Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

Barriers To Mental Health Seeking Among Army Aviation Personnel: A Preliminary Report, Aric J. Raus

National Training Aircraft Symposium (NTAS)

This research explores barriers to mental health seeking, self-reported symptoms, and perspectives on self-help mental-wellness options among U.S. Army Aviation Personnel. Safe aviation operations require constant focus and mental clarity. These requirements expand when considering the implications and added stress of military operations, especially in combat scenarios. Yet, recent studies demonstrate that aviation personnel avoid seeking healthcare due to fears of losing their medical certification. This report provides preliminary results from the first known study on barriers to mental health seeking among U.S. Army aviation personnel. Utilizing an anonymous survey instrument, facilitated primarily through Social Media recruiting of current and …

Infant Hedonic/Anhedonic Processing Index (Hapi-Infant): Assessing Infant Anhedonia And Its Prospective Association With Adolescent Depressive Symptoms, Jessica L. Irwin, Elysia Poggi Davis, Curt A. Sandman, Tallie Z. Baram, Hal S. Stern, Laura M. Glynn

Psychology Faculty Articles and Research

Background

Anhedonia, an impairment in the motivation for or experience of pleasure, is a well-established transdiagnostic harbinger and core symptom of mental illness. Given increasing recognition of early life origins of mental illness, we posit that anhedonia should, and could, be recognized earlier if appropriate tools were available. However, reliable diagnostic instruments prior to childhood do not currently exist.

Methods

We developed an assessment instrument for anhedonia/reward processing in infancy, the Infant Hedonic/Anhedonic Processing Index (HAPI-Infant). Exploratory factor and psychometric analyses were conducted using data from 6- and 12-month-old infants from two cohorts (N = 188, N = 212). …

Prevalence Of Depression, Anxiety And Stress After The Covid-19 Pandemic Period Among Students At The Medical University Of Sofia; Significance Of Demographic, Educational, And Pandemic-Related Variables, Nadya Avramova

Journal of Mind and Medical Sciences

This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress among undergraduate dental students at Sofia Medical University and to investigate its associations with some demographic, educational and pandemic-related variables. A self-reported questionnaire that included the validated DASS-21 scale was administered to a group of 2nd, 3rd, 4th, and 5th year students (n=70, response rate 95.7%). Results indicated abnormal levels of depression, anxiety, and stress in 34.3%, 65.7% and 59.7% of the participants, respectively. A much larger proportion of females suffered from abnormal levels of anxiety (56.6%) as compared with males (9%), p=.003. Single students exhibited significantly …

Reminiscence Therapy For Prevention Of Post-Stroke Anxiety And Depression In Adults, Carly Porter

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

Anxiety and depression are prevalent after a stroke.^1,2 Peer support is a non-pharmacologic intervention utilized to manage post-stroke anxiety and depression with inconsistent results.³ Reminiscence therapy is an intervention that has been studied in the dementia population but is a relatively new intervention for the stroke population and has the potential to impact the psychological care provided to stroke patients.⁴

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Psychology University Students’ Mental Health Status During Covid-19 Pandemic In Karachi, Pakistan, Aisha Noorullah, Mubarak Mansoor, Ayesha Zahid

Department of Psychiatry

Purpose: The COVID-19 pandemic has brought challenges in various domains of life but for low and middle-income country university students very demanding situations have emerged. University students’ psychological well-being has always been an area of concern worldwide and higher rates of anxiety and depression have been extensively reported among this cohort.
Objective: To determine the frequency of depressive symptoms, anxiety symptoms, and quality of sleep and the association of sleep quality and personality traits with anxiety and depressive symptoms among university students in Karachi, Pakistan in the context of the pandemic COVID-19.
Method: This web-based cross-sectional study was conducted among …

Family-Based Support As Social Determinants Of Health Protective Factor On Depression Of Parents Of Children With Autism Spectrum Disorder, Bisola E. Duyile

Theses and Dissertations

All parents experience challenges in their caregiving roles (Barańczuk & Pisula, 2020). However, parents raising a child/children with disabilities experience different social barriers (Oliver, 1996) that may also contribute to additional stressors in their caregiving role (Tomeny, 2016). Although these parents, on average, have reported greater symptoms of depression than parents of typically developing children, research shows that parents who reported receiving social support had lower symptoms of depression and stress (Das et al., 2017; Singh et al., 2017). Through the social determinants of health (SDOH) framework (ODPHP, 2022), the present study investigated informal/family-based support and its protective impact on …

Depression Secondary To Isotretinoin – A Case Report, Rohan Karkra, Megha Sadashiv, Kishor M

Digital Journal of Clinical Medicine

Depression is one of the leading causes of morbidity in the world and significantly affects the lives of people suffering from it. The exact cause of depression has not been established and it is believed to be a complex play between various social, biological, environmental, personal factors. A relatively rare but distinct cause includes pharmacological agents.

