Loss Of Interest In Activities Research Articles

Factors Associated with Depression among Prisoners in Women’s Class II-A Prison Jakarta

Depression is a common mental disorder, characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. Female prisoners represent groups at risk of depression where depression in prisoners is more vulnerable to female prisoners than men. This study aims to determine the factors associated with depression among prisoners in Women’s Class II-A Prison Jakarta. The study design used was cross-sectional with multivariate analysis, multiple logistic regression. The number of research samples is 200 prisoners taken using random sampling techniques. The results showed that the prevalence of depression among prisoners in Women’s Class II-A Prison Jakarta is 56,5%. Based on the results of the multivariate analysis, it can be seen that factors related significantly to depression are age (p-value = 0.012; POR = 2.144; 95% CI = 1.185 - 3.879) and recidivism status (p-value = 0.043; POR = 3.926; 95% CI = 1,047 –14,729) which the most influential factor on the incidence of depression is recidivism status. Government attention needs to be given to the mental health of prisoners by conducting various mental health programs and services such as regular screening and rehabilitation programs.

Prevalence of depression, anxiety and stress among school going adolescents in Delhi: a cross sectional study

Background: Adolescence is a stressful period due to physical, psychological, sexual changes and the presence of psychiatric disorders such as depression, anxiety and stress at this stage of life is a matter of concern. Depression is a common mental disorder, characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. The objective of this study is to find the prevalence and associated factors of depression, anxiety and stress among school going adolescents.Methods: This was a school based descriptive cross-sectional study conducted in the month of July 2018 in an urban school in New Delhi. A semi-structured, self-administered questionnaire to assess socio-demographic profile as well as depression anxiety stress scale (DASS)–21 was used to assess depression, stress and anxiety.Results: Overall prevalence of depression, anxiety and stress were found to be 47.9%, 65.3%, and 51.8% respectively. Most of student suffered from moderate depression (46.8%), anxiety (33.3%) and mild stress (60.9%). It was noted that these were more common among female students, late adolescent age group, students alone/ away from family, students from separated/ single parents, consuming alcohol and family pressure to perform well in school.Conclusions: The alarming risk of depression, anxiety and stress among students with low academic satisfaction as well as those who face family pressure to perform better calls for need of parents-student counselling sessions, as well as frequent extracurricular activities to help create a healthier school environment.

Emotional disorder symptoms, anhedonia, and negative urgency as predictors of hedonic hunger in adolescents

Affect and reward are associated with unhealthy eating and weight; however, less research has examined affective predictors of hedonic hunger (i.e., extreme reward responsivity, pleasure toward, and drive for food), particularly among adolescents. Whether symptoms indicative of emotional disturbance increase risk of adverse reward-based eating-related symptoms such as hedonic hunger, is unknown. Such evidence could explain why emotional problems increase risk of eating and weight problems among adolescents, when eating-related health problems often originate. This report examined baseline emotional disorder symptoms, negative urgency (i.e., tendency to act impulsively in response to negative affect), and anhedonia (i.e., loss of interest in activities and decreased pleasure) as prospective predictors of increases in hedonic hunger in adolescents; associations between changes in emotional disturbance problems and hedonic hunger were also examined. Ninth-grade students (N = 2598) from high schools completed paper-and-pencil surveys at baseline and a 1-year follow-up. In a multivariable model controlling for the covariance of emotional problems, higher negative urgency, general anxiety, and obsessive-compulsive symptoms, and lower anhedonia at baseline independently predicted increases in hedonic hunger one year later. Also, increases in negative urgency, general anxiety, and obsessive-compulsive symptoms and decreases in anhedonia independently predicted increases in hedonic hunger. Affect- and reward-related variables may be important contributors to risk of hedonic hunger in adolescence.

Recognizing and treating late-life depression

Patients over age 55 years who present with social isolation, loss of interest in activities, irritability, appetite loss, vague complaints, and insomnia are a diagnostic challenge for clinicians. This article describes a framework diagnosing and treating depression in older adults.

