Zung Depression Scale Research Articles

Characteristics of dropouts and completers from hypnobehavioral treatment for bulimia nervosa

This study compares demographic and psychological characteristics of a group of dropouts and completers from a hypnobehavioral treatment program for bulimia nervosa. Prior to treatment, 30 dropouts and 30 completers were assessed on the following questionnaires and scales: the Eating Disorders Inventory, the Zung Depression Scale, the General Health Questionnaire, the Eysenck Personality Inventory, the Stanford Hypnotic Clinical Scale, and five Visual Analogue Scales and Expectancy Scales. Results of ANOVA and chi-square analyses showed no significant differences between dropouts and completers on any of the demographic variables or psychological measures or scales. The results suggest that neither demographic nor psychological characteristics play a role in identifying dropouts from bulimia nervosa treatment.

Prevalence of depression among Israeli alcoholics

The Zung Depression Scale was given to 45 Israeli male alcoholics as diagnosed by DSM-III criteria. Eighteen subjects came from an outpatient alcohol clinic, and 27 came from an inpatient detoxification center. In this cohort, 60% of subjects were classified as having clinical depression, and major depressive disorder was found in 26% of inpatients and 17% of outpatients. Pattern analysis of the Zung showed a disproportionately high percentage of all subjects responding to clinical symptoms featured in bipolar disorder, while the inpatient group reported significantly more difficulty than the outpatient group on parameters of pervasive affective disorder, early and frequent waking, constipation, irritability, and emptiness.

A model clinical program for patients with diabetes and vision impairment.

A program was developed to improve independence, self-esteem, and glycemic control in patients with diabetes and blindness. Twenty-nine individuals with both insulin-dependent and noninsulin-dependent diabetes mellitus entered 12-week programs that included education focusing on diabetes self-management skills for the visually impaired, monitored exercise sessions, and group support. Glycated hemoglobin values fell from 13.0% +/- 0.6% (SEM) to 11.4% +/- 0.5% (P = .001). Exercise tolerance in a 12-minute walk test improved from 0.48 +/- 0.04 to 0.64 +/- 0.05 miles (P = .001). Marked improvements occurred in psychosocial indices, demonstrated through changes in the Rand Mental Health Index from 155 +/- 6 to 174 +/- 5 (P = .0001), the Rosenberg Self-Esteem Scale from 22 +/- 1 to 19 +/- 1 (P = .001), the Zung Depression Scale from 0.50 +/- 0.02 to 0.44 +/- 0.02 (P = .001), and the Diabetes Self-Reliance Test from 60 +/- 3 to 74 +/- 2 (P = .0001).

Reduced Sexual Activity in HIV-Infected Homosexual Men-Reply

In Reply. — Drs Brown and Pace raise interesting questions regarding the reasons why the human immunodeficiency virus (HIV)—infected men in our study, as well as HIV-infected persons in their own studies, have reduced their sexual activity in recent years. We recognize that personal health concerns may have had different meanings for the men in our study who reported this as a reason for change in sexual behavior. We do have some data concerning depression in our group of men. Of the 31 men in our study, 24, including 6 of the 7 who reported no sex partners in the 6-month period before the second questionnaire was administered in 1987, were administered measures of affective state, including the Zung Depression Scale, as part of a study of neuropsychiatric complications of HIV infection in 1986. 1 The men were also asked whether they had ever been diagnosed by a physician as

Studies of the Modified Somatic Perceptions Questionnaire (MSPQ) in Patients with Back Pain

The Modified Somatic Perceptions Questionnaire (MSPQ) was designed to measure heightened somatic awareness among patients with chronic pain. It was hoped that this questionnaire would help predict therapeutic responses for back pain patients. The reliability, validity, and predictive characteristics of this scale were tested among 97 patients with chronic low-back pain enrolled in a clinical trial of transcutaneous nerve stimulation and stretching exercises. Internal consistency was good (alpha = 0.78), and correlations with the Zung depression scale and certain MMPI scales were significant. Correlations with a baseline functional scale (the Sickness Impact Profile) were stronger than those with the MMPI. Unfortunately, the MSPQ did not correlate with functional outcomes, and was only weakly associated with pain outcomes. Thus, the MSPQ appears to be reliable and valid, but the somatic perceptions it measures may have little relation to patient outcomes.

Validity of orally administered Beck and Zung depression scales in a state hospital setting

Thirty-six consecutively admitted psychiatric inpatients were orally administered the Beck and Zung depression scales. Wide Range Achievement Test reading scores also were obtained. The Beck and Zung correlated significantly (p .001) with Diagnostic and statistical manual of mental disorders (DSM-III; American Psychiatric Association, 1980) depression criteria. When the patients were subdivided by diagnosis (Depression and mixed Depression vs. others), and depression scores compared, only the Zung significantly differentiated the two groups (F = 12.51, p less than .001). When subdivided by reading scores, both high (grade level M = 8.7) and low (grade level M = 3.2) groups' Beck and Zung scores correlated equally well with the DSM-III criteria measure. This study substantiates the common practice of orally presenting written tests to low functioning patients most convincingly in the case of the Zung Depression Scale.

