Mild Mood Disturbance Research Articles

Study to Assess Depression and Its Risk Factors among Patients with Chronic Medical Conditions Attending Selected Units of AIMS, Kochi

A quantitative approach descriptive study was conducted to assess depression and its risk factors among 150 subjects diagnosed with chronic medical conditions like diabetes mellitus, COPD and CAD. The objectives of the study were to identify depression among patients with chronic medical conditions, find out the risk factors for depression among patients with chronic medical conditions and find out the association between depression and its risk factors among patients with chronic medical conditions. The data was collected using socio demographic sheet and Beck's depression inventory (structured interview). The major findings of the study were, among the 150 patients, 42% of them had clinical depression at varying levels and one third of the patients i.e.34% had mild mood disturbance. The major risk factors for causing depression among patients with chronic medical conditions were low education, existence of co-morbid diseases, age, monthly income and use of medications. Significant association was found between depression and its risk factors like marital status, education, occupation, monthly income, family support, history of maternal deprivation and stressful life events. These findings necessitate the need for strategies to improve the patients well being and there by reducing the illness burden.

Eve Teasing and Adolescent’s Depression

Introduction: Depression in urban female adolescents is now a growing public health problem in Bangladesh. In recent time eve-teasing (sexual harassment) has become a burning issue. Adolescent girls face both psychological and social problems due to eve-teasing and it is one of the determinants of depression of adolescent girls.Objective: The study was done to assess the level and determine the factors of depression as well as to estimate the proportion of eve teasing among female adolescent students.Materials and Methods: This cross sectional study was performed at Shahid Ramijuddin Cantonment High School, Dhaka, situated in Shahid Mannan line during a period of one year starting from January 2013 to December, 2013. The study was carried out among 203 female students of class-IX and X aged 14 to 16 years. Beck Depression Inventory (BDI) was used to measure the level of depression. Pattern of eve teasing and factors of depression was identified by a number of questions.Results: Among 203 female adolescents 122 students from class-IX and 81 students from Class-X (Mean age 15.02±0.786 years), all are unmarried, 90.6% lived in nuclear family and only 9.45% lived in joint family. This study showed 32% respondents had moderate depression, 17.7% had mild mood disturbance, 10.3 % had borderline clinical depression, 4.9% had severe or extreme depression and 35% respondents found normal. The study also revealed that 75.9% school going girls aged 14 to 16 years experienced eve teasing. Poor school performance, friction with family members, lack of friendly relationship with teachers, 03 JAFMC Bangladesh. Vol 10, No 2 (December) 2014 no communication with friends are associated with depression but the association of substance abuse, smoking habit, heavy internet use with depression was not found. This study also revealed that, 53.2% depressed adolescent girls and 46.8% adolescent girls with no depression experienced eve teasing and depression is higher among girls who experienced eve teasing. So eve teasing is an important factor for female adolescent depression.Conclusion: Among the study subjects majority of the respondents are moderately depressed and large number of students have experienced eve teasing. Eve teasing has found significant association with depression. Several factors are responsible for depression but in case of female adolescents eve teasing is one of the important factor that needs urgent attention. So, it is essential to control eve teasing for prevention of depression of adolescent girls.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

Study on Level of Depression among Elderly Residing in an Old Age Home in Hyderabad, Telangana

Introduction: Depression is a major public health problem especially in geriatric population. With increasing trend of the concept of old age homes in India, the present study was designed to evaluate the depression among elderly in old age home and to recommend suggestive measures to prevent or reduce it. Material & Methods: An institution based cross sectional study was done in an old age home of Hyderabad. 80 elderly clients were interviewed using a pre designed pre tested questionnaire. Assessment of depression was done by using Beck’s Depression Inventory. Prior permission was taken from the Head of the old age home and informed consent was taken from the participants. Data entry was done using Microsoft Excel 2007 and analysis was done by using EPI INFO version 7. Results: Mean age of the respondents was 67.4±4.7 years with majority in 66-70 years age group (61%) and 55% were males. Mean depression score was 21.64. Maximum of elderly clients 39 (48%) had moderate depression and 23 (29%) had mild mood disturbance. Prevalence of depression was significantly associated with increased age; in females; and with duration of stay in old age home. Conclusions: Prevalence of depression was high in the present study and the associated factors noticed were increased age; in females; and with duration of stay in old age home.

