Dysthymic Symptoms Research Articles

Significance of Dysthymia Symptoms in Colleen Hoover’s Regretting You

Colleen Hoover's novel entitled Regretting You was first published in 2019. The novel reflects the intricate layers of human relationships of self-discovery, forgiveness, and lifelong family connections. Morgan and her teenage daughter, Clara, is dealing with the tragic deaths of Morgan's husband and Clara's father. As they deal with their grief and try to rebuild their lives, secrets and misunderstandings emerge, straining their relationship and causing them to experience dysthymia. Dysthymia is a lifelong form of depression, according to Michael E. Thase and Susan S. Lang. Then, how the symptoms of dysthymia depicted by Morgan and Clara in Colleen Hoover’s Regretting You? Employing a qualitative research approach, the researchers explore the symptoms of dysthymia, including changes in feeling, thinking, and behavior. Morgan and Clara's dysthymia evolves as they navigate the conflicts in the story, mainly due to the grief resulting from their loss. As a result, their mental and emotional health suffers greatly. This leads to the conclusion that their dysthymia exacerbates the tension in their mother-daughter relationship, making it difficult for them to communicate effectively and solve problems, all due to their enduring mild depression.

Virmentalness: Prototype of Therapy for Dysthymia Patients Using Virtual Reality

AbstractDepressive disorders can happen to anyone and will affect the pattern of life. However, there are still people who underestimate depression itself. Generally, depression problems or mental disorders are carried out with psychotherapy, a method for treating problems to find out the experienced problem and using anti-depressants. This study aims to produce a therapeutic aid for depression sufferers in this dysthymia by using Virtual Reality technology, which can be used by patients and medical experts, namely psychologists and psychotherapists, to use Virtual Reality-based therapy methods. The research method used is the prototyping method. The way to collect data is by interview and scientific literature. Researchers used Unity3D Software to create Virtual Reality applications. Virmentalness application is expected to help people with dysthymia symptoms in doing therapy to reduce symptoms. The application displays a 3D viewing environment of a room, a 360-degree atmosphere, and content video and audio for therapy methods. Keywords— Depressive disorders, Dysthymia, Virtual Reality, Therapy, Android

The impact of the COVID-19 pandemic on mental health in the general population: a comparison between Germany and the UK

BackgroundThe COVID-19 pandemic has led to dramatic social and economic changes in daily life. First studies report an impact on mental health of the general population showing increased levels of anxiety, stress and depression. In this study, we compared the impact of the pandemic on two culturally and economically similar European countries: the UK and Germany.MethodsParticipants (UK = 241, German = 541) completed an online-survey assessing COVID-19 exposure, impact on financial situation and work, substance and media consumption, mental health using the Symptom-Check-List-27 (SCL-27) and the Schizotypal Personality Questionnaire.ResultsWe found distinct differences between the two countries. UK responders reported a stronger direct impact on health, financial situation and families. UK responders had higher clinical scores on the SCL-27, and higher prevalence. Interestingly, German responders were less hopeful for an end of the pandemic and more concerned about their life-stability.ConclusionAs 25% of both German and UK responders reported a subjective worsening of the general psychological symptoms and 20–50% of German and UK responders reached the clinical cut-off for depressive and dysthymic symptoms as well as anxieties, it specifically shows the need for tailored intervention systems to support large proportions of the general public.

Depression from preschool to adolescence - five faces of stability.

The term 'stability' has different meanings, and its implications for the etiology, prevention, and treatment of depression vary accordingly. Here, we identify five types of stability in childhood depression, many undetermined due to a lack of research or inconsistent findings. Children and parents (n=1,042) drawn from two birth cohorts in Trondheim, Norway, were followed biennially from ages 4-14years. Symptoms of major depressive disorder (MDD) and dysthymia were assessed with the Preschool Age Psychiatric Assessment (only parents) and the Child and Adolescent Psychiatric Assessment (age 8 onwards). (a) Stability of form: Most symptoms increased in frequency. The symptoms' importance (according to factor loadings) was stable across childhood but increased from ages 12-14, indicating that MDD became more coherent. (b) Stability at the group level: The number of symptoms of dysthymia increased slightly until age 12, and the number of symptoms of MDD and dysthymia increased sharply between ages 12-14. (c) Stability relative to the group (i.e., 'rank-order') was modest to moderate and increased from ages 12-14. (d) Stability relative to oneself (i.e., intraclass correlations) was stronger than stability relative to the group and increased from age 12-14. (e) Stability of within-person changes: At all ages, decreases or increases in the number of symptoms forecasted similar changes two years later, but more strongly so between ages 12-14. Across childhood, while most symptoms of MDD and dysthymia become more frequent, they are equally important. The transition to adolescence is a particularly vulnerable period: The depression construct becomes more coherent, stability increases, the level of depression increases, and such an increase predicts further escalation. Even so, intervention at any time during childhood may have lasting effects on reducing child and adolescent depression.

