Medicine and Health Sciences Commons^™

An Evaluation Of Neuroplasticity And Behavior After Deep Brain Stimulation Of The Nucleus Accumbens In An Animal Model Of Depression., Steven M Falowski, Ashwini Sharan, Beverly A S Reyes, Carl Sikkema, Patricia Szot, Elisabeth J Van Bockstaele

Department of Neurosurgery Faculty Papers

BACKGROUND: Recent interest has demonstrated the nucleus accumbens (NAcc) as a potential target for the treatment of depression with deep brain stimulation (DBS).

OBJECTIVE: To demonstrate that DBS of the NAcc is an effective treatment modality for depression and that chemical and structural changes associated with these behavioral changes are markers of neuroplasticity.

METHODS: A deep brain stimulator was placed in the NAcc of male Wistar-Kyoto rats. Groups were divided into sham (no stimulation), intermittent (3 h/d for 2 weeks), or continuous (constant stimulation for 2 weeks). Exploratory and anxietylike behaviors were evaluated with the open-field test before and after …

Depression And Its Associated Risk Factors In Medical And Surgical Post Graduate Trainees At A Teaching Hospital: A Cross Sectional Survey From A Developing Country, Aisha Yousuf, Sidra Ishaque, Waris Qidwai

Department of Family Medicine

Objectives: To determine the frequency of depression among post graduate medical trainees in a teaching hospital of Pakistan and to explore the associated factors contributing to depression in them. Methods: It's a cross-sectional study at the Aga Khan University Hospital, Karachi. It was done in June 2008 till August 2008. Zung Self-Rating Depression Scale was administered among 172 post graduate trainees. Self administered questionnaires were used to assess the associated demographic and work related risk factors. Adjusted odds ratios (OR) were calculated by logistic regression. Results: The survey response rate was 172(82.69%). Depression in the overall sample was 103(59.88%), of …

Prevalence And Incidence Rates Of Dementia And Cognitive Impairment No Dementia In The Mexican Population: Data From The Mexican Health And Aging Study, Silvia Mejía-Arango, Luis Miguel Gutierrez

School of Medicine Publications and Presentations

Objective

To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population.

Methods

The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent 8 million subjects nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow up. Overall incidence rates and specific rates for sex, age and education were calculated.

Results

Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per …

Appropriate Medication Prescribing In Elderly Patients: How Knowledgeable Are Primary Care Physicians? A Survey Study In Parma, Italy., Vittorio Maio, Pharmd, Ms, Mph, Eric Jutkowitz, Ba, Karina Herrera Ba, Ms, Safiya Abouzaid Pharmd, Giavanna Negri, Pharmd, Stefano Del Canale, Md, Phd

College of Population Health Faculty Papers

What is known and Objective:  Increasing attention is being paid to inappropriate medication prescribing for the elderly. A growing body of studies have detected a prevalence of inappropriate prescribing ranging from 12% to 40% worldwide, including Regione Emilia-Romagna, Italy. To improve quality of prescribing, a multi-phase pilot project in the Local Health Unit (LHU) of Parma, Regione Emilia-Romagna, was established. This phase aimed to assess primary care physicians' knowledge of appropriate prescribing in elderly patients. Methods:  In total, 155 primary care physicians (51% of the total), convened by the LHU of Parma for an educational session, were asked to complete …

Pathways To Sexual Risk Taking Among Female Adolescent Detainees, Vera Lopez, Albert M. Kopak, Alyssa G. Robillard, Mary Rogers Gillmore, Rhonda Conerly Holliday, Ronald L. Braithwaite

Faculty Publications

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement …

Postpartum Depression And Help‐Seeking Behaviors In Immigrant Hispanic Women, Lynn Clark Callister, Renea Beckstrand, Cheryl A. Corbett

Faculty Publications

Objectives: To describe perceptions of immigrant Hispanic women experiencing symptoms of postpartum depression (PPD) and to identify barriers to seeking mental health services.

Design: Qualitative descriptive.

Setting: Community health clinic.

Participants: Twenty immigrant Hispanic women scoring positive for symptoms of PPD receiving health care at a community health clinic who declined mental health services participated in audiotaped interviews held in their homes.

Methods: Following Institutional Review Board approval and informed consent, interviews were conducted with study participants. Transcribed data were analyzed as appropriate for qualitative inquiry.

