Journal of affective disorders
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As the US population ages, more and more individuals will find themselves facing the demanding task of caring for terminally ill family members. Yet strikingly little is known about the emotional toll such caregiving exacts from caregivers, or how the stresses and strains of caregiving affect later grief reactions. This study examines the emotional adjustment and grief intensity of bereaved caregivers from their prebereavement (caregiving) baseline through the first year after the death and compares the effects of caregiving and subsequent bereavement on spouses and adult children. ⋯ The large dropout rate, reliance on self-report ratings and demographically homogeneous sample may limit generalizability of findings.
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Comparative Study
Treatment of mood-congruent psychotic depression with imipramine.
Most studies report a poor response of psychotic depressed patients to treatment with a tricyclic antidepressant alone compared to combined treatment with an antipsychotic preparation and compared to non-psychotic depressed patients. However, the issue of optimal treatment of psychotic depressed patients has not been resolved as yet. Previously, we reported a significant difference in response to mirtazapine compared to imipramine in a randomised, double-blind, fixed-blood-level study with in-patients with major depression. In the current study we focus on the treatment response to imipramine in a group of patients with psychotic depression and compare this to patients who manifest no psychotic features. Our aim in presenting these findings was to contribute to the discussion on the optimal treatment of psychotic depressed patients. ⋯ Our sample size was modest. This fact may caution against generalisation of the results.
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Comparative Study
Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners.
The Edinburgh Postnatal Depression Scale (EPDS) has been validated and used extensively in screening for depression in new mothers, both in English speaking and non-English speaking communities. While some studies have reported the use of the EPDS with fathers, none have validated it for this group, and thus the appropriate cut-off score for screening for depression or anxiety caseness for this population is not known. ⋯ The EPDS is a reliable and valid measure of mood in fathers. Screening for depression or anxiety disorders in fathers requires a two point lower cut-off than screening for depression or anxiety in mothers, and we recommend this cut-off to be 5/6.
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Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD. ⋯ The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.
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Bipolar disorder is a common, lifelong condition that can present during childhood, adolescence, adulthood or later in life. It may occur alone but, more frequently, is complicated by comorbid psychiatric and medical disorders. ⋯ This review summarizes common issues concerning recognition of bipolar disorder, particularly in younger patients, discusses the prevalence and treatment of anxious disorder and addictive comorbidity, and considers bipolar disorder in the institutionalized and forensic populations. Treatment options and the supporting evidence are discussed.