Profiles of Childhood Trauma in Women With Substance Use Disorders and Comorbid Posttraumatic Stress Disorders

Background: It is increasingly becoming accepted that substance use disorders, including substance abuse and substance dependence, are closely related to childhood trauma and posttraumatic stress disorders. Among women with substance use disorders, the majority report sexual, physical or emotional abuse, or neglect. However, it is poorly understood which types of childhood trauma co-occur in women with substance use disorders and how combinations of different types and severities of childhood trauma are related to clinical characteristics. This information is important to inform treatment of substance use disorders. Aim: The first aim of this research was to investigate profiles of childhood trauma in female patients with substance use disorders and posttraumatic stress disorders. The second aim was to examine relationships between these childhood trauma profiles and addiction characteristics or current clinical symptoms. Methods: We includeda 343 treatment-seeking women with substance use disorders and comorbid posttraumatic stress disorders according to DSM-IV. Five types of childhood trauma (sexual abuse, physical abuse, emotional abuse) were measured using the Childhood Trauma Questionnaire. Addiction characteristics were assessed by using the Addiction Severity Index-lite. Current severity of clinical symptoms was determined by the Symptom-Checklist-27. Latent profile analysis was conducted to distinguish profiles of childhood trauma. Analysis of variance was applied to examine the relationship between childhood trauma profiles and addiction characteristics or severity of clinical symptoms. Results: Nine out of ten women reported at least one type of childhood abuse or neglect. Four different childhood trauma profiles could be distinguished that characterized different types and severities of childhood trauma: ‘Low trauma’; ‘Moderate sexual abuse and emotional abuse’; ‘Severe sexual abuse and emotional abuse’; and ‘Severe levels of all types of trauma’. Profiles with more severe levels of childhood trauma showed an earlier age at initiation and escalation of substance use. Furthermore, childhood trauma profiles were related to current severity of depressive symptoms, dysthymic symptoms, sociophobic symptoms, and distrust. Conclusion: In women with substance use disorders and posttraumatic stress disorders, childhood trauma profiles can inform about addiction characteristics and severity of a wide range of clinical symptoms. This information is essential to understand current treatment needs and should be systematically assessed in women with substance use disorders and trauma exposure.

Childhood trajectories of peer victimization and prediction of mental health outcomes in midadolescence: a longitudinal population-based study

Exposure to peer victimization is relatively common. However, little is known about its developmental course and its effect on impairment associated with mental illnesses. We aimed to identify groups of children following differential trajectories of peer victimization from ages 6 to 13 years and to examine predictive associations of these trajectories with mental health in adolescence. Participants were members of the Quebec Longitudinal Study of Child Development, a prospective cohort of 2120 children born in 1997/98 who were followed until age 15 years. We included 1363 participants with self-reported victimization from ages 6 to 13 years and data available on their mental health status at 15 years. We identified 3 trajectories of peer victimization. The 2 prevailing groups were participants with little or moderate exposure to victimization (441/1685 [26.2%] and 1000/1685 [59.3%], respectively); the third group (244 [14.5%]) had been chronically exposed to the most severe and long-lasting levels of victimization. The most severely victimized individuals had greater odds of reporting debilitating depressive or dysthymic symptoms (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.27-5.17), debilitating generalized anxiety problems (OR 3.27, CI 1.64-6.51) and suicidality (OR 3.46, CI 1.53-7.81) at 15 years than those exposed to the lowest levels of victimization, after adjustment for sex, childhood mental health, family hardship and victimization perpetration. The association with suicidality remained significant after controlling for concurrent symptoms of depression or dysthymia and generalized anxiety problems. Adolescents who were most severely victimized by peers had an increased risk of experiencing severe symptoms consistent with mental health problems. Given that peer victimization trajectories are established early on, interventions to reduce the risk of being victimized should start before enrolment in the formal school system.

Clinical and Genetic Predictors of Delayed Remission After Multiple Levels of Antidepressant Treatment: Toward Early Identification of Depressed Individuals for Advanced Care Options.

