Medicine and Health Sciences Commons^™

Ready, Set, Action: Potential Breakthrough Therapy For Treatment-Resistant Depression, Alvin Garlejo

Master's Projects and Capstones

Major depressive disorder is a psychiatric illness that is associated with a variety of debilitating symptoms such as persistent sadness, lack of interest and motivation, lassitude, pessimistic thoughts, and in severe cases, suicidal ideation and behavior. Current psychological and pharmacological treatments have been demonstrated efficacious; however, an ever-growing number of individuals frequently report minimal to no improvement with these treatments; and in some cases, a worsening of symptoms. This inadequacy to treatment is commonly known as treatment-resistant depression. At Kadima Neuropsychiatry Institute, Dr. Feifel treats individuals with treatment-resistant depression with advanced treatments such as TMS and ketamine. During my fieldwork …

Analysis Of Food Security, Snap Benefit Duration, Income Level And The Relationship With Depression In Households With Children In Omaha., Tatiana Tchouankam

Capstone Experience

Food insecurity is defined as a lack of access to “sufficient, safe, and nutritious food that meets individuals’ dietary needs and preferences for an active and healthy life.” From 2015 to 2016, the number of people undernourished increased from 777 million to 815 million worldwide. Food insecurity affected 12.3 % of Nebraskans and 13.8% of the residents in Douglas County during the same year. There is evidence of associations between food insecurity, income level, and several adverse health outcomes, specifically with regards to mental health. The objective of this study was to examine food security, SNAP benefit duration (i.e., how …

Unconditional Cash Transfers For Reducing Poverty And Vulnerabilities: Effect On Use Of Health Services And Health Outcomes In Low-And Middle-Income Countries, Frank Pega, Sze Yan Liu, Stefan Walter, Roman Pabayo, Ruhi Saith, S L. Lhachimi

Department of Public Health Scholarship and Creative Works

Background

Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low‐ and middle‐income countries (LMICs). The relative effectiveness of UCTs compared with conditional cash transfers (CCTs; provided so long as the recipient engages in prescribed behaviours such as using a health service or attending school) is unknown.

Objectives

To assess the effects of UCTs for improving health services use and health outcomes in vulnerable children and adults in LMICs. Secondary objectives are to …

Organic Solvent Exposure And Depressive Symptoms Among Licensed Pesticide Applicators In The Agricultural Health Study, Miriam Siegel, Sarah E. Starks, Wayne T. Sanderson, Freya Kamel, Jane A. Hoppin, Fred Gerr

Epidemiology and Environmental Health Faculty Publications

Purpose

Although organic solvents are often used in agricultural operations, neurotoxic effects of solvent exposure have not been extensively studied among farmers. The current analysis examined associations between questionnaire-based metrics of organic solvent exposure and depressive symptoms among farmers.

Methods

Results from 692 male Agricultural Health Study participants were analyzed. Solvent type and exposure duration were assessed by questionnaire. An “ever-use” variable and years of use categories were constructed for exposure to gasoline, paint/lacquer thinner, petroleum distillates, and any solvent. Depressive symptoms were ascertained with the Center for Epidemiologic Studies Depression Scale (CES-D); scores were analyzed separately as continuous (0–60) …

Effects Of A Collaborative Care For Depression Intervention On Health Service Utilization And Depression Severity, Girlyn Arganza Cachaper

Health Services Research Dissertations

Depression is the leading cause of disability worldwide, disproportionately affecting the Medicaid population. Collaborative care programs for depression are transforming primary care to increase access and coordinate physical and behavioral health services. Understanding the relationships between components of collaborative care programs, characteristics of participants, and their effect on outcomes can maximize program effectiveness. A pilot collaborative care for depression program within a Medicaid managed care organization was evaluated using administrative claims and case management data. Participants (n=444) included adults with prior Medicaid coverage and a comparison group identified using one-to-one propensity score-matching. Multivariate logistic regression models estimated the odds of …

The Minds Of Mothers: Maternal Mental Health In An Urban Squatter Settlement Of Karachi., Fauziah Rabbani, Furqan Farooq Raja

Fauziah Rabbani

BACKGROUND:

Community-based information on maternal mental health in developing countries is meager and nearly non-existent in Pakistan.

OBJECTIVE:

To determine the proportion of probable cases of women with mental disorders and examine the associated conditions and risk factors which contribute to maternal mental ill-health.

METHODS:

With convenient sampling 260 mothers in an urban squatter settlement of Karachi were interviewed. The tools consisted of a household questionnaire collecting information on basic demographic and other characteristics and the Aga Khan University Anxiety and Depression Scale (AKUADS), an instrument to assess psychiatric morbidity.

