scholarly journals The maturing of therapy

2002 ◽  
Vol 180 (3) ◽  
pp. 200-204 ◽  
Author(s):  
Isaac M. Marks
Keyword(s):  
Cost Effectiveness ◽  
Problem Solving ◽  
Needs Assessment ◽  
Depressive Disorders ◽  
Coming Of Age ◽  
Mechanisms Of Action ◽  
Anxiety And Depression ◽  
Cognitive Problem ◽  
Scientific Principles ◽  
Do So

BackgroundPsychiatric therapy needs assessment regarding its maturation as a therapeutic science.AimsJudgement of whether such a science is emerging.MethodFour criteria are used: efficacy; identification of responsible treatment components; knowledge of their mechanisms of action; and elucidation of why they act only in some sufferers.ResultsBrief behavioural, interpersonal, cognitive, problem-solving and other psychotherapies have a mature ability to improve anxiety and depressive disorders reliably and enduringly, often only with instruction from a manual or a computer. Therapy's cost-effectiveness and acceptability deserve more attention. We know little about which treatment components produce improvement, how they do so and why they do not help all sufferers.ConclusionsTherapy is coming of age regarding efficacy for anxiety and depression, but is only a toddler regarding the scientific principles to explain its effects.

Does problem-solving treatment work through resolving problems?

2002 ◽  
Vol 32 (7) ◽  
pp. 1315-1319 ◽  
Author(s):  
LAURENCE MYNORS-WALLIS
Keyword(s):  
Problem Solving ◽  
Drug Treatment ◽  
Depressive Disorders ◽  
Controlled Trial ◽  
Antidepressant Medication ◽  
Mechanisms Of Action ◽  
Self Control ◽  
Treatment Result ◽  
Problem Resolution ◽  
Sense Of Mastery

Background. A randomized controlled trial of problem-solving treatment, antidepressant medication and the combination of the two treatments found no difference in treatment efficacy for major depressive disorders in primary care. In addition to treatment outcome, the trial sought to determine possible mechanisms of action of the problem-solving intervention.Method. Two potential mechanisms of action of problem-solving treatment were evaluated by comparison with drug treatment. First, did problem-solving treatment work by achieving problem resolution and secondly, did problem-solving treatment work by increasing the patients' sense of mastery and self-control?Results. Problem-solving treatment did not achieve a greater resolution in the patients' perception of their problem severity by comparison with drug treatment, neither did problem-solving treatment result in a greater sense of mastery or self-control.Conclusions. The results from this study did not support the hypotheses that for patients with major depression, by comparison with antidepressant medication: problem-solving treatment would result in better problem resolution; or that problem-solving treatment would increase the patients' sense of mastery and self-control.

The Relationship between Life Events and Personality Style to the Development of Depressive and Anxiety Disorders Among Adolescents

2020 ◽  
Vol 10 ◽  
Author(s):  
Noga Oschry-Bernstein ◽  
Netta Horesh-Reinman ◽  
Adar Avnon ◽  
Tomer Mevorach ◽  
Alan Apter ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Life Events ◽  
Depressive Disorders ◽  
Multinomial Logistic Regression ◽  
Statistical Correlation ◽  
Personality Characteristics ◽  
Dominant Factor ◽  
Anxiety And Depression ◽  
Unique Contribution ◽  
Early Trauma

Background:: The separateness of anxiety disorder and depressive disorder as two distinct disorders is often questioned. The aim of the current study is to examine whether there is a different profile of life events and personality characteristics for anxiety and depression disorders in adolescents. Methods:: One hundred forty-six adolescents participated in the study, 57 boys and 89 girls, ranging in age from 11-18 years (mean=15.08+1.97). The study group included 92 adolescents with a clinical diagnosis of depression or anxiety, and the comparison group included 54 teenagers with no known psychopathology. Results:: Multinomial logistic regression produced different predictive profiles for anxiety disorder and for depressive disorders. Life event variables, especially minor life events and early traumas, were found to be predictors for depression. Furthermore, interaction was found between early trauma and minor life events in the prediction of depression, such that the existence of trauma weakened the statistical correlation between minor life events and the onset of depression. In addition, contrary to the literature regarding adults, it was found that during adolescence personality variables have a unique contribution as predictive factors for vulnerability to the onset of anxiety and depression, thus reducing the significance of life events. Conclusion:: Our findings suggest that different profile of life events and personality characteristics can be identified for the two disorders. In addition, it appears that early traumas are a dominant factor that overshadows more recent life events at the onset of depression among adolescents.

