Ms. K is a 19-year-old Caucasian female with no prior psychiatric diagnoses who presented to outpatient clinic with chief complaint of depressed mood. She reports depressed mood, low energy, low motivation, low self-esteem, anhedonia, and loss of appetite for past 2 months. She reports sleeping only 4 hours per night and denies daytime naps. She was diagnosed with major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorder, 5 edition in our outpatient clinic. She denies suicidal thought, homicidal thoughts, or plan. She denies hopelessness, worthlessness, and recurrent thoughts of death. She denies history of mania, psychosis, PTSD, eating disorder or OCD. She works as a server at a local restaurant. She denies tobacco, alcohol use and other illicit substance use. She doesn’t have history of inpatient hospitalization, suicide attempt or homicide attempt. She had not tried psychotropics in the past. She doesn’t have any medical illness and not on any current medications. She has history of nocturnal enuresis at age 6 improved and remitted with minimizing fluid intake before bedtime and enuresis alarm. She was started on fluoxetine 10mg daily for 7 days and increase to 20mg daily for depression. She came for follow up 4 weeks later. She reported significant improvement in her mood, energy, interest, and sleep. She has been sleeping 8 hours per night. During the follow up she denied depressed and other depressive symptoms. She reported onset of nocturnal enuresis 1 weeks after start of fluoxetine. She is reporting nocturnal enuresis 4 times a week. fluoxetine 20mg daily was decreased to 10mg daily however enuresis persisted. After discussing with patient, we decided to discontinue fluoxetine and start escitalopram 10mg daily for depression. 4 days later, patient reported that nocturnal enuresis resolved completely. Patient reached remission of her depressive symptoms on escitalopram 10mg daily. Case reports describing SSRI induced incontinence with paroxetine, sertraline have been published. Escitalopram is extremely selective for serotonergic transport proteins when compared with other antidepressant such as sertraline, fluoxetine, paroxetine, and fluvoxamine. Clinicians should keep in mind the possibility that enuresis may possible be either precipitated or exacerbated by SSRI. In this poster, we discuss fluoxetine induced enuresis, possible mechanism and bladder pathophysiology.

Medication compliance/noncompliance was examined in context of: severity of symptoms; medical side effects; medication education; perceived stigma; and effects on family/social support system. A null hypothesis was formulated for each correlate, stating that those patients who reported a high level of an independent variable (IV) would not be any more likely to discontinue their medication than patients who reported a low level of an IV. To obtain data, a medical usage questionnaire and a depression, assessment (OQT"-45.2) were used. Statistical significance was not obtained for any of the hypothesized relationships but trends were consistent with the established literature. The implication points to the efficacy of relational therapy as a conjunct to the medical treatment of depression.

Films of three depress ed persons, one manic, and one normal individual were analyzed frame-by-frame to determine body activity rates. Speech rates were also determined. It was found that the manic had the highest activity rate, followed by the normal comparison, and with the depressed patients having the lowest activity rates. The depressed subjects also had lower speech rates than did the normal or the manic subjects. The term 'psychomotor retardation 1 is called into question, as the frequency distributions of movement durations were similar for all subjects. Implications for treatment and for development are also discussed.

<p> Major Depressive Disorder (MDD) is a common affective disorder associated with persistent states of negative mood and selective cognitive impairments. Fronto-temporal dysregulation in MDD patients is thought to contribute to the symptoms seen in these patients.</p> <p> Based on prior evidence of structural and functional alterations in the hippocampus (Hc) and prefrontal cortex (PFC) in MDD patients, we were interested in examining the changes in cerebral function that underlie the cognitive dysfunction seen in two different MDD populations. We studied psychotropically naïve depressed patients experiencing their first treated episode (FTE) of depression, MDD patients who had experienced multiple past treated episodes (MTE) of MDD and healthy controls.</p> <p> Two functional magnetic resonance imaging studies (fMRI) were conducted. The first study used an Hc dependent process dissociation task to examine Hc activation during recollection memory. The second fMRI study examined the activation in the PFC during reward and punishment conditions of a reversal-learning paradigm. Finally, we conducted magnetic resonance spectroscopy scans to measure levels of metabolites indicative of neuronal and glial cell integrity in the Hc of depressed patients and controls. </p> <p> We observed differing results across all three studies in our FTE and MTE depression groups. Our studies examining the Hc suggest that MTE patients have decreased activation in this region as well as corresponding memory errors during recollection memory. Additionally, these patients have smaller Hc volume and signs of increased neuronal membrane turnover. Conversely, our FTE patients displayed heightened Hc activation without memory deficits. Moreover, FTE patients had signs of increased glial cell density in the Hc without volumetric differences in this region. Our examination of reward processing revealed several health-to-illness gradients of activation in areas as the nucleus accumbens, anterior cingulate and ventral prefrontal cortices during the processing of rewards and punishers. </p> <p> These findings suggest that several regions in the brain may be sensitive to the impact of disease burden and repeated episodes of MDD. In the Hc, first treatment patients may engage in compensatory processes during the early stages of illness that are attenuated with repeated episodes of illness. Moreover, reward processing may be affected in the early course of the disorder, however with a protracted course of illness these regional alterations in activation become more pronounced.</p> / Thesis / Doctor of Philosophy (PhD)

No description available.

