Background: Depression is a very common disease and is caused both by the biological, physical, and psychosocial factors. At least 25 percent of women and 15 percent of all men are affected at some point in their lives. As a nurse, it is important to be aware of women's experience of depression to meet their needs for care. Aim: To illuminate women's experience of depression in order to better understand their needs for care. Method: Literature review in which ten scientific studies were analyzed and thematised. Eight qualitative studies and two studies of qualitative and quantitative method was retrieved from the database CINAHL Complete and PsycINFO. Keywords depression, women’s experience, experience of depression, female, nursing, major depression, women och social interaction were used. The theoretical framework used is Phil Barker's Tidal Model. Results: The results were presented in two main themes and five subthemes. First experiences of depression with subthemes physical and psychological symptoms, perceptions about the underlying causes and triggers, experiences of shame and guilt. Then the second main theme handling of his situation with subthemes experiences of isolation and loneliness and experiences of self-care. Discussions: The results discussed in the discussion of the result based on the findings Phil Barker's Tidal Model and also additional scientific articles, with the aim to deepening the understanding of the results. It is discussed that the nurse has an important role in responding to women who suffer from depression. When women feel that they are understood, they can more easily manage their situation and the prospects of recovery increases.

Objective: To determine: 1) 12-month prevalence rates of major depressive disorder (MDD) by race, comparing African Americans and Hispanics with whites, while controlling for covariates; 2) if there are any differences in treatment (i.e., pharmacotherapy, provider, and CAM) for MDD among African Americans, Hispanics and whites diagnosed with major depressive disorder (MDD) in the past 12 months; and 3) if there are any racial differences in DSM-IV diagnosed alcohol and/or drug abuse among those with a diagnosis of 12-month MDD. Methods: This retrospective study utilized data from the National Comorbidity Survey-Replication, which was designed to collect information on the mental health status of a nationally representative sample (n = 9282) of U.S. adults. Respondents with an MDD diagnosis in the past 12 months were included. The dependent variables were: 12-month MDD, pharmacotherapy, provider (mental health specialist), CAM and alcohol and/or drug abuse. Pharmacotherapy was examined by assessing respondents’ reported antidepressant use and whether the medication used was an SSRI/SNRI. The primary independent variable was race. Additional covariates included: age, gender, income, education, marital and employment status. Logistic regression was used to address the study objectives. Results: African Americans were significantly less likely to be diagnosed with MDD during the preceding 12-month period, when compared to whites, while controlling for covariates (OR= 0.6, p = 0.0169). Other significant variables for prevalence were female gender (OR= 1.8, p <0.0001), divorced/separated (OR= 2.0, p <0.0001) and not in the labor force (e.g., homemaker/retired) (OR= 1.5, p = 0.0033). Although African Americans and Hispanics reported lower antidepressant use, the results were not significant. With respect to SSRIs/SNRIs, African Americans reported significantly lower use, when compared to whites (OR= 0.3, p = 0.0309). Hispanics in the study were less likely to see a mental health professional (OR = 0.2, p = 0.0002). CAM use was significantly lower among individuals with less than 12 years, 12 years and 13 to 15 years of education (OR = 0.3, p = 0.0110; OR = 0.3, p = 0.0035; OR = 0.7, p = 0.0368, respectively) when compared to respondents with 16 years or more of education. When examining alcohol and/or drug use in those with diagnosed MDD in the preceding 12 months, females were less likely to be abusers (OR = 0.4, p = 0.0204). Conclusion: Among respondents with a diagnosis of MDD, race plays an important role in the types of treatment utilized to manage the disorder. Considering, the disability associated with depression, greater efforts are needed to improve antidepressant therapy for African Americans and mental health specialty treatment for Hispanics. / text