The validity of diagnostic systems for common mental disorders: a comparison between the ID-CATEGO and the DSM-III systems

1990 ◽  
Vol 20 (1) ◽  
pp. 209-218 ◽  
Author(s):  
David Grayson ◽  
Keith Bridges ◽  
Diane Cook ◽  
David Goldberg
Keyword(s):  
Discriminant Analysis ◽  
Depressive Disorders ◽  
Common Mental Disorders ◽  
Latent Trait ◽  
Mental Illnesses ◽  
Anxiety And Depression ◽  
Multiple Discriminant Analysis ◽  
Diagnostic Systems ◽  
Scale Scores ◽  
Initial Scale

SYNOPSISIt is argued that latent trait analysis provides a way of examining the construct validity of diagnostic concepts which are used to categorize common mental illnesses. The present study adds two additional aspects of validity using multiple discriminant analysis applied to two widely used taxonomic systems. Scales of anxiety and depression derived from previous latent trait analyses are applied to individuals reaching criteria for ‘caseness’ on the ID-CATEGO system and the DSM-III system, both at initial diagnosis and six months later. The first multiple discriminant analysis is carried out on the initial scale scores, and the results are interpreted in terms of concurrent validity. The second analysis uses improvement scores on the two scales and relates to predictive validity. It is argued that the ID-CATEGO system provides a better classification for common mental illnesses than the DSM-III system, since it allows a better discrimination to be made between anxiety and depressive disorders.

scholarly journals Loneliness and Depression among Polish High-School Students

2021 ◽  
Vol 18 (4) ◽  
pp. 1706
Author(s):  
Beata Dziedzic ◽  
Paulina Sarwa ◽  
Ewa Kobos ◽  
Zofia Sienkiewicz ◽  
Anna Idzik ◽  
...  
Keyword(s):  
High School ◽  
High School Students ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Young Person ◽  
Anxiety And Depression ◽  
School Students ◽  
Loneliness Scale ◽  
Emotional Loneliness ◽  
Anxiety Depression

Introduction: Having impaired relations and limited interpersonal contact is associated with a sense of loneliness, and can result in a number of mental disorders, including the development of depression. Approximately one in five adolescents in the world suffers from depression, and first episodes of such are occurring at increasingly young ages. Due to a lack of appropriate support from parents, teachers and the healthcare system, the young person feels alone when dealing with their problem. Aims: The aims of this study are to determine the prevalence of anxiety, depression, aggression and sense of loneliness among high school students, and to analyze a correlation between loneliness and depression. Materials and methods: The study was conducted on 300 high school students in Poland. The study material was collected using the Hospital Anxiety and Depression Scale (HADS-M) and De Jong Gierveld Loneliness Scale (DJGLS). Results: A feeling of loneliness correlated significantly with depressive disorders (p < 0.005), with the strongest effect between the total HADS-M score and the total loneliness scale score (r = 0.61). The overall presence of disorders as per HADS-M was found to be 23%, and borderline conditions were found in 19.3%. In 24% of the students, disorders were revealed on the anxiety subscale and in 46.3% on the aggression subscale. On DJGLS, a very severe sense of loneliness was observed in 6.67% of the subjects, and in 42.3% of them, a moderate feeling of loneliness was indicated. On the social loneliness subscale, a severe sense of loneliness was found in 22.7%, while on the emotional loneliness subscale, it was found in 16.7% of the subjects. Conclusions: In this study, a quarter of the student participants experienced anxiety and depression disorders. Students showing higher levels of anxiety, depression, and aggression also showed enhanced loneliness. Girls showed higher levels of anxiety, depression and aggression, as well as emotional loneliness.

scholarly journals Salivary Biomarkers of Stress, Anxiety and Depression

2021 ◽  
Vol 10 (3) ◽  
pp. 517
Author(s):  
Sylwia Chojnowska ◽  
Iwona Ptaszyńska-Sarosiek ◽  
Alina Kępka ◽  
Małgorzata Knaś ◽  
Napoleon Waszkiewicz
Keyword(s):  
Salivary Cortisol ◽  
Depressive Disorders ◽  
Immunoglobulin A ◽  
Strong Relationship ◽  
Fibroblast Growth Factor 2 ◽  
Stress Axis ◽  
Anxiety And Depression ◽  
Salivary Biomarkers ◽  
Appropriate Treatment ◽  
As Stress

