Introdução: A Depressão Psicótica (DP) afeta cerca de 15-20% dos pacientes com diagnóstico de depressão. Esta condição está ligada a maior cronicidade, maior incidência de tentativas de suicídio e maior frequência de internação hospitalar em relação à Depressão Não-Psicótica. No entanto, evidências recentes sugerem que a incidência de características psicóticas pode não estar relacionada à intensidade dos sintomas depressivos. O curso distinto de doença, associado a pior resposta ao tratamento e a pior prognóstico suscitam a discussão de que a depressão psicótica pode ser uma entidade clínica distinta da depressão, representando um ponto em um continuum que tem em um de seus extremos os transtornos psicóticos e no outro, os transtornos de humor. Objetivos: Avaliar se a presença de sintomas psicóticos em pacientes internados por episódio depressivo se correlaciona com a intensidade de sintomas depressivos. Avaliar se há diferenças clínicas e funcionais que podem se relacionar com os sintomas psicóticos dos pacientes da amostra. Observar a melhora de sintomatologia psiquiátrica ao longo da internação, e se há diferença na variação de sintomas, ao longo da internação, entre os pacientes psicóticos e não-psicóticos. Métodos: 288 pacientes internados por episódio depressivo em uma unidade psiquiátrica de um hospital geral universitário foram avaliados na admissão e na alta hospitalar. Foi realizada entrevista semi-estruturada com o MINI para avaliação diagnóstica. Nos dois momentos de avaliação foram aplicadas a Escala de Hamilton para Avaliação de Depressão (HAM-D), a Escala Breve de Avaliação Psiquiátrica (BPRS), a avaliação da Impressão Clínica Global (CGI) e a Escala Global de Avaliação do Funcionamento (GAF). Outros parâmetros clínicos e epidemiológicos também foram avaliados: idade de início de sintomas, quantidade de internações prévias, tentativas de suicídio prévias, tempo de duração da internação atual e realização de Eletroconvulsoterapia (ECT) durante a internação. Resultados: 131 pacientes (45,4%) apresentaram sintomas psicóticos. Após ajuste para controle de variáveis que tinham potencial de viés de confusão – história prévia de mania ou hipomania, história prévia de uso de substâncias, sexo, idade, e anos de estudo – os dois grupos tiveram resultados similares nos resultados da HAM-D, tanto na admissão quanto na alta. Em relação às outras medidas, no entanto, os pacientes com depressão psicótica apresentaram piores níveis de funcionamento (GAF), piores resultados na avaliação clínica (CGI) e escores mais elevados na BPRS, na admissão e na alta hospitalar. Conclusão: Os pacientes com depressão psicótica apresentaram história mais grave de sintomas psiquiátricos e maior prejuízo funcional. No entanto, as diferenças entre os pacientes psicóticos e não-psicóticos não tiveram relação com os sintomas depressivos dos pacientes. Tais achados vão ao encontro de evidências recentes que sugerem que a depressão psicótica pode ser um transtorno distinto da depressão maior. / Introduction: Psychotic Depression (DP) is a medical condition that affects a significant portion of depressive patients, 15-20%. This disorder is linked to greater cronicity, higher incidence of suicide attempts and a higher frequency of hospitalization, when compared to depressive episodes without psychotic features. Nevertheless, recent evidences suggest that the presence of psychotic symptoms may not correlate to depressive symptoms severity. The discrete clinical course, along with worse response to usual treatment and worse prognosis draw a hypothesis that Psychotic Depression might be a distinct disorder in relation to major depression. It reflects the intersection of psychotic and affective dimensions, and may be placed in a point of a continuum between psychotic and affective disorders. Objectives: To evaluate if the presence of psychotic symptoms in hospitalized depressive patients correlates to depressive symptoms intensity. To evaluate the existence of clinical and functioning differences among psychotic and non-psychotic depressive inpatients that could be related to the psychotic features. To estimate clinical improvement during hospitalization, and if there are dissimilarities in the variation of symptoms between psychotic and non-psychotic depressive individuals. Methods: 288 depressive inpatients of a psychiatric ward of a university tertiary hospital were assessed at admission and at discharge. We conducted MINI semi-structured interview to determine patient diagnosis. At both assessments we applied the Hamilton Depression Rating Scale (HAM-D), the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and the Global Assessment of Functioning (GAF). Other clinical and epidemiological parameters were also assessed: age at onset, number of previous hospitalizations, previous suicide attempts, length of stay and Electroconvulsive therapy (ECT) in current hospitalization. Results: 131 patients (45,4%) had psychotic features. After adjusting for potential confounding variables – previous presence of mania or hypomania, history of substance use, gender, age and years of study –, both psychotic and non-psychotic depressive patients presented similar HAM-D scores at admission and at discharge. However, psychotic depressive inpatients showed worse functioning levels (GAF), worse clinical status (CGI) and higher BPRS scores, both at admission and at discharge. Conclusion: Psychotic depressive inpatients presented more severe history of psychiatric symptoms and greater functioning disability. The differences between both groups of patients did not correlate to depressive symptoms. These findings are in conformity with recent evidences that suggest that psychotic depression might be a distinct disorder in relation to major depression.