Thesis (M Social Work (Social Work))--University of Stellenbosch, 2006. / This study is based on the perceptions and experiences of the psychosocial effect that post natal depression has on the partners of women diagnosed with this illness. Post natal depression is an emotional state of mind experienced by some women after the birth of a baby. In reality, it is a relatively scarce illness that is not openly spoken of in the community. Firstly the researcher will present an overview of the illness, and show the differences between the “baby blues”, post natal depression and post natal psychosis in order to heighten the awareness of this specific illness. Thereafter, the circumstances that lead to the illness as well as the symptoms present are explained since the women’s behaviour can impact on, as well as directly affect, both the partners psychosocial lives. To understand the circumstances in which a partner finds himself, the role of a man and father will be examined. With this in mind, the mans perceptions and experiences are further described with regard to his partner’s depression and how this affects him. Attention is also given to the different methods of treatment of postnatal depression, since the patient and her partner’s lives are directly impacted by professional involvement during the recovery period. This research is based on the opinions expressed by the participants of an existing support group for the partners of depressed women. The group is conducted by the researcher as a social worker in her private practice. Information was obtained through group sessions and followed up by individual interviews with each participant. The participants were required to comment on the way in which post natal depression had affected their relationship with their partners, babies and extended families as well as how they adjusted to the situation. The participants were recruited to describe their emotions with regard to the circumstances and express an opinion on the treatment available. They were also requested to suggest ways of improving the existing methods. The overall conclusion reached in this study is that social workers in the community are faced with a great challenge where post natal depression is concerned. Ideally this illness should be prevented but when it does occur, correct treatment is essential in order to obviate the breakdown of the family. The primary aim of any community is to provide and maintain a healthy family structure with both parents acting as role models. The purpose is to prepare children to develop into balanced adults in order to take their rightful place in society