Psychological effects of running loss on consistent runners.

This study examined the psychological effects of running loss upon consistent runners. We compared a group of 30 "Prevented Runners" who were unable to run for at least two weeks with a group of 30 "Continuing Runners" who ran without interruption on the Profile of Mood States (POMS), Rosenberg Self-esteem Scale, Zung Depression Scale, and a Running Information questionnaire. We found that Prevented Runners displayed significantly greater symptoms of psychological distress, including depression, anxiety, confusion, over-all mood disturbance, and lower self-esteem than did Continuing Runners. Deprivation of running may result in withdrawal symptoms of psychological distress for consistent runners who rely on running as a coping strategy for stress reduction and who feel dependent upon the psychological reinforcements of running.

Are prepared fears less severe, but more resistant to treatment?

In order to investigate the relationship between the extent to which clinical fears are prepared and clinically relevant characteristics of these fears (i.e. severity, age of onset and treatment outcome). the records of 63 obsessional and phobic patients were examined. Four independent raters scored the usable records ( N = 55) on preparedness. The preparedness scores were combined and related to objective indices of severity (patients' scores on the Fear Survey Schedule, the Zung Depression Scale and the Maudsley Obsessional-Compulsive Inventory, as well as the treatment duration), onset ages and treatment outcomes (pre-treatment minus post-treatment MOCI scores, for a subsample of obsessional patients only). In contrast to earlier studies, it was found that product-moment correlations among preparedness ratings were relatively low and that prepared fears did not make up a majority in the sample. Indices of severity either did not correlate at all or correlated negatively with preparedness ratings. The positive correlation between preparedness and onset ages reached borderline significance. Evidence suggestive of a resistance to treatment of prepared fears was obtained.

Interconvertability of five self-report measures of depression

This article describes the construction of a new self-report scale based directly on the DSM-III criteria for major depressive disorder. It provides data on the interconvertability of scores on this scale with scores obtained on the Beck Depression Inventory, the Zung Depression Scale, the Center for Epidemiologic Studies-Depression (CES-D) Questionnaire, and the Minnesota Multiphasic Personality Inventory Depression Scale (MMPI-D). The article also examines the relation between physical principles of measurement as described by physicists and psychiatric measurement. It concludes with an analysis of the connection between the dichotomies typical of diagnostic statements and the continuous, probabilistic data typical of self-report instruments.

Zinc deficiency in anorexia nervosa

Adolescents with anorexia nervosa were evaluated for clinical and biochemical evidence of zinc deiciency. To assess whether these patients would benefit from zinc supplementation, a double-blind, randomized, controlled trial was conducted. The mean zinc intake of the anorexic group calculated on the basis of three-day dietary records was 7.7 ± 5.2 mg/day, which is significantly below the recommended daily allowance of 15 mg for adolescents ( p < 0.001). The mean urinary zinc excretion in the anorexic group was 257.1 ± 212.7 μg/24 hours compared to 749.9 ± 897.8 μg/24 hours in the control group ( p < 0.005), This result suggests that the zinc status of anorexia nervosa patients may be compromised due to an inadequate zinc intake. Zinc supplementation (50 mg elemental zinc/day) was followed by a decrease in the level of depression and anxiety as assessed by the Zung Depression Scale ( p < 0.05) and the State-Trait Anxiety Inventory ( P < 0.05), respectively. Our data suggest that individuals with anorexia nervosa may be at risk for zinc deficiency and may respond favorably after zinc supplementation.

EFFECTS OF RETESTING WITH THE BECK AND ZUNG DEPRESSION SCALES IN ALCOHOLICS

The present study assessed the presence of testing effects arising from the repeated administration of both the Beck and Zung depression scales to a group of 60 inpatient alcoholics. Thirty-seven men and 23 women were randomly assigned to one of three groups and administered the depression scales on one, two or three occasions, in successive weeks of treatment. Although the between group comparisons of initial test administration did not indicate a true change in depression, a within group comparison of initial with subsequent test administrations indicated a clear improvement in depression scores on both scales. Apparently the result of the reactive effects of testing, the within group differences could easily mislead a researcher into believing depression was alleviated when in fact it was not. This sizeable testing effect has obvious implications for studies which repeatedly assess depression.