Results: Some of the women did not recognize and/or denied their symptoms attributing their …

Successful Aging And The Epidemiology Of Hiv, David E. Vance, Teena Mcguinness, Karen Musgrove, Nancy Ann Orel, Pariya L. Fazeli

Gerontology Faculty Publications

By 2015, it is estimated that nearly half of those living with HIV in the US will be 50 years of age and older. This dramatic change in the demographics of this clinical population represents unique challenges for patients, health care providers, and society-at-large. Fortunately, because of highly active antiretroviral therapy (HAART) and healthy lifestyle choices, it is now possible for many infected with HIV to age successfully with this disease; however, this depends upon one’s definition of successful aging. It is proposed that successful aging is composed of eight factors: length of life, biological health, cognitive efficiency, mental health, …

Predictors Of Elevated Depressive Symptoms In Pregnancy, Justine M. Kokoszka

Honors Scholar Theses

The purpose of this quantitative study was to examine factors that may place women at risk for developing depressive symptoms during pregnancy. It was part of a larger, randomized, double-blinded, placebo-controlled trial investigating the impact of docosahexaenoic acid

(DHA) in pregnancy as it relates to postpartum depression. Participants were women with a confirmed pregnancy(N= 45) who were administered the CES-D at two different times, 20-22 weeks gestation and 30-32 weeks gestation. Factors from a self-report of personal history were included in an analysis with the CES-D scores. A significant positive correlation was found between the first CES-D scores and body …

Improving Function In Age-Related Macular Degeneration: Design And Methods Of A Randomized Clinical Trial., Barry W Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions …

Association Of Depression With Treatment Outcomes In Type 2 Diabetes Mellitus: A Cross-Sectional Study From Karachi, Pakistan, Saman I. Zuberi, Ehsan U. Syed, Junaid A. Bhatti

Section of Diabetes, Endocrinology and Metabolism

Background: To assess the associations of depression with glycemic control and compliance to self-care activities in adult Patients with Type 2 Diabetes Mellitus. Methods: This cross-sectional study was conducted at a tertiary-care hospital in Karachi (Aga Khan University Hospital). Equal numbers of depressed and non-depressed Patients were consecutively recruited from the diabetic clinic. Information on demographic and clinical characteristics was collected in face-to-face interviews and from medical records. Hospital Anxiety Depression Scale (HADS) was used to measure depression. Associations of depressed status (HADS >= 8) with poor glycemic control (Hemoglobin A1c level >= 7%) and compliance to self-care activities were …

Depression And Anxiety In Patients With Epilepsy, With Or Without Other Chronic Disorders., A A Asadi-Pooya, M R Sperling

Department of Neurology Faculty Papers

BACKGROUND: Most people with epilepsy lead a normal emotional and cognitive life, however neurobehavioral problems can be found in a large number of patients. This study evaluates the prevalence of depression and anxiety among patients with epilepsy and determines whether having other chronic somatic illnesses increases the prevalence.

METHODS: Adults with epilepsy were recruited in either the inpatient epilepsy monitoring unit or the Outpatient Epilepsy Clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, included data about age, sex, education, having other chronic illnesses, and degree of seizure control. The Hospital Anxiety and Depression scale was …

The Association Between Vitamin D And Depression Among College-Aged Women, Constance M. Barysauskas

Masters Theses 1911 - February 2014

Approximately 15 million Americans are diagnosed with a major depressive disorder each year, with higher rates among women and college-aged adults. Recent research suggests a vitamin D insufficiency may be associated with an increased risk of depression among the elderly. However, studies have not been conducted among young women. A recent study of young adults in Massachusetts suggests that two-thirds of this population is vitamin D deficient. We evaluated the association between dietary vitamin D intake and serum levels of 25-hydroxyvitamin D (25(OH)D₃) and history of depression using data from the UMass Vitamin D Status Study, a cross-sectional …

Conflicts Of Interest In Clinical Practice Guidelines, Lisa Cosgrove, Allen F. Shaughnessy

Counseling and School Psychology Faculty Publication Series

Clinical practice guidelines are used increasingly across medical specialties and settings, making evaluation of their utility and validity a critical public health issue. In this paper, we describe some of the challenges that specialty organizations face as they try to ensure that their guidelines are trustworthy and useful. We examine the practice guidelines for Major Depressive Disorder recently published by the American Psychiatric Association (APA), identify five sources of potential bias that may affect the guideline development process and offer suggestions based on our review. For example, even for mild depression, this guideline privileges pharmacotherapy over other interventions, despite questions …

Trajectories Of Depression And Their Relationship With Health Status And Social Service Use, Chun-Min Chen, Judy Mullan, David Griffiths, Irene A. Kreis, Tzuo-Yun Lan, Herng-Chia Chiu

Graduate School of Medicine - Papers (Archive)

This longitudinal study was conducted between 1994 and 2004 in a cohort of Southern Taiwan community-living elderly residents. The study aims to explore the trajectories of depression and how these patterns differed between respondents who survived and those who died during data collection phases; this study also investigated how health status change and health/social service use predicted the different trajectories of depression. Eight hundred and ten participants had completed all six waves of the survey or were followed-up at each wave until death in the prospective study in Kaohsiung City. Depressive symptoms were evaluated by the Short Psychiatric Evaluation Schedule …

Disability, Depression And Disc Surgery: Lets Be Careful With The Evidence, Muhammad Shahzad Shamim

Section of Neurosurgery

No abstract provided.

Acceptability Of Behavioral Treatments For Insomnia, Daniel Bluestein, Amanda C. Healey, Carolyn M. Rutledge

Nursing Faculty Publications

Background: Behavioral treatments for insomnia are safe and efficacious but may not be embraced by patients in primary care. Understanding factors associated with acceptability can enhance successful use of these modalities. The objective of this study was to identify demographic and clinical/psychosocial correlates of behavioral insomnia treatment acceptability.