Abstract A longitudinal follow-up study of postnatal depression was performed in the years 1995-2000 in the University of Oulu. A volunteer, ramdomly selected group of 187 mothers from maternal wards of the University Hospital of Oulu were studied with different questionnaires in the first postpartum week. Depressive symptoms were re-assessed with Edinburgh Postnatal Depression Scale four months postpartum when paternal depression was evaluated with Beck Depression Inventory. 16.2% of the women were immediately after delivery screened as being depressed. Four months postpartum 13.0% of the mothers were depressed whereas 5.1 % of the fathers were having depressive symptoms. The cumulative incidence of maternal postnatal depression within the first four months was 22.2%. These mothers who immediately showed depressive symptoms were at a higher risk to be depressed later. Maternal age 30 years or less predicted postnatal depression. The occurrence of maternal postnatal depression varied slightly during different seasons; during dark time immediate depressive symptoms increased and the spring seemed to protect from later postnatal depression. Analgesia during vaginal delivery, e.g. nitrous oxide, epidural analgesia or paracervical blockade, protected from postnatal depression as well. Caesarean section, either elective or emergency, did not predict postpartum mental well-being. Scores from the GHQ and the EPDS were strongly interrelated. Seven (5%) fathers were depressed four moths postpartum. They all were men whose partners also scored high in the EPDS. Those mothers who were depressed interpreted infant facial signals differently, seeing less joy, disgust and anger, but more sadness in the infant facial pictures. Cultural variability was found in complex blended facial features of emotions, e.g. distress, in the Infant Facial Expression from Looking at Picture scale, although remarkable agreement was achieved and reinforced. In the videotaped early mother-infant interaction small, but essential, changes were observed at 10 months postpartum. Overall, mothers who had had persistent depressive symptoms showed less negative expressions and had less anger and anxiety in their interaction. Their children were slightly less impulsive and seemed to have less visual and communicative contact with their mothers. The dyad was characterised by short periods of uninvolvement between the mother and the infant; e.g. the moments of reciprocity were less frequent than in the non-depressed mothers. At 42 months postpartum, the children of the persistently depressed mothers scored lower on the Expressive language scale than the children of the mothers who were depressed in one measurement or never.