COMPARISON OF TWO DEPRESSION INVENTORIES: AN EXAMINATION OF CONSTRUCT VALIDITY

Summary.-The purpose of this study was to examine the relationship between two measures of depression and to compare scores of highly physically fit distance runners. 100 subjects, including 25 women, were administered the Profile of Mood States to measure stares and the Zung Depression Scale to measure depression. Subjects were below the norms for the Profile but not for the Zung. A correlation of .92 (i = 85.5) between scores was noted for the 25 women, while less variance was explained for the men (T = .645, i = 41.6). Despite participation in regular exercise, depression scores greater than 40 were obtained by 7 men and 5 women, indicating chat regular exercisers are not immune to depression. A number of studies have focused specifically on the effect of exercise on depression. Most follow one of two approaches, a description of the psychological differences between subjects who exercise regularly and subjects who do not and reduction of depression with regular exercise regime. Most studies have employed a single depression or mood scale (lo), and many different psychological inventories (Thematic Apperception Test, Minnesota Multiphasic Personality Inventory, Sixteen Personality Factor Questionnaire, Beck Depression Inventory, Zung Self-rating Depression Scale, and the Profile of Mood States have been used to measure depression. The many inventories pose a dilemma for sport researchers because each measures a specific aspect of depression. Depression has different meanings to different psychologists, so measurements vary (3). Rarely cited in sport research are comparisons of scores on inventories designed to measure depression defined similarly in each case. Research comparing scores on depression inventories can give estimates of construct validity of the inventories and assist in the selection of inventories for study. The scores on two depression inventories, the Profile of Mood States and the Zung Self-rating Depression Scale (13), were examined for that purpose. Since running has been shown to be psychologically beneficial to normal populations, similar benefits might be obtained for depressed subjects also. Literature on exercise and depression suggest that physical changes resulting from training may reduce depression in persons who suffer from depression

Comparison of two depression inventories: an examination of construct validity.

The purpose of this study was to examine the relationship between two measures of depression and to compare scores of highly physically fit distance runners. 100 subjects, including 25 women, were administered the Profile of Mood States to measure states and the Zung Depression Scale to measure depression. Subjects were below the norms for the Profile but not for the Zung. A correlation of .92 ( r2 = 85.5) between scores was noted for the 25 women, while less variance was explained for the men ( r = .645, r2 = 41.6). Despite participation in regular exercise, depression scores greater than 40 were obtained by 7 men and 5 women, indicating that regular exercisers are not immune to depression.

Medical, psychological and social correlates of work disability among men with Coronary artery disease

This study identifies the medical, psychologic and social factors that independently affect employment in patients with coronary artery disease (CAD). At coronary angiography, extensive clinical, psychological and social profiles were collected on 814 men younger than 60 years with documented CAD. Clinical factors studied included measures of symptom severity, prior myocardial infarction, coronary anatomy and left ventricular function. Psychosocial factors studied included the Minnesota Multiphasic Personality Inventory (MMPI), Zung Depression and Anxiety Scales, a type A structured interview, Jenkins Activity Survey and measures of education and social support. Multiple logistic regression analyses were used to assess the relative strength of the relation between these different factors and the patients' employment status. Many single factors differed between the 204 men (25%) who were disabled and the 610 (75%) who were not. Disabled men were less educated but no different in age, marital status or number of dependents. Disabled men had lower ejection fractions and higher indexes of angina, previous myocardial infarction and coexisting vascular disease. Disabled men also were more depressed and anxious and had lower ego strength and higher hypochondriasis scores on the MMPI, but were no different in type A behavior. By multivariable analysis, the most significant (p less than 0.01) independent predictors of work disability were, in decreasing order of importance, low education level, history of myocardial infarction, high levels of depression and high levels of hypochondriasis. It is concluded that psychological and social factors are strongly related to work status in patients with CAD, and may be more important than medical factors.

Sensory integration activity in nursing home residents' cognitions, affect, self-esteem and behavior.

Persons residing in a nursing home experience a variety of both age-related and pathological disabilities which combined with a relatively unchanging environment may diminish sensory and perceptual processing abilities. Deprivation has been related to cognitive, mood and other behavioral problems in several studies (8, 9, 10, 11 ). Sensory Integration ( 7 ) is a therapeutic modality focusing on stimulation of the five senses and includes exercises in proprioceptive and kinesthetic awareness. Group sessions were held three days a week, 45 min. per session, for 10 wk. To examine the effect of Sensory Integration group activities, 23 nursing home residents (age range 57-96 years; 21 males, 2 females; length of stay 10-184 mo.) were randomly assigned to an activity or control group. Two male residents died during the study and their data are not included. The activity group was significantly older than the control group (Activity M = 81.2 yr., S D = 9.16; Control M = 68.6 yr., SD = 6.84; tm = 3.56, p < .01). About one month prior to group activity all subjects were pretested with a variety of measures to assess affect, self-esteem, cognition, and ward behaviors. Tests included The Geriatric Depression Scale ( 1 ), Zung Depression Scale ( 12) , Center for Epidemiological Studies Depression Scale ( 5 ) , Cognitive Capacity Screening Exam~narion (2 ) , Geriatric Interpersonal Evaluation Scale ( 3 ) , Geriatric Rating Scale (4), and Self-esteem ( 6 ) . Multiple measures were used for assessing depression because the scales tend to emphasize different depressive symptoms. Subjects were retested on the same tests in the same order one month following termination of the group activities. Analyses by t test indicate no significant differences between groups. A slight trend for increased posttest scores was observed on both groups' depression scales and the Geriatric Rating Scale, Antisocial/Disruptive subscale indicated a slight but nonsignificant trend towards less disruption in the activity group. The sample size of nursing home residents may have been too small or the activity program of insufficient length considing the significantly older activity group. A ceiling and floor effect was also observed on some of the brief measures. Further study is needed to clarify the therapeutic role of activity-groups in enhancing the quality of life of elderly nursing home residents.