37-Year-Old Man With Fatigue and Erectile Dysfunction

37-Year-Old Man With Fatigue and Erectile Dysfunction

The Increased Vulnerability of Refugee Population to Mental Health Disorders

Around the world, the number of refugees displaced by war or violence reaches over 19 million. Rates of mental health disorders, such as anxiety disorders, post-traumatic stress disorder (PTSD) and depression were higher among refugee populations in comparison to the general population. This increased vulnerability has been linked to experiences prior to migration, such as war exposure and trauma. Additionally, anxiety and other mental health disorders can manifest due to stressors post-migration, such as separation anxiety and the added load of resettlement in a new country. In general, increased rates of these disorders remain prevalent in refugee populations long after resettlement; however, some studies have shown otherwise.1 In the Karenni refugees along the Burmese-Thai border, depression and anxiety rates (41% and 42%, respectively) were higher than the average rates of depression and anxiety among the general US population (7% and 10%, respectively).2 These rates have been linked to traumatic events like violence, harassment, and a lack of basic needs. Moreover, the mental health of refugees is thought to be distinct from the experiences of other traumatized populations, such as veterans and sexual assault victims, due to their unique traumatic experiences as well as acculturative stress that follows the resettlement process, which features entirely new settings, practices, and a lack of familiar support systems.3 Furthermore, this population showed a correlation of depression and anxiety disorders with post-resettlement hardships in regards to finding employment and adapting to a new environment culturally and linguistically. In another population, 82.6% of Cambodian refugees residing in a refugee camp on the Thailand-Cambodia border self-reported depression. Fifty-five percent were confirmed by the Hopkins Symptoms Checklist to have experienced symptoms of major depression.2 Symptoms of depression include changes in weight, sleep pattern, exhibiting a depressed mood for much of a day, a loss of interest in activities, lack of energy, feelings of worthlessness and guilt almost daily, lack of focus, and recurrent thoughts of death and suicide, which can include attempting or creating plans for suicide. Symptoms of PTSD include intrusion, avoidance, and hyperarousal. PTSD typically is associated with traumatic experiences. These traumatic events can include experiencing war, being held prisoner/hostage, torture and physical violence, death of a loved one, serious accidents/explosions, sexual harassment, and serious illness. Symptoms of generalized anxiety disorder include restlessness, irritability, fatigue, excessive worrying, having trouble relaxing, sleeping, and focusing.4 The current refugee demographic is a highly heterogeneous group, however, there has been an increase of refugees from Arabic speaking countries in recent years.5 Europe, in particular, has seen a large increase of asylum applicants from Arabic speaking countries, the most frequent being Syria (35.9% of applications) and Iraq (6.9% of applications). Despite the growth of Arabic speaking refugees, few studies have investigated the mental health of these populations in recent years. The large variations in results show that the refugee population is a diverse group. Complications in studies that inhibit direct comparison between refugee populations include the use of different psychometric instruments to measure mental health.5 Another factor that could promote the symptoms of PTSD, depression, and anxiety is acculturative stress. While trauma related to war negatively impacts mental health, the effects of acculturative stress on mental health among refugees resettled in Australia and Austria demonstrated that stress which accompanies the migration process can have similar effects.6 One cause of these stressors is acculturation, the process of integrating into a new culture while also maintaining one’s origin culture and identity. This process is dependent on the attitudes of both the migrant and host groups. There are inconsistencies present in existing studies investigating the effects of acculturation on mental health; however, acculturative stress in migration has been identified as a mental health risk factor.6 The purpose of this review was to investigate the relationship between refugee populations and their increased vulnerability to post-traumatic stress disorder, depression, and anxiety disorders. This study also examined the factors before, during, and after the migration process associated with increased vulnerability of refugees to mental health disorders.

An analytical study on preventing students from depression

Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person's ability to function at work and at home. This study is made with purpose to evaluate the level of depression and identify the corrective mechanisms and strategies to overcome the depression among the students community. Descriptive research design was used to collect the primary data from the sample of 100 students studying in Bangalore city through structured questionnaire constructed with standard set of questions. Appropriate statistical tools were employed to analyze the data, based on that finding are arrived and suggestions are made. It is considered to be ever increasing and demanding need to produce high quality output from educational institutions to build strong nations. This is considered to be an attempt to reach that destiny.

The effects of an educational program on depression literacy and stigma among students of secondary schools in Jazan city, 2016: A cluster-randomized controlled trial study protocol.