RESULTS:

The proportion of probable cases of mental disorder was …

Substance Use Disorders, Violence, Mental Health, And Hiv: Differentiating A Syndemic Factor By Gender And Sexuality, Kiyomi Tsuyuki, Eileen V. Pitpitan, Maria A. Levi-Minzi, Lianne A. Urada, Steven P. Kurtz, Jamila K. Stockman, Hilary L. Surratt

Center for Health Services Research Faculty Publications

This paper measures syndemic substance use disorder, violence, and mental health and compares the syndemic among HIV-infected heterosexual men, heterosexual women, and men who have sex with men (MSM). Data were from a sample of high needs substance-using, HIV-infected people in South Florida between 2010 and 2012 (n = 481). We used confirmatory factor analysis to measure a syndemic latent variable and applied measurement invariance models to identify group differences in the data structure of syndemic co-morbidities among heterosexual men, heterosexual women, and MSM. We found that variables used to measure the syndemic fit each sub-group, supporting that substance use …

Micronutrients, Inflammation And Depression Among Women Of Reproductive Age From The National Health And Nutrition Examination Survey 2005-2008, Joycelyn M. Faraj

Doctoral Dissertations

Depression is the leading cause of disease burden among women. Recent evidence indicates that inflammation is associated with depression, and factors that contribute to inflammation can be addressed through nutritional and lifestyle interventions. Vitamins B₆ and D have been linked with depression and have established roles in inflammation, yet their associations with depression in the presence of low-grade inflammation remain unknown. The purpose of this research was to investigate how high sensitivity C-reactive protein (hs-CRP), a biomarker of inflammation, contributes to different dimensions of depression and to determine to what degree inflammation affects the association between vitamins B_{6 …}

Associations Between Multi-Level Contextual Factors And Mental Health Service Utilization In Adolescents With Comorbid Depression And Substance-Use: Moderating Role Of School Connectedness On Racial/Ethnic Disparities In Service Utilization, Kate Thornton

Journal of the Georgia Public Health Association

Background: Comorbid depression and substance use has been a prevalent issue in adolescent health. Although rates have remained relatively stable, their level is still alarming and efforts to see a decrease have led leaders and organizations to call for research to better understand factors related to both depression and substance use as well as how these factors may change when these disorders occur together.

Methods: Data from the National Survey on Drug Use and Health (NSDUH) were utilized to pursue the research objectives for this study. The NSDUH is an ongoing cross-sectional survey of the civilian and non-institutionalized population of …

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

Smoking, Depression, And Hospital Costs Of Respiratory Cancers: Examining Race And Sex Variation, Baqar A. Husaini, Robert S. Levine, Phillip Lammers, Pam Hull, Meggan Novotny, Majaz Moonis

Center for Prevention Research Publications

Objective To investigate the effect of smoking and depression on hospital costs for lung cancer (LC).

Methods We extracted data on depression, smoking history, demographics, and hospital charges for patients with respiratory cancers (ICD-9 codes 161–163, 165) from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6665) was mostly white (86%) and male (57%). Age-adjusted rates were developed in accordance with Centers for Disease Control and Prevention methods, and hospital costs were compared for patients with LC with versus without depression and a smoking history.

Results Three findings (P<0.001) emerged: (1) the LC rate was higher among blacks than among whites, and higher among men than among women; (2) while 66% of LC patients smoked (more men than women without racial variation), 24% had depression (more females and whites were depressed); (3) the LC hospital cost was 54% higher than the non-LC hospital cost, and this cost doubled for patients with LC with depression and smoking versus those without such characteristics.

Conclusion While LC is more prevalent among …

Mental Health Of African Asylum-Seekers And Refugees In Hong Kong: Using The Social Determinants Of Health Framework, William Chi Wai Wong, Sealing Cheung, Heidi Yin Hai Miu, Julie Chen, Kelley Ann Loper, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Background: Hong Kong is non-signatory to the 1951 Refugee Convention and its 1967 Protocol, and has no systematic domestic policies committed to the rights of asylum-seekers and refugees (ASRs). This creates a tenuous setting for African ASRs there. This study explored how mapped social determinates of health has impacted the mental health and wellbeing of African ASR’s in Hong Kong.