M.Ed. (Psychology of Education) / Because of its prevalence, depression has been described as a common cold in communities all over the world. Thus, the primary purpose of this research study was to provide guidelines and support to help late adolescent boys suffering from non-clinical depression. The objective of this research had been successfully achieved. The late adolescent boys who were interviewed were identified by their educators and their peers as non-clinical depressed. The data were collected by means of observation and phenomenological interviews. The researcher followed a qualitative, explorative, descriptive and contextual method. In the second chapter the researcher describes the research design and method of the research. The approach to data collection, analysis and report writing to achieve the goal of this research study are also indicated. The third chapter deals with the phenomenological interviews that were conducted and the central themes that have been identified and categorised. The fourth chapter indicates guidelines to help and support late adolescent boys suffering from non-clinical depression. The research ensured trustworthiness to the participants during the research process. The researcher gained the confidence of the participants by spending time with them informally. The researcher ensured credibility of the research study by audio-taping the interviews conducted with the participants. Thereafter, the independent coder was given the transcribed interviews. Thereafter a consensus discussion was held with the independent coder. The researcher ensured that the research study was credible, transferable, dependable and confirmable. Ethical measures were also applied throughout the research. The researcher ensured that the participants would not be harmed, either physical or emotionally. The researcher ensured the participants of their anonymity. He did this by giving the participants pseudonyms and he made sure that the setting was not identifiable. Ethical measures were also applied throughout the research. The researcher ensured that the participants would not be harmed, either physical or emotionally. The researcher ensured the participants of their anonymity. He did this by giving the participants pseudonyms and he made sure that the setting was not identifiable. The participants were also informed about the advantages and disadvantages of participating in the research. The researcher received informed consent from the parents of the participants and from the principals of the schools where some of the interviews were conducted. He also obtained assent from the participants. All participants were informed about their privacy, benefits, withdrawal and the procedure to be followed. The researcher found late adolescent boys experience positive and negative challenges concerning non-clinical depression. They also experience role conflict related to their home circumstances and that conversation with others help keep depression at bay. The researcher found that the causes of nonclinical depression of late adolescent boys are poor family relationships and dysfunctional families. Guidelines were deducted from these results.

Metabolic syndrome is a constellation of risk factors, including abdominal obesity, hypertriglyceridemia, low HDL cholesterol, high blood pressure, and high fasting glucose, that commonly cluster together and can result in cardiovascular disease. The prevalence of metabolic syndrome and the components that comprise the syndrome vary by age and by racial/ethnic group. In addition, previous research has indicated that the risk factors contributing to metabolic syndrome may be exacerbated by exposure to perceived stress. This study utilized data from the 2002, 2004, and 2006 Health and Retirement Study (HRS) and National Health and Nutrition Examination Survey (NHANES) data sets. It was hypothesized that depression and anxiety (conceptualized as stress in this study) increase the risk of presenting with metabolic syndrome while social support decreases the risk of metabolic syndrome. While results of cross-sectional analysis do not indicate a significant relationship between depression and metabolic syndrome (t = -.84, ns), longitudinal analysis does indicate a significant relationship between depression and metabolic syndrome over time (t = -5.20, p <.001). However, anxiety is not significantly related to metabolic syndrome when the relationship is examined through cross-sectional analysis (t = -1.51, ns) and longitudinal analysis (&#967;² = 13.83, ns). Similarly, social support is not significantly related to metabolic syndrome when examined in cross-sectional (&#967;² = .63, ns) and longitudinal (t = 1.53, ns) analysis. Although level of stress is not significantly related to metabolic syndrome as a whole, there is a significant relationship between stress and both triglyceride level (t = -2.94, p = .003) and blood glucose level (t = -3.26, p = .001).

No description available.