本研究是一項關於北京中年抑鬱症患者主觀經驗的敘事分析。研究的目的在於探尋患者對於自身患病歷程的主觀詮釋，他們的服務需求以及對於中國大陸精神衛生社會工作進行反思。研究的參與對象為目的性抽樣所得到的來自北京的一個抑鬱癥自助團體的八名中年抑鬱癥患者。 / 患者回顧了他們不同階段的經歷：發病期、住院期以及康復期。然後他們對於這些經歷做了詮釋。基於不同領域的社會服務需求，對於醫院、社區、大眾傳媒以及政府，他們都給出了寶貴的意見。 / 研究發現，既有的理論觀點對於關著對自身經歷的詮釋有著重要的影響，尤其是生物醫學模型。認知觀點和性別觀點也可以在患者們的敘事中找到蹤跡。精神科醫生在患者的整個經歷中都處於重要的地位，他們的觀點和行為對患者也產生了重要的影響。 / 患者還受到社會和歷史因素的影響。他們的詮釋會受到社會觀念和文化價值的影響，比如命運、面子、孝順以及性別角色等等。而歷史事件諸如文化大革命以及天安門事件也會對他們的人生經歷以及他們的主觀詮釋造成影響。而中國目前的社會情境也是另一項重要的影響因素。 / 從他們的故事中，我們可以看到，最重要的主題就是他們在患病過程中認知模式的轉變，包括對待抑鬱癥本身，所接受的服務以及自身的看法。在他們的敘述中，另外兩個主題也是非常值得注意的，那就是和抑鬱症有關的“喪失以及醫院裡非人道的治療方式。 / 他們的故事為我們對於北京中年抑鬱症患者經歷的理解提供了非常豐富詳實的材料。這些發現對於知識理論的發展、政策的制定以及針對抑鬱症患者的臨床社會工作實踐都有著很大的啟示。整個社會以及不同領域的精神衛生專業人士都應該攜起手來幫助他們，共同去創造一個更加包容和諧的社會。 / This research was a narrative analysis of the subjective experiences of the depressed middle-aged adults in Beijing, China. The purposes of the research were to explore the clients’ subjective interpretation of their lived experience of depression, their service needs and reflect on the improvement of mental health social work in Mainland China. A purposive sample of eight depressed clients from a self-help group in a mental health hospital in Beijing participated in this study. / The clients talked about their experiences at different stages: the onset, in the hospital and the rehabilitation, and interpreted their experiences. They also gave some advice to the hospital, the community, the mass media and the government based on their social service needs. / The theoretical perspectives influenced the clients’ interpretations of their experiences, especially the biomedical model. The cognitive perspective and the gender perspective could also be found in the client’s narratives. The psychiatrists were very important in the whole process of the clients’ experiences. Their perspectives and behaviors also influenced the clients. / It is found that the clients were also influenced by social and historical factors. Their interpretations were affected by social beliefs and cultural values such as fate, face, filial piety and gender roles. The historical events such as Cultural Revolution and June.4th Movement also affected their experiences and interpretations. The current social context in China was another important factor affecting them. / From their stories, we could see that the main theme was change of their cognitive styles, including view of depression, service and themselves. Another two themes were highlighted in their narratives as well: the linkage of their losses with depression and the dehumanized treatment in the hospital. / Their stories have provided comprehensive materials for an in-depth understanding of depressed middle-aged adults in Beijing. Based on the findings, recommendations are made to knowledge development, policymakers and clinical social workers in helping the depressed clients. It is necessary for our society and mental health professionals in different areas to work together to help them and build an inclusive society. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Shi, Song. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 228-245). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts and appendixes also in Chinese. / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Rationale of the study --- p.1 / Chapter 1.2 --- Background of the study --- p.2 / Chapter 1.3 --- Research Questions --- p.3 / Chapter 1.4 --- Purposes and significance of the research --- p.4 / Chapter Chapter 2 --- Literature Review --- p.7 / Chapter 2.1 --- Adult depression --- p.7 / Chapter 2.1.1 --- Definition of adults’ depression --- p.7 / Chapter 2.1.2 --- Different perspectives on “depression“ --- p.9 / Chapter 2.1.3 --- Social factors associated with adult depression --- p.24 / Chapter 2.1.4 --- Cultural influences in Chinese society --- p.32 / Chapter 2.2 --- Treatment of depressed adults --- p.36 / Chapter 2.2.1 --- Psychotherapy --- p.36 / Chapter 2.2.2 --- Medication --- p.38 / Chapter 2.3 --- Research on subjective experiences of people with mental disorders --- p.39 / Chapter 2.4 --- Research on depression in Mainland China --- p.48 / Chapter 2.5 --- The roles of social work in mental health services --- p.51 / Chapter Chapter 3 --- Research Methodology --- p.58 / Chapter 3.1 --- Paradigmatic Considerations --- p.58 / Chapter 3.1.1 --- Social constructionism --- p.58 / Chapter 3.1.2 --- Social construction and mental illness --- p.61 / Chapter 3.1.3 --- Theoretical Framework --- p.63 / Chapter 3.2 --- Research Design --- p.70 / Chapter 3.2.1 --- Qualitative research strategy --- p.70 / Chapter 3.2.2 --- Sampling strategies --- p.75 / Chapter 3.2.3 --- Data collection procedures --- p.84 / Chapter 3.2.4 --- Data analysis procedures --- p.86 / Chapter 3.2.5 --- Strategies for validating findings --- p.88 / Chapter 3.3 --- Ethical issues --- p.91 / Chapter Chapter 4 --- Research findings --- p.93 / Chapter 4.1 --- The experiences of the participants --- p.93 / Chapter 4.1.1 --- The experience during the onset of depression --- p.94 / Chapter 4.1.2 --- The experience in hospital --- p.118 / Chapter 4.1.3 --- The experience in the rehabilitation period --- p.131 / Chapter 4.2 --- The interpretation of their experiences --- p.142 / Chapter 4.2.1 --- The interpretation of the process of suffering from depression --- p.143 / Chapter 4.2.2 --- The interpretation of the process of recovery --- p.148 / Chapter 4.3 --- Advice on their needs --- p.154 / Chapter 4.3.1 --- The hospital --- p.154 / Chapter 4.3.2 --- The community --- p.159 / Chapter 4.3.3 --- Mass media --- p.161 / Chapter 4.3.4 --- The government --- p.164 / Chapter 4.4 --- Summary --- p.170 / Chapter Chapter 5 --- Discussion and Recommendation --- p.171 / Chapter 5.1 --- Characteristics of the participants in this study --- p.171 / Chapter 5.2 --- Social and historical factors affecting the clients’ interpretation of suffering from depression --- p.173 / Chapter 5.2.1 --- Social beliefs and cultural values --- p.174 / Chapter 5.2.2 --- Social context --- p.183 / Chapter 5.2.3 --- Historical events --- p.184 / Chapter 5.3 --- Themes --- p.186 / Chapter 5.3.1 --- Change of Cognitive Style --- p.187 / Chapter 5.3.2 --- The linkage of loss with depression --- p.190 / Chapter 5.3.3 --- The dehumanized treatment of hospitalization --- p.193 / Chapter 5.3.4 --- The interrelationships among the themes --- p.195 / Chapter 5.4 --- Revisiting the proposed conceptual framework --- p.197 / Chapter 5.5 --- Significance and recommendations --- p.200 / Chapter 5.5.1 --- Significance and recommendations --- p.201 / Chapter 5.5.2 --- Limitations --- p.214 / Chapter Appendix A: --- Possible Probes for interview (English Version & Chinese Version) --- p.218 / Chapter Appendix B: --- Oral Consent form (English Version & Chinese version) --- p.225 / References --- p.228