Psychosocial illness among the drug abusers undergoing detoxification in Dhaka, Bangladesh

Abuse of drugs is a worldwide problem. Drug addiction is increasing tremendously in the South Asian countries especially in Bangladesh where such addiction is widespread among the younger age groups. It causes rapid erosion of educational, cultural, moral and family values. On the basis of defined criteria a total of 300 drug abusers who undergoing detoxification at the outpatient department of Central Drug Addiction Treatment Centre, Tejgaon, Dhaka were selected. The study was done for a period of one year from July 2013 to June 2014. Data were collected by face to face interview using pre-tested questionnaire. The analysis was done by computer using SPSS version 22.0. About 68% of the drug abusers had taken drugs for 2-5 years and 38% had taken three drugs during their life time. The major influencing factor for taking drugs was for peer pressure. Among the drug abusers 77% had taken Ganja, 60% Heroin as their first drug and 37% Yaba as their last drug. The depression was measured by the Beck's Depression Inventory that showed 55% of the drug abusers had moderate depression, 23% borderline clinical depression, 15% mild mood disturbance, 4% severe depression, and 3% had extreme depression. There were s ignificant associations between the duration of taking drugs (p<0.001), the number of taking drugs (p<0.006), and the age of first use of drugs (p<0.019) with depression. Majority of the drug abusers had depression and a significant number of them were involved in antisocial activities as well as violence. Family and social participation, behavioral therapies and proper medical management are essential to control drug addiction.South East Asia Journal of Public Health Vol.4(2) 2014: 36-41

Correlations between depression, cognitive status, functional scores, disability and lesion load in multiple sclerosis treated with interferon beta 1a

Abstract Introduction: Depression and cognitive impairment are the most frequent mental disorders in multiple sclerosis (MS) and represent an important cause of morbidity and mortality. The aim of the study was to analyse the main determinants of depression in multiple sclerosis. Materials and methods: Thirty-two patients with relapsing remitting multiple sclerosis (RRMS), treated with Interferon Beta 1a, without relapses and corticosteroid treatment in the last 30 days, were included in the study. The mean age of the patients was 35.4±9.2 years, M/F ratio 0.33. Depression level was evaluated by the Romanian version of Beck Depression Inventory (BDI) and the cognitive function with Paced Auditory Serial Addition Test 3 (PASAT 3), Symbol Digit Modalities Test (SDMT). The functional status and disability level of the patients were evaluated with Multiple Sclerosis Functional Composite and Expanded Disability Status Scale. In all patients a cerebral MRI with intravenous contrast administration was performed using a 1.5T MRI device. Results: Twenty-three patients were free of depression (score 1-10), 4 patients presented mild mood disturbance (score 11-16), 3 borderline clinical depression (score 17-20) and 2 moderate depression (score 21-30). The mean BDI score was 8.71±7.16. BDI score correlated significantly with EDSS (R=0.38, p=0.03), PASAT 3 (R=-0.42, p=0.01), SDMT (R=-0.58, p=0.0007), Timed 25-Foot Walk (R=0.43, p=0.01) and 9-Hole Peg Test (R=0.45, p=0.008). From the EDSS functional scores, significant correlations were found with the urinary score (R=0.4, p=0.01) and sensitive score (R=0.49, p=0.004). BDI score correlated significantly with the total number of T2 lesions (R=0.31, p=0.05) while there was no correlation with the number of active lesions. Conclusions: The main determinants of depression in RRMS patients are the cognitive impairment, the affection of fine hand movements (9-HP), gait impairment (T25FT) and bladder and sensitive dysfunction.

DEPRESSION

Depression has been estimated to have an increased prevalence amongst allpopulation and particularly among diseased population. Objectives: To determine prevalenceof depression among amputees after major traumas by using Beck Depression Inventory(BDI), in different hospitals of Rawalpindi and Islamabad. Methodology: A descriptive Crosssectional survey was done with a sample of 110 amputees of age between 15-60 years, indifferent hospitals of Rawalpindi and Islamabad. The study duration was completed from 1stJune 2013 to 1st January 2014. Details of data were collected through structured questionnaire.Questionnaire contained causes responsible for this depression and Beck’s Inventory Score tomeasure level of depression. Results: According to the data analyzed results shows that outof 110 amputees 28(25.5%) were having no depression, 35(31.8%) were mildly depressed,16(14.5%) were borderline depressed, 14(12.7%) were moderately depressed, 8(7.3%) wereseverely depressed and 9 (8.2%) were extremely depressed according to BDI. Conclusions:The current study suggests that amputees in sample have mostly mild mood disturbance BDI,as they were following rehabilitation and using assistive devices which reduces the impact ofdisability and dependency and helps coping with depression. Sample selection was from thosehospitals of Rawalpindi and Islamabad where a proper Rehabilitation setup was working and alot of emphasis was laid on the Rehabilitation regime after Amputation. So on the whole mostlypatients were mildly depressed according to BDI.