Methods: A cross-sectional survey was carried out with 374 African ASRs. The survey comprised of: (a) sociodemographics; (b) health status; (c) health behaviours; and, (d) social experiences. Associations between social determinants of health and depression screen were explored and multivariable …

Coping Styles And Depression Among Patients With Solid Organ Cancers Attending Two Tertiary Care Hospitals Of Karachi: A Cross Sectional Study., Khadija Vadsaria, Adnan Jabbar, Iqbal Azam Syed, Sameera Rizvi, Ghulam Haider, Haider Naqvi

Community Health Sciences

Cancer undoubtedly affects patients in all aspects. Cancer diagnosis is a stressful event and coping is the primary mechanism used to adjust and counteract the stress. This study aims to assess the coping styles and prevalence of depression among solid organ cancer patients during treatment phase, attending two tertiary care hospitals of Karachi. A cross-sectional survey was conducted among solid organ cancer patients at Aga Khan University Hospital and Jinnah Post Graduate Medical Center. Coping and depression were assessed by Brief COPE and Self Reporting Questionnaire (SRQ) 20 respectively. Purposive sampling technique was used to recruit 488 patients. Coping styles …

Research Methods In Occupational Health Psychology, Irvin Sam Schonfeld, Chu-Hsiang Chang

Publications and Research

http://www.springerpub.com/occupational-health-psychology.html

Occupational Health Psychology (OHP) is a rapidly expanding interdisciplinary field that focuses on the science and practice of psychology in promoting and developing workplace health- and safety-related initiatives. This comprehensive text for undergraduate and graduate survey courses is the first to encompass a wide range of key issues in OHP. It draws from the domains of psychology, public health, preventive medicine,nursing, industrial engineering, law, and epidemiology to focus on the theory and practice of protecting and promoting the health, well-being, and safety of individuals in the workplace and improving the quality of work life.

The text addresses key psychosocial …

Relationship Of Religiosity And Spirituality To Hazardous Drinking, Drug Use, And Depression Among Sexual Minority Women, Laurie Drabble, Cindy Veldhuis, Barth Riley, Sharon Rostosky, Tonda Hughes

Faculty Publications

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. …

What Are The Most Commonly Used Tools To Screen Depression In Hiv-Infected Gay And Bisexual Men?, Michael Isner

Honors Undergraduate Theses

Gay and bisexual men infected with human immunodeficiency virus (HIV) comprise a sizable, medically vulnerable population. Depression is the most commonly experienced mental health disorder affecting this group of people, lending itself to a host of risks associated with depression. As screening of depression in this population can be challenging, it is vital that clinicians have the best available tools and guidelines to detect depressive symptomology. This focused, comprehensive review of the literature examined current data describing the clinical instruments used to detect depressive symptoms in HIV-infected gay and bisexual men. The aim of this analysis was to seek out …

Behavioral Activation For Smoking Cessation And Mood Management Following A Cardiac Event: Results Of A Pilot Randomized Controlled Trial, Andrew M. Busch, Erin M. Tooley, Shira Dunsiger

Arts & Sciences Faculty Publications

Background: Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC).

Methods: Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or …

Utilization Of Traditional, Complementary And Alternative Medicine And Mental Health Among Patients With Chronic Diseases In Primary Health Care Settings In Cambodia, Siyan Yi, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Tyler Fleming, Carinne M. Brody

Background: Coping with chronic illnesses often involves major lifestyle changes that may lead to poor mental health. Furthermore, in order to treat the chronic conditions, many sufferers in Asia turn to traditional, complementary and alternative medicines (TCAM). This study explores prevalence of TCAM use and factors associated with anxiety and depressive symptoms among patients with chronic diseases in Cambodia.

Methods: In 2015, this cross-sectional study was conducted with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. …

Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff

Walden Dissertations and Doctoral Studies

There has been a steady increase in the incidence of diabetes in the United States. The purpose of this study was to determine whether there was a difference in the daily hassles of African American adults with a self-reported diagnosis of type 2 diabetes compared to those of African American adults without a self-reported diagnosis of type 2 diabetes. The theoretical underpinning for this quantitative, descriptive study was the cognitive appraisal theory (CAT), but the concept of stress and the effects stress has on the body was the broad framework that connected all the variables. The CAT was used to …

Defining Physician Burnout, And Differentiating Between Burnout And Depression—I, Bianchi Renzo, Irvin Sam Schonfeld

Publications and Research

A redefinition of burnout as a depressive condition is called for so that the harmful effects of unresolvable job stress can be more accurately and comprehensively assessed. As research compellingly suggests, reducing the harmful effects of unresolvable job stress to the experience of burnout's dimensions of emotional exhaustion, depersonalization, and reduced personal accomplishment is mistaken in that it denies the depressive core of the syndrome referred to as “burnout.” Replacing the notion of burnout by the concept of job-induced depression would help us be more effective in the management of occupational adversity.