Epidemiological studies show that China has a lower prevalence rate of major depression than that of Western countries. The disparity in prevalence is commonly attributed to the tendency of Chinese to somatize depression. Empirical evidence of Chinese somatization has yielded mixed results. The present study thus aimed to 1) examine differences in somatic and psychological symptom reporting between Chinese from Macau and Americans in America and 2) identify cultural and psychological variables that would predict somatization. Independent and interdependent self-construals, sociotropy, and emotional approach coping were hypothesized to predict somatization of depression. Participants included 353 Chinese and 491 American college students who completed self-report measures online. Contrary to prediction, results indicated that Americans endorsed a higher proportion of somatic symptoms than Chinese did. Sociotropy predicted both relative endorsement and severity of somatic symptoms for the American sample, whereas emotional expression coping was related to somatization in the Chinese sample. The findings challenge the common assumption of greater Chinese somatization and highlight the importance of context in understanding the relationships between somatization and cultural and psychological variables. Implications of the present study and future directions are discussed.

Two studies were conducted to examine the interpersonal world of the depressive. It was hypothesized that depressed subjects would not like nondepressed targets as much as would nondepressed subjects. In addition, it was hypothesized that depressed subjects would feel worse after speaking with nondepressed targets. Finally it was hypothesized that perceived similarity would mediate these effects by covarying with mood and liking measures. To assess these hypotheses, study one had depressed and nondepressed college students speak with one another in either depressed-depressed, nondepressed-depressed, or nondepressed-nondepressed pairs. Measures of liking for the person with whom they conversed, of perceived similarity toward the person with whom they conversed, and of the subject's mood were then taken. Although the results were mixed, it was found that depressed subjects felt worse after speaking to depressed targets, though there were no differences in liking or perceived similarity between the groups. Perceived similarity did covary with most of the liking measures for the depressed and nondepressed subjects. Study two examined whether depressives had best friends who were themselves more depressed than best friends who were nondepressives. It was hypothesized that the best friends of depressives would be more depressed. Furthermore, it was expected that the best friends would also be perceived as more depressed by the subjects. These hypotheses were confirmed when depressives brought their best friends in for a study and the level of depression for these best friends was measured. In addition, the depressed subjects reported feeling worse after speaking with their friends when compared to how the nondepressed subjects reported feeling after speaking with their best friends.

The health and mental health status of rural populations has often been neglected as a research priority; particularly in the case of rural youth. The purpose of this study is to examine the differences in depressed mood and suicide ideation of urban and rural youth and to determine what factors are associated with depressed mood and suicide ideation. More specifically, this study will examine depressed mood and suicide ideation of urban and rural youth (grades 5 to 8) in the Saskatoon Health Region (SHR) using data from the Student Health Survey. This project involved secondary data analysis of SHR’s Student Health Survey. There were 5,783 grade 5-8 students that participated in the survey. The final logistic regression models revealed similarities and differences between urban and rural youth in the risk factors that predicted the likelihood of students reporting symptoms of depressed mood and suicide ideation. For depressed mood, both urban and rural youth reported their relationship with their parents, their general mental health, low self-esteem, and suicide ideation as risk factors for depressed mood. Gender, age, having been drunk, and feeling like an outsider at school were risk factors for depressed mood in urban youth, while rural students reported that their living situation, their perception of their weight, being physically bullied, and being electronically bullied increased their likelihood of reporting symptoms of depressed mood. In terms of suicide ideation, both urban and rural youth were more likely to report depressed mood and a poor relationship with their parents as risk factors. Urban youth also reported being Aboriginal, that they had tried smoking, and being victims of physical bullying as risk factors. No additional risk factors were found for rural youth. This data will help to address local and national gaps in the literature about the mental health status of youth in rural populations. This research may inform policies and programming in both the health and education sectors.