The problem of assessment and diagnosis of depression in the elderly begins with the definition of depression being indefinite. In this study, the theory of learned helplessness was chosen because of its value in organizing research within a learning theory framework. The Beck Depression Inventory, measures of fluid and crystallized intellectual ability, locus of control, and attribution of success and failure were chosen as variables for an exploratory factor analysis. The purpose of selecting these variables was to assess the cognitive, motivational, and affective components of learned helplessness as they affected the responses of elderly subjects to depression items. Self report measures of income, education, and health, were included to assess the relationship of these variables to depression. A somatic factor was predicted to correlate with an affective factor of depression.

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Beeinträchtigungen des Arbeitsgedächtnisses und der präfrontalen Hirnaktivität (Hypofrontalität) sind Anwärter für Endophänotypen für bipolare Störungen. Diese Studie untersuchte zum ersten Mal manisch-depressive Patienten (n=14) mit einer Arbeitsgedächtnisaufgabe, die verschiedene Prozesse (Speicherung und Abgleich) und verschiedene Komponenten (objektbezogenes und visuell-räumliches) beinhaltete. Mit Hilfe der funktionellen Nah-Infrarot Spektroskopie wurde die neuronale Aktivität über dem präfrontalen Kortex erfasst. Bei der Kontrollgruppe, die der Patientengruppe vergleichbar war, zeigten Veränderungen von oxygeniertem und deoxygeniertem Hämoglobin eine Zunahme der Aktivität im ventero-lateralen, im dorso-lateralen und superioren präfrontalen Kortex in der objektbezogenen und visuell-räumlichen Arbeitsgedächtnisaufgabe im Vergleich zur Kontrollaufgabe. Obwohl sich die kognitive Leistung (Anzahl der korrekten Antworten und Reaktionszeit) zwischen den beiden Gruppen nicht unterschied, zeigte die Patientengruppe eine verminderte Gehirnaktivität während der Speicherphase der Arbeitsgedächtnisaufgaben. Die fNIRS kann als valides, leicht zu handhabendes, billiges und schnelles Mittel verwendet werden um (verminderte) präfrontale kortikale Aktivität zu messen. / Altered working memory and prefrontal brain activity (hypofrontality) are candidate endophenotypes for bipolar disorder. The present study investigated for the first time BI patients (n=14) in a working memory task including different processes (storage and matching) and components (object and spatial visual) with functional near-infrared spectroscopy (fNIRS) over prefrontal cortex. In healthy controls (n=14) comparable to the patient group, changes of oxygenated and deoxygenated haemoglobin indicated increased ventro-lateral, dorso-lateral prefrontal and superior frontal cortex activity for object and spatial visual working memory storage as compared to the control condition. Altough cognitive functioning (number of correct answers and reaction-time) was comparable between the two groups, the patient group showed diminished brain activity in the working memory conditions. fNIRS can be considered as a valid, easy manageable, low cost and rapid tool for measuring (diminished) prefrontal cortex functions.

A dissertation submitted to Faculty of Medicine in part fulfilment of the required for the degree of Master of Medicine in Psychiatry at the University of the Witwatersrand / Moclobemide is a reversible monoamine oxidase inhibitor. It is a short acting antidepressant, and previously studies were done comparing 300 to 600 mg dosages administered three times daily. Data on a twice daily dosage schedule is limited. This study compares the efficacy and tolerability of Moclobemide 150 mg twice daily as compared to two different three times a day schedules with total daily dosages of 300 to 450 mg respectively. Thirty one adult outpatients with major depressive disorder (as defined by DSM-IIIR) were included in this trial. It was controlled in a randomised double-blind manner. All treatments were found to be effective and no clinically significant differences between treatments could be demonstrated in this respect. Group 3 (150 mg b.d.) was found to be slightly more effective than the other two groups. Moclobemide was found to be effective at all dosage regimens with respect to treating co-morbid symptoms of anxiety and agitation. There were no differences between the groups with respect to type and frequency of adverse events. Overall tolerability was found to be good in all the treatment groups. Since the twice daily dosage is more convenient, it has been suggested that compliance will be enhanced on this regimen. The treatment response rates obtained confirm this conclusion. / IT2018