To identify clinical and genetic characteristics that can be used to recognize depressed patients who are likely to respond quickly versus those who will have a more delayed response following multiple treatment trials. The data used were obtained from the National Institute of Mental Health-sponsored Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, which was conducted between July 2001 and September 2006. Of the 4,041 treatment-naive participants in the original study, 1,953 with DNA samples were included. Major depressive disorder (DSM-IV criteria) was defined as baseline score > 14 on the 17-item Hamilton Depression Rating Scale. Time to remission was defined from the entry point to when a score ≤ 5 on the Quick Inventory of Depressive Symptomatology, Clinician Rating was achieved, irrespective of the type or number of treatments received. A Kaplan-Meier estimator was used for data description, proportional hazard regression for model building, and logistic regression for measures of predictive accuracy. The overall rate of remission across all levels of treatment was 65.6%, and the overall median (interquartile range) of time to remission was 11.4 (6.0-17.9) weeks. The predictors of delayed remission included unemployment (P = .004), severe medical comorbidity (P < .0001), severe baseline depression (P < .0001), more than 4 dysthymic symptoms (P = .005), more than 9 posttraumatic stress symptoms (P = .005), and serotonin receptor 1A (P = .006) and cytochrome P450 2D6 (P = .002 for C/T and P = .0004 for T/T) genetic variants. The final model had good predictive measures of accuracy of area under the curve (70%) and sensitivity (88%). The results offer clinical tools for clinicians to identify depressed individuals who are likely to have delayed remission with multiple antidepressant treatments and therefore might be candidates for advanced care options.

The cortisol awakening response in anxiety disorders and personality disorders and changes in salivary cortisol level after psychotherapy

IntroductionThe hypothalamus—pituitary—adrenal axis (HPA axis) dysregulation plays an important role in the pathophysiology of anxiety disorders. Salivary cortisol level is a useful indicator of HPA axis dysfunction.ObjectivesMost data suggests elevated cortisol awakening response (CAR) in anxiety disorders, but there are studies indicating opposite pattern (flat CAR).AimGoal of this study was to determine whether patients with anxiety and personality disorders show a specific daily cortisol patterns and weather this pattern changes after 12 weeks of intensive predominantly psychodynamic combined group and individual psychotherapy.MethodThe studied population comprised 77 patients, mainly females (72.7%), with primary diagnosis of anxiety disorder 40.9% or personality disorder 59.1%. The Symptom Checklist “0” was used to assess the pre- and post-treatment levels of patients’ symptoms. Pre- and post-treatment cortisol levels were measured in three saliva samples collected during one day (at awakening, 30 min after awakening, at 22.00).ResultsThe obtained results were partly similar to previous research. We found four different daily CAR patterns: decreased (drop 30 min after awakening), flat (rise 0–49% 30 min after awakening), normal (rise 50–75% 30 min after awakening) and elevated (rise over 75% 30 min after awakening), two of them (flat and elevated) were considered as typical for anxiety disorders. Groups of CAR pattern differed significantly in the level of sleep symptoms, dysthymia symptoms and avoidance/dependency symptoms. The changes in the CAR pattern after psychotherapy were not significant.ConclusionsAnxiety disorders and personality disorders are characterized by more than two specific daily salivary cortisol patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.

TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - ‘Anna’

This study is the first of a series of seven, and belongs to the second Italian systematic replication of findings from two previous series (Widdowson 2012a, 2012b, 2012c, 2013; Benelli, 2016a, 2016b, 2016c) that investigated the effectiveness of a manualised transactional analysis treatment for depression through Hermeneutic Single-Case Efficacy Design (HSCED). The therapist was a white Italian woman with 8 years of clinical experience and the client, Anna, was a 33-year old white Italian woman who attended 16 sessions of transactional analysis psychotherapy. Anna satisfied DSM-5 criteria for mild persistent depressive disorder (dysthymia) with anxious distress. The conclusion of the judges was that this was a good-outcome case: the dysthymic symptoms improved over the course of the therapy and were maintained in the ‘healthy’ range at the 6-month follow-up, the client reported a positive experience of the therapy and described important changes in intrapsychic and interpersonal patterns. In this case study, transactional analysis treatment for depression has proven its efficacy in treating persistent depressive disorder.