Physical Activity Program Is Helpful for Improving Quality of Life in Patients with Systemic Lupus Erythematosus.

Given the crucial events in systemic lupus erythematosus (SLE) such as joint and muscle pain, fatigue, depression, obesity and osteoporosis, the very thought of exercising can be challenging. This prospective study included 60 patients diagnosed with SLE in stable condition. A randomly selected group of 30 women had aerobic training on a bicycle ergometer for a period of 15 minutes, 3 times per week for 6 weeks, while the second group of 30 women performed isotonic exercises (to stretch and lengthen muscles and improve the range of motion) for 30 minutes, 3 times per week during the same period. Fatigue Severity Scale (FSS), Short Form 36 (SF36) questionnaire on the quality of life and Beck depression inventory (BDI) were analyzed at baseline and after 6 weeks. At baseline FSS score was 53.8 ± 5.7 and after the physical activity FSS score was 29.1 ± 7.8 (FSS ≥ 36; fatigue is present). The largest number of patients (66.7%) was in a moderate depressed state at the baseline, while after physical activities 61.7% of patients, had a mild mood disturbance. There were significant differences (p < 0.001) in values of all areas of quality of life questionnaire SF36 before and after the implementation of physical activity. The type of physical activity had no influence in FSS and BDI values. Continuous physical activity, regardless of its type, significantly improved quality of life of SLE patients. We recommend regular physical activity as an integral part of modern therapeutic approach in this patient population.

Depression and quality of life in patients with chronic kidney disease on haemodialysis in Central Province in Saudi Arabia

Introduction: Chronic kidney disease (CKD) implies long-standing, and usually progressive, impairment in renal function. Owing to the chronic nature of the illness, the majority of CKD patients may trigger physiological, psychological and social stressors at any point during the disease which interferes with their normal lifestyle and quality of life. Objectives: To investigate the prevalence of depression among CKD patients on dialysis in the central region of the Kingdom of Saudi Arabia (KSA) and to evaluate their lifestyle, social relationship and quality of life. Materials and methods: An observational cross-sectional hospital-based study. Data were collected from 159 CKD patients of either sex from haemodialysis units at King Abdulaziz Medical City of National Guard, Riyadh, King Saud Medical City, Riyadh and King Khalid General Hospital, Al Majma’ ah, KSA. A self-administered questionnaire containing demographic questions (Beck Depression Inventory) for measuring the severity of depression, and the HHHHHMM Scale and a modified form of WHOQOL (World Health Organization Quality of Life) questionnaire to evaluate the quality of life of CKD patients. Data were entered and analysed using IBM SPSS Statistics version 20 (IBM Corporation, Armonk, NY, USA). Results: The prevalence of depression among CKD patients was 57%. The majority of patients [112 (70.4%)] had depression at the beginning of the condition after being diagnosed with CKD, and the majority of the patients [127 (79.9%)] were leading a normal social life despite the disease. A significant association was observed between depression scale and depression at the beginning of the condition (P =0.043), showing that patients had mild mood disturbance (n =48, 30.2%), borderline clinical depression (n =28, 17.6%), moderate depression (n =38, 23.9%) or severe depression (n =23, 14.5%). A significant association was observed between depression scale and the QOL scale (P <0.001), showing that those within an acceptable quality of life had borderline depression (n =22, 78.5%), and those with an unacceptable quality of life, the majority, had severe depression (n =16, 69.5%). Conclusions: A high proportion of CKD patients on dialysis experienced depression, which eventually resulting in an impaired quality of life.

Pattern classification of brain activation during emotional processing in subclinical depression: psychosis proneness as potential confounding factor

We used Support Vector Machine (SVM) to perform multivariate pattern classification based on brain activation during emotional processing in healthy participants with subclinical depressive symptoms. Six-hundred undergraduate students completed the Beck Depression Inventory II (BDI-II). Two groups were subsequently formed: (i) subclinical (mild) mood disturbance (n = 17) and (ii) no mood disturbance (n = 17). Participants also completed a self-report questionnaire on subclinical psychotic symptoms, the Community Assessment of Psychic Experiences Questionnaire (CAPE) positive subscale. The functional magnetic resonance imaging (fMRI) paradigm entailed passive viewing of negative emotional and neutral scenes. The pattern of brain activity during emotional processing allowed correct group classification with an overall accuracy of 77% (p = 0.002), within a network of regions including the amygdala, insula, anterior cingulate cortex and medial prefrontal cortex. However, further analysis suggested that the classification accuracy could also be explained by subclinical psychotic symptom scores (correlation with SVM weights r = 0.459, p = 0.006). Psychosis proneness may thus be a confounding factor for neuroimaging studies in subclinical depression.