This study used mediation analysis to evaluate Beck’s model and Abramson’s model in a sample of 198 girls, in the 4th through 7th grades. Data from diagnostic interviews were used to create a continuous measure of depressive symptoms. Self-report measures, including the Life Events Checklist, the Cognitive Triad Inventory for Children, and the Children’s Cognitive Style Questionnaire, were used to assess perceptions of negative life events, Beck’s cognitive triad, and Abramson’s cognitive inferential style, respectively. Results of separate mediation analyses supported both Beck’s and Abramson’s cognitive theories of depression in children. There was a significant indirect effect of life events through Beck’s cognitive triad on symptoms of depression. Similarly, there was a significant indirect effect of life events through Abramson’s negative cognitive inferential style on depressive symptoms. Higher depressive symptoms were associated with a more depressotypic cognitive triad, a more depressotypic cognitive inferential style, and a greater number and greater magnitude of negative life events. Developmentally-sensitive analyses using the weakest link approach and moderated mediation (conditional process) analysis found support for both Beck’s and Abramson’s models. However, there was also some support for the developmental hypothesis that in younger children negative life events can have a direct effect on symptoms of depression; for the 4th graders in this study, direct effects and indirect effects were significant. However, for the 5th, 6th, and 7th graders indirect effects were significant, but direct effects ceased to be significant. Implications and suggestions for future research are provided. / text

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Objectives: (1) To ascertain whether adult siblings of disabled individuals are more prone to anxiety and depression symptomatology than a closely matched control group. (2) To examine the contribution that perceived parenting styles, attachment styles and personality traits play in the long-term affective outcome of these siblings. (3) To consider if the type of disability has a role in sibling affective outcome. Design: A cross-sectional, closely matched study design, with data collected through self-report. One-way ANOVAs, correlational analyses, moderation and mediation analyses were applied. Participants: Adult siblings of disabled individuals (SDI), were initially contacted through support groups, such as SIBS, the Down’s Syndrome Association, the National Autistic Society and the Prader-Willi Association (UK) and responded to a postal or e-mailed questionnaire; 150 participants returned the completed questionnaire. The 150 control group participants were closely matched on the variables of gender, age, marital status and when possible socio-economic status, in order to compare like with like. This group was contacted through friends, family, work colleagues and local businesses. Measures: All the participants completed a range of demographic questions; the SDI were additionally asked questions regarding their disabled sibling. The established measures used included the Hospital and Anxiety Depression Scale (Zigmond & Snaith, 1983), Experiences in Close Relationships (Brennan, Clark & Shaver, 1998), an adapted measure of the Descriptions of Parental Caregiving Style (DPCS, Hazan & Shaver, 1986) and the International Personality Item Pool (Goldberg, 1999). Results: The majority of SDI reported no increased anxiety or depression symptomatology, however, when compared the SDI did report higher levels of anxiety and depression symptomatology than the control group; also higher levels of perceived inconsistent mothering, attachment-related anxiety and neuroticism, with lower levels of extraversion than the control group. These variables mediated the path between having a disabled sibling and anxiety and depression, with the notable exception of perceived inconsistent mothering. This variable showed no association with any of the established measures for the SDI group; however, there were associations consistent with previous research for the control group. There was no moderation effect on anxiety or depression between the demographic variables and SDI. The autistic spectrum disorder siblings reported similar levels of anxiety symptomatology to Prader-Willi siblings but higher than Down’s syndrome siblings and the control group and they also reported the highest levels of depression symptomatology. Conclusions: The adult SDI’s higher propensity towards anxiety and depression is a cause for concern; particularly when explained through heightened levels of attachment-related anxiety, high levels of neuroticism and low levels of extraversion. The lack of association with perceived inconsistent mothering requires further investigation. These results can help guide interventions or clinical therapies; the emotional well-being of SDI is paramount as they will possibly be among the first group to assume responsibility for their disabled siblings.