Depression and hemispheric site of cerebral vascular accident

In order to investigate the possible role of left and right hemisphere neural structures in the manifestation of depression, 50 left brain damaged and 50 right brain damaged stroke inpatients were administered the Zung Depression Scale (ZD S) during the course of the rehabilitation phase of their treatment. These subjects were randomly chosen from all stroke patients receiving rehabilitation services who could be administered the ZDS. Approximately 30% of these subjects, regardless of the site of lesion, were clinically depressed. The severity of depression was independent of demographic factors and time since injury. Right brain damaged patients reported significantly more sleep disturbance, psychomotor agitation and pervasive sense of sadness. These results were discussed in light of previous findings that damaged to the left hemisphere results in greater depression. A model of reactive depression that results from neurological disability was proposed to partially account for these findings.

Depression and hemispheric site of cerebral vascular accident.

In order to investigate the possible role of left and right hemisphere neural structures in the manifestation of depression, 50 left brain damaged and 50 right brain damaged stroke inpatients were administered the Zung Depression Scale (ZD S) during the course of the rehabilitation phase of their treatment. These subjects were randomly chosen from all stroke patients receiving rehabilitation services who could be administered the ZDS. Approximately 30% of these subjects, regardless of the site of lesion, were clinically depressed. The severity of depression was independent of demographic factors and time since injury. Right brain damaged patients reported significantly more sleep disturbance, psychomotor agitation and pervasive sense of sadness. These results were discussed in light of previous findings that damaged to the left hemisphere results in greater depression. A model of reactive depression that results from neurological disability was proposed to partially account for these findings.

Mental health of the aged in the depopulated areas of Japan.

Over the past 20 years from 1961, we have been conducting research on the relation between the mental and physical state of old people and the depopulation process in the mountain areas of Japan. People over 65 years old have been studied annually, with the use of Hasegawa's method and Amako's scale of grading age and Zung's depression scale mentally. For their physical checkup, ECG and blood pressure, etc. were taken. In the early stages of our study, a significant difference was observed between the people in the depopulated areas and those living in the plains. However, we have been unable to find significant differences of the occurrence of senile dementia between these two areas since 1977, nor of the physical state of the elderly since 1981. We did observe more people with a higher level of Zung's depression scale in the depopulated areas in 1984. Since Japan's economic growth slowed down by the two oil shocks has never revitalized the depopulated areas, the old people are still left alone in the mountain areas. However, they now regularly receive good meal services by local welfare committees. Supermarkets have also appeared in some villages, so that the aged have easier access to nutritious food such as meats, fruits and milk. Still, we find bedridden elderly patients more often in these depopulated areas, as well as a statistically greater incidence of suicides (r = -0.42, p less than 0.01). It is our fervent desire that more psychological support should be given to the aged in the depopulated areas, such as visits to their homes by public nurses, or more frequent phone-calls by volunteers.

Clinical and laboratory effects of discontinuation of lithium prophylaxis.

Twelve patients who met Research Diagnostic Criteria for a history of bipolar affective disorder gave informed consent for open discontinuation of lithium therapy for 3 weeks. There was no significant change after lithium discontinuation in the number of depressive or manic symptoms, in mood score, in total Zung Depression score, or in any of the 20 items found in the Zung Depression scale. There were significant reductions in total severity of side effects, and improvement in the three side effects reflecting renal function: polydipsia, polyuria, and nocturia. These changes were reflected in the significant increase in urine specific gravity. Significant changes in side effects did not take place until at least 2 weeks after lithium was discontinued. Other significant relationships were found between increases in serum thyroid hormone levels and in urine specific gravity, and decreases in Vmax of platelet serotonin uptake and increases in degree of clonidine-induced hypotension.

Comparison of the validities of the Beck, Zung, and MMPI Depression scales.

Comparison of the validities of the Beck, Zung, and MMPI Depression scales.