In this case report, we describe the case of a 17-year-old girl who developed depression with psychotic symptoms on two occasions, both preceded by a history of Isotretinoin use. She was admitted and treated with anti-psychotics and psychotherapy with significant improvement in her mental …

Fear Of Covid-19, Anxiety, Depression And Suicide Among Elderly Patients With Chronic Physical Or Mental Diseases, Vasiliki Holeva, Vasiliki Aliki Nikopoulou, Eleni Parlapani, Konstantinos Karkaletsis, Styliani Kokkoni, Dimitrios Nouvakis, Patroklos Theocharis, Ioannis Diakogiannis

Journal of Mind and Medical Sciences

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9. According to the results, older chronic disease patients showed higher …

The Impact Of Covid-19 On The Psychological Well-Being Of Surgeons In Pakistan: A Multicenter Cross-Sectional Study, Sana Zeeshan, Mehdia Rajab Ali, Rehan N. Khan, Asad R. Allana, Nida Zahid, Muhammad Kazim Najjad, Arslan A. Abro, Muhammad Ali Nadeem, Zeeshan Mughal, Irshad Ahmed

Section of General Surgery

Introduction The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic left a profound and pervasive impact on the healthcare infrastructure on a global scale. Since its onset, the pattern of reported cases and its associated mortality had shown variability with intermittent peaks causing a significant effect on the psychological well-being of the surgeons of Pakistan. The aim of this study was to assess the effects of the COVID-19 pandemic on the mental well-being of surgeons in Pakistan. Methods This multicenter cross-sectional study was carried out to assess the impact of COVID-19 on the psychological well-being of surgeons in Pakistan. The …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

A Review On Psychosocial Distress Among General Population Of Pakistan During Covid-19 Pandemic, Anosh Arshad Chaudhary, Iqra Arooj, Amina Elahi

Journal of Bioresource Management

The COVID-19 crisis in 2019 significantly impacted human life all over the globe. Psychological health of general population has been affected by the unpredictable circumstances and impulsion of living in isolation, if suspected positive for coronavirus. During COVID-19 outbreak, escalation of various types of psychosocial distresses such as anxiety, sleep disorders and depression has been observed in the general population globally. Thus, there is an urgent need to combat these issues through well planned strategies. The focus of this review is to conduct a thorough evaluation of the available research on the effects of COVID-19 pandemic on the mental status …

Nutrition On The Prevention And Treatment Of Depression, Gracie Polen

Nursing | Senior Theses

Today, the general population consumes a diet high in sugars, saturated fats, incomplete protein sources, and the tendency to exceed the bodies caloric requirements. The trend of obesity due to poor dietary habits is alarming. Mental illness has increasingly risen over the past decade. Specifically, the incidence of depression has reached a startling rate. The relationship between poor dietary intake and depression have grown together and it is imperative that methods are introduced to aid in resolving this issue. The prevention and treatment of depression needs to be explored through alternative methods. Healthier dietary choices have been shown to have …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

The Various Nervous System Drugs Commonly Used For Treatment And The Disparities In Availability Of These Drugs In Minority Groups, Iman Haurami

Honors Scholars Collaborative Projects

The nervous system is a complex network in our body that is responsible for actions, reflexes, and even sensations. With the brain being part of the CNS, many common nervous system disorders are due to a defect in the central nervous system and the functions of this organ. These disorders include mental health problems, degenerative diseases, seizures, infections, and other possible genetic diseases. Many of these diseases are common in society and constantly researched. Even though these diseases are common, treatment accessibility and effects on people of minority groups are overlooked compared to the focus on majority groups. For drug …

Development And Management Of Depression During And After Pregnancy, Alexa Bouts, Maria Patnella, Jourdan Ujlaki, Emily Wells, Hannah Lamb, Michelle Musser