Esta pesquisa objetivou identificar os pontos de vista e o conhecimento sobre depressão de enfermeiros da rede básica de saúde. Os 73 enfermeiros participantes encontram-se na secretaria municipal de saúde e direção regional de saúde, ambos em São José do Rio Preto-SP. Acham-se distribuídos em 28 unidades de saúde. Em se tratando de um estudo psicométrico, foram utilizados quatro instrumentos para a coleta de dados: A- Pontos de vista sobre depressão; B- Conhecimento sobre depressão; C- Inventário de Beck; D- Escala de Zung. Todos foram auto-aplicados. Utilizou-se a análise quantitativa para os dados gerais e a qualitativa para a reflexão sobre os mesmos dados. Nos resultados gerais, a maioria das respostas evidencia acordo com o que se esperava, com médio conhecimento sobre depressão. Entretanto, as análises individuais dessas questões indicam que esses profissionais não estão em contato direto com o paciente, não sabem identificar pacientes deprimidos, não observam estes indicadores nos pacientes por eles atendidos ou não entendem que seja sua tarefa fazer esta identificação. Surgiram reflexões acerca da possível relação entre as ações de saúde mental com a formação profissional do enfermeiro. Desse modo, o ensino da depressão no curso de enfermagem e na educação continuada passam a ter maior importância no desenvolvimento das ações de enfermagem para a saúde mental. Esperamos que esta pesquisa constitua-se em para a assistência, para o ensino e para a pesquisa em enfermagem podendo sensibilizar os enfermeiros sobre a necessidade de uma atuação transformadora de suas práticas. / This research aimed at identifying the viewpoints and knowledge on depression of nurses working in the basic health network. The 73 participant nurses were stationed in the Municipal Health Secretariat and Regional Health Department in São José do Rio Preto-SP. They were distributed in 28 health units. Considering that this was a psychometric study, four instruments were used for data collection: A- Viewpoints on depression; B- Knowledge on depression; C- Beck's Inventory; D- Zung's Scale. All of them were self-applied. Quantitative analysis was used for general data and qualitative analysis was utilized for reflection on the same data. In the general results, most of the answers were in accordance with what was expected, that is, average knowledge on depression was shown. However, the individual analysis of such questions indicated that these professionals are not in direct contact with patients, they do not know how to identify depressed patients, they do not observe these indicators in the patients that they assist or do not understand that it is their task to do so. Reflections appeared on the possible relationship between mental health actions and nurses’ professional education. In this way, including studies about depression in undergraduate and continuing education become more important in the development of nursing actions for mental health. We believe that this research constitutes an important contribution to nursing assistance, teaching and research, since it is able to sensitize nurses as to the need for transforming actions in their practice.

Recent interest in cognitive behavioural therapy techniques for treatment of Chronic Fatigue Syndrome (CFS) has highlighted the contribution of psychological approaches to alleviating the debilitating symptoms of this illness. In previous research sufferers from CFS have been compared with depressed patients and patients with neuromuscular disease, as they share similar symptoms, but not diagnosis. This study attempts to compare four groups including a normal working group. A new measures was developed and piloted, designed to measure interpretations of symptoms in CFS. In addition standard instruments were used to focus on the measurement of high personal standards, perfectionism, emotional control and conscientiousness and levels of autonomy. Results showed the CFS group were similar to the normal working group on all standard scales and scored low on autonomous personality traits. Reasons for this result, and the clinical implications for treating such a heterogeneous patient group are discussed. Measures on the symptom interpretation scale show CFS patients are less likely to give an emotional explanation for their symptoms than the other participant groups. This has implications for communication between physician and patient, and the treatment of CFS with a psychological model.

Concerns about weight, shape and eating and attempts at dietary restraint are prevalent among young girls, but may increase the risk of the development of eating disorders, especially if low self-esteem or symptoms of depression are also present. The literature suggests that there may be links between mothers and daughters attitudes towards weight, shape and dietary restraint. The aim of the study was to investigate whether concerns about weight, shape and eating and attempts at dietary restraint differed between overweight and average-weight girls; and whether overweight girls had lower self-esteem, and/or more symptoms of depression than average-weight girls. Possible links between mothers' and daughters' attitudes towards weight and shape and dietary restraint were also investigated. Results showed that overweight girls had more concerns about weight, shape and eating and attempted dietary restraint more than average weight girls. Overweight girls had more negative perception of their athletic competence, physical appearance and global self-worth, and more symptoms of depression than average-weight girls. Mothers of overweight girls, who themselves had higher BMIs than the mothers of average-weight girls, had more concerns and negative beliefs about weight, shape and eating and attempted more dietary restraint, than the mothers of average-weight girls. Although there was some association between mothers' and daughters' concerns in the average-weight group these associations were not present in the overweight group. The conclusions were that overweight girls may be particularly vulnerable to the development of eating disorders, but that the links between mothers' and daughters' concerns are not straightforward.

