public and mental health policy. Firstly, definitional debates about recovery reflect wider ideological debates about the nature of mental health. The vagueness of these concepts and implicit assumptions inherent in dominant recovery and resilience discourses render them problematic because they individualize what are social problems. Secondly, these discourses, despite being seen as inherently liberatory are conceptually dependent on a notion of deficit in that talk of “positives” and “strengths” requires the existence of “negatives” and “weaknesses” for these concepts to make sense. We argue that this does little to substantially transform dominant understandings of psychological distress. Thirdly, these issues combine to impact upon the progressive potential of recovery. It comes to be seen as an individualistic experiential narrative accompaniment to medical understandings where the structural causes of distress are obscured. This in turn impacts upon the potential for recovery to be used to explore more collective, political aspects of emotional distress. Drawing on the work of Fraser, we use this critique to characterize “recovery” as a “struggle for recognition,” founded on a model of identity politics which displaces and marginalizes the need for social, political and economic redistribution to address many of the underlying causes of emotional distress. We conclude by stating that it is only when the collective, structural experiences of inequality and injustice are explicitly linked to processes of emotional distress that recovery will be possible.

Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies

BACKGROUND For a number of reasons, the results of previous meta-analyses may not fully reflect the mental health status of the average woman suffering from polycystic ovary syndrome (PCOS), or the causes of this distress. Our objective was to examine emotional distress and its associated features in women with PCOS. METHODS A comprehensive meta-analysis of comparative studies reporting measures of depression, anxiety or emotional-subscales of quality of life (emoQoL) was performed. PubMed, Embase, PsychInfo and the Cochrane trial register databases were searched up to November 2011 (see Supplementary Data for PUBMED search string). Unpublished data obtained through contact with authors were also included. The standardized mean difference (SMD) of distress scores was calculated. Subgroup analyses and meta-regression analysis of methodological and PCOS-related features were performed. RESULTS Twenty-eight studies (2384 patients and 2705 control women) were included. Higher emotional distress was consistently found for women with PCOS compared with control populations [main outcomes: depression: 26 studies, SMD 0.60 (95% confidence interval (CI) 0.47-0.73), anxiety: 17 studies, SMD of 0.49 (95% CI 0.36-0.63), emoQoL: 8 studies, SMD -0.66 (95% CI -0.92 to -0.41)]. However, heterogeneity was present (I(2) 52-76%). Methodological and clinical aspects only partly explained effect size variation. CONCLUSIONS Women with PCOS exhibit significantly more emotional distress compared with women without PCOS. However, distress scores mostly remain within the normal range. The cause of emotional distress could only partly be explained by methodological or clinical features. Clinicians should be aware of the emotional aspects of PCOS, discuss these with patients and refer for appropriate support where necessary and in accordance with patient preference.

What Do Chaplains Really Do? III. Referrals in the New York Chaplaincy Study

ABSTRACT The current study examines patterns of referrals to chaplains documented in the 1994–1996 New York Chaplaincy Study. The data were collected at thirteen healthcare institutions in the Greater New York City area. Of the 38,600 usable records in the sample, 18.4% were referrals, which form the sample for the current study (N = 7,094). The most common sources of referrals were nurses (27.8%) and patients themselves (22.3%), with relatively few referrals coming from physicians and social workers. The study shows the range of patient issues that are referred to chaplains, including emotional, spiritual, medical, relationship/support, and a change in diagnosis or prognosis. Although the reasons for referral varied by hospital setting and referral source, overall, patients were referred more frequently for emotional (30.0%) than for spiritual issues (19.9%). Results are discussed in relation to the need to clarify the role of the chaplain to the rest of the healthcare team, to recognize when there is a spiritual cause of emotional distress, and to establish effective referral protocols.

Hyperpigmentation and melasma

Facial and neck pigmentations are significant cosmetic problems. They are common in middle-aged women, related to endogenous (hormones) and exogenous factors (cosmetics, perfumes, sun exposure), and often represent paramount causes of emotional distress. Although melasma is the most common cause of facial pigmentation, there are many other forms including drug-induced and postinflammatory hyperpigmentation. We review pathogenesis, clinical and histopathological data, effect on quality of life, and treatment options in facial hyperpigmentation disorders.

LONELINESS IN OLDER WOMEN: A REVIEW OF THE LITERATURE

Older women report more loneliness than male peers. Loneliness is an area of concern related to the well being of older women because it is a cause of emotional distress and is linked to a variety of health problems in older individuals. Life changes, including widowhood and relocation, are associated with increased vulnerability to loneliness. Gender, social, and cultural factors influence the experience of loneliness in older women. Cognitive and interactionist theoretical approaches to loneliness have utility for nursing practice and research with older women who experience loneliness.

Emotional well-being, sexual behaviour and hormone replacement therapy

Improvements in the design of epidemiological studies of the climacteric and postmenopause have been made in the past 25 years. But more complex theoretical models are necessary if we are to give due emphasis to the influence of psychological, social, cultural and hormonal factors and their interactions. The majority of studies show that emotional problems are not more prevalent during the climacteric and postmenopause and that psychosocial factors, such as stressful life-events, are more likely causes of emotional distress during mid-life. Vaginal dryness increases in postmenopausal women but there are varied reasons for changes in other aspects of sexual behaviour which require further research. While estrogen may have a “mental tonic” effect when prescribed in high doses, HRT does not appear to have a significant effect upon mood or sexual behaviour over and above placebo effects and the relief from vasomotor and vaginal symptoms.

Maternity nurses: how parents see us

A major study of obstetrical units was conducted as far back as 1956 by Lesser and Keane in the United States. They found inadequacies in the emotional care and support given to labouring mothers. Danzinger (1979) observed women’s interactions with staff members in a traditional obstetrical setting and found both nurses and doctors offered arbitrary, uniform and, in her opinion, often inappropriate responses to labouring women. The rules for birthing conduct were laid down by professional rather than negotiated with individual women. Parents, however, tended to accept the rules and constraints and rarely violated them. Another study (Shields, 1978) examined subjective needs of labouring women. Supportive care was found to be most critical in the way mothers viewed their labour. Congruency between the mother’s expectation and perception of the time the nurse spent with her in labour also appeared to be important to mother’s satisfaction. Nunnally and Aguiar (1974) reported that attenders at prenatal classes had a significantly more favourable attitude to labour than did non-attenders. Birch (1982) examined the congruence between the anticipated and actual extent to which 30 mothers participated in decision making in labour. The majority of the mothers felt it important for them to have a say in decisions related to pain medication, privacy and ambulation during labour. Just over half of the mothers in her sample wanted a say in relating to fetal monitoring, internal examinations, whether or not they would receive food and fluids and choice of position for delivery. Approximately 40% of the women wanted a say as to when hospital personnel would be present, whether or not labour would be induced and whether or not they would have an enema. Ball (1981) undertook an extensive study in England to identify the patterns of care associated with different levels of emotional satisfaction or distress in the mother. Differences in levels of emotional satisfaction experienced by mothers were found to be statistically significant in relation to the type of parent craft classes attended, the social class of the mother and the mother’s feelings at the birth of her baby and the mother’s perception of postnatal care, as recalled 6-8 weeks after birth. One major cause of emotional distress reported by the mothers was feeling alone while they were in labour, particularly if they felt that labour had been difficult.