Depression is a serious mental health disorder and characterized by sadness, loss of interest in activities, and decreased energy. The aim of this study is to assess the effectiveness of the school intervention program on depression literacy and stigma among students of secondary schools. A cluster randomized trial will be conducted on sample of 360 students to assess the depression literacy and stigma towards depression before and after a designed intervention educational program. The intervention consists of a package of 2 lectures, 1 video contact, and group discussion of 5 myths about depression, posters, and brochure. The target population consists of all secondary school students in Jazan, where there are 13 secondary schools will be stratified according to sex (6 schools for boys and 7 schools for girls). The results of the study will provide evidence of the efficacy of educational intervention programs on increasing depression literacy among students of secondary schools in Jazan City. The expected outcome of this study is to increase the depression literacy rate among high school students in the intervention group.

A case series: Efficacy of short term EMDR on patients with persistent complex bereavement disorder (PCBD)

Grief is a normal response to loss of someone to whom a bond was formed; however, prolonged grief is considered pathological. Persistent complex bereavement disorder (PCBD) is defined as a persistent longing for the deceased over 12 months. Several treatment ways have been used for traumatic loss including eye movement desensitization and reprocessing (EMDR). In the current case series, effectiveness of EMDR on three PCBD patients will be indicated. Three patients applied to the clinic with similar complaints based on different traumatic backgrounds; commonly, all experienced death of a first-degree relative. Complaints of the patients were over-thinking about the deceased, sleep disturbances, self-blaming, social isolation, avoiding talks about lost relative, and loss of interest in activities. After pre-interviews, they were advised EMDR therapy. One session of EMDR was applied to two of the patients, and two EMDR sessions were conducted on one of them. After the sessions, the patients reported not feeling guilty about the loss anymore, returning their normal routines, feeling better, and showing decreased avoidance. Additionally, the scores of scales (CAPS, BAI, BDI, and IES-R) significantly declined. EMDR therapy can show successful results in a shorter time than other treatment ways used for PCBD treatment [1].Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depression: Current Scenario with reference to India

Introduction: Depression is an illness characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. In addition, people with depression normally have several of the following symptoms: Loss of energy, Change in appetite, Sleeping more or less, Anxiety, Reduced concentration, Indecisiveness, Restlessness, Feelings of worthlessness, Guilt or hopelessness, Thoughts of self-harm or suicide, (WHO World Health Day Campaign Essentials)

Suicidality in primary care patients who present with sadness and anhedonia: a prospective European study.

BackgroundSadness and anhedonia (loss of interest in activities) are central symptoms of major depression. However, not all people with these symptoms meet diagnostic criteria for major depression. We aimed to assess the importance of suicidality in the outcomes for primary care patients who present with sadness and anhedonia.MethodCohort study of 2,599 unselected primary care attenders in six European countries followed up at 6 and 12 months.Results1) In patients with sadness and/or anhedonia who were not depressed at entry to the study, suicide plans (OR = 3.05; 95 % CI = 1.50–6.24; p = 0.0022) and suicide attempts (OR = 9.08; 95 % CI = 2.57–32.03; p = 0.0006) were significant predictors of developing new onset depression at 6 or 12 months. 2) In patients with sadness and/or anhedonia who met CIDI criteria for major depression at entry, suicidal ideation (OR = 2.93; 95 % CI = 1.70–5.07; p = 0.0001), suicide plans (OR = 3.70; 95 % CI = 2.08–6.57; p < 0.0001), and suicide attempts (OR = 3.33; 95 % CI = 1.47–7.54; p = 0.0040) were significant predictors of persistent depression at 6 or 12 months.ConclusionsThree questions on suicidality could help primary care professionals to assess such patients more closely without necessarily establishing whether they meet criteria for major depression.

The acceptability of case-finding questions to identify perinatal depression

Background: Guidance from the National Institute for Health and Care Excellence advocates the use of two case-finding questions about depressed mood and loss of interest in activities to identify perinatal depression. However, there are no studies of their acceptability when administered in the antenatal and postnatal period. Methods: The study was an intra-mixed methods cohort study set in an antenatal clinic in an inner-city hospital in the North of England. Pregnant women attending a routine antenatal appointment at approximately 26 weeks' gestation completed a self-report survey at a routine hospital antenatal appointment and a postal survey between 5 and 13 weeks postnatal. Survey responses and free-text commentaries of women's views were analysed using descriptive statistics and qualitative content analysis. Results: Ninety-three percent of participants felt it was desirable to ask about perinatal mental wellbeing, and 97% felt comfortable answering the questions. Free-text comments revealed depressed and non-depressed women found the questions easy, simple and straightforward to answer. Conclusions: Case-finding questions to identify perinatal depression were generally acceptable to depressed and non-depressed pregnant and newly delivered mothers. Health professionals should consider the acceptability and appropriateness of this strategy in order to facilitate identification of perinatal mental health issues in routine maternity care practice.