Pharmacy and Wellness Review

Depression during pregnancy is common, whether it is a new onset of the disease or emerging symptoms of the already existent disease. Due to patient and prescriber concerns with antidepressant use during pregnancy, approximately three-quarters of those diagnosed with depression remain untreated. Furthermore, up to half of pregnant women with depression remain undiagnosed due to lack of recognition. As a result, both mother and fetus are at risk for negative health outcomes including substance abuse, functional impairment, increased risk of postnatal depression and poor pregnancy outcomes. Benefits must be balanced against the risks when considering pharmacologic treatment options to manage …

Treatment Preferences For Pharmacological Versus Psychological Interventions Among Primary Care Providers In Nepal: Mixed Methods Analysis Of A Pilot Cluster Randomized Controlled Trial., Anvita Bhardwaj, Dristy Gurung, Sauharda Rai, Bonnie N Kaiser, Cori L Cafaro, Kathleen J Sikkema, Crick Lund, Nagendra P Luitel, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

There is increasing evidence supporting the effectiveness of psychological interventions in low- and middle-income countries. However, primary care providers (PCPs) may prefer treating patients with medication. A secondary exploratory analysis of a pilot cluster randomized controlled trial was conducted to evaluate psychological vs. pharmacological treatment preferences among PCPs. Thirty-four health facilities, including 205 PCPs, participated in the study, with PCPs in 17 facilities assigned to a standard version of the mental health Gap Action Programme (mhGAP) training delivered by mental health specialists. PCPs in the other 17 facilities received mhGAP instruction delivered by specialists and people with lived experience of …

Effect Of Computer-Assisted Cognitive Behavior Therapy Vs Usual Care On Depression Among Adults In Primary Care: A Randomized Clinical Trial, Jesse H. Wright, Jesse J. Owen, Tracy D. Eells, Becky F. Antle, Laura B. Bishop, Renee Girdler, Lesley M. Harris, R. Brent Wright, Michael J. Wells, Rangaraj Gopalraj, Michael E. Pendleton, Shehzad Ali

Counseling Psychology: Faculty Scholarship

Importance Depression is a common disorder that may go untreated or receive suboptimal care in primary care settings. Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression.

Objectives To evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.

Design, Setting, …

Prevalence Of Mental Health Conditions Among 6078 Individuals With Down Syndrome In The United States, Anne Rivelli, Veronica Fitzpatrick, Sagar Chaudhari, Laura Chicoine, Gengjie Jia, Andrey Rzhetsky, Brian Chicoine

Journal of Patient-Centered Research and Reviews

Findings from a recent study of the largest documented cohort of individuals with Down syndrome (DS) in the United States described prevalence of common disease conditions and strongly suggested significant disparity in mental health conditions among these individuals as compared with age- and sex-matched individuals without DS. The retrospective, descriptive study reported herein is a follow-up to document prevalence of 58 mental health conditions across 28 years of data from 6078 individuals with DS and 30,326 age- and sex-matched controls. Patient data were abstracted from electronic medical records within a large integrated health system. In general, individuals with DS had …

Virtual Versus Face-To-Face Cognitive Behavioral Treatment Of Depression: Meta-Analytic Test Of A Noninferiority Hypothesis And Men’S Mental Health Inequities, Carly M. Charron, Kevin M. Gorey

Social Work Publications

Global rates of depression have increased significantly since the beginning of the COVID-19 pandemic. It is unclear how the recent shift of many mental health services to virtual platforms has impacted service users, especially for the male population which are significantly more likely to complete suicide than women. This paper presents the findings of a rapid meta-analytic research synthesis of 17 randomized controlled trials on the relative efficacy of virtual versus traditional face-to-face cognitive behavioral therapy (CBT) in mitigating symptoms of depression. Participants’ aggregated depression scores were compared upon completion of the therapy (posttest) and longest follow-up measurement. The results …

The Relationship Between Social Media Use And Depression And Anxiety Symptoms During Covid-19, Tene'sha L. Crews, Christina Sheerin

Undergraduate Research Posters

The rise of the coronavirus (COVID-19) pandemic has caused a global surge in exposure to disaster and crisis-related media. Increases in poor mental health outcomes such as anxiety and depression, are associated with increased exposure to such media content (Abbas et al., 2021; Riehm et al., 2020; Zhao & Zhou, 2020). In recent years, social media has become one of the most widely used sources for news; approximately 48% of adult Americans receive their news from social media (Pew Research Center, 2021). During the COVID-19 pandemic, there has been an increase in social media use due to social distancing and …

Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

Objective

This study Investigates more dimensions than previous studies simultaneously: pilots’ duty rosters, stress, sleep difficulties, fatigue levels, wellbeing, symptoms of depression, anxiety, and common mental disorders (CMD), and how they are interrelated.