Stress, anxiety and depressive disorders are often characterized by the activation of the stress axis, which results in similar symptoms at some point in these disorders. These disorders are closely related to each other—they occur simultaneously or follow one another. The diagnosis of stress, anxiety and depression is not a perfect procedure currently—it is based on patient observation and an interview with the patient and their family. There are no laboratory tests that would dispel the doubts of the doctor making the diagnosis and allow the appropriate treatment to be implemented as soon as possible. Therefore, this study will review the components of saliva that could be helpful in the quick diagnosis of stress, anxiety and/or depression. Such potential salivary biomarkers could also be useful in monitoring the effectiveness of pharmacological treatment prescribed by a psychiatrist. The following are promising salivary biomarkers of stress, anxiety or depression: cortisol, immunoglobulin A (sIgA), lysozyme, melatonin, α-amylase (sAA), chromogranin A (CgA) and fibroblast growth factor 2 (FGF-2). To the best valuable potential salivary markers of stress, we can include cortisol, lysozyme, sAA and CgA. To differentiate depression from stress, salivary cortisol and melatonin can be helpful. Fluctuations in the concentrations of the above-mentioned substances in saliva indicate a particularly strong relationship with typical human psychological problems, such as stress, depression or anxiety.

scholarly journals Ambulatory oxygen for treatment of exertional hypoxaemia in pulmonary fibrosis (PFOX trial): a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040798
Author(s):  
Anne E Holland ◽  
Tamera Corte ◽  
Daniel C Chambers ◽  
Andrew J Palmer ◽  
Magnus Per Ekström ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Interstitial Lung Disease ◽  
Randomised Controlled Trial ◽  
Lung Disease ◽  
Oxygen Therapy ◽  
Controlled Trial ◽  
Activity Level ◽  
Anxiety And Depression ◽  
Randomised Controlled

IntroductionInterstitial lung diseases are characterised by scarring of lung tissue that leads to reduced transfer of oxygen into the blood, decreased exercise capacity and premature death. Ambulatory oxygen therapy may be used to treat exertional oxyhaemoglobin desaturation, but there is little evidence to support its efficacy and there is wide variation in clinical practice. This study aims to compare the clinical efficacy and cost-effectiveness of ambulatory oxygen versus ambulatory air in people with fibrotic interstitial lung disease and exertional desaturation.Methods and analysisA randomised, controlled trial with blinding of participants, clinicians and researchers will be conducted at trial sites in Australia and Sweden. Eligible participants will be randomised 1:1 into two groups. Intervention participants will receive ambulatory oxygen therapy using a portable oxygen concentrator (POC) during daily activities and control participants will use an identical POC modified to deliver air. Outcomes will be assessed at baseline, 3 months and 6 months. The primary outcome is change in physical activity measured by number of steps per day using a physical activity monitor (StepWatch). Secondary outcomes are functional capacity (6-minute walk distance), health-related quality of life (St George Respiratory Questionnaire, EQ-5D-5L and King’s Brief Interstitial Lung Disease Questionnaire), breathlessness (Dyspnoea-12), fatigue (Fatigue Severity Scale), anxiety and depression (Hospital Anxiety and Depression Scale), physical activity level (GENEActive), oxygen saturation in daily life, POC usage, and plasma markers of skeletal muscle metabolism, systematic inflammation and oxidative stress. A cost-effectiveness evaluation will also be undertaken.Ethics and disseminationEthical approval has been granted in Australia by Alfred Hospital Human Research Ethics Committee (HREC/18/Alfred/42) with governance approval at all Australian sites, and in Sweden (Lund Dnr: 2019-02963). The results will be published in peer-reviewed scientific journals, presented at conferences and disseminated to consumers in publications for lay audiences.Trial registration numberClinicalTrials.gov Registry (NCT03737409).

scholarly journals Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders

2006 ◽  
Vol 189 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Tony Kendrick ◽  
Lucy Simons ◽  
Laurence Mynors-Wallis ◽  
Alastair Gray ◽  
Judith Lathlean ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Problem Solving ◽  
Community Mental Health ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Mental Health Nurses ◽  
Nurse Care ◽  
Gp Care ◽  
Community Mental Health Nurses

BackgroundUK general practitioners (GPs) refer patients with common mental disorders to community mental health nurses.AimsTo determine the effectiveness and cost-effectiveness of this practice.MethodRandomised trial with three arms: usual GP care, generic mental health nurse care, and care from nurses trained in problem-solving treatment; 98 GPs in 62 practices referred 247 adult patients with new episodes of anxiety, depression and life difficulties, to 37 nurses.ResultsThere were 212 (86%) and 190 (77%) patients followed up at 8 and 26 weeks respectively. No significant differences between groups were found in effectiveness at either point. Mean differences in Clinical Interview Schedule – Revised scores at 26 weeks compared with GP care were –1.4 (95% Cl –5.5 to 2.8) for generic nurse care, and 1.1 (–2.9 to 5.1) for nurse problem-solving. Satisfaction was significantly higher in both nurse-treated groups. Mean extra costs per patient were £283 (95% Cl 154–411) for generic nurse care, and £315 (183–481) for nurse problem-solving treatment.ConclusionsGPs should not refer unselected patients with common mental disorders to specialist nurses. Problem-solving should be reserved for patients who have not responded to initial GP care.

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