Randomized trial of pramipexole for patients with restless legs syndrome (RLS) and RLS-related impairment of mood

ObjectivesPatients with restless legs syndrome (RLS) have an elevated prevalence of mood disorders compared with the general population. We investigated the change of RLS-related mood impairment during treatment of RLS with pramipexole, a dopamine D3/D2 agonist. MethodsAdults with moderate to very severe RLS were enrolled in a 12-week, double-blind, placebo-controlled Phase IV pramipexole trial. A moderate to very severe RLS-related mood disturbance at baseline (score⩾2 on Item 10 of the International RLS Study Group Rating Scale [IRLS]) was also required. Pramipexole (0.125 to 0.75mg once daily) was flexibly titrated over the first 4weeks. ResultsThe intent-to-treat population comprised 199 patients on placebo and 203 on pramipexole. At week 12, adjusted mean total-score changes on IRLS were –14.2±0.7 for pramipexole and –8.1±0.7 for placebo (p<0.0001), and on the Beck Depression Inventory version II, –7.3±0.4 for pramipexole and –5.8±0.5 for placebo (p=0.0199). For IRLS item 10, the 12-week responder rate (reduction to no or mild mood disturbance) was 75.9% for pramipexole and 57.3% for placebo (p<0.0001). Study withdrawal rates were higher for placebo (20.5%) than for pramipexole (12.8%). ConclusionsIn patients with RLS-related mood disturbance, pramipexole improved RLS while also improving RLS-related mood impairment. Tolerability of pramipexole was similar to that in previous studies.

The impact of caring for persons living with HIV and AIDS on the mental health of nurses in the Limpopo Province

This study assessed the impact of caring for AIDS sufferers on the mental health of nurses. This assessment was measured against the level of burnout, stress and depression among 174 nurses caring for people living with HIV and AIDS in Limpopo Province, South Africa. A structured questionnaire was used for data collection. The questionnaire incorporated the AIDS Impact Scale (AIS), Maslach Burnout Inventory (MBI), Beck Depression Inventory (BDI) and the participants' demographic and professional profiles. Participants were conveniently selected from five selected hospitals in Limpopo Province. The study participants' valuation using the AIS showed that nurses tended to develop strong bonds and relationships with the patients; felt frustrated by their inability to help the terminally ill AIDS sufferers and were subsequently affected by the death of their patients. Personal accomplishments of the nurses remained high and the levels of emotional exhaustion and depersonalization levels were low. The BDI showed that over 3 out of 4 nurses were experiencing between mild mood disturbance and extreme depression. Higher average scores were noted for items of the depression scale like sadness, dissatisfaction, fatigue and low level of energy. The findings highlight the need to develop psychological support programmes for nurses caring for AIDS patients and promote the provision of social incentives and recognition of the role of nurses in AIDS care.

Investigating stress levels of residents: a pilot study

A pilot study of the levels of stress among residents was conducted in three departments in a university hospital prior to initiating a programme in stress management for residents. The Beck Depression Inventory, which is a brief, standardized self-report measure of depression, was given to residents in anaesthesiology, paediatrics and psychiatry. Six additional questions were asked about the functioning of peers and services residents would like to have available. Of the 113 residents surveyed, 16% were experiencing a mild mood disturbance. The researchers feel this is probably under-reported. Residents felt that about 15% of their colleagues were emotionally impaired; 10% may have a drug and/or alcohol problem; 12% were having marital problems. Eighty per cent of all residents studied said that they would attend support groups if they existed. Approximately 60% thought coping skills/stress management seminars would be useful, and 30% of the paediatric and anaesthesiology residents (60% of the psychiatry residents) said they would use confidential individual psychotherapy if it were available.

Concurrent incidence of depression and physical symptoms among hostile young women.

Analyses of questionnaire responses from 166 young women on the Cook-Medley Hostility scale of the MMPI, Beck Depression Inventory, and Wahler Physical Symptoms Inventory indicated significant differences between hostile and nonhostile women on depression scores, ranging from mild mood disturbance to borderline clinical depression. Hostile women also endorsed more items which indicated pervasive somatic complaints such as nausea, fatigue, respiratory, gastrointestinal, and cardiovascular distress. These results are discussed in the context of negative emotion and degenerative disease.