The association between fatigue and apathy in patients with either Parkinson's disease or multiple sclerosis.

Fatigue and apathy are common symptoms in both multiple sclerosis (MS) and Parkinson's disease (PD). Both symptoms are considered "amotivational"--fatigue is a lack of energy to start or complete an action and apathy is a loss of interest in activities. Whether the two symptoms are related to each other is not known. The present study sought to investigate the prevalence and severity of fatigue and apathy in MS and PD, and the relationship between the two. The Fatigue Severity Scale (FSS) and the Apathy Scale (AS) were administered to 89 consecutive PD and 73 consecutive MS subjects. The mean FSS score for PD subjects was 4.46 and 5.01 for MS; the average total AS score for PD was 12.4 and 12.5 for MS. Using a cutoff of >4.0 on the FSS to assess fatigue, 64% of PD subjects and 74% of MS subjects suffered from severe fatigue. Using an AS cutoff score of >14.0 to determine apathy, 57% of PD subjects and 52% of MS subjects were apathetic. There was a significant correlation between FSS score and AS score in both disorders. FSS average scores and AS total scores were significantly correlated with motor severity in PD but not in MS. Duration of disease was not correlated with either scale scores in either disorder. Results confirm that AS and FSS are correlated with each other in both disorders and that MS subjects rate their fatigue significantly higher.

Prevalence of Egyptian Childhood Depression Among Middle School Students

Background Childhood depression is a serious medical problem that causes an agonizing feeling of sadness and loss of interest in activities. It affects adolescents thinking, feeling and behavior, and it can cause emotional, functional and physical problems. Although mood disorders, such as depression, can occur at any time in life, symptoms may be different between teens and adults. Methods This cross section study assessed the prevalence of childhood depression from age 12 through 16 years and examined using Revised behavioral problem checklist (RBPCL) as a screening instrument. Prevalence rates were estimated on the basis of clinical diagnoses and other measures as MINI-KID and Childhood Depressive Inventory (CDI). A representative population sample of 739 children and adolescents aged between 12 and 16 years were assessed for ICD 10 fordepressive disorders Results From the sample studied results reveal that 353 males and 386 females and was divided according to the presence or absent of depressive symptoms into Group 1 without depression (89%) and Group 2 (10.5%) with depressive symptoms according RBPCL . further analysis of group 2 showing that mean age was (14±1)year, where (67%) were males (33%) females regarding the academic achievement of depressed adolescents denoting that (74%) were average, (20.5%) below average,(5%) failed in academic records. Using CDI for assessing severity of depression revealing that(40%) have mild, 24% moderate, 36% severe depression Conclusion The prevalence rates obtained vis-a-vis the availability of mental health services in Egypt reflected a major public health problem

