Psychological medicine
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Psychological medicine · Aug 2004
Onset, timing and risk for depression and anxiety in family caregivers to heart transplant recipients.
Family members adopt key caregiving roles in the maintenance of transplant recipients' health. While the bulk of the caregiving literature suggests that rates of psychiatric disorder should be high in these caregivers, the potential benefits of transplantation may instead lead to less distress than in other caregiving situations. We examined prevalence and risk factors for depressive and anxiety-related disorders in caregivers throughout 3 years after their family member's heart transplant. ⋯ Transplantation is associated with costs and benefits for not only patients but family caregivers. Caregivers' risk for psychiatric illness should be considered when developing interventions to promote families' long-term adjustment to the transplant process.
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Psychological medicine · Feb 2004
Post-traumatic stress disorder among patients with chronic pain and chronic fatigue.
Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD). ⋯ Optimal clinical care for patients with FM should include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.
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Psychological medicine · Jan 2004
Randomized Controlled Trial Comparative Study Clinical TrialA pragmatic cluster randomized controlled trial of an educational intervention for GPs in the assessment and management of depression.
General practitioners (GPs) can be provided with effective training in the skills to manage depression. However, it remains uncertain whether such training achieves health gain for their patients. ⋯ Although training programmes may improve GPs' skills in managing depression, this does not appear to translate into health gain for depressed patients or the health service.
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Psychological medicine · Oct 2003
Life events, social support and depression in childbirth: perspectives from a rural community in the developing world.
High rates of depression associated with childbirth have been reported in many parts of the developing world. However, the prevalence and associations of antenatal and post-natal depression in the rural population remain unknown. Disability associated with depression and its impact on infant health and development could have important public health implications for many developing countries where large proportions of the population are rural. ⋯ Over one-quarter of mothers in a rural sub-district of Pakistan suffer from depression shortly before and after childbirth. Rapidly changing traditional family structures and practices may be increasing the risk of depression in many women. Recognizing and treating depression should be initiated during the antenatal, rather than post-natal period.
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Psychological medicine · Aug 2003
Randomized Controlled Trial Clinical TrialBehavioural factors associated with symptom outcomes in a primary care-based depression prevention intervention trial.
A randomized trial of a primary care-based intervention to prevent depression relapse resulted in improved adherence to long-term antidepressant medication and depression outcomes. We evaluated the effects of this intervention on behavioural processes and identified process predictors of improved depressive symptoms. ⋯ A brief intervention designed to target cognitive-behavioural factors and promote adherence to pharmacotherapy in order to prevent depression relapse was highly successful in changing several behaviours related to controlling depression. Improvements in self-efficacy and several self-management behaviours that were targets of the intervention were significantly related to improvements in depression outcome.