Background

Several scientific studies have confirmed that fatigue can pose a significant risk to flight safety. Other studies reported positive depression screening results for more pilots, compared with the general population.

Method

A cross-sectional online survey was completed by 406 international pilots, who reported their duty rosters of the last two months. Pilots also self-assessed their stress-levels, sleep problems, fatigue, wellbeing, and mental health.

Results

Although pilots …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Putative Mechanisms Underlying The Antidepressant Actions Of Ketamine: A Review And Study Proposal, Tristan Reece

CMC Senior Theses

Major Depressive Disorder (MDD) is a highly debilitating and common psychiatric disorder that affects over 250 million people globally; it is among the most financially and emotionally burdensome illnesses in the world. Currently approved antidepressants are suboptimal in their efficacy and latency of therapeutic action. In contrast, single administrations of sub-anesthetic ketamine have been shown to rapidly alleviate depressive symptoms within hours, even in treatment-resistant patients. Ketamine is believed to exert these effects by increasing glutamatemediated neurotransmission and promoting rapid neurotrophic factor release, restoring the integrity of neural circuits that are compromised in depression. However, uncertainty surrounding its specific antidepressant …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

Depression As A Moderator Of The Relationship Between Perceived Injustice And Neuropsychological Performance Validity Among Individuals Previously Diagnosed With A Concussion, Jeremiah Lum

Clinical Psychology Dissertations

Concussion is one of the most common conditions seen within rehabilitation and neuropsychology. Given that many concussions are diagnosed following litigation-associated injuries, it is unsurprising that malingered neurocognitive deficit (i.e., deliberate underperformance on cognitive instruments in the interest of secondary gain) has dominated the concussion literature. Although the identification of malingering is essential to ethical assessment, its presence or absence is not the sole determinant of performance validity as a whole. Rather, performance validity is a broad construct involving effort, which refers to examinees’ investment in performing at capacity levels; emerging research suggests this can be affected by psychological factors …

Online Social Networking Among Clinically Depressed Young People: Scoping Review Of Potentially Supportive Or Harmful Behaviors, Carolyn L. Elias, Kevin M. Gorey

Social Work Publications

Online social networking sites are ubiquitous and prevalently used by young people. The COVID-19 pandemic demonstrated the potential for such sites to bring isolated people together to support their mental health. Virtual communications, however, are not without risks. Substantial knowledge exists on attendant risks and protections among the general population, but much less seems known about their effects among clinical populations. This scoping review mapped the novel knowledge and knowledge gaps related to online social networking experiences and perceptions of depressed young people, adolescents to emergent adults. It also explored moderators of their social networking supports versus harms. A broad …

Relative Effectiveness Of Online Cognitive Behavioural Therapy With Anxious Or Depressed Young People: Rapid Review And Meta-Analysis, Shikara T. Howes, Kevin M. Gorey, Carly M. Charron

Social Work Publications

Global estimates suggest that 25% and 20% of youth have reported elevated symptoms of depression and anxiety, respectively, since the beginning of the COVID-19 pandemic compared to baseline functioning (Racine et al., 2021). Cognitive behavioural therapy (CBT) has been found to significantly benefit young people experiencing anxiety and depression (Christ et al., 2020). Pandemic-related protocols have led many mental health services to shift to online platforms. We wondered about the comparative efficacy of online versus offline CBT for young people between the ages of 10-25. We responded with a rapid review and meta-analysis of eight randomized controlled trial outcomes. The …

The Acute And Persisting Impact Of Covid-19 On Trajectories Of Adolescent Depression: Sex Differences And Social Connectedness, Sabrina R. Liu, Elyssia Poggi Davis, Anton M. Palma, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Background

The COVID-19 era is a time of unprecedented stress, and there is widespread concern regarding its short- and long-term mental health impact. Adolescence is a sensitive period for the emergence of latent psychopathology vulnerabilities, often activated by environmental stressors. The present study examined COVID-19′s impact on adolescent depression and possible influences of different domains of social connectedness (loneliness, social media use, social video game time, degree of social activity participation).

Methods

A community sample of 175 adolescents (51% boys, mean age = 16.01 years) completed questionnaires once before and twice during the COVID-19 pandemic. Piecewise growth modeling examined the …