Mental Health Issues in Institutionalized Adolescent Orphans

The aim of the study was to determine the nature and extend of Mental Health issues in institutionalized adolescent orphans of District Kupwara. A case study of orphans aged 11 to 17 years from 04 orphanages in Kupwara. A structured and internationally standardized interview schedule MINI Kid (Mini International Neuropsychiatric Interview for Kids) was used for data collection and socio-demographic sheet was also used for additional information. Kapuswaour’s scale was used to see the Socio-economic status of kids. Data were cleaned and analyzed by SPSS version 16.00 windows. Eleven participants (13.75%) met DSM 1V criteria for MDE, 6.5% reported suicidal tendencies, 11.25% showed dysthymic symptoms, 10% panic disorder, 20% agoraphobia, 7.5% separation anxiety disorder, 16.25% social phobia, 15% specific phobia, 6.25% PTSD symptoms, 1.25% substance dependence (Non-alcoholic), 3.75% ADHD, 1.25% conduct disorder, 3.75% ODD, 8.75% GAD and nineteen participants i.e. 23.75% showed co-morbid conditions. Orphan-hood brings a host of various mental health vulnerabilities. A cultural recognition of Mental Health problems and the long term negative consequences of these issues need to be developed and interventions to address these vulnerabilities and risks for mental health problems among institutionalized orphans.

Comparaison du fonctionnement psychique de vingt sujets diagnostiqués schizophrènes

ObjectivesThis article presents a comprehensive, comparative study of mental functioning in subjects who have been diagnosed with schizophrenia, taking into account the various forms of the disorder: disorganized, paranoid, dysthymic, simple and undifferentiated. Rather than a purely symptomatic approach, it seeks to gain an understanding of the psyche by shedding light on the process of schizophrenic disorganization, taking trophic factors into account. This study demonstrates the value of approaching schizophrenic disorders through a psychodynamic understanding of mental functioning. MethodThis research is based on a study of mental functioning using the Rorschach inkblot test and the TAT, carried out on twenty men and women aged between twenty and sixty. The projective tests were scored and analysed according to the principles of the School of Paris. ResultsThe results highlight how mental functioning differs across the different forms of schizophrenia. In hebephrenia, the schizophrenic process dramatically inhibits all aspects of a person's mental functioning and particularly affects mental representations. In paranoid schizophrenia, however, the persistence of object representation and object relationships creates a more “lively” mental functioning even though the thought process itself is disorganised. Among subjects with dysthymic symptoms, object representations are more present but have a more stimulating and disruptive effect and, paradoxically, serve to maintain a form of recognition of objects and object relationships that allows for a more “animated” mental functioning. The mental functioning of subjects diagnosed with simple or undifferentiated schizophrenia appears more inert, as the schizophrenic process in this case has a particular impact on thought processes. DiscussionAlthough there are clear differences between the various forms of schizophrenia, there are points in common in the mental functioning of sufferers: there tends to be thought inhibition and blunted emotions, which combat the destruction of the emotional barrier in an ultimate defensive move, which has a regressive and destructive effect on the mind. This move impinges on psychological representations and emotions in particular. ConclusionThis study aims to use these psychopathological results to make a contribution to the debate on the unity or diversity of the different forms of schizophrenia.

Influence of early trauma on features of schizophrenia.

This proof-of-concept study examined if early trauma influences features of schizophrenia, consistent with hypothalamic-pituitary-adrenal (HPA) axis activation. Early trauma and current perceived stress were assessed in 28 treated schizophrenia cases, along with salivary cortisol, brain volumes, cognition and symptoms. Early trauma predicted more positive (r = .66, P = .005) and dysthymia symptoms (r -.65, P = .007), but less negative symptoms (r = -.56, P = .023), as well as reduced whole brain volumes (r = .50, P = .040) and increased amygdala to whole brain volume ratios (r = .56, P = .018). Larger volume reductions accompanied cortisol levels: evening values predicted smaller whole brain and hippocampal volumes whereas afternoon levels only significantly predicted smaller brain volumes in women. Sex differences were demonstrated between early trauma and cognition, with better cognition in traumatized women than other women and no male effects. Current perceived stress was related to dysthymia (especially in women) and diminished sense of purpose and social drive (especially in men). These results suggest that early trauma and current stress impact features of schizophrenia, consistent with stress sensitization and increased dopamine activity for treatment refractory positive symptoms, as well as the cascade of increased morning cortisol, reduced brain volumes, and depressive and deficit symptoms. Conversely, cognitive deficits and negative symptoms may arise from a distinct diathesis. The sex differences accord with the literature on human HPA function and stress responses. Early trauma may be a stressor in the aetiopathophysiology of schizophrenia, particularly for cases with treatment refractory positive symptoms, and may guide future treatment development.