Modeling Depression Treatment Strategies For Human Immunodeficiency Virus (Hiv) Positive Patients, Rongbing Xie

All ETDs from UAB

This dissertation empirically examines the associations between depression and HIV-related outcomes, simulates both care and outcomes under different depression care strategies, and compares the cost effectiveness of various depression care strategies to the current care strategy. The empirical investigations reveal the negative associations between depression and HIV-related outcomes using two longitudinal patient-level databases. Furthermore, the patterns and outcomes of depression care are identified and simulated using agent-based modeling. Finally, simulated costs and effectiveness are used to evaluate different depression care strategies for reducing new HIV infections and improving quality of life. The current standard of care for depression among patients …

Depressive Symptoms Among College Students: An Exploration Of Fundamental Cause Theory, Peter A. Carrico

Theses and Dissertations

Fundamental Cause Theory suggests that socioeconomic and demographic factors are causal to various illnesses, including depression. However, no known previously existing research has used Fundamental Cause Theory to create a model of depression among college students. To do this, the present study conducted a stepwise binomial logistic regression to examine how socioeconomic status and the sociodemographic variables of Gender, Race, and Sexual Orientation, and others predict depressive symptoms in a large sample of undergraduates when controlling for stressful life events and social support (N = 2,915). Results support the hypothesis that socioeconomic disparities in depressive symptoms are the result …

Burnout Or Depression: Both Individual And Social Issue, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended in our that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. The phenomena of interest (burnout or depression) should not be confused with the perspectives (individual or social) adopted to elucidate those phenomena. Both burnout and depression are best explained through the interaction of social or external conditions with individual or internal dispositions.

Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day

Walden Dissertations and Doctoral Studies

Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the …

Assessment Of Anxiety And Depression Among Breast Cancer Patients Undergoing Treatment In Ghana, Kofi Adesi Kyei

Walden Dissertations and Doctoral Studies

Breast cancer patients undergoing radiotherapy often experience severe levels of anxiety and depression. There is a gap in the research literature from Africa, particularly from Ghana, with few studies focusing on the assessment of anxiety and depression among breast cancer patients undergoing radiation treatment. A better understanding was essential to promote efforts to help breast cancer patients cope with their diagnosis and treatment and increase their overall quality of life. This mixed method study examined breast cancer patients in Ghana undergoing radiotherapy and their responses related to anxiety and depression through a concurrent triangulation involving an interview with selected professional …

Burnout Symptoms: Depressive Manifestations Under Psychosocial Labels?, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

It can be concluded that burnout symptoms represent depressive symptoms under nonmedical labels. Our analysis supports the view that burnout is synonymous with depression and constitutes a roadblock to transdisciplinary communication.

On The Depressive Nature Of The “Burnout Syndrome”: A Clarification, Renzo Bianchi, Irvin Sam Schonfeld, Pierre Vandel, Eric Laurent

Publications and Research

Key theoretical arguments and empirical findings converge to suggest that the burnout construct captures a depressive phenomenon. The reluctance to consider burnout a depressive condition may be due to (a) a neglect of the stress–depression relationship and (b) a difficulty coordinating dimensional and categorical approaches to psychopathology in burnout research. The dimensions and categories constitute two ways of describing (psychopathological) phenomena. Thus, dimensions and categories should be heuristically combined rather than opposed: burnout and depression can be studied both as ‘‘processes’’ or ‘‘end-states’’. Clarifying what burnout actually is matters in terms of conceptual parsimony, theoretical integration, nosological consistency, interventional effectiveness, …

Burnout Or Depression: Both Individual And Social Issue, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. Epstein and Privitera (April 8, 1398) rejected our recommendation on the grounds that burnout is not a “purely individual syndrome”. Problematically, Epstein and Privitera attributed to us an idea that is not ours. In these authors’ view, equating burnout with depression is synonymous with mistakenly individualising a social problem. For two reasons, the argument that depression cannot replace burnout because burnout is a social problem whereas depression is an individual …

Physician Burnout Is Better Conceptualised As Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Ronald Epstein and Michael Privitera reported that burnout affects more than half of practising physicians. The authors additionally warned against confusing burnout with depression. For two reasons we are concerned with the validity of these conclusions. First, there is now robust evidence that burnout is a depressive condition. Second, the published estimates of burnout’s prevalence rely on clinically groundless criteria, cobbled together without any rationale.

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …