Severity Of Mood Disturbance Research Articles

Existential well-being and spirituality of individuals with amyotrophic lateral sclerosis is related to psychological well-being of their caregivers

Existential well-being (EWB) and spirituality issues are important factors in determining quality of life (QoL) in amyotrophic lateral sclerosis (ALS) patients. No conclusive data among the relation between patient's EWB, their spirituality and caregivers' QoL are available. In the mainframe of a longitudinal study, we performed a cross-sectional analysis aimed to investigate EWB and spirituality issues in sporadic ALS (SALS) patients and the relations with caregivers' psychological features. Thirty-seven SALS patients, together with their caregivers, consecutively recruited at NEuroMuscular Omnicentre, in Milan, were included in this study. EWB and spirituality questions were administrated to patients and caregivers. Caregivers also completed questionnaires about quality of life (MQoL-SI), care burden (ZBI), depression (BDI) and anxiety (STAI). Both EWBs and questions about spirituality of SALS patients showed a positive correlation with MQoL-SI and EWBs in their caregivers. Conversely, SALS patients' EWB and spirituality were negatively correlated with caregivers' STAI, BDI and ZBI scores. In conclusion, existential well-being, as well as spirituality issues, perceived by SALS patients seems to be directly related with quality of life, severity of mood disturbance and burden experienced by their caregivers.

Prevalence of Anxiety and Depression in Patients with Severe COPD: Similar High Levels with and without LTOT

The benefits of long-term oxygen therapy (LTOT) on mood in Chronic Obstructive Pulmonary Disease (COPD) are unproven. Longitudinal studies are affected by disease progression, the increased package of care (with LTOT) and may not control for known confounders on mood. We compared the point prevalence and severity of mood disturbance in patients with severe COPD, not on LTOT (the −LTOT group) to those with COPD on LTOT (the +LTOT group). We mailed the Hospital Anxiety and Depression (HAD) Score to 182 consecutive patients with severe COPD, identified from respiratory case notes in three UK Hospitals. We compared 57 patients not prescribed LTOT to 57 patients on LTOT, and used stratified sampling to match the groups as far as possible for age, gender, lung function and other possible confounders on mood. Or these, 25% of patients in both groups scored in the ‘definite’ case range for anxiety (HAD score ≥ 11). 37% of the −LTOT group and 33% of the +LTOT group scored in the ‘definite’ range for depression (HAD score ≥ 11) (p = N.S). In both groups, only 11% of responders were prescribed anxiolytics and/or antidepressants. Further multiregression analysis confirmed that socio-demographic variables (e.g., lives alone, feels isolated or recent life events) were stronger predictors of mood than the prescription of LTOT or other traditionally accepted factors such as co-morbidity or the use of antidepressants or anxiolytics. High levels of anxiety and depression are present in severe COPD and appear under-treated. The +LTOT and −LTOT patients had a similar high prevalence of anxiety and depression.

Examining School Health Center Utilization as a Function of Mood Disturbance and Mental Health Difficulties

Purpose We examined the presence and severity of mood disturbance and mental health difficulties as predictors of students’ utilization of school health centers. Methods Mood disturbance and mental health difficulties were assessed through surveys completed at year end. Visits to school health centers were tracked prospectively over the year. Results Twenty-three percent of students with mental health difficulties visited the school health centers. Students reporting mood disturbance and difficulties were more likely to use school health centers and to use them more frequently than were students without such difficulties. More than half of all visitors were judged by health clinic staff to be experiencing impairment in functioning and reported difficulties, which typically lasted more than 6 months duration. Conclusions Although the presence of mental health difficulties increases the probability of students’ visiting school health centers, the majority of students with such difficulties do not avail themselves of this resource. Optimizing the effectiveness of school-based health services depends on understanding the interplay between availability and utilization of school-based services for students with mental health difficulties.

Relationship of Mood Disturbance to Cigarette Smoking Status Among 252 Patients With a Current Mood Disorder

The relationship between cigarette smoking and mood has received increasing attention. This retrospective study evaluated the relationship between mood disturbance and cigarette smoking status among patients with a current mood disorder. The association between level of nicotine dependence and severity of mood disturbance was also evaluated among current smokers. Retrospective data for 252 patients (63.5% male, 85.0% white) admitted for treatment of a mood disorder at the San Diego Veteran Affairs Mental Health Clinical Research Center between November 1988 and June 1997 were studied. All current cigarette smokers at admission (N = 126) were matched with nonsmokers (N = 126) on the primary DSM-IV Axis I mood disorder diagnosis, admission status (inpatient or outpatient), gender, age (+/- 5 years), and ethnicity. The Hamilton Rating Scale for Depression (HAM-D), the Beck Depression Inventory, and the Profile of Mood States (POMS) were administered to patients on admission. Conditional logistic regression analysis for matched sets with a backward elimination was used to identify factors independently predictive of current smoking status. A greater number of cups of coffee consumed per day (p = .002), a history of alcoholism (p = .004), and higher POMS fatigue subscale scores (p = .007) were predictive of current smoking status. Among current smokers, the HAM-D terminal insomnia item was positively associated with mean number of cigarettes smoked per day (p = .012). Cigarette smoking should be addressed in the treatment of patients with a current mood disorder. Smokers experience greater levels of fatigue than nonsmokers. In addition, higher cigarette consumption levels are associated with mild-to-severe symptoms of terminal insomnia.

Cognitive deficits in patients suffering from chronic fatigue syndrome, acute infective illness or depression.

Patients with chronic fatigue syndrome (CFS) report neuro-psychological symptoms as a characteristic feature. We sought to assess cognitive performance in patients with CFS, and compare cognitive performance and subjective workload experience of these patients with that of two disease comparison groups (non-melancholic depression and acute infection) and healthy controls. A computerized performance battery employed to assess cognitive functioning included tests of continuous attention, response speed, performance accuracy and memory. Severity of mood disturbance and subjective fatigue were assessed by questionnaire. All patient groups demonstrated increased errors and slower reaction times, and gave higher workload ratings than healthy controls. Patients with CFS and non-melancholic depression had more severe deficits than patients with acute infection. All patient groups reported more severe mood disturbance and fatigue than healthy controls, but patients with CFS and those with acute infection reported less severe mood disturbance than patients with depression. As all patients demonstrated similar deficits in attention and response speed, it is possible that common pathophysiological processes are involved. The differences in severity of mood disturbance, however, suggest that the pathophysiological processes in patients with CFS and acute infection are not simply secondary to depressed mood.

Fluctuations in Mood and Psychological Distress during the Menstrual Cycle

This paper examines fluctuations in mood and symptoms associated with psychological distress during the phases of the menstrual cycle in two samples of university women. The first (Study I) sample of women (N = 162) was randomly selected from the University population. The second sample (Study II) was women (N = 138) who attended a psychiatric clinic. The subjects completed a questionnaire which included measures of depression, anxiety and general psychological distress. Information about the menstrual cycle and contraceptive pills was elicited from the subjects who were unaware that affect during the menstrual cycle was being studied. In study I there were no significant differences in depression, anxiety or psychological distress between phases of the cycle. The results of study II indicated that even in a group of women with emotional problems, it was not possible to demonstrate an increase in the average severity of mood disturbance or psychological distress during any phase of the menstrual cycle. It was concluded that in general, university women between the ages of 18-30 who are mostly single, nulliparous, with or without significant psychopathology, seeking or not seeking psychiatric help do not experience significant or disruptive fluctuations in mood and symptoms of psychological distress during the phases of the menstrual cycle. Women who are afflicted with distressing and incapacitating cyclical fluctuations are best studied as a vulnerable subgroup.