Obliti is a game meant to promote empathy for people with depression, and applies a personal story to the experience. Empathy is the experience of understanding another person€™s condition from their perspective. You place yourself in their shoes and feel what they are feeling. 17 The story follows the character through corrupted dream states, stuck in an infinite loop; reliving the tarnished dreams. This paper will discuss the story of Obliti, its history and the way the design helped the story come to the forefront of the experience. Using lighting, first person character and art assets, Obliti puts the player into the shoes of the main character. The paper also includes a post mortem in order to discuss the challenges of working with paid art assets, making a game about your past and the overall outcome of the project. In order to test the effectiveness of Obliti, 20 subjects were asked to fill out a series of questions regarding mood and depression. The results of the study showed a change in mood from pretest and posttest, pointing toward empathy being transferred to the player. Part of the study asked players if they understood depression, in which there was a 10% change from €œNo,€� to €œI don€™t know,€� suggesting some internal thoughts were changed on the topic.

Mindfulness-based Cognitive Therapy (MBCT) is a manualised psychosocial, group-based 8 week course specifically designed for people with a history of depression. This study responds to the huge growth in the credibility of MBCT as a therapeutic option in the NHS as well as a rise in the popularity and awareness of mindfulness-based interventions (MBIs). This study is based on semi-structured interviews (N=38) with stakeholders in the field of MBIs in Sussex, and an online survey of Sussex NHS Foundation Trust (SPFT) staff (N=203), as part of a wider collaborative ethnography embedded within the Trust. It contributes to existing literature on the efficacy of MBIs by exploring existing provision and follow-up support, reviewing the perceived benefits and costs of embedding MBCT into the health services. This study has a particular focus on participants of a recent SPFT Randomised Controlled Trial (RCT) ‘Mindfulness for Voices' that investigated the efficacy of this therapy for people who hear distressing voices. This study brings together both the empirical and theoretical with its focus on mindfulness as a therapeutic technique that epitomises links between the mind, the body and society. This study draws on sociological work on embodiment and emotion in order to understand the experience of innovation as well as of MBIs – starting from the observation that many of those leading this area of research and implementation are also practising mindfulness. Furthermore, this study maps the theoretical shift from a narrow medical model of mental illness to one that characterises emotional health within a holistic and integrated paradigm, and which is influencing and shaping current practice. Key findings from this study are that MBIs, and MBCT in particular, can be beneficial to a diverse range of stakeholders within Sussex, including patient groups that were previously excluded from ‘talking cures' such as those with a diagnosis of psychosis. Factors that influence the acceptability, visibility and utilisation of an innovation such as MBCT include the role of opinion leaders and champions in garnering support, as well as the degree to which expectations about the future of this intervention are managed. Drawing on sociologies of knowledge and innovation in the health services, the case is used to show the use of experiential knowledge alongside evidence in bringing about innovation. Clinicians also work to develop accounts of the ‘values' at stake in MBIs; drawing on both evidence and experiential knowledge. The implementation of MBIs into the mainstream health service helps to illuminate some of these practices through being used to address conditions such as chronic pain and severe anxiety disorders which were hitherto seen as untreatable and characterised as ‘complex needs', or medically unexplained symptoms (MUS) and which can be stigmatising.

This collection of personal essays about incest, abuse, and depression explores the lasting effects of an invisible childhood. The essays follow the protagonist from the age of five to her early twenties. Her brother, at a young age, becomes sexually abusive of her and her sisters, and her parents fail to protect their daughters. The family is divided as the older girls strive to defend their little sisters, while their parents attempt to excuse their son. When her brother is finally sent away, the protagonist is left to salvage what remains of her relationships with her parents.