Clinical Anecdotes: A Logic in Madness

Clinical Anecdotes:A Logic in Madness Aaron J. Hauptman (bio) Key Words autonomy, rationality, mental illness, ethics The ultimate language of madness is that of reason. (Foucault 1961/1988, 95) In short, under the chaotic and manifest delirium reigns the order of a secret delirium. In this second delirium, which is, in a sense, pure reason, reason delivered of all the external tinsel of dementia, is located the paradoxical truth of madness. And this in a double sense, since we find here both what makes madness true (irrefutable logic, perfectly organized discourse, faultless connection in the transparency of a virtual language) and what makes it truly madness (its own nature, the special style of all its manifestations, and the internal structure of delirium). (Foucault 1961/1988, 91) At the urging of his parents, Mr. A, a college-age young man with a past diagnosis of Asperger’s syndrome, presented for assessment to an inpatient psychiatric hospital after making suicidal statements. He had been in his normal state of health and functioning well until a few months before presentation, at which point he had precipitously fallen into a severe depression. The trigger was the abrupt end of a 1-year-long relationship. This had been an exclusively online, romantic relationship that ended terribly and with a sudden shock after being cruelly manipulated by the other party. For his part, he had seen his partner as the love of his life and expected that they would meet in person and marry. A series of frantic moves after his significant other failed to show up for their planned in-person tryst resulted in his discovering the extent to which he was being manipulated, and the relationship was immediately broken off. A bright young man with classic symptoms of high-functioning autistic spectrum disorder, including concrete thinking and often considerable struggle with interpersonal relationships secondary to challenges in intuiting other peoples’ mental and emotional states, he had never been in a romantic relationship before and this turn of events was crushing. On assessment, he was clearly depressed. He admitted to sleep disturbance, loss of interest in activities, long periods of low energy that he spent in bed, weight loss owing to lack of appetite, subjective depression, and thoughts of death, all classic symptoms of severe major depression. He had been unable to get out of bed for months before this assessment and had ceased showering and changing clothes except for infrequent instances that came about at the desperate urging of his family. At the time of his presentation, he was increasingly vocal about desiring to let himself starve to death and he had already lost considerable weight. Clearly, he posed a risk to himself and his situation warranted a course of inpatient treatment. Begrudgingly, he accepted voluntary hospital admission. Once settled in, however, he made it very clear that under no circumstances would he use psychotropic medication. Electroconvulsive [End Page 303] therapy: clearly also not an option. Despite his depression, he had a doggedness with rationality, characteristic of his diagnosis of autism, and, although he still would not shower or shave, he would settle in readily to debate the logic of his treatment. His argument went along the following lines: I am depressed for a very good reason and if, because of that, I have these feelings then it is right for me to have these feelings. An artificial change of course, he seemed to feel, would be dishonest. He was still in love. He knew at this point that his love’s object was a fiction, but to him this did not change things. An improvement based on anything but an internally driven shift in his thinking was indefensible to him. A number of people tried to argue with him. “You could have started off depressed for a good reason,” one would say, “but then it became something organic.” “Depression is always organic, isn’t it? It is in your brain!” he would reply. He would argue that reneging on the love of his life would make him despicable and dishonest. He seemed to feel that the only thing left to attach him to the emotion and the promise of...

THE PREVALENCE OF DEPRESSION AND ITS RISK FACTORS AMONG MALAY ELDERLY IN RESIDENTIAL CARE

The motivation for the study is to improve the quality of life for elderly in residential care particularly the mental health aspect. Hence, the aim of this study is to examine the prevalence of depression and to identify risk factors related to depression among Malay elderly in residential care. Changes in social structure and economic status have shifted the direction of care for elderly people, as the value of filial piety has gradually declined among the modern Malays. The researchers hypothesized that the level of depression among institutionalized Malay elderly people is high. Altogether, 98 of Malay elderly (men 41.8%, women 58.2%) participated in this study from eight residential cares in Peninsular Malaysia. They were chosen according to the following criteria: Malay ethnic, aged 60 years and above, able to communicate and with no severe mental and/or physical health problem. The Geriatric Depression Scale (GDS-30) was used to assess depression among the elderly. Overall, the study found that 70.4% of the Malay elderly in the residential care were diagnosed with depression, where 39.8% had mild depression and 30.6% were suffered from major depression. Five factors were identified as the high risk factors of depression among the Malay elderly i.e., sadness, helplessness, isolation, loneliness and loss of interest in activities (76.8-86.9%). As a conclusion, the prevalence of depression among the Malay elderly in the present study is high. Besides arranging a regular program on screening for depression, it is also important for the residential care providers to create and organize special activities for the elderly in order to reduce them from the risk factors of depression. They should be ensured to have a healthier and happier life at the institutions, if the residential care providers would like to increase the elderly mental health status.

Symptom Burden Predicts Hospitalization Independent of Comorbidity in Community‐Dwelling Older Adults

To determine whether cumulative symptom burden predicts hospitalization or emergency department (ED) visits in a cohort of older adults. Prospective, observational study with a baseline in-home assessment of symptom burden. Central Alabama. Nine hundred eighty community-dwelling adults aged 65 and older (mean 75.3 ± 6.7) recruited from a random sample of Medicare beneficiaries stratified according to sex, race, and urban/rural residence. Symptom burden score (range 0-10). One point was given for each symptom reported: shortness of breath, tiredness or fatigue, problems with balance or dizziness, leg weakness, poor appetite, pain, stiffness, constipation, anxiety, and loss of interest in activities. Dependent variables were hospitalizations and ED visits, assessed every 6 months during the 8.5-year follow-up period. Using Cox proportional hazards models, time from the baseline in-home assessment to the first hospitalization and first hospitalization or ED visit was determined. During the 8.5-year follow-up period, 545 (55.6%) participants were hospitalized or had an ED visit. Participants with greater symptom burden had higher risk of hospitalization (hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.05-1.14) and hospitalization or ED visit (HR = 1.10, 95% CI = 1.06-1.14) than those with lower scores. Participants living in rural areas had significantly lower risk of hospitalization (HR = 0.83, 95% CI = 0.69-0.99) and hospitalization or ED visit (HR = 0.80, 95% CI = 0.70-0.95) than individuals in urban areas, independent of symptom burden and comorbidity. Greater symptom burden was associated with higher risk of hospitalization and ED visits in community-dwelling older adults. Healthcare providers treating older adults should consider symptom burden to be an additional risk factor for subsequent hospital utilization.