Methods: This nonexperimental, inventory-based, cross-sectional study enrolled patients from a hospital-sponsored primary care clinic and 2 urban academic family practices. Participants (n = 236) were 18 years of age or older who had clinically significant insomnia (Insomnia Severity Index score >= 8) and were recruited consecutively at these sites. A study coordinator …

Hippocampal Volume Differences In Gulf War Veterans With Current Versus Lifetime Posttraumatic Stress Disorder Symptoms, Brigitte A. Apfel, Jessica Ross, Jennifer Hlavin, Dieter J. Meyerhoff, Thomas J. Metzler, Charles R. Marmar, Michael W. Weiner, Norbert Schuff, Thomas C. Neylan

Public Health Resources

Background: Decreased hippocampal volume is described in posttraumatic stress disorder (PTSD) and depression. However, it is not known whether it is a risk factor for the development of PTSD or a consequence of PTSD. We sought to determine the effects of PTSD and depressive symptoms on hippocampal volume.

Methods: Clinical and magnetic resonance imaging data were collected in a cross sectional study of 244 GulfWarveterans. Measures included lifetime and current Clinician Administered PTSD Scale, Hamilton Depression Scale, Life Stressor Checklist, and Lifetime Drinking History. Magnetic resonance imaging data were acquired with a 1.5-T scanner and analyzed with automated …

Factors Associated With Suicidal Ideation In Oef/Oif Veterans, Chad M. Lemaire, David P. Graham

Public Health Resources

Background: The purpose of this projectwas to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.

Methods: A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.

Results: Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), …

Electroconvulsive Therapy For Major Depression Within The Veterans Health Administration, Paul N. Pfeiffer, Marcia Valenstein, Katherine J. Hoggatt, Dara Ganoczy, Dan Maixner, Erin M. Miller, Kara Zivin

Public Health Resources

Objectives: Electroconvulsive therapy (ECT) is the most effective treatment for severe or treatment resistant depression; however, the lack of widely accepted methods for determining when ECT is indicated may contribute to disparities and variation in use. We examined receipt of ECT among depressed patients in the largest coordinated health system in the US, the Veterans Health Administration.

Methods: Using administrative data, we conducted a multivariable logistic regression to identify individual clinical and sociodemographic predictors of receiving ECT, including variables of geographic accessibility to ECT, among patients diagnosed with major depressive disorder between 1999 and 2004.

Results: 307 (0.16%) …

Surface Facial Electromyography, Skin Conductance, And Self-Reported Emotional Responses To Light- And Season-Relevant Stimuli In Seasonal Affective Disorder, Kathryn Tierney Lindsey, Kelly J. Rohan, Kathryn A. Roecklein, Jennifer N. Mahon

Uniformed Services University of the Health Sciences

Background: Learned associations between depressive behavior and environmental stimuli signaling low light availability and winter season may play a role in seasonal affective disorder (SAD). The purpose of this study was to determine whether light and season environmental cues elicit emotional responses that are distinct in individuals with SAD.

Methods: Twenty-four currently depressed SAD participants were compared to 24 demographicallymatched controls with no depression history on emotional responses to outdoor scenes captured under two light intensity (i.e., clear, sunny vs. overcast sky) and three season (i.e., summer with green leaves, fall with autumn foliage, and winterwith bare trees) conditions. Emotion …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

Association Between Depression And C-Reactive Protein, Yunsheng Ma, David E. Chiriboga, Sherry L. Pagoto, Milagros C. Rosal, Wenjun Li, Philip A. Merriam, James R. Hébert, Matthew C. Whited, Ira S. Ockene

Faculty Publications

Objective. Depression has been associated with increased cardiovascular disease risk, and a depression-related elevation of high sensitivity C-reactive protein (hs-CRP) has been proposed as a possible mechanism. The objective of this paper is to examine association between depression and high sensitivity C-reactive protein (hs-CRP). Methods. Subjects consisted of 508 healthy adults (mean age 48.5 years; 49% women, 88% white) residing in central Massachusetts. Data were collected at baseline and at quarterly intervals over a one-year period per individual. Multivariable linear mixed models were used to assess the association for the entire sample and by gender. Results. The …

A Transformational Melancholy: One Law Professor's Journey Through Depression, Marjorie A. Silver

Scholarly Works

In the fall 2007 issue of the Journal of Legal Education, Professor James Jones shared his deeply personal, remarkable, ongoing, story of living, struggling and succeeding as a law professor with bipolar disorder (James T.R. Jones, Walking the Tightrope of Bipolar Disorder: The Secret Life of a Law Professor, 57 J. LEGAL ED. 349 (2007). His essay ended with an invitation to other members of the legal academy to contact him or Professor Elyn Saks, author of an extraordinary memoir about her life with schizophrenia, (ELYN R. SAKS, THE CENTER CANNOT HOLD (2007)) if interested in forming a confidential support …