Perceptions Of Depressive Symptoms Research Articles

O58 - Symptoms of depression in parents after discharge from NICU associated with family-centred care

In 2018 to 2020, a multicentre cohort study was conducted in 23 NICUs across 15 countries. The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Parents ( n = 635 mothers, n = 466, fathers) of infants ( n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants’ hospitalisations. Parents’ perception of family-centred care in the NICU was assessed using the Digi-FCC (parent-version) tool with daily text messages and a questionnaire at discharge. Parent’s perception of depressive symptoms was also assessed using the Edinburgh Depression Scale: first at discharge and secondly when infants reached 4-months of corrected age. After controlling for gestational age, multiple birth, parent education and relationship status: an association was found between mothers’ and fathers’ perception of family-centred care, and their depressive symptoms at and after discharge. Parent perceptions of family-centred care was influenced by their ability to participate and make decisions about infant care, by the emotional support provided by staff members, and by other factors such as parental amenities and unlimited access for parents and significant others. Our study shows that family-centred NICU care associates with parents’ depressive symptoms after a NICU stay. Depression is common in parents of preterm infants. The provision of family-centred care may protect the mental well-being of parents of preterm infants.

Understanding care needs of cancer patients with depressive symptoms: The importance of patients' recognition of depressive symptoms

ObjectiveThe majority of cancer patients with depressive symptoms does not perceive a need for psychological care. Reasons for this are still unclear. We examined the mediating role of cancer patients' perceptions of depressive symptoms in the relationship between depressive symptoms and perceived need for psychological care.MethodsFor this cross‐sectional study, we recruited 127 Dutch cancer patients with moderate to severe levels of depressive symptoms (Patient Health Questionnaire [PHQ]‐9≥10) who did not receive professional psychological care. Depressive symptoms were measured with the PHQ‐9 questionnaire, by using three different depression score operationalizations. We used mediation analyses to test the mediating role of patients' illness perceptions (measured with subscales of the Brief Illness Perception Questionnaire) in the relation between depressive symptoms and need for care.ResultsWhilst results did not show significant direct associations between depressive symptoms and perceived need for psychological care, we found positive indirect effects of severity (B = 0.07, SE = 0.04, p < 0.02), meeting the DSM‐5 diagnosis (B = 0.45, SE = 0.26, p < 0.02) and having relatively more affective symptoms (B = 2.37, SE = 1.10, p < 0.02) on need for care through the identity perception.ConclusionsIncluding assessments of patients' recognition of depressive symptoms and their perceptions of depression treatment efficacy might improve depression screening in cancer patients by more accurately identifying those with a need for psychological care. Moreover, improving patients' knowledge and recognition of symptoms as being depressive symptoms might be a possible target point in increasing care needs and hereby optimizing the uptake of psychological care in cancer patients with depressive symptoms.

"I Wanted to Be There as a Father, but I Couldn't": A Qualitative Study of Fathers' Experiences of Postpartum Depression and Their Help-Seeking Behavior.

Postpartum depression (PPD) is one of the most common mental health problems among new parents. Past studies have examined PPD in women; however, the condition is less understood in men. This study aimed to explore the lived experiences of men or fathers with PPD and to understand the barriers and facilitators of help-seeking among fathers with PPD. Eight fathers with PPD were interviewed and data were subsequently analyzed through interpretative phenomenological analysis. The fathers perceived fatherhood as an overwhelming experience and feelings of inadequacy and powerlessness were two of the main themes in the fathers’ experiences of PPD. The feeling of inadequacy and powerlessness was related to the fathers’ expectations for themselves and their role as a father. The fathers’ sense of inadequacy and powerlessness sometimes turned into anger and frustrations. In addition, the fathers experienced a variety of contributing stressors around the birth of their child. Further, the analysis revealed how the fathers’ help-seeking behavior was influenced by five contributing factors: recognition and perception of depressive symptoms; knowledge and beliefs about PPD; taboo, stigma and conforming to masculine norms; the fathers’ partner; screening and perinatal healthcare services. Paternal PPD has a significant impact on the fathers’ wellbeing and everyday lives. Findings indicate that parents-to-be may benefit from education on paternal PDD, and they highlight the importance of screening for paternal PPD and support tailored to the needs of fathers with signs of PPD.

Can remotely supervised exercise positively affect self-reported depressive symptoms and physical activity levels during social distancing?

The main objective of this cross-sectional study was to compare the self-reported depressive symptoms and physical activity (PA) levels among participants who performed self- nonexercising (NE), guided exercise (SGE), remotely supervised exercise (RSE), and face-to-face supervised exercise (FFE) during social distancing. Three hundred and forty-four individuals (≥18 years and 67% women) answered a self-reported online survey that included questions related to the physical exercise practice (e.g., supervised and remote) during social distancing and questions about perceptions of depressive symptoms (Montgomery-Åsberg Depression Rating Scale-Self Rated [MADRS-S] scores) and metabolic equivalent task minutes per week (METs min•wk-1) of moderate- and vigorous-intensity PA, and total PA scores (International Physical Activity Questionnaire-Short Form) before and during social distancing. The RSE group (n=45) showed higher METs of vigorous-intensity PA than the SGE (n=146) and NE (n=109) groups. The RSE and FFE (n=44) groups showed higher METs of the total PA scores than the SGE and NE groups. The NE group showed higher MADRS-S scores than the other groups. Lower MADRS-S scores depend on the exercise practice and higher METs of vigorous-intensity PA depend on the supervised exercise practice. Thus, telehealth interventions can be implemented during the pandemic to enhance vigorous PA.