Diagnostic accuracy of case-finding questions to identify perinatal depression

Guidelines for perinatal mental health care recommend the use of two case-finding questions about depressed feelings and loss of interest in activities, despite the absence of validation studies in this context. We examined the diagnostic accuracy of these questions and of a third question about the need for help asked of women receiving perinatal care. We evaluated self-reported responses to two case-finding questions against an interviewer-assessed diagnostic standard (DSM-IV criteria for major depressive disorder) among 152 women receiving antenatal care at 26-28 weeks' gestation and postnatal care at 5-13 weeks after delivery. Among women who answered "yes" to either question, we assessed the usefulness of asking a third question about the need for help. We calculated sensitivity, specificity and likelihood ratios for the two case-finding questions and for the added question about the need for help. Antenatally, the two case-finding questions had a sensitivity of 100% (95% confidence interval [CI] 77%-100%), a specificity of 68% (95% CI 58%-76%), a positive likelihood ratio of 3.03 (95% CI 2.28-4.02) and a negative likelihood ratio of 0.041 (95% CI 0.003-0.63) in identifying perinatal depression. Postnatal results were similar. Among the women who screened positive antenatally, the additional question about the need for help had a sensitivity of 58% (95% CI 38%-76%), a specificity of 91% (95% CI 78%-97%), a positive likelihood ratio of 6.86 (95% CI 2.16-21.7) and a negative likelihood ratio of 0.45 (95% CI 0.25-0.80), with lower sensitivity and higher specificity postnatally. Negative responses to both of the case-finding questions showed acceptable accuracy for ruling out perinatal depression. For positive responses, the use of a third question about the need for help improved specificity and the ability to rule in depression.

Body image perceptions in women with pelvic organ prolapse: a qualitative study

To describe perceptions of prolapse-specific body image in women with symptomatic prolapse. Women with symptomatic pelvic organ prolapse quantification stage ≥ II prolapse participated in semistructured focus groups or self-report questionnaire. Transcripts were independently reviewed and body image themes were identified and confirmed by consensus. Twenty-five women participated in focus groups and 27 in online questionnaires. Transcript analysis revealed 3 central themes and 25 body-image related subthemes. Women living with prolapse were more likely to feel self-conscious, isolated, "different," less feminine, and less attractive. Women often changed sexual intimacy practices because of embarrassment or discomfort, and many avoided intimacy all together. Prolapse greatly affected women's personal and professional activities causing some women to adjust routines or stop activities. Women reported loss of interest in activities, distraction while performing daily/work-related tasks, and embarrassment when asking for help with activities. Themes identified in this qualitative study demonstrate the profound effect of prolapse on a woman's body image.

Depressive Episode With Catatonic Features in a Case of Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS)

Three months previously, a 17-year-old girl had complained of right-hand side hemiparesis, and her brain magnetic resonance imaging (MRI) showed a signal change in the left temporoparietooccipital area. The 3243A>G mutation was found in mitochondrial DNA. She was diagnosed with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and was prescribed dichloroacetic acid to treat lactic acidosis. Her health improved. Two months later, she developed drowsiness and generalized weakness. A New lesion was not found on brain MRI, and electrodiagnostic findings were compatible with acute motor sensory axonal neuropathy. Her negative symptoms, such as depressed mood, loss of interest in activities, psychomotor retardation, and hypersomnia, were aggravated. She was prescribed antidepressants and psychostimulants by a psychiatrist after diagnosis of severe depression episode with catatonic features. One month later, her catatonic condition had improved with medication. Our experience shows that psychiatric diagnostic evaluation of abruptly regressed neurologic and clinical features is important, even in a patient with devastating underlying disease.