The ionotropic glutamate AMPA ((R,S)-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor mediates the majority of excitatory transmission in the CNS. AMPA receptors play a crucial role in both basal neurotransmission and synaptic plasticity events (such as long-term potentiation, LTP). Compounds that ‘potentiate’ AMPA receptor function (‘Ampakines’) are known to positively modulate glutamatergic AMPA receptor-gated currents, by slowing the deactivation and desensitisation rate of the receptors, in the presence of the endogenous agonist glutamate. Ampakines have been shown to facilitate LTP induction, improve cognition, and as such have potential in the treatment of conditions such as depression and psychoses (schizophrenia). The main aim of this thesis was to investigate the functional actions of two novel Ampakines, Org 26576 and Org 24448, in the mouse brain. The studies described in this thesis were designed to address this and are outlined as follows: 1. Characterisation and validation of an in vivo semi-quantitative model of [14C]-2-deoxyglucose autoradiography in the C57Bl/6J mouse The first study sought to develop and characterise a model of [14C]-2-deoxyglucose autoradiography, to allow measurement of regional alterations in local cerebral glucose use (LCGU) in the mouse CNS. Following intraperitoneal injection of [14C]-2-deoxyglucose in C57Bl/6J mice, the radiolabelled brains were sectioned and exposed to x-ray film. The resultant autoradiograms were semi-quantitatively analysed for relative optical densities in predetermined regions of interest. The baseline LCGU values in different brain regions were found to be consistent with previously published data. The model was also able to replicate the effects of a well-characterised compound, the NMDA receptor antagonist MK-801 (0.5 mg/kg), in respect to functional cerebral changes. Characteristic effects such as prominent increases in LCGU in the limbic system, and decreases in the somatosensory cortex were reproduced in the model. Thus the semi-quantitative [14C]-2-deoxyglucose model was reproducible and accurate and thus could be further used to investigate the effects of the novel Ampakines, Org 26576 and Org 24448, on cerebral function. 2. Investigation into the effects of acute administration of the novel Ampakines Org 26576 and Org 24448 on functional activity in the murine cerebrum Following the establishment of the methodology, regional alterations in LCGU in response to the Ampakines Org 26576 and Org 24448 were investigated using [14C]-2-deoxyglucose autoradiography. Both Org 26576 and Org 24448 produced regionally selective, dose-dependent increases in LCGU in the mouse cerebrum when administered acutely (~1 hr). The compounds displayed similar yet functionally distinct profiles of activation, the highest levels of activation occurred in areas of the limbic system (hippocampus), sensory systems, and various nuclei (raphe nucleus). Their effects were blocked by pre-administration of the potent selective AMPA receptor antagonist, NBQX (10 mg/kg), which itself had minimal effects on LCGU. These data provide an anatomical basis for the cerebral activation induced by these compounds, which are directly AMPA receptor mediated. Areas activated also closely correlated with brain regions implicated in various psychiatric conditions, and as such is suggestive of a potential therapeutic benefit of these compounds in conditions such as depression and schizophrenia. 3. Investigation into the effects of chronic administration of the novel Ampakines Org 26576 and Org 24448 on functional activity, neurogenesis and receptor/signalling alterations in the murine cerebrum Following the demonstration that acute administration of Org 26576 and Org 24448 displayed regionally selective and dose-dependent alterations in LCGU, the effect of chronic administration of the Ampakines Org 26576 and Org 24448 on regional functional alterations ([14C]-2-deoxyglucose autoradiography), neurogenesis (BrdU labelling), and proteins levels (GluR, MAPK, LynK and CREB) (Western blot analysis) were investigated. Chronic administration (7 and 28 days) of Org 26576 (1 mg/kg) and Org 24448 (10 mg/kg) induced functional cerebral increases in the mouse cerebrum particularly in areas of the mesocorticolimbic system, which were not only rapid in onset, with significant effects visible after 7 days administration; but importantly were also persistent and long lasting. Chronic administration of the compounds had no significant effect on the level of neurogenesis or on the levels AMPA receptor subunits (GluR1,2,3), and signalling pathways (MAPK/LynK-CREB pathway), implicated in AMPA/Ampakine signalling, in the murine hippocampus. These data show that the Ampakines Org 26576 and Org 24448 when administered chronically can potentiate complex neural networks intimately associated with disease states, the effects of which are maintained over prolonged periods. There was no evidence that this involved an effect on neurogenesis or the MAPK/LynK-CREB signalling pathway. 4. Modulation of AMPA receptor kinetics by Org 26576 and Org 24448 influences synaptic plasticity in the murine hippocampus The ability of Org 26576 and Org 24448 to modify baseline kinetic properties of AMPA receptors and a paradigm of synaptic plasticity, LTP, in the mouse hippocampus was investigated using electrophysiology. Both Org 26576 and Org 24448 produced dose-dependant increases in fEPSP amplitude without affecting the half-width of responses, in acute hippocampal slices. Concentrations of both compounds, equating to functionally active levels witnessed in vivo, potentiated a stable form of LTP; whilst higher EC50 concentrations prevented the maintenance of LTP. These results are suggestive that Org 26576 and Org 24448 are effective in boosting the neural correlate of cognition, LTP, and may have potential in treating cognitive deficits, for example those associated with depression, schizophrenia or Alzheimer’s disease. The data presented in this thesis illustrate that the novel Ampakines Org 26576 and Org 24448 centrally modulate brain regions and circuitry intimately associated with conditions such as depression and schizophrenia (psychoses), with effects that are rapid in onset and persistent over chronic periods of administration. Specifically targeting the glutamatergic system through the use of these compounds may provide an innovative approach to treat various conditions that may be partly due to a compromise of normal excitatory glutamatergic neurotransmission.