Perception of Depressive Symptoms in Patients after Myocardial Infarction

Background: The association between depressive symptoms and adverse outcomes in patients with coronary artery disease (CAD) is well recognized. However, few studies address the patient's perception of his physical and mental condition after a myocardial infarction (MI). The present study was designed to explore the subjective aspects of the psychological conditions in post-MI patients. Method and Results: A subject population of 8 male patients (age 59±5), selected by saturation sampling, with an average of 6 months post-MI, were submitted to an individual semi-structured interview and afterwards participated in 12 psychodynamic group sessions. Conclusion: There was a predominant non-acceptance of MI due to emotional barriers and this attitude has the potential to influence negatively the adherence to a comprehensive cardiovascular treatment, including pharmacological intervention for depression

Grandmothers and Self-Management of Depressive Symptoms

• Perceptions of depressive symptoms as an illness and in self-management and consequences of symptoms differed by provider diagnosis.

Oncologists' perception of depressive symptoms in patients with advanced cancer: accuracy and relational correlates.

BackgroundHealth care providers often inaccurately perceive depression in cancer patients. The principal aim of this study was to examine oncologist-patient agreement on specific depressive symptoms, and to identify potential predictors of accurate detection.Methods201 adult advanced cancer patients (recruited across four French oncology units) and their oncologists (N = 28) reported depressive symptoms with eight core symptoms from the BDI-SF. Various indices of agreement, as well as logistic regression analyses were employed to analyse data.ResultsFor individual symptoms, medians for sensitivity and specificity were 33% and 71%, respectively. Sensitivity was lowest for suicidal ideation, self-dislike, guilt, and sense of failure, while specificity was lowest for negative body image, pessimism, and sadness. Indices independent of base rate indicated poor general agreement (median DOR = 1.80; median ICC = .30). This was especially true for symptoms that are more difficult to recognise such as sense of failure, self-dislike and guilt. Depression was detected with a sensitivity of 52% and a specificity of 69%. Distress was detected with a sensitivity of 64% and a specificity of 65%. Logistic regressions identified compassionate care, quality of relationship, and oncologist self-efficacy as predictors of patient-physician agreement, mainly on the less recognisable symptoms.ConclusionsThe results suggest that oncologists have difficulty accurately detecting depressive symptoms. Low levels of accuracy are problematic, considering that oncologists act as an important liaison to psychosocial services. This underlines the importance of using validated screening tests. Simple training focused on psychoeducation and relational skills would also allow for better detection of key depressive symptoms that are difficult to perceive.

Perception of depressive symptoms by the Sardinian public: results of a population study.

BackgroundWith the exception of bereavement, the diagnosis of major depressive disorder in the DSM-IV does not take into account the context in which symptoms occur. Recent criticism has maintained that common sense suggests making a distinction between depression as mental disorder and sorrow as ‘normal’ reaction to social stress. Results of a study from Vienna support this view. This study sets out to examine whether these results can be replicated in a different cultural setting.MethodsIn 2012, a population-based survey was conducted by phone in Sardinia (n = 1,200). A fully structured interview was carried out which began with the presentation of a vignette depicting a diagnostically unlabeled case of depression, with or without provision of information about preceding stressful life events.ResultsIn general, as compared to the people from Vienna, the Sardinian public was much less prone to define depressive symptoms as expression of mental illness and more reluctant to recommend professional help. However, similar to Vienna, respondents presented with vignettes containing information on loss events were less likely to define depressive symptoms as indication of a psychiatric illness. They were also less willing to recommend professional help and relied more on self-help and support by family members and close friends.ConclusionsWe were able to replicate the result of the previous study that the public tends to perceive depressive symptoms differently depending on the context in which they occur. This lets us conclude that the divide between the public’s view of what depression is and the view of DSM-IV is not limited to a particular culture but seems to represent a more general phenomenon. In consequence, one might rethink the diagnostic criteria for major depressive disorder in order to reconcile both views.

Depression in older nursing home residents: The influence of nursing home environmental stressors, coping, and acceptance of group and individual therapy

Based on in-depth interviews with 65 older nursing home residents, this study examined the residents’ own understanding and perceptions of depressive symptoms, causes of their depression, their self-reported coping strategies, and their preferences for acceptable depression interventions. About half (n = 32) of all interviewees stated that they were either feeling depressed or experiencing negative affects. The major themes related to the causes of their depression were loss of independence, freedom and continuity with their past life; feelings of social isolation and loneliness; lack of privacy and frustration at the inconvenience of having a roommate and sharing a bathroom; loss of autonomy due to the institutional regimen and regulations; ambivalence toward cognitively impaired residents; ever-present death and grief; staff turnover and shortage; and stale programming and lack of meaningful in-house activities. Self-reported coping mechanisms included religion and stoicism, a sense of reality, positive attitude and family support. In regard to depression treatment, the interviewees appeared to prefer nursing home programs that reduce their isolation over group or individual psychotherapy.

The Effect of Diagnosis and Perceived Reward on Perceptions of Depressive Symptoms and Social Support

In three studies, we investigated the effect of diagnosis (i.e., depression versus a physical illness) on symptom perception and social support. Study 1 compared perceptions of objectively equivalent depressive symptoms labeled as either “depression” or “a heart condition.” Participants who imagined they were experiencing “depression” reported that their symptoms were due more so to psychological causes generally subject to internal control, and they considered social support as more important for improvement. In Studies 2 and 3, participants were told that another person was experiencing depressive symptoms reflecting a diagnosis of either “depression” or “a thyroid condition.” For these studies, the perceived reward of interacting with the other person played a critical role in moderating the influence of diagnosis, with low perceived reward being associated with a minimization of the depressed other's need for social support. We discuss the implications of these findings for understanding the stigmatization and amelioration of depression.