Loving-Kindness Meditation to Target Affect in Mood Disorders: A Proof-of-Concept Study.

Conventional treatments for mood disorders primarily focus on reducing negative affect, but little on enhancing positive affect. Loving-kindness meditation (LKM) is a traditional meditation practice directly oriented toward enhancing unconditional and positive emotional states of kindness towards oneself and others. We report here two independent and uncontrolled studies carried out at different centers, one in Boston, USA (n = 10), and one in Frankfurt, Germany (n = 8), to examine the potential therapeutic utility of a brief LKM group intervention for symptoms of dysthymia and depression. Results at both centers suggest that LKM was associated with large-sized effects on self-reported symptoms of depression (d = 3.33 and 1.90), negative affect (d = 1.98 and 0.92), and positive affect (d = 1.63 and 0.94). Large effects were also found for clinician-reported changes in depression, rumination and specific positive emotions, and moderate effects for changes in adaptive emotion regulation strategies. The qualitative data analyses provide additional support for the potential clinical utility of the intervention. This proof-of-concept evaluation of LKM as a clinical strategy warrants further investigation.

Attention-Deficit/Hyperactivity Disorder and Comorbid Subsyndromal Depression

Youths with attention-deficit/hyperactivity disorder (ADHD) may develop demoralization or depressive or dysthymic symptoms related to chronic social, familial, and academic difficulties that are associated with their ADHD and are at higher risk for developing mood disorders. We assessed the effectiveness of methylphenidate (MPH) on both ADHD and mood symptoms in children and adolescents diagnosed with ADHD and coexistent subsyndromal depression (SSD). A group of ADHD patients with SSD (n = 47), aged 8 to 18 years, received 12 weeks of MPH treatment. The severity of depressive and ADHD symptoms was assessed using the Child Depression Rating Scale (CDRS) and the Attention Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), respectively. A highly significant decrease in both ADHD-RS and CDRS scores was obtained in the total group (N = 47) after MPH treatment (P = 0.0001 and P = 0.0001, respectively). A significant positive correlation was found between the changes in the CDRS total scores and the ADHD-RS (r = 0.34, N = 47, P = 0.018). However, no such correlation was found in a subgroup (N = 8) of patients with "possible depression" (baseline CDRS score, 65-74; r = 0.026, P = 0.95). Methylphenidate treatment is effective for both ADHD and SSD symptoms. It seems that ADHD symptoms are less responsive to MPH in patients with relatively high CDRS scores (possible depression) and that those patients may be candidates for selective serotonin reuptake inhibitor treatment as a supplement for MPH. Further, larger, placebo-controlled, double-blind studies are needed to examine the impact of MPH or d-amphetamine on patients with ADHD/SSD and ADHD/major depressive disorder.

Is Facebook creating “iDisorders”? The link between clinical symptoms of psychiatric disorders and technology use, attitudes and anxiety

This study systematically tested whether the use of specific technologies or media (including certain types of Facebook use), technology-related anxieties, and technology-related attitudes (including multitasking preference) would predict clinical symptoms of six personality disorders (schizoid, narcissistic, antisocial, compulsive, paranoid and histrionic) and three mood disorders (major depression, dysthymia and bipolar-mania). In addition, the study examined the unique contributions of technology uses after factoring out demographics, anxiety and attitudes. Teens, young adults and adults (N=1143) completed an anonymous, online questionnaire that assessed these variables. Each disorder had a unique set of predictors with 17 of the 22 significant predictors being Facebook general use, impression management and friendship. More Facebook friends predicted more clinical symptoms of bipolar-mania, narcissism and histrionic personality disorder but fewer symptoms of dysthymia and schizoid personality disorder. Technology-related attitudes and anxieties significantly predicted clinical symptoms of the disorders. After factoring out attitudes and anxiety, Facebook and selected technology uses predicted clinical symptoms with Facebook use, impression management and friendship being the best predictors. The results showed both positive and negative aspects of technology including social media as well as apparently detrimental effects of a preference for multitasking.