Bakgrund: Depression är en vanlig sjukdom i världen, och äldre människor är särskilt utsatta. Den förväntas vara den näst vanligast funktionsnedsättning i världen efter hjärtsjukdom inom ett par årtionden. På grund av atypiska symtom är den inte alltididentifierad och därför underdiagnostiserad och underbehandlad, särskilt hos äldre. Syfte: Syftet med denna litteraturstudie var att beskriva äldres upplevelse av att levamed depression Metod: En beskrivande litteraturstudie som sammanfattar och analyserar resultatet avtretton kvalitativa studier. Huvudresultat: Identifierade teman var Känslolivets påverkan, Upplevelse avskamkänsla och stigmatisering, Syn på behandling och återhämtning, Samhörighet ochmeningsfullhet och Familjens roll i återhämtning.Flera studier visade på att de äldre inte förstod hur sjukdomen påverkade deras känsloroch tankar. De medgav att fördomar om sjukdomen var utbredd inom åldersgruppen ochbekände att deras egna tidigare obekantskap med depression hade lett till en saknadförståelse. De menade att det var en ledande faktor till att stigmatisering av sjukdomentillsammans med en rädsla för att associeras med galenskap. Att kunna dela erfarenhetermed vänner och familj ansågs viktigt för att bekämpa upplevelsen av ensamhet somvanligtvis är sammankopplad med depression. Slutsats: Denna litteraturstudie visade att upplevelsen av stigmatisering och känslor avensamhet var central i den äldres upplevelse av depression. För att förbättra behandlingen och lindra upplevelsen var det av vikt att skingra fördomar och förutfattade meningar om sjukdomen samt att inkludera familjen när relationen var god och berikande. / Background: Depression is a common disorder in the world, especially elderly areparticularly exposed. It is expected to become the second most common disability afterheart disease within a couple of decades. Because of atypical symptoms it is not alwaysidentified and thus underdiagnosed and undertreated, particularly in the elderly community. Aim: The aim of this litterature-review was to describe the experiences of depressionthe elderly. Method: A descriptive litterature-review compiling and analyzing the results of thirteen qualitative studies. Main Result: Themes identified were Impact on emotional life, Experience of shameand stigmatization, Views on treatment and recovery, Togetherness and meaningfulness and The family’s role in recovery. Several studies have shown that the elderly did not understand the impact of the disorder on their thoughts and feelings. They recognized that misconceptions about the disorder were widespread within their age group and acknowledged that their own previous unfamiliarity with depression lead to a lack of understanding. They sourced this to be a leading factor in the stigmatization of the disorder alongside with a fear of being associated with lunacy. To be able to share experiences with friends and family were key to combat feelings of loneliness commonly associated with depression. Conclusion: The litterature-review revealed that the experience of stigmatization and feelings of loneliness were central to the elderly’s experience of depression. To improve treatment and ease the experience, it was useful to dispel false beliefs and misconceptions about the disorder and to include family when family-relations were deemed good and nurturing.

Bakgrund: Depression är en vanlig sjukdom i världen, och äldre människor är särskilt utsatta. Den förväntas vara den näst vanligast funktionsnedsättning i världen efter hjärtsjukdom inom ett par årtionden. På grund av atypiska symtom är den inte alltid identifierad och därför underdiagnostiserad och underbehandlad, särskilt hos äldre. Syfte: Syftet med denna litteraturstudie var att beskriva äldres upplevelse av att leva med depression Metod: En beskrivande litteraturstudie som sammanfattar och analyserar resultatet av tretton kvalitativa studier. Huvudresultat: Identifierade teman var Känslolivets påverkan, Upplevelse avskamkänsla och stigmatisering, Syn på behandling och återhämtning, Samhörighet ochmeningsfullhet och Familjens roll i återhämtning.Flera studier visade på att de äldre inte förstod hur sjukdomen påverkade deras känsloroch tankar. De medgav att fördomar om sjukdomen var utbredd inom åldersgruppen ochbekände att deras egna tidigare obekantskap med depression hade lett till en saknadförståelse. De menade att det var en ledande faktor till att stigmatisering av sjukdomentillsammans med en rädsla för att associeras med galenskap. Att kunna dela erfarenhetermed vänner och familj ansågs viktigt för att bekämpa upplevelsen av ensamhet somvanligtvis är sammankopplad med depression. Slutsats: Denna litteraturstudie visade att upplevelsen av stigmatisering och känslor avensamhet var central i den äldres upplevelse av depression. För att förbättrabehandlingen och lindra upplevelsen var det av vikt att skingra fördomar ochförutfattade meningar om sjukdomen samt att inkludera familjen när relationen var godoch berikande. / Background: Depression is a common disorder in the world, especially elderly are particularly exposed. It is expected to become the second most common disability after heart disease within a couple of decades. Because of atypical symptoms it is not always identified and thus underdiagnosed and undertreated, particularly in the elderly community. Aim: The aim of this litterature-review was to describe the experiences of depressionthe elderly. Method: A descriptive litterature-review compiling and analyzing the results of thirteenqualitative studies. Main Result: Themes identified were Impact on emotional life, Experience of shameand stigmatization, Views on treatment and recovery, Togetherness and meaningfulnessand The family’s role in recovery. Several studies have shown that the elderly did not understand the impact of thedisorder on their thoughts and feelings. They recognized that misconceptions about thedisorder were widespread within their age group and acknowledged that their ownprevious unfamiliarity with depression lead to a lack of understanding. They sourced this to be a leading factor in the stigmatization of the disorder alongside with a fear ofbeing associated with lunacy. To be able to share experiences with friends and familywere key to combat feelings of loneliness commonly associated with depression. Conclusion: The litterature-review revealed that the experience of stigmatization and feelings of loneliness were central to the elderly’s experience of depression. To improve treatment and ease the experience, it was useful to dispel false beliefs and misconceptions about the disorder and to include family when family-relations were deemed good and nurturing.