Child Abuse and Psychiatric Illness

Child Abuse and Psychiatric Illness

Child Abuse and Neglect, MAOA, and Mental Health Outcomes: A Prospective Examination

Studies have examined the interaction of MAOA genotype with childhood maltreatment in relation to depressive symptomatology and alcohol abuse with conflicting findings. Both high- and low-activity allele combinations have been shown to be protective for maltreated children with direction of findings varying by study methodology and participants' sex. Participants in a prospective cohort design study involving court-substantiated cases of child abuse and neglect and a matched comparison group were followed up into adulthood and interviewed (N = 802). Eighty-two percent consented to provide blood, 631 gave permission for DNA extraction and analyses, and 575 were included in the final sample. This sample included male, female, white, and nonwhite (primarily black) participants. Symptoms of dysthymia, major depression, and alcohol abuse were assessed using the National Institutes of Mental Health Diagnostic Interview Schedule-III-R. Significant three-way interactions, MAOA genotype by abuse by sex, predicted dysthymic symptoms. Low-activity MAOA genotype buffered against symptoms of dysthymia in physically abused and multiply-maltreated women. Significant three-way interactions, MAOA genotype by sexual abuse by race, predicted all outcomes. Low-activity MAOA genotype buffered against symptoms of dysthymia, major depressive disorder, and alcohol abuse for sexually abused white participants. The high-activity genotype was protective in the nonwhite sexually abused group. This prospective study provides evidence that MAOA interacts with child maltreatment to predict mental health outcomes. Reasons for sex differences and race findings are discussed.

Study of Faradarmani Therapy on Schizophernia(A case study)

Faradarmani is a kind of complementary and alternative medicine in Iran. in shape of case study design in 8 months, the faradarmani therapy was performed on a woman with schizophrenia. Elham is a 40 years old woman and the diagnosis for her is acute undifferentiated schizophrenia, along with dysthymia. Her status during the period of therapy was closely observed by two psychiatrists, a neurologist, a general practitioner, an expert in clinical psychology, two faradarmani therapists and her family. And in order for determining her psychological components, the pre and post-test of MMPI II was taken use of. In the viewpoints of her doctors, psychologist, faradarmani therapists and her family, her improvements are essential. The MMPI II test, confirms the current normal psychological status of her.the results show that faradarmani had essential and noticeable effects on decreasing of schizophrenia and dysthymia symptoms. Faradarmani had no costs and side effects and decreases the need of usual therapies.

A short screening instrument for mental health problems: The Symptom Checklist-27 (SCL-27) in Poland and Germany

Objective. The symptom checklist SCL-27 is a short, multidimensional screening instrument for mental health problems. It contains six scales: depressive, dysthymic, vegetative, agoraphobic and sociophobic symptoms; symptoms of mistrust; and a global severity index (GSI-27). Methods. A survey of two student samples from Poland and Germany (n ∼ 400) is presented. Results. Most scales of the SCL-27 showed good to satisfactory reliability (i.e. Cronbach's α > 0.70). Some items displayed different characteristics in students than in non-student samples. These discrepancies can be explained partly by the particular situation students face and partly by some country-specific or language-specific aspects of the measuring instrument. Differences between Polish and German students were marginal at best; in general, the Polish students tended to assent more easily to the items of the SCL-27 than did the German students. Conclusions. The SCL-27 is suitable for international comparisons. In both, Germany and Poland, students display a characteristic response pattern that differs from those of other samples. It can be applied as a separate instrument or for reanalysis of data collected with the SCL-90_R.

The impact of depression, seizure variables and locus of control on health related quality of life in a community dwelling sample of older adults

Few studies have examined the impact of epilepsy on the quality of life of older people, although epilepsy is one of the most common neurological disorders of old age. This study investigated the association of depression, seizure type and frequency and locus of control on health related quality of life in community dwelling adults aged over 60 years. Sixty-four participants were administered a clinical diagnostic interview to assess depression and dysthymia, and completed measures of HRQOL (QOLIE-31), locus of control and provided information on seizure variables. Depression, dysthymia and more frequent seizures were important predictors of HRQOL, accounting for 63% of the variance, with dysthymia the strongest individual predictor of impaired HRQOL. This study has highlighted the negative consequences of depression, dysthymia and seizure frequency on HRQOL for older people with epilepsy. Importantly, these results indicate that rather than major depression, it is the more chronic symptoms of dysthymia that are most disruptive of HRQOL. Seizure frequency, but not seizure type, was also associated with reduced HRQOL. The results of this study suggest that clinical treatment in late adulthood should address seizure control while concurrently focusing on the management of depressive symptomatology to improve overall HRQOL.