Postpartum depression affects between 10 - 15% of all mothers within the first year after giving birth (Dietz, 2007; Epperson, 1999).  Studies that have focused on women's experiences of postpartum depression have found similar in experience of contrast between women's expectations of motherhood, and their actual experiences (Beck, 2002; Knudson-Martin & Silverstein, 2009; Mauthner, 1999).  Using a phenomenological approach, this study sought to explore women's experiences of contrast, understand how this experience contributed to their social construction of what motherhood meant, and ask if and how women might change the messages that they receive regarding being a mother. Seven women were recruited from a postpartum depression support group and interviewed in a focus-group setting.  Respondents noted that they experienced a great contrast between their expectations of motherhood and what they actually experienced.  These expectations, however, seemed ambiguous and generic.  Women reported that they were surprised by the amount of judgment and pressure they felt surrounding being a mother.  Participants seemed to challenge their preconceptions about being a mother by focusing on making choices that were best for them and their children and by allowing unhappy feelings to be compatible with their definition of a good mother.  Women in the study described wanting to hear messages that were honest and open about the realities of motherhood, both from the media and in their interactions with other women and loved ones.  Participants also seemed to feel strongly that more efforts should be made to reach out to new mothers. / Master of Science

Anxiety and depression are common mood disorders in cancer patients, regardless of mental state prior to diagnosis. A gap in the education of oncology nurses in an eastern Caribbean island was discovered regarding their ability to identify anxiety and depression symptoms and to help patients who suffered from these disorders. The purpose of this project was to improve oncology nurses' assessment skills by reviewing appropriate use of the Hospital Anxiety and Depression Scale (HADS) tool and familiarizing nurses with resources to help patients who score high on the HADS. The Levine conservation model was the theoretical framework for this project. The research question addressed whether a staff education module regarding the use of the HADS tool would improve staff knowledge about screening cancer patients for mood disorders in a clinic setting. This project involved a staff education module with a pretest/posttest assessment and evaluation of the responses and levels of improvement. A total of 10 oncology nurses with varying academic degrees and years of experience participated in the project. The pretest showed that many had inadequate knowledge of the HADS tool. Based on posteducation assessment scores, all participants understood how to use the tool to screen for mood disorders. The implication of this study for positive social change is that oncology nurses will be able to use a screening tool to identify undiagnosed anxiety and depression symptoms in cancer patients and provide patients with appropriate resources.

Depression is a potentially life-threatening disease that is one of the leading causes of disability in the world. In 2017, more than 300 million people suffered from depression. That equates to about 4.4% of the world's population, making it the world's second most common public health disease after cardiovascular disease. About 50% who are treated for depression develop unipolar treatment-resistant depression, a type of severe persistent depression in which conventional methods or drugs do not have effect.  Psilocybin is a tryptamine found in a variety of species of psychedelic mushrooms. Psilocybin is a prodrug that breaks down into the active substance psilocin which interacts with serotonin receptors and produces psychoactive effects. Psilocybin is classified as a schedule I drug in most of the world and is therefore not considered to have any medical value. Psilocybin has been researched intensively in recent years, mainly focusing on its potential antidepressant effect. Psilocybin's effects have been widely covered in English literature but hardly at all in Swedish literature. This bachelor thesis will hopefully fill that gap and encourage more research on the subject here in Sweden. The purpose of this bachelor thesis was to evaluate, based on published studies, whether psilocybin potentially can have an effective, safe, and long-lasting antidepressant effect on depressive symptoms. Six studies are presented, and the results indicate that that 20–30 mg of psilocybin together with psychological support in an optimal environment can potentially have a long-acting, safe, and effective antidepressant effect on adult people with moderate to severe unipolar depression. Based on these results, the drug classification of psilocybin should be questioned and investigated.